• 구강회복응용과학지
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• 제33권4호
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• pp.291-298
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• 2017

치조골 폭이 협소한 상악 전치부의 심미적인 임플란트 수복은 임플란트 식립체의 경사각과 위치가 제한되기 때문에 단순한 임플란트 식립만으로는 심미적인 임플란트 보철물을 제작하기 어려운 일이다. 임플란트 보철물이 변연 치은과 조화로운 출현윤곽을 재현하기 위해서는 임플란트 식립체의 이상적인 치조골 내 위치와 식립각이 설정될 수 있어야 하며, 이를 위해서는 종종 임플란트 식립 전 골증대술을 선행하여야 한다. 본 증례는 구개측의 심한 골 결손을 동반한 얇은 치조골 폭을 보이는 상악 전치 상실부에 골증대술을 시행한 후, 임플란트를 식립하여 심미 보철을 시행한 증례이다. 먼저 협측에 과량의 골증대술을 선행하여 불리한 임플란트 식립 위치를 보상할 수 있는 구개측 식립 경사를 확보하였으며, 임시보철물의 외형을 조정하여 인접 치아와 조화로운 변연 치은 높이와 치간 유두를 형성하였다. 최종적으로 지르코니아 코어를 가지는 도재수복물을 이용하여 보철 수복하였고 심미적, 기능적으로 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.

• 대한치과보철학회지
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• 제49권3호
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• pp.263-269
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• 2011

기존 인상채득법에 비해 보다 정확하고 편리한 보철치료를 위하여 최근 디지털 인상채득법이 개발되고 있다. CAD/CAM과 더불어 디지털 인상채득법의 도입으로 치과 진료의 디지털화가 현실로 다가오는 시점에서, 본 증례는 디지털 인상채득 후CAD/CAM으로 제작한 보철물과 기존 방식으로 인상채득하여 제작한 보철물의 차이점을 임상적으로 알아보고 그 과정을 자세히 소개하였다. 22세 여자 환자가 상악 좌측 중절치의 변색과 모양 개선을 위해 보철 치료를 주소로 내원하였다. 8년전 외상으로 인해 근관치료 및 포스트를 시행 후, 치관 결손부는 레진으로 수복한 상태였으며, 전부도재관 치료계획 수립 후 환자의 동의 하에 서로 다른 방식의 2가지 보철물을 제작하여 비교해 보기로 하였다. 환자의 지대치를 기준으로 각 보철물의 내면적합도를 비교해본 결과, 두 보철물 모두 임상적으로 수용할만한 결과를 얻을 수 있었으나 아직까지는 기존 방식 보철물에 비해 디지털 방식의 보철물이 내면적합도에 있어서 더 큰 오차를 보임을 알 수 있었다.

• 대한치과보철학회지
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• 제28권2호
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• pp.53-76
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• 1990

The purpose of this study was to evaluate the tensile bond strength of adhesive resins to successively recast Rexillium III and Degudent-U. Recasting was done 4times successively. Specimen $A_1$, were cast by new metal, and $A_2$ by surpus of $A_1$, $A_3$ by surplus of, $A_2$ $A_4$ by surplus of $A_3$, $A_5$ by surplus of $A_4$ plus 50% new metal. The types of surface treatment for resinbonded restoration in this experiment were electrolytic etching by OXY-ETCH(Oxy dental products, Inc., Hillside, New Jersey, U.S,A.), aluminum oxide blasting, anodic oxidation by EZ-OXISOR( Towagiken Co., Kyoto, Japan), electrotinplating by Kura Ace(Kuralay Co., Kyoto, Japan). Three kinds of cementing resin used in this study were Comspan(K.P. Cauil Co, Milford Delaware, U.S.A.), Super Bond C&B(Sun-Medical Co. Ltd., Kyoto,Japan), Panavia EX(Kuralay Co., Ltd., Osaka, Japan). Tensile bond strength was measured by Instron Universal testing machineModel 1125) and all the specimen were observed with SEM(JEOL, JSM-T2000) and mode of bond failure were recorded. The obtained results were as follows : 1. In electrolytic etched group, tensile bond strength was decreassed when recast alloy was used, and tensile bond strength of Compan and panavia EX were not significantly different(P>0.05). 2. In remaining group treated by aluminum oxide blasting, EZ-OXIOR, Kura Ace, tensile bond strength were not changed when recast alloy were used, and tensile bond strength of SuperBond(C&B and Panavia EX were not significantly different(P>0.05). 3. IN SEM evaluation, electrolytic etched group and electrotinplated group exhibited different image when recast alloy was used, and remaining groups treated by aluminum oxide blasting, EZ-OXISOR exhibited the same. 4. IN observation of bond failure, electrolytic etched group exhibited adhesive failure and remaing groups treated by aluminium oxid blasting, EZ-OXISOR, Kura Ace exhibited adhesive and cohesive failure.

