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Finite-element analysis of the shift in center of resistance of the maxillary dentition in relation to alveolar bone loss (치조골 상실에 따른 상악 치아군 저항중심의 변화에 관한 유한요소해석)

  • Sung, Sang-Jin;Kim, In-Tai;Kook, Yoon-Ah;Chun, Youn-Sic;Kim, Seong-Hun;Mo, Sung-Seo
    • The korean journal of orthodontics
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    • v.39 no.5
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    • pp.278-288
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    • 2009
  • Objective: The aim of this study was to investigate the changes in the center of resistance of the maxillary teeth in relation to alveolar bone loss. Methods: A finite element model, which included the upper dentition and periodontal ligament, was designed according to the amount of bone loss (0 mm, 2 mm, 4 mm). The teeth in each group were fixed with buccal and lingual arch wires and splint wires. Retraction and intrusion forces of 200 g for 4 and 6 anterior teeth groups and 400 g for the full dentition group were applied. Results: The centers of resistance were at 13.5 mm, 14.5 mm, 15 mm apical and 12 mm, 12 mm, 12.5 mm posterior in the 4 incisor group; 13.5 mm, 14.5 mm, 15 mm apical and 14 mm, 14 mm, 14.5 mm posterior in the 6 anterior teeth group; and 11 mm, 13 mm, 14.5 mm apical and 26.5 mm, 27 mm, 25.5 mm posterior in the full dentition group respectively according to 0 mm, 2 mm, 4 mm bone loss. Conclusions: The center of resistance shifted apically and posteriorly as alveolar bone loss increased in 4 and 6 anterior teeth groups. However, in the full dentition group, the center of resistance shifted apically and anteriorly in the 4 mm bone loss model.

Injuries and Prevention methods Associated with In-Line Skate (인라인 스케이트시 발생한 손상 밑 예방)

  • Lim Hong Chul;Chun Seung Joo;Rho Young Jin;Hwang Jin Ho;Park Chan Eung;Kim Tae Un
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.163-167
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    • 2003
  • Purpose: The purpose of this study is to describe causes and injury mechanisms during inline skating and to find preventive measures .Materials and Methods: We have carefully selected 57 patients who have been treated in our hospital and nearby hospital. There are 37 males and 20 females, and mean age is 9 years 9 months (range,6-40 years old) . We have meticulously investigated their injured sites, their favorite location for inline skating , their use of protective means while they were on the wheels and their injury mechanisms . Results: Injury consisted of 50 fractures,1 meniscal tear,2 medial collateral ligament rupture and 4 contusion or sprain. Fracture sites varied as follows : 33(66$\%$) cases in distal radius and ulna,5(10$\%$) in elbow. 3(6$\%$) in diaphysis of humerus, etc Location at the time of injury varied as follows : 22 cases(39$\%$) in their apartment complex, 19 cases in (33$\%$) narrow streets, and 16 cases(28$\%$) in parks Only five patients admitted that any means of protection were used.2 cases only had knee pad on , 1 case put on elbow pad in addition, and 2 cases put on wrist guard as well. However none of the patients had helmet on Conclusion: We would strongly like to stress the importance of using sufficient protections and of choosing area where it is safe to ride, in order to reduce the risk of accidents. In addition, continuous and effective prior education from inline skate circles may be in order before riding the inline skate.

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Second-Look Arthroscopy after ACL Reconstruction with Autograft Tendons (자가건을 이용한 전방 십자 인대 재건술 후 이차 관절경 검사)

