• Imaging Science in Dentistry
• /
• 제31권2호
• /
• pp.93-99
• /
• 2001

Purpose: To analyze the possible association between magnetic resonance imaging signal intensity of temporomandibular joint disk and posterior attachment, and the type and extent of disk displacement, disk configuration, effusion and clinical signs in patients with internal derangement. Materials and Methods: Magnetic resonance images of the 132 temporomandibular joints of 66 patients with temporomandibular joint displacement were analyzed. The clinical findings were obtained by retrospective review of the patients' records. The type and extent of disk displacement, disk configuration and effusion were evaluated on the proton density MR images. The signal intensity from the anterior band, posterior band and posterior attachment were measured on MR images. The associations between the type and extent of disk displacement, disk configuration, effusion and clinical signs and the MR signal intensity of disk and posterior attachment were statistically analyzed by student's t-test. Results: Of 132 joints, 87 (65.9%) showed anterior disk displacement with reduction (ADR) and 45 (34.1%) showed anterior disk displacement without reduction (ADnR). The signals from posterior attachments were lower in joints with ADnR than those of ADR (p<0.05). The results showed statistically significant (p<0.05) association between the type and extent of disk displacement and disk configuration, and decreased signal intensity of posterior attachment. There were no statistical associations between pain, noise and limited mouth opening, and signal intensity of disk and posterior attachment. Conclusions: The average signal from posterior attachment was lower in joints with ADnR than that of ADR. The type and extent of disk displacement and disk configuration appeared to be correlated with the signal intensity from posterior attachment.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제19권1호
• /
• pp.93-107
• /
• 1997

Magnetic resonance imaging has been used in the temporomandibular joint(TMJ) primarily to define morphology and positional relationship of associating structures. This report examines signal intensity characteristics of the posterior attachment as they related to the severity of internal derangement. Fifty six joints in 35 patients with a history of TMJ dysfunction were imaged writ MR using $T_1$-weighted spin echo sequence. According to disk position, ability to reduction, and the presence of osteoarthritis, the joints were categorized into three groups. A group 1 was anterior disk displacement with reduction; a group 2 was anterior disk displacement without reduction; a group 3 was anterior disk displacement without reduction and condyle had osteoarthritic change. The control group was determined by the clinical absence of any signs or symptoms of current or past TMJ pain and dysfunction. Calculated the relative value of MR signal intensity in posterior attachment and disk to cerebral cortex of temporal lobe by means of computer program, we have compared them with each groups. The result showed statistically little significant difference of disk signal intensity among each groups. but, signal intensity from posterior attachment in group 2 and 3 were significantly(p<0.05) decreased than control group. this might reflect an fibrosis or hyalinization of posterior attachment, which was part of remodeling process that occurs in disk displacement without reduction. However, this study could not demonstrate histologic confirmation of the decreased signal intensity in the posterior attachment. So, further investigation could be needed to understand the association between them.

• The Journal of Advanced Prosthodontics
• /
• 제9권1호
• /
• pp.14-21
• /
• 2017

PURPOSE. The aim of this study was to compare the retention of mini implant overdenture by the number, the type of magnetic attachment, and the directions of applied dislodging force. MATERIALS AND METHODS. The experimental groups were designed by the number and type of magnetic attachment. Twenty samples were tested with Magden implants. Each attachment was composed of the magnet assembly in overdenture sample and the abutment keeper in a mandibular model. Dislodging forces were applied to the overdenture samples (50.0 mm/min) in 3 directions. The loading was repeated 10 times in each direction. The values of dislodging force were analyzed statistically using SPSS at 95% level of confidence. RESULTS. The retentive force of group 2 was greater than that of group 1 in both types of attachment in every direction (P < .05). Oblique retentive force of flat type magnetic attachment was higher than that of cushion type attachment in both groups (P < .05). In group 1, oblique retentive force showed the highest and anterior-posterior retentive force showed the lowest value in both attachment types (P < .05). In group 2, both types of attachment showed the lowest retentive force with anterior-posterior direction of dislodging force (P <.05). CONCLUSION. Proper retentive properties for implant overdenture were obtained, regardless of the number and type of magnetic attachment. In both types of magnetic attachment, the greater retentive force was attained with more implants. Oblique retentive force of flat type magnetic attachment was greater than that of cushion type. Among all subgroups, anterior-posterior retentive force was the lowest among three different directions of dislodging force.

