다양한 진정법을 통한 뇌전증 환자의 통합 치과 치료의 증례보고

도레미,김승오 대한통합치과학회 2014 대한통합치과학회지 Vol.3 No.1

Epilepsy is one of the most common chronic neurologic conditions that defined by the occurrence of 2 or more unprovoked seizures. Patients with epilepsy often have difficulty for dental treatment though they have poor oral hygiene state. In this case report, 46-year-old male patient with severe epilepsy required comprehensive dental treatment. General anesthesia and conscious sedation with intravenous target controlled infusion method was successfully employed and patient was discharged without any complications.

Postoperative irradiation after implant placement: A pilot study for prosthetic reconstruction

도레미,김성태,금기창,김준원,심준성,정한성,박경미,정문규 대한치과보철학회 2016 The Journal of Advanced Prosthodontics Vol.8 No.5

PURPOSE. On maxillofacial tumor patients, oral implant placement prior to postoperative radiotherapy can shorten the period of prosthetic reconstruction. There is still lack of research on effects of post-implant radiotherapy such as healing process or loading time, which is important for prosthodontic treatment planning. Therefore, this study evaluated the effects of post-implant local irradiation on the osseointegration of implants during different healing stages. MATERIALS AND METHODS. Custom-made implants were placed bilaterally on maxillary posterior edentulous area 4 weeks after extraction of the maxillary first molars in Forty-eight Sprague-Dawley rats. Experimental group (exp.) received radiation after implant surgery and the other group (control) didn’t. Each group was divided into three sub-groups according to the healing time (2, 4, and 8 week) from implant placement. The exp. group 1, 2 received 15-Gy radiation 1 day after implant placement (immediate irradiation). The exp. group 3 received 15-Gy radiation 4 weeks after implant placement (delayed irradiation). RESULTS. The bone mineral density (BMD) was significantly lower in the immediate irradiation groups. BMD was similar in the delayed irradiation group and the control group. The irradiated groups exhibited a lower bone-toimplant contact ratio, although the difference was not statistically significant. The irradiated groups also exhibited a significantly lower bone volume and higher empty lacuna count than the control groups. No implant failure due to local irradiation was found in this study. CONCLUSION. Within the limits of this study, the timing of local irradiation critically influences the bone healing mechanism, which is related to loading time of prostheses.

장애환자의 치과진료 시 Sevoflurane 흡입진정의 활용

도레미,송영균,유태민,김승오,Doh, Re-Mee,Song, Young-Gyun,You, Tae-Min,Kim, Seung-Oh 대한치과마취과학회 2012 Journal of Dental Anesthesia and Pain Medicine Vol.12 No.2

Dental treatment under general anesthesia is considered for behavioral control of disabled patients who have severe anxiety or involuntary movement. However, in case of simple treatment, inhalation or intravenous sedation, which has earlier onset and recovery, is preferred. Conventionally, nitric oxide is used for inhalation sedation, nowadays sevoflurane can also be used due to easily titratable for controllable effect and less complications. In this case report, two patients with mental retardation required simple dental treatment. Deep sedation with inhaled sevoflurane were successfully employed and patients were discharged without any complications.

근위축성 측삭경화증 환자(ALS)의 치과 진료 시 목표농도 주입법을 이용한 정주 진정 마취: 증례 보고

도레미,김승오,Doh, Re-Mee,Kim, Seung-Oh 대한치과마취과학회 2012 Journal of Dental Anesthesia and Pain Medicine Vol.12 No.3

Amyotrophic lateral sclerosis (ALS) is one of the major neurodegenerative diseases that involves degeneration at all levels of the motor system- from the cortex to the anterior horn of the spinal cord. Patients with ALS often have difficulty of ambulation for dental treatment though they have poor oral hygiene state. General anesthesia may cause respiratory problem due to its high sensitivity to muscle relaxant and weakened upper airway. In this case report, 38-year-old female patient with ALS required many dental treatments. Conscious sedation with intravenous target controlled infusion method was successfully employed and patient was discharged without any complications.

