• 제목/요약/키워드: dentistry needs

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Cone beam CT를 이용한 안면골격형태에 따른 상기도 공간 분석 (Pharyngeal airway analysis of different craniofacial morphology using cone-beam computed tomography (CBCT))

  • 김용일;김성식;손우성;박수병
    • 대한치과교정학회지
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    • 제39권3호
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    • pp.136-145
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    • 2009
  • 상기도 공간은 3차원 입체 구조물로서 두부규격방사선사진 등으로 분석하기에는 평가의 한계가 존재하였다. 본 연구는 최근 방사선 피폭량 등의 감소로 그 활용도가 높아진 cone beam CT (CBCT)를 이용하여 안면골격형태에 따른 상기도 공간의 면적, 전후방 폭경 및 측방 폭경을 측정하고 그 관련성을 알아보았다. 102명을 대상으로 CBCT (VCT, Vatech, Seoul, Korea)를 촬영하였으며, FH plane에 평행하면서 aa point (the most anterior point on the anterior arch of atlas), $CV_{2ia}$, $CV_{3ia}$ point (most infero-anterior point on the body of the second & third cervical vertebra)를 지나는 평면을 기준으로 설정하였다. 각 항목의 계측치는 one-way ANOVA를 이용하여 통계처리하고 Duncan test로 사후검정하였다. 연구 결과, 안면 골격형태에 따른 측방 폭경에는 유의한 차이가 없었다. Group 2 (Class II) 집단은 aa plane, $CV_2$ plane, $CV_3$ plane에 의해 형성된 상기도 공간의 단면적이 좁았으며, 전후방 폭경도 Group 3 (Class III)에 비해 유의성 있게 좁았다. 수직 안면골격형태와 정상 안면골격 형태간의 유의성 있는 차이는 없었으나, aa plane에서 형성된 상기도 공간의 전후방 폭경은 Group 1V (Class I vertical)가 Group 1N (Class I normal)에 비해 유의성 있게 좁은 것으로 나타났다 (p < 0.05).

웹뷰어를 이용한 기공실과 진료실 측 간의 보철물 설계 형태의 공유: 증례 보고 (Web viewer for sharing of prosthesis design between laboratory and clinic: Case report)

  • 장성원;이호진;김소연;이두형
    • 대한치과보철학회지
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    • 제60권3호
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    • pp.276-282
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    • 2022
  • 성공적인 보철 수복물을 제공하기 위해서는 치과의사와 치과기공사 간의 긴밀한 의사소통은 중요한 요소이다. 치과기공사와 의견 교환은 주로 기공의뢰서와 사진촬영의 형태로 이루어져 왔으나 정보 전달이 제한될 수 있다고 보고되었다. 현재는 디지털 기술에 기반을 둔 보철물 제작이 일반화됨에 따라 영상 객체를 웹상에 저장하고 모바일 브라우저를 통해 손쉽게 확인할 수 있게 되었다. 본 논문에서는 CAD 소프트웨어를 이용하여 보철물을 설계하고 웹뷰어를 통해 치과의사와 설계된 보철물을 검토하여 보철물의 설계를 개선한 증례들을 소개한다. 본 프로토콜을 통해 교합면 및 치관 형태, 대합치 치료, 치은측 치간 공극의 크기, 가공치 하방 형태 등을 개선할 수 있었다. 이러한 웹뷰어를 통한 보철물 설계를 3차원적으로 치과의사와 공유하고 토의하여 수정하는 과정은 구강내 조건의 다양성과 개별화된 요구를 반영하는 데 기여하여 기능적이고 심미적인 보철물을 제작하는 데 도움을 줄 수 있다.

Safety and efficacy of target controlled infusion administration of propofol and remifentanil for moderate sedation in non-hospital dental practice

