• 대한치과보철학회지
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• 제62권2호
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• pp.104-112
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• 2024

다수 치아를 발치하면 환자는 사회적, 심리적, 심미적인 문제를 마주하게 된다. 이때, 치아를 발치하기 전 임시 즉시 의치를 제작하는 것을 통해 이러한 문제를 최소화할 수 있다. 특히, 디지털 기술을 활용해 임시 즉시 의치를 제작한다면 기공과정이 단순해 지고 환자의 적은 내원 횟수로 임시 즉시 의치를 완성할 수 있다. 한편, 소수의 잔존치가 남은 환자에서 고정성 임플란트 보철수복이 어렵고, 가철성 국소의치의 지지 및 유지가 불량할 것으로 예상되는 경우에 임플란트 지지 가철성 국소의치(Implant-supported removable partial denture)가 대체 치료 옵션으로 주목되며, 임플란트 보철물을 이용해 추가적인 지지 및 유지가 가능하다. 본 증례에서는 다수치아 발거 후 소수 잔존치 상황에서 디지털 기술을 활용해 임시 즉시 의치를 제작하였다. 이후 임플란트를 식립하고 서베이드 크라운을 제작해 가철성 국소의치의 지지, 안정, 유지를 제공하여 임상적으로 만족스러운 결과를 얻었기에 이를 보고하고자 한다.

• Journal of Periodontal and Implant Science
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• 제54권4호
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• pp.236-252
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• 2024

Purpose: Enamel matrix derivative (EMD) has demonstrated beneficial effects on wound healing following surgery. However, the effects of recombinant human fibroblast growth factor 2 (rhFGF-2) in periodontal regeneration therapy have not been extensively studied. This retrospective study was conducted to compare the wound healing outcomes of the modified papilla preservation technique (mPPT) between EMD and rhFGF-2 therapies. Methods: A total of 79 sites were evaluated for early wound healing using the modified early wound healing index (mEHI), which included 6 items: incision, fibrin clotting, step, redness, swelling, and dehiscence. A numeric analog scale, along with postoperative images of the 6 mEHI items, was established and used for the evaluations. The inter-rater reliability of the mEHI was assessed via intraclass correlation coefficients (ICCs). After adjusting for factors influencing the mPPT, the differences in mEHI scores between the EMD and rhFGF-2 groups were statistically analyzed. Additionally, radiographic bone fill (RBF) was evaluated 6 months after surgery. Results: The ICC of the mEHI was 0.575. The mEHI, redness score, and dehiscence scores were significantly higher in the rhFGF-2 group (n=33) than in the EMD group (n=46). Similar results were observed in the subgroup of patients aged 50 years or older, but not in those younger than 50 years. In the subgroup with non-contained bone defects, related results were noted, but not in the subgroup with contained bone defects. However, early wound healing did not correlate with RBF at 6 months after surgery. Conclusions: Within the limitations of this study, the findings suggest that early wound healing following the use of mPPT with rhFGF-2 is somewhat superior to that observed after mPPT with EMD. However, mEHI should be improved for use as a predictive tool for early wound healing and to reflect clinical outcomes after surgery.

• 대한치과보철학회지
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• 제46권4호
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• pp.343-350
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• 2008

