• 대한소아치과학회지
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• 제44권1호
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• pp.108-115
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• 2017

매복치의 치료방법으로 교정적 견인, 발치 후 임플란트, 자가치아이식 등 다양한 치료 방법이 있다. 그 중에서도 자가치아이식은 성장하는 환자들에게서 이식치 고유의 치주인대세포의 보존 및 치조골 성장이 가능하다는 점에서 좋은 치료방법이라고 생각된다. 이 증례에서는 성장중인 청소년의 이소 매복 치아를 자가치아이식으로 치료한 두 개의 증례를 소개하고자 한다. 첫 번째 증례에서 이소 매복된 좌측 하악 제2소구치를 발거 후 정위치로 자가치아이식하였고 혈소판 농축 피브린(PRF)과 mineral trioxide aggregate (MTA)를 사용하여 재생 근관 치료를 하였다. 석회화 치성낭으로 인해 이소매복된 좌측 하악 제2대구치를 지닌 두 번째 증례에서 병소의 적출술을 시행하였다. Obturator를 3개월 간 장착하여 매복치아의 자발적 맹출을 기대하였으나 맹출 양상이 없어 자가치아이식한 후 MTA를 이용한 근관치료를 하였다. 두 증례 모두 자가치아이식술로 이소매복치를 간단하고 빠르게 치료하였다. 성장하는 환자에게서 이소매복치의 자가치아 이식술은 임플란트나 보철물 수복 대신 좋은 치료 방법이 될 것이다.

• Journal of Periodontal and Implant Science
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• 제37권3호
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• pp.489-496
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• 2007

The ultimate goal of periodontal treatment is to regenerate the lost periodontal apparatus. Many studies were performed in developing an ideal bone substitute. Anorganic bovine-derived xenograft is one of the bone substitute, which were studied and have been shown successful for decades. The aim of this study is to evaluate the effect anorganic bovine-derived xenograft. Total of 20 patients, with 10 patients receiving only modified widman flap, and the other 10 receiving anorganic bovine-derived xenograft and flap surgery, were included in the study. Clinical parameters were recorded before surgery and after 6 months. The results are as follows: 1. The test group treated with anorganic bovine-derived xenograft showed reduction in periodontal pocket depth and clinical attachment level with statistically significance(p<0.001) after 6 months. The control group treated with only modified Widman flap showed reduction only in periodontal pocket depth with statistically significance(p<0.001) after 6 months. 2. Although periodontal probing depth change during 6 months did not show any significant differences between the test group and the control group, clinical attachment level gain and re-cession change showed significant differences between the two groups(p<0.05). On the basis of these results, anorganic bovine-derived xenograft improves probing depth and clinical attachment level in periodontal intrabony defects. Anorganic bovine-derived xenograft could be a predictable bone substitute in clinical use.

• 한국융합학회논문지
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• 제9권4호
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• pp.303-311
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• 2018

장애인과 보호자와의 관계 유형에 따른 장애인의 구강건강상태의 관련성을 알아보고자 장애인 보호자에게 장애인과 보호자의 응집력과 의사소통과정을 자기기입식으로 설문 조사하였고, 장애인의 구강건강상태는 DMFT index, 제1대구치 건강도, Pocket depth로 평가표를 작성하여 총 78부를 분석하였다. 통계프로그램은 SPSS win. 24.0을 이용하였으며 유의수준은 .05에서 검증하였다. 장애인과 보호자와의 관계 유형에 따른 장애인과 보호자의 응집력(p<.01), 의사소통과정(p<.01)에서 유의한 결과를 보였다. 장애인의 구강건강상태에서는 DMFT index(p<.01), 제1대구치 건강도(p<.01), Pocket depth(p<.01)에서 유의한 결과를 보였다. 따라서 장애인에게 어머니는 응집력, 의사소통과정, 구강건강상태 등 대부분의 항목에서 긍정적인 영향을 미치는 것으로 나타났다. 반면 장애인과의 응집력, 의사소통과정 등에서 낮은 영향을 미친 활동보조인력과 장애인의 구강건강상태에 낮은 영향을 미친 배우자에게는 장애인과 보호자의 관계 중요성을 제시함으로써 장애인 구강건강관리법 및 관심도를 높일 수 있는 정책적 지원 및 연구가 필요할 것으로 사료된다.

