• Journal of Periodontal and Implant Science
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• v.28 no.4
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• pp.645-660
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• 1998

The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was $0.83{\pm}0.12$ by non surgical treatment and $0.82{\pm}0.14$ by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving nonsurgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.

• Journal of Veterinary Clinics
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• v.29 no.6
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• pp.474-482
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• 2012

Elongation of cheek teeth roots in pet rabbits is very common, and is associated with malocclusion followed by reduced appetite, salivation, periapical abscess, and epiphora. Conservative methods including medication, drainage, irrigation, tooth trimming, intraoral and extraoral extraction, surgical treatment of periapical abscessation, and diet control have been adapted as the only treatments to resolve elongation of teeth roots. However, remaining challenges include the long-term period of cure and recurrence. This study was performed to investigate the possibility of nonvital pulp therapy on elongation of the mandibular cheek teeth roots in pet rabbits. Thirty-one pet rabbits with dental problems due to root elongation were submitted. Ten pet rabbits among them were treated by nonvital pulp therapy procedures (group A), while the others were treated by conservative methods (group B). Appetite improved within 1-5 days after nonvital pulp therapy and the treatment was discontinued 1 month postoperatively in group A. Abscess occurred in another site not treated with nonvital pulp therapy in only two rabbits. Growth of the mandibular cheek teeth treated with nonvital pulp therapy stopped, resulting in malocclusion, intraoral inflammation from the enamel spur, and abscess of the teeth roots. In the group B rabbits treated with conservative therapy, partial drainage, long term medication, recurrent oral trimming and control of repeated oral inflammation occurred. Consequently, buccotomy or tooth extraction was performed in group B. Owners were satisfied with nonvital pulp therapy preventing dental root abscess and repeated troubles including inflammation and malocclusion and reduction of the treatment period. These results suggest that nonvital pulp therapy can be performed on pet rabbits with elongation of mandibular cheek teeth roots.

• Journal of Oral Medicine and Pain
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• v.38 no.2
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• pp.137-142
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• 2013

Oral Medicine includes temporomandibular disorder, orofacial pains such as neuropathic pain, soft tissue diseases, halitosis, laser treatment, snoring, sleep apnea and identification through forensic dentistry etc. Such diseases are relatively common and cause great inconvenience and pain to the patients, as well as incur fatal health scare at times. In terms of oral medicine, the number of orofacial patients is growing due to a change in the life style and an increased stress as time goes in contemporary society and the demand of areas requiring oral medical professionalism, such as soft tissue lesions, snoring and sleep apnea, forensic dentistry evaluation and others are rapidly ascending. Consequently, among the areas in dental science, the calls for the expertism in oral medicine and its role are mounting. Analyzing the distribution according to disease entity, symptoms, duration of disease, and the prehistory courses of new patients visiting the department of oral medicine in a year provides information of the role and the relative importance of oral medicine in prospect and enables effective diagnosis and treatments for the patients. Therefore, in the present study, by analyzing new patients visiting the oral medicine clinic in our dental hospital for a year and by evaluating the role and the professionalism in future oral medicine, the authors concluded the followings: 1. It was founded that new patients to oral medicine mainly had temporomandibular disorders, soft tissue diseases, and neuropathic pains. 2. The number of patients with temporomandibular disorder appeared to be the highest percentage and the order within this was the patients with combined disorders, muscle disorder, and internal derangement of joint disc. 3. The number of patients with xerostomia appeared to be the highest percentage within soft tissue disease, followed by lichen planus and recurrent apthous ulcers. 4. The number of patients with burning mouth syndrome appeared to be the highest percentage within neuropathic pain.

