• 대한치과기공학회지
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• 제44권4호
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• pp.126-131
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• 2022

Purpose: The purpose of this study is to evaluate the quality of dental fixed prostheses fabricated by 3DP (three-dimensional printing). Methods: Ten main models were prepared for the study. Ten specimens were printed by 3DP (3DP group). Ten specimens were fabricated by the lost wax technique and casting method to complete the control group (LWC group). The marginal fit was measured for 20 specimens. The measurement of marginal fit was performed using the silicon replica technique. Finally, the marginal fit of 10 specimens from each group was calculated. An independent sample t-test was run to see if the calculated averages for the two groups were mutually significant (α=0.05). Results: According to the experimental results, the mean marginal fit of the 3DP group was 71.9 ㎛, and the LWC group was 55.3 ㎛. The means of the two groups were found to be significantly different (p<0.001) in the results of the independent sample t-test. Conclusion: The marginal fit of fixed dental prostheses produced by 3DP technology was examined with values greater than those fabricated by traditional technology. However, as it appeared to be a value within the range of clinically acceptable range recommended by numerous studies, it was determined that clinical application would be feasible.

• 대한소아치과학회지
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• 제27권1호
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• pp.146-150
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• 2000

장애인은 일반적으로 구강관리에 대한 인식과 수행능력의 부족으로 구강위생상태가 불량하며, 치과질환의 발생빈도가 높고 그 정도가심한 편이다. 장애인의 치과치료시 많은 어려움이 따르는 행동조절은 장애의 종류와 정도에 따라 심리적 물리적, 약물적 방법 및 전신마취 등을 선택할 수 있으나, 여러 가지 이유로 인하여 일반적인 방법으로 치료가 불가능할 경우 전신마취를 이용하게 된다. 장애인 환자에 있어서 보철치료는 정상인에서와 다를 바가 없으나 장애정도에 따라 치과의사의 세심한 주의가 필요하며, 수복후에도 철저한 구강위생관리를 위해 환자 스스로나 보호자의 각별한 노력이 요구된다. 본 증례는 경도의 장애를 가지고 있으나 치과치료에 대한 불안과 공포가 심하고, 다수치아의 수복을 위하여 장시간의 치과 치료가 요구된 경우로서 전신마취를 이용한 보존 외과적 처치 및 보철치료를 시행하여 비교적 양호한 결과를 얻었다.

• Journal of Chest Surgery
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• 제22권2호
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• pp.220-224
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• 1989

In candidates for aortic valve replacement [AVR]it is our primary intention to implant the largest possible vale prosthesis of at least 23 mm in diameter in patients with severe valvular aortic stenosis. However, in many patients there is an additional subvalvular asymmetric septal hypertrophy which in some cases may cause an postextrasystolic increase of the LV-aortic gradient. Another component of the aortic stenosis syndrome is a narrow valvular ring, or a combination of both. After complete removal of the diseased valve and decalcification the narrow aortic ring [< 23 mm] can be widened firstly by transaortic subvalvular septal myectomy- [TSM] thus unfolding the left ventricular outflow tract[LVOT]and secondly by extending the oblique aortic incision into the aortic valve ring or further down into the anterior leaflet of the mitral valve. The sub-and supra-valvular defect will be closed by patch enlargement of the aortic root [PEAR] using autologous pericardium. These techniques allow a considerable enlargement of the valvular ring of about 4 to 10 mm in circumference. In a retrospective study using a computerized program, 847 patients with AVR [1980-1984]were reviewed to evaluate the intraoperative hemodynamic results mainly concerning relief of the transvalvular gradient. In 626 patients AVR was performed, 151 patients had double valve replacement [AVR+MVR], and 70 patients had AVR plus additional surgical procedures. Concentrating on the AVR-group [n=626] there were 103 patients with TSM, 24 patients with PEAR and 20 patients with TSM+PEAR which demonstrated that in a total, of 147 patients of this groups [23.5%] an additional procedure was necessary. The Statistical evaluation of the intraoperative pressure measurements before and after AVR in relation to the size of the implanted prostheses indicated the lowest preoperative mean gradient in patients with AVR alone, the highest in patients who afforded TSM plus PEAR. However, after AVR the mean gradients in all three groups were very low [mean 5 to 10 mmHg]. These data indicate that in patients with a narrow aortic ring and additional considerable ASH, TSM and PEAR are suitable techniques to enlarge the aortic root to enable the implantation of an adequate aortic valve prosthesis. Long-term controls have shown that autologous pericardium is a qualified graft material for the ascending aorta.

