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Diagnosis and Effect of Maxillary Expansion in Pediatric Sleep-Disordered Breathing (소아 수면호흡장애의 진단과 상악확장술의 치료효과)

  • Kim, Doyoung;Baek, Kyounghee;Lee, Daewoo;Kim, Jaegon;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.4
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    • pp.369-381
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    • 2019
  • The aim of this study was to analyze the changes and improvements in symptoms of sleep-disordered breathing (SDB) using semi-rapid maxillary expansion (SRME) in children with narrow maxilla and SDB symptoms. Subjects were 15 patients with sleep disorder (apnea-hypopnea index, AHI ≥ 1) and narrow maxillary arch between 7 and 9 years of age. Before the SRME was applied, all subjects underwent pediatric sleep questionnaires (PSQ), lateral cephalometry, and portable sleep monitoring before expansion (T0). All subjects were treated with SRME for 2 months, followed by maintenance for the next 3 months. All subjects had undergone PSQ, lateral cephalometry, and portable sleep monitoring after expansion (T1). Adenoidal-nasopharyngeal ratio (ANR), upper airway width and hyoid bone position were measured by lateral cephalometry. The data before and after SRME were statistically analyzed with frequency analysis and Wilcoxon signed rank test. As reported by PSQ, the total PSQ scale was declined significantly from 0.45 (T0) to 0.18 (T1) (p = 0.001). Particularly, snoring, breathing, and inattention hyperactivity were significantly improved (p = 0.001). ANR significantly decreased from 0.63 (T0) to 0.51 (T1) (p = 0.003). After maxillary expansion, only palatopharyngeal airway width was significantly increased (p = 0.035). There was no statistically significant difference in position of hyoid bone after expansion (p = 0.333). From analysis of portable sleep monitoring, changes in sleep characteristics showed a statistically significant decrease in AHI and ODI, and the lowest oxygen desaturation was significantly increased after SRME (p = 0.001, 0.004, 0.023). In conclusion, early diagnosis with questionnaires and portable sleep monitoring is important. Treatment using SRME will improve breathing of children with SDB.

A Study on the Influence of Finishing and Polishing Methods on the Gap between Denture Base Resin and Soft Liner (의치의 마무리와 연마법이 의치상 레진과 연성 이장재 간의 공극에 미치는 영향에 관한 연구)

  • Jung, Seung-Hwan;Lee, Joon-Seok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.4
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    • pp.325-335
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    • 2008
  • The junction between resilient denture liner and the denture base is difficult to finish and polish due to difference of the physical property of the materials. Gaps tend to be formed during finishing and polishing procedures. The purpose of this study was measuring the width of junctional gap between $Molloplast-B^{(R)}$ and denture base material after finishing and polishing procedure, and evaluating the effect of method and direction on gap width. $Molloplast-B^{(R)}$ was processed (according to the manufacturer's instruction) against Lucitone $199^{(R)}$ acrylic resin. 50 specimens were fabricated with a raised center section. All of specimens were examined and photographed with a stereoscopic microscope(x120), and the largest gap along the junction of $Molloplast-B^{(R)}$ and acrylic resin on each specimen was measured. One-way analysis of variance(ANOVA) and independent t-test at 95% confidence level were used to analyze the data and to compare groups. The results of this study were as follows. In comparison with finishing tools, the gap width was the largest in $Molloplast^{(R)}$-Cutter and the smallest in FSQ-cross cut bur. There was statistically significant difference between FSQ-cross cut bur and $Molloplast^{(R)}$-Cutter(p<0.05). There was no significant difference in gap width between the direction of polishing. The mean value of gap width was the smallest in case of no polishing, and the largest in case of polishing with pumice & tin oxide. There was statistically significant difference between pumice and pumice & tin oxide. From the results, it is concluded that the use of $Molloplast^{(R)}$-Cutter in clinic need serious consideration even though it has good cutting ability. Further careful study is needed for finishing and polishing methods for decreasing gap width in junction of two materials.

