• 보건행정학회지
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• 제25권3호
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• pp.240-251
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• 2015

Background: Dentist's income is quite variable. We investigate the factors underlying the distribution of dental revenue and dentist income. Methods: Financial and structural variables of private dental practices(N=13,967) were examined with 2010 Economic Census microdata which include non-insurance revenue. We conducted quantile regression method(QRM) and ordinary least square(OLS) in treating skewness and heteroskedasticity of distributions. The effective estimation for the upper and lower range of distribution becomes possible by QRM. Results: Mid-career dentists are shown to have higher revenue and income. Male dentists achieve the higher revenue and income than female dentists in all quantiles. Group practices show lower income per owner than solo practices significantly. The revenue and income are increased with increasing size of clinics. The high cost in renting the clinic office is found to have a big positive effect on the revenue but a little positive effect on the income. Interestingly the density of dentists shows negative effect on the lowest quantile of the revenue but positive effect on the highest quantile. The lowest quantile of the revenue in the capital areas have the relatively high revenue. The lowest quantile of the income in metropolitan city show higher income than those in other areas significantly. Conclusion: The suggested QRM is shown to have more effective and efficient tool in finding out determinants of dentists' revenue and income of our concern. The results of this study are expected to be employed for dentists preparing for the opening practices in their organizational settings and locational selections. The distributional efficiency of dental human resources could be accomplished if policy makers guide dentists with this knowledge.

• 대한치과의사협회지
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• 제54권12호
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• pp.971-984
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• 2016

The increase rate of dentists' competition is very fast at metropolitan areas in South Korea. We compare metropolitan and rural parameters to investigate the relation between competition and revenue variation. The competition and revenue variables of 73 metropolitan and 75 rural areas were calculated from 2010 Census of Service Industry microdata which include non-insurance revenues of dental clinics. Independent sample t-test results showed that the level of competition among dental clinics in metropolitan areas is higher. The lowest and the low ranked revenues are higher in rural areas. The highest and the average revenues are higher in metropolitan areas. But, 25 percentile and median revenues has no significant difference between two areas. Simple log linear regression results showed that the number of clinics could explain the distribution of revenues in both areas better than the density of active dentists and Herfindahl-Hirschman index. In the areas with many clinics have high maximum and average revenues and low minimum revenues. The increasing rate of maximum revenues is higher in metropolitan areas though the decreasing rate of minimum revenues is higher in rural areas. Metropolitan areas have higher Gini coefficients than rural areas, but the increasing rate of Gini coefficients is lower than rural areas. Findings from this study are useful reference when the dentists select the opening areas. One is that the median revenues between metropolitan and rural areas have no significant difference. The other is that the rural areas ensure the more stable and uniform revenues. The results would help to relieve the consumptive competition among dentists and to achieve the distributional efficiency of dental human resources.

• Imaging Science in Dentistry
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• 제48권3호
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• pp.227-231
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• 2018

In recent years, as interest in maintaining beauty and a youthful appearance has grown, filler procedures such as soft tissue augmentation have become more popular. These fillers are sometimes seen as radiopaque shadows on radiographic images, either due to the fillers themselves or because of secondary reactions; such findings may present a diagnostic challenge to dentists. The present report describes 3 cases of dermal fillers observed in panoramic and cone-beam computed tomographic (CBCT) images. All 3 elderly female patients had filler injected into their cheeks and chin area for cosmetic purposes decades ago. On panoramic images, multiple symmetric radiopacities were observed in the facial area; on CBCT, these calcifications were seen in the subcutaneous tissue in various shapes and with varying density. In conclusion, dentists should be aware of the imaging characteristics of dermal filler, and should be able to differentiate dermal filler from other pathological findings.

• 의료법학
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• 제17권1호
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• pp.281-297
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• 2016

