• 구강회복응용과학지
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• 제25권3호
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• pp.243-253
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• 2009

임플란트 술식에서 방사선 영상 기술, 컴퓨터 소프트웨어의 발전으로 정확한 진단 및 surgical guide의 제작이 가능해졌다. 본 증례는 양악 무치악 환자에서 고정성 임플란트 보철을 위해 CAD/CAM technique을 이용하여 수술을 하고 즉시 하중을 가한 증례이다. Planning software program을 이용하여 해부학적 구조물과 단면상을 고려하여 상 하악에 각각 6개씩의 임플란트를 최적의 위치에 계획하였다. 정밀한 surgical guide 이용하여 미리 계획된 위치와 방향으로 무절개 임플란트 식립 수술을 시행하였다. 즉시 사용 가능한 고정성 임시 보철물을 미리 제작해 수술 직후 장착하여 환자의 만족도를 높였으며, 이를 6개월간 평가하여 심미적이며, 기능적으로 안정적인 최종 보철물을 제작할 수 있었다.

• 구강회복응용과학지
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• 제34권1호
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• pp.46-55
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• 2018

치조골의 흡수와 치주조직의 염증을 동반한 심한 치주질환 환자에서 임플란트를 통한 구강 회복은 임상적으로 어려움이 있다. 하지만 골 형태에 따른 적절한 임플란트 식립 위치를 선정한다면 불필요한 골 이식이나 연조직 수술을 최소로 할 수 있다. 최근에는 cone beam CT 촬영과 소프트웨어를 이용하여 환자의 해부학적 형태와 보철적인 위치를 고려하여 임플란트 식립 위치를 선정할 수 있게 되었고 3D printing 기술을 통해 제작된 surgical guide를 통해 계획된 위치로 정확한 수술이 가능하게 되었다. 본 증례는 70세 여성 환자로 심한 치주질환으로 인해 전악 치아의 발치가 필요하였으며 임플란트 지지 고정성 보철물로 전악 구강회복을 시행하였다. 수술 시에는 보철적인 위치를 고려한 surgical guide를 이용해 flapless 방식으로 임플란트를 식립하였고 수술 전에 CAD/CAM 방식으로 제작된 임시보철물을 즉시 부하하였다. 이후 맞춤형 지대주와 지르코니아를 이용한 보철물을 제작하였으며, 만족스러운 심미 및 기능 회복을 보였기에 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제33권1호
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• pp.52-55
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• 2016

Guide wire fracture during percutaneous coronary intervention (PCI) is rare. It can cause fatal complications such as thrombus formation, embolization, and perforation. Guide wire fracture could occur during intervention for severely calcified stenotic lesions, and rarely from distal small branches of stenotic lesions. There are several methods for its management depending on the material character, position, length of the remnant, and the patient's condition. If percutaneous retrieval was not achieved, the surgical procedure should be considered for prevention of potential risks, although the remnant guide wire does not usually cause complications. We experienced a patient with a guide wire fracture during PCI, and managed to prevent its complications through surgical removal of the remnant wire. We report this case here.

• Imaging Science in Dentistry
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• 제40권4호
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• pp.171-178
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• 2010

Purpose : The purpose of this study is to develop a surgical stent for dental implant procedure that can be easily applied and affordable by using cone beam computerized tomography (CBCT). Materials and Methods : Aluminum, Teflon-PFA (perfluoroalkoxy), and acetal (polyoxymethylene plastic) were selected as materials for the surgical stent. Among these three materials, the appropriate material was chosen using the CBCT images. The surgical stent, which could be easily placed into an oral cavity, was designed with chosen material. CBCT images of the new surgical stent on mandible were obtained using Alphard-3030 dental CT system (Asahi Roentgen Co., Ltd., Kyoto, Japan). The point of insertion was prescribed on the surgical stent with the multiplanar reconstruction software of OnDemand3D (CyberMed Inc., Seoul, Korea). Guide holes were made at the point of insertion on the surgical stent using newly designed guide jig. CBCT scans was taken for the second time to verify the accuracy of the newly designed surgical stent. Results : Teflon-PFA showed radiologically excellent image characteristics for the surgical stent. High accuracy and reproducibility of implantation were confirmed with the surgical stent. Conclusion : The newly designed surgical stent can lead to the accurate implantation and achieve the clinically predictable result.

