Minocycline에 의해 변색된 실활치의 치료

김대업,이광희,조진형,조현 大韓小兒齒科學會 2006 大韓小兒齒科學會誌 Vol.33 No.1

통상의 기계적 방법에 의해 치유가 안되는 감염된 치아의 치수치료에 항생제를 이용한 화학적 방법을 함께 적용할 수 있다. Metronidazole, ciprofloxacin 및 minocycline으로 조합된 항생제(3Mix)의 사용은 근관 및 치근단 주의 병소를 멸균시키는데 효과적이다. 이들 항생제 중 minocycline은 반합성 tetracycline 유도체로써 치아는 물론 콜라겐 조직의 변색을 유발하는 것으로 알려져 있다. 본 증례에서는 치수치료에 항생제를 사용하여 치료를 완료하였으나 minocycline에 의해 유발된 치아변색을 관찰하였다. 변색된 실활 영구치 중 구치는 금속도재관을 이용한 보철치료로 수복하였고 전치에는 과붕산나트륨과 증류수를 혼합 적용하는 표백술을 시행한 바, 심미적 개선을 관찰할 수 있었다. A mixture of metronidazole, ciprofloxacin, and minocycline(3Mix) in distilled water or in a root canal sealer were used to disinfect the infected endodontic and periapical lesions. It has been well acknowledged in recent literature that minocycline, a semisynthetic tetracycline derivative, causes discolorations in adult teeth and various other collagenous tissues. In these cases, pulp treatments were finished successfully using a combination of antibiotics but severe discolorations of the teeth were observed. Discolored non-vital posterior tooth was treated using the prosthodontic procedure. And anterior tooth was successfully treated using the walking bleach technique. Bleaching was performed by temporarily placing a mixture of sodium perborate and distilled water into the pulp chamber. There were significant esthetic improvement.

천식치료를 위한 시럽제의 복용이 치태지수와 치은지수에 미치는 영향

김대업 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.1

The teeth and gingivae of 20 children with asthma aged up to 6 years who had been taking syrup medicines regularly for at least six months were compared with those of a control group of 79 children of similar ages. Dental disease was assessed by measuring dental plaque(plaque index) and gingivitis(gingival index). The results of this study show that long-term admonostration of syrup medicine ketotifen sweetened with glucose incerase the plaque index and gingival index in children who had primary dentition. But there was no singificant difference between the two groups. By increasing the intake duration of syrup, both indices were increased.

항생제를 사용한 유치의 치수치료

김대업 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.1

본 연구는 항생제를 복합 투여하여 유치의 근관 및 치근단 주위 감염에 대한 효과를 임상적으로 관찰하고자 하였다. 근관 및 치근단 주위 병소의 멸균을 목적으로 metronidazole, ciprofloxacin 및 minocyclin을 증류수 및 근관시멘트와 혼합하여 적용하였다. 유치의 근관 입구로부터 하방에 Fissurotomy^(�) bur(SS White, USA)를 이용하여 약제 공간을 형성하였고 약제는 치수실 바닥까지 채웠다. 본 증례들에서 단회 적용으로 임상 증상이 개선되었다. 치은종창, 동통, 누공 등 모든 증상이 술 후 1주일 내에 소실되었다. 임상적으로 활용하기 위해서는 보다 많은 수의 증례와 장기간의 임상적 평가가 필요하며 아직까지 근관내 항생제 사용에 따른 부작용에 대한 보고가 없지만 항생제에 민감한 환아에 대해서는 사용에 주의가 필요할 것으로 사료된다. 저자는 행동조절이 곤란한 소아에서 생리적 치근흡수가 진행 중인 감염된 유치를 가진 환아들을 대상으로 항생제를 복합 사용한 바 증상의 개선을 관찰하였기에 보고하는 바이다. The purpose of this study was to observe the potentiality of a mixture of antibiotics to relieve the endodontic and periapical infections in primary teeth. A mixture of metronidazole, ciprofloxacin, and minocyclin in distilled water or in a root canal sealer were used to disinfect the infected endodontic and periapical lesions. For application of this mixture, medication cavities were prepared at orifices of root canals by using the Fissurotomy^(�) burs(S S White, USA). The cavities and buttom of pulp chamber were filled with antibiotics mixture. In this cases, clinical symptoms were improved following a single application of that mixture. Gingival swelling, pain, and fistulae were disappeared within a week. More long term evaluation will be needed. Although there were no reports of side effects, care should be taken if children are sensitive to antibiotics. Within the limitations of this case, the mixture of 3 antibiotics provided an excellent improvement in treatment of infected primary teeth under the physiologic root resorption.

