• Restorative Dentistry and Endodontics
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• 제6권1호
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• pp.109-114
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• 1980

Ease of manipulation, adequate mechanical properties, long years of experience and economical cost are the factors which have established amalgam as the most widely used material for dental restorations. But amalgam restoration may require replacement because of secondary caries, fracture, "fall-out", dimensional change, tarnish or corrosion etc.. These failures of amalgam restorations seem to arise from failures during operations rather than from the inherent shortcomings of the material itself or of the patient's mismanagement. It is anticipated that notonly number of analgam restoration, but failures will be increase after more extensive utilization of the medical insurance which began in 1977. Then authors think that it would be helpful for the development of better treatment in daily dental practice, to know the duration of amalgam restorations and the reasons for their replacement. The data for this survey was compiled from 2, 856 out-patients of the Department of Dentistry, Ewha Woman's University Hospital from January 1975 to December 1977. 260 cases among 1,718 fillings were studied, of which 205 cases both had a single reason for replacement and recognized the date of the previous filling. The results obtained were as follows; 1. Amalgam fillings were 58. 5 percent of all dental restorative materials. Of these, 15. 13 percent of the amalgam restorations had to be replaced. 2. The first reason for replacement of amalgam restorations was secondary caries (56.10%), the second was fracture (23.80%) and the third was "fall-out" (8.78%). 3. Among those amalgms requiring replacement, 52.2 percent had been in place less than 3 years, 70.7 percent within 5 years and 89.8 percent had been in place less than 10 years. Only 10.2 percent had been in place more than 10 years.

• 대한소아치과학회지
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• 제37권2호
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• pp.207-212
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• 2010

단백 C 결핍증은 항응고인자인 단백 C의 결핍으로 혈전 색전증의 위험성이 높다. 선천성 단백 C 결핍증 중 동형접합성 단백 C 결핍증은 단백 C의 활성도가 측정되지 않을 정도로 낮고 1/25만~50만의 발생 빈도를 가지는 희귀한 질환이다. 동형접합성 단백 C 결핍증의 주요 증상은 자반성 및 괴사성 피부 병변, 반상출혈, 실명, 중추신경계의 혈전증 등이다. 본 증례는 동형접합성 단백 C 결핍증인 만 4세 여아로 치아의 전반적인 우식을 주소로 내원하였다. 본 환아는 와파린 복용 중이었고 치과치료시 합병증의 예방을 위해 소아청소년과에 협진 의뢰하였다. 와파린 복용 중단 시 혈전으로 인한 심각한 합병증이 예상되어 와파린을 적절하게 (INR 3~5) 복용하되 치과 치료 중 과다 출혈 시 신선냉동혈장으로 조절할 것을 권고받았다. 이 환아는 실명을 동반한 중증 장애 아이로 행동조절이 어려웠고 과다 출혈시 신속한 처치가 가능하도록 하기 위해 전신마취 하에 치과치료를 시행하였다. 저자는 치아의 전반적인 우식을 주소로 내원한 만 4세 단백 C 결핍 환아에 대하여 전신마취 하 치과치료를 시행하였으며 다소의 지견을 얻었기에 보고하는 바이다.

• 대한장애인치과학회지
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• 제15권1호
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• pp.50-54
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• 2019

본 증례는 다수의 치아우식증을 주소로 내원한 근이영양증 환자의 전신마취 하 치과치료에 대한 보고이다. 근이영양증 환자들은 진행성 근육 약화로 인해 구강위생 관리하기가 힘들고 치아우식이 호발할 수 있다. 따라서 정기적으로 치과를 내원하고 올바른 구강 위생 습관을 확립할 수 있도록 환자 및 보호자교육을 실시하여야 한다. 치과치료 시에는 흡인으로 인한 호흡기 합병증이 발생하지 않도록 액체의 흡입을 주의 깊게 하여야 한다. 비협조적이거나 매우 어린 근이영양증 환자에서는 전신마취가 필요할 수 있다. 전신마취 시에는 악성 고열증의 위험 때문에 휘발성 마취제를 피해야 한다.

