실험적 골파괴와 골형성에 대한 방사선학적 연구

최순철,안형규,Choi Soon-Chul,Ahn Hyung-Kyu 대한영상치의학회 1988 Imaging Science in Dentistry Vol.18 No.1

Bone destruction was induced experimentally by the insertion of a bit of the arsenic compound into the pulp chambers of the right premolars and the artificial bone defects were produced in the periapical regions of the left premolars in 7 dogs. The serial standardized periapical radiographs using aluminum stepwedge attached to the XCP instruments, and resin bite blocks were taken following insertion of arsenic compound and at 2, 4, 7, 10, 14, 17, 21, 24 and 28 days in case of bone destruction and following bone injury and weekly thereafter for a total of 14 weeks in case of bone formation. The errors of the method were determined with error estimators described by the Duinkerke. All radiographs were evaluated by the visual examination after joint evaluation by three dental radiologists and analysed with densitometer. The following results were obtained; 1. Analysis of the bone destruction process 1) The error of the method in estimating two distances proved to be small (S.D. for the measuring error; 0.04㎜, S.D. for the over-all error; 0.06㎜, S.D. for the positioning error; 0.05㎜) 2) The radiographic changes were observed after 7 days in 6 cases, 4 days in 1 case and 10 days in 1 case by the visual examination. 3) Aluminum equivalent values were diminished after 2 days and the diminution of 0.58±0.19㎜ was demanded to be detected by the visual examination. 2. Analysis of the bone formation process 1) The error of the method in estimating two distances proved to be small (S.D. for the measuring error; 0.03㎜, S.D. for the over-all error; 0.04㎜ S.D. for the positioning error; 0.04㎜) 2) The radiographic changes were observed after 2 weeks in 5 cases and 3 weeks in 2 cases by the visual examination. 3) Aluminum equivalent values were increased after 1 week and the increase of 0.45±0.15㎜ was demanded to be detected by the visual examination. 4) Aluminum equivalent values were increased continuously for 7 or 9 weeks but there as only extremely small change after 10 weeks.

고령자 삼킴기능저하의 평가와 중재

고석민,이지나 대한노년치의학회 2022 대한노년치의학회지 Vol.18 No.2

Korea is on the verge of becoming a super-aged society, and the structure of the disease is changing accordingly. One of the measures to lower the medical and social burden for the elderly is early detection and prevention of elderly frailty. Oral frailty in elderly is reported to be manifested prior to whole body frailty. So, if oral frailty is diagnosed and treated early, independency in mobility and healthy aging of elderly can be effectively promoted. The Korean Academy of Geriatric Dentistry launched establishing a clinical guideline of oral frailty for Korean elderly with diagnostic criteria and treatment modality. If two out of the six criteria, chewing function, occlusal force, tongue force, salivary gland function, swallowing function, and oral hygiene, are checked as not ‘normal’ but ‘at risk’, the patient is diagnosed as having oral frailty. In this paper, evaluation methods and exercise therapies for swallowing function (out of the six criteria for oral frailty) is described in detail.

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.

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.

지역사회 구강돌봄진료제도 도입 제안 - 돌봄(의존성) 노인의 구강건강관리 시스템 -

이성근,고홍섭,소종섭,곽정민,박인임,이지나,정회인,김태완,강경리 대한노년치의학회 2022 대한노년치의학회지 Vol.18 No.1

Oral care and dental services for the dependent older people of Korea is still extremely limited and not easily provided. Depending on where the dependent older people resides, such as the nursing facilities, individual homes, and nursing hospitals, access to dental personnel and the scope of oral care and dental treatment can be quite different due to disparities in rules and regulations for different institutions. In this study, the term ‘community oral care/palliative treatment system (COCS)’ for the dependent older people was introduced, and implementation of ‘The integrated community oral care/palliative treatment system’ (ICOCS) for the dependent older people was recommended. Oral care/treatment for the dependent older people could be categorized into four areas as follows 1) Oral care; Oral hygiene care and oral function care, 2) Basic dental treatment; non-invasive or minimally invasive dental treatment such as dry mouth management, pain management, adjusting and repairing of dentures, 3) General dental treatment, 4) Emergency dental treatment. Oral care and basic dental treatment should be available to all dependent older people wherever they are. For general dental treatment and emergency dental treatment the dependent older people should be transported to dental facilities. The criteria for selecting subjects for COCS were as follows, the remaining life expectancy and the rate of physical decline, ambulatory of the older people for dental visit, the ability of self-oral hygiene care, and the ability of cooperating during general dental treatment. For establishing ICOCS for the entire Korea, it was proposed to set-up an organization called the Korean Community Oral Care Promotion Agency (tentative name) in the central government level and supporting organizations at the municipal level. It is proper time to establish oral care/treatment system for the dependent older people in the community when the nationwide system of care welfare system is actively implemented. This study will lay the foundation for a policy that can provide oral care for the dependent older people in the community and is expected to prevent deterioration, or even improve general health.

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.

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.

일반 측방 두부규격 방사선사진과 측방 추부규격 전산화 방사선사진에서의 계측점의 신뢰도에 대한 비교 연구

김형돈,김기덕,박창성,Kim Hyung-Don,Kim Kee-Deog,Park Chang-Seo 대한영상치의학회 1997 Imaging Science in Dentistry Vol.27 No.1

The purpose of this study was to compare & to find out the variability of head film measurements (and marks identification) between Fuji computed radiographic cephalometry and conventional cephalometry. 28 Korean adults were selected. Lateral cephalometric FCR film and conventional cephalometric film of each subject was taken. Four investigators identified 24 cephalometric landmarks on lateral cephalometric FCR film and conventional cephalometric film. The comparable measurements between lateral cephalometric FCR film and conventional cephalometric film were statistically analysed. The results were as follows : 1. In FCR film & conventional film, coefficient of variation (C.V.) of 24 landmarks was taken horizonta1ly & vertically. There is no significant difference of rank order of landmarks in C.V. between two films. 2. In comparison of significant differences of landmarks variability between FCR film & conventional film, horizontal value of coefficient of variation, showed significant differences in four landmarks among twenty-four landmarks, but vertical value of coefficient of variation showed significant differences in sixteen landmarks among twenty-four landmarks. FCR film showed significantly less variability than conventional film in 17 subjects among 20(4+16) subjects that showed significant difference.

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.