Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.32
no.2
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pp.168-173
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2006
The side effects of head and neck radiation therapy include mucositis, xerostomia, loss of taste, radiation caries, oral infection, osteoradionecrosis and trismus. When a patient is arranged to begin head & neck radiotherapy, oral pathologic lesions are examined and managed for the prevention of oral complications. The advanced odontogenic infection should be especially controlled before the radiotherapy and the patient must be instructed for proper oral prophylaxis. Generally the more conservative treatments, such as, scaling, restoration, endodontic treatment, are the care of choice and dental extraction is performed in advanced periapical and periodontal pathologic conditions. If the dental extraction should be done, the radiotherapy consequently will be delayed until there is epithelium covering the extraction socket, leaving no exposed bone. The cancer patient with severe emotional stress pray for the early radiation therapy, in spite of possibility of the recurrent odontogenic infectious lesions. So, the authors attempted to do the early radiation therapy by the conservative endodontic drainage and surgical incision & drainage without extraction of the infected teeth, and resulted in relatively good prognosis without the severe side effects of head and neck radiotherapy.
A variety of surface pre-treatments have been advocated to prepare the dentin prior to placement of a bonding agent. The purpose of this study was to evaluate the effect of various dentin conditioners upon the degree of resin impregnation to the dentinal tubules and the shear bond strength of a new dentinal bonding agent (Scotchbond 2) used in conjunction with a visible light cured composite (Silux). The healthy eighty human molars extracted due to periodontal or orthodontic reasons were used and randomly divided into five groups. All the grinded dentin surfaces were conditioned with 3% $H_2O_2$, Cavity Cleanser (Columbus/Bayer), Dentin Conditioner (GC Inter. Corp.), Scotchprep (3M Co.) according to the manufacturer's directions. The specimens were then demineralized in 10% HCl for 20 sec. and 24 hrs. in order to observe the resin tags in Hitachi X-450 scanning electron microscope at 25KV. Also, shear strengths were obtained using an Instron Testing Machine with a cross head speed of 1 mm/min. The following results were obtained ; 1. In group treating with Dentin Conditioner and Scotchprep, the resin strings were formed on most of the surfaces and penetrated more than $50{\mu}m$ into the tubules. 2. The inner surface of resin treated with Cavity Cleanser, indicating the resin strings formed partly and penetrated about in depth of $30{\mu}m$. 3. In control and experimental group treated with 3% $H_2O_2$, the resin tags were not formed, if any, penetrated shortly. 4. Shear bond strengths in groups treating with Dentin Conditioner and Scotchprep were statistically significant increase than with 3% $H_2O_2$. (P<0.01). 5. The Scotchprep treatment group was significantly higher in shear strength than groups treated with no conditioning and Cavity Cleanser.(P<0.01) 6. Shear bond strengths evaluated were gradually increase in proportion to the tag length of resin impregnation.
The purpose of this study was to observe shear bond strength of composite resin to dentin following surface treatment. Freshly extracted forty-eight sound human molars were used in this study. They were stored at $4^{\circ}C$ physiologic saline solution before experiment. The teeth was then mounted with self curing acrylic resin in brass mold. The buccal surfaces of the teeth were grinding approximately 1.5mm by means of water-irrigated grinding wheel to expose the flattened fresh dentin surfaces. The specimens were divided into 6 groups according to preparation and treatment procedures on dentin surfaces; Group 1: Untreated after preparation with No.301 diamond point Group 2: Treated with primer for 60 seconds after preparation with No.301 diamond point Group 3: Untreated after preparation with No.700 fissure carbide bur Group 4: Treated with primer for 60 seconds after preparation with No.700 fissure carbide bur Group 5: Untreated after grinding with 600 grit silicon carbide paper Group 6: Treated with primer for 60 seconds after grinding with 600 grit silicon carbide paper Light cure dental adhesive was applicated to each specimen. Silux plus(3M) was inserted then into polyethylene tube of 3mm diameter and 3mm height, and polymerized to dentin surface. All of the specimens were stored in distilled water at $35.6^{\circ}C$ for 24 hours prior to testing. The shear bond strength was measured using an Instron Universal Testing Machine. The results obtained from this study were as follows: 1. The shear bond strength to dentin was the highest in group II. 2. The shear bond strength to dentin was the lowest in group III. 3. There was no significant difference in shear bond strength to dentin according to preparation instrument. 4. The primer treatment group showed significantly greater shear bond strength than untreated group.
