• Restorative Dentistry and Endodontics
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• v.29 no.6
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• pp.515-519
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• 2004

Straight access cavity design allows the operator to locate all canals, helps in proper cleaning and shaping, ultimately facilitates the obturation of the canal system. However, change in the fracture strength according to the access cavity designs was not clearly demonstrated yet. The purpose of this study was to determine the influence of different access cavity designs on the fracture strength in endodontically treated mandibular anterior teeth. Recently extracted mandibular anterior teeth that have no caries, cervical abrasion, and fracture were divided into three groups (Group 1 : conventional lingual access cavity, Group 2 : straight access cavity, Group 3 : extended straight access cavity) according to the cavity designs. After conventional endodontic treatment, cavities were filled with resin core material. Compressive loads parallel to the long axis of the teeth were applied at a crosshead speed of 2mm/min until the fracture occurred. The fracture strength analyzed with ANOV A and the Scheffe test at the 95% confidence level. The results of this study were as follows: 1. The mean fracture strength decrease in following sequence Group 1 (4558.90{\;}\pm{\;}77.40{\;}N$), Group 2 ($494.07{\;}\pm{\;}123.98{\;}N) and Group 3 ($267.33{\;}\pm{\;}27.02{\;}N). 2. There was significant difference between Group 3 and other groups (P = 0.00). Considering advantage of direct access to apical third and results of this study, straight access cavity is recommended for access cavity form of the mandibular anterior teeth.

• Restorative Dentistry and Endodontics
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• v.19 no.1
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• pp.231-254
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• 1994

Fracture of cusp, on posterior teeth, especially those carious or restored, is major cause of tooth loss. Inappropriate treatments, such as unnecessarily wide cavity preparations, increase the potential of further trauma and possible fracture of the remaining tooth structures. Fracture potential may be directly related to the stresses exerted upon the tooth during masticatory function. The purpose of this study is to evaluate the fracture resistance of tooth, restored with composite resin inlay. In this study, MOD inlay cavity prepared on maxillary first premolar and restored with composite resin inlay. Three dimensional finite element models with eight nodes isoparametric solid element, developed by serial grinding-photographing technique. These models have various occlusal isthmus and depth of cavity, 1/2, 1/3 and 1/4 of isthmus width and 0.7, 0.85 and 1.0 of depth of cavity. The magnitude of load was 474 N and 172 N as presented to maximal biting force and normal chewing force. These loads applied onto ridges of buccal and lingual cusp. These models analyzed with three dimensional finite element method. The results of this study were as follows : 1. There is no difference of displacement between width of occlusal isthmus and depth of cavity. 2. The stress concentrated at bucco-mesial comer, bucco-disal comer, pulpal line angle and the interface area between internal slopes of cusp and resin inlay. 3. The vector of stress direct to buccal and lingual side from center of cavity, to tooth surface going on to enamel. The magnitude of vector increase from occlusal surface to cervix. 4. The crack of tooth start interface area, between internal slop of buccal cusp and resin inlay. It progresses through buccopulpal line angle to cervix at buccomesial and buccodistal comer. 5. The influence with depth of cavity to fracture of tooth was more than width of isthmus. 6. It would be favorable to make the isthmus width narrower than a third of the intercuspal distance and depth of cavity is below 1 : 0.7.

• Restorative Dentistry and Endodontics
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• v.19 no.2
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• pp.345-371
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• 1994