The Three Dimensional Analysis on Nasal Airway Morphology in Class III Malocclusion (골격성 III급 부정교합자의 Nasal Airway 형태에 관한 3차원적 분석 연구)

  • Kim, Moon-Hwan;Lee, Jin-Woo;Cha, Kyung-Suk;Chung, Dong-Hwa
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.4
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    • pp.389-403
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    • 2008
  • In Angle's Class III malocclusion, which has higher incidence in Korean than Western, depressed midfacial profile with protruded lower lips and mandible may give rise to many functional, esthetic, psychological, social problems. Due to the different malocclusion incidence according to racial differences, many previous studies focused on the relationship between Class II malocclusion and nasal airway obstruction. Previous studies used lateral cephalography which has limitations of 2 dimensional image with projection error and identification error. Therefore, the purpose of this study was to analyze morphologic differences in the nasal airway between normal occlusion and Angle's Class III malocclusion patients using 3-dimensional facial computed tomography. Thirteen normal occlusion(7 men and 6 women) and sixteen skeletal Class III(7 men and 9 women) patients were selected and 3-dimensional facial computed tomography taking was performed. Comparison between two group in volume and sectional area of nasal airway were carried out. The results were followed. 1. In the comparison of absolute nasal airway volume, oropharyngeal space of experimental group were larger than control group but there are no significant difference in other. 2. In the comparison of relative nasal airway volume, oropharyngeal space of experimental group were larger than control group but there are no significant difference in other. 3. In the oropharyngeal space width on frontal and lateral view, the similar tendency was revealed between two groups. 4. In the lateral curvature of nasal airway, the similar tendency was revealed between two groups.

Histomorphometric Study of Sinus Bone Graft using Various Graft Material (다양한 골이식재료를 이용한 상악동 골이식 4개월 후 조직형태계측학적 평가)

  • Lee, Ji-Young;Kim, Young-Kyun;Kim, Su-Gwan;Lim, Sung-Chul
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.2
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    • pp.141-147
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    • 2011
  • The aim of this study was to evaluate histomorphometrically and compare the efficiency of various bone graft material and autogenous tooth bone graft material which were used in sinus bone graft procedure. Subjects were the 24 patients who had treated with sinus bone graft using lateral approach from October 2007 to September 2009 at SNUBH. The average age was $52.51{\pm}11.86$ years. All cases was taken after 4month of procedure and divided into 3 groups according to bone graft material. Group 1: autogenous tooth bone graft material, Group 2: OrthoblastII(integra lifescience corp. Irvine, US)+Biocera(Osscotec, seoul, korea), group 3: DBX(Synthes, USA)+BioOss(Geistlich Pharm AG, Wolhusen, Switzerland). Total 37 implant placement area were included and evaluated(7 in group 1, 10 in group 2, 20 in group 3). Evaluation of new bone formation, ratio of woven bone to lamellar bone, ratio of new bone to graft material were performed on each tissue section. Kruskal-Wallis test was used for statistical analysis(SPSS Ver. 12.0, USA). New bone formation were $52.5{\pm}10.7%$ in group 1, $52.0{\pm}23.4%$ in group 2, $51.0{\pm}18.3%$ in group 3. There were no statistical significant differences between each groups. Ratio of woven bone to lamella bone were $82.8{\pm}15.3%$ in group 1, $36.7{\pm}59.3%$ in group 2, $31.0{\pm} 51.2%$ in group 3. Ratio of new bone to graft material were $81.3{\pm}10.4%$ in group 1, $72.5{\pm}28.8%$ in group 2, $80.3{\pm}24.0%$ in group 3. After 4 month of healing period, all group showed favorable new bone formation and around graft material and implant. Within limitation of our study, it is suggested that autogenous tooth bone graft material might be used as novel bone graft material for sinus bone graft.

