The purpose of this study was to analyse the gait characteristics of stroke patients walking on a Zebris system, through quantitative three-dimensional biomechanical analysis. They underwent a continuous rehabilitation training program (RTP). A comparison was made between 3 month and 6 month RTP participants. Their ages were between 60 and 65. The data were analyzed by t-test. The result of comparative analysis of the two groups can be summarized as below. Temporal-spatial data, sagittal plane angular kinematics data, and peak ground reaction force and max pressure data showed that there were no significant differences between the 3 month RTP group and the 6month RTP group (Table 2, Table3, Table 4). It can be suggested that patients with hemiplegia after stroke can improve their walking function through continuous RTP participation.
Alvarez-Arenal, Angel;Gonzalez-Gonzalez, Ignacio;deLlanos-Lanchares, Hector;Martin-Fernandez, Elena;Brizuela-Velasco, Aritza;Ellacuria-Echebarria, Joseba
The Journal of Advanced Prosthodontics
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v.9
no.5
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pp.371-380
/
2017
PURPOSE. The aim of this study is to evaluate and compare the stress distribution in Locator attachments in mandibular two-implant overdentures according to implant locations and different loading conditions. MATERIALS AND METHODS. Four three-dimensional finite element models were created, simulating two osseointegrated implants in the mandible to support two Locator attachments and an overdenture. The models simulated an overdenture with implants located in the position of the level of lateral incisors, canines, second premolars, and crossed implant. A 150 N vertical unilateral and bilateral load was applied at different locations and 40 N was also applied when combined with anterior load at the midline. Data for von Mises stresses in the abutment (matrix) of the attachment and the plastic insert (patrix) of the attachment were produced numerically, color-coded, and compared between the models for attachments and loading conditions. RESULTS. Regardless of the load, the greatest stress values were recorded in the overdenture attachments with implants at lateral incisor locations. In all models and load conditions, the attachment abutment (matrix) withstood a much greater stress than the insert plastic (patrix). Regardless of the model, when a unilateral load was applied, the load side Locator attachments recorded a much higher stress compared to the contralateral side. However, with load bilateral posterior alone or combined at midline load, the stress distribution was more symmetrical. The stress is distributed primarily in the occlusal and lateral surface of the insert plastic patrix and threadless area of the abutment (matrix). CONCLUSION. The overdenture model with lateral incisor level implants is the worst design in terms of biomechanical environment for the attachment components. The bilateral load in general favors a more uniform stress distribution in both attachments compared to a much greater stress registered with unilateral load in the load side attachments. Regardless of the implant positions and the occlusal load application site, the stress transferred to the insert plastic is much lower than that registered in the abutment.
Journal of Dental Rehabilitation and Applied Science
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v.28
no.3
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pp.309-318
/
2012
In advanced stages of periodontal disease, a lot of the periodontal tissue support are usually lost. The tissue destruction around some teeth is progressed to a level which requires either spontaneous exfoliation or extraction of several teeth due to their excessive mobility. In such cases, a comprehensive treatment plan encompassing the adequate periodontal and maintenance therapy, as well as perio-prosthetic treatment involving occlusal equilibration, is needed in order to restore health, function, and esthetics. Cross-arch fixed partial dentures(CAFPDs), one of the perio-prosthetic treatments, are used to stabilize the teeth with severely reduced periodontal tissue support. Unfortunately, however, a little is known about the occlusal scheme and biomechanical concept of CAFPDs. This paper will demonstrate summaries of the trauma from occlusion(TFO), Ante's law revisited, the treatment principles, the role of occlusion, and the long-term consequences for CAFPDs, and the possibility of CAFPDs through a case presentation.
