• 대한치과교정학회지
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• 제49권2호
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• pp.124-136
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• 2019

Orthodontic treatment is more complicated when both soft and hard tissues must be considered because an impacted maxillary canine has important effects on function and esthetics. Compared with extraction of impacted maxillary canines, exposure followed by orthodontic traction can improve esthetics and better protect the patient's teeth and alveolar bone. Therefore, in order to achieve desirable tooth movement with minimal unexpected complications, a precise diagnosis is indispensable to establish an effective and efficient force system. In this report, we describe the case of a 31-year-old patient who had a labio-palatal horizontally impacted maxillary left canine with a severe occlusal alveolar bone defect and a missing maxillary left first premolar. Herein, with the aid of three-dimensional imaging, sequential traction was performed with a three-directional force device that finally achieved acceptable occlusion by bringing the horizontally impacted maxillary left canine into alignment. The maxillary left canine had normal gingival contours and was surrounded by a substantial amount of regenerated alveolar bone. The 1-year follow-up stability assessment demonstrated that the esthetic and functional outcomes were successful.

• Journal of Periodontal and Implant Science
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• 제29권3호
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• pp.693-703
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• 1999

Since they were introduced by Ward in 1923, periodontal dressing have been routinely used following the periodontal surgery to avoid pain, infection, desensitizing teeth, inhibiting food impaction of the surgical areas, and immobilizing injured areas. Recently, however, the value of periodontal dressings and their effects on periodontal wound healing have been questioned, several authors have been reported that the use of dressing has little influence on healing following periodontal surgical procedures. In addition, there is evidence that when good flap adaptation is achieved, the use of a periodontal dressing does not add to patient comfort nor promote healing. The purpose of this study was to evaluate patient postoperative pain experience and discomfort with and without the use of periodontal dressing following periodontal surgery. Twenty-eight patients, 11 male and 17 female. were selected for this study; The age range was 31 to 56, with an average of 40.2years. Patient selection was based on existence of two bilateral sites presenting similar periodontal involvement, as determined by clinical and radiographic assessment, and requiring comparable bilateral surgical procedures. Using a splitmouth dressing. one site received a periodontal dressing while the other site did not. Pain assessment was made according to a horizontal, rating scale(0-10). After at least a two-week period, the second surgical precedure was performed using the alternate postoperative treatment. At the conclusion of the trial, a self-administered questionnaire on postoperative experience was administered, and were asked of their preference of either, dressed or undressed. The results were as follows: 1. A similar trend for mean pain and discomfort scores as assessed by patients both dressed and salinetreated procedures was evident during 7-day postsurgical period. 2. Statistical analysis of differences between the dressed side and salinetreated side with respect to pain, discomfort and patient's experiences revealed that both treatment sides behaved similarly at any postoperative day(P>0.05). 3. Considering the patient's preference, on the basis of pain and discomfort experienced, 43% preferred the saline-mouthwash and 32% preferred the dressing, 25% showing no preference for either the dressing or the saline-mouthwash. There is evidence to support the use of a periodontal dressing in retention of an apically positioned flap by preventing coronal displacement, or its use to provide additional support to stabilize a free gingival graft. However, there will always be a use for periodontal dressing although routine use of dressings may decrease because of better surgical techniques and the use of antibacterial mouth rinses.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권2호
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• pp.217-232
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• 2000

The author studied on the 128 cases of benign odontogenic tumors which had been diagnosed with biopsy during the period of Jan. 1989 to Dec. 1998 at the Kyungpook National University Hospital, Yeungnam University Medical Center, Keimyung University Dongsan Medical Center, and Taegu Catholic Medical Center. This study contained the clinicostatistical analysis of the frequency in relation to sex, age, locations, chief complaints, duration, radiographic findings, recurrence, teeth, and treatment methods. The results were as follow : 1. Of a total of 128 benign odontogenic tumors, ameloblastomas(57 cases; 44.5%) and odontomas (44 cases ; 34.4%) mostly occupied. The other types of lesions were 8 calcifying odontogenic cysts, 7 benign cementoblastomas, 4 myxomas, 3 adenomatoid odontogenic tumors, 2 calcifying epithelial odontogenic tumors, 2 ameloblastic fibro-odontomas, and 1 odontogenic fibroma. 2. In age and sex distribution, benign odontogenic tumors occured slightly more often in males(53.9%) than females(46.1%) and the majority of cases(79.7%) were found during 2nd, 3rd, and 4th decade. 3. There was a predilection for mandibular lesions(mandible-maxilla ratio, 2.6 : 1). 4. The most common chief complaint was swelling(29.7%) and in respect to duration, the cases less than 1 year(50.0%) mainly appeared. 5. There were 7 cases(13.0%) of recurrence on ameloblastoma and there was no recurrence in the others. 6. In Ameloblastoma It commonly occured during 3rd and 4th decade(59.6%) and mean age was 30.2 years. The majority of cases were occurred in mandible(96.5%) , especially mandibular molar and angle area(71.9%). The most common chief complaint was swelling(47.4%) and in respect to duration, the cases less than 1 year(52.6%) mainly appeared. In relation to teeth, there were resorption of root(52.6%), displacement of teeth(31.6%), and in relation to impacted teeth(43.9%). There was higher recurrence rate in the cases by conservative treatment(14.7%) than radical treatment(10.0%). As regards radiographic findings, conservative treatments were prevalent in the cases of unilocular type(85.7%) as compared with multilocular type(48.5%). and there was higherrecurrence rate in the cases of multilocular type(18.2%) than unilocular type(4.8%). As regards the type of treatment in relation to age, conservative treatments were prevalent in patients younger than 20 years of age. 7. In Odontomas It commonly occured during 2nd decade(50.0%) and in maxillary anterior teeth(40.9%). The most common chief complaint was delayed retention and permanent impaction of teeth(72.7%), and most frequently associated with impacted teeth(79.5%).

