• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.283-296
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• 2006

Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

• The korean journal of orthodontics
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• v.40 no.6
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• pp.373-382
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• 2010

Objective: The purpose of this study was to assess the dentoalveolar compensation in facial asymmetry individuals using an integration of a CBCT image and a laser scanned dental cast image. Methods: The subjects consisted of 30 adults with asymmetric mandibles and 20 adults with symmetric mandibles. The CBCT and laser scanned dental cast images were integrated with a registration technique. Canine and first molar position and angulation were assessed from reference coordinates. The differences between deviated and non-deviated sides were analyzed with the paired t-test. The differences shown according to menton deviation were also statistically analyzed using Pearson correlation analysis. Results: The experimental group showed deviated and non-deviated side differences (dev.-ndev.) in the position and angle of the canine and first molars. Menton deviation showed positive correlation with the deviation side (dev.-ndev.) for the maxillary and mandibular 1st molar angles, negative correlation with the deviation side for the vertical position of the maxillary 1st molars, transverse position of the mandibular canine, transverse position and vertical position of the mesio-lingual cusp of the mandibular 1st molars. Conclusions: The upper and lower canine and first molars of facial asymmetry individuals were compensated, so the transverse position, vertical position, and angle showed differences between the deviated/non-deviated sides.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.1
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• pp.62-69
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• 2000

Part of the locally applied, as well as the systemic applied, fluoride is absorbed into the body to aid in the prevention of caries. However, beyond a certain level, systemic distribution of fluoride can cause chronic fluorosis with attending systemic symptoms and dental fluorosis. Thus it is vital to determine the level of fluoride with minimal side effects which will provide optimal caries prevention. A commonly utilized method of regressively determining fluoride intade is to measure the fluoride concentration of excreted urine. Thus, the aim of this study was to determine the clearance time and concentration of fluoride in urine after administration of various doses of fluoride using HMDS-diffusion technique and fluoride ion electrode(Orion, 96-09, U.S.A.). Urine samples were collected in 7 adult subjects every morning after administration of fluoride supplements such as no fluoride(control group), 1mg fluoride(group 1), 2mg fluoride(group 2), 3mg fluoride(group 3), 4mg fluoride(group 4). The obtained results were as follows 1. Mean urinary fluoride concentration of control group was $0.707{\pm}0.362ppm$. 2. Fluoride levels followed as group 4(4.076ppm). group 3(2.400ppm), group 2(1.494ppm), group 1(1.051ppm) at day 1 after fluoride administration. There were no statistical differences between the urinary fluoride concentration of group 1, 2, 3 and control group after day 2, but there was statistical difference between group 4 and control group at day 2(p<0.05). 3. Urinary fluoride concentration increased and plateaued according to increasing fluoride dosage. The increased concentration remained significantly higher till day 2, but after day 3, there was no significant difference compared to the control.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.2
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• pp.262-274
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• 1999

Several alternatives for increasing the fluoride concentration in the mouth, such as water fluoridation, ingestion of fluoride supplements, fluoride paste, fluoride mouthrinse, application of fluoride gel are available. There is an impressive body of evidence that the topically deliverd fluorides are clinically effective in inhibiting the progression of dental caries. Recent studies on the cariostatic action of fluoride have indicated the importance of fluoride in the fluid environment of the teeth. The fluoride levels in unstimulated whole saliva can be considered indicative of F in the aqueous phase available for interaction with the tooth surface at a given time. The retention of F in the mouth after topical fluoride treatment is considered to be an important factor in the clinical efficacy of F. The aim of this study was to determine the elevation and clearance of fluoride in whole saliv after the following topical flouride treatments using HMDS-diffusion technique and fluoride ion electrode. The obtained results were as follow: 1. Average salivary fluoride concentration in the unstimulated whole saliva was $0.0152ppm{\pm}0.0091ppm$. Unstimulated salivary flow rate was between 0.34-0.36ml/min and there was no statistically significant difference among the groups(p>0.05). 2. Except for the immediate time after treatment, fluoride levels followed as APF gel>neutral gel>F-rinse>F-paste. There was no statistical difference between the salivary F concentration of F-paste group and that of control group after 2 hours. In case of F-rinse group, after 3 hours the concentration had dropped to baseline value. But there was statistically significant difference among the F concentraion of F gel groups and that of control group(p<0.05). 3. The mean $AUC_{0-120min}$ values were followed as neutral gel>APF gel>F-rinse>F-paste, and the values of the two former groups were significantly higher than those of the two latter groups(p<0.05).

