• Journal of Periodontal and Implant Science
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• 제27권3호
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• pp.575-584
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• 1997

The quality of periodontal instrument cutting edge is a basic element of effective root planing procedure. Using instruments, the sharp edge is changed into blunt or beveled edge. With the blunt instrument, the periodontal treatment can't be carried into accuracy and effective. The study on the wear of periodontal curet is insufficient, there are few publications about the change of sharpness of cutting egde after using instrument and a certen reports were published on the study of scanning electron microscope(SEM) examination. In this study, to declare the number of strokes for sharpening of instruments, the changes of cutting edge is measured by the clinical methods, tactile sensitivity examination and refraction light-white line test after scaling strokes and root planing strokes. SEM test was added for defined the changes of cutting edges. The 7/8 Gracey curets that have been never used was tested. Maxillary molars which were extracted from the School of Dental Medicine, Dankook University was used. Subjected teeth had attachment loss more than 6 mm in bucca-lingual surface and sufficient calculus of a band type in cervical area. The strokes of curet were executed 3, 5, 7, 9, 11, 13 times on scaling stroke and 10, 15, 20, 25, 30, 35 times on root planing stroke. A resident has periodontal experience over 3 years carried out the clinical examinations those tactile sensitivity examination and refraction light-white line test 5 times. The case there being tactile sensitivity certenly is 2, the case being felt tactile sensitivity is 1, and the case there not being tactile sensitivity is 0. The visual examination was recorded as following. The case that refracted white line is not recognised is 2, the case that uncerten is 1, and the case that acknowledged is 0. The results were obtained as follows. 1. After scaling strokes, the tactile sensitivity was reduced after 11 strokes and disappeared in 13 strokes. 2. In tactile sensitivity after root planing procedures, sensitivity was reduced after 25 strokes and disappeared in 35 strokes. 3. In case of visual examination, the detection of refracted white line was increased after 9 strokes of scaling procedures and the accuracy of wear wasn't showed after root planing procedures. 4. In SEM, metal projection was observed on new periodontal curet cutting edge and it was disappeared after scaling procedures. 5. In SEM, the cutting edge was showed changing linear into an aspect of the surface after 5 strokes of scaling procedures and 10 strokes of root planing procedures and showed beveled edge in 11 strokes of scaling procedures, 25 strokes of root planing procedures. The results of 3-type examination indicated that the sharpening of curet should be performed after 11 strokes of scaling procedures and 25 strokes of root planing procedures.

• Journal of Periodontal and Implant Science
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• 제29권3호
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• pp.469-484
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• 1999

The purpose of this study was to evaluate new bone formation following guided bone regeneration by resorbable and nonresorbable membrane. Six adult mongrel dogs were used. The first, second, third, fourth premolars in the mandible of each dog were extracted. Two months after tooth extraction, a buccal dehiscence defect was surgically created on each edentulous area. The experimental sites were divided into three groups according to the treatment modalities ; Group I-a: surgical treatment only ; Group I -b: allogenic decalcified freezed dried bone grafting ; Group II-a : e- PTFE membrane placement only ; Group II-b : allogenic decalcified freezed dried bone grafting and e-PTFE membrane placement ; Group III-a : Vicryl(R) mesh placement only ; Group III-b : allogenic decalcified freezed dried bone grafting and Vicryl(R) mesh placement . The animals were sacrificed at 8 weeks after operation and the specimens were prepared for histologic and histometric examination. The results were as follows : Clinically, all defect sites were healed without exposure of barrier membrane after the eight weeks. In Group I-a, dense connective tissues were impinged in the bony defect area. Well vascularized and fibrous bone marrow indicated that bone formation was still taking place was found. In Group I-b, in areas closer to the periphery, lamellation of the newly formed bone would found. In Group II-a, beneath the e-PTFE membrane a dense layer of connective tissue covering the most external portions of the regenerated tissue was seen. The new bone surfaces were lined with osteoid and osteoblast. In Group II-b, a dense layer of connective tissue covering the most external portions of the regenerated tissue was observed beneath the e-PTFE membrane. A notable amount of alveolar ridge regeneration was seen with new rigdes with well-contoured form. In Group III-a, the new bone surface were lined with osteoid and osteoblast, indicating active bone formation. A clear demarcation could not be noted between the host bone and new bone. In Group III-b, a notable amount of alveolar ridge regeneration was seen with new ridges assuming wellcontoured form. In areas closer to the periphery, lamellation of the newly formed bone would found. As histometric examination, the amount of bone formation was gained from $12.8mm^2$ to $26.3mm^2$. It was significantly greater in group II-b and group III-b compared to other groups(p<0.05) . These results suggest that Vicryl(R) mesh after DFDB grafting used in guided bone regeneration could create and sustain sufficient space for new bone formation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권2호
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• pp.142-149
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• 2008

