• 대한치과마취과학회지
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• 제13권4호
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• pp.209-214
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• 2013

Multiple caries in a pediatric patient often requires dental treatment under general anesthesia, especially when the patient is suffering from a systemic disease. The patient was a 6-year-old boy with Marfan syndrome and needed extensive dental treatment. Marfan syndrome is an inherited disorder resulting from mutations in Fibrillin-1 gene. Patients are known to have mainly cardiovascular, ocular, and musculoskeletal problems. Although clinical symptoms of the syndrome are age-realted, thus hindering early diagnosis of the disease in young children, our patient had been confirmed by a gene study at a younger age. Medical history of the patient revealed moderate to severe mitral regurgitation and aortic root dilatation, which required mitral valve replacement surgery with a mechanical valve. As a result, the patient was taking warfarin post-operatively and changes in medication had to be made before the dental treatment. Also, prophyalctic antibiotics had to be given before the treatment for prevention of (to prevent the) infective endocarditis. With careful control of the medications and bleeding tendency, general anesthesia and the treatment were done successfully without any complications.

• 대한치과마취과학회지
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• 제12권3호
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• pp.157-163
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• 2012

Background: The major goal of dental management before and after liver transplantation is the prevention of bacteremia from an oral source that could lead to systemic infection. However dental treatment in liver transplant patients have the risk of infection and bleeding. so it is needed special dental consideration. Methods: 42 liver transplant candidates who visited department of Advanced General Dentistry in Yonsei University College of dentistry from March 1, 2010 to February 29, 2012 were selected. The clinical data of those patients were analyzed; coagulation status such as PT, INR, aPTT, platelet count before and 6 months after liver transplantation, dental infectious foci, time interval between dental visit and operation date of liver transplantation. Results: Before liver transplant, the patient's PT and INR was prolonged, and the platelet count was lower than normal range. But 6 months later from liver transplantation, most of the figures turned into a normal range. The dental infection foci were chronic periodontitis, dental caries, chronic apical periodontitis, root rest et al but we did extraction of 6 root rest before liver transplantation and postponed other treatment after liver transplantation due to bleeding and infection risk of patients. Because of insufficient interval between dental visit and operation date, 64.3% of patients could not finish the dental treatment. Conclusions: The patients before liver transplantation have the risk of bleeding. The treatment of those patient should be removal of only factors that can cause dental infections after transplantation and other treatment must be postponed until the stable period of the transplant that patient's condition has improved.

• Journal of Oral Medicine and Pain
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• 제25권4호
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• pp.415-425
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• 2000

In order to obtain the basic data concerning the optimal lasing conditions in using Nd:YAG laser as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum, the author selected 36 human teeth having no cervical abrasion and caries (; 12 anteriors, 12 premolars. 12 molars) extracted due to periodontal diseases, and divided them into 4 groups as Group I, II, III and IV (; each group of 3 anteriors, 3 premolars, 3 molars), and prepared a cementum specimen with thickness of $1.0mm{\pm}0.2mm$ sectioned longitudinally at the middle of mesio-distal thickness (; Group I) or horizontally at 1mm-2mm below the cemento-enamel junction (; Group II, III, IV) from each tooth of each group by low speed diamond wheel saw, and treated them with 0.5 M ethylene diamine tetraacetic acid (; EDTA, pH=7.4) for 2 minutes for elimination of remnants during tooth-sectioning. And the author applied the laser energy from a fiberoptic delivered, free running, pulsed Nd:YAG laser (; wavelength 1064nm. pulse duration $120{\mu}sec$, fiber diameter $320{{\mu}m}$) to cementum surfaces in triplicates of one experiment under the following lasing conditions: 1. stationary mode of fiber in contact to cementum surfaces without air-spray (; Group I )/with air-spray (; Group II), 2. unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec without air-spray (; Group III)/with air-spray (; Group IV), 3. energy per pulse (mJ/pulse) [; energy density ($J/cm^{2}$)] in order of 1.0W/10Hz (100J/pulse); $124J/cm^{2}$, 0.5W/10Hz (50mJ/pulse); $62J/cm^{2}$, 0.4W/10Hz (40mJ/pulse); $50J/cm^{2}$, 0.3W/10Hz (30mJ/pulse); $37J/cm^{2}$, 4. exposure time of 1 second. And the author applied the platinum coating on surfaces of cementum specimens, and evaluated the characteristics of ultrastructural change on surfaces of cementum using the scanning electron microscopy. In general the ultrastructural loss of cervical cementum irradiated under the same lasing condition of laser energy density occurred least in specimens of Group IV. And especially, the ultrastructural loss of cervical cementum irradiated under the laser energy density of $37J/cm^{2}$ almost did not occur in specimens of Group IV. Therefore, it is considered that the pulsed Nd:YAG laser should be applied with the lasing conditions of unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec with air-spray and of laser energy density within $37J/cm^{2}$ as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum.

