• Title/Summary/Keyword: 보존적 처치

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HEALING OF HORIZONTAL ROOT FRACTURE : TWO CLINICAL CASES (수평치근파절의 두 가지 치험례)

  • Ki-Ok Kim;Sung-Kyo Kim
    • Restorative Dentistry and Endodontics
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    • v.26 no.5
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    • pp.443-446
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    • 2001
  • 급격한 치아외상은 치아 경조직에 손상을 주기도 하지만 치수와 치주조직에도 손상을 입힌다. 탈구(luxation)의 경우, 외상에 의해 치근단공 부위에서 신경혈관계의 파괴가 초래되지만 치근파절의 경우에는 파절전 부위에서 이와 유사한 손상이 나타난다. 그러므로 치근파절을 파절선 상부의 치관부에 대한 일종의 탈구로 보기도 한다. 본 증례보고는 외상에 의한 치근파절의 두 가지 치유양상을 비교한 것으로, 한 증례는 특정한 치과적 처치없이 스스로 치유된 경우이고 다른 한 증례는 치아고정 및 근관치료를 포함한 치과치료후에 치유된 경우이다. 수평치근파절의 치유에는 여러 가지 요인이 관여하지만 특히 치아동요도 및 치수생활력이 큰 영향을 미친다. 본 증례에서와 같이 치아의 동요도가 있는 경우에는 고정을 통해서 치유를 촉진하고 치수의 괴사가 초래된 경우에는 근관치료를 포함한 적절한 치과치료를 통해서 치유가 일어날 수 있다. 따라서 치근이 파절된 경우에는 장기간의 관찰을 통해 파절부 치유 및 치수손상 여부를 관찰, 진단하고 그에 따른 적절한 처치를 시행해야 할 것이다.

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A Surgical Treatment of the Esophageal Foreign Body (10 cases report) (수술적 처치가 필요했던 식도이물에 관한 임상적 고찰)

  • 황의두;황경환
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1117-1120
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    • 1997
  • Ten cases with esophageal foreign body were treated surgically from July 1980 to October 1995 at the Departme t of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. The mean age was 45.3 years, with a range from 25 to 71. Out of ten cases, 6 were female and four were male. Common symptoms were dysphagia, fever, foreign body sensation and neck pain. Three cases of foreign bodies were of fish bones, two of bubble paclcage of drugs, one case of a Eeer bottle cap, one of a piece glass, one of a bathtub plug, one of chicken and one of a bean. The diagnosis was established by esophagography using a water soluble contrast material and esophagoscopy. Among of ten cases, two had esophageal stricture due to the ingestion of Aye at a young age. One case had experienced psychological problems. All foreign bodies were removed by surgical procedures. Five cases were treated by cervical esophagostomy, one case by right thoracotomy, one case by retrograde bougienation through gastrostomy and two cases by cervical incision and drainage for cervical abscess. Three cases developed pos operative esophageal leaks which healed spontaneously and transient hoarseness developed in one case. One case developed traumatic pneumothorax and subcutaneous emphysema which was treated by closed thoracostomy. There were no operative deaths. C(ocean J Thorac Cardiovasc Surg 1997;30:1117-20)

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Real-time measurement of dentinal fluid flow during desensitizing agent application (상아질 지각과민 처치제의 적용 중에 일어나는 상아세관액 유동의 실시간 측정)

  • Kim, Sun-Young;Kim, Eun-Joo;Lee, In-Bog
    • Restorative Dentistry and Endodontics
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    • v.35 no.5
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    • pp.313-320
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    • 2010
  • Objectives: The aim of this study was to examine changes in the dentinal fluid flow (DFF) during desensitizing agent application and to compare permeability after application among the agents. Materials and Methods: A Class 5 cavity was prepared to exposure cervical dentin on an extracted human premolar which was connected to a sub-nanoliter fluid flow measuring device (NFMD) under 20 cm water pressure. DFF was measured from before application of desensitizing agent (Seal&Protect, SP; SuperSeal, SS; BisBlock, BB; Gluma desensitizer, GL; Bi-Fluoride 12, BF) through application procedure to 5 min after application. Results: DFF rate after each desensitizing agent application was significantly reduced when compared to initial DFF rate before application (p < 0.05). SP showed a greater reduction in DFF rate than GL and BF did (p < 0.05). SS and BB showed a greater reduction in DFF rate than BF did (p < 0.05). Conclusions: Characteristic DFF aspect of each desensitizing agent was shown in NFMD during the application procedure.

