• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.46-52
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• 2009

Purpose: To evaluate the usefulness of minimally invasive arthroscopy-assisted plate removal of a laterally inserted periarticular distal femur plate used for the treatment of AO type-C distal femur fractures. Materials and Methods: From October 2002 to November 2005, we evaluated 17 patients whose plates were removed through minimally invasive arthroscopy-assisted plate-removal technique and 15 patients who got their plates removed through conventional method without using arthroscopy, 32 patients in total. All these patients included in this study initially underwent open reduction and internal fixation of the distal femoral fractures with a lateral plate, and complained of continued pain over the lateral femoral condyle after the fracture fixation. The average age was 42.6 (ranges: 20~66) and initial fracture types included 16 cases of C1, 11 cases of C2, and 5 cases of C3 following AO/ASIF classification guidelines. Measured outcomes included: associated intra-articular pathologies, time needed to return to activities of daily living, patients' overall satisfaction, complications following the removal of hardware, and pain before and 6 months after the operation. Results: The distal-most end of the plate was placed in the knee joint in all cases and damage of the lateral articular capsule was found in 23 cases. Continuous wound discharge after surgery was found in one case who underwent arthroscopy-assisted plate removal, and it was treated by irrigation and re-suture. Average time needed to return to activities of daily living was 7 days in arthroscopy assisted group and 7.6 days in conventionally removed group. Fourteen patients (82.4%) who underwent arthroscopyassisted plate-removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 4.9 to 1.9, six months after the plate removal. Thirteen patients(86.7%) who underwent conventional plate removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 5.2 to 2.5, six months after the operation. Conclusion: Through minimally invasive arthroscopic-assisted plate removal, intrarticular pathology of the knee joint was able to be simultaneously identified and treated at the time of hardware removal. Damage of lateral capsule of the knee joint caused by the inserted plate for the treatment of type C distal femoral fracture was very frequently found and following the plate removal, patients experienced an improvement in pain score. We therefore recommend routine lateral distal femoral plate removal if the bony union is attained in such cases as type C distal femoral fractures whose distal most end of the plates are located in the joint.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.317-325
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• 2021

Purpose: This study compared the functional and radiologic outcomes of intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) for tibia fractures in distal tibial spiral fractures combined with posterior malleolar fractures, as well as the functional and radiologic outcomes with and without fixation for posterior malleolar fractures. Materials and Methods: From January 2010 to December 2018 the radiological and clinical outcomes of 30 skeletally mature patients with tibial spiral fractures (AO Foundation/Orthopaedic Trauma Association classification 42-A1, B1, C1) combined with posterior malleolar fractures were analyzed. Sixteen patients were treated with IMN, and 14 patients were treated with MIPO. Depending on the surgical methods, the radiologic and clinical outcomes were compared by evaluating the bone union time, postoperative alignment, postoperative displacement of the posterior malleolar fragment, and American Orthopaedic Foot and Ankle Society (AOFAS) score. Moreover, the functional and clinical outcomes with and without fixation for posterior malleolar fractures were compared. Results: The mean bone union time was 21.8 weeks in the IMN group and 23.1 weeks in the MIPO group (p=0.500). At the final follow up, the mean alignment was coronal angulation of 1.8°, sagittal angulation of 1.6° in the IMN group and coronal angulation of 1.2° and sagittal angulation of 1.7° in the MIPO group (conoral angulation: p=0.131, sagittal angulation: p=0.850). The postoperative and final radiologic evaluation showed no displacement of the posterior malleolar fragment and excellent joint congruity in all cases. At the final follow-up, the mean AOFAS score was 88.0 on average in the IMN group and 87.6 on average in the MIPO group (p=0.905). The ankle range of motion and AOFAS score were similar in the fixation group and no fixation group for posterior malleolar fractures. Conclusion: Both IMN and MIPO for tibial spiral fractures combined with posterior malleolar fractures result in satisfactory radiological and clinical outcomes.