연구목적: 본 연구에서는 한국인의 상하악 전치부간의 색조차이를 상하악 치아 순면의 정중부의 색조를 분광측색장치 (Spectrophotometer)를 이용하여 CIE $L^{*}a^{*}b^{*}$ 색체계로 비교분석을 하여, 실제 한국인의 상하악 전치부간의 색조차이에 관하여 알아보고 자 하였다. 연구대상 및 방법: 수복물이 없으며 치주적으로 건강한 정상적인 치관부의 형태의 상하악 12전치를 가진 20대, 30대, 40대, 50대 이상 10명씩 남녀 각 40명씩 총80명을 대상으로 색조 측정을 시행하였다. 연구재료: $SpectroShade^{TM}$ MICRO (MHT S.p.A., Italy) 디지털 색조 분석 기구로서 대상 치아의 디지털 영상을 채득하여 이를 기계 내에 포함된 색조 분석시스템을 통해 shade map의 형태로 입력 분석하여 주는 장치이다. 결론: 1. 전치부 상, 하악 치아간 색조차이는 중절치, 측절치, 견치 모두에서 ${\Delta}E^{*}$가 보다 큰 것으로 나타났다. 2. 상, 하악 견치 간 색조차이는 중절치, 측절치 간의 색조차이보다 더 두드러지고 중절치간 측절치간 색조차이 정도는 유사한 것으로 나타났다. 3. 남녀 성별에 따른 상, 하악 치아 간의 색조차이는 그 정도가 유사한 것으로 나타났다. 4. 각 연령대에 따른 상, 하악 치아간 색조차이의 정도는 연령대와 상관없이 유사한 것으로 나타났다.

• 대한치과교정학회지
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• 제34권1호
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• pp.47-61
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• 2004

교정치료의 목표는 치아와 악골의 기능성과 심미성을 높이며 안정성을 도모하는 데에 있지만, 치료 과정 중에 치근 흡수와 치조골 흡수와 같은 여러 가지 후유증이 발생할 수 있다 이러한 치근첨의 흡수는 예측이 불가능하고, 상아질 부위까지 파급될 수 있으며, 발생 후 비가역적이다. 치조골 흡수는 치주 지지의 관점에서 매우 중요한 후유증이다. 이에 여러 가지 구강악습관 중 손톱 깨물기 습관을 가진 아동의 교정 치료 전, 후의 치근과 치조골 높이 변화를 고찰하여, 교정 치료 시 적절한 생역학을 고려하고, 치근흡수와 치조골 상실의 가능성에 대처하고자 본 연구를 시행하였다. 연구대상은 1997년 7월부터 1999년 2월까지 연세대학교 치과대학병원 교정과에 교정치료를 목적으로 내원한 $10\~15$세까지의 청소년 중 큰 골격 변이가 없고, 함께 내원한 부모로부터 손톱 깨물기 습관이 있다고 확인되고 전형적인 손톱 형태 -정기적인 손톱 깎는 일이 없이 치아로 손톱을 뜯는 습관으로 변연이 불규칙한 손톱의 형태 -를 가진 환자 63명을 실험군으로, 같은 연령대의 손톱 깨물기 습관이 없는 환자63명을 대조군으로 설정하였다. 교정 치료 후 실험군은 31명, 대조군은 22명이었다. 교정 치료 전(T1)과 치료 후(T2), 각 군의 전치부 치근단 방사선 사진을 채득하여 치근의 길이와 치조골의 높이를 평가하여 다음과 같은 결과를 얻었다. 1. 교정 치료 전 실험군의 평균 치관/치근 비는 상악 4전치와 하악 우측 측절치에서 대조군보다 유의성 있게 큰 값을 보여주었다. 2. 교정 치료 전 실험군의 치근 길이는 하악 양측 중절치와 상$\cdot$하악 우측 측절치에서 상대적으로 대조군보다 더 짧은 값을 보였다. 3. 교정 치료 전 실험군의 치간골에서 대조군보다 유의성 있는 상실을 보인 곳이 있었다. 4. 교정 치료 후 실험군과 대조군 모두 치근 길이의 감소와 치간골 소실이 있었다. 5. 교정 치료 후 실험군에서 모든 치아의 치관/치근 비의 변화와 치근의 길이 감소가 대조군보다 유의성 있게 크게 나타났다. 6. 교정 치료 후 실험군의 모든 치아의 치간골 높이가 대조군보다 유의성 있게 감소하였다.

