• 한국치위생학회지
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• 제12권2호
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• pp.365-377
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• 2012

Objectives : This research was conducted to determine the effect of the Visiting Oral Health Care Program by examining the oral health of the elderly women, who are the beneficiaries of this Visiting Oral Care Program. Methods : This research was conducted from November of 2011 to February of 2012, in Chilgok-gun in the Kyeongbuk Province, South Korea. One hundred and twenty five (125) elderly women among the beneficiaries of the Visiting Oral Care Program within the area were randomly selected for the research. The research subjects would regularly visit the area senior citizen center, and they were divided into two groups, with 64 of them belonging to a control group, and the rest (61 people) belonged to a intervention group. The research subjects were examined for their dental health condition, and we investigated the effect of the Visiting Oral Care Program through this research. Results : 1. When they were asked about how many times they wash their dentures, the majority of the control group, 57.4% of them answered that they do it "once" a day. The majority of the intervention group answered "more than 3 times", with 35.2% of group mentioning that they wash their dentures more than 3 times a day(p<.001). 2. When the research subjects were asked to scale their overall quality of life before and after the Visiting Oral Care Program, the control group had rated 49.3 before the Service and 56.8 after the Service (p<.01), and scores for the individual factors to determine the overall quality of life has significantly improved as well (p<.01, p<.01, p<.01, p<.01, p<.01, p<.01, p<.01). 3. The oral hygiene condition after the Visiting Oral Care Program has shown improvement as well. The control group scored 64.2 for the severity of the symptoms of dental plaque before the dental care, and scored 46.8 after the dental care (p<0.1). The control group was diagnosed for the symptoms of coated tongue, and the severity of the symptoms were scaled as 3.7 before the Program and 2.0 after the Program (p<.01). Furthermore, the overall functionality of the oral cavity was improved as well. The control group showed 1.0 time increase in repetitive voluntary swallowing test (p<0.1), increased amount of sublingual saliva from 0.8mm to 1.4mm, and from 1.6mm to 2.0mm in dorsum linguae(p<0.1). Also, the control group showed an improvement in mouth opening as well, increased from 3.9 to 4.0cm after the oral care program (p<.05). When compared the result with the examination after the Visiting Oral Care Program, the two groups showed a significant difference with the control group showing a significant improvement compared to the intervention group(p<.01, p<.01, p<.01, p<.01, p<.05). 4. The correlation between the dental hygiene condition and the functionality of oral was made for the result of examining the beneficiaries for Visiting Oral Care Program. The amount of saliva showed a negative correlation with the severity of dental plaque (p<.05), and a positive correlation with the repetitive voluntary swallowing count (p<0.1). Also, mouth opening showed a positive correlation with repetitive voluntary swallowing count (p<.05). Conclusions : After the Visiting Orall Care Program, the beneficiaries of the program experienced improvement in their quality of life related to oral health, overall oral hygiene and functionality of oral.

• 대한치과보철학회지
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• 제52권4호
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• pp.346-351
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• 2014

흡착 의치는 의치상연 주위 전체를 가동 점막으로 봉쇄하여 연하나 교합 시 의치상 내면에 일시적으로 음압을 형성하여 의치의 유지와 안정을 강화한다. 본 증례의 환자는 81세의 남자 환자로 새로운 의치를 제작하고 싶다는 주소로 내원하였다. 의치의 유지와 저작 효율에 대한 환자의 높은 요구도를 고려하여 흡착 의치를 통한 총의치 제작을 계획하였다. 하악 후구치 융기 부위를 가압하지 않은 채로 예비 인상을 채득 후 상하악 진단모형을 제작하였다. 이후 개인 트레이 제작 후 최종 인상 채득과 동시에 고딕 아치 기록을 시행하여 중심위 및 수직 고경을 채득하였으며, 상악에는 해부학적 치아, 하악에는 비해부학적 치아를 배열하여 설측 교합을 형성하였다. 이상과 같이 완전 무치악 환자에서 하악 흡착 의치를 통한 총의치 수복은 만족스러운 유지와 기능을 회복할 수 있었기에 본 증례를 보고하고자 한다.