• 대한소아치과학회지
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• 제30권1호
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• pp.47-53
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• 2003

본 연구는 영구치와 유치의 상아질 표면에 상품화된 화학기계적 우식치질 제거용액인 $Carisolv^{TM}$(MediTeam, Sweden)를 사용하고 복합레진을 접착한 후 전단결합강도를 측정함으로써 $Carisolv^{TM}$의 사용이 복합레진의 접착에 미치는 영향을 평가하고자 하였다. 교정치료를 위하여 발거된 상, 하악 소구치 80개와 정상적으로 탈락한 손상이 없이 건전한 상악 유전치 80개의 순, 협면의 상아질을 노출시키고 $Carisolv^{TM}$를 실험군은 60초 적용하고 대조군은 $Carisolv^{TM}$를 사용하지 않았다. 상아질 접착제는 Scotchbond Multi-Purpose(3M, USA), Single Bond(3M, USA), Clearfil SE Bond(Kuraray, Japan), AQ Bond(Sun Medical, Japan)를 각각 제조사의 지시대로 적용하였고 광중합형 복합레진은 Z100(3M, USA)을 사용하였다. $5^{\circ}C$와 $55^{\circ}C$에 각 30초씩 계류시켜 1,000회 열순환시키고 Universal Testing Machine(Zwick Z020, Zwick Co., Germany)을 사용하여 전단결합강도를 측정하고 분석하여 다음과 같은 결론을 얻었다. 1. 각 군간 전단결합강도를 비교한 결과, 유치에 비해 영구치의 전단결합강도가 높게 나타났다. 영구치에서는 Clearfil SE Bond만 사용한 군에서 가장 높았고 $Carisolv^{TM}$와 AQ Bond를 병용한 군에서 가장 낮았다. 2. $Carisolv^{TM}$ 사용하지 않은 군과 사용한 군간의 전단결합강도를 비교한 결과, 영구치와 유치 모두에서 상아질 접착제의 종류에 관계없이 $Carisolv^{TM}$를 사용한 군이 사용하지 않은 군에 비해 전단결합강도가 통계학적으로 유의하게 낮게 나타났다(P<0.001). 3. 상아질 접착제의 종류에 따른 전단결합강도를 비교한 결과, 영구치와 유치 모두에서 Clearfil SE Bond를 사용한 군의 전단결합강도가 가장 높았으며 AQ Bond를 사용한 군의 전단결합강도가 가장 낮았다.

