• 구강회복응용과학지
• /
• 제33권3호
• /
• pp.178-188
• /
• 2017

목적:본 연구에서는 새로 개발된 다이오드 레이저 제품을 이용하여 레이저 파워에 따른 온도변화와 박테리아 멸균 비교실험을 통하여 기존 제품과의 임플란트 주위염치료에 대한 효과를 비교 실험하였다. 연구 재료 및 방법: 808 nm Diode laser와 810 nm Diode laser를 사용하여 디스크에 레이저를 60초간 조사하였으며, 출력은 1 - 2.5 W로 설정하였다. 온도측정 모듈과 온도측정 프로그램을 이용하여 disc 표면온도변화를 측정하였다. 또한, SLA, RBM이 코팅된 disc에 bacteria 도포 후, 808 nm Diode laser를 30초간 조사하였으며, 출력은 0.5 - 3 W로 설정하였다. 결과: 808 nm, 810 nm 두 장치 모두 출력이 증가함에 따라 온도 상승폭은 증가하였다. 모든 조건에서 810 nm laser를 조사하였을 때 초기온도상승속도, 하강속도 및 전후의 온도변화량은 808 nm laser 보다 높았다. 레이저 조사 후 티타늄 디스크 표면의 변화는 두 레이저 모두에서 관찰되지 않았다. Bacteria가 도포된 디스크에 808 nm laser를 조사한 결과, 출력이 증가 함에 따라 살균효과가 증가하는 것을 확인하였다. 결론: Diode laser를 임상에 적용하는 경우, 동일한 출력에서 온도의 변동폭이 적고 최대 상승온도가 낮은 808 nm laser가 환자에 안전할 것으로 사료된다. 하지만 실제로 임상에 적용하기 위해서는 보다 다양한 안전성평가를 실시하여 장비에 대한 신뢰성을 확보하여야 할 것이다.

• 대한치과보철학회지
• /
• 제53권2호
• /
• pp.105-110
• /
• 2015

목적: 새롭게 개발된 인상채득이 가능한 치유지대주를 이용한 인상채득과 기존의 임프레션 코핑을 이용한 인상채득을 3차원적으로 비교함으로써 개발된 시스템의 정확성을 평가하였다. 재료 및 방법: 10명의 환자에서 구치부에 임플란트(SuperLine; Dentium, Seoul, Korea)를 식립 후 치유지대주(MyHealing; Raphabio Co., Seoul, Korea)를 연결하였다. 식립 3개월 후 보철물 제작을 위한 인상채득시 인상채득이 가능한 치유지대주를 이용한 transfer 방식과 기존의 인상용 코핑을 이용한 pick-up 방식으로 두 번 인상채득 후 각각 주모형을 제작하였다. 맞춤형 보철 지대주(Myplant; Raphabio Co., Seoul, Korea)를 제작하고 각각의 주모형에 체결 후 치과용 스캐너(Scanner S600; Zirkonzahn, South Tyrol, Italy)로 가상의 모형을 형성하였다. 3차원 분석 프로그램(Geomagic Qualify 12; Geomagic, Morrisville, NC, USA)을 이용하여 두 개의 가상의 모형을 중첩하여 지대주의 위치와 기울기의 차이를 분석하였다. 측정값은 Kruskal Wallis과 Mann-Whitney U test 방법을 통해 분석하였고, 유의수준은 0.05 로 설정하였다. 결과: 두 가지 인상법에 따른 지대주의 위치는 근원심 방향에서 0.032 mm, 협설측 방향에서 0.029 mm, 상하 방향에서 0.023 mm의 차이를 보였다. 기울기는 근원심 방향에서 $0.755^{\circ}$, 협설측 방향에서 $1.275^{\circ}$, 상하 방향에서 $0.420^{\circ}$의 차이를 보였다. 결론: 인상채득이 가능한 치유지대주를 이용한 인상채득 방식은 기존의 전통적인 인상용 코핑을 이용한 방식과 비교 시 0.032 mm 이내의 차이를 보였고 기존 논문과의 비교 시 유사한 수치이다.

