• 대한소아치과학회지
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• 제41권2호
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• pp.145-151
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• 2014

본 연구의 목적은 전신질환으로 입원한 환자의 소아치과 협진 의뢰 현황에 대한 통계분석을 실시하여 소아치과로 의뢰되는 전신질환 환자 실태를 파악하는 것이다. 2012년 한 해 동안 연세대학교 세브란스 병원에 전신질환으로 입원한 소아환자 중 소아치과에 의뢰되어 실제 진료를 받았으며 그 기록이 온전한 391건을 대상으로 하였다. 환자의 나이, 성별, 전신질환명, 협진의뢰과, 협진주소, 치과적 진단명, 치과적 치료 내용, 사망여부로 분류하여 통계 분석하였으며 환자 정보의 수집은 연세의료원의 Clinical Data Retrieval System을 이용하였다. 총 288명의 환자(M:F=166:122)가 소아치과로 의뢰되었으며 평균 연령은 5.9세였다. 재활의학과에서 129건(33.1%), 소아혈액종양내과에서 80건(20.5%), 소아심장과에서 51건(13.0%), 소아신경과에서 44건(11.3%)이 의뢰되었다. 협진주소는 기본 구강검진(156cases, 39.7%), 치아우식증(55cases, 14.0%), 수술 전 검진(50cases, 12.8%)순으로 많았으며 이 외에도 구강통증, 외상, 치아동요도, 교정치료, 자해로 인한 외상, obturator 제작 등 다양한 주소로 의뢰되었음이 확인되었다. 협진 의뢰된 환자의 절반 가량은 특별한 치료 없이 구강검사만을 시행하였으며(193건, 49%), 보존치료 및 예방치료는 각각 63건, 60건으로 비슷한 것으로 나타났다. 전신질환으로 입원한 환자의 소아치과 의뢰 현황을 분석한 결과 구강검진을 포함한 다양한 주소로 의뢰됨이 확인되었으며 재활의학과 및 소아혈액종양내과에서 가장 많은 의뢰가 이루어졌다. 의뢰된 환자의 치과적 진단명은 치아우식증이 가장 많았고 이에 대한 비침습적이고 예방적 치과치료가 주로 이루어졌다. 입원환자의 전신건강관리와도 밀접한 구강질환 예방 및 처치를 위하여 치과협진이 독려되어야 할 것이며 이를 위한 의사 및 보호자의 인식 개선이 요구된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권5호
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• pp.414-421
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• 2004

This is a reprospective study on the care of odontogenic infections in admission patients with geriatric diseases. The study was based on a series of 480 patients at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, From Jan. 1, 2000, to Dec. 31, 2002. The Obtained results were as follows: 1. The systemic malignant tumor was the most frequent cause of the geriatric diseases with odontogenic infectious diseases, and refractory lung disease, systemic heart disease, type II diabetes mellitus, cerebrovascular disease, bone & joint disease, senile psychologic disease were next in order of frequency. 2. Male prediction(57.5%) was existed in the odontogenic infectious patients with geriatric diseases. But, there were female prediction in senile psychologic disease, systemic heart disease and cerebrovascular disease. 3. The most common age group of the odontogenic infectious patient with geriatric disease was the sixty decade(47.9%), followed by the seventy & eighty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with geriatric disease, peak incidence was occurred as toothache(52.7%), followed by extraction wish, tooth mobility, oral bleeding, oral ulcer, fracture of restoration, gingival swelling in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis & periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(34.2%) was showed in primary endodontic treatment (pulp extirpation, occlusal reduction and canal opening drainage) and followed by scaling, incision & drainage, only drugs, pulp capping, restoration in order.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권2호
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• pp.102-107
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• 2003

