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Analysis of the Mandibular Movements in Patients with Internal Derangement of the Temporomandibular Joint According to Diagnostic Subgroups (측두하악관절내장 환자의 진단분류에 따른 하악운동 특성의 분석)

  • 김병연;기우천;최재갑
    • Journal of Oral Medicine and Pain
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    • v.23 no.1
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    • pp.21-36
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    • 1998
  • The purpose of this study was analyse the mandibular movements in patients with internal derangement of the temporomandibular joint according to diagnostic subgroups. The author classified patients with internal derangement of the temporomandibular joint into 4 diagnostic subgroups by means of the magnet resonance imagings, and evaluated the clinical signs and the mandibular movements with Mandibular Kinesiograph(MKG) in each subgroups. The mandibular movements, measured in this study, were the types of movement in frontal and sagittal plane, velocities in opening and closing movement, and the opening and closing movement, and the opening and closing velocity pattern. The data were compared between the 5 groups including the normal group. The results were as follows : 1. Pain was more frequently observed in the anterior disc displacement without reduction group than in the anterior disc displacement with reduction group. Sound of joint was more frequently observed in the anterior disc displacement with reduction group, and limitation of mandibular opening movement was more frequently observed in the anterior disc displacement without reduction group. Duration of the anterior disc displacement without reduction group was significantly short compared to that of the anterior disc displacement with reduction group, and duration of the unilateral anterior disc displacement without reduction group was shortest in the experimental group. The frequency of Angle's classifications had not significant correlations between the experimental groups. 2. Active and passive range of the opening movement, maximum protrusive movement, maximum lateral movement toward left side were significantly decreased in the experimental groups compared to the control group, but there was no significant difference in the range of the maximum lateral movement toward right side between the control and experiment groups. In unilateral anterior disc displacement without reduction group, the range of maximum lateral movement toward unaffected side was no significant difference in the range of the maximum lateral movement between toward affected side and toward unaffected side. 3. Maximum opening velocity, maximum closing velocity, average opening velocity, average closing velocity and maximum velocity of terminal tooth contact were significantly decreased in the experimental groups compared to control group. There was no significant difference in maximum opening velocity and maximum velocity of Terminal tooth contact between the subgroups of the experimental group each other, but there was significant difference in maximum closing velocity, average opening velocity and average closing velocity between the subgroups each other. 4. In the frontal plane of the MKG, the frequency of complex deviation type(F-2)pattern was significantly increased in the anterior disc displacement with out reduction group compared to the anterior disc displacement with reduction group and the control group. In the sagittal plane, the frequency of coincident type(S-1)was decreased in the same group. 5. In the maximum opening velocity pattern, the frequency of no-peak type (OV-3)in the unilateral anterior disc displacement with reduction group was significantly increased compared to the control group. The frequency of 1-peak type (OV-1) and 2-peak type (OV-2) was decreased in the anterior disc displacement with out reduction group, but the frequency of no-peak type (OV-3)was increased in the same group. In the maximum closing velocity pattern, the frequency of no-peak type (CV-3) was significantly increased in the anterior disc displacement without reduction group. Compared to the anterior disc displacement with reduction group and the control group. The frequency of 1-peak type (CV-1) and 2-peak type (CV-2) in the anterior disc displacement with reduction group was decreased than that in the control group.

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THE EFFECT OF CYCLIC LOADING ON THE RETENTIVE STRENGTH OF FULL VENEER CROWNS (반복 하중이 Full veneer crown의 유지력에 미치는 영향에 관한 연구)

