• Title/Summary/Keyword: 치아 삭제

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A Study on the Enamel Surface Texture and Caries Susceptibility in Interdentally Stripped Teeth (치간삭제 후의 법랑질 표면조도와 치아우식 감수성에 관한 연구)

  • Kim, Kyong-Nim;Yoon, Young-Ju;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.31 no.6 s.89
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    • pp.567-578
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    • 2001
  • To investigate the difference of Texture exhibited on interproximal enamel surface with each different stripping method and the susceptibility of proximal enamel to demineralization after stripping and the application of a topical fluoride go] and sealant, one hundred human premolars, which were Previously extracted for orthodontic reasons were evaluated by means of Scanning electron microscopy and laser fluorescence. The results were as follows : 1. No matter what the initial stripping instrument was the furrows that resulted from all the stripping methods were not completely removed by careful polishing. 2. Among the enamel surfaces that were treated with three different initial abrasive instruments, followed by the same polishing method (Sof-$Lex^{(r)}$ disks), the enamel surfaces that were treated with 700 crosscut carbide bur showed the smoothest surfaces. 3. The stripped teeth, no matter what the initial stripping instrument was, were less resistant to initial demineralization than untreated teeth. But no difference in caries susceptibility according to differently stripped methods was found (p<(0.001). 4. Teeth treated with APF-gel or sealant were mote resistant to demineralization than those treated without other treatment after stripping (p<0.001). 5. Comparing groups treated with APF-gel to groups treated with sealant, the former was more resistant to demineralization than the tatter (p<0.05). In conclusion, enamel surfaces that were stripped jnterproximally were less resistant to demineralization even though various attempts were made to produce smooth, self-cleaning enamel surfaces. Therefore, additional treatment-sealant or calcifying/ fluoridating solution To the stripped enamel surfaces is recommended.

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Comparative Study of the Ablation Rates of Single-pulsed Er:YAG Laser Irradiation on Dentin and Enamel (상아질과 법랑질에 대한 Er:YAG 레이저의 일회 조사시 다양한 에너지 수준에 따른 삭제율에 관한 연구)

  • Yang, Seung-Jae;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.24 no.4
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    • pp.411-420
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    • 1999
  • 과거 수십년간 여러 가지 다른 레이저를 이용한 치아경조직에 대한 몇 가지의 생체외적 실험이 이루어졌다. 그러나 그 결과는 좋지 못하였다. 그러한 주 문제는 열작용이었다. 미국 식품의약국(FDA)에서 사용하도록 허가된 Er:YAG 레이저는 인간의 생체 치아를 삭제할 수 있는 최초의 레이저이다. 치아 삭제가 열작용의 원리에 의해 이루어지기는 하지만, 경조직의 미세폭발에 의하기 때문에 주변의 경조직과 연조직에 미치는 열작용은 거의 없다. 본 연구에서는 최근 국내에서 최초로 개발된 Er:YAG 레이저를 사용하여, 상아질과 법랑질에 일회 조사시 다양한 에너지 수준에 따른 삭제율을 연구하였다. 건조된 10개의 치아가 선택되었으며, 각각은 에폭시 레진에 포매되어 경화되었다. 그 후 다섯 개의 치아는 저속회전 다이아몬드 휠로써 교합면 삭제를 통해 상아질이 노출되었으며, 나머지 다섯 개의 치아는 협측 혹은 설측을 삭제하여 평평한 표면의 법랑질을 만들도록 하였다. 준비된 상아질과 법랑질 치아의 표면은 각각의 에너지 수준의 레이저를 조사할 6개의 구획으로 나누어 표본으로 삼았다. 상아질과 법랑질 표본은 에너지 수준에 따른 5개의 실험군(40 mJ, 80 mJ, 120 mJ, 160 mJ, 200 mJ)으로 나누어 그 삭제율을 분석하였다. 삭제된 부피는 삼차원 영상 표면분석기로 측정하였으며, 통계적으로 분석하였으며, 그 결과는 다음과 같다. 1. 상아질과 법랑질간의 삭제율의 차이는 통계적으로 유의한 차이가 있었다(p<0.0001). 2. 에너지 수준에 따른 삭제율의 차이는 통계적으로 유의한 차이가 있었다(p<0.0001). 3. 각각의 에너지 수준에서 상아질과 법랑질간의 삭제율의 차이는 통계적으로 유의한 차이가 있었으나(p<0.05), 40 mJ과 80 mJ에서는 유의한 차이를 보이지 않았다. 4. 상아질에서 각각의 에너지 수준 간의 삭제율이 유의한 차이를 보였으나(p<0.01), 160 mJ과 200 mJ간에는 삭제율의 유의한 차이가 없었으며, 법랑질에서도 각각의 에너지 수준 간의 삭제율이 유의한 차이를 보였으나(p<0.01), 120 mJ, 160 mJ, 200 mJ 간에 유의한 차이를 보이지 않았다. 본 연구에서는 건조된 치아에 다양한 에너지 수준의 Er:YAG 레이저를 적용했을 경우 상아질과 법랑질의 삭제 부피를 연구하여 정량화 및 통계적 분석을 하였다. 그 결과, Er:YAG 레이저는 치아경조직의 삭제에 매우 유용하였으며, 앞으로도 이를 임상적으로 널리 이용하기까지 좀더 다양하고 심화된 연구가 필요할 것으로 사료된다.