• 대한치과마취과학회지
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• 제13권4호
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• pp.209-214
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• 2013

Multiple caries in a pediatric patient often requires dental treatment under general anesthesia, especially when the patient is suffering from a systemic disease. The patient was a 6-year-old boy with Marfan syndrome and needed extensive dental treatment. Marfan syndrome is an inherited disorder resulting from mutations in Fibrillin-1 gene. Patients are known to have mainly cardiovascular, ocular, and musculoskeletal problems. Although clinical symptoms of the syndrome are age-realted, thus hindering early diagnosis of the disease in young children, our patient had been confirmed by a gene study at a younger age. Medical history of the patient revealed moderate to severe mitral regurgitation and aortic root dilatation, which required mitral valve replacement surgery with a mechanical valve. As a result, the patient was taking warfarin post-operatively and changes in medication had to be made before the dental treatment. Also, prophyalctic antibiotics had to be given before the treatment for prevention of (to prevent the) infective endocarditis. With careful control of the medications and bleeding tendency, general anesthesia and the treatment were done successfully without any complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권4호
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• pp.198-202
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• 2015

Proliferative periostitis is a rare form of osteomyelitis that is characterized by new bone formation with periosteal reaction common causes of proliferative periostitis are dental caries, periodontitis, cysts, and trauma. While proliferative periostitis typically presents as a localized lesion, in this study, we describe an extensive form of proliferative periostitis involving the whole mandibular ramus and condyle. Because the radiographic findings were similar to osteogenic sarcoma, an accurate differential diagnosis was important for proper treatment.

• Imaging Science in Dentistry
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• 제45권3호
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• pp.199-203
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• 2015

A 59-year-old male who had suffered from multiple myeloma for nine years and had been administered bisphosphonates for seven years visited a dental hospital for pain relief due to extensive caries in his left maxillary molars. The molars were extracted, leaving an exposed wound for three months. The radiograph showed sequestra formation and irregular bone destruction in the left maxilla. Sudden pain and gingival swelling in the right mandibular molar area occurred six months later. The interseptum of the right lower second molar was observed to be necrotic during surgery. These findings coincided with the features of bisphosphonate-related osteonecrosis of the jaw (BRONJ). In this case, the long intravenous administration of bisphosphonates and tooth extraction were likely the etiologic factors of BRONJ in a patient with multiple myeloma; moreover, the bilateral occurrence of BRONJ is a characteristic feature.

• 대한소아치과학회지
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• 제24권4호
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• pp.805-812
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• 1997

Despite dentistry's attempts to improve the dental health of the public and to minimize the effects of caries, many children still present with extensive destruction of primary anterior teeth. One of dentistry's most challenging tasks is to repair these teeth with restoration which are durable, retentive, and esthetic. Esthetic restoration can often be achieved with polycarbonate crowns, strip crowns, conventional S-S crowns, open-faced S-S crowns, commercially veneered S-S crowns. But, all of these have limitation. Advances in restorative materials and metal-bonding procedures have made possible new restorative techniques that combine the advantages of S-S crowns with the cosmetics of composite restoration methods. The described technique of bonding composite to trimmed and fitted S-S crowns offers many advantages over other techniques currently used to restore primary anterior teeth. 1. If S-S crowns are accurate trimmed and contoured, good retention of crowns is achieved. 2. The patient time required is similar to that of conventional S-S crowns. 3. Good esthetics and high bond strengths are achieved. 4. It is possible to use this veneering technique intraorally on crowns that have fractured veneers.

• 대한소아치과학회지
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• 제45권2호
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• pp.170-178
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• 2018

의학적 관리가 필요하거나 공포로 인해 치과치료를 기피하는 경우 등 다양한 경우에서 소아환자의 치과치료는 일반적인 행동조절만으로는 불가능한 경우가 많다. 이에 최근 전신마취를 이용한 치과치료에 대한 관심이 증가하는 추세이다. 본 연구는 서울대학교치과병원 소아치과에서 시행된 전신마취 하 치과치료에 대한 분석을 위하여 시행되었다. 2011년 10월부터 2015년 12월까지 서울대학교치과병원 소아치과에서 만 18세 미만의 환자를 대상으로 시행한 전신마취 1378례(1322명)에 대한 자료를 조사하였다. 성별은 남자가 805명(60.9%)로 여성보다 더 많았으며, 연령은 5 - 9세(56.0%)가 가장 많았다. 치료 전 전신상태는 ASA 1등급 67.8%, 2등급 이상이 32.2%이었다. 주된 치료는 치아우식증 치료(51.1%)가 가장 많았으며, 다음으로 외과적 치료(42.2%)가 많았다. 전신마취는 행동조절법 중 하나로 다양한 장점이 있으며, 협조가 부족한 환자에서 유용한 방법이 될 수 있다.

