Immuno-slot blot method를 이용한 우식 경험 아동과 비경험 아동간의 Streptococcus mutans에 대한 타액내 IgA 역가의 비교

음종혁,정태성,김신,Eum, Jong-Hyeok,Jeong, Tae-Sung,Kim, Shin 대한소아치과학회 2002 大韓小兒齒科學會誌 Vol.29 No.3

본 연구는 어린이의 치아우식증을 야기하는 주된 원인균인 Streptococcus mutans에 대한 타액내 Immunoglobulin A의 양을 좀 더 쉽고 빠르며 정확하게 분석하는 방법을 개발하는데 일차적 목적을 두었고 이 방법을 사용하여 우식 경험군과 비경험군 간의 타액내 IgA 역가에 차이가 있는지 관찰하였다. 본 연구에서 사용한 immune-slot blot method에서 항체 역가 측정의 기본 개념은 Streptococcus mutans의 단백질을 1/2씩 희석하여 nitrocellulose membrane에 결합시킨 후 1/100으로 희석된 타액에 의해 검출될 수 없는 최대의 단백질 희석배수를 구하는 것이다. 연구 결과 우식 경험군과 비경험군의 희석배수 평균치는 우식 비경험군이 $2^{6.278{\pm}2.260}$, 우식 경험군이 $2^{5.730{\pm}0.499}$로 IgA의 농도가 우식 비경험군에서 약간 높게 나타났다. 그러나 우식 비경험군의 경우 표준편차가 매우 높아 양 군간에 유의한 차이는 없었다. The aim of this study is to develop and establish rapid, convenient, and accurate method of analyzing salivary IgA against S. mutans semi-quantitatively. Relative salivary IgA titer was calculated as maximum dilution fold of S. mutans protein that was not detected by salivary antibody after measuring relative intensity of the immune blot bands by densitometry. Analyses were performed in caries-experienced and non-experienced children. Mean IgA titer of non-experienced group shows higher level than that of caries-experienced without statistical significance due to high individual variety of antibody titer in non-experienced group: $2^{6.278{\pm}2.260}$ in non-experienced group and $2^{5.730{\pm}0.499}$ in caries-experienced group(p=0.464). Those results suggest that naturally induced salivary IgA antibodies against S. mutans were present in all subjects, but high titer of antibodies were not achieved in caries-experienced group. On the contrary, antibody titer in non-experienced group shows marked individual variations suggesting that antibody production is multifactorial. In conclusion, immune-slot blot method developed in this study would be useful and applicable in semi-quantitative analysis of antibodies.

Midazolam의 비강내투여에 의한 진정요법

음종혁,김신 大韓小兒齒科學會 1995 大韓小兒齒科學會誌 Vol.22 No.2

Various methods have been attempted for behavioral control of uncooperative children in the field of pediatric dentistry. Uncooperative children is not only difficult to treat but there is also a tendency to provoke negative attitude for further dental treatment. Therefore the importance of sedative therapy by drug is unquestionable. Many drugs are being used for behavioral control. Midazolam, synthesized by Fryer & Walser in 1976, has outstanding characteristic and is widely used for behavioral control of uncooperative children. It's onset time is rapid and due to rapid metabolism, it has short acting time. Its low toxicity renders broad range of use in treatment and manifests and profound sleep and sedation which makes it an useful drug for behavioral control of uncooperative children in densitry. There are various routes of administration, but by intranasal method, the direct absorption rapid, rate of metabolism is reduced and is technically easy. Some children who were uncooperative were chosen among the patients who visited our department and the following results were obtained by attempting to induce sedation with intranasal administration of midazolam. 1. Remarkable sedative effect was observed within 10 min. in most case.(about 70%) 2. In some cases, higher dosage adjustment was required. 3. Less patient discomfort & rejection was found compared with other routes. 4. Only a few fell asleep completely, whereas most became drowsy or calm. 5. Duration was sufficient for most dental treatment. 6. Comedication was thought desirable. 7. Any adverse reaction or complication was not observed.

