Frankel appliance(FR-2)를 이용한 2급 부정교합 환자의 치험례

이긍호,최영철,부성언 大韓小兒齒科學會 1990 大韓小兒齒科學會誌 Vol.17 No.2

The functional regular(FR-2) is a removable orthodontic appliance developed by Rolf Frankel that is used during the mixed and early permanent dentition stages to effect changes in anteroposterior, transverse, and vertical jaw relationship in class Ⅱ malocclusions. This appliance serves as a template against which the craniofacial muscles function. The framework of the appliance provides an artificial balancing of the environment, thereby promoting more normal patterns of muscle activity. The Frankel also influences skeletal and dental development. The appliance removes muscle forces in the labial and buccal areas that restrict skeletal growth, thereby providing an environment that maximizes mandibular growth. The case presented here and the progressive analysis reveals the forward and downward growth of the mandible remarkably. This patient with severe overjet, convex profile, underdeveloped and retrognathic mandible have been treated with FR-2, and forward and downward growth of the mandible was observed.

천궁(Cnidii Rhizoma)의 메탄올 추출물이 GABA 및 Glycine 수용체에 미치는 영향

이종태,박재홍,이긍호 大韓小兒齒科學會 2005 대한소아치과학회지 Vol.32 No.1

천궁의 메탄올 수용액 추출물의 진정 작용을 밝히기 위하여 staircase test를 시행하였으며, 근육이완 효과를 검색하기 위하여 rotarod test를 시행하였다. 진정 작용의 기전 구명을 위하여 GABA 및 glycine 수용체에 작용하는 약물인 picrotoxin, yohimbine, isoniazid, strychnine 등의 약물을 이용하여 발작 유도에 걸리는 시간을 비교 관찰하였다. 또한 생체에서의 안전성을 검증하기 위하여 Irwin의 행동시험 및 신경세포에 대한 독성을 평가하기 위하여 MTT test를 실시하여 다음의 결과를 얻었다. 1. Staircase 실험에서 천궁 추출물을 10mg/kg 용량으로 경구 투여했을 때 climbing수는 대조군과 차이가 없었으나, rearing수에서는 대조군에 비하여 42%의 감소를 보였다. 2. 30mg/kg 용량으로 경구 투여했을 때, climbing수는 대조군과 차이가 없었으나, rearing수에서는 51%의 감소를 유발하였다. 3. 근육이완 작용을 탐색하기 위한 rotarod 실험에서는 대조군과 차이를 나타내지 않았다. 4. 천궁 추출물의 투여는 picrotoxin, isoniazid, yohimbine에 의한 발작에서는 큰 변화를 유발하지 않았으나, strychnine에 의한 발작 유도시간은 41%의 증가를 유발하였다. 5. 일반 행동에서도 특이한 변화를 유발하지 않았으며, 신경세포에 적용했을 때 특이한 독성 반응을 나타내지 않았다. 천궁의 메탄올 수용액 추출물은 현저한 진정 작용을 유발하며, 그 작용 기전으로서 glycine의 작용을 증가시켜 chlorideion의 세포내 유입으로 인한 억제성 신경전도를 유도한다고 사료된다. 또한 근육이완 작용도 나타나지 않았으며, 특이한 생체독성도 유발되지 않은 것으로 보아, 향후 치과임상에서 진정요법의 한 수단으로서 사용될 수 있다는 가능성을 제시한다. Cnidii Rhizoma (CR) was subjected to extraction with 70% methanol and tested to determine whether it has anxiolytic activity in mouse by employing staircase and rotarod tests. In addition, to understand the mechanism of anxiolytic action, CR, picrotoxin, yohimbine, isoniazid and strychnine were utilized to delineate the potential involvement of GABA and glycine receptors in the action of Cnidii Rhizoma. To gain insights into the safety of Cnidii Rhizoma extract, behavioral and MTT tests were carried out. The results were obtained as follows: 1. CR extract had little effect on climbing numbers in the stair case test. 2. CR extract had considerable anti-anxiety effects as evidenced by the reduction of rearing numbers in the stair case test. 3. CR extract had little effect on muscle relaxation. 4. Anxiolytic actions of CR extract appeared to be mediated by glycine receptor activation. 5. Cytotoxicity in the neuronal cell was not observed and no strange behaviors were found. In short, these results indicate that CR extract has the ability to exert anxiolytic activity, possibly by activating glycine receptor with little side effects in mouse.

