• 대한치과교정학회지
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• 제52권6호
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• pp.399-411
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• 2022

Objective: The objective of this randomized clinical trial was to study the skeletal and dental effects of low-level laser therapy (LLLT) along with a miniscrew-assisted expander (Hyrax) after six months of retention. Methods: After sequence generation, concealed allocation, and implementation, 24 female patients were randomly divided (1:1) into two-groups: bone-borne rapid palatal expansion (BBE) without LLLT (n = 12) and BBE with LLLT (n = 12). Eligibility criteria included female patients aged 10-13 years old with bilateral posterior crossbites. Intraoral and extraoral photographs, cone-beam computed tomography images, and digital study models were obtained before expansion and six months after retention. The 7 mm Hyrax appliance was anchored to four palatal mini-screws, which were activated twice daily for 15 days, then locked and kept in place as a retainer. LLLT was performed in the laser group during expansion and retention, according to the guidelines provided. Results: The records of 24 patients were analyzed. According to the post-retention measurements, both groups showed a significant increase in nasal and maxillary widths and total facial height. In the laser group, the Sella-Nasion-Point A and Point A-Nasion-Point B angles and the interpremolar apical distance were significantly increased. Conclusions: Within the limitations of this study, the results suggest that the parameters and protocol of LLLT do not clinically affect the efficiency of BBE in prepubertal and pubertal patients.

• 한국음향학회지
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• 제42권1호
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• pp.57-66
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• 2023

본 연구에서 제안한 에너지 하베스팅 장치는 입구가 넓고 출구가 좁은 퍼넬형 에너지 하베스터(Funnel Type Energy Harvester, FTEH)에 Macro Fiber Composite(MFC)가 외팔보 형태로 장착되어 있는 구조로서 MFC의 구조를 변화 시켰을 때 FTEH에 수확하는 에너지양의 특성을 이론과 실험을 통하여 분석하였다. MFC의 길이를 50 % 증가 시켰을 때 진동 변위는 3.5배 증가하였고, 두께를 75 % 감소시 30.9배 증가하였다. 수조 실험에서 최대 전력량은 스파이럴 스크루가 장착된 상태의 유연한 지지대에 수직으로 설치된 MFC가 스파이럴 스크루가 없고 견고한 지지대에 수평으로 설치된 경우보다 약 5배 정도 높았다. FTEH에 최적저항 4,010 kΩ을 적용하여 유속 0.24 m/s일 때 FTEH의 출력을 350 s 동안 커패시터에 에너지를 저장하면 4 ㎼·s에 도달하였다. 빠른 유속으로 유연한 지지대에 수직으로 설치된 대면적 MFC의 커패시터 충전 시간을 길게 하면 충전 에너지를 증가시킬 수 있음을 확인하였다.

• 대한두개안면성형외과학회지
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• 제24권2호
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• pp.52-58
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• 2023

Background: Complex orbital fractures are impure orbital fractures because they involve the orbital walls and mid-facial bones. The author reported an orbital wall restoration technique in which the primary orbital wall fragments were restored to their prior position in complex orbital fractures in 2020. As a follow-up to a previous preliminary study, this study retrospectively reviewed the surgical results of complex orbital wall fractures over a 4-year period and compared the surgical outcomes by dividing them into groups with and without balloon restoration. Methods: Data of 939 patients with facial bone fractures between August 2018 and August 2022 were reviewed. Of these, 154 had complex orbital fractures. Among them, 44 and 110 underwent reduction with and without the balloon technique respectively. Pre- and postoperative Naugle exophthalmometer (Good-Lite Co.) scales were evaluated. The orbital volume and orbital volume ratio were calculated from preoperative and 6 months postoperative computed tomography images. Results: Among 154 patients with complex orbital fractures, 44 patients underwent restoration with the balloon technique, and 110 patients underwent restoration without it. The Naugle scale did not differ significantly between the two groups, but the orbital volume ratio significantly decreased by 3.32% and 2.39% in groups with and without the balloon technique and the difference in OVR was significantly greater in patients in the balloon restoration group compared with the control group. Postoperative balloon rupture occurred in six out of 44 cases (13.64%). None of the six patients with balloon rupture showed significant enophthalmos at 6 months of follow-up. Conclusion: The balloon rupture rate was 13.64% (6/44 cases) with marginal screw fixation, blunt screws, and extra protection with a resorbable foam dressing. Furthermore, we restored the orbital wall with primary orbital fragments using balloon support in complex orbital wall fractures.

