• Journal of Dental Rehabilitation and Applied Science
• /
• v.24 no.2
• /
• pp.213-230
• /
• 2008

The aim of this study was to analyze the initial movement and the stress distribution of each tooth and periodontal ligament during the lingual lever-arm retraction of 6 maxillary incisors using FEA. Two kinds of finite element models were produced: 2-properties model (simple model) and 24-properties model (multi model) according to the material property assignment. The subject was an adult male of 23 years old. The DICOM images through the CT of the patient were converted into the 3D image model of a skull using the Mimics (version 10.11, Materialise's interactive Medical Image Control System, Materialise, Belgium). After series of calculating, remeshing, exporting, importing process and volume mesh process was performed, FEA models were produced. FEA models are consisted of maxilla, maxillary central incisor, lateral incisor, canine, periodontal ligaments and lingual traction arm. The boundary conditions fixed the movements of posterior, sagittal and upper part of the model to the directions of X, Y, Z axis respectively. The model was set to be symmetrical to X axis. Through the center of resistance of maxilla complex, a retraction force of 200g was applied horizontally to the occlusal plane. Under this conditions, the initial movements and stress distributions were evaluated by 3D FEA. In the result, the amount of posterior movement was larger in the multi model than in the simple model as well as the amount of vertically rotation. The pattern of the posterior movement in the central incisors and lateral incisors was controlled tipping movement, and the amount was larger than in the canine. But the amount of root movement of the canine was larger than others. The incisor rotated downwardly and the canines upwardly around contact points of lateral incisor and canine in the both models. The values of stress are similar in the both simple and multi model.

• The korean journal of orthodontics
• /
• v.33 no.4 s.99
• /
• pp.259-277
• /
• 2003

This study was designed to investigate the position of anteroposterior center of resistance for genuine intrusion and the mode of change of the minimum distal force for simultanous intrusion and retraction of the upper and lower incisors according to the increase of labial inclination. For this purpose, we used the three-piece intrusion arch appliance and three-dimensional finite element models of upper and lower incisors. 1. Positions of the center of resistance in upper incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 6m behind the distal surface of the lateral incisor bracket. 2) In $10^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 9mm behind the distal surface of the lateral incisor bracket. 3) In $20^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 12m behind the distal surface of the lateral incisor bracket. 4) In $30^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 16m behind the distal surface of the lateral incisor bracket. 2. Positions of the center of resistance in lower incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 10mm behind the distal surface of the lateral incisor bracket. 2) In $10^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 13m behind the distal surface of the lateral incisor bracket. 3) In $20^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 15m behind the distal surface of the lateral incisor bracket. 4) In $30^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 18m behind the distal surface of the lateral incisor bracket. 3. The patterns of stress distribution were as follows; 1) There were even compressive stresses In and periodontal ligament when intrusion force was applied through determined center of resistance. 2) There were gradual increase of complexity in compressive stress distribution pattern with Increase of the labial inclination when intrusion and retraction force were applied simultaneously. 4. With increase of the labial inclination of the upper and lower incisors, the position of the center of resistance moved posteriorly. And the distal force for pure intrusion was increased until $20^{\circ}$increase of the labial inclination.

• Journal of Chest Surgery
• /
• v.39 no.11 s.268
• /
• pp.815-821
• /
• 2006

Background: Carotid endarterectomy is an effective treatment modality in patients with severe carotid artery stenosis, but it may result in serious postoperative complications, We analyzed the results of the carotid endarterectomy performed in our institution to reduce the complications related to the card endarterectomy. Material and Method: We analyzed retrospectively the medical records of 74 patients(76 cases) who underwent carotid endarterectomy for carotid artery stenosis by a single surgeon from February 1996 to July 2004. Result: There were 64 men and 10 women. The mean age of the patients was 63.6 years old. Carotid endarterectomy only was performed in 63 cases, carotid endarterectomy with patch angioplasty in 8 cases, and carotid endarterectomy with segmental resection of internal carotid artery and end to end anastomosis in 5 cases. Intra-arterial shunt was used in 29 cases. The mean back pressures of internal carotid arteries checked after clamping common carotid arteries and external carotid arteries were $23.48{\pm}10.04$ mmHg in 25 cases with changes in electroencephalography(group A) and $47.16{\pm}16.04$ mmHg in 51 cases without changes in electroencephalography(group B). There was no statistical difference in the mean back pressure of internal carotid arteries between two groups(p=0.095), but the back pressures of internal carotid arteries of all patients with changes in electroencephalography were under 40 mmHg. When there was no ischemic change of electroencephalography after clamping common carotid artery and external carotid artery, we did not make use of intra-arterial shunt regardless of the back pressure of internal carotid artery. Operative complications were transient hypoglossal nerve palsy in four cases, cerebral hemorrhage occurred at previous cerebral infarction site in two cases, mild cerebral infarction in one case, hematoma due to anastomosis site bleeding in one case, and upper airway obstruction due to laryngeal edema probably caused by excessive retraction during operation in two cases. One patient expired due to cerebral hemorrhage occurring at previous cerebral infarction site. Conclusion: Carotid endarterectomy is a safe operative procedure showing low operative mortality. We suggest that intra-arterial shunt usage should be decided according to the ischemic change of electroercephalography regardless of the back pressure of internal carotid artery. Excessive retraction during operation should be avoided to prevent upper alway obstruction due to laryngeal edema and if upper airway obstruction is suspected, prompt management is essential.