에리저가 조사된 유전치 상아질과 복합레진의 전단결합강도에 관한 연구

이우석,이긍호 慶熙大學校 齒科大學 1995 慶熙齒大論文集 Vol.17 No.2

The purpose of this study is to compare the shear bond strength of composite resin to dentin which was irradiated by CO2 laser. 120 primary anterior teeth were divided into one control and five experimental groups. Control group was not surface-treated and experimental groups were laser-irradiated. The CO2 laser was used at the power of 1.0 W, 0.2 sec(Experimental group 1), 15 W, 02 sec(Experimental group 2), 2.0W, 02 sec(Experimental group 3), 2.5 W, 0.2 sec(Experimental group 4) and 3.0 W, 02 sec(Experimental group 5). The smear layer on the surface of dentin was removed, the orifices of dentinal tubules were opened and the shear .bond strength of composite resin to dentin was increased by the irradiation of CO2 laser. The results were as follows: 1. Higher shear bond strength was obtained in laser pre-treated groups than contol group. 2. The smear layer on the surface of dentin was removed by the irradiation of CO2 laser. 3. The highest shear bond strength was found in experimental group 2 and followed by experimental group 1,5,4 and 3. Experimental group 2 shows a significant difference from other groups(P<0.05), experimental group 1 shows a significant difference from experimental group 2,3(P<0.05) and there was no significant difference between experi mental group 3,4 and 5. 4. Surface-fusion of the dentin was occurred in experimental group 3,4,5 according to the increase of the laser energy.

치수 절단술 약제의 치수 섬유모세포에 대한 세포독성 연구

이영희,이긍호 大韓小兒齒科學會 2000 대한소아치과학회지 Vol.27 No.1

유치의 치수 절단술에 이용되는 약제들 (formaldehyde, formocresol, paraformaldehyde, ferric sulfate)이 농도 변화에 따라 치수 섬유모세포의 활성, 단백질 기질의 합성 및 무기질 침착에 미치는 영향을 규명하고자, 각각 0.01, 0.05, 0.10, 0.25, 0.50, 1.00㎕/㎖의 농도로 사람의 치수 섬유모세포에 24시간 적용시킨 후 세포활성검사와 함께, 조직의 재생과정 중 유기질이 되는 단백질의 합성능과 무기질 침착에 관여하는 알칼리성 인산효소의 활성에 미치는 영향을 완충액만을 투여한 대조군과 비교 평가한 결과 다음과 같은 결론을 얻었다. 치수 절단술 약제를 첨가한 후 24시간 배양하였을 때, formaldehyde, formocresol, paraformaldehyde 등의 경우 약제 농도가 증가함에 따라 대조군에 비하여 치수 섬유모세포의 세포활성이 크게 저하되었으며, ferric sulfate를 이용한 경우에는 세포활성이 유지되거나 약간 촉진되었다. formaldehyde, formocresol, paraformaldehyde 사이의 세포활성간에는 유의성 있는 차이가 보여지지 않았다. 치수 절단술 약제 첨가 후 배양액내의 총단백질양에는 큰 변화가 없었으나, paraformaldehyde에 의해 총단백질양이 약간 감소하였다. 약제 첨가 후 세포내의 단백질양을 측정하였을 때 ferric sulfate의 경우, 약제의 농도가 증가하였을 때도 지속적으로 단백질 합성이 저해됨을 알 수 있었다. formaldehyde, formocresol, paraformaldehyde, ferric sulfate는 치수 섬유모세포의 알칼리성 인산효소 활성을 약간 저해하였다. The effect of concentration as factor in cytotoxicity, protein synthesis and alkaline phosphatase activity was compared for pulpotomy medicaments (formaldehyde, formocresol. paraformaldehyde, ferric sulfate). Human pulp fibroblasts were exposed to a range of concentrations(0.01, 0.05,0.10, 0.25,0.50, 1.00㎕/㎖) of each agents, for period of 24hrs. The cell activities were evaluated by MTT assay, protein assay and alkaline phosphatase activity examination. The results as follows: 1. After 24hrs culture, pulp fibroblasts adding formaldehyde, formocresol and paraformaldehyde were suppressed cell activities with concentration increasing, but, no depression of cell activities by sulfate. No significant difference was in formaldehyde, formocresol and paraformaledhyde. 2. Protein synthesis by pulpotomy agents were not significant difference in pulp fibreblasts but protein synthesis were a little decreased by paraformaldehyde. 3. Alkaline phosphatase activity was a little decreased by pulpotomy medicaments.

