• 대한소아치과학회지
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• 제37권3호
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• pp.381-386
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• 2010

수직적으로 치관-치근 파절된 전치부에서 파절은 치근을 따라 다양한 부위에서 일어나기 때문에 그 깊이에 따라 치료 방법이 결정된다. 파절선이 치관부에 근접한 경우 치은 판막을 형성하여 파절 부위를 노출시키거나 교정적 또는 외과적으로 치아를 정출시키는 방법 등을 고려해 볼 수 있지만, 파절선의 위치가 깊은 경우 그 예후는 불량하며 치근의 1/3 이상을 넘어선 경우에는 발치가 일반적이다. 그러나 성장기 아동에서 상악 중절치의 발치는 심미적 문제, 치조골 흡수, 발음 문제 등 여러 합병증을 초래하게 되므로 성장기 동안 치아를 보존하는 것을 최우선의 목표로 한다. 그러므로 수직 치관-치근 파절된 전치부 치아의 치료 시 발치 대신 복합레진으로 파절선을 수복한 후 재식하는 의도적 재식술을 대안으로 선택할 수 있다. 본 증례에서는 외상으로 인하여 상악 중절치의 치관-치근 파절이 치근 1/2 정도로 깊게 발생한 혼합치열기 환아에서 해당치아를 의도적으로 발치하고 복합레진으로 파절 부위를 수복한 후 재식하였다. 이후 2년 동안 관찰한 결과 특이한 임상적 증상 없이 유지되고 있으며 심미적으로도 만족할 만한 결과를 얻을 수 있었다. 이 방법은 술식에 민감하며 장기적 예후에 대한 보고는 부족하지만, 치아를 보존할 수 있는 새로운 방법이라는 점에서 가치가 있다고 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권5호
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• pp.480-488
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• 2008

Orthodontists often treat cases which are difficult to treat with conventional orthodontics. In such cases, it could be treated with surgical procedures with the help of an oral surgeon. Especially, transverse deficiency of the mandible can be corrected by widening the transverse width of mandibular symphysis, using distraction osteogenesis. Transverse widening of mandibular sympysis is known as a safe treatment but still complications could occur during the treatment. We are reporting some complications of cases that mandibular symphysis transverse widening were applied. Some cases showed complications because of the inappropriate osteotomy line. Since straight vertical osteotomy line was inclined to the left, only the left bony segment was likely to expand. According to bio-mechanical considerations, it will be better to perform a step osteotomy, cutting the eccentric area of the alveolar crest and the centric area of the basal symphyseal area. Complications could also occur by the failure of the distraction device. The tooth borne distraction device was attached on the lingual side of the tooth with composite resin. During the distraction period, it was impossible to obtain appropriate distraction speed and rhythm because of frequent fall off of the distraction device. Therefore, distraction device should be attached firmly with orthodontic band or bone screw, etc. Tooth mobility increasement could also occur as a complication. 'Walking teeth phenomenon' was observed during the distraction period, showing severe teeth mobility and pain during mastication. These symptoms fade out during the consolidation period. Since the patient could feel insecure and uncomfortable, it should be notified to the patient before the procedure. Finally, alveolar crestal bone loss could occur. Alveolar crestal bone loss occurred because of lack of distraction device firmness and teeth trauma caused by lower lip biting habit. Therefore, adequate firmness of the distraction device and habit control will be needed.

• 대한치과교정학회지
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• 제19권2호
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• pp.57-73
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• 1989

The purpose of this study was to investigate the tissue response of the rat molar periodontium incident to intermittent orthodontic force. The author intended to observe the healing process of injured periodontium and the response of injured tissue to the resumed force. Oxytetracyclin 50mg/Kg was given to each rat intraperitonially. 5 days later, maxillary 1st molars were moved mesially from the incisors with closed coil spring of 100gram. 7 days later, the appliances were removed and 20mg/Kg of calcein were given intraperitonially to each rat. At the same time, maxillary left 1st molars of 15 rats were moved by the same method, but force was lowered to 20 gram. After 1 day, maxillary left 1st molars of another 15 rats were moved by the same method and 50mg/Kg of oxytetracycline was given intraperitonially. After 4 days, another 15 rats were treated as above. After 7 days, another 15 rats were treated as above. 1,4,7,10 and 14 days after change of force, 3 rats were sacrificed in each group respectively. 2 rats were decalcified, embedded in paraffin, and stained with hematoxylin-eosin stain and with Masson's trichrome stain. Another rat was embedded in polyester resin and undecalcified specimen were made. Microradiograms were taken with the undecalcified sections. Observations were made with light and fluorescence microscope. Following conclusions were made. 1. Connective tissue cells and vessels were infiltrated into the hyalinized tissue from the bony cleft and along the border of the hyalinized tissue with bone and root surface. At the same time, elimination of hyalinized tissue, bone and root resorption occurred. 2. Bone and root were resorbed directly and indirectly. 3. Hyalinized tissue was removed within 5 days after force removal. 4. Hyalinized zone was less extensive and easily removed as the rest period prolonged. 5. Hyalinized tissue developed more rapidly and extensively and lasted over 10 days as the force resumed on the already formed hyalinized tissue.

