Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.35
no.5
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pp.329-334
/
2009
Objective: To evaluate the ratio between bone-contact length and inter-segmental length of the rigid fixation screw used in bilateral sagittal split ramus osteotomy (BSSRO) for mandibular setback. Material and Methods: Records of 40 patients with Class III malocclusion were selected. 20 of them had BSSRO, while the other 20 had BSSRO with maxillary LeFort I osteotomy. All of the patients had three noncompressive bicortical screws inserted at the gonial angle through transcutaneous approach. Two screws were inserted antero-posteriorly above inferior alveolar nerve and one screw was inserted below. The lengths of bone-contact and that of inter-segmental part were measured using cone-beam computed tomography. Ratio between these two measured lengths was calculated. Results: Both bone-contact and inter-segmental lengths were longer in BSSRO group than in BSSRO with maxillary LeFort I osteotomy group. Ratio of bone-contact to inter-segmental length was lower in BSSRO group than in BSSRO with Lefort I group. Both bone-contact and inter-segmental lengths were longer at the antero-superior position than at the inferior position. However, their ratio showed little difference. Conclusion: This study suggest that stability of screws in BSSRO group was greater than in BSSRO with Lefort I group. Stability of screws at the antero-superior position was greater than at the inferior position. Ratio of bone-contact to inter-segmental lengths was 0.2 in average.
STATEMENT OF PROBLEM: Currently, many implant systems are developed and divided into two types according to their joint connection: external or internal connection. Regardless of the connection type, screw loosening is the biggest problem in implant-supported restoration. PURPOSE: The purpose of this study is to assess the difference in stability of abutment screws between the external and internal hexagonal connection types under cyclic loading. MATERIAL AND METHODS: Each of the 15 samples of external implants and internal abutments were tightened to 30 N/cm with a digital torque gauge, and cemented with a hemispherical metal cap. Each unit was then mounted in a $30^{\circ}$ inclined jig. Then each group was divided into 2 sub-groups based on different periods of cyclic loading with the loading machine (30 N/ cm - 300 N/cm,14 Hz: first group $1{\times}10^6$, $5{\times}10^6$ cyclic loading; second group $3{\times}10^6$, $3{\times}10^6$ for a total cyclic loading of $6{\times}10^6$) The removal torque value of the screw before and after cyclic loading was checked. SPSS statistical software for Windows was used for statistical analysis. Group means were calculated and compared by ANOVA, independent t-test, and paired t-test with ${\alpha}$=0.05. RESULTS: In the external hexagonal connection, the difference between the removal torque value of the abutment screw before loading, the value after $1{\tims}10^6$ cyclic loading, and the value after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading was not significant. The difference between the removal torque value after $3{\times}10^6$ cyclic loading and after $3{\times}10^6$, and additional $3{\times}10^6$ cyclic loading was not significant. In the internal hexagonal connection, the difference between the removal torque value before loading and the value after $1{\times}10^6$ cyclic loading was not significant, but the value after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading was reduced and the difference was significant (P < .05). In addition, in the internal hexagonal connection, the difference between the removal torque value after $3{\times}10^6$ cyclic loading and the value after $3{\times}10^6$, and additional $3{\times}10^6$ cyclic loading was not significant. CONCLUSION: The external hexagonal connection was more stable than the internal hexagonal connection after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading (t = 10.834, P < .001). There was no significant difference between the two systems after $3{\times}10^6$, and additional $3{\times}10^6$ cycles.