아동의 하악골에 발생한 복합 치아종의 외과적 처치에 관한 증례보고

이긍호,최영철,정우성 大韓小兒齒科學會 1999 대한소아치과학회지 Vol.26 No.3

악골에서 비교적 흔한 빈도로 발생하는 치아종은 치배조직의 과성장으로 인하여 발생한다.세계보건기구에서는 치아종을 복잡 치아종과 복합 치아종으로 구분하고 있다.치아종은 악골내 모든 부위에서 발생할 수 있지만 치아와 유사한 복합 치아종은 비교적 상악 전치부에 호발하고,불규칙한 형태를 나타내는 복잡 치아종은 하악 구치부에 호발한다.치아종의 원인은 정확히 알려져 있지 않으며 치배에 대한 구소적인 외상이나 감염이 주된 요인으로 추측되고 있고,최근에는 유전적인 원인에 대해서도 연구되고 있으나 아직 확실히 입증되지는 않고 있다.일반적인 증상이 없기 때문에 일상적인 방사선 검사에서 주로 발견되고 영구치의 맹출지연이나 유치의 만기잔존 등이 증상이 있을 수 있다.치아종은 구강내의 어떤 부위에서도 발생이 가능하고 드물기는 하지만 상악동,하악의 하연,하악지 및 하악과두 하방에서 발견되기도 하며,이공 부위에서 발생되는 경우도 있다. 치아종은 발육중인 치열과 악궁에 미치는 영향을 최소화하기 위하여 발견되는 즉시 낭포 및 주위 연조직을 함께 외과적으로 제거하는 것이 바람직하다.환자의 연령과 치과치료에 대한 협조도,영구치열의 발육상태,치아종의 악골내 위치 및 동시적인 치과치료가 요구되는 가를 고려하여 외래 진료실에서 하는 경우도 있고 전신마취를 통하여 하는 경우도 있다. 본 증례는 치아종의 악골내 위치가 깊지 않고 치과치료에 대한 협조도가 양호하다고 판단되는 환아에서는 외래 진료실에서 국소마취하에 수술하여 치료하였고,연령이 어리고 치아종이 악골내 위치가 깊어 장시간의 시술 시간이 요구되고 동시에 보존적인 치과치료가 필요한 환아에서는 전신마취하에 치료한 것을 보고한 것이다.두 증례에서 수술 4개월 후 외과적 결손 부위에 골이 형성되었고,매복된 영구치의 맹출이 정상적으로 이루어진 것으로 나타났다. The Odontogenic is relatively a common benign odontogenic tumor and caused by overgrowth of odontogenic tissues.The recent classification by World Health Organization divides odontoma into 2 groups such as compound odontoma and complex odontoma.Compound odontoma comprises dental tissues,resembling the morphology of a tooth and has predilection for the anterior maxilla.In contrast,complex odontoma has unorganized mass,not resembling the normal tooth and has predilection for the posterior mandible.The etiology of odontoma is unknown and almost asymptomatic.So,it usually is found in routine radiographic examination,and most common presenting symptom is impacted or unerupted permanent teeth and ratained primary teeth.It can occurs almost anywhere in jaws. It is desirable that odontoma should be removed by surgical enucleation including follicle and surrounding soft tissues.Considering the age and behavioral cooperation of patient,the develoment of parmanent dentition,the location of odontoma in jaw,the need for the concomitant operative dentistry,operation is performed in outpatient department with/without sedation or under general anesthesia with endotracheal intubation. In this case report,2 patients with compound odontoma were treated by surgical enucleation including follicle and surrounding soft tissues.One patient,about 5years old,was treated under general anesthesia and concomitant operative density was performed.The other patient,about 11years old,was treated under local anesthesia in outpatient department.In 2 cases,after 4 months,surgical defects were filled with new bone and normalization of eruption path of impacted permanent teeth was observed.

