• 제목/요약/키워드: Dental Clinic

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혼합치열기에 있는 법랑질형성부전증 환아의 이행적 치료 (TRANSITIONAL TREATMENT OF AMLEOGENESIS IMPERFECTA IN MIXED DENTITION: A CASE REPORT)

  • 황지영;최영철;김광철;박재홍;최성철
    • 대한소아치과학회지
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    • 제36권4호
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    • pp.601-606
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    • 2009
  • 법랑질형성부전증은 치아 법랑질의 유전성 결함으로 임상적으로 형성부전형, 성숙부전형, 석회화부전형의 3가지로 나뉜다. 이 질환은 유치와 영구치에서 모두 발생할수 있다. 본 증례의 환자는 8세 8개월에 상악 영구 전치의 맹출지연 및 하악 전치부위 치석, 전치부 개방교합을 주소로 개인병원에서 의뢰되어 본과에 내원하였다. 본과에서 임상검사 결과, 상, 하악 전치부의 얇은 법랑질과 좁은 치아 폭경을 보였으며, 특히 하악 전치부는 전체적인 형태상 불량하고 거친 표면을 나타냈다. 또한 온도 자극에 민감한 반응을 나타냈다. 상, 하악 제 1 대 구치는 심한 법랑질 파절과 마모를 보였다. 방사선 검사에서 전반적인 법랑질형성부전증을 보였으며 맹출하지 않은 치아에서도 법랑질형성부전증을 볼 수 있었다. 이에 본 환아는 형성부전형 법랑질형성부전증으로 진단내렸으며, 경희대학교 소아치과와 보철과의 협진하에 치료를 시행하였으며 지속적인 관찰 중이다. 법랑질형성부전증 환자의 효율적인 저작능력, 심미성 회복, 지각과민증 해소를 위하여 구강 위생교육, 구치부 및 전치부의 수복이 필요하다. 성장이 완료될 때까지 지속적인 예방치료 및 치아 수복이 필요하며 성장 완료 후에는 여러 과의 협진적 치료가 필요하다.

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수산화칼슘 근관충전제의 적용이 유치 치근상아질의 미세경도에 미치는 영향 (Effect of Calcium Hydroxide on the Microhardness of Root Dentin of Primary Tooth)

  • 전새로미;김종빈;유승훈
    • 대한소아치과학회지
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    • 제40권3호
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    • pp.177-184
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    • 2013
  • 수산화칼슘 근관충전제는 뛰어난 항균작용과 낮은 세포독성으로 우수한 유치 근관충전제로 평가되고 있다. 하지만 수산화칼슘을 근관 내 장기간 적용할 경우 치근 상아질에 미치는 부정적인 영향이 논의되고 있으며 많은 연구에서 영구치 근관에 수산화칼슘을 적용 후 상아질 경도의 감소가 확인되었다. 본 연구에서는 수산화칼슘 제제의 적용 기간에 따라 유치 치근 상아질의 미세경도를 측정하여, 수산화칼슘의 적용이 유치 치근 상아질의 미세경도에 미치는 영향을 평가하고자 하였다. 생리적 치근 흡수가 1/3이상 진행되지 않은 시기에 발거된 60개의 상악 유전치를 각각 20개 씩 대조군, 수산화칼슘과 요오드포름의 혼합제제(Vitapex, Neodent., Japan), 수산화칼슘과 증류수의 혼합제제를 적용하는 3개의 군으로 분류하였다. 각 치아는 같은 과정의 치수 절제술을 시행한 후 교정용 레진에 매몰하여 군당 5개 치아를 배정하고 24시간, 7일, 30일, 90일 후 치근 중앙부에서 2 mm 두께의 시편을 획득하여 비커스 미세경도 측정기를 통해 미세경도를 측정하였다. 측정된 미세경도 값은 Kruskal-Wallis test로 변수 간의 상호관계를 확인하였으며 사후 검정으로 Mann-Whitney test를 시행하였다. 시간에 따른 미세경도 값의 감소량은 선형 회귀분석을 통해 추이를 분석하였다. 수산화칼슘 근관 충전제가 유치의 치근 상아질의 미세경도에 미치는 영향을 조사한 결과, 다음과 같은 결론을 얻을 수 있었다. 수산화칼슘 근관 충전제를 유치의 근관에 적용 시 기간에 따라 치근상아 질의 미세경도가 감소하였으며, 이는 통계적으로 유의하였다(p < 0.05). 수산화칼슘과 요오드화포름의 혼합제제에 비해 수산화칼슘을 증류수에 혼합하여 적용한 경우 유치 치근상아질의 미세경도가 더 급격하게 감소하였으며, 이는 통계적으로 유의하였다(p < 0.05). 수산화칼슘을 적용하지 않은 대조군에서도 7일, 30일, 90일 후 기간에 따라 치근상아질의 미세경도가 감소하였으며, 이는 통계적으로 유의하였다(p < 0.05).

