• Title/Summary/Keyword: 보철 치료

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MULTIPLE CONGENITAL MISSING TEETH : CASE REPORT (선천성 다수 영구치 결손 환아의 증례보고)

  • Shin, Jeong-Geun;Kim, Jae-Gon;Yang, Yeon-Mi;Kim, Sung-Hee;Baik, Byeong-Ju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.1
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    • pp.122-130
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    • 2006
  • Congenital Missing Teeth(hypodontia, oligodontia) is the developmental absence of one or more teeth. It has been reported as being the most common anomaly of dental development in human, relatively common in the permanent dentition. In a recent review, Vastardis has quoted incidence ranges of $1.6%{\sim}9.6%$ in the permanent dentition. Brook has quoted a prevalence of $3.5%{\sim}6.5%$ in most populations, with severe hypodontia, defined as the absence of six or more teeth, having a prevalence of $0.3{\sim}0.4%$. The most commonly affected teeth are third molars, followed by maxillary lateral incisor, and second premolars. The etiology is unknown, several hypotheses include trauma, nutritional deficiency, infection, metabolic abnormalities, systemic disease and genetic influence. The multiple congenital missing is commonly associated with specific syndrome or severe systemic abnormalities such as cleft lip & palate and Down's syndrome. These cases present that children have multiple congenital missing teeth in the permanent dentition, without any systemic disease. Management of this condition must be considered orthodontic and prosthodontic treatment comprehensively. In these cases, children were treated by space maintainer or orthodontic appliance and follow-up checked.

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The status and improvement course of dental treatment for the disabled in Korea (Original Article 1 - 한국 장애인의 치과의료 이용실태와 개선방향)

  • Shim, Su-Hyun;Lee, Won;Choi, Bohm
    • The Journal of the Korean dental association
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    • v.48 no.4
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    • pp.280-287
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    • 2010
  • Objective: In spite of increasing dental treatment for the disabled, there was a few collected data on dental treatment status and dentists' perception in Korea. The purpose of this' study is to research the current dental treatment status for the disabled in Korea and to suggest public health policies for the disabled. Material and methods: Total of 68 dentists who have treated the disabled regularly were asked to fill questionnaires regarding dental treatments for the disabled. Results: 1. It is necessary to set up public dental center for the disabled in rural area. 2. In case of dental treatments relating to cerebral palsy, ADHD, autism, the compensation for treatment time and extra investment is needed. 3. Only 39.7% of dentists charged treatment fees to the disabled as same as normal patients. Moreover 38.2% of dentists answered that they didn't charge treatment fees at all when their patient are disabled. 4.23.5% of dentists provided all of dental treatments including dental implant and orthodontic appliances in Korea. However, 54.3% of dentists reported the improvement of access to dental implant, orthodontic and esthetic treatment is needed. 5. It is imperative for the government to improve the support system for the disabled. Conclusions: Through this research only 26.5% of dentists answered that they had received the fund from the government and 11.1% of them were satisfied with the support for the disabled in Korea. This indicated the improvement of government financial support system for the disabled is needed.

A study on the Shift of Burden of Proof in Medical Malpractice - Ruling of Jeonju Appellate Court 2017Na9346 - (의료과오소송에서의 증명책임에 대한 소고 -전주지방법원 2017. 7. 21. 선고 2017나9346판결-)

