• Title/Summary/Keyword: Splint

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A Prediction on the Conservative Treatment Outcome of TMD Patients by Prognostic Factors (측두하악장애 환자의 보존적 치료결과의 예측에 관한 연구)

  • Lee, Hye-Jin;Park, June-Sang;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.26 no.2
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    • pp.133-146
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    • 2001
  • This study was performed to predict the conservative treatment outcome of TMD patients by investigating the prognostic factors ; symptom duration, history of previous treatment, history of previous medication, history of trauma, disability of daily activity, severity of pain, noise, limitation of mouth opening(LOM) and maximum comfortable opening(MCO). Two hundreds and fifty-four subjects were selected for this study among the TMD patients who had visited the Dept. of Oral Medicine BNUH and been treated conservatively with medication, physical therapy, behavioral treatment, and splint therapy from 1991 to 2000. The subjects were divided into two groups improved or unimproved according to the treatment response following six months of conservative treatment. Those who showed less than 1 on NAS for pain, TMJ noise, and opening limitation belonged to the improved group and those who showed more than 2 on NAS belonged to the unimproved group. The two groups were compared with respect to symptom severity, number of diagnosis, history of trauma, previous treatment, previous medication, and disability of daily activity. A prognostic equation with the factors revealed to be significantly related to the prognosis of conservative treatment was obtained. The obtained results were as follows ; 1. In improved group, mean duration of history was 12 months, mean treatment duration of a patient was 4 months an mean number of treatment was about 10 times. In other words, in unimproved group, mean duration of history was 27.4 months, mean treatment duration of patient was 10.5 months and mean number of treatment was 19 times. 2. In unimproved group, multiple diagnosis, chronicity, disability of daily activity were significantly greater than that of the improved group. 3. Patients in unimproved group revealed severe noise at first visit and smaller maximum comfortable opening comparatively. 4. Prognostic factors such as duration of treatment, number of treatment, multiplicity, and chronicity and disability of daily activity showed a significant relation in prediction of improvement. 5. Prognostic equation with significant variables is as follows ; Y = 1.984 - 0.251Noise + 0.068MCO - 0.673Multiplicity. - 0.958Chronicity - 0.065Disability. Classification accuracy of 70.3 %, sensitivity of 71.4% and specificity of 66.7% were shown. 6. Prognostic equation with all factors is as follows : Y = 1.599 - 0.038Pain - 0.256Noise - 0.006Limitation + 0.068MCO - 0.580Multiplicity - 1.025Chronicity - 0.720Disability - 0.329Medication - 0.087Treatment + 0.740Trauma. Classification accuracy of 70.3 %, sensitivity of 73% and specificity of 64.3% were shown. 7. Prognostic value of the improved group with significant factors was $1.0446{\pm}1.0726$ and prognostic value of the unimproved group with significant factors was $-0.013{\pm}1.0146$. Prognostic value of the improved group with all factors was $1.0465{\pm}1.0849$ and prognostic value of the unimproved group with all factors was $-0.057{\pm}1.0611$.

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The Effect of Human Appendage Muscle Strength on Increase in Vertical Dimension from Intercuspal Position of Mandible (교두감합위로부터 출발한 수직교합고경의 단계적 증가가 사지 근력에 미치는 영향에 관한 연구)

  • Hong, Dong-Hee;Lee, Sung-Bok;Choi, Dae-Kyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.19 no.3
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    • pp.169-183
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    • 2003
  • According to our recent investigation that the increase in the occlusal vertical dimension made the appendage muscle strength got higher, the occlusal appliances were made by increasing the occlusal vertical dimension "from the centric relation" position of the mandible. In this experiment, the authors tried to study the change in the appendage muscle strength due to increase in occlusal vertical dimension from intercuspal position(ICP) of mandible with the same subjects and manner as the former experiment. For this study, ten male athletes in a mean age of 23 year who were joined the former study were selected. All the subjects had a complete or almost complete set of natural teeth and reported no subjective symptoms of temporomandibular disorders. Upper and lower casts were mounted on the semi-adjustable articulator at the intercuspal position and a point was marked on the attached gingival area between the right canine and the right 1st. premolar in each upper and lower cast. From the points, the occlusal vertical dimension was increased by 2mm, 3.5mm and 5mm, and then each 10 maxillary type occlusal splint at each 3-increased position were fabricated with heat curing clear acrylic resin. Including the intercuspal position, the 3 kinds of occlusal splints were placed on the subjects individually, and then isokinetic muscle strength on 7 parts of the human appendage which are shoulder, knee, ankle, wrist, forearm, elbow and hip was measured with the CYBEX 6000 SYSTEM (Lumex, NewYork, USA). The results were as follows: The highest mean value in muscular strength was shown at the position of 2mm-increased vertical dimension. The muscle strength during internal/external rotation of shoulder and knee, plantarflexion of ankle, flexion of elbow, and flexion and extension of hip at the increased occlusal vertical dimension position were significantly higher than them at the intercuspal position (p<0.05). Only in view of the increase in the appendage muscle strength, regardless of the way of making the occlusal splints by elevating the occlusal vertical dimension from the centric relation position or intercuspal position, the occlusal splints had an effect on the increase of isokinetic muscle strength at the occlusal vertical dimension which increased within the proper range on the habitual arc of closure.