• 대한치과의사협회지
• /
• 제50권3호
• /
• pp.126-139
• /
• 2012

Loss of dentition can lead to not only compromised esthetics and functions of the patient, but also alveolar bone resorption. Bone grafting with prosthetic reconstruction of the gingiva can be selected for the treatment, and it provides many benefits as prosthetic gingival reconstruction does not require a complicated surgical process and is available within a short period of time, with stable clinical results. However, conventional porcelain fused to metal prosthesis has certain limits due to its size, and deformation after several firing procedures. In this clinical report, the author would like to introduce a patient with severe alveolar resorption who was treated with gingiva-shaped zirconia/titanium CAD/CAM implant fixed prosthesis for esthetic and functional rehabilitation. Clinical reports Clinical report 1, 2 : A case of loss of anterior dentition with atrophied alveolar bone. Implant retained zirconia bridge applied with Procera implant bridge system to simulate the gingiva. Upper structure was fabricated with zirconia all ceramic crown. Clinical report 3, 4 : A case of atrophied maxillary alveolus was reconstructed with fixed implant prosthesis, a CAD/CAM designed titanium structure covered wi th resin on its surface. Anterior dentition was reconstructed with zirconia crown. Conclusion and clinical uses. All patients were satisfied with the outcome, and maintained good oral hygiene. Zirconia/titanium implant fixed prosthesis fabricated by CAD/CAM system was highly accurate and showed adequate histological response. No critical failure was seen on the implant fixture and abutment overall. Sites of severe alveolar bone loss can be rehabilitated by implant fixed prosthesis with CAD/CAM system. This type of prosthesis can offer artificial gingival structure and can give more satisfying esthetics and functions, and as a result the patients were able to accept the outcome more fondly, which makes us less than hard to think that it can be a more convenient treatment for the practitioners.

• 대한치과보철학회지
• /
• 제55권3호
• /
• pp.305-310
• /
• 2017

최근, CAD/CAM 기술이 발전하면서 하이브리드 보철물의 제작에 이용되고 있다. Double scanning technique은 시적용 납의치와 주모형을 스캔 후 중첩하여, 가상 디자인의 현실화와 보철 기공 과정의 간소화를 이루었다. 본 증례에서는 금속 혹은 지르코니아 대신 고성능 중합체인 Polyetherketoneketone (Pekkton, Cendres+$M{\acute{e}}taux$, Biel, Switzerland)를 framework의 재료로 사용했으며, 콤포짓이나 세라믹 혹은 의치용 치아 대신 Polymethyl methacrylate (PMMA) 비니어링 치아(Visio-lign, Bredent, Senden, Germany)를 최종 보철물로 사용하였다. Pekkton과 Visio-lign을 사용한 본 증례에서 만족할만한 치료 결과와 환자의 만족을 얻었으며, 추후 주기적인 유지관리 및 평가가 필요할 것으로 사료된다.

• Journal of Periodontal and Implant Science
• /
• 제39권3호
• /
• pp.311-320
• /
• 2009

Purpose: The aim of the present study was to analyze 7-year cumulative survival rate (CSR, %) of dental implants in the controlled diabetic patients and to evaluate the influence of the position, diameter and length of fixture, bone quality, age, gender and the method of maxillary sinus elevation on the survival rate. Methods: The data of 342 placed implants in the 104 diabetic patients collected between 1995 and 2007 at the Department of Periodontology in Yonsei University Hospital were analyzed. Results: Seven-year CSR of the 342 dental implants in the 104 controlled diabetic patients was 96.5%. The survival rates of the placed implants according the position have no statistically significant difference. The survival rates according to the length or diameter of the fixtures have no statistically significant difference. The survival rates according to the bone quality were 100% (Type I), 97.1% (Type II), 97.7% (Type III) and 85.7%(Type IV). The difference between the survival rate of Type I, II and III and that of Type IV was statistically significant. The survival rates according to patient gender were 96.8% (male), 95.5% (female). The survival rates according to patient age were 100% (${\leq}59$), 93.8% (${\geq}60$). The survival rates according to the method of sinus elevation in the maxillary posterior area were 96.8% (without sinus elevation), 92.9% (lateral approach) and 89.8% (crestal approach). Conclusions: Dental implants can be used successfully in the controlled diabetic patients. In case of upper posterior region which has poor bone density and older patients, the implant treatment should be more properly planed, executed, and followed-up.

• 대한치과보철학회지
• /
• 제34권1호
• /
• pp.70-84
• /
• 1996

This paper reports marginal bone loss around osseointegrated implants after loading in partially edentulous patients in dental hospital, Yonsei University. Two types of implants($Br{\aa}nemark^{TM},\;IMZ^{TM}$) were used. Through the digital measurement on periapical radiograph around 37 implants in human subjects, marginal bone loss was observed for 24 months after delivery of prostheses. The results were as follows; 1. According to experimental periods marginal bone loss in total implants was 1.775 mm at 12 months, 1.921 mm at 24 months after delivery of prostheses(p<0.05). 2. Marginal bone loss in the $Br{\aa}nemark$ implants was 1.831 mm at 12 months, 1.833 mm at 24 months after delivery of prostheses(p<0.05). 3. Marginal bone loss in the IMZ implants was 1.578 mm at 12 months, 2.907 mm at 23 months after delivery of prostheses(p<0.05). 4. During the first year after loading, the IMZ implants showed less marginal bone loss than the $Br{\aa}nemark$ implants but, during the next the $Br{\aa}nemark$ implants showed less than the IMZ implants(p>0.05). These results indicate that marginal bone loss around osseointegrated implants occurs within the first 12 months after delivery of prostheses and stabilizes thereafter, so it is necessary to be careful of using dental implants for the first year after delivery of prostheses.

