• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.464-469
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• 2011

Introduction: As dental implant surgery is becoming increasingly popular, it has become one of the causes for the hypesthesia of the inferior alveolar nerve, along with other surgical procedures, such as a third molar extraction. In addition, it tends to cause legal problems between the operator and patient. Therefore, there must be a proper method that is reliable, objective and economical to assess the nerve impairment. For this reason, an attempt was made to use an Electric Pulp Tester to assess inferior alveolar nerve block anesthesia. Materials and Methods: Thirty patients were tested. Electric pulp testing of the lower jaw skin was performed at the three different times, before anesthesia, at the onset of sensory changes and after 15 minutes waiting from the onset, and on the 10 points of the chin, which produced 10 sections on the skin area. Results: Twenty seven patients (90%) could feel the electric stimulus on the chin at all 10 points before local anesthesia and the scores represent the statistical differences between the right and left points except R4 and L4. After anesthesia, the difference between the right and left points (L3-R3, L4-R4, L5-R5) increased significantly with time but two points (L2, R2) showed no significant difference. The scores on the left chin (L3, L4, L5) increased, whereas the other points (R1-R5, L1, L2) showed no significant differences. Conclusion: This study highlights the potential clinical use of an electric pulp tester for an assessment of inferior alveolar nerve impairment.

• Journal of Periodontal and Implant Science
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• 제24권3호
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• pp.661-670
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• 1994

It is well known that the application of dressings after periodontal surgery have benefits to provide the comforts to patient and to promote the healing process with action of bleeding control and temporary stabilization for the operated mobile teeth. But until recently the relationship between periodontal dressings and cells which are composed of periodontium has not been clear. The purpose of this study was to evaluate the cytotoxic effect of soluble extracts from the four different kinds of periodontal dressings, two of them were eugenol type (K.H.pack, Wondrpak) and the others were non-eugenol type (Coe-pak, Periocare), on the human gingival fibroblasts in vitro. Human gingival fibroblasts were primarily cultured from gingiva around third molar during the extraction for preventive purposes. Extracts solution were prepared with culture medium by means of imersing the consistent size of periodontal dressing made from plastic mold. Cell were inoculated into the 24 well plate with $3\;{\times}\;10^4\;cells/well$ of medium at $37\;^{\circ}C$, 100% of humidity, 5% of $CO_2$, incubator for 24 hours. After discard of the supernatant of medium, those cells were cultured with original, 1/2, 1/5, 1/10 diluted soluble extract for 24, 48 and 72 hours, and counted the number of cells using the hemocytometer at each designed time and concentration. Also, the cytotoxic effect of soluble extract was measured by Wataha's MTT assay method. In briefly, cells were inoculated and cultured into 96 well culture plate with $2\;{\times}\;10^4\;cells/well$ for 24 hours. Soluble extracts were applied to cultured cells and incubated for 48 hours at same condition. $50\;{\mu}l$ of MTT solution and DMSO were added into each well for the detection of absorbance with ELISA reader. The measured data were calculated by value of colorimetric assay for survival rate. The results were as follows ; In the case of eugenol type of dressing, original, 1/2 and 1/5 diluted extracts of K.H.pack showed very low survival rate. And original extract of Wondrpak showed strong cytotoxic effect and 1/2 diluted extract showed moderate cytotoxic effect. In the case of Non-eugenol type of dressings, only original extract of Coe-pak revealed strong cytotoxic effect and Periocare had little cytotoxic effect. It is concluded that eugenol type of dressings showed more cytotoxic effect than non-eugenol types. This study suggest that use of non-eugenol dressings after periodontal surgery is recommended.

• 대한소아치과학회지
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• 제41권4호
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• pp.306-313
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• 2014