PURPOSE. This randomized controlled trial aimed to evaluate the effect of implants' two different diameters and cantilever lengths on the marginal bone loss and stability of mplants supporting maxillary prostheses. MATERIALS AND METHODS. Ninety-six implants were placed in sixteen completely edentulous maxillary ridges. Patients were randomly divided into two groups: Group A, implants were placed with a cantilever to anterior-posterior AP spread length (CL:AP) at a ratio of 1:3; Group B, implants were placed with a CL:AP at a ratio of 1:2. Patients were further divided into four sub-groups: Groups A1, A2, B1, and B2. Groups A1 and B1 received small diameter implants while Groups A2 and B2 received standard diameter implants. Bone height and stability measurements around each implant were performed at 0, 4, 8 and 24 months after definitive prostheses delivery. RESULTS. Statistical analysis of the mean implant stability and height values revealed an insignificant difference between Group A1 and Group A2 at all the different time intervals while significantly higher values in Group B1 in comparison with Group B2. Results also showed significantly higher values in Group A1 in comparison with Group B1 and an insignificant difference between Group A2 and Group B2 at all the different time intervals. CONCLUSION. It can be concluded that the use of small diameter implants placed with a CL:AP at a ratio of 1:3 provided predictable results and that the 1:2 CL:AP significantly induced more critical bone loss in the small diameter implants group, which can significantly reduce long term success and survival of implants
Journal of Dental Rehabilitation and Applied Science
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v.19
no.2
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pp.125-137
/
2003
The use of screw-retaind prosthesis on an osseointegrated implant is a popular treatment modality offering relative ease in the removal of the restoration. One of the complications associated with this modality is the loosening of the abutment and coping screws. Loosening of the screws results in patient dissatisfaction, frustration to the dentist and, if left untreated, component fracture. There are several factors which contribute to the loosening of implant components which can be controlled by the restorative dentist and lab technician. This article offers pratical solutions to minimize this clinical problem and describes the factors involved in maintaining a stable screw joint assembly. To avoid joint failure, adherence to specific clinical, as well as mechanical, parameters is critical. With respect to hardware, optimal tolerance and fit, minimal rotational play, best physical properties, a predictable interface, and optimal torque application are mandatory. In the clinical arena, optimal implant distribution; load in line with implant axis; optimal number, diameter, and length of implants; elimination of cantilevers; optimal prosthesis fit; and occlusal load control are equally important.
Journal of the korean academy of Pediatric Dentistry
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v.38
no.3
/
pp.250-259
/
2011
The aim of this study was to suggest a design for an orthodontic miniscrew which may work most favorably in the thin cortical bone of the adolescent. In this study, orthodontic miniscrews with different diameters, lengths, and body types were manufactured and implanted in two artificial bone samples with different cortical bone thickness. Maximum insertion torque, maximum removal torque, and lateral alteration torque were measured. As a result, the bone quality, body type, diameter, and the length all had their effects on the maximum insertion torque, maximum removal torque, and lateral alteration torque. Cortical bone thickness was the most important factor. In initial stability, conical types showed better results than cylindrical types. Increase in the diameter had favorable effects in achieving mechanical stability. Increase in the length did not have as much influence as the other factors did on the initial stability, but there was a statistically significant difference between screws of 6 mm and 8 mm lengths(p<0.05). In conclusion, the conical type screw with a diameter of 1.8 mm is most favorable in the thin cortical bone of the adolescent. In terms of length, the 8 mm screw is expected to perform better than the 6 mm screw.
We performed lateral ankle ligament reconstructions using Achilles allograft on patients who had failed previous Brostrom repair. The bone plug is fixed with an interference screw into the calcaneus, the tendon graft is passed through a fibular tunnel, and then anchored into the talus with the biotenodesis screw. The graft is strong enough to maintain joint stability until graft incorporation and remodeling occurs. In patients with chronic failed lateral ankle instability requiring graft for ligament reconstruction, this technique allows anatomic reconstruction without the need to sacrifice autogenous peroneal tendons.
Instant powders that only require mixing with water prior to consumption can be produced by extrusion for use in products such as instant beverages. Both extrusion processing conditions and particle size of powder are important to end-product characteristics. In this study, a twin-screw extruder was used under various processing conditions (feed moisture, barrel temperature, and screw speed) to produce extrudates from soft wheat flour, which were ground to powders with particle size ranges of less than 93, 93-145, and $145-249\;{\mu}m$. Effects of adding soy lecithin to wheat flour before extrusion were also investigated. Water absorption, solubility, suspension viscosity, and dispersibility of wheat powders were related to specific. mechanical energy measured during extrusion. Powder particle size was important to instant properties, especially ease of dispersal in water and stability to sedimentation. Addition of lecithin significantly improved dispersibility of powders.
