• Title/Summary/Keyword: 치과임상

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The Occurrence of Degenerative Change in the Mandibular Condyles of Korean Patients with Temporomandibular Disorders (측두하악장애 환자에서 하악과두의 퇴행성 변화의 발생 양상에 대한 연구)

  • Jo, Jung-Hwan;Park, Min-Woo;Kim, Young-Ku;Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.53-63
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    • 2011
  • Osteoarthritis (OA), the most common form of arthritis, is a result of both mechanical and biological events that destabilize the normal coupling of degradation and synthesis of articular cartilage chondrocytes and extracelluar matrix, and subchondral bone. Although it is likely that the molecular basis of pathogenesis is similar to that of other joints, additional study of the temporomandibular joint (TMJ) is required due to its unique structure and function. This study was carried out to evaluate the epidemiologic characteristics of TMJ osteoarthritis. The purpose of this study was to investigate the prevalence of TMJ OA in Patients with temporomandibular disorders (1405 men and 2922 women whose mean age was $30.2\; {\pm}\; 15.4$ and $33.1\;{\pm}\;15.2$ years, respectively) who had visited the TMJ and Orofacial Pain Clinic of Seoul National University Dental Hospital in 2007. Orthopantomograms, TMJ tomograms and transcranial radiographs were used to evaluate degenerative change of the mandibular condyle. The obtained results were as follows: 1. Degenerative change of the mandibular condyle was observed in 883 (20.4%) of 4327 subjects. The prevalence was significantly higher in women (706 patients, 24.1%) than in men (177 patients, 12.6%), and this significant difference between genders was observed in all age groups. 2. The prevalence of degenerative change of the mandibular condyle in TMD patients showed a gentle increase along with age. Such increase was statistically significant in women (P < 0.001), but not in men. 3. Sclerosis was observed the most frequently in all age groups and the mean age of the patients with osteophyte was the highest among four types of degenerative change. 4. Although men showed degenerative change in the left side more often and women showed degenerative change more frequently in both sides, the difference of distribution in sides between genders was not significant. In conclusion, the prevalence of degenerative change of the mandibular condyle in TMD patients is higher in women than in men, and increases steadily with aging, but not as dramatically as in other joints that show a steep increase in prevalence around the age of 45 years. It can be suggested that the epidemiologic characteristic of OA of the TMJ differs from those of other joints, and that a more extensive study based on the general population is necessary.

Comparison of Tension Type Headache Associated with Pericranial Tenderness and Headache Attributed to Temporomandibular Joint Disorder Using RDC/TMD Axis II (두개주변압통과 관련된 긴장성 두통과 측두하악장애에 기인한 두통과의 RDC/TMD Axis II에 따른 비교)

  • Park, Hyung-Yun;Bae, Sung-Jae;Yoo, Sang-Hoon;Chun, Yang-Hyun;Hong, Jung-Pyo;Auh, Q-Schick
    • Journal of Oral Medicine and Pain
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    • v.35 no.2
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    • pp.123-133
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    • 2010
  • The purpose of this study is to investigate Tension-type headache associated with pericranial tenderness and Headache attributed to temporomandibular joint disorder among Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score using RDC/TMD Axis II. Eighty five patients who visited the Kyung Hee University Dental Hospital were diagnosed as Tension-type headache associated with pericranial tenderness(n=48) and Headache attributed to temporomandibular joint disorder(n=37) by the International Classification of Headache Disorders, 2nd Edition, and were administered the Korean versions of the RDC/TMD Axis II- Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score. Then it was analyzed statistically by SPSS(ver. 10.0). T-test, The Wilcoxon-signed rank test and Mann-Whitney U test (p<0.05) were used. There were no significant differences in Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score between two groups. Tension type headache associated with pericranial tenderness and Headache attributed to temporomandibular joint disorder showed similar Axis II feature. Tension-type headache associated with pericranial tenderness may be related to Headache attributed to temporomandibular joint disorder.