• Journal of Periodontal and Implant Science
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• 제24권3호
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• pp.633-648
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• 1994

Synthetic bone graft materials have been used for the regeneration of periodontal tissue lost due to periodontal disease, but the limitations of these materials had prompted the use of composite grafts. Among those, a composite graft of calcium carbonate(CC) and calcium sulfate(CS) is one of those materials that has not been studied extensively. CC, which is extracted from a natural coral, is known to possess osteoconductive property. SC can play an adjunctive role in the regeneration of bone tissue, and has shown good resorbability and biocompatibility. This study was conducted in order to investigate the effects of CC and CS composite graft to the regeneration of bone in the intrabony defects of dogs. 3-wall intrabony defects ub size of $4mm{\times}4mm{\times}4mm$ were created in the alveolar bone in the premolar areas. Then those defects that were treated with root planning only were designated as control, while the experimental group 1 and 2 each received the CC and CS composite grafts in the ratio of 8 : 2 and 5 : 5 the animals were sacrificed after 8weeks and the specimens were histologically analyzed. The results were as follows ; 1. No inflammation or foreign body reaction were observed in all subjects. CS has not been seen due to complete resorption, and resorption pattern of CC was observed. 2. Significant differences(p<0.05) in new cementum formation were observed between control($1.42{\pm}0.64mm$) and experimental groups(group 1 ; $2.53{\pm}0.94mm$, group 2 ; $2.23{\pm}0.96mm$) but the difference between the two experimental groups was not significant. 3. Significant differences(p<0.01) in new bone formation were observed between control($0.59{\pm}0.55mm$) and experimental groups(group 1 ; $2.27{\pm}0.61mm$, group 2 ; $2.05{\pm}0.56mm$) but the difference between the two experimental groups was not significant. 4. The extent of apical epithelial migration has shown no significant difference between control($1.18{\pm}1.24mm$) and experimental groups(group 1 ; $0.51{\pm}0.54mm$, group 2 ; $0.73{\pm}0.70mm$). 5. The extent of bone formation was generally limited to the extent of cementum formation for all groups, and significant correlation was found in the amount of bone formation and cementum formation in experimental group 1.(Co.=0.86, p<0.01) These results suggest that the composite graft of CC and CS is biocomplatible and effective in the new bone and new cementum formations. In the case of 3-wall intrabony defects of dogs, the composite ratio of 8 : 2 and 5 : 5 had shown no significant differences in the healing.

• Journal of Periodontal and Implant Science
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• 제27권2호
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• pp.363-377
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• 1997

The main goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal diseases. Although conventional forms of periodontal therapy show sound clinical results, the healing results in long junctional epithelium. There have been numerous materials and surgical techniques developed for new attachment and bone regeneration. Bone grafts can be catagorized into: autografts, allografts, xenografts and bone substitutes. Synthetic bone substitute materials include hydroxyapatite, tricalcium phosphate, calcium carbonate, and Plaster of Paris. Calcium sulfate has found its use in dental practice for the last 30 years. Recent animal studies suggest that periodontal regeneration in 3 wall intrabony defect may be enhanced by the presence of calcium sulfate. And it is well known that 2 wall & 1 wall defect have less osteogenic potential, So we need to study the effect of calcium sulfate in 1 wall intrabony defect in dogs. The present study evaluates the effects of calcium sulfate on the epithelial migration, alveolar bone regeneration and cementum formation in intrabony defects of dogs. Four millimeter-deep one-wall intrabony defects were surgically created in the mesial aspect of anterior teeth and mesial & distal aspects of premolars. The test group received calcium sulfate grafts with a flap procedure. The control underwent flap procedure only. Histologic analysis following 8 weeks of healing revealed the following results: 1. The lengths of junctional epithelium were: 2.52mm in the control, and 1.89mm in the test group. There was no statistical significance between the two groups. 2. Alveolar bone formation were: 0.61mm in the control, and 1.88mm in the test group. There was a statistically significant difference between the two groups (p<0.05). 3. Cementum formations were: l.lmm in the control, and 2.46mm in the test group. There was a statistically significant difference between the two groups (p<0.05). 4. The length of CT adhesion were: O.97mm in the control, and 0.17mm in the test group. There was no statistically significant differences between the two groups These results suggest that the use of calcium sulfate in intrabony defects has little effect on junctional epithelium migration, but has significant effects on new bone and new cementum formations.

