두개하악장애 환자의 하악운동에 관한 연구

허성주,김광남,장익태,Heo, Seong-Joo,Kim, Kwang-Nam,Chang, Ik-Tae 대한치과보철학회 1994 대한치과보철학회지 Vol.32 No.1

The purpose of this study was to evaluate the mandibular movements of TMD patients comparing to normal persons. Sirognathograph was used to measure five parameters of mandibular movements of twenty normal persons and eight TMD patients. Five parameters were (1) Maximum opening during maximum opening and closing, (2) Mean velocity during maximum opening and closing, (3) Maximum opening during unilateral chewing, (4) Mean velocity during unilateral chewing, (5) Consistency of mandibular movement during unilateral chewing. Based on above results, new Mandibular Movement Index(M.M.I.) was formulated and compared to Helkimo's Clinical Dysfunction Index by measuring two indices before treatment and 2 weeks, 4 weeks, 6 weeks, 8 weeks after treatment. The conclusions were as follows: 1, The amounts of maximum opening and mean velocity during maximum opening and closing of TMD patients were less than those of normal persons(p<0.01). 2. The amounts of maximum opening and mean velocity during unilateral chewing of TMD patients were less than those of normal persons(p<0.05) (P<0.01). 3. Although TMD patients showed limited mandibular movements during unilateral chewing, the consistency of mandibular movements was better than that of normal persons(p<0.05). 4. Both mandibular movement index and Helkimo's Clinical Dysfunction Index, were useful in diagnosing TMD patients.

T.M.D. 환자의 교합치료후의 예후에 관한 연구

허성주(Seong-Joo Heo),임창준(Chang-Joon Yim),정헌영(Heon-Young Jeong) 대한턱관절교합학회 1994 구강회복응용과학지 Vol.10 No.1

임플란트 피개의치에서 지대주와 골의 변형률에 관한 연구

김명석,허성주,곽재영,김성균,Kim, Myung-Seok,Heo, Seong-Joo,Koak, Jai-Young,Kim, Sung-Kyun 대한치과보철학회 2009 대한치과보철학회지 Vol.47 No.2

연구목적: 임플란트 피개의치에서 연결고정형과 비연결고정형 보철물 지대주와 골의 변형률을 비교하고 임플란트 식립 경사에 따른 변형률을 비교 분석하고자 하였다. 연구 재료 및 방법: 2개의 아크릴릭 레진 모형의 좌측과 우측 견치 부위에 2개의 외부연결형 임플란트를 각각의 모형에 식립하였다. 한 모형에는 두 개의 임플란트를 평행하게 식립하였고, 다른 모형에는 순측과 설측으로 10도의 이개도(divergence)를 가지게 임플란트를 식립하였다. 모형에서 바를 이용한 연결고정형 지대주와 볼을 이용한 비연결고정형 지대주를 고정체에 번갈아 연결하고, 각각의 경우 대응하는 유지장치가 부착된 피개의치를 제작하여 지대주 상에 안착시켰다. 전기저항 스트레인 게이지(strain gauge)를 이용하여 피개의치에 100 N에서 200 N의 부하를 가하였을 때 지대주와 가상골 표면의 변형률(strain)을 측정하였다. 결과 및 결론: 측정된 값들을 통계분석하여 얻은 결과는 다음과 같다. 바를 이용한 연결고정형 보철물은 비연결형 보철물 보다 높은 변형률 값을 보였다. 그러나 방향은 주로 압축력이었으며 부하는 분산되었다(P<.05). 볼을 이용한 비연결고정형 보철물은 연결고정형보다 낮은 변형률 값을 보였다(P<.05). 순측경사된 임플란트에서는 비연결고정형 보철물이 연결고정형 보철물보다 더 높은 변형률 값을 보였다. 설측경사된 임플란트는 순측경사된 임플란트보다 낮은 변형률을 보였다(P<.05). 임플란트가 평행하게 식립된 경우보다 평행하지 않게 식립된 경우 지대주와 가상골의 변형률 값이 더 높았다(P<.05). Statements of the problem: Over the past decades, conventional complete dentures were used for various patients although they have incomplete function. Overdentures using dental implants could help the improvement of denture function. Purpose: The purpose of this study was to compare the strains of abutment and bone on implant overdenture between splinted and unsplinted type of prosthesis. Additionally, the strain values of parallel placed implant model and unparallel placed implant model were compared. Material and methods: Two acrylic resin model were prepared and two implants were placed at the canine positions in each model. In the first model, two implant were placed parallel. In the second model, two implants were placed with 10 degree labiolingual divergence. Two types of abutment were connected to the fixtures alternatively. One was splint type of Hader bar, the other was unsplint type of ball abutment. Overdentures were fabricated with corresponding attachment systems and seated on abutments. Strains of abutments and labial bone simulants were measured with electric resistance strain gauges when static load from 100 N to 200 N were applied to overdentures. Results: 1. Splinted type of overdentures using bar and clip showed higher absolute strain values. But the strain was compressive and the load was shared by two implants(P<.05). 2. Unsplinted type overdentures using ball and O-ring showed low absolute strain values(P<.05). 3. Labially inclined implant showed higher tensile strain values in unsplinted type of prosthesis than in splinted type of prosthesis. Lingually inclined implant showed rather low strain values under load(P<.05). 4. Non parallel implant model showed higher absolute strain values than parallel placed implant model comprehensively(P<.05).