임플란트 시술 부위의 정확하고 객관적인 골조직의 평가는 치료계획을 세우고 결과를 예측하는 과정에서 중요한 요소로 작용한다. 골조직 평가는 임플란트가 시술되는 치조골의 상부구조 제작 시기를 결정할 수 있는 가장 객관적 방법이다. 하지만 이러한 골조직 평가가 치과 임상의의 주관적인 견해에 의해서 기초가 수립되기 때문에 상당한 모순을 내포하고 있다. 치과임상들 역시 골조직에 대한 주관적인 평가의 문제점을 지적하고 있다. 따라서 정확하고 객관적인 기준을 마련하는 것이 요청된다. 과거 골밀도 평가는 임플란트 시술시 드릴링 작업과 같이 치고임상의의 주관적인 감각에 의존하였다. 그러나 이제는 컴퓨터 단층 촬영에서 나타난 각 픽셀에 대한 CT의 HU(Hounsfield unit)값을 이용하여 객관적이고 정확한 분류가 가능하게 되었다. Misch와 Kircos는 주관적인 골밀도 분류를 수치화하여 골조직을 D1부터 D5까지 다섯 단계로 나누었다. 하지만, 이 분류 방법도 정량화 된 테이터를 이용한 것이 아니라 감각에 의해 분류한 것을 단지 수치화한 것이다. 그러므로 더욱 객관적이고 정량화된 데이터의 비교 분석을 통해 임플란트 시술 부위의 골질을 평가할 필요가 있다. 임플란트시술은 치과의료분쟁에서 가장 높은 빈도를 차지하고 있다. 따라서 객관적인 검사와 합리적인 치료방법을 도입하여 임플란트 시술이 이루어진다면 의료분쟁에서 보다 합리적인 결과에 도달할 수 있을 것이며, 임플란트 시술의 실패율도 낮아 질 것이다. 따라서 본 연구의 궁극적인 목적은 객관적이고 정량화된 데이터를 기초로 한 법적으로 새로운 기준을 만들어서 환자뿐만 아니라 치과 임상의에게도 발생될 수 있는 의료분쟁을 최소화하고 하고자 하는 것이다.

• Imaging Science in Dentistry
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• 제35권2호
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• pp.63-68
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• 2005

Recently implant has become an important field in dental clinic. Radiographic examination of pre- and post- operation is essential for successful treatment. Clinicians should have knowledge about the purpose of the radiographic examination, suitable imaging modality for the cases, anatomic landmarks of tooth and jaw bone, advantage and limitation of panoramic radiographic examination for implant, principle and interpretation of cross-sectional imaging, bone mineral density, post-operative radiographic examination. This paper will be helpful to get above informations for dentists who want to do dental implant successfully.

• 구강회복응용과학지
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• 제27권4호
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• pp.359-370
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• 2011

임플란트의 골유착 성공 여부를 확인하기 위해서 방사선학적 분석방법을 사용하였다. 치근단 방사선 사진을 이용한 프렉탈 분석방법을 사용하여 기능하중 전 후의 임플란트 주변 골밀도를 분석하고 골유착에 실패한 임플란트와 성공한 임플란트 사이에 유의한 차이가 있는지 비교하였다. 본 연구에서는 원광대학교 치과병원에서 임플란트 식립 시술을 받은 30명의 환자에서 총 42개의 임플란트를 분석에 사용하였다. 환자는 14명의 남자와 16명의 여자로 구성 되었고 나이는 22세에서 73세 사이였다. 치조골의 trabecular 양상의 형태와 프렉탈 분석은 치근단 방사선 사진을 이용하였다. 총 2장의 치근단, 즉 임플란트 식립 직후와 임플란트 보철물 장착 후 기능 하중이 가해진 뒤 3개월 후의 방사선 사진이 사용되었다. 분석은 Image J(1.40s, National Institute of Health, Bethesda, USA)를 이용하여 시행하였다, 통계학적 분석방법은 one-way ANOVA(P<.05)를 이용하여 시행하였다. 그리고 Tukey multiple comparison test로 사후검정을 실시하였다. 프렉탈 분석 결과와 임플란트 주변의 골밀도 변화는 통계적으로 유의할만한 상관관계가 있으며 특히 하악에서 이런 결과가 더욱 명백하였다. 또한 두개의 실패한 임플란트의 경우 프렉탈 수치가 각각 1.2865에서 1.1521로, 1.1135에서 1.0478로 감소되는 경향을 나타냈다.

• Imaging Science in Dentistry
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• 제43권3호
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• pp.153-161
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• 2013

Purpose: To prevent low bone mineral density (BMD), that is, osteoporosis, in postmenopausal women, it is essential to diagnose osteoporosis more precisely. This study presented an automatic approach utilizing a histogram-based automatic clustering (HAC) algorithm with a support vector machine (SVM) to analyse dental panoramic radiographs (DPRs) and thus improve diagnostic accuracy by identifying postmenopausal women with low BMD or osteoporosis. Materials and Methods: We integrated our newly-proposed histogram-based automatic clustering (HAC) algorithm with our previously-designed computer-aided diagnosis system. The extracted moment-based features (mean, variance, skewness, and kurtosis) of the mandibular cortical width for the radial basis function (RBF) SVM classifier were employed. We also compared the diagnostic efficacy of the SVM model with the back propagation (BP) neural network model. In this study, DPRs and BMD measurements of 100 postmenopausal women patients (aged >50 years), with no previous record of osteoporosis, were randomly selected for inclusion. Results: The accuracy, sensitivity, and specificity of the BMD measurements using our HAC-SVM model to identify women with low BMD were 93.0% (88.0%-98.0%), 95.8% (91.9%-99.7%) and 86.6% (79.9%-93.3%), respectively, at the lumbar spine; and 89.0% (82.9%-95.1%), 96.0% (92.2%-99.8%) and 84.0% (76.8%-91.2%), respectively, at the femoral neck. Conclusion: Our experimental results predict that the proposed HAC-SVM model combination applied on DPRs could be useful to assist dentists in early diagnosis and help to reduce the morbidity and mortality associated with low BMD and osteoporosis.