• 대한소아치과학회지
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• 제28권3호
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• pp.383-390
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• 2001

상악중절치의 매복은 임상적으로 흔히 볼 수 있다. 대부분의 경우 중절치는 협측에 매복되어 있다. 이러한 협측매복은 치료가 무척 어렵다. 협측매복시 치은퇴축과 부착치은의 상실,치주낭이 발견된다. 따라서 성공적인 치료를 위해서는 외과적 술식을 통해서 부착치은의 소실을 최소화해야 할 것이다. 매복치의 위치와 부착치은의 양에 따라 수술방법으로 간단한 치은절제술(gingivectomy)외에도 필요하면 근단변위판막술(apically positioned flap), 측방변위판막술(laterally positioned flap), 유리치은 이식술(free gingival graft) 등과 같은 여러 판막술과 치아의 생리적인 맹출기전을 복제한 폐쇄 맹출법 (closed eruption technique)을 고려 할 수 있다. 하지만 치은절제술은 근단변위판막술에 비하여 부착치은의 양이 적어 많은 양의 부착치은 이 필요한 경우에는 근단변위판막술이 적응증이며 매복치아가 nasal spine근처에 있을 때는 폐쇄 맹출법을 선택해야 할 것이다. 본 증례에서 두 증례에서는 근단변위 판막술을 한 증례에서는 폐쇄 맹출법을 사용한 바 다음과 같은 결론을 얻었다. 폐쇄 맹출법이 더 심미적이었으나 부착치은의 양은 작았다. 이에 상악 중절치의 매복의 경우에서 올바른 임상적, 방사선학적인 검사를 통해 적응증에 맞는 외과적 수술로써 외과적 견인후 합병증을 최소화할 수 있었다.

• Journal of Periodontal and Implant Science
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• 제36권1호
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• pp.27-37
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• 2006

Although the main purpose of periodontal treatment to regenerate is the complete regeneration of periodontal tissue due to periodontal disease, most of the treatment cannot meet such purpose because healing by long epithelial junction. Therefore, diverse materials of resorbable and non-resorbable have been used to regenerate the periodontal tissue. Due to high risk of exposure and necessity of secondary surgical procedure when using non-resorbable membrane, guided tissue regeneration using the resorbable membrane has gain popularity, recently. However, present resorbable membrane has the disadvantage of not having sufficient time to regenerate date to the difference of resorption rate according to surgical site. Meanwhile, other than the structure stability and facile manipulation, acellular dermal matrix has been reported to be a possible scaffold for cellular proliferation due to rapid revascularization and favorable physical properties for cellular attachment and proliferation. The purpose of this study is to estimate the influence of acellular dermal matrix on periodontal ligament, cementum and alveolar bone when acellular dermal matrix is implanted to 1-wall alveolar bone defect. 4 dogs of 12 to 16 month old irrelevant to sex , which below 15Kg of body weight, has been used in this study. ADM has been used for the material of guided tissue regeneration. The 3rd premolar of the lower jaw was extracted bilaterally and awaited for self-healing. subsequently buccal and lingual flap was elevated to form one wall intrabony defect with the depth and width of 4mm on the distal surface of 2nd premolar and the mesial surface of 4th premolar. After the removal of periodontal ligament by root planing. notch was formed on the basal position. Following the root surface treatment, while the control group had the flap sutured without any treatment on surgically induced intrabony defect. Following the root surface treatment, the flap of intrabony defect was sutured with the ADM inserted while the control group sutured without any insertion. The histologic specimen was observed after 4 and 8 weeks of treatment. The control group was partially regenerated by periodontal ligament, new cementum and new alveolar bone. the level of regeneration is not reached on the previous formed notch. but, experimental group was fully regenerated by functionally oriented periodontal ligament fiber. new cementum and new alveolar bone. In conclusion, we think that ADM seems to be used by scaffold for periodontal ligament cells and the matrix is expected to use on guided tissue regeneration.

• Journal of Periodontal and Implant Science
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• 제32권1호
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• pp.213-224
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• 2002

The ultimate goal of periodontal disease therapy is to promote the regeneration of lost periodontal tissue, there have been many attempts to develop a method to achieve this goal, but none of them was completely successful. The purpose of this study was to compare the effects of treatment using BBP(R) with control treated by only modified Widman flap. 22 intrabony defects from 12 patients with chronic periodontitis were used for this study, 10 sites of them were treated with BBP(R) as experimental group and 12 site were treated by only modified Widman flap as control group. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded at 6 months later, and the significance of the changes was statistically analyzed. The results are as follows : 1. Probing depth of control(${\triangle}2.7{\pm}1.3mm$) and experimental group(${\triangle}3.6{\pm}1.8mm$) weres reduced with statistically significance(P<0.05), but this changes were not different between the two experiment, control group with statistically significance. 2. Gingival recession showed statistically significant increase in control group(${\triangle}2.1{\pm}1.2mm$)(P<0.05), but not in experimental group(${\triangle}0.5{\pm}0.7mm$), and this changes were different between the two experiment, control group with statistically significance(P<0.05). 3. Bone probing depth showed statistically significant decrease in experimental group(${\triangle}2.9{\pm}1.0mm$)(P<0.05), but not in control group(${\triangle}1.1{\pm}1.4mm$), and this changes were different between the two experiment, control group with statistically significance(P<0.05). 4. Loss of attachment showed statistically significant decrease in experimental group(${\triangle}3.1{\pm}1.7mm$), but not in control group(${\triangle}0.6{\pm}1.2mm$), and this changes were different between the two experiment, control group with statistically significance(P<0.05) On the basis of these results, treatment using BBP(R) improves the probing depth, bone probing depth and loss of attachment in intrabony defects.