Fracture of cusp, on posterior teeth, especially those carious or restored, is major cause of tooth loss. Inappropriate treatments, such as unnecessarily wide cavity preparations, increase the potential of further trauma and possible fracture of the remaining tooth structures. Fracture potential may be directly related to the stresses exerted upon the tooth during masticatory function. The purpose of this study is to evaluate the fracture resistance of tooth, restored with composite resin inlay. In this study, MOD inlay cavity prepared on maxillary first premolar and restored with composite resin inlay. Three dimensional finite element models with eight nodes isoparametric solid element, developed by serial grinding-photographing technique. These models have various occlusal isthmus and depth of cavity, 1/2, 1/3 and 1/4 of isthmus width and 0.7, 0.85 and 1.0 of depth of cavity. The magnitude of load was 474 N and 172 N as presented to maximal biting force and normal chewing force. These loads applied onto ridges of buccal and lingual cusp. These models analyzed with three dimensional finite element method. The results of this study were as follows : 1. There is no difference of displacement between width of occlusal isthmus and depth of cavity. 2. The stress concentrated at bucco-mesial comer, bucco-disal comer, pulpal line angle and the interface area between internal slopes of cusp and resin inlay. 3. The vector of stress direct to buccal and lingual side from center of cavity, to tooth surface going on to enamel. The magnitude of vector increase from occlusal surface to cervix. 4. The crack of tooth start interface area, between internal slop of buccal cusp and resin inlay. It progresses through buccopulpal line angle to cervix at buccomesial and buccodistal comer. 5. The influence with depth of cavity to fracture of tooth was more than width of isthmus. 6. It would be favorable to make the isthmus width narrower than a third of the intercuspal distance and depth of cavity is below 1 : 0.7.
Purpose: Ingrown toenails are a common disease in the adolescent period and the treatments could be more conservative for this early stage of the disease. This study is a case series on the results of a gutter splint for an adolescent ingrown toe nail as a simple, comfortable treatment method. Materials and Methods: From 2011 to 2018, 22 patients (mean age, 12.2 years; range, 8~15 years) with ingrown toenails were treated with a gutter splint. There were 16 boys and 6 girls with 7 patients on both great toes, and additional 4 both corners of a nail, giving a total of 33 splints. Flat, plastic straws and glue or suture were used to protect the nail corners under local anesthesia. The medical records were reviewed retrospectively and phone calls were made to obtain the long-term results. Results: Fifteen splints were fixed with a suture and the other 18 splints were fixed with glue. There were 9 cases of recurrence out of 33 gutter splints, 8 out of 15 sutured splints and 1 out of 18 glued splints (p=0.010). There was no gender (p=0.383) or age (p=0.305) difference in the number of recurrences. Conclusion: For growing people, ingrown nails can be cured easily by conservative treatment for a transiently shortened or broken toenail. The glued gutter splint had a reasonable success rate as a first line treatment.
