• 제목/요약/키워드: Dental Visit

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하악운동이상증의 임상양태 (Clinical Features of Oromandibular Dystonia)

  • 강신웅;최희훈;김기석;김미은
    • Journal of Oral Medicine and Pain
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    • 제36권3호
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    • pp.169-176
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    • 2011
  • 하악운동이상증(oromandibular dystonia, OMD)은 턱이나 구강조직의 반복적, 불수의적, 비정상적인 움직임으로 정의되며 저작기능과 교합에 문제를 초래하여 치과치료를 어렵게 하고 보철물의 유지곤란을 야기할 뿐 아니라 잦은 구강 연조직 손상이나 만성 안면통증의 원인이 되기도 하므로 치과의사의 관심이 필요한 질환이다. 본 연구는 단국대학교 치과대학 부속치과 병원 구강내과에 내원하여 OMD로 진단되어 치료를 받은 환자들의 병력기록부상의 관련 항목을 조사하여 OMD 환자들의 임상적 특징과 치료 유형을 분석하였다. 2007년 8월부터 2010년 4월까지 단국치대 부속병원 구강내과에 내원한 78명의 OMD 환자는 평균 72세의 고령이었으며 여자가 남자에 비해 3.6배 많았고, 평균 10개월 이상의 비교적 긴 병력기간을 보였다. 내원한 OMD 환자의 가장 흔한 주소는 턱의 통증이었으며 그 다음으로 빈도가 높은 주소는 턱과 구강조직의 조절 안 되는 반복적인 움직임과 구강조직의 통증이었다(p=0.000). OMD 유형은 페구형(jaw-closing dystonia)이 가장 많았고, 측방운동형(lateral jaw-deviation dystonia)과 복합형(combination dystonia)도 많이 발생하였다(p=0.001). 환자의 60% 이상은 OMD 발생과 관련하여 뚜렷한 원인을 인지하지 못했으나 약 19%의 환자들은 보철치료, 발치 등의 치과치료와 관련 있다고 보고하였다(p=0.000). 본원에 내원한 환자는 약물치료가 가장 먼저 시도되었고 진정제(clonazepam)가 거의 모든 환자(97%)에서 처방되었다. 이상의 결과로 볼 때, OMD는 뚜렷하게 노인, 특히 여성에게 많이 발생하는 질환으로서 턱과 구강조직의 통증을 유발하며 과반수 이상은 뚜렷한 원인을 모르지만 일부 환자들은 치과치료 후에 자신의 문제를 처음 인지하는 경향이 있다. 그러므로 치과의사는 환자를 치료할 때 OMD의 존재를 간과하지 않도록 관심과 주의를 기울일 필요가 있다.

비스포스포네이트 연관 악골괴사의 치료 방식과 투약 휴지기가 치료 예후에 미치는 영향 (The effectiveness of the surgical approach and drug-holiday on the treatment of bisphosphonate related osteonecrosis of the jaw patient)

  • 이승현;박군효;이재열;김용덕;신상훈;정인교;김규천;김욱규
    • 대한치과의사협회지
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    • 제53권2호
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    • pp.120-131
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    • 2015
  • Objective: The purpose of this study is to compare the surgical treatment with conservative treatment and to evaluate the effectiveness of drug-holiday in bisphosphonate related osteonecrosis of the jaw (BRONJ) patients who were diagnosed as stage 2. Patients and Method: From January 2012 to October 2014, seventy-two patients who visit to Pusan National University of Dental Hospital were diagnosed as stage 2 of BRONJ. All the patients had taken computed tomography(CT) and panoramic radiography. The surgical treatment including sequestrectomy of necrotic bone and curettage of soft tissue around the sequestrum were performed to fifty patients. Twenty-two patients underwent conservative treatment such as antibiotics medications, mouth rinsing and follow up checking for every two weeks. Prognosis of treatment was classified into 3 groups - response, unresponse, and worsens - according to clinical, radiographic symptoms. P-value less than 0.05 were regarded as significant. Results: In surgery group, forty-five patients (90%) were healed without recurrence or any complication and five patients (10%) showed the wound dehiscence or infection. In conservative treatment group, fifteen patients (68.2%) were healed without any complication, four patients (18.2%) did not show improvement and three(4.2%) patients$^{\circ}{\emptyset}$ symptoms increased. P-value among groups was 0.014. Evaluation of preoperative drug-holiday in surgery group did not show the effectiveness(p=0.478). Conclusion: Statistically, the prognosis of patients with stage 2 BRONJ treated with surgery was significantly better than conservative treatment. There was no statistical difference for the preoperative drug-holiday.

