• 대한치과보철학회지
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• 제56권1호
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• pp.64-69
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• 2018

치성점액종은 악골에 드물게 발생하는 양성 치성 종양이다. 본 증례의 60대 무치악 남성은 전상악부에 발생한 연조직 종괴 제거를 주소로 내원하였으며 절제 생검 결과 치성 점액종으로 확진되었다. 외과적 제거 후 잔존한 가동조직의 변형을 최소화 하기 위해 고안된 투명 레진 트레이로 인상을 채득하였다. 악간관계기록 및 납의치 시적시에 중립대 영역을 설정하고 기능적 연마면 형태를 인기하여 총의치의 안정성과 유지력을 증진시킬 수 있었다. 치성 점액종 제거 후 가동조직과 중립대를 고려하여 심미적, 기능적으로 만족스러운 총의치를 제작하였기에 이를 보고하는 바이다.

• Journal of Oral Medicine and Pain
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• 제20권2호
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• pp.407-420
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• 1995

This study was performed to evaluate and compare conservative treatment results by several parameters such as age, sex, symptom duration, type and timing of joint sound, parafunctional habits, splint type, and diagnostic classification. There have been too many articles reporting long term results of conservative treatment but articles related to comparison of treatment results by patients' self-evaluation have been rarely reported. For this study 258 patients with temporomandibular disorders(TMDs) were selected and examined by routine diagnostic procedure for TMDs. The subjects were classified into 5 TMDs subgroups ad treated with conservative treatments involving splints, physical modalities, jaw exercises, and counseling. Visual analogue scale(VAS) about pain, joint sound, and mouth opening limitation was recorded respectively during treatment period. From the VAS data and treatment duration, VAS treatment index(VAS Ti) was calculated. The obtained results were as follows : 1. Pain was the most frequent main symptom in subjects with temporomandibular disorders, and main symptom for mouth opening limitation was comparatively less than for pain or sound in disk displacement with reduction group or in degenerative joint disease group. 2. Degenerative joint disease group had the most poor treatment results and highest occlusal index of Helkim's index. 3. Good prognosis for conservative treatment was observed in acute group, under 6 months than chronic group, 6months over in symptom duration, and subjects with 40 years over in age showed the most poor prognosis. 4. Subjects treated with anterior repositioning splint had better treatment results than subjects treated with centric relation splint, but statistical significance in VAS Ti and treatment duration was not observed. 5. Treatment results according to affected side, types and point of joint sound did not show consistent statistical results. 6. The result for conservative treatment was observed poor in subjects with bruxism and clenching. 7. In studying coincidence between preferred chewing and affected side, frequency of preferred chewing side, in unilateral affection, was higher in ipsilateral than in contralateral side.

• Imaging Science in Dentistry
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• 제44권2호
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• pp.121-128
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• 2014

Purpose: The present study was performed to compare the planning of implant placement based on panoramic radiography (PAN) and cone-beam computed tomography (CBCT) images, and to study the impact of the image dataset on the treatment planning. Materials and Methods: One hundred five partially edentulous patients (77 males, 28 females, mean age: 46 years, range: 26-67 years) seeking oral implant rehabilitation were referred for presurgical imaging. Imaging consisted of PAN and CBCT imaging. Four observers planned implant treatment based on the two-dimensional (2D) image data-sets and at least one month later on the three-dimensional (3D) image dataset. Apart from presurgical diagnostic and dimensional measurement tasks, the observers needed to indicate the surgical confidence levels and assess the image quality in relation to the presurgical needs. Results: All observers confirmed that both imaging modalities (PAN and CBCT) gave similar values when planning implant diameter. Also, the results showed no differences between both imaging modalities for the length of implants with an anterior location. However, significant differences were found in the length of implants with a posterior location. For implant dimensions, longer lengths of the implants were planned with PAN, as confirmed by two observers. CBCT provided images with improved scores for subjective image quality and surgical confidence levels. Conclusion: Within the limitations of this study, there was a trend toward PAN-based preoperative planning of implant placement leading towards the use of longer implants within the posterior jaw bone.

