• 대한치과교정학회지
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• 제39권5호
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• pp.278-288
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• 2009

효과적인 교정치료계획의 수립을 위하여 치열군의 저항중심의 위치에 대한 평가는 필수적이다. 이번 연구의 목적은 상악 치열군(4전치, 6전치, 14치아)에서 치조골 손실에 따른 저항중심의 위치변화를 조사해보고자 하였다. 상악 전치열 14개 치아와 치주인대 및 0 mm, 2 mm, 4 mm 손실된 치조골의 3차원 유한요소 모델을 제작하였고 각 치아군(4전치, 6전치, 14치아)별로 치관부를 협측, 설측호선 및 splint wire로 고정하여 치아군 모델을 제작한 후 상악 중절치의 절단연 중점에서 연장된 splint wire에 4전치와 6전치군에는 200 g, 14치아군에는 400 g의 후방 견인력과 압하력을 적용하여 저항중심의 수직적, 수평적 위치를 분석하였다. 4전치군에서 저항중심의 수직 위치는 치조골 0 mm, 2 mm, 4 mm 손실에 따라 중절치의 절단연에서 치근방향 13.5 mm, 14.5 mm, 15 mm, 수평 위치는 후방 12 mm, 12 mm, 12.5 mm, 6전치군에서는 치근방향 13.5 mm, 14.5 mm, 15.5 mm, 후방 14 mm, 14 mm, 14.5 mm, 14치아군에서는 치근방향 11 mm, 13 mm, 14.5 mm, 후방 26.5 mm, 27 mm, 25.5 mm에 위치하였다. 모든 치아군에서 저항중심은 치조골 손실에 따라 치근첨 방향으로 이동하였으나, 치조정과의 거리는 가까워졌고, 4전치군과 6전치군에서 저항중심은 치조골 손실에 따라 후방으로 이동하였으나, 14치아군에서는 치조골 2 mm 손실 시에는 후방으로 이동하였으나, 4 mm 손실 시에는 전방으로 이동하였다.

• 대한물리치료과학회지
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• 제1권2호
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• pp.355-365
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• 1994

Ilizarov limb lengthening has been the new method to deal with a variety of orthopaedic problems. Ilizarov apparatus consists of stainless steel rings that surround the limb and are interconnected by threaded rods. Tensioned wires pierce the bone in the plane of each ring and are tightly attached to the ring. Ilizarov has reported distraction osteogenesis with the use of the typical fixator that allows functional loading. The purpose of this commentary is to introduce a four-stage rehabilitation protocol currently used by the authors in the physical therapy management of a post -limb lengthening. Each treament stage corresponds to a medical stage in the lengthening process. Treatment goals for each of the physical therapy treatment stage are presented to guide treatment planning. Two case examples are presented to illustrate the use of the management goals in treatment planning.

• 대한두개안면성형외과학회지
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• 제16권3호
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• pp.119-124
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• 2015

Background: The Kirschner wire (K-wire) technique allows stable fixation of bone fragments without periosteal dissection, which often lead to bone segment scattering and loss. The authors used the K-wire fixation to simplify the treatment of laborious comminuted zygomatic bone fracture and report outcomes following the operation. Methods: A single-institution retrospective review was performed for all patients with comminuted zygomatic bone fractures between January 2010 and December 2013. In each patient, the zygoma was reduced and fixed with K-wire, which was drilled from the cheek bone and into the contralateral nasal cavity. For severely displaced fractures, the zygomaticofrontal suture was first fixated with a microplate and the K-wire was used to increase the stability of fixation. Each wire was removed approximately 4 weeks after surgery. Surgical outcomes were evaluated for malar eminence, cheek symmetry, K-wire site scar, and complications (based on a 4-point scale from 0 to 3, where 0 point is 'poor' and 3 points is 'excellent'). Results: The review identified 25 patients meeting inclusion criteria (21 men and 4 women). The mean age was 52 years (range, 15-73 years). The mean follow up duration was 6.2 months. The mean operation time was 21 minutes for K-wire alone (n=7) and 52 minutes for K-wire and plate fixation (n=18). Patients who had received K-wire only fixation had severe underlying diseases or accompanying injuries. The mean postoperative evaluation scores were 2.8 for malar contour and 2.7 for K-wire site scars. The mean patient satisfaction was 2.7. There was one case of inflammation due to the K-wire. Conclusion: The use of K-wire technique was associated with high patient satisfaction in our review. K-wire fixation technique is useful in patient who require reduction of zygomatic bone fractures in a short operating time.