• 대한치과교정학회지
• /
• 제23권4호
• /
• pp.503-527
• /
• 1993

This paper describes a new method to create an animal model for TMJ internal derangement in the New Zealand white rabbits and the light and electron microscopical changes of posterior attachment of them. Twenty six rabbits(2.5-3.0kg), four normal and twenty two experimental, were used. The right disc of experimental animal was displaced anteriorly without sectioning the posterior attachment and tied to the zygomatic arch with nylon not to be reduced to the original position. The left TMJ was sham-operated to be compared with its right experimental one. Normal animals were sacrificed one day and eight weeks after experiment. Experimental animals were sacrificed one day, ten days, three weeks, five weeks and eight weeks after surgery respectively. They were fixed intravenously with $2\%$ glutaldehyde under general anesthesia and the samples of them were processed for light and electron microscopic examination. The purpose of this experiment is to make a suitable animal model of disc displacement without reduction for studying and understanding the cellular and morphologic events in posterior attachment of TMJ including early changes which were difficult to be observed in human TMJs. The results of this investigation suggest the following conclusions : 1. Authors induced anterior disc displacement surgically in rabbits with new method to examine histologic changes of posterior attachment. Tissue reactions of this model seem to be similar to those observed in human disc displacement. We think this animal model for anterior disc displacement may be used to explore and evaluate objectively the effects of many treatment modalities in disc displacements. 2. The animal disease model showed inflammation at early stage(one and ten days). At this stage there were mild-to-severe mononuclear inflammatory cell infiltration, numerous newly formed vessels, vessel dilatation and engormement and many fibroblasts. 3. At middle stage(three weeks), fibrosis occurred, where fibroblasts decreased in number, but their cytoplasm was profuse indicating high activity. Collagen fibers increased in number and the tissue looked more dense. 4. At late stage(five weeks and eight weeks) showed degenerative changes including perforation of posterior attachment, disintegration of collagen fiber bundles, degeneration of fibroblasts, metastatic ossification, and dystrophic calcification.

• Anatomy and Cell Biology
• /
• 제56권4호
• /
• pp.441-447
• /
• 2023

One of the suprahyoid muscles is the digastric muscle which comprises anterior and posterior bellies joined by an intermediate tendon. Because of its close relationship with the submandibular gland, lymph nodes, and chief vessels of the neck, detailed knowledge about the morphometry of the digastric muscle is essential. The objective of the current cross-sectional evaluative study is to record morphometry along with the digastric muscle's origin, insertion, and variability. Forty human cadavers (25 males and 15 females) were dissected, and the head and neck regions were studied in detail. The attachment of the digastric muscle anterior belly to the digastric fossa of the mandible was noted, and the distal attachment of the posterior belly to the mastoid notch was traced. The length of the anterior belly from the digastric fossa to its intermediate tendon and the length of the posterior belly from the intermediate tendon to its mastoid attachment were measured. There is a fair correlation between the length of the neck and the length of the anterior and posterior belly. The study also identified two cases of bilateral accessory bellies of the anterior belly of the digastric. Normal morphometric data is provided by this study on details of the digastric muscle. It is significant from a clinical and surgical point of view as the muscle lies in proximity to the important structures of the neck.

• Journal of Korean Neurosurgical Society
• /
• 제47권6호
• /
• pp.464-466
• /
• 2010

A 59-year-old female presented with headache and dizziness for one year. Magnetic resonance imaging revealed a $52{\times}28$ mm, wellcircumscribed, homogenously enhancing mass lesion without dural attachment located in the left lateral cerebellomedullary cistern. The tumor was excised, and a histological diagnosis was a mixed pattern meningioma of meningothelial and fibroblastic type. A meningioma in the posterior fossa without dural attachment is quite rare. We report a rare case of lateral cerebellomedullary cistern meningioma without dural attachment with literature review.