• 대한치과보철학회지
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• 제54권4호
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• pp.445-450
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• 2016

Piezography는 발음을 이용하여 채득된 보철 공간을 의미하며, 의치의 인공치와 연마면의 위치를 결정하는 참고점으로 사용하게 된다. 본 증례 대상은 67세 여성환자로, 새 의치 제작을 주소로 내원하였다. 기존 의치에서 2급 악간관계와 불량한 유지력을 확인할 수 있었으며, 안정적인 의치를 위해 piezography와 설측교합을 이용하기로 하였다. 통상적인 방법으로 인상 채득 후 주모형 상에서 상하악 기초상과 왁스 교합제를 제작하였고, 별도로 piezography를 위하여 하악에 추가적인 기초상을 하나 더 제작하였다. 이 추가 기초상에 실리콘 인상재를 적용 한 뒤 '시', '소', '메', '테', '데', '무' 여섯개의 발음으로 piezography를 채득하였다. 하악 인공치를 이 보철공간에 맞추어 배열한 뒤, 형태를 수정하여 설측 교합을 부여하였다. 그 결과, 환자는 새로운 의치에 기능적, 심미적으로 만족하였다.

• 대한치과의사협회지
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• 제55권6호
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• pp.400-410
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• 2017

Approximately 30% of adult patients who want orthodontic treatment have transverse discrepancy with insufficient width of the maxilla. Particularly, in Class III patients requiring orthognathic surgery, the frequency of insufficient width of the maxillary arch related to respiratory problems is high. We report a case of non-surgical maxillary expansion using a Hyrax type expander with an orthognathic surgery, based on the reports that the ratio of non-fused midpalatal suture is not high in adults. A 30 years and 2 months old woman with a long face showed an Angle Class III with a vertical growth pattern. Class III molar and canine relation, anterior edge bite, and mandibular incisor compensatory lingual inclination were observed. The posterior buccal overjet seemed to be appropriate, but I diagnosed that there was a transverse discrepancy, for the following reasons. The inter-canine and inter-molar widths were sufficient but excessive lingual inclination of the mandibular molars was observed when assessing the bucco-lingual inclination based on the center of resistance of the maxillary and mandibular first molar. For this reason, it was expected that intercuspal interference would occur during orthodontic decompensation. Therefore, slow maxillary expansion using Hyrax type expander was performed and 2-jaw rotation surgery was performed to improve aesthetic and occlusion. Adults can also improve width discrepancy by non-surgical methods, which can avoid SARPE requiring additional surgery or segmental surgery lacking stability and predictability.

• 대한치과보철학회지
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• 제40권6호
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• pp.560-571
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• 2002

Jaw relations and the recording methods have been controversial aspects of dentistry. The purpose of this study was to quantify the relative muscle activity of the masseter and temporal muscles in relation to different intermaxillary relations recorded by intra-oral tracer during maximal clenching and to decide the optimal mandibular position. Ten volunteers with healthy TMJ were studied. Intra-oral tracer was assembled and bite block was fabricated in the articulator. Intra-oral tracer was placed in the mouth, and four mandibular positions were recorded. EMG activity was recorded on a BIO-PAK system (Bio-Research Associates, Inc. USA.) in masseter and temporal muscle and compared in each mandibular positions. The results were as follows: 1. In comparison with maximum intercuspation, the chewing position was the most similar followed by tapping position, myocentric position and posterior border position. However the differences were not statistically significant. 2. In comparison of bilateral symmetry of masseter muscle, tapping position was the most symmetrical followed by chewing position and maximum intercuspation. Myocentric position and posterior border position were not symmetrical. (P<.05). 3. In comparison of bilateral symmetry of anterior temporal muscle, chewing position was the most symmetrical followed by posterior border position, maximum intercuspation, myocentric position and tapping position. However the differences were not statistically significant. 4. In comparison of proportionality of anterior temporal muscle to masseter muscle activity on left side, posterior border position was the greatest followed by myocentric position, taping position, chewing position and maximum intercuspation. And the proportionality of posterior border position was greater than that of maximum intercuspation. (P<.05). 5. In comparison of proportionality of anterior temporal muscle to masseter muscle activity on right side, myocentric position was the greatest followed by posterior border position, tapping position, maximum intercuspation and chewing position. However the differences were not statistically significant.

• 구강회복응용과학지
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• 제31권3호
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• pp.242-252
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• 2015

무치악 환자에서는 치아가 상실되면서 주위 치조골의 개조와 흡수가 일어나고, 이에 따라 총의치의 유지력 감소, 저작 효율의 저하와 통증으로 인해 의치 사용에 어려움을 겪게 된다. 이를 개선하기 위해 하악에 2 - 4개의 임플란트를 식립하고 어태치먼트에서 유지 또는 지지를 얻는 피개의치가 바람직한 치료 방법으로 고려되고 있다. 본 증례들은 하악 완전 무치악 환자들을 악간 관계, 골흡수 정도, 안모지지 등을 평가하여 하악에 2개의 임플란트 식립을 고려하고, 다양한 종류의 어태치먼트를 이용한 임플란트 피개의치 수복을 계획하여 치료하였다. 주기적인 경과 관찰 결과 심미적, 기능적으로 만족할만한 결과를 얻었기에 이를 보고하는 바이다.

