• 대한치과보철학회지
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• 제51권2호
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• pp.82-89
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• 2013

연구 목적: 본 연구는 양극산화 임플란트에 골형성단백질과 혈관내피세포성장인자를 코팅한 임플란트를 토끼의 경골에 식립하여 골과 임플란트 계면의 골유착 향상의 가능성을 평가하고자 시행하였다. 연구 재료 및 방법: 6마리의 토끼 양측 경골에 코팅을 하지 않은 양극 산화 임플란트(대조군)와 골형성단백질과 혈관내피세포성장인자를 코팅한 임플란트(실험군)을 각각 한쪽에 2개씩 식립하였다, 토끼는 2주, 8주에 각각 3마리씩 희생하였고 전체 식립된 임플란트는 24개이었다. 각 시기별, 그룹별 임플란트 수는 각각 6개씩이었다. 임플란트안정지수(resonance frequency analysis (RFA)), 회전 제거력(Removable torque measurement (RTQ))을 희생 시기에 측정하였다. 독립표본 t-test (SPSS Ver. 15.0, Chicago, USA)을 이용하여 2주, 8주에서 대조군과 실험군의 차이를 비교 분석하고, 유의수준95%에서 통계적으로 검정하였다. 결과:대조군과 실험군 모두 8주에서 우수한 골유착을 보였다. 특히 실험군에서 8주에 ISQ, RTQ 값 모두 대조군과 비교하여 우수한 값을 나타내었다 (P<.05). 하지만 2주에서는 두군 사이에 통계적 유의성을 보이지 않았다(P>.05). 결론: 골형성 단백질과 혈관내피세포성장인자를 임플란트 표면에 코팅하여 식립하는 것은 치유의 후반기에 골유착을 증대하는 것으로 사료된다.

• 대한치과의사협회지
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• 제47권10호
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• pp.669-676
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• 2009

Purpose : Anterior region is crucial area for esthetic implant restoration. However, the alveolar process undergoes atrophy after removal of teeth and creates unfavorable situation for implant installation. The knowledge of the thickness of alveolar bone is required to estimate and expect the bone resorption after extraction. The aim of this study is to measure facial, palatal and faciopalatal bone thickness on maxillary anterior teeth. Methods : Facial, palatal, and faciopalatal bone thickness were measured on the computed tomography (CT) images from 57 patients, using an image analyzer program (Ondemand$3D^{(R)}$, Cybermed, Seoul, Korea). Results : The thickness of facial bone in incisors, lateral incisors and canines were less than 1 mm. The thickness of facial bone increased from anterior to posterior region and the thickness of palatal bone increased from posterior to anterior region. Conclusion : The measurement can be used for planning implant surgery before extraction. CT has are clinically useful in the evaluation of thickness of alveolar bone.

• Journal of Periodontal and Implant Science
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• 제31권2호
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• pp.357-369
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• 2001

In this present study, the healing process and the recurrence of pigmentation were evaluated clinically and histologically in accordance with the extent and the range of pigmentation after phenol was applied to remove melanin pigmentation in gingiva. Six mongrel dogs were used. The melanin pigmentation in canine gingiva were classified into slight, moderate and severe according to the extent of pigmentation and divided into local and diffuse types according to the range. Following general and local anesthesia, 90% phenol was applied to the pigmented gingiva of the subjects with small cotton balls until the surface was etched to be whitish and was neutralized with small cotton balls soaked by 95% alcohol. The contralateral pigmented gingiva to the one treated with phenol, was treated by surgical deepithelialization. At 1, 3 and 8 weeks, the treated gingiva was examined clinically and evaluated histologically following H-E stain, and HMB 45 stain for melanocyte after biopsy. In the phenol treated sites, epithelium and connective tissue healed normally and there was no pigmentation at 1 week. At 3 weeks of healing, melanin repigmentation was observed in the severe local type and moderate to severe diffuse type. In the surgically deepithelialized sites, healing was delayed, compared to phenol treated sites and the infiltration of the inflammatory cells and congestion in connective tissue was shown at 1 week. At 3 weeks, healing was completed and there was a partial melanin repigmentation. At 8 weeks of healing, the extent and the range of repigmentation were increased in both group according to the extent or range priot to depigmentation procedure. These results suggpriorest that the removal of melanin pigmentation with 90% phenol application result in normal healing process of gingiva. However, in the severe local type and moderate to severe diffuse type, sites treated with phenol showed repigmentation at 3 week, which was earlier than surgical deepithelialized sites. Therefore it is required to select appropriate method according to initial condition of pigmentation.

