• 대한치과의사협회지
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• 제50권8호
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• pp.465-473
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• 2012

Prognosis is an anticipation of the probable response to periodontal therapy and a long-term prospect for maintaining a functional dentition. Hopeless cases or cases of simple gingivitis without systemic diseases generally have little problem to establish definite prognoses. However, it might become somewhat challenging to determine their prognoses in borderline cases. A risk factor for periodontal disease may be environmental, behavioral, or biologic factors that can be defined as an occurrence has been associated with destructive periodontitis. Some risk factors are modifiable, while others cannot be modified. Modifiable risk factors are environmental or behavioral in nature in contrast non-modifiable risk factors are usually intrinsic to the individual and therefore not easily changed. In this review, we will assess the various modifiable or non-modifiable risk factors for susceptibility 10 periodontal diseases.

• Restorative Dentistry and Endodontics
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• 제42권2호
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• pp.77-86
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• 2017

Palatogingival groove (PGG) is an anomaly in the maxillary anterior teeth, often accompanied by the area of bony destruction adjacent to the teeth with no carious or traumatic history. The hidden trap in the tooth can harbor plaque and bacteria, resulting in periodontal destruction with or without pulpal pathologic change. Related diseases can involve periodontal destruction, combined endodontic-periodontal lesions, or separate endodontic and periodontal lesions. Disease severity and prognosis related to PGG depend on several factors, including location, range, depth, and type of the groove. Several materials have been used and recommended for cases of extensive periodontal destruction from PGG to remove and block the inflammatory source and recover the health of surrounding periodontal tissues. Even in cases of severe periodontal destruction, several studies have reported favorable treatment outcomes with proper management. With new options in diagnosis and treatment, clinicians need a detailed understanding of the characteristics, treatment, and prognosis of PGG to successfully manage the condition.

• 대한치과의사협회지
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• 제57권12호
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• pp.758-767
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• 2019

The classification of periodontal disease in 1999 has been widely used for determining a diagnosis, establishing a treatment plan, and evaluating the prognosis of the patient with periodontal disease. However, scientific evidence from many studies indicates the need for a new classification system for periodontal and peri-implant disease. Summary at 2017 world workshop as follows: 1) Periodontal health and peri-implant health was defined; 2) Chronic periodontitis and aggressive periodontitis were unified as periodontitis; 3) Periodontitis was further classified by staging and grading to reflect disease severity and management complexity, rate of disease progression, respectively; 4) Periodontal disease as manifestation of systemic disease is based on the International Statistical Classification of Diseases and Related Health Problems-10 (ICD-10) code; 5) Periodontal biotype and biologic width was replaced to periodontal phenotype and supracrestal tissue attachment, respectively; 6) The excessive occlusal force was replaced by a traumatic occlusal force; 7) ≥3 mm of radiographic bone loss, ≥6 mm of pocket probing depth and bleeding on probing indicates peri-implantitis in the absence of radiograph at final prosthesis delivery.

• 대한치과의사협회지
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• 제55권4호
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• pp.276-283
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• 2017

Maxillary sinus squamous cell carcinoma is a relatively rare disease, comprising only 3% of malignant diseases of head and neck. As the growth rate is high and its prognosis is poor compared to others, the 5-year survival rate of maxillary sinus squamous cell carcinoma(MSSCC) is 23.4-49%. We introduce two rare clinical cases of squamous cell carcinoma originated from maxillary sinus of which symptoms include toothache and gingival swelling. On clinical examinations of both patients, deep periodontal pockets on upper right posterior teeth were detected. On panoramic images, the bony destruction of the maxillary sinus and its surrounding structures were not obvious and only alveolar bone loss was noted. It is difficult to diagnose MSSCC at an early stage due to symptoms of tooth pain and gingival swelling that are similar to that of periodontal diseases. However, if the symptoms do not improve after routine treatment of upper teeth, dentists should bear in mind of underlying malignant mass as differential diagnosis, thus early detection of the lethal disease. The aim of this study is to caution dental practitioners that malignancies have a potential to mimic periodontal diseases by introducing two cases of maxillary sinus squamous cell carcinoma presented as periodontitis.

