• Title/Summary/Keyword: 치아 손상

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TREATMENT OF DENTAL CARIES BY ER:YAG LASER IN CHILDREN (소아 환자에서 Er:YAG Laser를 이용한 우식 병소의 처치)

  • Jang, Eun-Young;Lee, Sang-Ho;Lee, Chang-Seop
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.4
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    • pp.558-563
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    • 2000
  • The lasers have been used in dentistry for more than 30 years and the application of lasers for drilling dental hard tissue has been investigated since the early developement of lasers. Recently, the Er:YAG laser was invented for hard tissue ablation. The Er:YAG laser, having a wavelength of 2.94um, is highly absorbed in both water and hydroxiapatite, leading to a very effective material for hard tissue removal by bursting off the solid tissue component that is, enamel and dentin are removed by the Er :YAG laser by water vaporization and microexplosion, without any melting of inorganic tissues. Therefore, the Er:YAG laser produced round craters with well defined margins and the surrounding tissues had no cracks and no charring. When used for cavity preparation, pulpal damage should not occur if hear buildup is minimized by careful selection of exposure parameters and by use of a water spray. The present study demonstrated that the Er:YAG laser cut the tooth substance adequately for composite resin restoration, without having undesirable side effects such as harmful effects on the pulp, discoloration or cracking etc. Also, the child patients were well cooperative during laser treatment mainly because of little noise, lesser vibration and minimal pain compared to conventional means of cavity preparation.

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3-D FEA of three different single tooth abutments : Cement-retained Vs Screw-retained (3종의 단일치아 수복용 지대주의 삼차원 유한요소법적연구 : 시멘트 유지헝 대 나사 유지형)

  • Lee, Jung-Min;Kim, Yung-Soo;Kim, Chang-Whe;Kim, Yong-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.37 no.2
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    • pp.269-288
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    • 1999
  • 현재 골 유착성 임플랜트는 안전하고 유용한 보철 수복 분야의 하나로 자리잡아 가고있다. 과거 완전 무치악 환자에게 있어서 저작 기능의 회복이란 면에 중점을 두었던 경향에서 현재 골유착 임플랜트의 높은 성공률에 의해 부문 무치악, 단일치 수복에 까지 다양하게 사용되고 있다. 특히 심미성과 인접치의 손상을 가하지 않는다는 면에서 단일치 수복에서 골유착 임플랜트 치료에 관심이 모아지고 있다. 단일치 수복에 있어서 심미성이 중요한 문제로 대두되면서 이런 수복에 사용될 수 있는 다양한 계통의 임플랜트들이 개발되어 사용되고 있다. 이중 가장 기본적인 Branemark 계통의 CeraOne 지대주, 최근에 개발된 전부도재 지대주인 CerAdapt 전부주조 지대주인 UCLA 계통등은 높은 성공률을 보이며 많이 사용되고 있다. 임상가들에 의해 나사유지형 보철물이 착탈성이란 관점에서 선호되고 있다. 시멘트유지형 보철물에서는 나사공이 없는 온전한 교합면을 유지한다는 면과 교합력을 받는 면적에 있어서 더 넓은 면을 가진다는 점등 더 많은 장점을 가진다고 주장하는 사람도 있다. 임상가들의 기호에 의해 선택되어지는 나사 유지형과 시멘트 유지형에 있어서 교합력이 야기하는 하중하에서 각각의 응력 분포를 분석할 필요성이 요구되었다. 이 연구는 단일치 수복에 사용되는 CeraOne, CerAdapt UCLA 계통에서 각각의 나사 유지형과 시멘트유지형에서의 응력분포를 삼차원 유한요소법으로 분석하고 상부 구조물에 가해지는 수직하중, 수평 하중, 경사 하중에 의해 야기되는 응력을 비교 분석한 것이다. 본 연구의 연구 결과는 다음과 같다. 1. CeraOne, CerAdapt, UCLA 지대주 모두 시멘트유지형보다 나사유지형에서 응력집중이 컸다. 2. CeraOne 시멘트유지형인 1번 모델에서 응력분산이 유리하였고, UCLA 나사 유지형인 6번 모델에서 가장 불리하였다. 3. 모든 모델에서 고정체 경부에서 가장 큰 응력 집중이 있었고 이것은 UCLA 지대주에서 가장 컸다. 4. 상부 구조물에서 주된 응력의 집중은 교합면에서 일어났다. 5. 골은 상부 피질골, 즉 고정체경부와 만나는 부위에서 가장 큰 응력의 집중이 일어났으며 수평, 경사 하중시 응력집중 양상은 힘을 가한 쪽의 반대쪽 고정체 경부에 응력이 집중되는 양상을 보였다. 6. 전체 모델과 골, 고정체 모두에서 수평 하중과 경사 하중시 보다는 수직 하중시 더 적은 응력값을 보였다.

