• 대한장애인치과학회지
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• 제14권2호
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• pp.97-101
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• 2018

저자는 입술 및 혀에 대해 자해증상을 보이는 2명의 Lesch-Nyhan 증후군 환아에서 구강조직에 대한 자해행동을 예방하기 위해 soft mouth guard를 이용한 보존적 치료법과 전악발거의 침습적 방법을 이용하여 치료한 증례를 보고하는 바이다. Lesch-Nyhan 증후군 환자의 자해행동을 예방하기 위한 치료법은 아직 정립된 기준이 존재하지 않아 각 환자의 자해양상 및 정도에 따라 치료방법은 달라질 수 있다. 가능하다면 치아를 보존할 수 있는 장치 또는 BTX-A 제재 등을 이용한 보존적 방법을 먼저 시도해 보는 것이 좋다. 이 때 치료의 성공률을 높이기 위해서는 치과적 접근 이외에도 소아정신과와의 협진을 통한 정신심리학적 접근, 필요시 약물치료를 고려하는 것 등 여러 방향으로 접근하는 것이 더욱 바람직한 결과를 가져올 것으로 사료된다. 보존적 접근이 실패할 경우 더 이상의 조직상실과 전신적 감염 예방을 위해 극단적 방법이지만 전악발거를 고려해야 할 것이다.

• 구강회복응용과학지
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• 제40권2호
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• pp.91-99
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• 2024

골격성 3급 무치악 환자의 경우 총의치 제작 시 잔존치조제 관계를 고려하여 교차교합을 형성해 줌으로써 의치의 안정을 얻을 수 있다. 골격성 3급 악간관계에서 전치부를 정상교합 관계로 형성하는 것은 전방 캔틸레버를 가중시켜 의치의 안정을 저하시킬 수 있다. 하지만, 환자들은 총의치를 사용할 때 기능적인 면 뿐 아니라 심미적인 면 또한 중요시한다. 전치부 인공치들이 어떻게 배열되느냐에 따라 총의치의 심미성이 좌우되어, 골격성 3급 악간관계를 갖는 무치악 환자에서 정상교합이나 절단교합을 활용한 총의치 제작 증례가 보고되고 있다. 본 증례에서는 3급 악간관계를 갖는 무치악 환자에게 상악 전치부에 중립대를 고려하여 전치부 절단교합을 형성하여 의치를 제작하였고, 우수한 심미적, 기능적 결과를 얻었다.

• 대한치과보철학회지
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• 제62권1호
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• pp.54-63
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• 2024

장기간 사용된 임플란트 피개의치는 부착장치의 마모와 전치부 교합집중, 인공치 파절, 의치의 회전 등을 보일 수 있다. 이러한 문제점은 추가적인 임플란트 식립을 이용한 임플란트보조 국소의치(IARPD, implant assisted removable partial denture)로의 전환으로 개선할 수 있다. 본 증례는 임플란트 피개의치를 사용하는 3급 악간관계 환자에서 전치부에 집중된 교합을 분산하고 의치의 회전방지를 위해 서베이드 크라운을 이용한 IARPD으로 전환하였다. 여러 단계의 임시수복물을 통해 적절한 기능과 심미를 가진 최종보철물의 형태를 결정하였으며 최종 보철물의 적절한 구치부 교합과 임플란트 주위 변연골 유지를 보였기에 이를 보고하는 바이다.

• 구강회복응용과학지
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• 제39권4호
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• pp.214-221
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• 2023

잔존 치조제의 흡수가 심하게 진행된 환자에서 안정된 의치를 제작하기 위해서는 여러가지 요소를 고려해야 한다. 그 중 하나는 중립대(Neutral zone)로, 기능하는 동안 구강 안에서 밖으로 향하는 혀의 압력과 밖에서 안으로 향하는 볼과 입술의 압력이 평형을 이루는 잠재적인 영역으로 정의된다. 만약 치조제의 흡수가 심한 경우에 통상적으로 잔존 치조제 상방에 치아를 배열한다면 치아는 기존 위치보다 설측에 위치하게 된다. 따라서 혀의 기능공간을 침범하게 되어 혀가 후방으로 위치하게 되고, 설측 변연의 봉쇄가 깨져 의치를 탈락시키는 요인으로 작용하게 된다. 또한 상·하악의 치조제를 잇는 치조정간선을 상정하고 저작력을 치조정간선에 일치시키도록 상·하악 인공치를 배열하는 것 또한 의치의 안정에 중요하다. 따라서 불량한 잔존 치조제를 지닌 환자에게 중립대 인상 및 치조제 관계 분석을 이용해 의치를 제작하여 좋은 임상 결과를 얻었기에 보고하는 바이다.

