Clinical Validity of Tooth Size Measurements Obtained via Digital Methods with Intraoral Scanning

Purpose@#Dental diagnostic records derived from study models are a popular method of obtaining reliable and vital information. Conventional plaster models are the most common method, however, they are being gradually replaced by digital impressions as technology advances. Moreover, three-dimensional dental models are becoming increasingly common in dental offices, and various methods are available for obtaining them. This study aimed to evaluate the accuracy of the measurement of dental digital models by comparing them with conventional plaster and to determine their clinical validity. @*Materials and Methods@#The study was conducted on 16 patients’ maxillary and mandibular dental models. Tooth size (TS), intercanine width (ICW), intermolar width (IMW), and Bolton analysis were taken by using a digital caliper on a plaster model obtained from each patient, while intraoral scans were manually measured using two digital analysis software. A one-way analysis of variance test was used to compare the dental measurements of the three methods.Result: No significant differences were reported between the TS, the ICW and IMW, and the Bolton analysis through the conventional and two digital groups. @*Conclusion@#Measurements of TS, arch width, and Bolton analysis produced from digital models have shown acceptable clinical validity. No significant differences were observed between the three dental measurement techniques.

Comparison of the bite force and occlusal contact area of the deviated and non-deviated sides after intraoral vertical ramus osteotomy in skeletal Class III patients with mandibular asymmetry: Two-year follow-up / 대한치과교정학회지

Objective@#The objectives of this study were to compare the time-dependent changes in occlusal contact area (OCA) and bite force (BF) of the deviated and non-deviated sides in mandibular prognathic patients with mandibular asymmetry before and after orthognathic surgery and investigate the factors associated with the changes in OCA and BF on each side. @*Methods@#The sample consisted of 67 patients (33 men and 34 women; age range 15-36 years) with facial asymmetry who underwent 2-jaw orthognathic surgery. OCA and BF were taken before presurgical orthodontic treatment, within 1 month before surgery, and 1 month, 3 months, 6 months, 1 year, and 2 years after surgery. OCA and BF were measured using the Dental Prescale System. @*Results@#The OCA and BF decreased gradually before surgery and increased after surgery on both sides. The OCA and BF were significantly greater on the deviated side than on the non-deviated side before surgery, and there was no difference after surgery. According to the linear mixed-effect model, only the changes in the mandibular plane angle had a significant effect on BF (p < 0.05). @*Conclusions@#There was a difference in the amount of the OCA and BF between the deviated and non-deviated sides before surgery. The change in mandibular plane angle affects the change, especially on the non-deviated side, during the observation period.

Nonsurgical maxillary expansion in a 60-year-old patient with gingival recession and crowding / 대한치과교정학회지

Maxillary transverse deficiency often manifests as a posterior crossbite or edgeto-edge bite and anterior crowding. However, arbitrary arch expansion in mature patients has been considered to be challenging due to the possible periodontal adverse effects such as alveolar bone dehiscence and gingival recession. To overcome these limitations, nonsurgical maxillary expansion of the basal bone has been demonstrated in young adults. However, the age range for successful orthopedic expansion has remained a topic of debate, possibly due to the underlying individual variations in suture maturity. This case report illustrates nonsurgical, miniscrew-assisted rapid palatal expansion (MARPE) in a 60-yearold patient with maxillary transverse deficiency accompanied by anterior and posterior crossbites, crowding, and gingival recession. The use of MARPE allowed relief of crowding and correction of the crossbite without causing significant periodontal adverse effects.

Nonsurgical maxillary expansion in a 60-year-old patient with gingival recession and crowding / 대한치과교정학회지

Maxillary transverse deficiency often manifests as a posterior crossbite or edgeto-edge bite and anterior crowding. However, arbitrary arch expansion in mature patients has been considered to be challenging due to the possible periodontal adverse effects such as alveolar bone dehiscence and gingival recession. To overcome these limitations, nonsurgical maxillary expansion of the basal bone has been demonstrated in young adults. However, the age range for successful orthopedic expansion has remained a topic of debate, possibly due to the underlying individual variations in suture maturity. This case report illustrates nonsurgical, miniscrew-assisted rapid palatal expansion (MARPE) in a 60-yearold patient with maxillary transverse deficiency accompanied by anterior and posterior crossbites, crowding, and gingival recession. The use of MARPE allowed relief of crowding and correction of the crossbite without causing significant periodontal adverse effects.

