• Title/Summary/Keyword: 치과치료 시 고려사항

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Esthetic considerations for anterior implant-supported prostheses: focus on surgical and prosthetic treatment (전치부 임플란트의 연조직 심미성을 달성하기 위한 외과적, 보철적 고려사항)

  • Park, Yeon-Hee;Ahn, Seung-Geun;Kim, Kyoung-A;Seo, Jae-Min
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.4
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    • pp.186-198
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    • 2021
  • As the increased certainty of osseointegration, new parameters are now being used to assess implant success. Accordingly, patients' and clinicians' high demands and expectation for esthetics have expanded and implant-supported restorations show better esthetic outcomes. The pre-implant treatment planning process, the implant surgical steps and the post-surgery prosthetic process can affect all esthetic outcomes. Prevention of esthetic implant failures can be achieved by appropriate treatment at each stage, considering the 3 factors of alveolar bone, soft tissue, and implants. It is necessary to achieve the esthetic implant prostheses followings: minimal invasive surgery, bone augmentation, ideal 3-dimensional implant position, peri-implant soft tissue management, and provisional restorations to optimize peri-implant soft tissue architecture.

CONSERVATIVE TREATMENT OF A UPPER CENTRAL INCISOR WITH POOR PROGNOSIS (예후가 불량한 상악 중절치의 유지)

  • Lee, Doo-Young;Kim, Seung-Hye;Choi, Hyung-Jun;Choi, Byung-Jai;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.3
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    • pp.368-373
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    • 2010
  • The incisors function as instruments for biting and cutting food during mastication. They also support the lips and face and maintain vertical dimension. In addition, they contribute to overall normal arch appearance. They play important role during the articulation of speech and assist in guiding jaw closure. Extraction and space maintenance are the most common treatment for a tooth with poor prognosis. However, in the mixed dentition, extraction of the upper permanent incisors results in many complications, such as resorption of alveolar bone, poor esthetics, pronunciation, and mastication. Considering these various roles of incisors in oral cavity, approach for traumatized incisors, even the ones with poor prognosis, should be considered first prior to simple extraction. The dentist must take into account the age of the patient, growth potential, occlusion, oral hygiene status, economic status and motivation towards dental health in addition to patient compliance. In this case, although the prognosis was predicted to be unfavorable due to short root and mobility, we could save the central incisor using conservative treatment, reposition by orthodontic appliance instead of extraction.

Soft tissue consideration in oral rehabilitation using implant in a patient after oral tumor resection (구강종양 골절제 환자의 임플란트 수복 시 연조직에 대한 고려사항)

  • Lee, Young-Hoon;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.4
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    • pp.458-466
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    • 2017
  • After the resection of oral tumor, defected maxillofacial structure caused functional difficulties including phonetics, mastication and esthetic aspects. In this cases, implant retained prosthesis can contribute to the functional enhancement. Regardless of the success rate in grafted bone, however, the soft tissue usually had a shape which was susceptible to inflammation. Moreover, infected graft bone presented rapid destruction. For success of the prosthetic treatment, adequate soft tissue treatment and frequent recall check are the essential factors to the successful implant prognosis.

DENTAL MANAGEMENT OF A PATIENT WITH MOYAMOYA DISEASE UNDER GENERAL ANESTHESIA (모야모야병(moyamoya disease) 환자의 전신마취 하 치과 치료)

  • Sang, Eun Jung;Song, Ji-Soo;Shin, Teo Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Hyun, Hong-Keun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.2
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    • pp.108-113
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    • 2017
  • Moyamoya disease is a disorder in which certain arteries in the brain are constricted. Blood flow can be blocked by the constriction and blood clots. The patients frequently experience transient ischemic attacks (TIA), cerebral hemorrhage, or may not experience any symptoms at all. It is reported that they have a higher risk of recurrent stroke and a distinct underlying pathophysiology. A 3-year-8-month old boy with moyamoya disease experienced cerebral infarctions five times, and he underwent a cerebrovascular anastomosis surgery four years ago. He showed swallow disturbance, general delayed development, hemiplegia, and strabismus. Also he had hypocalcified teeth with or without multiple caries lesions in all dentitions. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation. Moyamoya disease is associated with various medical conditions requiring a thoughtful deliberation and a careful examination before and during dental treatment. Pain and anxiety control during dental treatment is important because hyperventilation induced by crying has been seen to trigger TIA. Both isoflurane and sevoflurane are commonly used in patients with MMD, but dynamic autoregulation is better preserved during sevoflurane than isoflurane anesthesia. So sevoflurance general anesthesia may be recommendable to manage dental patients having multiple caries with moyamoya disease.

