Minimally Invasive Surgery in a Pediatric Palatal Plasmacytoid Myoepithelioma

남옥형,이백수,이수언,김광철,최성철 大韓小兒齒科學會 2016 大韓小兒齒科學會誌 Vol.43 No.1

Myoepithelioma는 타액선에 발생하는 드문 질환이다. Myoepithelioma는 소아 및 청소년보다 성인에서 호발한다. 구개부의 종창을 주소로 8세 여환이 본원으로 내원하였다. 환아의 나이와 상대적으로 큰 종양의 크기를 고려하여, 전신 마취 하에 구개부 점막 조직을 보존하는 보존적인 외과적 절제술이 시행되었다. 수술 부위의 치유가 적절히 일어났으며, 40개월의관찰기간 동안 재발되지 않았다. 주변의 구개부 조직을 보존하는 최소 침습적 제거술은 소아에서 발생되는 myoepithelioma 의 치료시 유용할 것으로 사료되었다. Myoepithelioma is a rare disease in the salivary gland. Myoepithelioma is more common in adults than in children or adolescents. An 8-years-old female patient visited our clinic with a chief complaint of a painless swelling on the palate. Conservative treatment that preserves the overlaying palatal mucosa while surgically excising the tumor was carried out under general anesthesia, because the patient was young and the size of the tumor was relatively large. The surgical wound healed well and there had not been any sign of recurrence during the regular follow-up period of 40 months. Minimally invasive surgical treatment which preserves peripheral palatal tissue can be useful in a pediatric myoepithelioma.

Evaluation of the periodontal and pulpal healing of replanted rat molars with doxycycline root conditioning

남옥형,Kyounga Cheon,김미선,이효설,최성철 대한치주과학회 2019 Journal of Periodontal & Implant Science Vol.49 No.3

Purpose: This study aimed to evaluate periodontal and pulpal healing in replanted rat teeth, preserved under different storage conditions, with or without root conditioning using doxycycline. Methods: A total of 40 maxillary first molars extracted from 20 Sprague-Dawley rats were stored for different durations under different conditions (5 minutes in dry storage and 60 minutes in Hank's balanced salt solution [HBSS]) and subsequently replanted. The rats were divided into 2 groups based on the use of root surface treatment: the doxycycline group (root surface treated with doxycycline) and the control group (no doxycycline treatment). Eight weeks after replantation, the animals were sacrificed, and the teeth were evaluated using micro-computed tomography (micro-CT) and histomorphometric analysis. Results: In the micro-CT analysis, the doxycycline group showed the same rate of occurrence of periapical radiolucency as was observed in the control group, but a lower degree of root resorption in teeth replanted after 60 minutes of storage in HBSS (P<0.05). In the histomorphometric analysis, the doxycycline group exhibited no improvement in either pulpal or periodontal healing of the replanted tooth after 5 minutes of dry storage, but showed a lower grade of surface root resorption (1.37±0.77) and inflammatory resorption in the teeth stored for 60 minutes in HBSS (1.33±0.71). Conclusions: In conclusion, doxycycline improved the periodontal healing of replanted teeth stored for 60 minutes in HBSS, whereas doxycycline did not improve periodontal healing of replanted tooth after 5 minutes of dry storage. Within the limits of this study, doxycycline showed more favorable periodontal healing despite delayed replantation.

뇌병변 장애 환자의 외상 치아에서 vacuum-formed splint를 이용한 교합 안정술

남옥형(Ok Hyung Nam),박재홍(Jae-Hong Park),김광철(Kwang Chul Kim),최영철(Yeong Chul Choi),최성철(Sung Chul Choi) Asia association of Disability and Oral health 2014 International Journal of Disability and Oral Healt Vol.10 No.2

Reposition and splinting has been widely recommended when clinicians treat traumatically dislocated tooth. This case represents stabilization of traumatized tooth in a cerebral palsy patient who failed resin wire splint because of parafunctional oral habit and lack of cooperation. Clinically, mobility of traumatized tooth decreased due to stabilization using vacuum-formed splint with posterior occlusal block in 2 weeks. Vacuum-formed splint may be a simple and effective stabilization technique for traumatized tooth in a cerebral palsy patient.

