• Title/Summary/Keyword: 치과적 문제

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A Convergence Study on the Differences in Medical Practices and Medical cost according to Auto Insurance Companies (자동차보험사별 진료특성과 진료비 차이에 관한 융합 연구)

  • Lee, Soo-ja;Lee, Chong Hyung;Park, Arma;Kim, Kwang-Hwan
    • Journal of the Korea Convergence Society
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    • v.8 no.5
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    • pp.61-68
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    • 2017
  • This study investigates the differences in medical practices and medical cost according to auto insurance companies based on 8,589,602 cases that were treated by auto insurance corporation for the year of 2015, from the beginning of January to the end of December. The results of this study can be summarized following. First, in terms of the general characteristic in medical treatment, especially the age, the highest figure in both non-life insurance and mutual aid cooperative was shown in the age of 50 to 59 at 22.8 per cent(p<0.001). Second, in terms of a medical cost per a hospital care, classified by clinic, the costs in the department of internal medicine were much higher than those in the surgical department, and the thoracic surgery among parts of the surgical department showed the highest figures in both non-life insurance and mutual aid cooperative. According to the above summarized results of this study, it can be concluded that Health Insurance Review and Assessment Service has to address the problem on the increase of unnecessary costs and the occurrence of social expenses caused by the delay of patients' rehabilitation and return to their daily lives, by carrying out the evaluation for the appropriateness to organizations that ask for payments of auto insurance.

Evaluation of Taste in the Patients with Recurrent Aphthous Ulceration by Electrogustometer (전기미각측정기를 이용한 재발성 아프타성 궤양 환자의 미각평가)

  • Jun, Jin-Yong;Ahn, Yong-Woo;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.32 no.1
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    • pp.1-8
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    • 2007
  • The purpose of this study was to investigate whether there were any changes in taste sensitivity with recurrent aphthous ulceration. Nintyseven subjects(25 males and 72 females) were included for the study and they were categorized into 2 groups(recurrent aphthous ulceration 27 persons, control 70 persons), recurrent aphthous ulceration group was investigated in the department of Oral Medicine, College of Dentistry, Pusan National University from April, 2005 to August, 2006 and control group was investigated in the clinic at Incheon city from June, 2006 to August, 2006. The electrical taste thresholds were measured using an electrogustometer of the 4 different sites(tongue tip, tongue lateral, circumvallate papilla and soft palate) in oral cavity. The results were as follows ; 1. The electrical taste threshold showed significant lower in the RAU group. 2. The electrical taste threshold showed significant lower in female group, and showed significant lower except soft palate in male group of the RAU group. 3. The electrical taste threshold showed a tendency to increase in all site of the multiple RAU group, but there were no significant differences. 4. The electrical taste threshold showed a tendency to increase in tongue lateral of the acute RAU group, and showed a tendency to increase in tongue tip, circumvallate papilla, soft palate of the chronic RAU group. 5. After treatment, electrical taste threshold was significant increase than initial visit in the RAU group. 6. After treatment, NAS showed a tendency to decrease in the RAU group.

IMMOBILIZATION OF LOWER MANDIBULAR ALVEOLAR BONE FRACTURE USING RESIN-WIRE OPEN CAP SPLINT (하악 유전치부 치조골 골절시 resin-wire open cap splint를 이용한 고정)

  • Kwon, Joung-Hyun;Choi, Byung-Jai;Choi, Hyung-Jun;Kim, Seong-Oh;Son, Heung-Kyu;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.175-180
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    • 2008
  • Traumatic injuries to the primary dentition are commonly encountered problems in dental practice. It is found that 30% of the children had injuries to the primary dentition and 22% to the permanent dentition. The greatest incidence of trauma to the primary dentition occurs at the ages of 2 and 3 as children start to learn motor coordination. Because teeth and alveolar bone are traumatized simultaneously, alveolar bone fractures are likely to occur when multiple teeth are involved in injuries. Dental splints are indicated for the management of maxillofacial fractures. They enable anatomic reduction of fractured segments and help immobilization and maintenance of the fragments after reduction. They also act as a stabilizer during rehabilitation. Various types of dental splints are available. In this case, routine resin-wire splint technique could not be applied because of the child's uncooperative behavior. Oral sedation was not indicated because N.P.O. had not been preceded. Therefore, we decided to use open-cap acrylic splint instead. Stabilization using open cap acrylic splint requires minimum chair time with reduced discomfort to both patient and dentist. It is an effective means of splint for uncooperative children and especially useful when other means of fixation have been failed. Because trauma on the primary dentition can affect the underlying permanent tooth germ, it is important to monitor eruption process of the permanent dentition.