매복치란 맹출 연령임에도 맹출이 되지 않았거나, 임상적, 방사선학적 관찰을 통해 완전한 맹출이 어려울 것으로 예상되는 치아이다. 매복치는 치근 변위와 흡수, 인접치의 치주적 문제, 재발성 통증, 낭종의 형성과 같은 잠재적인 문제의 원인이 될 수 있으며, 상악 전치부의 경우 심미적인 문제를 야기 할 수 있다. 이 연구는 조선대학교 치과 병원에 내원하여 매복치로 진단 받은 15세 이하의 소아 청소년 환자의 매복치 특성과 치료에 대해 분석해 보기 위해 시행되었다. 매복 제3대구치, 매복 과잉치, 매복 유치를 제외한 335명의 환자를 대상으로 한명의 조사자가 환자의 전자 차트 기록과 파노라마 방사선 사진, 치근단 방사선 사진을 통해 매복치아의 위치, 매목의 원인, 치료방법, 견인치료 기간 등을 조사 하였다. 매복의 빈도는 다음과 같았다 : 상악 견치, 상악 절치, 하악 소구치, 상악 소구치, 하악 견치. 치아 매복의 원인으로는 치배 위치나 맹출 경로 이상(38.04%), 국소적 병소의 존재(35.01%)가 대부분을 차지하였다. 매복치의 치료로는 교정적 견인(46.01%)가 가장 많았다. 국소적 병소 같은 명확한 방해요인이 있는 경우 견인 기간이 상대적으로 짧게 나타났으며, 상악 절치의 경우가 매복 상악 견치보다 짧은 견인기간이 관찰되었다. 본 연구에서, 교정적 견인의 성공률은 96.7%였으며, 5증례가 실패하였다. 3증례는 장치협조도 불량으로 인한 것 이었으며, 2증례는 치아 유착으로 인한 실패였다. 매복치의 견인은 연령이 증가 할수록 불리할 것으로 여겨진다. 따라서, 정기적 검진을 통한 조기의 진단과 적절한 치료계획이 매우 중요하다. 또한, 소아 청소년 환자의 성공적인 교정적 견인 치료를 위해서는 환아의 협조도가 특히 중요할 것으로 생각된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권5호
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• pp.355-364
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• 2011

Introduction: This study evaluated nerve recovery through retrospective study of patients with lingual nerve damage. Patients and Methods: The patients who visited Seoul National University Dental Hospital for an injury to the lingual nerve from April 1988 to August 2009 were enrolled in this study (n=41). The relevance of various factors including the causes of damage, age, etc. was analyzed by the subjective improvement based upon questionnaires and the clinical records. The evaluation variants were a subjective assessment and neurosensory examination composed of the direction, contact threshold, two-point discrimination, pin prick, thermal discrimination and current perception threshold. Results: The causes of lingual nerve damage were an extraction of the lower third molar (75.6%), local anesthesia (9.7%), incision and drainage (4.88%), trauma (2.44%). The evaluation of subjective prognosis exhibited no difference in sensory improvement depending on the cause, age and gender. Based upon the subjective evaluation, 44.7% of patients showed sensory improvement. The first hospital visit from injury was shorter in the group showing subjective improvement (3.41 months) than those showing no improvement (5.24 months) (P=0.301). Thirty six out of 41 patients were treated with only conservative therapy and 5 patients were treated by surgical intervention. Neurosensory examinations revealed improvement, although not statistically significant, and the degree was higher in the subjectively improved group. The contact threshold discrimination showed the highest correlation with subjective improvement (P=0.069). Most of the sensory recovery was gained within 12 months and the degree of improvement at the tip of the tongue was higher than that of the dorsum (P<0.001). Conclusion: The damaged lingual nerve improved at a rate of 44.7% and mostly within 12 months after the incident. There was no difference between the subjective prognosis and neurosensory examination depending on the cause of damage, age and gender, whereas the contact threshold discrimination was the best variant that reflected the subjective prognosis statistically.

• 대한치과보철학회지
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• 제36권2호
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• pp.245-257
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• 1998

This study was performed to measure the changes of the mandibular movement and the masticatory muscular activities - anterior temporal and masseter muscle of both side - reflected by intentional increase of anterior guidance angie. For this study, 5 volunteers (3 males and 2 females with average age of 24.0) were selected. Each volunteer had Angle's classification I and did not have any missing tooth except third molar and any extensive restorations. Metallic guide plate was made at volunteer's working model fabricated by improved dental stone and cemented to the palatal surface of maxillary central incisor using resin cement(Panavia $21^{(R)}$) and then adjusted not to give any occlusal interferences at intercuspal position. The activity of masticatory muscles and the changes of mandibular movement were recorded by EMG and Sirognathograph in Biopak analysing system(Bioresearch Inc., Milwaukee, Wisconsin, USA). Measurement was done at before experiment, immediatley after placement, 1 week after placement, immediately after removal, and 1 week after removal. The results were as follows: 1. Moderate phonetic disturbance and mild headache were occured to 3 volunteers for 2 days after setting and 1 volunteer had positive reaction to percussion and slight midline diastema. But all of these clinical signs were diappeared 1 week after removal and the other volunteer did not have any special clinical sign. 2. In the EMG of the mandibular rest position, the mean value of anterior tempotal muscle was increased immediately after placement(p<0.01) and then decreased 1 week after placement(p<0.05) and increased 1 week after removal(p<0.05) but not recovered as before experiment. The mean value of masseter muscle was decreased during the experiment period. 3. In the EMG during mandibular protrusive movement, all muscular activity was decreased during the experiment period. Reduced activity was not recovered 1 week after removal(p<0.03). 4. During the habitual opening, anteroposterior movement of mandible was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not statistically significant(p>0.1). Vertical movement was not shown significant difference during the experiment period(p>0.1). Lateral movement was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not recovered as before experiment. The opening and closing velocity of mandible was shown minor changes but not statistically significant. 5. During the habitual opening, anteroposterior movement of mandible was decreased 1 week after placement(p<0.05) and then increased immediately after removal and recovered 1 week after removal as before experiment. Vertical movement was not shown significant changes. Lateral displacement of mandible was increased continuously and recovered 1 week after removal. Opening velocity was temporarily increased immediately after removal but recovered and closing velocity was not shown significant changes. 6. During the right side chewing, anteroposterior movement of mandible was increased immediately after removal but recovered and vertical movement was not shown statistically significant results. Lateral displacement and velocity of mandible were not shown significant results. 7. During the left side chewing, the changes of mandibular movement pattern were not shown statistically significant results.