• Journal of Oral Medicine and Pain
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• 제38권3호
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• pp.247-253
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• 2013

신성골이영양증 (Renal osteodystrophy)은 만성 신질환 환자에서 관찰되는 골격성 변화를 특징으로 하는 질환으로 칼슘과 인 대사의 변화, 그리고 이차성 부갑상선 기능항진증의 결과로 나타난다. 방사선학적으로 지골의 말단, 장골과 악골 부위의 골막하 부위의 침식을 흔하게 관찰할 수 있다. 악안면 영역에서 골변화는 골밀도의 감소, 방사선 투과성 병소 (갈색 종양 : brown tumor), 피질골의 비박화와 치조백선의 소실을 보인다. 그러나 이러한 골변화가 악관절에 발생하는 것은 흔치 않은 일이다. 본 증례는 양측 하악 과두의 골변화를 보인 신성골이영양증 환자를 보고하고자 한다. 지난 10년 간 혈액 투석 치료와 3개월 전 신장암 수술 병력이 있는 41세 남자 환자가 좌측 턱의 통증을 주소로 2011년 2월 단국대학교 치과대학부속 치과병원 구강내과에 내원하였다. 양측 악관절의 골관절염과 유사한 방사선학적 소견을 보였고, 전치부 개방교합이 관찰되었다. CBCT를 이용한 방사선학적 특징과 생화학적 지표를 통해 신성골이영양증으로 인한 양측 턱관절의 골관절염으로 진단 되어 환자는 내과에서 신성골이영양증의 치료 방법의 하나인 칼슘 및 비타민 D 복용고 부갑상선 절제술을 시행 받았고, 그 동안 턱관절의 통증 조절을 위해 본원에서는 행동 요법과 약물 치료, 물리치료만 시행하였다. 약 1년 3개월 후 재검사에서 하악골의 골밀도와 피질골 두께가 증가하였고, 하악 과두 외형이 비교적 명확하게 바뀌었다. 골변화는 만성 신장 질환의 초기 단계부터 시작되므로 치과의사는 이러한 질환의 징후 및 가능성을 신속히 감별할 수 있어야 한다. 또한 골관절염과 신성골이영양증의 치료 프로토콜이 다르기 때문에 두 질환을 감별하는 것이 중요하다.

• Restorative Dentistry and Endodontics
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• 제27권2호
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• pp.113-121
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• 2002

Conventional intraoral radiography continues to be the most widely used image modality for the diagnosis of dental caries. But, conventional intraoral radiography has several shortcomings, including the difficulty of exposing and processing intraoral film of consistently acceptable quality. In addition, radiographic retaking that was the result of processing errors, may result in increased discomfort and radiation dose to the patient. Recently, various digital radiographies substitute for conventional intraoral radiography to overcome these disadvantages. The advantages of digital radiography are numerous. One of advantages Is the elimination of processing errors. In addition, the radiation dose for digital system is approximately 20% to 25% of that required for conventional intraoral radiography Another potential advantage of digital imaging is the ability to perform image quality enhancements such as contrast and density modulation, which may increase diagnostic accuracy. The purpose of this study was to compare the diagnostic ability of artificial proximal defects to conventional intraoral radiography, direct digital image(CDX2000HQ$^{\circledR}$) and indirect digital image(Digora$^{\circledR}$). Artificial defects were made in proximal surfaces of 60 extracted human molars using #1/2, #1, #2 round bur. Five dentists assessed proximal defects on conventional intraoral radiography, direct digital image(CDX2000HQ$^{\circledR}$) and indirect digital image(Digora$^{\circledR}$). ROC(Receiver Operating Characteristic) analysis and Two-way ANOVA test were used for the evaluation of detectability, and following results were acquired. 1. The mean ROC area of conventional intraoral radiography, direct digital image(CDX2000HQ$^{\circledR}$) and indirect digital Image(Digora$^{\circledR}$) were 0.6766, 0.7538, 0.6791(Grade I), 0.7176, 0.7594, 0.7361(Grade II), and 0.7449, 0.7608, 0.7414(Grade III), respectively. 2. Diagnostic ability of direct digital image was higher than other image modalities. But, there was no statistically significant difference among other imaging modalities for Grade I, II, III lesion(p>0.05). In conclusion, when direct and indirect digital system are comparable with conventional intraoral radiography. these systems may be considered an alternative of conventional intraoral radiography for the diagnosis of proximal surface caries.