• Journal of the Korean Crystal Growth and Crystal Technology
• /
• v.32 no.5
• /
• pp.191-198
• /
• 2022

Zirconia and titanium alloys, which are mainly used for dental implant materials, have poor osseointegration and osteogenesis abilities due to their bioinertness with low bioactivity on surface. In order to improve their surface bioinertness, surface modification with a bioactive material is an easy and simple method. In this study, akermanite (Ca₂MgSi₂O₇), a silicate-based bioceramic material with excellent bone bonding ability, was synthesized by a solid-state reaction and investigated its bioactivity from the analysis of surface dissolution and precipitation of hydroxyapatite particles in SBF solution. Calcium carbonate (CaCO₃), magnesium carbonate (MgCO₃), and silicon dioxide (SiO₂) were used as starting materials. After homogeneous mixing of starting materials by ball milling and the drying of at oven, uniaxial pressing was performed to form a compacted disk, and then heat-treated at high temperature to induce the solid-state reaction to akermanite. Bioactivity of synthesized akermanite disk was evaluated with the reaction temperature from the immersion test in SBF solution. The higher the reaction temperature, the more pronounced the akermanite phase and the less the surface dissolution at particle surface. It resulted that synthesized akermanite particles had high bioactivity on particle surface, but it depended on reacted temperature and phase composition. Moderate dissolution occurred at particle surfaces and observed the new precipitated hydroxyapatite particles in synthetic akermanite with solid-state reaction at 1100℃.

• The Korean Society of Law and Medicine
• /
• v.22 no.2
• /
• pp.49-79
• /
• 2021

Due to defendant's wrongful act by implant surgery, plaintiff has been suffered serious damages to his face and teeth, and pain caused by establishing implanted teeth. Jeonju Appellate Court sentenced to pay future medical expenses and alimony to the plaintiff in compensation for breach of duty or torts. The ruling is designed to relieve the burden of proof because it is extremely difficult for non-experts to determine whether dentists violated their 'duty of care' or whether there was a causal relationship between damages to medial treatment. It was judged that if symptoms that contributed to the patient's significant outcome occurred during or after surgery, such symptoms could be presumed to have been caused by medical negligence if indirect facts were proven to be other than medical negligence. Originally, the shifting of burden of proof in Germany, has already been developed in medical malpractice case since 1940s. In order to guarantee the patients' right, §630h German Civil Code (BGB) - presumption of negligence in the realization of controllable risk- has been also legislated. BGH (Bundesgerichtshof) has been interested in ensuring that the principle of equality between patients and doctors. So, in this study, we wanted to refer to German precedent cases to analyzing Korean medical malpractice lawsuit. In particular, the decision could be significant in that it approaches closer to allows the shifting burden of proof in drastically growing dental malpractice cases. This is clearly confirmed in the judgment of the dentist's "fault" that "if indirect facts about the symptom or occurrence are proven to be cause other than medical negligence, such symptoms can be presumed to be due to medical negligence."

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.50 no.1
• /
• pp.27-34
• /
• 2024

Objectives: Surgical intervention for removal of an impacted third molar can lead to significant pain and swelling. Corticosteroids show promise for mitigating postoperative sequelae across various surgical contexts. The use of corticosteroids following minor oral surgery, though controversial, has already been proven effective. However, little research has explored peroral prescription of corticosteroids despite its convenience for outpatients and for non-surgeons like implantologists and periodontists and others who don't have access to needle injections. The aim of this study was to address a void in the literature by comparing the effects of two styles of preoral administration of prednisolone after surgical removal of the mandibular third molar and to determine which style minimizes postoperative sequelae. Materials and Methods: A randomized, split-mouth clinical study was conducted to investigate the efficacy of two different styles of preoral prednisolone in mitigating postoperative sequelae following surgical extraction of impacted mandibular third molars. Fifteen participants were enrolled in the study. Random selection was used to determine the prescription style for the right and left mandibular arch. Group A included those who received a single dose of prednisolone 25 mg, while group B received prednisolone 5 mg postoperatively for a period of three days (5 mg three times/day on the first postoperative day, 5 mg twice/day on the second postoperative day; 5 mg once/day on the third postoperative day). Results: There was a significant difference in the distance between the corner of the mouth and tragus, which decreased with the time interval with respect to group B when compared to group A. Conclusion: The present study showed that a three-day tapered dose of prednisolone postoperatively was more effective in reducing post-extraction sequelae than a single-dose regimen.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.27 no.1
• /
• pp.1-13
• /
• 2011

