상악 전치부에 발생한 이중치: 증례보고

Fusion and gemination are irregularities in tooth development. It is often difficult to differentiate between gemination and fusion and it is common to refer to these anomalies as 'double teeth'. The deciduous teeth are most commonly involved, but in 0.1% of cases permanent teeth are affected, in which case aesthetic, funtional and periodontal problems can result. Double teeth present great difficulties in management and required a multidisciplinary approach. The central groove on the labial and palatal surfaces of a double tooth is extremely prone to caries, therefore early 'fissure sealing' is essential. In permanent dentition, surgical separation of fused teeth may be possible with subsequent orthodontic alignment and restorative treatment as needed to reshape the crown. Reshaping or reduction of a double tooth with a single canal may be attempted by modifying the appearance of the labial groove and the use of composite tints but is often impossible and extraction may be the only alternative. Orthodontic treatment and prosthetic replacement is then required. Implants may be an option for adolescents. The present study describes three clinical cases of double teeth in the position of the maxillary permanent incisors. The first case demonstrates an example of multidisciplinary care including surgical intraoral hemisection, root canal therapy, restorative and orthodontic treatment. The second and third cases describe the external and internal morphology of the two fused teeth by means of three dimensional dental computer tomography

수평 매복된 상악 중절치의 교정적 견인: 증례 보고

Maxillary central incisor impactions occur infrequently. Their origins include various local causes, such as odontoma, supernumerary teeth, space loss, and disturbances in the eruption path, also trauma and apical follicular cysts. Impacted teeth can cause serious dental and aesthetic difficulties as well as psychological problems especially in anterior regions. Although the impaction of maxillary incisor occurs less frequently than that of the maxillary canine, it is of concern to parents during the early mixed dentition stage because of the uneruption of the tooth. Forced eruption of impacted teeth should be considered in young patients because this technique can lead to suitable results from a periodontal, occlusal, and esthetic perspective at an earlier stage better than with other treatment options. This report presents the surgical and orthodontic treatment of cases with horizontally impacted and dilacerated maxillary central incisors. For each patient, we used the closed eruption method, placed an attachment on the impacted tooth on surgery, and fully closed the flap. Traction was applied immediately. The impacted tooth erupts through the healed tissue in a manner resembling normal eruption

어린이에서 함치성 낭과 연관된 매복 소구치와 대구치의 치료

Tooth impaction is a frequently observed eruption anomaly in pediatric dental practice. Young patients with impacted or unerupted teeth have more prediction for dentigerous cyst formation. Dentigerous cyst presents radiographic features, unilocular or multilocular radioluscency. Cysts occur most frequently in the premolar region except third molar. Dentigerous cysts can grow to a considerable size, and large cysts may be associated with a painless expansion of the bone in the involved area. Extensive lesions may result in facial asymmetry, osseous destruction, root resorption of proximal teeth and displacement of associated tooth. The nature of the causative tooth influences the type of surgical treatment required for the dentigerous cyst. If the cyst is associated with a supernumerary or wisdom tooth, complete enucleation of the cyst along with extraction of tooth may be the first treatment choice. Otherwise, preservation of the associated teeth should be considered to prevent a young patient from psychological and mental trauma because of the loss of tooth. We should consider the degree of tooth displacement, osseous destruction and growth pattern of oromaxillofacial area when planning treatment. Thus a proper and logical treatment planning can help a proper growth and development of oromaxillofacial area and can save the patient from a psychological and mental trauma. This report describes 4 cases of the management of impacted premolars and molars associated with dentigerous cysts in children

심실 중격 결손에 의한 감염성 심내막염 환자의 치과치료

Infective endocarditis is a life-threatening disease, although it is relatively uncommon. Substantial morbidity and mortality result from this infection. Therefore, primary prevention of endocarditis whenever possible is very important. The American Heart Association updated recommendations for the prevention of infective endocarditis in individuals at risk for this disease in 1997. But, utilization of antibiotic prophylaxis for patients at risk does not provide absolute immunity from infection. This report presents the case of infective endocarditis that occurred in spite of appropriate antibiotic prophylaxis in the ventricular septal defect(VSD) patient