• Clinics in Shoulder and Elbow
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• 제26권1호
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• pp.93-106
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• 2023

Reverse total shoulder arthroplasty (RTSA) emerged as a new concept of arthroplasty that does not restore normal anatomy but does restore function. It enables the function of the torn rotator cuff to be performed by the deltoid and shows encouraging clinical outcomes. Since its introduction, various modifications have been designed to improve the outcome of the RTSA. From the original cemented baseplate with peg or keel, a cementless baseplate was designed that could be fixed with central and peripheral screws. In addition, a modular-type glenoid component enabled easier revision options. For the humeral component, the initial design was an inlay type of long stem with cemented fixation. However, loss of bone stock from the cemented stem hindered revision surgery. Therefore, a cementless design was introduced with a firm metaphyseal fixation. Furthermore, to prevent complications such as scapular notching, the concept of lateralization emerged. Lateralization helped to maintain normal shoulder contour and better rotator cuff function for improved external/internal rotation power, but excessive lateralization yielded problems such as subacromial notching. Therefore, for patients with pseudoparalysis or with risk of subacromial notching, a medial eccentric tray option can be used for distalization and reduced lateralization of the center of rotation. In summary, it is important that surgeons understand the characteristics of each implant in the various options for RTSA. Furthermore, through preoperative evaluation of patients, surgeons can choose the implant option that will lead to the best outcomes after RTSA.

• 열처리공학회지
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• 제36권5호
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• pp.270-276
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• 2023

In this study, we analyzed two types of cold forging dies commonly used for manufacturing general nuts and screws to investigate the differences in WC powder according to the lifespan. For both Type I and Type II dies, it was observed that as the lifespan of the molds increases, the area fraction of Co becomes larger and the size of the powder becomes smaller. Moreover, there is a trend where the strength also increases as the lifespan gets longer. Actually, the hardness value of the sample with the longest lifespan is ~ 131 HV higher than the specimen of the shortest lifespan, It is noted that the reduction in toughness of the WC-Co mold is caused by insufficient Co and the decrease in contact surface area of WC-Co results in a reduced bonding surface area. The lifespan of cold-working WC molds increases when the W content and the volume fraction of WC are high, and the size of the WC powder is small. The results can significantly enhance producing high-quality molds with an extended lifespan using WC powder for cold forging.

• 한국임상수의학회지
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• 제39권6호
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• pp.294-301
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• 2022

Three-dimensional (3D) printing technique has been widely used for accurate screw and pin placement in orthopedic surgery and neurosurgery. However, there are few reports comparing the accuracy between the patient-specific guides and freehand Kirschner wire (K-wire) placement in toy, small and medium breed dogs. This study aimed to assess the accuracy of 3D printed patient-specific guides (PSGs) in pin insertion in the thoracolumbar vertebrae of toy breed dogs and compare the outcomes between novice and experienced surgeons. The experiment was conducted on the thoracolumbar vertebrae of 21 euthanized toy breed dogs (median weight, 5.95 kg). The optimal insertion angle placement was determined and patient-specific guides for K-wire insertion were designed and 3D printed using computed tomography (CT) and a 3D computer-aided design program of three vertebrae (Thoracic 12-Lumbar 1). K-wire tracts were made by experienced and novice surgeons and compared to assess the accuracy based on postoperative CT. Based on postoperative CT, in the experienced group, 61 out of 63 pins (96.8%) were fully contained inside the vertebral body and lamina, whereas two pins (3.2%) had perforated the vertebral canal (grade 3, 2-4 mm breach). However, all the pins in the novice group were fully contained. The use of 3D printed PSGs for pin insertion in the thoracolumbar region is an accurate and safe alternative to freehand screw placement by novice surgeons in toy, small and medium breed dogs. Operations with 3D printed PSGs allow novice surgeons to achieve better or similar outcomes in accurate placement of pin/screws in vertebrae.

• 대한치과교정학회지
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• 제53권2호
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• pp.125-136
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• 2023

Before progress was recently made in the application of temporary anchorage devices (TADs) in bio-mechanical design, orthodontists were rarely able to intrude molars to reduce upper posterior dental height (UPDH). However, TADs are now widely used to intrude molars to flatten the occlusal plane or induce counterclockwise rotation of the mandible. Previous studies involving clinical or animal histological evaluation on changes in periodontal conditions after molar intrusion have been reported, however, studies involving human histology are scarce. This case was a Class I malocclusion with a high mandibular plane angle. Upper molar intrusion with TADs was performed to reduce UPDH, which led to counterclockwise rotation of the mandible. After 5 months of upper molar intrusion, shortened clinical crowns were noticed, which caused difficulties in oral hygiene and hindered orthodontic tooth movement. The mid-treatment cone-beam computed tomography revealed redundant bone physically interfering with buccal attachment and osseous resective surgeries were followed. During the surgeries, bilateral mini screws were removed and bulging alveolar bone and gingiva were harvested for biopsy. Histological examination revealed bacterial colonies at the bottom of the sulcus. Infiltration of chronic inflammatory cells underneath the non-keratinized sulcular epithelium was noted, with abundant capillaries being filled with red blood cells. Proximal alveolar bone facing the bottom of the gingival sulcus exhibited active bone remodeling and woven bone formation with plump osteocytes in the lacunae. On the other hand, buccal alveolar bone exhibited lamination, indicating slow bone turnover in the lateral region.