• The korean journal of orthodontics
• /
• v.27 no.1
• /
• pp.65-78
• /
• 1997

This study was carried out in order to determine soft tissue response to incisor movement and mandibular repositioning and to determine feasibility of predicting vertical and horizontal changes in soft tissue with hard tissue movement. For this study, cephalometric records of 41 orthodontically treated adult females who had Angle's Class II division 1 malocclusion were selected and stepwise multiple regression analysis was employed. Following conclusions were obtained by analysing the changes of soft tissue and hard tissue before and after treatment. 1. Hard tissue measurements that showed significant changes before and after treatment were horizontal and angular changes of maxillary incisor, horizontal,vertical and angular changes of mandibular incisor, overjet, overbite, interincisal angle, mandibular repositioning, A,B, skeletal convexity and soft tissue measurements that showed significant changes were horizontal, thickness and angular changes of upper lip, horizontal and angular changes of lower lip, interlabial angle, nasolabial angle labiomental angle, Sri, Ss, Si and soft tissue convexity(P<0.05). 2. All Soft tissue measurements changed significantly before and after treatment had between one and four hard tissue independent variables at statistically significant level, indicating that all soft tissue changes were direct relationship with hard tissue changes 3. Ova jet, horizontal change of maxillary incisor, horizontal change of maxillary root apex and horizontal change of pogonion entered into prediction equations most frequentely indicating that they were more significant variables in prediction of vertical and horizontal changes in the soft tissue with treatment, but vertical changes of mandibular incisor not entered any prediction equations, indicating that it was not considered a good predictor for soft tissue changes with maxillary incisor retraction. 4. Horizontal and vertical changes in subnasale were found to have most independent variables, significant at the 0.05 level in prediction-equations(${\Delta}$Sn(H):Ur, Is(H), Pg(H), UIA,${\Delta}$Sn(V): Is(H), Pg(H), overjet, A), indicating that subnasale changes are influenced by complex hard tissue interaction. 5. Multiple correlation coefficient($R^2$) of the soft tissue prediction equations ranges from 0.2-0.6.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.43 no.1
• /
• pp.70-78
• /
• 2016

Many types of orthopedic appliances have been developed and used for the treatment of class II malocclusion in pediatric dentistry. Headgear is one of the extraoral appliances, which is used for the purpose of preventing the overgrowth of maxilla. Hotz appliance is used in couple with a cervical headgear for the expansion of maxilla and retraction of maxillary incisors. This case report is about the orthodontic treatment of three patients with class II division I malocclusion. These young patients were given orthopedic treatment in combination with a cervical headgear and Hotz appliance. After the treatment using these extraoral and intraoral appliances, succeeding treatments were practiced considering individual needs as follows: fixed orthodontic appliance for mandibular anterior crowding, Class II activator for retention and additory orthopedic treatment and the retention with Hotz appliance. Young patients with Class II division I malocclusion reported in this study received the orthodontic treatment using a cervical headgear and Hotz appliance as well as appropriate succeeding treatment afterward. All patients received improved convex profiles and lip protrusions by retracting maxilla and maxillary incisors.

• Clinics in Shoulder and Elbow
• /
• v.16 no.1
• /
• pp.10-16
• /
• 2013

Purpose: To know if magnetic resonance image (MRI) re-examination is needed before surgery, we compared the pre-operative MRI recorded at different time points and the corresponding arthroscopic findings. Materials and Methods: Depending on the timing of evaluation, the MRI was classified into three groups: group A, MRI was taken 1 month before the surgery (44 cases, average 16 days); group B, 1-6 months before the surgery (41 cases, average 91 days); and group C, 6-12 months before the surgery (25 cases, average 230 days). The anterior to posterior tear size (length) and medial retraction size (width) of rotator cuff tear were measured for each group and they were compared with the actual arthroscopic findings. Results: Results of this study showed that arthroscopic rotator cuff tear length and width were larger than those of MRI. The difference of the rotator cuff tear size was 3.6(${\pm}1.2$) mm of length and 0.6(${\pm}0.4$) mm of width in group A, 4.2(${\pm}1.7$) mm and 2.4(${\pm}1.1$) mm in group B, and 4.5(${\pm}2.1$) mm and 3.0(${\pm}1.5$) mm in group C. There was a tendency of the larger size difference for longer pre-operative period, but it was not statistically significant. Conclusion: The rotator cuff tear size did not show remarkable differences between pre-operative MRI taken within 1 year before surgery and the actual arthroscopy. It is concluded that additional MRI evaluation is not required within 1 year.