두 종의 external hex implant의 변연골 흡수에 관한 연구 : 예비연구 (preliminary study)

이지은,허성주,곽재영,김성균,한종현,Lee, Ji-Eun,Heo, Seong-Joo,Koak, Jai-Young,Kim, Seong-Kyun,Han, Chong-Hyun 대한치과보철학회 2008 대한치과보철학회지 Vol.46 No.2

목적: 치과 임플랜트 주위의 변연골 변화는 임플랜트의 기능적인 유지 뿐만 아니라 심미적 성공을 위해서도 중요하다. 변연골의 유지를 위한 임플랜트 디자인이 연구되고 있다. 이번 예비 연구는 두 종류의 external hex implant 시스템에서 임플랜트의 상부 미세 나사산이 변연골 변화량에 미치는 영향을 평가하고자 한다. 재료 및 방법: 총 24명의 환자를 대상으로 $Br{{\aa}}nemark$ 임플랜트 식립군 (1군, 거친 표면 임플랜트, 20개)과 원플란트 임플랜트 식립군 (2군, 미세나사산을 가진 거친 표면 임플랜트, 20개)으로 분류하였다. 기준 시점 (임플랜트 부하)과 부하를 가한 1년 뒤 임상적, 방사선학적 검사를 시행하였다. UTHSCSA Image Tool을 이용하여 임플랜트-보철 경계부로부터 변연골 높이 변화량으로 계측하였다. 계측치는 SAS 프로그램을 이용하여 three-level ANCOVA로 통계처리 하였다. 결과: 기준 시점과 비교하여 1년 기능 후, 두 그룹 간의 변연골 소실 변화량에 있어서 통계학적으로 유의한 차이가 있었다 (P<0.05). 1군의 평균 변연골 높이 변화량은 $0.83{\pm}0.31mm$, 2군에 있어서는 $0.44{\pm}0.36mm$ 이었다. 미세나사산을 가진 거친 표면 임플랜트가 미세나 사산을 가지지 않은 거친 표면 임플랜트 보다 더 적은 변연골 소실 변화량을 보였다. 결론: 미세나사산을 가진 거친 표면 임플랜트가 기능적 부하 후 변연골 높이를 유지하는데 있어 더 유리한 디자인으로 보인다. Statement of problem: Changes of the marginal bone around dental implants have significance not only for the functional maintenance but also for the esthetic success of the implant. It was proposed that bone-retention elements such as microthreads at the coronal part of implant might help maintain the marginal bone level. Purpose: This study was designed to evaluate the effect of microthread configuration within the marginal coronal portion of the implant fixture at the marginal bone changes after loading around two different external hex implants. Material and methods: Twenty-four patients were included and randomly assigned to treatment with $Br{{\aa}}nemark$ system implants (Group 1, rough-surfaced implants, n=20) and Oneplant system implants (Group 2, rough-surfaced neck with microthreads, n=20). Clinical and radiographic examinations were conducted at baseline (implant loading) and 1 year postloading. Data analysis was performed by the SAS statistical package version 9.1.3 (SAS Institute, Cary, NC, USA) and the final model was calculated by the MIXED procedure (three-level ANCOVA) for marginal bone change of each test group at baseline and 1 year follow-up. Results: Comparing to baseline, significant differences were noted in marginal bone level changes for the 2 groups at 1 year follow-up (P<0.05). Group 1 had a mean crestal bone level changes of $0.83{\pm}0.31mm$; Group 2 had a mean crestal bone level changes of $0.44{\pm}0.36mm$. Rough-surfaced with microthreads implants showed significantly less marginal bone loss than rough surfaced neck without microthread implants. Conclusion: A rough surface with microthreads at the implant was beneficial design to maintain the marginal bone level against functional loading.

