임상증상에 따른 악관절이상의 방사선학적 소견에 대한 비교연구

박태원,유동수,Park Tae-Won,You Dong-soo 대한영상치의학회 1989 Imaging Science in Dentistry Vol.19 No.1

The authors analyzed the clinical findings, radiological findings and their correlations in the temporomandibular joint disorders. The results were as follows: 1. The most prevalent age group was in the first decade, then the second decade and the third decade. Female were more common with a ratio of 3.4:1. 2. The most common clinical findings was the pain on open mouth position (42.3%), then came the clicking and limitation of mouth opening. 3. The most common bone change on the condyle side was the erosion, then came the flattening, the osteopyte and the sclerosis in that orders. 4. In the case of the crepitus, the coarse crepitus showed more radiological change than the fine crepitus. The 27% of the patients with crepitus showed the bone change and the patients with crepitus showed more bone change than any other clinical symptoms. 5. In the case of the mouth opening limitation, the evaluation of the translatory movement by transcranial projection was in accordance with the clinical evaluation. 6. The correlation between the clinical symptom and the condylar position within the mandibular fossa was not present and in the case of diagnosis of disc displacement, the transcranial projection seemed not to be able to substitute for the arthrography. Radiographically, the most prevalent age group which showed the bone change was in the first, the second and the third decade. And the bone change seemed to have no relationship with aging.

지역사회 거주 노인의 타액선 기능저하 (구강건조) 평가 및 중재

소종섭,정회인,강정현,김지훈 대한노년치의학회 2022 대한노년치의학회지 Vol.18 No.2

Salivary gland hypofunction (dry mouth) is the most common dysfunction in older adults. It causes a deterioration in oral health, mastication, and swallowing functions. It can also lead to systemic frailty. Early diagnosis and intervention are required to prevent oral and systemic frailty. This literature review introduced the salivary gland hypofunction assessment methods and interventions applicable in community-dwelling older adults. The study proposed an oral mucosal wetness test. The test uses an oral moisture-checking device as the primary test for assessment considering logistic aspects in application to the elderly in the community. The clinical oral dryness score (CODS) is an alternative test. The assessment method of oral mucosal wetness showed a significant correlation with salivary secretion rate. The CODS system is also significantly correlated with mucosal wettability, salivary secretion rate, and severity of oral dryness. Therefore, they have proven useful as test tools for assessing salivary gland hypofunction and oral mucosal wetting. The subjective questionnaire (xerostomia inventory) is also a useful tool for determining the severity of dry mouth and can be combined with other examination methods for salivary gland hypofunction such as oral mucosal wetness test or CODS. Essential interventions to salivary gland disfunction include drug coordination, prescription of artificial saliva, expert application of fluoride varnish, and salivary gland stimulation exercises. Careful consideration of other oral functions, such as occlusal force, tongue pressure, tongue movement, and oral hygiene management ability, is also required. Comprehensive intervention must be planned. Many studies have shown that the degradation of one function leads to that of another. Conversely, improving each function can improve other oral and integrated functions, such as masticatory and swallowing functions. The ultimate purpose of the intervention for salivary gland hypofunction in community-dwelling older adults is to improve and maintain oral functions—mastication, swallowing, and pronunciation. Therefore, interventions should include complex interventions such as oral exercise, tongue pressure enhancement training, oral hygiene, and interventions to improve salivary gland function. The intervention for individual salivary gland dysfunction should be planned with a comprehensive perspective for maintaining integrated oral function and contributing to the prevention and management of systemic frailty and its complications.

