• Journal of Hospice and Palliative Care
• /
• v.19 no.4
• /
• pp.303-309
• /
• 2016

Purpose: Malignant ascites is a common complication in terminal cancer patients. Less-invasive pigtail catheter insertion is the most frequent procedure in patients who need repeated ascites drainage. This study investigated effects and adverse events associated with catheter insertion for ascites drainage and evaluated prognostic outcomes. Methods: We reviewed medical records between 2010 and 2013 of hospice and palliative care institutions in Seoul, South Korea. Among 2,608 inpatients, 67 patients received ascites pigtail catheter drainage. We reviewed demographic data, palliative performance scale, laboratory data, duration of catheter insertion, prevalence and type of complications, use and duration of antibiotics, and survival time. Univariate and multivariate Cox regression models were used to evaluate prognostic outcomes related with catheter insertion. Results: Ascites drainage was performed most commonly in hepatobiliary and gastric cancer patients. Ascites symptoms improved in 55 patients after the catheter drainage. Adverse events included pain (19.4%), leakage (14.9%), disconnection (7.5%), catheter occlusion (6%) and fever (4.5%). In Cox regression analysis, survival time from the catheter insertion was significantly associated with Palliative Performance Scale (PPS) (HR 0.73; P value 0.045) and serum sodium level (HR 2.77; P value 0.003) in a multivariate model. Conclusion: Patients' PPS and serum sodium level should be considered before making a decision of pigtail catheter insertion.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.28 no.2
• /
• pp.147-161
• /
• 2012

This study is to assess the effect of horizontal misfit of an implant supported 3-unit fixed prosthodontics on the stress development at the marginal cortical bone surrounding implant neck. Two finite element models consisting of a three unit fixed prosthodontics and an implant/bone complex were constructed on a three dimensional basis. The three unit fixed prosthodontics were designed either shorter (d=17.8mm model) or longer (d=18.0mm model) by 0.1mm than the span of two implants placed at the mandibular second premolar and second molar areas 17.9mm apart. Fitting of the fixed prosthodontics onto the implant abutments was simulated by a total of 6 steps, that is to say, 0.1mm displacement per each step, using DEFORM 3D (ver 6.1, SFTC, Columbus, OH, USA) program. Stresses in the fixed prosthodontics and implants were evaluated using von-Mises stress, maximum compressive stress, and radial stress as necessary. The d=17.8mm model assembled successfully on to the implant abutments while d=18.0mm model did not. Regardless if the fixed prosthodontics fitted onto the abutments or not, excessively higher stresses developed during the course of assembly trial and thereafter. On the marginal cortical bone around implants during the assembly, the peak tensile and compressive stresses were as high as 186.9MPa and 114.1MPa, respectively, even after the final sitting of the fixed prosthodontics (for d=17.8mm model). For this case, the area of marginal bone subject to compressive stresses above 55MPa, equivalent of the $4,000{\mu}{\varepsilon}$, i.e. the reported threshold strain to inhibit physiological remodeling of human cortical bone, extended up to 2mm away from implant during the assembly. Horizontal misfit of 0.1mm can produce excessively high stresses on the marginal cortical bone not only during the fixed prosthodontics assembly but also thereafter.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.28 no.1
• /
• pp.67-78
• /
• 2012

The purpose of this study was to determine whether there were differences in shear bond strength to human dentin using IDS technique compared with DDS. Forty freshly extracted human molars were and devided into 4 groups. The control group specimens were, on the morrow of tooth preparation, light-cured after application of dentin bonding agent and cemented with resin cement. The IDS/SE(immediate dentin sealing, Clearfil$^{TM}$ SE Bond) and IDS/SB (immediate dentin sealing, Adapter$^{TM}$ Single Bond 2) specimens were, on the morrow of tooth preparation, light-cured after application of dentin bonding agent(Clearfil$^{TM}$ SE Bond and Adapter$^{TM}$ Sing Bond 2, respectively), whereas DDS specimens were not treated with any dentin bonding agent. IDS/SE, IDS/SB and DDS specimens were thermocycled. Following that delay, specimens were cemented with resin cement. The dentin bonding agent was left unpolymerized until the application of porcelain restoration. Shear bond strengths were measured using a universal testing machine. Specimens also were evaluated for mode of fracture using an optical microscope. The mean shear bond strengths of control group and IDS/SE groups were not statistically different from one another. The bond strength of IDS/SE group had a significantly higher mean than that of DDS group. There was no significant difference in the mean shear bond strength between IDS/SB(4.11MPa) and DDS group. The evaluation of failure modes indicates that most failures in the control group and IDS/SE groups were mixed, whereas failures in the DDS group were interfacial. When preparing teeth for indirect ceramic restoration, IDS with Clearfil$^{TM}$ SE Bond results in improved shear bond strength compared with DDS.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.25 no.2
• /
• pp.109-123
• /
• 2009

