• 대한치과의사협회지
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• 제48권3호
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• pp.190-195
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• 2010

Oral appliance therapy is a simple, reversible way for improving snoring and/or obstructive sleep apnea. It may be indicated for the patients who are unable to tolerate continuous positive airway pressure (CPAP) or who have potential risks for surgical intervention. Oral appliance therapy increases airway space by the providing stable anterior positioning of the mandible, pulling out tongue, lifting up soft palate, or changing the muscle activity of the genioglossus. Currently, more than 80 different types of oral appliances have been introduced for snoring and/or obstructive sleep apnea. They are classified by their characteristics such as mode of action, adjustability and material used. This article provides a detailed clinical protocol and treatment procedure for oral appliance therapy.

• 대한치과의사협회지
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• 제57권5호
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• pp.270-278
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• 2019

Oral appliances therapy is becoming increasingly recognized as a successful treatment for snoring and obstructive sleep apnea(OSA). Compared with continuous positive airway pressure(CPAP), the gold standard therapy for OSA, oral appliance therapy are less efficacious for severe OSA but are more acceptable and tolerable for patients, which in turn, may lead to a comparable level of therapeutic effectiveness. Nevertheless, the various side effects of oral appliance therapy, such as, increased salivation or dryness, pain or discomfort in the teeth or gums, occlusal discomfort in the morning, temporomandibular disorders, dental and occlusal changes may cause discontinuation of treatment or changes in treatment plan. Therefore, oral appliance therapy should be provided by a qualified dentist who can evaluate oral tissues, occlusion, and temporomandibular joints, and prevent and manage the possible side effects.

• Journal of Oral Medicine and Pain
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• 제45권2호
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• pp.29-33
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• 2020

Tardive dyskinesia (TD) is continuous, repetitive movement disorder of tongue, lip or jaw, induced by medication. It causes pain and dysfunction of oral structures but also interferes with dental treatment and overall social life of patients. As a dentist, it is imperative to recognize and manage TD, although currently, there is no definitive treatment for TD. This article reports a patient with TD of tongue, successfully managed with an oral appliance mimicking sensory tricks. Considering the limited treatment options for TD, an oral appliance, a simple and conservative approach, can be a meaningful treatment for some patients with orofacial dyskinesia.

• 턱관절균형의학회지
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• 제8권1호
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• pp.1-5
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• 2018

Objectives: The purpose of this review is to analyse the trends of clinical studies using oral appliance in Korean Medicine. Methods: We reviewed Korean Medicine papers by searching Korean web databases 'Korea Traditional Knowledge Portal (KTKP)', 'Korea Medical Information Portal (OASIS)', 'Academic Research Information Service (RISS)', 'Scientific and Technological Information Integration Service (NDSL)'. We classified the papers by the year of publishment, the title of journals, the type of study and contents. Results: 1. Clinical studies using oral appliance have been increasingly published since 2011. 2. Most of the studies were published in the Journal of TMJ Balancing Medicine. 3. 33 research papers were divided in to 6 original articles, 27 case reports. But almost presented a low level of evidence. 4. In the content of the studies, oral appliance were used for various diseases such as nervous system, musculoskeletal system and visceral system. Conclusions: We expect that various studies and clinical application will be actively carried out with the development of technology related to oral appliance.

• Journal of Oral Medicine and Pain
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• 제46권3호
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• pp.84-87
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• 2021

Morsicatio buccarum is a condition caused by chronic cheek biting. It means frictional hyperkeratosis by repetitive cheek biting, which may be associated with obsessive compulsion. Clinically it presents as rough, shaggy, whitish, often peeling surface. We report a 9-year-old female patient who complained oral ulceration on both buccal mucosa. The initial diagnosis was oral candidiasis because of whitish plaques which were peeled off. Topical antifungal agent was ineffective and the symptom did not disappear. By incisional biopsy, she was diagnosed with morsicatio buccarum. A soft oral appliance was placed in the patient's oral cavity. Although morsicatio buccarum improved significantly when the appliance was used, the oral lesion had a tendency to recur, when the patient stopped using the appliance. In case of recurrence, cognitive behavioral therapy for obsessive-compulsive disorder is needed for the fundamental treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권1호
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• pp.71-80
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• 2021