부산광역시 초등학교 양호교사의 학교구강보건에 대한 태도와 의견 (Attitudes and Opinions about School Oral Health Care among Health Teachers of Elementary School in Busan)

  • 전진호;류원향;이성훈
    • 한국학교보건학회지
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    • 제15권2호
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    • pp.205-218
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    • 2002
  • Objectives : Because elementary school children are sensitive and prevalent to dental caries, oral health care program for the elementary school children (ESOHCP) should be met the first priority for the national oral health care program. This study was performed to proposed the guidelines for executing the efficient ESOHCP through the evaluation of present oral health care and education status based on the attitudes and opinions of health teachers. Methods : Subjects were 181 health teachers those are a part of the total 273 elementary school health teachers in Busan. From April to June 2001, questionnaire survey on the teacher's attitude and opinion, present status of oral health care and education in their own school was done. Data was analyzed by $\chi^2$-test, t-test, ANOVA using SAS (ver 6.21) program. Results : Mean age of the teachers was 40 years (24~58 years) and mean scale of the subject school was 32 classes (5~58 classes). Above 90% of them agreed with the necessity and importance of ESOHCP, but actual level of concerning was lower. They gained the informations about oral health mainly from media (33%), PC net (26%), academic society (25%), and more used internet (p=0.012) in younger generation. Though most of them (96%) had a specified school dentist, only 58% had the experience of periodic oral health examinations in their own school. The major experienced ESOHCP was fluoride brushing and contest to choose the best healthy teeth. Oral health education given by the teachers was not professional but their own. About half (42%) of the teachers had never taken education during last one year. Major education materials were VTR tape (79%), teeth model (64%), CD (55%), booklet (50%), etc., and the teachers' preference was also VTR tape (43%) and CD (41%). When they need education materials, they frequently request to dentist's association (36%), academic society (35%), but rarely to dental clinics or dentists (6%). They prefer that two times (46%) of annual oral health education, with the contents of regular brushing (53%), but lower regular visit to clinics (13%). The interest to oral health care (p=0.016) increased with teacher's age. And, they agreed regular students education in case of higher interest(p=0.044). Intention about join in the model school program was decreased with scale of school (p=0.002). Conclusions : This result showed that the present status of ESOHCP is still insufficient. It considered that the health teachers' interest and role is most important for the maintenance and success of ESOHCP. The professional and efficient education program would be focused on the health teachers to induce drive on ESOHCP.

중학생들의 구강보건인식이 구강건강상태와 구강건강행위에 미치는 영향 (The Effect of Middle Schoolers' Oral Health Awareness on Oral Health Condition and Oral Health Behavior)