도재소부전장관(陶材燒付前奬冠) 파절수리시(破折修理時) 표면처리(表面處理) 방법(方法)에 따른 수복(修復)레진의 유지력(維持力)에 관(關)한 연구(硏究)

임헌송,허성주,조인호,Lim Heon-Song,Heo Seong-Joo,Cho In-Ho 대한치과보철학회 1992 대한치과보철학회지 Vol.30 No.1

Now composite resin restoration is clinically accepted in the repair of fractured PFM case, many mechanical surface treatment methods are performed to increase retentive force. The main purpose of this study was to compare the retentive force among the possible surface treatments and to insure the best method for the clinical application to the fractures porecelain and the exposed metal surface. To compare and to analyze the retentive force of repair resin, porcelain specimen were divided into 2 groups, etching group and non-etching group, and etching group were treated with 37% $H_3PO_4$, 1.23% APF, 10% HF and non-etching groups were treated with diamond bur, micro-sandblasasting. Also, metal specimens were divided by 2 groups : one was non-precious metal group which was treated with diamond bur, micro-sandblasting and tin plating and electrolytic etching, the other was precious metal group which was composed of micro-sandblasting treatment only and tin plating treatment with micro-sandblasting. Each specimen had been restored for 48 hours and the bond strength of each specimen was calculated with Universal testing machine. The results were as follows : 1. Porcelain specimen had higher bonding strength than metal specimen for the repair resin(P<0.01). 2. In porcelain specimen, 10% HF etching group had the highest bonding strength among etching and non-etching group. 3. Metal specimen treated with micro-sandblasting had highest bonding strength among the non-sandblasting had hightest bonding strength among the non-precious group, tin plating group had higher bonding strength than micro-sandblasting group between the precious metal groups. 4. Bonding strength of tin plating was increased in precious metal group only.

Modified simulated body fluid에 침전한 티타늄 표면에서 침전 기간에 따라 나타나는 파골 세포의 분화억제 양상

장현민,허성주,김성균,곽재영,Chang, Hyun-min,Heo, Seong-Joo,Kim, Seong-Kyun,Koak, Jai-Young 대한치과보철학회 2019 대한치과보철학회지 Vol.57 No.2

Purpose: The purpose of this study is to investigate the changes of osteoclast differentiation inhibition according to the period of precipitation when titanium disks were immersed in Modified simulated body fluid (mSBF). Materials and methods: Titanium alloy (Ti grade III) disks with machined surfaces and anodized surfaces were immersed in distilled water and mSBF, respectively. The immersion periods were 7 days, 14 days, 21 days and 28 days, and the control group was immersed in distilled water for each period. RAW 264.7 cells capable of differentiating into osteoclasts were used to measure the number of adherent cells, the measurement of TRAP activity, and the expression pattern of NFATc1 by western blotting. Results: The degree of inhibition of osteoclast differentiation was found to be statistically significant when the disks were immersed in mSBF for more than 14 days on both machined surfaces and anodized surfaces. There was no correlation between immersion time and cell attachment. When the disks were immersed for more than 14 days, TRAP activity was decreased and NFATc1 expression was inhibited. Futhermore, the decrease in TRAP activity and the inhibition of NFATc1 expression remained unchanged. Conclusion: Immersion of titanium disks in mSBF for more than 14 days can prevent RAW 264.7 cells from differentiating into osteoclasts. Inhibition activity does not change even if the immersion period is for more than 14 days. 목적: 본 연구의 목적은 티타늄 디스크를 Modified simulated body fluid (mSBF)에 침전시켰을 때, 침전 시킨 기간에 따른 파골 세포 분화 억제 변화 양상을 알아보는 것이다. 재료 및 방법: Machined surface와 anodized surface를 가진 티타늄 합금(Ti grade III)디스크를 각각 증류수와 mSBF에 침전 시켰다. 침전 기간은 7일, 14일, 21일, 28일 진행하였으며, 각각의 기간 동안 대조군은 증류수에 침전하였다. 파골 세포로 분화 가능한 RAW 264.7 세포를 점주하여 침전 기간에 따른 부착된 세포 수 측정, TRAP 활성 측정, western blot을 통한 NFATc1의 발현양상을 측정하였다. 결과: Machined surface와 anodized surface 모두에서 mSBF에14일 이상 침전하였을 때, 파골 세포의 분화를 억제하는 능력이 통계적으로 유의하게 나타났다. 침전 기간과 세포의 부착은 상관관계가 없었다. 14일 이상 침전시켰을 때, TRAP 활성은 감소되었으며, NFATc1의 발현은 억제되었다. 14일 이상 침전 시켰을 때, TRAP활성 감소 및 NFATc1 발현 억제 양상은 변함이 없었다. 결론: 티타늄 합금 디스크를 14일 이상 mSBF에 침전시키면 RAW 264.7 세포가 파골 세포로 분화하는 것을 막을 수 있다. 침전기간이 증가해도 분화 억제 양상은 변화하지 않는다.