• Journal of Veterinary Science
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• 제25권1호
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• pp.2.1-2.14
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• 2024

Background: Sufficient surgical resection is necessary for effective tumor control, but is usually limited for vertebral tumors, especially in the cervical spine in small animal neurosurgery. Objective: To evaluate the primary stability and safety of customized three-dimensional (3D)-printed implants for cervical spine reconstruction after total vertebrectomy. Methods: Customized guides and implants were designed based on computed tomography (CT) imaging of five beagle cadavers and were 3D-printed. They were used to reconstruct C5 after total vertebrectomy. Postoperative CT images were obtained to evaluate the safety and accuracy of screw positioning. After harvesting 10 vertebral specimens (C3-C7) from intact (group A) and implanted spines (group B), implant stability was analyzed using a 4-point bending test comparing with groups A and C (reconstituted with plate and pins/polymethylmethacrylate after testing in Group A). Results: All customized implants were applied without gross neurovascular damage. In addition, 90% of the screws were in a safe area, with 7.5% in grade 1 (< 1.3 mm) and 2.5% in grade 2 (> 1.3 mm). The mean entry point and angular deviations were 0.81 ± 0.43 mm and 6.50 ± 5.11°, respectively. Groups B and C significantly decreased the range of motion (ROM) in C3-C7 compared with intact spines (p = 0.033, and 0.018). Both groups reduced overall ROM and neutral zone in C4-C6, but only group B showed significance (p = 0.005, and 0.027). Conclusion: Customized 3D-printed implants could safely and accurately replace a cervical vertebra in dog cadavers while providing primary stability.

• 대한치과기공학회지
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• 제46권2호
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• pp.21-27
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• 2024

Purpose: This study aimed to analyze the stress distribution and deformation in implant abutments made from titanium (Ti-6Al-4V), zirconia, and polyetheretherketone (PEEK), including their screws and fixtures, under various loading conditions using finite element analysis (FEA). Methods: Three-dimensional models of the mandible with implant abutments were created using Siemens NX software (NX10.0.0.24, Siemens). FEA was conducted using Abaqus to simulate occlusal loads and assess stress distribution and deformation. Material properties such as Young's modulus and Poisson's ratio were assigned to each component based on literature and experimental data. Results: The FEA results revealed distinct stress distribution patterns among the materials. Titanium alloy abutments exhibited the highest stress resistance and the most uniform stress distribution, making them highly suitable for long-term stability. Zirconia abutments showed strong mechanical properties with higher stress concentration, indicating potential vulnerability to fracture despite their aesthetic advantages. PEEK abutments demonstrated the least stress resistance and higher deformation compared to other abutment materials, but offered superior shock absorption, though they posed a higher risk of mechanical failure under high load conditions. Conclusion: The study emphasizes the importance of selecting appropriate materials for dental implants. Titanium offers durability and uniform stress distribution, making it highly suitable for long-term stability. Zirconia provides aesthetic benefits but has a higher risk of fracture compared to titanium. PEEK excels in shock absorption but has a higher risk of mechanical failure compared to both titanium and zirconia. These insights can guide improved implant designs and material choices for various clinical needs.

• Hip & pelvis
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• 제35권4호
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• pp.259-267
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• 2023

Purpose: Nondisplaced femoral neck fractures have traditionally been treated with in situ fixation. However, poor surgical and clinical outcomes have been reported for fractures with valgus deformity >15°, and the reduction of valgus impaction has recently been emphasized. In addition, early degenerative osteoarthritis can be caused by cam-type femoroacetabular impingement after healing of femoral neck fractures. This study was designed with the objective of confirming the difference in progression of radiographic osteoarthritis according to the severity of the valgus deformity. Materials and Methods: Patients who underwent internal fixation using multiple cannulateld screws for management of nondisplaced femoral neck fractures were divided into two groups: high valgus group (postoperative valgus angle ≥15°) and low valgus group (postoperative valgus angle <15°). Evaluation of demographic data and changes in the joint space width from the immediate postoperative period to the latest follow-up was performed. Results: A significant decrease in joint space width in both hip joints was observed in the high valgus group when compared with the low valgus group, including cases with an initial valgus angle less than 15° and those corrected to less than 15° of valgus by reduction. No complications requiring surgical treatment were observed in either group; however, two cases of avascular necrosis, one in each group, which developed in the low valgus group after reduction of the fracture, were followed for observation. Conclusion: Performing in situ fixation in cases involving a valgus deformity ≥15° in non-displaced femoral neck fractures may cause accelerated narrowing of the hip joint space.