난치성 치주염환자로부터 채취한 치은연하 세균의 구성과 항생제 내성에 관한 연구

장범석,Chang, Beom-seok 대한치주과학회 2000 Journal of Periodontal & Implant Science Vol.30 No.4

It is becoming increasingly apparent that periodontitis consists of mixture of diseases, most of which respond favorably to traditional mechanical therapy. Among these variants of the disease, some appear to be associated with unusual microbial infections and defective host defenses. Many of these fail to respond to conventional treatment. The recognition that some forms of periodontitis are refractory to standard periodontal therapy has given rise to a new classification of peridontitis. A series of 1692 subgingival microbial samples sent to a diagnostic microbiology laboratory included 738 samples that could be identified as compatible with a clinical diagnosis of refractory or recurrent periodontitis. In descending order of prevalence the associated microbiota included Bacteroides forsythus(85%) ,Fusobacterium species(78%), Spirochetes(67%), Campylobacter rectus(64%), Porphyromonas gingivalis(59%), Peptostreptococcus micros(58%), motile rods(46%), Prevotella intermedia(33%), Eikenella corrodens(13%), Capnocytophaga species(12%) ,and Actinobacillus actinomycetemcomitans(6%). Antibiotic resistance to tetracycline, penicillin G, or metronidazole was particularly noticeable for Fusobacterium species, Capnocytophaga species, and Actinobacillus actinomycetemcomitans. It was largely absent for Campylobacter rectus. No antibiotic data were obtained for Porphyromonas gingivalis or Bacteroides forsythus, as these species were detected by immunofluorescence. The results indicate that a substantial number of microorganisms associated with refractory periodontitis are variably resistant to commonly-used antibiotics. Diagnostic microbiology must be considered an essential adjunct to the therapist faced with periodontal lesions refractory to conventional treatment.

20대 성인의 부착치은 폭경에 관한 연구

장범석,엄흥식,박덕영,Chang, Beom-Seok,Um, Heung-Sik,Park, Deok-Young 대한치주과학회 1998 Journal of Periodontal & Implant Science Vol.28 No.3

The purpose of this study was to investigate the width of attached gingiva of young adults with healthy gingiva. We compared the differences according to the tooth location. The width of attached gingiva of maxilla and mandible was measured by histochemical method. The results were as follows: 1. The width of buccal keratinized gingiva in maxilla was widest in incisors(5.2-5.6mm) and narrowest in first bicuspids(4.4-4.5mm). 2. The width of buccal keratinized gingiva in mandible was widest in incisors(4.3-4.5mm) and narrowest in first bicuspids(3.2-3.3mm). 3. The width of lingual keratinized gingiva in mandible was widest in first molars(5.5-5.6mm) and narrowest in incisors(2.9-3.0mm). 4. The width of buccal attached gingiva in maxilla was widest in incisors(4.1-4.4mm) and narrowest in molars (3.0mm). 5. The width of buccal attached gingiva in mandible was widest in incisors(3.2-3.4mm) and narrowest in second molars (1.7-1.8mm). 6. The width of lingual attached gingiva in mandible was widest in first molars(3.5-3.7mm) and narrowest in incisors(1.9-2.1mm).

Collagen액 국소도포가 치주조직의 재부착에 미치는 영향에 관한 조직병리학적 고찰

장범석,정종평,손성희,Chang, Beom-Seok,Chung, Chong-Pyong,Son, Seong-Heui 대한치주과학회 1988 Journal of Periodontal & Implant Science Vol.18 No.2

상악동을 천공한 임플란트의 생존율에 대한 후향적 연구

이재관,엄흥식,장범석,Lee, Jae-Kwan,Um, Heung-Sik,Chang, Beom-Seok 대한치주과학회 2006 Journal of Periodontal & Implant Science Vol.36 No.4

Perforation of maxillary sinus is a common complication of implant placement in posterior maxilla. The purpose of this study was to evaluate the prognosis of sinus perforated implants placed in partially edentulous maxillae. Eighteen sinus perforated implants in 15 patients were examined for cumulative survival rate, radiographic preoperative bone level, and radiographic marginal bone level change. Twenty-two non-perforated implants in the same patients served as control. The results were as follows; 1. There was no statistically significant difference in cumulative survival rate between sinus perforated implants and non-perforated implants (P>0.05). 2. There was no statistically significant difference in the marginal bone level between sinus perforated implants and non-perforated implants (P>0.05). 3. There was no statistically significant difference in cumulative survival rate according to the preoperative bone level (P>0.05). These results suggests that perforation of maxillary sinus may not affect implant success in posterior maxillae.