  • 조은숙
    • 한국산학기술학회논문지
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    • 제14권10호
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    • pp.5020-5028
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    • 2013
  • 본 연구는 제 2대구치가 맹출 하고, 영구치 치열이 완성을 이루어 평생 치열을 완성하는 중요한 시기인 중학생들 대상으로 구강보건인식이 구강건강상태와 구강건강행위에 어떠한 영향을 미치는지 조사하여 청소년들의 구강건강 프로그램 개발에 기초자료로 사용하고자 전주시 일부지역 소재의 중학교에 방문해 구강상태를 검진하고, 구강보건인식 및 행위에 대한 설문조사를 실시하였다. 구강검진 결과 치아우식증은 여학생이 치주질환은 남학생이 높게 나타났으며, 부정교합은 여학생이 높게 나타났다(p<0.038).구강보건인식은 남,녀간의 유의한 차이는 없었으나 5점 척도중 M=4.08로 높게 나타났다. 구강건강행위는 '잇몸에서 피가 날 때 치과를 방문한다.의 문항에서는 여학생(M=4.508)이 남학생(M=4.257)보다 더 높게 나타났다(p<0.05). '잇솔질 후 치과용 실을 사용한다'의 문항에서도 여학생(M=4.547)이 남학생(M=4.333)보다 더 높게 나타났다(p<0.05).구강보건인식은 구강건강행위에 95% 신뢰수준에서 유의미한 영향을 미치는 것으로 나타났다. 따라서 구강건강을 증진하기 위해 구강건강행위에 대한 교육이 요구되며, 행위에 영향을 미치는 구강보건인식 및 지식에 대한 프로그램 개발을 제시하는 연구가 필요하다.

Qraycam을 이용한 구강보건교육의 효과 (The effect of oral health education using Qraycam)

  • 강현경
    • 한국융합학회논문지
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    • 제10권5호
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    • pp.333-340
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    • 2019
  • 본 연구의 목적은 Qraycam을 이용한 구강환경검사, 구강보건태도 및 구강건강관리 행동점수의 전 후비교를 통하여 구강보건교육의 효과를 분석하고자 하였으며, 단일집단 사전 사후 연구설계로 진행되었다. 2018년 9월부터 12월 중순까지 실험 중재를 위한 실습대상자 33명과 구강보건교육 선호도 조사를 위한 학생 33명을 연구대상으로 하였다. 자료의 분석은 IBM SPSS 24.0 Ver을 이용하였고, 통계적 검정을 위한 유의수준은 0.05로 하였다. 그 결과, Qraycam을 사용한 중재 전 후의 구강환경 검사인 O' Leary index와 구취농도는 유의하게 감소하였다(p<.001). 중재 전 후에 따른 구강보건태도 점수와 구강건강관리 행동점수는 통계적으로 유의하게 높게 나타났다(p<.001). 학생들의 구강보건교육 선호도 중 "구강보건교육에서 유용하다"와 "치태를 인지하고 결정하는 능력이 좋다"는 항목에서 Qraycam을 사용하는 경우 만족도는 유의하게 높게 나타났다(p<.001). 결론적으로, 치과임상현장에서 Qraycam 사용을 통한 구강보건교육은 치과위생사들의 구강보건교육 효과를 증진시키기 위한 방법이 될 수 있을 것이다.

하악 치조골이 심하게 위축된 무치악 환자에서 폐구인상법을 이용한 총의치 수복 증례 (Complete denture made with closed-mouth impression technique on severely atrophied edentulous jaw)

  • 이석환;이성복;이석원
    • 대한치과보철학회지
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    • 제57권2호
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    • pp.195-202
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    • 2019
  • 치과보철과에는 장기간 총의치를 사용해 온 고령 환자 중에서 발치 후 시간의 경과와 함께 심하게 치조골이 위축된 상태로 환자들이 종종 내원하게 된다. 통상 하악 총의치는 하악 협붕 부위의 1차 지지를 기반으로 한 개구인상법에 의해 제작하는 것이 일반적이다. 하악 총의치의 유지력 및 안정성을 확보하기 위해서는 진단에서부터 의치 주위 조직의 기능 및 의치상의 경계, 교합평면, 악궁의 대합관계, 인공치아의 배열, 저작습관, 그리고 환자에 대한 교육과 장착 후 주의 사항 등을 충분히 고려해두어야 한다. 그러나 치조골 위축이 심하게 발생된 무치악 환자에서 개구인상법을 이용하여 제작한 하악 총의치는 간혹 실제 저작과정에서 유지와 안정에 한계를 보이는 경우가 있기 때문에, 이에 대한 대안으로 폐구인상법을 이용한 총의치 제작 방법을 선호하는 임상가들에 의해 개구인상법과 폐구인상법을 비롯한 다양한 인상채득 방법을 비교한 연구가 보고되기도 하였다. 본 증례에서는 폐구인상법을 토대로 한 기능인상으로 하악 총의치를 제작하여 동일한 환자에서 개구인상법으로 제작한 의치보다 나은 유지력과 안정성을 확인했고, 심하게 치조골이 위축된 상태의 구강조건에서 개구인상법으로 제작한 의치와 폐구인상법으로 제작한 의치의 임상적 결과를 비교한 내용에 대해 보고하고자 한다.

