• 대한치과교정학회지
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• 제29권6호
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• pp.637-648
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• 1999

교정 치료 후 이상적인 교합과 양호한 심미적 결과를 얻기 위해서 일반적으로 교정 장치 제거하기 4개월에서 7개월 전에 detailing을 시행한다. 이와 같은 과정을 finishing이라고 하며, 이 과정은 최종적인 양호한 결과를 얻는데 있어서 필수적이다. 일부 교정의는 finishing을 위한 특별한 이론적 근거 및 기준 없이 이 과정을 교정 치료의 마지막 단계에서 시행하면 되는 것으로 여기고 있다. 그러나, 최종적인 양호한 교정 치료 결과를 얻기 위해서는finishing 과정이 총 치료 계획의 부분으로 치료의 초기 단계에서부터 고려되어야만 하며, 교정 장치 제거를 위한 이론적 근거 및 기준에 근거한 finishing을 위한 checklist가 필요하다. 이 checklist는 크게 네 부류로 분류할 수 있다. 즉, 교합 요인, 심미적 요인, 치주적 요인과 습관적 요인으로 분류할 수 있다. 교합 요인에서 점검해야할 요소로는 alignment, marginal ridge discrepancy, interproximal contact, anterior inclination, posterior inclination, overjet, overbite, arch form과 functional occlusion 등이 있다. 심미적 요인에는 gingival form, crown form, crown width과 crown length 등이 있다. 치주적 요인에는 root angulation, bone level 등이 있다. 습관적 요인에는 mouth breathing, tongue position at rest, tongue thrust habit, lip biting, nail biting과 finger sucking 등이 있다.

• 대한심미치과학회지
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• 제25권1호
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• pp.15-24
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• 2016

전치부에서는 비록 임플란트가 기능적으로 문제가 없다고 하더라도 심미적인 문제가 있다면 실패로 간주한다. 2003년 Kan은 임플란트의 골 레벨은 인접치아의 골 레벨에 의해 결정된다고 보고하였다. 그 후로 많은 학자들이 인접치아의 골 소실이 있는 증례에서 어떻게 심미적 결과를 얻을 수 있는지에 대하여 연구해왔다. 2012년 Takino가 지금까지 여러 저널을 정리 및 분류하여 Class 1부터 4로 발표하였다. Class 1과 2는 인접치의 골소실이 없는 경우, Class 3,4는 인접치의 골소실이 있는 경우로 나누어서 각 분류마다 최적의 심미를 얻을 수 있는 방법에 대하여 설명하였다. 인접치의 골소실이 없는 경우에는 쉽게 심미적 결과를 얻을 수 있으나 인접치까지 골소실이 있는 경우는 수술이 복잡해지고 심미적 결과를 장담하기 힘들다. 따라서 장기적인 안정적 결과를 유지하기 위해서는 인접치에 대한 골재생술이 필요하다. 하지만 그 과정이나 치료법이 너무 복잡하여 이 저널에서는 기존의 수술법을 단순화하여 쉽게 비슷한 결과를 얻을 수 방법을 보고하고자 한다.

• 대한치과의사협회지
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• 제52권12호
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• pp.762-770
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• 2014

Bony exostosis, one of the osseous deformities, could act as a contributing factor of periodontal disease since it makes proper tooth brushing difficult and causes traumatic ulcer. The purpose of this case report is to show improvement of periodontal health by removal of bony exostoses and creation of physiologic osseous form. A 58 year-old female patient with recurrent ulcer and pain on bony exostoses located on left maxillary palatal area and both mandibular buccal areas was treated. Exostoses were removed and physiologically positive osseous form was created following vertical grooving, radicular blending, flattening interproximal bone and gradualizing marginal bone. The patient showed no further recurring traumatic ulcer and bone exposure. Moreover, periodontal pocket was eliminated and food impaction was decreased. In conclusion, periodontal health could be achieved through removal of multiple bony exostoses and development of ideal osseous form.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.27-46
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• 1996

