불소유리 가철성 교정장치의 항균효과에 관한 연구

장기택,Jang, Ki-Taeg 대한소아치과학회 1999 大韓小兒齒科學會誌 Vol.26 No.1

To study the antimicrobial effect of fluoride-releasing removable orthodontic appliances, 0 wt%(Group 1), 5 wt%(Group 2) and 10 wt%(Group 3) of $CaF_2$ were added to orthodontic resin. The specimens were then put in media in which S. mutans and Lactobacillus, known cariogenic bacteria, were cultured. Inhibiting zones were measured 24, 48 and 72 hours later. The following conclusions were reached: 1 In the Lactobacillus media, no zone of inhibition was observed regardless of the time passed. 2. In the S. mutans media, zones of inhibition were observed after 48 hours. 3. S. mutans showed greater inhibition in Group 3 compared to Group 2, after 72 hours rather than 48 hours(p<0.01).

서울대학교치과병원 장애인진료실에서 전신마취 하 치과치료를 받은 환자의 장애 질환 및 협진 현황 조사

장기택,김현정,염광원,서광석,Jang, Ki-Taeg,Kim, Hyun-Jeong,Yum, Kwang-Won,Seo, Kwang-Suk 대한치과마취과학회 2006 Journal of Dental Anesthesia and Pain Medicine Vol.6 No.2

Background: The number of patients with disabilities who require general anesthesia for dental treatment is increasing. Methods: We reviewed the cases of 538 patients with disabilities who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul national university dental hospital according to the types of disabilities and comprehensive treatments. Results: The patients mean age was 17.4 years and fifty-eight percent of the patients had epilepsy, autism, mental retardation and cerebral palsy. About twenty-five percent of the patients were medically compromised such as brain disease, heart disease and genetic problem. In 142 cases, more than two dentists from the clinical departments systemically co-worked to provide the patients with comprehensive treatment as accurately and quickly as possible under general anesthesia. Conclusions: The number of medically compromised patients was high and the system of comprehensive dental treatment was well run.

매복치의 자가치아이식

장기택(Ki Taeg Jang) 대한치과의사협회 2014 대한치과의사협회지 Vol.52 No.5

Transplantation of one"s own teeth from one site to another is called dental autotransplantation. The role of autotransplantation of teeth in several clinical situations, the clinical techniques involved and factors influencing success of the transplant are discussed. Autotransplantation of impacted or retained teeth is an appropriate treatment, if orthodontic traction has failed, especially in growing patients.

RESIN TAG FORMATION OF SELF-ETCHING ADHESIVES

김영재,장기택,Kim, Young-Jae,Jang, Ki-Taeg Korean Academy of Pediatric Dentistry 2003 大韓小兒齒科學會誌 Vol.30 No.1

본 연구는 자가부식 접착제의 치질로의 침투와 레진 tag 형성을 알아보고 부가적인 산부식이 레진 tag 형성에 미치는 효과를 관찰하기 위하여 계획되었다. 3종의 자가부식 접착제(SE bond, AQ bond and L Pop)와 one bottle adhesive(Single bond)를 사용하였고 발거한 구치로 교합면 법랑질과 상아질 시편을 제작하였으며 각 군당 5개씩 네 개의 군으로 나눈 총 20개의 시편을 양분하여 각각 접착제를 적용하기 전 35% 인산으로 산부식하거나 산부식처리하지 않았으며 이후 레진을 적용시키고 중합하였다. 시편은 Silverstone microtome으로 절단한 후 HCl 용액과 NaOCl 용액으로 처리하고 건조시킨 후 이온으로 피복하였으며 주사전자현미경으로 관찰하여 다음과 같은 결과를 얻었다. 1. 부가적 산부식 처리한 상아질은 모든 자가부식 접착제군에서 산부식하지 않은 상아질보다 resin tag의 길이와 두께가 증가하는 것이 관찰되었다. 2. 법랑질에서는 L Pop을 제외하고 부가적 산부식한 군에서 레진 tag의 두께가 산부식하지 않은 군보다 컸고 보다 명확한 부식양상을 관찰할 수 있었다. L Pop에서는 부식법랑질과 비부식법랑질간의 차이가 없었다. 본 연구의 결과는 자가부식형 접착제가 법랑질을 부식시키지 않고 상아세관으로 침투하는 정도가 산부식군에 미치지 못하다는 것을 의미한다. 이와 관련하여 접착강도와 미세누출 및 레진 tag 형태에 대한 부가적 연구가 필요할 것이다. The aims of the present study was to observe resin tag of the resin/enamel, dentin interface produced by self-etching adhesive systems and evaluate effect of additional acid etching on resin tag formation. Three self-etching primer(SE bond, AQ bond and L Pop) and an one bottle adhesive(Single bond) were used. Flat occlusal enamel and dentin disks were obtained from extracted human molars. A total of 20 surfaces were collected and divided into four groups of 5 samples. One-half of each specimen in each group was etched with 35% phosphoric acid prior to the application of each adhesive system, with the second half being kept unetched. Subsequently, resin composite was placed and polymerized. The samples were sliced and immersed into HCl and NaOCl solutions, followed by drying and sputter coating for examination with a SEM. The results were as follows; 1. Additional etching side of dentin displayed longer and thicker resin tag than unetched side in all self-etching adhesive groups. 2. In enamel, additional etching side displayed deeper and more distinct etching pattern than unetched side except L Pop. There is no difference between etched and unetched enamel in L Pop. The results obtained suggest the self-etching adhesive did not etch enamel and penetrate into dentinal tubule as deeply as did additional etching. Further research should include the evaluation of the relationship of boding strength, microleakage and resin tag morphology.

