• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.217-234
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• 2005

혈소판 농축 혈장은 구강과 안면부 재건수술에 새로이 사용되는 유용한 첨가물이다. 혈소판은 상처 치유과정에서 매우 중요하며, 혈소판은 상처부위에 빠르게 도달하여 응고를 형성한다. 그리고 다양한 성장인자를 분비한다. 이러한 성장인자는 골의 형성과 혈관의 증가, 골 이식재의 치유에 관여하는 것으로 생각된다. 본 연구의 목적은 실험 동물을 통하여 혈소판 농축 혈장에 함유된 혈소판의 정량화를 통한 성장인자 함유량을 추정하고, 방사선학적, 조직학적 평가를 통해 혈소판 농축 혈장이 초기의 골형성에 미치는 영향에 대한 평가를 하는데 있다. 15마리의 가토 두개골에 6mm trephine bur(외경 8mm)를 이용하여 경뇌막의 손상을 주지 않도록 하면서 4개의 결손부를 형성하였다. 각각의 두개골 결손부는 $Bio-Oss^{(R)}$만 이식한 군, PRP만 이식한 군, PRP와 $Bio-Oss^{(R)}$를 혼합하여 이식한군, 그리고 아무것도 이식하지 않은 군을 대조군으로 설정하였다. 각각의 재료를 이식한 후 비흡수성 차폐막($Tefgen^{(R)}$)을 위치시키고 흡수성 봉합사로 일차봉합을 시행하였다. 각 군 당 술 후 1, 2, 4주의 치유기간을 설정하였다. 동물을 희생시키고 두개골을 절제하였다. 먼저 방사선학적인 골 밀도 측정을 시행하고, 조직학적 평가를 위해 통법에 따라 조직 표본을 제작한 후 광학현미경으로 관찰하였다. 또한 가토 귀 변연정맥에서 채취한 10 ml의 혈액을 원심분리하여 혈소판 함유량을 평가하여 다음과 같은 결과를 얻었다. 1. 혈소판 농축 혈장은 일반 혈액에 비해 약 4.02배 많은 수의 혈소판이 함유되어 있었다. 2. 방사선적인 평가에서 1, 2, 4주 사이에 대조군과 비교하여 $Bio-Oss^{(R)}$에 PRP를 이식한 군에서 골의 밀도는 큰 차이를 보이고 있다(p<0.01). 하지만, 동일한 시기에 PRP만 이식한 군과 대조군의 차이는 발견할 수 없었으며 (p>0.05), $Bio-Oss^{(R)}$만 이식한 군과 $Bio-Oss^{(R)}$에 PRP를 이식한 군의 차이 또한 발견할 수 없었다(p>0.05). 3. 조직학적 평가에서 모든 이식재는 시간이 경과할수록 골 형성이 증가함을 알 수 있었다. 대조군에 비해 PRP만 이식한 군에서 더 두꺼운 섬유성 결합을 보이고 있다. 대조군과 PRP만 이식한 군과 비교해 $Bio-Oss^{(R)}$와 $Bio-Oss^{(R)}$에 PRP를 혼합 이식한 군에서 골의 형성이 더 진행됨을 알 수 있었다. $Bio-Oss^{(R)}$에 PRP를 혼합 이식한 군이 $Bio-Oss^{(R)}$만 이식한 군에서보다 더 많은 신생골 형성을 관찰할 수 있다. 이상의 결과에서 가토의 두개골 결손부에 $Bio-Oss^{(R)}$에 PRP를 혼합 이식하였을 경우 결손부의 초기 골 형성을 촉진 할 수 있음을 시사하였다.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.199-216
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• 2005