DLC 표면 처리에 따른 임플랜트 지대주 나사의 풀림 현상에 관한 연구

곽재영,허성주,장익태,임순호,이종엽,이광렬,Koak Jai-Young,Heo Seong-Joo,Chang Ik-Tae,Yim Soon-Ho,Lee Jong-Yeop,Lee Kwang-Ryeol 대한치과보철학회 2003 대한치과보철학회지 Vol.41 No.2

Statement of problem : Implant screw loosening remains a problem in implant prosthodontics. Some abutment screws with treated surfaces were introduced to prevent screw loosening and to increase preload. DLC(Diamond Like Carbon) film has similar properties on hardness, wear resistance, chemical stability, biocompatibility as real diamond materials. Purpose : The purpose of this study was to investigate the effect of lubricant layer on abutment screw and to discriminate more effective method between soft lubricant and hard lubricant to prevent screw loosening. Material and method : In this study, $1{\mu}m$ thickness DLC was used as protective, lubricating layer of titanium screws and 3 times removal torque was measured on the abutment screws to investigate the difference in 10 coated and 10 non-coated abutment screws. Results : The results indicated that the implants with DLC coating group were not more resistant to the applied force in screw loosening. At 32Ncm, the 3 times removal torque in DLC group were $27.75{\pm}2.89,\;25.85{\pm}2.35$ and $26.2{\pm}2.57$. The removal torque in no-coated abutment screws were $27.85{\pm}4.23,\;27.35{\pm}2.81$ and $27.9{\pm}2.31$, respectively. Conclusion : The lubricant layer used in this study was Diamond Like Carbon(DLC) and it have a properties of hard and stable layer. The DLC coating layer was hard enough to prevent distortion of screws in the repeated unscrewing procedure in clinical situation. The reduced friction coefficient in hard DLC layer was not effective to prevent screw loosening.

Effect of cyclic loading on axial displacement of abutment into implant with internal tapered connection: a pilot study

설현우,허성주,곽재영,김성균,한종현,Seol, Hyon-Woo,Heo, Seong-Joo,Koak, Jai-Young,Kim, Seong-Kyun,Han, Chong-Hyun The Korean Academy of Prosthodonitics 2013 대한치과보철학회지 Vol.51 No.4

연구 목적: 내측연결형 임플란트와 지대주의 연결체에 반복하중을 부여하였을 때 수직 침하를 평가하고자 하였다. 연구 재료 및 방법: 외측연결형 임플란트와 내측연결형 임플란트에 세 종류의 시멘트유지형 지대주를 각각 장착하였다. 즉, 외측연결형 지대주(Ext 그룹), 내측연결형 1-piece 지대주(Int-1 그룹), 내측연결형 2-piece 지대주(Int-2 그룹)를 사용하였으며, 각 그룹마다 7개의 시편을 준비하였다. 임플란트-지대주 연결체에 수직하중을 적용하기 위하여 임플란트 받침대에 고정한 후, 4 Hz의 빈도로 $150{\pm}10N$의 반복하중을 가하였다. 수직침하량은 0, 5, 10, 50, 100, 1,000, 5,000, 10,000회의 반복하중 후에 각각 측정하였다. 반복측정분산분석(RM-ANOVA)를 이용하여 반복하중의 영향을 분석하였으며, 패턴변화를 관찰하기 위하여 선형혼합모형(linear mixed model)을 사용하였다. 유의수준은5% 로 설정하였다. 결과: 10,000회 반복하중 후 수직침하량은, Ext 그룹에서 $0.714{\pm}0.488{\mu}m$, Int-1그룹에서 $5.286{\pm}1.604{\mu}m$, Int-2 그룹에서 $11.429{\pm}1.902{\mu}m$를 나타내었다. 패턴분석에서는, Int-1 그룹 및 Int-2 그룹에서 지속적인 수직침하가 관찰되었으며, Ext그룹에서는 수직침하현상이 관찰되지 않았다. 결론:10,000회 반복하중 후의 선형혼합모형을 통한 분석에서, Ext그룹은 수직침하현상을 보이지 않았으나, Int-1 및 Int-2 그룹은 지속적인 수직침하현상을 나타내었다. 또한, Int-2그룹에서 Int-1그룹보다 더 많은 수직침하량이 관찰되었다. Purpose: To evaluate the axial displacement of implant-abutment assembly after cyclic loading in internal tapered connection system. Materials and methods: External butt-joint connection implant and internal tapered connection implant were connected with three types of abutment for cement-retained prostheses, i.e. external type abutment (Ext group), internal tapered 1-piece abutment (Int-1 group), and internal tapered 2-piece abutment (Int-2 group). For each group, 7 implants and abutments were used. The implantabutments assemblies were clamped into the implant holder for vertical loads. A dynamic cyclic loading was applied for $150{\pm}10N$ at a frequency of 4 Hz. The amount of axial displacement of the abutment into the implant was calculated at each cycle of 0, 5, 10, 50, 100, 1,000, 5,000, and 10,000. A repeated measures analysis of variance (ANOVA) for the overall effect of cyclic loading and the pattern analysis by linear mixed model were used for statistical analysis. Differences at P<.05 were considered statistically significant. Results: The mean axial displacement after 10,000 cycles were $0.714{\pm}0.488{\mu}m$ in Ext group, $5.286{\pm}1.604{\mu}m$ in Int-1 group, and $11.429{\pm}1.902{\mu}m$ in Int-2 group. In the pattern analysis, Int-1 and Int-2 group showed continuous axial displacement at 10,000 cycles. There was no declining pattern of axial displacement in the Ext group. Conclusion: The pattern of linear mixed model in Ext group showed no axial displacement. There were continuous axial displacements in abutment-implant assemblies in the Int-1 and Int-2 group at 10,000 cycles. More axial displacement was found in Int-2 group than in Int-1 group.