At orthodontic treatment, we have made every effort to get rigid anchorage which is not stirred when teeth move. As a result, the miniscrew that is rigid anchorage was invented recently, and now it is used widely. Concerning the advantage of miniscrew, it is reduced dependence of extraoral anchorage and it shortens treatment time for rapid tooth movement. In contrast, the defect of miniscrew is falling off it resulted from increasing of the mobility. So the purpose of this research is to be of help to prognose clinical use of miniscrew, which is inserted for intraoral anchorage, by investigating and comparing the failure rate of miniscrew for loading time. This study researches the failure rate of miniscrew for teeth movement at the orthodontic treatment. The failure rate of miniscrew in mid course, after inserting 147 miniscrews in 51 patients, is 13%(20/147). It showed no statistically significant differences as compared man with woman, maxilla with mandible, double-head with uni-head miniscrew, and drilling and non-drilling before inserting the miniscrew. In comparison below twenties with over twenties and the times that we give load to miniscrew, it produced that the failure rate of miniscrew is 9.7% higher in the case of below the twenties than over the twenties. Also, the failure rate of loading immediately is 10.8% higher than loading after 7 days. According to using driver for the insertion of miniscrew, the failure rate of miniscrew is higher in the case of using machined driver than in the case of using hand driver when the level of significance is 95%. According to the research, we can suppose that the failure rate has no concern with using miniscrew on man or woman, maxilla or mandible, the shape of head, and drilling or non-drilling before insertion of miniscrew. Therefore, we can choose eclectic miniscrew as demands. In addition, we must notify the patient, below twenties, to be possibility of high failure rate. And It is strongly recommended to give load after $1{\sim}2$ weeks for healing of the insertion area.

• Journal of Periodontal and Implant Science
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• 제34권1호
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• pp.101-112
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• 2004

Osseointegrated implnats have proven to be successful in both full and partial edentulous patients since the 1960s and recently have shown successful results when used to restore single tooth missing. However, in most studies reporting the success of single implants, single implants replacing anterior teeth are more frequently mentioned than posterior single implants. Moreover, in studies regarding posterior single implants, the replaced region seemed to be variable; the maxilla, mandible and areas from the first premolar to the second molar were mentioned. However, considering the difference in bone quality in the mandible and maxilla, and the increased occlusal force in the posterior region, the success rates in each region may be different. In this study, the cumulative success rates and amount of bone loss of single implants replacing the mandibular first and second molar, respectively, were compared and analyzed to come to the following conclusion. 1. The 20 (20 persons) single implants that were placed in the mandibular first molar region were all successful and showed a 100% 5 year cumulative success rate. Among the 27 (24 persons) single implants replacing the mandibular second molar, 8 failed (27.63%) showing a 5 year cumulative success rate of 70.37%. 2. Among the 8 failed implants, one showed symptoms of postoperative infection and one complained of parenthesia. 6 implants failed after functional loading; 5 showed mobility and one resulted in fixture fracture. 3. After the attachment of the prosthesis, there was no significant statistical difference regarding the marginal bone loss in group 1 and group 2 during the checkup period (P>0.05). In conclusion, restoration of the mandibular first molar using single implants was found to be an excellent treatment modality, and when replacing mandibular second molars with single implants, poor bone quality and risk of overloading must be considered.

• 대한치과보철학회지
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• 제56권2호
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• pp.173-178
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• 2018

직접식 금속 레이저 소결 방식 시스템은 기공 오차 및 주조 결함 없이 제작 비용 및 제조 시간 단축을 장점으로 전악 임플란트 지지 고정성 보철물 제작에 유용하다. 본 증례에서는 직접식 금속 레이저 소결 방식과 치과용 캐드캠으로 제작된 단일구조 지르코니아 크라운을 사용하여 무치악 상악에서 임플란트 지지 고정성 치과 보철물의 성공적인 결과를 보고하고 임상적 의의를 평가하였다. 51세의 건강한 중년 여성이 상악 전 치아의 동요도를 주소로 서울대학교 치과병원에 내원하였다. 모든 상악 치아 발치 후 직접식 금속 레이저 소결 기술 및 캐드캠 단일구조 지르코니아 크라운을 사용하여 코발트-크롬 프레임을 포함하는 임플란트 지지 고정성 치과 보철물을 제작하였다. 최종 수복물 장착 6개월 후, 기계적 및 생물학적 합병증은 발견되지 않았고 보철물은 기능 및 심미적으로 만족스러운 결과를 보였다. 직접식 금속 레이저 소결 시스템을 이용하여 추가적인 기공 작업 없이 임플란트 지지 고정성 보철물을 제작하여 제조 시간을 단축하고 신뢰할 수 있는 정확도와 적합성을 얻었다.