Glass Ionomer 수복재와 와동이장재의 항균성에 관한 연구

음종혁,김신 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.1

Microorganisms may exist at the interface between prepared cavity and restorative material due to microleakage or incomplete removal of carious lesion, and this could result in pulpitis or secondary caries. In this perspective, the antibacterial potential of the restorative materials and cavity liners would be advantageous. The antibacterial effect of glass ionomer cements has already been proven but only partially, and there has not been much of a general comparative evaluation of the antibacterial effect of the materials being provided in an increasing number in these days. This research was intended to compare the antibacterial activity of glass ionomer restorative materials and glass ionomer cavity liners and resin cavity liner by employing agar diffusion test. The antibacterial activity of the Glass inomer materials including conventional chemically-cured glass ionomer cement, glass cermet cement, and light-cured glass ionomer cement to Streptococcus mutans, a leading causative microorganism in caries, was evaluated, which yielded the results as follows. 1. All the glass ionomer materials tested proved to have antimicrobial effects. 2. In the case of glass ionomer restorative materials, the bacterial inhibition zone was largest in the Vitremer and smallest in Fuji Ⅱ LC. Ketac-Silver and Ketac-Fil exhibited similar values (P<0.05). 3. In the case of glass ionomer cavity liners, it was in the order of Vitrebond, Fuji Lining Cement, Fuji Lining LC, with the latter showing the smallest zone (P<0.05). On the contrary, Timeline which is a kind of F-added resin cavity liners showed no antibacterial activity. 4. No material showed antibacterial activity when applied after immersed in saline for 24 hrs. 5. It was impossible to clarify the difference in antibacterial effect between light-cured and chemically-cured GIC materials and GIC cavity liners exhibited greater antibacterial effects comparing with GIC restorative materials (P<0.05).

매복된 상악 전치부의 자가이식 치험례

김신,음종혁,이애련,서수정,김주미,김주영,황보민 大韓小兒齒科學會 1994 大韓小兒齒科學會誌 Vol.21 No.2

The autotransplantation procedure were performed for the cases with impacted maxillary anterior teeth, which were thought unrealistic by the treatment with surgical exposure and orthodontic traction into the arches. The results were as follow : 1. As the treatment with autotransplantation is the last resort, the case indicated should be selected cautiously by adequate case analysis. 2. In order to reduce postoperative complication, damages to periodontal ligaments and adjacent bony structures should be minimized by conservative surgical procedures. 3. After autotransplantation procedures, postoperative endodonic treatment and continuous follow-up check with clinical and radiographic examination should be followed. Although the autotransplantation procedure is not the treatment of choice in most cases, it was thought to be a good alternative in certain cases when orthodontic treatment is unrealistic with continuous study to overcome the handicaps.