QUANTITATIVE COMPARISON OF PERMEABILITY IN THE ADHESIVE INTERFACE OF FOUR ADHESIVE SYSTEMS (열순환 후 상아질 접착 계면의 수분 투과성 변화에 대한 정량적 분석)

  • Chang, Ju-Hea;Yi, Kee-Wook;Kim, Hae-Young;Lee, In-Bog;Cho, Byeong-Hoon;Son, Ho-Hyun
    • Restorative Dentistry and Endodontics
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    • v.34 no.1
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    • pp.51-60
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    • 2009
  • The purpose of this study was to perform quantitative comparisons of water permeable zones in both the adhesive and the hybrid layer before and after thermo cycling in order to assess the integrity of the bonding interface. Twenty eight flat dentin surfaces were bonded with a light-cured composite resin using one of four commercial adhesives [OptiBond FL (OP), AdheSE (AD), Clearfil SE Bond (CL). and Xeno III (XE)]. These were sectioned into halves and subsequently cut to yield 2-mm thick specimens; one specimen for control and the other subjected to thermocycling for 10,000 cycles. After specimens were immersed in ammoniacal silver nitrate for 24 h and exposed to a photo developing solution for 8 h, the bonded interface was analyzed by scanning electron microscopy (SEM) and wavelength dispersive spectrometry (WDS) at five locations per specimen. Immediately after bonding. the adhesive layer of OP showed the lowest silver uptake, followed by CL, AD. and XE in ascending order (p < 0.0001); the hybrid layer of CL had the lowest silver content among the groups (p = 0.0039). After thermocycling, none of the adhesives manifested a significant increase of silver in either the adhesive or the hybrid layer. SEM demonstrated the characteristic silver penetrated patterns within the interface. It was observed that integrity of bonding was well maintained in OP and CL throughout the thermocycling process. Adhesive-tooth interfaces are vulnerable to hydrolytic degradation and its permeability varies in different adhesive systems, which may be clinically related to the restoration longevity.

Microtensile bond strength of resin inlay bonded to dentin treated with various temporary filling materials (임시 가봉재가 상아질과 레진 인레이의 미세인장 결합 강도에 미치는 영향)

  • Kim, Tae-Woo;Lee, Bin-Na;Choi, Young-Jung;Yang, So-Young;Chang, Hoon-Sang;Hwang, Yun-Chan;Hwang, In-Nam;Oh, Won-Mann
    • Restorative Dentistry and Endodontics
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    • v.36 no.5
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    • pp.419-424
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    • 2011
  • Objectives: This study was aimed to determine the effects of temporary sealing materials on microtensile bond strength between resin-coated dentin and resin inlay and to compare the bonding effectiveness of delayed dentin sealing and that of immediate dentin sealing. Materials and Methods: The teeth were divided into 4 groups: group 1, specimens were prepared using delayed dentin sealing after temporary sealing with zinc oxide eugenol (ZOE); group 2, specimens were prepared using immediate dentin sealing and ZOE sealing; group 3, specimens were prepared using immediate dentin sealing and Dycal (Dentsply) sealing; group 4, specimens were prepared using immediately sealed, and then temporarily sealed with a resin-based temporary sealing material. After removing the temporary sealing material, we applied resin adhesive and light-cured. Then the resin inlays were applied and bonded to the cavity with a resin-based cement. The microtensile bond strength of the sectioned specimens were measured with a micro-tensile tester (Bisco Inc.). Significance between the specimen groups were tested by means of one-way ANOVA and multiple Duncan's test. Results: Group 1 showed the lowest bond strength, and group 4 showed the highest bond strength (p < 0.01). When temporary sealing was performed with ZOE, immediate dentin sealing showed a higher bonding strength than delayed dentin sealing (p < 0.01). Conclusions: Based on these results, immediate dentin sealing is more recommended than delayed dentin sealing in bonding a resin inlay to dentin. Also, resin-based temporary sealing materials have shown the best result.

