양대혈관 우심실 기시 환아의 Sevoflurane을 이용한 깊은 진정 하 치과치료

현홍근,신터전,김영재,김정욱,장기택,이상훈,김종철,김현정,서광석,이정만,신순영,Hyun, Hong-Keun,Shin, Teo Jeon,Kim, Young-Jae,Kim, Jung-Wook,Jang, Ki-Taeg,Lee, Sang-Hoon,Kim, Chong-Chul,Kim, Hyun-Jeong,Seo, Kwang-Suk,Lee, Jung-Man,Shin, 대한치과마취과학회 2012 Journal of Dental Anesthesia and Pain Medicine Vol.12 No.2

Double outlet of right ventricle (DORV) refers to a congenital heart disease in which pulmonary and systemic circulation originates from the right ventricle. In the patient with DORV, it is important to maintain the balance between pulmonary and systemic circulation in anesthetic management. A 4-year-old boy with DORV, who underwent a Blalock-Taussig shunt operation, was transferred to the clinic with a chief complaint of multiple caries. Due to poor cooperability, it was impossible to treat the caries without sedation or general anesthesia. We planned to sedate him with consideration with detrimental effects associated with positive pressure ventilation for dental treatment. After a prophylactic administration of antibiotics, sevoflurane was administered through T-cannula site. Throughout the treatment, His blood remained stable around 80/40 mmHg, oxygen saturation remained around 91%. After 3 hour of sedation with sevoflurane (end-tidal sevoflurane con 1-1.8 vol%), he fully regained consciousness, and discharged from hospital without complications. In case of DORV patient, deep sedation with sevoflurane may be used as effective method of behavioral management during dental treatment.

법랑질 표면처리방법에 따른 치면열구전색재의 미세누출에 관한 비교연구

현홍근,김정욱,이상훈 대한소아치과학회 2001 大韓小兒齒科學會誌 Vol.28 No.3

최근 air-abrasion기술이 새로운 법랑질 표면처리법으로 소개되고 있는데, 이것이 산부식 처리한 것보다 치면열구전색 전처리에 있어 더 나은 결과를 보이는지 연구할 목적으로.저자들은 표면처리법 및 재료에 따른 미세누출도의 차이를 비교해 보고자 하였다. 9개의 군으로 나눈 시편치아에 산부식(1, 4, 7군). air-abrasion(2. 5, 8군). ail·-abrasion후 산부식(3. 6. 9군) 처리한 후, 3종의 치면열구전색재(1∼3군 : Teethmate-F.4∼6군 Ultraseal XT plus, 7∼9군 : DenSeal)로 전색, 중합하여 색소침투도를 관찰하였으며, 각 시편의 전색재를 분리, 주사전자현미경으로 관찰하여 다음과 같은 결과를 얻었다. 1 표면처리법에 따른 미세누출도는 air-abrasion군, 산부식군 air-abrasion 후 산부식군 순으로 작아졌다(p<0.05) . 단. 7군과 9군간의 유의차는 없었다. 2.미세누출도는 산부식군에서 7군, 4군, 1군, air-abl·asion군에서 8군, 5군, 2군, air-abrasion후 산부식군에서 9군, 3군. 6군 순으로 작아졌으나. 각각 4군과 7군 2군과 5군 3군과 6군간의 유의차는 없었다. 3. SEM상에서, 산부식군은 비교적 긴 레진돌기가 규칙적으로, air-abrasion군은 �裏�레진돌기가 불규칙적으로, air-abrasion후 산부식군에서는 이들이 혼재되어 있는 모습으로 관찰되었다. Recently, the reintroduction of air-abrasion technology in dentistry has added a new potential method of pre-treating teeth prior to placing sealants. The purpose of this in vitro study was to investigate microleakages of several pit and fissure sealants following various surface pre-treatment methods to the enamel , because there was a question concerning the validity of claim that this method was better than the conventional acid etching. Permanent molars were divided randomly into nine groups and treated accordingly: acid etching(group 1, 4, 7), airabrasion(group 2, 5. 8), acid etching after airabrasion(group 3, 6, 9). Then the authors placed and cured the three kinds of sealants(group 1∼3 : Teethmate-F, group 4∼6: Ultraseal XT plus, group 7~9: Denseal) according to the manufacturer's order. They were observed to determine the degree of microleakage . And these specimens were separated from the corresponding enamels and examined by Scanning Electron Microscope. The following results were obtained : 1. In comparing microleakage among tooth surface treatment methods. air-abrasion group (group 2, 5, 8) showed the greatest microleakage. while combination(air-abrasion + acid etching) group showed the least (p<0.05) . However, no significant differences were found between group 7 and 9. 2. The mean microleakages were ranked as follows(p<0.05) : In acid etching groups. group 7> group 4> group 1. In air-abrasive groups. group 8 > group 5 > group 2. In combination groups, group 9 > group 3 > group 6. However. no significant differences were found between group 4 and 7. between group 2 and 5, and be-tween group 3 and 6. 3. SEM showed that comparably longer resin tags were distributed regularly in acid etching groups and that shorter ones irregularly in airabrasion groups. It also showed that these two kinds of tags were distributed simultaneously in combination groups.