• 대한관절경학회지
• /
• 제3권2호
• /
• pp.109-114
• /
• 1999

목 적 : 내측 반월상 연골후각의 후방 경골 부착부위의 절단 파열은 흔하지 않고 기존의 수기로는 봉합이 어렵다. 이에 저자들은 내측 반월상 연골의 후방 경골 부착부위의 절단 파열의 임상 양상 및 pullout suture를 통한 새로운 봉합술을 소개하고자 한다. 대상 및 방법 : 년 9월부터 1999년 7월까지 9명의 환자에서 후방 경골 부착부위의 절단 파열을 경험 하였다. 평균 나이는 59.3세로 38세에서 70세까지의 분포였다. 전예에서 자기공명영상과 임상양상으로 진단하였고, 슬관절경을 통해서 확진과 치료를 하였다. 1예에서 2차적 관절경을 시행하여 봉합 된 반월상 연골의 치유여부를 확인하였다. 임상 양상 : 대개 중년이후의 나이에서 호발하며, 특별한 외상의 과거력이 없다. 슬관절 후면의 통증을 호소하였으나, 그 위치가 불명확한 특징이 있었다. 경도내지 중등도의 슬관절의 종창을 호소하였으며, 특징적으로 슬관절을 굴곡 시킬수록 심해지는 술관절 후면의 통증으로 완전한 굴곡의 장애가 있었다. 단순 방사선 사진에서 퇴행성 변화는 없거나, 나이에 비해서 미미한 양상이었다. 술 전 자기 공명영상이 진단에 있어서 매우 중요한 역할을 하며, 특히 관상면에서 반월상 연골의 후각이 후방 경골 부착부위에서 분리되어 있는 형태를 보인다. 수술 수기 : 4개의 표준 portal 로 도달하여 후각부의 절단파열을 확인하고, 변연절제술로 시야를 확보하고 후각의 후방 부착부위의 연골하골을 노출 시킨다. 전내측 또는 후내측 도달법으로 절단단율 PDS 로 봉합한다. PDS 봉합사를 전내측 도달법으로 밖으로 꺼내 놓는다. 경골 내측 근위부에 종절개를 가한 후에 ACL tibla guide를 이용하여 경골 내측 근위부에서 후각의 후방 경골부착부위까지 골 터널을 만든다. 강선 루프를 경골 터널을 통하여 삽입하여서 전내측 도달법으로 빼내고, PDS 봉합사를 사이에 끼워서 다시 경골 터널을 통해 아래쪽으로 당겨서 끌어낸다. PDS 봉합사를 경골 내측 근위부에 post-tie 방법으로 고정한다. 결 론 : 내측 반월상연골 후각의 후방 경골부착부위의 절단피열은 임상적으로 흔하지 않고 보고도 드물다. 임상 양상과 자기공명영상이 진단에 있어서 중요한 역할을 한다. 관절경적 pullout 봉합이 이런 형태의 파열에 대한 치료로서 유용할 수 있을 것으로 사료된다.

• 대한정형외과스포츠의학회지
• /
• 제1권1호
• /
• pp.61-64
• /
• 2002

소아에서후방십자인대의경골부착부위의견열골절은발생빈도가매우낮으며그보고된경우도드물다. 이에저자들은슬관절동통과종창을주소로내원하였으며, 슬관절 후방 슬와부에압통과 종창, 혈관절증, 후방 불안정성, 경골의 후방 전위, 슬관절신전제한소견을보이고있으며 방사선학적검사상후방십자인대의경골과간후면 부착부위에견열골절을 보이는13세 소년에게서 슬관절후방슬와부를 통한 견인 봉합술(pull-out suture)로 고정하여 치료한1예의 결과를 문헌 고찰과 함께보고하고자한다.

• 대한치과보철학회지
• /
• 제36권6호
• /
• pp.878-887
• /
• 1998

Although attachments have been utilized for a retainer of removable prostheses during several decades, there is little information on the force distribution by the attachments. This study was undertaken to evaluate the stress patterns developed by partial dentures employing rigid attachments on the supporting structures. Four types of the mandibular removable partial dentures were designed depending upon the position of the rigid attachment and the existency of lingual bracing. Under 100N of vertical and 25N of lateral loads on the 1st and 2nd lower molar of partial denture, stress distribution patterns and displacement were analysed with three dimensional finite element method by ANSYS version 5.3. 1. The highest stresses were concentrated on the distal alveolar crest of posterior abutment and the second stresses on the apical region of posterior abutment in the models. 2. The greatest displacement were shown on the distal alveolar crest of posterior abutment and the second displacement on the distal alveolar crest of anterior abutment in the models. 3. There was little difference between the models with intraoral attachment and those with extracoronal attachment. 4. There was little difference between the models with and without the lingual bracing.

• 대한정형외과학회지
• /
• 제56권5호
• /
• pp.445-449
• /
• 2021

슬관절내 삽입성 골낭종은 주로 십자인대의 골 부착부에 작은 낭종의 형태를 보이며, 보통 증상과 관련은 없는 것으로 알려져 있다. 저자들은 31세 남자의 슬관절에서 통증이 유발된 후방십자인대 대퇴 부착부 거대 삽입성 골낭종을 진단하고, 소파술과 골시멘트 충진술로 좋은 결과를 얻었기에 보고하고자 한다.