• 대한소아치과학회지
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• 제30권2호
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• pp.204-209
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• 2003

9세된 남아가 불안정한 교합을 주소로 내원하였다. 환아의 제1대구치는 치아우식증으로 광범위하게 치관이 파괴되어 환아는 자신의 교두감합위를 찾지 못해 하악을 변위시키면서 교합을 하였고 폐구시마다 동일한 위치로 다물지를 못하였다. 임상검사와 방사선 검사를 통하여 제1대구치에 크라운 수복을 하여 안정적인 교합으로 교합재건을 해주기로 하였다. 치료에 앞서 안정위로 유도하여 환아에게 안정위로 폐구하도록 교육하였고, 근첨형성술(apexification)을 포함한 근관치료와 interocclusal space확보를 위한 치관연장술과 수직고경의 거상을 계획하였다. 근관치료와 치관연장술 후 보철물 제작을 위해 치아를 삭제하고 안정위를 기준으로 수직고경을 증가시켜 임시치관을 제작 및 장착하고 1개월 동안 적응여부를 관찰하였다. 1개월 후 악관절장애등의 증상이 없어 크라운을 제작하였고, 이를 다시 임시장착하고 1개월동안 관찰하여 아무런 증상이나 불편감이 없어 최종접착을 하였다. 크라운을 최종장착한지 4개월 후 검사에서 환아는 안정적인 교합을 형성해가고 있었고, 크라운을 처음 장착했을 때 보였던 전치부 개방교합도 개선되어 정상적인 수평, 수직피개 교합을 보이고 있었다.

• 대한소아치과학회지
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• 제36권4호
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• pp.601-606
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• 2009

법랑질형성부전증은 치아 법랑질의 유전성 결함으로 임상적으로 형성부전형, 성숙부전형, 석회화부전형의 3가지로 나뉜다. 이 질환은 유치와 영구치에서 모두 발생할수 있다. 본 증례의 환자는 8세 8개월에 상악 영구 전치의 맹출지연 및 하악 전치부위 치석, 전치부 개방교합을 주소로 개인병원에서 의뢰되어 본과에 내원하였다. 본과에서 임상검사 결과, 상, 하악 전치부의 얇은 법랑질과 좁은 치아 폭경을 보였으며, 특히 하악 전치부는 전체적인 형태상 불량하고 거친 표면을 나타냈다. 또한 온도 자극에 민감한 반응을 나타냈다. 상, 하악 제 1 대 구치는 심한 법랑질 파절과 마모를 보였다. 방사선 검사에서 전반적인 법랑질형성부전증을 보였으며 맹출하지 않은 치아에서도 법랑질형성부전증을 볼 수 있었다. 이에 본 환아는 형성부전형 법랑질형성부전증으로 진단내렸으며, 경희대학교 소아치과와 보철과의 협진하에 치료를 시행하였으며 지속적인 관찰 중이다. 법랑질형성부전증 환자의 효율적인 저작능력, 심미성 회복, 지각과민증 해소를 위하여 구강 위생교육, 구치부 및 전치부의 수복이 필요하다. 성장이 완료될 때까지 지속적인 예방치료 및 치아 수복이 필요하며 성장 완료 후에는 여러 과의 협진적 치료가 필요하다.

• 대한치과교정학회지
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• 제12권2호
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• pp.145-154
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• 1982

Plaster models were constructed and orthopantomographs were taken for 86 male and 70 female primary school pupils, whose upper and lower permanent 4 incisors and 1st molars were completely erupted without crowding; whose deciduous canines and molars were found almost uniformly even without any visible tooth fractures, dental caries or restorations on proximal surfaces of the teeth. Certain reference points on the orthophantomograph were set up and measured and the values were compared with actual or predicted values from the models. The following results were obtained: 1. In regards to available space, the values from the orthopantomograph were greater than the values from the models by a mean of 3.24% on the upper and 10.06% on the lower for males; 3.05% on the upper and 10.01% on the lower for females. 2. In regards to total mesiodistal widths of permanent canine, 1st and 2nd premolars, the values from the orthopantomograph were greater than the presumed values based on the size of lower permanent 4 incisors from the models by a mean of 18.50% on the upper and 24.09% on the lower for males; 14.54 on the upper and 20.51% on the lower for females. 3. Comparing the magnified values of total mesiodistal widths of permanent canine, 1st and 2nd premolars with those of available space, the regression constants of regression equation (Y = a + bX) between them were a=3.2336, b=0.6533 on the upper and a=5.0138, b=0.3290 on the lower for males; a=2.5994, b=0.6521 on the upper and a=3.0113, b=0.6586 on the lower for females. 4. The correlation coefficients between the magnified values of available space and permanent canine, 1st and 2nd premolars were moderately positive as 0.6474 in the upper and 0.505 on the lower for males; 0.6493 on the upper and 0.6183 on the lower for females. 5. In regards to magnified values of the available space from the orthopantomographs there were no significant difference between sexes, (P>0.05) but of the total mesiodistal widths of permanent canine, 1st and 2nd premolars, a significant difference between sexes was found.(p<0.01).