의료협력과 국제 의료관광 네트워크에 관한 연구 - 센텀 메디컬 파트너스를 중심으로 - (Research for Network on Medical Association and International Medical Tourism - Based on Centum Medical Partners -)

  • 박기수;배종철;최봉준
    • 한국임상보건과학회지
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    • 제2권1호
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    • pp.59-71
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    • 2014
  • Purpose. Medical tourism is recently becoming a new industry with great growth potential. The South Korean government is shifting medical tourism from simple cultural tourism to a high value-added industry with a new paradigm. Methods. The government has been providing positive support and marketing policies since the introduction of the article concerning foreign patient attraction to the medical law in 2009, and various types of medical institutions around the country has participated actively in medical tourism by themselves or in cooperation of government bodies and made increasingly greater performance. Results. This study obtained the following results. The medical institutions in Korea have been making efforts to see more development and profitability in diverse ways, including medical tourism for foreign patients and the advance of the Korean medical institutions into foreign markets. However, many local governing bodies and medical institutions participating in medical tourism around the country have primarily focused on examination and treatment on the basis of foreign patients' visit to South Korea and rarely built a medical network with other countries directly for medical tourism. This study presents a case of building a local medical network and a network for international medical tourism successfully on the basis of the local medical association, CMP, which has been formed naturally in Busan. The success factors for CMP included 1) enthusiasm of the official in charge; 2) the medical level, the service level, and open-mindedness of participant medical institutions; 3) cost efficiency due to executive office management with no costs, no conflicts, and constant partnership; 4) security of non-competitive expertise for participants; 5) local factors of CMP; 6) participation of good agencies; 7) reinforcement of participation networks; and 8) post facto management and local doctor management. Conclusions. Its positive effects included patient introduction and greater profitability on an internal basis as well as construction of the collaboration system with the institutions related to medical tourism and confidence. However, there are some limitations: it is still difficult to predict performance due to the short period of their activities, and it is necessary to continue to observe their constant activities since a single medical association was involved.

건강신념모형을 적용한 일개 병원 임상간호사의 손씻기 수행도에 대한 연구 (A study on the hand washing practice of a clinical nurse in a hospital based on health belief model)

  • 김가현;권용선
    • 한국응용과학기술학회지
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    • 제35권2호
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    • pp.532-539
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    • 2018
  • 본 연구는 건강신념모형을 적용하여 임상에서 근무하는 간호사의 손씻기 수행도를 분석하기 위한 서술적 조사연구이다. 본 연구의 대상은 G 광역시에 위치한 일개 병원에 근무하는 임상 간호사 162명이다. 자료수집은 2017년 9월 1일부터 2017년 10월 31일까지였다. 수집된 자료는 SPSS (SPSS Version 20.0, IBM, US)를 이용하여 빈도분석, 백분율, 일원분산분석, t-검정, pearson 상관계수분석 및 다중회귀분석으로 통계처리 하였다. 일반적 특성에 따른 손씻기에 대한 수행도는 모든 영역에서 평균은 3.1점으로 높았으나 통계적으로 유의한 차이는 보이지 않았다. 일반적 특성에 따른 손씻기에 대한 건강신념은 연령에서는 지각된 유익성 영역에서 유의한 차이를 보였으며(p<0.05), 근무연수에서는 지각된 유익성, 지각된 장애성 영역에서 유의한 차이를 보였다(p<0.05). 다섯 개의 하위영역간의 상관관계를 분석한 결과는 지각된 유익성과 지각된 장애성은 부의 상관관계를 나타냈으며, 수행을 위한 동기는 정의 상관관계를 보였다. 본 연구의 결과를 통해 손씻기에 대한 건강신념을 고려한 지속적인 병원에서의 감염관리교육과 올바른 손씻기 교육을 진행한다면 손씻기 수행도가 높아질 것으로 판단된다.