• 구강회복응용과학지
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• 제26권2호
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• pp.97-109
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• 2010

연구목적 : 본 연구는 임플랜트 지대주에 동적하중을 가하기 전, 후의 풀림토크 변화를 측정함으로써 수종의 지대주에 가해진 단기간의 교합력이 임플랜트-지대주의 안정성에 영향을 미치는지를 연구하고자 하였다. 재료및 방법 : 임플랜트 고정체는 외부육각구조를 사용하였고, 티타늄합금 지대주, 지르코니아 지대주, 주조 금합금 지대주인 UCLA plastic abutment를 사용하였다. 초기 풀림회전력을 측정하고, 하중을 $10^5$ 회 가한후, 풀림회전력을 측정하였다. 초기 풀림회전력 상실률, 하중후 풀림회전력 상실률, 동적하중에 의한 풀림회전력 상실률을 계산하였다. 결과 : 초기 풀림회전력, 동적 하중후 풀림회전력, 초기 풀림회전력 상실률, 동적 하중후 풀림회전력 상실률, 동적 하중에 의한 풀림회전력 상실률은 각 지대주간 유의한 차이를 나타내지 않았다. 또한, 각 지대주 내에서 동적 하중 전후의 풀림회전력은 통계적으로 유의한 차이를 나타내지 않았다. 결론 : Titanium, zirconia, UCLA 지대주의 초기 나사풀림은 지대주간 유의한 차이가 없음을 알 수 있었고, 초기의 저작력은 하중전후 나사풀림에 큰 영향을 주지 않는다고 생각된다. 또한, UCLA, zirconia, titanium 지대주의 선택시 초기 나사풀림과 관련하여 특정 종류의 지대주 선택을 기피할 필요는 없다고 생각된다.

• Journal of Periodontal and Implant Science
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• 제35권1호
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• pp.163-176
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• 2005

3개월 동안 사용한 마모된 칫솔의 마모 정도와 양상을 관찰하고, 새 칫솔과 마모된 칫솔의 잇솔질 전 ${\cdot}$ 후 치태제거효율을 single-use design으로 비교 ${\cdot}$ 평가하여 3개월 주기의 칫솔 교체 주기의 근거를 임상적으로 확인 해보고자 하였다. 치주적으로 건강한 치과 대학생 42명을 대상으로 설문지를 통해 잇솔질 습관을 조사하고, 3개월간 동일한 칫솔과 치약을 사용하게 하였다. 3개월 후 피시험자를 무작위로 두 군(I, II)으로 나누고, 치석제거술을 시행한 뒤 2주후에 내원하도록 하였으며 내원 전 48시간동안은 잇솔질을 하지 않도록 지시하였다. 2주후 I군은 새 칫솔을, II군은 마모된 칫솔을 사용하도록 하였으며 잇솔질 전 ${\cdot}$ 후에 각각 구강 내를 erythrosin으로 염색한 후 6개의 Ramfjord 치아의 plaque score를 Patient Hygiene Performance (PHP) index로 측정하였다. 2주간의 washout period 후에 다시 치석제거술을 시행한 뒤, I군이 마모된 칫솔을, II군은 새 칫솔을 사용하게 하여 동일한 방법으로 PHP index를 각각 측정하였다. 마모된 칫솔은 수거하여 brushing surface area의 면적으로 마모도를 평가하였다. 결과는 paired t-test와 Pearson's correlation analysis로 통계처리 하였다. 2명이 탈락하였고 잇솔질 전 ${\cdot}$ 후에 대한 전체 부위, 치간 부위, 변연치은 부위의 plaque score는 두 칫솔 모두 통계학적으로 유의성 있게 감소하였으며 (p<0.0001), 두 칫솔을 비교한 경우에는 새 칫솔이 마모된 칫솔보다 치태 감소량이 통계학적으로 유의성 있게 많았다 (p<0.0001). 칫솔의 마모도는 평균 50.6% 증가하였으며, 마모도 증가에 따른 치태 감소량에는 직선적인 상관관계가 있었으나 통계학적인 유의성은 없었다. (전체 부위 r=-0.58, p=0.72 / 변연치은 부위 r=-0.50, p=0.76). Single-use design에서 3개월 동안 마모된 칫솔은 치태제거 능력에 있어서 새 칫솔보다 덜 효율적이였다. 칫솔의 마모도는 구강 위생 관리에 영향을 미치는 중요한 요인이며, 마모된 칫솔은 정기적인 교체가 요구된다. 또한, 치간 부위를 포함한 변연치은 부위의 치태를 정확하게 평가할 수 있는 치태지수에 대한 연구가 필요하겠다.