• 대한두개안면성형외과학회지
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• 제13권1호
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• pp.4-10
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• 2012

Purpose: The objective of this retrospective study was to assess the skeletal stability after orthognathic surgery for patients with cleft lip and palate. The soft tissue changes in relation to the skeletal movement were also evaluated. Methods: Thirty one patients with cleft received orthognathic surgery by one surgeon at the Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Osseous and soft tissue landmarks were localized on lateral cephalograms taken at preoperative (T0), postoperative (T1), and after completion of orthodontic treatment (T2) stages. Surgical movement (T0.T1) and relapse (T1.T2) were measured and compared. Results: Mean anteroposterior horizontal advancement of maxilla at point A was 5.5 mm, and the mean horizontal relapse was 0.5 mm (9.1%). The degree of horizontal relapse was found to be correlated to the extent of maxillary advancement. Mean vertical lengthening of maxilla at point A was 3.2 mm, and the mean vertical relapse was 0.6 mm (18.8%). All cases had maxillary clockwise rotation with a mean of 4.4 degrees. The ratio for horizontal advancement of nasal tip/anterior nasal spine was 0.54/1, and the ratio of A' point/A point was 0.68/1 and 0.69/1 for the upper vermilion/upper incisor tip. Conclusion: Satisfactory skeletal stability with an acceptable relapse rate was obtained from this study. High soft tissue to skeletal tissue ratios were obtained. Two-jaw surgery, clockwise rotation, rigid fixation, and alar cinch suture appeared to be the contributing factors for favorable results.

• 대한치과기공학회지
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• 제11권1호
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• pp.115-120
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• 1989

Many attempts for the compfrt, esthetics and improvement of Masticatory function of the patients with removable prosthesis have been made for several decades. The search for the ideal denture occlusion has been going on in an effort to find the tooth form which provides maximum denture stability and masticatory efficiency without damaging the health of the underlying bone. For the purpose, the basic concept of lingualized occlusion were suggested by payne(1941) and pound(1973) discussed a similar occlusal concept and used term " lingualized occlusion." The purpose of this literature study is to clarify and amplify a method to achieve bilateral balanced occlusion with the occlusal arrangement termed " lingualized occlusion." Lingualized occlusion can be achieved by use of anatomic teeth for the mandibular denture. Lingualized occlusion can be used in most denture combination. It is particulary helpful when the patient places high priority on esthetics but a nonanatomic occlusal scheme is indicated by oral conditions such a severe alveolar resorption, a class II jaw relationship or displaceable supporting tissue. Advantages of lingualized occlusion are summarized as follows : 1) Most of the advantages attributed to both the anatomic and nonanatomic forms are retained. 2) Cusp form is more natural in appearance compare to nonanatomic tooth form. 3) Good pnetration of the food bolus is possible. 4) Bilateral mechanical balanced occlusion is readily obtained for a region around arotric relation. 5) Bertical forces are centralized on the mandibular teeth. Lingualized occlusion provides a useful combination of several occlusal concept. Many. advantages of anatomic and nonanatomic occlusions are accomplished but the lingualized occlusal concept is not is not a panacea, and all other procedures still must be carefully excuted.

• 대한치과보철학회지
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• 제57권4호
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• pp.364-373
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• 2019

2급 악간관계를 갖는 환자는 1급 악간관계인 환자와는 달리 불안정한 교합을 가질 수 있으며, 무치악인 경우 총의치를 사용할 때 불안정한 교합을 보이면서 의치의 움직임이 커질 가능성이 있다. 이런 환자에 있어 임플란트 피개의치를 사용함으로써 의치의 안정을 향상시킬 수 있다. 임플란트 피개의 치에서 attachment 종류는 크게 bar type과 solitary type으로 나눌 수 있는데 각각 적응증이 있어 상황에 따라 적용을 달리 하여야 한다. 본 증례는 2급 악간관계를 가진 하악 무치악 환자에서 임플란트 피개의치를 계획함에 있어 디지털 기술을 이용함으로써 더 적합한 attachment를 선택하고 임플란트의 위치 및 깊이를 미리 계획하여 계획한 위치에 식립하였다. 상악은 국소의치로 수복하였고 하악은 임플란트 피개의치로 수복하여 만족할만한 결과를 얻었기에 이를 보고하고자 한다.