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Radiographic change of grafted sinus floor after maxillary sinus floor elevation and placement of dental implant (상악동저 거상술과 임플란트 식립 후 상악동저 변화에 대한 연구)

  • Cho, Sang-Ho;Kim, Ok-Su
    • Journal of Periodontal and Implant Science
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    • v.36 no.2
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    • pp.345-359
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    • 2006
  • Loss of maxillary molar teeth leads to rapid loss of crestal bone and inferior expansion of the maxillary sinus floor (secondary pneumatization). Rehabilitation of the site with osseointegrated dental implants often represents a clinical challenge because of the insufficient bone volume resulted from this phenomenon. Boyne & James proposed the classic procedure for maxillary sinus floor elevation entails preparation of a trap door including the Schneiderian membrane in the lateral sinus wall. Summers proposed another non-invasive method using a set of osteotome and the osteotome sinus floor elevation (OSFE) was proposed for implant sites with at least 5-6mm of bone between the alveolar crest and the maxillary sinus floor. The change of grafted material in maxillary sinus is important for implant survival and the evaluation of graft height after maxillary sinus floor elevation is composed of histologic evaluation and radiomorphometric evaluation. The aim of the present study was radiographically evaluate the graft height change after maxillary sinus floor elevation and the influence of the graft material type in height change and the bone remodeling of grafts in sinus. A total of 59 patients (28 in lateral approach and 31 in crestal approach) who underwent maxillary sinus floor elevation composed of lateral approach and crestal approach were radiographically followed for up to about 48 months. Change in sinusgraft height were calculated with respect to implant length (IL) and grafted sinus height(BL). It was evaluated the change of the graft height according to time, the influence of the approach technique (staged approach and simultaneous approach) in lateral approach to change of the graft height, and the influence of the type of graft materials to change of the graft height. Patients were divided into three class based on the height of the grafted sinus floor relative to the implant apex and evaluated the proportion change of that class (Class I, in which the grafted sinus floor was above the implant apex; Class II, in which the implant apex was level with the grafted sinus floor; and Class III, in which the grafted sinus floor was below the implant apex). And it was evaluated th bone remodeling in sinus during 12 months using SGRl(by $Br\ddot{a}gger$ et al). The result was like that; Sinus graft height decreased significantly in both lateral approach and crestal approach in first 12 months (p$MBCP^{TM}$ had minimum height loss. Class III and Class II was increased by time in both lateral and crestal approach and Class I was decreased by time. SGRI was increased statistically significantly from baseline to 3 months and 3 months(p<0.05) to 12 months(p$ICB^{(R)}$ single use, more reduction of sinusgraft height was appeared. Therefore we speculated that the mixture of graft materials is preferable as a reduction of graft materials. Increasing of the SGRI as time goes by explains the stability of implant, but additional histologic or computed tomographic study will be needed for accurate conclusion. From the radiographic evaluation, we come to know that placement of dental implant with sinus floor elevation is an effective procedure in atrophic maxillary reconstruction.

Deviations of Implant Position between Pre- and Post-operation in Computer-guided Template-based Implant Placement (Computer-guided template를 이용한 임플란트 식립에서 술 전과 술 후 사이의 임플란트 위치에 따른 변위량 검사)