• Journal of Biomedical Engineering Research
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• v.20 no.1
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• pp.37-44
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• 1999

Because of bone resorption, wear of ultra-high molecular weight polyethylene(UHMWPE) in total knee arthroplasty has been recognized as a major factor in long-term failure of knee implant. The surface damage and the following harmful wear debris of UHMWPE is largely related to contact stress. Most of the previous studies focused on the contact condition only at the articulating surface of UHMWPE. Recently, contact stress at the metal-backing interface has been implicated as one of major factors in UHMWPE wear. Therefore, the purpose of the is study is to investigate the effect of the contact stress for different thickness, conformity friction coefficient, and flexion degree of the UHMWPE component in total knee system, considering the contact conditions at both interfaces. In this study, a two-dimensional non-linear plane strain finite element model was developed. The results showed that the maximum value of von-Mises stress occurred below the articulating surface and the contact stress was lower for the more conforming models. All-polyethylene component showed lower stress distribution than the metal-backed component. With increased friction coefficient on the tibiofemoral contact surface, the maximum shear stress increased about twofold.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.3
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• pp.223-232
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• 2012

The purpose of this study was to investigate the effect of various thickness of porcelain on shear bond strength between metal coping and porcelain. So, various thickness of feldspathic porcelain and heat-pressed porcelain were built up and compared. 120 metal cube($4{\times}4{\times}4mm$) specimens were prepared. 60 specimens were applied to feldspathic porcelain and the others were applied to heat-pressed porcelain by 1mm, 1.5mm, 2mm, 2.5mm, 3mm and 3.5mm thickness. The measurement of shear bond strength was performed by Instron universal testing machine. The following results were obtained from this study. 1. As thickness of feldspathic porcelain increases, shear bond strength has decreased. Feldspathic specimens with 1mm porcelain thickness were significantly stronger than other feldspathic subgroups. 2. There was no significant difference of shear bond strength according to porcelain thickness in heat-pressed porcelain group. 3. In comparison between subgroups with same thickness, feldspathic porcelain group had stronger shear bond strength than heat-pressed porcelain. There were significant difference between 1mm and 3mm porcelain thickness group. 4. In almost cases, fracture surface was found on both metal and porcelain surfaces. As thickness of porcelain was increased, metal exposure was decreased.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.70-76
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• 2006

Purpose: This study presents 5 patients who had metallic anchor protrusion on glenoid after Bankart repair in anterior shoulder instability and reviewed the cause, clinical feature and arthroscopic removal technique. Method and Materials: 5 male with average age of 22 years (range 19 to 25 years) were included. 4 patients had arthroscopic Bankart repair and 1 patient had open repair for anterior shoulder instability. They had protruded metallic suture anchors on glenoid and the protruded suture anchors were removed arthroscopically using larger suture anchor empty inserter. Results: 4 patients had painful clicking sound with motion of abduction and external rotation and 1 patient showed shoulder instability. The ROM showed normal except mild degrees loss of external rotation. The position of protruded metallic anchor was 2, 3 and 5 O'clock in three patients and 4 O'clock in 2 patients. In 2 patients, the metallic suture anchor was malpositioned about 5mm off on the medial side from the anterior glenoid edge. All had Outerbrige classification Grade II-III chondral damage on humeral head and 1 patient showed glenoid cartilage destruction. None had shoulder instability after 2 years of follow-up. Constant score was 65 preoperatively and 89 postoperatively. ASES score was 67 preoperatively and 88 postoperatively. Conclusion: Symptoms of protruded suture anchor are not combined with instability. Most of symptoms were revealed from the rehabilitation period and confused with postoperative pain. Prompt diagnosis and early arthroscopic removal or impaction of protruded metallic suture anchor is recommended because of serious glenohumeral cartilage destruction. This is easy and simple and reproducible method to remove protruded metallic suture anchor arthroscopically.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.1
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• pp.8-15
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• 2016