Evaluation of time-dependent antimicrobial effect of sodium dichloroisocyanurate (NaDCC) on Enterococcus faecalis in the root canal (이염화이소시아뉼산나트륨 제재의 근관 내 사용 시 시간에 따른 E. faecalis에 대한 항균성 평가)

  • Kim, Hye-Jeong;Park, Se-Hee;Cho, Kyung-Mo;Kim, Jin-Woo
    • Restorative Dentistry and Endodontics
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    • v.32 no.2
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    • pp.121-129
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    • 2007
  • The purpose of this study was to assess the antibacterial effect of sodium dichloroisocyanurate (NaDCC), sodium hypochlorite (NaOCl), and chlorhexidine (CHX) on Enterococcus faecalis and to evaluate and to compare the time-dependant antimicrobial effect of NaDCC with NaOCl and CHX in the root canal in vitro before and after instrumentation. Extracted Human single teeth were prepared by serial instrumentation technique. The samples were autoclaved and contaminated for 3 days with E. faecalis monocultures. The teeth were then divided into 4 groups Each group was irrigated and inserted with 2% NaOCl, 2% NaDCC, 2% CHX and steri)ized saline. After 6, 12, 24, 72h, and 1 week incubation, sterilized paper point was inserted into the root canal. Paper points containing root canal contents were then placed on the agar plate. And then each root cana) was prepared with #4 and #5 GG (Gates-Glidden) drill. The debris were collected in the sterilized microtube and the plates were incubated at $37^{\circ}C$ in an increased $CO_2$ atmosphere. After 24h incubation the growth of bacteria around the paper points were measured. NaOCl and NaDCC solution shows similar antimicrobial effect for E. faecalis at 6, 12, 24, 72h and 1 week. In centrol group, irrigated with sterilized saline, no antimicrobial effect was observed. The results are in agreement with other investigators, who have shown the bactericidal property and possibility of NaDCC as a root canal irrigation solution. Thus it seems that NaDCC solutions can be clinically applied into the root canal within 1 week after dilution.

The Effect of Surface Defects on the Cyclic Fatigue Fracture of HEROShaper Ni-Ti rotary files in a Dynamic Model: A Fractographic Analysis (Fractographic 분석을 통한 HEROShaper 니켈티타늄 전동 파일의 피로파절에 미치는 표면결함의 역할)

  • Lee, Jung-Kyu;Kim, Eui-Sung;Kang, Myoung-Whai;Kum, Kee-Yeon
    • Restorative Dentistry and Endodontics
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    • v.32 no.2
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    • pp.130-137
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    • 2007
  • This in vitro study examined the effect of surface defects on cutting blades on the extent of the cyclic fatigue fracture of HEROShaper Ni-Ti rotary files using fractographic analysis of the fractured surfaces. A total of 45 HEROShaper (MicroMega) Ni-Ti rotary flies with a #30/.04 taper were divided into three groups of 15 each. Group 1 contained new HEROShapers without any surface defects. Group 2 contained HEROShapers with manufacturing defects such as metal rollover and machining marks. Croup 3 contained HEROShapers that had been clinically used for the canal preparation of 4-6 molars A fatigue-testing device was designed to allow cyclic tension and compressive stress on the tip of the instrument whilst maintaining similar conditions to those experienced in a clinic. The level of fatigue fracture time was measured using a computer connected the system. Statistical analysis was performed using a Tukey's test. Scanning electron microscopy (SEM) was used for fractographic analysis of the fractured surfaces. The fatigue fracture time between groups 1 and 2, and between groups 1 and 3 was significantly different (p<0.05) but there was no significant difference between groups 2 and 3 (p>0.05). A low magnification SEM views show brittle fracture as the main initial failure mode At higher magnification, the brittle fracture region showed clusters of fatigue striations and a large number of secondary cracks. These fractures typically led to a central region of catastrophic ductile failure. Qualitatively, the ductile fracture region was characterized by the formation of microvoids and dimpling. The fractured surfaces of the HEROShapers in groups 2 and 3 were always associated with pre-existing surface defects. Typically, the fractured surface in the brittle fracture region showed evidence of cleavage (transgranular) facets across the grains, as well as intergranular facets along the grain boundaries. These results show that surface defects on cutting blades of Ni-Ti rotary files might be the preferred sites for the origin of fatigue fracture under experimental conditions. Furthermore this work demonstrates the utility of fractography in evaluating the failure of Ni-Ti rotary flies.