산업장 근로자들의 구강건강 행위에 따른 행복지수 (Relationship of Oral Health Behavior to Happiness Indexes among Industrial Workers)

  • 윤현서
    • 한국콘텐츠학회논문지
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    • 제13권11호
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    • pp.313-321
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    • 2013
  • 본 연구는 경북지역 294명의 근로자들을 대상으로 행복지수에 구강건강 행위와, 주관적 구강건강인식의 영향을 파악하여 이를 바탕으로 산업장 근로자들을 위한 구강보건계획을 수립하는 기초자료로 활용하고자 하였다. 구강건강 행위에 따른 행복지수를 살펴보면 1년 내 정기검진여부에서는 정기검진을 받는 경우 단일문항 행복지수(p=0.002), 5문항 행복지수(0.012)에서 모두 높게 나타났고, 1년 내 스켈링을 받은 경우 단일문항 행복지수(p<0.001), 5문항 행복지수(p=0.003)모두 높게 나타났다. 칫솔질 횟수에서는 칫솔질 횟수가 많은 경우 단일문항 행복지수(p<0.001), 5문항 행복지수(p=0.023)으로 높았으며, 구강보건교육을 받은 경험이 있는 경우 단일문항 행복지수(p=0.041), 5문항 행복지수 모두에서 높게 나타났다. 근무지에 칫솔을 보관하는 경우에는 단일문항 행복지수(p=0.001), 5문항 행복지수(p<0.001) 모두에서 높게 나타났으며, 아플 때 즉시 치과방문이 가능한 경우 단일문항 행복지수(p<0.001), 5문항 행복지수(p<0.001)모두에서 높게 나타났다. 이상의 결과에서 산업장 근로자들의 행복지수를 높이기 위한 체계적인 구강건강프로그램이 마련되어야할 것이다.

CAD/CAM System을 활용하여 제작된 Coping Crown의 제작방식 및 재료에 따른 변연 적합도에 관한 연구 (The Study on Marginal discrepancy of Manufactured Coping Crown according to Production method and materials by using CAD/CAM System)

  • 이희성;신성훈;송준기
    • 한국산학기술학회논문지
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    • 제18권10호
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    • pp.448-453
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    • 2017
  • 본 연구는 CAD/CAM 시스템을 활용하여 제작방식 및 재료에 따른 Coping crown의 변연 적합도를 비교하여 최적의 제작방식 및 재료를 비교하고자 하였다. 제작방식 및 재료에 따른 코핑 크라운을 제작하였고, 리플리카 테크닉을 사용하여 변연적합도 측정을 실시하였다. 제작법과 재료에 따른 비교분석을 위해 이원배치분산 분석을 실시하였으며 서로 다른 평균값들의 비교 분석을 위해서 일원배치분산분석을 실시하였다. 연구결과 합금을 Milling법으로 제작한 MM군은 114.6, MS군은 111.4 값을 나타냈고, Milling/Sintering 법으로 제작한 MSC군은 67.2, MSS군은 50.9값을 나타냈고, Printing 법으로 제작한 SLME군은 100.5, SLMR군은 113.2값을 나타냈고, 세라믹의 Milling/Sintering 법으로 제작한 MSZ군은 35.6, MSC군은 36.3값을 나타냈고, 제작방식과 재료에 따른 이원배치분산분석 결과는 제작방식에에 따른 유의한 차이는 보이지 않았으나, 재료에 따른 유의한 차이는 나타내었다. 가장 높은 변연적합도를 보인 군은 세라믹 재료의 Milling/sintering 법이 가장 낮은 값을 보이며 최적의 방법으로 검증이 되었다. 그러나 CAD/CAM 시스템을 활용하여 제작된 Coping crown의 변연 적합도는 임상에서 허용이 가능한 수치값에 해당하므로 임상에 적용이 가능한 것으로 나타났다.

