• Journal of Biomedical Engineering Research
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• v.26 no.2
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• pp.123-127
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• 2005

Compression Hip Screw (CHS) is one of the most widely-used prostheses for the treatment of intertrochanteric fractures because of its strong fixation capability. Fractures at the neck and screw holes are frequently noted as some of its clinical drawbacks, which warrant more in-depth biomechanical analysis on its design variables. The purpose of this study was to evaluate changes in the strength with respect to the changes in design such as the plate thickness and the number of screw holes. Both mechanical test and FEM analysis were used to systematically investigate the sensitivities of the above-mentioned design variables. For the first part of the mechanical test, CHS (n=20) were tested until failure. The CHS specimens were classified into four groups: Group Ⅰ was the control group with the neck thickness of 6-㎜ and 5 screw holes on the side plate, Group Ⅱ 6-㎜ thick and 8 holes, Group Ⅲ 7.5-㎜ thick and 5 holes, and Group Ⅳ 7.5-㎜ thick and 8 holes. Then, the fatigue test was done for each group by imparting 50% and 75% of the failure loads for one million cycles. For the FEM analysis, FE models were made for each group. Appropriate loading and boundary conditions were applied based on the failure test results. Stresses were assessed. Mechanical test results indicated that the failure strength increased dramatically by 80% with thicker plate. However, the strength remained unchanged or decreased slightly despite the increase in number of holes. These results indicated the higher sensitivity of plate thickness to the implant strength. No fatigue failures were observed which suggested the implant could withstand at least one million cycles of fatigue load regardless of the design changes. Our FEM results also supported the above results by showing a similar trend in stress as those of mechanical test. In summary, our biomechanical results were able to show that plate thickness could be a more important variable in design for reinforcing the strength of CHS than the number of screw holes.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.2
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• pp.119-126
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• 2012

State of problem: Cement-retained implant-supported prostheses are routinely used in dentistry. The use of high strength cements has become more popular with the increasing confidence in the stability of the implant-abutment screw connection and the high survival rates of osseointegrated implants. No clinical data on retention of metal copings using CAD/CAM. To evaluate retention of metal copings using CAD/CAM system bonded to short titanium abutment with four different cements and compare retentive strength of metal copings with sandblasting or without sandblasting before cementation. Forty titanium abutment blocks were fabricated and divided into 4 groups of 10 samples each. Forty metal copings with occlusal hole to allow for retention testing were fabricated using CAD/CAM technology. The four cements were Fujicem(Fuji, Japan), Maxcem Elite(Kerr, USA), Panavia F2.0(Kurarary, Japan) and Superbond C&B(Sunmedical, Japan). The copings were cemented on the titanium abutment according to manufacture's recommendation. All samples were stored for 24h at 37oC in 100% humidity and tested for retention using universal testing machine(Instron) at a crosshead speed of 1.0mm/min. Force at retentive failure was recorded in Newton. The mode of failure was also recorded. Means and standard deviations of loads at failure were analyzed using ANOVA and Paired t-test. Statistical significance was set at P<0.05. Panavia F2.0 provided significantly higher retentive strength than Fujicem, Maxcem Elite(P<0.05). Sandblasting significantly increased bond strength(P<0.05). The mode of failure was cement remaining principally on metal copings. Within the limitation of this study, Panavia F2.0 showed significantly stronger retentive strength than Fujicem, Maxcem Elite(p<0.05). The Ranking order of the cements to retain the copings was Panavia F2.0, Fujicem = Maxcem Elite. Sandblasting significantly increased bond strength(P<0.05). The retentive strength of metal copings on implant abutment were influenced by surface roughness and type of cements.

• Journal of the Korean Society for Precision Engineering
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• v.24 no.2 s.191
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• pp.140-148
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• 2007

THRA(Total Hip Replacement Arthroplasty) has been widely used for several decades as a viable treatment of otherwise-unsolved hip problems. In THRA surgery, cement mantle thickness is critical to long-term implant survival of femoral stem fixed with cement. Numerous studies reported thin or incomplete cement mantle causes osteolysis, loosening, and the failure of implant. To analyze the effect of femoral stem rotation on cement thickness, in this study, we select two most popular stems used in THRA. Using CAD models obtained from a 3D scanner, we measure the cement mantle thickness developed by the rotation of a femoral stem in the virtual space created by broaching. The study shows that as the femoral stem deviates from the target coordinates, the minimum thickness of cement decreases. Therefore, we recommend development of a new methodology for accurate insertion of a femoral stem along the broached space. Also, modification of the stem design robust to the unintentional movement of a femoral stem in the broached space, can alleviate the problem.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.808-814
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• 2010