CLINICAL STUDY ON THE INTUBATION TO PERIAPICAL LESIOON (배농관(排膿管) 삽입(揷入)에 의(依)한 치근단병소(齒根端病巢) 처치(處置)의 임상적(臨床的) 연구(硏究))

  • Min, Byoung-Duck
    • Restorative Dentistry and Endodontics
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    • v.1 no.1
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    • pp.18-25
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    • 1975
  • The author has experienced 8 cases of periapical lesion which were very closed to adjacent root tip. To avoid damage on neighboring nerve and blood supply polyvinyl tube was inserted through buccal window leaving a little pathological changes in involved area. The results are as follows: 1. The purpose to maintain adjacent tooth vitality was achieved by means of intubation in the lesion. 2. Swelling and pain after operation was rather lesser than routine apical surgery, because of drainage. 3. The total treatment period seems longer than that of routine apical amputation.

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Treatment Outcome of Patients with Closed Lock by Conservative Therapy (보존적 처치에 따른 폐구성 과두걸림환자의 예후)

  • Myung-Yun Ko
    • Journal of Oral Medicine and Pain
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    • v.22 no.1
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    • pp.7-13
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    • 1997
  • In order to evaluate the outcome of conservative treatment for acute or chronic closed lock, 127 patients were subjected at the Dept. of Oral Medicine, PNUH, from 1991. All the symptoms were analyzed and the results according to treatment modalities were compared before and after treatment. 1. Closed lock patients were more often seen in women of twenty and thirty. 2. The most common reasons for treatment were functional pain, limitation of mouth opening, restricted laterotrusion to non-effected side, deflection on opening but, on the contrary, noise was the least. 3. Most of closed lock patients were curedin six months. 4. Conservative treatment including stabilization splint produced better results. 5. Functional pain and limitation of mouth opening were relieved and maximumm comfortable opening was expanded, but joint noise decreased in the chronic and increased in the acute.

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Prognosis of Recurred TMD Patients According to Conservative Treatment (재발된 측두하악장애 환자의 보존적 처치에 따른 예후)

  • Jang, Dong-Hun;Tae, Il-Ho;Ahn, Yong-Woo;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.33 no.2
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    • pp.219-228
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    • 2008
  • The purpose of this study is to compare the differences between first visits and the recurred time of TMD patients about the number of visits, the treatment plans, the symptoms and the results after the conservative treatments. This could lead us to assess the prognoses of TMDs treated conservatively. We investigated 54 patients who have visited the Department of Oral Medicine in PNUH from 1991 to 2001, diagnosed as TMDs and treated conservatively with medications, physical therapies and splints. The treatments were terminated since the subjects have shown much improvements and resumed when TMDs recurred from 1992 to 2002. We researched the diagnoses, symptoms, the number of visits, the treatment plans and the results comparing the time before and after the treatments were carried out and following are the results. 1. Both the primary and the recurred groups improved after having been treated conservatively. 2. Both the primary and the recurred groups showed no differences in pains and MCOs when they first visited though the noises and LOMs turned out to be more serious in primary group. 3. Both the primary and the recurred groups had no differences in pains, noises, LOMs, MCOs when the treatments were over. 4. The results of treatments were not affected by treatment plans, sex, diagnoses in both primary and recurred groups. 5. Most of the patents tended to visit less than 10 times in recurred patients.

Glenoid lesion in Traumatic Anterior Instability of Shoulder (견관절 외상성 불안정성 관절와 병변)

  • Lee, Seoung-Joon;Park, Jin-Young;Keum, Jung-Sup;Ye, Meng
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.23-26
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    • 2007
  • 관절와 병변은 급성 외상으로 인한 골절뿐 아니라 불안정성으로 인한 골 침윤으로 정의할 수 있으며, 이는 통상의 방사선학적 검사를 통하여 진단을 하지 못하는 경우도 있다. 전방 탈구와 동반된 전방 관절와 골절의 빈도는 5.4%에서 32%까지 보고되었다. Hovelius 등이 226명의 탈구환자를 대상으로한 연구에서 8%의 관절와 골절이 있었다고 보고하였고, 노령의 환자에서 약간의 빈도가 증가한다고 하였다. 또한 Rowe는 전방 관절와 골절이 있는 27명의 환자에서 기계적 안정성의 결함으로 62%의 재발성 탈구가 있었다고 보고하였다. 보다 최근의 방카르트 술기에 대한 보고에서 수술적 처치를 한 환자중 44%가 관절와 골절을 동반하였다고 보고하였다. Rowe 와 Zarins는 다발성 전방탈구 환자에서 관절와 병변이 잘 치료되었는지 여부에 따라 다른 결과를 낸다고 보고하였다. 전자에 따르면, 관절와 병변을 진단하는 것은 중요하며 환자의 최종적 예후는 이를 어떻게 치료했는지 여부에 따라 결정된다고 하였다. 관절와 상완관절의 불안정성에서 동반된 관절와 병변의 진단은 보존적 치료시나 수술적 치료 시 모두 중요한 인자라고 하겠다.