Restorative procedures can lead to weakening tooth due to reduction and alteraton of tooth structure. It is essential to prevent fractures to conserve tooth. Among the several parameters in cavity designs, cavity isthmus and depth are very important. In this study, MO amalgam cavity was prepared on maxillary first premolar. Three dimensional. finite element models were made by serial photographic method and cavity depth(1.7mm, 2.4mm) and isthmus (11 4, 1/3, 1/2 of intercuspal distance) were varied. linear, eight and six-nodal, isoparametric brick elements were used for the three dimensional finite element model. The periodontal ligament and alveolar bone surrounding the tooth were excluded in these models. Three types model(B, G and R model) were developed. B model was assumed perfect bonding between the restoration and cavity wall. Both compressive and tensile forces were distributed directly to the adjacent regions. G model(Gap Distance: 0.000001mm) was assumed the possibility of play at the interface simulated the lack of real bonding between the amalgam and cavity wall (enamel and dentin). When compression occurred along the interface, the forces were transferred to the adjacent regions. However, tensile forces perpendicular to the interface were excluded. R model was assumed non-connection between the restoration and cavity wall. No force was transferred to the adjacent regions. A load of 500N was applied vertically at the first node from the lingual slope of the buccal cusp tip. This study analysed the displacement, von Mises stress, 1 and 2 direction normal stress and strain with FEM software ABAQUS Version 5.2 and hardware IRIS 4D/310 VGX Work-station. The results were as follows: 1. G model showed stress and strain patterns between Band R model. 2. B model and G model showed the bending phenomenon in the displacement. 3. R model showed the greatest amount of the displacement of the buccal cusp followed by G and B model in descending order. G model showed the greatest amount of the displacement of the lingual cusp followed by B and R model in descending order. 4. B model showed no change of the displacement as increasing depth and width of the cavity. G and R model showed greater displacement of the buccal cusp as increasing depth and width of the cavity, but no change in the displacement of the lingual cusp. 5. As increasing of the width of the cavity, stress and strain were not changed in B model. Stress and strain were increased on the distal marginal ridge and buccopulpal line angle in G and R model. The possibility of the tooth fracture was increased. 6. As increasing of the depth of the cavity, stress and strain were not changed in B and G model. Stress and strain were increased on the distal marginal ridge and buccopulpal line angle in R model. The possibility of the tooth fracture was increased.

• Restorative Dentistry and Endodontics
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• v.13 no.2
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• pp.337-348
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• 1988

The purpose of this study was to examine the fracture strength and characteristics of teeth with MOD cavity preparation. Freshly extracted sound maxillary premolars were cleaned and stored in normal saline solution $37^{\circ}C$ for 72 hours before experiments. The roots of teeth were embedded in a self-curing resin, and the exposed crown were maintained in a vertical position by a modelling wax in a brass ring. The MOD cavities were prepared with No. 57 carbide bur under high speed to a depth of 2.0mm and a width of 2.0mm(Fig.1). All the prepared teeth specimens were divided into 7 groups according to the mode of cavity form and restorative materials (Table 1, 2): Group I, unpreapred, intact teeth as control Group II, prepared cavity without restoration Group III, prepared teeth restored with amalgam Group IV, prepared teeth restored with composite resin (P-10) Group V, prepared teeth with beveled enamel margins restored with composite resin (P-10) Group VI, prepared teeth restored with light-cured composite resin (P-30) Group VII, prepard teeth with beveled enamel margins restored with light-cured composite resin (P-30) After placement of restorations, all of the specimens were stored in water at $37^{\circ}C$ for 72 hours before testing. All of the specimens were tested on the Instron Universal Testing machine (No. 6025) in order to evaluate the strength of fracture. One metal ball 5.0mm in diameter contacting the specimens parallel to the occlusal surface was used to in this study (Fig. 1). The fracture characteristics of the specimens were examined with naked eye and in the scanning electron microscope (JSM-20). The results obtained from this study were as follows: 1. The mean fracture strength was the highest in group VI and that in group II was the lowest. 2. The progress of crack of teeth propagated into the pulp cavity. 3. In case of the group of the restored teeth, the crack occurred to be accompanied with cuspal fracture. 4. The crack of restored teeth was initiated along the pulpo-axial line angle of the cavity.

• Clinics in Shoulder and Elbow
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• v.19 no.2
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• pp.105-109
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• 2016

Arthroscopy is recognized as an important adjunct in treatment of intra-articular fractures. The author reports on successful treatment of a displaced transverse glenoid cavity fracture, reduced and fixed with arthroscopic assist, using two cannulated screws perpendicular to the fracture surface, in a patient with frail chest. One screw passed through the Neviaser portal, and the other screw passed through the base of the coracoid process. Arthroscopy assisted reduction and 2 cannulated screw fixation through the Neviaser portal and coracoid base appears to be a good method for treatment of transverse glenoid fractures.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.205-213
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• 1977