The Effect of Temporary Cement Cleaning Methods on the Retentive Strength of Cementation Type Implant Prostheses (임시 시멘트 제거방법이 시멘트 유지형 임플란트 보철물의 유지력에 미치는 영향)

  • Shin, Hwang-Kyu;Song, Young-Gyun;Shin, Soo-Yeon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.2
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    • pp.125-140
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    • 2011
  • The remnant of temporary cement on the intaglio surface of cast restoration may have a negative effect on the retentive strength of permanent cement. This study was to evaluate the effect of temporary cement cleaning methods on the retentive strength of cementation type implant prostheses. Prefabricated implant abutments - height 5.5mm, diameter 4.5mm, 6 degree axial wall taper with chamfer margins were used. Forty copings-abutment specimens were divided into four groups(each n=10) according to the cleaning methods for temporary cement(Temp-$Bond^{(R)}$) as follows : no temporary cementation(the control group), orange solvent, ultrasonic cleaning, air borne-particle abrasion. After the application of temporary cement and the separation, the cleaning procedure was performed according to the protocol of each group. The specimens were cemented with $Premier^{(R)}$ Implant $Cement^{TM}$. After the permanent cementation, the specimens were subjected to thermocycling and pulled out from the specimens with a universal testing machine at a cross-head speed of 0.5mm/min. After the retentive strength test, all the specimens were cleaned using ultrasonic cleaning, abraded with air borne-particles, and steam-cleaned. Likewise, the specimens were temporarily cemented(Temp-$Bond^{(R)}$ NE), cleaned according to the protocol of each group, cemented with $Premier^{(R)}$ Implant $Cement^{TM}$ and subjected to thermocycling and measurement of their retentive strength. The mean of group with orange solvent were significantly lower than those of other groups(p<0.05). There was no significance between group with ultrasonic cleaning and group with air borne-particle abrasion. Group with ultrasonic cleaning and group with air-particle abrasion were no significance at control group. There was no significance between group cemented with Temp-$Bond^{(R)}$ and group cemented with Temp-$Bond^{(R)}$ NE. Within the limitation of this study, it can be concluded that the temporary cement cleaning method with only orange solvent may have a negative effect on the retentive strength of permanent cement. Ultrasonic cleaning and air borne-particle abrasion methods are recommended for the temporary cement cleaning method on cementation type implant prostheses.

Comparative Study on the Ability of Instruments to Maintain Original Canal Curvature of Continuous rotary System and Single File System (Continuous rotary system과 single file system의 만곡 근관 형태 유지능에 대한 비교 연구)

  • Park, Sang-Hee;Kim, Deok-Joong;Song, Yong-Beom;Lee, Hye-Yun;Kim, Hyoung-Sun;Lee, Kwang-Won;Yu, Mi-Kyung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.371-383
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    • 2012
  • Shaping the root canal system to maintain original canal curvature is essential to clinical success in endodontic treatment. Opposed to most root canals that are curved, endodontic instruments are made from straight metal blanks. They have a tendency of straightening the root canal during preparation and frequently result in procedural errors. A new treatment method to maintain original canal curvature during shaping has been introduced for preventing procedural errors. The aim of this study was to compare the ability of instruments to maintain original canal curvature of continuous rotary system and single file system. Thirty ISO 15, 0.02 taper, Endo Training Blocks(Dentsplay Maillefer) were used. Specimens were assigned to 1 of 3 groups for shaping: specimens in group 1 were shaped with ProFile #20/.06 at the WL. Specimens in group 2 were shaped with Mtwo #35/.04 at the WL. Specimens in group 3 were shaped with WaveOne Primary reciprocating files at the WL after the glide path was achieved with PathFile. Pre- and postinstrumentation digital images were superimposed and processed with Matlab r2010b(The MathWorks Inc, Natick, MA) software to analyze the curvature-radius ratio(CRr), representing canal curvature modification. Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file were analyzed with 1-way ANOVA(P<.05). Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file system were analyzed with independent t-test(P<.05). A statistically significant difference(P<0.05) was noted on each Ni-Ti file. ProFile and WaveOne instrumentations maintained the original canal curvature significantly better(P<0.05) than Mtwo file. There were no significant difference(P>0.05) between continuous rotary system and single file system. Under the conditions of this study, ProFile and WaveOne instruments maintained the original curvature significantly better than Mtwo file and were less modification of the canal curvature compared. There was no significant difference between continuous rotary system and single file system in shaping of simulated canals. As clinical practitioners, it may be advantages to use hybrid approach when root canal shapes depending on the design and usage of Ni-Ti files.

