• Title/Summary/Keyword: 치과임상학

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Predictable Treatment in Dental Esthetics (예측 가능한 심미치과 치료)

  • Jang, Man-Soo
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.10 no.1
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    • pp.48-54
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    • 2001
  • 아름다움이라는 것은 완전히 객관적이기도 하지만 극히 주관적인 표현의 결과일 수 있다. 심미치의학은 얼굴에서 표현되는 이러한 주관적인 면과 객관적인 면을 조화시킬 수 있는 학문이기에 21세기에도 여전히 치과 치료에 있어서 중요한 화두 중의 하나임에 틀림이 없다. 과거 심미적인 치료로 행하였던 많은 치료 술식들(open faced crown, resin faced crown,3/4 crown,7/8crown등)이 치과 치료 술식의 발달과 함께 재료와 치아 보철물 제작술 등의 발달로 인해 점차 사라지거나 변화하고 있는 것이 사실이다. 지금 소개하는 증례들은 현재 치과계에서 심미적인 치료 술식으로 인정하고 있기에 이러한 치료 술식에 대한 이해가 필요할 것이다. 우리 임상가들의 최종목표는 환자들에게 자연스러운 얼굴과 웃음을 회복시켜주는 것이다. 각 증례에 대한 한계에 대해 미리 알 수 있는 방법을 모색해 보고, 예측 가능한 치료를 시행하기위한 과정들을 살펴보고자 한다.

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임상가를 위한 특집 1 - 지르코니아의 역사 및 이론적 배경

  • No, Gyeong-Ho;Ha, Seung-Ryong;Kim, Seong-Hun
    • The Journal of the Korean dental association
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    • v.47 no.12
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    • pp.798-803
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    • 2009
  • 지르코니아는 물리적 성질이 금속과 가장 가까운 세라믹이며, 색상이 치아와 비슷하여 치과분야에서 사용빈도가 증가하고 있는 재료이다. 지르코니아는 zirconium dioxide 결정체로서, 1975년 Garvie가 'ceramic steer' 이라고 명명하였듯이 기존의 세라믹과 비교하여 뛰어난 물성을 지니고 있다. 즉, 높은 내열성과 낮은 열전도도, 산성에서 알카리성까지 이르는 내화학 안정성, 낮은 열팽창성, 높은 강도 및 경도, 내마모성을 가지고 있기 때문에 이전부터 공업용 재료로 넓게 시용되어 왔다. 지르코니아의 상변 이를 이용한 toughening방법이 Garvie에 의해 제시됨으로서 세라믹의 최대 단점인 취성은 어느 정도 극복할 수 있게 되었고 이를 계기로 금관 및 계속가공 의치, 임플란트 지대주, 인레이, 온레이 등 치과의 여러 분야에 지르코니아를 적용할 수 있게 되었다. 최근에는 임플란트 매식체에 있어서도 그 적용을 시도함으로서 심미치과치료에 있어서 중요한 부분으로 자리 잡고 있다. 현재 지르코니아는 치과용 세라믹 중에서 가장 높은 기계적 물성을 보이기 때문에 구치부 에서의 사용 가능성이 시도되고 있으며, 코어의 두께를 감소시킴으로써 보철 술식에서 필요한 강도 및 심미성 두 마리 토끼를 잡을 수 있도록 많은 연구가 이루어지고 있다. 이에 지르코니아의 역사 및 이론적 배경에 대하여 알아보고자 한다.

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A Clinically, Radiologically Malignant, but Histopathologically Benign Lesion in Oral Cavity (구강내 발생한 임상적, 방사선학적 악성 및 조직병리학적 양성 병소)

  • Oh, Hyun Jun;Jeon, Jae-ho;Myoung, Hoon
    • The Korean Journal of Oral and Maxillofacial Pathology
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    • v.42 no.6
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    • pp.199-204
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    • 2018
  • Differential diagnosis of the malignant lesion and the benign lesion is critically important for the precise treatment. A clinician should diagnose in a comprehensive manner considering clinical, radiological, and histopathological perspectives. The lesion in the oral cavity in this study was clinically and radiologically malignant. However, the lesion was histopathologically benign. Surgical intervention was not performed except biopsy. The lesion improved after about one month of supportive medication after the biopsy. The importance of decision making process was emphasized in this report.