• 대한소아치과학회지
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• 제27권2호
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• pp.344-350
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• 2000

외상으로 인하여 치아가 받는 여러 가지 손상형태 중 치관-치근파절이 나타나는 빈도는 영구치에서 5%, 유치열에서는 2%라고 알려져 왔다. 치조정 하방에 파절선이 존재하고 치수노출을 동반한 치관-치근 파절에서는 크게 두가지의 보존적인 치료방법이 있다. 첫째, 교정력에 의해 정출시키는 방법과 둘째 치조와내에서 교합면 방향으로 재위치시키는 Intra-alveolar transplantation 등이 있다. 외과적 정출법은 1970년대에 소개된 이래로 교정적 정출법의 대안으로 많이 시행되고 있으며 높은 성공률을 가진 술식으로 여겨지고 있다. 본 증례는 외상으로 인해 상악 우측 중철치의 치수노출을 동반한 치관-치근 파절이 발생한 경우로 외과적 정출을 시행하기로 하였으나, 치근단 파절편의 길이가 짧아서 치아를 발거 후 회전시켜 재식하는 방법만으로는 파절선을 치조정 상방으로 위치시킬 수가 없었다. 따라서 치아를 발거한 후 파절편의 지지를 위해 치조와의 치근단부에 탈회냉동건조골을 이식한 후에 치근단 파절편을 노출한 후 suture splint를 시행하였다. 1년 3개월간의 관찰결과, 치조백선이 회복되고 정상적인 동요도를 보였으며, 염증성, 대체성 치근흡수 등과 같은 합병증은 발생되지 않았다.

• Journal of Periodontal and Implant Science
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• 제32권3호
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• pp.643-653
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• 2002

Periodontal supporting tissue goes through destruction by chronic inflammatory periodontal disease as two aspect. One is qualitive aspect such as alteration of periodontium, the other is quantitative aspect such as alveolar bone loss. According to many authors, PDL is responsible for biting force, and there are two mean. for measuring PDL's function - mobility test and biting force test. This study was conducted to compare the biting force with remaining bone level, that is, quantitative aspect of periodontium, in anterior and premolar teeth at periodontal maintenance phase. 17 patients on periodontal maintenance phase during 6 months at minimum were selected for this study. For the same condition, 4 anterior, canine, premolar teeth were tested by MPM-3000 bite-force register at the same time(a.m.l0-12), the same position, the same posture, by the same examiner. Patients of TMI), ill-fitting pros thesis, general disease, malocclusion and the teeth of TFO, absence of opposing teeth, malposition were excluded. Remaining bone level was measured on the panorama X-ray film through 5 level from 1mm below CEJ to root apex. Teeth were examined twice, and bigger one was selected. If the values showed large difference. examinatin was re-done and the mean was selected. The results were as follows ; 1. In the 4 anterior group, as the remaining bone is decreased, the average of maximal biting force is decreased. Especially, at 3/5 bone level, maximal biting force is decreased significantly(p<0.01). 2. In the canine group, as the remaining bone is decreased, the average of maximal biting force is decreased. Especially, at 2/5 bone level, maximal biting force is decreased significantly(p<0.01). 3. In the premolar group, as the remaining bone is decreased, the average of maximal biting force is decreased. Especially, at 3/5 bone level, maximal biting force is decreased significantly(p<0.05). From the results of this study, clinicians could utilize these efficiently when they have to determine the proper restorative materials, time for tooth extraction, treatment plan, prognosis.

• 대한소아치과학회지
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• 제37권3호
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• pp.368-373
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• 2010

상악 중절치는 저작시 음식물을 찢거나 자르는 기능 외에도 심미적으로 중요한 기능을 하며 상악 악궁의 형태 및 얼굴의 형태와도 관계가 있다고 알려져 있다. 그리고 발음을 하는데 있어서도 전치부는 매우 중요한 역할을 한다. 예후가 불량한 치아의 일반적인 치료는 발거 후 공간 유지장치를 하는 것이다. 그러나 혼합치열기에 있어 상악 영구 중절치의 발거는 치조골의 흡수, 불량한 심미성, 발음과 저작의 문제 등 여러 가지 합병증을 일으킬 수 있다. 이러한 이유로 상악 전치부의 치료는 보존적으로 행해져야 한다. 예후가 불량한 상악 전치부의 치료시 고려해야 할 사항으로는 환아의 나이, 성장 잠재력, 교합 관계, 구강 위생상태, 경제력 그리고 환아의 치료에 대한 협조도 등이 있다. 본 증례는 짧은 치근으로 인해 치아의 동요도가 있어 상악 좌측 중절치의 예후가 불안정함에도 불구하고 치아를 발거하지 않고 치료를 통해 상악 좌측 중절치를 정상 위치로 배열하고 보존하였다. 짧은 치근과 치아 회전으로 인한 추가적인 치근 흡수와 치아 동요도 증가 등 예후가 불안정하였지만 환아의 심리적 안정성, 나이, 심미성 등을 고려하여 보존적인 치료 후 양호한 결과를 얻었기에 이를 보고하는 바이다.