• 대한족부족관절학회지
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• 제19권4호
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• pp.181-187
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• 2015

Purpose: The purpose of this study is to retrospectively analyze the clinical results of screws and Kirschner wire (K-wire) fixation in patients with fracture dislocation of Lisfranc joint and the consequence of screw breakage. Materials and Methods: Sixty patients underwent Lisfranc joint open reduction and removal of internal fixators from January 2007 to December 2011. Forty-nine cases (81.7%) underwent operations with screw alone, and 11 cases (18.3%) underwent operations with both screws and K-wires. Type of internal fixators, duration of internal fixator removal, breakage of internal fixators and satisfaction with reduction were investigated. Additionally, American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scales were analyzed. Results: The internal fixator was broken in 5 cases (8.3%). The average duration of instrument removal was 154 days in the non-broken screw group and 268.6 days in the broken screw group (p<0.05). The average AOFAS midfoot scale was 77.4 in the non-broken screw group and 74.2 in the broken screw group. The most commonly damaged portion was the first tarsometatarsal (Lisfranc) joint. Conclusion: Treatment with screws and K-wires was effective in patients with fracture dislocation of Lisfranc joint. The appropriate time for screw removal should be considered.

• 대한치과교정학회지
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• 제47권1호
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• pp.21-30
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• 2017

Objective: The aim of this study was to investigate the three-dimensional (3D) position of the center of resistance of 4 mandibular anterior teeth, 6 mandibular anterior teeth, and the complete mandibular dentition by using 3D finite-element analysis. Methods: Finite-element models included the complete mandibular dentition, periodontal ligament, and alveolar bone. The crowns of teeth in each group were fixed with buccal and lingual arch wires and lingual splint wires to minimize individual tooth movement and to evenly disperse the forces onto the teeth. Each group of teeth was subdivided into 0.5-mm intervals horizontally and vertically, and a force of 200 g was applied on each group. The center of resistance was defined as the point where the applied force induced parallel movement. Results: The center of resistance of the 4 mandibular anterior teeth group was 13.0 mm apical and 6.0 mm posterior, that of the 6 mandibular anterior teeth group was 13.5 mm apical and 8.5 mm posterior, and that of the complete mandibular dentition group was 13.5 mm apical and 25.0 mm posterior to the incisal edge of the mandibular central incisors. Conclusions: Finite-element analysis was useful in determining the 3D position of the center of resistance of the 4 mandibular anterior teeth group, 6 mandibular anterior teeth group, and complete mandibular dentition group.

• 한국임상수의학회지
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• 제30권6호
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• pp.499-502
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• 2013

목 부위에 교상을 입은 8살의 중성화된 수컷 푸들이 내원하였다. 신체 검사에서, 보행이 불가능하였고 심부통증이 있는 사지의 불완전 마비로 UML 증상을 보였다. 방사선과 CT 검사에서 경추 1번의 횡돌기의 골절, 경추 2번의 가시돌기의 골절이 관찰 되었다. 보존적 처지를 1주일 실시 하였으나 증상이 완화 되지 않아 수술적 교정이 선택되었다. 수술적 안정은, 배쪽으로 접근하여 나사, K-wires 와 bone cement를 이용하여 내원 7일차에 실시 되었다. 수술 후 4주 이후 혼자 설 수 있었으며, 6주 이후 보행이 가능하였다. 본 증례에서는 등쪽과 배쪽 부위 중쇠뼈 골절을 교정하기 위하여 배쪽 복합 고정을 실시하였으며, 좋은 예후를 보였다.

• 대한방사선기술학회지:방사선기술과학
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• 제40권3호
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• pp.433-441
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• 2017

