매복 과잉치 발거시의 전후방적 위치선정

최형준,손흥규,최병재,황동환 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.3

Surgical removal of impacted mesiodens can be performed easily when exact position of mesiodens is identified. This case report is argued about methodological approach of exact antero-posterior postioning of mesiodens using conventional cross-sectional occlusal film and periapical film. The author concludes, 1. Among various methods of positioning mesiodens, exact position of mesiodens can be determined with occlusal film and periapical film. 2. On operation, exact antero-posterior position of mesiodens can be determined with comparing occlusal images of adjacent teeth and anatomic structure to real ones. 3. It is important that exact removal course of mesiodens has to be determined in addition to exact determination of one's position, and that it has to be determined in regard to position, morphological basis, direction of impacted pattern of mesiodens and adjacent anatomic structure. 4. In 2 cases presented, both are mesiodens of inverted conical type, and impacted direction are class Ⅰ and Ⅲ respectively according to classification author suggested, and surgery can be performed with ease by different approach directions.

구순 구개열 환아의 수유 보조 장치에 대한 증례보고

최형준,손흥규,최병재,박동석 大韓小兒齒科學會 1995 大韓小兒齒科學會誌 Vol.22 No.2

Cleft lip, cleft palate, cleft lip and palate are the most common congenital anomalies in cranio-orofacial region. These anomalies lead to esthetic problem as well as to difficulties in feeding and speech and also to chronic infection of upper airway and to disturbance of jaw growth during growing up. Especially, some difficulties during feeding make parents to be confused and puts infants in dangerous position. But these difficulties can be controlled by proper feeding methods according to pattern of cleft lip and palate. Among these feeding methods, feeding appliance is the most safe and relatively easy to manufacture. Early wearing of this appliance makes cleft lip and palate infants to a normal feeding and weight gain. As a member of team approach for the treatment of cleft lip and palate, a pediatric dentist should solve the feeding problems which cleft lip and palate infants and its parents are confronted and help in receiving further treatment.

미성숙 영구치의 치근파절에 관한 증례보고

최병재,손흥규,김수연,최형준 大韓小兒齒科學會 1997 大韓小兒齒科學會誌 Vol.24 No.3

During the eruption of permanent teeth, Traumatic root fractures in young permanent incisors are rare. They occur most commonly in the maxillary central incisors of male patient and are frequently seen in the coronal third of the root. Permanent incisors are very important in terms of esthetics as well as of function, and so conservative treatment is advisable. It is important to maintain vitality of pulp to achieve better result. Location of the fracture line determines the Prognosis. No clinical change were seen in this three case. A case of central incisor with apparent healing of a root fracture without any tratment is presented in this paper. Long term clinical observation is required periodically.

치아의 견인을 위한 버튼 접착시 오염이 인장강도에 미치는 영향

최병재,김성오,이제호,손흥규 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.2

We already know that it is very difficult to obtain an 'isolated field' for direct bonding during the surgical exposure of unerupted teeth. The aim of this in-vitro study is to simulate the clinical situation of forced eruption and to evaluate the tensile strengths of preligatured button with several types of contamination which can happen during the surgical exposure of unerupted teeth. Four orthodontic direct bonding systems were used. (Ortho-One, Rely-a-Bond, Ortho-Two, PhaseⅡ) Each material was divided into four groups(n=20) : Group 1. (Control, no contamination), Group 2. (Rinse etching agent with saline instead of water), Group 3. (Blood contamination of etched surface for 30 seconds), Group 4. (Blood contamination of primed surface for 30 seconds) 320 bovine anterior permanent teeth were divided into the above mentioned 16 groups. Enamel surface was flattened and ground under water coolant. Pre-ligatured buttons were prepared to the same form. (Cut 0.25 ligature wire 10 cm in length. Twist the ligature wire 30 times clockwise. Mark the wire 15mm and 35mm points from button. Make a loop sticking two points together and twist the loop 6 times counterclockwise.) The bonded specimens were stored at 37℃ saline solution for 3 days. then the tensile strength of each sample was measured with Instron universal testing machine, crosshead speed of 0.5mm/min. the following results were obtained : 1. As compared to control groups (Group 1) of each material, Rely-a-Bond had a significantly lower mean tensile strengths than other material. (p<0.01) 2. In Group 2. of Ortho-One and Rely-a-Bond, the mean tensile strengths decreased about 7.7% and 11.1%, respectively with statistical significances. (p<0.05) 3. In Group 2. of Ortho-Two and PhaseⅡ, the mean tensile strengths did not decrease. 4. In Group 3. of Ortho-One, Rely-a-Bond, Ortho-Two, and PhaseⅡ, the mean tensile strengths decreased about 60.8%, 56.1%, 60.2%, and 46.0%, respectively with statistical significances. (p<0.01) 5. In Group 4. of Ortho-One and Rely-a-Bond, the mean tensile strengths did not decrease. 6. In Group 4. of Ortho-Two and PhaseⅡ, the mean tensile strengths were decreased about 20.95% and 22.28%, respectively with statistical significances. (p<0.01) There were formations of a hump shaped mass from bonding resin under blood contamination which disturbed direct bonding procedure. According to Reynolds, the proper bond strength for clinical manipulation should be at least 45N or about 4.5Kg.F. According to these results, it can be concluded that Ortho-One could be used during surgical exposure of unerupted teeth. In any case, blood contamination of the etched surface should be avoided, but the blood contamination of primed surface of Ortho-One may not decrease bond strength. Just 'blowing-out' is enough to remove blood from primed surface of Ortho-One. You can verify the clean surface of the primer of Ortho-One after blowing out the blood contamination.

