• 한국산학기술학회논문지
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• 제18권5호
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• pp.111-119
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• 2017

본 연구는 치과의원에 내원한 환자의 치과서비스에 대한 차별감이 재이용의사에 미치는 영향을 파악하기 위하여 충청북도 J시 소재 치과의원에 내원한 만 20세 이상 환자 432명을 대상으로 2015년 3월 9일부터 2015년 3월 31일까지 설문조사를 실시하여 다음과 같은 결과를 얻었다. 재이용의사에 영향을 미치는 중요한 변수로는 치과 의료서비스 질의 의료진, 친절성, 병원 이미지, 이용 편의성, 및 서비스 가치, 치과 서비스에 대한 차별감이 있었고, 이 변수들의 전체 설명력은 78.2%이었다. 또한 고학력군, 월평균 가족수입 400만원 이상군, 사무직군, 임플란트 치료의 방문목적군, 주위소개군 뿐만 아니라 서비스 가치, 의료진, 환경시설, 이용 편의성, 친절성, 병원 이미지가 높을수록 유의한 관련성이 있었다. 따라서 치과서비스 제공자들은 환자들의 치과 서비스에 대한 차별감을 인지하여 외적인 요인뿐만 아니라 환자가 느끼는 차별감이 최소화 될 수 있도록 양질의 치과 서비스를 통해 이를 충족시키기 위한 노력이 필요하다고 본다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.26.1-26.7
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• 2019

Background: The aim of this study was to investigate clinical and pharmacoepidemiologic characteristics of medicationrelated osteonecrosis of the jaw. Methods: The study population is comprised of 86patients who were diagnosed with ONJ at Ewha Womans University Mokdong Hospital from 2008 to 2015. Factors for epidemiologic evaluation were gender, age, location of lesion, and clinical history. The types of bisphosphonates, duration of intake, and the amount of accumulated dose were evaluated for therapeutic response. Clinical symptoms and radiographic images were utilized for the assessment of prognosis. Results: Among the 86 patients, five were male, whereas 81 were female with mean age of 73.98 (range 45-97). Location of the lesion was in the mandible for 58 patients and maxilla in 25 patients. Three patients had both mandible and maxilla affected. This shows that the mandible is more prone to the formation of ONJ lesions compared to the maxilla. ONJ occurred in 38 cases after extraction, nine cases after implant surgery, six cases were denture use, and spontaneously in 33 cases. Seventy-six patients were taking other drugs aside from drugs indicated for osteoporosis. Most of these patients were diagnosed as osteoporosis, rheumatic arthritis, multiple myeloma, or had a history of cancer therapy. Higher weighted total accumulation doses were significantly associated with poorer prognosis (P < 0.05). Conclusion: Dose, duration, route, and relative potency of bisphosphonates are significantly associated with treatment prognosis of osteonecrosis of the jaw.

• International Journal of Oral Biology
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• 제45권3호
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• pp.84-91
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• 2020

The present study investigated the participation of D-serine and NR2 in antinociception produced by blockade of central erythropoietin-producing hepatocellular carcinoma (Eph) A4 (EphA4) signaling in rats with trigeminal neuropathic pain. Trigeminal neuropathic pain was modeled in male Sprague-Dawley rats using mal-positioned dental implants. The left mandibular second molar was extracted under anesthesia, and a miniature dental implant was placed to induce injury to the inferior alveolar nerve. Our current findings showed that nerve injury induced by malpositioned dental implants significantly produced mechanical allodynia; additionally, the inferior alveolar nerve injury increased the expression of D-serine and NR2 subunits in the ipsilateral medullary dorsal horn (trigeminal subnucleus caudalis). Intracisternal administration of EphA4-Fc, an EphA4 inhibitor, inhibited nerve injury-induced mechanical allodynia and upregulated the expression of D-serine and NR2 subunits. Moreover, intracisternal administration of D-amino acids oxidase, a D-serine inhibitor, inhibited trigeminal mechanical allodynia. These results show that D-serine and NR2 subunit pathways participate in central EphA4 signaling after an inferior alveolar nerve injury. Therefore, blockade of D-serine and NR2 subunit pathways in central EphA4 signaling provides a new therapeutic target for the treatment of trigeminal neuropathic pain.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.367-371
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• 2009