Background: The options for stabilization appliance therapy for masticatory muscle pain include soft occlusal and hard stabilization appliances. A previous study suggested that hard stabilization appliance therapy was effective for patients with local myalgia who developed long facets on their occlusal appliances. The objective of this study was to identify patients in whom a soft occlusal appliance should be used to treat masticatory muscle pain by analyzing the type of muscle pain present and patient factors that influenced the effectiveness of this treatment. Methods: The study included 42 patients diagnosed with local myalgia or myofascial pain according to the Diagnostic Criteria for Temporomandibular Disorders Diagnostic Decision Tree. The analysis of patient factors included variables believed to be associated with temporomandibular disorders. First, a temporary screening appliance was used for 2 weeks to assess each patient for bruxism during sleep. Soft appliance therapy was then started. For each patient, the effectiveness of the appliance was evaluated according to the intensity of tenderness during muscle palpation and the treatment satisfaction score at one month after starting treatment. Results: Data from 37 of the 42 patients were available for analysis. Twenty-five patients reported satisfaction with the appliance. In logistic regression analysis, the odds ratio for reduction of facet length was 1.998. Nineteen patients showed at least a 30% improvement in the visual analog scale score. The odds ratio for local myalgia was 18.148. Conclusion: Soft appliance therapy may be used in patients with local myalgia. Moreover, patients who develop short facets on the appliance surface are likely to be satisfied with soft appliance therapy. Soft appliance therapy may be appropriate for patients with local myalgia who develop short facets on their occlusal appliance.

• Journal of Oral Medicine and Pain
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• 제43권4호
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• pp.112-117
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• 2018

Purpose: The aim of this study is to compare the short-term effectiveness of hard and soft stabilizing appliances (H-A and S-A) in treating patients with acute temporomandibular joint (TMJ) disc displacement without reduction (DDwoR). Methods: Eighty one patients diagnosed as acute TMJ DDwoR at oral medicine of Chosun University Dental Hospital from November 2016 to September 2017 were included in this study. The subjects were divided into three groups: The control group (34 patients treated without occlusal appliance), the H-A group (31 patients treated with H-A) and the S-A group (16 patients treated with S-A). The pain intensity using Visual Analog Scale and maximum mouth opening (MMO) were evaluated every week for 8 weeks. Results: The improvement of the pain intensity and MMO in the H-A group and the S-A group compared with the control group were noted (p<0.05). Conclusions: This study suggests that hard and S-As may be equally useful in treating patients with TMJ DDwoR. S-A could be recommended to reduce the symptoms of TMJ DDwoR in short period.

• Journal of Oral Medicine and Pain
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• 제25권2호
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• pp.247-251
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• 2000

Snoring, the sign of obstructive sleep apnea may cause medical problems and also a serious problem in human relationship. Some of the treatment methods for snoring patients are drug therapy, intraoral appliance, surgical operation, etc. This is a case report of a 48 years old female patient who continuously complained about snoring after uvulopalatopharyngoplasty and a remarkable improvement of the symptom after the delivery of an oral appliance.