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CLINICAL APPLICATION OF MTA(MINERAL TRIOXIDE AGGREGATE) FOR APEXIFICATION (치근단 형성술(Apexification)에 있어서 MTA(Mineral Trioxide Aggregate)의 적용)

  • Baik, Byeoung-Ju;Jeon, So-Hee;Kim, Young-Sin;Kim, Jae-Gon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.4
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    • pp.700-708
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    • 2001
  • Traumatic injuries in young patients can result in the interruption of the development of the incompletely formed roots. In teeth with incomplete root-end formation and necrotic pulps, the root canals must be completely debrided. Because of a lack of an apical stop and the presence of thin and fragile walls in these teeth, it is imperative to perform apexification to obtain an adequate apical seal. Calcium hydroxide has become the material of choice for apexification. Despite its popularity for the apexification procedure, calcium hydroxide therapy has some inherent disadvantages that include variablility of treatment time, unpredictability of apical closure, difficulty in patient follow-up, and delayed treatment. An alternative treatment to long-term apexification procedure is the use of an artificial apical barrier that allows immediate obturation of the canal. MTA(Mineral Trioxide Aggregate) is a powder consisting of fine hydrophilic particles of tricalcium silicate, tricalcium aluminate, tricalcium oxide and silicate oxide. MTA has a pH of 12.5 after setting, similar to calcium hydroxide. This may impart some antimicrobial properties. MTA has low solubility and a radiopacity slightly eater than that of dentin. Also, MTA leaked significantly less than other materials and induced hard-tissue formation more than other materials.

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A Novel RUNX2 Mutation in a Korean Family with Cleidocranial Dysplasia (한국인 쇄골 두개 이형성증 가족에서의 RUNX2 유전자 돌연변이)

  • Lee, Ji Won;Song, Jisoo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Lee, Sang-Hoon;Kim, Jongbin;Kim, Jung-Wook
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.4
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    • pp.409-415
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    • 2019
  • Cleidocranial dysplasia (CCD) is an autosomal-dominant disease characterized by the delayed closure of cranial sutures, defects in clavicle formation, supernumerary teeth, and delayed tooth eruption. Defects in the Runt-related transcription factor 2 (RUNX2), a master regulator of bone formation, have been identified in CCD patients. The aim of this study was to identify the molecular genetic causes in a CCD family with delayed tooth eruption. The 23-year-old female proband and her mother underwent clinical and radiographic examinations, and all coding exons of the RUNX2 were sequenced. Mutational analysis revealed a single nucleotide deletion mutation (NM_001024630.4 : c.357delC) in exon 3 in the proband and her mother. The single C deletion would result in a frameshift in translation and introduce a premature stop codon [p.(Asn120Thrfs*24)]. This would result in the impaired function of RUNX2 protein, which may be the cause of delayed eruption of permanent teeth in the family.

Prosthetic rehabilitation by obturator considering the biomechanics in partially edentulous patient after maxillectomy (상악골 절제술을 받은 부분 무치악 환자에서 생역학을 고려해 제작한 구개 폐색장치를 이용한 보철 수복 증례)

  • Lee, Kang-Shin;Park, Ju-Mi;Ahn, Seung-Geun;Seo, Jae-Min;Park, Yeon-Hee;Lee, Jung-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.4
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    • pp.281-293
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    • 2021
  • Patients who went through maxillectomy can have severely impaired swallowing, mastication, and pronunciation functions because of palatal defects. Leakage occurs through the nasal cavity while eating, chewing becomes difficult due to the loss of teeth and alveolar ridges, and oral and nasal passages are not separated, leading to hyper-nasal sound, and significantly reducing the quality of life. To prosthetically reconstruct the defect, the weight of the obturator should be reduced as much as possible to minimize dropout because of gravity, and the bulb of the obturator should be properly extended into the defect to get additional retention and stability. In this case of a partially edentulous patient who underwent additional maxillary resection because of tumor recurrence, a metal framework was designed by applying the basic design principles of removable partial dentures. An obturator with improved retention, stability, and support was fabricated through functional impressions. The patient was satisfied with the improved facial expression, mastication, swallowing, and pronunciation, and showed stable occlusion and oral hygiene management during the follow-up period.

