• The Journal of Advanced Prosthodontics
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• 제1권1호
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• pp.19-25
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• 2009

STATEMENT OF PROBLEM. Primary stability at the time of implant placement is related to the level of primary bone contact. The level of bone contact with implant is affected by thread design, surgical procedure and bone quality, etc. PURPOSE. The aim of this study was to compare the initial stability of the various taper implants according to the thread designs, half of which were engaged to inferior cortical wall of type IV bone(Group 1) and the rest of which were not engaged to inferior cortical wall(Group 2) by measuring the implant stability quotient(ISQ) and the removal torque value(RTV). MATERIAL AND METHODS. In this study, 6 different implant fixtures with 10 mm length were installed. In order to simulate the sinus inferior wall of type IV bone, one side cortical bone of swine rib was removed. 6 different implants were installed in the same bone block following manufacturer s recommended procedures. Total 10 bone blocks were made for each group. The height of Group 1 bone block was 10 mm for engagement and that of group 2 was 13 mm. The initial stability was measured with ISQ value using Osstell $mentor^{(R)}$ and with removal torque using MGT50 torque gauge. RESULTS. In this study, we found the following results. 1. In Group 1 with fixtures engaged to the inferior cortical wall, there was no significant difference in RTV and ISQ value among the 6 types of implants. 2. In Group 2 with fixtures not engaged to the inferior cortical wall, there was significant difference in RTV and ISQ value among the 6 types of implants(P < .05). 3. There was significant difference in RTV and ISQ value according to whether fixtures were engaged to the inferior cortical wall or not(P < .05). 4. Under-drilling made RTV and ISQ value increase significantly in the NT implants which had lower RTV and ISQ value in Group 2(P < .05). CONCLUSIONS. Without being engaged to the inferior cortical wall fixtures had initial stability affected by implant types. Also in poor quality bone, under-drilling improved initial stability.

• 대한치과보철학회지
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• 제47권2호
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• pp.240-246
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• 2009

연구목적: 이 연구는 측방접근법을 통해 상악동 골이식을 시행한 후 임플란트를 식립하였을 때, 누적 생존률 및 성별, 연령별, 이식재, 자가골의 공여부, 술전 잔존골 양, 무치악 형태, 식립 시기, 임플란트 종류, 직경과 길이에 따른 임플란트의 생존률 및 변연골의 방사선학적 결과의 차이를 분석하고자 시행되었다. 연구 재료 및 방법: 상악 구치에 측방접근법을 통해 상악동 골이식술 후 임플란트 보철치료를 시행한 71명을 대상으로 하였으며 표면 처리된 나사모양의 임플란트를 사용하였다. Osseotite(BIOMET 3i, Warsaw, USA), Neoplant(Neobiotec, Seoul, Korea), $Br\ddot{a}nemark$(Nobel Biocare, Goteberg, Sweden)과 SSII(Osstem, Busan, Korea)를 사용하였다. 최소 6개월 이상의 기간 관찰 누적 생존률은 Kaplan-Meier 분석법을 이용하였으며 다른 요소에 따른 임플란트의 생존률의 유의성은 Chi-square test로 검정하였다. 결과: 상악동골 이식술이 시행된 모든 증례에서 임플란트 식립이 가능한 골 양이 얻어졌으며 92%의 생존률을 보였다. 결론: 상악동 골이식술을 시행한 후 임플란트 보철 수복은 자가골 단독 사용시에 자가골과 골대체 물질이 혼합된 것보다 우수한 생존률을 보였다. 지연 식립하는 경우가 임플란트와 동시에 식립하는 경우보다 생존률이 높았다.

• 대한치과보철학회지
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• 제47권2호
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• pp.119-124
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• 2009

연구목적: 치과 영역에서 환자들의 심미적인 요구가 증가하면서 자연 치아의 색조를 재현할 수 있는 수복물의 개발이 이루어졌으며, 이러한 연구의 일환으로 도재와 복합레진의 특성을 겸비한 Ceromer(Ceramic Optimized Polymer)가 개발되었다. Ceromer는 기존의 복합레진에 무기질을 고밀도로 충전하여 물리적 성질을 향상시켰다. 연구 재료 및 방법:본 실험에서는 두 종류의 Ceromer[$Targis^{(R)}$(Ivoclar-vivadent AG., Schaan, Liechtenstein), $BelleGlass^{(R)}$(Kerr Co., Orange, CA, USA)]를 이용해 레진 전장관 형태의 시편을 제작하고 증류수에 침전한 후 발생하는 체적과 중량의 변화를 관찰하였다. 결과 및 결론:두 종류의 Ceromer 모두 수중 침적 시간이 증가할수록 높이와 폭이 증가되었으며, $Targis^{(R)}$보다 $BelleGlass^{(R)}$에서 더 큰 누적변화율을 보였다. 72시간까지 급격한 증가를 보이다 이후 누적변화율의 증가는 감소하였다. 통계적 분석결과 $Targis^{(R)}$의 높이와 무게의 누적 변화량이 24시간군과 나머지군 사이에 유의한 차이를 보였으며, $BelleGlass^{(R)}$에서는 폭과 무게에서 누적 변화량이 24시간군과 나머지군 사이에 유의한 차이를 보였다(<.05). $Targis^{(R)}$와 $BelleGlass^{(R)}$ 두 군간의 비교에서는 높이, 폭, 무게의 변화량은 통계적으로 유의한 차이를 보이지 않았으나 변화양상은 다르게 관찰되었다.

