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Bruxism의 치료 -장치를 이용한 치료법을 중심으로-

  • Lee, Gi-Su
    • The Journal of the Korean dental association
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    • v.21 no.4 s.167
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    • pp.293-297
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    • 1983
  • Bruxism이란, 일반적으로 기능이외의 목적으로 상하악 치아를 악물거나 갈음질 하는 것이라고 정의된다. 동일한 상태를 서술하는 용어로 neuralgia traumatica, Karolyi effect, occlusal habit neurosis, parafunction 등이 있으며, 수면중의 이갈음질을 bruxism, 주간의 습관성 이갈음질을 bruxomania로 구분하기로 한다. 또한 centric bruxism과 eccentric bruxism으로 분류하기도 한다. eccentric bruxism은 통상적 의미의 수면중의 bruxism이며, 하악의 측방운동중의 이갈음질이고 뽀드득하는 갈음질 소리를 냄, 저작근육의 긴장도가 증가되어 있으면서 등장성수축을 나타내고, 비중심위의(eccentric) 교합간섭이 주요 유발인자인 반면에 centric bruxism은 중심교합위에서 상하악 치아를 간헐적으로 악무는 것(clenching)은 의미하고 - 지속적으로 악무고 있는 것은 clamping이라고 함.- 주로 주간에 행하며 갈음질소리를 들을 수 없고, 역시 저자근육의 긴장도가 증가되어 있으며 등률성수축을 나타내고, 중심교합위에 근접하여 존재하는 교두간섭이 유발인자이다. bruxism이나 clenching과 부정교합의 관계는 bruxism과 clenching은 부정교합을 야기할 수 있고, 부정교합도 역시 bruxism과 clenching을 유발시키는 작용을 할 수 있는 악순환적 관계이다. 현저한 부정교합을 가지고 있는 bruxism환자의 교정치료는 그 목적이 bruxism의 치료라기보다는 오히려 부정교합의 치료이며 부차적으로 bruxism의 치료를 기대하게 된다. 그러나 bruxism이 장기간 지속되어 치아 및 그 주위조직, 악관절과 신경근계에 심한 손상을 주었을때의 교정치료는 일반적으로 제한을 받을 뿐만아니라 bruxism의 처치에는 거의 무의미한 치료가 될 수 있다. 따라서 거자는 bruxism 환자의 교정치료라는 제목의 원고 청탁을 받았으나 편집위원의 양해아래 장치를 이용한 bruxism의 치료에 관하여 서술하려 한다.

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Case Report of Maxilla/Mandible Simultaneous Distraction with Molina$^{(R)}$ Distractor (Molina distractor를 이용한 상/ 하악 동시 신장술 증례의 보고)

  • Baek, Kyung-Won;Kim, Keun-Woo;Choi, Jin-Yeong
    • Korean Journal of Cleft Lip And Palate
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    • v.9 no.2
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    • pp.55-62
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    • 2006
  • 1980년 일리자로프가 하지에서의 골 신장술을 발표한 이래 수많은 외과 의사들이 임상연구와 발표를 거듭해 현재의 골 신장술을 이루었다. 악골에서 골 신장술의 적용은 1992년 8명의 악골 기형 환아에게 하악지 신장술을 적용한 맥카시의 발표를 기점으로 시작되었다. 골 신장술의 장점은 부족한 골조직과 함께 주변 연조직을 신장시키는 것으로 복합적 조직 결손을 보이는 선천성 악골 기형 환자들에게 특히 유리하게 적용시킬 수 있다. 반안모 왜소증은 안면 반측의 상/하악골 및 악관절, 연조직의 저성장 및 결손을 보이는 비교적 흔한 악골 기형이다. 하악지 신장술의 활발한 연구로 이를 이용한 악관절 증상과 안면 비대칭의 해소가 일차적 치료기법으로 선택되고 있다. 연구자들은 악관절 증상과 안면 비대칭을 주소로 내원한 성인 반안모 왜소증 환자에게 상악 및 하악의 동시 골 신장술을 적용하여 만족할 만한 결과를 얻었기에 이를 발표한다. 상악골의 Le Fort 제1형 골 절단술과 이환측의 하악지 시상분할 골절단술 후에 Molina distractor를 하악지에 적용하고 악간 고정을 통해 동시 신장을 꾀하였다. 수술 기법 및 평가 기법에 대하여 논의하였다.

