• 대한치과교정학회지
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• 제24권4호
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• pp.759-772
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• 1994

Orthodontists have experienced the treatment of cases with three lower incisors. Occasionally a lower incisor was either congenitally missing or so seriously damaged by injury or disease that its removal presented the best prospect for the patient. Sometimes the intentional extraction of a lower incisor is needed to produce enhanced functional and esthetic results with minimal orthodontic manipulation. Such cases have unfavorable anterior tooth size discrepancies and present difficulties in achieving good occlusal results. However such difficulties can be overcome by the sensible diagnosis and treatment plan. Three different cases are presented and the conclusions are listed. 1. It is important for orthodontist who tries to treat three lower incisor cases to measure and calculate accurately the degree of deviation of tooth size and morphology and the anterior tooth size ratio. 2. A diagnostic setup model should be made to determine whether the incisor extraction is appropriate and space closure is needed or not. It is the best way to be sure that the occlusal results, including overbite and overjet, will be acceptable and how far the degree of midline deviation is. It also shows the amount of interproximal reduction to achieve an acceptable occlusal result. 3. The class I relationship between the upper canine and the lower one must be obtained to establish the canine rise during eccentric movement by the concept of mutually protective occlusion. It also helps to maintain the stable occlusal result.

• 대한치과교정학회지
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• 제23권4호
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• pp.645-660
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• 1993

In this study, effects of incision of retrodiscal tissue and unilateral occlusal reduction on temporomandibular joint of rabbit were investigated. Twenty-seven adult New Zealand White Rabbits, weighing over 3.5kg, were utilized in this study. Temporomandibular joint surgery was performed in left temporomandibular joint of 24 rabbits to displace disc anteriorly through incising the retrodiscal tissue 1-2mm posterior to the disc. They were divided into two groups : twelve were left untreated after surgery, occlusal reduction was performed on left posterior teeth every 2 weeks in the other twelve rabbits, The remaining three served as the control group. The sample were sacrificed by 8, 12, and 16 weeks after surgery. Histologic examinations were performed after sacrificing them. The results were as follows : 1. Histologic findings which were manifested by flat articular fossa, broad articular surface, generalized recession of articular cartilage and sclerosis of subchondral bone were observed. These findings were similar to internal derangement. 2. In the rabbits untreated after surgery, thin cartilagenous layer and necrotic tissue were observed in 8 weeks group, calcifying cartilagenous layer was observed in 12 weeks group, and cartilagenous layer on anterior portion was observed in 16 weeks group. So, it showed gradual healing pattern into the normal tissue except displaced disc. 3. Occlusal trauma after surgery resulted in generalized recession of upper and lower articular surface. Necrosis and vertical split on condylar process of mandible were observed in 8 weeks group. Osteoclasts, exposure of subchondral bone due to erosion on upper and lower articular surface, and degenerative changes on retrodiscal tissue were observed in 16 weeks group. So, it showed continuous prowess pattern of osteoarthrosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권2호
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• pp.162-167
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• 2010

This is a case report about patient who had suffered from degenerative joint disease and treated by TMJ reconstruction with condylar prosthesis. The patient visited Korea University An-am hospital on 2007 complaining symptom about both TMJ pain, mouth opening limitation and open bite. From CT view there was severe resorption of both condylar head, therefore condylar prosthesis reconstruction was planned. After 3D RP model analysis for preparation, the patient was operated under general anesthesia for condylar prosthesis reconstruction and the symptom was alleviated. (increased mouth opening, reduced anterior open bite, full mouth occlusal contact achieved) Follow up was carried out monthly, but after this, patient refused follow up. After 26 months from the operation, the patient revisited for anterior open bite. In clinical evaluation, occlusal contact was remained, but anterior open bite was relapsed. From cephalometry analysis, severe resorption of glenoid fossa was found. Therefore, Autogenous disc reconstruction with alloplastic material was planned on August 2009. After another surgery, condylar prosthesis was regained its normal position in glenoid fossa, and occlusion was recovered properly.

• 대한치과의사협회지
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• 제23권11호통권198호
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• pp.921-925
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• 1985

우리는 매일 반복되는 진료행위를 통해서 개개의 치아와 그 주위조직에 대한 병적 이상을 발견하고 치료하는 일에는 익수해져 있으나, 두 개 혹은 그 이사의 일련의 치아들이 상하악의 대합치들과 어떠한 양상으로 조화를 이루며 교합기능을 유지해 나가고 그것들이 어떻게 보이지 않는 저작계의 통제에 의한 결과인가에 대해서는 거의 등한시 하고 있다. 다시 말해서 교합에 관여하는 기능적 요소와 임상적인 정상교합에 관한 이해, 그리고 이러한 개념을 임상적인 치료에 적용하는 일에 우리의 관심이 더욱 집중되어야 할 것이며, 이러한 연구를 통해서만 복잡하고 다양하게 나타나는 일련의 교합질환(Occlusal Disease)을 다룰 수 있으리라 생각된다. 교합의 임상적인 정의와 기본 개념, 그리고 정상적인 교합이 치주조직에 미치는 영향에 관하여 고찰해 보기로 한다.

