• 구강회복응용과학지
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• 제16권2호
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• pp.133-147
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• 2000

A well-planned, precise occlusal adjustment of natural teeth has some distinct advantages over other forms of occlusal therapy. It should be emphasized, however, that an occlusal adjustment is an irreversible procedure and has definite contraindications in some mouths. Generally, the treatment methods for the patients that has open-bite will be following as below. : (1) Use of removable orthopedic repositioning appliance, (2) Orthodontics, (3) Full or partial reconstruction of the dentition, (4) Orthognathic surgical procedure, (5) Occlusal adjustment of the existing natural teeth, (6) Any combination of the above. Above all, the advantages of occlusal adjustment of natural teeth are : (1) the patient is more able to adapt to the changes in jaw position and posture; (2) the phonetic or speaking ability of the patient is not significantly changed and usually is improved; (3) the esthetics of the natural teeth is not altered and often is better; (4) the hygiene of the individual teeth is easily maintained; and (5) the functional usage of the teeth as cutting and chewing devices is markedly improved. The objective of an occlusal adjustment, as with any form of occlusal therapy, is to correct or remove the occlusal interferences, or premature contacts, on the occluding parts of the teeth which prevent a centric relation closure of the mandible. A systematic, disciplined approach can be followed in treatment, the objectives should be listed. They are : (1) Centric relation occlusion of the posterior teeth. (2) Proper "coupling" of the anterior teeth. (3) An acceptable disclusive angle of the anterior teeth in harmony with the condylar movement patterns. (4) Stability of the corrected occlusion. (5) Resolution of the related symptoms. For the patient with open-bite on anterior and posterior teeth, this case report shows the treatment methods in combination the fixed prosthesis with the selective cutting of the natural teeth. Occlusal adjustment is no longer an elective procedure but a mandatory one for patients requiring restorations and those in treatment for TMD dysfunctions or those whose dentitions show signs of occlusal trauma. Occlusal adjustment is essential for all who do not display the above lists.

• 대한소아치과학회지
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• 제48권1호
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• pp.42-49
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• 2021

이 연구의 목적은 소아 및 청소년의 영구치 치관 파절시 파절편 재부착술의 추적 관찰 결과를 평가하고자 함에 있다. 21명의 27개의 영구치 파절편 재부착술을 시행한 환자를 대상으로 임상 사진, 방사선 사진 및 의무기록을 활용하여 평가하였다. 파절편 탈락은 총 17개 치아에서 관찰되었으며 반복적인 외상이 가장 빈번한 실패 원인이었다. 파절편 재부착술과 치수치료 시행 유무는 통계적으로 유의미하지 않았다(p > 0.05). 평균 파절편 비율은 0.482 ± 0.147이며 성공률은 파절편 비율과 유의미한 상관관계를 나타냈다(p = 0.018). 평균 파절편 유지 기간은 72개월이며 파절편 유지 기간과 파절편의 비율은 통계적으로 유의미한 상관관계를 나타냈다(p = 0.003). 소아 및 청소년의 영구치 치관 파절시 파절편 비율이 50% 미만인 환자에서 파절편 재부착술은 예측 가능한 치료 방법이 될 수 있다고 판단된다.

• 구강회복응용과학지
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• 제27권3호
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• pp.317-326
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• 2011

이공과 하악관 전방고리는 악골의 외과적 술식에서 중요한 기준점이 된다. 이번 연구의 목적은 전산화단층촬영를 이용해 이공과 하악관 전방고리의 형태를 분석하고, 이를 임상에 적용하기 위함이다. 외과적 수술이 계획된 96명(남성 33명, 여성 63명, 연령범위 17 ~ 43세, 평균연령 $24.6{\pm}4.99$세)의 환자를 대상으로 전산화단층촬영을 시행하였다. 전산화단층촬영 방사선영상에서 이공의 수평적, 수직적 위치, 치근첨과의 거리를 측정하였고, 하악관 전방고리는 치근첨에서의 거리, 협측 측방각도를 측정하였다. 이공의 위치는 하악 제2소구치 하방이 81례(46.0%)로 가장 많았으며, 하악 제1소구치와 제2소구치사이에 존재하는 경우는 67례(38.0%)로, 하악 제2소구치와 제1대구치 사이에 존재하는 경우는 19례(10.2%)로 나타났다. 이공과 하악골 하연과의 평균거리는 $12.20{\pm}1.77$ mm, 이공과 치근첨과의 평균거리는 $5.16{\pm}0.98$ mm. 하악관 전방고리의 평균 길이는 $5.80{\pm}2.00$ mm로 나타났다. 하악관 전방고리에 대한 협측 각도는 $47.7{\pm}9.07^{\circ}$로 나타났다. 치근첨과 이공과의 거리는 파노라마 영상에서는 $5.16{\pm}0.98$ mm로 나타났고, 전산화단층촬영영상에서는 $6.2{\pm}3.07$ mm로 나타났다. 이공과 하악관의 평균거리는 $5.39{\pm}1.62$ mm로 나타났다. 임플란트를 포함한 악골의 외과적 술식에서 이신경의 손상 및 외과적 외상의 위험을 최소화하고 최적의 수술결과를 얻기 위해서는 이공과 하악관 전방고리의 형태와 위치에 대한 정확한 평가가 이뤄져야 한다. 전산화단층촬영 영상은 이러한 해부학적 구조를 찾는데 유용할 것으로 생각된다.