  • Kim, Ki-Youn;Lee, Sun-Hyung;Chung, Hun-Young;Yang, Jae-Ho;Heo, Seong-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.38 no.5
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    • pp.583-594
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    • 2000
  • Dislodgement of a crown or extension bridge and the loosening of a retainer of a bridge is a serious clinical problem in fixed restoration. Generally these problems are considered to be associated with deformation of the restoration. During biting, the restoration is subjected to complex forces and deforms considerably within the limit of its elasticity. Deformation of the restoration under the occlusal force induces excessive stress in the cement film, which then leads to the cement fracture. Such a fracture may eventually cause loss of the restoration. Because most of the past retention tests for full veneer crown were done without fatigue loading, they were not exactly simulating intraoral environment. And the purpose of this study was to evaluate the effect of cyclic cantilever loading on the retentive strength of full veneer crowns depending on different type of cements and taper of prepared abutment. Steel dies with $8^{\circ}\;or\;16^{\circ}$ convergence angle were fabricated through milling and crowns with the same method. These dies and crowns were divided into 8 groups. Group 1 : $16^{\circ}$ taper die, cementation with zinc phosphate cement, without loading Group 2 : $16^{\circ}$ taper die, cementation with zinc phosphate cement, with loading Group 3 : $8^{\circ}$ taper die, cementation with zinc phosphate cement, without loading Group 4 : $8^{\circ}$ taper die, cementation with zinc phosphate cement, with loading Group 5 : $16^{\circ}$ taper die, cementation with Panavia 21, without loading Group 6 : $16^{\circ}$ taper die, cementation with Panavia 21, with loading Group 7 : $8^{\circ}$ taper die, cementation with Panavia 21 without loading Group 8 : $8^{\circ}$ taper die, cementation with Panavia 21, with loading After checking the fit of die and crown, the luting surface of dies and inner surface of crowns were air-abraded for 10 seconds. The crowns were cemented to the dies, with cements mixed according to the manufacturer's recommendations. A static load of 5kg was then applied for 10 minutes with static loading device. Twenty-four hours later, group 1, 3, 5, 7 were only thermocycled, group 2, 4, 6, 8 were subjected to cyclic loading after thermocycling. Retentive tests were performed on the Instron machine. From the finding of this study, the following conclusions were obtained 1. Panavia 21 showed significantly higher retentive strength than zinc phosphate cement for all groups (p<0.05). 2. There was a significant difference in the retentive strength between $8^{\circ}\;and\;16^{\circ}$ taper for zinc phosphate cement(p<0.05), but no significant difference for Panavia 21 (p>0.05). 3. Cyclic loading significantly decreased the retentive strength for all groups(p<0.05). 4. For zinc phosphate cement, there was 35% reduction of the retentive strength after loading in the $16^{\circ}$ taper die, 25% in the $8^{\circ}$ taper die, and for Panavia 21, 21% in the $16^{\circ}$ taper die, 18% in the $8^{\circ}$ taper die.

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Flexural strength of various kinds of the resin bridges fabricated with 3D printing (3D 프린팅으로 제작된 여러 종류의 레진브릿지의 굴곡강도에 대한 연구)

  • Park, Sang-Mo;Kim, Seong-Kyun;Park, Ji-Man;Kim, Jang-Hyun;Jeon, Yoon-Tae;Koak, Jai-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.4
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    • pp.260-268
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    • 2017
  • Purpose: Manufacturing with AM (Additive manufacturing) technique has many advantages; but, due to insufficient study in the area, it is not being widely used in the general clinic. In this study, differences of flexural strength among various materials of 3 unit fixed dental prosthesis were analyzed. Materials and Methods: A metal jig for specimens that had a 3-unit-fixed dental prosthesis figure were fabricated. The jigs were made appropriately to the specifications of the specimens. Three different kinds of materials of specimens which were NC (mathacrylic esther based), DP-1 (Bisphenol A epoxy acrylate type oligomer based), and DT-1 (urethane acrylate based) were printed with DLP machine. Five specimens for each kind of material were printed with an angle of $30^{\circ}$ from the horizontal surface. The specimens were placed on the jig and the flexural strength was measured and recorded using Universal testing machine. The recorded data was analyzed in SPSS using One-way ANOVA and Tukey HSD to determine the significance of the differences of flexural strength among the groups. Results: The flexural strengths of each group were the followings: NC, $1119{\pm}305$ N; DP-1, $619{\pm}150$ N; DT-1, $413{\pm}65N$. Using One-way ANOVA and Tukey Honestly Significant Difference test, significant difference was found between NC and the other groups (P < 0.05), but there was no significant difference between DP-1 and DT-1 (P > 0.05). Conclusion: Higher flexural strength was shown in 3-unit-fixed dental prosthesis that were 3D printed using a DLP machine with NC material.