유치레진치의 전치부 색조연구

현홍근 大韓小兒齒科學會 2007 大韓小兒齒科學會誌 Vol.34 No.4

유전치의 조기상실시 가철성 또는 고정성 공간유지장치의 제작이 필요하며, 보다 심미적인 결과를 얻기 위해서는 자연치아의 색조에 부합하는 레진치의 사용이 요구된다. 현재 가장 많이 사용되는 유치레진치는 Resin Natural Teeth™ (Nissin dental, Japan)로, A형 1번 색조와 A형 2번 색조로 구성되어 있다. 본 연구는 유치레진치의 전치부 색조특성을 이해하고 자연치아와의 색조비교를 위한 기본 자료를 만들기 위한 목적으로, Al 색조군과 A2 색조군의 유치레진치의 상악 4전치부의 순면을 각각 17 set에 대해 치아분광측색장치(spectrophotometer)인 ShadeEye NCC™(Shofu, Japan)로 각 3회씩 측정하여 CIE 표색계의 L^(*), a^(*), b^(*)값을 구하고 Kruskall-Wallis Test, Mann-Whitney U Test를 이용해 95%의 신뢰도(P<0.05)로 분석하여 다음과 같은 결과를 얻었다. 1. ΔE값 및 L^(*)값, b^(*)값의 분포로 볼 때, Al 색조군이 A2 색조군보다 치아위치별 색조차이가 작았다. 각 색조군내에서 a^(*)값의 치아위치별 색조차이는 거의 없었다(P>0.05). 2. Al 및 A2 색조군내에서의 ΔE값이 매우 작아(최대 ΔE≤1.23) 육안으로 그 차이를 구분하기 어려운 것으로 보이며, Al과 A2 색조군의 대표값 간의 ΔE값은 3.97로 육안으로 군 간의 차이를 구분할 수 있었다. 3. A1 색조군의 측정평균값은 L^(*)=73.8, a^(*)=-1.8. b^(*)=-4.7이었으며, A2 색조군의 측정평균값은 L^(*)=75.8,a^(*)= -2.7, b^(*)=-1.4이었다. 향후 자연 유전치에 대한 색조특성을 연구하여 본 결과와의 차이점을 비교해 색조적합성이 좋은 레진치의 개발이 필요할 것으로 사료된다. Removable or fixed space maintainer could be needed if one or some anterior primary teeth were missing, where resin pontics well-matched to natural primary teeth should be demanded to get an esthetic satisfaction. Resin Natural Teeth™(Nissin dental. Japan) is available currently in Korea, which consists of two shades ofcolors: type Al and A2. The purpose of this study is to elucidate the colors of the anterior primary resin teeth and to establish the data to compare those with the natural anterior primary teeth. CIE L^(*)a^(*)b^(*)s were measured each three times labially from 17 sets of maxillary four anterior teeth for type Al and A2 Resin Natural Teeth™ using ShadeEye NCC™(Shofu, Japan) which is one of spectrophotometers. The data were analysed statistically using Kruskall-Wallis Test and Mann-Whitney U Test. The results were as follows : 1. There were smaller teeth color differences in group Al than in group A2 when it comes to distributions of ΔE, L^(*)and b^(*). There were no statistically significant differences of a^(*) between teeth in the same group(P>0.05). 2. ΔE in group Al and A2 (maximum ΔE≤1.23) were very small, which could not be discerned by eyesight. ΔE between mean CIE L^(*)a^(*)b^(*)s of group Al and A2 was 3.97, which could be discernible by eyesight. 3. Mean measurements of group Al were L^(*)=73.8, a^(*)=-1.8, b^(*)=-4.7, and those of group A2 were L^(*)=75.8, a^(*)=-2.7, b^(*)=-1.4. It would be recommended that resin teeth compatible to the colors of the natural primary ones needed to be developed by investigating in vivo study.