• Imaging Science in Dentistry
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• 제30권4호
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• pp.265-274
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• 2000

Purpose: The aims of the present study are to determine the optimum compression rate in terms of file size reduction and diagnostic quality of the images after compression and evaluate the transmission speed of original or each compressed image. Materials and Methods: The material consisted of 24 extracted human premolars and molars. The occlusal surfaces and proximal surfaces of the teeth had a clinical disease spectrum that ranged from sound to varying degrees of fissure discoloration and cavitation. The images from Digora system were exported in TIFF and the images from conventional intraoral film were scanned and digitalized in TIFF by Nikon SF-200 scanner (Nikon, Japan). And six compression factors were chosen and applied on the basis of the results from a pilot study. The total number of images to be assessed were 336. Three radiologists assessed the occlusal and proximal surfaces of the teeth with 5-rank scale. Finally diagnosed as either sound or carious lesion by one expert oral pathologist. And sensitivity, specificity and k value for diagnostic agreement was calculated. Also the area (Az) values under the ROC curve were calculated and paired t-test and oneway ANOVA test was performed. Thereafter, transmission time of the image files of the each compression level was compared with that of the original image files. Results: No significant difference was found between original and the corresponding images up to 7% (1 : 14) compression ratio for both the occlusal and proximal caries (p<0.05). JPEG3 (1 : 14) image files are transmitted fast more than 10 times, maintained diagnostic information in image, compared with original image files. Conclusion: 1 : 14 compressed image file may be used instead of the original image and reduce storage needs and transmission time.

• 대한치과의사협회지
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• 제49권8호
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• pp.461-471
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• 2011

The detection of carious lesions is a key point to apply appropriate preventive measures or operative treatment of dental caries. A laser fluorescence device DIAGNOdent$^{(R)}$ (KaVo, Biberach, Germany) has also been shown to be of additional clinical value in the detection of initial caries. This report focus on the DIAGNOdent$^{(R)}$ for caries detection. DIAGNOdent$^{(R)}$ irradiate visible red light at a wavelength of 655 nm to elicit near-infrared fluorescence from caries lesion. This device is known as a reproducible method for caries detection, with good sensitivity and specificity especially for caries detection on occlusal and accessible smooth surfaces. DIAGNOdent$^{(R)}$ tended to be more sensitive method of detecting occlusal dentinal caries, however, showed more false-positive diagnoses than the visual inspection. So Clinician should not use the device as a clinician's primary diagnostic method and it is recommended that the device should be used in the decision-making process in relation to the diagnosis of caries as a second opinion in cases of doubt after visual inspection. The trend of modern dentistry would be a preventive approach rather than invasive treatment of the disease. This is possible only with early detection and respective preventive measures, DIAGNOdent$^{(R)}$ can help the changes.

• Restorative Dentistry and Endodontics
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• 제43권1호
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• pp.13.1-13.7
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• 2018

Dental erosion is frequently overlooked in clinical practice. The management of erosion-induced damage to the dentition is often delayed, such that extensive occlusal rehabilitation is required. These cases can be diagnosed by a careful clinical examination and a thorough review of the patient's medical history and/or lifestyle habits. This case report presents the diagnosis, categorization, and management of a case of gastro-esophageal reflux disease-induced palatal erosion of the maxillary teeth. The early management of such cases is of utmost importance to delay or prevent the progression of damage both to the dentition and to occlusal stability. Non-invasive adhesively bonded restorations aid in achieving this goal.

• 대한치과보철학회지
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• 제59권2호
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• pp.228-237
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• 2021

일생에 걸친 치아의 생리적 마모는 자연스러운 과정으로 여겨지고 있지만 치아 마모가 교합 수직고경의 감소, 저작 시 통증 및 저작 기능 상실, 심미성 소실 등의 병적 변화를 일으킨다고 판단되는 경우 치과의사가 이를 회복시켜주어야 한다. 본 증례 환자는 '아래 앞니가 입천장에 닿아서 아프다'는 주소로 내원하였다. 상악의 부적절한 보철물에 의한 하악 치열의 의원성 마모와 그에 따른 외상성 교합이 발생한 것으로 진단하였다. 진단모형 분석 및 납형조각을 통해 수직고경 거상을 결정하였으며 상악 및 하악을 적절한 고정성 보철물로 재수복하여 심미적 및 기능적으로 만족스러운 결과를 얻었기에 이를 보고하고자 한다.

