• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.179-185
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• 2018

Background: We analyzed the angle between the glenoid anterior surface and glenoid axis, the range of the glenoid apex and the location of the glenoid apex for assistance during shoulder surgery. Methods: Sixty-two patients underwent a computed tomography of the shoulder with a proximal humerus fracture. In the range of the glenoid apex, the ratios of the distribution of triangles with a Constant anterior and posterior area of the glenoid were measured. The location of glenoid apex was confirmed as the percentage of the position with respect to the upper part of the glenoid with the center of the part, analyzed the angle between the glenoid anterior surface and glenoid axis was measured. Results: The angle between the glenoid anterior surface and glenoid axis was $19.80^{\circ}{\pm}3.88^{\circ}$. The location of the glenoid apex is $60.36%{\pm}9.31%$, with the upper end of the glenoid as the reference. The range of the glenoid apex was $21.16%{\pm}4.98%$. When the height of the glenoid becomes smaller, the range of the glenoid apex tends to become larger (p=0.001) and the range of the glenoid apex becomes wider (p=0.001) as the glenoid width narrows. Conclusions: We believe the anatomical measurements of the glenoid will be helpful for a more accurate insertion in glenoid component. It is thought that more accurate insertion is possible if we can set other anatomical measurements using computed tomography imaging of the glenoid which can develop into the study of other anatomical measurements.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.113-119
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• 2018

Background: This study was undertaken to evaluate the positional relationship between planes of the glenoid component (the scapular plane and the perpendicular plane to the glenoid) and its surrounding structures. Methods: Computed tomography (CT) images of both shoulders of 100 patients were evaluated using the 3-dimensional CT reconstruction program ($Aquarius^{(R)}$; TeraRecon). We determined the most lateral scapular bony structure of the scapular plane and measured the shortest distance between the anterolateral corner of the acromion and the scapular plane. The distance between the scapular plane and the midpoint of the line connecting the posterolateral corner of acromion and the anterior tip of the coracoid process (fulcrum axis) was also evaluated. The perpendicular plane was then adjusted to the glenoid and the same values were re-assessed. Results: The acromion was the most lateral scapular structure of scapular plane and perpendicular plane to the glenoid. The average distance from the anterolateral corner of the acromion to the scapular plane was $10.44{\pm}5.11mm$, and to the plane perpendicular to the glenoid was $9.55{\pm}5.13mm$. The midpoint of fulcrum axis was positioned towards the acromion and was measured at $3.90{\pm}3.21mm$ from the scapular plane and at $3.84{\pm}3.17mm$ from the perpendicular plane to the glenoid. Conclusions: Our data indicates that the relationship between the perpendicular plane to the glenoid plane and its surrounding structures is reliable and can be used as guidelines during glenoid component insertion (level of evidence: Level IV, case series, treatment study).

• Clinics in Shoulder and Elbow
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• v.23 no.2
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• pp.71-79
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• 2020

Background: The glenoid version of the shoulder joint correlates with the stability of the glenohumeral joint and the clinical results of total shoulder arthroplasty. We sought to analyze and compare the glenoid version measured by traditional axial two-dimensional (2D) computed tomography (CT) and three-dimensional (3D) reconstructed images at different levels. Methods: A total of 30 cases, including 15 male and 15 female patients, who underwent 3D shoulder CT imaging was randomly selected and matched by sex consecutively at one hospital. The angular difference between the scapular body axis and 2D CT slice axis was measured. The glenoid version was assessed at three levels (midpoint, upper one-third, and center of the lower circle of the glenoid) using Friedman's method in the axial plane with 2D CT images and at the same level of three different transverse planes using a 3D reconstructed image. Results: The mean difference between the scapular body axis on the 3D reconstructed image and the 2D CT slice axis was 38.4°. At the level of the midpoint of the glenoid, the measurements were 1.7°±4.9° on the 2D CT images and -1.8°±4.1° in the 3D reconstructed image. At the level of the center of the lower circle, the measurements were 2.7°±5.2° on the 2D CT images and -0.5°±4.8° in the 3D reconstructed image. A statistically significant difference was found between the 2D CT and 3D reconstructed images at all three levels. Conclusions: The glenoid version is measured differently between axial 2D CT and 3D reconstructed images at three levels. Use of 3D reconstructed imaging can provide a more accurate glenoid version profile relative to 2D CT. The glenoid version is measured differently at different levels.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.151-156
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• 1999

Purpose : Average humeral head retroversion was showed significant wide range from literatures based on variable measuring technique, We performed computed tomography(CT) study in an effort to define the specific anatomy relationships and evaluate their use. Materials and Methods : Two hundreds shoulders and distal humeri CT scan with no known pathology were examined. The study population was divided to 10 groups by gender and age (from third to seventh decade). The number of each group was twenty. Retroversion of proximal humerus and glenoid were measured using the lines that were connected the central axis of humeral head, central points of the humeral epicondyles paralleling to the trochlea, paralled to the glenoid surface, midpoint between the transverse glenoid diameter and medial edge of the scapular. We also measured the bicipital groove distance from the humeral central axis and scapulothoracic angle. Results: Retroversion of proximal humerus was highly variable, ranging in this study from 13 to 58 degrees(mean 28.73) These values correlated with sex, not age, height or hand dominance. Glenoid retroversion at the inferior sections showed average 1.3 degree, did not signigicant differences. The central axis was an average of l0mm(5-15mm) posterior to the posterior margin of the bicipital groove. Scapulothoracic angle was average 43 degrees(25-53 degrees) Conclusion: Anatomical reconstruction of retroversion angle should be individualized and bicipital groove could be useful as landmark for the lateral fin of the prosthesis to be positioned an average of 10mm posteriorly.