• 대한치과보철학회지
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• 제36권2호
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• pp.245-257
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• 1998

This study was performed to measure the changes of the mandibular movement and the masticatory muscular activities - anterior temporal and masseter muscle of both side - reflected by intentional increase of anterior guidance angie. For this study, 5 volunteers (3 males and 2 females with average age of 24.0) were selected. Each volunteer had Angle's classification I and did not have any missing tooth except third molar and any extensive restorations. Metallic guide plate was made at volunteer's working model fabricated by improved dental stone and cemented to the palatal surface of maxillary central incisor using resin cement(Panavia $21^{(R)}$) and then adjusted not to give any occlusal interferences at intercuspal position. The activity of masticatory muscles and the changes of mandibular movement were recorded by EMG and Sirognathograph in Biopak analysing system(Bioresearch Inc., Milwaukee, Wisconsin, USA). Measurement was done at before experiment, immediatley after placement, 1 week after placement, immediately after removal, and 1 week after removal. The results were as follows: 1. Moderate phonetic disturbance and mild headache were occured to 3 volunteers for 2 days after setting and 1 volunteer had positive reaction to percussion and slight midline diastema. But all of these clinical signs were diappeared 1 week after removal and the other volunteer did not have any special clinical sign. 2. In the EMG of the mandibular rest position, the mean value of anterior tempotal muscle was increased immediately after placement(p<0.01) and then decreased 1 week after placement(p<0.05) and increased 1 week after removal(p<0.05) but not recovered as before experiment. The mean value of masseter muscle was decreased during the experiment period. 3. In the EMG during mandibular protrusive movement, all muscular activity was decreased during the experiment period. Reduced activity was not recovered 1 week after removal(p<0.03). 4. During the habitual opening, anteroposterior movement of mandible was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not statistically significant(p>0.1). Vertical movement was not shown significant difference during the experiment period(p>0.1). Lateral movement was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not recovered as before experiment. The opening and closing velocity of mandible was shown minor changes but not statistically significant. 5. During the habitual opening, anteroposterior movement of mandible was decreased 1 week after placement(p<0.05) and then increased immediately after removal and recovered 1 week after removal as before experiment. Vertical movement was not shown significant changes. Lateral displacement of mandible was increased continuously and recovered 1 week after removal. Opening velocity was temporarily increased immediately after removal but recovered and closing velocity was not shown significant changes. 6. During the right side chewing, anteroposterior movement of mandible was increased immediately after removal but recovered and vertical movement was not shown statistically significant results. Lateral displacement and velocity of mandible were not shown significant results. 7. During the left side chewing, the changes of mandibular movement pattern were not shown statistically significant results.