베체트 병의 구강궤양에 대한 국소인자의 영향에 관한 연구 (A Study on the Effects of Local Factors on the Oral Ulcers Observed in Behcet s Disease)

  • Myoung-Chan Kim;Chong-Youl Kim
    • Journal of Oral Medicine and Pain
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    • 제17권2호
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    • pp.75-86
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    • 1992
  • Of the many first-occuring major manifestations of Behcet's disease, the oral ulcer is most frequently observed, shows the highest mean recurrence rate, and the longest mean duration period. A study of the relationship between mechanical irritation buy local factors and the recurrence of oral ulcers was carried out to see if there is a correlation. The subjects chosen for the study were 81 patients who were referred to the Department of Oral Diagnosis at Yonsei University Dental Hospital from the Behcet clinic of Severace Hospital after being diagnosed as Behcet's disease patients. 1. By Shimuzu's classification, possible type was the most numerous with 55.55% ; while suspected type was 19.76% ; incomplete type, 17,28% ; and complete type, 7.41% were observed in that order. The male to female ration was 1 to 1.61, and the average age of onset was 17.63 years. 2. Oral ulcers developed most frequently on the tongue (48.28%), and lip(23.15%), buccal mucosa (20.69%), palate\pharynx(4.43%), and gingiva(3.45%) also showed ulceration. 3. 38.27% of the patients were HSV positive : 27.16% were CRP positive ; 12.34% were ASO positive ; 9.87% were RF positive ; and 3.7% were ANA positive. 4. According to the answers to the survey, fatigue(85.18%) was most frequently associated with Behcet's diseage. Trauma by tooth brushing (22.22%), un specified reasons (20.98%), hard food chewing (12.35%), and irritation by dentition and/or prosthesis (13.58%) were observed in association with Behcet's disease. 23.46% had a history of tonsilitis. 5. Oral ulcers on the anterior part of tongue and buccal mucosa were associated with local irritatants. 6. Oral ulcers on the lip and posterior portion of tongue were not associated with local irritants. Local irritation by dentition and oral ulcer on the anterior part of tongue and buccal mucosa was observed to coexit with one another : in other words, lo9cal factors can act to cause of recurrence of an oral ulcer and to delay the healing process in Behcet's disease. Therefore, elimination of local factors along with systemic therapy must be recommended when treating oral ulcers.

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구강건조증 환자의 임상적 특징에 관한 연구 (A Study on the Clinical Characteristics of Patients with Dry Mouth)

  • 오정규;김연중;고홍섭
    • Journal of Oral Medicine and Pain
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    • 제26권4호
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    • pp.331-343
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    • 2001
  • Advances in medical procedures and utilization of medication have resulted in expanding aged population, which leads to increased aged patients with salivary hypofunction and its associated symptoms in dental clinic. The purpose of this study was to investigate clinical characteristics of patients with dry mouth and its correlation with their salivary flow rate. Forty dry mouth patients (7 males, 33 females, mean age 42.0 years) whose flow rate of unstimulated whole saliva was less than 0.15 ml/min were included and their gender- and age-matched controls (7 males, 33 females, mean age 42.9 years) who did not report any complaints, suggestive of salivary gland dysfunction and had the flow rate of greater than 0.20 ml/min were included for comparison. The salivary flow rate was measured in both unstimulated and stimulated conditions. Dry mouth-related clinical information including history, dry mouth associated symptoms, exacerbating and relieving factors, drugs, systemic diseases, and family history was investigated using questionnaires. The differences in distribution of patients and control subjects to each question and their relation to the salivary flow rate were analyzed and we came to following conclusions. 1. There were statistically significant differences in the distribution of patients and controls to the following questions: the period and frequency of suffering from dry mouth; severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods, severity of discomfort in usual life due to dry feeling; self-assessment of residual salivary volume; taking medications. 2. The patients had more stress-related medical histories including indigestion, insomnia, and gastritis compared with controls. The patients took many kinds of medications to control their systemic diseases. 3. There were statistically significant differences in the salivary flow rate between different groups of patients to following questions: severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one. 4. The salivary flow rate of patients taking medications was significantly less than that of patients who did not take medications. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one.