• Physical Therapy Rehabilitation Science
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• v.6 no.4
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• pp.208-213
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• 2017

Objective: Despite reliable evidence of abnormal scapular motions increases, there is not yet sufficient evidence of abnormal humeral translations. This study aims to analyze the motion of the humeral head toward the scapula when the shoulder is actively abducted using the C-arm. Design: A case report. Methods: The participant was a healthy man without any limitation and pain during shoulder movement. The participant's shoulder was abducted; this movement in the frontal plane was measured using a C-arm (anterior-posterior view) and was analyzed with computer-aided design. The starting posture was $15^{\circ}$, and as the participant abducted his shoulder measurements were taken and analyzed at $30^{\circ}$, $60^{\circ}$, $90^{\circ}$, $120^{\circ}$, $150^{\circ}$, and ending at $165^{\circ}$. A line was drawn perpendicularly to the line connecting the humeral head axis to the glenoid, and another line was drawn perpendiculary to the line connecting the scapular axis to the glenoid. The distance between the two lines measured is defined as the e value. Results: At the starting posture ($15^{\circ}$), the central axis of the humeral head was located 1.92 mm inferior to the central axis of the scapula. The humeral head was superiorly translated from the starting posture to $120^{\circ}$, and then, showed an inferior translation to the ending posture ($165^{\circ}$). Conclusions: The results of this study showed that the humeral head moved upward from the starting posture ($15^{\circ}$) up to $120^{\circ}$ indicating, superior translation, and it moved downward when the posture was past $120^{\circ}$, indicating inferior translation.

• Journal of Oral Medicine and Pain
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• v.48 no.1
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• pp.16-24
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• 2023

Purpose: To determine the effects of botulinum toxin (BoNT) injection into the human masseter muscle on the morphology of the mandibular condyle bone using cone-beam computed tomography (CBCT). Methods: Twenty volunteers were randomly assigned to one of two groups. Group I received a single BoNT injection; Group II received two injections, with the second being administered 4 months after the first. CBCT scans of both temporomandibular joints (TMJs) were performed before and 6 months after the first injection. Bony changes in the cortical layers of the condyle heads were evaluated and the long and short axes of both mandibular condyles were measured. The thickness at the thinnest part of glenoid fossa was also quantitatively measured. Results: There was no significant difference between pre- and post-injection CBCT images. Furthermore, no changes in the cortical layers of the condyle heads were observed among the subjects who exhibited mild degenerative TMJ changes. The quantitative measurements (long axis, short axis, and the thickness of thinnest part of glenoid fossa roof) did not differ significantly between pre- and post-injection except for the long axis in Group I. Conclusions: Within the limitations of this study, it appears that BoNT injections into human masseter muscles do not alter the morphology of the mandibular condyle bone in healthy adults.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.295-317
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• 1991

The discrepancy between centric relation and centric occlusion have a great role on the successful prosthodontic and occlusal treatment. This study was performed to investigate the effect of the discrepancy between centric relation and centric occlusion on condylar guidance inclination and Bennett shift (immediate and progressive side shift). Sixteen adults who have physiologically normal occlusion and are free of TMJ dysfunction were selected. The amount of the sagittal CR-CO discrepancy in lower anterior incisor was obtained by Saphon Visi-Trainer. The amount of the CR-CO discrepancy in condylar level was measured on the individualized corrected tomography. Pantronic survey was performed by using a arbitrary hinge axis according to manufacturer's direction. All subjects were divided into two groups, group I (small) and group II (large), according to the amount of CR-CO discrepancy. At first the amount of the CR-CO discrepancy in condylar level between two groups was compared and then the condylar guidance inclination and Bennett shift between two groups were compared and analyzed. The results were as follows; 1. The average CR-CO discrepancy in lower anterior incisors was 0.7mm superoinferiorly, 0.49mm anteroposteriorly, and 0.88 mm in total. The average CR-CO discrepancy in condylar level was 0.43mm. 2. The CR-CO discrepancy measured on teeth level and condylar level were highly correlated (p<0.01). 3. The correlation of the condylar position in the glenoid fossa between two groups was not statistically significant. 4. The large CR-CO discrepancy group showed greater amount of Bennett shift and condylar guidance inclination, but there is no statistical significancy. 5. It seems that the CR-CO discrepancy have greater effect on progressive side shift than other elements of mandibular movements.