In order to evaluate the therapeutic effect of thoracostomy on the patients with pathological changes in pleural cavity which were caused by various etiological factors, a clinical study was carried out during a period of 5 and half years from May 1972 to September 1977 in the department of thoracic surgery, Hanyang University Hospital, and the following results were obtained. Of a total of 264 patients, 205 cases were male, and 59 female, exhibiting the ratio of male to female being 3.5 to 1. The pathological changes in pleural cavity could occur at any age from 4 months after birth to 76 years old, the peak incidence being in the third decade in either male or female. The incidence decreased in the second, fifth and fourth decade in order. The type of pathological changes observed and their frequencies of occurrences were 93 cases [35.2%] in pneumothorax, 62 cases [23.5%] in hemothorax, 48 cases [18.2%] in pyothorax, 46 cases [17. 4%] in hemopneumothorax, 13 cases [4.9%] in hydropneumothorax, and one case each in hydrothorax and chylothorax. The incidence of the primary diseases which predisposed the pathological changes in pleural cavity were, 119 cases [45-1%] in trauma, 64 cases [24.2%]in lung tuberculosis, 38 cases [14.4%] in pneumonia or empyema, 14 cases [5.3%] in lung emphysema and blebs, 13 cases [4.9%] in process after thoracotomy, 3 cases [1.1%] each in lung malignant tumor and lung paragonimiasis, one case in mechanical ventilator and 9 cases [3.4%] in unknown origin. The pathological changes in pleural cavity were located in the right side of the cavity in 124 cases, in the left side in 133 cases and in both sides in 7 cases, indicating that the difference between the incidence of the left and rightside occurences was insignificant. Of 93 cases of pneumothorax studied, 63 cases were found to have been tension pneumothorax and 30 cases non-tension pneumothorax, showing greater prevalence of tension type over non-tension type. Of 119 cases of trauma observed, 82 cases were accompanied with rib fractures and 37 cases were without any fracture [non-bone fracture]. Patients with the rib fractures were characterized by multiple rib fractures and multiple double fractures of ribs, accompanying with or without fracture of bones other than ribs, and patients with non-bone fracture were characterized by penetrating stab wound and blunt trauma. Of 264 cases who received thoracostomy, 207 cases [78.4%] demonstrated that their pathological changes in pleural cavity were removed and subsided by a simple measure of thoracostomy. In 43 cases [16.3%], various surgical measures including radical operation and thoracotomy were required for complete healing, since their pathological changes were not abolished by thoracostomy alone. The rest 14 cases [5.3%] were expired following thoracostomy.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.428-446
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• 1997

Restorative procedures can lead to weakening tooth due to reduction and alteration of tooth structure. It is essential to prevent fractures to conserve tooth. The resistance to fracture of the restored tooth may be influenced by many factors, among these are the cavity dimension and the physical properties of the restorative material. The placement of direct composite resin restorations has generally been found to have a strengthening effect on the prepared teeth. It is the purpose of this investigation to study the relationship between the cavity isthmus and the fracture resistance of a tooth in composite resin restorations. In this study, MO cavity was prepared on maxillary first premolar. Three dimensional finite element models were made by serial photographic method and isthmus(1/4, 1/3, 1/2 of intercuspal distance) were varied. Two types of model(B and R model) were developed. B model was assumed perfect bonding between the restoration and cavity wall and R model was left unfilled. A load of 500N was applied vertically at the first node from the lingual slope of the buccal cusp tip. This study analysed the displacement, 1 and 2 direction normal stress and strain with FEM software ABAQUS Version 5.2 and hardware IRIS 4D/310 VGX Work-station. The results were as follows : 1. Displacement of buccal cusp in R model occurred and increased as widening of the cavity, and displacement in B model was little and not influenced by cavity width. 2. There was a significant decrease of stress resulting in increase of fracture resistance in B model when compared with R model. 3. With the increase of the isthmus width, B model showed no change in the stress and strain. In R model, the stress and strain increased both in the area of buccal-pulpal line angle and the buccal side of marginal ridge, therefore the possibility of crack increased. 4. The stress and strain were distributed evenly on the tooth in B model, but in R model, were concentrated on the buccal side of the distal marginal ridge and buccal-pulpal line angle, therefore the possibility of fracture increased.