원내에서 5축 밀링기로 가공한 PMMA temporary crown의 다양한 임상적 활용

  • Suh, Sangjin
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.26 no.2
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    • pp.68-83
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    • 2017
  • With the increasing popularity of dental CAD / CAM, the kinds of materials that can be used and the range that can be utilized are also increasing. One of the biggest advantages of a dental CADCAM is that you can make a final prosthesis with one visit, but in case of zirconia or a complex aesthetic prosthesis, it is often difficult to make it in one day. In this case, temporary PMMA material can be used to provide a temporary crown with aesthetic and functional properties to the patient and can be used as a test crown or template for the final prosthesis. And if you are with a 5-axis milling machine in a clinic, you can make a temporary crown precisely to a large extent in a short time. In this article, various applications and clinical cases of PMMA temporary crown in the clinic will be presented.

Characteristics of teeth referred to a dental university hospital for endodontic reason (근관치료적 이유로 치과대학병원으로 의뢰된 치아들의 특성)

  • Jeon, Su-Jin;Hwang, Soo-Jeong;Seo, Min-Seock
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.3
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    • pp.143-152
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    • 2019
  • Purpose: The aim of this study is to investigate the characteristics of patients and teeth referred to a university dental hospital for endodontic problem. Materials and Methods: From January, 2017 to December, 2018, patients who were referred to a university dental hospital for endodontic problem were collected from clinical records. A total of 1171 patient records were analyzed. The status of the referred teeth was divided into three groups according to whether they were treated endodontically based on radiographs and clinical records at the time of referred visit. Results: 69.9% of the referred teeth were maxillary and mandibular first and second molars. The average time from referral to actual visit is 9.03 days and 65.6% of the case referred with referring letter. The most primary reasons of referral were persistent clinical symptom (pain, swelling, and sinus tract) (37.9%), diagnosis difficulty (16.7%), blockage of canal space (13.8%) and difficult tooth anatomy (11.4%). In the case of referral before endodontic treatment, the most primary reason of referral was failure to make a proper diagnosis. If the teeth were referred in the middle of endodontic treatment, the most primary reason of referral was persistent clinical symptom and blockage of canal space. In the case of referral after root canal filling, the most primary reason of referral was persistent clinical symptom. Conclusion: In the case of molars, the rate of persistent clinical symptom and blockage of canal space were the most primary reason of referral, and the rate of apical surgery and management of trauma was high in the case of anterior teeth.

A Retrospective Study on the Treatment of Dens Evaginatus for the Last 5 Years (최근 5년간 시행된 치외치 치료에 대한 후향적 연구)

  • Jonghwa, Lim;Gimin, Kim;Jaesik, Lee;Soonhyeun, Nam;Hyunjung, Kim
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.2
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    • pp.158-169
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    • 2022
  • The purpose of this study was to analyze treatment methods, results, timings and clinical signs and symptoms in failed cases of each treatment method of dens evaginatus on the premolar areas. In this study, 151 patients and 417 teeth were included. Resin restoration and direct pulp capping as preventive treatment and pulp revascularization, apexification and conventional endodontic treatment as endodontic treatment were included for treatment methods. In the preventive resin restoration, successful results were shown in the intact tubercles and also effective when the tubercles were fractured. In the direct pulp capping, resolved clinical symptoms and growth of the roots were shown when there was only pain during chewing without apical lesion. Apical lesion was the most common pretreatment signs and symptoms of the pulp revascularization, apexification and conventional endodontic treatment. In the pulp revascularization, successful results was obtained in most cases. But in some cases, root length or root wall thickness was not increased. Effective results were shown both of the apexification and conventional endodontic treatment. In order to increase success rate of preventive treatment of dens evaginatus, resin restoration was required to be done when tubercle did not occluded or in the presence of intact tubercles. When tubercle was fractured, root development stage and pulp condition should be considered for successful treatment.