서로 다른 삽입로를 이용한 최소 삭제 접착성 고정성 보철물의 임상 연구

도레미,이근우,Doh, Re-Mee,Lee, Keun-Woo 대한치과보철학회 2011 대한치과보철학회지 Vol.49 No.2

연구 목적: 전통적인 초기의 접착성 고정성 보철물이 가능한 보존적이고 가역적인 치료를 추구했지만 유지력의 상실이 큰 문제가 되면서 임상적 성공률이 낮은 단점이 있었다. 이러한 한계를 극복하고자 하는 여러 연구들 중, 자연 치아의 언더컷과 구조물의 각기 다른 삽입로를 이용하여 유지력을 얻는 3-piece형태의 변형된 접착성 고정성 보철물이 제안되었다. 이 연구의 목적은 변형된 형태의 접착성 고정성 보철물을 이용하여 수복 치료를 받은 환자에 대한 후향적 연구를 통하여 임상가들의 상실치 수복을 위한 치료 계획 수립에 도움을 주고자 함이다. 연구 재료 및 방법: 한 개 혹은 그 이상의 치아가 상실되어 수복을 요하여 2007년부터 연세대학교 치과대학병원 보철과에 내원하여 자연치아의 언더컷과 구조물의 각기 다른 삽입로를 이용하는 변형된 형태의 접착성 고정성 보철물 수복 치료를 받은 23명의 환자중 주기적 검사가 가능한 21명을 대상으로, 후향적으로 임상 및 방사선 검사 결과를 평가하였다. 결과 및 결론: 자연치아의 언더컷과 구조물의 각기 다른 삽입로를 이용한 접착성 고정성 보철물을 이용한 21명증례, 71 unit의 최대 25개월 (평균 7개월)간의 후향적 연구에서 다음과 같은 결과를 얻었다. 1. 자연치아의 언더컷과 구조물의 각기 다른 삽입로를 이용한 접착성 고정성 보철물은 단기간의 follow-up 에서 보철물의 탈락, 파절등의 기계적인 실패가일어나지 않았다. 2. 보철물 주변의 치주조직은 비교적 안정되었다. 3. 방사선 사진상 유의성있는 골흡수를 보이지 않았다. The object of this clinical study was to evaluate the short-term outcome of modified resin-bonded fixed partial dentures which utilizes the original tooth undercuts and different path of insertion of components. Materials and methods: 71 units of modified RBFPDs that were used in 21 patients at the Department of Prosthodontics, College of Dentistry, Yonsei University were evaluated. The follow-up period was up to 25 months, the mean being 7 months. Survival rate, mobility, percussion, probing depth, bleeding on probing, plaque index was recorded and radiographs were taken to monitor alveolar bone loss. Results & Conclusion: Within the limits of this short term retrospective study, it was concluded that: 1. No mechanical failure such as debonding or fracture of the framework was found during the follow-up period. 2. The periodontal apparatus was stable and no clinical change was observed after prosthetic treatment. 3. No significant marginal bone loss was found in the radiographic evaluation.

SLA 표면 처리와 미세나사선을 가진 내측 연결형의 국산 임플란트에 대한 후향적 연구

도레미,문홍석,심준성,이근우,Doh, Re-Mee,Moon, Hong-Suk,Shim, Jun-Sung,Lee, Keun-Woo 대한치과보철학회 2009 대한치과보철학회지 Vol.47 No.2