클로르헥시딘 바니쉬와 클로르헥시딘 양치액 사용시 치면 착색면적의 비교

이긍호,황정환,최영철 大韓小兒齒科學會 1998 대한소아치과학회지 Vol.25 No.3

The purpose of this study was to compare the staining ratio on the enamel surface following the use of chlorhexidine mouthwash and the chlorhexidine varnish application Labial and lingual surfaces of maxillary and mandibular incisors of adults were selected to evaluate the staining ratio. The control group was consisted of 8 individuals, the experimental group 1 and 2 were consisted of 50 each. Prophylaxis with pumice was performed to remove the stain already established on the enamel surface of all groups. The group 1 asked to use chlorhexidine mouthwash(Hexadent, chlorhexidine gluconate 1ml/100ml) for a was minute twice a day. Ther chiorhexidine varnish (chlorzoin, consisted of solution l (10% chlorhexidine acetate) and solution 2(polyurethane sealant)) was applied on the enamel surfaces of the group 2. After 4 weeks of experiment, intraoral photogrgh of tooth surfaces were taken in order to recorc the stained area on the enamel of the control and the experimental groups. Outline of leeth and the stained area in the photographs was traced on the OHP film. Scanner and computer processor were used to calculate stained surface ratio.

다발성 무치근 치아에 대한 치과적 처치

이미숙,이긍호,최영철 대한소아치과학회 2001 대한소아치과학회지 Vol.28 No.2

감각신경아세포종으로 생후 1년 6개월부터 약 1년간 6주기의 화학요법과 생후 1년 6개월에 29회에 걸친 방사선 조사(AP 4540 R+LAT 1080 R : total 5620 R)를 받은 후 후유증으로 상악치아 및 상악골의 발육장애를 보이는 10세 남아의 임상적, 방사선학적 관찰 및 치료 후 다음과 같은 지견을 얻었기에 보고하는 바이다. 1. 성장중인 어린이에서 악성종양의 치료를 위한 방사선 조사는 연조직 및 경조직(골, 연골, 치아)등의 성장장애를 유발할 수 있으므로 시술 전 충분한 고려가 필요하다. 2. 치배의 손상은 치관 및 치근의 형성장애를 유발하고 이에 따라 치조골의 성장장애가 나타나므로 치근이 없는 치아일지라도 치조골의 흡수를 억제하기 위하여 hawley type의 부분의치 등을 이용하여 잔존시켜야 한다. 3. 향후 성장이 완료된 이후(만 18세 이상)에 무치근 치아 및 무치악 부위에 틀니(denture)나 임플란트 등의 보철수복이 필요할 것으로 여겨진다. Chemotherapy and radiotherapy used on pediatric oncology patients often causes dentofacial anomalies. Defects noted include tooth and root agenesis, root thinning, root shortening, localized enamel defect and maxillofacial underdevelopment. The effect of radiotherapy usually is confined to the radiation site but the effect of chemotherapy may be more wide spread becuase of its systemic distribution. Many pediatric cancers are treated with a combination of radiation and multiagent chemotherapy. Dental treatment affected by chemotherapy and radiation therapy damate to developing teeth and maxilloface includes retention of teeth, space maintenance, prosthetic considerations, requirements for oral hygiene. The following case related to multiple rootless teeth.