간이식 예정인 간부전 환아의 치과치료 시 마취관리 -증례 보고-

박창주,장기택,염광원,김현정,Park, Chang-Joo,Jang, Ki-Taeg,Yum, Kwang-Won,Kim, Hyun-Jeong 대한치과마취과학회 2002 Journal of Dental Anesthesia and Pain Medicine Vol.2 No.2

Special anesthetic considerations were required for children with acute or chronic liver disease. We experienced a case of dental treatment to control infection under general anesthesia in the 2-year-old girl with liver failure. She was also scheduled for liver tansplantation. Her preanesthetic results of liver function test, electrolytes, and coagulation panel were unstable and out of normal ranges. Uneventful anesthetic induction using isoflurane and atracurium and nasotracheal intubation were carried out. General anesthesia was maintained with isoflurane for 2 hours. Oozing from multiple extraction sites was sustained, so the transfusion of platelet concentration 1 units, fresh frozen plasma 1 unit, and packed red blood cell 1 unit was done. She was recovered without complication but was transferred to pediatric intensive care unit for wound care with her endotracheal tube kept. She was transferred to a ward without noticeable complications next day. So we report this successful case of anesthetic management for dental treatment in a child with liver failure.

중합시간과 중합방법에 따른 자가중합형 상교정용 레진의 중합률의 비교에 관한 연구

유종욱,장기택,김종철,Yoo, Jong-Wook,Jang, Ki-Taeg,Kim, Chong-Chul 대한소아치과학회 1999 大韓小兒齒科學會誌 Vol.26 No.2