Park, Se-Jin;Jeong, Hwa-Jae;Shin, Hun-Kyu;Seo, Dong-Seok;Choi, Young-Min;Kim, Eugene
Journal of Korean Foot and Ankle Society
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v.18
no.1
/
pp.29-35
/
2014
Purpose: The purpose of this study is to compare the radiologic and clinical results of syndesmotic screw fixation and posterior malleolar fixation for syndesmotic injury in Lauge-Hansen classification pronation-external rotation (PER) stage IV ankle fractures with posterior malleolus fracture. Materials and Methods: We designed a retrospective study that included patients with Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture. Of 723 patients who underwent ankle fracture surgery from March 2005 to November 2012, 29 were included in this study. In this study, syndesmotic injury was treated with syndesmotic screw fixation or posterior malleolus fixation. There were 15 cases of syndesmotic screw fixation and 14 cases of posterior malleolar fixation. We compared the radiologic and clinical results at one year postoperatively. Posterior malleolus fragment size on a pre-operative computed tomographic image, and tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, and Takakura classification on a postoperative one year followup radiograph were used for comparison of the radiologic results. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society score, visual analogue scale score, and patient subjective satisfaction score. Results: Posterior malleolar fragment size was $12.62%{\pm}3.01%$ of the joint space in the syndesmotic screw fixation group and $27.04%{\pm}4.34%$ in the posterior malleolar fixation group. A statistical difference was observed between the two groups. However, other results, including tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, Takakura classification, and clinical scores showed no statistical difference. Conclusion: In the Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture, if the posterior malleolus fracture can be reduced anatomically and fixated rigidly, syndesmotic screw fixation, which can cause several complications, is usually not required for achievement of a satisfactory syndesmotic stability; this would be a recommendable option for treatment of syndesmotic injury.
Statement of problem : Implant screw loosening remains a problem in implant prosthodontics. Some abutment screws with treated surfaces were introduced to prevent screw loosening and to increase preload. DLC(Diamond Like Carbon) film has similar properties on hardness, wear resistance, chemical stability, biocompatibility as real diamond materials. Purpose : The purpose of this study was to investigate the effect of lubricant layer on abutment screw and to discriminate more effective method between soft lubricant and hard lubricant to prevent screw loosening. Material and method : In this study, $1{\mu}m$ thickness DLC was used as protective, lubricating layer of titanium screws and 3 times removal torque was measured on the abutment screws to investigate the difference in 10 coated and 10 non-coated abutment screws. Results : The results indicated that the implants with DLC coating group were not more resistant to the applied force in screw loosening. At 32Ncm, the 3 times removal torque in DLC group were $27.75{\pm}2.89,\;25.85{\pm}2.35$ and $26.2{\pm}2.57$. The removal torque in no-coated abutment screws were $27.85{\pm}4.23,\;27.35{\pm}2.81$ and $27.9{\pm}2.31$, respectively. Conclusion : The lubricant layer used in this study was Diamond Like Carbon(DLC) and it have a properties of hard and stable layer. The DLC coating layer was hard enough to prevent distortion of screws in the repeated unscrewing procedure in clinical situation. The reduced friction coefficient in hard DLC layer was not effective to prevent screw loosening.
Purpose: The purpose of this study was to evaluate retrospectively the clinical results of closed reduction and percutaneous screw fixation for unstable injuries on stress radiographs in subtle injuries of Lisfranc joint. Materials and Methods: From June 1997 to March 2003, 6 cases of unstable injuries on stress radiograph in subtle injuries of Lisfranc joint were treated by percutaneous cannulated screw fixation after closed reduction. All cases were injuried by indirect force (twisting injury). The average diastasis between the 1st and 2nd metatarsal base was 3 mm (2-4 mm) on initial nonweight bearing AP radiograph. The average follow-up period was 20 months. Clinical evaluation was assessed according to the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score. Results: The AOFAS midfoot score was average 86 (80-90) points. The average diastasis between 1st and 2nd metatarsal base was 2 mm (1-3 mm) on weight bearing AP radiograph in final follow up. The final diastasis was increased slightly than diastasis in initial postoperative radiographs. But the clinical results were good. There was no correlation between the degree of diastasis and the clinical results. On weight bearing lateral radiograph, the average difference with normal foot in the distance between plantar aspect of 5th metatarsus and medial cuneiform was 2 mm (0-3 mm). One case had mild arthritic change on the radiographs. Conclusion: When the Lisfranc injuries, especially in the subtle injuries were suspicious, the stress views are helpful to assess stability of the Lisfranc injuries and planning of treatment. For unstable injuries on stress radiographs in subtle injuries of Lisfranc joint, closed reduction and percutaneous screw fixation is useful method to expect good clinical results.
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