• 대한치과보철학회지
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• 제46권3호
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• pp.255-260
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• 2008

STATEMENT OF PROBLEM: Preparation of implant beds with lasers is considered a safe and reliable method, but the accuracy of this technique has not been examined. PURPOSE: The purpose of this study was to evaluate the accuracy and effectiveness of implant bed preparation using an Er,Cr:YSGG laser. MATERIAL AND METHODS: An Er,Cr:YSGG laser was applied to pig rib bone. The laser was employed at a 5.75 W power setting, 30 Hz/sec pulse repetition, and 70 ${\mu}s$ pulse duration with 50 % water and 60% air spray. According to laser tips the groups were divided as follows; Group 1: paralleled - shaped sapphire tip (0.6 mm${\Phi}$), Group 2: paralleled - shaped zirconia tip (0.6 mm${\Phi}$), Group 3: tapered sapphire tip (0.4 mm${\Phi}$). The Er,Cr:YSGG laser tip was separated by 1 mm from the bone and applied for 15 seconds in a non-contact mode. After the application, the bone was sectioned for specimens. Histologic measurements were determined by computerized morphometry. The length of the prepared bone surface was measured and the width of the entrance was measured. The results were analyzed with one-way ANOVA (P<0.05). RESULTS: The prepared length of group 3 was longer than that of group 2. The prepared bone width was larger than the width of the laser tip in every group. Additional bone removal was observed adjacent to the prepared area and displayed an irregular surface. CONCLUSION & DISCUSSION: Different cutting effects were observed according to the laser tip, emphasizing the importance of proper tip selection in the clinical setting. This preliminary study supported the existence of hydrokinetic effects.

• 구강회복응용과학지
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• 제22권4호
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• pp.349-365
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• 2006

State of problem : A number of investigation about increase of surface area via various surface treatments and modification of surface constituent have been carried out. Purpose : The surface characteristics and stability of implants treated with anodic oxidation, fluoride ion incorporation, and groups treated with both methods were evaluated. Material and method : Specimens were divided into six groups, group 1 was the control group with machined surface implants, groups 2 and 3 were anodic oxidized implants (group 2 was treated with 1M $H_2SO_4$ and 185V, group 3 was treated with 0.25M $H_2SO_4$ and $H_3PO_4$ and 300V). Groups 4, 5 and 6 were treated with fluoride. Group 4 was machined implants treated with 0.1% HF, and groups 5 and 6 were groups 2 and 3 treated with 10% NaF respectively. Using variable methods, implant surface characteristics were observed, and the implant stability was evaluated on rabbit tibia at 0, 4, 8 and 12 weeks. Result : 1. In comparison of the surface characteristics of anodic oxidized groups, group 2 displayed delicate and uniform oxidation layer with small pore size containing Ti, C, O and showed mainly rutile, but group 3 displayed large pore size and irregular oxidation layer with many crators. 2. In comparison of the surface characteristics of fluoride treated groups 4, 5, 6 and non-fluoride treated groups 1, 2, 3, the configurations were similar but the fluoride treated groups displayed rougher surfaces and composition analysis revealed fluoride in groups 4, 5, 6. 3. The fluoride incorporated anodic oxidized groups showed the highest resonance frequency values and removal torque values, and the values decreased in the order of anodic oxidized groups, fluoride treated group, control group. 4. According to implant stability tests, group 2 and 3 showed significantly higher values than the control group (P<.05). The fluoride treated groups showed relatively higher values than the non fluoride treated groups and there were significant difference between group 4 and group 1 (P<.05). Conclusion : From the results above, it can be considered that the anodic oxidation method is an effective method to increase initial bone stability and osseointegration and fluoride containing implant surfaces enhance new bone formation. Implants containing both of these methods should increase osseointegration, and reduce the healing period.