  • Douglas Lobb;Masoud MiriMoghaddam;Don Macalister;David Chrisp;Graham Shaw;Hollis Lai
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제23권1호
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    • pp.19-28
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    • 2023
  • Background: Fearful and anxious patients who find dental treatment intolerable without sedative and analgesic support may benefit from moderate sedation. Target controlled infusion (TCI) pumps are superior to bolus injection in maintaining low plasma and effect-site concentration variability, resulting in stable, steady-state drug concentrations. We evaluated the safety and efficacy of moderate sedation with remifentanil and propofol using TCI pumps in non-hospital dental settings. Methods: A prospective chart review was conducted on 101 patients sedated with propofol and remifentanil using TCI pumps. The charts were completed at two oral surgeons and one general dentist's office over 6 months. Hypoxia, hypotension, bradycardia, and over-sedation were considered adverse events and were collected using Tracking and Reporting Outcomes of Procedural Sedation (TROOPS). Furthermore, patient recovery time, sedation length, drug dose, and patient satisfaction questionnaires were used to measure sedation effectiveness. Results: Of the 101 reviewed sedation charts, 54 were of men, and 47 were of women. The mean age of the patients was 40.5 ±18.7 years, and their mean BMI was 25.6 ± 4.4. The patients did not experience hypoxia, bradycardia, and hypotension during the 4694 min of sedation. The average minimum Mean Arterial Pressure (MAP) and heartbeats were 75.1 mmHg and 60.4 bpm, respectively. 98% of patients agreed that the sedation technique met their needs in reducing their anxiety, and 99% agreed that they were satisfied with the sedation 24 hours later. The average sedation time was 46.9 ± 55.6 min, and the average recovery time was 12.4 ± 4.4 min. Remifentanil and propofol had mean initial effect-site concentration doses of 0.96 µ/.ml and 1.0 ng/ml respectively. The overall total amount of drug administered was significantly higher in longer sedation procedures compared to shorter ones, while the infusion rate decreased as the procedural stimulus decreased. Conclusion: According to the results of this study, no patients experienced adverse events during sedation, and all patients were kept at a moderate sedation level for a wide range of sedation times and differing procedures. The results showed that TCI pumps are safe and effective for administering propofol and remifentanil for moderate sedation in dentistry.

골격성 III급 부정교합을 가진 환자에서 임플란트 지지 고정성 보철을 이용한 구강회복 증례 (A case of oral rehabilitation using implant fixed prosthesis (skeletal class III malocclusion patient))

  • 강민정;선민지;문홍석;김종은
    • 대한치과보철학회지
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    • 제61권2호
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    • pp.125-134
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    • 2023
  • 골격성 3급 부정교합은 중심위 간섭이 없다면 매우 안정적인 교합 양식이다. 또한 특징적으로 전방 유도가 없고 전치부 반대교합이 동반될 경우 적절한 교합접촉이 없을 수도 있다. 이러한 환자에서 다양한 원인으로 다수 치아를 상실하여 광범위한 구강 회복을 필요로 하는 경우, 환자의 교합관계, 안모의 변화, 측두하악관절의 평가 등 정확한 진단과 면밀한 분석이 필수적이다. 환자의 주소에 따라 심미적 개선을 위해서는 악교정 수술이 동반되는 경우가 많으나 사정 상 불가능한 경우, 최소한의 수직고경 거상을 통해 부분적으로 심미적 개선이 달성될 수 있다. 측두하악관절 장애, 비기능적 악습관 발생, 저작근의 긴장 등 예기치 못한 문제가 발생할 수 있기에 본 환자에서는 가역적인 임시 가철성 의치를 통해 적응 가능 여부를 확인하였으며, 이후 고정성 임시 보철물을 통해 악관절 및 저작근의 적응 여부를 면밀히 관찰하였다. 이후 단계적 치료과정을 통해 상악 전악 임플란트 지지 고정성 보철물과 하악 고정성 보철물을 통해 안정적인 구치부 지지를 얻고 상악 전치부 심미의 부분적 개선을 이루었기에 본 결과를 보고하고자 한다.

치과진료와 방사선촬영 중에 치과위생사의 감염관리행위에 대한 실태조사 (Actual state of dental hygienist's behavior for infection control during dental practice and radiologic examination)

  • 최화영;최용석
    • 한국치위생학회지
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    • 제11권2호
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    • pp.169-178
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    • 2011
  • Objectives : This study was conducted to investigate the actual state of dental hygienist's behavior for infection control during dental practice and radiologic examination and to evaluate the dental hygienist's awareness of the importance of infection control in dental office. Methods : A survey on 218 dental hygienists was carried out. The respondents to complete a questionnaire were the dental hygienists who were in dental office on Gwang-ju area or attended complementary training conducted by the Seoul Branch of Korean Dental Hygienists Association in April 2010. The data were collected and analyzed with $x^2$ test, t-test, ANOVA using SPSS program. Results : The ratios of educational experience for infection control in dental practice and radiologic examination room accounted for 87.6% and 30.3% respectively. Behavior degree of mask-wearing in the dental practice and radiologic examination room were $4.60{\pm}0.70$ and $3.77{\pm}1.09$ respectively. Behavior degree of glove-wearing in the dental practice and radiologic examination room were $4.40{\pm}0.91$ and $3.68{\pm}1.17$ respectively. In case of the relation between educational experience and behavior degree in mask-wearing or glove-wearing, there was no significant difference in the performance of mask or glove wearing during dental practice, and mask-wearing during radiologic examination. However, there was a significant difference (p<0.05) in the performance of glove-wearing during radiologic examination, which revealed that behavior degree between the respondents having educational experience and the others no having it were $3.92{\pm}1.19$ and $3.58{\pm}1.14$ respectively. The surface disinfection control for radiation and protective equipments used in radiologic examination room was done by occasional needs without premeditated schedules. Conclusions : The result of this study shows lower behavior degree during radiologic examination compared with one during dental practice. We suggest that there are needs to raise the awareness of infection control and to improve infection control behavior, and through this study, the importance of education was verified.