치주치료의 가장 중요한 목적은 상실된 치주조직의 형태적, 기능적 재건이다. 법랑기칠 단백질 유도체(enamel matrix derivative: EMD)는 치주 병소에 사용시 상피세포의 증식을 억제하며 치주인대 및 백악아세포를 활성화시켜 무세포성 백악질 및 치주인대와 골조직의 생성을 유도한다고 보고되고 있다. 또한 법랑기질 단백칠 유도체는 골모세포의 증식 및 분화를 촉진시키며 alkaline phosphatase의 활성 및 mineralized nodule의 형성을 촉진시킨다고 보고되고 있다. 이에 본 연구에서는 토끼 두개골 결손부에 법랑기질 단백질 유도체와 이종골 이식재를 이식한 후 골밀도를 방사선학적으로 분석하고, 신생골 형성 및 주변 조직 반응을 조직학적으로 관찰, 평가하고자 하였다. 토끼 두개골에 6mm trephine bur(외경 8mm)를 이용하여 경뇌막에 손상을 주지 않도록 하면서 4개의 결손부를 형성하였다. 아무것도 이식하지 않은 군을 음성 대조군으로, 이종골 이식재 ($Bio-Oss^{(R)}$, Geistlich, Wolhusen, Switzerland)을 이식한 군을 양성 대조군으로 설정하였다. 법랑기질 단백질 유도체 ($Emdogain^{(R)}$, Biora, Inc., Sweden)만 이식한 군과 법랑기질 단백질 유도체와 이종골 이식재를 혼합하여 이식한 군을 설험군으로 설정하였다. 각각의 재료를 이식한 후 비흡수성 차폐막 ($Tefgen^{(R)}$, Lifecore Biomedical, Inc., U.S.A.)을 위치시키고 흡수성 봉합사로 일차봉합을 시행하였다. 각 군당 술 후 1, 2, 4주의 치유기간을 설정하였다. 동물을 희생시킨 후 두개골을 절제하여 먼저 방사선학적인 골밀도측정을 시행한 후 10% formalin에 고정한 후 통법에 따라 조직표본을 제작하여 광학현미경으로 관찰하였다. 1. 방사선학적인 평가에서 1, 2, 4주에 대조군과 법랑기질 단백질 유도체만 이식한 군과 비교해 이종골 이식재만 이식한 군과 이종골 이식재에 법랑기질 단백질 유도체를 이식한 군에서 더 큰 골의 밀도를 보이고 있었다 (P<0.01). 하지만, 동일한 시기에 대조군과 법랑기질 단백질 유도체만 이식한 군과의 차이는 발견할 수 없었으며 (P>0.05), 이종골 이식재만 이식한 군과 이종골 이식재에 법랑기질 단백질 유도체를 이식한 군의 차이 또한 발견할 수 없었다 (P>0.05). 2. 조직학적인 평가에서 1, 2, 4주에 대조군과 법랑기질 단백질 유도체만 이식한 군과 비교해 이종골 이식재만 이식한 군과 이종골 이식재에 법랑기질 단백질 유도체를 이식한군에서 골의 형성이 더 진행됨을 알 수 있었다. 법랑기질 단백질 유도체만 이식한 군이 대조군보다 2주에서 더 많은 신생골을 볼 수 있었으며, 이종골 이식재에 법랑기질 단백질 유도체를 이식한 군이 이종골 이식재만 이식한 군보다 1, 2주에서 더 많은 신생골을 관찰할 수 있었다. 이상의 결과에서 법랑기질 단백질 유도체는 토끼 두개골 결손부 치유단계에서 초기 골 형성을 촉진하는 것으로 사료되며 골 이식시에 법랑기질 단백질 유도체를 적용하는 것은 유용한 술식으로 사료된다.

• Journal of Veterinary Clinics
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• v.28 no.2
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• pp.225-231
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• 2011

The objective of the present study was to determine the progesterone levels that effects on the pulsatile and surge modes of FSH secretion. In previous studies we have shown that LH surge occurred in the follicular levels of progesterone, whereas there was no surge mode secretion of LH in either the sub luteal or luteal levels of progesterone. LH pulsatile frequencies were high in two groups such as follicular level and sub luteal level. But in the luteal level of progesterone the pulsatile pattern of LH were strongly suppressed. Namely, sub luteal levels of progesterone, around 1 ng/ml, completely suppressed the LH surge but did not affect the pulsatile frequency of LH secretion. Because of this we hypothesized that the two secretory patterns of FSH are similar to that of LH. Long-term ovariectomized Shiba goats that had received implants of estradiol capsules and three different progesterone silastic packet inducing follicular, subluteal and luteal levels of progesterone were divided into three groups such as non-P, low-P and high-P group. Blood samples were collected daily throughout the experiment for the analysis of gonadal steroid hormone levels and at 10-min intervals for 8 h on Days 0, 3, and 7 (Day 0: just before progesterone treatment) for analysis of the pulsatile frequency of FSH secretion. Then estradiol was infused into the jugular vein of all animals at a rate of 3 ${\mu}/h$ for 16 h on Day 8 to determine whether an FSH surge was induced. Blood samples were collected every 2 h from 4 h before the start of the estradiol infusion until 48 h after the start of the infusion. In each group, the mean ${\pm}$ SEM concentration after progesterone implant treatment was 3.3 ${\pm}$ 0.1 ng/ml for the high P group, 1.1 ${\pm}$ 0.1 ng/ml for the low P group, and < 0.1 ng/ml for the non-P group, concentrations similar to the luteal levels, subluteal levels, and follicular phase levels of the normal estrous cycle, respectively. The FSH pulse frequency was maintained highly in all groups on Day 0, Day 3 and Day 7. An FSH surge was induced in all 4 cases of the Non-P group. In the High P and Low P groups, the plasma concentrations of FSH remained low until 48 h after the start of estradiol infusion, and no occurrence of FSH surge was found in any of the animals. The results of this study not only confirm that the pulsatile patterns of FSH were not inhibited strongly relative to LH, they also suggest that some other mechanism and factor may be controlling the FSH secretion.