• Restorative Dentistry and Endodontics
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• v.19 no.2
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• pp.384-408
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• 1994

The purpose of this study was to evaluate the fracture resistance of tooth restored with gold inlay. A profound understanding of the isthmus width factor, which is one of the several parameters of cavity designs, would facilitate the appropriate cavity preparation in a specific clinical situation. In this study, the cavities for gold inlay were prepared in maxillary left first premolar. A three-dimensional model was designed using I-DEAS program. The model was composed of 2515- nodes and 2172 isoparametric brick elements. In the model isthmus width was varied into 1/4, 1/3 and 1/2 of intercuspal width respectively, and numeric values of the material properties of enamel, dentin and gold was set. Three types of load : concentrated load, divided load and distributed load was 500N. The empty cavities in the model were also examined using divided load and distributed load. The three - dimensional Finite Element Method was used to analysis the displacement and stress distribution. The results were as follows : 1. All of the experimental models which were filled with gold inlay revealed similar direction of displacement to that of the natural tooth model under the same load type. But in the models with empty cavities, as the isthmus width increased, the degree of displacement increased in the case of divided load type. 2. All experimental models which were filled with gold inlay showed stress concentration at load points, but in the models with empty cavities at divided load type, as isthmus width increased, stress was concentrated at the comer of the pulpal floor. 3. In the models with empty cavities at divided load type, tooth fracture was expected regardless of isthmus width, but all experimental models which were filled with gold inlay after cavity preparation were not susceptible to fracture. 4. In all experimental models which were filled with gold inlay after cavity preparation, displacement patterns were similar under both concentrated and divided load types. In the models with empty cavities, a divided load resulted in a bucco-lingual cuspal displacemenat in both sides, but a distributed load resulted in a lingual displacement of the tooth.

• Archives of Craniofacial Surgery
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• v.13 no.2
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• pp.104-110
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• 2012

Purpose: Who may dare to state that optimal choice of treating nasal bone fracture is closed reduction? Few decades of authors' experience in nasal bone fracture has lead to believe that more active and assertive approach in nasal bone fracture by performing simultaneous lateral osteotomy may be applied in proper indications to acquire more accurate reduction and cosmetically satisfying result. Methods: From May 2008 to October 2009, among 241 nasal bone fracture patients, 20 patients underwent simultaneous lateral osteotomy with nasal bone fracture reduction. Followed by rigid septal correction, nasal cavity is packed to stabilize the fracture segment for safer osteotomy. Through intranasal incision, in selected cases of difficult reduction or for cosmetic purposes, various types of lateral osteotomy was performed corresponding to the fracture anatomy, conditions of the nasal cavity. Postoperative nasal packing was retained for one week and nasal dorsum splint for 3 weeks. Results: Lateral osteotomy was utilized for difficult cases of closed reduction, for correction of wide nose, hump and deviation in 9, 5, 2, and 4 cases, respectively. Patient satisfaction was scaled 90% in satisfaction and moderate in 10% (2 cases), complaining of mild nasal tip deviation. Physicians detected 2 cases of apparent deformity with patient recognition; one patient with mild step deformity at the osteotomy site and the other patient with minimal implant mobility. Conclusion: By accompanying profound understanding of the fracture anatomy, more active and assertive approach in nasal fracture reduction can be coincide with simultaneous lateral osteotomy to reduce the rate of secondary deformity and to obtain more cosmetically satisfying result.

• The Journal of the Korean dental association
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• v.56 no.10
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• pp.572-580
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• 2018

Adequate access cavity is the key to achieving endodontic success. The aims of the access cavity can be considered as follows: 1) Creation of a smooth unimpeded pathway for instruments to canal orifices 2) Removal of the entire roof of the pulp chamber in order to inspect the pulp floor, 3) Preservation of natural tooth substance consistent with the above. Recently, contracted endodontic cavities based on minimally invasive endodontics has introduced. This has the benefit of preserving the pericervical dentin more than traditional access cavity with achieving long-term success. However, some studies reported controversial results regarding root canal detection, instrumentation efficacy (noninstrumented canal area, hard tissue debris accumulation, canal transportation, and centering ratio) as well as fracture resistance. Therefore, further studies are required for accepting contracted access cavity, and modified form of traditional and contracted access cavity could be considered.