• Restorative Dentistry and Endodontics
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• 제24권4호
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• pp.647-656
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• 1999

The purpose of this study was to investigate the shear bond strength and marginal microleakage of composite to enamel and dentin according to different treatment methods when the applied bonding agent was contaminated by artificial saliva. For the shear bond strength test, the buccal and occlusal surfaces of one hundred twenty molar teeth were ground to expose enamel(n=60) and dentin surfaces(n=60). The specimens were randomly assigned into control and 5 experimental groups with 10 samples in each group. In control group, a bonding system(Scotchbond$^{TM}$ Multi-Purpose plus) and a composite resin(Z-100$^{TM}$) was bonded on the specimens according to manufacture's directions. Experimental groups were subdivided into 5 groups. After polymerization of an adhesive, they were contaminated with at artificial saliva on enamel and dentin surfaces: Experimental group 1 ; artificial saliva was dried with compressed air. Experimental group 2 ; artificial saliva was rinsed with air-water spray and dried. Experimental group 3 ; artificial saliva was rinsed, dried and applied an adhesive. Experimental group 4 ; artificial saliva was rinsed, dried, and then etched using phosphoric acid followed by an adhesive. Experimental group 5, artificial saliva was rinsed, dried, and then etched with phosphoric acid followed by consecutive application of both a primer and an adhesive. Composite resin(Z-100$^{TM}$) was bonded on saliva-treated enamel and dentin surfaces. The shear bond strengths were measured by universal testing machine(AGS-1000 4D, Shimaduzu Co. Japan) with a crosshead speed of 5mm/minute under 50kg load cell. Failure modes of fracture sites were examined under stereomicroscope. The data were analyzed by one-way ANOVA and Tukey's test. For the marginal microleakage test, Class V cavities were prepared on the buccal surfaces of sixty molars. The specimens were divided into control and experimental groups. Cavities in experimental group were contaminated with artificial saliva and those surfaces in each experimental groups received the same treatments as for the shear test. Cavities were filled with Z-100. Specimens were immersed in 0.5% basic fuchsin dye for 24 hours and embedded in transparent acrylic resin and sectioned buccolingually with diamond wheel saw. Four sections were obtained from the one specimen. Marginal microleakages of enamel and dentin were scored under streomicroscope and averaged from four sections. The data were analyzed by Kruskal-Wallis test and Fisher's LSD. The results of this study were as follows. 1. The shear bond strength to enamel showed lower value in experimental group 1(13.20${\pm}$2.94MPa) and experimental group 2(13.20${\pm}$2.94MPa) than in control(20.03${\pm}$4.47MPa), experimental group 4(20.96${\pm}$4.25MPa) and experimental group 5(21.25${\pm}$4.48MPa) (p<0.05). 2. The shear bond strength to dentin showed lower value in experimental group 1(9.35${\pm}$4.11MPa) and experimental group 2(9.83${\pm}$4.11MPa) than in control group(17.86${\pm}$4.03MPa), experimental group 4(15.04${\pm}$3.22MPa) and experimental group 5(14.33${\pm}$3.00MPa) (p<0.05). 3. Both on enamel and dentin surfaces, experimental group 1 and 2 showed many adhesive failures, but control and experimental group 3, 4 and 5 showed mixed and cohesive failures. 4. Enamel marginal microleakage was the highest in experimental group 1 and there was a significant difference in comparison with other groups (p<0.05). 5. Dentin marginal microleakages of experimental group 1 and 2 were higher than those of other groups (p<0.05). This result suggests that treatment methods, re-etching with 35% phosphoric acid followed by re-application of adhesive or repeating all adhesive procedures, will produce good effect on both shear bond strength and microleakage of composite to enamel and dentin if the polymerized bonding agent was contaminated by saliva.