아동의 치과치료시 심박동과 동맥혈 산소포화도의 변화에 관한 연구

이상훈,이긍호,김광철 大韓小兒齒科學會 1993 大韓小兒齒科學會誌 Vol.20 No.1

The purpose of this study was to examine the effect routine dental procedures on pulse tate and oxygen saturation in children using the pulse oximetry(Nellcor N-250 Pulse oximeter/display midule, U.S.A.) and to develop a baseline for additional studies of oxygen saturation in sedated pediatric dental patients. The data were obtained from 65 children(2 to 15 years of age) treated at the Dipt. of Pedia. Dint.,Kyung-Hee Medical Center. Subjects were divided into 2 groups. An Amalgam treatment group and an Extraction group. Pulse rate and oxygen saturation were measured and recorded using pulse oximetry and were evaluated the change above or below three-minutes preoperative baseline for each step. The results were as follows: 1.In Amalgam treatment group, significant increases of pulse rate were observed during rubber dam application, local anesthetic injection, cavity preparation and anesthetic uptake. 2.In Extraction group,significant increases of pulse rate were observed during all treatment session. 3.In Amalgam treatment group, no significant increases of oxygen saturation were observed during all treatment session. 4.In Extraction group, significant increases of oxbgen saturation were ovserved during anesthitic uptake,tooth extraction and postoperative period.

레이저가 조사된 유전치 상아질과 복합레진의 전단결합강도에 관한 연구

이우석,이긍호 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.1

The purpose of this study is to compare the shear bond strength of composite resin to dentin which was irradiated by CO₂laser. 120 primary anterior teeth were divided into one control and five experimental groups. Control group was not surface-treated and experimental groups were laser-irradiated. The CO₂laser was used at the power of 1.0 W, 0.2 sec(Experimental group 1), 1.5 W, 0.2 sec(Experimental group 2), 2.0 W, 0.2 sec(Experimental group 3), 2.5 W, 0.2 sec(Experimental group 4) and 3.0 W, 0.2 sec(Experimental group 5). The smear layer on the surface of dentin was removed, the orifices of dentinal tubules were opened and the shear bond strength of composite resin to dentin was increased by the irradiation of CO₂laser. The results were as follows: 1. Higher shear bond strength was obtained in laser pre-treated groups than control group. 2. The smear layer on the surface of dentin was removed by the irradiation of CO₂ laser. 3. The highest shear bond stength was found in experimental group 2 and followd by experimental group 1,5,4 and 3. Experimental group 2 shows a significant difference from other groups(P<0.05), experimental group 1 shows a significant difference from experimental group 2,3(P<0.05) and there was no significant difference between experimental group 3,4 and 5. 4. Surface-fusion of the dentin was occurred in experimental group 3,4,5 according to the increase of the laser energy.

외상에 의해 설측 변위된 하악 제1유구치의 가철성 장치를 이용한 치료

이명성,이긍호,최영철,박재홍 大韓小兒齒科學會 2005 대한소아치과학회지 Vol.32 No.1

유치열에서 가장 외상이 호발하는 부위는 상악 유중절치이며, 영구치열에서 치관부 파절이 많이 나타나는 것과는 달리, 정출, 함입, 측방 변위, 탈구 등 지지조직에 한정된 손상이 많이 나타난다. 그러나, 유구치는 외상에 의해 손상을 받는 경우가 매우 드물게 보고되고 있으며, 단일 치아 또는 다수 치아의 파절이 주를 이루고 있다. 즉, 탈구 또는 변위되는 경우가 매우 드물고 이러한 경우의 치료에 대한 보고도 거의 없다. 본 증례는 4세 5개월 된 여아에서 외상으로 인해 하악 좌측 유측절치의 정출, 유견치의 탈구와 함께 제1유구치의 설측 변위가 발생하였는데, 계승 영구치의 맹출 시기와 환아의 협조도를 고려하여 가철성 장치를 이용한 하악 제1유구치의 재위치를 시도하여 양호한 결과를 얻었기에, 유구치의 외상으로 인한 변위 시 치료 방법의 선택에 도움이 되고자 보고하는 바이다. In the primary dentitions, the majority of dental injuries involve the anterior teeth, especially the maxillary primary central incisors. When injuries affecting primary and permanent teeth are compared, it appears that trauma to the primary dentition is usually confined to the supporting structures, i.e. luxation and exarticulation, while the largest proportion of injuries affecting the permanent dentition is represented by crown fractures. But, cases reporting trauma affecting primary molars are unusual in the literature and several reports describe fractures of posterior teeth. The main goal of this report is to describe the repositioning treatment using removable appliances to an uncommon case of lingual displacement of primary molar that happened to a 4 year 5 month-old female child.