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CONSIDERATIONS OF ANESTHETIC METHOD OF DEEP IMPACTED MESIODENS (심부 매복 정중 과잉치 수술 시 마취방법 선택)

  • Min, Soo-Young;Song, Je-Seon;Lee, Jae-Ho;Choi, Hyung-Jun;Son, Heung-Kyu;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.1
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    • pp.90-96
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    • 2012
  • Supernumerary tooth occurs most frequently at premaxilla area. Followed by mandibular premolar area, mandibular fourth molar area, maxillary paramolar area. Mesiodens are mainly impacted in the palatal area and surgical approach is made at palatal side. The time of surgery remains controversial. In case of inverted or horizontal impacted supernumerary tooth, intraosseous tooth movement and vertical growth of premaxilla makes surgical extraction more difficult. And also the more quantity of removed bone is, the higher degree of difficulty is. Inverted mesiodens of these cases were impacted superior to apex level of adjacent permanent incisor. Although CT examination revealed exact location of impacted tooth, surgical procedure including ostectomy may take a long time more than expected. So, before surgical extraction, it's need to be considered several factors such as necessity of CT taking, degree of difficulty, direction of surgical approach, necessity of general anesthesia etc.

A comparison of the fidelity of various zirconia-based all-ceramic crowns fabricated with CAD/CAM systems (수종의 CAD/CAM 시스템으로 제작한 지르코니아 기반 완전도재관의 적합도 비교)

  • Kim, Sung-Jun;Jo, Kwang-Hun;Lee, Kyu-Bok
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.148-155
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    • 2009
  • Statement of problem: The interest in all-ceramic restorations has increased as more techniques have become available. With the introduction of machinable dental ceramics and CAD/CAM systems there is a need to evaluate the quality levels of these new fabrication techniques. Purpose: This study is to evaluate the crown fidelity(absolute marginal discrepancy and internal gap) of various zirconia-based all-ceramic crowns fabricated with different CAD/CAM(computer-assisted design/computer-assisted manufacturing) systems and conventional cast metal-ceramic crowns. Material and methods: A resin tooth of lower right second premolar was prepared. After an impression was taken, one metal master die was made. Then 40 impressions of metal master dies were taken for working dies. 10 crowns per each system were fabricated using 40 working dies. Metal-ceramic crowns were cast by using the conventional method, and Procera, Lava, and Cerec inLab crowns were fabricated with their own CAD/CAM manufactruing procedures. The vertical marginal discrepancies and internal gaps of each crown groups were measured on a metal master die without a luting agent. The results were statistically analyzed using the one-way ANOVA and Tukey's HSD test. Results: 1. Vertical marginal discrepancies were $50.6{\pm}13.9{\mu}m$ for metal-ceramic crowns, $62.3{\pm}15.7{\mu}m$ for Procera crowns, $45.3{\pm}7.9{\mu}m$ for Lava crowns, and $71.2{\pm}2.0{\mu}m$ for Cerec inLab crowns. 2. The Internal gaps were $52.6{\pm}10.1{\mu}m$ for metal-ceramic crowns, $161.7{\pm}18.5{\mu}m$ for Procera crowns, $63.0{\pm}10.2{\mu}m$ for Lava crowns, and $73.7{\pm}10.7{\mu}m$ for Cerec inLab crowns. Conclusion: 1. The vertical marginal discrepancies of, 4 crown groups were all within the clinically acceptable range($120{\mu}m$). 2. The internal gaps of LAVA, Cerec inlab, and metal-ceramic crowns were within clinically acceptable range except Procera crown($140{\mu}m$).

