• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.5
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• pp.329-334
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• 2009

Objective: To evaluate the ratio between bone-contact length and inter-segmental length of the rigid fixation screw used in bilateral sagittal split ramus osteotomy (BSSRO) for mandibular setback. Material and Methods: Records of 40 patients with Class III malocclusion were selected. 20 of them had BSSRO, while the other 20 had BSSRO with maxillary LeFort I osteotomy. All of the patients had three noncompressive bicortical screws inserted at the gonial angle through transcutaneous approach. Two screws were inserted antero-posteriorly above inferior alveolar nerve and one screw was inserted below. The lengths of bone-contact and that of inter-segmental part were measured using cone-beam computed tomography. Ratio between these two measured lengths was calculated. Results: Both bone-contact and inter-segmental lengths were longer in BSSRO group than in BSSRO with maxillary LeFort I osteotomy group. Ratio of bone-contact to inter-segmental length was lower in BSSRO group than in BSSRO with Lefort I group. Both bone-contact and inter-segmental lengths were longer at the antero-superior position than at the inferior position. However, their ratio showed little difference. Conclusion: This study suggest that stability of screws in BSSRO group was greater than in BSSRO with Lefort I group. Stability of screws at the antero-superior position was greater than at the inferior position. Ratio of bone-contact to inter-segmental lengths was 0.2 in average.

• Journal of Periodontal and Implant Science
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• v.50 no.4
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• pp.209-225
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• 2020

Purpose: Marginal bone loss (MBL) is an important clinical issue in implant therapy. One feature that has been cited as a contributing factor to this bone loss is peri-implant mucosal thickness. Therefore, in this report, we conducted a systematic review of the literature comparing bone remodeling around implants placed in areas with thick (≥2-mm) vs. thin (<2-mm) mucosa. Methods: A PICO question was defined. Manual and electronic searches were performed of the MEDLINE/PubMed and Cochrane Oral Health Group databases. The inclusion criteria were prospective studies that documented soft tissue thickness with direct intraoperative measurements and that included at least 1 year of follow-up. When possible, a meta-analysis was performed for both the overall and subgroup analyses. Results: Thirteen papers fulfilled the inclusion criteria. A meta-analysis of 7 randomized clinical trials was conducted. Significantly less bone loss was found around implants with thick mucosa than around those with thin mucosa (difference, -0.53 mm; P<0.0001). Subgroups were analyzed regarding the apico-coronal positioning, the use of platform-matched vs. platform-switched (PS) connections, and the use of cement-retained vs. screw-retained prostheses. In these analyses, thick mucosa was found to be associated with significantly less MBL than thin mucosa (P<0.0001). Among non-matching (PS) connections and screw-retained prostheses, bone levels were not affected by mucosal thickness. Conclusions: Soft tissue thickness was found to be correlated with MBL except in cases of PS connections used on implants with thin tissues and screw-retained prostheses. Mucosal thickness did not affect implant survival or the occurrence of biological or aesthetic complications.

• The Journal of Korean Academy of Prosthodontics
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• v.30 no.4
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• pp.582-610
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• 1992

The long-term success of any dental implant is dependent upon the optimization of stresses which occur during oral function and parafunction. Especially, it has been suggested that there is an unique set of problems associated with joining an osseointegrated implant and a natural tooth with a fixed partial denture. For this particular case, although many literatures suggest different ways to avoid high stress concentrations on the bone surrounding the implant under static and dynamic loading conditions, but few studies on the biomechanical efficacy of each assertion have been reported. The purpose of this investigation was to evaluate the efficacies of clinically suggested methods on stress distribution under static load and shock absorption under dynamic load, using two dimensional finite element method. In FEM models of osseointegrated implant-natural tooth supported fixed partial dentures, calculations were made on the stresses in surrounding bone and on the deflections of abutments and superstructure, first, to compare the difference in stress distribution effects under static load by the flexure of fastening screw or prosthesis, or intramobile connector, and second, to compare the difference in the shock absorption effects under dynamic load by intramobile connector or occlusal veneering with composite resin. The results of this analysis suggest that : 1. Under static load condition, using an implant design with fastenign screw connecting implant abutment and prosthesis or increasing the flexibility of fastening screw, or increasing the flexibility of prosthesis led to the .increase in height of peak stresses in cortical bone surrounding the implant, and has little effect on stress change in bone around the natural tooth. 2. Under static load condition, intramobile connector caused the substantial decrease in stress concentration in cortical bone surrounding the implant and the slight increase in stress in bone around the natural tooth. 3. Under dynamic load condition, both intramobile connector and composite resin veneering showed shock absorption effect on bone surrounding the implant and composite resin veneering had a greater shock absorption effect than intramobile connector.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.4
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• pp.316-323
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• 2011