한국인(韓國人) 안면(顔面) 및 구강내(口腔內) 해부학적(解剖學的) 기준점(基準點) 측정(測定)과 垂直高經(수직고경)과의 관계(關係)에 대한 연구(硏究)

박숙현,허성주,조인호,Park Sook-Hyun,Heo Seong-Joo,Cho In-Ho 대한치과보철학회 1992 대한치과보철학회지 Vol.30 No.1

The purpose of this study was to obtain the guides of establishing vertical dimension by analyzing the facial and oral landmarks of Korean adults. The following conclusions were obtained from this study. 1. The ratio of bizygomatic width to dental arch width was 3.26 : 1 in male and 3.21 : 1 in female, and the ratio of vertical dimension to dental arch length was 2.49 : 1 in male and 2.39 : 1 in female. 2. It was obtained by analysis of multiple regression that the corelative formula, vertical dimension$=23.37+0.24{\times}bizygomatic$ $width+0.29{\times}dental$ arch length. 3. There was no statistically significant difference between the results of vertical dimension acquired by means of Hayakawa's prediction($68.04{\pm}3.16mm$ in male, $64.38{\pm}3.00mm$ in female) and that of vertical dimension by this study.

하악골 변연절제술 환자에서 임플란트를 지대치로 이용한 가철성 국소의치 수복 증례

백창현,허성주,곽재영,김성균,박지만,Baek, Chang-Hyun,Heo, Seong-Joo,Koak, Jai-Young,Kim, Seong-Kyun,Park, Ji-Man 대한치과보철학회 2016 대한치과보철학회지 Vol.54 No.2

Surgical management of oral cancer results in compromised masticatory and swallowing function which affects patient in social and psychological aspects due to reduced phonetic ability and facial deformity, thus, it is imperative to provide applicable prosthetic treatment to overcome such complications. This clinical study describes rehabilitation of a patient with squamous cell carcinoma treated with marginal mandibulectomy and implantation on preserved posterior portion of mandible to provide stability and support for subsequent denture treatment. Kennedy class IV removable partial denture has provided satisfactory results in esthetics and function. Bone level stability around implants was reported to be maintained during eight months of clinical observation. 구강암에 의해 하악골 절제술을 받은 환자들은 저작 및 연하 기능의 저하와 같은 문제가 발생하며 동반된 안모의 변화와 발음의 문제로 인하여 사회적, 심리적인 영향을 받게 된다. 따라서 보철적인 수복을 통해 하악골 변연절제술 환자의 문제를 개선해 나아가는 것이 무엇보다 중요하다. 본 증례는 편평세포암으로 인하여 하악골 변연절제술을 받은 환자에서 골결손이 일어나지 않은 후방부위에 전략적으로 임플란트를 식립하였고 임플란트를 통해 의치의 유지와 지지를 담당할 수 있도록 보철물을 설계하였다. 이를 바탕으로 Kennedy class IV 국소의치를 제작하여 만족스런 심미적, 기능적 결과를 얻었으며, 8개월 간의 임상 관찰 동안 임플란트 주변 골의 안정적인 유지가 관찰되는 바 이를 보고하고자 한다.