The purpose of this study was designed to compare with the effects of 4 different surface active bioceramics on the healing process of alveolar bone defects in dogs. Artificial alveolar bone defects depth 4-6mm, width 3-4mm) were created with # 6 round bur at interproximal areas of maxillary canine, maxillary 2nd premolar, mandibular canine, and mandibular 3rd premolar. porous hydroxyapatite(Interpore $200^R$) , 45S5 bioglass, CJ4/lOC crystalline glass, and JJ crystalline glass were implanted in intrabony defects randomly. Experimental groups were divided into 4 categories according to its implant material. After implantation, all groups were examined postoperatively 4 weeks to 12 weeks. 3 dogs was selected randomly and sacrificed after vascular perfusion with 2.5% glutaraldehyde at every 4 weeks. Tissue blocks with surroundig alveolar bone and soft tissues were removed and immersed in formaldehyde/glutaraldehyde fixative. After 20 weeks decalcification with EDTA and formic acid, sections were made and observed under light microscope and transmission electron microscope. In all experimental groups, the encapsulation of inactive connective tissue was observed around graft particles in 4 weeks. As time elapsed, the thickness of surrounding connective tissue was decreased. Osteoconductive bone growth pattern was seen apparently in all groups. CJ4/lOC crystalline glass showed the most active bone formation until 8 weeks. 45S5 bioglass was, however, the most active in new bone formation at 12 weeks. Though there was difference in resorption rate among grafting materials, the size of graft particles was decreased gradually. 45S5 bioglass was resorbed faster than the others. On the other hand, porous hydroxyapatite was degraded most slowly. Phagocytosed particulate matters was observed in the cytoplasm of multinuclear multinuclear giant cell and macrophage under transmission electron microscope. The results suggested suggested that 45S5 bioglass and CJ4/lOC crystalline glass may have some enhanced reparative potential when compared to porous hydroxapatite in the treatment of periodontal defeds. JJ crystalline glass reguires a further investigation of the safety of its use.

• Journal of Periodontal and Implant Science
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• 제23권3호
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• pp.359-373
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• 1993

The ultimate objective of periodontal therapy is not only stopping the progression of periodontal disease, but also promoting the regeneration of lost periodontal tissue. Guided Tissue Regeneration, which is based on the principle that the goal of periodontal regeneration can be achieved by preventing apical migration of gingival epithelium and blocking cells originating from connective tissue, has been developed and used as a clinical procedure, and although it has shown excellent results in connective tissue healing, there have not been many studies showing its effect on the regeneration of alveolar bone loss due to periodontal disease. The objectives of this study are to investigate the result of 12 months-long treatment following guided tissue regeneration using expanded polytetrafluoroehylene membrane, and to observe the presence of regenerated alveolar bone. Forty-one teeth from 28 patients with clinical diagnosis of periodontitis has been selected. In fifteen of those interproximal intrabony defects, only flap operation had been carried out, and designated as the control group. Twenty-six intrabony defects received e-PTFE membrane following flap operation, and designated as the experimental group. Eleven teeth whose membrane had been exposed were excluded from the experiment. Various measurements including probing depth, loss of attachment, probing bone level and gingival recession have been recorded at 6th month and 12th month, and the significance of the changes has been analyzed. The results are as follows: 1. Probing depth at 6th and 12th month has shown a significant decrease in both groups (p<0.01), but significantly higher decrease was found in the experimental group compared to the control at the month(p<0.05). 2. Loss of attachment at 6th and 12th month has shown a significant decrease in both groups, but significantly higher decrease was found in the experimental group compared to the control (p<0.05). 3. Probing bone level at 6th and 12th month has shown a insignificant decrease in the control group and significant decrease in the experimental group (p<0.01). Significantly higher decrease in probing bone level was found in the experimental group (p<0.05). 4. Gingival recession at 6th and 12th month has shown a statistically significant increase (p<0.05), and the control group showed higher increase compared to the experimental group although no statistical significance was found. As these results have shown, the use of e-PTFE membrane in intrabony pockets results in marked decrease in the loss of attachment and probing bone level. This seems to indicate that e-PTFE membrane may play a role in alveolar bone regeneration in intrabony defects.