Purpose: The purpose of this study was to investigate the effect of different thread designs on the marginal bone stresses around dental implant. Materials and methods: Standard ITI implant(ITI Dental Implant System; Straumann AG, Waldenburg, Switzerland), 4.1 mm in diameter and 10 mm in length, was selected as control. Test implants of four different thread patterns were created based on control implant, i.e. maintaining all geometrical design of control implant except thread pattern. Four thread designs used in test implants include (1) small V-shape screw (model A), (2) large V-shape screw (model B), (3) buttress screw (model C), and (4) trapezoid screw (model D). Surface area for unit length of implant was 14.4 $mm^2$ (control), 21.7 (small V-shape screw), 20.6 (large V-shape screw), 17.0 (buttress screw) and 28.7 $mm^2$ (trapezoid screw). Finite element models of implant/bone complex were created using an axisymmetric scheme with the use of NISA II/DISPLAY III (Engineering Mechanics Research Corporation, Troy, MI, USA). A load of 100 N applied to the central node on the crown top either in parallel direction or at 30 degree to the implant axis (in order to apply non-axial load to the implant NKTP type 34 element was employed). Quantification and comparison of the peak stress in the marginal bone of each implant model was made using a series of regression analyses based on the stress data calculated at the 5 reference points which were set at 0.2, 0.4, 0.6, 0.8 and 1.0 mm from implant wall on the marginal bone surface. Results: Results showed that although severe stress concentration on the marginal bone cannot be avoided a substantial reduction in the peak stress is achievable using different thread design. The peak marginal bone stresses under vertical loading condition were 7.84, 6.45, 5.96, 6.85, 5.39 MPa for control and model A, B, C and D, respectively. And 29.18, 26.45, 25.12, 27.37, 23.58 MPa when subject to inclined loading. Conclusion: It was concluded that the thread design is an important influential factor to the marginal bone stresses.

• Journal of Veterinary Clinics
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• v.20 no.1
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• pp.138-141
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• 2003

First case, a one-year-old female Shih Tzu weighing 3 kg with closed transverse fractures of bilateral mandibular body between 2nd and 3rd premolar teeth were treated surgically with bone plates and screws, and cranial luxation of temporomandibular joints were reduced to closed method. Second case, a 8.4 years old male Yorkshire terrier weighing 2.6 kg with closed transverse/oblique fractures of bilateral mandibular body between premolar and molar teeth were treated surgically with bone plates and screws. Radiographic examination revealed that the fractures in two cases fixed well and temporomandibular joint was stabilized. One month after operation, jaw activity was excellent and malocclusion wasn't observed.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.180-185
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• 2018

Objective : Many lumbosacral fixation techniques have been described to offer a more screw-bone purchase. The forward anatomical fixation parallel to the endplate is still the most preferred method. Literature revealed little knowledge regarding the mechanical stability of lumbosacral trans-endplate fixation compared to the traditional trans-pedicular screw fixation method. The aim of this study is to assess the pull-out strength of lumbosacral screws penetrating the end plate and comparing it to the conventional trans-pedicular screw insertion method. Methods : Eight lumbar and eight sacral vertebrae, with average age 69.4 years, Left pedicles of the 5th lumbar vertebrae were used for trans-endplate screw fixation, group 1A, right pedicles were used for anatomical trans-pedicular screw fixation, group 1B. In the sacral vertebrae, the right side S1 pedicles were used for trans-endplate fixation, group 2A, left side pedicles were used for anatomical trans-pedicular screw fixation, group 2B. The biomechanical tests were performed using the axial compression testing machine. All tests were applied using 2 mm/min traction speed. Results : The average pull-out strength values of groups 1A and 1B were $403.78{\pm}11.71N$ and $306.26{\pm}17.55N$, respectively. A statistical significance was detected with p=0.012. The average pull-out strength values of groups 2A and 2B were $388.73{\pm}17.03N$ and $299.84{\pm}17.52N$, respectively. A statistical significance was detected with p=0.012. Conclusion : The trans-endplate lumbosacral fixation method is a trustable fixation method with a stronger screw-bone purchase and offer a good alternative for surgeons specially in patients with osteoporosis.

• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.201-206
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• 2005

Objective: To evaluate the accuracy and safety of C1-C2 transarticular screw insertion, we retrospectively review surgical records and postoperative radiological findings. Methods: From January 2001 to October 2003, the C1-C2 transarticular screw fixation and posterior wiring with iliac bone grafts was performed in 16 patients. 6 patients had rheumatoid arthritis which caused cervical instability, 3 patients had os odontoideum, 3 patients had type 2 odontoid process fracture, 3 patients had traumatic transverse ligament injury and 1 patients who had been managed with C1-C2 wire fixation had psoriatic arthritis. Results: Osseous fusion was documented in 15 patients(93.8%). Only one patient was recorded screw loosening because of postoperative infection. One patient had only one screw placed because of abnormal anatomical structure, one patients was breakage of a Kirschner wire, and one screw was medial location to lateral mass of C1, but clinical results was excellent and radiological instability was not noted. Conclusion: The author's experience demonstrates that C1-C2 transarticular screw fixation with wired bone graft is a safe procedure with higher fusion rate but precaution is needed to avoid the neural damage, vertebral artery injury, and hardware failure.

