• Title/Summary/Keyword: 보철 치료

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Structural equation modeling for association between patient satisfaction and quality of life after implant surgery (임플란트 만족도와 삶의 질 간의 관련성에 대한 구조방정식모델 분석)

  • Chung, Sun-Young;Cho, Jin-Hyun;Lee, Kyu-Bok;Choi, Youn-Hee;Song, Keun-Bae
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.4
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    • pp.291-299
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    • 2011
  • Purpose: This study was designed to measure patient satisfaction and oral health-related quality of life and to assess an association between patients' satisfaction and oral health-related quality of life after implant surgery by using structural equation modeling. Materials and methods: A total of 257 participants who visited 6 dental clinics located in Daegu city for the purpose of implant treatment participated in this study. Six months after completion of implant surgery, the patients' satisfaction and oral health-related quality of life were surveyed. The effect of factors associated with patients' satisfaction such as functions and aesthetics, maintenance and cost on oral health-related quality of life after implant surgery was analyzed using AMOS 4.0. Results: Oral health-related quality of life was improved in all dimensions of OHIP-14 after implant surgery. Functions and aesthetics as well as maintenance had a significant effect on oral health-related quality of life (P<.05), while cost was not a critical factor influencing oral health-related quality of life. Conclusion: High satisfaction with functional aspects and maintenance aspects significantly affected good quality of life. The result of this study supported the fact that education and management for patients after implant therapy were positively related to good quality of life based on a theoretical model.

Anticoagulation Management after Mitral Valve Replacement with the St. Jude Medical Prosthesis (승모판치환 환자의 항응혈제 치료)

  • 김종환;김영태
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1172-1182
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    • 1998
  • Background: Primary goal of anticoagulation treatment in patients with mechanical heart valve is the effective prevention of thromboembolism and safe avoidance of bleeding as well. Material and Method: Two-hundred and nine patients with the St. Jude Medical prosthesis operated on between 1984 and 1995, for mitral(MVR 122), aortic(AVR 39) and double mitral and aortic valve replacement(DVR 48) respectively, were studied on the practically achieved levels of anticoagulation and the clinical outcomes. Patients were on Coumadin and followed up by monthly visit to outpatient clinic for examination and prothrombin time measurement to adjust the International Normalized Ratios(INRs) within the low-intensity target range between 1.5 and 2.5. Result: A total anticoagulation follow-up period was 1082.0 patient- years(mean 62.1 months) and INRs of 10,205 measurements were available for evaluation. The accomplished INRs among the replacement groups were not significantly different and only 65% of INRs were within the target range. And, in individual patients, only 37% of patients had INRs included within the target range in more than 70% of tests during follow-up period. The levels of INRs in patients with atrial fibrillation, which was found in 57% of patients, were definitely higher than the ones measured in patients with regular rhythm(p<0.001). Thromboembolisms were experienced by 15 patients with the incidence of 1.265%/patient- year(MVR 1.412%, AVR 0.462% and DVR 1.531%/patient-year) and major bleeding by 4 patients with the incidence of 0.337%/patient-year(MVR 0.424%, AVR none and DVR 0.383%/patient-year). Frequent as well as prolonged missing of prothrombin time tests was the main risk factor strongly associated with the thromboembolic complications(odds ratio 1.99). The proportion of INRs within target range of less than 60% in individual patient was the highly significant risk factor of both thromboembolic and overall embolic and bleeding complications(p<0.004 and p<0.002 respectively). Conclusion: In conclusion, the low-intensity therapeutic target range of INRs was adequate in patients with AVR and in sinus rhythm. However, the patients with replacement of the mitral valve were more likely to require higher target range of INRs, especially in the presence of atrial fibrillation, to achieve the practical levels of anticoagulation enough to prevent thromboembolic complications effectively. For the higher therapeutic target range of INRs between 2.0∼3.0, further accumulation of clinical evidences are required. It is highly desirable to improve the patients' compliance under continuous instructions in visiting outpatient clinic and in taking daily Coumadin without omission and to keep INRs consistently within optimal range with tight control for minimization of chances and of periods of exposure to the risk of complications. And, particularly, patients with high risk of complications and with wide fluctuation of INRs should be better managed with frequent monitoring anticoagulation levels.