• 대한치과보철학회지
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• 제46권2호
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• pp.193-200
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• 2008

임플랜트 고정체의 표면처리 기술의 발달에 기인하여 골유착의 성공률이 좋아지고 있으며 임플랜트를 이용하는 보철물의 형태와 임상 술 식도 다양하게 발전되고 있다. 상악의 임플랜트 피개의치는 아직 표준화된 치료법에 대한 의견이 분분하다. 본 연구는 상악 무치악의 치료를 위하여 해부학적인 요소와 생역학적인 요소를 고려하여 양측 견치부 또는 소구치부위에 2개의 임플랜트를 식립할 때의 응력분포를 삼차원 유한요소분석을 이용하여 관찰하고자 하여 다음과 같은 결론을 얻었다. 1. 임플랜트를 양측 견치 부위에 식립한 모형에서 부하가 가해지는 우측의 임플랜트의 원심면에 최대 응력이 집중되었다. 2. 임플랜트를 양측 제2소구치 부위에 식립한 모형에서 임플랜트 주위의 응력 분포는 부하지점의 거리와 상관없이 고르게 나타났다. 3. 치조골에 발생하는 응력 분포의 관찰 결과, 임플랜트가 양측 제2소구치 부위에 식립된 모형이 양측 견치부위에 식립된 모형보다 고르게 나타났다. 이상의 결과로 볼 때, 상악 피개의치를 위한 임플랜트 식립 위치는 견치 부위에서보다 제2소구치 부위가 구강점막, 주위 골과 임플랜트에 전달되는 응력의 분포에 유리한 것으로 사료된다.

• 대한치과보철학회지
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• 제46권2호
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• pp.209-216
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• 2008

본 연구의 목적은 내측연결형 임플랜트와 일체형 지대주를 사용하여 최종 보철물을 시적한 뒤에 5만 번의 반복하중 후에 다시 체결하고 20만 번의 반복하중을 가한 후의 지대주 풀림토크와 20만 번의 반복하중을 받은 지대주 풀림토크가 어떻게 달라지는지를 비교하고자 하는 것이다. 실험 재료로는 타이타늄 지대주와 DLC 코팅된 지대주를 사용하였다. 실험군은 4군으로 모두 8개의 ITI SLA $4.1{\times}10mm$ 를 사용하였다. A군과 B군은 5만번, 20만번 반복하중을 가하고 Periotest값과 풀림 토크값을 측정하였으며 C군과 D군은 20만번 반복하중을 가하고 Periotest 값과 풀림토크값을 측정하였다. 풀림 토크값의 측정은 디지털 토크 게이지를 사용하였고, 반복하중은 MTS. (Bionix 850 II, MTS, U.S.A.)를 사용하였으며 100N/cm의 힘을 20도의 경사, 14Hz 의 조건으로 가하였다. A군과 C군은 코팅하지 않은 타이타늄 지대주를 사용하였으며, B군과 D군은 DLC 코팅한 지대주를 사용하였다. 1. 5만번 반복하중을 가한 뒤 측정한 풀림 토크는 B군에서 약간 더 큰 평균값을 보였다. 하지만 통계학적으로 두 군간에 유의한 차이를 보이지 않았다 (P>0.05). 2. 20만번 반복하중을 가한 뒤 측정한 최종 풀림 토크 값은 A군은 C군보다, B군은 D군보다 약간 더 큰 평균값을 보였으나 통계학적으로 두 군간에 유의한 차이를 보이지 않았다 (P>0.05). 3. 20만번 반복하중을 가한 최종 풀림 토크 값은 A, B군과 C, D군 사이에 통계학적으로 유의할 만한 차이가 없었다 (P>0.05).