12세 이하 아동의 제1대구치 복합레진 수복의 재수복률에 관한 연구

정윤영,남옥형,김미선,이효설,최성철,Jeong, Yunyeong,Nam, Okhyung,Kim, Misun,Lee, Hyo-seol,Choi, Sungchul 대한소아치과학회 2018 大韓小兒齒科學會誌 Vol.45 No.3

Although the frequency of composite resin restoration in children is gradually increasing, there are insufficient researches about the rate of composite resin repair in children. The purpose of this study was to evaluate the repair rate of composite resin restorations in the permanent first molar in children under 12 years old. This study retrospectively analyzed 169 children treated with composite resin restoration in the permanent first molar from May 2014 to April 2015. According to the location of the tooth, the repair rate was higher in the mandible than maxilla and in the left than right. In the classification of restoration, the repair rate was the highest in the class II cavity, and the repair rate was the lowest in the restoration of the occlusal surface only. Repair rate in two years was 14.8%, and repair hazard ratio decreased with age. The most common reason of composite resin restoration replacement was the secondary caries (74.1%). Within the limits of study, the repair rate of children was higher than that of adult due to the characteristics of children. Therefore, dentists should understand these characteristics and try to reduce the repair rate of composite resin composite restorations. 이번 연구의 목적은 12세 이하의 아동의 제1대구치 복합레진 수복물에 관하여 후향적 연구를 하여 재수복률을 평가하고자 함에 있다. 이번 연구는 2014년 5월부터 2015년 4월까지 경희대학교 치과병원 소아치과를 내원하여, 제1대구치에 복합레진 수복을 진행한 12세 이하의 환자 169명의 재수복률과 그 원인을 분석하였다. 재수복률은 성별에 따라 통계적으로 유의한 차이는 보이지 않았다. 제1대구치의 위치에 따라서 상악보다는 하악이 그리고 우측보다는 좌측에서 재수복률이 높았다. 와동의 종류에 따라서 2급 와동에서 가장 재수복률이 높았고, 교합면만 수복한 경우 재수복률이 가장 낮았다. 2년간의 재수복률은 14.8%로 나타났으며, 연령이 증가함에 따라 재수복의 위험도는 감소하였다. 재수복의 가장 주된 원인은 이차우식(74.1%)이었다. 아동의 영구치 복합레진 수복물의 재수복률은 성인 보다 높은 것으로 나타났으며, 영구치의 맹출도, 환자의 협조도 및 구강위생 관리능력이 중요한 영향을 미치는 것으로 사료되었다.

Predictive Factors of Ectopic Eruption of the Maxillary First Permanent Molar

선지민,남옥형,김미선,이효설,최성철 大韓小兒齒科學會 2016 大韓小兒齒科學會誌 Vol.43 No.3

In order to provide a diagnostic basis for predicting the possibility of the self-correction of ectopic first permanent molars, differences among normal eruption, reversible and irreversible ectopic eruption of maxillary first permanent molars were retrospectively analyzed. The angles of the long axes and the occlusal lines between the maxillary first permanent molar and the adjacent tooth were measured by panoramic radiographs. The occlusal relationship of second primary molars was also investigated. There is a statistically significant difference between the ectopic eruption group and normal group (p < 0.05), but not between the reversible and irreversible ectopic eruption groups (p > 0.05). The angles between the second primary molar and the first permanent molar, the second primary molar and the second permanent molar in ectopic groups showed a smaller degree than those of the control group. Mesial step was found more frequently in the ectopic eruption group than the normal group. In conclusion, the angulation of the first permanent molar and tooth germ of the maxillary second permanent molar showed close relation with ectopic eruption of the maxillary first permanent molar and ectopic first permanent molar is likely to occur in class Ⅲ patients with maxillary deficiency. 본 연구는 이소맹출한 상악 제1대구치의 자율적 수정 가능성을 예측할 수 있는 진단적 기초를 제공하기 위하여 정상군과가역성과 비가역성 이소맹출의 차이점을 비교 평가하고자 후향적으로 분석하였다. 상악 제1대구치와 인접치아 간의 장축과교합평면간의 각도를 파노라마상에서 측정하였고, 제2유구치의 교합관계도 조사하였다. 이소맹출군과 정상군은 통계학적으로 유의한 차이를 보였지만(p < 0.05), 가역성과 비가역성 이소맹출군 간에는 통계학적으로 유의한 차이는 없었다(p > 0.05). 제2유구치와 제1대구치 그리고 제2대구치 치배 간의 각도는 정상군에 비해 이소맹출 군에서 작은 값을 보였으며, 근심 계단형이 이소맹출군에서 더 높은 빈도로 관찰되었다. 본 연구의 결과를 토대로 상악 제1대구치의 이소맹출은 상악 제1대구치와 제2대구치 치배의 각도와 관련이 있으며, 이소맹출한 상악 제1대구치는 상악 저성장의 3급 부정교합 환자에서 보다 빈번하게 나타나는 경향이 있는 것을 알 수 있었다.

