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Effect of bone-implant contact pattern on bone strain distribution: finite element method study (골-임플란트 접촉 양상에 따른 골 변형 연구: 유한요소법적 연구)

  • Yoo, Dong-Ki;Kim, Seong-Kyun;Koak, Jai-Young;Kim, Jin-Heum;Heo, Seong-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.3
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    • pp.214-221
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    • 2011
  • Purpose: To date most of finite element analysis assumed the presence of 100% contact between bone and implant, which is inconsistent with clinical reality. In human retrieval study bone-implant contact (BIC) ratio ranged from 20 to 80%. The objective of this study was to explore the influence of bone-implant contact pattern on bone of the interface using nonlinear 3-dimensional finite element analysis. Materials and methods: A computer tomography-based finite element models with two types of implant (Mark III Br${\aa}$nemark$^{(R)}$, Inplant$^{(R)}$) which placed in the maxillary 2nd premolar area were constructed. Two different degrees of bone-implant contact ratio (40, 70%) each implant design were simulated. 5 finite element models were constructed each bone-implant contact ratio and implant design, and sum of models was 40. The position of bone-implant contact was determined according to random shuffle method. Elements of bone-implant contact in group W (wholly randomized osseointegration) was randomly selected in terms of total implant length including cortical and cancellous bone, while ones in group S (segmentally randomized osseointegration) was randomly selected each 0.75 mm vertically and horizontally. Results: Maximum von Mises strain between group W and group S was not significantly different regardless of bone-implant contact ratio and implant design (P=.939). Peak von Mises strain of 40% BIC was significantly lower than one of 70% BIC (P=.007). There was no significant difference between Mark III Br${\aa}$nemark$^{(R)}$ and Inplant$^{(R)}$ in 40% BIC, while average of peak von Mises strain for Inplant$^{(R)}$ was significantly lower ($4886{\pm}1034\;{\mu}m/m$) compared with MK III Br${\aa}$nemark$^{(R)}$ ($7134{\pm}1232\;{\mu}m/m$) in BIC 70% (P<.0001). Conclusion: Assuming bone-implant contact in finite element method, whether the contact elements in bone were wholly randomly or segmentally randomly selected using random shuffle method, both methods could be effective to be no significant difference regardless of sample size.

Scapular Free Flap (유리 견갑 피판 이식술)

  • Chung, Duke-Whan;Han, Chung-Soo;Yim, Chang-Moo
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.24-34
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    • 1996
  • There are many kinds of free flaps for management of extensive soft tissue defect of extremities in orthopaedic field. Free vascularized scapular flap is one of the most useful and relatively easy to application. This flap has been utilize clinically from early eighties by many microsurgical pioneers. Authors performed 102 cases of this flap from 1984 to 1995. We have to consider about the surgical anatomy of the flap, technique of the donor harvesting procedures, vascular varieties and anatomical abnormalities and success rate and the weak points of the procedure. This flap nourished by cutaneous branches from circumflex scapular vessels emerges from the lateral aspect of the subscapular artery 2.5-5cm from its lateral origin passing through the triangular space(bounded by subscapularis, teres minor, teres major, long head of triceps). The terminal cutaneous branch runs posteriorly around the lateral border of the scapular and divided into two major branches, those transeverse horizontally and obliquely to the fascial plane of overlying skin of the scapular body. We can utilize these arteries for scapular and parascapular flap. The vascular pedicle ranged from 5 to 10 cm long depends on the dissection, usually two venae comitantes accompanied circumflex scapular artery and its major branches. The diameter of the circumflex scapular artery is more than 1mm in adult, rare vascular variation. Surgical techniques : The scapular flap can be dissected conveniently with prone or lateral decubitus position, prone position is more easier in my experience. There are two kinds of surgical approaches, most of the surgeon prefer elevation of the flap from its outer border towards its base which known easier and quicker, but I prefer elevation of the flap from its outer border because of the lowering the possibilities of damage to vasculature in the flap itself which runs just underneath the subcutaneous tissue of the flap and provide more quicker elevation of the flap with blunt finger dissection after secure pedicle dissection and confirmed the course from the base of the pedicle. There are minimal donor site morbidity with direct skin closure if the flap size is not so larger than 10cm width. This flap has versatility in the design of the flap shape and size, if we need more longer and larger one, we can use parascapular flap or both. Even more, the flap can be used with latissimus dorsi musculocutaneous flap and serratus anterior flap which have common vascular pedicle from subscapular artery, some instance can combined with osteocutaneous flap if we include the lateral border of the scapular bone or parts of the ribs with serratus anterior. The most important shortcoming of the scapular free flap is non sensating, there are no reasonable sensory nerves to the flap to anastomose with recipient site nerve. Results : Among our 102 cases, overall success rate was 89%, most of the causes of the failure was recipient site vascular problems such as damaged recipient arterial conditions, and there were two cases of vascular anomalies in our series. Patients ages from 3 years old to 62 years old. Six cases of combined flap with latissimus dorsi, 4 cases of osteocutaneous flap for bone reconstruction, 62 parascapular flap was performed - we prefer parascapular flap to scapular. Statistical analysis of the size of the flap has less meaningful because of the flap has great versatility in size. In the length of the pedicle depends on the recipient site condition, we can adjust the pedicle length. The longest vascular pedicle was 14 cm in length from the axillary artery to the enter point cutaneous tissue. In conclusion, scapular free flap is one of the most useful modalities to manage the large intractable soft tissue defect. It has almost constant vascular pedicle with rare anatomical variation, easy to dissect great versatility in size and shape, low donor morbidity, thin and hairless skin.