Statement of problem: Since the introduction of the concept of osseointegration in dental implants, high long-term success rates have been achieved. Though the use of dental implants have increased dramatically, there are few studies on domestic implants with clinical and objective long-term data. Purpose: The aim of this retrospective study was to provide long-term data on the $Implantium^{(R)}$ implant, which features a sandblasted and acid-etched surface and internal connection with microthreads. Material and methods: 106 $Implantium^{(R)}$ implants placed in 38 patients at Yonsei University Hospital were examined to determine the effect of various factors on implant success and marginal bone loss, through clinical and radiographic results during a 6 to 30 month period. Results: 1. Out of a total of 106 implants placed in 38 patients, one fixture was lost, resulting in a 99.1% cumulative survival rate. 2. Among the 96 implants which were observed throughout the study period, the survival rates were 97.0% in the maxilla and 100% in the mandible. The survival rate in the posterior regions was 98.9% and 100% in the anterior regions. 3. The mean bone loss during the first year after prosthesis placement was 0.17 mm, while the mean annual bone loss after the first year was 0.04 mm, which was statistically less than during the first year(P<.05). 4. There was no significant difference in marginal bone loss according to age during the first year(P>.05), but after the first year, the mean annual bone loss in patients above 50 years was significantly greater(P<.05) compared with patients under 50 years. 5. No significant difference in marginal bone loss was found according to the following factors: gender, jaw, location in the arch, type of implant(submerged or non-submerged), presence of bone grafts, type of prostheses, and type of opposing dentition(P<.05). Conclusion: Based on these results, the sole factor influencing marginal bone loss was age, while factors such as gender, jaw, location in the arch, type of implant, presence of bone grafts, type of prostheses and type of opposing dentition had no significant effect on bone loss. In the present study, the success rate of the $Implantium^{(R)}$ implant with a SLA surface and internal connection with microthreads was satisfactory up to a maximum 30 month period, and the marginal bone loss was in accord with the success criteria of dental implants. 연구목적: 골유착이라는 개념이 도입된 후, 임플란트의 등장은 치과계에 많은 변화를 일으키게 되었다. 임플란트를 이용한 상실치아의 수복은 안정된 시술방법으로 시행되어져 왔으며 그 적용 범위가 확대되었고 사용 빈도도 급격히 증가해왔다. 이에 따라 국산 임플란트의 사용 빈도도 높아지고 그 종류 또한 증가하였으나 장기간의 임상적, 객관적인 자료를 가진 국산 임플란트의 수는 많지 않은 상태이다. 본 연구는 연세대학교 치과대학 병원에 내원한 환자 중 SLA 표면 처리 및 미세나사선을 가진 내측 연결형의 $Implantium^{(R)}$ 임플란트를 이용하여 치료받은 38명의 환자에게 식립된 106개의 임플란트를 대상으로 6개월에서 30개월까지의 임상적, 방사선학적 결과를 후향적으로 분석하였다. 연구재료 및 방법: 진료기록부를 통해 성별, 연령, 식립 위치, 식립 부위의 골 상태, 식립된 임플란트의 직경 및 길이, 2차수술및골이식여부, 대합치의 유형, 임상적 합병증의 유형 및 빈도 등을 조사하여 그에 따른 분포 및 생존율의 차이와 함께 이들 항목이 변연골 흡수량에 미치는 영향을 조사하였다. 방사선 사진분석으로 임플란트 식립시, 보철물 장착 후 첫 6개월 내지 1년간, 그 이후 연간 변연골 흡수량을 측정하여 분석하였다. 결과: 1. 총 38명에게 식립된 106개의 임플란트 중 1개가 실패하여 누적 생존율은 99.1%로 나타났다. 2. 보철물 장착 후 최소 6개월 이상 정기검진이 가능했던 96개의 임플란트에서 상악에서의 생존율이 97.0%, 하악에서의 생존율은 100%였고, 구치부에서의 생존율은 98.9%였으며 전치부에서의 생존율은 100%였다. 3. 보철물 장착 후 첫 1년간의 변연골 흡수량은 평균 0.17 mm 이었으며, 1년 이후의 연간 변연골 흡수량은 평균 0.04 mm로 통계학적으로 유의차 있게 적은 골소실량을 나타내었다(P<.05). 4. 보철물 장착 후 첫 1년간 연령에 따른 변연골 흡수량의 차이는 보이지 않았으나(P>.05), 1년 이후의 정기 검진 기간에서 50세 이상의 환자에서 50세 미만의 환자보다 큰 연간 변연골 흡수량을 보였다(P<.05). 5. 성별 간, 악궁 간, 전치부와 구치부위 간, 2차 수술 및 골 이식 여부, 보철물의 유형, 대합치의 유형에 따른 변연골 흡수량의 차이는 보이지 않았다(P>.05). 결론: 이상의 결과를 토대로 변연골 흡수량에 영향을 주는 요소로 연령을 들 수 있었으며 성별, 악궁 간, 악궁 내 위치, 2차 수술 및 골 이식 여부, 보철물의 유형, 대합치의 유형에 따른 변연골 흡수량의 차이는 없었다. 본 연구에서 최대 30개월까지의 기간 동안 SLA 표면 처리 및 미세나사선을 가진 내측 연결형의 국산 임플란트의 임상적인 성공률은 만족스러운 결과를 보였으며 변연골 흡수량도 임플란트 성공 기준에 부합하였다.