Efficiency of ceramic bracket debonding with the Er:YAG laser (세라믹 브라켓의 제거 시 Er:YAG 레이저의 효능)

  • Suh, Chung-Hwan;Chang, Na-Young;Chae, Jong-Moon;Cho, Jin-Hyoung;Kim, Sang-Cheol;Kang, Kyung-Hwa
    • The korean journal of orthodontics
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    • v.39 no.4
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    • pp.213-224
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    • 2009
  • Objective: The aim of this study was to find out whether Er:YAG laser can aid in debonding ceramic brackets, and to see what kind of method will be the most appropriate for debonding. Methods: One hundred and ninety teeth, monocrystalline brackets ($MISO^{TM}$, HT, Ansan-Si, Korea), polycrystalline brackets ($Transcend^{TM}$ series 6000, 3M Untek, Monrovia, CA, USA) and the KEY Laser3 (KavoDental, Biberach, Germany) were used. Experimental groups were classified according to the type of ceramic brackets, and the amount of laser energy (0, 140, 300, 450, 600 mJ). After applying laser on the bracket at two points at 1 pulse each, the shear bond strength was measured. The effect of heat caused by laser was measured at the enamel beneath the bracket and pulp chamber. After measuring the shear bond strength, adhesive residue was evaluated and enamel surface was investigated using SEM. Results: All ceramic bracket groups showed a significant decrease in shear bond strength as the laser energy increased. The greatest average temperature change was $3.78^{\circ}C$ on the enamel beneath the bracket and $0.9^{\circ}C$ on the pulp chamber. Through SEM, crater shape holes caused by the laser was seen on the enamel and adhesive surfaces. Conclusions: If laser is applied on ceramic brackets for debonding, 300 - 450 mJ of laser energy will be safe and efficient for monocrystalline brackets ($MISO^{TM}$), and about 450 mJ for polycrystalline brackets ($Transcend^{TM}$ series 6000).

Comparative Study of the Ablation Rates of Er: YAG Laser Irradiation on Dentin and Enamel (Er:YAG 레이저를 이용한 법랑질과 상아질의 절삭율 연구)

  • Kim, Kun-A;Ahn, Yong-Woo;Ko, Myung-Yun;Park, June-Sang
    • Journal of Oral Medicine and Pain
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    • v.30 no.1
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    • pp.131-140
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    • 2005
  • The purpose of this study was to examine the ablation rate of Er: YAG laser irradiation on dentin and enamel and to observe the microscopic structures of cavities formed after ablation of enamel and dentin in using a bur and cavities formed after ablation using laser. Er:YAG laser irradiated at 200 mJ, 250mJ, 300mJ at the frequency of 20Hz, 15Hz. The following results were obtained : 1. The ablation rate of dentin groups at power of 3 W-6 W was about $1.103{\sim}2.639mm^3/sec$ and there were no significant differences between power of 4.5 W$\sim$6 W. 2. The ablation rate of enamel groups at power of 3 W-6 W was about $0.413{\sim}0.969mm^3/sec$ and there were no significant differences between power of 4 W$\sim$6 W. 3. With SEM examination of the cavity surface treated with the conventional high speed bur revealed relatively flat appearance almost covered with a debris like smear layer. 4. With SEM examination of the lased surface of dentin groups revealed no smear layer and no debris and openings of dentinal tubules were clearly opened. But the lased surfaces of the groups over 3 W were irregular and particles were loosely attached on it. 5. With SEM examination of the lased surface of enamel groups revealed severely destructed surface at the 6 W group and melting drop materials at the 3 W group. But the lased surface of 4 W group revealed clearly ablated surface. Therefore when cutting teeth using Er:YAG laser, the lasing power which can make effective ablation rate and minimize the thermal effect could be 3W at dentin and 4W at enamel. But, further studies and additional data collection will be necessary for appropriate lasing condition of Er:YAG laser.