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Femoral Tunnel Obliquity between the Transtibial and Anteromedial Portal Technique in Single Bundle Anterior Cruciate Ligament Reconstruction (전방십자인대 단일 다발 재건술에서 경경골 술기 및 전내측 삽입구를 이용한 대퇴골 터널의 기울기)

  • Lee, Ju-Hong;Park, Jong-Hyuk;Bae, Hyeon-Kyeong;Kim, Jong-Gil;Wang, Sung-Il
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.41-47
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    • 2010
  • Purpose: To compare the obliquity of femoral tunnels prepared with transtibial (TT) versus anteromedial portal technique (AM) using x-ray in single-bundle anterior cruciate ligament (ACL) reconstruction. Materials and Methods: Among one-hundred thirty two patients who were undergoing ACL reconstruction from January 2007 to December 2009, thirty patients using TT and twenty patients using AM, those who had single-bundle ACL reconstruction, were evaluated with plain radiographs including anteroposterior, intercondylar notch and lateral view to compare the obliquity of bone tunnels. Results: The mean coronal obliquity of femoral tunnel for TT was $71^{\circ}$ (range; $65^{\circ}{\sim}77^{\circ}$), while for AM was $51^{\circ}$ (range; $39^{\circ}{\sim}60^{\circ}$) and the mean sagittal obliquity of femoral tunnel for TT was $22.7^{\circ}{\pm}7.8$, while for AM was $30.2^{\circ}{\pm}6.9$, their differences between them were statistically significant (P<0.05). However, there were no differences between two techniques on the tibial tunnel obliquity in coronal and sagittal plane. Conclusion: Anterior cruciate ligament reconstruction using AM portal technique allows more horizontally oriented and divergent femoral tunnel compared to that of transtibial technique. This seems to enable the graft placement into the femoral footprint and preserve the posterior cortical wall.

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A Study on the Ratio of Weight-far-Height in Insurance Medicine (비체중(比體重)의 보험의학적고찰(保險醫學的考察))