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The study on success rate of single implant replacing the mandibular first and second molars (하악 제1, 2대구치 단일 임플란트의 생존율에 관한 연구)

  • Jung, Taek-Gyun;Paeng, Joon-Young;Cho, Jin-Hyun;Lee, Sang-Han
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.252-260
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    • 2013
  • Purpose: After the introduction of concept of osteointegration, dental implantology have been successful procedure in the dental field. Recently, it has shown successful results when used to restore single tooth missing. Considering the difference in bone quality of the mandible and maxilla, and the increased occlusal force in the posterior region, the success rates in each region may be different. In this study, success rates of single implants placed in the mandibular first and second molar areas were analyzed. Materials and methods: The subjects were patients (284 patients, 308 implants) who had been operated with single implant installation from 2002 to 2009 in seven dental clinics in Daegu city. One hundred sixty eight implants were placed in the mandibular 1st molar and 140 implants were placed in the mandibular 2nd molar. They were analyzed according to implant site, age, sex, length and diameter. Results: The survival rates of single implant of this study were 97.6% in the mandibular 1st molar and 92.9% in the mandibular 2nd molar. In the mandibular 1st molar, 4 implants were failed. In the mandibular, 2nd molar, 10 implants were failed. Conclusion: The restoration of the mandibular 1st molar using single implant was found to be clinically acceptable treatment and showed higher survival rate than mandibular 2nd molar single implant. Single implant in mandibular 2nd molar needs careful consideration of poor bone quality, risk of overloading and anatomical structure of the mandible.

Flexibility of resin splint systems for traumatized teeth (외상성 치아모형에서의 레진 스플린트 시스템의 유연성 비교연구)

  • Park, Jin-Hong;Shin, Joo-Hee;Ryu, Jae-Jun;Lee, Jeong-Yol;Shin, Sang Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.4
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    • pp.389-393
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    • 2017
  • Purpose: The aim of this study is to evaluate the flexural strength of flexible resins and the flexibility of different resin splint (RS) systems in comparison with resin wire splint (RWS) system. Materials and methods: Three different resin materials (G-aenial flo, GA, GC; Superbond, SB, Sun medical; G-fix, GF, GC) were tested flexural strength test in accordance with ISO-4049:2000. For the flexibility test of splint systems, a artificial model with resin teeth was used to evaluate three types of resin splint systems (GA, SB, and GF) and one resin wire splint system. The left central incisor was simulated 'injured teeth' with third degree mobility. Three consecutively repeated measurements of periotest value were taken in horizontal direction, before and after splinting to access tooth mobility. The splinting effect was calculated through the periotest value. Differences were evaluated through One-way Anova and Tukey HDS post-hoc tests for pair-wise comparison (${\alpha}=.05$). Results: Although GA group showed significant higher flexural strength than SB and GF groups, all of three different resin splint systems produced a significantly higher and rigid splinting effect compared with 016" resin-wire splint system (P < .05). Conclusion: Within the limits of an in vitro study, it can be stated that resin splint systems are too rigid and may not be acceptable to treat tooth avulsion.

Analysis of current nursing homes in Korea and to assess the role and prospect of dentists in comparison to Japanese long term care insurance system (한국노인요양시설 구강 위생 현황과 일본 노인요양보험법 비교를 통한 치과의사의 역할과 전망)

  • Shin, Ri-Hye;Bae, Hanna Eun-Kyong;Choi, Sung-Ho;Park, In-Im; Ohyama, Takashi;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.83-91
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    • 2008
  • Statement of problem: The introduction of "The Long-term Care Insurance System" (a public nursing care insurance scheme) is scheduled from July in 2008. Lately, the importance of oral health care had increased. Introduction and establishment of the methodology (nursing care procedure) based on professional dental knowledge is inevitable. Purpose: The purpose of this study was to rouse recognition of the importance of dental care in the long term elderly care in nursing homes, with implementation of the new insurance law. Material and methods: Visited two institutions for the elderly, Yudang Village and Sungjiwon located in Suwon city to investigate the present conditions in terms of (1) the detailsof the institution, (2) the activities concerning with dental care in the institution, and (3) the consciousness and recognition regarding dental care of the staffs. Results: In two institutions, under the present conditions, oral cleaning (including the cleaning of denture) for residents was operated with no professional advices and limited professional dental care. It was found that there was very little awareness of aspiration pneumonia. The members of staff however, did recognizethe necessity of professional maintenance and management of oral care in daily nursing care, and that many residents hold dental problems. They were very eager in introducing the methodology (nursing care procedure) in dental care in nursing homes.