치면건조제와 접착제의 사용에 따른 치면열구전색재의 전단결합강도에 관한 연구

The application of sealants is a highly technique-sensitive procedure, requiring an extremely dry field prior to placement. Moisture contamination of the etched enamel surface before sealant placement is cited as the main reason for sealant failure. The purpose of this study was to evaluate the effects of different methods of sealant application on the shear bond strength of sealants to enamel. In groups 1, 2, 3, 4 Teethmate(unfilled sealant) was used, while Ultraseal XTplus(filled sealant) was used in groups 5, 6, 7, 8. Groups 1 and 5(control) were acid etched for 15 seconds using 35% phosphoric acid, washed and then dried. In groups 2, 6 drying agents were applied, and in groups 3, 7 bonding agents were applied and light cured. In groups 4 and 8 both drying agent and bonding agent were applied. Then sealant was cured to the specimen using molds 3mm in diameter and 2mm in height. Thermocycling was performed and shear bond strength was finally measured. The following results were obtained : 1. Groups using filled sealant(groups 5, 6, 7, 8) showed higher shear bond strengths compared to groups using unfilled sealant(groups 1, 2, 3, 4). 2. Among groups using unfilled sealant(groups 1, 2, 3, 4), groups 2, 3, 4 showed significantly higher shear bond strength compared to group 1(p0.05) among groups using filled sealant(groups 5, 6, 7, 8). 4. When modes of fracture were examined, cohesive failure was observed in groups 2, 3 and 4

Ferric sulfate를 이용한 유치치수절단술의 3년 후 임상평가

The objective of this report is to assess clinically and radiographically the state of the primary molars pulpotomized with a 15.5% ferric sulfate solution. The subjects selected were healthy children treated at the pediatric dental clinic of the Seoul National University Hospital in Korea. Thirty teeth were pulpotomized with a ferric sulfate solution(FS). Another twenty-one teeth were pulpotomized with 20% dilute formocresol(FC). Clinical and radiographic data for the fifty-one primary molars were collected with a mean follow-up period of 34 months. The success rate for the FS group was 80.0%. The success rate for the FC group was 81.0%. The differences in the results between the two groups were analyzed statistically utilizing the chi square test. External root resorption was observed in four teeth of FS group and four of the FC group. Periapical bone destruction was observed in three of FS group and two of FC group. There were no significant statistical differences between the success rates for FS group and the FC group

유아용 조제 분유가 치태 pH에 미치는 영향에 관한 연구

Infant formula in nursing bottle, with inappropriate feeding habits, is major factor associated with the development of nursing caries. Although each infant formula has different carbohydrate and protein composition, studies comparing cariogenic potential of many Korean-branded infant formulas are deficient. In addition, it is on the point of being difficult to evaluate the cariogenecity of milk due to development of many infant formulas. In this study, to evaluate the cariogenic potential of many infant formulas, after oral rinse with six Korean-branded infant formulas(three milk based formulas, one soy based formula and two specific formulas for infants with allergy to milk protein and with lactose intolerance) for ten adult volunteers(eight males and two females), plaque pH change was measured with In vivo/In vitro combination technique and results were as follows. 1. All six different kinds of Korean-branded commercial infant formulas dropped the plaque pH significantly(p0.05)

3차원 스캐너를 이용한 상악 제1유구치 치관의 크기와 형태에 관한 연구

The purpose of this study was to elucidate the size and morphologic characteristics of maxillary primary first molars in Korean children using three-dimensional laser scanner and compare three-dimensional image with preformed stainless steel crown. Scanned three-dimensional images of dental cast taken from 132 children(male 62, female 70) by three-dimensional laser scanner(Breuckmann opto-Top HE100, INUS, Korea) were used. Mesiodistal diameter, buccolingual diameter, occlusogingival height and crown shape of each image were calculated by Rapidform 2004 program(INUS, Korea). The values were statistically compared by independent samples t-test with 95% of significant level. The results were as follows : 1. No significant difference in crown size was found between left and right maxillay primary first molar(p>0.05). 2, Significant difference in mesiodistal diameter, buccolingual diameter, buccal occlusogingival height was found between male and female (p<0.05), and crown size of male was bigger than that of female. 3. Average image of maxillay primary first molar was shaped three-dimensionally and measured. In comparison with 3M stainless steel crown, this image was similar with No.4 or No.5 SS crown in male, No.4 in female. In comparison with ILSUNG SS crown, this image was similar with No.5 in male, No.4 in female. 4 Mesiolingual line angle area, distolingual line angle area and buccogingival ridge were more obvious in average image than 3M stainless steel crown. ILSUNG SS crown was more square and had longer mesiodistal diameter than average 3D image