• 대한치과보철학회지
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• 제46권2호
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• pp.116-124
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• 2008

문제 진술: 임플랜트 시스템은 임플랜트와 지대주 사이에서 빈 공간이 발생하여 세균의 저장소로서 작용하게 되어 임플랜트 주위 연조직에 염증반응을 야기할 수 있다. 목 적: 이 연구의 목적은 임플랜트-지대주 간극의 미세 누출에 관여하는 치주질환원인균으로 추정되는 Porpyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Treponema denticola, Aggregatibacter actinomycetemcomitans의 검출률을 조사하는 것이다. 연구재료 및 방법: 시료채취는 27명의 환자들에서 행하였고 소독된 페이퍼포인트를 이용하여 $1{\times}PBS$로 옮겼다. 치주질환원인균의 검출은 16 rDNA에 근거한 종특이적인 프라이머를 지닌 중합효소체인반응을 이용하였다. 결과: 임플랜트 고정체내에서의 Porphyromonas gingivalis와 Prevotella intermedia의 검출률은 59%와 82%였다. 환자의 임플랜트 연구에서는 Porphyromonas gingivalis와 Prevotella intermedia의 검출률은 44%와 82%였다. 환자혀에서의 Porphyromonas gingivalis와 Prevotella intermedia의 검출률은 82%와 82%였다. 결 론: 현재의 임플랜트 시스템은 임플랜트 내부의 세균 군집화와 미세누출을 안전하게 예방할 수 없다.

• 지역사회간호학회지
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• 제11권2호
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• pp.399-410
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• 2000

In this, analyzing the type of subjectivity in which people would have about home visit nursing services originating from public health care centers. I tried to research more effective ways to improve home visit nursing care services. and later. for the development of home visit nursing care. to supply basic data. The method for this study was the Q-method. created by William Stephenson. and was adequate for the study of subjectivity. For this study. through the deep interview. literature inquiry, and the discussion course. 206 Q-statement sentences were abstracted. and based on them, after Q-sample-selection. I then collected the Q-categorized-result from 32 subjects from Mar. 10. 2000 to Mar. 25. 2000. Through the statistic a analysis of PC-Qunal program. the subjectivity species were categorized and analyzed. The study results show that there are 3 sorts of recognition types. and they are analyzed in the following; The first type: the positively receiving type shows that they feel thankful and a trusting feeling about home visit nursing. The second type: the negatively mistrusting type shows that they had doubtful attitudes about the specialty of home visit nursing: they wanted medicine or nutrition remedies rather than health education and concerning the their own health care, they prefered the hospitals or clinics. The third type: the conditional receiving type shows that even though they had a positive receiving attitude about home visit nursing wanting to consult with the home visit nurses about the difficult problem which could not easily be settled, hoping that the home visit nurses could visit them more often, in their actual lives. they strongly indicated their attitudes concerning money as more important than home visits. The subjects in these 3 types commonly had a good feeling about the kindness of the home visit nurses: the first and third types also had a positive recognition about home visit nursing; however. in aspects of the evaluation and receiving attitudes, they showed a big difference. When all the above results are integrated. in the case of the first type the home visit nursing service, which satisfied the demand for health care of the medically weak people. should be continuously supplied. Additionally in case of the second type (negatively mistrust). continuous education and support should be supplied with enough interest to lead their concerns about their own health care as well as lead medical spending in a productive and effective direction in order to change their impressions. Through this study. I learned that the recognition of the objectives of home visit nursing services can be categorized in to 3 types and could be analyzed. Thus I wish that this study helps to present basic data which contributes to the development of the home visit nursing field.

• 대한치과보철학회지
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• 제44권1호
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• pp.124-134
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• 2006

Statement of problem: Streptococcus produces energy and forms extracellular polysaccharides by metabolizing sucrose. Insoluble glucan, a kind of extracellular polysaccharide, is the important material of dental plaque. Fructose affects the metabolism of sucrose. Purpose: The purpose of this study was to evaluate the effect of fructose on the metabolism of sucrose in Streptococcus mutans. Materials and methods: To determine the effect of fructose on the formation of artificial plaque by Streptococcus mutans Ingbritt, S. mutans and fructose were placed in beakers containing M17 broth and sucrose. The wires were hung on frameworks inserted into cork stoppers, and then immersed in each of the beakers. After the incubation with gentle shaking, each wire was weighed. To analyze the effect of fructose on the sucrose metabolism by S. mutans or glucosyltransferase, S. mutans and fructose were placed in M17 broth containing sucrose. After the incubation. the remaining sucrose and polymers were analysed by thin layer chromatography. Results: The following results were obtained; 1. When Streptococcus mutans was cultured in the media containing 3% sucrose for 8 hours, the mean weight of formed artificial plaque on the wires was $124.3{\pm}3.0mg$, whereas being reduced to $20.7{\pm}10.2mg$ in the media added with 3% sucrose and 4% fructose(p<0.05) 2. When the control containing glucose was added with sucrose, the optical density of Streptococcus mutans solution cultured for 24 hours was not increased compared with the control, while being increased by adding with fructose. 3. When Streptococcus mutans was incubated in the media added with sucrose and fructose for 8 hours, the number of viable cells was increased compared with the media added with sucrose. 4. The amount of remained sucrose was increased in Streptococcus mutans culture supernatant of media added with sucrose and fructose than with sucrose only. but the amount of produced insoluble glucan was decreased. 5. The amounts of remained sucrose and produced soluble glucan were increased in the culture of glucosyltransferase-contained media added with sucrose and fructose than with sucrose only, but the amount of produced insoluble glucan was decreased . Conclusion: These results indicated that the sucrose metabolism and the production of insoluble glucan were inhibited in Streptococcus mutans by adding fructose in the media containing sucrose.