Kostmann 증후군과 골수이형성 증후군 환아의 증례보고

현홍근(Hong-Keun Hyun) Asia association of Disability and Oral health 2008 International Journal of Disability and Oral Healt Vol.4 No.1

Congenital neutropenia or Kostmann syndrome is an inherited disorder manifesting in infancy and characterized by severe bacterial infections. The myelodysplastic syndromes(MDS) are a group of stem cell disorders characterized by a reduction in one or more elements of the peripheral blood. This paper reports a case of Kostmann syndrome and MDS with oral complications such as generalized gingivitis and periodontitis, oral mucosal ulcer, petechiae. The features of these syndromes are reviewed and their oral manifestations and significance to dental management outlined.

유전치 심미수복치료를 위한 임상적 고려

현홍근(Hong-Keun HYUN) 대한치과의사협회 2011 대한치과의사협회지 Vol.49 No.1

The esthetic demands are growing in treatment of primary maxillary incisors as well as permanent ones. There is something dissatisfying about in the keen eyes of the pediatric dentists on their esthetic results of efforts because current tooth color system is created for the purpose of the application to the permanent incisors. In this study using the scientific color measurement device, I would like to introduce a color scheme for the primary maxillary incisors and suggest clinical tips for the better results of resin composite restorations.

뇌병변장애 환자의 개구 및 연하 촉진을 위한 K-point 자극법

현홍근(Hong-Keun Hyun) 대한치과의사협회 2018 대한치과의사협회지 Vol.56 No.8

Patients with a wide range of cerebrovascular disease may have difficulty in opening their mouths, resulting in failing to swallow foods and maintain their oral hygiene. K-point was introduced as an effective trigger point to stimulate the jaw opening reflex for those patients. K-point stimulation may be useful as one of methods of helping open the jaw for dental examinations, or for placing foods onto the dorsum of the tongue and swallowing them effectively. Although this method cannot always guarantee the success of the jaw opening for every patient, it may still be considered to be an effective one to apply to patients having difficulty in jaw opening and swallowing disorder.