하악 소수 잔존치 환자에서 임플란트 보조 국소의치 수복 증례 (Implant-assisted removable partial denture restoration in small number of residual teeth in mandible: A case report)

  • 박종하;김지환
    • 대한치과보철학회지
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    • 제62권3호
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    • pp.215-223
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    • 2024
  • 본 증례의 환자는 기존 의치에 불편함을 느껴 새로운 의치를 원하여 내원하였다. 하악 좌측 제2대구치를 제외한 모든 치아를 상실한 상태였다. 환자의 나이가 65세였기에 임플란트와 의치를 국민건강보험 제도를 이용하여 치료할 수 있었고, 환자는 하악에 임플란트를 이용한 의치 제작을 원하였다. 새 의치에 적응하기 위해 임시 의치를 제작하여 장착하고 충분한 적응 기간을 거쳐서 치료를 진행하였다. 상악은 총의치, 하악은 전방부에 임플란트 2개를 식립하여 임플란트 상부 보철물을 서베이드 크라운 형태로 제작하고 임플란트 보조국소의치를 제작하였다. 골흡수가 심한 하악 소수 잔존치 상태에서 효율적인 치료 비용과 기능적으로 환자와 술자 모두 만족하였다. 임플란트 상부 보철물을 서베이드 크라운 형태로 제작한 임플란트 보조 국소의치는 경제적, 해부학적인 한계로 총의치, 임플란트 피개의치, 임플란트 지지 완전 고정성 보철이 어려운 경우에 효과적인 대안이 될 수 있다. 그러나 과학적으로 근거가 높은 수준의 연구가 부족하여 향후 면밀한 정기검진 및 교합 검사가 필요할 것이다.

S대학 치위생과 실습실에 내원한 환자의 치아우식상태와 구강위생관리능력, 구강건강행위 실태 (A Study on the Oral Health Status, PHP Index and Oral Health Behavior of Patients in 'S' College Dental Clinic)

  • 김진;우희선;정문희
    • 치위생과학회지
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    • 제9권1호
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    • pp.145-151
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    • 2009
  • 본 연구는 구강건강행위와 구강건강상태, 구강위생관리능력과의 상호관계를 분석하여, 치과위생관리를 위한 기초자료를 제공하고자 2007년 9월 5일부터 12월 1일까지 S대학 치위생과 구강위생실습실을 내원한 스켈링 실습환자를 대상으로 실시하였으며, SPSS WIN 12.0 프로그램을 이용하여 분석하였다. 1. 연령이 낮을수록 우식경험처치치아의 수(FT index)가 높은 것으로 조사되었으며, 구강위생용품 영역, 정기적인 치과방문 영역, 식이조절 영역에서는 연령이 증가할수록 구강건강행위가 높은 것으로 조사되었다. 2. 대상자의 구강건강행위 정도는 5점 만점에서 2.62로 대체적으로 낮은 수준으로 조사되었으며, 잇솔질 영역에서는 '위아래로 치아를 닦고 잇몸과 혀도 닦는다', 구강위생용품 영역에서는 '구강양치액(가그린)을 사용 한다', 정기적인 치과방문 영역에서는 '아픈 경우 미루지 않고 치과에 방문 한다', 식이조절 영역에서는 '우식성식품 보다 청정식품을 섭취 한다', 교육 및 관심 영역에서는 '흡연이 구강건강에 좋지 않음을 교육받는 적이 있다'가 가장 높게 조사되었다. 3. 구강건강행위가 높을수록 우식경험미처치치아(DT index)의 수가 낮아지는 것으로 조사되었으며, 구강건강행위가 높을수록 우식경험처치치아의 수는 높은 것으로 조사되었다. 치면세마 실습실에 내원한 환자의 구강위생관리능력 수준을 분석한 결과 '양호' 25%, '보통' 36.3, 불량 30.4, 매우불량 8.3%로 조사되어 대부분의 환자들의 구강위생관리 능력이 불량한 것으로 조사되었으며, 구강건강행위가 높을수록 구강위생관리능력 지수는 낮아지는 것으로 조사되었다. 4. 구강건강행위와 우식경험미처치치아(DT index) 간에 음(-)의 상호관련성이 있는 것으로 분석되어, 구강건강행위가 높을수록 우식경험미처치치아(DT index)의 수는 낮아지는 것으로 조사되었다(p < .01). 구강건강행위와 우식경험처치치아(FT index) 간에 양(+)의 상호관련성이 있는 것으로 분석되어, 구강건강행위가 높을수록 우식경험처치치아(FT index) 수는 높아지는 것으로 조사되었다(p<.01). 구강건강행위와 구강위생관리능력 지수(PHP index) 간에 음(-)의 상호관련성을 보이고 있어 구강건강행위가 높을수록 구강위생관리능력 지수(PHP index)는 낮아지는 것으로 조사되었다(p < .01).