Compomer is composed of matrix and filler : matrix is made of the combination of resins and polycarboxylic molecules that are light-cured, and a filler is a glass component which is capable of ion-release. The resin content of compomers produces polymerization shrinkage which can adversely affect marginal adaptation. Pretreatment is a fundamental step which is treated with conditioner or primer in the use of these materials. Microleakage of restorative materials has been investigated mostly by dye penetration method. Dye penetration method was not quantitative and not measured repeatedly. Fluid filtration method, introduced and developed by Pashley's group, has been extensively used for 20 years for research purpose to understand the physiology of dentin, as well as the effects of various restorative treatments on dentin permeability. It permits quantitative, nondestructive measurment of microleakage in a longitudinal manner. The purpose of this study was to evaluate the change of dentin permeability according to the process of compomer restoration. In this study. Cl V cavities were prepared on buccal surface of thirty extracted human molars. The prepared cavities were etched by 37% phosphoric acid. The experimental teeth were randomly divided into three groups. Each group was treated with following materials Group 1 : Prime & Bond NT/Dyract AP, Group2: Single Bond/F2000 compomer, Group 3 : Syntac Single Component/Compoglass. The bonding agent and compomer were applied for each group following manufacturers information. Dentin permeability of each group was measured at each process by fluid filtration method; Step 1 : preparation(smear layer). Step 2 : etching(smear layer removal), Step 3 : applying the bonding agent, Step 4 : filling the compomer. Dentin permeability was expressed by hydraulic conductance ($\mu\textrm{l}$ min$^{-1}$cm$H_2O$$^{-1}$). The data were analysed statistically using One-way ANOVA and Sheffe's method. The results were as follows : 1. Dentin permeability differences between each process were significant except between step 1 and step 2(p<0.01). 2. Dentin permeability after removal of smear layer was highly increased(p<0.01). 3. In most case, decrease of dentin permeability was obtained by applying bonding agent(p<0.01). 4. Dentin permeability differences among the experimental groups were not significant(p>0.05). 5. None of compomers used in this study showed perfect seal at the interface.
The conservative treatment for impingement and rotator cuff tear includes rest, nonsteroidal anti-inflammatory drugs (NSAIDs), local steroid injection and physiotherapy depending on the purpose to relieve the pain and inflammation, in addition, stretching exercise to recover flexibility and strengthening exercise to recover the function could be used. When these conservative treatments are divided into multiple steps, the first one contains pain relief, modification of daily activity and stretching exercise. Second step includes strengthening exercise of the anterior/posterior cuff and peri-scapular muscles and eventually. The third step includes training program to return to job, housework and hobby activities and maintain. Thus, the key of these step wise approach for the treatment of impingement and rotator cuff tear is exercise program. Understanding of various exercise program and apply to the patients properly is most important for the conservative treatment of impingement and cuff tear.
Park Jin Soo;Chung Moon Sang;Yoon Kang Sub;Baek Goo Hyun;Lee Ji Ho;Kang Seung Baek;Kim Dong Wook
Clinics in Shoulder and Elbow
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v.2
no.2
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pp.187-198
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1999
Purpose: The authors compared the results of Ender nailing for the proximal humerus fractures with those of the conservative methods radiographically. Materials and Method: Nine patients(mean age: 69 years.) received Ender nailing, and the other nine patients, conservative treatments(mean age: 73 years). All fractures were 2 part fractures. The Ender nails were inserted either through posterior elbow approach or transepicondylar approach. A simple Velpeau bandage was applied to the conservative treatment group. The average follow-up was 15 months. Results: The initial status of the anatomical reduction, i.e., the values of the medial shift, overlapping and the varus agulation, were little changed at follow-up radiographs in both the Ender nailing group and the conservative treatment group. There was no significant difference for the status of anatomical reduction between the Ender nailing group and the conservative treatment group. The stability of fixation by Ender nails, i.e., the degree of fanning out of the nails was poor in most cases. Not a few problems/complications happened in cases of Ender nailing group; backing out of the nail in three cases, penetration of the nails into the humeral heads in 3, fractures or cracking of the humerus around the nail insertion area in 4 and reduction loss in one. Conclusion: We could not get better results with the use of Ender nail. We use no longer Ender nails for the proximal humerus fractures. Further studies are needed for the better option for the proximal humerus fractures.