• Restorative Dentistry and Endodontics
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• 제23권2호
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• pp.701-709
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• 1998

Many dental composites are Bis-GMA based resin which diluted with the more fluid monomer triethylenglycol dimethacrylate(TEGDMA). TEGDMA is often present in exess so that some quantity remains unreacted following photo-initiated polymerization. TEGDMA is a component of some resin composites which contributes to their cytotoxicity. The presence of dentin between resin composite and pulp space reduce the cytotoxicity in vitro. The root system from extrcted human third molar was removed and then a circular occlusal cavity 4mm in diameter was prepared, leaving a remaining dentinal thickness to the roof of the pulpal chamber within the range 1.0-1.5mm. Dentine was treated with 37% phosphoric acid prior to Z 100 placement without using bonding resin(group 1). In group 2, SMP(Scotchbond Multi Purpose) primer, bonding resin prior to Z 100 placement were applied sequently. In group 3, moulds with internal dimensions 4mm diameter by 2mm depth were used to contain the composite alone with an equvalent mass on tooth model, and then they were immersed directly into water. The purpose of this study is to evaluate the release rate and quantity of TEGDMA with or without the application of bonding resin. Both release rate and total cumulative amount of TEGDMA for the three groups were determined using reversed-phase HPLC at times up to 10 days. The results were as follows: 1. All experimental groups showed the highest rate of release was in the first sample period(0-4.32 min) and the rate of release declined exponentially thereafter. 2. The maximum release rate and total cumulative account of TEGDMA in the tooth model of group 1 and group 2 with the use of SMP bonding resin were reduced however ther were no significant differences between these groups(P>0.05). 3. In the first sample period(0-4.32 min), the rate of release of TEGDMA from composite resin in group 3 immersed directly into water was significantly higher than that in group 1 and group 2 of tooth model(P<0.05). Conclusively, TEGDMA diffusion from Z 100 resin was not effectively prevented by the presence of dentin in spite of using the SMP bonding resin.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권3호
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• pp.196-204
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• 2002

For the study of its stability when the screw has been fixed after sagittal split ramus osteotomy(SSRO) of the mandible, the methods of screw arrangement are classified into two types, triangular and straight. The angles of screws to the bone surface are classified as perpendicular arrangements, the $60^{\circ}$ anterioinferior screw, known as triangular, and the most posterior screw, called straight arrangement, thus there are four types. The finite element method model has been made by using a three dimensional calculator and a supercomputer. The load directions are to the anterior teeth, premolar region, and molar region, and the bite force is 1 Kgf to each region. The distribution of stress, the von-Mises yield strength, and safety of margin refer to the total sum of transformed energy have been studied by comparison with each other. The following conclusion has been researched : 1. When shear stress is compared, in the triangular arrangement in the form of "ㄱ", the anterosuperior screw is seen at contributing to the support of the bone fragment. In the straight arrangement, substantial stress is seen to be concentrated on the most posterior angled screw. 2. When the von-Mises yield strength is compared, it seemed that the stress concentration on the angled anteroinferior screw is higher, it shows a higher possibility of fracture than any other screw. In the straight arrangement, stress appeared to be concentrated on the most posteriorly angled screw. 3. When the safety margins of the transfomed energy are compared, the energy conduction is much greater in the case of the angled screw than in the case of the perpendicular screw. The triangular arrangement in the form of "ㄱ" shows a superior clinical sign to that of the straight arrangement. Judging from the above results, when the screw fixation is made after SSRO in practical clinical cases, two screws should be inserted in the superior border of mandibular ramus and a third screw of mandibular inferior border should be inserted in the form of triangular. All screws on the bony surface should be placed perpendicularly-$90^{\circ}$ angles apparently best promote bony support and stability.