Double Processing Obturator for the Hemi-maxillectomy Treated Patient (Hemi-Maxillectomy 환자에서 이중온성법을 이용한 폐색장치의 제작)

  • Hong, Jun-won;Song, Kwang-yeob;Park, Mi-hee;Jeong, Soo-yang;Kim, Kyoung-il;Ahn, Seung-geun;Park, Ju-mi
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.4
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    • pp.329-336
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    • 2009
  • In the case of congenital malformation, acquired trauma, or maxillectomy by neoplasm, the defect in maxilla is combined with nasal cavity, maxillary sinus and oral cavity. This results in abnormal function in pronunciation, mastication, and swallowing. In this situation, the purposes of prosthodontics are also applied. The purposes of obturator for acquired maxillary deficiency patients are restoring pronunciation, mastication, and swallowing, and make patients comfortable and esthetic satisfaction. Reducing weight of the obturator makes edentulous ridge heathy and functional. It also improves patients' comfort. Hollow obturator also reduces unnecessary stress because improves physiologic function, as it weights less than 6.55-33.06% compare to usual one. This case presents the double-processing method for maxillary obturator in the patient treated hemi-maxillectomy due to malignancy neoplasm. We report this case because the patient acquired functional and esthetic satisfaction from double-processing obturator.

A study for middle-aged on oral health knowledge, oral health care and satisfaction with prosthetic treatment (중년층의 구강건강지식, 실천 및 보철치료 만족실태 조사)

  • Go, Eun-Jeong;Lee, Yong-Hwan;Park, Kwang-Hwan
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.5
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    • pp.671-683
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    • 2011
  • Objectives : The purpose of this study was to examine the oral health knowledge and actual oral health care of the selected subjects, their decision making about prosthetic treatment, the state and characteristics of their prosthetic treatment and their satisfaction with prosthetic treatment in an attempt to provide some information on the improvement of the quality of life related to oral health and the promotion of oral health. Methods : The subjects in this study were 250 people who received education in two different lifelong education institutions in the city of Busan. After a survey was conducted from May 23 to June 15, 2011, the answer sheets from 217 respondents were analyzed. Results : 1. As for the general characteristics of the respondents, the men(52.1%) outnumbered the women. Those who were in their 60 and up(47.5%) made up the largest age group, and the married people(65.4%) outnumbered the unmarried ones. By occupation, the company employees(20.3%) made up the biggest group. By education, the greatest group was high-school graduates(36.1%). By monthly mean income, the biggest group gained an income of 2.01 million won or more(36.9%). As to medical security, community-based insurance was most prevailing (36.9%). In terms of health promotion, the largest group worked out to stay fit(52.4%). 2. Regarding oral health knowledge, they had a good knowledge about the cause of dental caries(56.7%), but they weren't well aware of the right time for regular dental checkup(47.9%). In relation to oral health care, regular scaling wasn't prevailing(16.9%). 3. Regarding connections between the general characteristics and satisfaction with prosthesis, the less-educated respondents expressed significantly more dissatisfaction(p=0.015). By monthly mean income, those who had a smaller income were dissatisfied in general(p=0.028). Conclusions : The findings of the study illustrated that it's required to spread awareness of the importance of oral health among people in general, and that differentiated incremental oral health care should be provided for different age groups. In order to raise the satisfaction of patients with prosthesis, how to relieve their pain and anxiety and how to adjust prosthetic treatment cost properly should carefully be considered. In addition, the government should take measures to offer assistance for the low-income classes in preparation for an increase in the elderly population.

