• 대한치과의사협회지
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• 제48권4호
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• pp.280-287
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• 2010

1. 치과의사 분포가 적은 군 단위 이하 비도시 지역의 장애인 치과 접근도를 개선해야 할 필요가 있다. 2. 장애 환자의 진료시 일반인 진료 시와 다르게 보조 인력의 추가 투입의 필요성 및 만일의 사고시의 보상 제도가 마련되어야 할 것으로 생각된다. 3. 응답한 치과의사의 39.7%만이 장애인에게 일반인과 같은 수가를 적용하고 있었고, 38.2%의 치과의사는 장애인에게 전혀 비용을 받지 않고 있었다. 4. 여러 어려움에도 불구하고 대다수의 장애인을 진료하는 치과의사들은 일반인과 마찬가지로 장애환자에게 필요한 치료를 모두 제공하려고 노력하고 있는 것으로 생각된다. 그러나 임플란트, 보철 교정, 심미 치료의 접근성은 어려운 것으로 나타났다. 5. 현행의 공공 지원금 배분이 접근도가 높은 공공 병원에 집중되고 있어 실제 수행하는 진료 비중에 따른 분배 체계의 합리적인 개선이 요구되는 상황으로 보인다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권1호
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• pp.41-45
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• 2009

Background: Reduced bone height is one of the major problems faced in restoring tooth loss with implants. By the use of short implants, it is possible to reduce complicated and invasive treatment such as bone graft, allowing more simple surgery. But short implants are generally considered to have lower success rates than that of standard implants. Purpose: To assess the results of short Straumann implants by a retrospective study of short Straumann implants with TPS(titanium plasma-sprayed) and SLA(sandblasted, large grit, acid etched) surfaces. Materials and methods: 173 implants in 106 patients who received short Straumann implant surgery(${\le}8\;mm$) in the department of oral and maxillofacial surgery, Kyunghee Dental Hospital, from February 1996 to October 2006 were selected and studied. All of the implants were followed up after prosthetic rehabilitation. The average follow-up period was 34 months with 119 months as the longest follow up period. The average follow-up period after prosthetic rehabilitation was 31 months. 64 females(60.4%) and 42 males(39.6%) participated in the research with the age range of 19 to 85(mean age 47). 20 patients(18.9%) were under 40, 85 patients(80.2%) were over 40 and under 70, and only one patient(0.9%) was over 70 years old. Results: 27 implants(15.6%) had TPS surface while 146 implants(84.4%) had SLA surface. 9 implants(5.2%) were 3.3, 108 implans(62.4%) were 4.1mm and 56 implants(32.4%) were 4.8mm in diameter. 167 implants(96.5%) were 8mm and 6 implants(3.5%) were 6mm in length. There were 24 implants(13.9%) on the maxillas and 149 implants(68.8%) on the mandibles. 119 implants(68.8%) were rehabilitated with FPD(fixed partial denture), 47 implants(27.2%) with single crowns and 4 implants(2.3%) with overdentures. Among the fixed partial dentures, 30 of them were splinted with short implants only. After over an year of follow-up period, 139 implants(96.5%) out of 144 implants showed marginal bone loss of less than 1mm. 3 out of 173 implants failed showing 98.27% survival rate. Conclusions: The use of short Straumann implants(${\le}8mm$) can be a simple and reliable treatment method in minimal residual bone height.

• Journal of Periodontal and Implant Science
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• 제28권4호
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• pp.645-660
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• 1998

The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was $0.83{\pm}0.12$ by non surgical treatment and $0.82{\pm}0.14$ by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving nonsurgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권3호
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• pp.276-282
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• 2008

Objective: This is to report the efficacy of the sandwich technique for bone augmentation in a moderate atrophic posterior mandible through clinical and histological results in two cases. Subjects and Method: Two patients selected had moderate bone resorption in left lower edentulous area. Sandwich osteotomy using the piezosurgery was performed and the osteomized alveolar segments were elevated by 6mm in each two patients. The interpositional mineral allograft materials were inserted in the atrophic posterior mandibles. After four months healing period, bone biopsies in the grafted areas and placement of dental implants were performed. In both cases, panoramic views were taken preoperatively to measure the alveolar bone height for diagnosis, to monitor patient healing, and to evaluate bone healing and bone gain. Results: Sufficient vertical bone height was gained by using the sandwich technique and implants were placed successfully. In radiological evaluation, there was minimal resorption of bone height after the second operation and in histomorphometric evaluation, they showed favorable new bone formation without inflammation in the grafted areas. Conclusion: The sandwich technique can be an effective choice for augmenting vertical bone height in the atrophic mandible. More of cases and long term follow-up are needed to evaluate bone resorption and implant prognosis.

