• 대한치과보철학회지
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• 제56권3호
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• pp.227-234
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• 2018

과도한 치아의 마모는 심미적인 문제와 치아의 과민성, 수직 고경의 감소 등의 합병증이 발생한다. 본 증례는 20년 동안 류마티스 관절염 기왕력을 가진 환자를 문진, 임상적 및 방사선학적 검사를 통해 마모가 발생한 원인을 분석하고 완전 구강 회복술을 시행한 것이다. 최종보철물 제작 후 보철물 파절 예방과 안정된 측두하악관절의 유지를 위해 나이트 가드를 제작하였다. 심미적, 기능적으로 만족할만한 결과를 보였기에 이를 보고하는 바이다.

• 한국치위생학회지
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• 제10권5호
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• pp.807-817
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• 2010

Objectives : The purpose of this study was to analyzes the job implementation of dental hygienist at dental hospital(university), dental clinic and general hospital in the city of Gwangju. Methods : The subjects in this study were dental hygienists who worked at dental hospital(university), dental clinic and general hospital in the city of Gwangju. A survey was conducted by post from June 10 to August 10. Out of the collected data, 204 answer sheets were analyzed. Results : 1. 'Medical & Dental history taking', 'Extra & Intra oral examination' and 'Dental hygiene care plane' in dental clinic were significantly higher than dental hospital(university) and general hospital(p<0.001). 'Remove of extrinsic stain' and 'Treatment of hypersensitivity tooth' in dental clinic and general hospital were significantly higher than dental hospital(university)(p<0.001). 'Preventive dental caries treatment' and 'Diet control' were shown the low frequency of job implementation. 2. Almost task elements of dental assistance duty shown that dental hygienists under the 24 years old were significantly higher dental hygienists over the 30 years old(p<0.05) and dental clinic and general hospital were significantly higher than dental hospital(university)(p<0.05) in frequency of job implementation. 3. 'Dental staff supervision', 'Patient management' and 'Dental chart arrangement' shown that dental hygienists over the 30 years old were significantly higher than dental hygienists under the 24 years old in frequency of job implementation(p<0.05). 'Infection control' of dental hygienists over 30 years old was significantly lower than dental hygienists under the 24 years old(p<0.001). Conclusions : The results of this study indicate that a scope of dental hygienists' job need to extend also in order to accomplish a job efficiently, is suggested that the effort is necessary to improve a quality of dental hygienist and to change of recognition of the dentist about dental hygienists' job.

• 한국치위생학회지
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• 제9권2호
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• pp.193-205
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• 2009

The purpose of this study was to use the result as basic resources for oral health project for elderly people. we found the needs of oral health project and perceived oral health status, oral health knowledge, attitude, behavior of elderly people. we conducted a study on 194 elderly more than 60 years living in several social welfare facility, asylum, or care centers in Jeolla province. Through self-filled questionnaires and direct interviews from December 2008 to January 2009. The obtained result were as follows. 1. In perceived oral health status, 57.7% of respondents said they have hypersensitivity and 42.8% of respondents needed denture. 2. In oral health promoting behavior, 67.0% of respondents said they didn't have any tooth brushing and 45.9% of respondents said they haven't visited to dentist for the last year. 3. In oral health knowledge, 94.8% of respondents gave correct answers on dental caries prevention but only 7.2% of respondents gave correct answers on dental caries cause. 4. In oral health attitude, 40.2% of respondents said they don't recognize the importance of oral hygiene devices. 46.9% of respondents the unnecessary to see a dentist even though they don't have toothache. 5. Needs of oral health project, 53.6% of respondents said they wanted to have a dentist come over their house. Therefore, oral health projects should have vehicles of dental treatment equipment. It is necessary to visit places where elderly people live and treat them in person. Also, it is vital to continue educate people about oral health knowledge in a systematic way to change their attitude toward oral health. Moreover, it is necessary to implement oral health promotion behavior more proactively.