• 대한치과보철학회지
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• 제52권4호
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• pp.324-330
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• 2014

임플란트와 자연치를 연결하여 보철물을 제작할 경우, 자연치에 함입현상이 일어날수 있음은 여러 보고로 알려져 있다. 이를 설명하는 메커니즘은 여러가지가 있으며, 이에 임플란트와 자연치를 연결 하는 보철물 형태는 권장되지 않는다. 본 증례는 임플란트와 인접 하지만, 연결되어 있지는 않은 자연치가 인접면 접촉과 연관되어 함입이 일어난 증례이다. 68세 여성이 상악 좌측 제2소구치 및 제2대구치 발치후, 임플란트 수술 및 보철수복을 받았으며, 임플란트 사이의 제1대구치는 크라운 치료를 받았다. 2.5년 후, 제2대구치 근심면의 접촉이 느슨해져 상기 보철물의 근심면 합착을 시행하였다. 그로부터 7개월후, 제1대구치의 약 2 mm 함입이 발생하였으며, 치주문제로 인한 통증도 발생하였다. 제1대구치의 크라운을 제거하고 다시 정출이 일어났고, 치주 통증도 사라졌다. 이에 본 증례를 분석, 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제58권4호
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• pp.154-157
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• 2015

Plastibell is one of the three most common devices used for neonatal circumcision in the United States, with a complication rate as low as 1.8%. The Plastibell circumcision device is commonly used under local anesthesia for religious circumcision in male neonates, because of cosmetic reasons and ease of use. Occasionally, instead of falling off, the device may get buried under the skin along the shaft of the penis, thereby obstructing the normal flow of urine. Furthermore, the foreskin of neonates is highly vascularized, and hence, hemorrhage and infection are possible when the skin is cut. Necrosis of penile skin, followed by urethral obstruction and renal failure, is a serious surgical mishap requiring immediate corrective surgery and medical attention. We report a case of fulminant urosepsis, acute renal failure, and pyelonephritis in a 4-day-old male neonate secondary to impaction of a Plastibell circumcision device. Immediate medical management was initiated with fluid resuscitation and mechanical ventilation; thereby correcting life threatening complications. Pediatricians and Emergency Department physicians should be cognizant of the complications from Plastibell circumcision device in order to institute appropriate and timely management in neonates.

• 대한소아치과학회지
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• 제34권4호
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• pp.646-650
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• 2007

2003년 4월부터 2006년 4월까지 안양 지역에 위치한 개인 소아치과 병원에 내원한 환아 7038명을 대상으로 임상적, 방사선학적 검사를 통해 성별, 상악 정중과잉치의 수, 치관의 형태와 위치, 치관 방향을 조사하여 다음과 같은 결론을 얻었다. 1. 과잉치를 가진 환아는 239명으로 3.40%(총 241명, 3.42%)에 해당하였고 총 289개의 과잉치가 있었다. 2. 과잉치는 1개 있는 경우가 191명으로 가장 많았고, 2개 있는 경우도 48명 있었으며, 3개 이상 있는 경우는 없었다. 3. 상악 정중과잉치는 3.2:1로 여아보다 남아에서 호발하였다. 4. 과잉치는 왼쪽에 있는 경우가 55.4%로 약간 더 많았고, 모양은 원추형, 방향은 역위형이 가장 많았다. 5. 하악 정중과잉치는 2명에서 관찰되었다.