Purpose: The purpose of this research is to determine whether pontic metal substructures, which are currently used in clinical surgeries, are designed appropriately and identify the problems that can occur due to their shape, size, and position. Then it aimed to emphasize the importance of making and designing pontic metal substructures based on basic principles. Materials and Methods: This research measured pontic basal surface (P1) used sample metal substructures in this study, gingiva margin (P2), and the porcelain thickness of maximum infrabulge of labial surface around 1/3 of cervix dentis (P3). One-way ANOVA analysis was carried out to test the differences among groups, Tukey Honestly Significant Difference Test was conducted for statistical analysis among groups. Results: For porcelain thickness and SD value, the P1 part was $1.2-1.8({\pm}0.17)mm$ for experimental group 1, $1.2-1.7({\pm}0.17)mm$ for experimental group 2, and $0.4-2.8({\pm}0.92)mm$ for experimental group 3. Next, the P2 part was $1.4-1.6({\pm}0.07)mm$ for experimental group 1, $1.3-1.8({\pm}0.07)mm$ for experimental group 2, and $0.5-2.7({\pm}0.67)mm$ for experimental group 3. The P3 part was $1.4-1.7({\pm}0.10)mm$ for experimental group 1, $1.5-2({\pm}0.10)mm$ for experimental group 2, and $0.9-3.1mm({\pm}0.90)$ for experimental group 3. There was no significance when One-way ANOVA analysis/Tukey Honestly Significant Difference Test was conducted for statistical analysis among groups (P > 0.05). Conclusion: The suggested metal substructures can be used clinically as they meet the requirements that pontic must have.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.3
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• pp.138-149
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• 2022

The clinical applicability of ceramics can be increased by analyzing the causes of fractures after fracture testing of dental ceramics. Fractography to analyze the cause of fracture of dental ceramics is being widely applied with the development of imaging technologies such as scanning electron microscopy. Setting the experimental conditions is important for accurate interpretation. The fractured specimens should be stored and cleaned to avoid contamination, and metal pretreatment is required for better observation. Depending on the type of fracture, there are dimple rupture, cleavage, and decohesive rupture mainly observed in metals, and fatigue fractures and conchoidal fractures observed in ceramics. In order to reproduce fatigue fracture in the laboratory, which is the main cause of fracture of ceramics, a dynamic loading for observing slow crack growth is essential, and the load conditions and number of loads must be appropriately set. A typical characteristic of a fracture surface of ceramic is a hackle, and the causes of fracture vary depending on the shape of hackle. Fractography is a useful method for in-depth understanding of fractures of dental ceramics, so it is necessary to follow the exact experimental procedure and interpret the results with caution.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.142-149
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• 2009

Purpose: We wanted to assess the radiological and clinical results and the prognostic factors after an operation for capitellar fractures associated with/without other injury around the elbow. Materials and Methods: Among the 25 patients (mean age: 49 years-old) who underwent open reduction and internal fixation for capitellar fractures, there were nineteen type 1 fractures and six type 3 fractures. The mean follow up period was 14.8 months. We assessed the factors affecting the radiological and functional results, such as the fracture pattern, the patient age and the surgical approaches. Results: In 24 of 25 patients, bony union was achieved at postoperative 1 year. There were eighteen excellent, four good, two fair and one poor functional results according to the Broberg and Morrey elbow score. The most common type was type 1 and the most common associated injury was lateral condylar fracture. The patients with type 1 fracture rather than the patients with type 3 fracture and the patients who had an extraarticular associated fracture rather than an intraarticular associated fracture had better clinical outcomes. Conclusion: 22 (88%) of the patients were satisfied at the result. The type of capitellar fracture and an associated intraarticular elbow fracture were shown to be important prognostic factors in this study.

• 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 Dental Rehabilitation and Applied Science
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• v.25 no.2
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• pp.95-107
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• 2009

The purpose of this research was to examine the fitness of zirconia cores that were made by different sintering methods; generic electricity furnace and microwave furnace. Firstly, 12 cores for each group were made by using each different sintering process and attached them to a metal die with silicon. The internal and marginal gap of sintered zirconia was measured by using Skyscan 1076 micro-CT, then it was reorganized by CT-An software. To each samples, we extracted B-L image, M-D image of cutting side, and cross-sectional side of tooth long axis and calculated the mean value of marginal, axial, and occlusal gap each side. Results: 1. The mean marginal gap of sintered zirconia was $36.20{\mu}m$ for EVE, $47.67{\mu}m$ for LAV, $52.47{\mu}m$ for DEN, and $54.63{\mu}m$ for CER. 2. For the axial wall, the research showed the largest value of $63.49{\mu}m$ for EVE, but there were no statistical significance. 3. In related to the occlusal internal measurement, DEN showed the smallest value ($77.06{\mu}m$), EVE and CER showed significantly high value. From this study, it is suggested that CAD/CAM zirconia core which was made in the process of microwave sintering has clinically acceptable values in marginal and internal gap.