• 대한장애인치과학회지
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• 제14권1호
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• pp.11-16
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• 2018

In order to increase the accessibility of dental care for people with disabilities, National Health Insurance Service has implemented an additional point system of National Dental Insurance for dental treatment of patients with a special health care need (AID). The purpose of this study is to investigate the types and status of AID in Korea using data of the Health Insurance Review and Assessment Service from 2011 to 2017. The basic consultation fee is increased by 9.03 points (713 won) for brain disorder, intellectual disability, mental disability, or autistic disorder. From 2011 to 2015, the number of claims with a basic consultation fee increased from 90,456 to 141,179. Dental treatment and surgical treatment fee is increased by 100% of the defined insurance score for each of the 15 items. During the five years from 2012 to 2016, the number and amount of claims for each item increased steadily. Of the total claims for 5 years, endodontic treatment was highest, with 107,477 cases, followed by 51,641 cases of scaling. There are two types of dental safety observation fee, simple and complex. The simple safety observation fee is 10,370 won per day, and the complex safety observation fee is 20,750 won per day. Dental safety observation fees were charged 34 times in 2015, 14 times in 2016, and 41 times through May 2017. From 2011 to 2017, the number and amount of claims using AID for dental care for people with disabilities increased. However, considering that the number of registered dental users with disability was about 560,000 in 2016, the number of claims using AID is 1-20,000, which is less than 2% of registered dental users with disability. Therefore, it is necessary to expand dental services for people with disabilities including AID.

• 대한장애인치과학회지
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• 제15권1호
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• pp.23-28
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• 2019

다발성 우식이 있는 청소년 지적장애 환자들은 협조도가 불량하고 치료 부위가 광범위하며 구강 관리 유지가 어려울 수 있다. 따라서 장애와 환자의 상태에 맞게 최소 침습적 치료보다는 적극적인 크라운 수복 치료와 유지관리 및 보호자와 환자를 대상으로 식이 관리 및 칫솔질 교육을 진행하도록 해야한다. 청소년기 다발성 우식이 있는 지적장애 환자에 대해 더 적극적인 치료와 양호한 유지관리가 이루어지도록 치과의사와 보호자 모두 적극적인 노력이 이루어져야 할 것이다. 환자 맞춤의 치과 치료 방법을 선택하고 보호자 교육을 통해 이를 유지관리 및 예방에 힘쓸 수 있게 해야 하며, 보호자는 개선된 구강상태를 유지하고 예방하기 위해 가정에서의 구강위생관리를 중요하게 잘 수행해야 할 것이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권5호
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• pp.330-337
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• 2003

This is a retrospective study on the care of odontogenic infections in admission patients with major bleeding disorders. The study was based on a series of 514 patients treated at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, from Jan. 1, 2000, to Dec. 31, 2002. The obtained results were as follows : 1. The cardiovascular disease was the most frequent cause of the systemic diseases with major bleeding disorders, and liver disease, cerebrovascular disease and renal failure were next in order of frequency. But, there was the most frequent dental consultation in the liver disease, owing to the many odontogenic infectious diseases. 2. Male prediction (66.3%) was almost existed in the odontogenic infectious patients with major bleeding disorders. But, there was slight female prediction (53.4%) in the cardiovascular disease. 3. The most common age group of the odontogenic infectious patients with major bleeding disorders was the fifty decade(27.2%), followed by the forty, sixty & thirty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with major bleeding disorder, peak incidence was occurred as toothache (42.2%), followed by intraoral bleeding, ulcer pain, dental extraction in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis and periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(44.2%) was showed in primary endodontic drainage(pulp extirpation, occlusal reduction & canal opening drainage) and followed by the incision & drainage, the medications & oral hygiene instruction, scaling, indirect pulp capping in order.

