• 치위생과학회지
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• 제15권2호
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• pp.232-237
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• 2015

이 연구는 강릉원주대학교 치과대학 학생들의 임상실습을 위해 사용되고 있는 DCU에서 배출되는 물 속 종속영양세균의 수준을 평가하면서 사용빈도에 따른 세균 오염수준의 차이를 확인하고 기회 감염성 병원균의 존재를 분자생물학적 방법을 사용하여 확인하였다. 임상 실습실에서 사용되는 DCU 36개를 대상으로 초음파치석제거기에서 물 시료를 수집하여 평균 CFU/ml를 조사하고 초음파치석제거기의 한달 사용빈도에 따라 DCU를 세 집단으로 분류하여 세균오염수준을 비교하였다. 또한 수집한 물 시료에서 세균의 genomic DNA를 추출한 후 PCR 분석을 통해 기회감염성 병원균의 존재를 확인한 결과는 다음과 같다. 학생 실습에 사용한 DCU에서 수집한 물 시료의 평균 종속영양세균수준은 16,095 CFU/ml로 ADA에서 권장하는 200 CFU/ml 이하의 수준에 적합하지 않은 것을 확인하였다. 초음파 치석제거기의 한 달 사용빈도에 따라 3집단으로 나누어 CFU/ml를 조사하였을 때, 초음파치석제거기를 한 달에 1번 이상 3번 미만 사용한 DCU에서 평균 CFU/ml가 20,070 CFU/ml로 가장 높게 나타났으며, 3번 이상 사용한 유니트는 CFU/ml 평균이 8,420 CFU/ml로 가장 적게 나타났다. 3개군의 CFU/ml 차이는 통계학적으로 유의성이 있는 것을 보여주었고(p<0.05), 그 중 사용빈도가 가장 높은 군에서 유의하게 낮은 CFU/ml를 보여주었다. 치과에서 사용하는 DCU에 존재하는 기회감염성 병원균이 학생실습에 사용하는 DCU에서도 분리되었다. 36개의 genomic DNA 시료 중 1개의 시료에서 Pseudomonas species가 검출되었고, 2개의 시료에서 비결핵성 Mycobacterium species가 검출되었다. 따라서 학생실습용으로 사용되는 DCU는 학생들과 대상자에게 잠재적 감염의 원인이 될 수 있으며, 실습 전 학생들의 보호장비 착용과 실습 후 수관관리가 필요하다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권4호
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• pp.197-199
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• 2013

Three-dimensional (3D) computed tomography image models are helpful in reproducing the maxillofacial area; however, they do not necessarily provide an accurate representation of dental occlusion and the state of the teeth. Recent efforts have focused on improvement of dental imaging by replacement of computed tomography with other detailed digital images. Unfortunately, despite the advantages of medical simulation software in dentofacial analysis, diagnosis, and surgical simulation, it lacks adequate registration tools. Following up on our previous report on orthognathic simulation surgery using computer-aided design/computer-aided manufacturing (CAD/CAM) software, we recently used the registration functions of a CAD/CAM platform in conjunction with surgical simulation software. Therefore, we would like to introduce a new technique, which involves use of the registration functions of CAD/CAM software followed by transfer of the images into medical simulation software. This technique may be applicable when using various registration function tools from different software platforms.

• Imaging Science in Dentistry
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• 제38권4호
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• pp.203-208
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• 2008

Purpose : The purpose of this study was to develop a system for the measurement and simulation of the TMJ movement and to analyze the mandibular movement quantitatively. Materials and Methods : We devised patient-specific splints and a registration body for the TMJ movement tracking. The mandibular movements of the 12 subjects with facial deformity and 3 controls were obtained by using an optical tracking system and the patient-specific splints. The mandibular part was manually segmented from the CT volume data of a patient. Three-dimensional surface models of the maxilla and the mandible were constructed using the segmented data. The continuous movement of the mandible with respect to the maxilla could be simulated by applying the recorded positions sequentially. Trajectories of the selected reference points were calculated during simulation and analyzed. Results : The selected points were the most superior point of bilateral condyle, lower incisor point, and pogonion. There were significant differences (P<0.05) between control group and pre-surgical group in the maximum displacement of left superior condyle, lower incisor, and pogonion in vertical direction. Differences in the maximum lengths of the right and the left condyle were 0.59${\pm}$0.30 mm in pre-surgical group and 2.69${\pm}$2.63 mm in control group, which showed a significant difference (P<0.005). The maximum of differences between lengths of the right and the left calculated during one cycle also showed a significant difference between two groups (P<0.05). Conclusion : Significant differences in mandibular movements between the groups implies that facial deformity have an effect on the movement asymmetry of the mandible. (Korean J Oral Maxillofac Radiol 2008; 38 : 203-8)

