• 대한치과의사협회지
• /
• 제55권3호
• /
• pp.230-239
• /
• 2017

Root coverage can be an efficacious treatment not only in aspect of dental symptoms like root caries and hypersensitivity, but also in aspect of esthetic problem. There are several predictable methods for gaining a connective tissue attachment to an exposed root surface. Among them, this case report will deal with three cases using enamel matrix derivative and connective tissue graft to recover esthetic and physiological periodontal environment and its form. This case report deals with three patients with gingival recession which has occurred by different causes. They were treated with de-epithelialized graft accompanied by application of enamel matrix derivative. 6-12 months later, all three patients showed considerable root coverage and clinically stable condition of healing. In conclusion, within the limitation of this study, de-epithelialized connective tissue graft accompanied by application of enamel matrix derivative shows stable and clinical acceptable results in aspect of root coverage.

• 구강회복응용과학지
• /
• 제37권1호
• /
• pp.48-60
• /
• 2021

치아의 병적 이동으로 전치가 정출되고 수직 피개가 깊은 치주염 환자에서는 치주 염증 치료와 더불어 정출된 전치의 위치 개선이 필요하다. 그러나 깊은 수직 피개로 교정 장치 부착이 어렵고, 역학적으로 전치 압하보다 구치 정출이 더욱 쉽게 발생하는 문제점이 있다. 특히 골격적 장안모를 보이는 환자에서 구치 정출을 통한 상대적 전치 압하는 안모의 악화를 야기하므로, 치료 계획에서부터 이를 차단하기 위한 설계가 필요하다. 본 증례에서는 전치가 정출되어 과개 교합을 보이는 치주염 환자에서, 철저한 치주 치료와 하악 전치에 부착한 cute bracket과 골성 고정원을 이용한 고정원 보강으로 하악 전치의 양호한 압하 치료 결과를 얻을 수 있었으며, 8년간 경과 관찰하여 이를 보고하고자 한다.

• Journal of Periodontal and Implant Science
• /
• 제31권3호
• /
• pp.625-631
• /
• 2001

The anatomic structure around interproximal area plays an important role not only in the natural teeth, but also in the implant. The loss of papilla can lead to cosmetic deformity, phonetic problem, food impaction on the anterior dentition, and masticatory problem, food impaction and proximal caries on the posterior dentition. The purpose of this study was to evaluate the relationship between interdental papilla existence and distance from contact point to alveolar crest in Korean posteior dentition. 45 Korean adult patients(31males, 14 females) participated in this study. Measurements were carreid out total 126 interproximal areas, 18 first premolar, 31 second premolar, 40 first molar, and 37 second molar areas. Papilla index was recorded as suggested by Jemt. Distance between contact point and alveolar crest measrued by Florida $probe^{R}$, after flap elevation. Each distance was measured 10 times by every 0.1mm unit. The results showed that the mean Papilla index 1.37 and mean distance between contact point and alveolar crest was 7.44mm. The correlation between the Papilla index and distance was high negative correlation(Pearson correlation=-0.47), and it was statistically significant(P=0.000) When the distance between contact point and alveolar crest was 5mm, the loss of papilla was appeared almost in half cases. When the distance was 6mm, the papilla loss was present 95%, when 7mm, the papilla loss was 100%.

• 치위생과학회지
• /
• 제14권3호
• /
• pp.364-370
• /
• 2014

본 연구는 구강건강상태와 감지 건강상태의 연관성을 조사하기 위하여 구강건강상태지표인 우식경험영구치지수와 지역사회치주지수를 조사하였고 감지 건강상태를 조사하기 위하여 건강과 관련한 삶의 질을 평가하는 지표인 EQ-5D를 조사하여 위 변수들의 연관성을 조사분석하여 다음과 같은 결론을 얻었다. 전신 움직임에 문제가 있다고 응답한 대상자들의 우식경험영구치지수가 1.18배 높았으며 동통 및 불편감에 문제가 있다고 응답한 대상자들의 우식경험영구지지수가 1.16배 높았고 감지 건강상태와 치주병은 연관성이 없었다. 결론적으로, 감지 건강상태는 우식경험영구치지수와 유의한 연관성이 관찰되었다. 따라서 감지 건강상태(EQ-5D)는 구강건강상태를 예측하는 지표로 추천할 수 있으며 나아가 삶의 질을 증진시키는 객관적인 도구로도 활용 가능하다고 생각된다.

• 구강회복응용과학지
• /
• 제31권2호
• /
• pp.126-133
• /
• 2015

염증에 의해 파괴된 치주조직은 외과적 방법만으로 조직의 완전한 재생과 심미수복을 이루는 것이 어렵다. 특히, 임플란트와 관련된 문제라면 심미성의 향상을 얻기가 더욱 어렵다. 23세 여자 환자가 비심미적인 전치부 임플란트 보철물을 개선하고자 내원하였다. 개인 치과의원에서 수차례 치조골 이식술과 연조직 이식술을 받았으나 실패한 상태였다. 염증을 제거하고 심미성을 향상시키기 위해 유리치은이식술 시행 후 골유도재생술과 혈관개재 골막결합조직 이식술(vascularized interpositional periosteal connective tissue graft)을 이용한 치조제증대술을 시행하였다. 심미적 보철물 제작을 위해 임플란트 지지형 보철물 대신 인접 자연치를 이용한 전통적인 고정성 보철물을 선택하였다. 상악 전치부 치열에서 비심미적인 임플란트 보철물을 외과적 그리고 보철적 접근을 통한 다각적 방법을 병용함으로써 더 우수한 심미성을 회복한 증례를 소개하고자 한다.