유산칼슘이 합성 수산화인회석의 탈회에 미치는 영향

김대업 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.4

Many kinds of soluble calcium salts such as calcium lactate are known to reduce the enamel demineralization. In this study, calcium lactate was tested for its effect on the demineralization process of hydroxyapatite. Syuthetic hydroxyapatites were used as a standardized material instead of human enamel which is rarely heterogenous. And, for the purpose of hydroxyapatite demineralization, lactic acid was used. By comparing the weight of hydroxyapatite pre-demineralization and post-demineralization, it was possible to examine the effect of calcium lactate on demineralization. The weight of demineralized hydroxyapatite was reduced by about 46% and 59% with 20mM and 40mM calcium lactate, respectively. In conclusion, low concentrations of calcium lactate showed an inhibitory effect on the demineralization of synthtic hydroxyapatite.

유아 모친의 우유병우식증 및 치아우식증 예방에 대한 지식 및 태도 조사

김대업,이지영,이광희,조중한 大韓小兒齒科學會 1997 大韓小兒齒科學會誌 Vol.24 No.1

The purpose of this study was to investigate the knowledge and attitude of a group of mothers who had infants about baby bottle tooth decay(BBTD) and dental caries prevention. The sample consisted of 261 mothers who had infants from 6 to 36 months from certain areas of Dae-jeon city. The mothers were asked to answer a questionnaire which included a series of questions regarding general information concerning the infant and his mother, knowledge about BBTD and methods of prevention using fluoride, knowledge about behavioral risk factors contributing to caries of the infant, attitude toward oral health care of the infant, opinions regarding the effectiveness of methods to prevent dental caries and sources of oral health information. The results of this study were as follow. 1. 85.4% of the respondents thought that prolonged bottle feeding would harm the teeth of the infant, but 77% of the respondents had never heard of baby bottle tooth decay. 2. Levels of knowledge about methods of prevention using fluoride were relatively low and there were significant relationships between the levels of this knowledge and the educational level of the respondents(P<0.05). 3. Only 7.3% of the respondents thought that prolonged breast feeding would harm the teeth of the infant. 4. Overall oral health care of the infants was relatively insufficient. 5. Only 28.7% of the respondents selected either when the first tooth erupt or deciduous dentition complete as the time a infant should first be seen by a dentist. 6. 64.6% of the respondents thought that toothbrushing should be instituted once the first tooth appears. 7. Among the six methods of preventing caries in infants, respondents ranked the effective of fluoride lower than making regular dental visits and reducing intake of sugared foods. 8. Most frequently cited sources of information about dental health were newspapers, magazines and books (65%), followed by friednds, neighborhoods and families(55%).

불화나트륨이 조골세포의 생리적 활성에 미치는 영향

김대업 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.3

The clinical use of fluoride with a well known osteogenic action in osteoporotic patients is rational, because this condition is characterized by impaired bone formation. However, its anabolic effect has not been demonstrated well in vitro. The purpose of this study was to investigate the effects of sodium fluride on the physiological role of osteoblastic cell. Osteoblastic cells were isolated from fetal rat calvaria. The results were as follows: 1. Mineralized nodules were shown in osteoblastic cell cultures, which had been maintained in the presence of ascorbic acid and β-glycerophosphate up to 21 days. when cultures were treated with pulses of 48 hr duration before apparent mineralization was occurring 2-fold increased in their number was detected, 2. Alkaline of phosphatase activity of osteoblastic cells was inhibited by sodium fluoreid in dose-dependent manner. 3. The effect of sodium fluoride on the osteoblastic cell proliferaion was measured by the incorporation of 〔³H〕-thymidine into KNA>As a result, sodium fluoride at 1~100μM increased the 〔³H〕-thymidine incorporation into DNA in a dose depedndent manner. 4. The signaling mechamism activated by sodium fluoride dose-dependently enhanced the tyrosine phosphorylation of activated by sodium fluorid dose-dependently enhanced the tyrosine phosphorylation of the adaptor molecule shc?? and their association with grb2, one of earlier evrlier vents in a MAP kinase activation pathway cascade used by a significant subest of G protein-coupled receptors. 5. The phosphorylation of CREB(cAMP response element binding protein) was inhibited by the sodium fluoride in MC3T3I cells. In conclusion. the results of this study suggested that the mitogenic effect of the sodium fluoride in MC3Tl cell was stimulated in a dose-dependent manner and suggested "an important role for the interaction between shc and Grb2" in controlling the prolifera-tion of osteoblasts.