• Journal of radiological science and technology
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• v.32 no.3
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• pp.271-276
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• 2009

The aim of this study was to evaluate the effect of Bone Mineral Density(BMD) at mandible. So, we studied how to measure the BMD at mandible using DEXA(Dual energy X-ray absorptiometry, DEXA) by Horner er al (1996) and knew reproducibility of the measurements. Thirty-five patients (13 men, 22 women, mean age : 25.4 years) were examined using the GE Lunar Prodigy Advance(LUNAR Corporation, madison, USA). They were examined in Semiprone position of their body and true lateral position of their mandible selected the Lumbar lateral mode. We used the custom mode in analysis when ROI (area $30{\times}2.5\;mm^2$). Three ROIs ($30{\times}2.5\;mm^2$, $50{\times}2.5\;mm^2$, $20{\times}2.5\;mm^2$) were located each at the two different sites of the mandible (angle of mandible and mental symphysis) and BMD was measured. Differences in BMD measurement was statistically compared according to the size and location of ROI. BMD was $1.320{\pm}0.358g/cm^3$ in men and was $1.152{\pm}0.340g/cm^3$ in women. BMD at the angle of mandible was $1.201{\pm}0.361g/cm^3$ in men and was $1.025{\pm}0.377g/cm^3$ in women. BMD of men at the mental symphysis was $1.434{\pm}0.341g/cm^3$ and that of women was $1.19{\pm}0.358g/cm^3$. With the ROI of $20{\times}2.5\;mm^2$, BMD was $1.262{\pm}0.384g/cm^3$ in men and was $1.113{\pm}0.357g/cm^3$ in women. With the ROI of $50{\times}2.5\;mm^2$, BMD of men was $1.320{\pm}0.358g/cm^3$ and that of women was $1.129{\pm}0.340g/cm^3$. There was a statistically significant difference of BMD according to the size and location of ROI. When measuring mandible BMD, there are good for increasing ROI and locate between ramus and mental symphysis. Especially following exam, refer to same size and location with fore exam. According to study which measure mandible BMD, It's correct to measure better a portion of mandible then whole of BMD. Using DEXA protocol is studied good for the additional study to compare the BMD at mandible. Later date, It will be good for measurement value in implant and bone graft quantitatively. Using DEXA method gain BMD threshold value in korean.

• Journal of Korean society of Dental Hygiene
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• v.7 no.4
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• pp.583-594
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• 2007