• 구강회복응용과학지
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• 제22권3호
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• pp.221-230
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• 2006

Recently, the need for esthetic results has increased the interest for all-ceramic crown prosthesis. Furthermore, the development of zirconium core via CAD/CAM system has allowed the all ceramic restorations to be applied to almost all fixed prosthesis situations. But, the increased strength has been reported to increase in proportion with the bond strength of cement, and recently, the tribochemical system which increases the bond strength through, silica coating and silanization has been introduced. The purpose of this study was to compare the $Rocatec^{TM}$ system and $CoJet^{TM}$ system with the traditional acid etching and silanization method of the irconium based ceramic. The surface character was observed via SEM(X2000), and the bond strength with the resin cement were measured. 50 In-Ceram Zirconia (Adens, Korea) discs were fabricated and embedded in resin, group 1 was treated with glass-bead blasting and cleaning, group 2 was treated with 20% HF for 10 minutes and silanized, group 3 was treated with the $Rocatec^{TM}$ system, and group 4 was treated with the $CoJet^{TM}$ system. Each group was comprised of 10 specimens. The specimens were cemented to a $3mm{\times}5mm$ resin block with Super-Bond C&B. The shear bond strength was measured with the $Instron^{(R)}$ 8871 at a crosshead speed of 0.5mm/min. The results were as follows. 1. According to SEM results, there were little difference between group 1 & group 2, but in group 3 and 4, silica coating was detected and there was increase in surface roughness. 2. The shear bond strength decreased in the order of group 3(46.28MPa), group 4(42.04MPa), group 2(31.56MPa), and group 1(27.46MPa). 3. There was significant differnce between group 1&2 and group 3&4(p<0.05). From the results above, it can be considered that the conventional method of acid etching and silane treatment cannot increase the bond strength with resin cements, and that by applying the tribochemical system of $Rocatec^{TM}$ system and $CoJet^{TM}$ system, we can achieve a stronger all ceramic restoration. Further studies on surface treatments to increase the bond strength are thought to be needed.

• 구강회복응용과학지
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• 제16권1호
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• pp.13-25
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• 2000

Optimal Pressable Ceramic is one of the all-ceramic restorations with a shaded translucent pressed core and layering porcelains. The purpose of this study was to evaluate the marginal fidelity according to margin types and measurement sites, and to evaluate fracture strength according to margin types. Twenty seven OPC crowns made according to 3 types of cervical finishing lines were used in this study. Marginal gaps were measured before and after cementation. A Steromicroscope(SZ-ST(R), Olympus, Japan) was used to measure the space between the margin of OPC crown and the finishing line of metal model. Marginal gaps were measured at the labial, mesial, lingual and distal site, which were demonstrated in advance. Fracture strength testing was carried out using an Instron(Model M100EC, Mecmesin, England) at a cross head speed of 5 mm/min. All crowns were loaded until catastrophic failures occurred. The result were as follow: 1. In comparison according to variable margin before cementation, the marginal gap were increased in chamfer margin($47.50{\pm}18.39{\mu}m$), $120^{\circ}$shoulder margin ($55.21{\pm}14.4{\mu}m$) and $90^{\circ}$shoulder margin($71.18{\pm}13.30{\mu}m$) in ascending order, and there were significant differences between chamfer margin and $90^{\circ}$shoulder margin, $120^{\circ}$shoulder margin and between $120^{\circ}$shoulder margin and $90^{\circ}$shoulder margin respectively(p<0.05). 2. In comparison according to variable margin after cementation, the gap discrepancies were increased in chamfer margin($60.78{\pm}30.37{\mu}m$), $120^{\circ}$shoulder margin($66.67{\pm}11.18{\mu}m$) and $90^{\circ}$shoulder margin($85.78{\pm}17.23{\mu}m$) in ascending order, but there was significant difference only between chamfer margin and $90^{\circ}$shoulder margin(p<0.05). 3. Labio-lingual points showed a better marginal fidelity than that of proximal point(p<0.05). 4. Chamfer margin($48.76{\pm}8.45kgf$) showed higher fracture strength than $120^{\circ}$ shoulder margin($40.57{\pm}7.90kgf$) and $90^{\circ}$ shoulder margin(32.7.90kgf) (p<0.05), but there was significant difference only between chamfer margin and $90^{\circ}$ shoulder margin(p<0.05).