Full Mouth Rehabilitation in a Patient with Limited Restorable Space (수복 공간이 부족한 환자에서의 완전구강회복)

  • Lim, Kwang-Gil;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.2
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    • pp.145-156
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    • 2010
  • Loss of posterior support may cause overloading and excessive wear of remaining teeth. Moreover, the extrusion of antagonistic teeth leads to the destruction of the occlusal plane. The loss of vertical dimension of occlusion (VDO) also emerges clinically, which may bring the loss of esthetic appearance and function. These patients who suffer from the loss of posterior support, often require vigorous periodontal treatments (osteotomy, crown lengthening) and extensive oral rehabilitation. Sixty three years old female patient visited for the prosthetic treatment of the posterior edentulous area. She had no other systematic disease and parafuctional habits for prosthetic treatment. Intraoral and radiographic examinations were done. The evaluation of VDO and vertical dimension of rest position were evaluated for proper prosthetic procedures and diagnostic wax up was done. As a result of diagnosis, VDO was increased by 2 mm considering the loss of VDO and space for the prosthetic treatment. After the pretreatments, initial preparation of teeth and provisionalization were carried out. Six weeks later of provisionalizaion, final preparation and impression was performed. Using the duralay resin copings, jaw relation was registered. The master cast was mounted and definitive restoration was fabricated. After the evaluation of esthetic and function, pick up impression for clinical remounting was done. Lucia jig was made for new jaw relation and occlusal adjustment on the articulator. Definitive restoration was delivered and the patient was periodically recalled for additional occlusal adjustment. From this case, the satisfactory functional and esthetic results through full mouth rehabilitation with increase vertical dimension were achieved.

Effect of Porcelain Firing Process on the Marginal and Internal Fit of Ni-Cr Alloy Metal-Ceramic Crown (도재 소성과정이 Ni-Cr 금속도재관의 변연 및 내면 적합도에 미치는 영향)

  • Kim, Ki-Baek;Kim, Seok-Hwan;Kim, Jae-Hong
    • Journal of dental hygiene science
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    • v.14 no.3
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    • pp.405-410
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    • 2014
  • The purpose of this study in vitro investigation was to compare the marginal and internal fit of Ni-Cr alloy metal ceramic crown before and after porcelain veneering. Furthermore, this study evaluated whether the influence of the porcelain firing on the precision of fit of dental prostheses. The maxillary right incisor was selected as an abutment for experiments. Ten working models were prepared. Ni-Cr alloy cores appropriate for each abutment were prepared by lost wax technique. The marginal area and four internal areas of the crowns were measured at two stages: before veneering process and after upper porcelain firing. Silicone replica techniques were used. The data were statistically analyzed with the paired t-test (${\alpha}=0.05$). $Mean{\pm}SD$ marginal and internal gap were $67.1{\pm}23.3{\mu}m$ for the nickle chrome alloy core group and $74.4{\pm}21.9{\mu}m$ for the metal ceramic crown group. There were statistically significant differences in all investigated areas (p<0.05). Within the limitations of this study, none of the Ni-Cr alloy metal crown values measured after porcelain firing process exceeded $120{\mu}m$, which is the clinically acceptable threshold.

Analysis of the incidence of dementia in complete edentulous patients using the National Health Insurance Service-Elderly Cohort Database (NHIS-ECD) (국민건강보험공단 노인 코호트 자료를 이용한 완전 무치악 환자의 치매 발병률 분석)

  • Koo, Bonsuk;Yoo, Jin-Joo;Kim, Manyong;Lim, Hyunsun;Yoon, Joon-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.3
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    • pp.193-200
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    • 2020
  • Purpose: To investigate the relationship between dementia and complete tooth loss on both sides or one side using large demographic data. Materials and methods: A retrospective cohort study was designed using the National Health Insurance Service-Elderly Cohort Database (NHIS-ECD) which was established for people over the age of 60. The experimental group was the complete edentulous cohort, which had a history of treatment for national health insurance covered complete denture on both sides or one side from July 1, 2012 to December 31, 2013. And the control group was the dentulous cohort, which had a history of conservative dental treatment for the same period. All subjects had no history of diagnosis or treatment of dementia during this time. These cohorts were matched 1:1 by age, gender, and place of residence according to the propensity score matching method. Then the incidence of dementia was compared between these cohorts. Results: Compared with those groups, the incidence of dementia was significantly higher in the experimental group (12.13%) than in the control group (9.74%) (P<.05). No clear association between other factors has been identified. Conclusion: The analysis of large-scale demographic data shows that the incidence of dementia is high in complete edentulous patients on both sides or one side.