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A comparative study of the improvement after different self-assessment methods of tooth preparation (치아 삭제의 다른 자가 평가 방법 후 개선에 대한 비교 연구)

  • Kim, JungHan;Son, Keunbada;Lee, Kyu-Bok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.4
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    • pp.220-227
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    • 2019
  • Purpose: The purpose of this study was to compare the degree of tooth preparation abilities of students according to three self-assessment methods. Materials and Methods: forty-eight sophomores in Kyungpook National University College of Dentistry were divided into three experimental groups. Students performed tooth preparation of the left mandibular first molar for full gold crown. They performed self-assessment using the three methods (visual, digital, and putty index self-assessment group), and reperformed tooth preparation. An intraoral scanner was used to scan each tooth model (prepared tooth and unprepared tooth), and data were acquired in standard tessellation language (STL) file format. The STL files of prepared tooth and unprepared tooth were superimposed using the 3-dimensional analysis software (Geomagic control X). And the reduction amount was measured. In the statistical analysis, all values of reduction amount were analyzed with the Wilcoxon signed rank test and Kruskal-Wallis test (α = 0.05). Results: The three self-assessment methods showed statistically significant differences (P < 0.001). The putty index self-assessment group showed the highest reduction in error than the digital self-assessment method. Conclusion: Within limitations of this study, students showed significant differences in improvement of tooth preparation ability according to the three self-evaluation methods.

Porcelain Laminate Veneer Restoration (Porcelain laminate veneer의 수복)

  • Shin, Soo-Yeon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.2
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    • pp.191-200
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    • 2012
  • The patients' demand for treatment of unesthetic anterior teeth is steadily growing. Accordingly, several treatment options such as porcelain laminate veneers(PLV) have been proposed to restore the esthetic appearance of the dentition. Porcelain laminate veneers are considered minimally invasive, but they also require removal of sound enamel. One critical step in the porcelain laminate veneer technique is the achievement of sufficient ceramic thickness, and several different strategies for tooth preparation can be found in the literature. This clinical report describes a step-by-step protocols for preparation of these restorations used with the silicone index from diagnostic wax-up and the acrylic resin mock-up. Conservative use of porcelain laminate veneers provided satisfactory esthetic outcomes and preserved sound tooth structure.

Minimal Intervention Dentistry - 이론과 실제

  • 손호현
    • Proceedings of the KACD Conference
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    • 2003.05a
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    • pp.290-290
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    • 2003
  • 지난 20세기 동안, 치아 우식에 대한 치료는 G.V. Black이 제안한 '예방 확대' 개념에 따른 와동형성 원칙에 따라 외과적 치칠 삭제의 형태로 수행되어져 왔다. 즉, 치아 우식 병소에 발견되면 치과의사들은 망설임 없이 핸드 피스를 들고 우식 부위 치질을 삭제하며, 수복재료에 따라 적합한 형태로 건전한 치질을 삭제하여 수복 와동을 형성하였다. 그러나 치아 우식에 대한 많은 연구 결과, 원인균과 산 생산 및 탈회와 재석회화 등에 대한 정보가 알려졌고, 접착 수복이 비약적 발전을 하여 임상 적용이 일반화되면서, 지난 10여년 이래 치아 우식에 대한 치료 개념이 점차 최소 치질 삭제와 건전 치질 보존으로 전환되어 왔고 이러한 개념을 통칭하여 Minimal Intervention Dentistry라 하고 있다. 21세기에는 치아 우식에 대한 치료가 minimal intervention dentistry의 개념 하에 점차 폭넓게 임상에 적용될 것으로 예상되며, 다음과 같은 원칙들이 제시되고 있다.(중략)

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Ablation Effects of Er:YAG Laser at Various Energy Levels, Different Repetition Rates and Irradiation Time on Enamel (Er:YAG 레이저를 법랑질에 조사 시 에너지수준, 조사반복율 및 조사시간에 따른 삭제효과)