  • Im, Young-Hoon
    • The Journal of the Korean life insurance medical association
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    • v.2 no.1
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    • pp.195-217
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    • 1985
  • A statistical analysis on the ratio of weight-for-height in insurance medicine was carried out in a total of 12,690 insured persons who were medically examined at the Honam medical department, Dong Bang life insurance company, ltd. from June, 1979 to February, 1984. The results were as follows: 1. The mean value of the ratio of weight-for-height(W/H ratio) was $102.3{\pm}11.3%$ in all males, and $105.2{\pm}103.6%$ in all females. The difference of the values between males and females showed statistical significance(P<0.001). The mean value of W/H ratio in all the insureds was $103.8{\pm}12.9%$. In each age group, the mean value of female was higher than that of male without exception(P<0.001). The mean value of both sexes in each age group showed gradual increase with age except for the age group over 50(P<0.001). 2. The incidences of the average weighted, overweighted and underweighted lives were respectively 91.6% in all males, 84.2% in all females(P<0.001); 7.9% in all males, 15.4% in all females(P<0.001); 0.5% in all males, 0.4% in all females(P>0.05). The incidences of average weighted, overweighted and underweighted lives in all the insureds were respectively 87.6%, 12.0% and 0.5%. The incidence of the average weighted lives in male in each age group was always higher than that in female with the exception of the age group below 19(P<0.001), whereas the incidence of the overweighted lives in male in each age group was always lower than that in female(P<0.05 in the age group below 19, P<0.001 in the other age groups). The incidence of average weighted lives of both sexes in each age group showed gradual decrease with age from the second to fifth decade(P<0.001), whereas the incidence of the overweighted lives of both sexes in each age group showed gradual increase with age from the second to fifth decade(P<0.001). 3. The relative frequency distribution polygons of W/H ratio of both sexes drawn in a pair on one coordinate plane revealed lying in juxtaposition each other horizontally and showed the shifting of female's polygon to male's one toward the direction of greater value of W/H ratio at a short distance which increased gradually with age. 4. Correlations between both sexes and among age groups relating to W/H ratios of the insureds seem to be a physiological phenomenon of body build and should be considered on the rating of the build. Author prepared a rating table of build based on the correlations above menthioned. Some gradients by sex and age in the rating table of build are organized; in female group, the ratings of 0, 30-50, 50-100 and 100-D are to calculate by the build with W/H ratio of 80-125%, $126{\sim}145%,\;146{\sim}165%$ and over 166% respectively in the age group of 29 or under, by the build with W/H ratio of $80{\sim}130%,\;131{\sim}150%,\;151{\sim}170%$ and over 171% respectively in the age group of $30{\sim}59$, and by the build with W/H ratio of $80{\sim}135%,\;136{\sim}155%,\;156{\sim}175%$ and over 176% respectively in the age group of 60 or over. In male group, the ratings of 0, $30{\sim}50$, 50-100, and 100-D are to calculate by the build with W/H ratio of $80{\sim}120%,\;121{\sim}140%,\;141{\sim}160%$ and over 161% respectively in all ages. Of under weighted lives, in both sexes, the ratings of 30-50 and 50-D are to calculate by the build with W/H ratio of $76{\sim}79%$ and under 75% respectively. The results of the ratings according to a rating table by author were as follows: The incidence of the ratings of 0, 30-50, 50-100 and 100-D showed no difference between male and female. The incidence of the ratings of 0(indicating the average weighted lives) showed gradual decrease with age and the incidence of the ratings of 30-50 and 50-100(indicating the overweighted lives) showed gradual increase with age. These results are thought to be considerably reasonable because the incidence of the builds in each age group is supposed to have no difference by sex and the incidence of the overweighted lives would increase with age.

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The Comparison of Lens Movement by the Fitting States of Soft Contact Lenses in Normal and Dry Eyes (정상안과 건성안에서 피팅상태에 따른 각막에서의 소프트렌즈 움직임 비교)