• 대한소아치과학회지
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• 제28권2호
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• pp.247-254
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• 2001

최근에는 외상이 증가되는 추세이며, 외상 받은 치아에 대한 조속한 치료와 올바른 처치를 위해선 외상성 손상에 대한 역학적인 면을 아는 것이 중요하다. 본 조사의 목적은 강릉대학교 치과병원 소아치과에 외상을 주소로 내원한 아동 120명(재외상환자 포함)에 대한 성별 및 나이에 따른 발생 빈도, 손상 받은 치아의 개수, 손상 유형, 원인 및 손상 받은 장소, 월별, 시간대별 빈도, 손상 받은 치아의 위치, 외상 후 내원까지의 경과시간 등에 대한 조사를 통해 외상에 대한 교육과 예방에 도움이 되고자 시행하였다. 1. 성별에 따른 발생 빈도는 1.6 : 1로 남아의 비율이 높았다. 2. 나이에 따른 발생 빈도는 2~4세와 8~10세 때 빈도가 높았다. 3. 외상시 손상 받은 치아의 개수는 1개일 경우(51.7%)가 많았다. 4. 손상의 유형은 유치에서는 치주조직 손상이 많았고, 영구치는 경조직과 치주조직의 손상 비율이 유사하였으나 유치에 비해 경조직 손상의 비율이 많이 증가하였다. 5. 손상의 원인은 두 치열 모두에서 낙상의 비율이 높았으며 영구치열에서는 스포츠에 의한 손상 비율이 증가하였다. 6. 손상 받은 장소로는 유치는 집(38.8%), 영구치는 거리(42.5%), 학교(35%)의 비율이 높았다. 7. 월별 발생 빈도는 7월에서 빈도가 가장 높았다. 8. 시간대에 따른 빈도는 유치는 오전, 영구치는 오후에 높은 빈도를 보였다. 9. 외상시 손상 받은 치아의 위치는 유치, 영구치 모두 상악, 특히 중절치의 비율이 높았다. 10. 외상 후 내원까지의 경과시간 절반 이상(59.2%)가 당일에 내원하였으며, 손상 정도가 심할 경우가 경미한 손상일 경우보다 당일 내원하는 경우가 많았다.

• Journal of Preventive Medicine and Public Health
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• 제7권1호
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• pp.29-94
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• 1974

Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

• Journal of Acupuncture Research
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• 제17권1호
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• pp.55-66
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• 2000