• 한국치위생학회지
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• 제18권3호
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• pp.269-280
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• 2018

Objectives: The purpose of this study was to investigate the change in the posture of dental hygiene students and clinical dental hygienists when implementing dental scaling before and after posture correction training using the rapid upper limb assessment (RULA) method and 3D motion analysis. Methods: Thirty-two healthy volunteers performed dental scaling to remove artificial calculus on dental manikin. The movement and angle of the joints were verified by RULA and 3D motion analysis during the procedure. The subjects were also photographed for 1 minute during the procedure for 10 minutes while the calculus was removed. After the removal of the calculus, the subject and the instructor checked the video together. Posture correction training was conducted by the instructor so that the subject could perform the calculus removal operation in the correct posture. Artificial calculus of the adjacent teeth was then removed for the same period of time, and the change in posture was reviewed. Results: The total score of the posture change using RULA was $5.72{\pm}0.58$ before training and $4.31{\pm}0.10$ after training, showing a significant decrease after training (p<0.001), and upper arm, lower arm, wrist position, neck and waist position showed significant decrease after training. The three-dimensional motion analysis showed significant differences according to the criteria measured at all measurement sites except the left shoulder (p<0.05) Conclusions: It was confirmed through RULA and 3D motion analysis that postural correction training using calculus removal images was effective, and that correct postural education is essential to preventing musculoskeletal diseases caused by removal of calculus.

• 대한치과기공학회지
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• 제39권1호
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• pp.43-52
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• 2017

Purpose: Physical and chemical properties of gold is most suitable to be restored of teeth to its original state. Recently zirconia was used instead of gold because of esthetical and intimacy of human body. Because of high strength and high abrasion resistance of zirconia, all zirconia artificial tooth lead to wear the original tooth of opposite site. To preserve this original tooth, zirconia artificial tooth covered with dental ceramic glass was used. When joining the zirconia core and dental ceramic glass, difference of their thermal expansion coefficient and wetting ability is generated the residual stress at interface lead to crack. In order to solve this problem, intermediate layer what is called zir-liner was imported to decrease the residual stress and increase the bonding strength. Methods: In this study, to identify the optimum conditions for manufacturing process, various methods to rough the surface of zirconia core were adopted, and vary the thickness of interlayer, and analyzed bond strength. Results: Bond strength of sanding specimens group showed higher than that of non-sanding specimens group, and once applied intermediate layer with sanding specimens showed highest bond strength with 28 MPa. SEM photomicrographs of zirconia cores fired at $1500^{\circ}C$ showed parallel straight lines in sanding and pockmarked surface in blasting surfaces as abrasion traces. Observation of the destruction section after shear test by SEM were carried out. Liner applied non-sanding group and non-liner applied sanding group all showed interfacial crack. Sandblasting group with non-liner showed remained dental ceramic glass on the surface of zirconia. Sandblasting group with once applied liner showed partially remained liner and dental ceramic glass on the surface of zirconia. XRD analysis revealed that sandblasting group showed higher monoclinic peaks than other specimens group and this result was due to the high collision energy for stress induced phase transformation. Conclusions: A study on the improvement of bonding strength between zirconia and dental ceramic glass steadily carried out for the future to practical use.

• 치과방사선
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• 제23권2호
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• pp.277-285
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• 1993

This study was performed to evaluate the role of Waters' view and panoramic view for the interpretation of mucosal cyst of the maxillary sinus and to determine the radiographic features of that according to the sites and sizes. For this study, clinically 25 cases of mucosal cyst of the maxillary sinus were used, and experimentally with two dry skulls, rubber ball of 15mm in diameter for marked radiopacity, and two jelly balls of 8 and 20㎜ in diameter for the similar radiopacity to cyst were used. The 25 cases with 25 panoramic views and 15 Waters' views were first analyzed, and secondly, the radiographic features of artificial lesions attached to the each wall of the antrum on Waters' view and panoramic view were analyzed. The obtained results were as follows: At clinical analysis, 1. 4 cases of 13-14㎜, 4 cases of 15-19mm, 14 cases of 20-25㎜, 3 cases of over 30㎜ in dia- meter were found on panoramic views. And 24 cases of 25 cases showed no relationship with teeth, and only 1 case was associated with advanced periodontal disease 2. The majority of mucosal cysts appeared to arise the posterior portion of the floor of the sinus and were superimposed with the inominate line of zygoma and the horizontally linear image of hard palate on panoramic view. 3. Only 2 cases of 15 cases were identified on both films. At experimental analysis, 4. On Waters' view, the images of the artificial lesion of the anterior portion and midportion of the floor of the sinus were lessend in diameter compared with the real size. On panoramic views, the images of the lesion were more radiolucent with lessened diameter than images on Water' view. 5. The images of the lesion of the posterior wall and the posterior portion of the floor of sinus on panoramic view were well detected by the preeducated group but not or poorly detected by the non-preeducated observer group. 6. On Waters' view, both observer groups recognized that the cystic images of the posterior portion of the floor of the maxillary sinus were superimposed with the petrous portion of the skull.

