• 대한치과교정학회지
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• 제47권5호
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• pp.313-322
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• 2017

Objective: Miniscrew-assisted rapid palatal expansion (MARPE) is a means for expanding the basal bone without surgical intervention in young adults. Here, we assessed the differences in dental, alveolar, and skeletal measurements taken before (T0), immediately after (T1), and 1 year after (T2) MARPE. Methods: Twenty-four patients (mean age, 21.6 years) who had undergone MARPE and cone-beam computed tomography at T0, T1, and T2 were included. Changes in the following parameters were compared using paired t-tests: intercusp, interapex, alveolar, nasal floor, and nasal cavity widths; inclination of the first molar (M1) and its alveolus; and thickness and height of the alveolar bone. A linear mixed-effects model was used to determine variables that affected periodontal changes in the M1. Results: MARPE produced significant increases in most measurements during T0-T2, despite relapse of some measurements during T1-T2. The alveolar thickness decreased on the buccal side, but increased on the palatal side. The alveolar crest level at the first premolar moved apically. Changes in the thickness and height of the alveolar bone were affected by the corresponding initial values. Conclusions: MARPE can be used as an effective tool for correcting maxillomandibular transverse discrepancy, showing stable outcomes 1 year after expansion.

• 대한물리의학회지
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• 제11권1호
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• pp.93-105
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• 2016

PURPOSE: The purpose of this study was to determine the effect of corrective exercise on hip joint range of motion, lower limb alignment, radiographs of hip and knee joints, and quadriceps muscle activity in a patient with knee joint valgus deformity. METHODS: A single-subject A-B-A experimental design was used to determine the effects of therapeutic exercise. The single-subject was a 27-year-old male, who presented with knee joint valgus deformity. Corrective exercise program was performed for 40 min/day twice a week for 12-week. Range of motion (hip flexion, extension, abduction, adduction, internal rotation, and external rotation), lower limb alignment test (Q-angle, rear foot alignment, and leg length), standing anterior-posterior radiographs (neck shaft angle and knee joint space), and quadriceps muscle activity of both lower limbs were measured before (A 1), after 6 weeks (B 1) and after 12-weeks (B 2) of corrective exercise and after 6 weeks of exercise completion (A 2). RESULTS: Hip range of motion increased in all directions of both sides at B 2 and A 2 compared to at A 1. Q-angle of both side and leg length discrepancy decreased at B 2 and A 2 compared to at A 1. Neck shaft angle and knee joint space of both sides improve at B 2 and A 2 compared to at A 1. Quadriceps of both side muscle activities improved at B 2 and A 2 compared to at A 1. CONCLUSION: We demonstrated that corrective exercise increases range of motion, and improves lower limb alignment and muscle activity in a patient with knee joint valgus deformity.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.776-779
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• 2006

Purpose: Prior to closure of the epiphysis of the distal phalanx, fracture usually occurs through the growth plate, Salter-Harris type I or II, or through the juxtaepiphyseal region 1 to 2 mm distal to the growth plate. The terminal tendon of extensor inserts into the epiphysis only, while insertion site of the flexor digitorum profundus spans both the epiphysis and metaphysis. Because of the difference between these tendon insertions, this injury mimics a mallet deformity. But, this type of injury does not involve a tear or avulsion of the extensor, unlike mallet finger of adults. Seymour was the first to describe this type of injury in children and called after his name, Seymour's fracture. This fracture is prone to infection or remain the residual deformity unless adequate treatment. Methods: We report a case of Seymour's fracture. A 9-year-old boy presented a laceration of the nail matrix, with the nail lies degloved from the nail fold on the right middle finger gotten from an impact against a door. An X-ray examination showed the fracture line lying 1 mm distal to the growth plate. The injury was treated with debridement and the fracture was reduced by applying hyperextension force. Under the C-arm, a single 0.7 mm K-wire was used to immobilize the distal interphalangeal joint. Intravenous antibiotics were applied for 5 days after surgery. Results: The K-wire was removed in the 3rd week. No infection or significant deformity was found until follow-up of 12 months. Conclusions: Seymour's fracture may be at first classically mallet deformity by its appearance. But it is anatomically different and more problematic injury. If it isn't corrected at the time of injury, derangement of the extensor mechanism, and growth deformity of the distal phalanx may occur. The fracture site should be debrided, removed of any interposed soft tissue, and the patient should be given appropriate antibiotics. Reduction should be maintained by K-wire fixation. We experienced no infection or premature epiphyseal closure.