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A Study on LED Driver Compatible with Triac-dimmer Employing Active Bleeder (능동 블리더 회로를 적용한 조광기 호환용 LED 구동회로에 관한 연구)

  • Yeom, Bong-Ho;Kim, Teak-Woo;Kim, Ju-Rae;Hong, Sung-Soo
    • Proceedings of the KIPE Conference
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    • 2013.07a
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    • pp.159-160
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    • 2013
  • 본 논문에서는 백열등 조도 조절용 조광기에 호환 가능한 LED 구동회로를 제안한다. 조광기와 일반적인 LED 구동회로를 연결할 경우 트라이악(Triac)의 오동작에 의해 플리커(Flicker) 현상이 발생하는 문제점을 지니고 있다. 트라이악의 오동작을 방지하기 위해서는 트라이악에 일정 크기 이상의 전류가 인가되어야 하며 이를 만족하기 위한 조광기 호환회로가 필수적이다. 이러한 호환회로로써 수동 블리더(Passive Bleeder)는 전 동작 구간에서 전력소모가 발생하는 단점을 지니고 있다. 본 논문의 제안회로는 역률 만족을 위 해 Valley-fill 회로를 적용하였으며 트라이악의 오동작 시점을 정확히 검출하여 새로운 방식의 능동 블리더(Active Bleeder)를 적용함으로써 조광기의 오동작을 방지하면서 수동 블리더에 비해 효율이 개선되는 장점을 지닌다. 또한, Valley-fill과 인덕터를 적용한 1단 구성으로 효율개선 및 역률 개선의 장점과 입력 전류 리플의 감소로 인한 EMI 노이즈 저감 효과를 나타낸다. 본 논문에서는 제안된 회로의 타당성을 검증하기 위하여 13W급 조명용 LED 구동회로의 시작품 제작을 통해 그 우수성을 확인한다.

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A CASE OF CORONOID PROCESS MALFORMATION MIMICKING CONDYLAR HEAD (관절과두를 닮은 오훼돌기 변형증의 일 증례)

  • Kim, Jong-Ryoul;Lee, Seong-Geun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.157-161
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    • 1994
  • A 14-year-old male patient was referred to us for evaluation of Right TMJ clicking sound and mandibular deviation during mouth opening. On examinaaation, protrusion and lateral excursion was also restricted. Radiographs showed hook-like curved elongation of Right coronoid process with limitation o right condylar translation. His past medical and dental history was noncontributory. This patient underwent an extraoral coronoidectomy and the specimen revealed coronoid process malformation mimicking condylar head. Microcoically, the specimen discloses mature bony trabeculae. At postoperative 5 days, physical therapy was instituted. At present, this patient could open his mouth well with any clicking sound and mandibular deviation. The asymmetric face of this patient is expectated to be corrected by periodic observation and remained growth porential. If not to be corrected, orthognathic surgery will be done.

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Full-mouth rehabilitation by immediate implantation combined with orthognathic surgery: a clinical report (악교정 수술을 동반한 임플란트 보철물을 이용한 완전구강회복 증례)

  • Ahn, Hye-Rim;Heo, Ji-Ye;Kim, Chul-Hoon;Hwang, Hee-Seong;Kim, Bok-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.1
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    • pp.57-64
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    • 2016
  • Clinical therapy that combines full-mouth rehabilitation with immediate implantation and orthognathic surgery poses a challenge to prosthodontists. This clinical report describes a multidisciplinary approach to the diagnosis and treatment of a patient presenting with skeletal discrepancy and rampant caries. The results thus achieved indicate that full-mouth rehabilitation by fixed immediate and early loading implantation accompanied by orthognathic surgery can be a predictable and effective treatment procedure.

CLINICAL STUDY OF MAXILLOFACIAL PROSTHESES;OSSEOINTEGRATED IMPLANTS FOR MAXILLOFACIAL PROSTHESES (악안면 보철의 임상적 고찰;골내 매식술을 통한 보철적 회복에 관하여)

  • Min, Seung-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.5
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    • pp.406-414
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    • 2001
  • In recent decade, there has been a very rapid development in technical possibilities to provide patients with maxillofacial prostheses. Dr. Brenemark first introduced possibility of use of maxillofacial interosseous implant in patients with ablative tumor surgery in 1979. He did introduce the new type of maxillofacial implants system which widen the fixture flange on top of the bone. The advantages of fixed prostheses with implants were well known to various ways, easy to attach, keep clean prostheses, and not to disturb recipient bed. But there are some problems to install implants on maxillofacial regions, because mostly facial bone has very thin cortical bone and poor bone quality. It needs more retention between implant and bone which overcome that fault with fixture flange. To make maxillofacial prostheses, it should be understood general procedure of maxillofacial laboratory work. Ear and midface maxillofacial fabrication which include nose and eye defects will be described step by step.

