• 대한정형외과스포츠의학회지
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• 제1권1호
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• pp.26-30
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• 2002

목적: 동종골-슬개건-골을이용한전방십자인대재건술시인간골간섭나사못의초기및조기고정력을알아보려고하였다. 대상및방법 : 동종골-슬개건-골을이용한전방십자인대재건술을28 슬관절에대해수술후6주, 12주, 6개월, 1년에추적조사하였다. Lachman test, flexion rotation drawer test, jerk test등의이학적검사를시행하였고KT-1000 측정을동시에시행하여경골의전방전위정도를측정하였다. Lachman test는 0$\~$2mm 전방전위까지를정상으로하였고KT-1000 측정은정상측과비교하여 2mm 이내는정상으로하였다. 마지막검사시M RI를시행하였다. 결과: 단일예를제외하고는모두이학적검사와KT-1000 측정상정상범위에속하였다. 실패한일례는수술소견상이식물이경골터널에서의근위전위되었으며이는넓어진터널을감안하지않고단하나의간섭나사못을사용한기술적실수로평가되었다. 결론: 인간골골피간섭나사못은전방십자인대의재건술을시행하는데충분한초기및조기고정력을보여주었다.

• 대한골관절종양학회지
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• 제17권2호
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• pp.73-78
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• 2011

목적: 사지 장골의 거대한 골 낭종이나 소파술 후 남은 골 결손부에 시행한 "내재형 피질 지주골 이식술"의 치료결과를 평가하였다. 대상 및 방법: 사지 장골의 거대한 골 낭종이나 소파술 후 남은 골 결손부에 대하여 내재형 동종 피질 지주골과 동종 망상골 이식술을 시행한 7예를 대상으로 하였다. 6예에서는 추가적인 금속판 내고정술이 시행되었다. 원발병소는 단순 골낭종이 3예, 섬유성 이형성증에서 속발된 동맥류성 골낭종이 2예, 이전에 수술한 골시멘트를 제거한 후 남은 골 결손이 1예, 섬유성 이형성증이 1예였다. 3예에서는 최초 내원시 병적 골절이 동반되어 있었다. 골 융합의 진행, 생역학적 지지기능 및 기능적 결과를 평가하였으며 평균 추시 기간은 25.4개월이었다. 결과: 전예에서 이식된 동종 피질 지주골은 숙주골과 융합되었으며 6예의 골간단부에서는 평균 4.2개월에, 5예의 골간부에서는 평균 5.8개월에 융합되었다. 부가적인 수술 등의 조치없이 7예 중 6예에서 생역학적 지지가 가능하였으며 동종골 이식과 직접 관련된 합병증은 발생하지 않았다. 최종 추시시 기능적 평가상 평균 29.6으로 우수한 결과를 보였다. 결론: 거대한 골 낭종이나 소파술 후 남은 골 결손부에 시행한 내재형 피질 지주골 이식술은 추가적인 생역학적 안정성과 나사못 고정의 골지주판을 제공하여 조기거동과 우수한 기능적 결과를 가능하게 하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권6호
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• pp.251-258
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• 2018

Corticotomy was introduced as a surgical procedure to shorten orthodontic treatment time. Corticotomy removes the cortical bone that strongly resists orthodontic force in the jaw and keeps the marrow bone to maintain blood circulation and continuity of bone tissues to reduce risk of necrosis and facilitate tooth movement. In the 21st century, the concept of regional acceleratory phenomenon was introduced and the development of the skeletal anchorage system using screw and plate enabled application of orthopedic force beyond conventional orthodontic force, so corticotomy has been applied to more cases. Also, various modified methods of minimally invasive techniques have been introduced to reduce the patient's discomfort due to surgical intervention and complications after surgery. We will review the history of corticotomy, its mechanism of action, and various modified procedures and indications.