  • Lee, Soo-Kyoung;Yoon, Seok-Chan
    • The Korean Society of Law and Medicine
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    • v.22 no.2
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    • pp.49-79
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    • 2021
  • Due to defendant's wrongful act by implant surgery, plaintiff has been suffered serious damages to his face and teeth, and pain caused by establishing implanted teeth. Jeonju Appellate Court sentenced to pay future medical expenses and alimony to the plaintiff in compensation for breach of duty or torts. The ruling is designed to relieve the burden of proof because it is extremely difficult for non-experts to determine whether dentists violated their 'duty of care' or whether there was a causal relationship between damages to medial treatment. It was judged that if symptoms that contributed to the patient's significant outcome occurred during or after surgery, such symptoms could be presumed to have been caused by medical negligence if indirect facts were proven to be other than medical negligence. Originally, the shifting of burden of proof in Germany, has already been developed in medical malpractice case since 1940s. In order to guarantee the patients' right, §630h German Civil Code (BGB) - presumption of negligence in the realization of controllable risk- has been also legislated. BGH (Bundesgerichtshof) has been interested in ensuring that the principle of equality between patients and doctors. So, in this study, we wanted to refer to German precedent cases to analyzing Korean medical malpractice lawsuit. In particular, the decision could be significant in that it approaches closer to allows the shifting burden of proof in drastically growing dental malpractice cases. This is clearly confirmed in the judgment of the dentist's "fault" that "if indirect facts about the symptom or occurrence are proven to be cause other than medical negligence, such symptoms can be presumed to be due to medical negligence."

Clinical Manifestations in Orofacial Movement Disorders (구강안면 운동장애의 임상적 증상 발현)

  • Ryu, Ji-Won;Yoon, Chang-Lyuk;Cho, Young-Gon;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.375-382
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    • 2008
  • This study was a preliminary study to establish diagnostic criterias and treatment for Orofacial Movement Disorders. The 33 Orofacial Movement Disorder patients who were visited in the department of Oral Medicine from September, 2007 to December, 2007 were selected for this study. We analyzed the age, sex, systemic diseases, the diagnosis and the cause of the patients' chief complaints, the self-consciousness and the types of orofacial movements. The obtained results were as follows : 1. Female were predominant in orofacial movement disorders(81.82% vs 18.18%) and mean age was 78.78(56 to 87) years. 2. They almost had systemic diseases(81.82%). Hypertenstion was the most common disease(22.41%) and diabetes mellitus(17.24%), depression(8.62%), gastritis(8.62%) in turns. 3. In clinical manifestation, temporomandibular disorder was the most frequently complained symptom(33.33%), and soft tissue disease(21.57%), burning mouth syndrome(17.65%), orofacial movement itself(15.69%), diffuse orofacial pain(6명, 11.76%) in turns. 4. Most orofacial movement disorders are idiopathic(72.73%), and related to prosthetic treatment(24.24%), related to antidepressant medication(3.03%) in turns. 5. The jaw-closing type was the most common type of orofacial movement disorders, and lateral type(33.33%), jaw-opening types(16.67%) in turns. 6. There were more patients who did not conscious of their orofacial movements than those who did.(54.55% vs 45.45%). In conclusion, dentists must be consider the orofacial movement disorders in patients who have orofacial pain. Also, dentists should obtain a proper history and perform a clinical examination to avoid misdiagnosis and inappropriate, irreversible treatment.

Effect of Experimental Muscle Fatigue on Muscle Pain and Occlusal Pattern (실험적으로 유발되는 근피로가 근통증 및 교합양상에 미치는 영향)

