• 구강회복응용과학지
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• 제34권3호
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• pp.147-156
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• 2018

교합점 기록재를 통해 교합점을 분석하는 방법이 신뢰할 만한가에 대해서는 사용하는 방법이 결과에 미칠 수 있는 영향을 고려해야 한다. 교합점 기록은 교합점 기록재료와 두께, 교합력, 사용 횟수, 재료의 물리적 특성, 매개 물질 등 많은 변수에 의해서 정확도, 신뢰도에 영향을 받을 수 있다. 그럼에도 불구하고 교합점 기록재에 대한 연구는 환자의 교합력과 기록재의 두께 등 일부 요소에 대한 평가가 주를 이루어 다양성이 부족하다. 변수를 통제하기 위해 교합지는 가능하면 매 회 새것을 사용하고 구강 내 건조상태를 확보하며 가급적 얇은 교합지를 사용하여야 한다. 또한, 한가지 방법만으로 분석하는 것은 지양하여야 하며, 보조 수단을 함께 활용할 것이 추천된다.

• The Journal of Advanced Prosthodontics
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• 제4권1호
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• pp.7-12
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• 2012

PURPOSE. Articulation paper mark size is widely accepted as an indicator of forceful tooth contacts. However, mark size is indicative of contact location and surface area only, and does not quantify occlusal force. The purpose of this study is to determine if a relationship exists between the size of paper marks and the percentage of force applied to the same tooth. MATERIALS AND METHODS. Thirty dentate female subjects intercuspated into articulation paper strips to mark occlusal contacts on their maxillary posterior teeth, followed by taking photographs. Then each subject made a multi-bite digital occlusal force percentage recording. The surface area of the largest and darkest articulation paper mark (n = 240 marks) in each quadrant (n = 60 quadrants) was calculated in photographic pixels, and compared with the force percentage present on the same tooth. RESULTS. Regression analysis shows a bi-variant fit of force % on tooth (P<.05). The correlation coefficient between the mark area and the percentage of force indicated a low positive correlation. The coefficient of determination showed a low causative relationship between mark area and force ($r^2$ = 0.067). The largest paper mark in each quadrant was matched with the most forceful tooth in that same quadrant only 38.3% of time. Only 6 2/3% of mark surface area could be explained by applied occlusal force, while most of the mark area results from other factors unrelated to the applied occlusal force. CONCLUSION. The findings of this study indicate that size of articulation paper mark is an unreliable indicator of applied occlusal force, to guide treatment occlusal adjustments.

• 대한치과교정학회지
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• 제21권2호
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• pp.325-340
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• 1991

There are evidences that occlusal splint therapy is critical to diagnose hidden akeleto-occlusal disharmonies in malocclusion patients and capable of enhancing stability after orthodontic treatment. In addition, evidences have implicated occlusal splint therapy in condylar positional changes during TMJ disorder treatment. In view of these evidences, this study was performed to investigate the effect of occlusal splint therapy on condylar positional changes in malocclusion patients and the possible clinical application of the occlusal splint as an additional orthodontic tool. For this study, 8 Angle's Class I malocclusion patients, who had centric occlusion-centric relation discrepancy within 1.0 mm and had no clinical symptoms of TMJ disorder, were selected as control group. And 22 malocclusion patients who had centric occlusion-centric relation discrepancy over 1.0 mm were selected and subdivided as Class I Malocclusion group, Class II div. 1 malocclusion group, Class II div. 2 malocclusion group, Open bite group, and Mandibular asymmetry group. For each subject the occlusal splint with mutually protected type of occlusal scheme was applied for 3 months. Condylar positions in centric relation and centric occlusion were measured using Panadent articulators and Panadent condylar position indicator (CPI) before and after occlusal splint therapy. On the basis of this study, the following conclusions might be drawn: 1, In control group, Class II div. 2 malocclusion group, and mandibular assymetry group, there were no significant differences in condylar positions before and after occlusal splint therapy. 2. In Class I malocclusion group, condyles were moved $0.27{\pm}0.45mm$ forward (p < 0.05) and $0.98{\pm}0.25mm$ upward (p < 0.01) after occlusal splint therapy. 3. In Class I malocclusion group, condyles were moved $0.24{\pm}0.21mm$ backward (p < 0.05) and $1.01{\pm}0.33mm$ upward (p < 0.01) after occlusal splint therapy. 4. In open bite group, condyles were moved $1.24{\pm}0.30mm$ upward (p < 0.01) after occlusal splint therapy. 5. In both control and experimental groups, there were no significant differences in lateral condylar positions before and after occlusal splint therapy.