The following results have been obtaind after examing 72patients with facial paralysis who were hospitalzed and treated through the time period of December 1st, 1996 to November 30th, 1999 at the Department of Acupuncture and Moxibustion of Seoul Oriental Medicine, Kyungwon University. During the examination, those 72 patients were divided into two groups, and One group was treated by oriental-western treatment, the other group was treated by oriental treatment. Oriental treatments were acupuncture and moxibustion, herb medicine, physical treatment and hygienic treatment. The one of main western treatments is steroid therapy. The results were obtained as follows : 1. In regard to signs at the first medical examination, lacrimation was showed highest number and facial paralysis, dysgeusia, hyperacusis were showed in numerical order. 2. In regard to prescription of oriental herb medicine, Kamissangbotang(加味雙補湯) was prescribed in greatest numbers and Boyangwhanotang(補陽還五湯), Kamiboiktang(加味補益湯), Ligigepungtang(理氣祛風湯) were prescribed in numerical order. 3. In regard to treatment number, 10~19 times for treatment was showed highest number and 1~9 times, 20~29 times, 40~49 times were showed in numerical order . 4. In regard to mean treatment times about injury region and main sign, the effect of oriental-western treatment was showed as follows: lacrimal gland disorder, hyperacusis, dysgeusia, facial paralysis were treated for 15.1, 27, 13.2 and 21.4 times, repectively. The effect of oriental treatment was showed as follows: lacrimal gland disorder, hyperacusis, dysgeusia, facial paralysis were treated for 34.8, 22.1, 33.8 and 16.3 times, respectively. 5. In regard ta the effect of treatment about injury region and main sign, oriental-western treatment was showed as follows: cases of lacrimal gland disorder were showed 1 of excellent case, 1 of fair case, 5 of good cases. In hyperacusis patients, there was showed 1 of fair case. In dysgeusia patients, there was showed 1 of excellent case, 3 of fair cases, 1 of good case. In facial paralysis, there were showed 5 of fair cases. Oriental treatment was showed as follows: In lacrimal gland disorder, the excellent were 4 cases, the fair were 10 cases, the good were 3 cases and the poor were 4 cases, In hyperacusis, the fair were 5 cases, the poor 2 cases. In dysgeusia, the excellent were 4 cases, the fair were 1 case, the good were 1 case and the poor was 1 case, In facial paralysis, the excellent were 9 cases, the fair were 4 cases, the good 3 cases and the poor were 3 cases. 6. The effect of total treatment was as follows: 30 cases were showed fair effect, 19 cases were showed excellent effect, 13 cases were showed good effect and 10 cases were showed poor effect. 7. In regard to attack factor, overlabour was showed highest number and wind-cold, mental stress, trauma, ear disease, common cold, dental diseae, reason unknwon were showed in numerical order. 8. In regard to premonitory symptoms, non significant symptoms were in 38 cases, the pain of peri-stylomastoid region were in 38 cases and headache, dysaesthesia of periorbit, dysgeusia, stomatitis, eyelid tic were showed in numerical order. 9. In regard to sex, male were 33 cases and female were 39 cases. The distribution of age was disclosed that thirty, forty, fifty, seventy, sixty, twenty and below twenty years were revealed in turn. Sex and paralytic side were showed as follows: male-left were 15 cases, male-right were 18 cases, female-left were 19 cases and female-right were 19 cases. In regard to attack frequence in month, March was showed highest number and January, April, May, August, October, etc were showed in numerical order. In regard to attack frequence in season, spring was showed highest number and winter, summer, fall were showed in numerical order, but attack frequence between four seasons wasn't showed significant difference.

• 대한소아치과학회지
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• 제29권2호
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• pp.139-145
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• 2002

유치에서는 영구치에 비해 법랑질의 두께가 얇고 약하며 상대적으로 큰 치수강으로 인하여 단시간에 치아우식증이 치수까지 이환되며, 외상 또는 치과치료 중 갑작스런 움직임으로 인하여 치수가 노출되는 경우가 빈번하다. 이러한 이유로 어린이에서의 치수처치는 필수적이며, 유치에서 치수치료의 목적은 감염된 치수조직을 제거하여 동통을 완화시키는 것 이외에도 크게는 치열궁을 보존하여 저작기능을 보호하고, 미래의 영구치열이 적절한 교합관계를 이루게 하는데 있다. 유치열에서 성공적인 치수치료를 위해서는 유치 치수의 형태, 유치 근관의 해부학적 형태, 치근형성, 그리고 유치 치근의 흡수와 관련된 특별한 문제점들에 대한 이해를 필요로 한다. 상악 대구치와 마찬가지로 상악 유구치의 근심 치근이 형태에 있어서 가장 큰 변이를 보인다고 알려져 있으며, 이 치근 내에 존재하는 모든 근관을 처치하지 못한다면 결국 치수치료는 실패할 것이다. 본 증례는 근관치료 중이거나 후에 지속적인 동통이나 근관 내 출혈이 지속되는 경우에서 상악 유구치의 근심협측치근의 제 2근심협측근관을 발견하고 처치한 후 임상증상 및 동통이 사라지고, 양호한 예후를 보였다. 또한 발거된 상악 유구치를 대상으로 한 조사 결과 상악 제 1유구치는 35개 증 8개(22.8%), 상악 제 2유구치는 33개 중 22개(66.6%)의 치아에서 제 2근심협측근관이 발견되었으며. 이는 상악 유구치의 근심협측치근 내에 두 개의 근관이 존재할 가능성이 높다는 것을 의미한다.