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.24.1-24.7
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• 2020

Background: In daily practice, three-dimensional patient-specific jawbone models (3D models) are a useful tool in surgical planning and simulation, resident training, patient education, and communication between the physicians in charge. The progressive improvements of the hardware and software have made it easy to obtain 3D models. Recently, in the field of oral and maxillofacial surgery, there are many reports on the benefits of 3D models. We introduced a desktop 3D printer in our department, and after a prolonged struggle, we successfully constructed an environment for the "in-house" fabrication of the previously outsourced 3D models that were initially outsourced. Through various efforts, it is now possible to supply inexpensive 3D models stably, and thus ensure safety and precision in surgeries. We report the cases in which inexpensive 3D models were used for orthodontic surgical simulation and discuss the surgical outcomes. Review: We explained the specific CT scanning considerations for 3D printing, 3D printing failures, and how to deal with them. We also used 3D models fabricated in our system to determine the contribution to the surgery. Based on the surgical outcomes of the two operators, we compared the operating time and the amount of bleeding for 25 patients who underwent surgery using a 3D model in preoperative simulations and 20 patients without using a 3D model. There was a statistically significant difference in the operating time between the two groups. Conclusions: In this article, we present, with surgical examples, our in-house practice of 3D simulation at low costs, the reality of 3D model fabrication, problems to be resolved, and some future prospects.

• Journal of International Society for Simulation Surgery
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• 제4권1호
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• pp.13-16
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• 2017

Fibular free flap reconstruction is the flap of the choice in long-span mandibular bone reconstruction. The most common disadvantage of the fibular flap is short bone height to install dental implant. Double barrel fibular flap has been tried, however, bulky flap in the oral cavity hinder its use. Titanium reconstruction plate has been used simultaneously with the free fibular flap to stabilize occlusion and to fix the fibular flap. In this study, titanium reconstruction plate was fixed in the lower border of the mandible and the fibular free flap was fixed in the superior border of the titanium plate to improve implant-crown ratio. This new technique improved the longevity of the dental prosthodontics with dental implants.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권3호
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• pp.227-236
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• 2021

Background: Emergencies in outpatient clinics are rare. However, potentially catastrophic events can be challenging to manage due to a variety of factors, including limited equipment and staff. The purpose of this quality improvement project was to improve the staff knowledge and familiarity with critical performance elements for emergencies encountered in the setting of a periodontics clinic. Methods: Emergency cognitive aids tailored to the clinic's resources were created for anaphylaxis, airway obstruction, and sublingual hemorrhage. The project pre-post-test repeated measures design evaluated the effectiveness of cognitive aids using a combination of hands-on simulation, written knowledge assessments, and self-efficacy surveys. Training sessions and simulations were provided to the clinic's existing care teams made up of a periodontist and two dental assistants with an anesthetist who was present for simulations involving sedation. Due to the small sample size (N = 14) and non-normal distribution, all metrics were evaluated using non-parametric statistics. Results: Significant improvements were found in knowledge assessment (-2.310, P = 0.021) and self-efficacy (-2.486, P = 0.013) scores when retention after a training session before and after the introduction of cognitive aid was compared. The mean simulation scores and times improved steadily or reached maximum scores during the project progression. Conclusion: Training sessions before and after cognitive aid introduction were effective in improving knowledge, self-efficacy, and simulation performance. Future projects should focus on validating the process for creating contextualized cognitive aids and evaluating the effectiveness of these cognitive aids in larger samples.

• The Journal of Advanced Prosthodontics
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• 제14권1호
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• pp.12-21
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• 2022