Purpose: The purpose of this study was to evaluate the feasibility of the outfracture osteotomy sinus graft technique with the evaluation of 5-year survival rate of the implants placed in the atrophic edentulous posterior maxillary area. Materials and methods: One hundred and thirteen cases of 96 patients who visited our center from Aug 2004 to July 2009 and were diagnosed as atrophic edentulous maxillary alveolar ridge, were selected and underwent augmentation sinus surgery with outfracture osteotomy technique. Feasibility of the outfracture osteotomy technique was investigated with clinical and radiographic evaluation to assess the survival rate of the total dental implants in augmentation sinus surgery of this new kind. Total fixture number available in follow-up period was 179, in which the lost 10 patients were excluded out of 96 patients. Results: Five-year cumulative survival rate was 97.2% with 5 failures of total 179 fixtures. The average follow-up period was 29 and a half months, with the minimum and maximum follow-up periods of 4 months 21 days and 59 months 14 days, respectively. Conclusion: Traditional infracture technique is a popular method for an augmentation sinus surgery. The authors modified this classical method by outfracturing and readapting the bony window after sinus graft, with excellent treatment results evidenced by high survival rate of 97.2% (174 out of 179 fixtures), which proves the feasibility of the newly-designed outfracture osteotomy sinus graft technique.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.340-345
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• 2009

Purpose: The purpose of this study was to evaluate the surgical success of bone reconstruction of the severely atrophic maxilla using autogenous block bone onlay graft from the ramus and ilium prior to dental implantation. And we measured the amount of vertical height change Material and Methods: 26 partially edentulous patients(32 case) who needed block onlay bone graft before implant placement in posterior maxillary area from 2002 to 2009 were selected for this study. Patients consisted of 20 males & 6 females and the average of their age was 54.2. Patients who were treated with ramal bone were 19 case and patients who were treated with iliac bone were 11 case. Digital panoramic X-ray was taken at the day of surgery, 3 months and 6 months later after the surgery. Vertical height change & resorption rate of grafted bone were measured with the same X-rays and compared Results: Two out of 32 bone grafts had to be removed because of inflamation at the grafts area(97.3%). The mean of radiographic vertical height change(change rate) of post-op. 3 month was 0.54mm(8.5%)and 6 month was 0.99mm(15.9%). Compairing to intraoral donor site(ramus), iliac bone had more vertical height change(1.18mm) at 6 month after surgery. Conclusions: Within the limit of this study, autogenous block onlay grafts can be considered a promising treatment for severely atrophic maxilla.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권4호
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• pp.161-167
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• 2013

Objectives: The objective of this study is compare the rate of marginal bone resorption around hydroxyapatite-coated implants given different loading times in order to evaluate their stability. Materials and Methods: The study was conducted retrospectively for one year, targeting 41 patients whose treatment areas were the posterior maxilla and the mandible. Osstem TS III HA (Osstem Implant Co., Busan, Korea) and Zimmer TSV-HA (Zimmer Dental, Carlsbad, CA, USA), which employ the new hydroxyapatite coating technique, were used. The patients were divided into two groups - immediate and delayed loading - and the bone level at the time of loading commencement and after one year of loading was measured using periapical radiography. Differences between the groups were evaluated using Mann-Whitney (${\alpha}$=0.05). Results: For all patients as a single group, the survival rate of the implants was 100%, and the mean marginal bone loss was $0.26{\pm}0.59mm$. In comparison of the differences by loading, mean marginal bone loss of $0.32{\pm}0.69mm$ was recorded for the immediate loading group whereas the delayed loading group had mean marginal bone loss of $0.16{\pm}0.42mm$. However, the difference was not significant (P>0.05). Conclusion: Within the limited observation period of one year, predictable survival rates can be expected when using immediately loaded hydroxyapatite-coated implants.

• 대한구순구개열학회지
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• 제6권2호
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• pp.91-105
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• 2003

There are significant limitations in the precision of mandibular distraction in setting a desired occlusal and facial esthetic outcome. The purpose of this study is to present the simulation method for the distraction osteogenesis treatment planning. 3-D surgery simulation software programs V-works and V-Surgery(Cybermed, Seoul, Korea) were used from the 3D CT data in addition to the conventional data facial photography, panorama and cephalogram, dental cast model. We have utilized already for the various surgical procedures to get information preoperatively for the maxillofacial surgery like cancer localization and reconstructive surgery, orthognathic surgery and implant surgery in the department of Oral and Maxillofacial surgery, Seoul National University Hospital. On the software, bone cutting can be done at any place and any direction. Separated bone segment can be mobilized in all 3 dimensional direction. After the 3D simulation on the software program, mock surgery on the RP model can be performed. This planning method was applied to two hemifacial microsomia patients. With this protocol, we could simulate the movement of bony segment after maxillofacial distraction osteogenesis

• Journal of Periodontal and Implant Science
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• 제46권4호
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• pp.244-253
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• 2016