  • Lee, Sae-Yong;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.26 no.4
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    • pp.395-406
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    • 2001
  • 지난 수십년동안, 다양한 레이저기기를 이용하여 치아 경조직에 대한 응용 실험을 수행되었다. 그러나, 발생한 주요한 문제는 열발생과 플라즈마 형성과 같은 부작용이 지속된다는 점이었다. 실망스러운 실험결과에 따라 치아 삭제에 대한 레이저의 응용에 대한 연구가 거의 진행되지 못하였다. 본 연구의 목적은 국내에서 처음으로 개발된 얼비움레이저기기를 사용하여 다양한 에너지 수준과 다양한 펄스빈도에서 법랑질의 삭제율을 비교하고자 하였다. 본 연구에 사용된 레이저기기는 국내에서 최초로 개발된 $2.94{\mu}m$ 펄스를 $250{\mu}s$ 방출하는 얼비움야그레이저 기기이다. 기기의 에너지는 20 mJ에서 350 mJ까지 다양하게 방출하며, 최대 출력은 3.5 W이다. 22개의 치아를 에폭시 레진에 포매하고 경화하였다. 치아의 법랑질을 회전 다이아몬드 칼을 흐르는 물과 함께 사용하여 협측 또는 설측으로 평탄하게 삭제하였다. 제작된 법랑질표면은 6개의 구획으로 구분하여 에너지 수준과 펄스빈도에 따라 조사하였다. 본 연구에서 사용된 표본 수는 132개이며, 삭제율을 조사하기 위한 모든 표본은 22개의 실험 군으로 분류하였다. 실험결과는 다음과 같다. 1. 에너지 수준간에는 유의한 삭제율의 차이가 있었다. 2. 40 및 80 mJ로 조사한 경우에는 펄스빈도 간에 차이가 없었지만, 120 mJ의 출력으로 동일한 에너지를 조사한 경우에는 20 Hz가 40 또는 80 mJ로 조사한 경우 보다 가장 삭제효과가 높았다. 3. 연속조사 한 경우 조사시간 경과에 따라 법랑질의 삭제율은 증가되지 않았다. 결론적으로 효과적으로 법랑질을 삭제하기 위해서는 적절한 에너지와 펄스의 레이저를 사용해야 하며, 또한 항상 정확한 초점거리를 유지해야 할 것으로 사료된다.

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Ablation Rate and Intrapulpal Temperature by Addition of Water Spray During Er:YAG Laser Irradiation (Er:YAG laser를 이용한 치아삭제시 물분사량이 삭제율과 치수내 온도변화에 미치는 영향)

  • Kim, Jung-Moon;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.375-381
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    • 2005
  • Er:YAG laser has been considered a promising alternative to dental drill and many researches indicate that adjustment to variable parameters, including water flow rate, pulse energy and pulse repetition rate, can be made to improve ablation ability and efficiency of the laser. Of these parameters, addition of water spray during irradiation has been thought to ablate dental hard tissue more rapidly and safely. The purpose of this study was to investigate tooth ablation amount by Er:YAG laser irradiation as related to varied water flow rates added and, ultimately to find the most effective water flow rate for ablation. In addition, the temperature change of pulp chamber during irradiation was also monitored on the irradiated and opposite pulpal walls, respectively. An Er:YAG laser with contact mode was employed. Extracted human molars were split into two pieces for ablation experiment. Pulse energies of 200 and 300 mJ with a pulse repetition rate of 20 Hz and 5 water flow rates (1.6, 3.0, 5.0, 7.0, and 10.0 ml/min) were applied. Each irradiation was performed for 3 seconds. According to these parameters, experimental groups were divided into 10 subgroups which consisted of 5 specimens. For temperature experiment, another 5 tooth-specimens were prepared in the manner that pulp chamber was open through access cavity preparation and two temperature-measuring probes were placed respectively on the irradiated and the opposite walls of pulp chamber. From the experiment on ablation amount related to different water flow rates, it was shown that the least water flow rate of 1.6 ml/min ablated more than any other water flow rates (p<0.000). When the irradiation for 3 seconds, combined with the pulse repetition time of 20Hz and the water flow rate of 1.6 ml/min was done to tooth specimen, the temperature rise was not noticeable both on the irradiated and the opposite pulpal walls (less than 3$^{\circ}C$) and there was no significant difference in temperature rise between the two pulse energies, 200 and 300 mJ. From the results of this study, it is suggested that tooth ablation with Er:YAG laser can be done effectively and safely at a energy between 200 and 300 mJ/pulse and a pulse repetition rate of 20 Hz when the lasing is conjugated with the water flow rate of 1.6ml/min.