  • Kim, Won;Kim, Seung-Mi;Kim, Hyo-Jung;Song, Eun-Young;Lee, Si-Ho;Oh, Nam-Sik
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.2
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    • pp.175-184
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    • 2011
  • With a development of implant restoration technique, there are increasing use of computer-guided system for edentulous patients. It was carried out simulated operation based on CT information about patient's bone quantity, quality and anatomical landmark. However, there are some difference between the programmed implant and post-operative implant about it's position. If the deviation was severe, it could happen a failure of 'passive fit' and not suited for path of implant restoration. The aim of this presentation is to evaluate about a degree of deviations between programmed implant and post-operative implant. Five patients treated by 'NobelGuide' system (Nobel Biocare AB, G$\ddot{o}$teborg, Sweden) in Department of Prosthodontics, Inha University were included in this study. The patients were performed CT radiograph taking and intra-oral impression taking at pre-operation. Based on CT images and study model, surgical stent was produced by NobelBiocareTM. To fabricated a pre-operative study model, after connected lab analog to surgical template, accomplished a pre-operative model using type 4 dental stone. At final impression, a post-operative study model was fabricated in the conventional procedures. Each study model was performed CT radiograph taking. Based on CT images, each implant was simulated in three dimensional position using $Procera^{(R)}$ software (Procera Software Clinical Design Premium, version 1.5; Nobel Biocare AB). In 3D simulated model, length and angulation between each implant of both pre- and post-operative implants were measured and recorded about linear and angular deviation between pre-and post-operative implants. A total of 24 implants were included in this study and 58 inter-implant sites between each implant were measured about linear and angular deviations. In the linear deviation a mean deviation of 0.41 mm (range 0~1.7 mm) was reported. In the angular deviation, a mean deviation was $1.99^{\circ}$ (range $0^{\circ}{\sim}6.7^{\circ}$). It appears that the both linear and angular mean deviation value were well acceptable to application of computer-guided implant system.

Socio-medical Study on Gonorrhoea with Special References of Prevalence, PPNG and Antibiotic Resistance (임질환자(淋疾患者)에 관(關)한 사회의학적(社會醫學的) 연구(硏究) -유병률(有病率), PPNG 및 항균제내성(抗菌劑耐性)을 중심(中心)으로-)

  • Lee, Seong-Ho;Hwang, In-Dam;Park, Young-Soo;Koh, Dai-Ha
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.41-50
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    • 1983
  • The incidence of sexually transmitted disease, especially gonorrhoea has risen despite the progress in its diagnosis and treatment. For the effective control programs of sexually transmitted disease, it should be required socio-medical approaches. A study on gonorrhoea and penicillinase-producing Neisseria gonorrhoeae(PPNG) was conducted in Jeonju and Kunsan area from March, 1982 through August, 1982. The 221 entertrainers were studied in order to determine the prevalences of gonorhoea and PPNG. Socio-demographic informations of the entertainers were obtained by interviewing them. Gonococci were cultured on Thayer-Martin enrichment media for isolation, and PPNG was confirmed using beta-lactamase reagent ($PADAC^{tm}$ Beta-Lactamase Test Strips, Galbiochem-Behring). The results of the study are summarized as follows; 1. The average age of the entertainers studied was $26.1{\pm}4.7$ years. 2. The average years of working in entertaining business was $2.4{\pm}1.4$ years, and the average income per month was $239,592{\pm}90,480$ won. On the education level, 70.6% of the entertainers were middle or high school graduates 3. 47.5% of the entertainers were using contraceptives. 90.5% have experienced artificial abortion. 4. 37(16.7%) out of 221 entertainers were revealed to gonorrhoea, and 13 (35.1%) of gonorrhoea patients were by PPNG. 5. The prevalence rates of gonorrhoea and the proportion of PPNG by age were not significant statistically. Meanwhile, the colelations between the rates of gonorrhoea and education, frequency of love-making with customers and type of sexual partner were highly significant statistically. 6. 37 strains of gonococci isolated were almostly resistant to several antimicrobial agents, especially amikacin, clindamycin and chloramphenicol. Furthermore PPNG strains were completely resistant to not only above drugs but also penicillin.

