• Journal of Oral Medicine and Pain
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• 제41권4호
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• pp.169-179
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• 2016

Purpose: This study is designed to analyse etiology and bone pattern at the first visit using cone-beam computed tomography (CBCT) and to evaluate the treatment outcome of conservative treatment in temporomandibular disorder (TMD) patients with rheumatoid arthritis (RA). Methods: One hundred condyles in 50 subjects with RA were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Dental Hospital, diagnosed as TMD. Condylar bone changes were classified by normal, erosive bony change, proliferative bony change and combined group (erosive bony change+proliferative bony change). They were treated conservatively with physical therapy, medication, behavioral therapy and/or occlusal stabilizing splint therapy. After 3 months on average, patients were re-evaluated with regards to subjective symptoms and the clinical findings were investigated. Results: TMD patients with RA have behavioral contributing factors such as parafunctional habit. The results that analyse bone pattern at the first visit using CBCT proliferative bony changes group (32.6%) were more common than erosive bony changes group (15.2%). In comparison between unilateral and bilateral bony change in temporomandibular joint, the ratio showed no significant differences. After 3 months of conservative treatments, pain, noise, limitation of motion (LOM) were markedly improved regardless of occlusal splint therapy. However only LOM was significantly improved through occlusal splint therapy during 3 months. Conclusions: TMD patients with RA had similar behavioral contributing factors and characteristics of CBCT images shown in general TMD patients and also similar response to conservative treatment so it is difficult to differentiate. Therefore when TMD patients show symptoms corresponding to clinical diagnostic criteria of RA at the first visit, serological testing should be conducted and through this, early diagnosis and treatment of RA should be initiated.

• Archives of Plastic Surgery
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• 제41권4호
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• pp.394-397
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• 2014

Background Proximal interphalangeal joint (PIPJ) dislocations represent a significant proportion of hand clinic visits and typically require frequent follow-ups for clinical assessment, orthotic adjustments, and physiotherapy. There are a large number of treatment options available for PIPJ dislocations, yet no prospective or controlled studies have been carried out, largely due to the diversity of the various types of injuries. Methods We retrospectively reviewed all the PIPJ dislocations in our institution over a five-year period and directly compared the different splinting techniques that we have used over this time frame. Results There were a total of 77 dislocations of the PIPJ (57 men and 20 women) that were included in our study. We found that our management has shifted gradually from complete immobilisation to controlled early mobilisation with figure-of-eight splints. Following treatment, the range of motion of the PIPJ in the figure-of-eight group was significantly greater than that in the other three methods (P<0.05) used. There were significantly fewer hospital visits in the figure-of-eight splint group than in the other treatment groups. Conclusions The treatment of PIPJ dislocations has undergone a significant evolution in our experience. Early controlled mobilisation has become increasingly important, and therefore, splints have had to be adapted to allow for this. The figure-of-eight splint has yielded excellent results in our experience. It should be considered for all PIPJ dislocations, but careful patient selection is required to achieve optimum results.

• Restorative Dentistry and Endodontics
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• 제25권3호
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• pp.371-380
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• 2000

The effect of fiber reinforcing materials on the fracture strength of composite resin was evaluated. Each ten composite resin bars reinforced by glassfiber[Fiber-Splint ML$^{(R)}$(Polydentia SA, Switzerland)], polyethylene fiber [Ribbond$^{(R)}$(Ribbond Inc., U.S.A.)] and polyaramid fiber[Kevlar$^{(R)}$(DuPont, U.S.A.)] were loaded under the 3-point compression technique. Another ten pure composite resin bars without reinforcement were used as a control group. Then mean fracture strength and standard deviation were calculated and a ANOVA and Scheffe test were used in statistics. The results were as follows: 1. Kevlar group showed the highest fracture strength as 175.5MPa (p<0.05). Fiber-Splint ML group showed the lowest fracture strength as 112.7MPa. 2. The mean value of fracture strength in Ribbond group was 136.4MPa, and that of unterated control group was 143.6MPa. No difference was found between the two groups. 3. Ribbond and Kevlar reinforcement groups showed a catastrophic failure, where complete separation of pieces occurs to a unseparated fracture pattern. The use of Kevlar reinforcement fibers with composite resin showed significant increase in the average load failure and the presence of the fibers did prevent the catastrophic crack propagation present in the unreinforced samples. The use of Ribbond reinforcement fibers with composite resin showed no significant increase in the average load failure. However, the presence of the fibers did prevent the catastrophic crack propagation. Because high strength of glassfiber are rapidly degraded on exposure to moisture and humidity. The use of Fiber-Splint ML reinforcement fibers with composite resin showed significant decrease in the average load failure and displayed catastrophic fractures.