• 대한치과보존학회:학술대회논문집
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• 대한치과보존학회 2002년도 추계학술대회
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• pp.721-721
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• 2002

For about half a century. dental implants made of titanium have developed as a method of restoration for the tooth loss. In these days. the titanium implants seem to be considered as the alternative for the conventional prosthodontics. But its hard to say that the titanium implants are superior to the treatments that preserve the natural tooth. As this is a general opinion among dentists. the implant will not be able to be the alternative for all the prosthetic treatments. Clinically, there are many causes for extracting tooth. The severe destruction of the tooth structure or periodontal diseases leads to inevitable tooth extraction. When the complete cure is doubtful because of narrow intraoral visibility and improper accessibility in approaching to the tooth and periodontal lesion, we. clinicians often inevitably extract tooth. Passive treatments like conventional restoration, curettage or surgical flap cant be the perfect treatments for the tooth that has subgingival root caries or severe periodontal diseases involved furcation. Many clinicians might have been forced to pull out the relatively healthy tooth by the difficulties of approaching to the lesions and poor prognosis. Though the intentional tooth replantation is performed sometimes. as it doesnt have enough scientific foundation. it has not been considered as a popular treatment method yet. I have been felt keenly the necessity of positive tooth preservation, so I have been attempting the treatment that has new concept. calling Natural Tooth Implantation (NTI) clinically. NTI differs from the tooth replantation in the goal for the treatment and biological healing process. Now. I confirm that NT! is a very positive and valid method of tooth preservation. Like you can get from the name. NTI is the dental implant procedure using natural teeth and similar to the healing process of the titanium implants in many aspects. I have been using biocompatible composite resin. DRM. with NTI and got affirmative clinical results from that. So I would like to introduce.roduce.

• International Journal of Oral Biology
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• 제48권2호
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• pp.9-18
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• 2023

The rapid detection of bacteria in the oral cavity, its species identification, and bacterial count determination are important to diagnose oral diseases caused by pathogenic bacteria. The existing clinical microbial diagnosis methods are time-consuming as they involve observing patients' samples under a microscope or culturing and confirming bacteria using polymerase chain reaction (PCR) kits, making the process complex. Therefore, it is required to analyze the development status of substances and systems that can rapidly detect and analyze pathogenic microorganisms in the oral cavity. With research advancements, a close relationship between oral and systemic diseases has been identified, making it crucial to identify the changes in the oral cavity bacterial composition. Additionally, an early and accurate diagnosis is essential for better prognosis in periodontal disease. However, most periodontal disease-causing pathogens are anaerobic bacteria, which are difficult to identify using conventional bacterial culture methods. Further, the existing PCR method takes a long time to detect and involves complicated stages. Therefore, to address these challenges, the concept of point-of-care (PoC) has emerged, leading to the study and implementation of various chair-side test methods. This study aims to investigate the different PoC diagnostic methods introduced thus far for identifying pathogenic microorganisms in the oral cavity. These are classified into three categories: 1) microbiological tests, 2) microchemical tests, and 3) genetic tests. The microbiological tests are used to determine the presence or absence of representative causative bacteria of periodontal diseases, such as A. actinomycetemcomitans, P. gingivalis, P. intermedia, and T. denticola. However, the quantitative analysis remains impossible, and detecting pathogens other than the specific ones is challenging. The microchemical tests determine the activity of inflammation or disease by measuring the levels of biomarkers present in the oral cavity. Although this diagnostic method is based on increase in the specific biomarkers proportional to inflammation or disease progression in the oral cavity, its commercialization is limited due to low sensitivity and specificity. The genetic tests are based on the concept that differences in disease vulnerability and treatment response are caused by the patient's DNA predisposition. Specifically, the IL-1 gene is used in such tests. PoC diagnostic methods developed to date serve as supplementary diagnostic methods and tools for patient education, in addition to existing diagnostic methods, although they have limitations in diagnosing oral diseases alone. Research on various PoC test methods that can analyze and manage the oral cavity bacterial composition is expected to become more active, aligning with the shift from treatment-oriented to prevention-oriented approaches in healthcare.

• Imaging Science in Dentistry
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• 제53권3호
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• pp.193-198
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• 2023

Purpose: Artificial intelligence (AI) is poised to play a major role in medical diagnostics. Periodontal disease is one of the most common oral diseases. The early diagnosis of periodontal disease is essential for effective treatment and a favorable prognosis. This study aimed to assess the effectiveness of AI in diagnosing periodontal bone loss through radiographic analysis. Materials and Methods: A literature search involving 5 databases (PubMed, ScienceDirect, Scopus, Health and Medical Collection, Dentistry and Oral Sciences) was carried out. A specific combination of keywords was used to obtain the articles. The PRISMA guidelines were used to filter eligible articles. The study design, sample size, type of AI software, and the results of each eligible study were analyzed. The CASP diagnostic study checklist was used to evaluate the evidence strength score. Results: Seven articles were eligible for review according to the PRISMA guidelines. Out of the 7 eligible studies, 4 had strong CASP evidence strength scores (7-8/9). The remaining studies had intermediate CASP evidence strength scores (3.5-6.5/9). The highest area under the curve among the reported studies was 94%, the highest F1 score was 91%, and the highest specificity and sensitivity were 98.1% and 94%, respectively. Conclusion: AI-based detection of periodontal bone loss using radiographs is an efficient method. However, more clinical studies need to be conducted before this method is introduced into routine dental practice.