측두하악관절에 대한 cone beam형 전산화단층영상과 자기공명영상의 비교

김규태,최용석,황의환,Kim, Gyu-Tae,Choi, Yong-Suk,Hwang, Eui-Hwan 대한영상치의학회 2008 Imaging Science in Dentistry Vol.38 No.3

Purpose : To compare and evaluate the diagnostic ability of cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ). Materials and Methods : CBCT and MRI of 46 TMJs of 23 patients with TMJ disorders were evaluated. They were divided into 3 groups according to the position of the articular disc of the TMJ at closed mouth position and the reduction of the disc during open mouth position on MRI: no disc displacement group (NDD), disc displacement with reduction group (DDR), and disc displacement without reduction group (DDWR). With PACS viewing soft-wares, position of mandibular condyle in the articular fossa, osseous change of mandibular condyle, shape of articular fossa, and mediolateral and anteroposterior dimensions of mandibular condyle were evaluated on CBCT and MRI. Each value was tested statistically. Results : The position of mandibular condyle in the articular fossa were concentric in the NDD, DDR, and DDWR of CBCT and NDD of MRI. However, condyle was positioned posteriorly in DDR and DDWR of MRI. Flattening, sclerosis and osteophyte of the mandibular condyle were much more apparent on DDR of CBCT than MRI. And the erosion of the condyle was much more apparent on DDWR of MRI than CBCT. Box and Sigmoid types of articular fossa were found most frequently in DDR of MRI. Flattened type was found most frequently in DDR of CBCT and deformed type was found most frequently in DDWR of CBCT. No significant difference in mediolateral and anteroposterior dimensions were shown on CBCT and MRI. Conclusion : Since MRI and CBCT has unique diagnostic imaging ability, both modalities should be used together to supplement each other to evaluate TMJ.

정상 해부학적 구조물에 대한 X-선 영상의 비교 연구

최향희,최의환,김재덕,Choi Heang-Hee,Choi Eui-Hwan,Kim Jae-Duk 대한영상치의학회 1999 Imaging Science in Dentistry Vol.29 No.1

Purpose: To compare radiographic images of Digora/sup (R)/ system and Ektaspeed Plus film obtained from normal adults. Materials and methods: Storage phosphor plate(SPP) was placed in a film holder behind Ektaspeed Plus film package without lead foil. The effect of film on SPP was studied in a separate in vitro experiment. Forty-seven sets of images were prepared for the evaluaton. The regions of interest(ROI) for evaluation were designated at seven sites including normal anatomical structures. The image quality for each ROI was evaluated on enhanced and unenhanced storage phosphor(SP) images and Ektaspeed Plus film. Results: Two film-SPP configurations showed significantly different gray levels at each step of the aluminum step wedge(p<0.05). The contrasts were comparable. Enhanced SP images were significantly superior to unenhaned images and film in all anatomical sturctures(p<0.01). The differences between unenhanced SP images and film were significant(p<0.05) except root canal and cortical bone on alveolar crest. For anatomical items. there were statistically significant difference among five observers(p<0.05). Conclusions: The image quality of enhanced SP images were superior to Ektaspeed Plus film. and Digora system is potentially applicable to clinical diagnosis.

비정형 치통 및 삼차 신경통 환자의 임상 특징과 치료 반응의 관계

최서영,정성희,주혜민,옥수민,안용우 대한노년치의학회 2022 대한노년치의학회지 Vol.18 No.1

Unexplained toothache is likely to be neuralgia that appears in the teeth. Atypical odontalgia(AO) and trigeminal neuralgia(TN), which are commonly seen in types of neuralgia, can be distinguished by identifying their clinical characteristics. The purpose of this study is to provide information for differential diagnosis by analyzing clinical features of patients suffering from these two diseases. From 2013 to 2022, medical records of 124 patients diagnosed with AO or TN who visited the Department of Oral Medicine at Pusan National University Dental Hospital were analyzed. Analysis was performed on 12 factors related to the patient’s clinical features. Patients with AO are generally younger than those with TN, and few patients show complete improvement (p<0.05). Compared to TN patients who showed sharp pain, AO patients mainly complained of dull pain, which lasted all day (p<0.05). In both diseases, unilateral pain predominantly appeared and the appearance of increased pain during contact stimulation was higher in patients with TN (p<0.05).Patients with AO often developed symptoms after dental treatment and responded relatively well to antidepressants. In contrast, TN patients were less associated with dental treatment, and antiepileptic drugs could reduce pain. In conclusion, the age of patients, pain duration, increased pain to stimulation, pain related to dental treatment, and type of medication indicating the therapeutic effect are important factors that differentiate between AO and TN.