• Journal of Periodontal and Implant Science
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• 제45권6호
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• pp.193-204
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• 2015

Purpose: With the increasing prevalence of orthodontic treatment in adults, clear aligner treatments are becoming more popular. The aim of this study was to evaluate the effect of orthodontic treatment on periodontal tissue and to compare orthodontic treatment with fixed appliances (FA) to clear aligner treatment (CAT) in periodontitis patients. Methods: A total of 35 patients who underwent orthodontic treatment in the Department of Periodontology were included in this study. After periodontal treatment with meticulous oral hygiene education, patients underwent treatment with FA or CAT, and this study analyzed patient outcomes depending on the treatment strategy. Clinical parameters were assessed at baseline and after orthodontic treatment, and the duration of treatment was compared between these two groups. Results: The overall plaque index, the gingival index, and probing depth improved after orthodontic treatment (P<0.01). The overall bone level also improved (P=0.045). However, the bone level changes in the FA and CAT groups were not significantly different. Significant differences were found between the FA and CAT groups in probing depth, change in probing depth, and duration of treatment (P<0.05). However, no significant differences were found between the FA and CAT groups regarding the plaque index, changes in the plaque index, the gingival index, changes in the gingival index, or changes in the alveolar bone level. The percentage of females in the CAT group (88%) was significantly greater than in the FA group (37%) (P<0.01). Conclusions: After orthodontic treatment, clinical parameters were improved in the FA and CAT groups with meticulous oral hygiene education and plaque control. Regarding plaque index and gingival index, no significant differences were found between these two groups. We suggest that combined periodontal and orthodontic treatment can improve patients' periodontal health irrespective of orthodontic techniques.

• 재활복지공학회논문지
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• 제3권1호
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• pp.21-25
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• 2009

일반적으로 완전 이식형 인공중이는 이식형 마이크로폰과 진동 트랜스듀서를 포함한 모든 구성 요소가 측두골 부근 피부 아래에 이식되는 보청기이다. 마이크로폰과 트랜스듀서의 경우 이식 전과 후의 동작 주파수 특성 등이 달라진다. 이러한 특성변화와 이식 대상자의 청력특성에 알맞은 보청기 동작을 수행하기 위해 적합과정을 수행하게 된다. 일반 공기전도형 보청기나 부분 이식형 보청기의 경우 적합을 위한 전선 연결부가 존재하나 완전이식형의 경우에는 몸속에 모두 이식됨으로 이러한 전선의 연결이 어려우며 이에 따라 기존 보청기의 적합 프로그램을 적용하는 하드웨어를 이용한 적합이 어렵다. 본 논문에서는 완전 이식형 인공중이를 위한 무선 적합 하드웨어에 적용 가능한 적합 소프트웨어를 설계 및 구현하였다. 구현한 적합 소프트웨어는 마이크로폰과 트랜스듀서의 특성과 난청자의 청력도를 반영하여 적절한 청력 보상치를 산출할 수 있다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권3호
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• pp.242-246
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• 2006

Objective : This is to report the criteria of success of intraoral distraction osteogenesis for alveolar augmentation in the severely atrophied alveolar defects through clinical result of 2 cases. Subjects and Methods : Anterior segmental osteotomy was performed and alveolar distractors (Martin and Leibinger, Germany) were applied each in 2 patients with severely defected anterior maxillary area. The osteomized alveolar segments were distracted by 1mm a day after latency period. After the consolidation period implants were installed with removal of distractor. The implants were evaluated clinically and radiographically. Results : In Case I, the distracted bone was directed to the palatal side, and another augmentation treatment - block bone graft, guided bone regeneration - was needed. In Case II, the successful alveolar bone augmentation was achieved. Dental implant was placed on distracted alveolar bone, and showed good osseointegration and good function without any complication. Conclusion : Distraction osteogenesis can be a good choice for alveolar ridge augmentation of severely atrophied ridges. However, the anterior esthetic prosthetics relies on the control of the vector, the kind of distractor, the healing capacity of patient and the etiology of atrophy. Therefore another study of each category would be needed.