맹출장애를 보이는 상악 전치의 맹출유도

심정호,음종혁,정태성,김신 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.1

상악 전치의 맹출장애는 임상적으로 비교적 흔한 치열발육 이상으로 환자측에서 인지하기 쉬우며 심미적, 사회 심리적으로 중요한 문제가 될 수 있다. 맹출장애의 치료방법으로는 주기적 관찰, 공간 확보, 치은 절제술을 포함한 단순 노출 교정적 견인 외과적 노출과 교정적 견인의 병행, 발거 후 자가치아이식 등 여러 방법이 있다. 이 중 적절한 치료방법을 선택하기 위해서는 우선 환자의 내과적, 치과적 병력을 고려해야 하고 치아의 위치, 상태, 치근 형성정도 및 만곡여부, 맹출을 위한 공간 확보 여부, 주위 치조골 및 치주조직의 상태 , 견인 방법 , 이동에 소요되는 기간 등을 고려해야 한다. 저자는 상악 전치부의 맹출장애를 보이는 두 증례를 치험한 바, 첫 번째 증례는 상악 우측 중절치의 이소맹출과 우측 견치의 맹출지연을 주소로 내원한 환자로서, 견치를 노출시킨 후 견인을 시행하였으며 현재 우측 중절치를 배열중이다. 두 번째 증례는 상악 좌측 중절치의 맹출지연을 주소로 내원한 환자로서, 상악 좌측 중절치를 발거한 후 자가치아이식을 시행하였다. 위 증례를 통해서 치아의 맹출력을 기대할 수 없거나 맹출방향이 비정상적인 경우에는 외과적 노출과 견인을 동반한 방법을 우선 적용할 수 있으나, 치아의 위치 이상이 심각하거나 치근의 위치가 과도하게 이탈된 경우에는 자가치아이식을 포함한 외과적 술식이 맹출유도에 도움이 된다는 사실을 확인하였다. Unerupted maxillary anterior teeth is not a common case, However it may present practitioners with management problem. The cause of impaction is considered to be multifactorial, and local cause is the most common. These impacted teeth require surgical intervention, removal, transplantation, or surgical exposure, with or without orthodontic traction to align the malpositioned tooth. The preferred option is surgical exposure and or thodontic correction. Surgical intervention and orthodontic correction should not be delayed to avoid unnecessary difficulties in aligning the tooth in the arch. Surgical exposure should be performed with the intent of providing sufficient attached gingiva rather than simply uncovering the crown, which results in only alveolar mucosal attachment. Attached gingiva is essential to secure the gingival tissues to the adjacent teeth at the dentogingival junction. Thus preventing loss of periodontal tissues as a result of the pull of the surrounding soft tissues and facial museles. Labially impacted maxillary anterior teeth uncovered with an apically positioned flap technique have more unesthetic sequelae than those uncovered with a closed-eruption technique. In the case of severly displaced impacted teeth, autotransplantation ensures preservation of the alveolar bone and will facilitate future placement of an osseointegrated implant once growth has ceased or if ankylosis/resorption of the transplant occurs.

제1대구치의 맹출지연에 관한 임상적 고찰

황보민,이애련,서수정,음종혁,김주영,김주미,김신 大韓小兒齒科學會 1994 大韓小兒齒科學會誌 Vol.21 No.2

Among the permanent teeth, the first permanent molars play the greatest role in occlusion and function. So, the congenital missing, abnormal reuption or abnormal formation of the first permanent molars in the course of arch development would inflict normal development of dental arches. Therefore, early detection of abnormal cases related to first permanent molars and understanding of current and predictable clinical problems are essential for proper occlusal guidance in children. With the aim of investigating the clinical patterns of delayed eruption of first permanent molars in children, panoramic tomograms of the childern in mixed and early permanent dentition were observed and analyzed. The results were as follows : 1. Among the delayed eruption of first permanent molars, on tooth or bilateral teeths were affected most frequently. Delayed eruption was more prevalent in maxilla than in mandible. 2. The formation of tardily erupted teeth were also delayed. 3. Delayed eruption was generally limited in first molars or molar segments. 4. Delayed eruption of first permanent molars is accompanied by abnormal position of tooth germs, for example, ectopic eruption, delayed dental age, delayed localized tooth formation and generalized congenital missing. 5. There was a tendency of delayed formation or congenital missing of second molars distal to tardily erupted 1st molars. And that was more marked in maxilla than in mandible. 6. There was reported that affected 1st molars show various size and shapes. Maxillary 1st molars showing delayed eruption showed a tendency of having 3 cusps. But, tardily erupted mandibular 1st molars showed no significant reduction in mesiodistal dimension, as reported. 7. In some cases, the delayed eruption of 1st permanent molars was associated with ectopic eruption, but their formation was not usually retarded. 8. In skeletal classⅢ cases, there showed a tendency of mandibular 1st molars to erupt earlier than maxillary 1st molars with greater interval than in normal occlusion.