A study on sagittal root position of maxillary anterior teeth in Korean (한국인에서 상악 전치의 시상 치근 위치에 대한 연구)

  • Kong, Hyun-Jun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.2
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    • pp.88-94
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    • 2020
  • Purpose: The purpose of this study was to analyze the sagittal root position of maxillary anterior teeth and report the frequency of each classification in Korean for immediate implant placement. Materials and Methods: A retrospective review of cone-beam computed tomography (cone-beam CT) images was conducted on 120 patients (60 male and 60 female) who fulfilled the inclusion criteria. After reorientation of the axis, cone-beam CT images were evaluated and the relationship of the sagittal root position (SRP) of the maxillary anterior teeth to its associated osseous housing was recorded. Class I, II, and III were classified respectively when the root was positioned on the labial, central, and palatal aspect of the alveolar bone. Class IV was the position that at least two thirds of the root is engaging both the labial and palatal cortical plates. Then, the angulation of the root axis and the alveolar bone axis was measured. Descriptive statistics and Kruskal-Wallis test were used to compare the angulation according to the root position and SRP class. Results: The frequency distribution of sagittal root position of maxillary anterior teeth indicated that 81.1%, 10.3%, 1.9%, and 6.7% were classified as Class I, II, III, and IV, respectively. The sagittal angulation at approximately 77.5% of central incisor, lateral incisor, and canine was < 20 degrees, but the angle at more than 42.7% of canine was ≥ 20 degrees. Within the class, the angulation was statistically significantly greater in Class I (16.19) compared to Class II (8.72) and Class III (9.93), and smaller in Class IV (3.79). Conclusion: Within the limitation of this study, a majority of the maxillary anterior roots were positioned close to the buccal cortical plate. However, some roots have very thin alveolar bone and sagittal angulation larger than 30 degrees. Therefore, cone-beam CT analyses of the sagittal root position and the sagittal angulation are recommended for the selection of the appropriate dental implant treatment approach.