Brain Areas Subserving Torrance Tests of Creative Thinking: An Functional Magnetic Resonance Imaging Study

BACKGROUND AND PURPOSE: Torrance Tests of Creative Thinking (TTCT) is a well-known and commonly used measure of creativity. However, the TTCT-induced creative hemodynamic brain activity is rarely revealed. The purpose of this study is to elucidate the neural correlates of creative thinking in the setting of a modified version of the figural TTCT adapted for an functional magnetic resonance imaging (fMRI) experiment. METHODS: We designed a blocked fMRI experiment. Twenty-five participants (11 males, 14 females, mean age 19.9±1.8) were asked to complete the partially presented line drawing of the figural TTCT (creative drawing imagery; creative). As a control condition, subjects were asked to keep tracking the line on the screen (line tracking; control). RESULTS: Compared to the control condition, creative condition revealed greater activation in the distributed and bilateral brain regions including the left anterior cingulate, bilateral frontal, parietal, temporal and occipital regions as shown in the previous creativity studies. CONCLUSIONS: The present revealed the neural basis underlying the figural TTCT using fMRI, providing an evidence of brain areas encompassing the figural TTCT. Considering the significance of a creativity test for dementia patients, the neural correlates of TTCT elucidated by this study may be valuable to evaluate the brain function of patients in the clinical field.

Neuro-Scientific Studies of Creativity

Creativity has historically been investigated in psychological and educational aspects, and developed by psychologists and educationists. Recent progress of computational and cognitive science has opened new horizons in the neuro-scientific approach, bridging the concept of creativity and specialized brain function. This review discusses the psychological and educational theories of creativity, and focuses on the recent works in neuroscience dealing with creativity in view of divergent thinking. We also summarize the brain areas and their networks found by the neuroimaging studies, especially functional magnetic resonance imaging.

The Functionality of Facial Appearance and Its Importance to a Korean Population

BACKGROUND: Many people have an interest in the correction of facial scars or deformities caused by trauma. The increasing ability to correct such flaws has been one of the reasons for the increase in the popularity of facial plastic surgery. In addition to its roles in communication, breathing, eating, olfaction and vision, the appearance of the face also plays an important role in human interactions, including during social activities. However, studies on the importance of the functional role of facial appearance. As a function of the face are scare. Therefore, in the present study, we evaluated the importance of the functions of the face in Korea. METHODS: We conducted an online panel survey of 300 participants (age range, 20-70 years). Each respondent was administered the demographic data form, Facial Function Assessment Scale, Rosenberg Self-Esteem Scale, and standard gamble questionnaires. RESULTS: In the evaluation on the importance of facial functions, a normal appearance was considered as important as communication, breathing, speech, and vision. Of the 300 participants, 85% stated that a normal appearance is important in social activities. CONCLUSIONS: The results of this survey involving a cross-section of the Korean population indicated that a normal appearance was considered one of the principal facial functions. A normal appearance was considered more important than the functions of olfaction and expression. Moreover, a normal appearance was determined to be an important facial function for leading a normal life in Korea.

Analysis of the Effects of Breast Reconstruction in Breast Cancer Patients Receiving Radiotherapy after Mastectomy

BACKGROUND: Immediate breast reconstruction after mastectomy and delayed breast reconstruction with post-supplementary treatment are the two types of breast reconstruction currently performed when treating breast cancer. Post-mastectomy radiation therapy (PMRT) not only reduces local recurrence but also improves overall survival. However, the complications and survival rates associated with PMRT need to be clear when determining the timing of breast reconstruction. Accordingly, we investigated the optimal timing of breast reconstruction by observing patients who underwent mastectomy followed by PMRT, based on their overall health and aesthetic satisfaction. METHODS: We retrospectively reviewed 21 patients who underwent breast reconstruction with PMRT between November 2004 and November 2010. We collected data regarding the various methods of mastectomy, and the modality of adjuvant therapy, such as chemotherapy, hormone therapy, and radiotherapy. Telephone interviews were conducted to study the general and aesthetic satisfaction. RESULTS: Patients who received PMRT after breast reconstruction showed a greater complication rate than those undergoing breast reconstruction after PMRT (P=0.02). Aesthetic satisfaction was significantly higher in the groups undergoing breast reconstruction after PMRT (P=0.03). Patients who underwent breast reconstruction before PMRT developed complications more frequently, but they expressed greater aesthetic satisfaction with the treatment. CONCLUSIONS: It is recommended that the complication rates and aesthetic satisfaction after breast reconstruction be carefully considered when determining the optimal timing for radiotherapy.