A Retrospective Study of Luxation Injuries in Primary Teeth: Prognosis with Splinting

송기언,남옥형,김미선,이효설,김광철,최성철 대한소아치과학회 2017 大韓小兒齒科學會誌 Vol.44 No.2

This study investigated the prognosis of luxation injuries in primary teeth treated with splinting. This study retrospectively analyzed 92 children with luxation injuries to their primary teeth who were treated with splints between 2010 and 2015. Prognoses were analyzed in patients who had been followed for more than 6 months. The prognoses with splinting were based on clinical and radiographic evaluations performed during the follow-up examinations. The mean patient age was 42.1 months, and 67.4% were male. The most common cause of luxation injury was falling, and the mean splint duration was 2.4 weeks. The success rate of splinting was 58.9%. The highest rate of success was achieved following subluxation, while repositioning and splinting of lateral luxation had the lowest rate of success. Pulp necrosis was the most common unfavorable prognosis in the luxation injuries. Depending upon the type of luxation, splint therapy had acceptable prognoses and might be a feasible treatment option.

소아 청소년 환자에서 발생한 269개의 구강 악안면 영역 낭 : 10년간의 후향적 임상 연구

홍혜린,남옥형,김미선,최성철,이효설 大韓小兒齒科學會 2016 大韓小兒齒科學會誌 Vol.43 No.3

This study aimed to identify the characteristics of jaw cysts among children and adolescents treated at the Kyung Hee University Dental Hospital from 2005 to 2015. A retrospective observational study was conducted of 269 jaw cysts diagnosed in 253 patients. The following variables were recorded: gender, age, prevalence and location of lesions, clinical symptoms and treatment. Statistical analyses were performed using the SPSS (version 20.0). Our results suggest that the cysts are slightly more prevalent in males. Cystic lesions of the jaws in children are predominantly odontogenic and developmental in origin. Dentigerous cysts predominate in developmental cysts and the most frequent diagnosis is radicular cysts in inflammation cysts. The most common location of the cysts is in the mandible, particularly the lower molar region. In numerous cases, the patients have no clinical symptoms. Most cysts were surgically enucleated with tooth extraction. Furthermore, our findings demonstrate that the characteristics of jaw cysts in children are distinctive and differ in several respects from the corresponding distribution of jaw cysts in adult population. Therefore, knowledge of the clinical, radiological and histopathological behavior of jaw cysts and periodic radiographic examination are key factors for early diagnosis and adequate treatment of jaw cysts in children. 낭은 액체 또는 반유동성 액체를 함유하는 상피세포층으로 둘러싸인 공동이다. 낭은 모든 연령대에서 진단될 수 있으나, 소아 청소년 환자는 성인들과 다른 병소의 종류와 양상을 보일 수 있으며, 후속 영구치가 발육 중이므로 치료법도 다를 수 있다. 본 연구는 2005년 1월부터 2015년 3월까지 최근 10년간 경희대학교 치과병원을 내원한 19세까지의 소아 청소년환자 중임상적, 방사선학적 및 조직학적으로 낭으로 확진된 253명의 환자들을 분석하였다. 그 결과 낭은 남아 142명(56.1%)에서다소 많았으며, 치성낭이 209개(82.6%)로 대다수를 차지하였고, 전체적으로 발육성 낭이 염증성 낭보다 많았다. 발육성 낭에서는 함치성낭, 염증성 낭은 치근낭이 많았다. 한편 하악 구치부에서 발생 비율이 높았다. 환자들 중 많은 경우 임상 증상이 없었으며, 낭의 치료 방법으로는 적출술만을 시행하고 원인치 발거를 동시에 진행한 경우가 많았다.