Manganese and Iron Interaction: a Mechanism of Manganese-Induced Parkinsonism

  • Zheng, Wei
    • Proceedings of the Korea Environmental Mutagen Society Conference
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    • 2003.10a
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    • pp.34-63
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    • 2003
  • Occupational and environmental exposure to manganese continue to represent a realistic public health problem in both developed and developing countries. Increased utility of MMT as a replacement for lead in gasoline creates a new source of environmental exposure to manganese. It is, therefore, imperative that further attention be directed at molecular neurotoxicology of manganese. A Need for a more complete understanding of manganese functions both in health and disease, and for a better defined role of manganese in iron metabolism is well substantiated. The in-depth studies in this area should provide novel information on the potential public health risk associated with manganese exposure. It will also explore novel mechanism(s) of manganese-induced neurotoxicity from the angle of Mn-Fe interaction at both systemic and cellular levels. More importantly, the result of these studies will offer clues to the etiology of IPD and its associated abnormal iron and energy metabolism. To achieve these goals, however, a number of outstanding questions remain to be resolved. First, one must understand what species of manganese in the biological matrices plays critical role in the induction of neurotoxicity, Mn(II) or Mn(III)? In our own studies with aconitase, Cpx-I, and Cpx-II, manganese was added to the buffers as the divalent salt, i.e., $MnCl_2$. While it is quite reasonable to suggest that the effect on aconitase and/or Cpx-I activites was associated with the divalent species of manganese, the experimental design does not preclude the possibility that a manganese species of higher oxidation state, such as Mn(III), is required for the induction of these effects. The ionic radius of Mn(III) is 65 ppm, which is similar to the ionic size to Fe(III) (65 ppm at the high spin state) in aconitase (Nieboer and Fletcher, 1996; Sneed et al., 1953). Thus it is plausible that the higher oxidation state of manganese optimally fits into the geometric space of aconitase, serving as the active species in this enzymatic reaction. In the current literature, most of the studies on manganese toxicity have used Mn(II) as $MnCl_2$ rather than Mn(III). The obvious advantage of Mn(II) is its good water solubility, which allows effortless preparation in either in vivo or in vitro investigation, whereas almost all of the Mn(III) salt products on the comparison between two valent manganese species nearly infeasible. Thus a more intimate collaboration with physiochemists to develop a better way to study Mn(III) species in biological matrices is pressingly needed. Second, In spite of the special affinity of manganese for mitochondria and its similar chemical properties to iron, there is a sound reason to postulate that manganese may act as an iron surrogate in certain iron-requiring enzymes. It is, therefore, imperative to design the physiochemical studies to determine whether manganese can indeed exchange with iron in proteins, and to understand how manganese interacts with tertiary structure of proteins. The studies on binding properties (such as affinity constant, dissociation parameter, etc.) of manganese and iron to key enzymes associated with iron and energy regulation would add additional information to our knowledge of Mn-Fe neurotoxicity. Third, manganese exposure, either in vivo or in vitro, promotes cellular overload of iron. It is still unclear, however, how exactly manganese interacts with cellular iron regulatory processes and what is the mechanism underlying this cellular iron overload. As discussed above, the binding of IRP-I to TfR mRNA leads to the expression of TfR, thereby increasing cellular iron uptake. The sequence encoding TfR mRNA, in particular IRE fragments, has been well-documented in literature. It is therefore possible to use molecular technique to elaborate whether manganese cytotoxicity influences the mRNA expression of iron regulatory proteins and how manganese exposure alters the binding activity of IPRs to TfR mRNA. Finally, the current manganese investigation has largely focused on the issues ranging from disposition/toxicity study to the characterization of clinical symptoms. Much less has been done regarding the risk assessment of environmenta/occupational exposure. One of the unsolved, pressing puzzles is the lack of reliable biomarker(s) for manganese-induced neurologic lesions in long-term, low-level exposure situation. Lack of such a diagnostic means renders it impossible to assess the human health risk and long-term social impact associated with potentially elevated manganese in environment. The biochemical interaction between manganese and iron, particularly the ensuing subtle changes of certain relevant proteins, provides the opportunity to identify and develop such a specific biomarker for manganese-induced neuronal damage. By learning the molecular mechanism of cytotoxicity, one will be able to find a better way for prediction and treatment of manganese-initiated neurodegenerative diseases.

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A study on the perimandibular tissues before and after orthodontic treatment with orthognathic surgery in mandandibular prognathic patients (하악골 전돌자의 악교정 수술을 동반한 교정치료 전후 하악골 주위조직의 변화에 관한 연구)

  • Yang, Byung-Ho;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.30 no.2 s.79
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    • pp.261-272
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    • 2000
  • Severe skeletal anteroposterior and vertical discrepancy is difficult to obtain satisfactory result by only orthodontic treatment, and much anteroposterior movement and treatment stability require orthodontic treatment with orthognathic surgery. The treatment goal of mandibular prognathic patients is to promote the function of stomatognathic system including mastication and phonetics, to improve the esthetics of facial profile and to maintain stability. Positional changes of hyoid bone, pharynx and tongue were seen with mandibular movement after orthognathic surgery. This study was performed to observe the changes of perimandibular tissues of orthodontic patients with skeletal mandibular prognathism who treated with orthodontic treatment, and the changes of hyoid bone, pharyx and tongue by relapse or recurrance after before and after orthognathic surgery and retention. The 22 patients who had mandibular prognathism were selected. They treated with orthodontic treatment with sagittal split ramus osteotomy as orthognathic surgery. And lateral cephalometric radiographs were taken 3 times : pre-surgery (T1), immediate post-surgery (T2) and 2 years alter retention (T3). The results were as follows : 1. The hyoid bone returned back after clockwise rotation to maxilla and occlusal plane during retention (P<0.01). 2. The hyoid bone moved posterior-inferiorly by mandibular surgery and returned back anterior-superior after retention. (P<0.01) 3. The changes of pharyngeal depth showed a little decrease at upper area in post- surgery, but it was not a significant difference generally through before, after and retention. 4. In relating to tongue base, the angle of tongue base was decreased and the dorsal area of tongue base moved to inferior-posterior direction and to superior direction again after retention (P<0.01). 5. Related to the thickness of upper and lower lip, the thickness of upper lip decreased after surgery, and the soft tissues below lower lip increased after surgery and decreased after retention.