The Effect of Packing Method of Relining Material on the Flexural Strength of Denture Base Resin (첨상용 레진의 성형법이 의치상의 굴곡강도에 미치는 영향)

  • Kim, Min-Chul;Kim, Yu-Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.2
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    • pp.197-207
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    • 2011
  • The study aimed at examining how different reline resins affect flexural strength and flexural modulus of denture base. A total of 80 specimens ($64{\times}10{\times}3.3$ mm, according to ISO 1567:1999) of heat-polymerized resin, 40 specimens for (Lucitone199(Dentsply Int., NewYork, USA), SR Ivocap(Ivoclar AG, Schaan, Liechtenstein)) respectively, were polymerized according to the manufacturer's instructions and divided into eight groups(n = 10). Control group specimens remained intact. Specimens in the other groups were abraded on both sides to 2 mm thickness, and were relined in 1.3 mm thickness with 3 types of resins (Lucitone199(Dentsply), SR Ivocap(Ivoclar), and Rebase II(Tokuyama Co., Ltd, Tokyo, Japan)). All specimens were preserved in distilled water at $37^{\circ}C$ for 50 hours, and then were subjected to flexural strength testing in a universal testing machine using 3-point loading. A crosshead speed of 5 mm/min was used, and the distance between the supports was 50 mm. Data analyses included one-way analysis of variance(ANOVA) and the Tukey Honestly Significant Difference test (p=.05). Both heat-polymerized resin groups and auto-polymerized resin groups showed statistically low flexural strength and flexural modulus than control groups. Specimens relined with Lucitone 199 showed significantly higher flexural strength and flexural modulus than those relined with SR-Ivocap. Specimens relined with auto-polymerized resin showed significantly lower flexural strength and flexural modulus than those relined with heat-polymerized resin. Relining with heat-polymerized resins showed superior mechanical properties to relining with an auto-polymerized resin. Relining with the same heat-polymerized resin as the denture base does not affect mechanical properties of a denture. Lucitone199 using a compression-mould technique resulted in the highest flexural strength.

Histomorphometry and Stability Analysis of Loaded Implants with two Different Surface Conditions in Beagle Dogs (하중을 가한 두 가지 표면의 임플란트에 관한 조직형태학적 분석 및 안정성 분석 (비글견을 이용한 연구))

  • Kim, Sang-Mi;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.4
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    • pp.337-349
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    • 2008
  • Despite an improved bone reactions of Mg-incorporated implants in the animals, little yet has been carried out by the experimental investigations in functional loading conditions. This study investigated the clinical and histologic parameters of osseointegrated Mg-incorporated implants in delayed loading conditions. A total of 36 solid screw implants (diameter 3.75 mm, length 10mm) were placed in the mandibles of 6 beagle dogs. Test groups included 18 Mg-incorporated implants. Turned titanium Implants served as control. Gold crowns were inserted 3 months. Radiographic assessments and stabilitytests were performed at the time of fixture installation, $2^{nd}$ stage surgery, 1 and 3 months after loading. Histological observations and morphometrical measurements were also performed. Of 36 implants, 32 displayed no discernible mobility, corresponding to successful clinical function. There was no statistically significant difference between test implants and controls in marginal bone levels (p=0.413) and RFA values. The mean BIC % in the Mg-implants was $54.4{\pm}20.2%$. The mean BIC % in the turned implant was $48.9{\pm}8.0%$. These differences between the Mg-implant and control implant were not statistically significant (P=0.264). In the limitation of this study, bone-to-implant contact (BIC) and bone area of Mg-incorporated oxidized implant were similar to machine-turned implant. The stability analysis showed no significantly different ISQ values and marginal bone loss between two groups. Considering time-dependent bone responses of Mg-implant, it seems that Mg-implants enhanced bone responses in early loading conditions and osseointegrated similarly to cp Ti implants in delayed loading conditions. However, further investigations are necessary to obtain long-term bone response of the Mg-implant in human.