• Journal of Oral Medicine and Pain
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• v.32 no.2
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• pp.177-185
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• 2007

Iatrogenic injury following dental treatments and the use of local anesthetics may cause taste disorders. The aims of this study were to investigate quantitative and qualitative changes of taste due to unilateral inferior alveolar nerve block anesthesia and further to evaluate potential effects on taste function related to anesthesia or hypoesthesia of inferior alveolar nerve, possibly occurring after dental procedure. 30 healthy volunteers in their twenties participated in this study (male to female = 1:1, mean age of $24.0{\pm}1.8$ years). Each subject received inferior alveolar nerve block anesthesia on his or her right side with 2% lidocaine HCl containing 1:100,000 epinephrine. Before and after anesthesia, electrogustometric test and chemical localized test for salty, sweet, sour and bitter tastes were performed on the eight sites in the oral cavity; right and left anterior and lateral tongue and circumvallate papilla of the tongue and soft palate. Unilateral inferior alveolar nerve anesthesia produced elevation of electrical taste threshold and reduction of intensity ratings for all 4 tastes (salty, sweet, sour and bitter) over anterior and lateral tongue and circumvallate papilla on the ipsilateral side (p<0.05). Contralateral sides exhibited decreased intensity ratings for salty and sweet taste (p<0.05) on anterior and lateral tongue while there was no significant difference in electrogustometric testing. Based on the results of this study, it is assumed that unilateral local anesthesia on inferior alveolar nerve can affect chorda tympani and glossopharyngeal nerves on the same side, leading to taste deficits. Taste intensity on the contralateral side may, in part, be deteriorated as well.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.1
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• pp.25-34
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• 2006

Fluoride released from dental restorative materials effectively declines the incidence and activity of dental caries and inhibits tooth demineralization. This study investigated the fluoride release and uptake characteristics of one composite resin $(Z-250^{TM})$ three glass ionomer-based restorative material ($Dyract^{(R)}$ AP, Fuji II $LC^{(R)}$, Fuji IX GP $Fast^{(R)}$) Forty discs(6mm diameter and 1mm height) were prepared for each material. Each disc was immersed in 5ml of distilled water within polyethylene vial and stored at $37^{\circ}C$. The distilled water was changed every 24 hours and the release of fluoride was measured for 31 days. At the end of this period, each specimen was subjected to one of four treatments : (A) no fluoride treatment (control), (B) application of a fluoride dentifrice (500ppm) for three minutes three times; (C) application of the 1.23% acidulated phosphate fluoride(APF) foam for one minute once, (D) the same regimen as (B), plus application of the APF foam for one minute once. Then, all samples were reassessed for an additional 7 days. For all samples, the greatest fluoride release was observed after the first day of the study but diminished with time. On the 7th day of the study, fluoride release level was stabilized. Fuji II $LC^{(R)}$ and Fuji IX GP $Fast^{(R)}$ released higher amount of fluoride than other materials ; however, no statistically significant difference was found from Fuji II $LC^{(R)}$ and Fuji IX GP $Fast^{(R)}$. The amount of fluoride of $Dyract^{(R)}$ AP, Fuji II $LC^{(R)}$ and Fuji IX GP $Fast^{(R)}$ was increased after fluoride treatment, and diminished with time.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.2
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• pp.153-163
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• 2021

Purpose: The aim of this study was to evaluate the effects of four surface treatment methods to improve zirconia roughness and three types of resin cement on the shear bond strength (SBS). Materials and methods: A total of 120 zirconia blocks were randomly divided into four surface treatments: non-treatment (Control), airborne-particle abrasion (APA) with 50 ㎛ Al2O3 (APA50), APA with 125 ㎛ Al2O3 (APA125), and ZrO2 slurry (ZA). Three resin cements (Panavia F 2.0, Superbond C&B, and Variolink N) were applied to the surface-treated zirconia specimens. All specimens were subjected to SBS testing using a universal testing machine. The surface of the representative specimens of each group was observed by scanning electron microscope (SEM). SBS data were analyzed with oneway ANOVA, two-way ANOVA test and post-hoc Tukey HSD Test (α=.05). Results: In the surface treatment method, APA125, APA50, ZA, and Control showed high shear bond strength in order, but there was no significant difference between APA125 and APA50 (P>.05). Also, ZA showed significantly higher shear bond strength than Control (P<.05). In the resin cement type, Panavia F 2.0, Superbond C&B, and Variolink N showed significantly higher shear bond strength in order (P<.05). In SEM images, the zirconia surfaces of the APA50 and APA125 showed quite rough and irregular shapes, and the zirconia surface of the ZA was observed small irregular porosity and rough surfaces. Conclusion: APA and ZrO2 slurry were enhanced the surface roughness of zirconia, and Panavia F 2.0 containing MDP showed the highest shear bond strength with zirconia.