The aim of the study was to assess the influence of insertion torque of bone quality and to compare axial force, moment and von Mises stress using finite element analysis of plastoelastic property for bone stress and strain by dividing bone quality to its thickness of cortical bone, density of trabecular bone and existence of lower cortical bone when implant inserted to mandibular premolar region. The $Br{\aa}nemark$ MKIII. RP implant and cylindrical bone finite model were designed as cortical bone at upper border and trabecular bone below the cortical bone. 7 models were made according to thickness of cortical bone, density of trabecular bone and bicortical anchorage and von Mises stress, axial force and moment were compared by running time. Dividing the insertion time, it seemed 300msec that inferior border of implant flange impinged the upper border of bone, 550msec that implant flange placed in middle of upper border and 800msec that superior border of implant flange was at the same level as bone surface. The maximum axial force peak was at about 500msec, and maximum moment peak was at about 800msec. The correlation of von Mises stress distribution was seen at both peak level. The following findings were appeared by the study which compared the axial force by its each area. The axial force was measured highest when $Br{\aa}nemark$ MKIII implant flange inserts the cortical bone. And maximal moment was measured highest after axial force suddenly decreased when the flange impinged at upper border and the concentration of von Mises stress distribution was at the same site. When implant was placed, the axial force and moment was measured high as the cortical bone got thicker and the force concentrated at the cortical bone site. The influence of density in trabecular bone to axial force was less when cortical bone was 1.5 mm thick but it might be more affected when the thickness was 0.5 mm. The total axial force with bicortical anchorage, was similar when upper border thickness was the same. But at the lower border the axial force of bicortical model was higher than that of monocortical model. Within the limitation of this FEA study, the insertion torque was most affected by the thickness of cortical bone when it was placed the $Br{\aa}nemark$ MKIII implant in premolar region of mandible.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.25 no.2
• /
• pp.83-94
• /
• 2009

The aim of this study was to investigate the shear bond strength between zirconia ceramic and resin cement according to various surface treatments. The surface of each zirconia ceramic was subjected to one of the following treatments and then bonded Rely X Unicem or Rely X ARC resin cement; (1) Rocatec system and $50{\mu}m$ surface polishing, (2) No treatment and $50{\mu}m$ surface polishing, (3) Rocatec system and $1{\mu}m$ surface polishing, (4) No treatment and $1{\mu}m$ surface polishing. Each of eight bonding group was tested in shear bond strengths by universal testing machine(Z020, Zwick, Ulm, Germany) with crosshead speed of 1mm/min. The results were as follows; 1. Rocatec treatment groups showed greater bonding strengths than No Rocatec groups. There was significant difference of among groups(P<0.001) 2. For Rocatec groups, $50{\mu}m$ surface roughness groups showed greater bonding strengths than $1{\mu}m$ surface roughness groups.(P<0.001) But for No Rocatec groups, There was no significant difference of among groups(P>0.05) 3. Rely X Unicem groups showed greater bonding strengths than Rely X ARC groups. There was significant difference of among groups(P<0.01) Within the conditions of this study, Rocatec treatment was an effective way of increasing zirconia bonds to a resin cement, even in the case of self-adhesive resin cement.

