The distinction between isolated and combined injuries is crucial both for treatment and prognosis. For most combined injuries, surgical treatment continues to be favored over nonoperative treatment. It is generally agreed that isolatel PCL injuries do well without surgery. There has been an interest by many authors to fix the graft directly to the posterior aspect of the tibia(tibial inlay). With this procedure, tibial graft fixation will be more direct and theoretically reduce the bending effects of the graft with a fixation site far away from the tibial insertion. Modified tibial inlay technique, which is the posterior approach does not require the patient to be in the prone or lateral decubitus position during the operation. Use of a double-bundle reconstructive technique is attractive and has been performed by some surgeons. At this time, this procedure is still being investigated and should not be routinely used in the clinical setting until studies have indicated an advantage over current single-bundle techniques. However theologically, double-bundle reconstructive technique is more useful in severe posterior unstable knee. Recent advances have increased our knowledge of the anatomy and mechanical characteristics of the PCL. Basic science research has further increased our awareness of the interaction of the posterolateral structures with the PCL. To achieve restoration of normal posterior laxity, it is critical to address the posterior as well as the postero-lateral structures. Surgical treatment is often complex and requires a wide range of surgical techniques and skills to treat associated injuries. When the PCL is reconstructed, most surgeons choose to reconstruct the anterolateral component using a graft of sufficient size and strength. The initial postoperative rehabilitation should be addressed cautiously in an effort to avoid excessive forces on delicate repairs and reconstructions in these complex injuries. Further research is necessary to evaluate new surgical approaches such as double-bundle reconstructions and tibial inlay techniques as well as improved techniques for capsular and collateral ligament injuries.
1968년부터 1970년까지 뽕나무위축병에 관하여 접목전염 및 곤충매개전염시험을 한바 결과를 요약하면 다음과 같다. 1. 병근에 건전수목을 절접하므로서 활착주수중 30%의 전염율을 나타냈다. 건전근에 병수목을 절접함에 있어서는 병수목을 월동전에 채취 저장하였다가 익춘 공시한 것은 활착주수중 14%가 전염되였는데 반하여 월동후에 채취한 병수목에 있어서는 전혀 발병되지 않았다. 건전대목에 병수목을 절접하여 불활착된 것 중 대아가 발조한 것은 전혀 발병되지 않았다. 2. 뽕나무위축병의 무병지대에서 채집한 마름무늬매 미충을 중증위축병주에서 7일, 14일, 21일 간식 각각흡즙시킨 성충을 무병실생묘에 방사접종한 결과 7일구는 전염되지 않았으며 14일구는 22%, 21일구는 61% 전염율을 나타냈다. 흡즙시간과 접종시간은 길수록 전염율이 높았다.
The purpose of this study was to measure thermal expansions of dental investments, Biovest(Casting Investment. Dentsply International INC, U.S.A.), Multi-Best (Use for all dental chrome-cobalt alloys, The Ransom & Randolph Co. U.S.A.), Kerr(Inlay Investment. Sybron Kerr, U.S.A.), O. K. (Inlay Investment. Shofu Dental MFG, Co. Japan), Whip-Mix (Cristobalite Inlay Investment. Whip-Mix Corporation. U.S.A.). Thermal expansion of specimens(5mm in diameter and 50mm in length) was measured by a dilatometer at the temperature range from $20^{\circ}C$ to $700^{\circ}C$ by comparing expansion between standardized quartz and experimental specimens with heating rate about $300^{\circ}C$/hr. The following results were obtained. 1. The coefficient of thermal expansion of Biovest was $15{\times}10^{-6}/^{\circ}C$ in the water powder ratio 18/100 and $14{\times}10^{-6}/^{\circ}C$ in the water powder ratio 28/100. Those of Multi-Best were $9{\times}10^{-6}/^{\circ}C$ in the water powder ratio 14/100 and $7{\times}10^{-6}/^{\circ}C$ in the water powder ratio 24/100. 2. The coefficient of thermal expansion of Kerr were $17{\times}10^{-6}/^{\circ}C$ in the water powder ratio 38/100 and $14{\times}10^{-6}/^{\circ}c$ in the water powder ratio 48/100. Those of O. K. were $9{\times}10^{-6}/^{\circ}C$ in the water powder ratio 33/100 and $7{\times}10^{-6}/^{\circ}C$ in the water powder ratio 43/100 3. The coefficient of thermal expansion of Whip-Mix were $14{\times}10^{-6}/^{\circ}C$ in the water powder ritio 40/100 and $12{\times}10^{-6}/^{\circ}c$ Fein the water powder ratio 50/100. Those of Hi-Heat were $11{\times}10^{-6}/^{\circ}c$ in the water powder ratio 28/100 and $10{\times}10^{-6}/^{\circ}c$ in the water powder ratio 38/100.