• 치위생과학회지
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• 제16권6호
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• pp.481-487
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• 2016

본 연구는 단면조사로 노인의 구강건강과 치매의 관계를 알아보고자 편의추출된 65세 이상 노인 197명을 대상으로 주관적 건강, 주관적 구강건강 및 관리, 핵심음식 저작능력, OHIP-14, KDSQ를 설문조사하고 구강검사를 실시하여 의치장착여부, 총 잔존치아수, 임플란트와 고정식보철물을 포함한 총 기능치아수를 조사하였다. 그 결과, KDSQ-C가 6점 이상인 치매검사 요구군에서 전신질환 유병률이 높았고, 주관적 건강상태에 부정적 응답 비율이 높았으며, 건강에 대한 염려가 많았고, KDSQ-V와 KDSQ-D도 유의하게 높았다. 정상군과 치매검사 요구군 간의 틀니장착자율, 총 잔존치아수, 총 기능치아수, 1일 칫솔질 횟수, 치아 통증 정도, 치주질환에 대한 주관적 증상정도, 주관적 구강건강상태, 주관적 구강건강염려의 차이는 없었다. 그러나, 치매검사 요구군이 주관적 치과치료 필요도가 높고 구강건강관련 삶의 질 제한정도가 높고 핵심음식 저작능력은 낮았으며 특히 딱딱한 음식군을 저작하기 어렵하고 하였다. KDSQ-C는 OHIP-14와 강한 양의 상관관계를 가지고 핵심음식 저작능력, 총 잔존치아수와는 약한 음의 관계를 가지고 있었다. 다중회귀분석에서는 KDSQ-D, KDSQ-V, OHIP-14 순으로 KDSQ-C에 영향을 미치는 것으로 나타났다. 따라서, 인지능력에 구강건강이 전신건강에 비해 미치는 영향력이 크지는 않지만 구강건강 또한 인지능력과 일부 관계할 수 있으며 인과관계를 분석하기 위해서는 더 정교한 역학연구가 필요할 것으로 제안한다.

• 대한치과교정학회지
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• 제33권2호
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• pp.113-120
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• 2003

본 연구는 불화나트륨과 자일리톨 성분으로 구성된 구강 청정용 저작성 정제 (덴포정, 하미 즐, 부천, 경기 )가 교정치료 중인 환자의 구강위생 상태에 미치는 영향을 알아보기 위해 시행되었다. 교정치료 중인 18세 이상의 성인 환자 30명을 대상으로 약제사용 전, 2주 후, 4주 후에 피험자의 상악과 하악 전치 부위 및 구치 부위에서 각각 치은 지수, 치은 출혈 지수, 치태 지수를 측정하여 다음과 같은 결과를 얻었다. 1. 상하악 전치부와 구치부 모두에서 치태 지수가 약제사용 전에 비해 사용 2주 후와 4주 후 유의성 있게 감소하였다. (p<0.05).또한, 적용 2주 후와 4주 후의 지수를 비교하였을 때 4주 후에 좀 더 개선된 경향을 보였으나, 통계적 유의성은 나타나지 않았다(p>0.05). 2. 치은 지수, 치은 출혈 지수도 상하악 전치부와 구치부 모두에서 적용 전에 비하여 2주 후와 4주 후 유의성 있게 감소하였다(p<0.05).적용 2주 후와 4주 후의 지수의 비교 검증에서 통계학적으로 유의할 만한 차이는 보이지 않아 구강위생 상태의 개선이 계속 유지됨을 보였다. 본 연구의 결과는 치태 지수, 치은 지수, 치은 출혈 지수가 실험 정제 적용 후에 감소하여 구강위생 상태가 개선되었음을 보였다. 이러한 결과를 통해 덴포정을 교정치료 중인 한자에서 부가적으로 사용하였을 경우 치주조직의 건강을 증진시키는데 도움을 줄 수 있으리라고 생각된다.