• Restorative Dentistry and Endodontics
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• 제44권4호
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• pp.39.1-39.8
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• 2019

The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권6호
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• pp.563-566
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• 2010

Retrobulbar abscess is a rare, but severe complication of paranasal sinusitis. The clinical presentations are eyelid swelling, erythema, proptosis, conjunctival chemosis, restricted ocular movement, and decreased visual acuity. Diagnostic methods available for evaluating retrobulbar abscess include sinus X-ray, ultrasonography, computed tomography (CT), and bacterial culture. For the treatment of retrobulbar abscess, immediate surgical drainage and systemic antibiotic therapy are needed. Proper diagnosis and treatments are necessary for preventing visual loss, cavernous sinus thrombosis, subdural abscess, and other lifethreatening complications. A patient, a 30-year-old man, was admitted to our hospital because of progressive eyelid swelling, erythema, ptosis and decreased visual acuity on the right eye after endodontic treatment. The sinusitis occurred secondary to the infection from an upper molar tooth. The spread of the infection led to the orbit via ethmoidal sinus and posterior orbital wall. Immediate surgical intervention was performed and systemic antibiotics was administrated. The symptoms and signs are improved after treatments, so we present our case with a brief review of the literature.

• Restorative Dentistry and Endodontics
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• 제21권1호
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• pp.300-310
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• 1996

Recently, there have been attempts to obstruct the dentinal tubules and remove the smear layer by way of laser irradiation in the root canal during endodontic treatment. This treatment was designed to make the root canal to be nonporous. Using 33 extracted single rooted teeth, 30 teeth were divided into 3 groups (10 each), and 3 teeth were used as samples for SEM. Using Nd : YAG laser, the control group was not irradiated, experimental group l(1W group) was irradiated with 1W, 15pps, 15sec., 3 times, 6.7mJ and experimental group 2(3W group) was irradiated with 3W, 15pps, 15sec., 3 times 20mJ. Thereafter the roots were immersed in methylene blue for 8 hours, and the dye infiltration pattern was observed under stereomicroscope and canal wall surface change was observed under SEM. The results are as following ; 1. As a result of evaluating the dye infiltration rate of the apical and middle 1/3, there was significant difference between control group and 1W group, control group and 3W group and there was no significant difference between 1 W group and 3W group. 2. In each group, as a result of comparing the dye infiltration rate of the apical and middle 1/3, there was no significant difference in control and 1W group but significant difference in 3W group. 3. In the control group smear layer was scarecely found and many dentinal tubules were found to be open. 4. In the 1W group, the number of dentinal tubules were decreased and gradual changes of the dentin surface could be seen and 3W group, almost no dentinal tubules could be found and the dentin surface was changed a little more and showed signs of partial fusion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권5호
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• pp.507-513
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• 2000

Objective : The purpose of this study is to evaluate the vitality of the teeth in and adjacent to the mandibular fracture line according to variable conditions of fracture and to establish the protocol of treatment of fracture line teeth. Materials and Methods : The vitality of 97 teeth in fracture line and 104 teeth adjacent to fracture line of 52 patients were invested preoperatively. Of these, 66 teeth in fracture line and 72 teeth adjacent to fracture line were monitored at least 6 months after operation. An electric pulp tester was used to measure pulpal response. The relationships between the vitality of teeth in variable time(preoperation, immediate post-operation; within 1 week after operation, and 6 months after operation) and variable conditions of fracture(horizontal, vertical gap of fracture line, the number of fracture line)were evaluated statistically. Result : The vitality of fracture line teeth in the 6 months after operation statistically differed by the vertical gap of fracture line and the number of fracture line. The vitality of fracture line adjacent teeth in the immediate post-operation only statistically differed by the vertical gap of fracture line. There were statistically differences between preoperative EPT value and vitality of fracture line teeth on 6 months after operation. There were 5 cases of complications including periapical and periodontal abscess. Of these, only one tooth was extracted and the others were well treated with endodontic treatment and subgingival curettage. Conclusion : It is recommended to retain teeth and to monitor the vitality of teeth in and adjacent to fracture line, unless there is an absolute indication for extraction.