• 대한소아치과학회지
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• 제32권4호
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• pp.675-681
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• 2005

성장기 아동의 III급 부정교합의 치료에는 많은 악기능 정형장치가 사용되어 왔으며 다양한 형태로 변화하여 발전되어 왔다. Horseshoe appliance는 Schwarz에 의해 소개된 장치로서 elastic의 견인력으로 장치의 free sliding 효과를 통해, 하악와와 과두의 관계를 재정립시켜, 악골 주위의 연조직이나 muscle matrix와 조화되는 새로운 위치에 하악골을 repositioning 시켜 악골관계를 개선시킬 수 있다. 또한 하악의 후하방 회전 효과를 극소화시켜 전안면고경의 증가를 방지할 수 있고, 구외장치에 비해 환자의 협조도가 좋다. 저자들은 전치부 반대교합을 주소로 전북대학교 치과병원 소아치과에 내원한 III급 부정교합 환자에게 Horseshoe appliance를 사용한 결과 하악골에 대한 상대적인 상악골의 전방 성장과 교합평면의 반시계방향 회전, 상악 전치의 순측 경사와 하악 전치의 설측 경사로, 3개월 내에 전치부 반대교합이 해소되는 효과를 얻었다.

• Journal of Oral Medicine and Pain
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• 제32권4호
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• pp.375-381
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• 2007

교합안정장치는 턱관절장애의 관리를 위해 가장 많이 선택되어지는 치료방법이다. 교합안정장치는 치료목적을 달성하기 위해 구강 내에서 매일 수 시간씩 착용하며, 전체적인 치료기간은 적게는 6개월에서 길게는 2년 가량이 소요된다. 구강 내에서 교합안정장치는 틀니나 고정식 교정장치의 경우처럼 의도하지 않게 타액이나 산소로부터 세균을 보호하고, 세균의 저장고로서 역할을 수행할 수 있는 가능성이 있다. 이런 조건은 일반적으로 치주질환과 구취를 유발하는 주요 원인균인 혐기성 세균과 치아우식에 중요한 역할을 하는 S. mutans의 서식에 용이한 환경을 제공하게 되어 교합안정장치을 사용하게 되면서 발생되는 나쁜 맛이나 치주질환, 치태 형성 및 치아우식의 원인요소가 될 수 있다. 이 실험에서는 교합안정장치 사용 전후 구강 내 특정 치아에서 혐기성 세균과 S. mutans 수의 변화를 비교함으로써 교합 안정장치가 이들 세균 수 증가에 어떠한 영향을 끼치며, 그것이 임상적으로 어떤 의미를 가지는지에 대해 알아보고자 하였다. 총 4명의 남성(평균나이 27.5 세)이 참여하였고, 하루 9시간씩 상악교합안정장치를 취침시간 동안에만 사용하였으며, 총 5일 간 진행하였다. 5일 후 교합안정장치를 제거한 구강에서 상악좌측제2대구치, 상악좌측중절치, 하악좌측제2대구치를 각각 선택하여 치태와 타액이 혼재된 샘플을 정해진 규격으로 채취하였다. 각각의 샘플은 혐기성 세균 배양을 위한 혈액한 천배지와 S. mutans 선택배지에 각각 $100{\mu}{\ell}$씩 도말하여 $37^{\circ}C$ 10% $CO_2$ 조건으로 3일간 혐기 배양하였다. 각각의 배지에서 배양된 세균을 집락형성단위(CFU) 기준으로 육안으로 세어 최종적으로 CFU/ml로 환산해 기록하였다. 얻어진 자료를 통해 다음과 같은 결론을 내렸다. 1. 교합안정장치 사용에 따라 구강 내 혐기성 세균 수와 S. mutans 수의 변화가 생겼다. 2. 혐기성 세균의 경우 교합안정장치 사용에 따라 상악제2대구치(P=0.003)와 상악중절치(P=0.020)에서 모두 그 수가 유의하게 증가하였다. 3. 교합안정장치의 장착은 직접 피개되지 않은 대합치아의 혐기성 세균 수 증가에도 간접적인 영향을 끼쳤다. 4. S. mutans의 경우 교합안정장치 사용에 따라 상악제2대구치(P=0.043)와 상악중절치(P=0.049)에서 모두 그 수가 유의하게 증가하였다. 5. 교합안정장치의 장착은 직접 피개되지 않은 대합치아의 S. mutans 수에 어떤 영향도 끼치지 않았다.