  • Fang, Zhen-Zhu;Yoo, Moon-Jib;Kim, Myung-Ho;Bahng, Seung-Chu;Kim, You-Jin;Park, Hee-Gon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.38-44
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    • 2007
  • Purpose: To evaluate status of reconstructed ACL and changes around graft through second-look arthroscopy after arthroscopic reconstruction of the ACL with autograft tendons. Material and Methods: Between Jun. 2003 and Feb. 2007, the second look arthroscopy was performed on 22 cases. Second-look arthroscopy was conducted on average 15.1 $(7\sim31)$ months after reconstruction. 15 cases received hamstring tendon autograft, 7 cases received bone-patellar tendonbone autograft. We measured graft tension using displacement by probing, synovial coverage by visual analysis at second-look arthroscopy The assay in Lysholm score, Lachmann test and KT-2000 arthrometer were evaluated status of reconstructed ACL. Results: The hamstring tendon group showed normal tension in 11 cases and lax tension in 4 cases. The patellar tendon group showed normal tension in 3 cases, lax tension in 2 cases and partial tear in 2 cases. In the hamstring tendon group, synovial coverage was good in 11 cases, half in 3 cases and pale in 1 case, and the bone-patellar tendon-bone group was good in 4 cases and half in 3 cases. The patellar tendon group was superior to the hamstring tendon group in Lysholm score (p<0.05), but insignificance difference in KT-2000 arthrometer results statistically. Conclusion: The hamstring tendon group was superior to the bone-patellar tendon-bone group in second-look arthroscopy after ACL reconstruction with autograft tendons results, but long term follow up will be necessary to further evaluated.

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Operative Treatment of Distal Clavicle Fracture with Acromioclavicular Joint Injury (견봉 쇄골 관절의 손상을 동반한 원위 쇄골 골절의 수술적 치료)

  • Kang, Ho-Jung;Koh, Il-Hyun;Joo, Jong-Hwan;Chun, Yong-Min;Kim, Hyung-Sik
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.59-66
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    • 2011
  • Purpose: We wanted to evaluate the clinical and radiological outcomes and the prognosis of various surgical treatments for the distal clavicle fracture with an acromioclavicular joint injury. Materials and Methods: A retrospective study of 21 patients with a minimum of 12 months follow up was done. We classified acromioclavicular (AC) injury into type I (only intra-articular fracture (IAF), 5 cases), type II (IAF with widening of the AC joint > 7 mm, 9 cases) and type III (IAF with AC joint superior subluxation > 50%, 7 cases). The distal clavicle fractures were fixed using plate (9 cases), mini screws (1 case), K wire and tension band wiring (10 cases) and transarticular pinning (1 case). Acromioclavicular or coracoacromial ligament reconstruction was not done in all the cases. Results: In 20 of 21 cases, bone union was achieved at an average of 8.4 weeks. Traumatic arthritis (5 cases), AC joint widening (4 cases) and AC joint subluxation (2 cases) were noted at the last follow up. The average UCLA score was 32.6 in the type I AC joint injuries, 34 in type II and 34.1 in type III. There was no relationship between the clinical outcomes and the preoperative AC joint injury pattern, postoperative traumatic arthritis, AC joint widening or AC joint subluxation (p>0.05). Conclusion: Satisfactory results were achieved by acute reduction and firm fixation of the distal clavicle fracture with AC joint injury. There was no relationship between the pattern of AC joint injury, the residual radiologic findings and the functional outcome.

The Diagnostic Usefulness of Stress Radiography in Chronic Lateral Ankle Instability (만성 발목 관절 외측 불안정성의 진단에서 스트레스 방사선검사의 유용성)

  • Kim, Yong-Min;Cho, Byung-Ki;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Park, Kyoung-Jin;Kim, Dong-Hwan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.35-40
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    • 2011
  • Purpose: This study was performed to evaluate the diagnostic usefulness of ankle stress radiograph for evaluation of chronic lateral ankle instability. Materials and Methods: Among patients undergoing the modified-Brostrom procedure, 42 cases with complete rupture of the anterior talofibular ligament were enrolled in this study. Sixty Korean adults (120 cases) were recruited as the control group. Radiologic measurement of talar tilt and anterior talar translation was performed through stress radiographs using Telos device. We obtained the normal range of Korean adults, and used as a standard value for judgment of mechanical instability. We analyzed the sensitivity, specificity, positive and negative prediction value of ankle stress radiograph. Results: On ankle stress radiograph, normal range of talar tilt angle and anterior talar translation was below $8.3^{\circ}$, below 7.6mm. Talar tilt angle on varus stress radiograph showed 57% of sensitivity, 97% of specificity, 89% of positive and 86% of negative prediction value. Anterior talar translation on anterior drawer stress radiograph showed 69% of sensitivity, 97% of specificity, 91% of positive and 90% of negative prediction value. Conclusion: Ankle stress radiograph had a good specificity, positive and negative prediction value for the evaluation of mechanical instability. However it underestimated the mechanical instability of ankle joint. It must be remembered that normal stress radiograph does not exclude ankle instability.