• Journal of Oral Medicine and Pain
• /
• v.32 no.3
• /
• pp.283-292
• /
• 2007

In several treatment modalities for snoring and obstructive sleep apnea (OSA), oral appliances mainly including mandibular advancement appliance (MAA) and tongue retaining device (TRD) are recognized as a non-invasive, reversible alternative with favorable results. Tongue bulb is a major component of TRD which prevents the tongue from approaching the posterior wall of the pharynx and can be combined with MAA. Determination of tongue bulb size for the patient is important for therapeutic effect, but frequently needs time-consuming work. For effective fabrication and standardization of tongue bulbs, this study aimed to categorize tongue bulb size for healthy young men and to examine its relation with maximum retention force and with physical parameters including tongue-related variables. 36 non-snoring, asymptomatic young men with normal occlusion were voluntarily participated in this study (mean age: $24.47{\pm}2.58$ years). Experimental procedures consisted of prefabrication of tongue bulb set (20 types with a width of 27-36mm and thickness of 8 and 10 mm), determination of tongue bulb size and the maximum retention force for each subject, and measurement of physical parameters including body mass index (BMI), neck circumference and width, thickness and length of tongue. This study showed that there was significant difference of retention force among the bulb size-related groups both in upright and supine position (p<0.05) and that retention force increased with bulb size. Correlation of tongue bulb size with physical parameters was not clearly verified and there was no significant difference in retention force between upright and supine positions. Based on our results, it can be suggested that retention force relates with tongue bulb size, ultimately with tongue volume. A further study needs to be performed in the patients with snoring and OSA.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.29 no.2
• /
• pp.163-173
• /
• 2013

When the mandible performs opening movement, the condyle-disk complex conducts sliding movement along the articular eminence. Thus, anatomic configuration of articular eminence is very important to normal movement of TMJ. The purpose of this study was to measure the posterior slope of the articular eminence and evaluate the effect of a pathologic bone change in the condylar head on the stiffness of articular eminence, and compare the differences of the articular eminence slope by gender and age using dental cone-beam CT. As using i-CAT Cone-Beam Computed Tomography, the CT images of 204 TMJs of 102 patients(43 men and 59 women, mean age: 37.7 years) who were diagnosed at Wonkwang University Sanbon Dental Hospital were evaluated. All images were converted into a TMJ analysis mode to observe the continuous sagittal section images and coronal section images of the joints. To observe and assess bone changes in the condyle, three dentists measured the stiffness of the articular eminence on the same images, and when two of the three dentists agreed on their reading, these results were adopted and recorded. The articular eminence slope, considering the condylar anatomic configuration, was measured in three regions, namely, lateral part, central part, and medial part of the condyle. In the cases of a normal condyle(NCBC) and a condyle(CBC) with bone change, the articular eminence slopes were $57.0^{\circ}$(NCBC) and $51.8^{\circ}$(CBC) at the medial part, $57.9^{\circ}$(NCBC) and $52.4^{\circ}$(CBC) at the central part, and $55.1^{\circ}$(NCBC) and $49.5^{\circ}$(CBC) at the lateral part of the condyle. And the articular eminence slope of the condyle with bone change demonstrated less steepness than that of normal condyle (p<0.05). The articular eminence slope showed mediolaterally that it was the steepest at the central, followed by at the medial, and at the lateral (p<0.05). There were no significant differences by the gender and the age (p.0.05).

• The korean journal of orthodontics
• /
• v.38 no.4
• /
• pp.240-251
• /
• 2008

Objective: The purpose of this study was to evaluate the effect of head position changes on the root parallelism between adjacent teeth on panoramic radiographs. Methods: A model with normal occlusion was constructed in the SolidWorks program, then RP (rapid protyping) model was fabricated. The model was repeatedly imaged and repositioned five times at each of the following nine positions: ideal head position, $5^{\circ}$ up, $10^{\circ}$ up, $5^{\circ}$ down, $10^{\circ}$ down, $5^{\circ}$, right, $10^{\circ}$, up, and $5^{\circ}$ right rotation, $10^{\circ}$ right rotation. Panoramic radiographs were taken by Planmeca ProMax and the angle between the long axes of adjacent teeth was directly measured in the monitor. Results: Axes of adjacent teeth tended to converge toward the occlusal plane when the head tilted up and converged in the opposite direction to the occlusal plane when the head tilted down. Anterior teeth showed the most notable differences. When one side of the head tilted up $5^{\circ}$ and $10^{\circ}$ along the anteroposterior axis (Y axis), tooth axes of the same side tended to converge toward the occlusal plane and tooth axes of the opposite side tended to converge in the opposite direction to the occlusal plane. When the head rotated to one side along the vertical axis (Z axis), the canine and lateral incisor of the same side converged in the opposite direction to the occlusal plane and the canine and lateral incisor of the other side converged toward the occlusal plane. Conclusions: When assessing the root parallelism on panoramic radiographs, the occlusal plane cant (anteroposterior or lateral) or asymmetry of the dental arch should be considered because these can cause distortion of tooth axes on panoramic radiographs.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.24 no.4
• /
• pp.325-335
• /
• 2008