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초중등학생의 구강보건관리에 대한 인식도 조사 (A Study of Students' Knowledge Level of Dental Health Care)

  • 김교웅;남철현
    • 한국학교보건학회지
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    • 제13권2호
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    • pp.295-317
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    • 2000
  • This study was conducted to prevent oral disease of primary school, middle school, and high school students, providing basic data for the development of oral health education programs. Data were collected from 898 primary school, middle school, and high school students from March 2, 1999 to May 31, 1999. The results of this study are summarized as follows; 1) The subjects of this study were primary school students(32.6%), middle school students(33.0%), and high school students(34.4%). Boy students were slightly more prevalent than girl students. That is, primary school boys were 56.3%, middle school boys were 53.2%, and high school boys were 52.6%. 2) According to the self-judgement of oral health, primary school students were better than middle/high school students and boy students were better than girl students, 63.5% of primary school students and 57.8% of middle/high school students brushed their teeth once or twice a day. 3) 76.3% of middle/high school students and 63.5% of primary school students experienced dental caries. Girl students were higher than boy students in experiencing dental caries, 35.9% of primary school students and 27.6% of middle/high school students experienced periodontal disease. 4) 22.9% of primary school students and 7.9% of middle/high school students received oral examinations periodically. Girl students showed a higher rate than boy students in primary school, while boy students showed a higher rate than girl students in middle/high school. 5) Explaining to the reasons for reluctant visits to dental hospitals and clinics, 'no time to go' was highest(22.9% of primary school students; 27.4% of middle/high school students) and the rate of 'feeling scared' was second highest. Middle/high school students were more reluctant to visit dental hospitals and clinics than primary school students. In case of problematic symptoms in the mouth, the rate of 'feeling painful or cold in teeth when eating cold or hot foods' was highest, 71.3% of primary school students was concerned about oral health, while 68.6% of middle/high school students was concerned about it. 6) In gathering to the sources of information on oral health, the rate of medical institutions was highest(30.0%) in primary school students, while the rate of family members or persons around them was highest in middle/high school students. 7) 54.9% of primary school students received oral health education, while 13.1% of middle/high school students received it. Only 4.7% of middle school and high school girls received it. In relation to dental health education, the rate of 'possibility of prevention of oral caries or disease of the gum' was highest. 79.5% of primary school students and 80.3% of middle school students answered that they would attend oral health education. 8) 60.4% of primary school students and 60.2% of middle/high school students think the purpose of oral health is to prevent dental caries and disease of the gums. In preventing dental caries, 78.8% of primary school students and 71.8% of middle school students thought that periodical oral examination was effective, 88.4% of primary school students and 88.8% of middle/high school thought that brushing one's teeth was effective and 64.1% of primary school students and 50.7% of middle school students thought that the use of toothpaste containing fluoride was effective. In preventing periodontal disease, 91.1% of primary school students and 90.2% of middle/high school students thought that brushing one's teeth was effective, while 72.4% of primary school students and 70.3% of middle/high school students thought that teeth cleaning was effective. 9) 16.0% of middle school students and 12.7% of high school students thought that their oral health condition was healthy. According to individual experiences in dental treatment, the rate of experience of middle school students was higher than that of high school students, 12.7% of middle school students received oral examinations periodically, while only 3.3% of high school students did so. 10) In cases of 'having no problematic symptoms in the mouth' and 'concerns about oral health', the rate of middle school students was higher than that of high school students. In gathering obtaining information on oral health, the rate of obtaining it through broadcast media including TV, Radio, etc. was highest in middle school students, while the rate of obtaining it through family members or persons around them was highest in high school students. 11) 81.7% of middle school students have not received oral health education. In case of girl students, 97.3% have not received it in high school students. 85.6% of middle school students and 151.2% of high school students think that oral health education is necessary. 12) According to the knowledge level of oral health, the point of high school students($26.33{\pm}2.33$) was similar to the point of high school students($26.23{\pm}2.30$). It appeared that the point of primary school students was highest($26.35{\pm}2.50$) The more concerned about oral health the students were the higher the knowledge level of oral health was. In conclusion, the middle/high school students' knowledge level of oral health was lower than primary school students. The rate of middle/high School students' experience in oral health education was too low. Therefore, it is necessary to intensify oral health education for middle/high school students. Especially, the necessity of oral health education to girl students is strongly recommended. Developing an oral health education program for primary school, middle school, and high school students, related public authority and organizations, teachers; and dentists must actively make efforts together in order to maintain healthy teeth through having students prevent dental caries and periodontal disease.