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Ultrasonographic Utility for Arthroscopic Examination of Knee (슬관절 관절경 검사 시 초음파 검사의 유용성)

  • Byun, Ki-Yong;Rhee, Kwang-Jin;Kim, Kyung-Cheon;Kim, Dong-Kyu;Kim, Bo-Kun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.1
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    • pp.18-23
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    • 2009
  • Purpose: To evaluate the relationship between the real pathology & abnormal finding found by ultrasonography. Without an MRI test being done beforehand, an arthroscopy is done after an ultrasonography to show abnormal lesions during a knee abnormality. Materials and Methods: The subjects were 42 patients out of 49 cases, excluding those with rheumatoid arthritis, septic arthritis and patients suspected with a ligament tear, which were examined by ultrasonography alone before receiving a knee arthroscopy in our hospital from July 2007 to July 2008. In every case, a physical examination, simple X-ray and knee ultrasonography was done. An arthroscopy was performed when there was ultrasonographic abnormal finding. Before the procedure, a MRI test was not performed and when abnormal findings were found by an arthroscopy, an appropriate surgery was done. Results: During the ultrasonographic examination, there were various sized effusions in the suprapatellar pouch. Also, in addition there were eleven cases of medial meniscus abnormalities, sixteen cases of lateral meniscus abnormalities, and two cases of cystic lesions. Throughout the arthroscopic examination, there were 14 cases of medial meniscus abnormalities, 20 cases of lateral meniscus abnormalities, 15 cases of cartilage damages, 9 cases of medial pathologic plica, 2 cases of intra-articular loose bodies, 5 cases of chondromalacia, 2 cases of cyst, and 2 cases of synovitis. When an effusion abnormality was found by the ultrasonography in a suprapatellar pouch, there was a 100% probability of knee pathology. When a medial meniscus abnormality was found with an ultrasonography, there was a 90.9% probability of a real pathology. When a lateral meniscus abnormality was found there was 81.2% probability of a real pathology. Ultrasonography was 100% accurate when it came to cystic lesions. Conclusion: Knee ultrasonography performed before an arthroscopy seems to be a very useful examination method when suspecting intra-articular lesions.

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Changes in the Titer of Tooth Root Antibodies Accompanying Root Resorption Associated with Orthodontic Tooth Movement (치아이동시 치근 흡수에 따른 치근항체의 역가 변화)