• The korean journal of orthodontics
• /
• v.42 no.6
• /
• pp.280-290
• /
• 2012

Objective: This study aimed to compare the effects of conventional and orthodontic mini-implant (OMI) anchorage on tooth movement and arch-dimension changes in the maxillary dentition in Class II division 1 (CII div.1) patients. Methods: CII div.1 patients treated with extraction of the maxillary first and mandibular second premolars and sliding mechanics were allotted to conventional anchorage group (CA, n = 12) or OMI anchorage group (OA, n = 12). Pre- and post-treatment three-dimensional virtual maxillary models were superimposed using the best-fit method. Linear, angular, and arch-dimension variables were measured with software program. Mann-Whitney U-test and Wilcoxon signed-rank test were performed for statistical analysis. Results: Compared to the CA group, the OMI group showed more backward movement of the maxillary central and lateral incisors and canine (MXCI, MXLI, MXC, respectively; 1.6 mm, p < 0.001; 0.9 mm, p < 0.05; 1.2 mm, p < 0.001); more intrusion of the MXCI and MXC (1.3 mm, 0.5 mm, all p < 0.01); less forward movement of the maxillary second premolar, first, and second molars (MXP2, MXM1, MXM2, respectively; all 1.0 mm, all p < 0.05); less contraction of the MXP2 and MXM1 (0.7 mm, p < 0.05; 0.9 mm, p < 0.001); less mesial-in rotation of the MXM1 and MXM2 ($2.6^{\circ}$, $2.5^{\circ}$, all p < 0.05); and less decrease of the inter-MXP2, MXM1, and MXM2 widths (1.8 mm, 1.5 mm, 2.0 mm, all p < 0.05). Conclusions: In treatment of CII div.1 malocclusion, OA provided better anchorage and less arch-dimension change in the maxillary posterior teeth than CA during en-masse retraction of the maxillary anterior teeth.

• The korean journal of orthodontics
• /
• v.29 no.5 s.76
• /
• pp.521-534
• /
• 1999

The purpose of this study was to find the difference of stress distribution on canine altered by the application point of preangulated T-loop spring. For this study, the finite element models of upper left canine, upper left second premolar and upper left first molar were made. Also, the finite element models of $0.017{\times}0.025$ inch preangulated, preactivated T-loop spring and $0.018{\times}0.025$ inch stainless steel wire were made. Three types of T-loop spring were made . the middle of activated T-loop is positioned in accordance with the middle position of distance of bracket position of both the canine and first molar, 2mm anterior, 2mm posterior. We compared the forces and the distribution of stress that were generated by the difference of position of T-loop spring. The results were as follows. 1. All of the 3 types of T-loop spring showed the similar retraction forces. 2. All showed the similar amount & pattern of stress distribution. 3. The centers of rotation of canine in 3 types of T-loop spring were same and were positioned between C and D plane. 4. The canine showed the intrusive force by 2mm anterior positioned T-loop spring, but the extrusive force by 2mm posterior positioned T-loop suing. Neverthless, because of the small amount of the forces, the effect of vertical force was not significant.

• The korean journal of orthodontics
• /
• v.37 no.6
• /
• pp.407-420
• /
• 2007

The aim of this study was to compare the differences in closing extraction spaces between maxillary first premolar and second premolar extractions using 3-dimensional finite element analysis (FEA). Methods: Maxillary artificial teeth were selected according to Wheeler's dental anatomy. The size and shape of each tooth, bracket and archwire were made from captured real images by a 3D laser scanner and FEA was performed with a 10-noded tetrahedron. A $10^{\circ}$ gable bend was placed behind the bull loop on a $0.017"{\times}0.025"$ archwire. The extraction space was then closed through 12 repeated activating processes for each 2mm of space. Results and Conclusions: The study demonstrated that the retraction of anterior teeth was less for the second premolar extraction than for the first premolar extraction. The anterior teeth showed a controlled tipping movement with slight extrusion, and the posterior teeth showed a mesial-in rotational movement. For the second premolar extraction, buccal movement of posterior teeth was highly increased.

• The korean journal of orthodontics
• /
• v.38 no.5
• /
• pp.337-346
• /
• 2008

Objective: The purpose of this study was to determine whether an exogenous electric current to the alveolar bone surrounding a tooth being orthodontically treated can enhance tooth movement in human and to verify the effect of electric currents on tooth movement in a clinical aspect. Methods: This study was performed on 7 female orthodontic patients. The electric appliance was set in the maxilla to provide a direct electric current of $20{\mu}A$. The maxillary canine on one side was assigned as the experimental side, and the other as control. The experimental canine was provided with orthodontic force and electric current. The control side was given orthodontic force only. Electrical current was applied to experimental canines for 5 hours a day. The amount of canine movement was measured with an electronic caliper every week. Results: The amount of orthodontic tooth movement in the experimental side during 4 weeks was greater by 30% compared to that of the control side. The amount of increase in tooth movement in the experimental side was statistically significant. The amount of tooth movement in the experimental side during the first two weeks was !Bleater than that in the following two weeks. The amount of weekly tooth movement in the control side was decreased gradually. Conclusions: These results suggested that the exogenous electric current from the miniature electric device might accelerate orthodontic tooth movement by one third and have the potential to reduce orthodontic treatment duration.