• The Journal of Advanced Prosthodontics
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• 제12권2호
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• pp.49-54
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• 2020

PURPOSE. The purpose of this study was to compare the performance of Accura to that of the T-scan for indicating occlusal contacts. MATERIALS AND METHODS. Twenty-four subjects were selected. Their maxillary dental casts were scanned with a model scanner. The Stereolithography files of the casts were positioned to align with the occlusal plane. Occlusal surfaces of every tooth were divided into three to six anatomic regions. T-scan and Accura recordings were made during two masticatory cycles. The T-scan and Accura images were captured at the maximum bite force and overlapped to the cast. Photographs of interocclusal records were used as the reference during overlap. The occlusal contacts were counted to compare the T-scan and Accura. McNemar's test was used for statistical significance and the corresponding P-values were calculated from a chi-square distribution with one degree of freedom. The accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Accura were calculated relative to the T-scan values as a control. RESULTS. No statistical differences (P>.05) were found between the T-scan and Accura methods. The accuracy of Accura was 75.8%, sensitivity was 82.1%, specificity was 60.1%, PPV was 82.9%, and NPV was 60.1%. CONCLUSION. Accura could be another possible option as a computerized occlusal analysis system for indicating occlusal contacts at maximum intercuspation.

• 대한치과교정학회지
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• 제30권1호
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• pp.91-99
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• 2000

본 연구는 조선대학교 치과대학 부속치과병원 교정과에 내원한 환자 중 악태모형을 제작하고 CPI (condylar position indicator) 에 의한 하악과두의 위치를 평가하여 중심위 -중심교합 편위양이 전후방 및 수직적으로 1.0 mm 이내, 측방으로 0.3 mm 이내인 정상 범주를 벗어나는 성인 여자 환자 16명을 대상으로 교합안정장치를 3개월간 장착하고, 이들을 장착 기간에 따라 장착 직전, 장착 1개월 후, 장착 2개월 후, 장착 3개월 후로 분류하여 교합안정장치의 장착에 따른 교합력과 교합접촉점 수의 변화 여부를 평가하기 위해 T-scan system을 이용하여 다음과 같은 결론을 얻었다. 1. 교합력의 변화는 교합안정장치 장착 직전에서 장착 1개월 후 사이에 유의성 있게 감소되었다 (P<0.05). 2. 교합력의 변화는 교합안정장치 장착 1개월 후부터 장착 3개월 후 까지는 유의한 차이를 보이지 않았다 (P>0.05). 3. 전치부 교합접촉점 수의 변화는 장착기간에 관계없이 유의성있는 차이가 없었다 (P>0.05). 4. 구치부 교합접촉점 수의 변화는 교합안정장치 장착 직전에서 장착 1개월 후 사이에 유의성 있게 감소되었다 (P<0.05). 5. 구치부 교합접촉점 수의 변화는 교합안정장치 장착 1개월 후부터 장착 3개월 후 까지는 유의한 차이를 보이지 않았다 (P>0.05). 6. 교합접촉점 수의 변화는 전치부에서 보다는 구치부에서 절대적으로 영향을 미쳤다. 이상을 종합해볼 때, 교합안정장치는 장착 1개월 후면 어느정도 중심위로의 하악골 안정을 기대할 수 있을것으로 사료된다.

• 치위생과학회지
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• 제23권4호
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• pp.378-388
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• 2023

Background: With increasing interest in health in old age, aspects of oral aging are being considered. The Korean Academy of Geriatric Dentistry recently proposed the diagnostic criteria for oral frailty in older adults in Korea. This study aimed to conduct a cross-sectional survey of factors related to oral frailty among community-dwelling older adults and identify differences in oral frailty status according to age and sex. Methods: Among 217 older adults aged ≥60 years who visited a senior center in Wonju, 206 completed all tests for oral frailty. Among them, data from those with a Korean Version of the Modified Barthel Index score ≥90 were used in the final analysis. After evaluating oral frailty diagnostic factors such as chewing ability, occlusal force, tongue pressure, oral dryness, oral cleanliness, and swallowing function, oral hypofunction was determined according to the oral frailty diagnostic criteria. Subsequently, the evaluation results were compared based on sex and age. Results: Significant differences in chewing ability, maximum occlusal pressure, and maximum tongue pressure were observed between sexes. However, these differences did not affect oral frailty diagnosis. All diagnostic factors of oral frailty, except for the risk of oral dryness and swallowing dysfunction, showed significant differences with age. However, no significant difference was observed in the prevalence of oral frailty. Additionally, this study found no relationship between sex and oral frailty factors using the oral frailty diagnostic criteria. However, it also found that age plays a significant role as an oral frailty diagnostic indicator, in addition to oral dryness and swallowing function. Conclusion: Sex and age did not affect oral frailty diagnosis. However, patients' chewing ability, occlusal force, and tongue pressure were affected by sex and age. Therefore, sex and age should be considered when diagnosing and intervening in oral frailty in the future.