• 대한치과교정학회지
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• 제39권2호
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• pp.95-104
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• 2009

본 연구는 self-tapping screw의 특징적 구조인 cutting flute의 길이 및 형태 변화에 따른 미니 임플랜트의 식립 및 제거 토크를 비교해보기 위해 시행되었다. 외경, 내경, 길이 및 pitch 등 다른 조건이 모두 동일하고 cutting flute의 형태만 다른 세 종류의 미니 임플랜트를 사용하였다(A군; 2.6 mm 길이의 flute가 형성된 그룹, B군; 3.9 mm의 길이이면서 직선형의 flute를 갖는 그룹, C군; 3.9 mm의 길이이면서 나선형의 flute를 갖는 그룹). 골밀도를 균일하게 하기 위해 실험용 인공골(Sawbones Inc., USA)을 사용하였으며, 수직력 및 회전속도를 일정하게 하기 위해 구동식 토크시험기를 이용하였다. 그 결과 다음과 같은 결론을 얻었다. 총 삽입 시간은 2 mm 두께의 피질골 시편에서는 세 군간에 차이를 보이지 않으나, 4 mm 두께의 피질골 시편에서는 C군 > B군 > A군 순으로 짧은 삽입 시간을 보였다. 최대 삽입 토크는 2 mm 두께의 시편에서는 A군이 다른 두 군에 비해 높은 값을 보이나, 4 mm 두께의 피질골 시편에서는 C군 > A군 > B군 순으로 높은 값을 보였다. 최대 제거 토크는 2 mm 두께의 피질골 시편에서는 세 군 사이에 차이가 없으나, 4 mm 두께의 피질골 시편에서는 C군이 다른 두 군에 비해 높은 값을 보여주었다. 이상의 결과로 보아 피질골이 두꺼운 부위에 미니 임플랜트를 식립할 경우 cutting flute의 길이 및 형태 또한 고려하여 미니 임플랜트를 선택하는 것이 바람직하다.

• 대한치과교정학회지
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• 제38권4호
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• pp.228-239
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• 2008

식립 후 힘의 부하가 조기에 이루어지는 마이크로임플란트의 경우 식립 시의 골응력 혹은 스트레인의 관리가 그 안정성에 있어 중요한 요인으로 작용할 수 있다. 이에 본 연구에서는 3D 유한요소법을 사용하여 교정용 마이크로임플란트 식립 시 피질골에 발생하는 응력(스트레인)을 해석하였다. 0.9 mm 직경으로 미리 드릴링한 1mm 두께 피질골에 마이크로임플란트(AbsoAnchor SH1312-7, Dentos, Daegu, Korea)가 식립되는 전체 과정(10회전, 식립 깊이 5 mm)의 모사를 위해 총 1,800 step의 유한요소해석을 실시하였다. 식립 진행과 더불어 생기는 나사산 주위 피질골의 기하학적 형상변화를 유한요소해석에 반영하기 위하여 지속적인 remesh를 실행하였으며, 빠른 수렴을 위해 마이크로임플란트는 강체로, 피질골은 강소성체로 모델링하였다. 해석 결과, 마이크로임플란트 식립 시 피질골에 발생되는 스트레인은 임플란트 주위골 전체에서 정상적인 골개형을 위한 한계치로 보고되고 있는 $4,000\;{\mu}$-strain을 상회하였고, 나사산 첨부 인접골에서는 스트레인이 100% 이상에 달하였다. 계산된 피질골 식립토오크는 약 1.2 Ncm 정도로 가토 경골에 동일 모델의 마이크로임플란트을 식립하며 측정한 값에 약간 미달하였으나 근접한 수치를 보였다. 본 연구를 통해, 마이크로임플란트의 식립과정을 3D 유한요소법으로 재현할 수 있음을 확인하였고, 또한 마이크로임플란트 식립에 의해 피질골에 발생하는 스트레인 크기는 생리적인 골개형을 저해할 수 있는 수준임을 확인할 수 있었다.