  • Kim, Jae-Chang;Lim, Hyun-Dae;Kang, Jin-Kyu;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.33 no.3
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    • pp.279-294
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    • 2008
  • This study aimed to make an analysis of the occlusion in the state of muscle fatigue produced by excessive mouth opening and clenching during the dental treatment to control the dental pain and to evaluate the sensory nerve in the muscle pain state. Most of the reasons why patients visit the dental office result in pain-either conceivably the dental origin pain or the non-dental origin pain. The dental offices have many therapeutic actions to produce the masticatory muscle fatigue for the treatment. Dental treatment with long minutes of mouth opening can cause some headaches, masticatory muscle pain and mouth opening difficulties. Patients with mastication problems who visits a dental office to alleviate pain run against another unexpected pain with other aspects. This study uses T-scan II system(Tekscan Co., USA) for the evaluation on the occlusal pattern in the experimental muscle fatigue after clenching, opening the mouth excessively and chewing gum. The occlusal contact pattern is analyzed by the contact timing, namely first, intercuspal, maximum and end point of contact. This inspection was performed at frequencies of 2000Hz, 250 Hz and 5 Hz before and after each experimental muscle pain was produced to 24 subjects who had normal occlusion without the orthodontic treatment or a wide range of the prosthesis by using $neurometer^{\circledR}$ CPT/C(Neurotron, Inc. Baltimore, Maryland, USA). The measuring sites were mandibular nerve experimental muscle fatigue respectively. This study could obtain the following results after the assessment of occlusion and sensory nerve of the experimental muscle fatigue. 1. There were the fastest expression after the excessive mouth opening in muscle fatigue and after tooth clenching in muscle pain. In the visual analog scale that records the subjective level, there was the highest scale after the clenching in the muscle fatigue in jumping off the point of pain. 2. Tooth contact time, contact force, relative contact force on the point of the first contact had no difference, and there were decreases in the contact force after the excessive mouth opening on intercuspal position point, after the excessive mouth opening and the gum chewing on the point of the maximum, and in the contact time after all the experimental muscle fatigue state on the point of the end contact. 3. There was no statistic significance in the current perception threshold before and after the experimental muscle fatigue. 4. There was no significant difference in the contact number, the maximal contact number on the point of the first contact, and the contact number after the mouth opening and gum chewing on the point of the intercuspal position and the contact number after the experimental muscle fatigue on the maximum point, and showed significant decreases. In conclusion, it was found that the occlusal pattern can cause the changes on the case of the clinical muscle weakness by intra-external oral events. It was important that the sedulous attention to details is required during dental treatment in case of excessive mouth opening, mastication and clenching.

A study of the arch length discrepancy and the diagnostic analysis (치열궁내 공간 부조화와 진단적 평가에 관한 연구)

  • Ryu, Young-Kyu;Ahn, Kwang-Seok
    • The korean journal of orthodontics
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    • v.34 no.1 s.102
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    • pp.1-11
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    • 2004
  • Predicting the arch length discrepancy by simply comparing the available arch perimeter with tooth materials is merely a 2-dimensional analysis of the teeth movement. However, the real teeth movement takes place 3-dimensionally and is affected by various factors such as, the arch fen the curve of Spee and the axis of the incisors. The purpose of this study is to clarify the relationship between the decrease in the arch perimeter and the horizontal positional change of the incisors after extraction of the 1st bicuspids, for more analytic evaluation of the arch length discrepancy at pre-treatment model analysis stage. In addition to that to evaluate the effect of the curve of Spee, teeth axis to the basal plane, and the incisional crowding to the treatment outcome. All patients were treated at the department of orthodontics, dental hospital, Yonsei university. Inclusion criteria for patients selection were as follows. $\cdot$ Angle classification I malocclusion with bialveolar protrusion $\cdot$ Extraction of 4 1st bicuspids $\cdot$ No tooth anomaly or prosthesis $\cdot$ No abnormal attrition $\cdot$ No ectopically erupted teeth $\cdot$ Angle classification I canine and molar relationship $\cdot$ Less than 3mm of crowding Model analysis of the above patients was performed and the following conclusions were obtained. 1. When the intercanine distance was maintained, the available space for the distal movement of the mandibular incisors after the extraction of the 4 1st bicuspids was larger than the space provided by the extraction of the 4 1st bicuspids. However the difference was less than 1mm. The more tapered the anterior arch form, the larger the difference. 2. Compared to the situation in which the intercanine distance was maintained, when the intercanine distance was expanded to meet the width of the Posterior teeth, the incisors could move about 3mm more distally. 3. The positional difference of the incisal tip was insignificant whether the central incisors were moved by tipping or bodily movement. 4. When the anterior crowding was solved without changing the intercanine distance, the larger the anterior arch length was, the more the anterior movement of the incisors. 5. When the curve of Spee was levelled, the increase in the arch perimeter was less than half of the deepest curve of Spee.