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Effect of cavity shape, bond quality and volume on dentin bond strength (와동의 형태, 접착층의 성숙도, 및 와동의 부피가 상아질 접착력에 미치는 영향)

  • Lee, Hyo-Jin;Kim, Jong-Soon;Lee, Shin-Jae;Lim, Bum-Soon;Baek, Seung-Ho;Cho, Byeong-Hoon
    • Restorative Dentistry and Endodontics
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    • v.30 no.6
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    • pp.450-460
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    • 2005
  • The aim of this study was to evaluate the effect of cavity shape, bond quality of bonding agent and volume of resin composite on shrinkage stress developed at the cavity floor. This was done by measuring the shear bond strength with respect to iris materials (cavity shape , adhesive-coated dentin as a high C-factor and Teflon-coated metal as a low C-factor), bonding agents (bond quality: $Scotchbond^{TM}$ Multi-purpose and Xeno III) and iris hole diameters (volume; 1mm or 3mm in $diameter{\times}1.5mm$ in thickness). Ninety-six molars were randomly divided into 8 groups ($2{\times}2{\times}2$ experimental setup). In order to simulate a Class I cavity, shear bond strength was measured on the flat occlusal dentin surface with irises. The iris hole was filled with Z250 restorative resin composite in a bulk-filling manner. The data was analyzed using three-way ANOVA and the Tukey test. Fracture mode analysis was also done When the cavity had high C-factor, good bond quality and large volume, the bond strength decreased significantly The volume of resin composite restricted within the well-bonded cavity walls is also be suggested to be included in the concept of C-factor, as well as the cavity shape and bond quality. Since the bond quality and volume can exaggerate the effect of cavity shape on the shrinkage stress developed at the resin-dentin bond, resin composites must be filled in a method, which minimizes the volume that can increase the C-factor.

EFFICIENCY OF DENTIN CUTTING AND ROOT -END RETROCAVITY PREPARATION USING ULTRASONIC DIAMOND INSTRUMENTS AND THEIR INFLUENCE ON TOOTH STRUCTURE (초음파 다이아몬드 기구의 상아질 삭제 효과, 치근단 역충전 와동 형성효율 및 치질에의 영향)

  • Lim, Choon-Hee;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.23 no.1
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    • pp.54-67
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    • 1998
  • The purposes of this study were to evaluate the efficiency of dentin cutting and root-end cavity preparation, and to determine the incidence of tooth crack when root-end retrograde cavity preparation was done with. ultrasonic diamond instruments. To evaluate the efficiency of dentin cutting, ultrasonic diamond and stainless steel instruments were applied to 20 exposed bovine dentin surfaces perpendicularly or parallely at the low, and medium power settings for 1 minute ($Miniendo^{TM}$, EIE, CA, U.S.A.). The resultant cavity depth was measured. To evaluate the efficiency of cavity preparation and to investigate the incidence of tooth crack, 165 mesiobuccal, distobuccal and palatal root-ends of extracted human maxillary first molars were resected by 3 mm perpendicularly to the long axis of tooth using a slow speed diamond saw after root canal preparation and filling. Retrocavities were prepared using a ultrasonic diamond instrument or a stainless steel one of the low- or medium power settings of 2 or 6. Time consumed and the number of strokes used for the cavity preparation were measured and the incidence of tooth cracks was evaluated under a stereomicroscope. The results were as follows: Both at the low and medium power settings, and both with perpendicularly- and parallely applied tips to dentin, diamond instruments showed higher dentin cutting efficiency than stainless steel ones did (p<0.01). When tips were applied to dentin perpendicularly, both diamond instrument and stainless steel one showed higher cutting efficiency with medium power setting than with low power one (p<0.01). Both at the low- and medium power settings, both diamond instrument and stainless steel one showed higher cutting efficiency when tips were applied perpendicularly to dentin surface than applied parallely (p<0.01). At the medium power setting, the number of stroke and time consumed were less with diamond instrument than with stainless steel one (p<0.05) for the retrograde cavity preparation. At the low power setting, diamond instrument induced less tooth cracks than stainless steel one did (p<0.01).