Non-extraction treatment in Class III malocclusion by using improved superelastic NiTi wire (III급 부정교합 환자에서 초탄성 Ni-Ti alloy wire를 이용한 비발치 치료)

  • Min, Sam;Chung, Chu-Ryung;Hwang, Chung-Ju;Cha, Jung-Yul
    • The korean journal of orthodontics
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    • v.41 no.4
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    • pp.297-306
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    • 2011
  • Nonextraction camouflage treatment in mild Class III malocclusion is achieved by backward movement of the lower dentition and forward movement of the upper dentition. Many camouflage treatment modalities have been used for distal tipping and distal movement of mandibular posterior teeth. The amount of distal movement of mandibular dentition can be improved in cases of severe crowding, even without the patient's cooperation, by using miniscrews for anchorage. However, miniscrew insertion may be unsuccessful, and it may contact the adjacent root because of the distal movement of dentition. Distal tipping of mandibular dentition can be achieved using multiloop edgewise archwires and intermaxillary elastics. However, the complexity of this wire design causes discomfort to patients. Recently, a new treatment using improved superelastic NiTi wires (ISWs) and intermaxillary elastics has been introduced. ISWs can deliver orthodontic force more effectively, and their use with molar tip-back treatment has several advantages-this approach is effective, simple, and easy to use and reduces patient discomfort. The aim of this study was to report a case of camouflage treatment using ISW with tip-back and intermaxillary elastics for distal tipping of mandibular posterior dentition and to evaluate the effectiveness of this treatment in a clinical setting.

IMPACTED PREMOLARS AND MOLARS ASSOCIATED WITH DENTIGEROUS CYSTS IN CHILDREN (어린이에서 함치성 낭과 연관된 매복 소구치와 대구치의 치료)

  • Shin, Cha-Uk;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.718-724
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    • 2008
  • Tooth impaction is a frequently observed eruption anomaly in pediatric dental practice. Young patients with impacted or unerupted teeth have more prediction for dentigerous cyst formation. Dentigerous cyst presents radiographic features, unilocular or multilocular radioluscency. Cysts occur most frequently in the premolar region except third molar. Dentigerous cysts can grow to a considerable size, and large cysts may be associated with a painless expansion of the bone in the involved area. Extensive lesions may result in facial asymmetry, osseous destruction, root resorption of proximal teeth and displacement of associated tooth. The nature of the causative tooth influences the type of surgical treatment required for the dentigerous cyst. If the cyst is associated with a supernumerary or wisdom tooth, complete enucleation of the cyst along with extraction of tooth may be the first treatment choice. Otherwise, preservation of the associated teeth should be considered to prevent a young patient from psychological and mental trauma because of the loss of tooth. We should consider the degree of tooth displacement, osseous destruction and growth pattern of oromaxillofacial area when planning treatment. Thus a proper and logical treatment planning can help a proper growth and development of oromaxillofacial area and can save the patient from a psychological and mental trauma. This report describes 4 cases of the management of impacted premolars and molars associated with dentigerous cysts in children.

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In vitro cytotoxicity of four kinds orthodontic band cements (수종 치과 교정용 밴드 시멘트의 세포독성에 관한 실험적 연구)

  • Lee, Won-Chul;Park, Soo-Byung
    • The korean journal of orthodontics
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    • v.34 no.4 s.105
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    • pp.351-362
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    • 2004
  • Orthodontic band cements are widely used in the fields of orthodontics, but they are commonly known as cytotoxic material. Within an oral cavity several ions and components are released from orthodontic band cements, thus causing inflammation or injury to the Periodontal tissue. Therefore, it is very important to estimate the biocompatibility of orthodontic band cements. The purpose of this study was to assess the cytotoxic effect of orthodontic band cements to HGF cells. A zinc phosphate cement, a glass ionomer, a resin modified glass ionomer, and compomer were used to evaluate three cytotoxicity assays: cell proliferation assay, MTT assay, and agar ovelay assay The results were as follows: 1. In the cell proliferation assay, Gl>ZPC, RMGI, RMGI24, GI24>compomer24, ZPC24, compomer>metal ring lined up in order of cytotoxicity 2. In the MTT assay, GI>ZPC, RMGI>GI24>ZPC24, compomer, metal ring, RMGI24, compomer24 lined up in order of cytotoxicity. 3. In the agar overlay test, GI>GI24, ZPC, ZPC24, RMGI>RMGI24, compomer, compomer24, metal ring lined up in order of cytotoxicity.

