• 제목/요약/키워드: Comprehensive dental treatment

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완전 구강 회복술 (Full Mouth Rehabilitation)

  • 이승규;이성복;권긍록;최대균
    • 구강회복응용과학지
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    • 제16권3호
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    • pp.171-185
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    • 2000
  • The treatment objectives of the complete oral rehabilitation are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. There may be many roads to achieving these objectives, but they all convey varing degrees of stress and strain on the dentist and patient. There are no "easy" cases of oral rehabilitation. Time must be taken to think, time must be taken to plan, and time must be taken to perform, since time is the critical element in both success and failure. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. Firstly, we must evaluate the mandibular position. The results of a repetitive, unstrained, nondeflective, nonmanipulated mandibular closure into complete maxillomandibular intercuspation is not so much a "centric" occlusion as it is a stable occlusion. Accordingly, we ought to concern ourselves less with mandibular centricity and more with mandibular stability, which actually is the relationship we are trying to establish. The key to this stability is intercuspal precision. Once neuromuscular passivity has been achieved during an appropriate period of occlusal adjustment and provisionalization, subsequent intercuspal precision becomes the controlling factors in maintaining a stable mandibular position. Secondly, we must evaluate the planned vertical dimension of occlusion in relationship to what may now be an altered(generally diminished), and avoid the hazard of using such an abnormal position to indicate ultimate occlusal contacting points. There are no hard and fast rules to follow, no formulas, and no precise ratios between the vertical dimension of occlusion. Like centric relation, it is an area, not a point.

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일부(一部) 대학생(大學生) 신체발육(身體發育) 및 건강상태(健康狀態)에 관(關)한 조사(調査) (A Study on the Physical Growth and Health Status in University Students)

  • 권이혁;차철환
    • Journal of Preventive Medicine and Public Health
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    • 제1권1호
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    • pp.67-78
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    • 1968
  • For the purpose of ascertaining the status of physical growth and health status of the University students, a intensive survey was conducted by the authors towards a total of 2,638(male; 2,228, female; 410) who passed the written entrance examination at the Seoul National University. The items included the measurements on physical growth, various physical indixes, visual acuity, tuberculosis and dental status. The findings and results can be summarized as follows: 1. Physical Growth No significant difference was found in the physical growth between classes(literature and science) and by ages. In males, the means of body height, body weight, chest-girth and sittingheight were $168.0{\pm}5.07cm,\;55.7{\pm}5.71kg,\;85.8{\pm}4.4cm\;and\;91.5{\pm}2.21cm$, respectively. In females, these were $157.4{\pm}4.57\;cm,\;00.4{\pm}5.75kg,\;80.3{\pm}4.51cm\;and\;86.1{\pm}3.30cm$, respectively. Basing on the above measurements several physical indixes were calculated as follows ; Relative body weight 33.15 in males and 32.02 in females. Relative chest-girth 51.07 and 51.01, relative sitting-height 54.46 and 54.70 $R\ddot{o}hrer$ index 1.00 and 1.02, Kaup index 1.97 and 2.04, Vervaeck index 83.63 and 83.03, and Pelidisi index 89.94 and 92.45. 2. Visual Acuity Among the students of science classes those of 0.8 and below in vision on left and right occupied 46.4% and 45.0%, those of 0.6 and below 39.1% and 41.2%, respectively. Among the students of literature classes those of 0.8 and below occupied 46.3% and 42.9%, and those of 0.6 and below occupied 41.4% and 39.0, respectively. In males those of 0.8 and below occupied 46.8% and 44.5% and 0.6 and below occupied 41.9% and 39.7%, while in females 0.8 and below occupied 43.9%, and 42.4%, and 0.6 and below occupied 38.3% and 37.3%, respectively. In males those of 0.8 and below in corrected vision occupied 12.1% and 10.3%, while in females 12.9% and 12.2%, respectively. More students of abnormal vision were found among science classes and the proportions of corrected vision were 38.9% and 37.4% in males, and 33.9% and 33.2% in females, respectively. 3. Tuberculosis Among the total, 55 students were diagnosed as tuberculosis, of whom 50 were minimal cases, 2 were moderately advanced cases and 3 were far advanced cases. 4. Dental Status Among the total, 81.2% were of decayed teeth, 20.8% filled, 9.5% missed, 5.0% extraction needed, 9.1% sunplatinum bridges, 3.3% golden bridges and 5.5% golden inlay. Regarding tartar on teeth moderate, heavy and light grades occupied 49.5%, 29.7% and 20.3%, respectively and 0.8% had none. 5. Comprehensive evaluation According to criteria 4 grades were applied to comprehensive evaluation as follows : A...excellent in physical status B...with some physical defects but no difficulties in study C...need treatment D...need treatiment and rest Out of the total, A grade occupied 21.6%, B 76.2% and C. and D 2.2.

