• 대한치과보철학회:학술대회논문집
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• 대한치과보철학회 2001년도 추계학술대회
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• pp.34-34
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• 2001

• 대한정형외과학회지
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• 제55권5호
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• pp.405-410
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• 2020

목적: 퇴행성 요추부 척추 질환에 대한 수술적 치료로 척추 경 나사못(pedicle screw) 삽입술이 전통적으로 사용되어왔다. 이에 대한 대안으로 제시된 피질골 궤도 나사못(cortical-bone trajectory screw)은 덜 침습적인 후방 요추부 고정이 가능한 점과 몇몇의 생체 역학 연구에서 보고한 우수한 기계적 안정성을 장점으로 가지고 있다. 본 연구의 목적은 후방 감압술 후 후방 고정술 및 유합을 시행한 환자에 있어 피질골 궤도 나사못 고정술의 초기 실패에 관한 사례의 임상적 및 방사선적 결과를 알아보고자 함에 있다. 대상 및 방법: 요추의 퇴행성 척추 협착 및 척추 전방 전위에 대한 전통적인 척추 경 나사못 고정을 대안하여 피질골 궤도 나사못을 사용하여 2013년부터 2018년까지 수술적 치료를 시행한 311명의 환자를 대상으로 하였다. 수술 후 조기 고정 실패는 수술 후 6개월째, 외래 추시에서 시행한 컴퓨터 단층촬영(computed tomography) 및 방사선 사진상 나사못의 이완, 이탈 및 파손과 같은 고정 실패가 일어날 시로 정의하였다. 결과: 조기 고정 실패는 311예 중 46예(14.8%), 나사못 이완이 46예(14.8%), 이탈이 12예(3.9%), 파손이 4예(1.3%)에서 발생하였다. 해당 고정 실패가 일어난 부위 분석 시, L1이 7예(15.2%), L2가 3예(6.5%), L3가 4예(8.7%), L4가 4예(8.7%), L5가 4예(8.7%), 그리고 S1이 24예(52.2%)였다. 주로 말단 피질골 궤도 나사못 중에서도 S1 나사못에서 이완, 이탈 및 파손과 같은 고정 실패가 주로 발생하였다. 결론: 피질골 궤도 나사못 고정은 기존의 척추 경 나사못 고정과 비교했을 때 동등한 임상 결과 또는 적은 합병증을 나타낼 수 있는 하나의 대안이 될 수 있으나 골다공증이 있거나 특히 L5-S1 유합부위에서 전방지지구조가 되지 않는 조건일 때, 이완, 이탈, 파손 등의 조기 고정 실패가 나타나는 결과가 있었다.

• Clinics in Shoulder and Elbow
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• 제2권2호
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• pp.133-137
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• 1999

Purpose: There are so many different methods with the their own advantages and disadvantages for acute AC dislocation and distal unstable clavicle fracture. We evaluated the usefulness of temporary Bosworth's coracoclavicular fixations using the cannulated screw and reviewed our clinical results. Materials and Methods: We evaluated 34 cases of temporary coracoclavicular fixations with cannulated screw and washer for acute AC dislocation(25cases in the Type V, Ⅲ) and distal unstable clavicle fracture(9cases in the Type ⅡB, Ⅱ+Ⅲ). All cases were fixed by the same techniques, guided cannulated screw under C-arm after the repair of the CC ligament within 1 week. Bases on the regular check, screws were removed at the 6-12 weeks under local anesthesia. The final clinical and radiological results(average 14 months follow-up) were rated with the UCLA scale. Results : All shoulders were gained nearly full ROM passively at the 3-4 weeks. The overall satisfactory resuIts(excellent or good) were achieved 88%(22/25) in the acute AC dislocation and all in the distal unstable clavicle fracture. There were no definite complications except three initial fixations loosening. Conclusion: Temporary Bosworth's coracoclavicular fixation using the cannulated screw with guided pin was simple precedure and provided enough initial stability for acute AC dislocation and distal unstable clavicle fracture.

• Journal of Korean Dental Science
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• 제2권1호
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• pp.19-27
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• 2009

Tightening of the screws in implant restorations should be accurate and precise. If applied torque is too low, screw loosening would be occurred. With too high torque, the screw fracture might take place. Various torque generating devices are developed and employed to apply a proper torque. The purpose of this investigation was to determine and compare the accuracy of the torque controllers. In this study, 4 types of torque controllers were used; electronic torque controller, torque limiting device, torque indicating device and contra angle torque driver. Digital torque gauge was employed to measure the de-torque value. Thirty cycles of tightening and loosening were done with each torque controller. All implant torque controllers have shown slight errors and deviations. The torque liming device exhibited the most accurate data. No significant difference was found among the mean de-torque values of the electronic torque controller, torque indicating device and contra angle torque driver. In the limitation of this study, it would be recommended that the implant torque controllers should be checked whether uniformed and precise torque can be generated and a measuring error should be corrected.