• 대한치과보철학회지
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• 제44권2호
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• pp.229-242
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• 2006

Statement of problem: In order to increase preload with reducing the friction coefficient, abutment screws coated with pure gold and Teflon as dry lubricant coatings have been introduced. But the reported data indicate that if screw repeated tightening and loosening cycle, an efficiency of increasing preload was decreased by screw surface wearing off. Purpose: This study was to evaluate the influence of tungsten carbide/carbon coating, which has superior hardness and frictional wear resistance, on the preload of abutment screws and the stability of coating surface after repeated closures. Material and method: The rotational values of abutment screws and the compressive forces between abutment and fixture were measured in implant systems with three different joint connections, one external butt joint and two internal cones. Moreover the stability and the alteration of coating surface were examined by comparison of the compressive force and the removable torque values during 10 consecutive trials, observation with scanning electron microscope and analyzed the elemental composition with energy dispersive x-ray spectroscopy Results and conclusion: 1. Application of coating resulted in significant increase of compressive force in all implant systems(P<.05). The increasing rate of compressive force by coating in external butt joint was gloater than those in internal cones (P<.05). 2. Coated screw showed the significant additional rotation compared to non-coated screw in all implant systems (P<.05). There were no significant differences in the increasing rate of rotation among implant systems (P>.05). 3. Removable torque values were greater with non-coated screw than that with coated screw (P<.05). 4. Coated screw showed insignificant variations in the compressive forces during 10 consecutive trials(P>.05) 5. After repeated trials, the surface layer of coated screw was maintained relatively well. However surface wearing and irregular titanium fragments were found in non-coated screw.

• 대한치과보철학회지
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• 제44권2호
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• pp.250-263
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• 2006

Statement of problem: Ti-alloy has been used widely since it was produced in the United States in 1947 because it has high biocompatibility and anticorrosive characteristics. Purpose: The pure titanium, however, was used limitedly due to insufficient mechanical charateristics and difficult manufacturing process. Our previous study was focused on the development of a new titanium alloy. In the previous study we found that the Ti-Ta-Nb alloy had better mechanical characteristics and similar anticorrosive characteristics to Ti-6Al-4V Material and methods: In this study, the cytotoxicity of the Ti-Ta-Nb alloy was evaluated by MTT assay using MSCs(Mesenchaimal stem cells) and L929 cells(fibroblast cell line). The biocompatibility of the Ti-Ta-Nb alloy was performed by inserting the alloy into the femur of the rabbits and observing the radiological and histological changes surrounding the alloy implant. Results: 1. In the cytotoxicity test using MSCs, the 60% survival rate was observed in pure titanium, 84% in Ti-6Al-4V alloy and 95% in Ti-10Ta-10Nb alloy. 2. In the animal study, the serial follow-up of the radiographs showed no separation or migration revealing gradual bone ingrowth surrounding the implants. Similar radiographic results were obtained among three implant groups pure titanium, Ti-6Al-4V alloy and Ti-10Ta-10Nb alloy. 3. In the histologic examination of the bone block containing the implants. the bone ingrowth was prominent around the implants with the lapse of time. There was no signs of any tissue rejection, degeneration, or inflammation. Active bone ingrowth was observed around the implants. In the comparison of the three groups, the rate of bone ingrowth was better in the Ti-10Ta-10Nb alloy group than those in pure titanium group or Ti-6Al-4V alloy group. In conclusion, Ti-10Ta-10Nb alloy revealed better biocompatibility in survival rate of the cells and bone ingrowth around the implants. Therefore we believe a newly developed Ti-10Ta-10Nb alloy can replace currently used Ti-6Al-4V alloy to increase biocompatibility and to decrease side effects. Conclusion: In conclusion, Ti-10Ta-10Nb alloy revealed better biocompatibility in survival rate of the cells and bone ingrowth around the implants. Therefore we believe a newly developed Ti-10Ta-10Nb alloy can replace currently used Ti-6Al-4V alloy to increase biocompatibility and to decrease side effects.