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Er,Cr:YSGG 레이저를 조사한 임플란트 표면의 주사전자현미경적 연구
조필귀,민승기,권경환,김영조,Jo, Pil-Kwy,Min, Seung-Ki,Kwon, Kyung-Hwan,Kim, Young-Jo 대한악안면성형재건외과학회 2006 Maxillofacial Plastic Reconstructive Surgery Vol.28 No.5
Today, there is considerable evidence to support a cause-effect relationship between microbial colonization and the pathogenesis of implant failures. The presence of bacteria on implant surfaces may result in an inflammation of the peri-implant mucosa, and, if left untreated, it may lead to a progressive destruction of alveolar bone supporting the implant, which has been named as peri-impantitis. Several maintenance regimens and treatment strategies for failing implants have been suggested. Recently, in addition to these conventional tools, the use of different laser systems has also been proposed for treatment of peri-implant infections. As lasers can perform excellent tissue ablation with high bactericidal and detoxification effects, they are expected to be one of the most promising new technical modalities for treatment of failing implants. It is introduced that Er,Cr:YSGG laser, operating at 2780nm, ablates tissue by a hydrokinetic process that prevents temperature rise. We studied the change of the titanium implant surface under scanning electron microscopy after using Er,Cr:YSGG laser at various energies, irradiation time. In this study, Er,Cr:YSGG laser irradiation of implant fixture showed different effects according to implant surface. Er,Cr:YSGG laser in TPS surface with RBM not alter the implant surface under power setting of 4 Watt(W) and irradiation time of 30sec. But in TPS surface with $Ca_3P$ coating alter above power setting of 2W and irradiation time of 10sec. TPS surface with RBM showed microfracture in 4W, 30sec and TPS surface with $Ca_3P$ coating showed destruction of fine crystalline structure, melting in excess of 2W, 10sec. We concluded that proper power setting, air, water of each implant surface must be investigated and implant surface must be irradiated under the damaged extent.
구치부 지지의 상실과 마모로 인해 교합이 붕괴된 환자에서 수직고경 회복을 동반한 구강회복 증례
조유진,정수아,양홍서,박상원,임현필,윤귀덕,박찬,Jo, Yu Jin,Jung, Sua,Yang, Hong-So,Park, Sang-Won,Lim, Hyun-Pil,Yun, Kwi-Dug,Park, Chan 대한치과보철학회 2018 대한치과보철학회지 Vol.56 No.4
다수의 치아 상실과 치아 마모로 인해 교합이 붕괴된 경우 교합 고경의 변경이 필요할 수 있다. 그리고 이러한 경우 심미적이면서도 근신경계와 조화를 이룰 수 있는 고경을 결정하는 것이 중요하다. 본 증례는 치아상실 및 마모로 인해 교합 수직 고경의 감소가 관찰된 환자에서 진단 모형과 방사선 사진 및 다양한 임상적 검사 등의 교합관계분석을 통해 교합 수직 고경을 회복을 동반한 보철 수복을 진행한 경우로, 기능적인 면과 심미적인 면에서 양호한 결과를 얻었기에 이를 보고하는 바이다. Multiple tooth loss and excessive occlusal wear can result in damage to occlusal disharmony, functional disorders and esthetic problems, requiring comprehensive prosthetic treatments. Changing vertical dimension harmonized with surrounding muscle tissue is important. In this case, the patient with loss of vertical dimension caused by severe tooth loss and tooth wear was treated with the analysis of vertical dimension, such as diagnostic model, radiography and various clinical exams. the patient was satisfied with favorable functions and esthetics for 1 years of follow-up.
구치부 교합 지지 상실과 전치부 과개 교합을 가진 환자의 교합 재설정을 통한 구강 회복 증례
장우형,조유진,임현필,윤귀덕,박상원,Jang, Woo-Hyung,Jo, Yu-Jin,Lim, Hyun-Pil,Yun, Kwi-Dug,Park, Sang-Won 대한치과보철학회 2020 대한치과보철학회지 Vol.58 No.1
The loss of posterior support and the abnormal jaw relation can cause pathologic findings. If deep bite patients with multiple missing teeth, can not have the stable posterior contact, the mandible moves posteriorly, and consequently the overjet and overbite get worse. And when the mandibular irregular occlusal plane is corrected, it is easier to have the bilateral balanced occlusion with the maxilla. So the treatment goal is to give proper posetrior support and establish appropriate anterior guidance, and ultimately provide improved mastication and esthetics recovery. In this case, a 68 year old man, having deep bite without posterior support was evaluated by the vertical dimesion decision flow-chart. An available prosthetic height, anterior occlusal relation such as overjet, overbite and the esthetic part such as facial height and the cephalometric analysis are the factors to be considered. 구치부 교합 지지 상실과 비정상적 전치부 교합 관계는 조화롭지 않은 교합으로 이어지며 다양한 병적 소견을 유발한다. 다수 치아 결손된 과개 교합 환자의 경우 안정된 구치부 접촉을 얻지 못하게 되면 하악이 후방으로 변위되어 수직 및 수평 피개가 심화되기 쉽다. 또한 하악 교합평면이 올바르지 못한 경우에는 이를 개선시켜 주어야만 상악 의치와의 양측성 균형 교합을 얻는데 용이하다. 따라서 치료 목표는 구치부에는 최대 교두간 접촉위를 부여하고, 전치부에는 적절한 수평 및 수직 피개로 전방유도가 이루어지게 함으로써, 안정적인 교합이 이루어지도록 한다. 본 증례는 68세 남환으로 구치부 교합 지지가 상실되고, 전치부 과개 교합을 가진 상태였다. 구치부와 전치부의 보철물 수복 공간, 수직 및 수평 피개와 같은 전치부 교합 관계, 그리고 측방 두부규격 방사선 사진 등, 수직 고경 결정 평가표에서 제시하는 항목들에 대한 분석들을 종합하여 수직 고경 거상의 유무 및 거상량을 결정하고, 치료 진행하였다.
