• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권4호
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• pp.143-150
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• 2018

The number of geriatric patients seeking dental service is ever-rising because of increased life expectancy, also with problem of increased chronic medical conditions. One of them are patients on anti-thrombotic medication. Bleeding complication after minor oral surgery by anti-thrombotic agents is of concerns to dentists on dental management of these patients. Risk and benefit of the anti-thrombotic agents must be weighed before initiating dental procedures, which should be established as a treatment guideline. Purpose of the paper is to optimize the management of the dental patients on antithrombotic medication via standardization of treatment protocol of such a patient.

• 융합정보논문지
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• 제10권3호
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• pp.134-140
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• 2020

본 연구의 목적은 노인요양시설 거주 노인과 비거주 노인의 구강건강상태를 비교하는 것이었다. 연령, 성별, 기초생활수급상태가 동일한 469명을 매칭하여 구강건강상태를 비교분석하였다. 노인요양시설 거주 노인들은 시설 비거주 노인보다 치아우식 우병률(p=0.019), 우식영구치수(p=0.001), 상실영구치수(p=0.047)가 더 높았고 충전영구치수(p<0.001)는 더 낮은 것으로 확인되었다. 시설 거주 노인들은 비거주 노인들보다 치아우식에 유병될 확률이 1.93배 더 높았고, 충전치아를 가지게 될 확률은 0.73배였다. 의치를 장착하게 될 확률은 상악이 0.15배, 하악이 0.13배였으며, 의치필요도는 상악이 5.61배, 하악이 5.65배였다. 의치 장착여부 및 필요도에 대한 보정된 오즈비는 모두 유의한 것으로 나타났다. 이 결과를 바탕으로 노인요양시설 거주 노인의 구강건강증진을 위한 구강보건정책 수립을 위한 근거 자료로 활용할 수 있을 것으로 생각된다.

• 한국치위생학회지
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• 제9권1호
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• pp.153-168
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• 2009

This study was executed to find out the outcome of Incremental Dental Care from September to November, 2004. 40 visitors to oral health center were examined on the oral conditions every week, seven times during above-mentioned period. Various tests were practiced in order to check their oral conditions before and after IDC such as tooth-brushing method/frequency/duration, calculus index, PHP index, halitosis and dental caries activity. Question and answer sheets were presented to student dental hygienists and 40 visitors respectively after IDC program. Results obtained are as follows. 1. Rotation method of toothbrushing increased from 27.8% to 88.9%. for men and increased from 27.3% to 95% for women. 2. Toothbrushing frequency increased from 2.8 times to 3.0 times a day for men and increased from 2.6 times to 3.1 times for women. Toothbrushing duration increased from 2.3 minutes to 2.8 minutes for men and increased from 2.1 minutes to 2.9 minutes for women. 3. Calculus index reduced from 0.5 to 0.1 for men and reduced from 0.7 to 0 for women. PHP index reduced from 3.7 to 3.0 for men and reduced 3.2 to 1.7 for women. However, halitosis didn't mark any significant difference before and after IDC. 4. Saliva buffering capacity of medium plus showed no change for men(94.5%), however increased from 95.4% to 100% for women. Dental caries activity of medium plus in S.mutans reduced by 4.3 times(72.2% to 16.7%) for men and reduced by 2 times(36.4% to 18.1%) for women. LB test results reduced by 1.5 times(50% to 33.3%) for men and reduced by 2.5 times(50% to 18.1%) for women. Alban's test results reduced by 1.4 times(83.3% to 61.1%) for men and reduced by 1.2 times(81.8% to 68.2%) for women. 5. All participants including visitors and students realized the importance of IDC and expressed a great satisfaction with IDC program. In conclusion, it is considered very necessary that IDC program should be maintained and extended to whole country so as to enhance the peoples' oral health conditions.

• 치위생과학회지
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• 제13권4호
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• pp.426-433
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• 2013

본 연구는 국민건강영양조사 제4기 자료를 이용하여 미취학 아동의 치아우식상태와 어머니 구강건강상태와의 관련성을 파악하고자 하였다. 원시자료에서 가족 아이디 변수를 이용해 아동과 어머니를 짝짓기하여 최종 823명의 자료를 추출하였다. 통계분석은 복합표본설계를 반영하기 위하여 가중치를 고려한 분석을 실시하였으며, 어머니의 인구사회학적 특성과 구강건강행태 및 구강건강상태에 따른 자녀의 우식경험유치지수의 차이를 분석하고, 이들 간의 관련성을 알아보기 위해 다중회귀분석을 시행하였다. 분석결과, 미취학 아동의 우식경험유치지수는 어머니의 사회인구학적 특성 중 나이에 따른 차이가 통계적으로 유의하였으며 (p=0.005), 어머니의 구강건강행태 중 지난 1년 동안 치과검진 유무에 따른 차이가 통계적으로 유의하였다(p=0.034). 또한 어머니의 우식경험영구치지수에 따른 자녀의 우식경험유치지수의 차이도 통계적으로 유의하였다(p=0.016). 한편 어머니의 인구사회학적 특성과 구강건강행태를 보정한 후, 어머니와 자녀의 구강건강상태 관련성을 분석한 결과 어머니의 우식경험영구치지수는 자녀의 우식경험유치지수와 유의한 관련성이 있는 것으로 나타났다. 따라서 어머니의 구강건강상태가 양호할수록 자녀의 구강건강상태 또한 양호함을 알 수 있었다. 이러한 연구 결과는 어머니의 구강건강상태가 자녀들에게 영향을 미칠 수 있음을 보여주므로 어머니들의 구강건강상태를 향상시킬 수 있는 효과적인 구강보건교육 프로그램이 개발되어야 한다고 생각된다.