• 대한치과교정학회지
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• 제30권5호
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• pp.599-611
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• 2000

교정치료에 의해 빚어지는 치조골 소실의 정도를 좌, 우측 제1대구치의 근, 원심면에서 치료 전, 후의 파노라마 필름을 이용하여 비교평가하고 치조골 소실에 미치는 영향 요소들을 알아보고자 하였다. 고정식 교정장치 치료를 받은 216명의 환자들은 104명의 성장군과 112명의 성인군으로 나뉘어 졌으며 4개 소구치의 발거가 이루어진 경우는 각각 50명씩이었다. 치료 전, 후 파노라마 사진에서 상하 좌우 제1대구치의 근심 및 원심 부위의 치조골 높이를 백악법랑질경계에서 치조골의 최첨점까지 치아 장축에 평행하게 계측하여 다음과 같은 결론을 얻었다. 1. 치료 시작시, 성인군은 성장군보다 유의하게 치조골 수준이 낮았다. 2. 치료 후 치조골 수준은 치료 전 수준보다 유의하게 낮았다. 3. 성장군과 성인군 간에 치조골 변화량의 유의한 차가 없었다. 4. 성인발치군은 비발치군보다 유의하게 더 많은 치조골 소실을 모든 원심면에서 보였다. 5. 상악은 하악보다 통계적으로 유의하게 더 많은 치조골 소실을 근심면에서 보였다. 6. 성인군은 원심면에서 근심면보다 유의하게 더 많은 치조골 소실을 보였다.

• Journal of Periodontal and Implant Science
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• 제44권6호
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• pp.300-306
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• 2014

Purpose: A laterally positioned flap (LPF) combined with a subepithelial connective tissue graft (SCTG) is one of the conventional approaches for resolving gingival recession defects, with the advantages of flap flexibility and extended coverage of the tissue graft. However, thus far, evidence is lacking for the use of this technique for the treatment of advanced gingival recession defects. This report discusses three Miller class III cases with interproximal bone loss and wide and deep defects treated with a combination procedure of a modified laterally positioned flap (mLPF) and SCTG. Methods: mLPF combined with SCTG was performed for each case. The defect size and the degree of hypersensitivity at baseline and the final appointment in each case were documented. Results: The three cases had a mean initial defect of $7.7{\pm}1.5mm$ and a mean residual defect of $1.7{\pm}1mm$ at the 6-, 3-, and 36-month follow-up, respectively, after the root coverage surgery. The symptom of hypersensitivity was improved, and the patients were satisfied with the clinical outcomes. Conclusions: The results demonstrated that the combination of mLPF with SCTG is promising for treating these advanced cases with respect to obtaining the expected root coverage with the gingival tissue.

• 대한치과교정학회지
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• 제22권3호
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• pp.579-589
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• 1992

Non-steroidal anti-inflammatory agents are used to relieve pain and to reduce swelling in dental clinics. This experiment was performed to study the effect of non-steroidal anti-inflammatory agents in Sprague-Dawley rats on orthodontic tooth movement. Thirty rats were used and divided six groups of five rats each. The first group, administered saline and no orthodontic force, served as a normal group. The second group, administered saline and applied experimental force, was control group. The other four groups were administered Aspirin, Pontal, Tyrenol and Indomethacin each, and applied experimental orthodontic force by 1/4 inch elastic, inserted into the interproximal space between maxillary first and second molar in rats. All experimental rats were sacrificed after three days, and the specimens were sectioned horizontally five times serially, and counted the number of osteoclasts appeared at the compressed surface of interradicular bone on first buccal root of first molar on light microscope. The obtained results were as follows: 1. The number of osteoclast on the compressed surface of the interradicular bone on first buccal root of the first molar in the four non-steroidal anti-inflammatory agents groups decreased in contrast to control group. 2. In non-steroidal anti-inflammatory agents group, the number of osteoclast in Indomethacin group was least among the all non-steroidal anti-inflammatory agents groups. From the above results, it was believed that the non-steroidal anti-inflammatory agents may have the inhibitory effect of tooth movement during orthodontic treatment.