예방적 레진수복의 미세누출에 관한 연구

Preventive resin restoration, extended concept of occlusal pit and fissure sealing, is procedure composed of as follows. Cavity preparation is limited to areas of initial caries The cavity is then restored with composite resin, while other sound pits and fissures are sealed with pit and fissure sealant. If pit and assure sealant with which microrestoration is possible is used, it may be of great benefit to both patient and operator in case of difficult-to-control children s treatment. However study on preventive resin restoration using this kind of materials have been scarce. The purpose of this study was to compare the microleakage of four different modes of preventive resin restoration. Restoration using only composite resin was compared together Fifty-five bicuspids were prepared with small class I cavity preparation on the occlusal surface, divided into the following groups and restored accordingly. Group 1 : Cavity was restored with Z-100 composite resin Group 2 : Cavity was restored with Z-100 composite resin. Pits and fissures were then sealed with Teethmate F-1 Group 3 : Cavity was restored with Z-100 composite resin Pits and fissures were then sealed with Ultraseal XT-plus Group 4 : Cavity and pits and fissures were restored with Ultraseal XT-plus altogrether Group 5 : Cavity was restored with Ultraseal XT-plus. Pits and fissures were then sealed with the same material. After restoration, the samples were thermocycled 500 times between and with a dwell time of 30 seconds. After thermocycling, the samples were dipped into 1% methylene blue solution for 24 hours, then rinsed with tap water. The teeth were then embedded in resin and cut buccolingually along the tooth axis and observed with a stereomicroscope to determine the degree of microleakage. The results were as follows : 1. Group 4 showed the greatest microleakage, while group 3, showed the least. The mean microleakage decreased in the following order:4>1>5>2>3. 2. There was no stastically significant difference between group 1 and group 5(p>0.05). However, group 1 showed significantly greater microleakage compared to group 2 and 3(p0.05). However group 2 showed significantly less microleakage compared to group 4 and 5(p<0.05) 4. Group 3 showed significantly less microleakage compared to group 4 and 5(p<0.05). 5. Group 5 showed significantly less microleakage than group 4(p<0.05)

표면처리방법에 따른 복합레진의 결합강도에 관한 실험적 연구

According to extensive use of composite resin which have superior esthetic property, every effort on improving bonding strength between a tooth and composite resin has been continued. Acid etching technique is a method that micro-etches the tooth surface which provides bonding with composite resin possible. Recently, there were several reports that mechanical treatment obtained from air-abrasion can provide similar bonding strength with acid etching technique. So, this experimental study was designed to compare the shear bonding strength between using air-abrasion technique and using acid etching technique. Initially, bovine teeth were divided into enamel and dentin experimental groups. Respectively each group was categorized into three subgroups. One subgroup was acid etched with 35% phosphoric acid, then bonded with composite resin. The other subgroup was air-abraded with particles sprayed with 160psi air pressure using air abrasion unit(KCP-1000, A.D.T., U.SA), and composite resin was bonded. In another subgroup, composite resin was bonded after acid etching following air-abrasion. So, enamel experimental groups were made of E1 (acid etched only), E2(air-abraded only), E3(acid etched following air-abraded), and dentin experimental groups were made of D1(acid etched only), D2(air-abraded only), D3(acid etched following air-abraded). Each subgroup had 10 specimens. Dentin bonding system(Scotchbond Multi-purpose, 3M Co., U.S.A.) and composite resin(Z-100, 3M Co., U.S.A.) were applied on treated surface using 5mm diameter gelatin capsule as manufacturer's direction. After 1200 times thermocycling between and , shear bond strength was measured in 5mm/min crosshead speed with Instron(Instron Co., U.S.A.), and also treated enamel and dentin were observed with SEM(JEOL Co., Japan). The following results were obtained: 1. In the enamel experimental groups, acid etched following air-abraded group had highest shear bond strength, but there was no significant difference compared to acid etched group. Air-abraded only group had lowest shear bond strength, and there was significant difference compared to the rest of groups. 2. In the dentin experimental groups, acid etched following air-abraded group had highest shear bond strength, but there was no significant difference compared to acid etched group. Air-abraded only group had lowest shear bond strength, and there was significant difference compared to the rest of groups. 3. In the SEM study, air-abraded enamel and dentin had irregular and rough surfaces