The purpose of this study was to conduct a survey on the senses that preliminary dental hygienists have on employment, who applied for the National Dental Hygienist Examination, so that it could provide a basic reference required for fostering good human resources specializing in oral health with a sense of mission and responsibility as professional. To meet these goals, a self-administered questionnaire survey was conducted for participants in a refresher education meeting for preliminary dental hygienists across three major regions(Seoul, Daejeon and Busan), which was held by the Korean Dental Hygienists Association(KDHA) on Jan. 15, 2006. Total 289 sheets of questionnaire were collected, and 262 sheets except invalid or incomplete ones were used for examination and analysis. As a result, this study came to the following conclusions: First, it was found that 40.4% respondents wanted to be employed in dental clinic or hospital. Most respondents(90.1%) answered that faithfulness is most valued as prerequisite qualification for employment in hospital, and highest percentage of respondents(39.3%) wanted to earn 16 to 17 million Korean won annually. For internship opportunities, 61.9% respondents replied that they could willingly accept the internship, provided that basic pay and switchover to regular employee are all assured. Second, as the results of survey on employment circumstances around respondents, it was found that most respondents(58.3%) were employed in dental clinic or hospital, and highest percentage of respondents(35.0%) earned 15 to 16 million Korean won. Third, it was found that interpersonal relationships among employees had most significant effects(4.81) on selection of employment, which was followed by in-house welfare benefits 1(monthly/annual vacation, resting room, etc; 4.56). For possible influential factors on the selection of employment depending on whether employed or not, it was found that there were Significant differences in pay, welfare benefit 2(seminar, orientation, refresher training opportunities, etc), post-wedding continued employment and merit system between employees and non-employees(pE0.05). Fourth, the survey on respondents' occupational senses of dental hygienist showed that major tasks of dental hygienists were represented by oral disease prevention(92.6%), case management(71.5%), oral health education(66.3%), hospital/clinic management and dental management support(10.4%) and public oral health activities(6.7%) respectively. For job satisfaction, it was found that almost half respondents(48.9%) showed satisfaction at their job and 32.6% felt satisfied at and proud of their job. That is, majority of respondents(81.5%) felt satisfied at their job as dental hygienist. For follow-up requirements to qualify for dental hygienists, it was found that 73.3% felt it necessary to give more investments to self-development, 62.2% respondents considered protection of membership's rights as one of future assignments that KDHA should be more committed to. For future social awareness about dental hygienists as occupation, 69.2% respondents expected that they would be better developed and treated as professional. And desired training courses as a part of qualification for professional dental hygienists were represented by case management(services, manners, etc; 33.3%), implant(28.9%), esthetics(correction, prosthesis, whitening; 18.9%) and so on. For an item on working years, it was noted that 75.9% respondents would keep working as dental hygienists as long as they could.

• Journal of Periodontal and Implant Science
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• v.32 no.4
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• pp.837-846
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• 2002

그람 음성균의 감염에 의한 만성 염증질환인 치주염이 동맥경화를 동반한 허혈성 심장질환 (협심증이나 심근 경색)을 일으킬 수 있는 위험인자로 작용할 수 있다는 보고가 있었다. 그러나, 그 기전에 관해서는 명확하게 알려져 있지 않다. 작용기전의 하나로서, 치주염에 의해 치주조직에서 국소적으로 생긴 염증성 싸이토카인(IL-1${\beta}$, IL-6, $PGE_2$, TNF-${\alpha}$)이 혈행을 따라 이동하여 심혈관에서 동맥경화를 일으킬 수 있다는 가설이 제시되고 있는데, 이 가설을 검증해 보고자 한다. 서울대학교 병원 순환기 내과에 불안정 협심증이나 심근경색으로 입원한 환자 및 과거 이 질환의 병력을 갖고 있거나 검진 목적으로 내원하여 관상동맥 조형술을 받은 환자들 중 동맥경화로 진단받은 사람을 실험군(24명)으로 하고, 동맥경화로 진단받지 않은 사람을 대조군(12명)으로 하였다. 치주질환의 활성도를 나타내는 치은 지수, 치태 지수, 치주낭 깊이, 부착 상실을 측정하였다. Paper strip을 실험대상 치아(Ramfjord's teeth)들 중에서 가장 깊은 치주낭을 가진 두 개의 치아를 택하여 각 치아의 가장 깊은 치주낭에 30초간 삽입한 후 밀폐된 plastic tube에 넣고 ELISA kit를 이용하여 IL-1${\beta}$, IL-6, TNF-${\alpha}$, $PGE_2$의 농도를 측정하였다. 환자의 plasma에서도 동일한 싸이토카인의 농도를 측정하였다. 설문조사를 통해 동맥경화의 위험 인자로 간주되어온 고혈압, 당뇨, 가족력, 심근경색이나 협심증의 기왕력, 흡연의 유무를 기록하였다. 혈액검사를 하여 total cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, WBC, CRP (C-reactive protein)의 농도를 측정하였다. 치주조직에 대한 임상 검사 결과 치은의 염증상태를 나타나는 지표인 치은 지수에서만 실험군이 대조군에 비해 유의할 정도 (p=0.0174)로 높게 나타났고, 만성적인 염증의 결과로 인한 치조골의 사실 정도를 나타내는 치주낭 깊이나 부착 상실에서는 유의할 만한 차이를 보이지 않았다. 치주낭에서 측정한 염증성 싸이토카인 중 IL-1${\beta}$, $PGE_2$가 실험군에서 유의할 만한 차이 (p=0.005, 0.022)를 보이며, 더 높은 농도로 나타났고, TNF-${\alpha}$는 대조군에서 유의성 있게 (p=0.009) 높게 나타났다. 그러나, plasma의 싸이토카인이나, serum lipid/lipoprotein, C-reactive Protein, WBC는 유의할 만한 차이를 보이지 않았다. 또한 치은열구액내의 싸이토카인과 이에 상흥하는 싸이토카인 간에 상관관계는 관찰되지 않았다. 다변량 로지스틱 회귀분석 결과, 치은열구액내의 IL-1${\beta}$와 TNF-${\alpha}$ 만이 동맥경화와 유의성 있는 관련성을 보였고, 특히 IL-1${\beta}$와 교차비는 273으로 상당한 관련성을 보여주었다. 결론적으로, 치주조직에서 국소적으로 생긴 염증성 싸이토카인이 그대로 혈행으로 이동하여 혈장내의 싸이토카인 농도를 높이는 것은 아니다. 그러나, 치주염으로 인해 치은열구내액내에 국소적으로 증가된 염증성 싸이토카인은 동맥경화와 상당한 관련성을 가진다.