GROWTH AND DEVELOPMENT OF ARCH FORM (치열궁의 성장 변화)

  • Sohn, Byung-Wha;Baik, Hyoung-seon
    • The korean journal of orthodontics
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    • v.28 no.1 s.66
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    • pp.17-27
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    • 1998
  • Study on growth change of dental arch is considered to both an important data in orthodontic diagonsis and treatment planning as well as analysis of treatment results , also, arch form is important in anthropology and dentistry, even more so in prosthodontics and orthodontics. In the field of orthodontics, studies on the functional aspect of upper and lower teeth and maintenance of stability of dentition and occlusion were carried out from the early days. Some of the early studies include explanation of growth change in dental arch from measuring directly fom human stroll, and afterwards, cephalometrics x-rays were introduced; accordingly, studies using cephalometric measurement and linear measurements of study models were often performed. By this method, arch width, arch depth and perimeters were measured, and growth change or dental arch was studied. The subject ror this study were sn children(boys and girls or ages from 3 yens to 12 years from Kang-won district and Seoul, who has no history of orthodontic treatment and who show healthy status and normal growth and development. Cephalometric x-ray, panoramic x-ray, and study model were taken for each subject consecutively for 2 years, and the subjects are still followed up. 400 pairs of study models from the past two years were used in this study; mesio-distal diameater of each tooth, intercanine width, intermolar width, canine depth, molar depth and arch perimeters were measured. Afterwards, mean value and each standard deviation of each age group and each gender were obtained, and representation graph were drawn. The following conclusion were obtained. 1. Intercanine width showed gradual increase until the age of 10-years and after that, showed no increase. 2. Intermolar width in upper arch showed gradual increase : intermolar width in lower arch showed no significant chang, and after the age of 9-years, showed increase. 3. Cainine arch depth showed relatively rapid increase after the age of 6-years, and this pattern was more obvious in lower arch. 4. Molar arch depth increased gradually in both archs and it decrease after the age of 10-years : this phenomenon was more prominent in the lower arch. 5. Arch perimeter showed gradual inerease and convert to plateau at the age of 10-years, after that, it decreased. this pattern was more prominent in lower arch.

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THE ANTERIOR-POSTERIOR AND VERTICAL RELATIONSHIP OF THE GROWING CHILDREN WITH CLASS III MALOCCLUSION BY LATERAL CEPHALOMETRIC MEASUREMENT (측모두부방사선 사진을 이용한 성장기 III급 부정교합아동의 전후방적, 수직적 악골관계에 대한 연구)

  • Yang, Ku-Ho;Choi, Nam-Ki;Kim, Seong-Nam
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.2
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    • pp.291-297
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    • 2003
  • While making diagnosis and the treatment plan for the growing children who visited at Chonnam National University Hospital for orthodontic treatment, authors obtained 8 lateral cephalometric measurements in antero-posterior and vertical relationship such as APDI, WITS, ANB, SN-MP, ODI, PFH/AFH, Y-axis, SUM for children aged 7 to 9 with class III malocclusion and compared them with these of 73 children of elementary school aged 7 to 9 with proper profile and normal occlusion in Gwangju. The results were as follows: 1. Between normal occlusion and class III malocclusion, ANB, SN-MP, ODI, SUM, except PFH/AFH and Y-axis showed statistically significant differences(p<0.05). 2. Between mesurements to describe skeletal disorder of antero-posterior relationship such as APDI, WITS, ANB and skeletal disorder of vertical relationship such as SN-MP, ODI, PFH/AFH, Y-axis, SUM, all of them in both normal occlusion and Class III malocclusion showed significant correlation, except Y-axis, SUM correlation(p<0.01). 3. Wald' statistics of WITS, ANB and APDI expressing skeletal disorder of antero-posterior relationship showed 7.118, 5.148, 0.741, respectively and Wald' statistics of ODI, Y-axis, PFH/AFH, SN-MP, SUM were presented 28.348, 2.238, 1.376, 0.090, 0.089, respectively. Therefore, WITS and ODI could be considered as useful diagnotic measurements for class III malocclusion.