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Evaluation of friction of ceramic brackets in various bracket-wire combinations (브라켓 각도 변화에 따른 세라믹 브라켓의 마찰력 측정)

  • Cha, Jung-Yul;Kim, Kyung-Suk;Kim, Dong-Choon;Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.36 no.2 s.115
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    • pp.125-135
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    • 2006
  • The purpose of this study was to measure and compare the level of frictional resistance generated from three currently used ceramic brackets; 1, Crystaline $V^{(R)}$, Tomy International Inc., Tokyo, Japan; 2, $Clarity^{(R)}$, 3M Unitek, Monrovia, CA, USA; 3, $Inspire^{(R)}$, Ormco, Orange, CA, USA; with composite resin brackets, Spirit, Ormco, Orange, CA, USA; and conventional stainless steel brackets, Kosaka, Tomy International Inc., Tokyo, Japan used as controls. In this experiment, the resistance to sliding was studied as a function of four angulations $(0^{\circ},\;5^{\circ},\;10^{\circ}\;and\;15^{\circ})$ using 2 different orthodontic wire alloys: stainless steel (stainless steel, SDS Ormco, Orange, CA, USA), and beta-titanium (TMA, SDS Ormco, Orange, CA, USA). After mounting the 22 mil brackets to the fixture and $.019{\times}.025$ wires ligated with elastic ligatures, the arch wires were slid through the brackets at 5mm/min in the dry state at $34^{\circ}C$. Silica-insert ceramic brackets generated a significantly lower frictional force than did other ceramic brackets, similar to that of stainless steel brackets. Beta-titanium archwires had higher frictional resistance than did stainless steel, and all the brackets showed higher static and kinetic frictional force as the angulation increased. When the angulation exceeded $5^{\circ}$, the active configuration emerged and frictional force quickly increased by 2.5 to 4.5-fold. The order of frictional force of the different wire-bracket couples transposed as the angle increased. The silica-insert ceramic bracket is a valuable alternative to conventional stainless steel brackets for patients with esthetic demands.

The compensatory adaptation of anterior teeth according to the skeletal relation (악골관계에 따른 전치부교합의 보상적 적응에 관한 연구)

  • Oh, Chang-Keun;Yoon, Young-Jooh;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.30 no.2 s.79
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    • pp.175-183
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    • 2000
  • The purpose of this study was to identify the compensatory adaptation of dentoalveolar structure according to the various skeletal relation through the statistical correlation between the anteroposterior, vertical skeletal and dentoalveolar relation. For this study, the sample were consisted of 101 adult subjects (51male and 50 female, mean age; male 23.6 years, female 21.5 years) who had good occlusion with the range of normal overjet and overbite and acceptable Angle's class I molar relationship which had not been related orthodontically The results were as follows : 1. Even though acceptable normal occlusion, the range of measurements which represent anteroposterior, vertical skeletal relation and dentoalveolar relation were very wide. 2. Upper and lower incisor axis were significantly correlated with anteroposterior skeletal relation, which means the mote lingual inclination of upper anterior teeth and the more labial inclination of lower anterior teeth according to the more anterior position of mandible to the maxilla (P<0.01). 3. Upper and 1ower anterior alveolar bone height was statistically correlated with the lower anterior vertical skeletal height. 4. Upper and 1ower alveolar bone height were not correlated with anteroposterior skeletal relation (P>0.05). 5. The correlation between the incisor axis and vertical skeletal was more closely related in upper anterior teeth than the lower anterior teeth. To summarize the above results, even though acceptable normal occlusion, skeletal and dentoalveolar relation was very widely ranged, and there were close relationship between the anteroposterior skeletal relation and the inclination of upper and lower anterior teeth and between the vertical skeletal relation and upper and lower anterior alveolar bone height. These finding can be concluded as compensatory adaptation to the different skeletal relationship.