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편측성 완전 구순 구개열 환자의 구개열 형태 및 치궁의 분석 (A Study Model Analysis of Complete Unilateral Cleft Lip & Palate Patients)

  • 임대호;김승룡;신효근
    • 대한구순구개열학회지
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    • 제2권1_2호
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    • pp.5-14
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    • 1999
  • The aim of treatment of cleft lip and palate is to correct the cleft and associated problems surgically and thus hide the anomaly so that patients can lead normal lives. This correction involves surgically producing a face that does not attract attention, a vocal apparatus that permits intelligible speech, and a dentition that allows optimal function and esthetics. In neonatal periods, gross distortion of tissues surrounding the cleft requires considerable effort and time due to post operative functional defect and scarring and induces milk feeding problem, malocclusion of deciduous or permanent dentition, congenital missing teeth, skeletal dysplasia. The occurrence of a cleft deformity is a source of considerable shock to the parents of an afflicted baby, and the most appropriate approach is very important things. Thus we tried to analysis of dental arch, shape and size of deformity in cleft patients. The results were obtained as follows. 1. When the cast measurements of UCLP subjects at first visit it was found that the mean length was 9.29mm at the alveolar cleft width, also that was 11.7mm at the anterior width and 14mm at the posterior cleft width. 2. Comparison of UCLP group at first visit and just lip surgery, it was found that the older group showed a insignificant reduction in the width of the cleft in the alveolar, canine, and tuberosity regions. 3. The maxillary casts of the UCLP group at 6 months differ Significantly from those of the at 3 months in both length and width. but there was no statistical difference except anterior ridge length of nonclefted site. 4. Comparison at 6 months and 18 months, there was a greater change in length of the alveolar cleft width, intercanine width, and anterior cleft width. Maxillary arch became wider at both the canine region and intertuberosity region. also posterior anteroposterior length was increased but anterior AP length was decreased from 8.1mm to 7.7mm. There was meaningful increase at intertuberosity length; however, a significant reduction in width t-t'

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