The purpose of this study was to evaluate histomorphometrically a toothash - plaster of Paris mixture associated with collagen membrane ($Bio-Gide^{(R)}$), regarding new bone formation in the peri-implantitis defects in dogs. Three mandibular molars were removed from 1-year-old mongrel dogs. After 2 months of healing, 2 titanium implants with sandblasted with large grit and acid etched (SLA) surface were installed in each side of the mandible. Experimental peri-implantitis was induced with ligatures after successful osseointegration. Ligatures were removed after identification of bone defect beneath the level of 5th thread of fixture on radiographic image. The mucoperiosteal flaps were elevated and the contaminated fixtures were treated with chlorhexidine and saline. The bone defects were assigned to one of the following treatments: no guided bone regeneration (GBR) procedure (group 1), GBR with Bio-$Oss^{(R)}$ and Bio-$Gide^{(R)}$ (group 2), or GBR with toothash - plaster of Paris mixture (TPM) and Bio-$Gide^{(R)}$ (group 3). The dogs were sacrificed after 8 or 16 months. The mean percentages of new bone formation within the limits of the 5 most coronal threads were $17.83{\pm}10.69$ (8 weeks) and $20.13{\pm}13.65$ (16 weeks) in group 1, $34.25{\pm}13.32$ (8 weeks) and $36.33{\pm}14.21$ (16 weeks) in group 2, and $46.33{\pm}18.39$ (8 weeks) and $48.00{\pm}17.78$ (16 weeks) in group 3, respectively. The present study confirmed statistically considerable new bone formation within the threads in group 3 compared with group 1 at 8 and 16 weeks (P<0.05). Although, data analysis did not reveal significant differences between group 2 and 3, the latter showed better results during the period of 8 or 16 weeks. Our findings support the effectiveness of TPM as a GBR material in the treatment of peri-implantitis bone defect.

• Journal of Periodontal and Implant Science
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• 제27권1호
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• pp.217-234
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• 1997

The purpose of present study is to compare the effect of treatment using $Guidor^{(R)}$ as a barrier membrane in conjunction with platelet-derived growth factor and insulin like growth factors on experimental dehiscence defects. Following the resection of premolar crowns, roots were submerged. After 12 weeks of healing period, experimental dehiscence defects of 4mm in height and 4mm in width were surgically created on the mid-facial aspect of the lower premolar roots in each of 4 adult dogs. After root planning and demineralization of the root surface with citric acid, the control groups received 4% methylcellulose gel only, the test group I received 4% methylcellulose gel and were covered by $Guidor^{(R)}$ and the test group II were treated with PDGF and IGF and 4% methylcellulose gel with $Guidor^{(R)}$ coverage. Histological and histomorphometric analysis following 8 weeks of healing revealed the following results. 1. The new bone formation showed no statistically significant difference in all groups with $0.59{\pm}0.82mm$($14.03{\pm}19.60%$) for control, $0.70{\pm}0.39mm$($16.30{\pm}9.01%$) for group I, $0.87{\pm}0.76mm$($18.74{\pm}16.03%$) for group II. 2. The new cementum formation showed no statistically significant difference in all groups with $0.54{\pm}0.48mm$($l6.38{\pm}14.57%$) for control, $0.95{\pm}0.38mm$($23.43{\pm}9.30%$) for group I, $1.01{\pm}0.75mm$($22.10{\pm}16.ll%$) for gorup II. 3. The root resorption showed statistically significant differences betweenthe control group and all test groups(p<0.05) with $2.11{\pm}0.53mm$($52.93{\pm}12.32%$) for control, $0.63{\pm}0.27mm$($15.32{\pm}7.05%$) for group I, $0.89{\pm}0.33mm$ ($19.26{\pm}7.11%$) for group II. On the bases of these results, there were no statistically difference between treatment using resorbable membrane and resorbable membrane in conjunction with PDGF and IGF in the dehiscence defects, where it was difficult to maintain space. The use of membrane seemed to be more effective in the inhibition of root resorption.