The Effects of Modified Constraint-Induced Movement Therapy on Hand Functions of Children With Hemiplegic Cerebral Palsy (수정된 강제유도 운동치료가 편마비를 가진 뇌성마비 아동의 상지 기능에 미치는 영향)

  • Bang, Hyun-Soo;Jang, Sang-Hun
    • The Journal of Korean society of community based occupational therapy
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    • v.7 no.1
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    • pp.25-35
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    • 2017
  • Objective : The aims of this study was to investigate the effects of modified constraint induced movement therapy(CIMT) on upper extremities function of children with hemiplegic cerebral palsy. Methods : The participants of this study are 4 children with hemiplegic cerebral palsy aged between 8 to 11 years old. During the modified CIMT period, the unaffected hand of the subjects was restrained by a hand splint for 8 weeks, five days per week, five hours a day. And the affected upper extremity was strongly trained by performing functional tasks, which were individually structured use of the affected arm. Measurements used to assess hand function are Jebsen Hand Function Test, and 3D Motion Analysis. The Jebsen Hand Function Test was performed repeatedly every two weeks. The 3D Motion Analysis was performed before and after the 8 weeks of modified constraint induced movement therapy. Results : After the modified CIMT, there was a significant improvement in completed time for the 6 tasks of Jebsen Hand Function Test(p<.05). 3D Motion Analysis was that the finger tapping and the hand tapping has been significantly decreased (p<.05), and the pronation-supination movement has been significantly increased as well(p<.05). Conclusion : In the results of this study, it is evidenced that modified CIMT is effective treatment for upper extremities function of children with hemiplegic cerebral palsy. For future research, it is recommended to examine various periods and protocol of modified CIMT including impact of long periods application.

The Influence of Epinephrine Concentration in Local Anesthetics on Pulpal and Gingival Blood Flows (국소마취제에 함유된 에피네프린의 농도가 치수 및 치은 혈류에 미치는 영향)