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.1
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• pp.175-180
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• 2008

Traumatic injuries to the primary dentition are commonly encountered problems in dental practice. It is found that 30% of the children had injuries to the primary dentition and 22% to the permanent dentition. The greatest incidence of trauma to the primary dentition occurs at the ages of 2 and 3 as children start to learn motor coordination. Because teeth and alveolar bone are traumatized simultaneously, alveolar bone fractures are likely to occur when multiple teeth are involved in injuries. Dental splints are indicated for the management of maxillofacial fractures. They enable anatomic reduction of fractured segments and help immobilization and maintenance of the fragments after reduction. They also act as a stabilizer during rehabilitation. Various types of dental splints are available. In this case, routine resin-wire splint technique could not be applied because of the child's uncooperative behavior. Oral sedation was not indicated because N.P.O. had not been preceded. Therefore, we decided to use open-cap acrylic splint instead. Stabilization using open cap acrylic splint requires minimum chair time with reduced discomfort to both patient and dentist. It is an effective means of splint for uncooperative children and especially useful when other means of fixation have been failed. Because trauma on the primary dentition can affect the underlying permanent tooth germ, it is important to monitor eruption process of the permanent dentition.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.2
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• pp.196-203
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• 2003

The application of sealants is a highly technique-sensitive procedure, requiring an extremely dry field prior to placement. Moisture contamination of the etched enamel surface before sealant placement is cited as the main reason for sealant failure. The purpose of this study was to evaluate the effects of different methods of sealant application on the shear bond strength of sealants to enamel. In groups 1, 2, 3, 4 Teethmate(unfilled sealant) was used, while Ultraseal XTplus(filled sealant) was used in groups 5, 6, 7, 8. Groups 1 and 5(control) were acid etched for 15 seconds using 35% phosphoric acid, washed and then dried. In groups 2, 6 drying agents were applied, and in groups 3, 7 bonding agents were applied and light cured. In groups 4 and 8 both drying agent and bonding agent were applied. Then sealant was cured to the specimen using molds 3mm in diameter and 2mm in height. Thermocycling was performed and shear bond strength was finally measured. The following results were obtained : 1. Groups using filled sealant(groups 5, 6, 7, 8) showed higher shear bond strengths compared to groups using unfilled sealant(groups 1, 2, 3, 4). 2. Among groups using unfilled sealant(groups 1, 2, 3, 4), groups 2, 3, 4 showed significantly higher shear bond strength compared to group 1(p<0.05). There were no significant differences among groups 2, 3 and 4. 3. There were no significant differences(p>0.05) among groups using filled sealant(groups 5, 6, 7, 8). 4. When modes of fracture were examined, cohesive failure was observed in groups 2, 3 and 4.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.1
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• pp.66-71
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• 2013

Muscular dystrophy is a genetically heterogeneous group of disorders characterized by progressive muscle weakness of variable distribution and severity. Fukuyama type congenital muscular dystrophy (FCMD) is an unusual form of muscular dystrophy with autosomal recessive inheritance and is clinically characterized by an early age of onset, severe central nervous system involvement, facial muscle weakness, and multiple joint contractures. Muscular dystrophy is susceptible to perioperative respiratory, cardiac and other complications. Patients with FCMD have upper airway muscle weakness, therefore general anesthesia is preferred to sedation regarding maintaining the airway when treating these patients. The development of malignant hyperthermia in general anesthesia for patients with muscular dystrophy is a concern. Total intravenous anesthesia should be used instead of inhaled anesthetics because of the risk of malignant hyperthermia. A 3-year-9-month old, 13kg girl with Fukuyama type congenital muscular dystrophy was scheduled for dental treatment under general anesthesia. She had multiple caries and 14 primary teeth needed caries treatment. Prior to general anesthesia, oral premedication with 9 mg midazolam was given. General anesthesia was induced and maintained with target controlled infusion of propofol $3{\sim}3.5{\mu}g/mL$. The patient with progressive muscular dystrophy was successfully treated under total intravenous anesthesia with a target controlled infusion of propofol. There were no complications related to anesthesia and dental treatment during or after the operation. This case suggests that target controlled infusion of propofol is a safe and appropriate anesthetic technique in FCMD patients for dental treatment.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.3
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• pp.130-137
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• 2021