• 대한심미치과학회지
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• 제30권2호
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• pp.71-90
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• 2021

가상 환자 데이터 세트는 단일 환자로부터 획득한 구강스캔 안면스캔 전신스캔 하악운동경로데이터 등 다양한 소스의 진단 데이터를 하나의 3차원 좌표계로 정렬한 데이터의 집합이다. 치과의사는 가상 환자 데이터 세트를 사용하여 효과적으로 치료 계획을 수립하고 다양한 치료 계획을 가상공간상에서 시뮬레이션 할 수 있으며, 가상 환자 데이터 세트에서 환자의 미소를 디자인 후 그 결과를 시뮬레이션하고 최적의 치료결과를 선택할 수 있다. 가상공간에서 선택된 치료 계획은 3D 프린팅, 밀링, 사출 성형과 같은 제조 기술을 사용하여 환자에게 동일하게 전달될 수 있다. 이러 치료 계획의 전달은 임시 수복물 제작 및 환자의 구강 내에서 목업 확인을 통해 최종 보철물 제작으로 연결할 수 있다. 이와 같이 진단 데이터, 중첩 및 가공의 정확도가 보장된다면 3차원 가상공간 상에서 시뮬레이션된 3D 디지털 스마일 디자인을 실제 환자에게 정확하게 전달할 수 있다. 가상환자데이터세트의 임상적용방법으로 동기능적교합측정 검사를 통해 교합조정치료를 치료계획에서 배제할수 있는 의사결정방법과, 턱관절질환을 가지고 있는 청소년기 특발성 척추측만증 환자의 턱관절 치료전후 전신스캔 비교분석방법, 그리고 전악수복증례인 상하악 총의치환자 진료시 가상환자데이터세트에 기반한 교합평면분석 및 디지털심미분석방법을 제시하였다.

• Journal of Oral Medicine and Pain
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• 제38권3호
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• pp.275-289
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• 2013

본 연구는 측두하악장애에 대한 치과 내원환자의 인지도와 이해도를 조사, 분석하기 위해 시행되었다. 인제대학교 부산백병원 치과 혹은 울산광역시 소재 한빛치과병원을 방문한 총 243명의 환자에게 설문조사를 시행하였고, 설문지의 모든 문항에 대해 성실히 답한 195명을 대상으로 하여 다음과 같은 결과를 얻었다. 1. "측두하악장애"란 용어를 인지하고 있는 환자는 전체 대상자의17.4%였고, 총 12년 이상의 학력을 가진 군(82.4%, p<0.01)은 다른 군에서 보다 "측두하악장애"에 대한 인지도가 유의하게 높았다. "턱관절질환"이란 용어를 인지하고 있는 환자는 전체 대상자의 81.0%였고, 30-49세 연령군(45.6%, p<0.05)과 총 12년 이상의 학력을 가진 군(60.1%, p<0.01)에서 다른 군보다 "턱관절질환"이란 용어에 대한 인지도가 유의하게 높았다. 2. 전체의 과반수 이상인 50.6%가 턱관절질환의 개념으로 "턱을 무리하게 사용해서 생기는 병이다"를 선택했다. 3. 턱관절질환에 대해 들은 경로로TV, 라디오(41.4%)가 가장 많았고, 가족과 친구(20.2%), 병원 및 병원관계자(18.2%), 인터넷(15.7%) 및 신문과 잡지(4.5%)순이었다. TV, 라디오를 통해서 턱관절질환에 대해 들어본 응답자 중 30-49세 연령군이 다른 군보다 유의하게 높은 비율(52.4%, p<0.05)을 보였다. 인터넷을 통해서 턱관절질환에 대해 들어본 응답자 중 18-29세 연령군이 다른 군보다 유의하게 높은 비율(61.3%, p<0.01)을 보였다. 병원과 병원관계자를 통해서 턱관절질환에 대해 들어본 응답자 중 총 12년 이상의 학력을 가진 군(75%, p<0.05)이 다른 군보다 유의하게 높은 비율을 보였다. 4. 환자들은 입을 벌리고 다물 때 턱에서 나는 소리(26.9%), 입을 크게 벌리지 못한다(25.1%), 귀 앞쪽 부위의 통증(13.7%)을 턱관절질환의 증상과 징후로 골랐다. 턱관절질환의 원인으로는 딱딱하거나 질긴 음식을 즐겨먹기(19.5%), 아래, 윗니가 잘 안 맞물림(19.0%), 한쪽 어금니로 음식씹기(18.5%)를 많이 선택했다. 턱관절질환의 치료법으로 턱관절수술(28%)을 가장 많이 꼽았고, 구강내 장치치료(23.9%), 물리치료(14.6%)가 그 뒤를 따랐다. 턱관절질환의 예방법으로 딱딱한 음식의 섭취를 줄인다(21.1%), 입을 너무 크게 벌리지 않는다(17.0%), 양쪽 어금니로 음식을 씹는다(15.4%)를 많이 선택했다.