• 대한장애인치과학회지
• /
• 제4권1호
• /
• pp.21-25
• /
• 2008

A 33-years-old female pateint with cerebral palsy showing spastic quardriplegia and severe mental retardation was scheduled for dental implant restorations. Before implant surgery we had to take implant CT. But, because of her involuntary motion and communication difficulty, sedation was needed in order to take CT. After 8 hour NPO, propofol infusion sedation with TCI (target controlled infusion) system was administered. The propofol blood concentration of the patient was maintained 2-3 ${\mu}$/ml to keep deep sedation to prevent uncontolled movement. During sedation, we monitored ECG, pulse oximetry, blood pressure, capnometry for patient safety. Oxygen was administered via nasal prong for preventing hypoxemia and to keep airway during sedation some bands were applied to lift mandible. Total duration was 20 minutes for taking CT, and she was discharged from hospital after 30 minute rest without complication.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제35권1호
• /
• pp.21-25
• /
• 2009

Objective: The purpose of this study is to determine the prevalence of sinus disease and abnormalities in patients scheduled for dental implant in maxillary posterior area using cone beam CT. Patients and Method: One hundred five maxillary sinuses in eighty-seven patients who underwent cone beam CT for dental implant in maxillary posterior area were included. Any patients who had previous history of sinus operations were not included. The sinus abnormalities were classified as follows ; normal (membrane thickness <2 mm), mucosal thickening (membrane thickness ${\geq}$ 2 mm and < 6 mm), partial opacification (membrane thickness > 6 mm but not full), full opacification and mucous retention cyst. The relationship between the remaining bone height, sinus symptoms and maxillary sinus abnormality was statistically surveyed. Results: Of 105 maxillary sinuses in 87 patients, 80 (76%) maxillary sinuses showed abnormalities ; 4 of 4 symptomatic patients and 76 of 101 asymptomatic patients. Mucosal thickening was the most common sinus abnormality. Only 3 (4%) of 80 maxillary sinus abnormalities were caused by the odontogenic origin. The prevalence of maxillary sinus abnormalities was higher in the symptomatic group than asymptomatic one (p<0.05). Conclusion: Maxillary sinus abnormalities were very common in the patients who were planning implantation in maxillary posterior areas. This result supports that thorough evaluation for maxillary sinus is recommended when implant treatment is planned for those areas.

• 한국방사선학회논문지
• /
• 제14권5호
• /
• pp.537-543
• /
• 2020

현대사회의 노인 인구는 첨단 의료기술과 최소 침습 수술로 인해 빠르게 성장하고 있다. 따라서 의료기기를 사용하는 경향이 증가하기 때문에 병원성 감염이 우려된다. 따라서 현대 의학의 최우선 목표는 감염예방이다. 최근 3D 프린팅을 이용하여 환자 맞춤형 임플란트 이식술이 늘고 있다. 대표적 재료로 이용되는 것이 수산화인회석이다. 현재 HA 디스크 멸균을 위한 흡수선량 기준이 없으므로, HA 디스크 표면에 오염된 대장균과 충치균을 감마선 코발트와 선형 가속기를 이용하여 각 흡수선량 0, 0.5, 1.0, 3.0, 5.0 kGy로 조사 후, 십진 희석법으로 검체에서 균 수를 측정하였다. 멸균 후 대장균, 충치균의 생존 비교분석을 위해 비모수 검정법을 시행하였으며, 그 결과 대장균은 1 kGy 이상, 충치균은 3 kGy 이상에서 멸균되었다. 방사선 멸균 흡수선량 권고사항보다 낮은 수치에서 멸균을 시행하는 것도 가능할 것으로 생각된다.

• 대한치과의사협회지
• /
• 제55권12호
• /
• pp.842-849
• /
• 2017

The term, 'crossed occlusion' implies clinical situation in which the residual teeth in one arch have no contact with those in the antagonistic arch, resulting in the collapse of occlusal vertical dimension. The treatment goal of this pathologic condition is restoration of the collapsed vertical dimension and stabilization of abnormal mandibular position. Previously, konus removable prostheses or tooth supported overdentures were suggested to solve crossed occlusion. Nowadays, dental implants have been used for definitive support to solve this problem. In this case report, a 65 years old female patient had a crossed occlusion, in which the maxillary posterior residual teeth and mandibular anterior residual teeth cross. Interim removable and fixed dental prostheses were used to confirm the proper vertical and horizontal jaw relation. After that, the mandibular posterior edentulous region was restored with implant-supported fixed dental prostheses. Computer tomography guided implant surgery was performed according to the concept of the restoration-driven implant placement. The maxillary anterior edentulous region was restored with Kennedy class IV removable prosthesis, considering the patient's economic status. The patient's jaw position and prostheses have been well maintained at the follow-up after 6 months of definitive restoration. The antero-posterior crossed occlusion problems appeared to be effectively solved with the combination of removable in one arch and implant-supported fixed prostheses in the other.