• The Journal of Advanced Prosthodontics
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• 제9권5호
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• pp.358-363
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• 2017

PURPOSE. The purpose of this study was to evaluate the reliability of computer-aided replica technique (CART) by calculating its agreement with the replica technique (RT), using statistical agreement analysis. MATERIALS AND METHODS. A prepared metal die and a metal crown were fabricated. The gap between the restoration and abutment was replicated using silicone indicator paste (n = 25). Gap measurements differed in the control (RT) and experimental (CART) groups. In the RT group, the silicone replica was manually sectioned, and the marginal and occlusal gaps were measured using a microscope. In the CART group, the gap was digitized using optical scanning and image superimposition, and the gaps were measured using a software program. The agreement between the measurement techniques was evaluated by using the 95% Bland-Altman limits of agreement and concordance correlation coefficients (CCC). The least acceptable CCC was 0.90. RESULTS. The RT and CART groups showed linear association, with a strong positive correlation in gap measurements, but without significant differences. The 95% limits of agreement between the paired gap measurements were 3.84% and 7.08% of the mean. The lower 95% confidence limits of CCC were 0.9676 and 0.9188 for the marginal and occlusal gap measurements, respectively, and the values were greater than the allowed limit. CONCLUSION. The CART is a reliable digital approach for evaluating the fit accuracy of fixed dental prostheses.

• 대한치과교정학회지
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• 제24권4호
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• pp.945-956
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• 1994

In the past the jaw and occlusal relationship in centric occlusion were merely considered in case of orthodontic diagnosis and treatment planning. As the fact that functional disturbance of the temporomandibular joint may be caused by occlusal interference was recognized, the importance of functional occlusion and centric relation is emphasized today. Known the importance of centric relation, there are various opinions about definition of centric relation and its taking methods. The purpose of this study was to investigate the relative centric condyle position and to compare the reproducibility of the recordings utilizing different centric relation records obtained by different taking methods. The 15 adults with normal occlusion were participated in this study. Every four centric relation records were taken in each of three methods - leaf gauge, Dawson and myomonitor method. Then the relative centric condyle position, the distance between the condylar position in centric occlusion and the position in centric relation and the reproducibility were studied using SAM 2 articulator and mandibular position indicator. The results were as follows ; 1. The trend of condyle position was different depending on centric relation taking methods. 2. The position of condyle in centric relation by leaf gauge and Dawson methods was superior to that by myomonitor method, and the position by myomonitor method was relatively antero-inferior. 3. The distance between the condylar positions in centric occlusion and the position in centric relation was longest in myomonitor method. 4. The reproducibility had little differences in transverse direction among three methods, while leaf gauge method showed the highest reproducibility and myomonitor method did the lowest reproducibility in antero-posterior and supero-inferior direction.

• 대한치과교정학회지
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• 제28권1호
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• pp.113-122
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• 1998

본 연구는 조선대학교 부속 치과병원 교정과에 내원하여 교정치료를 시행하고 있는 환자중 Panadent 교합기 및 condylar position indicator(CPI)를 이용하여 중심위-중심교합 편위양을 측정한 결과, 전후방 및 수직적 편위양이 1.00mm이내, 측방편위양이 0.30mm 이내인 정상범주를 넘는 부정교합 환자 47명을 대상으로 하여 3개월간 교합안정장치를 24시간 장착하고, CPI 및 transcranial projection을 이용하여 교합안정장치 장착전과 장착후의 하악과두의 위치변화를 관찰한 결과 다음과 같은 결론을 얻었다. 1. CPI상의 모든 군에서 중심교합-중심위 사이에 통계적인 유의성이 있었다(p<0.001). 2. transcranial projection상의 superior joint space의 Rt와 Lt+Rt/2에서 중심교합-중심위 사이에 통계적인 유의성이 있었다(p<0.05). 3. CPI상의 모든 superior-inferior components군에서 교합안정장치 사용 전, 후의 중심교합-중심위 사이에 통계적인 유의성이 있었다(p<0.01). 4. transcranial projection상의 superior joint space의 Rt를 제외한 모든 군에서 교합안정장치 사용 전, 후의 중심교합-중심위 사이에 통계적인 유의성이 없었다. 이상의 결론을 종합해 볼 때 중심교합-중심위 사이의 변화를 평가하는데는 transcranial projection보다 CPI가 보다 유용하며, 교합안정장치는 하악과두의 전, 후방적 위치변화보다는 수직적 위치변화에 미치는 영향이 보다 큰 것으로 보인다.

• Journal of Korean Dental Science
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• 제16권2호
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• pp.128-148
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• 2023

Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.