Objective:The aim of this study is to evaluate contributions of individual finger forces associated with various levels of submaximal voluntary contraction tasks. Background: Although many researches for individual finger force have been conducted, most of the studies mainly focus on the maximal voluntary contraction. However, Information concerning individual finger forces during submaximal voluntary contraction is also very important for developing biomechanical models and for designing hand tools, work equipment, hand prostheses and robotic hands. Due to these reasons, studies on the contribution of individual finger force in submaximal grip force exertions should be fully considered. Method: A total of 60 healthy adults without any musculoskeletal disorders in the upper arms participated in this study. The young group (mean: 23.7 yrs) consisted of 30 healthy adults (15 males and 15 females), and the elderly group (mean: 75.2 yrs) was also composed of 30 participants (15 males and 15 females). A multi-Finger Force Measurement (MFFM) System developed by Kim and Kong (2008) was applied in order to measure total grip strength and individual finger forces. The participants were asked to exert a grip force attempting to minimize the difference between the target force and their exerted force for eight different target forces (5, 15, 25, 35, 45, 55, 65, and 75% MVCs). These target forces based on the maximum voluntary contraction, which were obtained from each participant, were randomly assigned in this study. Results: The contributions of middle and ring fingers to the total grip force represented an increasing trend as the target force level increased. On the other hand, the contributions of index and little fingers showed a decreasing trend as the target force level increased. In particular, Index finger exerted the largest contribution to the total grip force, followed by middle, ring and little fingers in the case of the smallest target force level (5% MVC), whereas middle finger showed the largest contribution, followed by ring, index and little fingers at the largest target force levels (65 and 75% MVCs). Conclusion: Each individual finger showed a different contribution pattern to the grip force exertion. As the target force level increase from 5 to 75% MVC, the contributions of middle and ring fingers showed an increasing trend, whereas the contributions of index and little fingers represented a decreasing trend in this study. Application: The results of this study can be useful information when designing robotic hands, hand tools and work equipment. Such information would be also useful when abnormal hand functions are evaluated.
Je, Hong-Ji;Jeon, Young-Chan;Jeong, Chang-Mo;Lim, Jang-Seop;Hwang, Jai-Sug
The Journal of Korean Academy of Prosthodontics
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v.42
no.4
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pp.397-411
/
2004
Purpose: The purpose of this study was to determine the effect of anchorage systems and palatal coverage of denture base on load transfer in maxillary implant-supported overdenture. Material and methods: Maxillary implant -supported overdentures in which 4 implants were placed in the anterior region of edentulous maxilla were fabricated, and stress distribution patterns in implant supporting bone in the case of unilateral vertical loading on maxillary right first molar were compared with each other depending on various types of anchorage system and palatal coverage extent of denture base using three-dimensional photoelastic stress analysis. Two photoelastic overdenture models were fabricated in each anchorage system to compare with the palatal coverage extent of denture base, as a result we got eight models : Hader bar using clips(type 1), cantilevered Hader bar using clips(type 2), Hader bar using clip and ERA attachments(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4). Result: 1. In all experimental models, the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. In every experimental models with or without palatal coverage of denture base, maximum fringe orders on the distal ipsilateral implant supporting bone in an ascending order is as follows; type 3, type 1, type 4, and type 2. 3. Each implants showed compressive stresses in all experimental models with palatal coverage of denture base, but in the case of those without palatal coverage of denture base, tensile stresses were observed in the distal contralateral implant supporting bone. 4. In all anchorage system without palatal coverage of denture base, higher stresses were concentrated on the most distal implant supporting bone on loaded side. 5. The type of anchorage system affected in load transfer more than palatal coverage extent of the denture base. Conclusion: To the results mentioned above, in the case of patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant, and poor bone quality, selecting a resilient type attachment or minimizing the distal cantilevered bar is considered to be an appropriate method to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.
Peri-implantitis could be the result of biomechanical and occlusal overload as well as microbiologic invasion. The dental implant may be more susceptible to dental plaque than the natural tooth, as the predictability of a stable soft tissue attachment complex has not yet been confirmed. With the development of peri-implantitis, the implant surface would be exposed to the oral environment and becomes coated with bacteria. The objective of therapy for this condition is to regain integration of the implant with bone. Since fibroblast adherence to surfaces is impeded by endotoxin, it would seem that decontamination would be desirable to obtain maximum osseointegration. The purpose of this study was to determine whether various chemotherapeutic and mechanical treatments(distilled water, air-powder abrasive, hypersaturated citric acid, tetracycline) can detoxify contaminated titanium implant surface by means of kinetic LAL test. Experimental rough surface titanium disks were fabricated. All of them were divided into two groups(A.a group and P.g group) and each contaminated by A. actinomycetemcomitans and P. gingivalis suspension. Contaminated disks were treated with distilled water, air-powder abrasive, citric acid and tetracycline, and then all disks were placed into LPS-free water for elution. The results were as follows : 1. In A.a group, LPS elute level of all test groups were significantly lower than control group(p<0.05). 2. In A.a group, LPS elute level of test 2, test 3 and test4 groups were significantly lower than that of control group(p<0.05). But, among the test 2, test 3, test4 groups, the significant differences were not detected. 3. In P.g group, LPS elute level of test 2, test 3 and test 4 groups were lower than that of control group(p<0.05). But, among the test groups, the significant differences were not detected. From the result of this study, it would be concluded that air-powder abrasive, hypersaturated citric acid and tetracycline treatments may be effective at reducing endotoxin level on rough titanium implant surfaces, and can be clinically used. But the treatments in peri-implantitis differentially impact osseointegration making one method clinically superior. To gain this knowledges, further molecular biologic and histopathologic studies should be developed.