• Journal of Periodontal and Implant Science
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• 제28권2호
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• pp.249-264
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• 1998

The present study evaluates the effects of calcium sulfate and DFDB on alveolar bone regeneration and cementum formation and connective tissue adhesion in intrabony angulated 1 wall defects of dogs. Four millimeter-deep angulated one-wall intrabony defects were surgically created in the mesial & distal aspects of premolars and with flap operaion alone(control group), with calcium sulfate(experimental group 1), with composit graft of 50% calcium sulfate and 50% DFDB(experimental group 2), with DFDB alone(experimental group 3). Histologic analysis following 8 weeks of healing revealed the following results: 1. The lengths of connective tissue adhesion was $1.05{\pm}0.48mm$ in the control, $1.30{\pm}0.67mm$ in the test group I, $0.97{\pm}0.22mm$ in the test group II and $0.93{\pm}0.15mm$ in the test group III. There was no statistical significance between control and all experimental groups. 2. Changes in alveolar bone level was $0.97{\pm}0.27mm$ in the control group, $1.45{\pm}0.42mm$ in the test group I, $2.00{\pm}0.33mm$ in the test group II, $1.88{\pm}0.34mm$ in the test group III. There was no statistically significant difference between control and experimental group I. There was a statistically significant difference between the control and experimental group II,III.(p<0.05). There was no statistically significant difference between all experimental group. 3. Cementum formation was $1.13{\pm}0.17mm$ in the control, $1.78{\pm}0.31mm$ in the test group I, $2.17{\pm}0.38mm$ in the test group II, $2.15{\pm}0.47mm$ in the test group III with statistically significant differences between control group and all experimental group(P<0.05). There was no statistically significant differences between all experimental group. These results suggest that the use of composit graft of 50% calcium sulfate and 50% DFDB and DFDB alone in angulated 1 wall intrabony defects has little effects on connective tissue adhesion, but has significant effects on new bone and new cementum formations.

• Journal of Periodontal and Implant Science
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• 제28권2호
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• pp.219-237
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• 1998

Numerous bone graft materials have been used in Periodontics, in an attempt to reach the main goal of periodontal therapy, i.e. the regeneration of periodontal tissue lost due to destructive periodontal diseases. The present study investigates the effect of composite graft of DFDB and Calcium sulfate with and without Calcium sulfate barrier in Periodontal 1-wall intrabony defects in dogs. Following the initiation of general anesthesia by I.V. administration of 40mg/Kg of Pentobabital, second premolar was extracted and full thickness flap elevated. The crown portion of premolars was removed. Exposed root canals were sealed with Caviton and covered completely with flap. After the healing period of 8 weeks, the surgical sites were re-opened and 1-wall intrabony defects were created, and treated with flap operation alone(control group), with composit graft of 80% DFDB and 20% Calcium sulfate(Experimental group 1), with composite graft of DFDB and calcium sulfate with calcium sulfate membrane( Experimental group 2). Healing response was histologically observed after 8 weeks and the results were as follows : 1. New bone formation was 70 % in the control group, 93 % in the Experimental group I, 89 % in the Experimental group II. There was a no differences between Experimental groups. 2. New cementum formation was not significantly different between control and two Experimental groups. 3. The length of connective tissue adhesion was 30 % in the control, 7% in the Experimental group I and 11 % in the Experimental group II. 4. After 8weeks, calcium sulfate was completely resorbed, while DFDB particle remained. These results suggest that the use of composite graft of allogenic DFDB and Calcium sulfate with and without Calcium sulfate barrier in periodontal 1 wall intrabony defects have little effect on connective tissue adhesion, but has beneficial effect on new alveolar bone and new cementum formation, and prevent downgrowth of epithelium and connective tissue effectively.