Pulp Response of Mineral Trioxide Aggregate, Calcium Sulfate or Calcium Hydroxide (Mineral trioxide aggregate, calcium sulfate와 calcium hydroxide의 치수에 대한 반응)

  • Yun, Young-ran;Yang, In-Seok;Hwang, Yun-Chan;Hwang, In-Nam;Choi, Hong-Ran;Yoon, Suk-Ja;Kim, Sun-Hun;Oh, Won-Mann
    • Restorative Dentistry and Endodontics
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    • v.32 no.2
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    • pp.95-101
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    • 2007
  • This study was performed to verify the possibility of MTA and calcium sulfate as a pulp capping agent through comparing the dental pulp response in dogs after capping with MTA, calcium sulfate, and calcium hydroxide. 24 teeth of 2 dogs, 8 month old, were used in this study. Under general anesthesia, cervical cavities were prepared and pulp was exposed with sterilized #2 round bur in a high speed handpiece. MTA calcium hydroxide, and calcium sulfate were applied on the exposed pulp. Then the coronal openin,fs were sealed with IRM and light-cured composite. Two months after treatment, the animals were sacrificed. The extracted teeth were fixed in 10% neutral-buffered formalin solution and were decalcified in formic acid-sodium citrate. They were prepared for histological examination in the usual manner. The sections were stained with haematoxylin and eosin. In MTA group, a hard tissue bridges formation and newly formed odontoblasts layer was observed. There was no sign of pulp inflammatory reaction in pulp tissue. In calcium hydroxide group, there was no odontoblast layer below the dentin bridge. In pulpal tissue, chronic inflammatory reaction with variable intensity and extension occurred in all samples. In calcium sulfate group, newly formed odontoblast layer was observed below the bridge. Mild chronic inflammation with a few neutrophil infiltrations was observed on pulp tissue. These results suggest that MTA is more biocompatible on pulp tissue than calcium hydroxide or calcium sulfate.

THE INFLUENCE OF THE VITAL BLEACHING AGENTS ON TRANSLUCENCY OF THE BOVINE ENAMEL (생활치 미백제가 우치 법랑질의 투명도에 미치는 영향)

  • Kim, Dong-Jun;Kim, Young-Ju;Kim, Hak-Geun;Park, Eun-Jong;Seo, Eun-Ju;Hwang, Yun-Chan;Oh, Won-Mann;Hwang, In-Nam
    • Restorative Dentistry and Endodontics
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    • v.30 no.3
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    • pp.178-183
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    • 2005
  • This study was done to evaluate whether vital bleaching agents could influence on the translucency of the bovine enamel. The anterior bovine teeth that were extracted one day before and without any gross discoloration were obtained and then were preserved in physiologic saline. 6 mm cylindrical tooth specimens were fabricated with diamond puncher perpendicularly on labial surface of bovine tooth. After embedded in transparent acrylic resin with labial surface being exposed, they were cut to a thickness of 1.2 mm with low speed diamond saw (Isomat, Buehler Co., Lake Bluff, IL, USA). They were smoothly ground to 1 mm thickness of enamel with sandpaper. 24 specimens were randomly divided into 3 groups and control group respectively. Opalescence (10% carbamide peroxide, Ultradent, South Jordan, USA), Rembrandt (10% carbamide peroxide, DenMat, USA) and Opalescence F (15% carbamide peroxide with fluoride, Ultradent, USA) were applied on labial sides of the bovine enamel for 7 days (bleaching agents were reapplied every 24 hours) and the opposite surface was contacted to cotton that soaked in distilled water. The control group was soaked in distilled water. Three stimulus value X, Y and Z were evaluated with colorimeter (Color ' Color Differencerneter, Model TC-6FX, Tokyo Denshoku Co., Japan) on the labial surface of all specimen three times on white and black background plate before the bleaching agents were applied and on 3rd, 5th and 7th day after applied. The degree of translucency was normally assessed by measuring the inverse property, opacity (contrast ratio). 10% Opalescence, 15% Opalescence-F, and control group showed no significant variation in the translucency of bovine enamel, However Rembrandt decreased the translucency of it (p < 0.01).