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2000년대 치주처치의 전략 (Periodontal Management strategies for the future in Korea)

  • 정현주;손성희
    • Journal of Periodontal and Implant Science
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    • 제27권3호
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    • pp.533-547
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    • 1997
  • 과학기술이 발전함에 따라 치주과학 영역에서도 1960년 이후 1980년대에 걸쳐 괄목할 만한 학문적 발전이 이루어졌으며 1990년에는 이에 의거한 치주질환의 예방 및 조절방법이 개발되어 사용되고 있다. 미래의 치주처치전략은 대상 지역의 특성과 보건환경에 따라 달라지므로 여기에서는 한국내 치주치료요구도와 치주치료 담당 일반치과의와 치주전문의의 수, 처치 내용에 대해 점검하고 현재의 치주처치 추세를 검토한 후 향후의 치료전략에 대해 언급하고자 한다. 1980년도 역학조사에 의하면 전체 인구의 82%가 치주질환(치은염+치주염), 35세 성인 인구의 30-40%가량이 치주염에 이환되어 있고 15세 청소년 인구중 0.1%가 유년형치주염에 이환되고 있다. 평균 수명이 증가하면서 65세 이상의 노년층도 전인구의 6%(성인 50%), 2000년도에는 6.9%(성인 52%)로 증가하고 치아보유율도 증가하므로 치주질환 치료요구도는 상승하리라 전망된다. 현재 한국내 치주전공 과정을 거친 치과의사는 약 780인 정도이다, 1996년 류의 연구에 의하면 이들도 대부분 일반치과의(개원의, 공증보건의 포함)로서 진료하고 있으며 의료보험하에서의 치주치료의 비중은 매우 낮다(4.66%). 포괄적 치주적 검사도 보편적이지 않고 대학병원급의 극히 일부에서만 이행되고 있는 실정이다. 향후의 치주질환이 처치전략에는 의료보험 운용시 치주적 배려와 간편한 치주검사과정을 통한 조기진단 및 조기치료, 진행기질환 및 난치성질환자의 치주전문으로의 의뢰가 포함될 것이며 각 환자에게는 개별적이며 임상시험 결과에 근거하는 evidence-based approach에 의한 치료선정 과정이 활용되리라 전망한다.

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도시 저소득층 고령 주민의 구강건강실태 (Oral Health Status of Needy Old Residents in Urban Area)

  • 손우성;허복;박수병;김진범
    • 보건교육건강증진학회지
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    • 제13권1호
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    • pp.72-89
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    • 1996
  • 도시 고령 영세민들의 구강건강을 증진하기 위한 구강보건진료사업을 개발하는 데에 기초자료를 마련할 목적으로, 부산광역시 해운대구 운봉영구임대아파트 단지 주민들 중 44세이상의 인구를 대상으로 구강건강행동과 구강건강실태를 조사분석 검토한 결과를 요약하면 다음과 같다. 1. 1일 잇솔질횟수는 44-54세에서 1,9회, 55-64세에서 1.7회, 65세이상에서 1.7회이었고, 식후 잇솔질률은 44-54세에서 73.7%, 55-64세에서 식후 잇솔질률은 70.6%, 65세이상에서 식후 잇솔질률은 76.5%이었다. 2. 우식경험영구치지수는 44-54세에서 15.5개, 55-64세에서 16.4개, 65세이상에서 26.6개이었다. 3. 우식영구치율은 44-54세에서 23.9%, 55-65세에서 11.6%, 65세이상에서는 11.7%이었고, 상실영구치율은 44-54세에서 55.5%, 55-65세에서 62.8%, 65세이상에서는 77.4%이었으며, 처치영구치율은 44-54세에서 20.0%, 55-65세에서 25.0%, 65세이상에서는 10.9%이었다. 4. 건전영구치수는 44-54세에서 16.4개, 55-64세에서 15.6개, 65세이상에서 5.4개이었고, 현존영구치수는 44-54세에서 23.7개, 55-64세에서 21.6개, 65세이상에서 10.9개이었다. 5. 치면세마필요자율은 44-54세에서 75.0%, 55-64세에서 83.3%, 65세이상에서 76.9%이었으며, 복합치주병치료 필요자율은 44-54세에서 16.7%, 55-64세에서 13.3%, 65세이상에서 15.4%이었다. 6. 치면세마 필요분악률은 44-54세에서 59.3%, 55-64세에서 71.5%, 65세이상에서 71.5%이었으며, 복합치주병치료 필요분악를은 44-54세에서 5.6%, 55-64세에서 4.1%, 65세이상에서 5.7%이었다. 7. 도시 저소득층 고령 주민들의 구강건강향상을 위해서 체계적이고 포괄적인 구강보건진료사업을 개발하여야 한다.

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