가철성 상교정 장치에 많이 사용되는 자가중합형 상교정용 레진의 미반응 단량체는 레진의 물성과 생물학적인 면에 많은 영향을 끼친다. 따라서 미반응 단량체를 최소화하고 중합률을 최대로 하는 중합방법에 대한 연구는 중요한 의의를 갖는다. 저자는 자가중합형 상교정용 레진의 중합시간과 중합방법에 따른 중합률을 비교해보기 위해 시편을 다음과 같이 5군으로 나누어 연구를 진행하였다. 상교정용 레진의 분말과 용액을 혼합하여 제 1군은 $28^{\circ}C$의 공기중에 보관하였고, 제 2군은 $28^{\circ}C$의 물에, 제 3군은 $28^{\circ}C$의 물과 30psi의 압력에, 제 4군은 $43^{\circ}C$의 물에, 제 5군은 $43^{\circ}C$의 물과 30psi의 압력하에 각각 보관하였고, 10분, 1시간, 12시간, 1일, 3일 경과 후에 각 시편을 Fourier 변환적외선분광법을 이용하여 중합률을 측정하여 다음과 같은 결론을 얻었다. 1. 모든 군에서 중합시간이 경과함에 따라 중합률도 지속적으로 증가하는 양상을 보였다. 10분 경과 후의 결과와 비교하여 볼 때, 제 1군은 12시간 경과 후부터 중합률의 증가가 유의성이 있었고, 제 2군과 3군, 4군, 5군은 1시간 경과 후부터 유의성이 있었다(p<0.05). 2. 10분과 1일, 3일 경과 후에 제 5군, 제 4군, 제 3군, 제 2군, 제 1군의 순서대로 중합률이 높았다. 3. 중합시 온도에 따른 비교에서, 1일 경과 후를 제외하고는 모든 시간에서 $43^{\circ}C$에서 중합시킨 군의 중합률이 $28^{\circ}C$에서 중합시킨 군의 중합률 보다 유의성 있게 높았다(p<0.05). 4. 압력은 12시간 경과 후를(p<0.05) 제외하고는 중합률에 영향을 주지 못했다. 5. 보관방법은 1시간 경과 후를(p<0.05) 제외하고는 중합률에 영향을 주지 못했다. Autopolymerized resin facilitates a more rapid and easier means for the construction of removable orthodontic appliances than heat cured resin. But many reports reveal that more unreacted monomer is found in autopolymerized resin. It is very important to achieve maximum degree of polymerization because if polymerization is inadequate, high level of unreacted monomer has been shown to adversely affect mechanical and physical properties, and also the question of allergy or toxicity to methylmethacrylate must be considered. The purpose of this study was to compare the degree of polymerization according to curing method and curing time. Five groups were desinged ; Group 1 was polymerizied at room temperature($28^{\circ}C$) ; Group 2 in $28^{\circ}C$ water ; Group 3 in $28^{\circ}C$ water under 30psi pressure ; Group 4 in $43^{\circ}C$ water ; Group 5 in $43^{\circ}C$ water under 30psi pressure for 10 minutes, 1 hour 12 hours, 1 day and 3 days. The degree of polymerization was measured by means of Fourier Transform Infrared spectroscopy. The results were as follows: 1. The degree of polymerization increased constantly in accordance with curing time in all groups and after curing for 10 minutes, Group 1 showed significantly higher degree of polymerization after 12 hours and Group 2, Group 3, Group 4, Group 5 after 1 hour(p<0.05). 2. The degree of polymerization decreased in the order of Group 5, Group 4, Group 3, Group 2, Group 1 except when the curing time was 1 hour and 12 hours(p<0.05). 3. The degree of polymerization of Group 4, Group 5 cured at $43^{\circ}C$ showed significantly higher degree of polymerization than Group 2, Group 3 at $28^{\circ}C$ except when the curing time was 1 day(p<0.05). 4. Among Group 2, Group 3 and Group 4, Group 5, the pressure had no effect on polymerization except when the curing time was 12 hours(p<0.05). 5. Between Group 1 and Group 2, the method of storage had no effect on polymerization except when the curing time was 1 hour(p<0.05).

Twin Block을 이용한 II급 부정교합의 치료증례

박수진,장기택,김종철,Park, Soo-Jin,Jang, Ki-Taeg,Kim, Chong-Chul 대한소아치과학회 1998 大韓小兒齒科學會誌 Vol.25 No.1

Twin Blocks are simple bite-blocks that effectively modify the occlusal inclined plane to induce favorably directed occlusal forces by causing a functional mandibular displacement. These devices use upper and lower bite-blocks that engage on occlusal inclined planes. Twin Blocks use the forces of occlusion as the functional mechanism to correct the malocclusion. To get an excellent result in the treatment by using the Twin Block appliances, proper case selection must be needed. Twin Block treatment is performed in two stages. Twin Blocks are used in the active phase to correct the anteroposterior relationship and establish the correct vertical dimension. Once this phase is accomplished, the Twin Blocks are replaced with an upper Hawley type of appliance with an anterior inclined plane, which is then used to support the corrected position as the posterior teeth settle fully into occlusion. The Twin Block is the most comfortable, the most esthetic ane the most efficient of all the functional appliances. Twin Blocks have many advantages compared to other functional appliances. Patients can wear Twin Blocks 24 hours per day and can eat comfortably with the appliances in place. From the moment Twin Blocks are fitted, the appearance is noticeably improved. There is less interference with normal function. Integration with conventional fixed appliances is simpler than with any other functional appliance. Twin Blocks allow independent control of upper and lower arch width. Appliance design is easily modified for transverse and sigittal arch development. The authors treated Class II malocclusion with Twin Blocks. and the results as follows; 1. Rapid profile improvement was achieved in 2-3 months. 2. There was excellent patient cooperation. 3. Severe overjet and overbite were reduced. 4. Class II molar relationship was changed to Class I.