• Journal of Oral Medicine and Pain
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• 제35권4호
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• pp.245-258
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• 2010

흡연은 전신뿐 아니라 구강에서 발생하는 다양한 질병의 중요한 위험 인자이며, 치과의사가 금연 치료에 참여하는 것은 개인의 전신 건강과 치주치료와 임플란트 치료 같은 치과 치료의 예후에도 큰 차이를 보여주는 것으로 알려져 있다. 흡연이 구강암과 같은 생명을 위협하는 비교적 흔치 않은 질병으로부터 경미한 구강 내 증상에 이르기까지 구강 환경에 다양한 영향성과 관련한 많은 근거가 있음에도 불구하고, 흡연과 구강건강의 관련성에 대한 환자들의 인식 수준을 조사한 연구는 적고, 금연진료에 대한 국내 치의학계의 관심과 참여는 더욱 부족하다. 그러므로 본 연구는 국내 치과 외래 환자의 흡연 양상과 치과계의 금연 진료 현황을 파악하여 금연 진료 방향을 모색해 보고자 하였다. 대한치과의사협회 문화복지부의 후원으로 전국 11개 치과대학병원의 구강내과, 구강외과 및 치주과 환자 중 825명이 니코틴 패치를 이용한 4주 금연 프로그램 및 설문에 참여하였고, 297명이 금연 설문에 참여하였다. 각 설문지 분석을 통해 각 치과대학병원의 조사 현황, 치과 외래 환자의 흡연 양상을 분석하였고, 치과에서 시행된 4주간의 금연 치료의 참여목적과 성공률을 조사하였다. 본 연구의 결과에 따르면, 흡연자는 주로 30-50대 중 장년층이 많았고, 흡연기간은 연령 증가에 비례하며, 하루 흡연량은 30대에서 가장 많았다. 금연시도는 30,40대에서 금연시도 비율이 높았고 그 기간은 대부분 1-3개월이었다. 흡연의 이유로는 스트레스 해소와 습관이 가장 높은 빈도를 보였으며 Heavy Smoking Index (HSI)는 20대가 가장 낮고 (71.4%) 60대가 가장 높았다(93.7%). 흡연 경고 문구에 대해 참가자의 68%는 금연을 떠올렸다. 구강질환(구강점막질환, 치주질환, 치아우식증)과 흡연의 관련성에 대한 실험참가자들의 인식도는 비교적 높았지만(50~68%) 금연 성공률은 일반 의과진료실에 비해 아주 낮은 결과를 보였다(22.7%). 흡연관련 질환 예방 업무에서의 치과의사의 중요성을 고려할 때, 금연치료에 치과의사들이 보다 적극적으로 참여할 수 있는 인식의 변화가 필요하다. 낮은 치료 성공율이 체계화되지 못한 진료내용 때문임을 고려할 때, 5As' 방법 등과 같은 금연관련 상담에 대한 지속적인 치과의사 교육과 환자 교육을 위한 다양한 자료의 개발을 통해 금연 성공률을 높일 수 있도록 해야 한다.

• 대한치과보철학회지
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• 제52권3호
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• pp.252-257
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• 2014

완전 무치악 환자에서 전악 수복시 환자 고유의 악간관계, 교합평면의 위치, 구순지지, 치아형태와 교합양상을 알 수 없기 때문에 그 모든 것을 임시의치에 기록한 후 이것을 최대한 최종 보철물에 반영하여 이상적인 보철물을 제작해 주어야 한다. 본 증례의 환자는 치주질환에 의한 다수 치아 동요가 존재하여 예후가 불량한 잔존치아 전악 발거 후 임플란트 식립하여 임시치아에 환자의 수직 및 수평 악간관계, 교합평면의 위치, 수직 및 수평 피개의 양, 치아 크기, 전치부 길이를 기록하였다. 그 후 임시치아를 스캐너와 CAD/CAM 기술을 이용하는 double scanning technique로 복제하여 임시치아와 동일한 형태의 단일 구조 지르코니아 브릿지 보철물을 제작하였다. 치료 이후 4개월간의 임상 관찰에서 환자는 심미적, 기능적으로 만족하고 안정적으로 유지되었기에 이를 보고하고자 한다.