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ROOT RESORPTION OF PRIMARY TEETH WITHOUT PERMANENT SUCCESSORS (계승영구치가 선천적 결손된 유치의 치근 흡수)

  • Lee, Jung-Eun;Lee, Jae-Ho;Choi, Hyung-Jun;Kim, Seong-Oh;Song, Je-Seon;Son, Heung-Kyu;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.625-630
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    • 2009
  • Root resorption of primary teeth usually occurs as the succeeding permanent teeth erupt, which induces differentiation of the hemopoietic cells into osteoclasts. Their root resorption pattern reflects the eruption path of the succeeding permanent teeth, and eventually the primary teeth shed as their succeeding permanent teeth erupt. Even when a permanent tooth germ is congenitally missing, root resorption of the corresponding primary tooth may still occur due to various factors, such as inflammation, traumatic occlusal force, and weakness of periodontium etc. Such congenital missing of permanent teeth is a commonly observed phenomenon in human be ing, and it often accompanies delayed retention of primary teeth. The etiologic factors for congenital missing in elude not only systemic diseases, but also local factors and human evolution process. In the radiographs of the cases in this report, the primary teeth without succeeding permanent teeth show pathologic root resorption. Root resorption progressed about 1/2~3/4 of the roots, and the surfaces of the resorption area were irregular. Considering high susceptibility of the periodontal ligament of primary teeth to root resorption, pathologic root resorption of primary teeth with delayed retention can be explained by the increased masticatory muscle force and abnormal occlusion developed during the mixed dentition. When the primary teeth without succeeding permanent teeth are lost, decision for space maintenance is required and long-term treatment plan for further prosthetic or orthodontic treatment should be establsihed.

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Dentists' Opinions in The Dental Field of Present Health Insurance Claim and Review (건강보험중 구강요양급여의 청구 및 심사에 관한 치과의사의 견해)

  • Chang, Yong-Seog;Ahn, Yong-Woo;Park, June-Sang;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.215-230
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    • 2005
  • The study was intended to investigate how dentists in private dental clinic thought on the present claim and review of dental insurance to reflect it in future establishing dental insurance policies. 1,465 dentists who were running own dental clinic in Pusan Metropolitan City and the south part of Kyungsang province were surveyed in February, 2004. A total of 406 copies of finished questionnaire were finally retrieved and analyzed. The findings are as follows. 1. About insurance claim affairs : Most of the subject of insurance claim was by dentist himself or dental hygienist(nurse). Agency claiming was carried under 20% of total insurance claim. 2. The degree of attendance on insurance lecture : The degree of attendance on insurance lecture was relatively low. 3. Filing a protest against insurance claim : Filing a protest against insurance claim was reavealed about half-and-half for "have been" or "have not been". 4. Private clinic dentist,s opinion about the regulations affecting review of dental insurance : Private clinic dentists opinion about current guide for insurance review of dental fee was“the guidance is difficult and unfair cutback of claim fee may be carried”. 5. The affairs about health insurance review agency : About 70% of private clinic dentists have dissatisfaction on health insurance review agency. 6. Standpoint of private clinic dentists about issuance of receipt for dental fee : About 70% of private clinic dentist have an difficulty in issuance of receipt for dental fee. 7. The affairs about change insurance noncoverage treatment to insurance coverage treatment : Most of private clinic dentists hoped that insurance coverage about full mouth scaling, pit and fissure sealant, fluoride application. But they do not hoped that insurance coverage about geriatric denture, prothodontic treatment except precious metal, photopolymerization resin treatment.