  • Jung, Da I;Lim, Shin Kyu;Kim, So Ra;Park, Mijung
    • Journal of Korean Ophthalmic Optics Society
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    • v.16 no.1
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    • pp.21-30
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    • 2011
  • Purpose: The study was performed to compare the differences in lens rotation, lens movement by blinking and lens centration with alignment or steep fitting of soft contact lens in normal and dry eyes. Methods: Total 40 eyes (aged 20~30 years) were classified into the normal (n=20) or dry eye group (n=20) by the diagnosis methods for dry eyes and worn soft contact lens (polymacon material) with alignment fitting or steep fitting. Lens rotation, lens movement by blinking and lens centration were separately measured immediately after lens wearing and after stabilization of tear film and compared by fitting states of soft contact lenses. Results: With steep fitting of soft contact lens in dry eyes, averaged lens rotation immediately after lens wearing was not significantly different from that of the normal eye group with alignment fitting however, lens rotation after stabilization in dry eyes was significantly larger than that in normal eyes. Any significant difference in lens movement by blinking was not shown in normal eyes. However, lens movement by blinking in dry eyes was increased with steep fitting. The range of lens centration on cornea in normal eyes with alignment fitting was more vertically distributed. On the other hand, the range of lens centration on cornea in dry eyes with alignment fitting was more horizontally distributed. Lens centration was shown to be changed by stabilization of tear film. That is, lens centrations were somewhat vertically widespread immediately after lens wearing and restrictively distributed in horizontal direction, respectively, with steep fitting in dry eyes. Conclusions: These results suggested that lens movements and centration in dry eyes were different from those of normal eyes. Especially, those differences between normal and dry eyes were much bigger with steep fitting of soft contact lenses. Thus, those differences should be considered for the comfortable and safe fitting of soft contact lens in dry eyes.

A Three-Dimensional Modeling Study of Lake Paldang for Spatial and Temporal Distributions of Temperature, Current, Residence Time, and Spreading Pattern of Incoming Flows (팔당호 수온, 유속, 체류시간의 시.공간적 분포 및 유입지류 흐름에 관한 3차원 모델 연구)

  • Na, Eun-Hye;Park, Seok-Soon
    • Journal of Korean Society of Environmental Engineers
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    • v.27 no.9
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    • pp.978-988
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    • 2005
  • A three-dimensional dynamic model was applied to Lake Paldang, Han River in this study. The model was calibrated and verified using the data measured under different ambient conditions. The model results were in reasonable agreements with the field measurements in both calibration and verification. Utilizing the validated model, we analyzed the spatial and temporal distributions of temperature, current, residence time, and spreading pattern of incoming flows within the lake. Relatively low velocity and high temperature were computed at the surface layer in the southern region of the Sonae island. The longest residence time within the lake was predicted in the southern region of the Sonae island and the downstream region of the South Branch. This can be attributed to the fact that the back currents caused by the dam blocking occur mainly in these regions. Vertical thermal profiles indicated that the thermal stratifications would be occurred feebly in early summer and winter. During early spring and fall, it appeared that there would be no discernible differences at the vertical temperature profiles in the entire lake. The vertical overturns, however, do not occur during these periods due to an influence of high discharge flows from the dam. During midsummer monsoon season with high precipitation, the thermal stratification was disrupted by high incoming flow rates and discharges from the dam and very short residence time was resulted in the entire lake. In this circulation patterns, the plume of the Kyoungan stream with smallest flow rate and higher water temperature tends to travel downstream horizontally along the eastern shore of the south island and vertically at the top surface layer. The model results suggest that the Paldang lake should be a highly hydrodynamic water body with large spatial and temporal variations.

Assessment of Phytoplankton Viability Along the Salinity Gradient in Seomjin River Estuary, Korea (섬진강 하구역에서 염분구배에 따른 식물플랑크톤 활성도 평가)

