기능 노출 기간에 따른 골 유착성 임플란트의 촉각 감지도와 최대 교합력의 변화

정복영,전영식,한동후,Jung, Bock-Young,Jeon, Young-Sik,Han, Dong-Hoo 대한치과보철학회 1999 대한치과보철학회지 Vol.37 No.1

During the previous several decades the osseointegrated implants have been considered as the most ideal therapy for the fully edentulous or partially edentulous patients. Although the research on the biocompatibility of osseointegration, the oral tactile function, and the histo-neurologic study had been performed, the change of the oral tactile sensibility and maximal occlusal force according to the postinsertion time of implant prostheses has not been studied. The purpose of this study was to compare the oral tactile sensibility and maximal occlusal force of implant pros-theses to natural teeth according to the specific postinsertion time intervals. The fifty seven patients treated with $Br{\aa}nemark$ implants during the recent seven years were involved in this study. The oral tactile sensibility and maximal occlusal force were measured according to the postinsertion time (${\leqq}6\;months,\;{\leqq}12\;{\leqq}\;18\;months\;{\leqq}\;24\;months,\;and\;{\geqq}20\;months$) 1. The passive tactile threshold of implants was higher than 6-7 times when comparing to natural teeth(P<0.05) 2. The absolute pressure threshold in horizontal and vertical direction for the passive tactile sensibility had decreased significantly in the post insertion time 13-18 months group and had increased significantly in the post insertion time over 25 months group (P<0.05) 3. 50% limit thickness and 100% absolute thickness for the active tactile sensibility had decreased significantly in the postinsertion time 7-12 months group ($AT_{50}:P<0.005,\;AT_{100}:P<0.05$) 4. The maximal occlusal force of the implants prostheses had decreased when comparing with natural teeth in the postinsertion time 1-6 months group(P<0.05) and after that there was no significant difference between the implant prostheses and natural teeth(P<0.05) 5. Maximal occlusal force according to the postinsertion time had increased significantly in the 13-18 months group (P<0.05) after that there was no significant difference. 6. There was positive correlation between age and oral tactile sensibility tested in horizontal and vertical direction ($P_{H:r}=0.39,\;P_{v:r}=0.41$) and there was no correlation between age and maximal occlusal force, age and active tactile sensibility 7. According to the results or the questionnaire, 76.6% of the patients were satisfied with the function and 96.7% of the patients were satisfied with the sensibility. In conclusion oral tactile sensibility and maximal occlusal force of implants have changed with the postinsertion time. Oral tactile function of implants was lower than that of the natural teeth, but for the maximal occlusal force there was no difference between implants and natural teeth.

수종의 점막조정제간에 Candida albicans의 성장 양상 비교

정복영,강우진,정문규,Jung, Bock-Young,Kang, Woo-Jin,Chung, Moon-Kyu 대한치과보철학회 1995 대한치과보철학회지 Vol.33 No.3

The use of tissue conditioners has come into favor for preprosthetic treatment and the treatment of Denture stomatitis, but the major problem in the use of the tissue conditioner is the growth of C.albicans. To compare the growth of C.albicans according to the type and the wearing period of the tissue conditioner, three commercial tissue conditioners were relined to intraoral plates which were delivered to 14 smoking, 12 nonsmoking healthy men. Cultures were made from the conditioner surface at 2, 7, 14, 21 days after after intraoral placement. The frequency of positive culture and colony counts of C.albicans were measured by imprint culture technique. The following results were achieved : 1. The frequency of positive cluture had increased significantly for all materials used. 2. The frequency of positive culture had incresed significantly around 2,14 days for day for COE-Comfort, SR-Ivoseal. 3. There were no significant difference in the colony counts of C.albicans among the mate rials used. 4. There were an over-all increase with the wearing period of tissue conditioners and significant increase around 2, 7, 14 days for COE-Comfort, and 2, 14 days for SR-Ivoseal, viscogel in colony counts. 5. Smoking had no effect on the growth of C.albicans. That is, there were no difference among the materials used in the growth of C.albicans. In the clinical application of tissue conditioners, we should avoid a long term use of it, but in inevitable cases, special disinfection procedures should be considered.

하악공 전달마취후 복시 -증례보고-

최은혜,서지영,정복영,김성태,김기덕,박원서,Choi, Eun-Hae,Seo, Ji-Young,Jung, Bock-Young,Kim, Sung-Tae,Kim, Kee-Deog,Park, Won-Se 대한치과마취과학회 2007 Journal of Dental Anesthesia and Pain Medicine Vol.7 No.2

Inferior alveolar nerve block anesthesia is one of the most common procedures in dental clinic. Although it is well known as safe procedure, complications always can be occurred. Ocular complications such as diplopia, loss of vision, opthalmoplegia are very rare, but once it happens, dentist and patient can be embarrassed and rapport will be decreased between them. We experienced one diplopia case after inferior alveolar nerve block anesthesia and treated without any further complication. We report this case and describe the cause, diagnosis, and treatment objectives of diplopia caused by inferior alveolar nerve block anesthesia.