• Restorative Dentistry and Endodontics
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• 제25권2호
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• pp.289-298
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• 2000

Carbamide peroxide is usually used for vital teeth bleaching at home. Complications such as tooth hypersensitivity and/or gingival irritation are frequently reported. Therefore, this study was performed to evaluate any possible histological changes in pulp and periodontal tissue by carbamide peroxide bleaching gel in rats. 10% and 15% carbamide peroxide containing nightguard for upper molar were worn for 4 hours a day. The rats were sacrificed after 1 day, 2 days, 3 days, 4 days and 6 days application of carbamide peroxide respectively. The results were as follows : Mild infiltration of inflammatory changes below the junctional epithelium and hyperplasia of epithelium were observed in both 10% and 15% carbamide peroxide treated groups. In all experimental groups, odontoblasts were changed from columnar to cuboidal shape and/or obliterated and the focal loss of predentin was observed in pulp horn. With increasing time of application, these changes were more remarkable, but limited in pulp horn. Inflammatory reactions, vacuolar changes and hyaline degenerations of the pup tissue were also observed in some cases. These results suggested that carbamide peroxide gel used in home bleaching could cause reversible pulpal irritation.

• Restorative Dentistry and Endodontics
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• 제34권2호
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• pp.154-161
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• 2009

8.3%의 carbamide peroxide를 함유한 펜형 코팅용 미백제인 BlancTis Forte (NIBEC, Seoul & JinCheon)를 실험군으로, 3% hydrogen peroxide를 함유한 Whitening Effect Pen (LG, Seoul) 제재를 대조군으로 각각 피험자 20명에게 2시간씩 1일 2회 제조사의 지시대로 치아표면에 4주간 적용하도록 지시하고 색조개선 효능과 안전성을 평가하였다. 미백 효과는 미백 전 및 미백 2주, 4주, 및 미백 종료 4주 후에 $Shadepilot^{TM}$을 이용하여 색 변화를 측정하였고. 매 내원시기마다 모든 환자는 치수생활력 검사와 치주 및 치태 검사를 통해 부작용 여부 (치아과민증 및 구강 내 연조직의 부작용)를 기록한 후 다음과 같은 결과를 얻었다. 1, 실험군 및 대조군의 색 변화량 (${\Delta}E$)은 2이상으로 인지할 수 있는 색 변화를 보였으며, 두 제품간에는 통계적으로 유의한 차이를 보이지 않아 (p > 0.05) 유사한 미백효능을 나타냄을 알 수 있었다. 2. 미백효과는 명도의 개선보다는 주로 a, b값의 변화에 의한 것으로 특히 실험군에서 b값의 변화, 즉 황색조의 개선효과가 대조군에 비해 유의성 있게 높은 것으로 나타났다 (p < 0.05). 3. 치아나 치은의 과민증이나 이상증상을 호소하는 피험자는 없어 두 제품 모두 안전성을 확인할 수 있었다.

• 대한소아치과학회지
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• 제27권1호
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• pp.54-61
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• 2000