• Journal of Periodontal and Implant Science
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• 제38권1호
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• pp.23-30
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• 2008

Purpose: The purpose of this study was to investigate the incidence of curet fracture and its contributing factors. Material and Methods: Fifty-eight periodontal curets which were broken during periodontal treatment in Kangnung National University Dental Hospital for 1 year were used as study materials. The blade thickness of new curets and broken ones was measured using a digital micrometer. Types of treatment procedures, clinical experience of operators, point of breakage, and method of removal of broken fragments were recorded for each broken curet. Results: The incidence of curet fracture in root planing (16.4 curets per 1,000 procedures) was higher than those in flap surgery (7.5) or supragingival scaling (2.7). No curet was broken during supportive periodontal treatment. The incidence of fracture did not seem to be related with clinical experience of operators. The most frequent breakage point of the curets were upper 1/3 of blades. Fifty-six of 58 broken fragments were removed by non-surgical methods. Two broken tips which could not removed non-surgically were left in the pockets, and proved to be removed spontaneously 1 week later. Conclusion: Root planing showed higher incidence of curet fracture than any other type of periodontal treatment. Most of the fractured fragments were removed by non-surgical method. Further study is needed to develop methods of removal of the fragments which can not be removed non-surgically.

• Journal of Periodontal and Implant Science
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• 제29권3호
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• pp.539-553
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• 1999

The purpose of this 6-months study was to compare the clinical and radiographic outcomes following guided tissue regeneration treating human mandibular Class II furcation defects with a bioabsorbable BioMesh barrier(test treatment) or a nonabsorbable ePTFE barrier(control treatment). Fourteen defects in 14 patients(mean age 44 years) were treated with BioMesh barriers and ten defects in 10 patients(mean age 48 years) with ePTFE barriers. After initial therapy, a GTR procedure was done. Following flap elevation, root planing, and removal of granulation tissue, each device was adjusted to cover the furcation defect. The flaps were repositioned and sutured to complete coverage of the barriers. A second surgical procedure was performed at control sites after 4 to 6 weeks to remove the nonresorbable barrier. Radiographic and clinical examinations(plaque index, gingival index, tooth mobility, gingival margin position, pocket depth, clinical attachment level) were carried out under standardized conditions immediately before and 6 months after surgery. Furthermore, digital subtraction radiography was carried out. All areas healed uneventfully. Surgical treatment resulted in clinically and statistically equivalent changes when comparisons were made between test and control treatments. Changes in plaque index were 0.7 for test and 0.4 for control treatments; changes in gingival index were 0.9 and 0.5. In both group gingival margin position and pocket depth reduction was 1.0mm and 3.0mm; clinical attachment level gain was 1.9mm. There were no changes in tooth mobility and the bone in radiographic evaluation. No significant(p${\leq }$0.05) difference between the two membranes could be detected with regard to plaque index, gingival index, gingival margin position, pocket depth, and clinical attachment level. In conclusion, a bioabsorbable BioMesh membrane is effective in human mandibular Class II furcation defects and a longer period study is needed to fully evaluate the outcomes.

• 대한치과의사협회지
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• 제50권8호
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• pp.474-481
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• 2012

The periodontal flap surgery is the most widely utilized surgical procedure to reduce the pocket depth and to access the subgingival root surfaces for scaling and root planing. The diagnosis of the periodontal lesion and the objective of the surgery will dictate the type of flap procedure which will be utilized to obtain the best result. The incisions, type of flap and the selection of suturing design must be planned and executed to fit the problem. Periodontal flaps are designed to preserve gingival integrity and to gain access to root surfaces for residual calculus removal and to thoroughly remove granulation tissue so bone defects can be visualized and treated. Gentle and efficient procedures result in optimum healing and minimal postoperative pain. When flaps need to be repositioned apically or less often, coronally, then the flaps must sit passively at the appropriate level before suturing. To ensure this, buccal and lingual flaps need to be elevated beyond the mucogingival junction so the elasticity of the mucosa allows for flap mobility. Sometimes it may be necessary to extend the flap elevation apically with a split incision approach to minimize the effect of the less elastic periosteum. Vertical incisions can aid in flap positioning by allow ing the clinician to suture the flap at a different level to the adjacent untreated gingiva. In osseous periodontal surgery, flaps are apically positioned to minimize postoperative pocket depth. In regenerative periodontal surgery including implant surgery, soft tissue cove rage of bony defects, graft materials, membranes, and bio logic agents is important so sulcular incisions and light suturing techniques are crucial.