• Restorative Dentistry and Endodontics
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• 제25권1호
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• pp.46-55
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• 2000

During bonding procedure of composite resin, the prepared cavity can be contaminated by saliva. In this study, marginal microleakage and shear bond strength of a composite resin to primed enamel and dentin treated with artificial saliva(Taliva$^{(R)}$) were evaluated. For the marginal microleakage test, Class V cavities were prepared in the buccal surfaces of fifty molars. The samples were randomly assigned into 5 groups with 10 samples in each group. Control group was applied with a bonding system (Scotchbond$^{TM}$ Multi-Purpose plus) according to manufacture's directions without saliva contamination. Experimental groups were divided into 4 groups and contaminated with artificial saliva for 30 seconds after priming: Experimental 1 group ; artificial saliva was dried with compressed air only, Experimental 2 group ; artificial saliva was rinsed and dried. Experimental 3 group ; cavities were etched with 35% phosphoric acid for 15 seconds after rinsing and drying artificial saliva. Experimental 4 group ; cavities were etched with 35% phosphoric acid for 15 seconds and primer was reapplied after rinsing and drying artificial saliva. All the cavities were applied a bonding agent and filled with a composite resin (Z-100$^{TM}$). Specimens were immersed in 0.5% basic fuschin dye for 24 hours and embedded in transparent acrylic resin and sectioned buccolingually with diamond wheel saw. Four sections were obtained from one specimen. Degree of marginal leakage was scored under stereomicroscope and their scores were averaged from four sections. The data were analyzed by Kruscal-Wallis test and Fisher's LSD. For the shear bond strength test, the buccal or occlusal surfaces of one hundred molar teeth were ground to expose enamel(n=50) or dentin(n=50) using diamond wheel saw and its surface was smoothed with Lapping and Polishing Machine(South Bay Technology Co., U.S.A.). Samples were divided into 5 groups. Treatment of saliva-contaminated enamel and dentin surfaces was same as the marginal microleakage test and composite resin was bonded via a gelatin capsule. All specimens were stored in distilled water for 48 hours. The shear bond strengths were measured by universal testing machine (AGS-1000 4D, Shimaduzu Co., Japan) with a crosshead speed of 5 mm/minute. Failure mode of fracture sites was examined under stereomicroscope. The data were analyzed by ANOVA and Tukey's studentized range test. The results of this study were as follows : 1. Enamel marginal microleakage showed no significant difference among groups. 2. Dentinal marginal microleakages of control, experimental 2 and 4 groups were lower than those of experimental 1 and 3 groups (p<0.05). 3. The shear bond strength to enamel was the highest value in control group (20.03${\pm}$4.47MPa) and the lowest value in experimental 1 group (13.28${\pm}$6.52MPa). There were significant differences between experimental 1 group and other groups (p<0.05). 4. The shear bond strength to dentin was higher in control group (17.87${\pm}$4.02MPa) and experimental 4 group (16.38${\pm}$3.23MPa) than in other groups, its value was low in experimental 1 group (3.95${\pm}$2.51 MPa) and experimental 2 group (6.72${\pm}$2.26MPa)(p<0.05). 5. Failure mode of fractured site on the enamel showed mostly adhesive failures in experimental 1 and 3 groups. 6. Failure mode of fractured site on the dentin did not show adhesive failures in control group, but showed mostly adhesive failure in experimental groups. As a summary of above results, if the primed tooth surface was contaminated with artificial saliva, primer should be reapplied after re-etching it.

• Imaging Science in Dentistry
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• 제34권1호
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• pp.19-23
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• 2004

Purpose: To compare the diagnostic accuracy of Kodak Insight film with other intra-oral films in the detection of dental caries. Materials and Methods : Periapical radiographs of 99 extracted human teeth with sound proximal surfaces and interproximal artificial cavities were made on Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Kodak Insight films and automatically processed. Six dentists examined the presence of dental caries using a five-point confidence rating scale and compared the diagnostic accuracy by ROC (Receiver Operating Characteristic) analysis and ANOVA test. Results: The sensitivity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.84, 0.77, 0.75 and 0.79 respectively. The specificity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.97. 0.95. 0.96 and 0.94 respectively. The mean ROC areas (Az) of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.917, 0.910, 0.894, 0.909 respectively. There was no significant differences between Az of Insight film and other films (p = 0.178). Conclusion: Theses results suggested that Kodak Insight film have the comparative diagnostic accuracy of dental caries with Ultraspeed and Ektaspeed films.