Considerations in implant crestal module to preserve peri-implant tissue (임플란트 주위 조직 보존을 위한 임플란트 경부의 디자인에 관한 고찰)

  • Kim, Hong-Jun;Kim, Jee-Hwan;Kim, Sung-Tae;Lee, Jae-Hoon;Park, Young-Bum
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.4
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    • pp.346-353
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    • 2011
  • Purpose: The peri-implant soft tissue is remodeled by the initial marginal bone resorption affecting the prognosis and esthetic result of treatment. Thus various designs on implant neck design are studied to preserve peri-implant bone. The purpose of this study is to review on the causes of initial marginal bone resorption, the configuration of peri-implant soft tissue, and the implant crestal module favorable in preserving peri-implant tissue. Materials and methods: The studies on the causes of initial marginal bone resorption and the implant crestal modules are researched and reviewed using Pubmed database. The implant crestal modules including one piece and two-piece implant, internal and external hex abutment, taper and butt joint connection, scalloped design abutment, and platform switching concept are reviewed. Results: A number of clinical and experimental studies preferred one piece implant to two-piece in preserving initial peri-implant tissue. For two piece implants, internal hex abutment and taper joint connection appear more favorable than external hex abutment and butt joint connection relatively. Controversial issues still exist on scalloped design requiring more studies on it. Although the rationale is not certain, the concept of platform switching seems favorable in preserving initial peri-implant tissue based on clinical and experimental studies. Conclusion: Each implant crestal module contains its own advantages and disadvantages with various controversial issues. In the aspect of preservation of initial peri-implant tissue, however, one-piece implant seems beneficial. In cases when two-piece implant is more appropriate due to prosthodontic concerns or any other problems, the application of platform switching concept, internal connection abutment, and taper joint connection may be favorable for the preservation of peri-implant tissues.

Effect of Bleaching on Restorative Materials and Restorations-Review (치아미백제가 수복재와 수복물에 미치는 영향에 관한 고찰)

  • Shim, Youn-Soo;Choi, Jae-Yoon
    • Journal of dental hygiene science
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    • v.6 no.3
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    • pp.153-158
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    • 2006
  • Bleaching of vital and nonvital teeth is becoming a more commonly used treatment in the dental office and at home. To improve appearance and remove discoloration, the teeth of specific patients are treated with a variety of bleaching agents. The typical bleaching agents contains carbamide or hydrogen peroxide as the active component. The purpose of the review article was to summarize and discuss the available information concerning the effect of peroxide releasing bleaching agent on dental restorative materials and restorations. Information from all original scientific full papers or reviews listed in PubMed or ISI Web Science were included in the review. Bleaching may exert a negative influence on restorations and restorative materials. Advice is provided based on the current literature to minimize the impact of bleaching treatment on restorative materials and restorations.

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Kinematic Analysis of a Mastication Model Employing the 6-DOF Parallel Mechanism (6자유도의 병렬기구를 사용한 저작 모델의 기구학적 분석)