Signs and symptoms of temporomandibular disorders in instrumental performers (악기연주자의 측두하악장애 징후와 증상)

  • Jang, Jae-Young;Choi, Young-Chan;Bae, Jung-Hee;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.2
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    • pp.86-95
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    • 2015
  • Purpose: The aim of the study was to evaluate the subjective symptoms and clinical signs through the TMD-questionnaire, clinical examination and radiography against the many instrumental performers and to investigate the association between playing instruments and TMDs. Materials and Methods: A total of 803 instrumental performers received TMD-related questionnaire and evaluations of prevalence and disease distribution were performed. Among those who reported at least one symptom of TMD, 70 volunteers visited in clinic then received clinical examination and radiography for diagnosis and evaluations of prevalence and disease distribution were performed. 70 subjects were divided into three groups as woodwind, brass wind, string. Comparative analysis of disease distribution was performed. Results: Among 803 instrumental performers, 610 people (75.97%) were reported to one or more symptoms of TMD. The most frequent symptom was click (29.68%).70 subjects underwent a clinical examination and radiography survey results, the most frequent symptom was a click (29.75%). Most commonly diagnosed disease was a myofacial pain (30.53%).Comparison of the three groups, a significant difference was not observed in the clinical sign. But among subject symptom, muscle pains howed significant differences in accordance with the Group (P = 0.024). During the 70 people who underwent clinical examination, 66 people (94.3%) showed moderate to severe attrition, mild to severe tongue ridging, mild to severe cheek ridging assigns of parafunction. Conclusion: Instrumental performers showed a high prevalence of TMD and the most of the musicians with temporomandibular disorder had bruxism or clenching habits.

Comparison of flexural strength according to thickness between CAD/CAM denture base resins and conventional denture base resins (CAD/CAM 의치상 레진과 열중합 의치상 레진의 두께에 따른 굴곡 강도 비교)

  • Lee, Dong-Hyung;Lee, Joon-Seok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.3
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    • pp.183-195
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    • 2020
  • Purpose: The purpose of this study is to compare the flexural strength of CAD/CAM denture base resins with conventional denture base resins based on their thicknesses. Materials and Methods: For the conventional denture base resins, Lucitone 199® (C-LC) was used. DIOnavi - Denture (P-DO) and DENTCA Denture Base II (P-DC) were taken for the 3D printing denture base resins. For the prepolymerized PMMA resins, Vipi Block Gum (M-VP) and M-IVoBase® CAD (M-IV) were used. The final dimensions of the specimens were 65.0 mm x 12.7 mm x 1.6 mm / 2.0 mm / 2.5 mm. The 3-point bend test was implemented to measure the flexural strength and flexural modulus. Microscopic evaluation of surface of fractured specimen was conducted by using a scanning electron microscope (SEM). After testing the normality of the data, one-way ANOVA was adopted to evaluate the differences among sample groups with a significance level of P = 0.05. The Tukey HSD test was performed for post hoc analysis. Results: Under the same thicknesses, there are significant differences in flexural strength between CAD/CAM denture base resins and conventional denture base resins except for P-DO and C-LC. M-VP showed higher flexural strength than conventional denture base resins, P-DC and M-IV displayed lower flexural strength than conventional denture base resins. Flexural modulus was highest in M-VP, followed by C-LC, P-DO, P-DC, M-IV, significant differences were found between all materials. In the comparison of flexural strength according to thickness, flexural strength of 2.5 mm was significantly higher than that of 1.6 mm in C-LC. Flexural strength of 2.5 mm and 2.0 mm was significantly higher than that of 1.6 mm in P-DC and M-VP. In M-IV, as the thickness increases, significant increase in flexural strength appeared. SEM analysis illustrates different fracture surfaces of the specimens. Conclusion: The flexural strength of different CAD/CAM denture base resins used in this study varied according to the composition and properties of each material. The flexural strength of CAD/CAM denture base resins was higher than the standard suggested by ISO 20795-1:2013 at a thickness of 1.6 mm or more though the thickness decreased. However, for clinical use of dentures with lower thickness, further researches should be done regarding other properties at lower thickness of denture base resins.