• 대한치과교정학회지
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• 제24권4호
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• pp.933-943
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• 1994

The present study was undertaken to determine the effect of tensile force on DNA and protein biosynthesis in bone cells, and to identify the cell type(s) which primarily respond to external physical force among the heterogenous bone cell populations. As a prerequisite for this study, two bone cell populations which retain fibroblastic and osteoblastic feature were isolated from fetal rat calvaria with sequential enzyme digestion scheme. Tensile force was delivered to each bone cell population by two acrylic resin plates connected with a orthodontic expansion screw during culture period. Rate of DNA and protein synthesis in each bone cell population were assessed by the incorporated radioactivity of $[^3H]-thymidine$ into DNA and $[^3H]-proline$ into fraction of collagenase-digestible protein and noncollagenous protein, respectively. DNA synthesis of osteoblast-like calvarial cell populations was increased significantly by the application of tensile force for 24 hours. In contrast, no alteration in DNA synthesis of fibroblast-like populations could be observed in response to applied force. Tensile force induced the change in protein synthesis of bone cell populations with the same pattern. Total protein and collagen synthesis were increased whithin 24 hours in osteoblast-like populations, but not in fibroblast-like populations by tensile force application. These findings indicate that physical force can affect cellullar activity of the particular cell population, not all cell Populations residing in bone and osteoblasts respond more sensitively than fibroblasts. So osteoblasts can modulate the behavior of other bone cells including osteoclasts by producing several local regulating factors of bone metabolism. In this context, preferential responsiveness of osteoblasts to applied tensile force observed in this study suggests that osteoblasts may play an important role in regulation of physical force-induced remodelling process.

• 대한치과교정학회지
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• 제43권5호
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• pp.242-247
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• 2013

Objective: To test the null hypothesis that no difference exists between the effects of at-home bleaching and in-office bleaching on shear bond strength (SBS) with bracket bonding at 4 different time intervals after dental bleaching. Methods: Ninety extracted human premolars were randomly divided into 9 groups (n = 10) according to the bleaching methods used (at-home bleaching and in-office bleaching) and the storage time in artificial saliva (30 min, 1 day, 2 weeks, and 3 weeks before bonding). The control group was stored in artificial saliva for 7 days. Brackets were bonded with the Transbond XT adhesive system, and SBS testing was performed. The adhesive remnant index (ARI) was used to assess the amount of resin remaining on the enamel surfaces after debonding. The SBS data were analyzed by analysis of variance (ANOVA) and the Tukey test. For the ARI, the Kruskal-Wallis test was performed. Significance for all statistical tests was predetermined to be p < 0.05. Results: The SBS of the unbleached group was significantly higher (p < 0.05) than that of the bleached groups (except for the group bonded 30 min after at-home bleaching). Conclusions: The null hypothesis was not totally rejected. All bleaching groups tested had decreased SBS of the brackets to the enamel, except for the group bonded 30 min after at-home bleaching. The SBS returned to values close to those of the unbleached enamel within 3 weeks following bleaching.

• 대한심미치과학회지
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• 제10권1호
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• pp.30-45
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• 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.

• 대한치과보철학회지
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• 제53권3호
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• pp.244-249
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• 2015

최근 디지털 기술이 발달하면서 임플란트 식립 시 가이드 템플릿을 이용하는 컴퓨터 가이드 수술이 활발하게 이루어지고 있으며, 임플란트 보철시 구강스캐너를 이용하는 방법이 소개되고 있다. 가이드 템플릿의 제작방법은 크게 RP 제작 시스템과 벡터 밀링 시스템으로 나눌 수 있는데, 각각은 우수한 정확성에도 불구하고 임상적 적용에 있어 약간의 아쉬운 점을 보이고 있다. 이에 본 증례에서는 CBCT 및 구강스캐너로 획득한 디지털 영상을 이용하여 쾌속조형법으로 왁스재료의 작업모형을 제작하고 그 위에 교정용 레진으로 금속애관을 픽업해 내는 방법을 사용하여 임플란트 수술용 가이드 템플릿을 제작하여 수술에 사용하였으며, 임상적으로 임플란트 식립 및 최종보철물 제작 시 만족스러운 결과를 얻을 수 있어서 이를 보고하고자 한다.