• Clinical and Experimental Pediatrics
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• 제48권4호
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• pp.433-437
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• 2005

위석은 비교적 흔하지 않은 질환이지만, 진단을 못할 경우 위궤양과 출혈, 장천공, 장중첩증, 장폐쇄, 복막염 등의 심각한 합병증을 동반할 수 있는 만성적 복통의 한 원인이며, 모발석 환아의 대부분은 발모벽과 식모증의 과거력이 있다. 저자들은 내원 4년 전까지 자기 머리카락을 뽑아서 먹는 습관이 있었고, 이후 간헐적 복통과 오심, 구토를 일으킨 11세 여아에서 모발석을 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권3호
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• pp.259-266
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• 2005

The function of the masseter and anterior temporal muscles was assessed by electromyography in 30 patients with mandibular prognathism (20 patients with facial asymmetry and 10 patients without facial asymmetry) before orthognathic surgery and 4weeks afterwards. Electromyogram(EMG) recordings were made during resting, clenching and swallowing. We compared with right-left difference of this recording and asymmetry index before and after orthognathic surgery. The result of this study was as follows. 1. There was no significant right-left difference in muscle activities of masticatory muscles both asymmetric groups and controls and many variable change after orthognathic surgery.(P>0.05) 2. The mean electric activity of the masticatory muscles was found to have decreased during more clenching than resting, but there was no statistically significant difference because of individual difference of measuring values.(P>0.05) 3. The asymmetry index of masticatory muscles in asymmetric groups was significantly greater during clenching compared with controls.(P<0.05) In conclusion, no right-left difference of muscle activities was found in patients with facial asymmetry before orthognathic surgery and 4weeks afterwards. Not only muscular functioning but also many other factors, such as occlusion, temporomandibular joint disorder and trauma, probably affect facial asymmetry and will be analyzed in future studies. And we will need long term follow-up after orthognathic surgery.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.607-612
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• 2010

Purpose: Maxillectomy for malignant tumor resection often leads to functional and aesthetic sequalae. Reconstruction following maxillectomy has been a challenging problem in the field of head and neck cancer surgery. In this article, we described three dimensional midface reconstructions using free flaps and their functional and aesthetic outcomes. Methods: We reconstructed 35 cases of maxillectomy defects using 9 radial forearm free flaps, 7 lattisimus dorsi musculocutaneous free flaps, 6 rectus abdominis musculocutaneous free flaps, 4 fibular osteocutaneous free flaps, and 9 anterolateral thigh free flaps, respectively. We classified post-maxillectomy defects by Brown's classification. 1 Articulation clarity was measured with picture consonant articulation test. Swallowing function was evaluated with the University of Washington quality-of-life Head and Neck questionnaire by 4 steps.2 Aesthetic outcomes were checked to compare preoperative with postoperative full face photographs by 5 medical doctors who did not involve in our operation. Results: The average articulation clarity was 92.4% (100-41.9%). 27 (81.9%) patients were able to eat an unrestricted diet. Aesthetic results were considered excellent in 18 patients (51.4%). Functional results were best in the group reconstructed with fibular osteocutaneous free flap. Considering the range of wide excision, aesthetic results is best in the group reconstructed with anterolateral thigh free flap. Conclusion: The free flap is a useful technique for the reconstruction of the midface leading to good results, both functionally and aesthetically. Especially, because osteocutaneous flap such as fibular osteocutaneous free flap offered bone source for osteointegrated implant, It produces the best functional results. And perforator flap like as anterolateral thigh free flap reliably provides the best aesthetic results, because it provides sufficient volume and has no postoperative volume diminution.

• 구강회복응용과학지
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• 제26권1호
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• pp.33-38
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• 2010

상악의 악성 종양에 대한 치료로서 상악골 절제술이 시행되며 필연적으로 이것은 환자 구개부에 결손부를 생성한다. 이로 인해 안모의 변형, 연하, 저작, 발음 등 다양한 문제가 발생할 수 있다. 상악골 절제술 후 이런 문제들을 극복하기 위해 외과적 재건 또는 보철적 치료가 치료 방법으로 선택될 수 있으나 대부분의 상악골 절제술 환자에서 구강악안면 재건의 방법으로 구개폐쇄장치가 더 선호된다. 본 증례는 Aramany 분류 II급에 해당하는 상악골 부분 절제술을 시행한 환자에게 구개폐쇄장치의 유지와 안정을 얻고 모든 기존의 금관수복물을 유지할 수 있는 swing-lock attachment를 사용하여 수복한 임상과정 및 결과에 관하여 보고하고자 한다.

• 대한영양사협회학술지
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• 제10권4호
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• pp.442-451
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• 2004