  • Lee, Jae-Sang;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.28 no.6
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    • pp.475-484
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    • 2003
  • 동통조절을 위해 국소마취제는 치과임상에서 광범위하게 사용되어진다. 가장 널리 쓰이는 국소마취제는 리도카인이고 이는 마취효과의 지속 및 지혈효과 등의 목적으로 혈관수축제를 포함하고 있다. 대표적 혈관수축제인 에피네프린은 임상에서 1:300,000에서부터 1:50,000의 농도로 다양하게 사용되어진다. 수복치료를 위해서는 통상적으로 1:100.000농도의 에피네프린이 사용되고 있고 외과적 근관치료시 지혈효과를 위해서는 1:50,000농도의 에피네프린이 추천되고 있다. 이들 농도의 에피네프린을 포함한 리도카인으로 국소마취시 에피네프린의 농도가 치수의 혈류 및 치은의 혈류에 미치는 영향을 이해할 필요가 있고 그 영향이 전기치수검사에 대한 치수의 반응성에 미치는 영향도 이해할 필요가 있다. 따라서 혈관수축제를 포함한 국소마취제에 의한 치수혈류의 변화와 치수신경의 반응성을 이해하는 것은 중요하다 하겠다. 본 연구의 목적은 두 가지 농도의 에피네프린을 포함한 국소마취제로 마취시 나타나는 치수 및 치은의 혈류 변화를 치수신경의 반응성과 비교, 관찰함으로써 국소마취제가 치수 및 치은에 미치는 영향을 파악하고자 함에 있다. 24세에서 27세까지의 10명의 피검자의 건전한 상악중절치를 시험에 이용하였다. Laser Doppler flowmeter의 probe을 고정하기 위한 splint를 간접법으로 인상용 putty를 이용하여 제작하고 치수 및 치은의 혈류량, 그리고 전기치수검사에 대한 반응성을 측정하기 위한 3개의 구멍을 만들었다. 피검자를 10분간 안정시킨 후 마취 전 10분간 정상 혈류량과 전기검사치를 측정하고 1:50,000 epinephrine과 1:100,00 epinephrine이 각각 함유된 2% 리도카인 용액 0.9 ml를 상악 좌측 중절치 치근단부위 협점막에 침윤마취하였다. 마취 후 70분간 치수 및 치은 혈류량을 laser Doppler flowmeter를 이용해 연속적으로 측정하여 그 수치를 컴퓨터에 저장하였고, 매 5분 간격으로 전기치수검사를 시행하여 그 측정치를 기록하였다. 매 시간 간격의 평균 혈류량을 정상 혈류량에 대한 백분율로 나타내고, 각각의 농도에서 최소 치수 및 치은 혈류량을 Paired t-test, Wilcoxon's signed rank test. Duncan's multiple range test. Fisher's exact test등을 이용. 통계분석 하여 다음과 같은 결과를 얻었다. 에피네프린이 함유되어 있지 않은 리도카인을 협점막에 주사시 혈류변화가 거의 나타나지 않았으나 1:50,000 및 1:100.000 에피네프린이 함유된 2% 리도카인을 협점막에 침윤마취시 치수 및 치은 혈류 공히 현저히 감소하였다(p<0.01). 1:50,000 에피네프린군은 1:100,000 에피네프린군에 비해 치수 혈류량이 현저히 억제되어 나타났으나(p<0.01), 치은 혈류량에서는 유의성 있는 차이를 나타내지 않았다(p>0.05). 두 농도의 에피네프린 군 공히 치은혈류는 치수혈류에 비해 유의하게 많은 감소를 나타내었다(p<0.05). 1:100,000 에피네프린 군에서 마취액 주입 후 치수혈류 최대감소가 가장 먼저 나타났고 이어서 전기검사에 대한 치수의 반응성 소실 및 치은혈류 최대 감소의 순으로 나타났다(p<0.05). 1:50,000 에피네프린군의 경우가 1:100,000 에피네프린군의 경우에 비해 마취지속시간이 길게 나타났으나 유의성은 없었다(p>0.05).

Effect of Allogenic Adipose-derived Stromal Cells on Wound Healing in BALB/c Mice (BALB/c 마우스에서 동종 지방유래 기질세포가 창상치유에 미치는 영향)

  • Yoon, Jeong-Won;Lim, Jin-Soo;Kim, Jung-Nam;Yoo, Gyeol
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.323-328
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    • 2010
  • Purpose: Adipose-derived stromal cells (ADSCs) are multipotent cells that have been found to promote wound healing through the process of angiogenesis and reepithelialization. Generally, it is well known that the antigenicity of ADSCs doesn't affect stem cell therapy. In this study, we investigated the effect of allogeneic ADSCs in the wound healing process by applying allogeneic ADSCs on the wound healing splint model of mice. Methods: Adipose tissue was harvested from the epididymal fat pads of BALB/c and C57BL/6 mice. Twenty four mice BALB/c were divided into three groups; control, isogeneic, and allogeneic groups. Two full thickness defects with 6 mm diameters were created on the back of BALB/c mice. $1{\times}10^6$ ADSCs from BALB/c mice were applied on the isogeneic group. In the allogeneic group, ADSCs from the C57BL/6 mice were applied. No cells were applied to the control group. The sizes of the wounds were evaluated in 3, 5, 7, 10, and 14 days after the wounds were applied, and tissues were harvested in 7 and 14 days for histological analysis. Results: Wound healing rates had showed significant increase in 10, and 14 days when the isogeneic group was compared to the control group, but the allogeneic group showed significantly decrease compared to the isogeneic group (p<0.05). Histological scores in the isogeneic group were significantly high, but significantly lower in the allogeneic group when compared to the isogeneic group in 2 weeks (p<0.05). In the isogeneic group, thick inflammatory cell infiltration with abundant capillaries were observed in 1 week, and thick epithelium with many large capillaries were observed in 2 weeks. Conclusion: When isogeneic ADSCs were applied to wounds, they presented a faster wound healing rate compared to controls and the allogeneic group. Unlike general stem cell therapy, these findings suggest that cell therapy targeted at enhancing wound healing may benefit from the use of ADSCs with identical antigenicity, as opposed to allogeneic or xenogenic ADSCs.