• 대한소아치과학회지
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• 제27권2호
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• pp.256-261
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• 2000

파절의 종류는 치관파절 치근파절, 동시에 나타난 치관-치근파절이 있고 치수노출에 따라 단순파절과 복잡파절로 나뉜다. 치아파절이 치은 연하로 침범하여 치아장축을 따라 나타난 경우나 치근의 1/3 이상을 넘어선 경우 발치가 원칙이다. 그러나 치근쪽 파절편을 교정적으로 정출시켜서 수복시켜 주는 방법과 인위적으로 발치하여 적절하게 수복 가능한 위치로 재식 시켜주는 방법을 선택적으로 이용할 수 있다. 본 증례에선 치아외상으로 상악 중절치가 치관-치근 파절된 혼합치열기의 환아에서 의도적 재식술을 이용하여 발치 후 즉일 근관치료와 역충전 후 레진수복을 시행하여 치료하였기에 보고하는 바이다.

• The Journal of Advanced Prosthodontics
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• 제11권6호
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• pp.324-330
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• 2019

PURPOSE. The aim of the study was to evaluate and compare the fracture resistance and modes of fracture of monolithic zirconia crowns with two preparation designs. MATERIALS AND METHODS. Forty human maxillary first premolar teeth were extracted for orthodontic purposes and divided into two main groups (n=20): Group A: monolithic traditional zirconia; Group B: monolithic translucent zirconia. The groups were further subdivided into two subgroups (n=10): (A1, B1) shoulder margin design; (A2, B2) feather-edge margin design. Teeth were prepared with either a 1 mm shoulder margin design or a feather-edge margin design. The prepared teeth were scanned using a digital intraoral scanner. The crowns were cemented using self-adhesive resin cement. All cemented teeth were stored in water for 7 days and thermocycling was done before testing. All samples were subjected to compressive axial loading until fracture. The fractographic analysis was done to assess the modes of fracture of the tested samples. RESULTS. The highest mean values of fracture resistance were recorded in kilo-newton and were in the order of subgroup A1 (2.903); subgroup A2 (2.3); subgroup B1 (1.854) and subgroup B2 (1.523). One-way ANOVA showed a statistically significant difference among the 4 subgroups. Concerning modes of fracture, the majority of samples in subgroups A1 and B1 were fracture of restoration and/or tooth, while in subgroups A2 and B2, the majority of samples fractured through the central fossa. CONCLUSION. Even though all the tested crowns fractured at a higher level than the maximum occlusal forces, the shoulder margin design was better than the feather-edge margin design and the monolithic traditional zirconia was better than the monolithic translucent zirconia in terms of fracture strength.

• 대한소아치과학회지
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• 제28권4호
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• pp.638-642
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• 2001

최근에 소개된 Plasma arc lamp를 이용한 고광도 광조사기는 조사되는 광도를 크게 증가시켜 필요한 조사시간을 단축시키고자하는 연구의 결과중 하나이다. 교정 임상에서 브라켓의 접착시 고광도 광조사기를 사용하여 시술시간을 줄인다면 환자뿐만 아니라, 술자에게도 시간적이나 경제적으로 많은 도움을 줄 것이다. 이 연구의 목적은 Plasma arc light를 사용하여 접착시킨 브라켓의 치면에 대한 전단강도를 측정하고 이를 기존의 할로겐 램프를 이용한 광중합 방법과 비교해보기 위함이다. I군은 할로겐 램프를 사용하는 $XL3000^{(R)}$을 이용하여 총 50초간 광중합하였고 II군은 plasma arc lamp를 사용하는 $Flipo^{(R)}$를 이용하여 2초간 광중합하였으며 III군도 $Flipo^{(R)}$를 이용하여 총 5초간 광중합하여 전단강도 측정을 시행한 결과는 다음과 같다. 1. 세 군의 전단강도의 평균은 비슷한 수치를 나타내었다. 2. 세 군간의 통계학적 유의 차가 없었다(p>0.05).