  • Park, Soo-Byung;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.24 no.2
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    • pp.303-317
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    • 1994
  • This study was designed to measure the changes in the titer of tooth root antibodies accompanying root resorption associated with orthodontic tooth movement in dogs to explore a role of the specific immune response in root resorption during orthodontic tooth movement. Five adult mongrel dogs, 2 years of age, were used in the study. Six lower incisors were extracted as sources of homologous antigen in the dogs. Tooth root antigen preparations were made from a 6M Guanidine-HCl-10% EDTA(pH5.0) extract of these root dentins. Root resorption was elicited by intrusion of six maxillary incisors with 200-250gm intrusive force. In 9th week, resorbing six maxillary anterior teeth were extracted. Serum samples were taken from each dog prior to intrusion and weekly for 11 consecutive weeks. Serum autoantibody titers were determined with an enzyme-linked immunosorbent assay. As controls for antibody specificity, sera which were previously incubated with tooth root antigen as well as sera to an unrelated bacterial antigen (Porphyromonas gingivalis 33277) for 3 hours at 25 were measured in all runs. Root resorption was monitored monthly using occlusal radiographs. And then root resorption patterns were observed with a zoom stereo microscope (Model SZH-121, Olympus optical Co. Ltd.). Incisors did not show clear radiographic evidence of significant and progressive root resorption, but periodontal ligament space had widened. But root resorption was observed on the apical regions of the maxillary incisors with a zoom stereo microscope. Teeth showed the shallow depression generally accompanying deep resorption. These demonstrate a slight tendency for an immediate decrease followed by rebound to levels above the pre-treatment baseline. A peak titer of autoantibody to dentin antigen occurred on day 28, then steadily decreased during the 9th week period as the roots resorbed and then rapidly spiked in animals when the resorbing teeth were extracted. When sera is incubated with tooth root antigen, serum activity in the ELISA was almost absent. This is because serum activity in the ELISA could be removed by absorption of the serum with dog dentin antigen. Serum ELISA activity to the unrelated bacterial antigen remained essentially unchanged in all animals throughout the experimental period. When the time course of changes in autoantibody to homologous tooth root antigen prepatration and unrelated bacterial antigen was compared, no significant differences were found(${\alpha}=0.05$). In general, the overall pattern of changes in autoantibody was similar to the two antigens. These findings suggest the possibility that these immunologic changes precede a significant development of root resorption lesions rather than merely reflecting their presence. Therefore, this suggests that the changes of antibody levels may have some predictive value for root resorption.

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Effects of Green Tea Extract on Intestinal Mucosal Esterification of $^{14}C$-Oleic Acid in Rats (녹차 추출물이 흰쥐 소장세포의 지방 에스테르화 과정에 미치는 영향)

  • Seo, Yun-Jung;Noh, Sang-K.
    • Food Science and Preservation
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    • v.15 no.3
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    • pp.450-455
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    • 2008
  • Previously, we have shown that green tea extract lowers the intestinal absorption of cholesterol, fat, and other fat-soluble compounds. We conducted this study to determine whether green tea extract affects the rate of $^{14}C$-oleic acid esterification into various lipids in the intestinal mucosa of rats. Male Sprague-Dawley ruts were had free access to a nutritionally adequate AIN-93G diet and deionized water. Initially, the rat's mucosal content of total lipids was measured following 1 mL olive oil administration with (green tea group) or without (control group) 100 mg green tea extract powder. At 1 h and 5 h, intestinal segments were extracted for total lipid analysis. Secondly, to measure mucosal esterification rates of lipids, an abdominal incision was made along the midline, and a 10-cm long jejunal segment of the small intestine was ligated in situ. Then, micellar solutions with or without green tea extract were injected into the ligated jejunal segments and incubated for 10 mill. The micellar solution contained $200.0\;{\mu}$ Ci $^{14}C$-oleic acid, $200.1\;{\mu}mol$ unlabelled oleic acid, $66.7\;{\mu}mol$ 2-monooleoylglycerol, $66.7\;{\mu}mol$ palmitoyl-sn-glycero-3-phosphocholine, 2.2 mmol glucose, $50.0\;{\mu}mol$ albumin, and 16.5 mmol Na-taurocholate per L of phosphate buffered saline (pH, 6.3) with or without 8.87 g green tea extract powder. At 10 min, each rat was sacrificed by cervical dislocation under anesthesia and the segment was removed for lipid analysis. Significant differences were observed in mucosal triglyceride content at 1 h and 5 h in ruts given green tea extract. Significant differences in the rate of $^{14}C$-oleic acid esterification into triglycerides and phospholipids fractions were observed between control and green tea groups. However, There were no significant differences in other lipid fractions. These results indicate that the lowered esterification rates of $^{14}C$-oleic acid into triglycerides and phospholipids fractions is attributable to presence of green tea extract. This may be associated with an inhibitory effect of green tea catechin on the mucosal processes of lipids, leading to the inhibition of intestinal absorption of lipids.