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Usability Assessment of Plan Transfer between TOMO HAD and Radixact : Planning Study (TOMO HDA와 Radixact 치료 계획 간 Transfer에 대한 유용성 평가 : Planning Study)

  • An, Ye Chan;Kim, Jong Sik;Kwon, Dong Yeol;Kim, Jin Man;Choi, Byeong Ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.117-128
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    • 2018
  • Purpose : To evaluate the usability of plan transfer between TOMO HD and Radixact, we compared the differences of dose in transferred plans by evaluating the dose of normal organ and target. TOMO HDA and Radixact. The completed plans were transferred each other and we compared the differences of dose by evaluating the DVH of each plans. Materials and Methods : We planned 4 different plans assuming the treatment of 2 cases in Head and Neck Cancer and 2 cases Prostate cancer. Each plan was designed so that 95 % of the prescription dose was irradiated over 99 % of the target volume, and the normal organ constraints dose was based on the SMC tolerance dose protocol. Each plan was transferred to each equipment and DVH(dose volume histogram) analysis of the transferred plans was compared and evaluated. Results : The Mean dose of CTV and GTV was increased and decreased in the transferred plans, but there was no significant differences. The target coverage of CTV and GTV was decreased in all cases of transferred plans from TOMO HAD to Radixact, and the change of CI and HI in CTV was within 0.1. Normal organ dose was increased in most cases when transferring from HAD to Radixact in both treatment plans. Conclusion : According to the results of this experiment, the target coverage was above the standard and the normal organ dose was almost same or decreased when transferring the plans from Radixact to HDA equipment. However the target coverage was reduced when transferring the plans from HDA to Radixact and there was an increase in dose in normal organs that could cause sever side effects such as Optic Chiasm ($D_{max}$1.38 Gy), Bladder ($D_{max}$3.07 Gy), Penile Bulb ($D_{max}$1.14 Gy). Therefore, it is necessary to pay attention to the dose change when transferring the plan and one-time transfer due to equipment inspection will be useful for efficient radiation therapy, but if the transferred treatment plans continue for several consecutive days, the treatment plan should be resumed.

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Numerical Analysis of Pile Foundation Considering the Thawing and Freezing Effects (융해-동결작용을 고려한 말뚝 기초에 관한 수치해석 연구)

  • Park, Woo-Jin ;Park, Dong-Su;Shin, Mun-Beom;Seo, Young-Kyo
    • Journal of the Korean Geotechnical Society
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    • v.39 no.5
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    • pp.51-63
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    • 2023
  • Numerical analysis was conducted to determine the effect of soil behavior by thawing and freezing of seasonal frozen soil on pile foundations. The analysis was performed using the finite element method (FEM) to simulate soil-pile interaction based on the atmosphere temperature change. Thermomechanical coupled modeling using FEM was applied with the temperature-dependent nonlinear properties of the frozen soil. The analysis model cases were applied to the MCR and HDP models to simulate the elastoplastic behavior of soil. The numerical analysis results were analyzed and compared with various conditions having different length and width sizes of the pile. The results of the numerical analysis showed t hat t he HDP model was relat ively passive, and t he aspect and magnit ude of t he bearing capacit y and displacement of the pile head were similar depending on the length and width of the pile conditions. The vertical displacement of the pile head by thawing and freezing of the ground showed a large variation in displacement for shorter length conditions. In the MCR model, the vertical displacement appeared in the maximum thaw settlement and frost heaving of 0.0387 and 0.0277 m, respectively. In the HDP model, the vertical displacement appeared in the maximum thaw settlement and frost heaving of 0.0367 and 0.0264 m, respectively. The results of the pile bearing capacity for the two elastoplastic models showed a larger difference in the width condition than the length condition of the pile, with a maximum of about 14.7% for the width L condition, a maximum of about 5.4% for M condition, and a maximum of about 5.3% for S condition. The significance of the effect on the displacement of the pile head and the bearing capacity depended on the pile-soil contact area, and the difference depended on the presence or absence of an active layer in the soil and its thickness.