• 대한족부족관절학회지
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• 제17권2호
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• pp.130-135
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• 2013

Purpose: Preshaped Locking compression plate(LCP) has holes with fixed angle between screw and plate and have advantage firm fixation because it has stability of angular and axial deformity. We evaluated usefulness of LCP after open reduction and internal fixation in distal fibular fracture. Materials and Methods: Between December 2011 and May 2012, 23 patients with fracture of distal fibula were followed up at least 12 months underwent open reduction and internal fixation with LCP. There were 15 males and 8 females with a mean age 39.8(20~69) years. According to Danis-Weber classification, there were 20 cases of type B and 3 cases of type C. There were 13 cases of isolated lateral malleolus fractures, 1 case of bimalleolar fracture, 6 cases of trimalleolar fractures and 3 cases of distal tibia fractures with proximal fibula fracture. Intraoperatively, we assessed whether preshaped LCP fit lateral margin of distal fibula or not and evaluated quality of reduction and postoperative complications. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer Results: Of all cases, complete bone union was achieved and average radiological bone union time was 7.3(6~12) weeks. The clinical results were excellent in 18 cases(78%), good in 5 cases(22%). There were 5 cases of plate with 3 holes, 13 cases of plate with 4 holes, 2 cases of plate with 5 holes, 1 case of plate with 6 holes and 2 cases of plate with 7 holes. The average number of screws at proximal fragement was 2.5 and at distal fragment was 3.5. In 14 cases (60.8 %), we needed re-bending of plate because the distance between plate and lateral cortical margin of distal fibula was more than 5 mm at anteroposterior X-ray after reduction. All cases have anatomical reduction and there were no complications of wound infections. There were no complaint about hardware irritation. Conclusion: At fractures of distal fibula,preshaped LCP had a excellent stability although far cortex was not fixed with screw and bending of plate. And there are less complications of hardware irritation and wound problems. But, Some complement would be needed because there were no complete fitting between precontour of LCP and lateral cortical margin of distal fibula.

• 한국임상수의학회지
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• 제24권2호
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• pp.182-191
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• 2007

Bioabsorbable devices have been utilized and experimented in many aspects of orthopaedic surgery. Depending upon their constituent polymers, these materials can be tailored to provide sufficient rigidity to allow bone healing, retain mechanical strength for certain period of time, and then eventually begin to undergo degradation. The objective of this study was to estimate extent in which Poly-L-latic acid (PLLA) implants had bioabsorbability and biocompatibility with bone and soft tissue in dogs and also to develop bioabsorbable, biocompatible materials with the appropriate strength and degradation characteristics to allow for regular clinical use for treating orthopedic problems in humans as well as animals. Eighteen dogs were used as experimental animals and were inserted two types of PLLA implants. PLLA rods were inserted into subcutaneous tissue of back or the abdomen wall. And the rods were tested for material properties including viscosity, molecular weight, melting point, melting temperature, crystallinity, flexural strength, and flexural modulus over time. PLLA screws were inserted through cortical bone into bone marrow in the femur of the dogs and stainless steel screw was inserted in the same femur. Radiographs were taken after surgery to observe locations of screw. Histological variations including cortical bone response, muscular response, bone marrow response were analyzed over the time for 62weeks. The physical properties of PLLA rods had delicate balances between mechanical, thermal and viscoelastic factors. PLLA screws did not induce any harmful effects and clinical complications on bone and soft tissue for degradation period. These results suggest that PLLA implants could be suitable for clinical use.

• 대한치과보철학회지
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• 제41권5호
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• pp.674-688
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• 2003

Statement of Problem : With increasing demand of the implant-supported prosthesis, it is advantageous to use the different platform width of the fixture according to bone quantity and quality of the patients. Purpose : The purpose of this study was to assess the loading distributing characteristics of two implant designs according to each platform width of fixture, under vertical and inclined loading using finite element analysis. Material and method : The two kinds of finite element models were designed according to each platform width of future (4.1mm restorative component x 11.5mm length, 5.0mm wide-diameter restorative component x 11.5mm length). The crown for mandibular first molar was made using UCLA abutment. Each three-dimensional finite element model was created with the physical properties of the implant and surrounding bone. This study simulated loads of 200N at the central fossa in a vertical direction, 200N at the outside point of the central fossa with resin filling into screw hole in a vertical direction and 200N at the buccal cusp in a 300 transverse direction individually Von Mises stresses were recorded and compared in the supporting bone, fixture, and abutment screw. Results : The stresses were concentrated mainly at the cortex in both vertical and oblique load ing but the stresses in the cancellous bone were low in both vertical and oblique loading. Bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. The magnitude of the stress was greater with the oblique loading. Increasing the platform width of the implant fixture decreased the stress in the supporting bone, future and abutment screw. Increased the platform width of fixture decreased the stress in the crown and platform. Conclusion : Conclusively, this investigation provides evidence that the platform width of the implant fixture directly affects periimplant stress. By increasing the platform width of the implant fixture, it showed tendency to decreased the supporting bone, future and screw. But, further clinical studies are necessary to determine the ideal protocol for the successful placement of wide platform implants.