• Journal of Periodontal and Implant Science
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• 제23권1호
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• pp.97-108
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• 1993

치주조직의 초기치유과정에서 가장 중요한 역할을 하는 치주인대세포의 부착과 전개에 대한 형태학적 관찰을 위하여 교정치료 목적으로 발거된 치아로부터 치주인대조직을 채취하여 초기배양하고 동일한 양($5{\times}10^3ml$)의 치주인대 세포를, 2장의 유리가 포함된 35mm 배양접시에 접종한 후, $CO_2$ 배양기에서 배양하여 세포배양개시후 10분, 30분, 90분, 6시간, 12시간, 24시간의 시간간격에 따라서 광학위상차현미경과 주사전자현미경을 이용하여 세포부착과 전개양상을 관찰한 결과 다음과 같은 결과률 얻었다. 10분간 배양한 세포는 구형을 나타내었으며, 기질측의 세포질이 박판엽상으로 확장되어 기질에 부착개시한 양상이 보였다. 배양 30분 후 판모양의 세포돌기인 박판상돌기에서 세사상돌기롤 내어 부착하는 양상이 관찰되었고, 세포표면은 소기포와 미세융모로 덮여 있었다. 90분간 배양한 세포에서 핵은 세포의 중심부에 위치하였고 세포질이 방사선상으로 확장되어 부착된 양상을 보였으며, 미전개된 세포중심부에는 미세융모와 소기포로 덮여져 있었다. 배양 6시간 후 세포는 신장된 양상을 보였고 타원형의 핵이 관찰되었다. 세포의 양극에서 박판상돌기가 관찰되었고 다시 세사상돌기가 분지되는 양상을 보였는데 이 돌기의 말단부는 팽대되어 기질에 부착하였다. 12시간 배양한 후의 치주인대 세포는 뚜렷한극성화를 보이면서 길게 신장된 양상을 나타내었다. 배양 24시간 경과후 신장된 양상의 핵이 세포의 한쪽극에 치우쳐 있었으며, 세포외형은 길게 신장된 방추상의 형태가 관찰되었다.

• Journal of Periodontal and Implant Science
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• 제44권1호
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• pp.13-19
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• 2014

Purpose: The purpose of this study was to retrospectively evaluate the survival of periodontally hopeless teeth that were intentionally extracted and replanted after a delay and to compare the radiographic characteristics of the survival group with those of the failure group. Methods: The clinical and radiographic data from patients who underwent delayed intentional replantation between March 2000 and July 2010 were reviewed. Twenty-seven periodontally hopeless teeth were extracted and preserved in medium supplemented with antibiotics for 10-14 days. The teeth were then repositioned in the partially healed extraction socket and followed for 3 to 21 months. The radiographic parameters were analyzed using a paired t test and the cumulative survival rate was analyzed using Kaplan-Meier analysis. Results: Seven replanted teeth failed and the overall cumulative survival rate was 66.4%. In the survival group, the amount of bone loss was reduced from 68.45% to 34.66% three months after replantation. There was radiologic and clinical evidence of ankylosis with 5 teeth. However, no root resorption was found throughout the follow-up period. In the failure group, bone formation occurred from the bottom of the socket. However, a remarkable radiolucent line along the root of a replanted tooth existed. The line lengthened and thickened as time passed. Finally, in each case of failure, the tooth was extracted due to signs of inflammation and increased mobility. Conclusions: Delayed intentional replantation has many advantages compared to immediate intentional replantation and could serve as an alternative treatment for periodontally involved hopeless teeth. However, techniques for maintaining the vitality of periodontal structures on the tooth surface should be developed for improved and predictable results.

• 대한심미치과학회지
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• 제22권1호
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• pp.30-46
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• 2013