The evaluation of contralateral breast's dose and shielding efficiency by breast size about breast implant patient for radiation therapy (인공 유방 확대술을 받은 환자의 유방암 치료 시 크기에 따른 반대 측 유방의 피폭 선량 및 차폐 효율 평가)

  • Kim, Jong Wook;Woo, Heon;Jeong, Hyeon Hak;Kim, Kyeong Ah;Kim, Chan Yong;Yoo, Suk Hyun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.329-336
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    • 2014
  • Purpose : To evaluate the dose on a contralateral breast and the usefulness of shielding according to the distance between the contralateral breast and the side of the beam by breast size when patients who got breast implant receive radiation therapy. Materials and Methods : We equipped 200 cc, 300 cc, 400 cc, and 500 cc breast model on the human phantom (Rando-phantom), acquired CT images (philips 16channel, Netherlands) and established the radiation treatment plan, 180 cGy per day on the left breast (EclipseTM ver10.0.42, Varian Medical Systems, USA) by size. We set up each points, A, B, C, and D on the right(contralateral) breast model for measurement by size and by the distance from the beam and attached MOSFET at each points. The 6 MV, 10 MV and 15 MV X-ray were irradiated to the left(target) breast model and we measured exposure dose of contralateral breast model using MOSFET. Also, at the same condition, we acquired the dose value after shielding using only Pb 2 mm and bolus 3 mm under the Pb 2 mm together. Results : As the breast model is bigger from 200 cc to 500 cc, The surface of the contralateral breast is closer to the beam. As a result, from 200 cc to 500 cc, on 180 cGy basis, the measurement value of the scattered ray inclined by 3.22 ~ 4.17% at A point, 4.06 ~ 6.22% at B point, 0.4~0.5% at C point, and was under 0.4% at D point. As the X-ray energy is higher, from 6 MV to 15 MV, on 180 cGy basis, the measurement value of the scattered ray inclined by 4.06~5% at A point, 2.85~4.94% at B point, 0.74~1.65% at C point, and was under 0.4% at D point. As using Pb 2 mm for shield, scattered ray declined by average 9.74% at A and B point, 2.8% at C point, and is under 1% at D point. As using Pb 2 mm and bolus together for shield, scattered ray declined by average 9.76% at A and B point, 2.2% at C point, and is under 1% at D point. Conclusion : Commonly, in case of patients who got breast implant, there is a distance difference by breast size between the contralateral breast and the side of beam. As the distance is closer to the beam, the scattered ray inclined. At the same size of the breast, as the X-ray energy is higher, the exposure dose by scattered ray tends to incline. As a result, as low as possible energy wihtin the plan dose is good for reducing the exposure dose.

A Refined Method for Quantification of Myocardial Blood Flow using N-13 Ammonia and Dynamic PET (N-13 암모니아와 양전자방출단층촬영 동적영상을 이용하여 심근혈류량을 정량화하는 새로운 방법 개발에 관한 연구)

  • Kim, Joon-Young;Lee, Kyung-Han;Kim, Sang-Eun;Choe, Yearn-Seong;Ju, Hee-Kyung;Kim, Yong-Jin;Kim, Byung-Tae;Choi, Yong
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.73-82
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    • 1997
  • Regional myocardial blood flow (rMBF) can be noninvasively quantified using N-13 ammonia and dynamic positron emission tomography (PET). The quantitative accuracy of the rMBF values, however, is affected by the distortion of myocardial PET images caused by finite PET image resolution and cardiac motion. Although different methods have been developed to correct the distortion typically classified as partial volume effect and spillover, the methods are too complex to employ in a routine clinical environment. We have developed a refined method incorporating a geometric model of the volume representation of a region-of-interest (ROI) into the two-compartment N-13 ammonia model. In the refined model, partial volume effect and spillover are conveniently corrected by an additional parameter in the mathematical model. To examine the accuracy of this approach, studies were performed in 9 coronary artery disease patients. Dynamic transaxial images (16 frames) were acquired with a GE $Advance^{TM}$ PET scanner simultaneous with intravenous injection of 20 mCi N-13 ammonia. rMBF was examined at rest and during pharmacologically (dipyridamole) induced coronary hyperemia. Three sectorial myocardium (septum, anterior wall and lateral wall) and blood pool time-activity curves were generated using dynamic images from manually drawn ROIs. The accuracy of rMBF values estimated by the refined method was examined by comparing to the values estimated using the conventional two-compartment model without partial volume effect correction rMBF values obtained by the refined method linearly correlated with rMBF values obtained by the conventional method (108 myocardial segments, correlation coefficient (r)=0.88). Additionally, underestimated rMBF values by the conventional method due to partial volume effect were corrected by theoretically predicted amount in the refined method (slope(m)=1.57). Spillover fraction estimated by the two methods agreed well (r=1.00, m=0.98). In conclusion, accurate rMBF values can be efficiently quantified by the refined method incorporating myocardium geometric information into the two-compartment model using N-13 ammonia and PET.

