• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.10 no.1
• /
• pp.30-45
• /
• 2001

In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.

• Journal of Trauma and Injury
• /
• v.26 no.4
• /
• pp.304-307
• /
• 2013

Food bolus impaction is the most common cause of esophageal foreign body obstruction in adults. Other causes include intentional ingestion in psychiatric patients or prison inmates. We experienced successful treatment of a patient with intentional ingestion of multiple sharp foreign bodies(25 cutter and razor fragments). A 47-year-old male patient who was suffering from chronic alcoholism was admitted, via the emergency room, with dysphagia and neck pain. He was suffering from alcoholic liver cirrhosis and psychiatric problems, such as chronic alcoholism, anxiety disorder and insomnia. The patient had intended to leave the hospital after having swallowed the sharp objects. Plain radiographs and computed tomography (CT) scan showed multiple, scattered metal fragments in the esophagus, stomach, and small bowel. We performed emergent endoscopy and successfully removed one impacted blade in the upper esophagus using by a snare with an overtube. The rest of the fragments had already passed through the pylorus, so we could not find them with endoscopy. We checked the patient with simple abdominal radiographs and careful physical examinations every day. All remaining fragments were uneventfully excreted through stool during the patient's 6 day hospital stay. Finally, we were able to confirm the presence of the objects in the stool, and radiographs were negative. The patient was discharged without complications after 14 days hospital stay and then was followed by the Department of Psychiatry.

• The Journal of the Korean dental association
• /
• v.52 no.12
• /
• pp.762-770
• /
• 2014

Bony exostosis, one of the osseous deformities, could act as a contributing factor of periodontal disease since it makes proper tooth brushing difficult and causes traumatic ulcer. The purpose of this case report is to show improvement of periodontal health by removal of bony exostoses and creation of physiologic osseous form. A 58 year-old female patient with recurrent ulcer and pain on bony exostoses located on left maxillary palatal area and both mandibular buccal areas was treated. Exostoses were removed and physiologically positive osseous form was created following vertical grooving, radicular blending, flattening interproximal bone and gradualizing marginal bone. The patient showed no further recurring traumatic ulcer and bone exposure. Moreover, periodontal pocket was eliminated and food impaction was decreased. In conclusion, periodontal health could be achieved through removal of multiple bony exostoses and development of ideal osseous form.

• Journal of Korean Medicine Rehabilitation
• /
• v.18 no.4
• /
• pp.13-24
• /
• 2008

Objectives : The purpose of this study was to investigate the effect of Poncirus Trifoliata(PT) on improvement of fecal impaction in spinal cord injured(SCI) rats. Methods : Fifteen adult Sprague-Dawley female rats were used weighing 200~250 g. A complete spinal cord transection was performed surgically at the T10 cord level. Experimental groups were assigned into 3 groups: Control(n=5), SCI+vehicle(n=5) and SCI+PT(n=5). PT was administered 100mg/kg in 0.5ml every 24 hours from 1st operation day to 7th day. We measured the body weight and food intake as well as the number and the weight of fecal pellet every morning. After 1 week of operation, whole colon was divided into proximal and distal segments under anesthesia. Each segment of colon was mounted with longitudinal direction in a organ bath. We measured spontaneous contraction and compared the area under the curve in each segments. Enhanced responses were observed by acetylcholine($10^{-6}M$), 40 mM KCl solution, L-NAME($10^{-4}M$). Results : The fecal number and weights were significantly higher in the group of SCI+PT than SCI+vehicle group(p<0.05). In organ bath study, area under the curves of the spontaneous contraction in SCI+vehicle and SCI+PT groups were significantly increased compared to control group. Contractility of distal colon in response to acetylcholine or KCl in SCI+vehicle group was significantly decreased compared to other groups(p<0.05). Conclusions : These results suggest that PT might be useful to promote bowel emptying in spinal cord injured rats.

• Journal of Periodontal and Implant Science
• /
• v.30 no.1
• /
• pp.203-212
• /
• 2000

Putrefactive activity within the oral cavity is the principal cause of halitosis. The most common intraoral sites of oral malodor production are tongue, interdental and subgingival areas. The other foci may include faulty restorations, sites of food impaction and abscesses. Periodontal disease frequently involves pathological oral malodor, which is caused mainly by volatile sulfur compounds(VSC), such as hydrogen sulfide, methyl mercaptan, and dimethyl sulfide. The purpose of this study is to evaluate the association between oral malodor and periodontal status. Volatile sulfur compounds in mouth air were estimated by portable sulfide monitor($Halimeter^{TM}$). The results were as follows : 1. The levels of volatile sulfur compounds were significantly greater in a periodontitis group than in a control group(P<0.01). The amounts of VSC in mouth air from patients with periodontal involvement were four times greater than those of the control group. 2. The significant positive correlation was found between VSC concentrations and the number of pocket depth above 4mm(P<0.01), but correlation between VSC concentrations and plaque score was not statistically significant(P>0.05). 3. In the periodontitis group, VSC concentrations of pre-treatment significantly decreased after scaling and root planing(P<0.01). 4. No statistically significant correlation was found between VSC concentrations and sex / age in the periodontitis group. The above results indicate that periodontal disease may play a role as an important factor of oral malodor and deep periodontal pockets are a source of volatile sulfur compounds.

