• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권5호
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• pp.330-337
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• 2003

This is a retrospective study on the care of odontogenic infections in admission patients with major bleeding disorders. The study was based on a series of 514 patients treated at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, from Jan. 1, 2000, to Dec. 31, 2002. The obtained results were as follows : 1. The cardiovascular disease was the most frequent cause of the systemic diseases with major bleeding disorders, and liver disease, cerebrovascular disease and renal failure were next in order of frequency. But, there was the most frequent dental consultation in the liver disease, owing to the many odontogenic infectious diseases. 2. Male prediction (66.3%) was almost existed in the odontogenic infectious patients with major bleeding disorders. But, there was slight female prediction (53.4%) in the cardiovascular disease. 3. The most common age group of the odontogenic infectious patients with major bleeding disorders was the fifty decade(27.2%), followed by the forty, sixty & thirty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with major bleeding disorder, peak incidence was occurred as toothache (42.2%), followed by intraoral bleeding, ulcer pain, dental extraction in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis and periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(44.2%) was showed in primary endodontic drainage(pulp extirpation, occlusal reduction & canal opening drainage) and followed by the incision & drainage, the medications & oral hygiene instruction, scaling, indirect pulp capping in order.

• 대한치과보철학회지
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• 제56권3호
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• pp.243-249
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• 2018

과도한 치아 마모를 가진 환자들을 치료를 시작할 때 수직교합고경의 상실과 수복을 위한 공간의 적절성으로 분류하게 된다. 본 증례의 환자는 80세의 여성으로 구치부 교합지지가 상실되어 대합치가 정출하면서 교합평면의 붕괴가 일어나고 잔존 치아의 마모 증가가 동반되어 보철을 위한 약간의 악간 공간의 상실이 발생하였다. 이러한 경우 최소한의 수직교합고경의 증가를 부여하고 안정화기간을 거쳐 안정된 교합접촉을 제공한다면 성공적으로 치료할 수 있다. 본 증례에서는 수직고경의 증가를 동반하여 단일 구조 지르코니아를 이용한 고정성 보철물과 상악 가철성 국소의치로 수복을 하였고 이러한 치료과정을 통하여 기능적, 심미적으로 만족스러운 결과를 얻어 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권1호
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• pp.58-64
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• 2012

Purpose: Dental emergencies vary from toothaches to oral and maxillofacial traumas. Because the number of dental emergency cases has increased recently, we analyzed characteristics of patients seen during the last 2 years, in an effort to find a trend. Methods: This study was carried out with emergency room patients visiting the Department of Oral and Maxillofacial Surgery from 2009 to 2010. Results: The total number of patients studied was 1,162; the ratio of males to females was 1.73:1. The most frequent age group was 0 to 9 years, followed by 20 to 29 years. Trauma (58.7%) was the most frequent cause followed by acute toothache, oral hemorrhage, infection, and temporomandibular (TMJ) disorder. In the trauma group, injuries of soft tissue and alveolus were prevalent. The most common causes of soft tissue injury were falls, safety violations and assault. The highest incidence of emergencies was seen in patients 0 to 9 years old (41.8%). The most common causes of jaw fracture were falls, assaults, and traffic accidents in that order. In the acute toothache group, most patients had pulpitis (41.2%). In the infection group, most had buccal space abscesses (40.0%). In the hemorrhage group, post-operative bleeding cases (80.5%) were the majority, and hemostasis was obtained mostly by pressure dressings. For the TMJ disorder group, masticatory muscle disorder (65.4%) was more common than TMJ dislocation. Conclusion: In this study, trauma was the most frequent reason for patients who visited the emergency room. However, acute toothache, hemorrhage, infection and TMJ disorders were also seen frequently. Dental emergency patients could be better treated by understanding patterns of dental emergencies and performing proper diagnoses.

• 대한소아치과학회지
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• 제37권3호
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• pp.275-287
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• 2010

치아 우식증은 범발성 질환이고 이에 대한 생체반응은 단순하지 않으며 질병 과정과 숙주의 활성 모두를 반영하는 복합적인 반응이다. 이러한 반응을 이해하기 위해서는 질병의 세포학적, 분자학적인 면을 이해하는 것이 필수적이다. 이에 본 연구는 임상적으로 건강한 치아와 우식이 진행된 치아로부터 얻어진 치수 안의 유전자 발현을 규명하고 우식 병소에서 일어나는 치유 및 재생에 관계되는 분자와 면역 세포들 사이의 분자 생화학적 상호작용을 규명하기 위해서 우식치아와 건전치아의 치수를 이용하여 cDNA 미세배열(microarray) 분석과 역전사효소 중합효소 연쇄반응 (RT-PCR) 분석, 그리고 면역화학염색법 (immunohistochemistry)을 시행하여 다음과 같은 결론을 얻었다. 1. cDNA 미세배열 분석 결과, 건전치아군인 대조군에서는 143개의 유전자가, 우식치아군인 실험군에서는 377개의 유전자가 1.6배이상 발현되었다. 2. 역전사효소 중합효소 연쇄반응 분석에서 14개의 유전자를 선택하였고 cDNA 미세배열 분석결과와 동일한 결과를 확인하였다. 3. TGF-${\beta}1$의 면역조직화학적 관찰 결과, 건전치에 비해 우식치의 상아모세포와 치수에서 특히 강하게 발현되었다.