Purpose: The sunken chest deformity without breast asymmetry is not a rare condition encountered in augmentation mammaplasty. Therefore, failure to recognize the deformity and improper surgical plan will lead to a suboptimal result. The authors review the experience of breast augmentation in simple sunken chest patient based on retrospectively collected data. Methods: From January, 2008 to January, 2009, patients with simple sunken chest underwent endoscopic submuscular augmentation mammaplasty through axilla, using silicone implants. Patient demographics were queried and outcomes were assessed. Results: Eleven patients (22 breasts) were followed up for 8.2 months after surgery. Sunken chests were augmented with implant size of approximately 248.9 cc (range: 213~286 cc) and contralateral chest with 211.4 cc (range: 180~235 cc). Simultaneous camouflaging the chest wall depression with breast augmentation resulted in good aesthetic outcome. All of the patients were satisfied with the surgery. There were no complications among all patients. Conclusion: We have demonstrated proper surgical planning with precise implant selection to optimize results in patients with small breast and simple sunken chest. Even though asymmetry still remains after the operation, it is still considered as acceptable.

• Clinics in Shoulder and Elbow
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• v.26 no.3
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• pp.312-322
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• 2023

Background: Silicone radial head prostheses (SRHP) are considered obsolete due to reports of frequent failure and destructive silicone-induced synovitis. Considering the good outcomes of modern non-radial silicone joint implants, the extent of scientific evidence for this negative view is unclear. The aim of this research was to systematically analyze the clinical evidence on complications and outcomes of SRHP and how SRHP compare to both non-SRHP and silicone prostheses of other joints. Methods: A systematic literature review was conducted through the Cochrane, PubMed, and Embase databases. Results: Eight cohort studies were included, consisting of 142 patients and follow-up periods ranging from 23 months to 8 years. Average patient satisfaction was 86%, range of 71%-100%, and 58 complications were seen, but no cases of synovitis. These outcomes were in line with non-SRHP. Four case series with 11 cases of synovitis were found, all due to implant fractures years to decades after implantation. Six systematic reviews of currently used non-radial silicone joint implants showed excellent outcomes with low complication rates. Conclusions: Since SRHP have satisfactory clinical results and an acceptable complication rate when selecting a patient group in suitable condition for surgical indications, it is considered that SRHP can still be chosen as a potential surgical treatment method in current clinical practice.

• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.669-678
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• 2008

Purpose: The purpose of this study was to evaluate 2 years cumulative survival rate of implants on augmented sinus area using MBCP, mixture of MBCP and ICB, and mixture of MBCP and autogenous bone by means of clinical and radiologic methods. Materials and Methods: In a total of 37 patients, 41 maxillary sinuses were augmented and 89 implant fixtures were installed simultaneously or after a regular healing period. The patients were divided in 3 groups: MBCP only, MBCP combined with ICB, MBCP combined with autogenous bone. After delivery of prosthesis, along 2 years of observation period, all implants were evaluated clinically and radiologically. And the results were as follows. Results: The results of this study were as follows. 1. A 2 year cumulative survival rate of implants placed with sinus augmentation procedure using MBCP was 97.75%. 2. Survival rate of implants using MBCP only was 97.62%, MBCP and ICB was 100%, MBCP and autogenous bone was 95%. There was no statistically significant difference between 3 groups. 3. Only 2 of 89 implants were lost before delivery of prosthesis, so it can be regarded as an early failure. And both were successfully restored by wider implants. Conclusion: It can be suggested that MBCP may have predictable result when used as a grafting material of sinus floor augmentation whether combined with other graft(ICB, autogenous bone) or not. And the diameter, length, location of implants did not have a significant effect on 2 year cumulative survival rate.

• Journal of Applied Reliability
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• v.17 no.1
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• pp.50-57
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• 2017

Purpose : This paper is a comparative analysis results of the fatigue test for dental implants and accelerated life test by using a static type loading device commonly used in Korea and a dynamic type loading device (universal-joint) recommended by FDA. Methods : Fatigue tests of dental implant is based on ISO 14801 and classified into static load test and dynamic load test. The tests were carried out on three test specimens by four load stress steps under each loading device. For analysis on failure mode such as crack, fracture and permanent deformation of test specimens, we used X-ray three-dimensional computed tomography on test specimens before and after the fatigue tests. The design of the accelerated life test was based on the analysis results of the fatigue life data obtained from the dynamic load test and the statistical analysis software (Minitab ver.15) was used to analyze the appropriate life distribution. Results : As a result of the fatigue tests and the accelerated life tests at same acceleration condition under each test method, the fatigue life under the dynamic type loading device (universal-joint) was shorter than when static type loading device was applied. Conclusion : This paper can be used as a reference when the universal-joint type loading device for implants fatigue test is applied as ISO 14801.