• 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.

• 대한두개안면성형외과학회지
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• 제19권3호
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• pp.163-167
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• 2018

Velopharyngeal insufficiency (VPI) is a common complication after primary palatoplasty. Although the several surgical treatments of VPI have been introduced, there is no consensus guide to select the optimal surgical treatment for VPI patients. The selection of surgical treatment for VPI depends on a multimodal patient evaluation, such as perceptual speech evaluation, nasometery and nasoendoscopy. We can provide more adequate treatment for VPI through the deeper understanding of anatomy and physiology in VPI.

• The Journal of Advanced Prosthodontics
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• 제7권1호
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• pp.76-84
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• 2015

This article reviews the topic of how to identify and develop a removable partial denture (RPD) path of placement, and provides a literature review of the concept of the RPD path of placement, also known as the path of insertion. An optimal RPD path of placement, guided by mutually parallel guide planes, ensures that the RPD flanges fit intimately over edentulous ridge structures and that the framework fits intimately with guide plane surfaces, which prevents food collecting empty spaces between the intaglio surface of the framework and intraoral surfaces, and ensures that RPD clasps engage adequate numbers of tooth undercuts to ensure RPD retention. The article covers topics such as the causes of obstructions to RPD intra-oral seating, the causes of food collecting empty spaces that may exist around an RPD, and how to identify if a guide plane is parallel with the projected RPD path of placement. The article presents a method of using a surgical operating microscope, or high magnification (6-8x or greater) binocular surgical loupes telescopes, combined with co-axial illumination, to identify a preliminary path of placement for an arch. This preliminary path of placement concept may help to guide a dentist or a dental laboratory technician when surveying a master cast of the arch to develop an RPD path of placement, or in verifying that intra-oral contouring has aligned teeth surfaces optimally with the RPD path of placement. In dentistry, a well-fitting RPD reduces long-term periodontal or structural damage to abutment teeth.

• 대한치과기공학회지
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• 제29권1호
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• pp.147-154
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• 2007

• Archives of Plastic Surgery
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• 제47권3호
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• pp.281-281
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• 2020

• 한국CDE학회논문집
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• 제16권3호
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• pp.216-226
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• 2011

Surgeon dentists usually rely on their experiential judgments from patients' oral plaster casts and medical images to determine the positional and directional information of implant fixtures and to perform drilling tasks during dental implant surgical operations. This approach, however, may cause some errors and deteriorate the quality of dental implants. Computer-aided methods have been introduced as supportive tools to alleviate the shortcomings of the conventional approach. In this paper, we present an approach of 3D dental implant simulation which can provide the realistic and immersive experience of dental implant information. The dental implant information is primarily composed of several kinds of 3D mesh models obtained as follows. Firstly, we construct 3D mesh models of jawbones, teeth and nerve curves from the patient's dental images using software $Mimics^{TM}$. Secondly, we construct 3D mesh models of gingival regions from the patient's oral impression using a reverse engineering technique. Thirdly, we select suitable types of implant fixtures from fixture database and determine the positions and directions of the fixtures by using the 3D mesh models and the dental images with software $Simplant^{TM}$. Fourthly, from the geometric and/or directional information of the jawbones, the gingival regions, the teeth and the fixtures, we construct the 3D models of surgical guide stents which are crucial to perform the drilling operations with ease and accuracy. In the application phase, the dental implant information is combined with the tangible interface device to accomplish 3D dental implant simulation. The user can see and touch the 3D models related with dental implant surgery. Furthermore, the user can experience drilling paths to make holes where fixtures are implanted. A preliminary user study shows that the presented approach can be used to provide dental students with good educational contents. With future work, we expect that it can be utilized for clinical studies of dental implant surgery.