Effects of orthodontic mini-implant position in the dragon helix appliance on tooth displacement and stress distribution: a three-dimensional finite element analysis / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to investigate the stress distribution on the orthodontic mini-implant (OMI) surface and periodontal ligament of the maxillary first and second molars as well as the tooth displacement according to the OMI position in the dragon helix appliance during scissors-bite correction. METHODS: OMIs were placed at two maxillary positions, between the first and the second premolars (group 1) and between the second premolar and the first molar (group 2). The stress distribution area (SDA) was analyzed by three-dimensional finite element analysis. RESULTS: The maximal SDA of the OMI did not differ between the groups. It was located at the cervical area and palatal root apex of the maxillary first molar in groups 1 and 2, respectively, indicating less tipping in group 2. The minimal SDA was located at the root and furcation area of the maxillary second molar in groups 1 and 2, respectively, indicating greater palatal crown displacement in group 2. CONCLUSIONS: Placement of the OMI between the maxillary second premolar and the maxillary first molar to serve as an indirect anchor in the dragon helix appliance minimizes anchorage loss while maximizing the effect on scissors-bite correction.

Treatment of Lymphedema of the Scrotum and Penis Using Scrotal Flaps

PURPOSE: Lymphedema of the scrotum and penis is a functionally and emotionally incapacitating problem for patients. Patients suffer pain from swelling, chronic irritation, repeated infections, drainage, and sexual dysfunction. Although there are various methods for the treatment of scrotal and penial lymphedema, achieving a satisfactory reconstruction in severe cases still remains a challenge due to the lack of locally available tissue. METHODS: A 33-year-old man sustained severe lymphedema of the scrotum and penis. He reported a history of swelling since 25 years, which had been intensified during the past few months. There was no history of irritation, surgery, trauma, infection or travel to endemic countries. The authors reconstructed the scrotum and penis using 4 scrotal flaps made by incising the enlarged scrotum crucially. RESULTS: The postoperative course was uneventful. Histopathologic examination showed nonspecific chronic inflammation. The patient was followed up for 18 months and a good reconstructive result was obtained with no recurrence. CONCLUSION: The authors' method is safe and easy to perform. This method may be a convenient and reliable alternative for the treatment of severe lymphedema of the scrotum and penis.

Burden of COPD among Family Caregivers / 결핵및호흡기질환

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major health problem resulting in significant burden for patients and families. However, family caregivers' burden has not been well recognized. The objectives of this study were to evaluate the level of caregivers' burden and to explore the related factors based on family, patient, and social support factors. METHODS: A face-to-face interview with 86 family caregivers who had been taking care of COPD patients was conducted. The participants answered a self-administered questionnaire. The questionnaire included the level of family caregivers' burden, health status and the relationship within the family, functional limitation of patients perceived by family caregivers and the social support. RESULTS: The level of caregivers' burden among participants was considerably high. Risk factors for caregivers' burden included low educational level of family caregivers, low family income, hours of caregiving, and functional limitation of the patients. Protective factors for caregivers' burden were good relationship within the family and support from other family members or friends. CONCLUSION: It is proved that family caregivers are facing significant burden in taking care of COPD patients. To reduce family caregivers' burden, it is necessary to address socioeconomic status of the family and to provide various community resources including financial support and nursing services.

Three dimensional analysis of tooth movement using different sizes of NiTi wire on NiTi scissors-bite corrector / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to compare the difference in three dimensional tooth movement using three different wire sizes (0.018 x 0.025-in, 0.016 x 0.022-in, 0.016-in) on a NiTi scissors-bite corrector. METHODS: Computed tomography (CT) images of the experimental model before and after tooth movement were taken and reconstructed into three dimensional models for superimposition. The direction and the amount of tooth movement were measured and analyzed statistically. RESULTS: The lingual and intrusive movements of the crown of the maxillary second molar were increased as the size of the NiTi wire increased. The roots of the maxillary second molars moved buccally except for the 0.016-in group. The intrusive movement of the roots of the maxillary second molars was increased as the size of the NiTi wire increased. Due to the use of orthodontic mini-implants, anchorage loss was under 0.2 mm on average. CONCLUSIONS: The 0.018 x 0.025-in NiTi wire was most effective in lingual and intrusive movement of the maxillary second molar which was in scissors-bite position. Indirect skeletal anchorage with a single orthodontic mini-implant was rigid enough to prevent anchorage loss.