• Journal of Technologic Dentistry
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• v.26 no.1
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• pp.69-76
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• 2004

The objective of this finite element method study was to analyze the stress distribution induced on a supporting bone by 3.75mm, 4.0mm, 5.0mm diameter of dental implant fixture(13mm length). 3-dimensional finite element models of simplified gold alloy crown(7mm height) and dental implant structures(gold cylinder screw, gold cylinder, abutment screw, abutment, fixture and supporting bone(cortical bone, cancellous bone) designs were subjected to a simulated biting force of 100 N which was forced over occlusal plane of gold alloy crown vertically. Maximum von Mises stresses(MPa) under vertical loading were 9.693(3.75mm diameter of fixture), 8.885(4.0mm diameter of fixture), 6.301(5.0mm diameter of fixture) and the highest von Mises stresses of all models were concentrated in the surrounding crestal cortical bone. The wide diameter implant was the good choice for minimizing cortical bone-fixture interface stress.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.3
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• pp.295-313
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• 2006

Statement of problem. Higher fracture rates were reported for Branemark implants placed in the maxilla and for 3.75 mm diameter implants installed in the posterior region. Purpose. The purpose of this study was to investigate the fracture of a fixture by finite element analysis and to compare different diameter of fixtures according to the level of alveolar bone resorption. Material and Methods. The single implant and prosthesis was modeled in accordance with the geometric designs for the 3i implant systems. Models were processed by the software programs HyperMesh and ANSA. Three-dimensional finite element models were developed for; (1) a regular titanium implant 3.75 mm in diameter and 13 mm in length (2) a regular titanium implant 4.0 mm in diameter and 13 mm in length (3) a wide titanium implant 5.0 mm in diameter and 13 mm in length each with a cementation type abutment and titanium alloy screw. The abutment screws were subjected to a tightening torque of 30 Ncm. The amount of preload was hypothesized as 650 N, and round and flat type prostheses were 12 mm in diameter, 9 mm in height were loaded to 600 N. Four loading offset points (0, 2, 4, and 6 mm from the center of the implants) were evaluated. To evaluate fixture fracture by alveolar bone resorption, we investigated the stress distribution of the fixtures according to different alveola. bone loss levels (0, 1.5, 3.5, and 5.0 mm of alveolar bone loss). Using these 12 models (four degrees of bone loss and three implant diameters), the effects of load-ing offset, the effect of alveolar bone resorption and the size of fixtures were evaluated. The PAM-CRASH 2G simulation software was used for analysis of stress. The PAM-VIEW and HyperView programs were used for post processing. Results. The results from our experiment are as follows: 1. Preload maintains implant-abutment joint stability within a limited offset point against occlusal force. 2. Von Mises stress of the implant, abutment screw, abutment, and bone was decreased with in-creasing of the implant diameter. 3. With severe advancing of alveolar bone resorption, fracture of the 3.75 and the 4.0 mm diameter implant was possible. 4. With increasing of bending stress by loading offset, fracture of the abutment screw was possible.

• Journal of Korean Neurosurgical Society
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• v.30 no.11
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• pp.1271-1277
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• 2001

Objectives : Since vertebroplasty has been introduced, we performed short segment pedicle screw fixation with augmented intra-operative vertebroplasty in patients with unstable thoraco-lumbar fracture. Our intentions are to demonstrate the efficacy and indication of this new technique compare to conventional methods. Material and Methods : The surgery comprised of pedicle screw fixations on one level above and below the fracture site, and the fractured level itself, if pedicle is intact, and intra-operative vertebroplasty under the fluoroscopic guide with in-situ postero-lateral bone graft. Also, in cases of bone apposition, we removed those with small impactor through a transfascetal route. During the last 2 years, we performed in seven(7) unstable thoraco-lumbar fracture patients who consisted of two different characteristics, those four(4) with primary or secondary osteoporosis and three(3) of young and very healthy. All patients were followed clinically by A.S.I.A. score and radiography. Results : Mean follow up period was 14 months. We observed well decompressed state via transfascetal route in cases of bone fragments apposition and no hardware pullout in osteoporotic cases, no poly-methyl-methacrylate (PMMA) leakage through the fracture sites into the spinal canal, and no kyphotic deformities in both cases during follow-up periods. All patients demonstrated solid bony fusion except one following osteoporotic compression fracture on other sites. Conclusions : In the management of unstable thoraco-lumbar fracture, we believe that this short segment pedicle screw fixation with augmented intra-operative vertebroplasty reduce the total length or levels of pedicle screw fixation without post-operative kyphotic deformity.