• 치위생과학회지
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• 제15권6호
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• pp.775-785
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• 2015

본 연구는 KNHANES 제6기 1차 년도(2013년) 자료를 이용하여 성인의 구강위생용품 사용에 영향을 미치는 요인을 파악하고자 하였다. 만 19세 이상 성인 4,839명을 최종 분석대상자로 하여 다음과 같은 결론을 얻을 수 있었다. 교차분석 결과 구강위생용품의 사용(하루 칫솔질 빈도, 치실 사용 여부, 치간칫솔 사용 여부, 구강양치용액 사용 여부)은 성별, 나이, 교육수준, 가구소득, 결혼상태, 치과의료 이용, 치과검진 여부와 통계적으로 유의한 관련성을 나타냈다. 구강위생용품 사용에 미치는 변수를 로지스틱 회귀분석으로 살펴본 결과 성별, 교육수준이 공통적인 영향요인으로 나타났으며, 구강위생용품에서 모두 공통되지는 않았지만 구강건강상태와 치과의료 이용, 최근 1년간 치과검진 여부가 통계적으로 유의한 관련성을 나타냈다. 치과 전문인력인 치과위생사는 구강위생용품을 세분화하여 각 영향 요인을 인식하고 개인의 특성 및 구강상태를 반영한 구강보건교육매체 및 프로그램 개발을 통해 국민구강보건증진에 기여해야 할 것이다.

• Journal of Oral Medicine and Pain
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• 제36권4호
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• pp.225-234
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• 2011

흡연은 전신건강 뿐 아니라 구강건강에도 유해하여 구강암과 치주염의 발생, 창상치유 지연, 치아상실 등과 관련성을 가지는 것으로 알려져 있다. 이미 흡연과 구강건강의 관련성에 대한 연구가 많이 있지만, 구강건강에 대한 인식도나 위생관리 등 흡연 외의 다양한 요소가 구강건강에 영향을 줄 수 있으며 타액 분비나 구취처럼 흡연과의 관련성이 확실히 밝혀지지 않은 부분도 존재한다. 그러므로 구강위생에 대한 인식 수준이 상대적으로 높고 추적조사가 용이한 치과대학생이라는 집단에서 흡연자와 비흡연자의 구강건강을 상태를 장기적, 포괄적으로 비교한다면 흡연이 구강건강에 미치는 영향을 보다 명확하게 확인할 수 있을 것이다. 본 연구는 장기적 연구에 앞서 치과대학생 중 흡연자들의 흡연 특성을 파악하고, 흡연자들과 비흡연자들의 전반적인 구강건강상태를 비교하여 보고하고자 하였다. 2010년 4월 21일부터 2011년 4월 20일까지 단국대학교 치과대학 치의학과에 재학 중인 1학년부터 4학년까지의 남학생 224명 중 지원자 192명(85.7%)을 대상으로 하여 설문지 조사와 임상검사를 시행하였다. 설문지조사에는 흡연 양태, 음주, 니코틴의존도, 구강위생관리, 간이심리검사가 포함되었고 임상검사에는 치아 및 치주 상태, 니코틴 착색, 타액분비량, 전기 미각역치, 구취에 대한 평가가 시행되었다. 본 연구에서, 흡연자군은 금연자군, 비흡연자군에 비해 연령이 약간 높고, 음주를 하는 경우가 많았으며 알코올섭취량도 많았다(p<0.05). 세 군은 타액분비율, 구취, 전기미각역치 등의 임상조사에서는 유의한 차이를 보이지 않았으나, 양치질 횟수나 치과방문 횟수에 차이가 없음에도 불구하고 우식경험영구치율(DMFT rate), 치주가료필요 정도 및 니코틴 착색 정도에 있어서 흡연자군과 비흡연자군 사이에는 차이가 관찰되었다(p<0.05). 본 연구의 피검자들이 평균 25세로서 흡연자군이라 해도 흡연기간이 길지 않고 흡연량이나 니코틴의존도가 낮은 수준임에도 불구하고 치주조직에는 이미 유해한 효과를 주고 있다고 판단된다. 기초 자료 분석이지만 흡연은 치주조직에 신속히 영향을 미치므로 금연 치료를 조기에 시행할 필요가 있다.