악관절 내장증 환자의 최대 개구시 하악과두 운동량에 대한 자기공명영상 평가; 경두개촬영법과의 비교

조봉혜,Cho Bong-Hae 대한영상치의학회 2001 Imaging Science in Dentistry Vol.31 No.4

Purpose: To evaluate the condylar movement at maximal mouth opening on MRI in patients with internal derangement. Materials and Methods: MR images and transcranial views for 102 TMJ s in 51 patients were taken in closed and maximal opening positions, and the amount of condylar movement was analyzed quantitatively and qualitatively. Results: For MR images, the mean condylar movements were 9.4 mm horizontally, 4.6 mm vertically and 10.9 mm totally, while those for transcranial views were 12.5 mm, 4.6 mm, and 13.7 mm respectively. The condyle moved forward beyond the summit of the articular eminence in 41 TMJs (40.2%) for MR images and 56 TMJs (54.9%) for transcranial views. Conclusion: The horizontal and total condylar movements were smaller in MR images than in transcranial views.

디지털방사선영상에서 추출한 해면질골의 강도와 미세구조의 형태계측학적 분석에 대한 연구

한승윤,이선복,오성욱,허민석,이삼선,최순철,박태원,김종대,Han Seung-Yun,Lee Sun-Bok,Oh Sung-Ook,Heo Min-Suk,Lee Sam-Sun,Choi Soon-Chul,Park Tae-Won,Kim Jong-Dae 대한영상치의학회 2003 Imaging Science in Dentistry Vol.33 No.2

Purpose : To evaluate the relationship between morphometric analysis of bone microstructure from digital radiographic image and trabecular bone strength. Materials and Methods : One hundred eleven bone specimens with 5 mm thickness were obtained from the mandibles of 5 pigs. Digital images of specimens were taken using a direct digital intraoral radiographic system. After selection of ROI (100 × 100 pixel) within the trabecular bone, mean gray level and standard deviation were obtained. Fractal dimension and the variants of morphometric analysis (trabecular area, periphery, length of skeletonized trabeculae, number of terminal point, number of branch point) were obtained from ROI. Punch sheer strength analysis was performed using Instron (model 4465, Instron Corp., USA). The loading force (loading speed 1 mm/min) was applied to ROI of bone specimen by a 2 mm diameter punch. Stress-deformation curve was obtained from the punch sheer strength analysis and maximum stress, yield stress, Young's modulus were measured. Results: Maximum stress had a negative linear correlation with mean gray level and fractal dimension significantly (p<0.05). Yield stress had a negative linear correlation with mean gray level, periphery, fractal dimension and the length of skeletonized trabeculae significantly (p < 0.05). Young's modulus had a negative linear correlation with mean gray level and fractal dimension significantly (p < 0.05). Conclusions : The strength of cancellous bone exhibited a significantly linear relationship between mean gray level, fractal dimension and morphometric analysis. The methods described above can be easily used to evaluate bone quality clinically.