The purpose of this study was to evaluate the relationship between monomer compositions and the changes in the degree of conversion in the various layers of composites after additional heat curing. Four types of composites and 3 types of inlay ovens were used in this study. Composite was placed in a 4-mm thick teflon mold, and light cured from the top for 60 seconds. Ten samples were prepared for each composite ; 5 of these were additionally heat cured in an inlay oven as the manufacturer recommended. After light curing or light and heat curing, the samples were sectioned into four parts and assigned to groups A, B, C, or D according to their distance from the light source. These sections were then thinned to 50-$70{\mu}m$, and these wafers were analyzed with a Fourier Transform Infrared Spectrometer(FI-IR) to determine the degree of conversion. A standard baseline technique was used to calculate the degree of conversion. $^{13}C$ NMR spectra of bis-GMA, TEGDMA and bis-EMA, were acquired using a Varian Gemini spectrometer operated at 200 MHz. $CDCl_3$ solvent was used for qualitative analysis. The degree of conversion was affected by bis-GMA : TEGDMA ratio but it seemed to be also affected by other factors. When the composites were heat cured, significant increases in the degree of conversion were noted throughout the samples, but the amount of increase differed between materials. Thus, clinical performance of a heat-treated composite inlay may be different depending on materials.
Background: The incidence of blow out fractures is increasing and the techniques of diagnosis and treatment have been recently evolving. Despite its clinical significance, there has been no study on orbital inferiomedial blow out fractures. Therefore, this study was designed to investigate the clinical significance of treatment of orbital inferiomedial blow out fractures. Methods: A retrospective review of fifty-seven patients who could be followed up for at least 1 year after surgical reconstruction of pure inferiomedial blow out fracture was undertaken. The transconjunctival approach was performed in all cases. The onlay technique was used in 32 patients and the inlay/sheet method was used in 25 patients. We evaluated the clinical outcomes using the chi-square test. Results: In the group using the onlay technique, postoperative diplopia and enophthalmos were observed in 14 cases and 3 cases, respectively. Of these, 5 cases and 3 cases lasted for more than 6 months, respectively. In the group using the inlay/sheet method, postoperative diplopia was observed in 9 cases, but there were no cases of enophthalmos. Among the 9 diplopia cases, 4 lasted for more than 6 months. Conclusion: Postoperative diplopia and enophthalmos were increased after treatment of inferiomedial blow out fractures compared to isolated medial (0.6%, 0.3%) or inferior (1.8%, 0.6%) blow out fractures. Therefore, careful dissection is necessary not to injure the inferior oblique muscle to decrease the incidence of postoperative diplopia. Moreover, the inlay/sheet method is an effective option for reconstruction of inferiomedial blow out fractures.
Background Although prepectoral implant-based breast reconstruction has recently gained popularity, dual-plane reconstruction is still a better option for patients with poor-quality mastectomy skin flaps. However, shoulder morbidity is aggravated by subpectoral reconstruction, especially in irradiated patients. This study aimed to demonstrate shoulder exercise improvement in subpectoral reconstruction by delayed prepectoral conversion with an acellular dermal matrix (ADM) inlay graft technique at the time of expander-to-implant exchange after irradiation. Methods Patients with breast cancer treated for expander-to-implant exchange after subpectoral expander insertion and subsequent radiotherapy between January 2021 and June 2022 were enrolled. An ADM inlay graft was inserted between the pectoralis major muscle and the previously inserted ADM. The ADM was sutured partially overlapping the pectoralis muscle from the medial side with the transition part, to the muscle border at the lateral side. Perioperative shoulder joint active range-of-motion (ROM) for forward flexion, abduction, and external rotation was also evaluated. Results A total of 35 patients were enrolled in the study. Active shoulder ROM significantly improved from 163 degrees preoperatively to 176 degrees postoperatively in forward flexion, 153 to 175 degrees in abduction, and 69 to 84 degrees in external rotation. There was no difference in patient satisfaction regarding the final outcome between the conventional prepectoral reconstruction group and the study group. Conclusion Shoulder exercises in irradiated patients who underwent subpectoral reconstruction were improved by delayed prepectoral conversion using an ADM inlay graft. It is recommended that subpectoral reconstruction not be ruled out due to concerns regarding muscle contracture and shoulder morbidity in radiation-planned patients with poor mastectomy skin flaps.