치과에서 수복물제작에는 지난 50년간 금속을 이용한 금속도재관이 많이 사용되어 왔다. 그러다 보니 심미적이고 생체 친화적이며 금속 알러지등의 문제로 인한 환자들의 사고의 변화에 따라서 'metal free restoration'에 대한 관심이 점점 높아지고 있다. 특히 그 동안 많이 사용되어왔던 귀금속 가격이 급등하여 더 이상 구강 내 수복 물로써 제 역할을 하는 것은 불가능하게 되었으며, PFM수복은 술자로 하여금 chipping과 파절로 인한 문제점을 안고 있다. 따라서 구치부 임플란트 수복물로써 보다 심미적이고 강도가 높은 재료의 요구로 인하여 그 어느 때보다 CAD/CAM이 주목을 받고 있다. Full zirconia 수복을 위해서 고려해야 할 사항은 1. 강도 2. 콤비네이션 작업은? 3. 빛 투과성은? 4. crack이 발생한 경우의 처치는? 5. 블럭의 색조 재현상은? 6. 대합치 마모도 7. 저온 열화 현상 등을 들 수가 있는데, 본 연구에서는 블럭의 색조 재현상에 대해서 정리하고자 한다. Full zirconia 수복을 꺼려하는 가장 커다란 이유 중에 하나가 바로 기존의 PFM 수복과 비교했을 때 자연스러운 색조를 재현하기가 어렵다는 점이며, 교합 조정 후에 컬러링한 표면이 삭제된 후 나타나는 보기 싫은 블럭의 노출로 인하여 많은 임상가들이 꺼려하고 있다. 지르코잔의 블럭을 약 4년 여 동안 사용하면서 이러한 점들은 어느 정도 극복되어질 수 있는 문제라고 여겨지며, 어떻게 하면 그 가급적 주변 보철물 또는 자연 치아와의 조화 이룰 수 있는 수복물을 만들 수 있을 것인가에 관해 정리였다.

• Journal of Periodontal and Implant Science
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• 제38권1호
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• pp.97-102
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• 2008

Purpose: Periodontal intrabony defects have great deal of importance since they contribute to the development of periodontal disease. Current treatment regimens for intrabony defects involve grafting of numerous bony materials, GTR using biocompatible barriers, and biomodification of root surface that will encourage the attachment of connective tissue. Xenograft using deproteinized bovine bone particles seems to be very convenient to adjust because it doesn't require any donor sites or imply the danger of cross infections. These particles are similar to human cancellous bone in structure and turned out to be effective in bone regeneration in vivo. We here represent the effectiveness of grafting deproteinized bovine bone particles in intrabony defect and furcation involvements that have various numbers of bony walls. Materials and methods: Open flap debridement was done to remove all root accretions and granulation tissue from the defects within persisting intrabony lesions demonstrating attachment loss of over 6mm even 3 months after nonsurgical periodontal therapy have been completed. Deproteinized bovine bone particles($BBP^{(R)}$, Oscotec, Seoul) was grafted in intrabony defects to encourage bone regeneration. Patients were instructed of mouthrinses with chlorohexidine-digluconate twice a day and to take antibiotics 2-3 times a day for 2 weeks. They were check-up regularly for oral hygiene performance and further development of disease. Probing depth, level of attachment and mobility were measured at baseline and 6 months after the surgery. The radiographic evidence of bone regenerations were also monitored at least for 6 months. Conclusion: In most cases, radio-opacities increased after 6 months. 2- and 3-wall defects showed greater improvements in pocket depth reduction when compared to 1-wall defects. Class I & II furcation involvements in mandibular molars demonstrated the similar results with acceptable pocket depth both horizontally and vertically comparable to other intrabony defects. Exact amount of bone gain could not be measured as the re-entry procedure has not been available. With in the limited data based on our clinical parameter to measure pocket depth reduction following $BBP^{(R)}$ grafts, it was comparable to the results observed following other regeneration techniques such as GTR.

• 구강회복응용과학지
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• 제35권3호
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• pp.160-169
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• 2019

목적: 이번 연구의 목적은 정적인 방법과 동적인 방법으로 형성된 지르코니아 표면에 부착된 바이오필름에 대한 LED 칫솔의 항균 효과를 평가하고자 하였다. 연구 재료 및 방법: 구강 바이오필름을 형성하기 위해 직경 12 mm, 두께 2.5 mm의 지르코니아 디스크를 24-well plate(정적 방법)와 Center for Disease Control and Prevention (CDC) biofilm reactor (동적 방법)에 디스크를 넣어 바이오필름을 형성하였다. 디스크는 아무 처치도 하지 않은 대조군, 상용화된 광역학(PDT) 키트, 치솔질(brushing) 단독, LED 치솔군, LED 치솔과 에리스로신을 같이 적용한 군, 이렇게 5개 그룹으로 구성하였다. 각 군별 처치 후, 개별 디스크를 시험관에 넣고 60 초 동안 vortexing하여 세균을 분리한 후, 분리된 세균 용액을 선택 배지를 이용하여 살아있는 세균 수를 확인한 후 실험 방법에 따른 항균 효과를 계측하였고, 주사전자현미경(SEM)을 통하여 세균의 형태 변화를 관찰하였다. 결과: 바이오필름의 형성과 구성비는 동적인 방법과 정적인 방법에 따른 차이는 관찰되지 않았다. 대조군과 실험군간에 세균의 생존률에 유의한 차이가 있었다(P < 0.05). LED 치솔과 에리스로신을 같이 적용한 군에서 가장 높은 항균 효과가 관찰되었다(P < 0.05). 주사전자현미경 사진상에서 광역학치료군과, LED 치솔군, LED 치솔과 에리스로신을 같이 적용한 군은 세균의 형태 변화가 관찰되었으나, 대조군과 치솔질 단독 사용군에서는 세균의 형태 변화가 관찰되지 않았다. 결론: 이번 연구 결과 지르코니아 표면에 부착된 바이오필름을 효과적으로 제거하는 방법으로 LED 치솔과 에리스로신을 같이 적용하는 것이 추천된다.