EFFECT OF FIBER DIRECTION ON THE POLYMERIZATION SHRINKAGE OF FIBER-REINFORCED COMPOSITES (섬유 보강 복합레진의 섬유 방향이 중합수축에 미치는 영향)

  • Yom, Joong-Won;Lee, In-Bog
    • Restorative Dentistry and Endodontics
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    • v.34 no.4
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    • pp.364-370
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    • 2009
  • The aim of this study was to evaluate the effect of fiber direction on the polymerization shrinkage of fiber-reinforced composite. The disc-shaped flowable composite specimens (d = 10 mm, h = 2 mm, Aeliteflo A2, Bisco, Inc., IL, USA) with or without glass fiber bundle (X-80821P Glass Fiber, Bisco, Inc., IL, USA) inside were prepared, and the longitudinal and transversal polymerization shrinkage of the specimens on radial plane were measured with strain gages (Linear S-series 350${\Omega}$, CAS, Seoul, Korea). In order to measure the free polymerization shrinkage of the flowable composite itself, the disc-shaped specimens (d = 7 mm, h = 1 mm) without fiber were prepared, and the axial shrinkage was measured with an LVDT (linear variable differential transformer) displacement sensor. The cross-section of the polymerized specimens was observed with a scanning electron microscope to examine the arrangement of the fiber bundle in composite. The mean polymerization shrinkage value of each specimen group was analyzed with ANOVA and Scheffe post-hoc test (${\alpha}$=0.05). The radial polymerization shrinkage of fiber-reinforced composite was decreased in the longitudinal direction of fiber, but increased in the transversal direction of fiber (p<0.05). We can conclude that the polymerization shrinkage of fiber-reinforced composite splint or restoratives is dependent on the direction of fiber.

Evaluation of polymerization ability of resin-based materials used for teeth splinting (레진계 치아 스플린팅 재료들의 중합능력 평가)

  • Lee, Jeong-Gil;Kim, Soo-Yeon;Lee, Jae-Kwan;Kim, Jin-Woo;Park, Se-Hee;Cho, Kyung-Mo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.4
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    • pp.290-296
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    • 2018
  • Purpose: The aim of this study was to evaluate the polymerization ability of resin-based materials used for teeth splinting according to the thickness of cure. Materials and Methods: For this study, the Light-Fix and G-FIX developed for resinous splinting materials and the G-aenial Universal Flo, the high-flowable composite resin available as restorative and splinting material, were used. Ten specimens of the thickness of 2, 3, 4 and 5 mm and 5 mm in diameter for each composite resin (total 120) were prepared. The microhardness of top and bottom surfaces for each specimen was measured by the Vickers hardness testing machine. The polymerization ability of the composite resin for each thickness was statistically analyzed using independent T-test at a 0.05 level of significance. Results: There was no difference of polymerization ability regardless of the thickness in the Light-Fix and G-FIX. The G-aenial Universal Flo showed significantly low polymerization ability from the thickness of the 3 mm (P < 0.05). Conclusion: The Light-Fix and G-FIX, which are resin-based materials used for teeth splinting, are expected to be suitable for light curing up to 5 mm in thickness.

Full-mouth rehabilitation with increasing vertical dimension on the patient with severely worn-out dentition and orthognathic surgery history: A case report (악교정수술 병력을 가진 과도한 치아 마모를 보이는 환자의 수직고경 증가를 동반한 전악 수복 증례)

  • Sang-Myeong Tak;Chang-Mo Jeong;Jung-Bo Huh;So-Hyoun Lee;Mi-Jung Yun
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.1
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    • pp.33-43
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    • 2023
  • Pathological wear across the entire dentition causes problems such as collapsed occlusal plane, reduced vertical dimension, anterior premature contact, inadequate anterior guidance, and tooth migration, thereby induce symptoms such as temporomandibular joint disorder, reduced masticatory efficiency, and tooth hypersensitivity. For the treatment of patients with excessive wear, evaluation of vertical dimension should be preceded along with analysis of the cause. The patient in this case was a 45-year-old female with a history of orthognathic surgery. Through clinical examination, radiographic examination, and model analysis, overall tooth wear, interdental spacing in the anterior maxillary region, retruded condylar position, and insufficient interocclusal space for prosthetic restoration were confirmed. Full mouth rehabilitation with increased vertical dimension was planned, the patient's adaptation to the new vertical dimension was evaluated with a removable occlusal splint and temporary prosthesis, and cross-mounting was performed based on the temporary restoration to fabricate the definitive zirconia prosthesis, maintaining the adjusted vertical dimension. It showed satisfactory functional and esthetic results through stable restoration of the occlusal relationship.