• 대한치과보철학회지
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• 제45권6호
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• pp.769-779
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• 2007

Statement of problem. When TiN coating is applied to the abutment screw, occurrence of greater preload and prevention of the screw loosening could be expected due to decrease of frictional resistance. However, the proper thickness of TiN coating on abutment screw has not been yet reported. Purpose. The purpose of this study is to find out the appropriate TiN coating thickness by evaluating the detorque force and the surface change of titanium abutment screw with various TiN coating thickness. Material and methods. 1. Material Thirty five non-coated abutment screws were prepared for TiN coating. TiN coatings were prepared by Arc ion plating method. Depending on the coating deposition time(CDT), experimental groups were divided into 6 groups(CDT 30min, 60min, 90min, 120min, 150min, 180min) and those of 1 group was not coated as a control group. Each group was made up of 5 abutment screws. 2. Methods FE-SEM(Field Emission Scanning Electron Microscoper) and EDX(Energy Dispersive X-ray Spectroscopy) were used to observe the surface of the abutment screw. Electric scales was used to measure the weight of the abutment screw after the repeated closing and opening of 10 trials. Detorque force was measured with digital torque gauge, at each trial. Results. 1. As the coating deposition time increased, the surface became more consistent and smooth. 2. As for the abutment screws that were TiN coated for more than 60 minutes, no surface change was found after the repeated closing and opening. 3. The TiN coated abutment screws showed less weight change than the non-coated abutment screws. 4. The TiN coated abutment screws showed higher mean detorque force than the noncoated abutment screws. 5. The abutment screw coated for 60 minutes showed the highest mean detorque force. Conclusion. The coating layer of proper thickness is demanded to obtain consistent and smooth coating surface, resistance to wear, and increased detorque force of the abutment screw. In conclusion, the coating deposition time of 60 minutes indicated improved mechanical property, when TiN coating was conducted on titanium abutment screw.

• Journal of Korean Neurosurgical Society
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• 제39권4호
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• pp.251-255
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• 2006

Objective : To determine the clinical and radiological safety of 15 consecutive patients managed with plate and screw fixation systems applied to the cervical lateral mass. Methods : 15 patients who underwent posterior cervical and T1 arthrodesis were reviewed from Jan 2002 to Dec 2004. Posterior cervical screw and plate fixation was applied on the lateral mass of the cervical spine. The authors have tried lateral mass screw fixation using a modified Magerl's technique [$20^{\circ}$ lateral and $20{\sim}30^{\circ}$ rostral screw trajectory] under preliminary radiological study. The average patient age was $39.73^{\circ}{\pm}11.00\;years$, and the average follow-up period was $9.73^{\circ}{\pm}6.77\;months$. Computed tomography scans taken after surgery were reviewed to confirm the attempted screw trajectory correct and safety. Results : Three of 93 lateral mass screws were malpositioned but clinical damage was not noted. Two of 8 pedicle screws on the T1 vertebrae were not placed on the correct pedicle area. Screw and plate loosening was observed in one case but was not subjected to an additional procedure because of maintained screw position observed during follow-up periods. Conclusion : The results of this study indicate that lateral mass screw fixation using the Modified Magerl's technique on the cervical lateral mass may provide safe and effective application on the patients. In addition, the chance of incorrectly placed screws was higher in T1 pedicle screw fixation than in lateral mass screw fixation of the cervical area.

• 대한치과의사협회지
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• 제53권11호
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• pp.804-816
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• 2015

PURPOSE: The aim of this study was to evaluate the influence of the oxide layer removal process in the Co-Cr-Mo (CCM) abutment after casting procedure on the prosthesis settlement and screw stability. MATERIALS AND METHODS: CCM abutments of four different interface conditions (CCM-M; machined, CCM-O; oxide layer formed, CCM-B; blasted, CCM-P; polished after blasted) and gold abutment (Gold-C; Cast with type III Gold alloy) were used. The initial settling values of abutments were evaluated according to the difference of implant-abutment length when the tightening torques were applied at 5 Ncm and 30 Ncm, and the settling values of abutments caused by loading were evaluated according to the difference of implant-abutment length before and after loading with 250 N, 100000 cycle. The loss ratios of removal torque for abutment screws were evaluated according to the difference in value of removal torques under 30 Ncm tightening torque applied before and after cyclic loading. RESULTS: The CCM-P and CCM-B group showed a higher initial settling value compared with the Gold-C group (P<.05), while the Gold-C group showed the highest settling values caused by loading (P<.05) and no significant differences were observed for between CCM groups (P>.05). The loss ratio of removal torque values for the CCM-B, CCM-P groups did not differ significantly from that of the Gold-C group (P>.05). CONCLUSION: Even though the oxide layer was removed by different methods, CCM abutment with internal conical connection structure showed lower abutment settling and similar screw loosening after cyclic loading compared with gold abutment.