  • Lim, Youngkyun;Baek, Seung Ho
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.23 no.5
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    • pp.513-523
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    • 2017
  • We evaluated the viability of phytoplankton along the salinity gradient in the flood and ebb tides of spring tide of February and the ebb tide of neap tide of March 2017 in the Seomjin River Estuary. Additional laboratory experiments were also conducted to determine the reason of the pH changes along the salinity gradient using the field natural sample in February. In field, saltwater was well mixed at downstream vertically and the salinity gradient was horizontally appeared toward upstream of freshwater zone. There were strong negative correlations between salinity and nutrient (nitrate + nitrite R=0.99, p<0.001, and silicate R=0.98, p<0.001), implying that those two nutrients of freshwater origin were gradually diluted with mixing the saltwater. On the other hands, relatively high phosphate concentration was kept in the stations of saltwater over 15 psu, indicating that it was caused by resuspended sediments of Gwangyang Bay and downstream by tidal water mixing.Among phytoplankton community structure in winter, Eucampia zodiacus have occupied to be c.a. 70 % in the most stations. Based on the field survey results for survivability of phytoplankton by phytoPAM instrument, there was positive correlations between salinity and chlorophyll a (R=0.82, p<0.001) and, salinity and active chlorophyll a (R=0.80, p<0.001), implying that the dominant marine diatom species may have significantly damaged in low salinity conditions of upstream. Also, maximum mortality rate of phytoplankton caused by low salinity shock was appered to be 75% in the upstream station. In particular, the pH in spring tides of February had tended to increase with high phytoplankton accmulated stations, suggesting that it was related with absorption of $CO_2$ by the photosynthesis of dominant diatom. In laboratory experiments, phytoplankton mass-mortality caused by low salinity shock was also occurred, which is confirmed with reducing the photosynthetic electron transport activity. Following the phytoplankton mass-mortality, bacteria abundance was significantly increased in 24 hours. As a result, the mass-proliferating bacteria can produce the $CO_2$ in the process of biodegradation of diatoms, which can lead to pH decrease. Therefore, marine phytoplankton species was greatly damaged in freshwater mixing area, depending on along the salinity gradient that was considered to be an important role in elevating and reducing of pH in Seomjin River Estuary.

EFFECT OF IRRIGATION METHODS ON THE ADHESION OF RESILON/EPIPHANY SEALER AND GUTTA-PERCHA/AH 26 SEALER TO INTRACANAL DENTIN (근관 세척법이 Resilon/Epiphany sealer와 Gutta-percha/AH 26 sealer의 근관 상아질과의 접착에 미치는 영향)

  • Kim, Seo-Kyong;Hwang, Yun-Chan;Hwang, In-Nam;Oh, Won-Mann
    • Restorative Dentistry and Endodontics
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    • v.33 no.2
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    • pp.98-106
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    • 2008
  • The purpose of this study was to evaluate whether intracanal irrigation method could affect the adhesion between intracanal dentin and root canal filling materials (Gutta-percha/AH 26 sealer and Resilon/Epiphany sealer). Thirty extracted human incisor teeth were prepared. Canals were irrigated with three different irrigation methods as a final rinse and obturated with two different canal filling materials (G groups: Gutta-percha/AH 26 sealer, R groups: Resilon/Epiphany sealer) respectively. Group G1, R1-irrigated with 5.25% NaOCl Group G2, R2-irrigated with 5.25% NaOCl, sterile saline Group G3, R3-irrigated with 5.25% NaOCl, 17% EDTA, sterile saline Thirty obturated roots were horizontally sliced and push-out bond strength test was performed in the universal testing machine. After test, the failure patterns of the specimens were observed using Image-analyzing microscope. The results were as follows. 1. Gutta-percha/AH 26 sealer groups had significantly higher push-out bond strength compared with the Resilon/Epiphany sealer groups (p < 0.05). 2. Push-out bond strength was higher when using 17% EDTA followed by sterile saline than using NaOCl as a final irrigation solution in the Resilon/Epiphany sealer groups (p < 0.05). 3. In the failure pattern analysis, there was no cohesive failure in Group G1, G2, and R1. Gutta-percha/AH 26 sealer groups appeared to exhibit predominantly adhesive and mixed failure patterns, whereas Resilon/Epiphany sealer groups exhibited mixed failures with the cohesive failure occurred within the Resilon substrate.

In Vitro Evaluation of Shear Bond Strengths of Zirconia Cerami with Various Types of Cement after Thermocycling on Bovine Dentin Surface (지르코니아 표면 처리와 시멘트 종류에 따른 치면과의 전단 결합 강도 비교 연구)