  • Khang, G.;Tsutsumi, Sadami
    • Journal of Biomedical Engineering Research
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    • v.20 no.4
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    • pp.479-484
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    • 1999
  • 본 연구에서는 사람의 턱 운동과 턱 사이에 작용하는 힘(혹은 압력)을 그대로 나타낼 수 있는 저작로봇을 개발하는 것을 궁극적인 목표로 한다. 이러한 저작로봇이 개발되면, 치과의사가 환자의 턱운동에 나타나는 병변을 진단하고 치료하는데 큰 도움이 될 것으로 사료된다. 또한 , 본 연구에 채택한 병렬기구(parallel mechanism)에대한 순기구학적( forward kinematics)분석은 일반적인 병렬기구의 실계에도 응용될 것으로 기대된다. 본 연구진이 1차적으로 설계한 모델은 베이스와 플랫폼(platform), 그리고 이 둘을 연결하는 3개의 다리로 구성되어 있다. 다리와 플랫폼은 3자유도의 관절로 다리와 베이스는 1자유도의 경첩 관절로 연결되어 있으며, 이 3개의 경첩 관절은 베이스 위의 수평면에서 직선을 따라 움직인다. 경첩 관절의 수평 변위와 세 다리의 길이가 주어졌을 때 플랫폼의 위치와 오리엔테이션을 구하는 순기구학의 해( 解)를 계산해내는 알고리즘을 개발하였다. 이 알고리즘의 특징은 매 순간 오차를 계산하여 이 오차가 줄어드는 방향으로 나아가도록 시간간격(time step)을 조절하는 것이다. 본 알고리즘은 현재 가장 보편적으로 사용되고 있는 뉴튼-렙슨 방법에 비하여 3가지 장점을 나타내고 있다. 우선 , 초기치(initial guess)에 관계없이 수렴한다는 것이다. 또한, 본 알고리즘은 뉴튼-렙슨 방법에 비하여 수렴속도가 훨씬 빠르며, 연산 시간이 매우 짧아져 실제적인 실시간 적용에 적합하다. 마지막으로, 뉴튼-렙슨 방법에서는 여러 개의 해 가운데 어느 곳으로 수렴할 지 예측 할수 없으나 본 알고리즘에서는 초기치에 가장 가까운 해로 수렴한다. 이러한 순기구학의 다중성(multiplicity)문제를 해결하기 위하여 두 개의 조건을 제시하였으며, 이를 적용한 시뮬레이션 결과에 의하면 항상 원하는 해(true solution)에 수렴할 수 있었다.발생량의 감소를 기대 할 수 있는 친환경기술로 유지관리비를 최소화할 수 있는 장점이 있었다. 않은 사람들 중 미래의 검진실행의지에 건강소식지가 영향을 미친 경우는 48.7%였다. 보건교육을 받은 후 유방암 자가검진 실천율은 사업군에서 53.9%로 받기 전의 27.3%보다 증가하였으나 대조군의 경우는 별 차이가 없었다. 연령별로는 60대가 가장 높았고 사업군에서 검진율의 증가분은 30대가 가장 컸다. 교육수준별로는 사업군은 고졸이, 대조군은 전문대졸이 가장 높았고 사업군에서 검진율의 증가분은 고졸에서 가장 컸다. 보건교육 후 유방암과 관련된 건강지식의 정도는 사업군이 3.7점으로 대조군보다 유의하게 높았으며, 유방암 자가검진법을 실천하는 사람들의 동기는 ‘일반 대중매체의 영향’이 가장 많았으며 건강소식지가 동기인 경우도 20.4%였다. 사업군에서 건강소식지가 유방암 자가검진법 실천에 영향을 미친 경우가 79.6%였으며 유방암 자가검진법에 관한 보건교육을 받고 실천하지 않은 사람들 중 미래의 실천의지에 건강소식지가 영향을 미친 경우는 43.6%였다. 이상의 소견에서 지역주민을 대상으로 인쇄매체를 통한 보건교육은 인쇄물만으로도 쉽게 실천 할 수 있는 유방암 자가검진법이 가장 효과적이었으며, 자궁암검진에 관해서도 검진을 받을 수 있도록 지역사회의 보건의료의 하부구조를 정비하여 제도적 장치를 마련하고 정보를 제공한다면 자궁암검진 실천율도 증가할 것이다.고 12.9% 의 발달율을 보여 유의적인 차이를 보이지 않았다. 이상의 결과로 보아 핵이식 수정란을 효율적으로 생산하기 위하여 수핵난자의 세포질에 ionomycin 과 DMAP 의 혼합처리로 탈핵난자의 활성화를 유도하는 것이 효율을 증진시킬 수 있었다고 본다. 또한 공핵수정란을 수정 후 90시간과 114시간 개별 배양하여 할구를 공핵체로 핵이식에 이용하였을 때도 그룹배양에 비하여 효율이 떨어지지 않음을 알 수 있었으며, 수정란의 할구

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Biocompatibility of Ti-8Ta-3Nb alloy with fetal rat calvarial cells (백서 태자 두개관세포에서 Ti-8Ta-3Nb 합금의 생체적합성)