This study was to know the usefulness of argon laser for composite resin, to prove the polymerized effect of heat treatment of composite resin inlay and to get the curing method for optimal physical properties of composite resin inlay. In this study we used four light curing units and one heat curing unit: Visilux $II^{TM}$, a visible light gun: $SPECTRUM^{TM}$, an argon laser: Unilux AC$^{(R)}$ and Astorn XL$^{(R)}$, visible light curing unit: CRC-$100^{TM}$ for heat treatment. Compared to a control group, we divided the experemental groups into five as follows: Control group: Light curing(Visilux $II^{TM}$) Experimental group 1 : Light curing(Visilux $II^{TM}$) + Light curing(Unilux AC$^{(R)}$) Experimental group 2: Light curing(Visilux $II^{TM}$) + Light curing(Astron XL$^{(R)}$) + Heat treatment(CRC-$100^{TM}$) Experimental group 3 : Laser curing($SPECTRUM^{TM}$) Experimental group 4 : Laser curing($SPECTRUM^{TM}$) + Light curing(Unilux AC$^{(R)}$) Experimental group 5 : Laser curing($SPECTRUM^{TM}$) + Light curing(Astron XL$^{(R)}$) + Heat treatment (CRC-$100^{TM}$) According to the above classification, we made samples through the curing of Clearfil CR Inlay$^{(R)}$, which is a composite resin for inlay, in a separable cylindrical metal mold and polycarbonate plate. And then, we measured and compared the value of compressive strength, diametral tensile strength and the surface micro hardness of each sample. The results were as follows : 1. Among the experimental groups, group 5 showed the highest value of compressive strength, $157.50{\pm}10.24$ kgf and control group showed the lowest value of compressive strength, $103.93{\pm}21.93$ kgf. Control group showed significant difference with the experimental groups(p<0.001). Group 2 which was treated by the heat showed higher compressive strength than that of group 1 which was not, and there was significant difference between group 1 and group 2(p<0.001). Group 5 which was treated by heat showed higher compressive strength than group 4 which was not, and there was significant difference group 4 and group 5(p<0.001). 2. Among the experimental groups, group 5 showed the highest value of diametral tensile strength, $95.84{\pm}1.97$ kgf and control group showed the lowest value of diametral tensile strength, $81.80{\pm}2.17$ kgf. Control group which was cured by visible light showed higher diametral tensile strength than group 3 which was cured Argon Laser. Group 2 which was treated by heat showed higher compressive strength than that of group 1 which was not, and there was significant difference between group 1 and group 2(p<0.001). Group 5 which was treated by heat showed higher compressive strength than group 4 which was not, and there was a significant difference group 4 and group 5(p<0.001). 3. Among the experimental groups, group 5 showed the highest value of microhardness of top surface, $148.42{\pm}9.57$ kgf and control group showed the lowest value of microhardness, $111.43{\pm}7.63$ kgf. In the case of bottom surface, group 5 showed the highest value of $146.19{\pm}7.62$ kgf, and control group showed the lowest, $104.03{\pm}11.05$ kgf. Group 3 which was cured by Argon Laser showed higher diametral tensile strength than control group which was cured only with a visible light gun. Group 2 which was treated by heat showed higher compressive strength than that of group 1 which was not, and there was a significant difference between group 1 and group 2(p<0.001). Group 5 which was treated by heat showed higher compressive strength than group 4 which was not, and there was a significant difference group 4 and group 5(p<0.001). 4. According to the above results, we took a conclusion that argon laser can be used as a useful unit for curing the composite resin and heat treatment can improve the physical properties of the composite resin inlay.