• Journal of Oral Medicine and Pain
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• 제48권1호
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• pp.31-36
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• 2023

This report presents the case of a 14-year-old male with rheumatoid arthritis (RA) in both temporomandibular joints (TMJs), in whom a bone scan and laboratory tests were used to confirm the diagnosis. The patient visited the Department of Orofacial Pain and Oral Medicine at the affiliation hospital with a complaint of a 1-year history of bilateral TMJ pain and sound. Clinical examination revealed bilateral TMJ and masseter muscle pain during mouth opening and palpation. Radiological examination revealed no significant morphological changes in either TMJ. The patient was prescribed medications at the first visit to address the pain, inflammation, and stiffness. A bone scan and laboratory tests were planned/scheduled for differential diagnosis between simple arthralgia and osteoarthritis. The bone scan revealed increased radiotracer uptake in both TMJs. The laboratory tests revealed a RA factor of 82.4 IU/mL, which is more than four times the normal range. The final diagnoses were bilateral TMJ early rheumatoid arthritis (ERA) and juvenile idiopathic arthritis. We created a stabilization splint and referred the patient to the Department of Rheumatology for further evaluation of the ERA. After fitting of the stabilization splint and giving instructions regarding its use, the patient has been receiving monthly follow-up checks for symptoms and undergoes follow-up blood tests every 3 months. About 14 months after the initial visit, the pain had significantly decreased from a Visual Analog Scale score of 5 to 1, and the RA factor decreased to 66.6 IU/mL. A regular follow-up check will continue until the end of growth.

• 대한심미치과학회지
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• 제32권1호
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• pp.23-32
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• 2023

비기능적 습관을 가진 환자는 턱관절 장애, 저작 근육의 근막통증증후군 등과 함께 치아의 광범위한 마모를 유발한다. 지속되는 교모는 수직교합고경의 감소를 동반하게 되며 이는 안모의 변화, 저작 효율 저하, 측두하악 관절 장애 등의 문제가 발생할 수 있다. 이런 수직교합고경 감소 환자의 3차원적인 교합 회복과 재구성을 위해서는 정확한 진단 및 분석과 예지성 있는 치료계획 수립이 필요하며, 생리적인 수직교합고경의 회복 및 정상적인 교합평면 재설정을 동반한 보철치료가 필요하다. 본 증례는 구강 악습관에 의한 전반적인 치아의 마모와 저작근의 불편감, 그리고 수직교합고경 감소로 인한 심미적 불만족을 호소하는 환자의 수직교합고경 증가를 동반한 완전 구강 회복 증례이다. 교합안정장치를 통한 측두하악관절의 안정과 고딕아치 기록장치를 이용한 악간관계 재설정 및 임시 수복물을 통한 경과 관찰을 통해 기능적, 심미적으로 좋은 결과를 보였기에 이를 보고하고자 한다.

• 대한소아치과학회지
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• 제29권4호
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• pp.586-591
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• 2002

이갈이(bruxism)는 일반적으로 주간의 이악물기(clenching)와 야간의 이갈이(grinding)를 포함하는데 이악물기는 상하악의 정적인 관계에서 대합하는 치열이 힘있게 다물어지는 것을 의미하고 이갈이는 하악의 편심운동시에 상하악이 동적인 관계에서 힘 있게 다물어지는 것을 의미한다. 이갈이의 원인은 아직까지 정확하게 밝혀진 것은 없지만 가장 큰 요인으로 정서적 스트레스를 들 수 있고, 수면장애나 약물, 중추신경장애 등을 원인으로 볼 수 있다. 이갈이의 치료는 근본적인 치료법은 아직까지 없으나 정서적 스트레스를 감소시키고, 교합조정이나 교합안정장치, 약물요법, 물리치료 등을 통해서 이갈이의 증상 및 징후를 치료하는 것이 치료의 목표가 된다. 본 증례는 이갈이를 주소로 내원한 환자에서 교합안정장치를 통하여 이갈이가 감소하는 결과를 얻었기에 보고하는 바이다.