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.1
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• pp.25-32
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• 2019

Purpose: The size, shape, and volume of prosthetic appliance depend on the metal artifacts resulting from dental implant during head and neck treatment with radiation. This reduced the accuracy of contouring targets and surrounding normal tissues in radiation treatment plan. Therefore, the purpose of this study is to obtain the images of metal representing the size of tooth through MVCT, SMART-MAR CT and KVCT, evaluate the volumes, apply them into the proton therapy plan, and analyze the difference of dose distribution. Materials and Methods : Metal A ($0.5{\times}0.5{\times}0.5cm$), Metal B ($1{\times}1{\times}1cm$), and Metal C ($1{\times}2{\times}1cm$) similar in size to inlay, crown, and bridge taking the treatments used at the dentist's into account were made with Cerrobend ($9.64g/cm^3$). Metal was placed into the In House Head & Neck Phantom and by using CT Simulator (Discovery CT 590RT, GE, USA) the images of KVCT and SMART-MAR were obtained with slice thickness 1.25 mm. The images of MVCT were obtained in the same way with $RADIXACT^{(R)}$ Series (Accuracy $Precision^{(R)}$, USA). The images of metal obtained through MVCT, SMART-MAR CT, and KVCT were compared in both size of axis X, Y, and Z and volume based on the Autocontour Thresholds Raw Values from the computerized treatment planning equipment Pinnacle (Ver 9.10, Philips, Palo Alto, USA). The proton treatment plan (Ray station 5.1, RaySearch, USA) was set by fusing the contour of metal B ($1{\times}1{\times}1cm$) obtained from the above experiment by each CT into KVCT in order to compare the difference of dose distribution. Result: Referencing the actual sizes, it was appeared: Metal A (MVCT: 1.0 times, SMART-MAR CT: 1.84 times, and KVCT: 1.92 times), Metal B (MVCT: 1.02 times, SMART-MAR CT: 1.47 times, and KVCT: 1.82 times), and Metal C (MVCT: 1.0 times, SMART-MAR CT: 1.46 times, and KVCT: 1.66 times). MVCT was measured most similarly to the actual metal volume. As a result of measurement by applying the volume of metal B into proton treatment plan, the dose of $D_{99%}$ volume was measured as: MVCT: 3094 CcGE, SMART-MAR CT: 2902 CcGE, and KVCT: 2880 CcGE, against the reference 3082 CcGE Conclusion: Overall volume and axes X and Z were most identical to the actual sizes in MVCT and axis Y, which is in the superior-Inferior direction, was regular in length without differences in CT. The best dose distribution was shown in MVCT having similar size, shape, and volume of metal when treating head and neck protons. Thus it is thought that it would be very useful if the contour of prosthetic appliance using MVCT is applied into KVCT for proton treatment plan.

• Journal of Oral Medicine and Pain
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• v.32 no.4
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• pp.441-447
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• 2007

Internal derangement of the temporomandibular joint(TMJ) is defined as an abnormal relationship of the articular disc to the condyle. Mandibular manipulation is one of the conservative treatments to be considered first to manage the patients with anterior disc displacement without reduction. Mandibular manipulation is used to increase articular mobility and to restore the displaced disc into an anatomically normal position. While Farrar's technique has been popularly used, Minagi et al., Mongini and Suarez introduced the manipulation technique conducted by the patients themselves. But there is no study on the efficacy of self-manipulation technique, comparing with conventional one. The aim of this study was to investigate the efficacy of the conventional and self-manipulation technique, which was modified to complement the previously described technique by Minagi et al., in the treatment of patients with anterior disc displacement without reduction. TMD patients, who visited Department of Oral Medicine of Seoul National University Dental Hospital from December, 2002 to November, 2004 and were diagnosed as anterior disc displacement without reduction by TMJ magnetic resonance imaging (MRI) were enrolled. Conservative treatments including physical therapy, exercise, behavioral therapy, stabilization splint therapy, and manipulation therapy were done to every single patient until the symptomsimproved enough to discharge the patient. The charts were reviewed retrospectively according to the type of manipulation. In the results, patients whose maximum mouth opening was more than 40 mm was higher in the self-manipulation group(69.9%) than in the conventional manipulation group(42.9%). But difference between two groups was not significant. According to the fact that we decided to discharge the patients whentheir mouth opening increased to more than 40 mm and subjective symptoms such as pain and discomfort were improved as well, treatment period of discharged patients was significantly shorter in the self-manipulation group($29.2{\pm}12.3$ weeks) than in the conventional manipulation group ($61.0{\pm}38.0$ weeks) (p<0.01). In conclusion, in the treatment of TMD patients with anterior disc displacement without reduction, the self-manipulation technique which is performed by patients themselves is an effective treatment modality for increasing the range of mouth opening and shortening the total treatment period.