PURPOSE. The purpose of this study was to investigate changes in retention and wear pattern of Locator^® and ADD-TOC attachments on a digital milled bar by performing chewing simulation and repeated insertion/removal of prostheses in fully edentulous models. MATERIALS AND METHODS. Locator (Locator^®; Zest Anchors Inc., Escondido, CA, USA) was selected as the control group and ADD-TOC (ADD-TOC; PNUAdd Co., Ltd., Busan, Republic of Korea) as the experimental group. A CAD-CAM milled bar was mounted on a master model and 3 threaded holes for connecting a bar attachment was formed using a tap. Locator and ADD-TOC attachments were then attached to the milled bar. Simulated mastication and repeated insertion/removal were performed over 400,000 cyclic loadings and 1,080 insertions/removals, respectively. Wear patterns on deformed attachment were investigated by field emission scanning electron microscopy. RESULTS. For the ADD-TOC attachments, chewing simulation and repeated insertion/removal resulted in a mean initial retentive force of 24.43 ± 4.89 N, which were significantly lower than that of the Locator attachment, 34.33 ± 8.25 N (P < .05). Amounts of retention loss relative to baseline for the Locator and ADD-TOC attachments were 21.74 ± 7.07 and 8.98 ± 5.76 N (P < .05). CONCLUSION. CAD-CAM milled bar with the ADD-TOC attachment had a lower initial retentive force than the Locator attachment. However, the ADD-TOC attachment might be suitable for long-term use as it showed less deformation and had a higher retentive force after simulated mastication and insertion/removal repetitions.

• 대한치과의사협회지
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• 제50권11호
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• pp.660-669
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• 2012

We describes the process of 3D virtual treatment planning and of CAD/CAM for surgical splint in orthognathic surgery. The potential benefits and disadvantages of 3D virtual approach and the use of CAD/CAM system for the treatment of the patient with a maxillofacial deformity are discussed. For the more convenient applications,3D software should be improved.

• Journal of Oral Medicine and Pain
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• 제24권1호
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• pp.81-94
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• 1999

This study intends to find usefulness of the computer assisted dental identification in mass disaster. The variety of dental characteristics was investigated through the research of dental records of 508 adults. And a computer assisted simulation program was used to evaluate the selectivity of dental identification. Findings were as follows : 1. Combinations of dental characteristics were found 155 types. The most various dental characteristic was showed on the mandibular first molar. 99.0% of subjects had dental characteristics for dental identification. 2. The posterior teeth, in comparison with anterior teeth, showed higher selectivity in dental identification which was enhanced by information on the material, type and cavity of the restoration. 3. The variety of dental characteristics was mainly found on the combinations of missing tooth with the material, type and cavity of the restoration. 4. The computer assisted dental identification program, with informa- tion about one's tooth state, made individual identification possible when there was only a part of the teeth in a corpse. 5. The computer assisted dental identification had considerably high selectivity based on the variety of dental characteristics. And it was also performed faster and preciser than the existing identification methods. Based on the results of this study, there are various combinations of the feature of the tooth itself with dental characteristics caused by a certain type of treatment on the teeth. And using the computer assisted dental identification program based on this, dental identification can be more efficient economically and more useful than any other forensic identification methods.

• 대한치과재료학회지
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• 제44권4호
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• pp.337-348
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• 2017

본 연구에서는 소성 시 냉각속도를 조절하는 것과 동시에 소성 후 추가적인 후열처리를 시행하는 것이 후열처리를 시행하지 않는 것보다 합금의 경도 상승에 더욱 효과적인지 알아보고자, 다목적용 Ag-Pd-Zn-In-Sn계 합금을 이용하여 모의소성 시 냉각속도의 조절이 소성 및 후열처리에 따른 합금의 경도변화에 미치는 영향을 조사하여 다음과 같은 결과를 얻었다. 다목적용 Ag-Pd-Zn-In-Sn계 합금의 모의소성 시 냉각속도를 조절함에 따라 합금의 연화가 억제되었다. Stage 0(4단계의 냉각속도 중 가장 빠른 속도; 소성로 챔버가 소성 종료 즉시 전체가 열린 상태로 냉각되는 단계)으로 냉각속도를 조절하여 합금을 소성한 경우, 모의소성 과정에서 합금이 연화되었으며, 적절한 시간동안의 후열처리가 경도상승에 효과적이었다. Stage 3(4단계의 냉각속도 중 가장 느린 속도; 소성로 챔버가 소성완료 후 닫혀진 상태로 냉각되는 상태)으로 냉각속도를 조절하여 합금을 소성한 경우, 모의소성 과정에서 합금이 연화되지 않았으며, 추가적인 후열처리는 합금의 경도를 하강시켰다. Stage 0으로 모의소성 된 합금에서 30분간의 후열처리에 의해 경도가 크게 상승한 원인은 소성에 의해 기지 내로 고용되었던 석출물이 다시 기지 밖으로 활발하게 석출된 것에 기인하였다. Stage 3으로 모의소성 된 합금에서는 후열처리에 의해 석출물이 기지 내로 다시 고용되었고, 새로운 석출상의 생성이 미미하여 후열처리가 경도 상승에 기여하지 못하였다.