• 대한소아치과학회지
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• 제39권4호
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• pp.397-403
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• 2012

미성숙 영구치는 치아우식증, 외상, 비정상적인 치아 형태로 인한 파절 등에 의하여 치수 생활력을 상실할 수 있다. 이때 이용되는 치료법이 치근단 형성술로서 실활치의 치근단 치수 부위에 광화된 조직의 형성을 통하여 치근단 폐쇄를 유도한다. 현재 수산화칼슘 치근단 형성술이 가장 많이 이용되는데 근관 내에 수산화칼슘을 장기간 적용할 경우 치근단 경조직 형성을 유도할 수 있지만, 강한 알칼리성으로 인하여 치근 약화를 야기하여 치아 파절 위험성이 높아진다. 그러므로 근관 충전 시 치아보강을 위한 수복이 고려되어야 한다. 본 증례는 생활력을 상실한 미성숙 영구치에서 장기간의 수산화칼슘 치근단 형성술 후 치아 보강을 위하여 MTA plug, 섬유강화형 포스트 그리고 복합 레진을 이용한 근관 충전을 시도하였기에 보고하는 바이다.

• 대한소아치과학회지
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• 제35권2호
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• pp.268-277
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• 2008

상악 정중부 과잉치는 혼합치열기 및 영구치열기 아동에서 많은 병발증을 야기한다. 본 연구에서는 지난 6년간 경북대학교 병원 소아치과에 내원한 상악 정중부 과잉치를 지닌 1171명의 아동을 대상으로 임상적, 방사선학적 검사를 통해 상악 정중부 과잉치의 양상과 병발증을 조사하고 발거 후 병발증의 치유율에 관해 조사 평가하여 다음과 같은 결론을 얻게 되었다. 1. 상악 정중부 과잉치를 발견하게 된 동기로는 다른 원인으로 상악 중절치부를 우연히 방사선사진 촬영한 경우 23.4%, 상악 정중부 과잉치의 맹출 16.1%, 충치 치료를 위해 상악 중절치부를 방사선사진 촬영한 경우 15.1%로 나타났다. 2. 상악 정중부 과잉치로 인한 병발증이 나타나지 않은 경우는 36.8%, 인접 영구전치의 맹출 지연을 야기한 경우가 34.4%, 정중 이개가 16.1%였다. 3. 상악 정중부 과잉치의 외과적 발거 시 인접 영구중절치의 치령은 치근길이의 1/2이상에서 2/3이하가 54.7%였다. 4. 상악 정중부 과잉치의 발거 후 정중 이개와 인접 상악 영구전치의 맹출 지연 치유율은 외과적 발거 시 인접치의 치령이 치근 길의 1/2이하인 경우 맹출 지연에서 65.27%로 유의성있게 높았으며(P<0.05), 정중 이개에서는 인접측절치와 중절치 간의 총생이 없는 경우에서 그 치유율이 68.23%로 유의성있게 높았다(P<0.05).

• Restorative Dentistry and Endodontics
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• 제28권1호
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• pp.89-99
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• 2003