Retention of CAD/CAM Metal Copings Cemented on Short Titanium Abutments with Different Cements (짧은 티타늄 지대주에 합착된 CAD/CAM 금속 코핑의 시멘트 종류에 따른 유지력 비교)

  • Kim, Hyo-Jung;Song, Eun-Young;Yoon, Ji-Young;Lee, Si-Ho;Lee, Yong-Keun;Oh, Nam-Sik
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.2
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    • pp.119-126
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    • 2012
  • State of problem: Cement-retained implant-supported prostheses are routinely used in dentistry. The use of high strength cements has become more popular with the increasing confidence in the stability of the implant-abutment screw connection and the high survival rates of osseointegrated implants. No clinical data on retention of metal copings using CAD/CAM. To evaluate retention of metal copings using CAD/CAM system bonded to short titanium abutment with four different cements and compare retentive strength of metal copings with sandblasting or without sandblasting before cementation. Forty titanium abutment blocks were fabricated and divided into 4 groups of 10 samples each. Forty metal copings with occlusal hole to allow for retention testing were fabricated using CAD/CAM technology. The four cements were Fujicem(Fuji, Japan), Maxcem Elite(Kerr, USA), Panavia F2.0(Kurarary, Japan) and Superbond C&B(Sunmedical, Japan). The copings were cemented on the titanium abutment according to manufacture's recommendation. All samples were stored for 24h at 37oC in 100% humidity and tested for retention using universal testing machine(Instron) at a crosshead speed of 1.0mm/min. Force at retentive failure was recorded in Newton. The mode of failure was also recorded. Means and standard deviations of loads at failure were analyzed using ANOVA and Paired t-test. Statistical significance was set at P<0.05. Panavia F2.0 provided significantly higher retentive strength than Fujicem, Maxcem Elite(P<0.05). Sandblasting significantly increased bond strength(P<0.05). The mode of failure was cement remaining principally on metal copings. Within the limitation of this study, Panavia F2.0 showed significantly stronger retentive strength than Fujicem, Maxcem Elite(p<0.05). The Ranking order of the cements to retain the copings was Panavia F2.0, Fujicem = Maxcem Elite. Sandblasting significantly increased bond strength(P<0.05). The retentive strength of metal copings on implant abutment were influenced by surface roughness and type of cements.

BOND STRENGTH AND MICROLEAKAGE IN RESIN BONDING TO TOOTH STRUCTURE (치질접착에서 접착강도와 변연누출)

  • Kim, Jin-Hee;Park, Jeong-Won;Park, Jin-Hoon;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.24 no.4
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    • pp.570-577
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    • 1999
  • Intuitively, higher bond strengths should result in less leakage. However, the relationship between bond strengths and microleakage value is complex and not clearly understood. The purpose of this study was to evaluate the relationship between tensile bond strengths and microleakage values in the same restorations to understand the behavior of resin bonding to tooth structure. One-hundred and twenty enamel or dentin specimens from freshly extracted bovine mandibular incisors were used. The specimen was treated with 32% phosphoric acid for 15 seconds and rinsed for 20 seconds. the teeth were divided into four groups by means of wet bonding technique or dry bonding. One-Step$^{TM}$ adhesive were applied to the specimen. The specimens were immersed in 2% methylene blue solution for 7 days, and tensile bond strength and microleakage were measured. The results were as follows: 1. Significant negative correlation was found between bond strengths and micro leakage values. Hence, higher bond strengths seem to be associated with lower microleakage, and vice versa (r=-0 50, p<0.05). 2. The Enamel/Wet group showed significantly higher bond strength than Enamel/Dry one, and Dentin/Wet group showed higher strength than Dentin/Dry one (p<0.05). 3. Microleakage was significantly less ill wet bonding than in dry one at dentin (p<0.05), however, there was no significant difference between wet and dry bonding at enamel (p>0.05).

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