섭식연하장애와 치과적 관리

현홍근(Hong-Keun Hyun) 대한치과의사협회 2015 대한치과의사협회지 Vol.53 No.11

섭식·연하장애는 수술이나 치료로 인한 기질적 원인, 뇌혈관장애나 뇌성마비, 근육이나 신경장애 등으로 인한 기능적 원인, 그리고 거식증이나 폭식증과 같은 심리적 원인에 의해 발생할 수 있다. 치과의원급에서는 주로 음식물의 인식장애 단계부터 인두로의 전달장애 단계까지의 환자에게 적극적으로 도움을 줄 수 있으며, 그 방법으로는 치의학적 전문지식을 바탕으로 환자의 섭식, 저작과정을 주의 깊게 관찰하여 문제점을 파악하여 각 단계에 적절한 기초 훈련과 섭식 훈련을 실시하는 것이며, 또한 필요시 혀 접촉 보조장치와 같은 장치를 제작하여 환자에게 장착시키고 섭식, 연하 훈련을 시행하여 환자의 연하능력을 개선시켜줄 수 있다. 하지만 무엇보다 가장 중요한 것은 환자가 식전과 식후에 엄격한 구강관리를 시행할 수 있도록 잘 지도하고, 치과의 정기적 방문과 전문적 관리를 통해 구강내 저작기관의 해부학적, 기능적 문제점을 해결해 주도록 하며, 이 때 마다 심리적으로도 환자가 섭식, 연하에 문제가 없도록 세심하게 설명하고 상담해 주는 것으로, 이는 모두 치과의사의 책무라고 할 수 있다. Swallowing disorders or dysphagia, which are difficulties with the act of swallowing, can occur at different phases such as oral, pharyngeal, and esophageal phase in the swallowing process. These disorders can be caused by structural, functional abnormalities or psychological problems. Dentists can actively provide patients suffering from dysphagia with comprehensive professional care, especially from the cognitive stage of food to the pharyngeal stage of the swallow. Many cases of dysphagia can be improved with careful managements based on dental professionals" knowledge, including meticulous evaluation of masticatory and swallowing functions, training on eating and swallowing, and fabrication of palatal or lingual augmentation prosthesis. The important thing is that prevention of these disorders through the oral health care instruction and planned follow-up dental visit at periodic intervals in order to manage the problems caused by anatomical, functional, and psychological reason.

상아질 접착에서 collagenase와 esterase가 미세인장결합강도에 미치는 영향

정영정,현홍근,김영재,김정욱,이상훈,김종철,한세현,장기택 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.2

상아질-레진 접착강도에 대한 collagenase와 esterase의 영향을 살펴보기 위해, 소구치의 교합면 상아질에 Single Bond 2와 Clearfil SE Bond로 접착을 시행하고 미세 시편을 제작하여 PBS, collagenase 용액, esterase 용액에 4주간 보관한 후 미세인장결합강도를 측정, 비교하여 다음과 같은 결론을 얻었다. 1. 모든 보관 용액에서 Single Bond 2의 미세인장결합강도는 Clearfil SE Bond보다 유의하게 낮았다(p<0.05). 2. Single Bond 2의 미세인장결합강도는 collagenase군이 PBS군, esterase군보다 낮았다(p>0.05). 3. Clearfil SE Bond의 미세인장결합강도는 esterase군이 PBS군에 비해 낮았으나(p>0.05), collagenase군보다는 높았다(p>0.05). Collagenase군은 PBS군에 비해 유의하게 낮은 미세인장결합강도를 보였다(p<0.05). The purpose of this study was to evaluate the effect of collagenase and esterase on the microtensile bond strength (μTBS) in dentin bonding. After resin composites were bonded to occlusal dentin, μTBS specimens were formed and stored in PBS, collagenase, or esterase solution. After 4-week storage, μTBS was determined and, the results were as follows: 1. μTBS values of Single Bond 2 were lower than those of Clearfil SE Bond for all storage medium (p<0.05). 2. In single Bond 2 group, collagenase solution lowered bond strength more than PBS and esterase solution (p>0.05). 3. In Clearfil SE Bond group, esterase solution lowered bond strength more than PBS(p>0.05). Collagenase solution lowered bond strength more than esterase solution(p>0.05) and PBS(p<0.05).

한국 어린이에서 하악 유절치와 그 계승 영구치의 선천적 결손 간의 관계

김현진,현홍근,김정욱,이상훈,김종철,한세현,장기택 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.1