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A THREE-DIMENSIONAL FEM COMPARISON STUDY ABOUT THE FORCE, DISPLACEMENT AND INITIAL STRESS DISTRIBUTION ON THE MAXILLARY FIRST MOLARS BY THE APPLICATION OF VAR10US ASYMMETRIC HEAD-GEAR (비대칭 헤드기어의 적용시 상악제 1 대구치에 나타나는힘과 변위 및 초기 응력분포에 관한 3차원 유한요소법적 연구)

  • Kim, Jong-Soo;Cha, Dyung-Suk;Ju, Jin-Won;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.31 no.1 s.84
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    • pp.25-38
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    • 2001
  • The purpose of this study was to compare the force, the displacement and the stress distribution on the maxillary first molars altered by the application of various asymmetric head-gear. For this study, the finite element models of unilateral Cl II maxillary dental arch was made. Also, the finite element models of asymmetric face-bow was made. Three types of asymmetric face-bow were made : each of the right side 15mm, 25mm and 35mm shorter than the left side. We compared the forces, the displacement and the distribution of stress that were generated by application of various asymmetric head-gear, The results were as follows. 1. The total forces that both maxillary first molars received were similar in all groups. But the forces that mesially positioned tooth received were increased as the length of the outer-bow shortened, and the forces that normally positioned tooth received were decreased as the length of the outer-bow shortened. 2. In lateral force comparison, the buccal forces that normally positioned tooth received were increased as the length of the outer-bow shortened, and the buccal fortes that mesially positioned tooth received were decreased as the length of the outer-bow shortened. Though the net lateral force moved to the buccal side of normally positioned tooth as the length of the outer-bow shortened, both maxillary first molars received the buccal force. That showed 'Avchiai Expansion Effect' 3. The distal forces, the extrusion forces and the magnitudes of the crown distal tipping that mesially positioned tooth received were increased as the length of the outer-bow shortened, and the forces that normally positioned tooth received were decreased as the length of the outer-bow was shortened. 4. The magnitude of the distal-in rotation that normally positioned tooth received were increased as the length of the outer-bow was shortened. But, mesially positioned tooth show two different results. For the outer-bow 15mm shortened, mesially positioned tooth showed the distal-in rotation, hut for the outer-bow 25mm and 35mn shortened, mesially positioned tooth showed the distal-out rotation. Thus, the turning point exists between 15mm and 25mm. 5. This study of the initial stress distribution of the periodontal ligament at slightly inferior of the furcation area revealed that the compressive stress in the distobuccal root of the normally positioned tooth moved from the palatal side to the distal side and the buccal side successively as the length of the outer-bow shortened. 6. This study of the initial stress distribution of the periodontal ligament at slightly inferior of the furcation area revealed that the magnitudes of stress were altered but the total stress distributions were not altered in the mesiobuccal root and the palatal root of normally positioned tooth, and also three roots of mesially positioned tooth as the length of the outer-bow shortened.

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