Cement-retained implant prosthesis has several advantages in the esthetic and occlusal aspects. However, the difficulty of the retrievability and the possibility of peri-implantitis induced by the cement excess would be a threatening factor to the implant prognosis. Peri-implantitis resulting from the remaining cement could occur later on to the patients with periodontitis history. Retention can be controlled by selecting the right cement type. Retention of the cement was the strongest in the resin cement, followed by resin modified glass ionomer cement, poIycarboxylate cement, zinc phosphate cement and glass ionomer cement. Retention of the provisional cement weakened after thermocycling. Other factors such as the abutment number, abutment alignment, height and taper of the abutment can also affect the total retention. To the success of the cement-retained prosthesis, it's important to select the right cement for the clinical purpose. The prosthesis should be fabricated in accordance with the biomechanical requirements. The prosthesis should be cemented with the techniques to reduce the excess cement as much as possible. In addition, the excess cement should be identified using the radiography and carefully removed.
Failure of fixed implant supported prosthesis is caused by biomechanical factors such as excessive occlusal stress and biological factors such as bacterial infections and inflammation. Implants with severe bone resorption that have worsened without being resolved due to implant complications should be removed and then new treatments should be planned, taking into account remaining teeth, remaining implants, and residual alveolar. The patient of this case removed some of fixed implant prosthesis of mandible. The condition of the remaining alveolar bone was reassessed for further implant replacement and a few implants were placed. Then implant assisted removable partial denture (IAPRD) treatment is performed using implant surveyed bridge as abutment. Through this treatment, the clinical results were satisfactory on aspect of masticatory function recovery and oral hygiene management.
As the nature of triathlons is competition in three successive sports, triathletes experience elevated levels of stress on the body that are absent in single-sport athletic events, and consequently there are more potential medical problems to prepare for. Triathletes can also experience problems such as hypothermia, heat illness, excessive exposure to ultraviolet radiation, musculoskeletal injuries and trauma, immunosuppression, and haemolysis. Depending on the potentiality of such above-listed problems occurring in any given race, race organizers will prepare preventative measures and treatments accordingly. Olympic distance is not the only triathlon racing distance. Sprints, which are normally around half the Olympic distance, are common distances, as well as Long (2 km swim, 80 km bike, 20 km run), Ironman (3.8 km swim, 180 km bike, 42 km run), and ultra-distance events varying in length. Races of longer duration normally result in a higher percentage of athletes experiencing the above-mentioned medical problems, as well as inducing additional health risks such as hyponatraemia. Minimizing the occurrences of serious health issues is possible through the following means: carefully preparing for the probable race-day weather conditions; proper management and organization of the race; preparing an extensive water-safety and ground-course safety plan; distributing necessary nutrition along the course; and stressing the importance for athletes to have proper knowledge concerning race nutrition, biomechanical technique, physical preparation, and utilization of safe equipment. While risks of competing in triathlon are many, the instances of such medical problems are not excessive, and the triathlon has a reputation of being a reasonably safe sport as long as athletes with high risk take added precautions.
Kim, Eugene;Park, Se-Jin;Lee, Ho-Seok;Park, Jai-Hyung;Park, Jong Kuen;Ha, Sang Hoon;Murase, Tsuyoshi;Sugamoto, Kazuomi
Clinics in Shoulder and Elbow
/
v.21
no.3
/
pp.151-157
/
2018
Background: Nonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan. Methods: Eight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, $90^{\circ}$ flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion. Results: Ulno-humeral joint moved to the varus on the coronal plane during flexion, $25.45^{\circ}$ in the non-united cubitus valgus group and $-2.03^{\circ}$ in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane $-26.75^{\circ}$ in the non-united cubitus valgus group and $-3.09^{\circ}$ in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern. Conclusions: The non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.
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