Xylitol-resistant Streptococcus mutans와 xylitol-sensitive Streptococcus mutans의 세포 성질에 관한 비교연구

이홍모,김정욱,장기택,이상훈,한세현,김종철,Lee, Hong-Mo,Kim, Jung-Wook,Jang, Ki-Taeg,Lee, Sang-Hoon,Hahn, Se-Hyun,Kim, Chong-Chul 대한소아치과학회 2003 大韓小兒齒科學會誌 Vol.30 No.4

Xylitol은 대체감미제로써 mutans streptococci에 의해서 대사되지 않으며 오히려 이들 균체내에서 glucose대사를 억제하여 mutans streptococci의 성장을 저해하고, 산성 대사물의 생산을 감소시킴으로써 치아우식억제효과를 나타내는 것으로 알려져 있다. 이와 같이 xylitol에 의해 성장의 억제를 받는 S. mutans strain을 xylitol-sensitive($X^S$) strain이라고 한다. 하지만 xylitol에 지속적으로 노출될 경우 더 이상 xylitol에 의해 성장억제가 나타나지 않는 xylitol-resistant($X^R$) strain이 출현함이 실험적이나 임상적으로 보고 되었다. 본 연구는 $X^S$ strain과 여기에서 얻은 변이종 $X^R$ strain의 성장과 세포외 pH 그리고 수산화인회석 표면에 대한 부착능과 세균응집능을 비교함으로써 $X^R$ strain의 출현이 xylitol의 치아우식억제효과에 미치는 영향을 확인하고자 하였으며, 다음과 같은 결론를 얻었다. 1. $X^R$ strain은 $X^S$ strain의 성장과 세포외 pH와 차이를 나타내지 않았다. 2. $X^R$ strain과 $X^S$ strain은 수산화인회석 부착능에 있어서 차이를 나타내지 않았으며(p>0.05), 자당 의존성 수산화인회석 부착에서는 $X^R$ strain에 비해 $X^S$ strain이 더 높은 부착능을 나타내었다(p<0.05). 3. 타액유도성 응집에서는 $X^R$ strain이 더 낮은 타액의 농도에서 응집 반응을 보였다. Xylitol has been used as sugar substitute to prevent dental caries. It is not fermented by most dental plaque bacteria and interferes with the growth of mutans streptococci. Therefore the production of acidic metabolites and the growth of mutans streptococci are inhibited. S. mutans strains which are inhibited to grow under the presence of xylitol are referred as xylitol-sensitive ($X^S$) strains. However, experimental and clinical studies have shown that there were mutated groups of S. mutans strains that are not affected by xylitol. They are referred as xylitol-resistant($X^R$) strains. The aim of the present study was to investigate that emergence of $X^R$ strain would effect on the anticariogenecity of xylitol by comparing the growth rate, the extracellular pH, hydroxyapatite adhesion and the agglutination of the $X^R/X^S$ strains. Overall we came out with following results : 1. No difference in the growth rate and the extracellular pH was found between the $X^S$ strain and the $X^R$ strain. 2. No difference in adhesion to hydroxyapatite surface was found between the $X^R$ strain and the $X^S$ strain (p>0.05) and adhesion of the $X^S$ strain was greater than that of $X^R$ strain in the sucrose-dependent adhesion to hydroxyapatite (p<0.05). 3. The $X^R$ strain was agglutinated in the lower concentration of saliva than that of $X^S$ strains.

시술자와 방습법에 따른 치면열구전색제의 유지에 관한 연구

조재용,김정욱,장기택,김종철,한세현,이상훈,Cho, Jae-Yong,Kim, Jung-Wook,Jang, Ki-Taeg,Kim, Chong-Chul,Hahn, Se-Hyun,Lee, Sang-Hoon 대한소아치과학회 2003 大韓小兒齒科學會誌 Vol.30 No.3