The aim of this study was to evaluate shear bond strength of pressed reinforced composite resin ($TESCERA^{TM}$ ATL) veneering to zirconia with various surface treatments. Forty sintered zirconia specimens and forty pockmarked zirconia specimens were fabricated. All the materials were categorized as Group 1 (Control : porcelain veneering on zirconia surface), Group 2 ( $TESCERA^{TM}$ ATL dentine veneering after bonding agent application on zirconia surface), Group 3 ($TESCERA^{TM}$ ATL dentine veneering on pockmarked zirconia surface), Group 4 ($TESCERA^{TM}$ ATL dentine veneering after bonding agent application on pockmarked zirconia surface), Group 5 (Thermocycling on Group 1), Group 6 (Thermocycling on Group 2), Group 7 (Thermocycling on Group 3), and Group 8 (Thermocycling on Group 4). SBS(Shear bond strength) of 8 groups was determined with an Instron Universal Testing Machine. Also fractured surface of specimens were observed with a scanning electron microscope. There were no significant differences in the initial SBS between Group 1(control group), Group 3, and Group 4. (p>0.05) Group 2 presented the lowest SBS values. There was a no significant difference between just as 24hour water storage and simulated aging on pockmarked zirconia groups. (p>0.05) A formation of pockmarked irregularities on zirconia surface as mechanically pitted surface was reliable method for establishing a stronger bond between $TESCERA^{TM}$ ATL and zirconia-based material.

• Journal of Periodontal and Implant Science
• /
• v.28 no.4
• /
• pp.645-660
• /
• 1998

The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was $0.83{\pm}0.12$ by non surgical treatment and $0.82{\pm}0.14$ by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving nonsurgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.

• Journal of Periodontal and Implant Science
• /
• v.33 no.4
• /
• pp.599-613
• /
• 2003

The goal of periodontal treatment is regeneration of the periodontium. Bone graft and absorbable PLA/PGA membrane have been used for this purpose. In this study, 4${\times}$4mm 1-wall intrabony defects were surgically created bilaterally in the mandible of five male beagles. The control group went through a conventional flap operation, while the experimental group I was treated with absorbable PLA/PGA membranes only, group II was treated with absorbable membrane and calcium phosphate. The results are the following : 1. The defect height was 4.82${\pm}$0.45mm in the control group, 4.93${\pm}$0.79mm in the experimental I group, and 4.92${\pm}$0.62mm in the experimental II group. There was no statistically significant difference among 3 groups(P <0.05). 2. The amount of junctional epithelium migration was 30.90${\pm}$9.92% of the defect height in the control group, 39.16${\pm}$7.51% in the experimental I group, and 38.68${\pm}$12.22% in the experimental II group. There was no statistically significant difference among 3 groups(P <0.05). 3. The amount of connective tissue adhesion was 36.38${\pm}$9.03% in the control group, 14.73${\pm}$3.93% in experimental I group, and 27.87${\pm}$9.70% experimental II group. Experimental group I was a statistically significantly different from control group(P <0.05). 4. The amount of new cementum regeneration was 32.92${\pm}$10.51%, 50.04${\pm}$7.61%, and 39.62${\pm}$12.14% for the control, experimental I, and experimental II group respectively. Experimental group I was a statistically significantly different from control group(P<0.05). 5. The amount of new alveolar bone regeneration was 27.24${\pm}$7.49%, 40.75${\pm}$8.03%, and 36.47${\pm}$15.11% for the control, experimental I, and experimental II group respectively. Experimental group I was a statistically significantly different from control group(P <0.05). The results suggest that the use of PLA/PGA membrane in 1-wall intrabony defect of beagle dogs may promote periodontal regeneration. Further studies are required to determine their regeneration effects.