Identify the status of pretreatment on antithrombotic agents in practice at the dentist's office (치과에서 시행되고 있는 시술 전 항혈전제 관련 처치에 대한 실태 파악)

  • Han, A Lum
    • 한국노년학
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    • v.40 no.2
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    • pp.227-237
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    • 2020
  • The purpose of this study is to understand using of antithrombotic agents in clinical settings. The number of patients receiving antithrombotic therapy is increasing in the long term due to the increased prevalence of cardiovascular disease in the elderly. There is a guideline for discontinuation of antithrombotic treatment before dental treatment, but the present study shows that there is a difference from the actual clinical situation. We used an online survey methodology to involve 1000 participants. The questionnaires were asked about general items and Clinical experience such as history of antithrombotic history, experience of complications due to antithrombotics, discontinuation of use, reasons for discontinuing use. The result is as follows. The incidence of delayed bleeding was found to be 55.1%, and discontinuation of antithrombotic therapy before withdrawal was 87.8%. Among respondents 98.3% responded that they stopped antithrombotics because of delayed bleeding and 57.4% responded that they would stop for three to five days. Korean dentists maybe cope with delayed bleeding considering the emotional problem of the patient, the relationship with the patient's physician, and the additional socioeconomic problems.

Development of the Oral Health Education Program for North Korean Defectors in South Korea (북한이탈주민 대상 구강보건교육 프로그램 개발)

  • Jeong, Mi-Ae
    • The Journal of the Korea Contents Association
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    • v.21 no.6
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    • pp.791-803
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    • 2021
  • To improve the oral health level of North Korean defectors, it is necessary to improve awareness of oral health care along with treatment of oral diseases. The purpose of this study is to develop an oral health education program that can be applied to North Korean defectors who have settled in local communities. To develop the program, three steps were taken: literature review, in-depth interview with experts, and program development applying the Dick&Carey model. As a result of in-depth expert interviews, what should be considered in oral health education for North Korean defectors is the need to understand North Korean defectors in advance, to familiarize themselves with the daily language of North Korea, to develop a synchronization strategy suitable for North Korean defectors, and to connect with whole body health. It was found that there was a need to establish the contents of education and to seek realistic education methods that reflect the characteristics of local communities. As a result of developing the program, fifty learning goals were developed, and ten sessions were planned. The oral health education program for North Korean defectors developed in this study will be of practical help to dental hygienists planning oral health education for North Korean defectors in the future and North Korean defectors.

CASE REPORTS OF TREATMENT OF ERUPTION-DISTURBED MX. FIRST MOLAR BY SURGICAL EXPOSURE (맹출 장애를 가진 상악 제1대구치의 외과적 노출을 이용한 치험례)

  • Seok, Choong-Ki;Nam, Dong-Woo;Kim, Hyun-Jung;Kim, Young-Jin;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.11-18
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    • 2004
  • The eruption of permanent teeth represents the movement in the alveolar bone before appearance in oral cavity, to the occlusal plane after appearance in oral cavity, and additive movement after reaching th the occlusal plane. Tooth eruption is mostly controlled by genetic signals. The eruption stage is divided to preeruptive alveolar stage, alveolar bone stage, mucosal stage according to the process of growth and development. If the disturbance is occured in any stage of eruption, tooth does not erupt. The cause of eruption disturbance are ectopic position of the tooth germ, obstruction of the eruption path and defects in the follicle or PDL. In the treatment of eruption disturbance, surgical procedures are commonly used. There are three kind of surgical procedure ; surgical exposure, surgical repositioning, surgical exposure and traction Surgical exposure is basic procedure. This involves removal of mucosa, bone, lesion that are surrounding the teeth, dental sac when necessary to maintain a patent channel between the crown and the normal eruptive path into the oral cavity. To ensure this patency, many techniques including cementation of a celluloid crown, packing with gutta-percha or zinc oxide-eugenol, or a surgical pack, are used. When surgical exposure is conducted, operators should not expose any part of cervical root cement and not injure periodontium or root of adjunct tooth. After surgical exposure, tooth should be surrounded by keratinized gingiva. There is direct relationship between the extent of development of pathophysiologic aberrations and the intensity of the manipulative injury inflicted on the tooth by surgical treatment, so operator should consider this thing. In these cases, surgical exposure is conducted on Maxillary 1st milars that have a eruption disturbance and improve the eruption disturbance effectively.

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