치면열구전색제의 예방효과는 전색제의 유지와 매우 밀접한 상관관계가 있으며 시술시의 환경과 시술 방법, 개개 환자의 구강 위생이 유지에 영향을 미치는 것으로 알려져 있다. 현재 우리나라에서는 대규모로 '치아홈메우기 사업'이 진행 중에 있지만 시술 여건이나 시술자에 따라 여러 가지 방법의 방습법과 치면 세마가 행해지고 있는 실정이다. 본 연구의 목적은 치면열구전색제의 시술 시 소아치과의사, 일반치과의사, 치과위생사 등 시술자에 따른 유지율 차이와 러버댐과 코튼롤(cotton roll) 방습법 등 격리 방법에 따른 유지율의 차이를 알아보고 실패가 일어나는 치아의 특정 부위를 알아보기 위한 것이다. 6세-11세인 119명의 아동(남자 64명, 여자 55명)에서 상하악 제1대구치에 시술된 279개의 치면열구전색제를 대상으로 1년 후의 유지율을 조사하였다. 이 아동들은 평균 연령이 $8.59{\pm}0.772$세였으며 각각 러버댐을 사용한 소아치과의사가 시술한 1군, 러버댐을 사용한 일반치과의사가 시술한 2군, 코튼롤(cotton roll)을 사용한 치과위생사가 시술한 3군으로 나누었다. 1년 후의 치면열구전색제의 유지율을 조사하여 다음과 같은 결론을 얻었다. 1. 1년 후의 치면열구전색제 유지율은 러버댐을 사용한 소아치과의사가 시술한 1군이 90.8%, 러버댐을 사용한 일반치과 의사가 시술한 2군은 85.0%, 코튼롤을 사용한 치과위생사가 시술한 3군은 64.7%였으며 1군과 2군간에는 통계적인 유의차가 없었으나(P>0.05) 1,2군과 3군 간에는 통계적인 유의차가 있었다(P<0.05). 2. 상악과 하악의 유지율 비교에서 1군과 2군은 차이가 없었으나(P>0.05) 3군은 차이가 있었다(P<0.05). 3. 실패부위 분석에서 교합면의 실패는 58.3%, 협/설면구는 41.7%를 차지하였다. Currently, 'National program of dental sealant' has begun in Korea, but various isolation techniques and preparation is performing. The aim of the present study was to compare pit and fissure sealant retention rates between different operators using two different isolation techniques. Additionally, the failed surface was examined. One examiner performed the examination after one year of the initial operation. The population consisted of 119 children(mean age $8.59{\pm}0.772$) of which the total sealed number was 279 permanent first molars. Pediatric dentists sealed 131 molars using the rubber dam isolation technique (Group 1), general practitioners sealed 80 molars using the rubber dam isolation technique (Group 2), and dental hygienists sealed 69 molars using the cotton roll isolation (Group 3). The results were as follows ; 1. The complete retention rate between Group 1 (90.8%) and 2 (85.0%) showed no significant statistical difference (P>0.05). However, there were significant statistical different retention rates between Group 1 and Group 3(64.7%) and between Group 2 and Group 3 (p<0.05). 2. In comparing retention rates between maxilla and mandible, Only Group 3 showed a significantly lower complete retention rate in mandible than maxilla (p<0.05). 3. In failed surface analysis, occlusal failed surface was 58.3%, buccal/palatal failed surface was 41.7%.

소아치과 환자에서의 세보플루란을 이용한 흡입 심진정법

이원호,김영재,장기택,이상훈,서광석,김현정,염광원,박창주,Lee, Won-Ho,Kim, Young-Jae,Jang, Ki-Taeg,Lee, Sang-Hoon,Seo, Kwang-Suk,Kim, Hyun-Jeong,Yum, Kwang-Won,Park, Chang-Joo 대한치과마취과학회 2004 Journal of Dental Anesthesia and Pain Medicine Vol.4 No.2

Background: Sevoflurane, a rotatively new inhalational anesthetic. has non-pungent odor and is less reluctant to pediatric patients. The purpose of this study is to examine the feasibility of sevoflurane in inhalational sedation instead of the nitrous oxide for short and simple dental treatments in pediatric patients. Patients and Methods: Fifteen healthy children, whose dental treatment was abandoned due to their little or no cooperation, were selected with their caregivers' written permission. Deep sedation was induced and maintained with oxygen and 1-5% sevoflufane via specially designed nasal mask. Blood pressure, heart rate, oxygen saturation, and electrocardiogram were monitored at 3-nin interval. A dental anesthesiologist, who was independent of dental treatments, was wholly responsible for the sedation procedure. Post-sedation complications and operator's and caregiver's acceptability of this type of inhalational sedation were also investigated. Results: The systolic and diastolic blood pressure, heart rate, and oxygen saturation was significantly depressed during the deep sedation using sevoflurane (P < 0.05). No severe post-sedation complications were found, however, bradycardia was reported in 3 patients. Almost all the operators and caregivers answered that they would adapt this sedation procedure again if possible. Conclusion: In this study, inhalational deep sedation using sevoflurane for dental treatments was found to be very useful. Furthermore, the application of sevoflurane to conscious sedation for pediatric and adult dental patients should be added.