• 한국치위생학회지
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• 제6권3호
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• pp.243-261
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• 2006

Priority setting in national health insurances in major advanced countries and the nation was investigated to draw the criteria for priority setting and suggest the most rational criteria for dental insurance so as to help secure the efficiency of medicare financing and individual's health right and also elevate medical consumers' satisfaction with health insurance. 1. Priorities in national health insurance are different from country to country, depending on the medical security systems, priority introducing conditions, and social environment, but have many common factors. 2. The priority setting criteria for national health insurance in those countries include the following in common: the efficiency, equity, and cost effect of treatment, emergency of treatment, consumption of expense, efficacy of treatment, patient's receptiveness, patient's demand, severity of disease, and patient's responsibility for the disease. 3. In oral diseases, severe diseases including oral cavity cancer are low in rate, and in-hospital treatments are few. From the above findings, it is suggested that dental insurance should establish discriminative criteria for priority setting by reflecting the aspects of dental diseases and system difference between dental and other health insurances and taking account of efficiency of treatment through prevention, cost effect, prevalence and incidence of generalized diseases, and individual's financing burden.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4491-4501
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• 2016

Verruco-papillary lesions (VPLs) of the oral cavity described in the literature involve a spectrum of conditions including squamous papilloma, verruca vulgaris, focal epithelial hyperplasia, condyloma, proliferative verrucous leukoplakia and verrucous carcinoma. A majority of the VPLs are slow growing, benign in nature and have a viral aetiology. Virus associated benign mucosal outgrowths are not too difficult to diagnose either clinically or by microscopy. Apart from virus-associated lesions, VPLs harboring malignant potential or behaviour such as verrucous carcinoma, proliferative verrucous leukoplakia, oral verrucous hyperplasia (OVH), oral papillary squamous cell carcinoma (PSCC) and oral conventional squamous cell carcinoma with papillary features (CSCC) need to be further clarified for better understanding of their predictable biologic behavior and appropriate treatment. Current understanding of potentially malignant VPLs is perplexing and is primarily attributed to the use of confusing and unsatisfactory terminology. In particular, the condition referred to as oral verrucous hyperplasia (OVH) poses a major diagnostic challenge. OVH represents a histopathological entity whose clinical features are not well recognised and is usually clinically indistinguishable from a verrucous carcinoma and a PSCC or a CSCC. A consensus report published by an expert working group from South Asia as an outcome of the 'First Asian Regional Meeting on the Terminology and Criteria for Verruco-papillary Lesions of the Oral Cavity' held in Kuala Lumpur, Malaysia, recognised the clinical description of these OVH as a new entity named 'Exophytic Verrucous Hyperplasia'. Previously described clinical features of OVH such as the 'blunt' or 'sharp' variants; and the 'mass' or 'plaque' variants can now collectively fall under this newly described entity. This paper discusses in detail the application of the standardized criteria guidelines of 'Exophytic Verrucous Hyperplasia' as published by the expert group which will enable clinicians and pathologists to uniformly interpret their pool of OVH cases and facilitate a better understanding of OVH malignant potential.

• Journal of Oral Medicine and Pain
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• 제49권2호
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• pp.35-39
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• 2024

Osteomyelitis of the jaw is an inflammatory process of the bone marrow that is caused by odontogenic local infection and trauma such as tooth extraction and fractures in the oral and maxillofacial region. The clinical signs include pain, swelling, pus formation, and limited mouth opening. Chronic osteomyelitis presents a diagnostic challenge because of the variability of symptoms across different disease stages and varying health conditions of the patients. This report presents a case of osteomyelitis that was misdiagnosed as a temporomandibular joint disorder (TMD) after tooth extraction. The patient was treated for inflammation after tooth extraction in the early stage; however, as the osteomyelitis progressed chronically, symptoms mimicked those of a TMD. The patient was finally diagnosed with osteomyelitis 6 months after tooth extraction. A review of this case and relevant literature revealed the necessity for a differential diagnosis of chronic osteomyelitis that mimics TMD symptoms.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권4호
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• pp.334-347
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• 2006

The aim of this study is to evaluate the reasonableness of the medical fee on oral and maxillofacial surgery field according to surgeon's opinions and actual conditions. The medical fee has significant influence on hospital income, the supply and distribution of medical manpower, quality and facilities of medical services. Questionnaire survey was sent to 86 oral and maxillofacial surgeons who worked more than 3 years in general hospital. Among them, 25 doctors replied the 109 answers survey and the average of treatment time and physician work relative value on each category was calculated. And the health insurance cost (that has been applied since 2003) was compared with the questionnaire results. And finally we investigated items that health insurance system did not include in oral and maxillofacial field but actually performed in oral and maxillofacial surgery clinic. The result was that the medical fee did not properly reflect physician work relative value of actual treatments. In case of complicated extraction, work relative value needed 3.5 times enhancement of present value. For simple impacted tooth extraction 1.8 times, for impacted tooth extraction including odontomy 1.7 times, and for fully impacted tooth more than 2/3 of it located into the alveolar bone, 1.8 times enhancement needed. In respect of the present physician work relative value, hemimandibulectomy with neck lymph node dissection for the malignancy is appropriated as 3.3 times of open reduction and internal fixation for the mandibular fracture, but the questionnaire result showed 25 times discrepancy. In conclusion, this research shows the need for intervention that health insurance included items and legal relative medical value must act in union with treatment in clinic to reduce the imbalance between them.