• Journal of Periodontal and Implant Science
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• v.31 no.4
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• pp.833-846
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• 2001

Recently, use of natural medicine is getting more attention, and some of them are believed to be effective in　the treatment of periodontitis. Among them, the seeds of safflower(Carthamus tinctrorius L.) have been proven to be effective through its use in bone diseases such as fracture and osteoporosis. During the last few years, studies using the seeds of safflower gown in Korea have been active, and it has been reported that safflower seed extract increase the proliferation and the alkaline phosphatase(ALP) activity of human periodontal ligament fibroblast(hPDLF), osteoblast, and that they promote the mineralization process. In animal studies, when safflower seed extract were administered orally new bone formation was promoted. Recently, in an effort to find out the most effective osteogenic components, among many components of the safflower seed, various safflower seed fraction extracts were obtained by multistep extraction of the safflower components using various solvents. Among these, saf-M-W fraction extracted by methanol and water was most effective in increasing osteogenic potential of osteoblasts. In this study, the effect of safflower seed fraction extract, saf-M-W, on the growth and differentiation of hPDLF and MC3T3-E1 cell was investigated. The toxicity of saf-M-W on both cells was measured using M'IT(3-(4,5dimethylthiazol-2-y1)-2,5-diphenyl tetrazolium bromide) test, and ALP activity was measured using the colorimetric assay of hPDLF. In addition, in MC3T3-El cells, the expression of ALP, bone sialoprotein(BSP) mRNA was observed using Northern blot, and the mineralized nodule formation Was observed using von Kossa stain and phase-contrast microscope. 1. In concentrations below $10{\mu}g/ml$, saf-M-W didn't show any toxicity on hPDLF and MC3T3-El cell. 2. The change in saf-M-W concentration had no effect on the ALP activity of hPDLF. 3. In MC3T-E1 cells, mRNA expressions of ALP and BSP were greater in the experimental group treated with $10{\mu}g/ml$ concentration of saf-M-W compared with the control group. 4. In MC3T3-El cells, abundance of mineralized nodules were formed in the experimental group treated with $10{\mu}g/ml$ Concentration of saf-M-W, while no mineralized nodule was formed in the control group. These results suggest that safflower seed fraction extract, saf-M-W. didn't show any toxicity on hPDLF and MC3T3-E1 cell at concentrations below $10{\mu}g/ml$ and effectively enhanced the differentiation and osteogenic potential of MC3T3-El cell.