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Influence of Panax Ginseng on DNA Synthesis of Submandibular Gland in Mice (고려인삼이 마우스의 악하선 DNA 합성능에 미치는 영향( I ))

  • Kwon, Y.C.;Chae, Y.B.;Chang, W.S.
    • The Korean Journal of Physiology
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    • v.8 no.1
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    • pp.23-26
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    • 1974
  • It was planned to evaluate the influence of Panax Ginseng upon DNA synthesis of submandibular gland in mice by observing incorporation of $[^3H]$ thymidine into the tissue cells. Thirty male mice $(body\;weight:\;18{\sim}20\;g)$ were divided equally into two groups. One group received every day (subcutaneously) 0. 05 ml/10 g body weight of ginseng extract(4 mg of ginseng alcohol extract in 1ml of saline), while !he other group received the same amount of saline, for 5 days. On the 5th experimental day, all animals received $1\;{\mu}Ci/g$ body weight of $[^3H]$ thymidine intraperitoneally 2 hours after the last medication. Five animals, at a time, of each group were sacrificed 1, 10, and 24 hours after $[^3H]$ thymidine administration, and the radioactivity of cells in their mandibular gland was measured autoradiographically in terms of the % number of radioactive cells in 1,000 tell counts (Radioactive Index, R.I.). It was found that the radioactive indices of mice that received ginseng were lower than the corresponding values of mice that received saline. The inference from the above result was that the ginseng suppressed DNA synthesis of cells in the mandibular gland.

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A POSITIONAL ANALYSIS OF MANDIBULAR CONDYLE ON THE SUBMENTOVERTEX RADIOGRAPH FOR DIAGNOSIS OF TEMPOROMANDIBULAR JOINT DYSFUNCTION (악관절기능장애 진단을 위한 두부축방향 방사선사진에서의 하악과두의 위치분석)

  • Kim Seok-Ho;Choi Soon-Chul;Byun Jong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.21 no.1
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    • pp.73-81
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    • 1991
  • The purpose of this study was to analyze the position of mandibular condyle on the submentovertex radiograph, thereafter to evaluate the usefulness of submentovertex radiograph in diagnosis of temporomandibular joint dysfunction, and to check the best method of tomographic techniques. Submentovertex radiographs which were taken in 75 temporomandibular joint dysfunction patients and 75 normal persons were used as the sample for this study. The obtained results were as follows: The submentovertex radiograph was a improper method in diagnosis of temporomandibular joint dysfunction and discrimination of affected side. The selective tomography was a better method than any other tomographic techniques in diagnosis of temporomandibular joint dysfunction.

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Combined Surgical and Orthodontic Treatment of Bimaxillary Dento-Alveolar Protrusion: A Report of Case (전방부분절 골절단술에 의한 상하악 전돌증의 악교정 1 예)

  • Byun, Sang-Kil;Lee, Hee-Keung;Jin, Byung-Rho;Oh, Meung-Chull;Kim, Tae-Joo;Kim, Young-Jun
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.271-279
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    • 1985
  • The authors treated a case of bimaxillary dentoalveolar protrusion corrected by anterior segmental osteotomies: As presurgical treatment & process, closing of the upper anterior spacing with fixed appliances was worked out, cephalometric predicition & model surgery was done, and fabrication of intra-arch acrylic resin splints were made. It was not necessary to make an intermaxillary fixation with wire after surgery. Only intramaxillary fixation of anterior retracted mobile segment with resin plate was required for 8 weeks. After surgical treatment, leveling of the upper and lower arch with rectangular arch wire were accomplished as the Intrusion of anterior teeth proceeded. We will continue to improve the class II molar relationship by using class II elastics and have a good occlusiion through the orthodontic treatment.

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Effect of ionizing radiation on cultured submandibular gland (SG) cells of mouse (전리 방사선 조사에 의한 마우스 배양 악하선 세포의 변화)

  • Lee, Song-Jae
    • The Journal of Korean Society for Radiation Therapy
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    • v.4 no.1
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    • pp.71-77
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    • 1990
  • The present study was undertaken to investigate effects of ionizing radiation on DNA synthesis and chromosomal abnormality in cultured submandibular gland(SG) cells. SG cells from C57BL/6N Crj mice were cultured in Dulbecco's modified Eagle's medium (DME) supplemented with $10\%$ fetal bovine serum, antibiotics and fungizone. The cultured SG cells were irradiated with graded doses of gamma ray ($^{60}Co$) at a dose rate of 58.4rad/min. The effect of irradiation of $^{60}Co$ on DNA synthesis in cultured cells was evaluated by measuring the incorporation of 3H-TdR. Using conventional chromosome techniques and Giemsa staining methods, chromosomal abnormalities in cultured SG cells, induced by irradiation of $^{60}Co$ werw examined. Cytological observations were carried out by a light microscope with high resolving power. The results obtained were as follows : 1. DNA synthesis of SG cells was quantitatively dependent on a radiation dose compare to control. 2. A polyploids and few chromosome-type break, such as single and double breaks, deltions and triradial figures were more predominantly in irradiated SG cells than in control. This increase of chromosomal abnormality was in the proposition to the irradiation doses.

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