산성 고자당 액상배지를 사용한 미취학아동의 우식활성검사 성적과 우식경험유치면지수의 상관성

김대업,이광희 大韓小兒齒科學會 1992 大韓小兒齒科學會誌 Vol.19 No.1

The purpose of this study was to develop a practical caries activity test to be used for selecting the children of high caries activity. For simultaneous culture of Streptococcus mutans and Lactobacillus, new culture medium was prepared. 30% sucrose liquid medium was made and lactic acid was added to lower the pH of the medium to 5.4. 138 preschool children were examined for dmfs index. The plaque sample was obtained from buccal surfaces of upper posterior teeth. through the 96hours of incubation period, acid production of both Streptoccoccus mutans and Lactobacillus was evaluated by the color change of liquid medium every 24hour, and pH-decline velocity was measured after 72hours and 96hours. dmfs index was correlated significantly with the acid production score and the velocity of pH decline. Acidic high sucrose liquid medium can be used as culture medium for cariogenic bacteria.

변색된 치아의 심미성 회복에 관한 임상증례

김대업,정호석 大韓小兒齒科學會 1994 大韓小兒齒科學會誌 Vol.21 No.2

There were two cases of esthetic improvement of discolored teeth. First case was 12-year-old girl whose upper right central incisor was discolored after traumatic injury. She was treated by walking bleaching technique. Endodontic retreatment was done, and then the mixture of Superoxol and sodium perborate was applied and changed every week. After 3 weeks, esthetic result was obtained and fracture site was rcovered with light-curing composite resin. Second cases was 11-year-old girl whose teeth were discolored by fluorosis. She was treated by vital bleaching technique. A resin splint was made and then 30% and 15% carbamide peroxide was applied using this splint. After 4 weeks, a noticeable improvement in the color and the brightness of the teeth was achieved.

성인 치과공포증 환자의 치료

김대업 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.2

치과의사는 진료실에서 불안이나 치과공포증을 가지는 환자들을 자주 만나게 된다. 치과의사들은 환자의 불안과 공포를 해결하기 위하여 여러 가지 비약물적인 방법을 먼저 고려하게 된다. 그러나 약물을 사용하는 다양한 치과 내 진정요법이 치과공포증 환자에게 더 효과적일 수 있다. 저자는 4명의 치료 증례를 통해 가벼운 아산화질소 흡입진정으로부터 전신마취 등의 방법으로 성인 치과공포증 환자에 대처하였던 과정을 소개하고자 한다. We dentists perform many of routine dental procedures and must deal with much of the population's dental anxiety and fear. Dentists have used many non- pharmacological modalities initially to overcome anxiety and fear, including distraction, empathy, desensitization, and so on. However, certain patients need pharmacological backup of anxiety and fear to conquer dental treatment. This article presents four cases to introduce the methods from nitrous oxide and oxygen inhalation to general anesthesia for difficult adult dental phobic patients to deal with.

유치원 아동의 우식경험도와 치과의사에 대한 불안의 상관성

김대업,이광희 大韓小兒齒科學會 1994 大韓小兒齒科學會誌 Vol.21 No.2

The purpose of this study was to investigate the relationship between the caries experience and anxiety level to the dentist in the preschool children. 511 preschool children were brought to the dental hospital and examined for caries experience. Caries experience was measured as dDT index, fFT index, dDfFT index, dDT rate, and fFT rate. Children were requested to draw a dentist. Drawings were analyzed by the method of Human Figure Drawing Anxiety Score. Pearson correlation coefficents and their significance were calculated between caries experience and anxiety scores. There were significant negative correlation between fFT index and anxiety scores, between dDfFT index and anxiety scores, and between fFT rate and anxiety scores. There was significant positive correlation between dDT rate and anxiety scores. The results seemed to suggest that dental treatment experience reduced children's anxiety toward dentists. But, because there was obvious negative correlation between age and anxiety scores, age factor : should be considered in the interpretation of the results.