The junction between resilient denture liner and the denture base is difficult to finish and polish due to difference of the physical property of the materials. Gaps tend to be formed during finishing and polishing procedures. The purpose of this study was measuring the width of junctional gap between $Molloplast-B^{(R)}$ and denture base material after finishing and polishing procedure, and evaluating the effect of method and direction on gap width. $Molloplast-B^{(R)}$ was processed (according to the manufacturer's instruction) against Lucitone $199^{(R)}$ acrylic resin. 50 specimens were fabricated with a raised center section. All of specimens were examined and photographed with a stereoscopic microscope(x120), and the largest gap along the junction of $Molloplast-B^{(R)}$ and acrylic resin on each specimen was measured. One-way analysis of variance(ANOVA) and independent t-test at 95% confidence level were used to analyze the data and to compare groups. The results of this study were as follows. In comparison with finishing tools, the gap width was the largest in $Molloplast^{(R)}$-Cutter and the smallest in FSQ-cross cut bur. There was statistically significant difference between FSQ-cross cut bur and $Molloplast^{(R)}$-Cutter(p<0.05). There was no significant difference in gap width between the direction of polishing. The mean value of gap width was the smallest in case of no polishing, and the largest in case of polishing with pumice & tin oxide. There was statistically significant difference between pumice and pumice & tin oxide. From the results, it is concluded that the use of $Molloplast^{(R)}$-Cutter in clinic need serious consideration even though it has good cutting ability. Further careful study is needed for finishing and polishing methods for decreasing gap width in junction of two materials.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.27 no.2
• /
• pp.197-207
• /
• 2011

The study aimed at examining how different reline resins affect flexural strength and flexural modulus of denture base. A total of 80 specimens ($64{\times}10{\times}3.3$ mm, according to ISO 1567:1999) of heat-polymerized resin, 40 specimens for (Lucitone199(Dentsply Int., NewYork, USA), SR Ivocap(Ivoclar AG, Schaan, Liechtenstein)) respectively, were polymerized according to the manufacturer's instructions and divided into eight groups(n = 10). Control group specimens remained intact. Specimens in the other groups were abraded on both sides to 2 mm thickness, and were relined in 1.3 mm thickness with 3 types of resins (Lucitone199(Dentsply), SR Ivocap(Ivoclar), and Rebase II(Tokuyama Co., Ltd, Tokyo, Japan)). All specimens were preserved in distilled water at $37^{\circ}C$ for 50 hours, and then were subjected to flexural strength testing in a universal testing machine using 3-point loading. A crosshead speed of 5 mm/min was used, and the distance between the supports was 50 mm. Data analyses included one-way analysis of variance(ANOVA) and the Tukey Honestly Significant Difference test (p=.05). Both heat-polymerized resin groups and auto-polymerized resin groups showed statistically low flexural strength and flexural modulus than control groups. Specimens relined with Lucitone 199 showed significantly higher flexural strength and flexural modulus than those relined with SR-Ivocap. Specimens relined with auto-polymerized resin showed significantly lower flexural strength and flexural modulus than those relined with heat-polymerized resin. Relining with heat-polymerized resins showed superior mechanical properties to relining with an auto-polymerized resin. Relining with the same heat-polymerized resin as the denture base does not affect mechanical properties of a denture. Lucitone199 using a compression-mould technique resulted in the highest flexural strength.