오승환,민승기,권경환,조필귀,송윤강,Oh, Sung-Hwan,Min, Seung-Ki,Kwon, Kyung-Hwan,Jo, Pil-Kwy,Song, Yun-Kang 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.4
Malignant hyperthermia is a catastrophic, hypermetabolic syndrome that arises in susceptible individuals when they are exposed to certain inhalational anesthetics or muscle relaxants. It is characterized by hyperthermia, tachycardia, acidosis, and muscle rigidity. It has been noted that the majority of cases of malignant hyperthermia are fatal unless early diagnosis and treatment are performed. We experienced a 24 year old male Malignant hyperthermia presented for orthognathic surgery under $O_2-N_2O$-sevoflurane anesthesia without succinylcholine. Two half hours after induction, tachycardia developed and was followed by unstable blood pressure and hyperpyrexia. Anesthesia was terminated and vigorous emergency treatment was attempted. The patient was treated by the intravenous administration of dantrolene sodium. The diagnosis of an acute malignant hyperthermia reaction by clinical criteria can be difficult because of the nonspecific nature and variable incidence of many of the clinical signs and laboratory findings. So the malignant hyperthermia clinical grading scale is recommended for use as an aid to the objective definition of this disease. This clinical grading system provides a new and comprehensive clinical case definition for the malignant hyperthermia syndrome. We recently encountered a case of delayed malignant hyperthermia during sevoflurane anesthesia that was successfully treated by the intravenous administration of dantrolene sodium. In conclusion, exposure to sevoflurane should be avoided in patients thought to be susceprible to malignant hyperthermia.
가토의 상악동 골이식술시 미분화 간엽 줄기세포의 골형성 효과
오승환,채영원,김범수,여인범,조필귀,Oh, Sung-Hwan,Choi, Young-Won,Kim, Bum-Soo,Yeo, In-Bum,Jo, Pil-Kwy 대한악안면성형재건외과학회 2006 Maxillofacial Plastic Reconstructive Surgery Vol.28 No.6
Undifferentiated mesencymal stem cells(UMSCs) have been thought to be multipotent cells that can replicate as undifferentiated cells and that have the potential to differentiate into lineages of mesenchymal tissue including the bone, cartilage, fat, tendon, muscle, and marrow stroma. It can be used to sinus lifting, Guided bone regeneration, other bone graft in dental part. The purpose of this study is to evaluate the effect of mesencymal stem cells on sinus augmentation with autogenous bone, fibrin glue mixture in a rabbit model. 8 New Zealand white rabbits were divided randomly into 4 groups based on their time of sacrifice(1, 2, 4 and 8 weeks). First, undifferentiated mesenchymal stem cells were isolated from iliac crest marrow of rabbits and expanded in vitro. cell culture was performed in accordance with the technique described by Tsutsumi et al. In the present study, The animals were sacrificed at 1, 2, 4 and 8 weeks after transplantation, and the bone formation ability of each sides was evaluated clinically, radiologically, histologically and histomorphologically. According to the histological observations, Stem cell group showed integrated graft bone with host bone from sinus wall. At 2 and 4weeks, It showed active newly formed bone and neovascularization. At 8 weeks, lamella bone was observed in sinus graft material area. Radiologically, autobone with stem cell showed more radiopaque than autobone without stemcell. there were significant differences in bone volume between 2 and 4 weeks (p<0.05). In summary, the autobone with stem cells had well-formed, newly formed bone and neovasculization, compared with the autobone without stem cells (esp. 2 weeks and 4 weeks) The findings of this experimental study indicate that the use of a mixture of mesenchymal stem cell yielded good results in osteogenesis and bone volume comparable with that achieved by autogenous bone. Therefore, this application of this promising new sinus floor elevation method for implants with tissue engineering technology deserves further study.