• The Journal of Korean Academy of Prosthodontics
• /
• v.48 no.3
• /
• pp.194-201
• /
• 2010

Purpose: The purpose was to compare the marginal fidelity and the fracture resistance of the zirconia crowns according to the various coping designs with different thicknesses and cement types. Materials and methods: Zirconia copings were designed and fabricated with various thicknesses using the CAD/CAM system (Everest, KaVo Dental GmbH, Biberach., Germany). Eighty zirconia copings were divided into 4 groups (Group I: even 0.3 mm thickness, Group II: 0.3 mm thickness on the buccal surface and the buccal half of occlusal surface and the 0.6 mm thickness on the lingual surface and the lingual half of occlusal surface, Group III: even 0.6 mm thickness, Group IV: 0.6 mm thickness on the buccal surface and the buccal half of occlusal surface and the 1.0 mm thickness on the lingual surface and the lingual half of occlusal surface) of 20. By using a putty index, zirconia crowns with the same size and contour were fabricated. Each group was divided into two subgroups by type of cement: Cavitec$^{(R)}$ (Kerr Co, USA) and Panavia-$F^{(R)}$ (Kuraray Medical Inc, Japan). After the cementation of the crowns with a static load compressor, the marginal fidelity of the zirconia crowns were measured at margins on the buccal, lingual, mesial and distal surfaces, using a microscope of microhardness tester (Matsuzawa, MXT-70, Japan, ${\times}100$). The fracture resistance of each crown was measured using a universal testing machine (Z020, Zwick, Germany) at a crosshead speed of 1 mm/min. The results were analyzed statistically by the two-way ANOVA and oneway ANOVA and Duncan's multiple range test at $\alpha$=.05. Results: Group I and III showed the smallest marginal fidelity, while group II demonstrated the largest value in Cavitec$^{(R)}$ subgroup (P<.05). For fracture resistance, group III and IV were significantly higher than group I and II in Cavitec$^{(R)}$ subgroup (P<.05). The fracture resistances of Panavia-$F^{(R)}$ subgroup were not significantly different among the groups (P>.05). Panavia-$F^{(R)}$ subgroup showed significantly higher fracture resistance than Cavitec$^{(R)}$ subgroup in group I and II (P<.05). Conclusion: Within the limitation of this study, considering fracture resistance or marginal fidelity and esthetics, a functional ceramic substructure design of the coping with slim visible surface can be used for esthetic purposes, or a thick invisible surface to support the veneering ceramic can be used depending on the priority.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.26 no.3
• /
• pp.359-371
• /
• 2010

Facial asymmetry has been found with a higher frequency (70~84%) in skeletal class III malocclusion patients. Anticipating the poor prognosis of prosthesis due to malocclusion, occlusal stability must be obtained by orthodontic treatment. Moreover, orthodontic surgery would be needed in some severe cases for better functional and esthetic results. The orthognathic surgery is performed on one jaw or two jaw depending on the results of facial diagnosis. Genioplasty may change the vertical, horizontal, sagittal position of chin by osteotomy or augmentation using implants, also. This case is about a 24 year-old male patient who visited our clinic to solve the facial asymmetry and mandibular prognathism. Skeletal class III malocclusion, maxillary canting and menton deviation to left by 13 mm were detected. Multiple ill-fitting prostheses, unesthetic maxillary anterior prostheses, and several dental caries were found. After pre-operative orthodontic treatment, Le-Fort I osteotomy, sagittal split ramus osteotomy, genioplasty, right mandibular angle augmentation were done for the correction of jaw relation and asymmetry. By diagnostic wax-up after post-operative orthodontic treatment, maxillary full mouth rehabilitation and mandibular posterior restorations were planned out. For better result, clinical crown lengthening procedure was done on #11, 12 and implant was placed on left mandibular first molar area. The patient was satisfied with the final prostheses. Because of his high caries risk, long-term prognosis will depend on the consistent maintenance of oral hygiene and periodic follow-up.