• 구강회복응용과학지
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• 제39권3호
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• pp.133-145
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• 2023

하악전돌 양상을 보이는 3급 부정교합은 골격성 3급과 치아변위에 의한 가성 3급으로 나눌 수 있다. 골격성 부정교합은 수복공간 확보 및 심미적, 기능적 결과를 얻기 위해 적절한 수직 및 수평 악간관계를 설정하면 양호한 치료결과를 얻을 수 있다. 본 증례는 하악 전돌과 전치부 마모 및 교합수직고경의 감소를 보이는 환자에서 임플란트와 고정성 보철물을 이용하여 완전구강회복을 시행하였다. 모형 분석과 디지털 진단을 시행 후 수직고경을 거상한 임시수복물을 제작하여 구치부 지지를 확보하고 안정적인 중심교합을 평가하였고, 이를 반영한 최종보철물로 양호한 기능과 심미를 회복할 수 있었기에 이를 보고하는 바이다.

• 대한치과기공학회지
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• 제31권1호
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• pp.63-74
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• 2009

Partial or complete prosthesis is needed when teeth are lost due to various kinds of reason. Artificial teeth recover occlusion instead of natural teeth. Artificial teeth are required of esthetics, fragile resistance and abrasive resistance. Artificial tooth is made of acrylic resin or porcelain. Nowadays, acrylic resin artificial teeth are mainly used. Acrylic resin teeth are occluded with natural teeth, gold alloy, Ni-Cr alloy or porcelain etc. Acrylic resin teeth have similar translucency, gloss of natural teeth. And it has good chemical bond with denture base material, but it has low wear resistance. The aim of this study is to compare wear resistance among several denture teeth(Endura, SR-orthosit-PE, Planustar) and between artificial resin denture teeth and opposing 3 restorative materials(gold, Ni-Cr alloy, porcelain). Wear tests were conducted with a rotating wear testing apparatus(pin-on-disk type wear tester) under conditions of rpm 180, 75 minutes and constant loading of 50N. The upper part was the cusp of maxillary first molar and the lower part was a disk type restorative materials. To make similar oral environment, water was supplied continually. The acrylic resin teeth wear was determined by weighing the cusp each 5 minutes during 75 minutes test. Vicker's hardness tester was used to evaluate the surface hardness of test specimens. The SEM was used to evaluate the wear surfaces. The results were as follows: 1. Wear rates of acrylic resin teeth opposing to the restorative materials were high in order of Porcelain, Gold, Ni-Cr alloy (p<.05). 2. Wear resistance rate opposing to the Porcelain disk, was shown in order of Endura, SR-orthosit-PE, Planustar. The wear rate of opposing to porcelain disk was above two times more than that of other groups (p<.05). 3. Wear resistance rates opposing to the Gold, Ni-Cr alloy disk, was shown in order of Endura, SR-orthosit-PE, Planustar (p<.05). 4. A degree of the surface hardness is directly proportional to the degree of wear resistance. There are statistically significant differences between each groups (p<.05).

• 구강회복응용과학지
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• 제25권3호
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• pp.243-253
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• 2009

임플란트 술식에서 방사선 영상 기술, 컴퓨터 소프트웨어의 발전으로 정확한 진단 및 surgical guide의 제작이 가능해졌다. 본 증례는 양악 무치악 환자에서 고정성 임플란트 보철을 위해 CAD/CAM technique을 이용하여 수술을 하고 즉시 하중을 가한 증례이다. Planning software program을 이용하여 해부학적 구조물과 단면상을 고려하여 상 하악에 각각 6개씩의 임플란트를 최적의 위치에 계획하였다. 정밀한 surgical guide 이용하여 미리 계획된 위치와 방향으로 무절개 임플란트 식립 수술을 시행하였다. 즉시 사용 가능한 고정성 임시 보철물을 미리 제작해 수술 직후 장착하여 환자의 만족도를 높였으며, 이를 6개월간 평가하여 심미적이며, 기능적으로 안정적인 최종 보철물을 제작할 수 있었다.

• Archives of Plastic Surgery
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• 제40권4호
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• pp.341-347
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• 2013

Background Intractable chronic scalp ulcers with cranial bone exposure can occur along the incision after cranioplasty, posing challenges for clinicians. They occur as a result of severe scarring, poor blood circulation of the scalp, and focal osteomyelitis. We successfully repaired these scalp ulcers using a vascularized bipedicled pericranial flap after complete debridement. Methods Six patients who underwent cranioplasty had chronic ulcers where the cranial bone, with or without the metal plate, was exposed along the incision line. After completely excising the ulcer and the adjacent scar tissue, subgaleal dissection was performed. We removed the osteomyelitic calvarial bone, the exposed metal plate, and granulation tissue. A bipedicled pericranial flap was elevated to cover the defect between the bone graft or prosthesis and the normal cranial bone. It was transposed to the defect site and fixed using an absorbable suture. Scalp flaps were bilaterally advanced after relaxation incisions on the galea, and were closed without tension. Results All the surgical wounds were completely healed with an improved aesthetic outcome, and there were no notable complications during a mean follow-up period of seven months. Conclusions A bipedicled pericranial flap is vascularized, prompting wound healing without donor site morbidity. This may be an effective modality for treating chronic scalp ulcer accompanied by the exposure of the cranial bone after cranioplasty.