The purpose of this study was to evaluate the effects of bleaching agent through the dentinal tubules of cervical area in the intracoronal bleaching of pulpless teeth on cutured fibroblast cells. Extracted human incisors were enlarged to # 40 K-file and obturated with gutta-perella and AH 26 sealer. The gutta-percha was removed to 2mm below the cementoenamel junction of the root The teeth were divided into 3 experimental and control groups. Experimental groups; Experimental group 1: Temporary inlay wax filld with 30% $H_2O_2$ in pulp cavity. Experimental group 2: Temporary inlay wax filld with 30% $H_2O_2$ in pulp cavity after placement of ZOE cement to cementoenamel junction. Experimental group 3: Temporary inlay wax filld with 30% $H_2O_2$ in pulp cavity after application of Copalite to cementoenamel junction. Control group: Temporary inlay wax filled without 30% $H_2O_2$ in pulp cavity under the same condition at each experimental group. Each tooth was immersed in well of multidish cultured fibroblast cell for 48 hours. The cellular multiplication and cell viability were calculated at the interval of 1, 3, 5. 7 hours and the morphological changes in well were observed and their photographs were taken with inverted microscope. The obtained results were as follows : CD The cellurar multiplicaton and cell viability decreased in all experimental groups at 1 hour after experiment and the morphology of fibroblast cell was changed from star shape to round (2) The cell viability was lowered to 34 % in experemental group 1, 44 % in experimental group 2, and 38 % in experemental group 3 at 3 hours after experiment (3) The cell multiplication was decreased to 54% in experemental group 1. 47% in experimental group 2, and 40% in experemental group 3 at 7 hours after experiment. (4) The decrease of cell number and morphological changes of fibroblast cell were remarkable in experimental group 1, group 3 and 2 in order. These results suggest that the fibroblast cells receive severe damage by 30% $H_2O_2$ solution leaked through the dentinal tubules and the dentinal tubules are able to be obturated better by ZOE cement than by Copalite.
Purpose: The aim of this study was to present new a model that allows the study of the bone healing process, with an emphasis on the biological behavior of different graft-to-host interfaces. A standardized "over-inlay" surgical technique combined with a differential histomorphometric analysis is presented in order to optimize the use of critical-size calvarial defects in pre-clinical testing. Methods: Critical-size defects were created into the parietal bone of 8 male Wistar rats. Deproteinized bovine bone (DBBM) blocks were inserted into the defects, so that part of the block was included within the calvarial thickness and part exceeded the calvarial height (an "over-inlay" graft). All animals were sacrificed at 1 or 3 months. Histomorphometric and immunohistochemical evaluation was carried out within distinct regions of interest (ROIs): the areas adjacent to the native bone (BA), the periosteal area (PA) and the central area (CA). Results: The animals healed without complications. Differential morphometry allowed the examination of the tissue composition within distinct regions: the BA presented consistent amounts of new bone formation (NB), which increased over time ($24.53%{\pm}1.26%$ at 1 month; $37.73%{\pm}0.39%$ at 3 months), thus suggesting that this area makes a substantial contribution toward NB. The PA was mainly composed of fibrous tissue ($71.16%{\pm}8.06%$ and $78.30%{\pm}2.67%$, respectively), while the CA showed high amounts of DBBM at both time points ($78.30%{\pm}2.67%$ and $74.68%{\pm}1.07%$, respectively), demonstrating a slow remodeling process. Blood vessels revealed a progressive migration from the interface with native bone toward the central area of the graft. Osterix-positive cells observed at 1 month within the PA suggested that the periosteum was a source of osteoprogenitor elements. Alkaline phosphatase data on matrix deposition confirmed this observation. Conclusions: The present model allowed for a standardized investigation of distinct graft-to-host interfaces both at vertically augmented and inlay-augmented sites, thus possibly limiting the number of animals required for pre-clinical investigations.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
제29권4호
/
pp.219-225
/
2003
Purpose: Platelet Rich Plasma(PRP) application is increasing with sinus inlay bone graft, but there is few research with radiographic ananlysis on effect of PRP in maxillary sinus. The author investigated the amount of bony changes of maxillary sinus for dental implantation among the patients with maxillary inlay graft. Materials and Methods: With 10 patients who were treated with sinus inlay autologous bone grafting combined with PRP technique, and with 5 patients who were treated with sinus inlay grafting only without PRP, the panoramic radiographys which were taken at preoperation, immediate postoperation, 3months postoperation, and 4 months postoperation(a month after dental implantation)periods were analysed. The films had been scanned, and then proceeded throughout image analysis system. The bone density of maxillary grafted sites was compared with adjacent tooth enamel density and remeasured according to density luminosity of each film. The density changes on PRP group and bone graft only group were analysed with non-parameteric statistics method. Results: In PRP combined patients group, bone density on postoperation periods was increased totally. The remarkable enhanced change of bone density was observed on 3 months postoperation period, thereafter the increasing rate was slightly reduced. In only bone graft patients group, bone density on postoperation periods was also increased compared with preoperation period, but the bone density of 4 months postoperation period was decreased compared with 3 months postoperation period. The amount of bone density on PRP group was significantly changed according to periods in contrast to bone graft only group. Conclusion: The bone density on PRP group was remarkably increased at 3 months postoperation compared to bone graft only group and it was seemed to be associated with more new bone formation, less grafted bone resorption at bone grafted sites with PRP.
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