• Journal of Periodontal and Implant Science
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• 제32권1호
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• pp.41-49
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• 2002

The aim of this study was to compare periodontal conditions around mesially tipped molars by a tipping degree. Patients who had been consecutively treated at the Department of Periodontology, Chonbuk National University Hospital from October 1999 to August 2001 were assessed with radiographs taken at their molar regions. Of all molars investigated, 142 molars of 116 patients tipped mesially more than 10 degrees to the line perpendicular to an occlusal plane were selected for the study. The tipped molars were divided into 2 groups with a reference to a tipping degree, i.e., 66 slightly tipped(group 1 : <$30^{\circ}$) and 76 severely tipped molars (group 2 : ${\geq}30^{\circ}$). Probing depth(PD), plaque retention index(PRI) at mesial surfaces of tipped molars and tooth mobility(TM) were recorded at the clinical examination. Tipping degree(TD) and alveolar bony defect(ABD) at the mesial surface of the molars were measured in a radiograph. The results showed that no statistical differences were found between groups in all measured variables. In Pearson correlation analysis performed in the same group, a positive relationship was shown between PRI and PD in the group 1 and, in the group 2, between PRI and PD as well as PRI and ABD(p < 0.01). However, no statistically significant relationship was found between TD and all other variables in both groups. Within limitations of this study, it may be concluded that tipping degree did not seem to influence periodontal conditions, i.e., PD, ABD and TM of mesially tipped molars per se, but plaque presence/absence seemed to mainly affect the periodontal conditions of the tipped molars.

• Journal of Periodontal and Implant Science
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• 제28권2호
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• pp.291-310
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• 1998

This study was performed to evaluate the effects of extracts of Drynariae Rhizoma on the characteristics of rat calvaria cells(RCV) and bone marrow cells(RBM) which have the important role on the bone formation in vitro. Drynariae Rhizoma has been known as the useful herbal medicament for treatment of the wound healing including regeneration of bone fracture, and also has been used to treat the periodontal lesions, tooth mobility, gingival bleeding and pus discharge via sulcus in Oriental Medicine. In control group, the cells were cultured alone with Dulbeco's Modified Eagle's Medium contained with 10% fetal bovine serum, 100U/ml penicillin, $100{\mu}g/ml$ streptomycin, $0.5{\mu}g/ml$ amphotericin-B. In experimental group, extracts of Drynariae Rhizoma(0.1, 1, 5, 10, $50{\mu}g/ml$) were added into the above culture condition. And then each group was characterized by examing the cell proliferation at 1, 3, 7, 14, 21, 30th day, the amount of total protein synthesis and alkaline phosphatase activity of RCV at 2,4th day and those of RBM at 3, 6th day. And also, the calcified nodule of RCV was examed at 3, 5th day in three goup, control, experimental, culture with the PDGF group. The results were as follow ; 1. Both RCV and RBM cells in Drynariae Rhizoma-treated experimental group proliferated more rapidly than nontreated control group. The experimental group below $5{\mu}g/ml$ Drynariae Rhizoma-treated showed more prominent cell proliferation from the 7th day to the 21st day than the control group and above $10\;{\mu}g/ml$ treated group in RCV. 2. Amount of total protein synthesis was more increased in Drynariae Rhizomatreated group than in control group. In $5{\mu}g/ml$ Drynariae Rhizoma-treated group showed most prominent protein synthesis of the any other exrperimental group and control group. 3. Alkaline phosphatase activity also more increased in Drynariae Rhizomatreated group than control group. 4. Mineralized nodules in Drynariae Rhizoma-treated group were more than not in control group but also in PDGF-treated group. From the above results, Drynariae Rhizoma appeared to enhanced the proliferation, protein synthesis, alkaline phosphatase activity and cellular ability of mineralized nodule formation than PDGF. So that, we conclude that Drynariae Rhizoma enhances the activities of bone cells which have the important role on the periodontal regeneration and optimal application of Drynariae Rhizoma was thought to be useful as the means in bone regeneration.