치주큐렛 파절에 대한 연구

권오장,이재관,장범석,엄흥식,Kwon, Oh-Jang,Lee, Jae-Kwan,Chang, Beom-Seok,Um, Heung-Sik 대한치주과학회 2008 Journal of Periodontal & Implant Science Vol.38 No.1

Purpose: The purpose of this study was to investigate the incidence of curet fracture and its contributing factors. Material and Methods: Fifty-eight periodontal curets which were broken during periodontal treatment in Kangnung National University Dental Hospital for 1 year were used as study materials. The blade thickness of new curets and broken ones was measured using a digital micrometer. Types of treatment procedures, clinical experience of operators, point of breakage, and method of removal of broken fragments were recorded for each broken curet. Results: The incidence of curet fracture in root planing (16.4 curets per 1,000 procedures) was higher than those in flap surgery (7.5) or supragingival scaling (2.7). No curet was broken during supportive periodontal treatment. The incidence of fracture did not seem to be related with clinical experience of operators. The most frequent breakage point of the curets were upper 1/3 of blades. Fifty-six of 58 broken fragments were removed by non-surgical methods. Two broken tips which could not removed non-surgically were left in the pockets, and proved to be removed spontaneously 1 week later. Conclusion: Root planing showed higher incidence of curet fracture than any other type of periodontal treatment. Most of the fractured fragments were removed by non-surgical method. Further study is needed to develop methods of removal of the fragments which can not be removed non-surgically.

덮개 나사 조기 노출이 임플란트의 생존율에 미치는 영향

김용건,이재관,장범석,엄흥식,Kim, Yong-Gun,Lee, Jae-Kwan,Chang, Beom-Seok,Um, Heung-Sik 대한치주과학회 2006 Journal of Periodontal & Implant Science Vol.36 No.4

The early exposure of cover screws is a common complication of 2-stage implant technique. The exposure of cover screws between stage I and IT surgery may cause inflammation in the soft tissues surrounding the implants, and lead to peri-implantitis or marginal bone loss. The purpose of this study was to evaluate the effect of the early exposure of cover screws on implants placed using 2-stage technique. Two hundred and nineteen implants in 77 patients were examined for cumulative survival rate, radiographic marginal bone level change, cause and frequency of the early exposure. The results were as follows: 1. Twenty-five implants showed early exposure of cover screws with a frequency of 11.4%. 2. Cumulative survival rate of the implants with early cover screw exposure was 88.0%, and that of the implants without cover screw exposure was 96,9%. 3. At the time of stage IT surgery and 1 year after loading, the marginal bone loss was greater around the implants with early exposure of cover screws than around the implants without cover screw exposure(p <0.05), 4, There was no statistically significant difference in the frequency of the early exposure according to the implant diameter, gender, and smoking(p >0,05).

저용량 독시싸이클린 투여가 만성 치주염에 미치는 임상적 미생물학적 효과

김상준,엄흥식,장범석,이재관,Kim, Sang-Jun,Um, Heung-Sik,Chang, Beom-Seok,Lee, Jae-Kwan 대한치주과학회 2009 Journal of Periodontal & Implant Science Vol.39 No.1

Purpose: Tetracycline and its chemically modified non-antibacterial analogues can inhibit certain host-derived tissue destructive collagenases such as matrix metalloproteinases. The purpose of this study was to evaluate clinical and microbiologic effects of the subantimicrobial dose of doxycycline(SDD) in conjunction with scaling and root planing. Materials and methods: A total of 30 patients with chronic periodontitis who were going to receive scaling and root planing were randomly allocated to receive either a doxycycline hyclate for 3 months or nothing. Clinical probing depth, clinical attachment level, gingival recession, and bleeding on probing were measured by one periodontist. After a periodontal examination, microbial samples were collected using sterile paper points. The effect of SDD in conjunction with scaling and root planing on alterations of the periodontal pathogens (Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Porphyromonas gingivalis) were also assessed using l6S rRNA polymerase chain reaction. Results: During the treatment period, clinical parameters for both treatment group and control group were improved. After 3 months, reductions in probing depth and gains in clinical attachment level were significantly greater for the SDD group than control group. Microbial analysis showed that there was no alteration of the periodontal pathogens and no difference between the groups. Conclusion: This study suggested that the subantimicrobial dose of doxycycline as an adjunct therapy with scaling and root planing might be effective and safe in the management of chronic periodontitis.