아말감은 널리 사용되어 온 대표적 치과재료이지만 치질과의 접착성이 없어 와동의 형태에 의해 유지되는 단점을 가진다. 아말감 수복물은 산화물에 의한 변연봉쇄가 일어나기 전까지 초기에 큰 미세누출을 보이며 수복초기에 이를 적절하게 예방하지 않으면 타액이나 미생물이 와동내에 침투하게 되고 이로 인해 수복 후의 과민반응, 충전물의 용해 및 파괴, 변연 변색과 2차 우식이 유발되어, 결과적으로 수복물의 수명이 단축되며 치수 병변이 발생될 수도 있다. 최근 기존 아말감 수복의 장점을 그대로 유지하면서 치질삭제를 줄이고 변연을 봉쇄하며 소와열구에 예방적 처치를 함께 할 수 있는 수복법이 제안되었는데 이를 이른바 sealed amalgam이라 한다. 이 술식은 예방적 확대 없이 병소만을 제거한 뒤 수복물 변연과 인접 소와열구에 치면열구전색재를 도포함으로서 소와열구의 예방적 충전은 물론 수복물 변연과 치질사이의 틈을 봉쇄하여 미세누출을 감소시킬 수 있다고 하였다. 이에 저자는 아말감 수복후 수복물의 마무리 처리와 전색재 적용시점을 달리 하여 sealed amalgam 수복과 기존의 아말감 수복과의 미세누출의 차이를 비교하고자 30개의 상, 하악 소구치를 준비하여 V급 와동을 소구치의 협, 설측에 형성하고 통상적 아말감 수복을 시행한 후 다음의 각 군으로 나누어 처리하였다. 제 1 군 : 24시간 후 연마 (대조군) 제 2 군 : 연마하지 않음, 즉시 전색재 적용 제 3 군 : 연마하지 않음, 열순환(thermocycling) 500회 후 전색재 적용 위의 처리 후 각 군을 $5^{\circ}C$와 $55^{\circ}C$의 온도변화를 30초씩 번갈아 주며 총 500회의 열순환을 실시한 후 1% methylene blue 용액에 침윤시켜서 100% 습도가 유지된 $37^{\circ}C$ 항온기에 24시간 보관하였다. 치아를 레진에 매몰한 후 협설측으로 치아 장축에 평행하게 절단하여 stereomicroscope를 사용해 색소침투도를 관찰하여 다음과 같은 결론을 얻었다. 1. 평균 미세누출은 연마하지 않고 바로 치면열구전색재를 도포한 2군이 가장 낮았고, 연마만 시행한 1군이 가장 높았다. 2. 실험군간의 미세누출 비교에서 연마만 시행한 1군은 2군에 비해 미세누출이 켰으며 통계적으로 유의성 있는 차이를 보였다(p<0.05). 3군은 1군보다 평균미세누출이 작았으나 통계적으로 유의한 차이가 없었다(p>0.05). 2군은 3군보다 평균 미세누출이 작았으나 통계적으로 유의한 차이가 없었다(p>0.05).

• Restorative Dentistry and Endodontics
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• 제36권4호
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• pp.306-312
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• 2011

연구목적: 본 임상 연구의 목적은 15% 과산화수소를 함유한 전문가용 치아 미백제의 광활성화 여부에 따른 미백효과와 안전성에 관해 평가하는 것이다. 연구 재료 및 방법: 33명의 지원자를 광조사를 하는 실험군(n = 17)과 광조사를 하지 않는 대조군(n = 16)으로 무작위로 나누고 Zoom2 미백제(15% $H_2O_2$, Discus Dental)로 총 45분간 치료하였다. Vitapan Classical shade guide와 Shadepilot (DeguDent)을 이용해 스크리닝 검사 시, 미백직후, 미백 종료 1달 및 3달 후 색조측정을 시행하였다. 통계분석을 위해 t-test, repeated measure ANOVA 와 카이제곱 검정을 시행하였다. 결과: Zoom2 미백제는 미백 전후를 비교할 때 실험군과 대조군 모두에서 뚜렷한 색조 변화를 가져왔다. 하지만, 두 군 사이의 색조 변화량을 비교했을 때 통계학적으로 유의성 있는 차이는 관찰되지 않았다(p > 0.05). 또한 미백 종료 3달 후에도 치아의 색조 회귀는 관찰되지 않았다. 미백 후 일시적인 지각과민증은 전체 환자의 39.4%에서 보고되었지만, 두 군간의 차이는 보이지 않았다(p > 0.05). 결론: 광조사로 인해 부가적인 미백효과의 증가는 물론 어떠한 부작용 증가도 관찰되지 않았다.