• Journal of Korean Neurosurgical Society
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• 제55권6호
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• pp.337-342
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• 2014

Objective : To determine deformity correction by postural correction and subsequent balloon inflation in acute vertebral compression fractures (OVCFs) and to examine the effect of bone mineral density on deformity correction. Methods : A totol of 50 acute OVCFs received balloon kyphoplasty. Lateral radiographs were taken and analyzed at five different time points : 1) preoperative, 2) after placing the patient in prone hyperextended position, 3) after balloon inflation, 4) after deposition of the cement, and 5) postoperative. All fractures were analyzed for height restoration of anterior (Ha), middle (Hm) and posterior (Hp) vertebra as well as Cobb angle and Kyphotic angle. The bone mineral density (BMD) of lumbar spine was measured by dual-energy X-ray absorptiometry. According to the T-score, the patients were divided into two groups which were osteoporosis group and osteopenia group. Results : Postoperative measurements of Ha, Hm and the Cobb angle demonstrated significant reduction of 4.62 mm, 3.66 mm and $5.34^{\circ}$ compared with the preoperative measurements, respectively (each p<0.05). Postural correction significantly increased Ha by 5.51 mm, Hm by 4.35 mm and improved the Cobb angle by $8.32^{\circ}$ (each p<0.05). Balloon inflation did not demonstrate a significant improvement of Ha, Hm or the Cobb angle compared with baseline prone hyperextended. Postural correction led to greater improvements of Ha, Hm and Cobb angle in osteoporosis group than osteopenia group (each p<0.05). Conclusion : In acute OVCFs, the height restoration was mainly attributed to postural correction rather than deformity correction by balloon inflation. BMD affected deformity correction in the process of postural correction.

• 대한치과교정학회지
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• 제47권2호
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• pp.77-86
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• 2017

Objective: The aim of this study was to evaluate the skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion (MARPE) in young adults by cone-beam computed tomography (CBCT). Methods: This retrospective study included 14 patients (mean age, 20.1 years; range, 16-26 years) with maxillary transverse deficiency treated with MARPE. Skeletal and dentoalveolar changes were evaluated using CBCT images acquired before and after expansion. Statistical analyses were performed using paired t-test or Wilcoxon signed-rank test according to normality of the data. Results: The midpalatal suture was separated, and the maxilla exhibited statistically significant lateral movement (p < 0.05) after MARPE. Some of the landmarks had shifted forwards or upwards by a clinically irrelevant distance of less than 1 mm. The amount of expansion decreased in the superior direction, with values of 5.5, 3.2, 2.0, and 0.8 mm at the crown, cementoenamel junction, maxillary basal bone, and zygomatic arch levels, respectively (p < 0.05). The buccal bone thickness and height of the alveolar crest had decreased by 0.6-1.1 mm and 1.7-2.2 mm, respectively, with the premolars and molars exhibiting buccal tipping of $1.1^{\circ}-2.9^{\circ}$. Conclusions: Our results indicate that MARPE is an effective method for the correction of maxillary transverse deficiency without surgery in young adults.

• 대한족부족관절학회지
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• 제9권1호
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• pp.47-51
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• 2005

중등도 이상의 변형을 가진 족근 관절 관절염에 대해 관혈적 관절 고정술은 양호한 결과를 보였으며 경비골 도달법에 의한 관절 고정술이 이상적인 족근 관절의 고정 위치를 얻는데 보다 용이하였다.

• 대한치과교정학회지
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• 제45권4호
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• pp.153-163
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• 2015

Objective: The purpose of this study was to assess rotational patterns of dentofacial structures according to different vertical skeletal patterns by cone-beam computed tomography (CBCT) and analyze their influence on menton deviation in skeletal Class III deformity with mandibular asymmetry. Methods: The control group consisted of 30 young adults (15 men, 15 women) without any severe skeletal deformity. The asymmetry group included 55 adults (28 men, 27 women) with skeletal Class III deformity and at least 3-mm menton deviation from the midsagittal plane; it was divided into the hyperdivergent and hypodivergent subgroups using a mandibular plane angle cutoff of $35^{\circ}$. Fourteen rotational variables of the dental arches and mandible were measured and compared among the groups. Correlations between menton deviation and the other variables were evaluated. Results: The asymmetry group showed significantly larger measurements of roll and yaw in the mandible than the control group. The hypodivergent subgroup showed significant differences in maxillary posterior measurements of yaw (p < 0.01) and maxillary anterior shift (p < 0.05) compared with the hyperdivergent subgroup. All the mandibular measurements had significant correlations with menton deviation (p < 0.01). Most measurements of roll were positively correlated with one another (p < 0.01). Measurements of yaw and roll in the posterior regions were also positively correlated (p < 0.05). Conclusions: Menton deviation in skeletal Class III deformity with mandibular asymmetry is influenced by rotation of mandibular posterior dentofacial structures. The rotational patterns vary slightly according to the vertical skeletal pattern.