A clinical report of hybrid telescopic double crown denture with friction pin in a failed double crown denture case (실패한 이중관 국소의치에서 하이브리드 텔레스코픽 이중관 국소의치를 이용한 임상증례)

  • Park, Jong-Hoon;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.2
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    • pp.201-209
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    • 2021
  • In removable partial dentures, many types of retentive systems have been studied and applied in clinical treatment. One of those systems is the double crown denture system which is widely used in European countries such as Germany and Sweden. Telescopic double crown dentures have several advantages such as convenience in maintaining oral hygiene, enabling to transfer occlusal force along the long axis of the abutment, and secondary splinting effect between the abutments which leads to higher clinical performance compared to conventional removal partial dentures. In this clinical case, the patient was initially restored with a maxillary hybrid telescopic double crown denture with friction pin using remaining natural teeth as abutments. After 7 years, due to lack of recall check-up and poor oral hygiene, the abutment teeth were affected by periodontitis and 4 out of 5 of the abutment teeth had to be extracted. 3 additional implants were placed and the original abutment tooth with the inner crown was maintained. The mandible had fixed prostheses including implants but nevertheless, with strategic implant placement, the patient adapted well and was satisfied with the new maxillary tooth-implant combined double crown denture.

Implant-assisted removable partial denture in a maxillary edentulous patient: A case report (상악 무치악 환자에서 전방부 임플란트 지지 고정성 보철물을 이용한 임플란트 보조 국소의치 수복 증례)

  • Kang, Hyun-Mo;Kim, Jee-Hwan;Kim, Jae-Young
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.442-452
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    • 2022
  • Implant-assisted removable partial denture (IAPRD) can be considered as a simple and cost-effective treatment approach for an edentulous patient with anatomical or financial limitations. Recently, it was reported that the application of IARPD with implant supported fixed prostheses covered by the National Health Insurance Service (NHIS) were increasing. This case report describes the treatment of maxillary fully edentulous patient with anterior four-implant-supported fixed prosthesis and distal extension IARPD. This treatment approach may be advantageous over maxillary implant overdentures in some circumstances. The patient was satisfied with improved function and esthetics in the anterior area and financial benefit from the NHIS. Further long-term clinical studies are needed to establish clinical validity of the treatment approach described in this case report.

A MORPHOMETRIC STUDY ON THE PRIMARY MOLARS AND PREFORMED STAINLESS STEEL CROWN (유구치 치관 및 기성금속관의 크기에 관한 계측학적 연구)

  • Choi, Ji-Eun;Cheong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.355-362
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    • 2001
  • Data derived from odontometric studies are useful in many areas. Especially crown diameter of primary teeth is important in not only anthropology but also clinical dentistry. The purposes of this study were to compare diameters of primary molars of Korean children with those of preformed stainless steel crown, and examine racial characteristics of primary molars of Korean children. The mesiodistal and buccolingual diameters of primary molars were measured on dental casts taken from 235 children(male 105, female 131), with digital calipers. And the data were compared with those of preformed stainless steel crowns. The results were as follows; 1. No significant difference was observed between the right and left members of antimeric teeth and all primary molars of male were larger than those of female. 2. The diameters of primary molars of Korean are smaller than those of Austrailian aborigines and there was significant difference between diameters of primary molars of Korean and those of other populations. 3. There were size differences between diameters of maxillary, mandibular first molar and preformed stainless steel crown than other primary molars, relatively.

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Fabrication of removable partial denture on scleroderma patient using 3-dimensional intraoral scanner (전신성 피부경화증 환자에서의 3차원 구강스캐너를 이용한 가철성 국소의치 제작 증례)

  • Kim, Ung-Gyu;Han, Jung-Suk;Yoon, Hyung-In;Yeo, In-Sung Luke
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.116-125
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    • 2021
  • A three-dimensional (3D) intraoral scanner, which is one of the major developments in digital dentistry, is widely used in fixed prosthodontics. The application of intraoral scanner is now increasing in removable prosthodontics. Sclerotic change induced by scleroderma causes the limitation of mouth opening and multiple loss of the teeth. Conventional prosthodontic procedures are challenging for patients with this disease. This study showed a case of digital approach to the removable prosthodontic treatment of a patient who had the scleroderma and the consequent microstomia. At the provisional stage, the optical impression of patient's oral structures was digitally obtained. Using a 3D printer, the provisional dentures were fabricated. After extraction of hopeless tooth, the definitive digital impression was taken and the metal frameworks were fabricated, based on the data acquired from the impression. The definitive removable partial dentures were completed and delivered to the patient, who was satisfied with the prostheses.