A Case Report on the Ossification of the Posterior Longitudinal Ligament Treated by CHUNA Manual Therapy (추나요법으로 치료한 후방 종인대 골화증 1예)

  • Kim, Mi-Young;Park, Sung-Cheul;Kang, Sung-Ho;Song, Yung-Sun;Shin, Byung-Cheul
    • The Journal of Korea CHUNA Manual Medicine
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    • v.3 no.1
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    • pp.153-166
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    • 2002
  • Objective : There is no case report on the ossification of the posterior longitudinal ligament(OPLL) treated by CHUNA manual therapy in oriental medicine. We experienced a patient(32-year-old female) with OPLL improved by CHUNA manual therapy in X-ray image and visual analogue scale(VAS), and we report it clinically. Methods : During the patient with OPLL was treated CHUNA manual therapy, acupuncture, and physical therapy, we examined cervical X-ray, CT and Moire topography and evaluated the patient's symptoms by VAS. And we observed whether the changes exist or not in X-ray and VAS. Results : VAS in symptoms was improved significantly(p<0.05), and the radiologic X-ray image in OPLL patient was improved. Conclusion : OPLL was generally treated conservative treatment and operation in severe case. But CHUNA manual therapy may be more effective in conservative treatment of OPLL, if more clinical studies and reaches are accomplished.

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Outcome of Type 3 Talar Neck Fractures by Means of Medial Malleolar Osteotomy and Large Distractor (족관절 내과 절골술 및 대형신연기를 이용한 제3형 거골 경부 골절의 치료 결과)

  • Park, Sung Hae;Lee, Jun Young;Lee, Jung Woo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.45-51
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    • 2019
  • Purpose: The clinical and radiological results of patients with type 3 talar neck fractures treated with the anteromedial approach using medial malleolar osteotomy and large distractor were analyzed retrospectively. Materials and Methods: From March 2009 to August 2016, 12 patients with a type 3 talar neck fracture, who underwent the anteromedial approach using a medial malleolar osteotomy and large distractor and who could be followed-up for more than 12 months after the operation, were examined. The patients were examined for the presence of Hawkins signs by anteroposterior and lateral radiographs and osteonecrosis by magnetic resonance imaging (MRI) on the postoperative 3 months. Subsequently, every 3 months, radiographic union was assessed by a simple radiograph and clinical symptoms. Twelve months postoperatively, posttraumatic arthritis was assessed and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was analyzed. Results: In 7 cases, osteonecrosis was found on MRI performed 3 months after surgery. On the other hand, at the 12 months follow-up, all of them obtained AOFAS scores of 83.86±4.53 without surgical treatment. Radiographic union was achieved in all cases. The mean union period was 5.3 months. In 10 cases, traumatic arthritis was found after the radiographical and clinical evaluation. In addition, all of them could carry on everyday life by conservative treatment. The AOFAS ankle-hindfoot score was measured to be 85.17 on average. Other complications included superficial wound infection in 2 cases. Conclusion: An anteromedial approach using a medial malleolar osteotomy and a large distractor in the surgical treatment of patients with type 3 talar neck fractures can achieve anatomical reduction of the displaced fragment without a lateral dissection. This is considered to be another good surgical option.

Osteoarthritis of the Temporomandibular Joint (측두하악관절의 골관절염)

  • Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.87-95
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    • 2013
  • Osteoarthritis (OA) of the temporomandibular joint (TMJ) is a severe form of temporomandibular disorders (TMDs), presenting gradual breakdown of articular cartilage and subchondral bone by the functional load sustained to exceed the physiologic tolerance of the joint. In such a joint loaded, offensive bioactive materials such as matrix degrading proteins, cytokines, and free radicals increase in concentration to shift the tissue response in the joint to degeneration from regeneration or remodeling. Recently, it has been issued that obesity can play an offensive role in pathogenesis of OA in a metabolic way. Adipokines released by adipose cells are present at higher concentration in the arthritic joint and joints of obese individuals. However, because of conflicting data reported, further scientific study should be performed to elucidate the practical role of adipokines in pathogenesis of TMJ OA. As far as the clinical signs and symptoms of TMJ OA are not much different from those of other forms of TMD and any definitive treatment modality to control directly the bone resorptive activity is not available yet, the treatment of TMJ OA should be directed to reduce the physical load and enhance the physiologic tolerance of the joint by means of conservative treatment such as physical therapy, medication, and occlusal splint therapy for sufficient period and, if needed after that, supplementary surgical procedure such as intra-articular injection, arthrocenthesis, and arthroscopic surgery that have turned out to be effective to control OA signs and symtpoms. Enthusiastic reassurance and motivation for patients to control behaviors for themselves to reduce unnecessary functional load in daily life is very important for the joint to reach to more favorable orthopedic stability of the TMJ more quickly, guaranteeing more successful management TMJ OA.