• 대한방사선치료학회지
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• 제26권2호
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• pp.329-336
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• 2014

목 적 : 인공 유방 확대술을 받은 환자가 유방암 방사선치료를 받을 경우 유방의 크기별로 치료 조사야와의 거리에 따른 치료반대 측 유방조직에 피폭되는 선량 및 차폐의 효율성을 평가해 보고자 한다. 대상 및 방법 : 인체팬텀(Rando-phantom)을 이용하여 유방 모형의 크기별 (200 cc ~ 500 cc) CT영상을 획득한 후 크기 별로 일 선량 180 cGy의 왼쪽 유방암 방사선 치료계획을 세웠다. 유방 모형이 커질수록 치료 반대 측 유방모형의 표면과 X선의 진행지점 사이에 발생하는 거리가 가까워지게 설정하였고, 체표에 입사하는 선속중심축을 기준으로 3 cm, 6 cm 떨어진 점에서 반대측 유방 표면에 수직으로 내린 거리를 각 A point, B point로 설정하였다. 그리고 유두지점에서 외측으로 2 cm 되는 점을 C point, 체표중앙에서 외측으로 6 cm 되는 점을 D point로 설정하였다. 유방 모형의 크기별로 각 측정지점에 MOSFET을 부착하여 6 MV, 10 MV, 15 MV의 X선 에너지로 조사하여 측정하였다. 이와 동일한 조건으로 납 2 mm의 두께로 차폐한 후의 선량 값과 납 2 mm 아래에 bolus 3 mm를 부착하여 차폐한 후의 선량 값을 얻었다. 결 과 : 유방 모형이 200 cc에서 500 cc로 커짐에 따라 유방 모형의 표면과 X선의 진행지점과의 거리가 A point에서는 2.14 cm에서 최대 1.23 cm으로 근접하였고 B point에서는 2.55 cm에서 1.31 cm으로 근접하였다. 유방 모형의 크기에 따라 180 cGy 기준으로 200 cc 대비 500 cc의 산란선 측정값이 A point에서 3.22 ~ 4.17%, B point에서 4.06 ~ 6.22%, C point는 0.4~0.5% 증가하였고, D point에서는 크기별로 측정값의 차이가 0.4% 미만이었다. X선 에너지가 커짐에 따라 6 MV 대비 15 MV X선에서 180cGy 기준으로 산란선이 A point에서는 4.06~5%, B point에서는 2.85~4.94%, C point에서는 0.74~1.65% 증가하였고, D point에서는 측정값 차이가 0.4% 미만이었다. 차폐체로 납 2 mm를 사용하였을 경우 A와 B point에서 평균 9.74%, C point에서 2.8%, D point에서 1% 미만의 산란선 감소효과가 있었고, 납과 bolus를 함께 차폐하였을 경우 A와 B point에서 평균 9.76%, C point에서 2.2%, D point에서 1% 미만의 산란선 감소효과가 있었다. 결 론 : 일반적으로 인공 유방 확대술을 받은 환자의 경우 유방의 크기에 따라 치료 반대편 유방 표면과 치료조사야의 거리가 가까울수록 유방 표면이 받는 산란선이 증가하였다. 동일한 크기의 유방 모형에서는 사용 X선 에너지가 커질수록 산란선에 의한 피폭이 증가하는 경향을 보였고, 이는 사용 X선의 에너지 선택에 있어 유방암의 방사선 치료계획에서 허용되는 한도에서는 낮은 X선 에너지의 사용이 반대측 유방의 선량 감소에 유리할 것으로 여겨진다.