The purpose of this study was to investigate the bonding of resin- based root canal sealer, AH26 when the sealer was applied as a thin layer between dentine and gutta-percha surface. In this study forty non-caries extracted human molars and resin-based root canal sealer(AH 26, DeTrey/Dentsply, Germany) were used. Disks of gutta-percha, 6mm in diameter.6mm thick (Diadent/Dentsply, Korea) for thermoplastic obturation were used and dentin surfaces were treated with 2% NaOCl(Group 1) or 2%NaOCl+17% EDTA(Group 3). Disks of gutta-Percha, 6mm in diameter.6mm thick (Diadent/Dentsply, Korea) for conventional obturation were used and dentin surface were treated with 2% NaOCl(Group 2) or 2%NaOCl+17% EDTA(Group 4). Enamel was removed by a horizontal section 1mm below the deepest portion of the central occlusal groove by using a watercooled low speed diamond saw. A second horizontal section was done around cementoenamel junction. Exposed dentin surface was cut to approximately $8{\times}8{\;}mm$ rectangular shape and was ground against 320, 400, 600 grade silicon carbide abrasive paper serially. After grinding, the dentine surface were soaked in a solution of 2% NaOCl for 30 minutes and twenty of specimens were treated with 17% EDTA solution for 1 minute. The treated specimens were washed and dried, Root canal sealer, AH26 was prepared according to the manufacture's instructions The Gutta-percha and dentin surface were coated with a thin layer of the freshly mixed seal or. The specimens were left overnight at room temperature. After their initial set, they were transferred to an incubator at $37$^{\circ}C$ for 72 h. After 72 hours, resin blocks were made. The resin block was serially sectioned vertically into stick of $1{\cdot}1mm$. Twenty sticks were prepared from each group. After that, tensile bond strength f3r each stick was measured with Microtensile Tester Failure patterns of the specimens at the interface between gutta-percha and dentin were observed under the SEM(x1000) and Stereomicroscope (LEICA M42O, Meyer Inst., TX U.S.A) at 1.25 x25 magnification. The results were statistically analysed by using a One-way ANOVA and Tukey's test. The results were as follows; 1. Tensile bond strengths($mean{\pm}SD$) were expressed with ascending order as follows: Group 1, $3.09{\pm}$ 1.05Mpa : Group 2, $6.23{\pm}1.16MPa$ : Group 3, $7.12{\pm}1.07MPa$ : Group 4, $10.32{\pm}2.06MPa$. 2. Tensile bond strengths of the group 2 and 4 used disks of gutta-percha for conventional obturation were significantly higher than that of the group 1 and 3 used fir thermoplastic obturation. (p < 0.05). 3. Tensile bond strengths of the group 3 and 4 treated with 2% NaOC1+17% EDTA were significantly higher than that of the group 1 and 2 treated with 2% NaOCl. (p < 0.05). 4. In analysis of failure patterns at the interface between sealer and gutta-percha, there were observed 49 (61%)cases of adhesive failure patterns and 31 (39%) cases of mixed failures patterns.

• 대한소아치과학회지
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• 제37권2호
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• pp.246-251
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• 2010

치아의 매복은 치배의 이상 위치 혹은 맹출로에 장애가 있어서 일어나지만, 그 정확한 기전은 아직 알려지지 않았다. 하악 제1대구치 매복의 발생율은 0.01~0.25%로 매우 드물지만, 이러한 매복은 인접 치아의 우식 또는 치근 흡수, 치조골의 저성장, 치주적 문제들을 일으킬 수 있기 때문에 최대한 빨리 매복을 해소시켜줄 필요가 있다. 매복된 하악 제1대구치가 근심경사 되어있을 경우 이를 직립시키기 위한 여러 생역학적 접근법이 있지만, 대부분의 방법들은 상호간의 힘(reciprocal force)에 의해 고정원 단위의 이동이 일어난다는 문제가 있다. 최근 골격성 고정원(SAS, Skeletal Anchorage System)의 도입으로 목표 치아 혹은 목표 분절에 직접적인 힘을 정확하게 전달할 수 있게 됨에 따라 단기간의 효율적 치아 이동이 가능하게 되었다. 본 증례에서는 만곡된 치근을 가진 매복 하악 좌측 제1대구치에서 치아의 직립을 위해 골격성 고정원인 miniplate를 사용 하였다. miniplate는 후구치 부위에 식립되었으며, 교정력을 적용한 10개월 후 매복치가 구강 내로 노출되고 직립되었다. 이에 하악 좌측 제1대구치를 고정성 교정장치에 포함시켜 정상 교합을 얻을 수 있었다.이와 같이 골격성 고정원을 사용함으로써 교정술식을 단순화시키고 교정치료 기간을 줄이며 부작용이 적었던 장점 등이 있어 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.4.1-4.10
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• 2019