• Journal of Korean Neurosurgical Society
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• v.62 no.5
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• pp.567-576
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• 2019

Objective : Minimal data exist regarding non-operative management of suspected pseudarthrosis after pedicle subtraction osteotomy (PSO). This study reports radiographic and clinical outcomes of non-operative management for post-PSO pseudarthrosis at a minimum 5 years post-detection. Methods : Nineteen consecutive patients with implant breakage indicating probable pseudarthrosis after PSO surgery (13 women/six men; mean age at surgery, 58 years) without severe pain and disability were treated with non-operative management (mean follow-up, 5.8 years; range, 5-10 years). Non-operative management included medication, intermittent brace wearing and avoidance of excessive back strain. Radiographic and clinical outcomes analysis was performed. Results : Sagittal vertical axis (SVA), proximal junctional angle, thoracic kyphosis achieved by a PSO were maintained after detection of pseudarthrosis through ultimate follow-up. Lumbar lordosis and PSO angle decreased at final follow-up. There was no significant change in Oswestry Disability Index (ODI) scores and Scoliosis Research Society (SRS) total score, or subscales of pain, self-image, function, satisfaction and mental health between detection of pseudarthrosis and ultimate follow-up. SVA greater than 11 cm showed poorer ODI and SRS total score, as well as the pain, self-image, and function subscales (p<0.05). Conclusion : Non-operative management of implant failure of probable pseudarthrosis after PSO offers acceptable outcomes even at 5 years after detection of implant breakage, provided SVA is maintained. As SVA increased, outcome scores decreased in this patient population.

• Journal of Audiology & Otology
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• v.23 no.2
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• pp.112-117
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• 2019

Background and Objectives: The purpose of this study was to evaluate the efficacy of revision cochlear implant (CI) surgery for better speech comprehension targeting patients with low satisfaction after first CI surgery. Subjects and Methods: Eight patients who could not upgrade speech processors because of an too early CI model and who wanted to change the whole system were included. After revision CI surgery, we compared speech comprehension before and after revision CI surgery. Categoies of Auditory Performance (CAP) score, vowel and consonant confusion test, Ling 6 sounds, word and sentence identification test were done. Results: The interval between surgeries ranged from eight years to 19 years. Same manufacturer's latest product was used for revision surgery in six cases of eight cases. Full insertion of electrode was possible in most of cases (seven of eight). CAP score (p-value=0.01), vowel confusion test (p-value=0.041), one syllable word identification test (p-value=0.026), two syllable identification test (p-value=0.028), sentence identification test (p-value=0.028) had significant improvement. Consonant confusion test (p-value=0.063), Ling 6 sound test (p-value=0.066) had improvement but it is not significant. Conclusions: Although there are some limitations of our study design, we could identify the effect of revision (upgrade) CI surgery indirectly. So we concluded that if patient complain low functional gain or low satisfaction after first CI surgery, revision (device upgrade) CI surgery is meaningful even if there is no device failure.

• Korean Journal of Audiology
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• v.23 no.2
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• pp.112-117
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• 2019

Background and Objectives: The purpose of this study was to evaluate the efficacy of revision cochlear implant (CI) surgery for better speech comprehension targeting patients with low satisfaction after first CI surgery. Subjects and Methods: Eight patients who could not upgrade speech processors because of an too early CI model and who wanted to change the whole system were included. After revision CI surgery, we compared speech comprehension before and after revision CI surgery. Categoies of Auditory Performance (CAP) score, vowel and consonant confusion test, Ling 6 sounds, word and sentence identification test were done. Results: The interval between surgeries ranged from eight years to 19 years. Same manufacturer's latest product was used for revision surgery in six cases of eight cases. Full insertion of electrode was possible in most of cases (seven of eight). CAP score (p-value=0.01), vowel confusion test (p-value=0.041), one syllable word identification test (p-value=0.026), two syllable identification test (p-value=0.028), sentence identification test (p-value=0.028) had significant improvement. Consonant confusion test (p-value=0.063), Ling 6 sound test (p-value=0.066) had improvement but it is not significant. Conclusions: Although there are some limitations of our study design, we could identify the effect of revision (upgrade) CI surgery indirectly. So we concluded that if patient complain low functional gain or low satisfaction after first CI surgery, revision (device upgrade) CI surgery is meaningful even if there is no device failure.