• 한국산학기술학회논문지
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• 제16권4호
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• pp.2356-2363
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• 2015

본 연구는 볼트강도등급 10.9에 의해 추천되는 조임 토크 640~800(Nm)가 볼트-너트 체결체에 가해졌을 때 풀림 방지를 위한 코일 스프링의 삽입 및 시뮬레이션 기반 설계 최적화에 관한 것이다. 먼저 볼트-너트-코일스프링으로 구성된 조립체에 대하여 등가응력에 기반을 둔 구조 안전성 판단을 위한 조립체 구조해석 시뮬레이션을 수행한다. 그리고 이러한 해석 시뮬레이션 결과로부터 설계 개선안 도출을 위한 설계전략을 수립한다. 또한 이 전략 안에서 기존 설계의 성능을 개선해 나가는 반복 과정을 제안한다. 이 과정에서는 먼저 반응표면법을 사용하여 설계 파라미터 후보점을 찾고, 그 후보점의 반응값과 실제 시뮬레이션 결과를 비교함으로써 설계 후보점(코일스프링 감감수 N = 6)이 최적인지를 검증한다.

• 대한치과보철학회지
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• 제53권4호
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• pp.301-309
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• 2015

목적: 이 연구의 목적은 지대주 나사 잔여 전부하 비율과 시멘트 파손유무 평가를 통해 나사 시멘트 유지형 임플란트 보철물(screw- and cement-retained implant prosthesis: SCP)의 임상적 수행 능력을 알아보는 것이다. 재료 및 방법: 구치부 부분 무치악 환자들을 대상으로 임플란트가 식립되었으며 3 - 6개월의 치유기간 후 SCP임플란트 보철물이 장착되었다. 추적관찰을 통해 임플란트의 생존율이 평가되고 보철물 성공률도 평가되었다. SCP 보철물의 나사 잔여 전부하 비율 및 시멘트 파손 비율이 측정되었다. 결과: 20명의 환자로부터 21개의 SCP보철물(43개의 임플란트)이 최대 64개월까지 관찰되었다. 관찰기간(평균 34개월) 동안 골융합에 실패한 임플란트는 하나도 없었다. 지대주, 나사, 도재 혹은 보철물 프레임 파절이나 나사 풀림 등은 없었으므로 보철물 성공율은 100%였다. SCP 보철물의 나사 잔여 전부하 비율은 97.61% (${\pm}16.29$), 그리고 시멘트 파손비율은 9.5%이었다. 결론: 본 실험의 한계 내에서, 나사 풀림과 시멘트 파손이란 관점에서 SCP 디자인의 임플란트 보철물은 양호한 단기 임상 결과를 보였다.

• 대한치과보철학회지
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• 제43권3호
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• pp.338-351
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• 2005

Statement of problem. Accurate fit between the implant components is important because the misfit of the implant components results in frequent screw loosening, irreversible screw fracture, plaque accumulation, poor soft tissue reaction, and destruction of osseointegration. Purpose. This study is to evaluate the machining accuracy and consistency of the implant fixture/ abutment/screw interfaces of the internal connection system by using a Stereoscopic Zoom microscope and FE-SEM(field emission scanning electron microscope) Materials and methods. The implant systems selected in this study were internal connection type implants from AVANA(Osstem^{\circledR}), Bioplant(Cowell-Medi^{\circledR}), Dio(DIO^{\circledR}), Neoplant(Neobiotech 􀋓), Implantium(Dentium􀋓)systems. Each group was acquired 2 fixtures at random. Two piece type abutment and one piece type abutment for use with each implant system were acquired. Screw were respectively used to hold a two piece type abutment to a implant fixture. The implant fixtures were perpendiculary mounted in acrylic resin block. Each two piece abutment was secured to the implant fixture by screw and one piece abutment also secured to the implant fixture. Abutment/fixture assembly were mounted in liquid unsaturated polyester. All samples were cross-sectioned with grinder-polisher unit. Finally all specimens were analysed the fit between implant fixture/abutment/screw interfaces Results and conclusions. 1. Implant fixture/abutment/screw connection interfaces of internal connection systems made in Korea were in good condition. 2. The results of the above study showed that materials and mechanical properties and quality of milling differed depending on their manufacturing companies.