상악대구치의 치경부 접근도가 치태조절에 미치는 영향

노태경,엄흥식,장범석,Roh, Tae-Kyung,Um, Heung-Sik,Chang, Beom-Seok 대한치주과학회 2000 Journal of Periodontal & Implant Science Vol.30 No.4

The purpose of this study was to evaluate the influence of accessibility to dental cervices of maxillary molars upon plaque control level of these areas. Fifthy-seven dental students with healthy gingiae participated in this study. Maxillary dental casts were fabricated for each participants. Using the casts, cervical accessibility was measured at the mid-palatal point of maxillary first and second molars. Cervical accessibility was defined as the perpendicular distance from the entrance of gingival sulcus to the imaginary line between the most protruded points of palatal gingiva and tooth surface, and classified into degree I(${\leq}0.5mm$), II($>0.5mm,\;{\leq}1.0mm$), III($>1.0mm,\;{\leq}1.5mm$), and IV(>1.5mm). Plaque score was recorded as the distance from crest of gingival margin to the most coronal extent of plaque. Measurements of plaque score were repeated 3 times at 1-week intervals. After the baseline measurements, the participants began to use unitufted brushes on randomly assigned right or left side. Two weeks later, a session of plaque score records identical to the baseline measurements was started. The maxillary second molars showed higher cervical accessibility than the first molars(p<0.01), but the plaque scores of maxillary second molars were also higher than those of first molars(p<0.01). For the maxillary first molars, correlation between accessibility and plaque score was statistically significant, but such correlation was not found for the second molars. Use of unitufted brushes decreased the plaque score(p<0.01). Correlation between accessibility and the degree of plaque score improvement was not found. These findings suggest that cervical accessibility may influence the amount of plaque, and use of adjunctive oral hygiene devices may be helpful in maintaining optimal oral hygiene level at the areas of low cervical accessib ility.

유지치주치료의 환자 순응도해 대한 후향적 연구

박웅규,이재관,장범석,엄흥식,Park, Woong-Kyu,Lee, Jae-Kwan,Chang, Beom-Seok,Um, Heung-Sik 대한치주과학회 2009 Journal of Periodontal & Implant Science Vol.39 No.1

Purpose: The purpose of this study was to investigate the degree of compliance with supportive periodontal therapy(SPT), to determine if any significant differences existed in the characteristics of compliant, erratically compliant and non-compliant patients and to identify reasons for poor compliance. Materials and methods: Four hundred five patients who initially visited between July 2003 and December 2004 and were treated until June 2005 were retrospectively evaluated for their compliance with SPT in terms of attendance for a recommended schedule of visits. Patients' compliance was classified as complete compliance(attended more than 80% of the recommended appointments), erratic compliance(attended less than 80% of the recommended appointments or discontinued) and non-compliance(did not return for SPT). Analysis was made for each group to correlate the degree of compliance with gender, age, smoking, distance between their houses and the hospital, disease severity, type of therapy, implant, plaque control instruction and systemic diseases. Tele research of erratically compliant and non-compliant patients was carried out to identify reasons for their poor compliance. Results: Only 24.7% of the patients were in complete compliance. The highest drop-out rate(32.4%) occurred in the first year. A significantly greater percentage of non-smokers and patients who finished plaque control instruction were in complete compliance. A significantly greater percentage of patients without implant and patients who had been treated by only scaling and root planing were in non-compliance. More males were found to be compliant with SPT, although this was marginally significant. There were no significant differences between compliant, erratically compliant and non-compliant patients with regard to age, distance, disease severity and systemic disease. The survey revealed that the main reasons for poor compliance with SPT were inconvenient location and insufficient time. Conclusion: Patients' compliance with SPT was poor and the highest drop-out rate(32.4%) occurred in the first year. Significant relationships were found between the degree of compliance and smoking, type of therapy, implant, plaque control instruction and gender.

최후방 단일치 임플란트의 생존율에 대한 후향적 연구

정성우,이재관,엄흥식,장범석,Jung, Sung-Woo,Lee, Jae-Kwan,Um, Heung-Sik,Chang, Beom-Seok 대한치주과학회 2008 Journal of Periodontal & Implant Science Vol.38 No.4

Purpose: The purpose of this study was to assess the long term survival rates of the most posterior single tooth implant and to evaluate the influence of implant characteristics on implant survival. Material and Methods: This retrospective report presents findings on 37 patients with 43 implants replacing single molars. The inclusion criteria were having implants replacing a molar of the most posterior region and follow-up data over at least 6 months. Data were recorded regarding the incidence of complications and survival rates of these implants. Results: The range of follow-up was from 9 to 66 months(mean: 40.2 months). The cumulative survival rate of total implants was 93.0% which reflects the loss of three implants: one had broken neck, one implant failed because of infection, one implant showed failed osseointegration. Abutment- screws loosening occurred in five implants(11.6%). Conclusion: Within the limits of this study, a single tooth-implant can serve as a good long-term and predictable treatment modality to replace the most posterior teeth with low complication and failure rates.