Minimally Invasive Laser-Assisted Biopsy of the Oral Lesions for Oral Graft-Versus-Host Disease after Hematopoietic Stem-Cell Transplantation

김윤미,윤희정,김현실,김기덕,정복영,방난심,박원서,Kim, Yun-Mi,Yun, Hee-Jung,Kim, Hyun-Sil,Kim, Kee-Deog,Jung, Bock-Young,Pang, Nan-Sim,Park, Won-Se The Korean Academy of Orofacial Pain and Oral Medi 2012 Journal of Oral Medicine and Pain Vol.37 No.3

조혈줄기세포이식은 면역 결핍 질환, 자가 면역 질환, 악성 조혈 종양의 주된 치료법이다. 이종 조혈줄기세포이식의 주요한 합병증은 이식편대 숙주질환이다. 구강 점막 생검은 이식편대 숙주 질환의 확진과 치료계획 수립을 위해 필요하나 영양 결핍과 화학 요법으로 인해 전신상태가 불량한 환자에게 출혈과 균혈증을 일으킨다. 본 논문에서는 레이저를 이용한 최소 침습적 조직생검의 효능을 평가하였다. 모두 3개의 증례가 소개되었고 모든 환자의 의료 기록, 임상 사진, 조직병리학적 결과가 레이저를 이용한 조직생검의 효능을 평가하기 위해 검토되었다. 모든 환자는 생검 후 불편감이 없었고 심각한 합병증이 발생하지 않았다. 생검 조직의 질이 이식편대 숙주 질환을 확진하는 데에 적당했다. 구강 점막의 레이저를 이용한 최소 침습적 생검은 통상의 조직병리학적 생검에 비해 출혈을 일으키지 않아 감염과 균혈증, 술 후 흉터 생성을 줄이므로 이식편대 숙주 질환의 확진에 이로울 것이다. Hematopoietic stem-cell transplantation (HSCT) is a treatment for immune deficiency, autoimmune diseases, and hematopoietic malignancies. The main complication of allogenic HSCT is graft-versus-host disease (GVHD). Oral mucosal biopsy is needed for a definitive diagnosis and treatment planning of GVHD, but this procedure causes bleeding and bacteremia in a poor general condition. We evaluated the efficacy of laser-assisted biopsy as a minimally invasive treatment. Three cases were described in this article. All patients' medical records, clinical photographs, and histopathologic findings were reviewed. All patients felt comfortable and no severe complications occurred. The quality of the obtained biopsy material was adequate for a definitive diagnosis of GVHD. Laser-assisted, minimally invasive biopsy of the oral mucosa does not cause bleeding, and it reduces the chances of infection, bacteremia, and postoperative scarring compared to the usual histopathologic biopsy procedure. It would thus be advantageous to use this procedure to biopsy GVHD patients.

항응고제 복용 환자에서 저분자량 헤파린을 사용한 구강 내 소수술

황세영,윤희정,방난심,정복영,김기덕,김형준,박원서,Hwang, Se-Young,Yun, Hee-Jung,Pang, Nan-Sim,Jung, Bock-Young,Kim, Kee-Deog,Kim, Hyung-Jun,Park, Wonse 대한치과마취과학회 2012 Journal of Dental Anesthesia and Pain Medicine Vol.12 No.2

Anticoagulation therapy with warfarin sodium is used to reduce the risk of thromboembolic events in patients with valvular heart disease, prosthetic heart valve, recurrent myocardiac infarction, etc. To keep anticoagulation state and minimize bleeding risk, patients with high risk of thromboembolism have been usually hospitalized for heparinization before oral surgery like extraction. However, this protocol requires time and high expense because of the long period of hospitalization and this is why low-molecular-weight heparin (LMWH) therapy is receiving attention in medical field as well as dentistry. LMWH has several advantages over unfractionated heparin (UFH) including predictable anticoagulant response which makes coagulation monitoring unnecessary in most patients and longer half-life than heparin which enables the patients to give themselves a subcutaneous injection once or twice daily. These advantages of LMWH make patients get oral surgery on an outpatient basis so that they can save time and cost. This case report introduces the use of LMWH in dental surgery and suggests proper use of LMWH. Though LMWH bridging therapy is widely used most of the previous studies are observational studies. Therefore randomized controlled trials are necessary to evaluate the safety and efficacy of LMWH bridging therapy.