  • Cho, In-Goo;Cui, De-Zhe;Kim, Young-Joon;Lee, Kyung-Ku;Lee, Doh-Jae
    • Journal of Periodontal and Implant Science
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    • v.36 no.4
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    • pp.849-861
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    • 2006
  • 타이타늄은 기계적 특성이 우수하고 생체적합성이 뛰어나 의료용 장비의 주 재료로 사용되고 있으며 타이타늄 보다 기계적 특성이 더 우수한 타이타늄 합금들(주로 Ti-6Al-4V와 Ti-6Al-7Nb 합금)도 개발되어 치과와 의료용 임플란트로 사용되고 있다. 그러나 타이타늄 합금 성분들 중 알루미늄 (aluminum)과 바나디움(vanadium)은 인체에 노출되면 세포손상과 신경계에 문제를 일으킬 수 있다. 따라서 인체에 독성이 없으면서 기계적 성질과 생체적합성이 우수한 타이타늄 합금의 개발이 필요하다. 최근 인체에 독성이 없는 성분들이 함유된 새로운 ${\beta}$ - 형태의 타이타늄 합금들이 개발되고 있는데, ${\beta}$ - 타이타늄 합금은 그 기계적 성질이 기존의 ${\alpha}+{\beta}$ 타이타늄 합금에 비해 우수하다고 알려져 있다. 최근 새로운 ${\beta}$ - 타이타늄 합금이 전남대학교 부설 타이타늄 연구소에서 개발되었다. 이 연구는 새로 개발된 ${\beta}$ - 타이타늄 합금의 생채 적합성을 세포 증식도, 알카리 인산 분해 효소 활성과 유전자 증폭을 통해 알아보고자 하였다. 그 결과는 다음과 같다; 1. Titanium-6aluminum-4vanadium (Ti-6Al-4V) 합금 표면애서의 세포 증식율은 Titanium-Titanium8Tantalum-3Niobium (Ti-8Ta-3Nb) 합금과 순수 타이타늄 표면에 비해 유의하게 낮았다(p<0.00l). Ti-8Ta-3Nb 합금 표면에서의 증식도는 순수 타이타늄 표면과 유사하였다. 2. Ti-8Ta-3Nb 합금과 순수 타이타늄에서 배양된 세포이 알카리 인산 분해 효소의 활성도는 Ti-6Al-4V 합금에서의 것보다 유의하게 높았다 (p<0.001). 3. 유전자 증폭 분석 결과, Ti-8Ta-3Nb 합금과 순수 타이타늄에서 collagen type I과 bone sialoprotein mRNA 가 유사한 수준으로 발현되었다. 이상의 결과는 생체 적합성 측면에서 Ti-8Ta-3Nb 합금과 순수 타이타늄의 차이가 없음을 보여주며 따라서 Ti-8Ta-3Nb 합금이 의학 및 치의학 영역에서 새로운 임프란트 재료로 사용될 수 있음을 의미한다.

Detorque force and surface change of coated abutment screw after repeated closing and opening (코팅된 지대주 나사의 반복 착탈 후 풀림력과 표면변화에 대한 연구)

  • Jang, Jong-Suk;Kim, Hee-Jung;Chung, Chae-Heon
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.500-510
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    • 2008
  • Statement of problem: Recently researches about WC/C (Tungsten Carbide/Carbon) or TiN (Titanium Nitride) coating on abutment screws are going on. It decreases friction coefficient, resistance against corrosion and withdrawal of physical fragility when the coating is applied to the metal surfaces. It is reported that coated abutment screws improved abrasion, adaptability and detorque force. Purpose: This study is about the effects of coated abutment screws on loosening of screw and for the purpose of solving the loosening phenomenon of abutment screws which is clinical problem. Material and methods: Detorque force and surface changes are compared when 10 times of repeated closing and opening are applied to both uncoated titanium abutment screws (Group A) and coated abutment screws with WC/C (Group B) and TiN (Group C). Each group was made up of 10 abutment screws. Results: 1. Before repeated closing and opening, Somewhat rough surface with regular direction was observed in Group A. Coated granules were observed in group B and group C and overall coated layer appeared in regular and smooth form. 2. Before repeated closing and opening, The coated surface showed bigger and thicker size of coated granules in Group C than Group B. 3. After repeated closing and opening, abrasion and deformation of abutment screw surface was observed in Group A and Group B. Exfoliation phenomenon was observed in Group B. 4. Group A showed biggest range of decrease when the weight changes of abutment screws were measured before and after repeated closing and opening. Group C showed less weight changes than Group B but there was no statistical difference between two groups. 5. Group B and Group C showed higher average detorque force than Group A and there was statistical difference. 6. Group A showed more prominent decrease tendency of average detorque force than Group B and Group C. Conclusion: Coated abutment screws with WC/C or TiN did not show prominent surface changes than uncoated titanium abutment screws even though they were repeatedly used. And they showed excellent resistance against friction and high detorque force. Thus it is considered that adaptation of WC/C or TiN coating on abutment screws will improve the screw loosening problem.