A Study of Current Perception Threshold of Trigeminal Nerve after Tooth Implantation (치아임플란트 시술 후 삼차신경에서의 전류인지역치에 대한 연구)

  • Lim, Hyun-Dae;Lee, Jung-Hyun;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.187-200
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    • 2007
  • This study attempted to contribute to the clinical application of implant operation by making a quantitative nerve examination using a neurometer for the evaluation of sensory disturbances that could be incurred after the implantation in the dental clinics, and it intended to establish an objective guideline in the evaluation of sensory nerve after the operation of implant. An inspection was performed with the frequencies of 2000Hz, 250 Hz and 5 Hz before and after the operations of tooth implant using $Neurometer^{(R)}$ CPT/C (Neurotron, Inc. Baltimore, Maryland, USA) for 44 patients who had performed an implant operation among the patients coming to Daejeon Sun Dental Hospital in 2006 and 30 people for control group. The measuring sites were maxillary nerve ending and mandibular nerve ending of trigeminal nerve according to the implant operating regions. The current perception threshold (CPT) by each nerve fiber was specifically responded under the electric stimulation of 2000 Hz in case of $A{\beta}$ fiber and of 250 Hz in case of $A{\delta}$ fiber and of 5Hz in case of C fiber. The CPT test could be performed to assess the damages of peripheral nerve in the trigeminal nerve area and it stimulated selective nerve fibers by generating the electricity of specific frequency in the peripheral nerve area. The nerve fibers with varied thickness were responsive selectively to the electric stimulation with different frequencies; accordingly, they applied the electric stimulation with different frequencies and the reaction threshold of $A{\beta},\;A{\delta}$ and C fibers selectively responsive to each electric current could be individually evaluated. In the assessment through the CPT, the increase and decrease of the CPT could be measured so that sensory disturbances such as hyperaesthesia or hypoaesthesia could be diagnosed. This study could obtain the following results after the assessment of the CPT before and after the implant operation. 1. In the assessment before and after the implant operation, the CPT in the frequencies of 2000 Hz, 250 Hz, 5 Hz for maxillary branch increased on the whole after the operation and the CPT for mandibular branch in the $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz )after the operation increased statistically significantly. 2. For the groups of patients with medically compromised or its subsequent medicinal prescription, there were no significant differences before and after the implant operation and for the control groups, significantly high CPT was shown after the implant operation in the left $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz). 3. In the comparison of the measured value of the CPT before the operation between the control group and the implant operation group, the latter group had a significantly high measured value of the CPT in the right $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz) and there were significant differences in $A{\beta}$-fiber(2000 Hz) in the CPT assessment after the implant operation for the control group. 4. Male participants had higher CPT than female counterparts; however, there were no statistic significances. In the CPT evaluation before and after implant operation, there were no statistical differences in the male group while the right C-fiber(5 Hz) and left $A{\beta}$-fiber(2000Hz) were significantly high in the female group. 5. In the comparison between the group who complain sensory disturbance and the other group, the CPT increased on the whole in the former group, but there were no statistical significances. In the groups, whom there was an increase in VAS, the CPT after the implant operation in the right C-fiber(5 Hz) increased significantly; meanwhile, in case that the VAS mark was '0' before and after the operation, the CPT after the operation in the left $A{\beta}$-fiber(2000 Hz) increased significantly. This study suggested that the CPT measurements using $Neurometer^{(R)}$ CPT/C, provide useful information of objective and quantitative sensory disturbances for tooth implantation.