Purpose: The various suture techniques can be utilized in order to maximize the keratinized tissue healing around dental implants. The aim of this study is to compare the soft tissue healing pattern between two different suture techniques after implant placement. Materials and Methods: 15 patients with 18 implants were enrolled in this study. Simple implant placement without any additional bone graft was performed. Two different suture techniques were used to tug in the mobilized flap near the healing abutment after paramarginal flap design. Digital intraoral scan was performed at baseline, post-operation, stitch out, and 3 months after operation. The scan data were aligned using multiple points such as cusp, fossa of adjacent teeth, and/or healing abutment. After subtracting scan data at baseline with other time-point results, closed space indicating volume increment of peri-implant mucosa was selected. The volume of the close space was measured in mm³. The volume between two suture techniques at three time-points was compared using nonparametric rank-based analysis. Results: Healing was uneventful in both groups. Both suture technique groups showed increased soft tissue volume immediately after surgery. The amount of volume increment significantly decreased after 3 months (P < 0.001). Flap folding suture group showed higher median of volume increment than interrupted suture group after 3 months without any statistical significance (P > 0.05). Conclusion: After paramarginal flap reflection, the raised flaps stabilized by flap folding suture showed relatively higher volume maintenance after 3-month healing period. However, further studies are warranted.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.3
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• pp.211-218
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• 2019

Purpose: The purpose of the present study was to compare the accuracy of four different metal copings fabricated by CAD/CAM technology and to evaluate clinical effectiveness. Materials and methods: Composite resin tooth of the maxillary central incisor was prepared for a metal ceramic crown and duplicated metal die was fabricated. Then scan the metal die for 12 times to obtain STL files using a confocal microscopy type oral scanner. Metal copings with a thickness of 0.5 mm and a cement space of $50{\mu}m$ were designed on a CAD program. The Co-Cr metal copings were fabricated by the following four methods: Wax pattern milling & Casting (WM), Resin pattern 3D Printing & casting (RP), Milling & Sintering (MS), Selective laser melting (SLM). Silicone replica technique was used to measure marginal and internal discrepancies. The data was statistically analyzed with One-way analysis of variance and appropriate post hoc test (Scheffe test) (${\alpha}=.05$). Results: Mean marginal discrepancy was significantly smaller in the Group WM ($27.66{\pm}9.85{\mu}m$) and Group MS ($28.88{\pm}10.13{\mu}m$) than in the Group RP ($38.09{\pm}11.14{\mu}m$). Mean cervical discrepancy was significantly smaller in the Group MS than in the Group RP. Mean axial discrepancy was significantly smaller in the Group WM and Group MS then in the Group RP and Group SLM. Mean incisal discrepancies was significantly smaller in the Group RP than in all other groups. Conclusion: The marginal and axial discrepancies of the Co-Cr coping fabricated by the Wax pattern milling and Milling/Sintering method were better than those of the other groups. The marginal, cervical and axial fit of Co-Cr copings in all groups are within a clinically acceptable range.

• Journal of radiological science and technology
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• v.30 no.4
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• pp.313-320
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• 2007

There are the Medical Radiation Health and Safety Act(the Patient Radiation Health and Safety Act, the Radiologic Technologist Act), the Medical Laboratory Technologist Act, the Physical Therapy Practice Act, and the Dental Hygienist Act, etc in America. However, Korea has only one Act for a medical radiologic technologist(including radiation therapy technologist, nuclear medicine technologist), medical laboratory technologist, physical therapist, occupational therapy examiner, dental hygienist, and so on. It is the Medical Technologist Act. Therefore, the Medical Radiation Health and Safety Act for a radiologic technologist(including radiation therapy technologist, nuclear medicine technologist) has to be enacted independently in Korea. It is the purpose of this Act to provide for the appropriate certification of persons using radioactive materials, equipment emitting ionizing radiation on humans or performing medical imaging for diagnostic and therapeutic purposes. In Korea, the radiologic technologist is a "fusion technologist" who is a person other than a licensed practitioner as a radiographer, radiation therapist, nuclear medicine technologist, computed tomography technologist, magnetic resonance technologist, mammographer, sonographer, medical dosimetrist, quality management technologist, etc. This Act will have some provisions related to the definitions, reserved title, scope of practice, specialized technologist, application for licensure, radiologic technology council, renewal, continuing education, the radiation control advisory commission, etc. This Act will ensure that quality radiation therapy treatments are delivered and that quality diagnostic information is presented for interpretation, which will lead to accurate diagnosis, treatment and cure. Accurate diagnosis can be provided only when a personnel is properly educated in technique, equipment operation and radiation safety. In the end, this Act will protect the civil right to health. By regulating the personnel responsible for performing those procedures, this Act will mean improved care for patients-higher quality images, improved accuracy, and less exposure to radiation.