CUTTING EFFICACY OF Er:YAG LASER AND CONVENTIONAL BUR IN DECIDUOUS AND PERMANENT TEETH (Er:YAG laser와 Conventional bur의 유치와 영구치 치아삭제효과 비교)

  • Park, In-Cheon;Lee, Chang-Seop;Lee, Nan-Young;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.2
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    • pp.272-285
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    • 2003
  • This study was conducted to observe the microscopic structures of cavities formed after ablation of primary teeth, permanent teeth, enamel and dentin in using a bur and cavities formed after ablation using laser and the following results were obtained after comparing the effects of ablation. Using a #330 bur and Er:YAG laser irradiated at 150 mJ, 200 mJ, 250 mJ and 300 mJ all at the frequency of 5 Hz, 1 mm enamel and dentin samples were ablated and the ablation time was measured. In order to measure the surfaces ablated, 5 each of primary teeth and permanent teeth were ablated using a #330 bur and Er:YAG laser at 150 mJ, 200 mJ, 250 mJ and 300 mJ for 1 sec and the cross section and vertical section were observed. The following results were obtained : 1. Cutting time of Er:YAG laser was longer than that of conventinal high-speed bur regardless of teeth type. 2. Cutting on enamel, Cutting time of conventional high-speed bur in deciduous teeth was longer than in permanent teeth(P<0.05). But Er:YAG laser was not showed any difference between the deciduous and permanent teeth(P>0.05). 3. Cutting on dentin, Cutting time of conventional high-speed bur in permanent teeth was longer than deciduous teeth. Er:YAG laser of 150 mJ, 5 Hz in permanent teeth was longer than in deciduous teeth(p<0.05). But laser of other power did not showed mean difference. 4. The cavity surface treated with the convetional high-speed bur revealed a relatively flat appearance, almost covered with a debris-like smear layer. Cavity wall showed striped appearance because of blade of bur. 5. The cavity surface treated by the Er:YAG laser system was irregular or rough surface with the absence charring, carbonization, or cracking of the dentin. In addition, there was an absence of a smear layer. Cavity floor was round and relatively smooth. According to these results, cutting time of Er:YAG laser was almostly same in permanent and deciduous teeth, but more effective in dentin than enamel. Cutting the sample, Er:YAG laser was needed more time than conventional bur. But SEM findings suggested that laser device produced favorable surface characteristic(i.e, no smear layer, irregular surface, cracking).

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A Collision Model for Haptic Simulation of Tooth Preparation (치아 형성의 햅틱 시뮬레이션을 위한 충돌 모델)

  • Kim, Ki-Min;Kim, Jai-Hyun;Park, Jin-Ah
    • Proceedings of the Korean Information Science Society Conference
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    • 2011.06a
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    • pp.438-441
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    • 2011
  • 가상현실기반 충치치료 훈련 시스템에서 필수적으로 구현되어야 하는 부문은 절삭도구인 버(bur)를 이용하여 치아를 삭제하는 과정이다. 치아에 비하여 시술도구의 크기가 상대적으로 매우 작기 때문에 보다 정교한 충돌감지뿐만 아니라 치아 삭제에 따른 형태변형에 동기화된 정확한 충돌 모델이 요구된다. 따라서 본 논문에서는 디스턴스 필드를 이용한 볼륨 모델을 치아에 적용하고 이를 형태변형 시각화와 햅틱 렌더링에 함께 이용하는 실시간 충돌 모델을 제안한다. 또한 안정적인 햅틱 피드백을 위해 버의 포인트 쉘 생성 방법과 시간 응집도에 따른 점 접촉 모델 가속화 방법을 제시한다.

Clinical performance of esthetic ceramic partial-coverage restorations with supra-gingival margin using minimally invasive tooth preparation method according to the concept of adhesive dentistry (접착치의학 개념에 따른 최소 침습적 치아 삭제법을 적용한 심미적인 치은 연상 변연 도재 부분피개관 수복 증례)

  • Hong, Myung-Sik;Choi, Yu-Sung;Lee, Jong-Hyuk;Ha, Seung-Ryong
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.3
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    • pp.319-332
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    • 2021
  • With the rapid development of aesthetic ceramic materials and resin adhesives, the transition from metal ceramic crown to all-ceramic restoration is being actively carried out. When making porcelain restorations, the advantages can be maximized only when appropriate forms and techniques are used. Recently, an esthetic partial-coverage restoration method with supra-gingival margins was introduced by applying a minimally invasive tooth removal method that preserves enamel as much as possible and enhances adhesion efficiency. Through this, various advantages such as minimization of tooth structure removal and ease of excess cement removal can be obtained. In addition, since this manufacturing method does not require cord packing, it is possible to save time for impression taking and reduce patient discomfort. Furthermore, the margins can be clearly obtained without the intervention of gingival fluid or blood, making it possible to manufacture more accurate restorations. In the following cases of patients with partial tooth defects, esthetic ceramic partial-coverage restorations with supra-gingival margin was applied using minimally invasive tooth preparation method according to the concept of adhesive dentistry. Therefore, unnecessary tooth abutment preparation was prevented and residual tooth structure could be preserved as much as possible. After delivery of the ceramic partial-coverage restorations, favorable outcome was obtained.