• Restorative Dentistry and Endodontics
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• 제22권1호
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• pp.479-489
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• 1997

The purpose of this study was to evaluate the effect of the Nd : YAG laser on the tooth hypersensitivity by the observation of the morphological changes of the dentinal surface irradiated with Nd : YAG laser by use of SEM. In 40 mandibular and maxillary molars without any carious lesion or restoration, severe attrition and abrasion, Enamel was removed with fine grit diamond bur and exposed dentinal surfaces were polished with Soflex discs. In control group (10 teeth), exposed dentinal surfaces were acid-etched with 10 % Maleic acid for 15 seconds. In the experimental group 1 (10 teeth), acid-etched dentinal surfaces with 10% Maleic acid were prepared by Nd : YAG laser (6 watts power, 1 psi water, 18 psi air) for 2 minutes. In the experimental group 2 (10 teeth), exposed dentinal surfaces were irradiated with Nd: YAG laser (10 watts power, 3 psi water, 10 psi air) until the painted black stains on the dentinal surfaces were completely removed. In the experimental group 3 (10 teeth). dentinal surfaces were prepared with Nd : YAG laser (6 watts power, 1 psi water, 18 psi air) until the painted black stanins on them were completely removed and then the irradiated dentinal surfaces were acid-etched with 10 % Maleic acid for 15 seconds. The specimens were routinely processed and observed with scanning electron microscope. The results were as follows : 1. In the irradiated dentinal surfaces, the characteristics of the melting and recrystalization on the dentinal surfaces were observed. Compared with the results in the control group, we could observe that in the irradiated dentinal surfaces, the aperture of the dentinal tubules were reduced and there were more debris obstructing the dentinal tubules. 2. In the irradiated dentinal surfaces, crater structures were commonly present and in the crater bottoms, there were a lot of bead like melted dentin structures, which had the ruptured opening in the center of them. 3. The melted dentins and cracks in the smear layer were less frequently observed in the irradiated dentinal surfaces using copious cooling water than in the irradiated dentinal surfaces using scare cooling water.

• 한국산학기술학회논문지
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• 제11권4호
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• pp.1534-1539
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• 2010

본 연구는 서울시에 소재한 S중학교 1학년 251명, S남자고등학교 1학년 220명을 대상으로 구강검진을 실시한 결과 아래와 같다. 구강증상에 대한 중, 고등학생들의 치아 지각과민 경험은 고등학생이 23.2%로 중학생 14.3%보다 차갑고 뜨거운 음료 혹은 음식을 마시거나 먹을 때 치아가 아픈 경험이 있었으며, 유의한 차이를 보였다($\chi^2=6.08$, p<.05). 치아 통증에 대한 경험은 고등학생이 9.1%로 중학생 4.4%보다 치아가 쑤시고 욱신거리고 아픈 경험이 있었으며, 유의한 차이를 보였다($\chi^2=4.23$, p<.05). 중학생과 고등학생의 구강건강행태 결과 중학생이 48.6%로 고등학생 26.4%보다 지난 1년 간 치과병원을 간 적이 더 높게 나타났으며, 통계적으로도 유의한 차이를 보였다($\chi^2=24.56$, p<.001). 하루 동안 잇솔질 시기는 중학생이 68.5%로 고등학생 57.3%보다 아침식사 후에 이를 많이 닦았으며($\chi^2=6.39$, p<.05), 점심식사 후에는 고등학생이 16.8%로 중학생 7.2%보다 이를 많이 닦았으며, 통계적으로도 유의한 차이를 보였다($\chi^2=10.58$, p<.01). 또한 중학생과 고등학생의 구강검사 판정결과 고등학생이 44.1%로 중학생 22.3%보다 우식치아가 많았으며($\chi^2=25.36$, p<.001), 중학생이 9.6%로 고등학생 4.1%보다 상실치아가 더 많았고, 통계적으로도 유의한 차이를 보였다($\chi^2=5.39$, p<.05).

• Journal of Periodontal and Implant Science
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• 제28권4호
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• pp.645-660
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• 1998

The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was $0.83{\pm}0.12$ by non surgical treatment and $0.82{\pm}0.14$ by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving nonsurgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.