• Journal of Oral Medicine and Pain
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• v.31 no.2
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• pp.155-165
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• 2006

The purpose of this study was to evaluate treatment outcome and prognosis of the patients with orofacial pain disorders who visited for treatment in the Department of Oral Medicine, Dankook University Dental Hospital from January 2002 to December 2004. Orofacial pain disorders were categorized into TMD(myogenous, arthrogenous and muscle-joint combined TMDs), neuropathic pain disorder, oral soft tissue disease and complex condition simultaneously having more and two aforementioned categories and treatment period, method and treatment outcome were evaluated. The results of this study were as follows; 1. Average longevity of treatment period was the longest in the neuropathic pain, followed by soft tissue disease, complex conditions, arthrogenous TMD, muscle-joint combined TMD and myogenous TMD in order. 2. When treatment methods were largely categorized into pharmacologic, physical and oral appliance therapy, pharmacologic therapy was used the most frequently for the patients with neuropathic pain or oral soft tissue diseases, oral appliance therapy for those with arthrogenous TMD and physical therapy for those with myogenous TMD. 3. Of physical therapeutic methods used in our clinic, EAST and microwave was employed the most frequently in the patients with myogenous TMD, ultrasound for those with arthogenous TMD and LLLT for those with neuropathic pain or oral soft tissue disease. 4. In comparison with change of pain after treatment, there existed a tendency that pain from neuropathic pain disorders persisted while pain from TMD was getting better or totally disappeared. 5. Concerning the change of mouth opening range in the TMD subgroups, there was no significant difference among the subgroups but significant difference existed among opening ranges, indicating comfortable maximum mouth opening increased the most following treatment. Improvement of active range of mouth opening was the most considerable in those with disc displacement without reduction. It can be said on the basis of the findings from this study that various treatments currently used for the orofacial pain showed good results with TMD in regards with pain control and improvement of function, suggestive of favorable prognosis, while neuropathic pain or soft tissue disease was the clinical conditions difficult to resolve, requiring a long and persistent treatment.

• The Journal of Korean Academy of Prosthodontics
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• v.52 no.2
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• pp.113-120
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• 2014

This study will evaluate the effectiveness of various pretreatments when fiber-reinforced composite (FRC) post is bonded to endodontically treated tooth with resin cement. Materials and methods: Canal shaping of FRC post (DT Light post, Size 3, Bisco Inc., Schaumburg, IL, USA) was performed on endodontically treated premolars at 1.5 cm from CEJ. Samples were divided into 6 groups of surface treatment after conventional washing and drying to the canal. Total of 24 FRC posts were randomly divided into 6 groups of surface treatment as follows: Group C: control - no surface treatment, Group A: airborne-particle abrasion (Cojet sand, 3M ESPE), Group S: silanization (Bis-silane, Bisco Inc.), Group M: universal primer (Monobond-plus primer, Ivoclar Vivadent Inc.), Group AS: silanization after airborne-particle abrasion, Group AM: universal primer treatment after airborne-particle abrasion. Pretreated fiber posts were cemented with resin-based luting material and photo-polymerized and cut to the thickness of 1 mm. Push-out test using a universal testing machine was performed. Bonding failure strength of post dislodgement was measured and the type of bonding failure was classified. Data were analyzed with Kruskal-Wallis test and multiple comparison groups were performed using Tukey HSD value of rank test (${\alpha}=0.05$). Results: Group AS showed significantly highest bonding strength. Group S, group AM, group A, and group M showed lower bonding strength in order. The control group showed the lowest bonding strength. Conclusion: Surface treatment with silane showed to be the most effective of the surface pretreatment methods for cementation of FRC post. Surface treatment with universal primer showed no significant difference compared with no surface treatment group as for bonding strength.