• 한국치위생학회지
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• 제16권2호
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• pp.295-301
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• 2016

Objectives: The purpose of the study was to investigate the association between denture wearing and dementia using a Mini-Mental State Examination (MMSE-K) in the community dwelling elderly. Methods: The study subjects were 184 community dwelling elderly using Korean version of mini-mental state examination(MMSE-K). The variables included the general characteristics of the subjects, denture earing, number of mastication tooth, subjective mastication ability, and MMSE(dementia). Denture wearing was divided into two groups of the natural dentition including the fixed prosthesis and removable denture including the complete and/or partial denture. The data were analyzed by ${\chi}^2$ test, t-test, and binary logistic regression using SPSS version 22.0 program. Logistic regression was used to analyze the association of MMSE-K score and denture wearing, and 95% confidence interval was calculated. The subjective mastication ability was measured by Likert 5 points scale. Dementia was measured by MMSE-K. Results: There was a significant association between MMSE-K score and denture wearing. The odds ratio(OR) of denture waering was 6.01(95% CI: 2.824-12.784). After adjusting the age, gender, residence and education, OR was 5.53(95% CI: 2.364-12.935). Conclusions: This study showed a significant association between MMSE-K score and denture wearing in the Korean elderly.

• Archives of Plastic Surgery
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• 제40권6호
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• pp.735-741
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• 2013

Background The prosthetic dura is an essential element in the protection of the cranial parenchyma and prevention of cerebrospinal fluid leakage. Although prosthetic dura are widely used in neurosurgery, they occasionally provoke infection, which can be a major concern after neurosurgical treatment. However, removal of the prosthetic dura carries a risk of brain parenchyma injury and cerebrospinal fluid leakage. The salvage of infected prosthetic dural material has not been adequately addressed in the literature. In this study, we demonstrate the value of the combination of a meticulous surgical debridement of necrotic tissue and simultaneous muscle free flap for intractable postoperative epidural abscess without removal of the infected prosthetic dura. Methods Between 2010 and 2012, we reviewed the data of 11 patients with persistent infection on the prosthetic dura. The epidural infections each occurred after a neurosurgical procedure, and there was soft tissue necrosis with the disclosure of the underlying prosthetic dura and dead bone around the scalp wound. To salvage the infected prosthetic dura, meticulous debridement and a muscle free flap were performed. Results All 11 patients experienced complete recovery from the complicated wound problem without the need for further surgical intervention. No signs of prosthetic dural infection were observed during the mean follow-up period of 11 months. Conclusions The combination of a meticulous surgical debridement and coverage with a muscle free flap is an effective treatment for salvage of infected prosthetic dura.

• 구강회복응용과학지
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• 제17권2호
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• pp.107-112
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• 2001

The prosthodontic treatment of severely resorbed edentulous patients has been one of the frustrating areas due to extensive loss of tissues. The integrated neuromuscular balance among tongue, lip, and cheek is compromised. The retention, stability, and support are the three major factors to influence the clinical outcome. Fish described a denture as having three surface, with each surface playing an independent and important role in the over all fit, stability, and comfort of the denture. He recommended that the polished surface should be a series of inclines so that pressure from muscular activity will retain dentures. Within the denture space there is an area that has been termed the neutral zone. The neutral zone is that area in the mouth where, during function, the forces of the tongue pressing outward are neutralized by the forces of the cheeks and lips pressing inward. According to Jacobson and Krol, neuromuscular control interacts to provide retention and the relationship of polished surface of denture base to the surrounding muscular structure of orofacial capsule facilitates the stability and retention. This neutral zone concept has been demonstrated with various modification by a number of authors. The theory used to develop the denture base contours is based on the belief that the muscle should functionally mold not only the border but the entire polished surface. Lott and Walsh reported the clinical success on complete mandibular dentures with application of neutral zone concept. A number of studies demonstrated that denture stability and retention are more dependent on correct position of the teeth and correct contour of external surfaces of the denture in a severely resorbed alveolar ridge. This article presents a prosthodontic approach to treatment of a edentulous patient using neutral zone technique to improve the retention and stability of the prosthesis.