Purpose: The aim of this study was to characterize the healing in the grafted calvarial defects of rats after adjunctive hyperbaric oxygen therapy. Methods: Twenty-eight male Sprague-Dawley rats (body weight, 250-300 g) were randomly divided into two treatment groups: with hyperbaric oxygen therapy (HBO; n=14) and without HBO (NHBO; n=14). Each group was further subdivided according to the bone substitute applied: biphasic calcium phosphate (BCP; n=7) and surface-modified BCP (mBCP; n=7). The mBCP comprised BCP coated with Escherichia-coli-derived recombinant human bone morphogenetic protein-2 (ErhBMP-2) and epigallocatechin-3-gallate (EGCG). Two symmetrical circular defects (6-mm diameter) were created in the right and left parietal bones of each animal. One defect was assigned as a control defect and received no bone substitute, while the other defect was filled with either BCP or mBCP. The animals were allowed to heal for 4 weeks, during which those in the HBO group underwent 5 sessions of HBO. At 4 weeks, the animals were sacrificed, and the defects were harvested for histologic and histomorphometric analysis. Results: Well-maintained space was found in the grafted groups. Woven bone connected to and away from the defect margin was formed. More angiogenesis was found with HBO and EGCG/BMP-2 (P<0.05). None of the defects achieved complete defect closure. Increased new bone formation with HBO or EGCG/BMP-2 was evident in histologic evaluation, but it did not reach statistical significance in histometric analysis. A synergic effect between HBO and EGCG/BMP-2 was not found. Conclusions: Within the limitations of this study, the present findings indicate that adjunctive HBO and EGCG/BMP-2 could be beneficial for new bone formation in rat calvarial defects.

• Journal of Periodontal and Implant Science
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• 제46권3호
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• pp.207-217
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• 2016

Purpose: The aim of this study is to analyze and visualize the distribution of patients visiting the periodontology department at a dental college hospital, using a geographic information system (GIS) to utilize these data in patient care and treatment planning, which may help to assess the risk and prevent periodontal diseases. Methods: Basic patient information data were obtained from Dankook University Dental Hospital, including the unit number, gender, date of birth, and address, down to the dong (neighborhood) administrative district unit, of 306,656 patients who visited the hospital between 2007 and 2014. The data of only 26,457 patients who visited the periodontology department were included in this analysis. The patient distribution was visualized using GIS. Statistical analyses including multiple regression, logistic regression, and geographically weighted regression were performed using SAS 9.3 and ArcGIS 10.1. Five factors, namely proximity, accessibility, age, gender, and socioeconomic status, were investigated as the explanatory variables of the patient distribution. Results: The visualized patient data showed a nationwide scale of the patient distribution. The mean distance from each patient's regional center to the hospital was $30.94{\pm}29.62km$ and was inversely proportional to the number of patients from the respective regions. The distance from a regional center to the adjacent toll gate had various effects depending on the local distance from the hospital. The average age of the patients was $52.41{\pm}12.97years$. Further, a majority of regions showed a male dominance. Personal income had inconsistent results between analyses. Conclusions: The distribution of patients is significantly affected by the proximity, accessibility, age, gender and socioeconomic status of patients, and the patients visiting the periodontology department travelled farther distances than those visiting the other departments. The underlying reason for this needs to be analyzed further.

• Journal of Periodontal and Implant Science
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• 제39권sup2호
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• pp.239-251
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• 2009

Purpose: Full-mouth disinfection enables to reduce the probability of cross contamination from untreated pockets to treated ones, for completing the entire SRP under local anesthesia with chlorhexidine as a mouth wash in two visits within 24 hours. This study aimed to compare the clinical effects of modified full-mouth disinfection (Fdis) after 6 months with those of conventional SRP (cSRP). Methods: Thirty non-smoking chronic periodontitis subjects were randomly allocated two groups. The Fdis group underwent the entire SRP under local anesthesia in two visits within 24 hours, a week after receiving supragingival scaling. A chlorhexidine (0.1%) solution was used for rinsing and subgingival irrigation for Fdis. The cSRP group received SRP per quadrant under local anesthesia at one-week intervals, one week after they had received scaling. Clinical parameters were recorded at baseline, after 1, 3 and 6 months. Results: There are significant (P<0.05) decreases in the sulcus bleeding index, and plaque index, and the increases in gingival recession were significantly smaller with Fdis after six months compared with cSRP. There was significant improvement in the probing depth and clinical attachment level for initially medium-deep pockets (4-6mm) after Fdis compared with cSRP. Multi-rooted teeth showed significantly larger attachment gain up to six months after Fdis. Single-rooted teeth showed significantly more attachment gain, 1 and 6 months after Fdis. Conclusions: Fdis has more beneficial effects on reducing gingival inflammation, plaque level, probing depth, gingival recession and improving clinical attachment level over cSRP.