Three dimensional analysis of tooth movement using different types of maxillary molar distalization appliances / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to compare the three dimensional changes of tooth movement using four different types of maxillary molar distalization appliances; pendulum appliance (PD), mini-implant supported pendulum appliance (MPD), stainless steel open coil spring (SP) and mini-implant supported stainless steel open coil spring (MSP). METHODS: These experiments were performed using the Calorific machine? which can simulate dynamic tooth movement. Computed tomography (CT) images of the experimental model were taken before and after tooth movement in 1 mm thicknesses and reconstructed into a three dimensional model using V-works 4.0TM. These reconstructed images were superimposed using Rapidform 2004TM and the direction and amount of tooth movement were measured. RESULTS: The mean reciprocal anchor loss ratio at the first premolar was 17 - 19% for the PD and SP groups. The appliances using mini-implants (MPD or MSP) resulted in less anchorage loss (7 - 8%). On application of a pendulum appliance or MPD, distalization was obtained by tipping rather than by bodily movement. Furthermore, the maxillary second molar tipped distally and bucally. But on application of MSP, distalization was achieved almost by bodily movement. CONCLUSIONS: Regarding tooth movement patterns during molar distalization, stainless steel open coil spring with indirect skeletal anchorage was relatively superior to other methods.

Schwannoma in the Postauricular Sulcus being Misdiagnosed as Lipoma: A Case Report

Schwannomas or neurilemmomas are the most often found as solitary, slow-growing, asymptomatic, well-encapsulated, firm yet transversely mobile benign mass in head and neck region. Most of Schwannomas appear in the cranial nerve, especially vestibular nerve, but must always be considered to be able to appear in any parts where the nerve tissues are distributed. Sometimes, inaccurate preoperative clinical diagnosis leads to accidentally resecting the affected nerve and produces permanent neurological deficits. We experienced a extremely rare schwannoma being confused with lipoma in upper left postauricular sulcus. After simple mass excision without considering possibility of schwannoma, the patient complained of dull sensation and pinprick pain in the superior part of the ipsilateral postauricular area. When clinical symptom and physical examinations are insufficient to distinguish schwannoma from other benign soft masses, and the mass along the critical nerve pathway can possibly be originated from the designated nerves, we would like to recommend radiologic examinations such as ultrasonography and/or MRI for correct diagnosis prior to operation. Moreover, when it is adjacent the neurovascular structures, meticulous microscopic surgery must always be performed so as not to impair the important structures.

Comparison of finite element analysis of the closing patterns between first and second premolar extraction spaces / 대한치과교정학회지

OBJECTIVE: 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 degrees gable bend was placed behind the bull loop on a 0.017" x 0.025" archwire. The extraction space was then closed through 12 repeated activating processes for each 2 mm 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.

Analysis of Necrotizing Fasciitis Patient by Causative Pathogens

PURPOSE: Necrotizing fasciitis is a rapid progressive, life-threatening disease. Many organisms have been identified for causative pathogens of necrotizing fasciitis. And necrotizing fasciitis caused by Vibrio vulnificus is a matter of grace concern in Southwest seashore of Korea recently. But concrete analysis between these pathogens was not executed yet. METHODS: Sixty necrotizing fasciitis patients were included in this study. We divided the patients into 2 groups: Group A was the case which Vibrio vulnificus was cultured for causative pathogen of necrotizing fasciitis, and Group B was the case of other organisms. And we analysed each group for treatment, progression and prognosis. RESULTS: There was no significant difference between two groups in total hospital stay but there was a great difference in ICU stay and progression to septic shock. Also, there was a great difference in mortality within 48 hours but there was no difference in mortality of 48 hours after hospital visit. CONCLUSION: This indicates that intial management of necrotizing fasciitis cased by Vibrio vulnificus is the key of treatment. So initial medical management with early surgical intervention is necessary for necrotizing fasciitis.