골 모델제작에 사용되는 3차원 프린팅 선택적 레이저 소결(selective laser sintering; SLS) 방식과 광 경화 조형(stereo lithography apparatus; SLA) 방식은 정밀도와 해상도는 좋으나 프린터가 고가이며 운용에 전문지식이 필요하고, 전산화단층 DICOM(digital imaging and communications in medicine)영상을 STL(stereolithography)로 변환하는 프로그램도 고가여서 3차원 프린팅 업체에서 모델을 제작하여 많은 시간과 비용이 소요되므로 일반적으로 골절수술에 사용하지 못하고 있다. 골절환자의 골 모델을 제작하려면 3차원 영상변환프로그램과 3차원 프린팅시스템의 사용이 편리하고 구입 및 운용비용이 저렴해야 하며 큰 골 모델제작이 가능하여야 수술에 사용할 수 있다. 이에 본 연구에서는 DICOM Viewer OsiriX와 와이어형태의 열가소성 재료를 사용하는 용융적층조형(Fused Deposition Modeling; FDM) 방식의 3차원 프린터를 이용하여 출력 크기에 제한이 없고 적은 비용으로 유지와 제작을 할 수 있도록 일반화하여 많은 병원에서 골절수술에 사용할 수 있도록 골절수술환자의 맞춤형 골 모델을 제작할 수 있는 3차원 프린팅 시스템을 개발하였으며 정형외과학의 교육, 연구, 진료의 전 분야에 걸쳐 광범위하게 응용될 것으로 예상되며, 대학병원뿐 아니라 일반병원에서도 편리하게 사용될 것으로 기대된다.

• 구강회복응용과학지
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• 제36권4호
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• pp.272-281
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• 2020

영구치가 선천 결손된 아동에서 유치가 발거되면, 교정적으로 공간을 폐쇄하거나, 성장이 끝나고 임플란트 수복을 시행할 때까지 공간을 유지하게 된다. 그러나 점차 치조골은 위축되고, 향후 보철 수복을 어렵게 하거나 비심미적인 결과를 야기할 수 있으므로, 임상의는 결손 공간과 치조골의 유지 모두 고려해야 한다. 본 증례에는 2개의 하악 전치가 결손된 환아에서 교정용 골성 고정원을 이용한 임시 보철 수복을 시행한 증례이다. 2개의 골성 고정원을 치조정 2 - 3 mm 하방에 수평으로 식립하였으며, 강선이 삽입된 인공치로 고정하였다. 2년의 경과 관찰동안 치은 염증이나 골성 고정원의 탈락은 발생하지 않았다. 또한 방사선 평가에서 인접 치조골의 성장이 저해되지 않았으며, 치조골 폭경 역시 양호하게 유지되었다.

• 대한치과보철학회지
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• 제45권1호
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• pp.60-70
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• 2007

Statement of problem: The cement-type abutment would be needed for the reduction of its body in order to correct the axis and to assure occlusal clearance. In the case of intraoral preparation, there is a potential risk that generated heat could be transmitted into the bone-implant interface, where it can cause deterioration of tissues around the implant and failed osseointegration. Purpose: The purpose of this study was to assess the difference of the heat transmitting effect on external and internal connection implant types under various conditions. Material and method: For evaluating the effects of alternating temperature, the thermocoupling wires were attached on 3 areas of the implant fixture surface corresponding to the cervical, middle, and apex. The abutments were removed 1mm in depth horizontally with diamond burs and were polished for 30 seconds at low speed with silicone points using pressure as applied in routine clinical practice. Obtained data were analyzed using Mann-Whitney rank-sum test and Wilcoxon / Kruskal-Wallis Tests. Result: Increased temperature on bone-implant interface was evident without air-water spray coolant both at high speed reduction and low speed polishing (p<.05). But, the difference between connection types was not shown. Conclusion: The reduction procedure of abutment without using proper coolant leads to serious damage of oral tissues around the implant irrespective of external and internal connection type.

• 대한두개안면성형외과학회지
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• 제19권3호
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• pp.175-180
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• 2018

Background: The facial bone has a complex structure compared to other bones, and various types of fractures can occur due to its characteristics. Among them, in comminuted fractures of anterior maxillary wall, multiple depressed and impacted bony segments cannot be reduced easily when performing internal fixation using plates and screws or wires, and inadequate restoration leads to a range of complications. This paper introduces an alternative technique using a resorbable mesh with fibrin glue to restore comminuted fractures of anterior maxillary wall. Methods: Thirteen patients were diagnosed with comminuted fractures of anterior maxillary wall between March 2017 and February 2018 in the authors' hospital. All patients with comminuted fractures of anterior maxillary wall underwent restoration using resorbable mesh with fibrin glue. The patients' demographics, causes of facial trauma, mean operation time, length of hospital stay, follow-up period, and complications were recorded. Results: No major complications and only one hypoesthesia of the skin area was noted. Three months after surgery, the hypoesthesia recovered completely. After surgery (mean, 3.9 months; range, 2-12 months), computed tomography showed that the bone fragments in all patients were fixed successfully in their anatomical places. Conclusion: In comminuted fractures of anterior maxillary wall, the use of a resorbable mesh with fibrin glue can be an advantageous and effective method for a successful restoration without complications.