• 대한소아치과학회지
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• 제46권2호
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• pp.173-182
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• 2019

본 연구의 목적은 혼합치열기 초기에 III급 부정교합을 보이는 어린이에서 수직성장을 유도하는 III급 고무줄을 걸 수있도록 고안된 구강내 가철식장치를 사용하여 반대교합을 치료시, 그 구체적인 치료기간을 알아보고, 이에 영향을 주는 변수를 확인하는 것이다. 본 소아치과에 III급 부정교합을 주소로 내원하여 구강내 가철식 장치로 치료를 완료한 56명의 환자를 대상으로 치료개시 연령, 치료기간 및 치료유형, 수평피개량, 수직피개량 등의 자료를 수집하였다. 환자군의 교정개시 연령은 8.75세이었고, 교합이 넘어갈때까지 3.31개월, 이후 정상 피개까지 1.90개월이 소요되어, 대부분이 개시 6개월 이내에 개선되었다. 전체 치료기간은 21.79개월이었고 환자의 협조도(p = 0.000)와 고정식 교정장치의 여부(p = 0.032)가 치료기간에 유의하게 영향을 주었다. 결론적으로 본 연구의 가철식장치는 수년간 장시간 장착하며 악정형력을 주는 구강외 장치에 비해서 그 치료기간이 6개월 이내로 짧으며, 혼합치열기 III급 부정교합 어린이에서 효과적으로 이용할 수 있다.

• Restorative Dentistry and Endodontics
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• 제27권2호
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• pp.175-182
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• 2002

Dental caries is a chronic disease that causes the destruction of tooth structure by the interaction of plaque bacteria, food debris, and saliva. There has been attempts to induce remineralization by supersaturating the Intra-oral environment around the surface enamel, where there is incipient caries. In this study, supersaturated remineralized solution "R" was applied to specimens with incipient enamel caries, and the quantitative analysis of remineralization was evaluated using microradiography. Thirty subjects volunteered to participate in this study. Removable appliances were constructed for the subjects, and the enamel specimen with incipient caries were embedded in the appliances. The subjects wore the intra-oral appliance for 15 days except while eating and sleeping. The removable appliance were soaked in supersaturated solution "R", saline, or Senstime$^{\circledR}$ to expose the specimen to those solutions three times a day, 5 minutes each time. After 15 days, microradiography was retaken to compare and evaluate remineralization The results were as the following: 1. The ratio of remineralized area to demineralized area was significantly higher in the supersaturated solution "R" and Senstime$^{\circledR}$ than in the saline (p<0.05) 2. Remineralization in the supersaturated buffer solution "R" occurred in the significantly deeper parts of the tooth. compared to the Senstime$^{\circledR}$ group containing high concentration or fluoride. (p<0.05) As in the above results, the remineralization effect of remineralized buffer solution "R" on incipient enamel caries has been proven. For clinical utilization, further studies on soft tissue reaction and the effect on dentin and cementum are necessary In conclusion compared to commercially available fluoride solution. remineralization solution“R”showed better remineralization effect on early enamel caries lesion, so it is considered as effecient solution for clinical application.

• 대한소아치과학회지
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• 제24권3호
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• pp.597-601
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• 1997

This paper presents improper use of latex-elastic ring in movement of teeth and its consequence. Simple orthodontic movement of teeth including closure of diastema may be achieved by the use of simple method with fixed or removable appliance associated with latex-elastic ring. But, if it is used alone, it acts as a local irritant and then produces localized periodontitis. In case of localized periodontitis resulting from latex-elastic ring, diagnosis is difficult because the patient is usually unaware of the presence of the rings on the roots of the involved teeth and because the ring is not probed and is radiolucent and therefore not discernible radiographically and clinically. Occasionally, surgery is requred for the detection. This case emphasizes the necessity that the use of latex-elastic ring in closing diastema should be accompanied with removable or fixed appliance as well as close professional supervision. Its use without adequate provision for stabilization or retention on the crowns of teeth results in destruction of periodontal support and the teeth may be lost.