Cone-beam CT와 multi-detector CT영상에서 측정된 CT number에 대한 비교연구

김동수,한원정,김은경,Kim, Dong-Soo,Han, Won-Jeong,Kim, Eun-Kyung 대한영상치의학회 2010 Imaging Science in Dentistry Vol.40 No.2

Purpose : To compare the CT numbers on 3 cone-beam CT (CBCT) images with those on multi-detector CT (MDCT) image using CT phantom and to develop linear regressive equations using CT numbers to material density for all the CT scanner each. Materials and Methods : Mini CT phantom comprised of five 1 inch thick cylindrical models with 1.125 inches diameter of materials with different densities (polyethylene, polystyrene, plastic water, nylon and acrylic) was used. It was scanned in 3 CBCTs (i-CAT, Alphard VEGA, Implagraphy SC) and 1 MDCT (Somatom Emotion). The images were saved as DICOM format and CT numbers were measured using OnDemand 3D. CT numbers obtained from CBCTs and MDCT images were compared and linear regression analysis was performed for the density, $\rho$ ($g/cm^3$), as the dependent variable in terms of the CT numbers obtained from CBCTs and MDCT images. Results : CT numbers on i-CAT and Implagraphy CBCT images were smaller than those on Somatom Emotion MDCT image (p<0.05). Linear relationship on a range of materials used for this study were $\rho$=0.001H+1.07 with $R^2$ value of 0.999 for Somatom Emotion, $\rho$=0.002H+1.09 with $R^2$ value of 0.991 for Alphard VEGA, $\rho$=0.001H+1.43 with $R^2$ value of 0.980 for i-CAT and $\rho$=0.001H+1.30 with $R^2$ value of 0.975 for Implagraphy. Conclusion: CT numbers on i-CAT and Implagraphy CBCT images were not same as those on Somatom Emotion MDCT image. The linear regressive equations to determine the density from the CT numbers with very high correlation coefficient were obtained on three CBCT and MDCT scan.

악안면부의 섬유골성 병소 명칭에 대한 고찰

이병도,Lee, Byung-Do 대한영상치의학회 2007 Imaging Science in Dentistry Vol.37 No.1

Fibro-osseous lesions are composed of connective tissue and varying amount of mineralized substances, which may be bony or cementum-like structures. It is necessary for oral radiologist to differentiate due to the tendency of these fibro-osseous lesions to show similar histopathologic appearances, while the management of each lesion is different. However we often encounter a little difficulty in judgement because there are some overlaps between concept of each lesions. So recently I suggest, we face a need to review basic concept and classification of several fibro-osseous jaw lesions. In this article, several fibre-osseous lesions, such as fibrous dysplasia, cemento-ossifying fibroma and cemento-osseous dysplasia, will be discussed basing on the review of literature. particular emphasis will be made on the nomenclature revision of WHO's classification in 1992.

실험적 골 병소에 대한 콘빔형전산화단층영상과 초음파영상의 비교

김민성,박철우,김규태,최용석,황의환,Kim, Min-Sung,Park, Cheol-Woo,Kim, Gyu-Tae,Choi, Yong-Suk,Hwang, Eui-Hwan 대한영상치의학회 2010 Imaging Science in Dentistry Vol.40 No.3

Purpose : This study was performed to evaluate the diagnostic ability of ultrasonography in detection of bone defects and new bone formation. Materials and Methods : Experimental bony defects were prepared on the parietal bone samples acquired from 3.5 kg New Zealand male rabbits. The defects were evaluated using ultrasonography and CBCT, and examined histologically at interval of 1, 3, 6, and 8 weeks. Results : Ultrasonograph demonstrated hyperechogenicity in the defect area at 3 weeks and broadened hyperechogenicity from the margin of bone defect at 6 and 8 weeks due to new bone formation. On the CBCT images, new bone formation was first observed at 3 weeks around the margin of the defect, and showed gradually increase at 6 and 8 weeks. Histologic findings revealed existence of the fibroblasts and fibrous connective tissue with abundant capillary vessels only at 1 week, but osteoid tissue and newly formed trabecular bone at 3 weeks. Bone remodeling in the defect area was observed at 6 weeks and increased calcification and dense trabecular bone formation was observed at 8 weeks. Conclusions : Ultrasonograph proved to be a very useful diagnostic tool in detecting the bony defect and new bone formation. Additionally, ultrasonography provided valuable information regarding the blood supply around the defect area.