• 구강회복응용과학지
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• 제28권1호
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• pp.87-101
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• 2012

이갈이는 이를 갈거나 악무는 것을 포함하는 부기능적인 행위를 말하며 광범위하게는 주간 및 야간에 나타나는 것을 모두 포함한다. 이갈이의 원인으로는 기본적으로 말초성 요인과 중추성 요인으로 나누어 살펴볼 수 있는데 현재까지의 연구 결과를 종합하여 볼 때 중추성 요인이 주로 작용하는 것으로 알려져 있다. 이러한 이갈이는 교모, 치경부 미세파절, 교근 비대, 교근 및 측두근의 통증, 턱관절의 통증 및 움직임의 제한, 치아 및 수복물 파절, 치수염, 외상성 교합 등을 유발 할 수 있고 특히 이악물기의 경우 협점막 압흔이나 협점막 백선 또는, 혀의 측면에 압흔 등을 유발한다. 이갈이의 정확한 진단을 위해 구강내 장치, 근전도, 수면다원검사 등을 이용하며 미국수면장애학회의 경우 이갈이의 임상 진단 기준을 제시하고 있다. 그러나 아직까지 이갈이의 명확한 원인이 밝혀져 있지 않기 때문에 치료법의 선택은 신중하여야 한다. 이갈이가 중등도 이상이고 임상 증상이나 징후를 유발하는 경우에 이갈이를 관리하기 위한 방법으로는 위험 요인의 조절, 구강내 장치, 보툴리눔 독소 주사, 약물 치료, 바이오피드백 등이 있으며 구강내 장치 요법이 현재로서 가장 합리적인 방법이다. 이갈이 치료와 교근비대에 대한 심미적인 개선을 같이 원하는 환자에서는 보툴리눔 독소 주사 요법이 이용될 수 있다.

• Restorative Dentistry and Endodontics
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• 제30권2호
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• pp.102-111
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• 2005

본 연구는 근관치료시의 flare-up발생률과 환자의 술 전 상태 및 술식 등에 따른 flare-up의 발생 빈도를 알아보고자 한 것이다. 자료는 근관치료 받은 840개 치아로부터 얻었다. 심한 동통이나 종창으로 응급 내원하여 보다 적극적인 치료를 필요로 하는 경우만을 flare-up으로 분류하였다. 1. 전체 840개 치아 중 13개에서 발생, $155\%$의 발생률을보였다. 2. 성별 및 치아에 따른 유의차는 없었다. 3. 술 전 증상이 존재하는 경우 및 치근단 병소가 존재하는 경우가 높은 발생률을 보였다. 4. 무수치의 경우가 생활치나 비가역성 치수염 보다 높은 발생률을 보였다. 5. 다내원 근관치료의 경우 높은 발생률을 보였다. 6. 재근관치료시 높은 발생률을 보였다. 이상의 결론을 통해 flare-up은 환자의 술 전 증상, 치아의 술 전 상태 및 재근관치료 여부에 따라 높은 발생률을 보이고 있음을 알 수 있었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권6호
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• pp.561-566
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• 2008

This is a retrospective clinical study on 2,955 patients who had visited the Emergency Room of Sang-gye Paik Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 4 years from Aug. 2002 to Dec. 2006. The obtained results were as follows. The total number of patients was 2,955 and the ratio of male to female was 1.72:1. The age distribution peak was the 1st decade (30.8%), followed by the 3rd decade (14.3%) and the 4th decade (14.0%). Trauma (62.3%) was the most frequent cause in dental emergency patients, pulpitis (13.0%) and infection patients were next in order of frequency. In trauma patients group, facial bone injury, tooth injury, soft tissue injury were included and soft tissue injury group was most prevalent, followed by tooth injury group and facial bone group. In total patient, the ratio of admission was 3.5%. We obtained the results of the distribution of primary emergency care in the traumatic injury, causal distribution of the jaw fracture, distribution of related medical department in multiple associated injuries, distribution of emergency care in infection, causal distribution and control methods of oral bleeding, distribution of TMJ disorder. The trauma patient group was major in the dental patients who had visited the emergency room, but other various groups were included. So we should analyze the pattern and the variation of the dental emergent patient to provide the proper treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권2호
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• pp.91-99
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• 2023

Background: Extrusion of debris is a major factor that results in postoperative pain during root canal treatment with various instruments and instrumentation techniques. Therefore, instrumentation techniques that extrude minimal debris into the periapical area while reducing pain are desirable. This study aimed to compare the incidence of postoperative pain and intake of analgesic medication (frequency and quantity) after endodontic treatment of mandibular posterior teeth using two single files and full-sequence continuous rotary systems with different kinematic motions. Methods: Thirty-five of 105 patients were assigned equally to three groups according to the instrumentation system used: ProTaper Next (PN) X2, 25/06 (Dentsply, Maillefer, Ballaigues, Switzerland), One Shape (OS), #0.25/06 (Micro Mega, Besancon, France), and Wave One Gold (WG), Red - #0.25, 0.07 (Dentsply, Maillefer, Ballaigues, Switzerland). Five specialists were included in this study design; each professional prepared 21 teeth, and randomly selected 7 per instrument system. The VAS sheet ranging from 0 to 10 was used to record the initial and postoperative pains at 24, 48, and 72 h, and 7^th day after single visit endodontic treatment in mandibular premolars and molars with a diagnosis of asymptomatic irreversible pulpitis with or without apical periodontitis. Postoperatively, an analgesic, ibuprofen 400 mg was administered for intolerable pain at a dose of 1 tablet for 6 h. The patients were asked over the telephone regarding postoperative pain at intervals of 24, 48, and 72 h, and 7^th day using a visual analogue scale. Result: There were no statistically significant differences among the PN, OS, and WG systems (P > 0.05) with regard to the incidence of postoperative pain at any of the four time points assessed. Conclusion: The intensity of postoperative pain, frequency, and analgesic intake were similar across all three types of instrument systems; however, the reciprocating single file (WG) was associated with less postoperative pain than the full sequence continuous rotary file.