• 구강회복응용과학지
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• 제21권1호
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• pp.1-14
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• 2005

The purpose of this study was to assess the loading distributing characteristics of implant prosthesis of internal connection system(ITI system) according to position and direction of load, under vertical and inclined loading using finite element analysis (FEA). The finite element model of a synOcta implant and a solid abutment with $8^{\circ}$ internal conical joint used by the ITI implant was constructed. The gold crown for mandibular first molar was made on solid abutment. Each three-dimensional finite element model was created with the physical properties of the implant and surrounding bone. This study simulated loads of 200N at the central fossa in a vertical direction (loading condition A), 200N at the outside point of the central fossa with resin filling into screw hole in a vertical direction (loading condition B), 200N at the centric cusp in a $15^{\circ}$ inward oblique direction (loading condition C), 200N at the in a $30^{\circ}$ inward oblique direction (loading condition D) or 200N at the centric cusp in a $30^{\circ}$ outward oblique direction (loading condition E) individually. Von Mises stresses were recorded and compared in the supporting bone, fixture, and abutment. The following results have been made based on this study: 1. Stresses were concentrated mainly at the ridge crest around implant under both vertical and oblique loading but stresses in the cancellous bone were low under both vertical and oblique loading. 2. Bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. The magnitude of the stress was greater with the oblique loading than with the vertical loading. 3. An offset of the vertical occlusal force in the buccolingual direction relative to the implant axis gave rise to increased bending of the implant. So, the relative positions of the resultant line of force from occlusal contact and the center of rotation seems to be more important. 4. In this internal conical joint, vertical and oblique loads were resisted mainly by the implant-abutment joint at the screw level and by the implant collar. Conclusively, It seems to be more important that how long the distance is from center of rotation of the implant itself to the resultant line of force from occlusal contact (leverage). In a morse taper implant, vertical and oblique loads are resisted mainly by the implant-abutment joint at the screw level and by the implant collar. This type of implant-abutment connection can also distribute forces deeper within the implant and shield the retention screw from excessive loading. Lateral forces are transmitted directly to the walls of the implant and the implant abutment mating bevels, providing greater resistance to interface opening.

• The Journal of Advanced Prosthodontics
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• 제8권2호
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• pp.131-136
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• 2016

PURPOSE. The aim of this study was to observe stress concentration in the implant, the surrounding bone, and other components under the pull-out force during the crown removal. MATERIALS AND METHODS. Two 3-dimensional models of implant-supported conventional metal ceramic crowns were digitally constructed. One model was designed as a vertically placed implant ($3.7mm{\times}10mm$) with a straight abutment, and the other model was designed as a 30-degree inclined implant ($3.7mm{\times}10mm$) with an angled abutment. A pull-out force of 40 N was applied to the crown. The stress values were calculated within the dental implant, the abutment, the abutment screw, and the surrounding bone. RESULTS. The highest stress concentration was observed at the coronal portion of the straight implant (9.29 MPa). The stress concentrations at the cortical bone were lower than at the implants, and maximum stress concentration in bone structure was 1.73 MPa. At the abutment screws, the stress concentration levels were similiar (3.09 MPa and 3.44 MPa), but the localizations were different. The stress at the angled abutment was higher than the stress at the straight abutment. CONCLUSION. The pull-out force, applied during a crown removal, did not show an evident effect in bone structure. The higher stress concentrations were mostly observed at the implant and the abutment collar. In addition, the abutment screw, which is the weakest part of an implant system, also showed stress concentrations. Implant angulation affected the stress concentration levels and localizations. CLINICAL IMPLICATIONS. These results will help clinicians understand the mechanical behavior of cement-retained implant-supported crowns during crown retrieval.