모야모야병(Moyamoya disease) 환자의 치과치료시 고려사항 : 증례 보고

도레미,유태민,성낙환,송승례,신수일 대한통합치과학회 2019 대한통합치과학회지 Vol.8 No.1

Moyamoya disease is a chronic, progressive cerebrovascular disorder that leads to an abnormal vascular network at the base of a brain due to the stenosis or occlusion of the internal carotid artery. The purpose of this study is to provide a review of dental treatment considerations for Moyamoya disease patients. According to the article review, dental treatment of patients with Moyamoya disease needs the following considerations. Firstly, the treatment should consider stress reduction therapies. Secondly, bleeding tendency of patients should be taken into consideration. Lastly, medication treatment should be considered. As Moyamoya disease can be a progressive systemic vascular disease, if a bleeding operation is required in the dental treatment then medical consultation by a professional should precede the treatment. 모야모야병(Moyamoya disease)은 뇌경동맥의 협착이나 폐쇄에 의해서 뇌기저부에 비정상적 혈관망을 갖는 만성 진행성 뇌혈관 질환이다. 본 연구에서는 모야모야병에 대한 문헌 고찰과 함께 모야모야병 환자의 치과 치료 증례를 보고하면서, 모야모야병 환자에 대한 치과치료시 고려해야 사항에 대해 살펴보고자 한다. 모야모야병 환자의 치과 치료시 고려사항으로는 첫 번째로, 스트레스 감소 요법에 대한 고려가 필요하다. 두 번째로 출혈 경향에 대한 고려가 필요하며, 세 번째로 약물 처방에 대한 고려가 필요하다. 이 질환은 진행형인 전신 혈관 질환으로 고려될 수 있으므로, 치과 진료시 출혈을 일으키는 침습적 치료가 예정되어 있을시 반드시 의과 협진이 선행되어야 한다.

치과적 중증 장애인에서 임플란트를 이용한 보철 치료

도레미 대한치과의사협회 2023 대한치과의사협회지 Vol.61 No.8

Dental implant treatment is no longer a novel and experimental method, instead, it has become one of the primary options for restoring lost teeth. This technique must be carefully considered and applied to patients with disabilities to improve their oral function and quality of life. Despite its benefits, patients with disabilities are often hesitant to undergo oral reconstruction using implants, particularly those with severe disabilities who may face challenges during treatment due to communication difficulties, lack of cooperation, and involuntary movements. These challenges may lead to uncertain treatment outcomes and prognoses. This paper reviews the critical factors to consider when performing oral reconstruction using implants in patients with severe disabilities. Considering these factors, the uncertainty associated with treatment can be reduced, and the reconstruction using implant prostheses that can be maintained over the long term can be contemplated.

지대주 결찰부의 파절 제거 증례 보고

도레미,Tae-min You,신수일,송승례,성낙환 대한통합치과학회 2017 대한통합치과학회지 Vol.6 No.1

Various types of removal kits have been offered by several companies to address implant prosthetic complications, but complications are not easy to resolve. In particular, the fracture of the internal tapered abutment is difficult to remove with conventional tools if the abutment and the seal inside the fixture are rigid. This clinical report reported a case of abutment fracture in internal taper connection type fixture. A 63-year-old male patient presented with a broken implant restoration that was connected into an internal taper type implant. To retrieve the remnant of the broken abutment in the fixture, multiple instruments were applied to break conical seal. The broken abutment was barely removed with rotary diamond instrument, damaging the internal taper connection area of the fixture. Though there was no cold welding was reported, conical tight seal generated by applied preload make difficult to removal abutment without screw.

고정밀도 알루미늄 스크롤 제작 기술 개발

도레미(R. M. Do),한영훈(Y. H. Han),문지훈(J. H. Mun) 한국정밀공학회 2014 한국정밀공학회 학술발표대회 논문집 Vol.2014 No.5월