Background: The mandibular third molar (M3) is typically the last permanent tooth to erupt because of insufficient space and thick soft tissues covering its surface. Problems such as alveolar bone loss, development of a periodontal pocket, exposure of cementum, gingival recession, and dental caries can be found in the adjacent second molars (M2) following M3 extraction. The specific aims of the study were to assess the amount and rate of bone regeneration on the distal surface of M2 and to evaluate the aspects of bone regeneration in terms of varying degree of impaction. Methods: Four series of panoramic radiographic images were obtained from the selected cases, including images from the first visit, immediately after extraction, 6 weeks, and 6 months after extraction. ImageJ software^® (NIH, USA) was used to measure linear distance from the region of interest to the distal root of the adjacent M2. Radiographic infrabony defect (RID) values were calculated from the measured radiographic bone height and cementoenamel junction with distortion compensation. Repeated measures of analysis of variance and one-way analysis of variance were conducted to analyze the statistical significant difference between RID and time, and a Spearman correlation test was conducted to assess the relationship between Pederson's difficulty index (DI) and RID. Results: A large RID (> 6 mm) can be reduced gradually and consistently over time. More than half of the samples recovered nearly to their normal healthy condition (RID ≤ 3 mm) by the 6-month follow-up. DI affected the first 6 weeks of post-extraction period and only showed a significant positive correlation with respect to the difference between baseline and final RID. Conclusions: Additional treatments on M2 for a minimum of 6 months after an M3 extraction could be recommended. Although DI may affect bone regeneration during the early healing period, further study is required to elucidate any possible factors associated with the healing process. The DI does not cause any long-term adverse effects on bone regeneration after surgical extraction.

• Journal of Oral Medicine and Pain
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• 제33권2호
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• pp.111-120
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• 2008

다양한 전신질환으로 입원한 환자들의 전신질환별 구강질환의 주소와 치료내용을 조사하여 기본적인 구강질환의 실태를 파악하고자 본 연구를 시행하였는데, 전신질환으로 입원하여 구강질환의 진단과 치료를 위하여 내원한 환자를 대상으로 연구한 결과 다음과 같은 결론을 얻었다. 1. 주된 전신질환인 내분비, 영양 및 대사 질환의 경우 구강질환은 치은염 및 치주질환 44.9%, 타액선의 질환 22.4%, 치아우식증 12.2%, 치수 및 치근단주위의 질환 4.1%, 매몰치와 매복치, 치아경조직의 기타질환 각각 2% 순서로 나타났다. 2. 주된 구강질환인 치은 및 치주질환의 경우 전신질환은 인슐린-비의존성 당뇨 39.2%, 뇌경색 29.4%, 신경근 및 신경총장애 5.6%, 뇌내출혈 3.9%, 위의 악성 신생물, 갑상선기능항진증, 정신분열증, 알콜성 간질환, 신증후군 각각 2% 순서로 나타났다. 이상의 결과로 전신질환이 있는 환자의 구강질환과 구강질환이 있는 환자의 전신질환에 대해서는 일정부분 파악이 되었으나 향후 전신질환으로 입원한 환자의 구강질환과 전신질환과의 상관관계에 대한 연구가 이루어져야 한다고 사료된다.

• 대한소아치과학회지
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• 제39권4호
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• pp.404-411
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• 2012

치아의 매복은 맹출로 내의 물리적 장애물이나 치아의 비정상적 위치에 의해 발생한 치아 맹출의 정지로, 하악 제2대구치의 매복은 비교적 드물다. 매복된 하악 제2대구치는 우식, 치주염, 제1대구치 치근흡수 등을 유발하므로 조기 진단과 치료가 요구된다. 첫 번째 증례는 10세 남자 환자로 하악 양측 제2대구치의 매복을 구리선을 이용하여 치료하였다. 두 번째 증례는 12세 여자 환자로 구강검진 도중 하악 좌측 제2대구치의 매복이 발견되어 Humphrey 장치를 이용하여 치료하였다. 세 번째 증례는 17세 여자 환자로 하악 우측 소구치부에 식립한 미니 임플란트를 고정원으로 하는 uprighting spring을 이용하여 하악 우측 제2대구치의 매복을 치료하였다. 네 번째 증례는 18세 남자 환자로 매복된 하악 좌측 제2대구치에 부착한 교정용 버튼과 하악지에 식립한 미니 임플란트를 elastic thread로 연결하여 치료하였다.