• International Journal of Oral Biology
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• 제35권2호
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• pp.43-49
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• 2010

Enterococcus faecalis, a gram-positive bacterium, has been implicated in endodontic infections, particularly in chronic apical periodontitis. Proinflammatory cytokines, including tumor necrosis factor-$\alpha$ (TNF-$\alpha$), are involved in the pathogenesis of these apical lesions. E. faecalis has been reported to stimulate macrophages to produce TNF-$\alpha$. The present study investigated the mechanisms involved in TNF-$\alpha$ production by a murine macrophage cell line, RAW 264.7 in response to exposure to E. faecalis. Both live and heat-killed E. faecalis induced high levels of gene expression and protein release of TNF-$\alpha$. Treatment of RAW 264.7 cells with cytochalasin D, an inhibitor of endocytosis, prevented the mRNA up-regulation of TNF-$\alpha$ by E. faecalis. In addition, antioxidant treatment reduced TNF-$\alpha$ production to baseline levels. Inhibition of extracellular signal-regulated kinase (ERK) and p38 mitogen-activated protein (MAP) kinase also significantly attenuated E. faecalis-induced TNF-$\alpha$ expression by RAW 264.7 cells. Furthermore, activation of NF-${\kappa}B$ and AP-1 in RAW 264.7 cells was also stimulated by E. faecalis. These results suggest that the phagocytic uptake of bacteria is necessary for the induction of TNF-$\alpha$ in E. faecalis-stimulated macrophages, and that the underlying intracellular signaling pathways involve reactive oxygen species, ERK, p38 MAP kinase, NF-${\kappa}B$, and AP-1.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권1호
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• pp.57-61
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• 2010

In the presence of acute pericoronitis of mandilbular third molar, antibiotic therapy and early incision and drainage are the method of choice, followed by definitive surgical extraction of the tooth as soon as it becomes subacute. If excision of the overlying tissues is decided on, it should be done adequately. All overlying tissues must be throughly excised, and the crown portion of the unerupted tooth should be completely exposed. After excision has been completed, the wound should be managed with a surgical dressing. This should be allowed to remain approximately 7 days. And then, surgical extraction of the impacted mandibular third molar can be done usually. In this operation, there are many complications, such as, postoperative bleeding, infection, trismus, dysphasia and paresthesia. The surgeon are discredited and medicolegal problem may be occurred in the presence of many distressed complications. Therefore, the relatively nonsurgical treatment is the method of choice. So, authors selected the conservative treatment methods of incision and drainage, primary endodontic drainage, operculectomy without surgical extraction of the mandibular third molars. The results were more favorable without the postoperative complication in Wonju old offender prison.

• 대한소아치과학회지
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• 제33권3호
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• pp.504-509
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• 2006

소아치과는 소아와 청소년의 구강상태에 대하여 보존, 교정, 치주, 외과치료 등 다방면의 치료를 복합적으로 시행한다는 점에서 타분야와 구분된다. 초창기의 소아치과학은 유치와 영구치의 우식의 치료, 발치 등에 국한되었으나, 최근에는 교정, 소 수술, 심미, 예방치료 등으로 진료의 범주가 확대되고 있다 2005년 11월 현재 소아와 청소년을 대상으로 하는 개인치과에서 근무하는 치과의사 50명을 대상으로 설문지를 발송하고 회송된 설문지 21매를 토대로 진료현황을 분석한 결과 다음과 같은 결론을 얻었다. 1. 일주일 간 평균적으로 진료하는 환자의 수는 82.4명이었고, 각 환자당 평균적으로 치료받는 치아의 수는 2.35개였다. 2, 전체 치료 중 예방치료가 15.7%, 수복치료가 55.7%, 치수치료가 15.6%, 외과치료가 10.5%, 교정치료가 2.4%를 차지하였다. 3. 수복치료 중 아말감이 3.8%, 글래스 아이오노머가 5.5%, 복합레진이 63.0%, 스테인레스 기성금관이 277%를 차지하였다.