Improvement of the Elbow Function with Early Mobilization and Rigid Fixation of Coronoid Fracture by Tension Band Technique (압박 긴장대 방법을 이용한 구상 돌기 골절의 견고한 고정과 조기 운동을 통한 주관절 기능의 향상)

  • Rhyou, In-Hyeok;Suh, Bo-Gun;Kim, Hyung-Jin;Chung, Chae-Ik;Kim, Kyung-Chul
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.159-166
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    • 2009
  • Purpose: We wanted to evaluate the surgical results of early mobilization after rigid fixation of small coronoid fracture using the tension band technique Materials and Methods: Eight cases of coronoid fracture were fixed with the tension band technique and using K-wire and wire through the medial approach. All the cases were Regan-Morrey type 2. According to O'Driscoll, they were classified as 5 cases of the tip type (subtype 2) and 3 cases of the anteromedial type (1 case of subtype 2, and 2 case of subtype 3). The associated collateral ligament injuries (6 cases) and radial head/neck fractures (4 cases) were managed simultaneously. After immobilization for 5~7 days, active ROM exercise with a fitted hinge brace started and continued till postoperative 6 weeks. The patients were assessed for pain, ROM and functional disability using the Mayo elbow performance score (MEPS) at an average of 11 months (range: 6~28 months). The ulnar nerve symptoms were also investigated. Results: We observed solid union in all the coronoid fractures without hardware failure. An average of 2.2 wires (range: 2~4) were used. The mean extension was $3^{\circ}$(range: $0^{\circ}\sim25^{\circ}$), the mean flexion was $137^{\circ}$(range: $130^{\circ}\sim140^{\circ}$), the mean pronation was $69^{\circ}$(range: $45^{\circ}\sim90^{\circ}$) and the mean supination was $78^{\circ}$(range: $45^{\circ}\sim90^{\circ}$). The mean MEPS was 96 (range: 65~100). Ulnar nerve symptoms occurred at postoperative one day and persisted in one patient with the terrible triad of taking radial head excision and residual medial instability. Conclusion: The tension band technique uses easily obtained, economic K-wires and the wire was strong enough to permit early elbow ROM exercise and the technique might improve the elbow function. It was especially useful for fixation of multiple small fragments.

Arthroscopic ACL Reconstruction Using Fresh-Frozen Achilles Allograft -Clinical results, Recovery of sports activity- (아킬레스 동종건을 이용한 전방십자인대 재건술후 임상적 결과와 운동력 회복 평가)

  • Chun Churl Hong;Ha Dae Ho;Kim Dong Chul;Kim Hyun Jun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.31-36
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    • 2002
  • Purpose : ACL (anterior cruciate ligament) reconstruction using achilles allograft was done for whom ACL injured person in recreational sports activity. The purpose of this study was to evaluate the clinical results and return to their sports activity in these patients. Materials and Methods : ACL injured 56 amateur athletes who had experienced sports 3 times a week more than 5 years, reconstructed with Achilles allograft, and it was analyzed subjective and objective parameter, Tegner scoring, Telos stress arthrometer, Lysholm Knee Scoring System and modified Feagin scoring system. The average age was 25 years old (range: 18$\~$49), the average follow up period was 15 months (range: 12$\~$19). Morbid sports were football (29 cases), basket ball (14 cases), badminton (5 cases), tennis (3 cases), squash (2 cases) and otherwise (3 cases). Result : The mean Lysholm Knee Scoring System was improved to 88.2 from 60. Telos arthrometer in anterior stress test revealed 2.3 mm improved from 7.1 mm. The modified Feagin scoring system showed 50 cases (89$\%$) with excellent and good results. We had obtained 12 cases (21$\%$) of Tegner score VI, 32 cases (57$\%$) of score V, 20 cases (35%$\%$ of score IV, 3 (5.3$\%$) cases of score III. Conclusions : Reconstruction of anterior cruciate ligaments can restore stability sufficient to allow sports activity in ACL injured patients, but it’s difficult to achieve 'normal' sports activity. So we will have to solve the reasons of this dissatisfaction at furthermore.

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