• 한국컴퓨터정보학회논문지
• /
• 제26권12호
• /
• pp.187-193
• /
• 2021

연구의 목적은 전신질환의 활동제한과 구강건강의 연관성을 알아보고자 국민건강영양조사 제7기 원시자료를 활용하여 19세 이상 남자 2,574명, 여자 3,250명전체성인 5,824명의 응답을 분석하였다. 구강건강의 씹기와 말하기 문제가 있을 때 성인의 전신질환 활동제한이 많은 것으로 나타났으며, 치주질환 치료, 발치 및 구강 내 소수술, 보철물 제작·수리의 치과치료를 받았을 때 전신질환의 활동제한이 유의미하게 높았다(p<.001). 전신질환으로 인한 활동제한에 영향력을 주는 요인으로는 연령(1.03배), 남자(0.84배), 교육수준(0.57, 0.45, 0.31배), 음주(0.32배), 씹기(1.86배)와 말하기(1.84배)문제, 치주질환 치료(1.27배), 부러진 치아치료(2.1배)를 받았을 때 전신질환의 활동제한이 발생할 확률이 높았다. 또한 씹기와 말하기 문제가 있을 때 삶의 질이 낮아지는 것이 통계적으로 유의미하게 나타났다.

• Journal of Periodontal and Implant Science
• /
• 제42권3호
• /
• pp.105-109
• /
• 2012

Purpose: Soft tissue recessions frequently cause esthetic disharmony and dissatisfaction. Compared with soft tissue coverage around a tooth, the coverage of an implant site is obviously unpredictable. Particularly in the cases of thin mucosa, a significant greater amount of recession takes place compared to thick mucosa. To overcome this problem, this case report demonstrates a two-step mucosal dehiscence coverage technique for an endosseous implant. Methods: A 33-year-old female visited us with the chief complaint of dissatisfaction with the esthetics of an exposed implant in the maxillary left cental incisor region. A partial-thickness pouch was constructed around the dehiscence. A subepithelial connective tissue graft was positioned in the apical site of the implant and covered by a mucosal flap with normal tension. At 12 months after surgery, the recipient site was partially covered by keratinized mucosa. However, the buccal interdental papilla between implant on maxillary left central incisor region and adjacent lateral incisor was concave in shape. To resolve the mucosal recession after the first graft, a second graft was performed with the same technique. Results: An esthetically satisfactory result was achieved and the marginal soft tissue level was stable 9 months after the second graft. Conclusions: The second graft was able to resolve the mucosal recession after first graft. This two-step approach has the potential to improve the certainty of esthetic results.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제37권
• /
• pp.11.1-11.5
• /
• 2015

Rapid palatal expansion(RPE) with the tooth-born appliance is not sufficient to apply to the patients with periodontal problem or insufficient tooth anchorage, and it leads to tipping of the anchorage teeth and increasing teeth mobility and root resorption. To avoid these disadvantages, we present the case using palatal screws and custommade palatal expander. A 23-year-old patient underwent surgically assisted rapid maxillary expansion with the Hyrax expansion using 4 tent screws. The study models were used to measure the pre-/-post surgical width of the anterior and posterior dental arches with a digital sliding caliper. In the result, the custom-made palatal expander with 4 tent screws is suitable for delivering a force to the mid-palatal suture expansion. And it is low cost, small sized and simply applied. The results indicated that maxillary expansion with the custom-made palatal anchorage device is predictable and stable technique without significant complications in patients.

• Journal of Periodontal and Implant Science
• /
• 제32권1호
• /
• pp.69-87
• /
• 2002

Implant material, implant design, surface quality, status of the bone, surgical technique, and implant loading conditions were regarded as prerequisites for osseointegration which is a prime condition for implant success. The aim of this review paper was to investigate the survival rate of single implants in relation to the prerequisites for osseointegration. Fifty-eight papers reporting survival rates of single implants were selected by use of the 'PubMed' and hand searching. The survival rate of single implants were assessed with reference to factors influencing osseointegration. The results showed that single implants in general showed a high survival rate except a few failures in certain extreme conditions and early stages. Those failures and complications such as screw loosening and esthetic problem were almost solved with the development of implant components and surgical techniques and a better understanding of biology around a single implant. Single-tooth implant-replacement is now considered as a reliable and predictable treatment option for a single missing tooth and its application seems to expand to compromised situations which were previously thought to be impossible for single implant therapy.

• Journal of Periodontal and Implant Science
• /
• 제36권4호
• /
• pp.925-938
• /
• 2006

The aim of this study was to systematically investigate the complications of single implant-supported restorations followed more than 5-year. Thirty-five studies were selected for the systematic review. A total of 3932 single implants were included at the beginning of studies. Thirty-one implants were removed before loading and 91 implants after loading. The overall implant loss rate was 3.1 %. Implant losses were concentrated on the period between loading and 2-year follow-up, and, after a stable period, increased after 5-year follow-up. The mean marginal bone loss at single-tooth implants was well within 0.2 mm/year, i.e., acceptable annual bone loss by the implant success criteria. However, considerable amounts of single implants suffered a marginal bone loss at implant more than 0.2 mm/year. Fistula was a frequent biological complication in the early studies. The most frequent technical problem was a screw loosening, but its frequency was reduced after the use of a gold screw and torque controller. Within the limits of this study, the complications of single implants might be underestimated due to the lack of information about the biological and technical complications available in the relevant literature.