경희대학교 소아치과에 내원한 아동의 진단 모형 분석을 이용한 영구치 맹출 단계

오태준,남옥형,김미선,이효설,김광철,최성철 대한소아치과학회 2019 大韓小兒齒科學會誌 Vol.46 No.1

Individual dental age is used as an index of chronological age estimation and is an important indicator of the child’s growth stage. Dental age does change greatly over time, but it changes constantly. And updating information about this change is important. The purpose of this study was to provide information about tooth eruption stage using diagnostic model analysis and to investigate tooth eruption sequence and estimate chronological age based on this information. Tooth eruption stages were measured on a diagnostic model from 488 patients in 5 - 13 year old children. Based on the information on eruption stage, eruption sequence in maxilla was first permanent molar, central incisor, lateral incisor, first premolar, canine, second premolar and second permanent molar. Eruption sequence in mandible was first permanent molar, central incisor, lateral incisor, canine, first premolar, second premolar and second permanent molar. There were significant differences between males and females in the eruption stage of canine, first and second premolar, and second molar at several ages. The chronological age of male and female was estimated by the coefficient of determination of 0.816, 0.826 respectively. 개인의 치령은 연령 추정의 한 지표로 사용되고 있으며, 아동의 성장 단계를 알 수 있는 중요한 지표가 된다. 치령의 변화는 시대의변화에 따라 크지는 않지만, 꾸준히 변하게 되며 이에 대한 정보의 업데이트의 중요성은 널리 알려져 있다. 이에 이 연구는 진단 모형을 이용해 한국 아동의 치아 맹출 단계에 대한 정보를 제공하고, 이 정보를 바탕으로 치아 맹출 순서를 조사하고 연령 추정을 시행해보았다. 5 - 13세 아동 488명의 진단 모형을 통해 치아 맹출 단계에 대해 조사하였다. 맹출 단계 정보를 바탕으로 한 영구치의 맹출 순서는 남녀 모두 상악에서는 제1대구치, 중절치, 측절치, 제1소구치, 견치, 제2소구치였으며, 하악에서는 제1대구치, 중절치, 측절치, 견치, 제1소구치, 제2소구치, 제2대구치 순서로 나타났다. 일부 나이에서 견치, 제1,2소구치, 제2대구치에서 남녀 간의 유의한 맹출 단계수준의 차이를 보였다. 연령별 맹출 단계를 바탕으로 선형회귀분석을 이용해 연령 추정을 시행해 본 결과 남아와 여아의 나이를 결정계수 0.816와 0.826 수준으로 추정해 볼 수 있었다.

Retrospective Study of Clinical Characteristics and Treatments in Natal and Neonatal Teeth