• 대한소아치과학회지
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• 제24권4호
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• pp.776-780
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• 1997

Patient with alveolar abscess due to dental caries with severe alveolar bone loss, severe tooth mobility, root resorption need extraction of tooth because it is impossible to carry out pulp treatment and restoration by using conventional method. Early loss of primary molar might cause masticatory interference, extrusion of opposing tooth, problem in maintaining space and interference on eruption of permanent tooth. Especially, early loss of primary second molar before the eruption of permanent first molar might cause space closure by mesially erupted permanent first molar and impaction of second premolar. In such a case, distal shoe space maintainer and removable space regaining appliance was the first choice of treatment. But, distal shoe space maintainer need precise adaptation and might cause chronic inflammation if the oral hygiene is poor. In a case using removable space regaining appliance, patient's cooperation is most important. If the distal root of primary second molar is comparably sound and alveolar abscess with alveolar bone loss is localized at mesial root, hemisection should be carried out for precise guide to eruption of the permanent first molar, restoration of masticatory fuction and solution to the discomfort of the patient

• 대한치과교정학회지
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• 제23권4호
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• pp.447-454
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• 1993

Patient with skeletal class II relationship was treated with L-ARS. L-ARS is fixed functional appliance that could be effective in children and adolescent patient who don't wear activator. The following results were obtained ; 1) Growth of Mandible was stimulated and overjet was decreased, therefore coupling of anterior teeth was established with L-ARS which is fixed functional appliance. 2) These changes were accomplished with Mandibular skeletal growth with no effect on the Maxilla. 3) L-ARS was especially effective on patient who deny to wear the removable functional appliance.

• 대한치과의사협회지
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• 제44권2호통권441호
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• pp.123-132
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• 2006

Patients who have impacted tooth are found commonly in orthodontic treatment. Although it is difficult to find the cause of impacted teeth, the most common, causes are prolonged retention of the deciduous teeth, trauma, aberrant sequence of eruption, lack of space and deficiency of Vitamin D. Impacted teeth may lead to esthetic and functional problems and root resorption of adjacent teeth, so we should treat it as soon as possible. Commonly used treatment method is the following: After surgically uncovering of the impacted teeth, a bond of orthodontic appliance is established, and orthodontic traction is started with a removable or fixed appliance. We used the modified lingual arch with a soldered auxiliary appliance in lingual arch for traction of lower impacted teeth. The modified lingual arch could control the magnitude and direction of the applied force with one-arch treatment, and also could give continuous force to impacted tooth without patient patient cooperation. We achieved good results with the modified lingual arch.

• 대한치과보철학회지
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• 제21권1호
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• pp.67-72
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• 1983

Path of insertion(1) can be defined that the direction of movement of an appliance from the point of initial contact of its rigid parts with the supporting teeth to the place of final rest. Krol(2) described that in the conventional path of insertion, all the rests are seated more or less simultaneously but in the use of the rotational path one segment of the partial denture is seated first then the remainder of the prosthesis is rotated into position. The rotational path of insertion is limited primarily to the tooth borne prosthesis. Its great advantages are the elimination of anterior clasps to improve ethetic and reduction of tooth coverage to minimize plaque accumulation. Either a rigid minor connector or proximal plate provides retention through its intimate contact with a proximal tooth surface below the height of contour as indicated at a o-degree tilt. A specially designed rest in conjunction with this retentive component satisfies the basic requirements of clasp design. The purpose of this study was a clinical evaluation of rotational path removable partial dentures. Author delivered rotational path removable partial dentures to three different cases of patients and evaluated function of the dentures, difficulties of removal and insertion of the dentures and supporting structures of the abutment teeth by means of clinical and X-ray examinations for eighteen months. According to the examination data author came to the conclusion that the prognosis of the rotational path removable partial dentures was excellent.

• 대한장애인치과학회지
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• 제9권2호
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• pp.122-126
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• 2013

14세 남환이 정기검진을 위해 내원하여 임상 구강검사 결과 상악 전치의 돌출과 상악궁 협착이 관찰되었다. 환아는 뇌성마비를 가지고 있었으나 간단한 설명을 이해하고 쉬운 지시를 수행할 수 있었으므로 가철성 장치를 이용한 교정치료를 시도하였다. 단계적이고 주의 깊은 접근을 통해 상악궁 협착 해소 및 상악 전치의 돌출을 완화할 수 있었다. 뇌성마비 환아의 경우 특징적으로 상악 전치의 돌출이 흔히 나타나는데, 이는외상의 위험에 쉽게 노출된다. 하지만 뇌성마비 환아에서 나타나는 특징적인 반사, 침 흘리기 습관, 행동조절의 어려움 등을 이유로 많은 임상의들이 교정 치료를 포기하게 된다. 적절한 환자 선정과 수행 가능한 치료목표를 세운다면, 뇌성마비 환아에서도 단계적이고 반복적인 행동조절과 약물을 이용하여 치료가 가능하다. 교정 치료를 통해 얻어진 상악 전치의 돌출 완화는 외상의 위험성을 줄이고 더 나은 심미성을 제공하는 긍정적인 효과를 가져오게 된다. 따라서 임상의들은 뇌성마비 환아의 치료에 대한 인식 변화 및 개선을 위한 적극적인 노력이 필요할 것이며, 뇌성마비 환아들은 더 나은 구강 건강을 영위할 수 있을 것이다.