• 대한심미치과학회지
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• 제10권1호
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• pp.30-45
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• 2001

In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권3호
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• pp.160-165
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• 2017

Objectives: Dry socket may occur secondary to the removal of any tooth. However, most dry socket cases develop in the third molar region. Dry socket is multifactorial in nature and has been treated using various modalities with varying success rates. This study assessed the efficacy of platelet rich fibrin (PRF) in established dry socket. Materials and Methods: Ten patients of either sex aged from 41 to 64 years with established dry socket according to established criteria were treated using PRF. Evaluation was performed by observing the reduction of pain using visual analogue scale, analgesic tablet use over the follow-up period, and healing parameters. Results: Pain was reduced on the first day in all patients with decreased analgesic use. Pain was drastically reduced during follow-up on the first, second, third, and seventh days with a fall in pain score of 0 to 1 after the first day alone. The pain scores of all patients decreased to 1 by the first day except in one patient, and the scores decreased to 0 in all patients after 48 hours. Total analgesic intake ranged from 2 to 6 tablets (aceclofenac 100 mg per tablet) over the follow-up period of 7 days. Healing was satisfactory in all patients by the end of the seventh day. Conclusion: PRF showed early pain reduction in established dry socket with minimal analgesic intake. No patients had allergic reactions to PRF as it is derived from the patient's own blood. PRF showed good wound healing. Our study suggests that PRF should be considered as a treatment modality for established dry socket.

• 대한족부족관절학회지
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• 제1권2호
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• pp.102-111
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• 1997

저자들은 1993년 9월부터 1996년 5월까지 본원 정형외과에 입원하여 Pilon 골절로 치료받고 1년 이상 추시 가능하였던 19례(18명)를 대상으로 다음과 같은 결론을 얻었다. 1. Ovadia와 Beals의 분류상 제1형이 2례, 제2형이 3례, 제3형이 10례, 제4형이 1례, 제5형이 3례였고, 제3형이 53%로 가장 많았으며, 교통사고와 추락손상 등 고에너지 손상에 의한 골절이 16례로 전체의 약 84%를 차지하였다. 2. 손상의 정도가 비교적 적은 제1형과 제2형에서는 모두 양호 이상의 임상결과를 나타내었으며, 제4형과 5형에서는 손상의 정도가 심하고 이로인한 정확한 정복의 어려움으로 인해 보통 이하의 성적을 나타내었다. 3. 합병증은 외상후 관절염이 6례로 가장 많았으며 손상정도가 심한 3형 이상에서 정확한 정복이 이루어지지 않은 경우에 발생하였으며, 방사선학적 평가가 보통이하였던 제3형 3례에서 부정 유합이 발생하였으나 임상결과와의 연관성은 없었다. 4. 저자들은 제한된 관혈적 정복 및 내고정술로 연부조직의 합병증을 현격히 줄일 수 있었으며, 손상의 정도가 적고 정확한 정복이 가능한 경우, Pilon 골절의 좋은 치료 술식의 하나라고 사료된다.

• 대한치과교정학회지
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• 제28권2호
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• pp.237-253
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• 1998

골격성 제 III급 부정교합 환자에서 성장조절이나 절충치료로 해결하기 어려운 경우 악교정 수술을 시행하게 되며, 이러한 환자의 대부분이 최대의 효과를 얻기 위해 상하악 동시 수술이 필요하다. 이러한 양악 수술에서, 교합평면의 설정은 진단 및 치료에 매우 중요한 기준이 되어지며, 바람직한 기능 및 심미적인 결과와 술후 안정성을 얻을수 있도록 계획되어져야 한다. 본 연구에서는 양악 수술을 시행받은 골격성 제 III급 부정교합 환자 48명 (남자25명 여자23명, 평균 연령 21.5세)을 대상으로 하여 교합평면의 설정에 사용되어지는 몇가지 진단 기준중, 많이 사용되어지고 있는 Delaire의 구조적, 구성적 분석에 의한 각 개인의 이상적인 교합평면의 술후 안정성에 대해서 평가하고자 이상적인 교합평면에 부합되게 수술이 시행된 군(A군-24명)과 이 평면에서 벗어난 군(B군-24명)으로 나누어, 수술 직전($T_1$)과 수술 직후($T_2$-평균 4.3일), 수술 8개월 이상 경과 후($T_3$-평균 1년 3개월)에 두군의 측모 두부 방사선 사진을 비교하여 다음과 같은 결론을 내렸다. 1. 양악 수술 후 $T_2와\;T_3$시기의 유의차를 보인 값은 교합평면과 하악평면이 이루는 각 이었으며 그외의 교합평면의 경사도에선 유의성 있는 차이를 보이지 않았다. 즉 교합평면의 술후 재발량은 SN평면과, FH평면에 대해서 각각 $0.24^{\circ}{\pm}2.43{\circ},\;0.15{\circ}{\pm}2.16{\circ}$로 양악 수술 후 교합평면의 안정성은 유지되었다. 2. A군과 B군사이에서 교합평면의 안정성에는 유의성 있는 차이가 없었다. 3. A군및 B군내에서 교합평면의 안정성은 술자 및 수술방법에 따라 유의성 있는 차이를 보이지 않았다. 4.술후 교합평면의 변화($T_3-T_2$)는 술후의 치아에 의한 변화 보다는 악골의 변화($T_3-T_2$)와 높은 순상관관계를 보였으며 특히 하악골의 변화와 높은 순상관관계를 보였다. 5. 술후 교합평면의 변화($T_3-T_2$)는 수술에 의한 상악골의 impaction양, 하악골의 후퇴량($T_2-T_1$)과는 상관관계를 보이지 않았다.