• 전기화학회지
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• 제1권1호
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• pp.33-39
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• 1998

본 연구에서는 전자-선 증발법으로 제조된 비정질의 텅스텐 산화물 박막과 전해질 계면에서 진행되는 전기화학반응을 1 M $LiCLO_4/PC$유기 전해질 계면에서 비정질의 텅스텐 산화물 박막 내부로 삽입된 리튬의 양론 값과 박막 전위의 변화에 대하여 연구하였다. 특히 복소수 임피던스 스펙트럼으로부터 제안된 박막과 전해질 계면의 등가 회로는 리튬의 층간 반응 기구가 텅스텐 산화물 박막/유기 전해질 계면에서 리튬 이온의 전하 전달 현상, 텅스텐 산화물 박막에 리튬의 흡착현상 및 박막 내부로의 리튬의 흡수 및 확산 현상으로 구성되어 있다는 것을 알 수 있었다. 또한 CNLS fitting법에 의하여 시뮬레이션된 $R_{ct},\;C_{dl},\;D$, 및 $\sigma_{Li}$ 등의 열역학 및 속도론적 변수 값 등의 상관 관계로부터,비정질의 텅스텐 산화물 박막의 소. 발색 특성은 이들 변수값과 관련이 있었으며, 특히 $Li_y,WO_3$, 박막 내의 리튬의 몰비 y=0.167및 전극 전위 E=2.25 V(vs. Li)에서 전기 발색의 한계값을 갖는 것으로 조사되었다.

• 대한치과교정학회지
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• 제26권2호
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• pp.125-139
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• 1996

저자는 성장기 III급 부정교합자의 치료후 성장완료시까지 장기관찰 기록을 통하여 III급 부정교합치료 전략 수립에 도움이 되는 유용한 정보를 얻었다. 장기 관찰 결과는 다음과 같이 요약할 수 있었다. 첫째, 전치부 반대교합의 조기 개선시에 상악에서 상당한 전방성장이 많은 증례에서 관찰되었다. 둘째, 악골에 대한 정형적 치료에 의한 성장조절은 장기적인 관점에서 제한적인 효과만 인정되었다. 셋째, 반대교합을 가진 어린 환자에서 얻은 어떤 자료도 장기적인 관점에서 그 환자의 치료후 안정성을 예측할 수 있는 것은 없었다. 그러나 gonial angle은 어느 정도 예측의 가능성을 보였다. 넷째, 성장이 된 연령에서 하악에 대한 정형적 후방력이나 하악의 급작스런 위치 변화는 악관절에 좋지 못한 영향을 줄 수 있었다. 따라서 저자는 다음과 같이 III급 치료 전략을 제시한다. ${\cdot}$반대교합은 가능하다면 조기에 개선하는 것이 좋으며, 정형적 치료는 10세 이전에 1-2년 정도 사용하는 것이 좋겠다. ${\cdot}$ 이후에 바로 phase II 치료에 들어가지 말고 성장이 어느 정도 끝나는 시점까지 기다린다. 즉 여자는 14세, 남자는 17세 경까지 기다린 후에 교정치료로 마무리할 것인지 악교정 수술을 할 것인지 결정한다. 관찰 기간 동안에 성장에 영향을 줄 수 있는 기도문제, 혀자세, 습관, 제3대구치의 발육 등을 감독하고, 성장에 관한 자료를 채득한다. 이렇게 하므로서 앞에서 관찰한 치료 완료 후의 재발로 인한 재치료 문제를 줄일 수 있고,실제적인 치료기간을 단축할 수 있어 환자나 술자에게 모두 유익하다고 생각한다.

• Imaging Science in Dentistry
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• 제39권3호
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• pp.149-156
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• 2009

Purpose : The purpose of this study was to develop a stent-based image guided surgery system and to apply it to oral and maxillofacial surgeries for anatomically complex sites. Materials and Methods : We devised a patient-specific stent for patient-to-image registration and navigation. Three-dimensional positions of the reference probe and the tool probe were tracked by an optical camera system and the relative position of the handpiece drill tip to the reference probe was monitored continuously on the monitor of a PC. Using 8 landmarks for measuring accuracy, the spatial discrepancy between CT image coordinate and physical coordinate was calculated for testing the normality. Results : The accuracy over 8 anatomical landmarks showed an overall mean of $0.56{\pm}0.16\;mm$. The developed system was applied to a surgery for a vertical alveolar bone augmentation in right mandibular posterior area and possible interior alveolar nerve injury case of an impacted third molar. The developed system provided continuous monitoring of invisible anatomical structures during operation and 3D information for operation sites. The clinical challenge showed sufficient accuracy and availability of anatomically complex operation sites. Conclusion : The developed system showed sufficient accuracy and availability in oral and maxillofacial surgeries for anatomically complex sites.