포스트의 종류에 따른 Empress 2 도재관의 색상에 관한 비교연구 (COLOR COMPARISON OF VARIOUS POST SYSTEMS WITH EMPRESS 2 CROWNS)

  • 이영수;유동엽
    • 대한치과보철학회지
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    • 제39권2호
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    • pp.197-207
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    • 2001
  • Development of new ceramics and esthetic needs of patients increase the use of all ceramic restorations. Fractured teeth often need metal post and core as foundation for final restoration. When all ceramic restorations are planned, metal post and core may lead to compromised esthetics because of opacity and gray color of metal post and core. Many techniques have been proposed to solve this problem such as application of an opaque porcelain to the metal core or all ceramic post and core. This study was performed to evaluate effect on color of Empress 2 crown according to various post systems. Color was evaluated by the CIE $L^*a^*b^*$ systems and measured by spectrophotometer (Model CM-3500, Minolta, Japan). Specimens were divided into 4 groups as follows Group 1 : gold cast post specimen + Empress 2 crown specimen Group 2 : application of an opaque porcelain to gold cast post specimen + Empress 2 crown specimen Group 3 : cosmopost specimen + Empress 2 crown specimen Group 4 : In-ceram post specimen + Empress 2 crown specimen. The results obtained as follows, 1. $L^*$ Values showed that group 2, 3, 4 were higher than group 1 with significant difference and group 2, 3, 4 were not significantly different. 2. $a^*$ Values and $b^*$ values also showed that group 2. 3, 4 were higher than group 1 with significant difference and group 2, 3, 4 were not significantly different. 3. ${\Delta}E^* ab$ Values showed that ${\Delta}E^* ab$ 3 was the highest value and ${\Delta}E^* ab$ 5 was the lowest value.

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심미와 기능 회복을 위한 교정- 라미네이트 수복 치료 증례 (Case report: Laminate prosthesis with orthodontic treatment for achieve anterior esthetics and functional occlusion)

  • 이한나
    • 대한심미치과학회지
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    • 제23권2호
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    • pp.80-85
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    • 2014
  • 가지런한 치열을 얻기 위해 교정 치료는 치아 보존적인 의미에서 단연 First choice가 일 수 밖에 없다. 그러나 왜소치나 치아 크기의 불균형인 경우, 변색 치아나 파절, 심한 마모 치아인 경우 교정만으로는 심미적으로 완성도 높은 결과를 가져올 수 없다. 모든 치료에서 그러하지만, 특히 심미 치료에서는 치아 교정과 보철 치료, 혹은 치주 치료 및 임플란트등 항상 통합적인 진단과 치료계획이 필요한 경우가 많다. 그리고 다양한 치과 분야의 협진 진료가 필요한 환자에서는 안모와 치아의 심미적 만족뿐 아니라 기능적인 교합관계를 이룸으로써 장기간 안정적이며 조화로운 상태가 유지될 수 있는 치료가 전제되어야 한다. 본 증례는 전치부와 소구치에 cross bite가 있고, 상악 우중절치 절단에 마모가 있는 37세 여성 환자에서 교정과 라미네이트 수복치료를 동반한 경우이다. 치아교정을 통하여 전체적인 치아 위치를 재구성하여 기능교합을 이루었고, 최소한의 치질삭제로 라미네이트 수복치료를 함으로써 전치부 심미를 회복하였다. 최종 보철물을 장착하고 2년간 주기적인 follow up통해 예후를 관찰중이며, 부정교합의 재발이나 보철물 파절은 현재까지 관찰되지 않았다.

Salivary Levels of ErbB2 and CEA in Oral Squamous Cell Carcinoma Patients

  • Honarmand, Marieh;Farhad-Mollashahi, Leila;Nakhaee, Alireza;Nehi, Masoume
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권sup3호
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    • pp.77-80
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    • 2016
  • Oral squamous cell carcinoma (OSCC) is one of the ten most common causes of cancer death worldwide. Assessment of molecular changes can help detect and control lesions. The aim of this study was evaluation of salivary levels of ErbB2 and CEA in OSCC patients. In this case-control study, 27 OSCC patients and 26 healthy controls participated. After obtaining consent and filling out a questionnaire, unstimulated saliva samples were collected from people in the morning for measurement of the two markers using ELISA. Data were analyzed using Mann Whitney U test in SPSS 19 software with P<0.05 considered significant. Subjects were in the age range of 40 to 65 years. \Salivary level CEA was elevated in OSCC samples ($42.6{\pm}21.1ng/ml$) as compared to those of controls ($22.6{\pm}22.1ng/ml$) (p< 0.01), but no significant variation was noted for ErbB2 ($5.2{\pm}1.8ng/ml$ and $4.93{\pm}2.14ng/ml$, p=0.28). The role of ErbB2 as a tumor marker in patients with OSCC must still be regarded as controversial and needs further studies to clarify any significance for early detection or screening. In contrast the salivary level of CEA may find application for early detection of patients.