  • Cho, Soo-Hyun;Cho, In-Ho;Lee, Jong-Hyuk;Nam, Ki-Young;Kim, Jong-Bae;Hwang, Sang-Hee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.23 no.3
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    • pp.249-257
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    • 2007
  • State of problem : The use of zirconium oxide all-ceramic material provides several advantages, including a high flexural strength(>1000MPa) and desirable optical properties, such as shading adaptation to the basic shades and a reduction in the layer thickness. Along with the strength of the materials, the cementation technique is also important to the clinical success of a restoration. Nevertheless, little information is available on the effect of different surface treatments on the bonding of zirconium high-crystalline ceramics and resin luting agents. Purpose : The aim of this study was to test the effects of surface treatments of zirconium on shear bond strengths between bovine teeth and a zirconia ceramic and evaluate differences among cements Material and methods : 54 sound bovine teeth extracted within a 1 months, were used. They were frozen in distilled water. These were rinsed by tap water to confirm that no granulation tissues have left. These were kept refrigerated at $4^{\circ}C$ until tested. Each tooth was placed horizontally at a plastic cylinder (diameter 20mm), and embedded in epoxy resin. Teeth were sectioned with diamond burs to expose dentin and grinded with #600 silicon carbide paper. To make sure there was no enamel left, each was observed under an optical microscope. 54 prefabricated zirconium oxide ceramic copings(Lava, 3M ESPE, USA) were assigned into 3 groups ; control, airborne-abraded with $110{\mu}m$ $Al_2O_3$ and scratched with diamond burs at 4 directions. They were cemented with a seating force of 10 ㎏ per tooth, using resin luting cement(Panavia $F^{(R)}$), resin cement(Superbond $C&B^{(R)}$), and resin modified GI cement(Rely X $Luting^{(R)}$). Those were thermocycled at $5^{\circ}C$ and $55^{\circ}C$ for 5000 cycles with a 30 second dwell time, and then shear bond strength was determined in a universal test machine(Model 4200, Instron Co., Canton, USA). The crosshead speed was 1 mm/min. The result was analyzed with one-way analysis of variance(ANOVA) and the Tukey test at a significance level of P<0.05. Results : Superbond $C&B^{(R)}$ at scratching with diamond burs showed the highest shear bond strength than others (p<.05). For Panavia $F^{(R)}$, groups of scratching and sandblasting showed significantly higher shear bond strength than control group(p<.05). For Rely X $Luting^{(R)}$, only between scratching & control group, significantly different shear bond strength was observed(p<.05). Conclusion : Within the limitation of this study, Superbond $C&B^{(R)}$ showed clinically acceptable shear bond between bovine teeth & zirconia ceramics regardless of surface treatments. For the surface treatment, scratching increased shear bond strength. Increase of shear bond strength by sandblasting with $110{\mu}m$ $Al_2O_3$ was not statistically different.

The Pattern of Initial Displacement in Lingual Lever Arm Traction of 6 Maxillary Anterior Teeth According to Different Material Properties: 3-D FEA (유한요소모델에서 레버암을 이용한 상악 6전치 설측 견인 시 초기 이동 양상)

  • Choi, In-Ho;Cha, Kyung-Suk;Chung, Dong-Hwa
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.2
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    • pp.213-230
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    • 2008
  • The aim of this study was to analyze the initial movement and the stress distribution of each tooth and periodontal ligament during the lingual lever-arm retraction of 6 maxillary incisors using FEA. Two kinds of finite element models were produced: 2-properties model (simple model) and 24-properties model (multi model) according to the material property assignment. The subject was an adult male of 23 years old. The DICOM images through the CT of the patient were converted into the 3D image model of a skull using the Mimics (version 10.11, Materialise's interactive Medical Image Control System, Materialise, Belgium). After series of calculating, remeshing, exporting, importing process and volume mesh process was performed, FEA models were produced. FEA models are consisted of maxilla, maxillary central incisor, lateral incisor, canine, periodontal ligaments and lingual traction arm. The boundary conditions fixed the movements of posterior, sagittal and upper part of the model to the directions of X, Y, Z axis respectively. The model was set to be symmetrical to X axis. Through the center of resistance of maxilla complex, a retraction force of 200g was applied horizontally to the occlusal plane. Under this conditions, the initial movements and stress distributions were evaluated by 3D FEA. In the result, the amount of posterior movement was larger in the multi model than in the simple model as well as the amount of vertically rotation. The pattern of the posterior movement in the central incisors and lateral incisors was controlled tipping movement, and the amount was larger than in the canine. But the amount of root movement of the canine was larger than others. The incisor rotated downwardly and the canines upwardly around contact points of lateral incisor and canine in the both models. The values of stress are similar in the both simple and multi model.