• 대한치과교정학회지
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• 제27권2호
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• pp.197-208
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• 1997

제 III급 부정교합 환자의 치료를 위해서는 각 환자의 문제점들과 상태를 다양한 진단방법들을 동원하여 분석한 후에 가장 적절한 치료방법을 선택하여야 한다. 초진시에 치성 또는 기능성 또는 골격성인 원인들의 감별이 분명한 증례에서는 치료계획 수립이 큰 문제가 없지만, 감별이 모호한 증례에서는 많은 어려움을 경험하게 된다. 이에 저자는 각 치료방법을 적용하여 치료한 제III급 부정교합 환자 482명 (남;253,여 ;229)을 대상으로 치료방법에 따라 네 군으로 분류하였다. D군은 가철성 교정장치나 악기능장치를 사용하여 치료한 115명(남;64, 여;51), A군은 악정형장치로 치료한 210명 (남;111, 여 ;99), B군은 고정식 교정장치로 Camouflage 하여 치료한 63명 (남;30, 여 ;33), C군은 악교정 수술로 치료한 94명(남;48, 여;46)이었다. 초진시에 촬영한 측모두부방사선사진에서 전후방, 수직적, 치성, 악골의 형태학적인 계측항목들을 선정하여 각 군에서 측정한 계측치의 평균값 및 표준편차를 구하였고 네 군간의 유의성 여부를 검정하여 아래와 같은 결과를 얻었다. 1. SNA각과 Nasion Perpendicular Plane에서 A점까지의 거리는 네 군간에 유의한 차이가 없었으며, SNB, Wits, Nasion Perpendicular Plane에서 B점까지의 거리, Facial angle, Facial convexity, APDI의 값은 C,A,B,D군의 순이었지만 A군과 B군간에는 유의한 차이가 없었다. 2. 전안면고경, 후안면고경, 하전안면고경의 값이 남자에서는 C,B,A,D의 순으로 유의성 있는 차이를 나타냈으며, 여자에서는 C와 B군간에는 유의한 차이가 없게 나타났다. 3. 남자에서 전두개저에 대한 하악체 길이의 비율, 하악체의 길이와 Symphysis의 길이는 C,B,A,D순으로 나타났으나 B군과 A군사이에는 유의한 차이가 없었고, 여자에서는 Ramus height, 하악체 길이, 전두개저에 대한 하악체 길이의 비율이 네군에서 유의한 차이를 나타냈고 Symphysis의 길이는 C군과 B군 사이에서는 유의한 차이가 없었다. 4. 상악전치 치축은 C,B,A,D순으로 크게 나타났으며 네 군간에서 유의한 차이가 나타났다. 5. Nasolabial angle의 값은 C,A,B,D순으로 작게 나타났으나 유의한 차이는 C와 A,B,D군 간에서만 나타났다.

• 대한치과의사협회지
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• 제54권7호
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• pp.563-574
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• 2016

A clear overlay appliance is a type of a removable appliance made from transparent thermoplastic plastic film that covers the entire dentition to move the teeth. It is one of the most favored orthodontic methods opted for by adult patients; this treatment is esthetic, does not cause discomfort and allows oral hygiene to be easily managed when compared to other conventional fixed treatment methods. However, the use of clear overlay appliances, such as invisalign or clear aligner, is associated with various clinical challenges. In particular, the appliances require longer treatment periods compared to fixed treatment, and due to the structural characteristics of the appliances, it is difficult to make proper posterior occlusion and certain type of tooth movement, including extrusion, rotation and tip. Thus, the clear overlay appliances are regarded as supplementary appliances by most orthodontists and have been used for simple orthodontic treatments, such as partial anterior alignments or orthodontic relapse cases. Owing to the remarkable advancement in the field of 3D digital technology over a period of 15 years, the accuracy and convenience of modern clear overlay appliances have continuously improved. Moreover, orthodontic outcomes have also been greatly improved by the introduction of new materials and successful application of various biomechanical methods from conventional orthodontic treatments in the design of clear overlay appliances. This study investigates the clinical limitations that should be considered during the application of clear overlay appliances and also examines the efforts and methods used to overcome these challenges.