• 구강회복응용과학지
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• 제39권1호
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• pp.9-20
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• 2023

목적: 하악 부분 무치악 모형에서 pick-up type 인상용 코핑을 사용한 개방형 인상 채득법과 transfer type 인상용 코핑을 사용한 폐쇄형 인상 채득법, 개방형 인상 채득법에서 pick-up type 인상용 코핑 고정 재료에 따른 인상 채득 정확성을 비교 하고자 하였다. 연구 재료 및 방법: 하악 부분 무치악 모형의 좌측 구치부에 직경 4.5 mm, 길이 11.5 mm의 임플란트 고정체 두 개 식립 후 3D 프린터를 이용하여 개방형 개인 트레이 30개 폐쇄형 개인 트레이 10개를 제작하였다. 제작한 개인 트레이를 이용하여 PN군: 개방형 인상 채득법(non-splint), PG군: 개방형 인상 채득법(splint GC pattern resin), PH군: 개방형 인상 채득법(splint Herifix), TN군: 폐쇄형 인상 채득법으로 나누어 각 군당 10회씩 총 40회의 인상 채득을 진행하였다. 인상채득 후 석고 모형을 제작하여 모델 스캐너로 스캔 후 역설계 프로그램으로 스캔오차를 측정하여 95% 유의수준으로 평가 하였다. 결과: 폐쇄형 인상 채득법 TN군이 개방형 인상 채득법 PN군 보다 더 낮은 오차값을 보였다. 개방형 인상 채득법(splint)에 사용된 인상용 코핑 고정 재료 간의 비교 결과에서는 PH군에서 가장 낮은 오차값을 보였으며 PN군, PG군 순으로 정확한 인상 채득 정확성을 보여주었다. 결론: 임플란트 인상 채득 방법이나 인상용 코핑의 연결 고정 유무에 따른 각 군 간의 정확성에 유의한 차이는 없다.

• 대한치과보철학회:학술대회논문집
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• 대한치과보철학회 2001년도 추계학술대회
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• pp.59-59
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• 2001

• 대한치과의사협회지
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• 제25권10호통권221호
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• pp.927-930
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• 1987

하기 내용은 네델란드 Amsterdam치대의 Hansson교수와 스웨덴 Karolinska의 Riise교수의 ‘악관절 기능장애환자의 진단 및 처치’에 관한 course work의 내용중 일부이며 최근에 유럽제국에서는 시술이 간편하여 임상가에게 널리 이용되는 방법중에 하나이다. 현금에는 TMJ를 전공하는 학자들도 그 분야의 광범위성에 비추어 전공을 세분화하는 경향이 있어 Dr. Hansson은 splint therapy에 의한 muscle activity를 Dr. Riise는 occlusal adjustment를 주로 연구하고 있다.

• 대한소아치과학회지
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• 제26권1호
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• pp.62-68
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• 1999

One of the many dilemmas that the clinical restorative dentist must face is treating young adolescent patient who prematurely loses his permanent teeth. Temporary prosthetic replacement can be achieved with removable denture, orthodontic band-wire fixed denture, adhesion bridge, composite resin splint with reinforcing material until the patients go through growth and development. But, all of these have limitations. Advances in restorative materials and reinforcement materials have made possible new techniques which are as much esthetic, conservative and more economic and stronger than adhesion brides. Two cases are being presented where gas-plasma treated, woven polyethylene fabric to reinforce composite resin was used to fabricate a temporary prosthetic restoration to replace a missing maxillary central incisor. This relatively noninvasive and basically reversible procedure allows the patient to decide the final restoration as he or she goes thorough maturation of the hard and soft tissues.