• 대한인간공학회지
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• 제36권4호
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• pp.305-323
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• 2017

Objective: The purpose of this study was to determine breast shape and ratio of breast enlargement women prior to development of breast enlargement patient's bra. Background: Although there are many previous studies on women's breast that did not undergo breast augmentation surgery, no studies have examined the breast type and proportion of women with breast augmentation. Method: In this study, we analyzed ratios and angles with photographs taken before and after breast augmentation on the frontal and lateral views of the breast, UPF and projection were analyzed too. We also compared the pre-operative and post-operative rates with those of previous breast studies, as well as the post-operative breast types for the desirable breast types. Results: The length and width of the breast base and the height of the breast projection increased after the operation. The rate of increase in width is larger than the vertical distance in the breast base, and the rate of increase in height of the projection is larger than the increase in the width. Specifically, in the vertical distance, the rate of increase in the lower portion is larger than that in the upper portion. In the width, the rate of increase on the inside is larger than that on the outside. Conclusion: The angles of the static relationship with the projection increased and the angles of the minor relation decreased. The changes in the size of the breast were visually observed in the overlapping of the triangle shape before and after the surgery. The changes were composed of the line connecting the angle and the measurement points. The pre-operative upper pole fullness (UPF) was mostly 0 and - 1, but after the surgery, +1, 0, -1, +2 were distributed, while post-operative levels of projection were distributed in the order of level 3> level 1> level 2. In comparison with the desirable breast type, it was found that the anatomical type was a more natural breast type than the round type of implant. Application: These results can be useful as basic data for the breast analysis of breast enlargement patients and their bra patterns.

• 대한치과보철학회지
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• 제55권3호
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• pp.305-310
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• 2017

최근, CAD/CAM 기술이 발전하면서 하이브리드 보철물의 제작에 이용되고 있다. Double scanning technique은 시적용 납의치와 주모형을 스캔 후 중첩하여, 가상 디자인의 현실화와 보철 기공 과정의 간소화를 이루었다. 본 증례에서는 금속 혹은 지르코니아 대신 고성능 중합체인 Polyetherketoneketone (Pekkton, Cendres+$M{\acute{e}}taux$, Biel, Switzerland)를 framework의 재료로 사용했으며, 콤포짓이나 세라믹 혹은 의치용 치아 대신 Polymethyl methacrylate (PMMA) 비니어링 치아(Visio-lign, Bredent, Senden, Germany)를 최종 보철물로 사용하였다. Pekkton과 Visio-lign을 사용한 본 증례에서 만족할만한 치료 결과와 환자의 만족을 얻었으며, 추후 주기적인 유지관리 및 평가가 필요할 것으로 사료된다.

• 대한두개안면성형외과학회지
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• 제21권2호
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• pp.92-98
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• 2020

Background: Posttraumatic acquired facial deformities require surgical treatment, with options including scar revision, fat grafts, implant insertion, and flap coverage. However, each technique has specific advantages and disadvantages. Methods: From 2016 to 2018, 13 patients (eight with scar contracture and five with a depressed scar) were treated using dermofat grafts from the groin. The harvested dermofat was then inserted into the undermined dead space after the contracture was released, and a bolster suture was done for fixation considering the patient's contour and asymmetry. A modified version of the Vancouver Scar Scale and satisfaction survey were used to compare deformity improvements before and after surgery. Results: In most cases, effective volume correction and an aesthetically satisfactory contour were maintained well after dermofat grafting, without any major complications. In some cases, however, lipolysis proceeded rapidly when inflammation and infection were not completely eliminated. A significant difference was found in the modified Vancouver Scar Scale before and after surgery, with a p-value of 0.001. The average score on the satisfaction survey was 17.07 out of 20 points. Conclusion: A dermofat graft with the groin as the donor site can be considered as an effective surgical option that is the simplest and most cost-effective method for the treatment of acquired facial deformities with scar contracture.