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턱관절장애의 연구진단기준을 이용한 역학적 연구;예비보고 (THE EPIDEMIOLOGIC STUDY OF THE PATIENTS WITH TEMPOROMANDIBULAR JOINT DISORDERS, USING RESEARCH DIAGNOSTIC CRITERIA FOR TMD (RDC/TMD): PRELIMINARY REPORT)

  • 임재형;김영균;윤필영
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권2호
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    • pp.187-195
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    • 2008
  • Purpose: This epidemiologic research was carried out to investigate the degree and aspects of symptoms of patients suffered from TMD using RDC/TMD. Subjects and Methods: Subjects were the patients who had visited to SNUBH dental clinic from Jan. 2005 to Dec. 2005, and total 117 patients were included (M: 22, F:95). The signs and symptoms of physical, psychological and behavioral factors were retrospectively evaluated by questionnaires in the RDC/TMD. The patients were examined through clinical and radiological method, and diagnosed by same investigator. They were divided into 3 groups such as osteoarthritis group (group 1), internal deragnement (group 2), myofascial pain dysfunction syndrome group (MPDS, group 3). In addition, in patient with complex diagnosis they were divided into subgroups in detail (ex. group 1+group 2). In the questionnaire, several items were selected to calculate the graded pain score (grade $0{\sim}IV$), depression and vegetative symptoms, nonspecific physical symptoms(pain items included) and nonspecific physical symptoms(pain items excluded) in each group. Results: As a result of classification by diagnostic criteria of this study, the patients were distributed to 45% of group 1, 47% of group 2, 8% of group 3 in this study. In younger patients (under 25-year old, n=40), group 2 was occupied 57% (n=23) and group 1 was 35%, group 3 was 8%, while group 1 was occupied 75% in elderly-patients (over 40-year old, n=28) in present study (group 2: 21%, group 3: 4%). In the analysis of depression and vegetative symptoms, majority of patients in Group 2 were included in 'normal', and in Group 3 it appeared to have larger proportion of 'moderate' & 'severe' than others. According to nonspecific physical symptoms, there have been tendencies of higher ratio of 'severe' in patients with MPDS. In graded pain score, more than half (58%) of subjects were included in grade 0 and low disability (Grade I and II), and 27% were revealed high disability (grade III, IV).

흉총창에 의한 심방파열 치험 2례

  • 이두연;곽상룡
    • Journal of Chest Surgery
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    • 제13권1호
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    • pp.60-65
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    • 1980
  • We have experienced 2 cases of the hunshot wound sof the chest involving cardiac injuries at department of the thoracic surgery, Capital Armed Forces General Hospital during I year from April I 1979 to Jan. 1980. In one case of two patients , he was a 22 years old man who was transported to this emergency room 4 hour 10 minutes after having gunshot wound of the left chest by helicopter. Physical examination showed small inlet in left 3rd ICS and left parasternal border, large outlet in left 8th ICS and left scapular line, no breath sound on left side and distant heart sound. chest roentgenography demonstrated marked pleural effusion in left side and mediastinum shifted to right. As soon as chest X-ray was taken, the bleeding through penetrating wound became profuse and cardiac arrest ensued. Closed chest cardiac massage was started and vigorous transfusion continued, but no effective cardiac activity could not be obtained. The patient was pronounced dead due to exsanguinating hemorrhage from wuwpected cardiac wounds. In this critically injured patient with evidence of intrathoracic hemorrhage and suspected cardiac penetration, only emergency thoracic exploration and immediate surgical control of bleeding points might offer the maximum possibility of survival. The other case was a 23 years old man who was transferred to the emergency room 4 hours 50 minutes after having kmultiple communicated fractures of sternum and linear fracture of right mandible by a missile. Examination revealed about 30% skin loss of the anterior chest wall, weak pulse of 96 beats/min., distant heart sound and decreased breath sounds bilaterally. finding on the chest X-ray films showed multiple sternal fractures, marked pericardial effusion indicating hemopericardium. So, the patient was moved immediately to the operation room where, after endotracheal tube inserted, a median sternotomy was performced. A hemorrhagic congestion of the right upper lobe and marked bulging pericardium were disclosed. The pericardium was opened anterior to right phrenic nerve and exsanguinating hemorrhage ensued from the 0.5cm lacerated wound in the auricle of right atrium. The rupture site of right atrium was occluded with non-crushing vascular clamps and then was over sewn with interrupted sutures. It was thought to be highly possible that he was alive long enough to have cardiorrhaphy because of cardiac tamponade, which prevented exsanguinating hemorrhage. He was taken closed reduction for linear fracture of right mandible 2 weeks after repair of ruptured right auricle in dental clinic. This patient's post-operative course was not eventful.

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