• Journal of dental hygiene science
• /
• v.11 no.4
• /
• pp.325-332
• /
• 2011

To get the evidences for decreasing the discomfort, dissatisfaction, and for improving management of the implant prothesis through assessment implant patients' awareness and discomforts about care of the prostheses. The subjects were 300 implant patients who treated in the 20 dental clinics in Pusan, Ulsan and Daegu. The general characteristics, recognition, maintenance, discomfort and dissatisfaction, and oral hygiene status were collected. Level of the discomfort and dissatisfaction was measured by a 5 Likert scale, and analyzed by the equivalent of 100. The life-span of the implants was overestimated, however, periodic recall check and scaling were underwent. The level of discomfort and dissatisfaction was generally good, but many of them (65.3%) complained the food impaction. As a result of the multiple regression analysis, level of the discomfort and dissatisfaction increased in case of more number of the prosthesis ($\beta$=0.864), however decreased in case of more frequent teeth brushing ($\beta$=0.737), more frequent periodic check ($\beta$=-0.737), longer duration from the implantation ($\beta$=-0.090). It is very important for the implant patients to be recognized that the lack of care may shorten the life-span of the implant prosthesis. Therefore, efforts of the continuous oral hygiene care such as, periodic recall check, scaling, teeth brushing, the correct using of additional oral hygiene product, and education would be more emphasized.

• Journal of Periodontal and Implant Science
• /
• v.29 no.3
• /
• pp.693-703
• /
• 1999

Since they were introduced by Ward in 1923, periodontal dressing have been routinely used following the periodontal surgery to avoid pain, infection, desensitizing teeth, inhibiting food impaction of the surgical areas, and immobilizing injured areas. Recently, however, the value of periodontal dressings and their effects on periodontal wound healing have been questioned, several authors have been reported that the use of dressing has little influence on healing following periodontal surgical procedures. In addition, there is evidence that when good flap adaptation is achieved, the use of a periodontal dressing does not add to patient comfort nor promote healing. The purpose of this study was to evaluate patient postoperative pain experience and discomfort with and without the use of periodontal dressing following periodontal surgery. Twenty-eight patients, 11 male and 17 female. were selected for this study; The age range was 31 to 56, with an average of 40.2years. Patient selection was based on existence of two bilateral sites presenting similar periodontal involvement, as determined by clinical and radiographic assessment, and requiring comparable bilateral surgical procedures. Using a splitmouth dressing. one site received a periodontal dressing while the other site did not. Pain assessment was made according to a horizontal, rating scale(0-10). After at least a two-week period, the second surgical precedure was performed using the alternate postoperative treatment. At the conclusion of the trial, a self-administered questionnaire on postoperative experience was administered, and were asked of their preference of either, dressed or undressed. The results were as follows: 1. A similar trend for mean pain and discomfort scores as assessed by patients both dressed and salinetreated procedures was evident during 7-day postsurgical period. 2. Statistical analysis of differences between the dressed side and salinetreated side with respect to pain, discomfort and patient's experiences revealed that both treatment sides behaved similarly at any postoperative day(P>0.05). 3. Considering the patient's preference, on the basis of pain and discomfort experienced, 43% preferred the saline-mouthwash and 32% preferred the dressing, 25% showing no preference for either the dressing or the saline-mouthwash. There is evidence to support the use of a periodontal dressing in retention of an apically positioned flap by preventing coronal displacement, or its use to provide additional support to stabilize a free gingival graft. However, there will always be a use for periodontal dressing although routine use of dressings may decrease because of better surgical techniques and the use of antibacterial mouth rinses.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.29 no.4
• /
• pp.317-326
• /
• 2013

This study was to compare the cumulative survival rate of implant-supported fixed prostheses and to analyze association between risk factors and cumulative survival rate of implant-supported fixed prostheses. In order to assess the clinical status of implant-supported fixed prostheses, individuals who treated in the Department of Prosthodontics, Pusan National University Dental Hospital, between 2000 to 2007 were examined. The results of this study were as follows: 1. Length of service of implant-supported fixed prostheses was $6.6{\pm}32.0$ years (mean), 11.7 years (median). 2. Age and sex of patient was found to have no statistically significant influence on longevity of implant-supported fixed prostheses (P>.05). 3. Reason of tooth extraction wax found to have statistically significant influence on implant-supported fixed prostheses (P<.05). The longevity of fixed prostheses was low in tooth extraction case due to periodontal disease (median:9.0 years). 4. Location of implant-supported fixed prostheses was found to have statistically significant influence on longevity of fixed prostheses (P<.05). The longevity of fixed prostheses was low in molar region (median:8.8 years). 5. Number of units in implant-supported fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 6. Condition of opposing dentition was found to have no statistically significant influence on longevity of implant-supported fixed prostheses (P>.05). 7. Food impaction (40.5%), porcelain fracture (25.8%), screw loosening (23.6%) were frequent complications.