• Restorative Dentistry and Endodontics
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• 제25권4호
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• pp.606-618
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• 2000

Dental pulp infection is most commonly caused by extensive dental caries, and some bacterial species invade root canals; bacterial components and products are thought to be associated with the pathogenesis of periapical periodontitis. A principle driving force behind pulpal disease response appears to lie in the host immune system's to bacteria and their products. We examined the production of interleukin $1{\beta}$ (IL-$1{\beta}$) and tumor necrosis factor ${\alpha}$(TNF-${\alpha}$) from human peripheral mononuclear cells, lymphocytes and monocytes stimulated by heat-killed Acitnobacillus actinomycetemcomitans (ATCC 29523), Porphyromonas gingivalis (ATCC 33277) and Prevotella intermedia (ATCC 25611), and also by their sonicated bacterial extracts (SBE), respectively. The effects of three strains of heat-killed bacteria and their SBEs on the morphology of cultured blood cell lines HL-60 (KCLB 10240) and J774A.1 (KCLB 40067) were observed under the inverted microscope. Ultrastructural changes of J774A.1 exposed to heat-killed P. intermedia and its SBE were investigated using transmission electron microscopy. Production of IL-$1{\beta}$ was reduced in human peripheral mononuclear cells after stimulation by sonic bacterial extracts of A. actinomycetemcomitans, P. gingivalis, and P. intermedia. Heat-killed and sonic extract of P. gingivalis inhibited the production of TNF-${\alpha}$ in peripheral mononuclear cells. Production of TNF-${\alpha}$ was inhibited in peripheral monocytes after stimulation by sonic extracts of A. actinomycetemcomitans, P. gingivalis, and P. intermedia. HL-60 and J 774A.1 cells showed granular degeneration after treatment with heat-killed and sonic extracts of A. actinomycetemcomitans, P. gingivalis, and P. intermedia Chromatin margination and shrinkage were observed in 774A.1 treated with heat-killed P. intermedia. Cell wall structure and organelles were destroyed and vacuoles were formed in cytoplasm in J774A.1 treated with P. intermedia sonic extract. These results suggest that A actinomycetemcomitans, P gingivalis and P intermedia may have an important role in the formation and progression of pulpal diseases via both modulation of production of IL-$1{\beta}$ and TNF-${\alpha}$ from blood mononuclear cells and cytopathic effects.

• 대한치과보철학회지
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• 제57권3호
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• pp.288-295
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• 2019

임플란트 지지 보철물의 'passive fit'은 보철물의 장기적인 성공과 합병증의 최소화에 핵심적인 요소이다. 그리고 이 요소는 보철물의 제작과정에 의해 대부분 결정된다. 전통적인 주조 방식은 금속의 수축 변형이 발생하여 광범위한 임플란트 보철물에 적용하는데 제한이 있었다. 그러나 Computer-aided design/Computer-aided manufacture (CAD/CAM) 밀링 방식과 3D 프린팅 방식을 사용하면 이러한 한계점을 극복할 수 있다. 본 증례는 광범위한 임플란트 보철물을 사용한 완전 구강 회복 증례이다. 가철성 임시 보철물을 제작하여 심미와 기증을 평가하고 임플란트 식립을 위한 가이드로 사용하였다. 임플란트 식립 후, 임플란트 고정성 임시 보철물이 장착되었다. 추가적인 평가와 조정 후, 최종 보철물이 CAD를 사용하여 설계되었고, CAM을 사용하여 제작되었다. 전치부 임플란트의 나사 유지형 상부구조물은 밀링되어 제작되었고, 전치부 및 구치부 금속도재관의 금속구조물은 3D 프린팅되어 제작되었다. 보철물은 양호한 적합도를 보였고 술자와 환자 모두 증례의 최종 결과에 심미적, 기능적으로 만족하였다.