Protein-calories malnutrition is common among patients in the hospital. In particular, elderly patients with neurologic disorders has more risk of nutritional deficiency due to swallowing difficulty. Enteral tube feeding is more economical, physiological and immunological than parenteral nutrition for patients who have adequate gastrointestinal function. This study was conducted patients with neurologic disorders who received enteral nutrition at Asan Medical Center from February 1 to October 10, 2002. The control group (48 patients) were given traditional feeding methods 4 times a day while the treatment group (45 patients) were given improved feeding methods 3 times a day. We assessed nutritional status of patients and compared to both groups. We investigated body weight, serum albumin, hemoglobin, total lymphocyte count by means of nutrition markers. The objectives of this study is to reduce the time needed for nutritional requirement of patients without an increase in gastrointestinal intolerances. The results of this study are as follows: 1. Nutritional status of many patients in both groups were either malnourished or at risk for malnutrition. 2. The time to arrive to the nutritional requirements were 6.21 $\pm$ 0.35 days for the control group and 4.24 $\pm$ 0.52 days for the treatment group. The treatment group showed a significantly shorter amount of time. 3. The changes of the nutritional marker in the control group showed a significant drop in body weight, serum albumin and serum hemoglobin while the treatment group experienced a significant increase in body weight, serum albumin and total lymphocyte count. 4. Feeding intolerane such as diarrhea, high residual volume, ileus, nausea and vomiting were investigated. Diarrhea found in 25.1% (12 patients) of the control group and 22.2% (10 patients) of the treatment group and these findings are not significant.

• Journal of Oral Medicine and Pain
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• 제22권1호
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• pp.167-181
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• 1997

The aim of this study was to investigate the relationship between velocity and factors which could affect the velocity of mandibular movement. For this study, 30 dental students without any masticatory signs and symptoms and 90 patients with temporomandibular disorders(TMD) were selected as the control group and the patients group, respectively. After determining Angle's classification and lateral guidance pattern of occlusion, clinical examination for TMD was perfomed. Velocity and distance of mandibular movements were recorded with BioEGN, reproducibility index of lateral excursions was evaluated by Pantronic(PRI) and BioEGN (BERI) activity in masticatory and cervical muscles were measured with BioEMG, and occlusal contact time and cross-arch unbalance(Total left-right statistics, TLR) on clenching were recorded with T-scan, respectively. The results of this study were as follows : 1. Velocity in the patients was faster than that in the controls in most mandibular movements, but on wide opening and closing movement, result was reverse. 2. Velocity on closing movements were faster than that on opening movements in the control group and a similar tendency was also shown in the patients group. 3. Patients with muscle disorders showed a tendency to have the highest value of velocity of all diagnostic subgroups, while patients with degenerative joint diseases showed a tendency to have the lowest value. 4. Patients with canine guidance showed a tendency to have the highest value of velocity in three subgroups by lateral guidance pattern, while patients with group function showed a tendency to have the lowest value. 5. BERI had a positive correlation with opening velocity on lateral excursion, while TLR had a negative correlation with opening velocity on swallowing. 6. EMG activity on clenching in masticatory muscles had negative correlation with opening velocity on border movements, and on swollowing, while the activity in rest correlated positively with opening velocity on border movements. 7. There were positive correlation between the velocity and the distance in long components of mandibular trajectory.

• 구강회복응용과학지
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• 제32권4호
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• pp.351-357
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• 2016

상악절제술 후 환자들의 재건 치료는 쉽지 않은 과정이다. 상악골 결손은 저작, 발음, 연하 장애를 초래하여 기능적인 회복이 필요하다. 폐쇄장치 제작의 목표는 결손부를 대체하여 구강기능을 회복하고 환자에게 편안함과 심미성을 제공하는 것이다. 본 증례에서는 임플란트를 이용한 인두 폐쇄장치 제작 후 획득한 저작력과 심미성 그리고 개선된 유지력을 보고하고자 한다.

• 치위생과학회지
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• 제21권1호
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• pp.8-18
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• 2021

The purpose of this study is to provide the general history of fostering dentists in Japan and introducing their new roles. This research was conducted based on the government policy report on dentists and the information published by each educational institution. Based on the collected data, the official websites were used to represent the latest statistics of the institutions. The number of dentists in Japan has increased. The government established the National Examination for Dentists to guarantee the quality of dentists. After the standards for developing questions for the national examination were established in 1985, the contents of the examination have been appropriately improved by revising the standards every four years. This improvement has required dental students to study a variety of subjects for six years at dental school. Since dentists in Japan are required to respond to various demands from the nation; the Model Core Curriculum for Dental Education was developed to teach medical ethics and abilities to ensure that dentists conduct themselves professionally. Recently, the roles of dentists have been changing in Japan. When providing dental services to older patients over the age of 65, dentists and other dental professions focus on maintaining oral functions, such as saliva secretion, bite force, tongue movement, and masticatory/swallowing functions. However, oral function-related services for children are different. In addition to providing essential dental services, dental practitioners also provide special treatment, such as oral muscle training, myofunctional therapy, health guidance, and space retainers to the child patients with developmental insufficiency in oral functions. Dentistry in Japan has undergone numerous changes over the years and has continued to offer high-quality dental health services. Thus, information gained from the Japanese experience may be helpful to dental professions in other developed countries for planning oral health measures.