Analysis of Necrotizing Fasciitis Patient by Causative Pathogens

PURPOSE: Necrotizing fasciitis is a rapid progressive, life-threatening disease. Many organisms have been identified for causative pathogens of necrotizing fasciitis. And necrotizing fasciitis caused by Vibrio vulnificus is a matter of grace concern in Southwest seashore of Korea recently. But concrete analysis between these pathogens was not executed yet. METHODS: Sixty necrotizing fasciitis patients were included in this study. We divided the patients into 2 groups: Group A was the case which Vibrio vulnificus was cultured for causative pathogen of necrotizing fasciitis, and Group B was the case of other organisms. And we analysed each group for treatment, progression and prognosis. RESULTS: There was no significant difference between two groups in total hospital stay but there was a great difference in ICU stay and progression to septic shock. Also, there was a great difference in mortality within 48 hours but there was no difference in mortality of 48 hours after hospital visit. CONCLUSION: This indicates that intial management of necrotizing fasciitis cased by Vibrio vulnificus is the key of treatment. So initial medical management with early surgical intervention is necessary for necrotizing fasciitis.

Comparison of the shear bond strength of brackets in regards to the light curing source / 대한치과교정학회지

With the introduction of the xenon plasma arc curing light and the LED curing light as orthodontic curing lights, the polymerizing time of orthodontic composites has clearly decreased. In contrast to various research cases regarding the polymerization time and bond strength of the xenon plasma arc curing light, not enough research exists on the LED curing light, including the appropriate polymerization time. The objective of this research was to compare the bond strength of the plasma curing light and the LED curing light in regards to the polymerization time. The polymerization time needed to achieve an appropriate adhesion strength of the bracket has also been studied. After applying orthodontic brackets using composite resin onto 120 human premolars, the plasma arc curing light and the LED curing light were used for polymerization for 4, 6, and 8 seconds accordingly. This research proved that the LED curing light provided appropriate bond strength for mounting orthodontic brackets even with short seconds of polymerization. The expensive cost and large size of the device limits the use of the plasma arc curing light, whereas the low cost and easy handling of the LED curing light may lead to greater use in orthodontics.

A Case of Pressure Sore in Congenital Insensitivity to Pain with Anhidrosis

PURPOSE: Congenital insensitivity to pain with anhidrosis(CIPA) is a rare form of autosomal recessive peripheral sensory neuropathy. Patients with CIPA show loss of pain sensation, which leads to corneal ulcers and opacities, self-mutilation of the tongue and fingertips, as well as fractures with subsequent joint deformities and chronic osteomyelitis. The purpose of this report is to highlight the fact that pressure sores also are a potential complication of CIPA. METHODS: This case report describes a patient presenting with pressure sores resulting from CIPA. A 5-year-old boy was referred to our department for the treatment of a 5x5cm sacral pressure sore as a result of a hip spica cast applied for the treatment of a left hip joint dislocation. He had a history suggesting CIPA such as multiple bony fractures, mental retardation, recurrent hyperpyrexia, anhidrosis, and clubbing fingers due to oral mutilation. A microscopic examination of the sural nerve showed mainly large myelinated fibers, a few small myelinated fibers and an almost complete loss of unmyelinated fibers. After wound preparation for two weeks, the exposed bone was covered with two local advancement flaps. RESULTS: Two weeks later, complete wound healing was achieved. A 16-month follow-up showed no recurrence. However, the patient presented with a new pressure sore on the left knee due to orthosis for the treatment of the left hip joint dislocation. CONCLUSION: The early diagnosis of CIPA and special care of pressure sores are important for preventing and treating pressure sores resulting from CIPA.

The effect of lip thickness on lip profile change after orthodontically treated patients with 4 first bicuspid extraction / 대한치과교정학회지

After orthodontic treatment, there are several changes in soft tissue profile. Changes appear at lower anterior facial profile area, especially upper and lower lip. But there are many individual variations in the pattern of changes. So, this study was conducted to find out that the basic upper lip thickness could be one of the factors that could influence the treatment results. The samples were composed of 43 adult patients who had their 4 first premolars extracted. Groups were classified by their basic lip thickness. In group 1(thin upper lip group), there was negative relationship between mentolabial angle and lower lip change. In group 2(average lip thickness group), upper lip change was related to upper incisor change, lower incisor change, lower lip change and nasolabial angle change. And lower lip change was related to upper lip change, upper incisor change, lower incisor change. In group 3(thick upper lip group), there was no relation between both lip change and other variables.