• 대한치과교정학회지
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• 제47권4호
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• pp.256-267
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• 2017

Objective: To evaluate transverse skeletal and dental changes, including those in the buccolingual dental axis, between patients with skeletal Class III malocclusion and facial asymmetry after bilateral intraoral vertical ramus osteotomy with and without presurgical orthodontic treatment. Methods: This retrospective study included 29 patients with skeletal Class III malocclusion and facial asymmetry including menton deviation > 4 mm from the midsagittal plane. To evaluate changes in transverse skeletal and dental variables (i.e., buccolingual inclination of the upper and lower canines and first molars), the data for 16 patients who underwent conventional orthognathic surgery (CS) were compared with those for 13 patients who underwent preorthodontic orthognathic surgery (POGS), using three-dimensional computed tomography at initial examination, 1 month before surgery, and at 7 days and 1 year after surgery. Results: The 1-year postsurgical examination revealed no significant changes in the postoperative transverse dental axis in the CS group. In the POGS group, the upper first molar inclined lingually on both sides (deviated side, $-1.8^{\circ}{\pm}2.8^{\circ}$, p = 0.044; nondeviated side, $-3.7^{\circ}{\pm}3.3^{\circ}$, p = 0.001) and the lower canine inclined lingually on the nondeviated side ($4.0^{\circ}{\pm}5.4^{\circ}$, p = 0.022) during postsurgical orthodontic treatment. There were no significant differences in the skeletal and dental variables between the two groups at 1 year after surgery. Conclusions: POGS may be a clinically acceptable alternative to CS as a treatment to achieve stable transverse axes of the dentition in both arches in patients with skeletal Class III malocclusion and facial asymmetry.

• 대한치과교정학회지
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• 제47권4호
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• pp.238-247
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• 2017

Objective: The aim of this study was to compare recycled and unused orthodontic miniscrews to determine the feasibility of reuse. The comparisons included both miniscrews with machined surfaces (MS), and those with etched surfaces (ES). Methods: Retrieved MS and ES were further divided into three subgroups according to the assigned recycling procedure: group A, air-water spray; group B, mechanical cleaning; and group C, mechanical and chemical cleaning. Unused screws were used as controls. Scanning electron microscopy, energy-dispersive X-ray spectrometry, insertion time and maximum insertion torque measurements in artificial bone, and biological responses in the form of periotest values (PTV), bone-implant contact ratio (BIC), and bone volume ratio (BV) were assessed. Results: Morphological changes after recycling mainly occurred at the screw tip, and the cortical bone penetration success rate of recycled screws was lower than that of unused screws. Retrieved ES needed more thorough cleaning than retrieved MS to produce a surface composition similar to that of unused screws. There were no significant differences in PTV or BIC between recycled and unused screws, while the BV of the former was significantly lower than that of the latter (p < 0.05). Conclusions: These results indicate that reuse of recycled orthodontic miniscrews may not be feasible from the biomechanical aspect.

• 대한치과교정학회지
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• 제48권1호
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• pp.39-47
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• 2018

Objective: The aim of this study was to establish the normative data of dentofacial transverse dimensions according to the skeletal maturation stage in Korean adolescents with good occlusion, assess gender differences and determine correlations between transverse variables. Methods: A total of 577 Korean subjects between ages 7 to 19 years and exhibiting skeletal Class I occlusion were categorized by skeletal maturation index (SMI) of Fishman using hand-wrist radiographs. Dentofacial transverse dimensions were assessed using posteroanterior cephalograms. Independent two-sample t-tests were used to analyze differences between genders. Pearson correlation coefficient was used to determine the correlation between transverse measurements. Results: Dentofacial transverse norms relevant to skeletal maturation stages were established. The average maxillomandibular width difference and ratio at growth completion was 22.16 mm and 77.01% for males; 23.70 mm and 74.06% for females, respectively. Males had greater facial, maxillary and mandibular widths compared to females at every SMI stage. The maxillary and mandibular intermolar widths showed the strongest correlation for both sexes (r = 0.826 for males, r = 0.725 for females). Conclusions: Dentofacial transverse norms of Korean adolescents were established according to developmental stage. All dentofacial widths were greater in males at growth completion. Maxillary and mandibular intermolar widths were strongly correlated. This study may serve as a guideline for the assessment of dentofacial transverse growth according to skeletal maturation stage in Korean adolescents with good occlusion.