• Journal of Periodontal and Implant Science
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• 제25권3호
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• pp.568-586
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• 1995

542 periodontal patients having early-onset periodontitis(EOP) have been reclassified into a more homogeneous phenotypic subsets by newly revised radiographic criteria. Representative patients of each EOP subform have been examined of serum IgG subclass antibodies against periodontopathic bacteria, Porphyromonas gingivalis(Pg) 381 and of genetic markers for IgG allotypes to clarify the relationship between these parameters and phenotype expression of each subform. The early onset periodontitis could be reclassified by the radiographic parameters combining the mean interproximal alveolar bone loss(BL) and the radiographic ratio(between 1st molars and the adjacent teeth: Ratio) with statistical significance(p<0.001 by MANOVA). Moreover these EOP subforms could clearly be delineated from adult periodontitis. Of subform I and II(localized type EOP) patients with minimal mean bone loss(BL<5.0), patients demonstrating disease activities in localized areas(Ratio.>1.5) showed the elevated responses in all the IgG subclasses against Pg compared with those of patients without disease activity(Ratio <1.5). There were gradual increase in the IgG2 and IgG4 titers against Pg as the disease developed into the generalized forms suggesting the possible role of these antibodies in modulating the phenotype expression. The genetic marker study for IgG allotype revealed that mean IgG2 and IgG4 subclass titers were significantly higher(p<0.01, p<0.05, respectively) in patients who were positive for G2m(n). This indicated that IgG subclass responsiveness against the bacterial antigens are under the immnuogenetic control. The observed frequencies of G2m(n) were significantly higher (p<0.05) in subfrom IV patients who had the characteristic features of classical rapidly progressing periodontitis indicating the possible genetic predisposition in these patients.

• Journal of Yeungnam Medical Science
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• 제39권4호
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• pp.322-331
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• 2022

Background: The combined use of biomaterials for regeneration may have great biological relevance. This study aimed to compare the regenerative potential of biphasic calcium phosphate (BCP) alone and with growth factor enamel matrix derivatives (EMDs) for the regeneration of intrabony defects at 1 year. Methods: This randomized controlled trial included 40 sites in 29 patients with stage II/III periodontitis and 2/3 wall intrabony defects that were treated with BCP alone (control group) or a combination of BCP and EMD (test group). BCP alloplastic bone grafts provide better bio-absorbability and accelerate bone formation. EMDs are commercially available amelogenins. Mean values and standard deviations were calculated for the following parameters: plaque index (PI), papillary bleeding index (PBI), vertical probing pocket depth (V-PPD), vertical clinical attachment level (V-CAL), and radiographic defect depth (RDD). Student paired and unpaired t-tests were used to compare the data from baseline to 12 months for each group and between the groups, respectively. The results were considered statistically significant at p<0.05. Results: At 12 months, the PI and PBI scores of the control and test groups were not significantly different (p>0.05). The mean V-PPD difference, V-CAL gain, and RDD difference were statistically significant in both groups at 12 months (p<0.001 for all parameters). Intergroup comparisons showed that the mean V-PPD reduction (2.13±1.35 mm), V-CAL gain (2.53±1.2 mm), and RDD fill (1.33±1.0 mm) were statistically significant between the groups at 12 months (p<0.001 for all parameters). Conclusion: BCP and EMDs combination is a promising modality for the regeneration of intrabony defects.