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Evaluation of Geometric Correspondence of kV X-ray Images, Electric Portal Images and Digitally Reconstructed Radiographic Images (kV X선 영상, 전자조사문 영상, 디지털화재구성 영상 간 기하학적 일치성 평가)

  • Cheong, Kwang-Ho;Kim, Kyoung-Joo;Cho, Byung-Chul;Kang, Sei-Kwon;Juh, Ra-Hyeong;Bae, Hoon-Sik;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.18 no.3
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    • pp.118-125
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    • 2007
  • In this study we estimated a geometric correlation among digitally reconstructed radiographic image (DRRI), kV x-ray image (kVXI) from the On-Board Imager (OBI) and electric portal image (EPI). To verify geometric correspondence of DRRI, kVXI and EPI, specially designed phantom with indexed 6 ball bearings (BBs) were employed. After accurate setup of the phantom on a treatment couch using orthogonal EPIs, we acquired set of orthogonal kVXIs and EPIs then compared the absolute positions of the center of the BBs calculated at each phantom plane for kVXI and EPI respectively. We also checked matching result for obliquely incident beam (gantry angle of $315^{\circ}$) after 2D-2D matching provided by OBI application. A reference EPI obtained after initial setup of the phantom was compared with 10 series of EPIs acquired after each 2D-2D matching. Imaginary setup errors were generated from -5 mm to 5 mm at each couch motion direction. Calculated positions of all center positions of the BBs at three different images were agreed with the actual points within a millimeter and each other. Calculated center positions of the BBs from the reference and obtained EPIs after 2D-2D matching agreed within a millimeter. We could tentatively conclude that the OBI system was mechanically quite reliable for image guided radiation therapy (IGRT) purpose.

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Functional MRI of Visual cortex in the Patients with Occipital Lobe Ischemia (후두엽의 허혈성 뇌졸중 환자에서 시각피질의 기능적 자기공명영상)

  • 이영준;정태섭;윤영수;한승한;조영재;배준호
    • Investigative Magnetic Resonance Imaging
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    • v.3 no.2
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    • pp.173-178
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    • 1999
  • Purpose : To evaluate the usefulness of functional MRI (fMRI) of visual cortex in patients with ischemic infarction in the occipital lobe. Materials and Methods : Four patients with the symptoms and signs of visual cortical ischemia were included. Functional MRI was performed by 2D-FLASH technique with the parameter of 90/56msec TR/TE, $40^{\circ}$ flip angle, $240{\times}240{\;}FOV,{\;}64{\times}128$ matrix number, 8.32 seconds acquisition time, 8mm slice thickness. An axial slice including both visual cortices was selected and alternative activation and resting of the visual cortex was performed using red color photostimulator. all patients undertook visual field test, and vascular abnormality was examined by MRA (n=4) and DSA (n=2). fMRI results were compared with the results of a visual field test, conventional MRI and cerebral angiography. Results : On fMRI, decreased activity of the visual cortex was found in the occipital lobe corresponding to stenosis of the posterior cerebral artery or its branch noted on angiogram. However, 2 of 4 patients showed no abnormal findings on conventional MRI. Visual field defect was noted in 3 patients, one and of whom showed no abnormality on conventional MRI and diffusion-weighted image, but revealed decreased activity in the corresponding visual cortex on fMRI. Conclusion : fMRI may be a sensitive method for detection of the status of decreased blood flow or vascular reserve which other methods can not.

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