• Journal of Periodontal and Implant Science
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• 제29권3호
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• pp.561-578
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• 1999

The goal of periodontal therapy is the periodontal regeneration by the removal of microorganisms and their toxic products from the periodontally diseased root surface. To achieve periodontal regeneration, root conditioning as an adjunct to root planing has been done. There are low pH etchants such as citric acid, tetracycline-HCl, and EDTA solution which is a neutral chelating agent. The purpose of present study was to examine the effect of root conditioning by citric acid, tetracycline HCl, and EDTA. Total 35 root specimens(6${\times}$3${\times}$2mm) were prepared from the periodontally diseased teeth, scaled and root planed. The specimens were treated with normal saline for 1 minute, saturated citric acid(pH 1) for 3 minutes, 50mg/ml tetracycline-HCl(pH 2) for 5 minutes, 15% EDTA(pH 7) for 5 minutes using rubbing technique. The specimens were examined under scanning electron microscopy at 1000, and 3000 magnification. On the microphotographs taken at 1000 magnification, the numbers of opened and patent dentinal tubules per unit area(10,640${\mu}m^2$) were counted. And the diameters of opened dentinal tubules per unit are (10,640${\mu}m^2$) were measured. The differences of number and diameter among all groups were statistically analyzed by Kruskal Wallis Test. The results were as follows; 1. In the specimens applied with normal saline(control group), the root surface was finely cracked, and was covered by irregular smear layer. Neither exposed dentinal tubules nor any patent dentinal tubules could be seen. 2. In the specimens applied with saturated citric acid(experimental 1 group), the globular collagen fibers were exposed around the peritubular space, and many dentinal tubules were revealed. 3. In the specimens applied with tetracycline-HCl(experimental 2 group), the process-like collagen fibers were exposed around the peritubular space, and some dentinal tubules were revealed. 4. In the specimens applied with 15% EDTA(experimental 3 group), the root surface was covered by the collagenous fibrillar network, and many dentinal tubules were revealed. 5. The numbers of opened and patent dentinal tubules were significantly more in exp. 1 group and exp. 3 group than in exp. 2 group(P<0.05). But there was no significant difference between exp. 1 group and exp. 3 group. In control group, the number of opened and patent dentinal tubules could not be counted because any dentinal tubules couldn't be seen. 6 . The diameter of opened dentinal tubules was significantly smaller in exp. 1 group and exp. 3 group than in exp. 2 group(P<0.05). But there was no significant difference between exp. 1 group and exp. 3 group. In control group, the diameter of opened dentinal tubules could not be measured because any dentinal tubules couldn't be seen. The results demonstrate that root conditioning with citric acid, tetracycline- HCl, and EDTA is more effective in periodontal healing than only root planing, and 15% EDTA solution can replace low pH etching agents such as citric acid, tetracycline-HCl for root conditioning.

• Journal of Periodontal and Implant Science
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• 제29권3호
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• pp.483-509
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• 1999

Biodegradable barrier membrane has been demonstrated to have guided bone regeneration capacity on the animal study. The purpose of this study is to evaluate the effects of cultured calvarial cell inoculated on the biodegradable barrier membrane for the regeneration of the artificial bone defect. In this experiment 35 Sprague-Dawley male rats(mean BW 150gm) were used. 30 rats were divided into 3 groups. In group I, defects were covered periosteum without membrane. In group II, defects were repaired using biodegradable barrier membrane. In group III, the defects were repaired using biodegradable barrier membrane seeded with cultured calvarial cell. Every surgical procedure were performed under the general anesthesia by using with intravenous injection of Pentobarbital sodium(30mg/Kg). After anesthesia, 5 rats were sacrificed by decapitation to obtain the calvaria for bone cell culture. Calvarial cells were cultured with Dulbecco's Modified Essential Medium contained with 10% Fetal Bovine Serum under the conventional conditions. The number of cell inoculated on the membrane were $1{\times}10^6$ Cells/ml. The membrane were inserted on the artificial bone defect after 3 days of culture. A single 3-mm diameter full-thickness artificial calvarial defect was made in each animal by using with bone trephine drill. After the every surgical intervention of animal, all of the animals were sacrificed at 1, 2, 3 weeks after surgery by using of perfusion technique. For obtaining histological section, tissues were fixed in 2.5% Glutaraldehyde (0.1M cacodylate buffer, pH 7.2) and Karnovsky's fixative solution, and decalcified with 0.1M disodium ethylene diaminetetraacetate for 3 weeks. Tissue embeding was performed in paraffin and cut parallel to the surface of calvaria. Section in 7${\mu}m$ thickness of tissue was done and stained with Hematoxylin-Eosin. All the specimens were observed under the light microscopy. The following results were obtained. 1 . During the whole period of experiment, fibrous connective tissue was revealed at 1week after surgery which meant rapid soft tissue recovery. The healing rate of defected area into new bone formation of the test group was observed more rapid tendency than other two groups. 2 . The sequence of healing rate of bone defected area was as follows ； test group, positive control, negative control group. 3 . During the experiment, an osteoclastic cell around preexisted bone was not found. New bone formation was originated from the periphery of the remaing bone wall, and gradually extended into central portion of the bone defect. 4 . The biodegradable barrier membrane was observed favorable biocompatibility during this experimental period without any other noticeable foreign body reaction. And mineralization in the newly formed osteoid tissue revealed relatively more rapid than other group since early stage of the healing process. Conclusively, the cultured bone cell inoculated onto the biodegradable barrier membrane may have an important role of regeneration of artificial bone defects of alveolar bone. This study thus demonstrates a tissue-engineering the approach to the repair of bone defects, which may have clinical applications in clinical fields of the dentistry including periodontics.