• Journal of Oral Medicine and Pain
• /
• v.30 no.2
• /
• pp.163-199
• /
• 2005

Dentistry had been considered to be a relatively safe zone from the risk of medical accidents for there are less number of emergency cases. However, in these days, the number of medical dispute is increasing that the dentists would not be able to overlook it as if it is none of their matters. Hence, researches on various medical accidents and analyses on related matters to seek proper management have been carried out recently, but the datas are not enough yet. This study analysed the actual conditions of medical accidents as well as disputes and the general awareness of dental practitioners in local clinics with the purpose of understanding the general situation and to suggest counterplan. The study was conducted by analysing 1,882 questionnaires collected from total of 3,684 dentists belonging to Seoul Dental Association and where Doctors and Hospitals Medical Malpractice Insurance for dentists is administered. The results were as follows: 1. 98.47% of the respondents doubted the risk of medical accident and dispute. 2. 27.42% of the respondents experienced medical dispute, and there was no significant difference between the rate of medical disputes and the resident training. 3. Among the cases of medical accidents, those related to the periodontal/operative treatment showed the highest rate of 20.50%, and that related to implant treatment was 6.17%. 4. 43.02% of the respondents explained about the treatment procedure before the treatment while 25.90% started the treatment without consent of the patients. 5. Medical dispute resulted from not having any explanation or consent of the patients were of 16.55%. 10.26% had difficulties in solving the problem for missing the medical records. 6. 49.73% responded to be capable of administering first aid treatment. Among them, 23.60% were equipped with accurate knowledge regarding the emergency care. 7. During medical dispute, 88.09% sought counsel from other dentists, and Local district dental association was found to be the most frequently asked group. 8. In cases of medical dispute, 5.26% of the respondents were asked to submit relevant data from customer protection organization, and among them, 75.61% acceded the demand sincerely. 9. After the settlement of the dispute, 83.63% recovered relatively stable state of mind. 10. 99.46% of the respondents felt the necessity of medical dispute management organization, and 78.58% responded that it was urgent. 11. 66.70% of the respondents joined Doctors and Hospitals Medical Malpractice Insurance, although they had not experienced medical dispute. However, 73.36% of the respondent were not aware of it, and 93.36% of the members were not aware of the procedure of the dispute settlement. 12. 79.0% of the respondents who joined the Doctors and Hospitals Medical Malpractice Insurance still felt confused when medical dispute occured, but relatively safer than before. 13. When medical dispute was settled through Doctors and Hospitals Medical Malpractice Insurance, 71.92% of the dentists were contented more than moderately, however, 35.16% of the patients were contented. 14. For complement of Doctors and Hospitals Medical Malpractice Insurance, 53.22% of the respondents felt that insurance company, dentist, and patient should all participate in bringing mutual agreement for quick settlement of the dispute. In addition, 29.08% of the respondents wanted insurance company to prevent patients from disturbing their practices. From the above results, improvement of the general awareness on increasing rate of medical disputes, and education as well as complementary measures for settlement of the disputes are required.

• Journal of Periodontal and Implant Science
• /
• v.32 no.2
• /
• pp.429-455
• /
• 2002

There are numerous kind of materials and techniques to regenerate the periodontal tissue which has been lost due to destructive periodontal disease, including bone graft material. Many bone graft materials have been reported and among these materials, synthetic material has been developed fin the long time because of its sufficient supply economically. Calcium sulfate which was evaluated as including much calcium, has been used in the clinical field. In the dental field calcium sulfate has been used as bone graft material and Kim reported that improved bone formation and more amount of new attachment after grafting calcium sulfate. but, because calcium sulfate has the problem that it generates the heat in setting period and resolves fast, we need to evaluate the effect of the improved calcium sulfate on periodontal tissue. The present study evaluates the effect of paste type calcium sulfate on the epithelial migration, alveolar bone regeneration, cementum formation and gingival connective tissue attachment in intrabony defect in dogs. Four millimeter deep and four millimeter wide 3-wall defects were surgically created in the mesial or distal aspects of premolars or molars. the test group received paste-type calcium sulfate with a flap procedure and the control group underwent flap procedure only. Histologic analysis after 8 weeks of healing revealed the following results : 1. The length of epithelial growth(the distance from CEJ to the apical end of JE) was 0.52${\pm}$0.26mm in the control and 0.56${\pm}$0.25mm in the test group. there was no statistically significant difference between the two groups. 2. The length of connective tissue adhesion was 1.74${\pm}$1.06mm in the control and 1.28${\pm}$0.57mm in the test group. there was no statistically significant difference between the two groups. 3. The length of new bone was 2.01${\pm}$0.95mm in the control and 2.62${\pm}$0.81mm in the test group. there was no statistically significant difference between the two groups. 4. The length of new cementum was 1.86${\pm}$0.80mm in the control and 2.77${\pm}$ 0.86mm in the test group. there was a statistically significant difference between the two groups.(P<0.01) These results suggest that the use of paste type calcium sulfate in 3-wall intrabony defects has significant effect on new cementum formation , but doesn't have any significant effect on the prevention of junctional epithelium migration and new bone formation. Finally, the paste type calcium sulfate that is used in this study is suggested to be the material that can have a significant effect on the periodontal healing, if its biocompatibility is improved.