많은 연구에서, 유치와 그 계승 영구치의 선천적 결손 간에는 상당한 연관관계가 있는 것을 보고하였다. 그러나 하악 전치부에서, 유치의 선천적 결손에도 불구하고, 그 계승 영구치는 정상적으로 존재하는 증례가 임상적으로 종종 관찰되기도 한다. 본 연구의 목적은 한국 어린이에서 하악 유절치와 그 계승 영구치의 선천적 결손 간의 상호 연관관계를 평가하는 데에 있다. 2005년 1월 1일부터 2008년 9월 5일까지 서울대학교치과병원에 내원하여 파노라마 방사선사진을 촬영한 6세 이하의 남녀 어린이 총 14,307명을 대상으로 하악 전치부의 치아양상을 관찰하여 유치와 영구치의 선천적 결손 관계를 평가하여 다음과 같은 결과를 얻었다. 1. 하악 유절치의 결손률은 0.24%였으며, 하악 유절치가 존재 시 후속 영구치가 존재할 승산(odds)은 7163.5였으며, 유절치의 결손 시 후속 영구절치가 존재할 승산(odds) 0.79였다. 2. 하악 유절치 결손의 증례 중 후속 영구치가 모두 존재하는 경우는 44.12%였다. 유절치의 양측 결손 시 후속 영구치가 하나라도 존재할 승산(odds)은 유절치 편측 결손 시에 비하여 1.57 배였다. 3. 유절치 결손이 있을 때 유절치의 편측 결손일 승산(odds)은 여자가 남자에 비해 2.2 배였다. 또한, 유절치 결손이 있을 때 후속 영구절치가 존재할 승산(odds)은 남자가 여자의 경우에 비하여 2.22 배였다. Many studies have shown that there is a strong relationship between the congenitally missing primary teeth and their succedaneous permanent teeth. However, especially in case of lower anterior region, we can observe the existence of permanent teeth even though their precedent primary teeth were missed at times. The purpose of this study was to reveal the relationship between the congenitally missing primary lower anterior teeth and their succedaneous permanent teeth in Korean children. Total of 14,307 children, under 6 years of age, who attended the department of pediatric dentistry, Seoul National University Dental Hospital, Seoul, Korea from January 1st 2005 to September 5th 2008 were radiologically examined using the panoramic x-ray in order to analyze the relationship between the congenitally missing primary lower anterior teeth and their succedaneous permanent teeth. The results were as follows : 1. The prevalence of congenitally missing lower anterior teeth in primary dentition was 0.24%. The odds ratio of both the primary and permanent anterior teeth being present was 7163.5 and only the permanent anterior teeth being present was 0.79. 2. The percentage of all succedaneous permanent teeth being present was 44.12% in cases of missing lower primary anteriors. The odds ratio of at least one succedaneous permanent teeth being present in cases of bilateral primary anterior teeth missing was 1.57 times more common than in cases of unilateral primary teeth missing. 3. The odds ratio of primary missing teeth being unilateral was 2.2 times higher in females. Moreover, the odds ratio of succedaneous permanent teeth being present in cases of primary teeth missing was 2.22 times higher in males.

전위된 상악 견치 및 하악 측절치의 치험례

권해숙,현홍근,김영재,김정욱,장기택,김종철,한세현,이상훈 大韓小兒齒科學會 2009 大韓小兒齒科學會誌 Vol.36 No.4

Tooth transposition is an anomaly of eruption characterized by the interchanged positions of two adjacent teeth, which is divided into complete and incomplete transposition. There are three common approaches for treating transposition: aligning the involved teeth in their transposed positions, moving them to their correct anatomic position in the arch and extracting one of the transposed teeth. Considerations in treatment plans are esthetic, function, risk of jeopardizing the roots and damaging the supporting structures, position of the root apex, developmental stages of teeth and expected compliance. The presented case reports described one maxillary canine-the first premolar transposition and two mandibular lateral incisor-canine transpositions. The former transposed teeth were arranged in their transposed position, and the latter transposed teeth were rearranged into their normal position. 치아전위란 인접한 두 치아의 위치가 서로 바뀐 치아 위치 이상을 말하며, 치관과 치근의 위치에 따라 완전전위와 불완전전위로 나눌 수 있다. 하악보다는 상악에 편측성으로 호발하며, 특히 상악 견치에서 자주 발생한다. 전위는 발견 시기와 전위된 양상에 따라 치료방법이 달라질 수 있다. 본 증례는 상악 견치와 제1소구치 간의 전위가 일어난 10세 7개월의 환아와 하악 측절치와 견치 간의 전위가 일어난 8세 11개월 환아와 8세 9개월 환아의 교정치료에 대한 것으로 양호한 치료 결과를 얻었고, 증례 별로 치료방법의 차이점에 관한 고찰을 하였기에 이를 보고하는 바이다.