• Journal of Periodontal and Implant Science
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• 제33권3호
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• pp.457-474
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• 2003

The ultimate objective of periodontal treatment is to get rid of an on-going periodontal disease and further regenerate the supporting tissue, which is already destroyed, functionally. Currently, the bone grafting operation using various kinds of bone grafting materials and the operation for induced regeneration of periodontal tissue using the blocking membrane are performed for regeneration of the destroyed periodontal tissue. However, there are respective limitations Galenical preparations, which are used for regeneration of periodontal of tissue, has less risk of rejective reaction or toxicity that may be incidental to degradation and their effect is sustainable. Thus, in case they are applicable to a clinic, they can he used economically. Chitosan has such compatibility, biological actions including antibacterial activity, acceleration of wound treatment, etc., and excellent mechanical characteristics, which has recently aroused more interest in it. Also, it has been reported that it promotes osteogenesis directly or indirectly by functioning as a matrix to promote migration and differentiation of a specific precussor cell (for example, osteoblast) and further inhibiting the function of such a cell as fibroblast to prevent osteogenesis. In this study, the pure chitosan solution, which was obtained by purifying chitosan, was used. However, since this chitosan is of a liquiform, it is difficult to sustain it in a defective region. It is, therefore, essential to use a carrier for delivering chitosan to, and sustaining it gradually in the defective region. In the calvarial defect model of the Sprague-Dawley rat, it is relatively easy to maintain a space. Therefore, in this study, the chitosan solution with which ACS was wetted was grafted onto the defective region, For an experimental model, a calvarial defect of rat m s selected, and a critical size of the defective region was a circular defect with a diameter of 8 mm. A group in which no treatment was conducted for the calvarial defect was set as a negative control group. Another group in which treatment was conducted with ACS only was set as a positive control group (ACS group). And another group in which treatment was conducted was conducted with by grafting the pure chitosan solution onto the defective region through ACS which was wetted with the chitosan solution was set an experimental group (Chitosan/ACS group). Chitosan was applied to the Sprague-Dawley rat's calvarial bone by applying ACS which was wetted with the chitosan solution, and each Sprague-Dawley rat was sacrificed respectively 2 weeks and 8 weeks after the operation for such application. Then, the treatment results were compared and observed histologically and his tometrically. Thereby, the following conclusions were obtained. 1. In the experimental group, a pattern was shown that from 2 weeks after the operation, vascular proliferation proceeded and osteogenesis proceeded through osteoblast infiltration, and at 8 week after the operation, ACS was almost absorbed, the amount of osteogensis was increased and many osteoid tissue layers were observed. 2. At 2 weeks after the operation, each amount of osteogenesis appeared to be 8.70.8 %, 13.62.3 % and 4.80.7 % respectively in the experimental group, the positive control group and the negative control group. Accordingly, it appeared to be higher in the Experimental group and the positive control group than in the negative control group, but there was no significant difference statistically (p<0.01). 3. At 8 weeks after the operation, each amount of osteogenesis appeared to be 62.26.1%, 17.42.5 % and 8.21.4 % respectively in the experimental group, the positive control group and the negative control group. Accordingly, it appeared to be substantially higher in the experimental group than in the positive control group and the negative control group, and there was a significant difference statistically (p<0.01). As a result of conducting the experiment, when ACS was used as a carrier for chitosan, chitosan showed effective osteogenesis in the perforated defective region of the Sprague-Dawley rat's calvarial bone.