Sports Injuries in College Taekwondo Players: Retrospective Analysis of 47 Players (대학 태권도 선수들에서의 스포츠 손상: 47명에 대한 후향적 연구)

  • Jung, Hong-Geun;Park, Hee-Gon;Kim, Jong-Phil;Kim, You-Jin;Kim, Ki-Choul;Kim, Young-In;Lee, Sang-Min
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.69-74
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    • 2006
  • Purpose: To perform the retrospective analysis of the sports injuries sustained by the college Taekwondo athletes in the respect of the injury patterns, mechanism of injury and clinical outcome Materials and Methods: This study is based on 47 out of 49 college Takwondo athletes, who had experienced the Takwondo related musculoskeletal injuries severe enough to visit the clinic for medical treatment. The mean age at the time of injury was 18.8 years and 39 were males and 8 females. The Taekwondo career was average 9.6 years and the injuries were sustained at average 6.7 years of their career. The injuries were analyzed by the detailed interview with thorough physical examination. Results: Forty-seven Taekwondo athletes in the study experienced average 1.8 injury/person (total 85 cases) with 26 persons of one time experience(55.3%), 11 persons of 2 times(23.4%),4 persons of 3 times (8.5%),5 persons of 4 times (10.6%) and 1 person of 5 times (2.2%). Injuries occurred during training in 50 cases (58.8%), while during match in 35 cases (41.2%). Injuries occurred during the attack phase of the match are 26 cases (31.7%) while 49 cases (57.6%) during the defense phase. As for the pattern of injury, fracture was the most common with 49 cases (57.6%), followed by ligament injury with 21 cases (24.7%). The upper extremity injuries were 32 cases (37.7%) while the lower extremity injuries were 44 cases (51.8%) Mode of medical treatment were operation in 15cases(17.7%), cast in 21 cases(24.7%), splint in 33 cases (38.8%), physical therapy in 15cases(17.7%) and acupuncture in 1 case(1.1%) Conclusion: Almost all the college Taekwondo athletes (96%) experienced sports injuries severe enough to receive medical treatments with the fracture being the most common injury pattern. The injuries occurred more commonly during the defense phase of the competition.

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Clinical Study of Rhabdomyolysis After Exercise (운동 후 발생한 횡문근 융해증의 임상적 고찰)

  • Ahn, Young-Joon;Yi, Seung-Rim;Yoo, Jae-Ho;Zoo, Min-Hong;Kim, Seong-Wan;Park, Ji-Man;Yang, Bo-Kyu
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.2
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    • pp.110-114
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    • 2007
  • Purpose: This study evaluate clinical findings & management of rhabdomyolysis after strenuous activities in military police recruit. Materials and Methods: This study was carried out from June $1^{st}$, 2004 and May $23^{nd}$, 2005. The study subjects were 13 military police recruit patients who were admitted to our hospital with intractable muscle pain and swelling, and had suspicions of Rhabdomyolysis. The patients were given various blood tests (CPK, CK-MB, AST, BUN/Cr, and Electrolyte) and clinically observed. The patients were all males, and their average age was 20 $(19\sim21)$ years. Seven cases were due to push-up exercises, 5 was due to a soccer game, and 1 was due to riot control activities. The patients complained of swelling and tenderness in various parts of the extremities. Four complained of swelling and tenderness in forearm, 3 in upper arm, 1 in shoulder, and 5 in lower extremity. The diagnosis of rhabdomyolysis was made if the patient complained clinical symptom and had a blood CPK level of above 1,000 IU/L at the time of admission. Patients who took medication or had medical problem were excluded from this study. Bone scans were taken of all patients 4 hours after giving 99mTc-MDP 20mCi intravenously. Treatment was bed rest and fluid therapy. Patients who complained of excessive pain were given splint immobilization. Results: The average hospitalization day for the 13 patients was 20 days ($14\sim42$ days). Excluding one patient who exhibited ARF at time of admission, all patients showed a decrease of blood CPK below 1000 IU/L at an average hospitalization time of 8 days ($2\sim11$ days). The patient with ARF recovered after hemodialysis and fluid therapy. Conclusion: Patients complaining of swelling and severe muscle pain after excessive exercise or training should be suspicious of exercise induced rhabdomyolysis, and should be given blood tests and fluid therapy immediately.

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