The purposes of this study were to evaluate the microtensile bond strength of one-step adhesives accord ing to various dentin surface treatments and to observe the interface between resin(Z-100$^{TM}$) and dentin under SEM. In this study forty-five non-caries extracted human molars and three adhesive systems were used ; AlI-Bond 2(AB), One-Up Bond F(OU), AQ-Bond(AQ). ; In Group 1, 2, 3, AB was used and tooth surfaces were treated by smearing(S), ultrasonic cleansing(US), etching(E) respectively. In Group 4. 5, 6, One-Up Bond F was used and tooth surfaces were also treated as the same way above. In Groups 7, 8, 9, AQ Bond was used and tooth surfaces wet$.$e treated as the same way. Each specimen was prepared for microtensile bond testing, and were stored for 24hrs in 37$^{\circ}C$ distilled water. After that, microtensile bond strength for each specimen was measured. Specimens were fabricated to examine the failure patterns of interface between resin and dentin and observed under the SEM. The results were as follows ; 1. The results(mean$\pm$SD) of microtensile test were group 1, 25.69$\pm$4.31MPa; group 2, 40.93$\pm$10.94MPa; group 3, 47.65$\pm$8.85MPa; group 4, 35.98$\pm$9.14MPa; group 5, 39.66$\pm$8.45MPa; group 6, 43.26$\pm$13.01MPa; group 7, 25.07$\pm$4.2MPa;group 8, 30.4$\pm$4.74MPa;group 9, 33.61$\pm$7.88MPa. 2. One-Up Bond F was showed the highest value of 36.98$\pm$9.14MPa in dentin surface treatment with smearing, and there were significant differences to the other groups (p<0.05). 3. All-Bond 2 was showed the highest value of 40.93$\pm$10.94MPa in dentin surface treatment with ultra-sonic cleansing, but was no significant difference to One-Up Bond F(p>0.05) 4. All-Bond 2 was showed the highest value of 47.65$\pm$8.85MPa in dentin surface treatment with etch ing(10%phosphoric acid), and there were significant differences to the other groups(p<0.05). 5. All-Bond 2 was showed the highest value of 47.65$\pm$8.85MPa in dentin surface treatment according to manufacture's directions. but was no significant difference to One-Up Bond F(p>0.05). 6. AQ Bond was skewed the lowest microtensile bond strength with various dentin surface treatment, and the were significant differences to the other groups(p<0.05).
Intracoronal bleaching is currently disregarded by many clinicians because of the potential consequence of cervical resorption. To prevent this complication it is recommended that intra coronal barrier materials be placed over the root canal obturation and sodium perborate be used with water rather than with hydrogen peroxide. The purpose of this study was to evaluate the amount of the hydrogen peroxide penetration according to the difference in intracanal base materials and sodium perborate preparation. Fifty extracted intact premolars were instrumented, and filled with gutta-percha. And then the outer surface of the teeth was sealed with wax exposing the CEJ. The prepared teeth were placed in plastic tubes containing 1.5ml distilled water with their entire root submerged into the solution, The teeth were divided into the following five groups. In the first two groups gutta-percha was removed without placement of barrier, and then water or superoxole(30% $H_2O_2$) with sodium perborate were used respectively for bleaching. In the other three groups, after removal of gutta-percha, an intracanal isolating barrier(ZPC, IRM, Fuji II LC) was placed and then bleached with sodium perborate and superoxole. The bleaching procedure was performed 4 times with 1 week interval. The results were as follows : 1. All the groups showed a tendency of increasing penetration amount with increasing treatment times(P<0.05). 2. After the 1st and 2nd treatments, there was no significant difference in microleakage among the groups. 3. After the 3rd bleaching with superoxole and sodium perborate, there was no significant difference in microleakage between gutta-percha alone group and gutta-percha with ZPC, Fuji II LC barrier group. But significant difference was found between IRM barrier group and other groups(P<0.01). 4. After the 4th bleaching with superoxole and sodium perborate, there was no significant difference between gutta-percha alone group and gutta-percha with barrier groups. 5. After the 4th treatment, the group bleached with sodium perborate and water without barrier showed lower hydrogen peroxide penetration than that of other groups(P<0.01).
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