• Journal of dental hygiene science
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• v.15 no.2
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• pp.106-112
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• 2015

This study was conducted to provide with baseline data with the purpose of increasing the values of medical services. Self-administered questionnaire survey was conducted on 236 patients at a dental clinic follow-up visit in dentist clinic Gyeongnam area from June 2013 to August 2013. All statistical analyses were performed using SPSS. The motivation visiting the dental clinic is that the first one is introduction from the family and friends, the second is accessibility, the third is conspicuity and the last one is awareness of the dentist. The main variables in the process of treatment are service system, kindness, satisfaction of service, efficient of re-call system. The relief of discomfort at revisit show the highest score in the process of implant treatment and intention of revisit hereafter do in the prostheses process. In the correlation between main variables, service system and relief of discomfort at revisit (r=0.440, p<0.001), kindness and satisfaction of medical service (r=0.675, p<0.001), revisit hereafter and satisfaction of service (r=0.387, p<0.001) and efficiency of re-call system and revisit showed the highest correlation. The influence on satisfaction of dental service show meaningful level in kindness (p<0.001) and efficiency of re-call system (p<0.05). The intention of revisit is affected meaningfully by relief of uncomfort (p<0.05), service system (p<0.05), kindness (p<0.01) and efficiency of re-call system (p<0.01). In summary, the personal network of patients is most important variable at intention for revisit of dental clinic. As satisfaction of kindness and efficiency of re-call system is higher, satisfaction of medical service and intention for revisit are shown higher. Therefore further research for improvement of satisfaction for medical service and of intention of revisit at the dental clinic should be carried out.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.321-328
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• 2003

Background: The St. Jude Medical prosthesis is one of the popularly used artificial prosthesis, therefore the National Medical Center reports the long-term clinical results of patients who underwent prosthetic valve replacement with St. Jude medical valve for 18 years. Material and Method: Between January, 1984 and June, 2002, a series of 163 consecutive patients who had Implanted St. Jude prosthesis at the National Medical Center were reviewed. Mean age was 42.9$\pm$15.1 years and male to female ratio was 69:94. The operative procedure comprised of 87 MVR, 30 AVR, 45 DVR, and 1 TVR. The reoperative procedure comprised of 21 MVR, 2 AVR, and 14 DVR. Follow-up rate was 96.9%, and cumulative follow-up was 823.8 patient-years. Result: Early mortality rate was 7.9% (13 patients), late mortality rate was 8.7% (13 patients) and late mortality due to valve related complication was 47% (7 patients). Actual survival rate at 10 and 18 years were 91.7$\pm$2.1% and 91.0$\pm$1.9%. Linearized Incidence was as follows: thromboembolism, 1.09%/ patient-year; anticoagulant related hemorrhage, 0.36%/patient-year; valve thrombosis, 0.24%/patient-year; paravalvular leakage, 0.12%/patient-year; and prosthetic bacterial endocarditis, 0.12%/patient-year linearized incidence of over all valve related complication was 1.94%/patient-year. Freedom from valve related complication at 10 and 18 years were 89.1$\pm$3.3% and 88.4$\pm$3.9%. Freedom from valve related death at 10 and 18 years were 95.1$\pm$1.2% and 95.1$\pm$1.0%. Valve related complication was related the age of patient, especially anticoagulant related hemorrhage was more common in patients over 60 years of age. Valve related complication, death were higher in DVR than AVR or MVR, and valve related death was higher in reoperation. There was no relationship between valve related complication or death and implant valve of size. Conclusion: The long-term clinical results of patients implanted with St. Jude Mechanical prosthesis was quite satisfactory with a low incidence of valve related complication and mortality.

• Journal of dental hygiene science
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• v.15 no.3
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• pp.272-279
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• 2015

This study was conducted to provide baseline data which could suggest a direction of role based efficient integrated clinical education by avoiding duplicate of contents through analyzing clinical courses. Among the 7 clinical courses, orthodontics and periodontology were the most published subjects which were published in 5 kinds of books and dental materials was the least published subject which was published in 2 kinds of books on investigation of overlapping contents based on titles that appeared on chapters and verses of all textbooks for clinical courses. Dental implant was covered in 4 subjects such as oral maxillofacial surgery, prosthodontics, periodontology and dental materials which was the most number. Other overlapping contents were restoration treatment, occlusion and malocclusion, temporomandibular joint diseases, anesthesia sedation, tooth trauma, systemic disease and dental treatment, dental casting, isolation techniques, tooth bleaching, pulp protection, gingivitis periodontitis, tooth development, etc. Reviews of textbooks of clinical courses should be conducted in a detailed manner by systematic, various studies in order to improve quality of the textbooks.