Bone-like Apatite Formation on Ultrafine-Structure in Modified Electrolytic Solution

  • Jang, Jae-Myung;Choe, Han-Cheol
    • 한국표면공학회:학술대회논문집
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    • 한국표면공학회 2017년도 춘계학술대회 논문집
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    • pp.155-155
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    • 2017
  • Surface modifications are commonly utilized to adjust the properties of the titanium and its alloy surface to the specific needs of the medical applications, but there are disadvantages such as poor osteoconductive properties and low adhesion of bone cell to implant surface. In order to improve these disadvantages, changes in surface properties have an important effect on osseointegration during implantation. In this paper we applied new technological method for improving a unique surface modification using the characteristic of an electrolytic Solution. Thus, in the electrolyte containing NaF in Na2SO4, TiO2 nanoporous was uniformly formed, and HAp nanoparticles were electrodeposited around the TiO2 nanopores, but in the electrolyte containing NH4F in (NH4)H2PO4, the coarse protrusions including HAp nano particles were regularly deposited onto the TiO2 barrier layer. The surface characteristics and the distributed elements and have been investigated by EDS analysis, and ultra-fine structure of surface are carried out using FE-SEM. To investigate the behavior of the anion, the analysis of chemical states was performed by XPS, and the narrow spectrums for Ti2P, Ca 2p, and P 2p seems to be almost similar depending on the characteristics of the electrolyte solution respectively. In addition, Ca 2p spectrum could be resolved into two peaks for Ca 2p3/2 and 2p1/2 at 347.4 and 351.3 eV, which are related to hydroxyapatite. And, the P peak can also be deconvoluted into two peaks for P1/2 and P3/2 levels with binding energy 134.2 and 133.4 eV, respectively. From the result of soaking test, the apatite morphologys were well-formed onto the modified surface according to the different conditions.

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마우스에서 타액선암 동위종양 모델 제작을 위한 실험적 연구 (AN EXPERIMENTAL STUDY FOR ESTABLISHMENT OF ORTHOTOPIC SALIVARY TUMOR MODELS IN MICE)

  • 박영욱;정성훈
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권2호
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    • pp.81-93
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    • 2007
  • Purpose: Adenoid cystic carcinoma (ACC) is a relatively rare tumor that arises in glandular tissues of the head and neck region and sometimes has a protracted clinical course with perineural invasion and delayed onset of distant lung metastasis. Treatment failure of salivary ACC is most often associated with perineural and hematogenous tumor spread. However, very little has been known about the cellular and molecular mechanisms of perineural invasion and hematogenous distant metastasis of parotid ACC. This study was designed to develop an orthotopic tumor model of parotid adenoid cystic carcinoma in athymic nude mice. Experimental Design: A melanoma cell line was injected into the parotid gland of athymic mice to determine whether such implantation was technically feasible. A parotid ACC cell line was then injected into the parotid gland or the subcutaneous tissue of athymic mice at various concentrations of tumor cells, and the mice were thereafter followed for development of tumor nodule. The tumors were examined histopathologically for perineural invasion or regional or distant lung metastasis. We used an oral squmous cell carcinoma cell line as control. Results: Implantation of tumor(melanoma) cell suspension into the parotid gland of nude mice was technically feasible and resulted in the formation of parotid tumors. A parotid ACC cell line, ACC3 showed no significantly higher tumorigenicity, but showed significantly higher lung metastatic potential in the parotid gland than in the subcutis. In contrast, mucosal squmous cell carcinoma cell line doesn’t show significantly higher lung metastatic potential in the parotid gland than in the subcutis. The ACC tumor established in the parotid gland seemed to demonstrate perineural invasion of facial nerve, needs further study. Conclusion: An orthotopic tumor model of salivary ACC in athymic nude mice was successfully developed that closely recapitulates the clinical situations of human salivary ACC. This model should facilitate the understanding of the cellular and molecular mechanisms of tumorigenisis and metastasis of salivary ACC and aid in the development of targeted molecular therapies of salivary ACC.