• Journal of Periodontal and Implant Science
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• 제33권3호
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• pp.485-497
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• 2003

Grapefruit seed extract has been reported to have antimicrobial effect. The purpose of this study was to evaluate the antimicrobial and anti-gingivitis effect of chewing gum containing grapefruit seed extract and xylitol. 40 healthy subjects with gingivitis or early periodontitis were divided into two groups. Subjects in the experimental group chewed gum containing grapefruit seed extract and xylitol while subjects in the control group chewed gum containing only xylitol. All subjects received scaling and tooth brushing instruction. 1 week after scaling was set as baseline. Gingival index and plaque index were scored at baseline, 1 week, 2 week, 3 week and 4 week. Bleeding index, probing pocket depth and clinical attachment level were scored at baseline, 2 week and 4 week. The number of total bacteria and Streptococcus mutans in unstimulated saliva of experimental group were counted at 1 week, 2 week, 3 week and 4 week. Gingival indices of experimental group and control group at baseline, 1 week, 2 week, 3 week and 4 week were 0.850${\pm}$0.298, 0.575${\pm}$0.345, 0.533${\pm}$0.332, 0.459${\pm}$0.311, 0.408${\pm}$0.224 and 0.758${\pm}$0.379, 0.592${\pm}$0.276, 0.563${\pm}$0.281, 0.454${\pm}$0.194, 0.413${\pm}$0.199 (mean${\pm}$SD), respectively. Plaque indices of experimental group and control group at baseline, 1 week. 2 week, 3 week and 4 week were 0.497${\pm}$0.500, 0.375${\pm}$0.484, 0.332${\pm}$0.471, 0,286${\pm}$0.452, 0.210${\pm}$0.407 and 0.411${\pm}$0.492, 0.375${\pm}$0.484, 0.354${\pm}$0.479, 0.313${\pm}$0.463, 0.193${\pm}$0.395, respectively. Bleeding indices of experimental group and control group at baseline, 2 week and 4 week were 0.377${\pm}$0.177, 0.298${\pm}$0.152, 0.192${\pm}$0.108 and 0.383${\pm}$0.124, 0.318${\pm}$0.153, 0.225${\pm}$0.126, respectively. Probing pocket depth of experimental group and control group at baseline, 2 week and 4 week were 2.56${\pm}$1.00, 2.40${\pm}$0.65, 2.23${\pm}$0.64 and 2.45${\pm}$0.682.37${\pm}$0.57, 2.19${\pm}$0.57, respectively. Clinical attachment level of experimental group and control group at baseline, 2 week and 4 week were 2.58${\pm}$1.01, 2.43${\pm}$0.67, 2.26${\pm}$0.65 and 2.49${\pm}$0.70, 2.40${\pm}$0.59, 2.22${\pm}$0.62, respectively. The % of reduction of total bacteria in saliva of experimental group at 2 week, 3 week and 4 week were 46 ${\pm}$ 53%, 53 ${\pm}$ 5% and 69 ${\pm}$ 33%. The % of reduction of Streptococcus mutans count in saliva of experimental group at 2 week, 3 week and 4 week were 52${\pm}$69%, 88${\pm}$30% and 89${\pm}$17%. From these findings, it can be concluded that regular use of grapefruit seed extract /xylitol chewing gum may be effective to control and prevent gingivitis and may have caries-preventive effect.