조원창,남옥형,김미선,이효설,김광철,최성철 대한소아치과학회 2017 大韓小兒齒科學會誌 Vol.44 No.2

Natal teeth that are already present at birth and neonatal teeth that erupt shortly after birth may cause various complications. The purpose of this study is to evaluate the characteristics of natal/neonatal teeth in Korean infants who visited to Kyung Hee University Dental Hospital from 2006 to 2015. A retrospective review of clinical data, including the sex of the patients, chief complaints of the mothers, clinical appearances and locations of the natal/neonatal teeth, and associated complications and treatments, was collected. Overall, a total of 75 teeth were found in 48 patients and 69% of the infants had natal teeth, while 31% had neonatal teeth, all of which were mandibular incisors. Females showed more natal/neonatal teeth than males. Major reasons for visiting the dental clinic were parental anxiety, referrals from other clinics, Riga-Fede disease, and pain during breastfeeding. Extraction was the most common treatment choice; observation and grinding were also used. 선천치와 신생치는 출생시 맹출했거나 조기에 맹출하는 치아로 다양한 합병증을 가지고 있으나, 많은 부모들이 이에 대한 정보부족으로 적절한 치료 없이 불편을 겪고 있다. 본 연구는 2006 - 2015년에 경희대학교 치과병원 소아치과를 내원한 환아에게서 발견되는선천치와 신생치의 특성을 평가하고자 한다. 환아들의 성별, 부모의 주소, 임상적인 특징과 합병증 및 치료법을 조사하여 후향적 연구를 진행하였다. 환아들 가운데 69%는 선천치를, 31%는 신생치를 가졌으며 모두 하악 절치였다. 여환이 남환보다 많았고 내원 주소로는 부모의 걱정이 가장 많았으며 병원 의뢰와 리가 페데병(Riga-Fede disease) 그리고 수유시 통증이 그 뒤를 이었다. 치료방법으로는 발치가 가장 많았으며 치아 유지와 치아 다듬기도 행해졌다. 선천치와 신생치는 다양한 특성과 합병증을 가지고 있으므로 치과의사는 아이의 전반적인 건강을 위해 이러한 치아의 병리에 대해정확히 이해하는 것이 중요하다.

The Effect of the Transmission of Coronavirus Disease-2019 on the Mentality of Parents and Children After the First Wave of Infections

김정연,이고은,남옥형,이효설,최성철,김광철,김미선,Kim, Jeongyeon,Lee, Koeun,Nam, Okhyung,Lee, Hyo-seol,Choi, Sungchul,Kim, Kwangchul,Kim, Misun Korean Academy of Pediatric Dentistry 2021 大韓小兒齒科學會誌 Vol.48 No.3

이 연구의 목적은 코로나바이러스감염증-2019의 전파가 학령기 아동과 부모의 심리에 미친 영향을 수면장애와 우울증의 측면에서 평가하는 것이었다. 2020년 4월 2일부터 2020년 4월 25일까지 강동 경희대학교 치과병원 소아치과를 방문한 123명의 부모와 108명의 학령기 아동을 대상으로 직접 기입 방식의 설문조사를 실시하였다. 참가자들은 Pittsburgh Sleep Quality Index, Generalized Anxiety Disorder (GAD) - 7, Center for Epidemiology Scale for Depression 로 평가되었다. 로지스틱 회기 분석은 유의 수준 5%로 시행되었다. 부모의 GAD, 우울증, 낮은 수면의 질은 각각 34.1%, 17.1%, 44.7%에서 나타났다. 아동의 GAD 유병률은 20.4%였다. 로지스틱 회기분석 결과 코로나바이러스 관련 안전재난문자로 인한 스트레스가 부모의 불안장애, 우울증과 관련이 있었다. 아동의 경우, 코로나바이러스감염증 발생 이후의 감정 변화 정도가 GAD와 연관성이 있었다. 이 연구를 통해 코로나바이러스감염증-2019의 유행으로 인한 어린이와 보호자들의 심리적 상태 변화가 있음을 확인하였고, 치과진료 시 이들의 심리상태를 고려해야 하겠다. The purpose of this study is to evaluate the effect of the spread of a new type of coronavirus infection (COVID-19) on the mental state in school-age children and parents focusing on the aspects of sleep disorders and depression. A questionnaire survey was conducted for 123 parents and 108 school-age children who visited Department of Pediatric Dentistry, Kyung Hee University Dental Hospital at Gangdong from April 2, 2020 through April 25, 2020, via the direct writing method. Participants were assessed with Pittsburgh Sleep Quality Index, Generalized Anxiety Disorder (GAD)-7, Center for Epidemiology Scale for Depression. Logistic regressions were used with a level of significance of 5%. The prevalence of GAD, depression, and poor sleep in parents were 34.1%, 17.1% and 44.7%, respectively. The prevalence of GAD in children was 20.4%. Logistic regression showed that stress from Emergency Alert Messages about COVID-19 was associated with GAD and depression in parents. In children, the degree of emotional change after COVID-19 was associated with GAD. This study confirmed that there was a change in the psychological status of children and guardians due to the epidemic of coronavirus disease-2019, and it would be necessary to consider their psychological status during dental treatment.