THE EFFECTS OF THE PLATELET-DERIVED GROWTH FACTOR-BB ON THE PERIODONTAL TISSUE REGENERATION OF THE FURCATION INVOLVEMENT OF DOGS (혈소판유래성장인자-BB가 성견 치근이개부병변의 조직재생에 미치는 효과)

  • Cho, Moo-Hyun;Park, Kwang-Beom;Park, Joon-Bong
    • Journal of Periodontal and Implant Science
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    • v.23 no.3
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    • pp.535-563
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    • 1993
  • New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration alre basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, biological mediators. Platelet-derived growth factor (PDGF) is one of polypeptide growth factor. PDGF have been reported as a biological mediator which regulate activities of wound healing progress including cell proliferation, migration, and metabolism. The purposes of this study is to evaluate the possibility of using the PDGF as a regeneration promoting agent for furcation involvement defect. Eight adult mongrel dogs were used in this experiment. The dogs were anesthetized with Pentobarbital Sodium (25-30 mg/kg of body weight, Tokyo chemical Co., Japan) and conventional periodontal prophylaxis were performed with ultrasonic scaler. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree III furcation defect was made on mandibular second(P2) and fourth(P4) premolar. For the basic treatment of root surface, fully saturated citric acid was applied on the exposed root surface for 3 minutes. On the right P4 20ug of human recombinant PDGF-BB dissolved in acetic acid was applied with polypropylene autopipette. On the left P2 and right P2 PDGF-BB was applied after insertion of ${\beta}-Tricalcium$ phosphate(TCP) and collagen (Collatape) respectively. Left mandibular P4 was used as control. Systemic antibiotics (Penicillin-G benzathine and penicillin-G procaine, 1 ml per 10-25 1bs body weight) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operated sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 2, 4, 8, 12 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. At 2 weeks after surgery, therer were rapid osteogenesis phenomenon on the defected area of the PDGF only treated group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. New cementum fromation was observed from 2 weeks after surgery, and the thickness was increased until 8 weeks with typical Sharpey’s fibers reembedded into new bone and cementum. In both PDGF-BB with TCP group and PDGF-BB with Collagen group, regeneration process including new bone and new cementum formation and the group especially in the early weeks. It might be thought that the migration of actively proliferating cells was prohibited by the graft materials. In conclusion, platelet-derived growth factor can promote rapid osteogenesis during early stage of periodontal tissue regeneration.

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Expression of Epidermal Growth Factor Receptor in the Inflamed Gingival Epithelium and the Dental Follicle (염증성 치은 상피와 치낭의 표피성장인자 수용체의 발현 및 실험적 치아이동에 미치는 영향에 관한 연구)

  • Kim, Young Ho;Bae, Chang
    • The korean journal of orthodontics
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    • v.27 no.2
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    • pp.349-357
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    • 1997
  • Epidermal growth factor(EGF), a single chain polypeptide of 53 amino acids with a molecular weight of 6,045 Da, was first isolated from the male mouse submandibular glands. EGF stimulates cellular proliferation and differentiation in several tissues and accelerates the rate of wound healing. EGF is bound to the specific receptor(EGFR) on the cell membrane of its target cell. EGFR is a transmembrane glycoprotein with a molecular weight of 170,000 Da and is detectable on a large variety of cell types and tissues. The authors investigated the expression of EGFR in the normal and inflamed human gingival epithelium to study the role of EGFR in the inflammation of the gingival epithelium, and the expression of EGFR in the dental follicle by using in situ mRNA hybridization and immunohistochenistry. The results weree as follows : 1. The expression of EGFR mRNA in the normal gingival epithelium on in situ mRNA hybridization was mainly localized on the basal cell layer, and the spinous layer was weakly positive The granular and cornified layers were negative 2. The expression of EGFR protein in the normal gingival epithelium on inmunohistochemistry was localized on the cornified and granular layers, and the spinous layer was weakly positive. The basal cell layer was completely negative 3. The expression of EGFR mRNA in the inflamed gingival epithelium on in situ mRNA hybridization was evenly and homogeneously distributed in the whole layers of the gingival epithelium except the cornified layer. The staining intensity appeared to increase progressively from the basal cell layer to the cornified layer. 4. The expression of EGFR protein in the inflamed gingival epithelium on immunohistochemistry was evenly and homogeneously distributed in the whole layers of the gingival epithelium. The staining intensity appeared to increase progressively from the cornified layer to the basal cell layer. 5. Strong positive reaction was seen in the epithelial cell rests of Malassez, whereas only background staining was seen in other cells of the dental follicle. In conclusion, the up-regulation of EGFR in the inflamed gingival epithelium and the high amounts of EGFR in the epthelial cell rests of Malassez in the dental follicle can be regarded as responses to the possible damages to the oral environment to maintain the homeostatic conditions.

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