컴퓨터를 이용한 속도 조절형 치과 국소마취 기구: 문헌고찰

김영진,이준형,이강희,김기덕,정복영,방난심,박원서,Kim, Young-Jin,Lee, Jun-Hyung,Lee, Kang-Hee,Kim, Kee-Deog,Jung, Bock-Young,Pang, Nan-Sim,Park, Wonse 대한치과마취과학회 2013 Journal of Dental Anesthesia and Pain Medicine Vol.13 No.4

Background: Today, there are computer controlled local anesthesia devices used clinically. The main principle is to control injection speed by computer aided system, and it relieves pain. However, there are few objective data considering this subject. In this literature review, we researched studies about computer controlled anesthetic delivery. We compared pain control effect of computer controlled to conventional local anesthetic syringe system. Methods: A bibliographic search in PubMed was performed and we reviewed original articles. Results: There were 18 publications that compared pain control effect of computer controlled to conventional system. There were 8 articles reported of children, similar pain control effect was found in 7 of them. One study showed superior pain control effect of computer controlled anesthetic delivery. For adults, 10 studies showed superior pain control effect in computer aided system. Conclusions: Computer controlled anesthetic delivery has similar or superior pain control effect compared to conventional local anesthetic syringe system. For both children and adults, computer controlled anesthetic delivery could be clinically useful, still it may be more effective for adults.

간이식 환자의 출혈 경향과 치과적 고려 사항

박원서,백윤재,도레미,김기덕,정복영,방난심,윤희정,유태민,Park, Wonse,Baik, Yoon-Jae,Doh, Re-Mee,Kim, Kee-Deog,Jung, Bock-Young,Pang, Nan-Sim,Yun, Hee-Jung,You, Tae-Min 대한치과마취과학회 2012 Journal of Dental Anesthesia and Pain Medicine Vol.12 No.3

Background: The major goal of dental management before and after liver transplantation is the prevention of bacteremia from an oral source that could lead to systemic infection. However dental treatment in liver transplant patients have the risk of infection and bleeding. so it is needed special dental consideration. Methods: 42 liver transplant candidates who visited department of Advanced General Dentistry in Yonsei University College of dentistry from March 1, 2010 to February 29, 2012 were selected. The clinical data of those patients were analyzed; coagulation status such as PT, INR, aPTT, platelet count before and 6 months after liver transplantation, dental infectious foci, time interval between dental visit and operation date of liver transplantation. Results: Before liver transplant, the patient's PT and INR was prolonged, and the platelet count was lower than normal range. But 6 months later from liver transplantation, most of the figures turned into a normal range. The dental infection foci were chronic periodontitis, dental caries, chronic apical periodontitis, root rest et al but we did extraction of 6 root rest before liver transplantation and postponed other treatment after liver transplantation due to bleeding and infection risk of patients. Because of insufficient interval between dental visit and operation date, 64.3% of patients could not finish the dental treatment. Conclusions: The patients before liver transplantation have the risk of bleeding. The treatment of those patient should be removal of only factors that can cause dental infections after transplantation and other treatment must be postponed until the stable period of the transplant that patient's condition has improved.

하악공 전달마취 후 발생한 일시적인 시력 저하

임지영,윤희정,방난심,정복영,김기덕,박원서,Lim, Gee-Young,Yun, Hee-Jung,Pang, Nan-Sim,Jung, Bock-Young,Kim, Kee-Deog,Park, Won-Se 대한치과마취과학회 2012 Journal of Dental Anesthesia and Pain Medicine Vol.12 No.1

One of the most common procedures in dentistry is the inferior alveolar nerve block anesthesia but visual problem can occur during this procedure. Transient visual acuity decrease after inferior alveolar nerve block anesthesia can result from unintended intravascular injection. In this case report, we present ocular complication that has rarely been reported. The understanding of anatomy related to this case is discussed with suggestions for proper management of the patients. The dental management for ocular complications includes a correct diagnosis, management by understanding of patient's anatomic variations. This will prevent intravascular injection.

위장관으로 흡인된 치과기구의 처치

방난심,이강희,김영진,정복영,Pang, Nan-Sim,Lee, Kang-Hee,Kim, Young Jin,Jung, Bock-Young 대한치과마취과학회 2013 Journal of Dental Anesthesia and Pain Medicine Vol.13 No.2

Foreign body indigestion during dental procedures is uncommon but sometimes associated with severe and life threatening morbidity. The dentist should decide whether multidisciplinary intervention is necessary and how urgently it has to be done. The active removal of foreign bodies depends on the size, shape, type and duration of impaction, along with the location in the gastrointestinal tract. In this report, we presented how to manage gastric foreign body related swallowing during dental procedure and investigated the predictive risk factors, precaution, and prompt management in foreign body ingestion.

하악 좌측 제1소구치 부위의 임플란트 식립을 위한 하치조신경 국소마취 후 발생한 Paresthesia

조지헌,이강희,방난심,박원서,김기덕,정복영,Jo, Ji-Hun,Lee, Kang-Hee,Pang, Nam-Sim,Park, Wonse,Kim, Kee-Deog,Jung, Bock-Young 대한치과마취과학회 2013 Journal of Dental Anesthesia and Pain Medicine Vol.13 No.2

Most of the dental treatments have been routinely performed under the local anesthesia and the effectiveness has also been proved safe. However, even not frequently dentists face some complications associated with the local anesthesia. In this report, the experience of the paresthesia after mental nerve block anesthesia for an implant placement of the mandibular premolar was presented to raise awareness of the complications related with local anesthetic procedure and to discuss about the causes, the proper treatments and the preventive approach of the paresthesia.