Nd: YAG 레이저 조사가 Clacium Fluoride 형성 및 치아 내산성에 미치는 영향

최병재,김성오,손흥규,이제호,박광균 大韓小兒齒科學會 1999 大韓小兒齒科學會誌 Vol.26 No.2

불소도포시 주로 형성되는 calcium fluoride는 구강내 환경에서 pH에 의해 조절되는 불소의 저장고 역할을 하여 치아우식 예방에 있어서 중요한 역할을 하는 것으로 알려져 있다. 따라서 불소도포의 우식예방 효과는 calcium fluoride를 얼마나 많이 형성시켜 오래 지속시키는 가에 달려있다. 이에 치아 내산성 증가에 효과 있다고 알려진 Nd:YAG 레이저 조사가 calcium fluoride형성 및 치아 내산성에 미치는 영향에 대해 알아보기 위해서 실험을 시행하였다. 소의 영구전치에서 276개의 시편을 제작하여 아무런 처치를 하지 않은 군을 대조군으로 하고 1.23% acidulated phosphate fluoride (APF) 5분, 30분 도포 및 Nd:YAG 레이저 조사에너지 밀도 20J/㎠,40J/㎠의 조건에 따라 불소 도포군, 레이저 조사군, 불소 도포후 레이저 조사군, 레이저 조사후 불소 도포군으로 분류하였다. 불소도포를 시행한 경우 이를 다시 KOH 처리 여부에 따라 나누어 23개의 실험조건을 만들었다. 각 실험조건에 12개의 시편을 배정하고 이중 10개의 시편은 불소 및 무기인 측정에, 나머지 2개의 시편은 표면 관찰에 사용하였다. KOH 비처지군에서 0.1N HCIO4로 enamel biopsy를 시행하여 탈회 법랑질의 불소농도 및 탈회깊이를 측정하였으며, KOH 처치군에서는 1 M KOH로 24시간 처리하여 calcium fluoride를 정량 후 enamel biopsy를 시행하였다. 실험결과 얻어진 자료 및 주사 전자현미경 관찰 소견을 비교하여 다음의 결과를 얻었다. 1. KOH 비처치군에서 탈회된 법랑질의 불소농도는 레이저조사 후 불소도포시 레이저 에너지 밀도 증가에 따라 증가되는 경향을 보였다. 2. KOH 비처치군에서 법랑질 탈회깊이는 불소를 5분 도포후 레이저 20J/㎠를 조사한 경우를 제외하고는 레이저와 불소를 병행하여 처치시 각각을 단독으로 치치시보다 탈회깊이가 작았다 (p<0.05). 3. Calcium fluoride의 양은 레이저의 조사에 의해 유의 있게 증가하지 않았다 (p>0.05). 4. Calcium fluoride 입자는 불소만 도포한 경우에 비해 레이저 조사후 불소도포시 입자크기가 증가되었으며, 불소도포후 레이저 조사시 입자크기의 증가와 함께 일부 융합된 양상을 보였다. 5. KOH 처치군에서 법랑질의 불소농도는 불소를 30분 도포후 레이저를 조사한 경우를 제외하고는 대조군의 불소농도와 유의한 차이가 없었다(p>0.05). 6.KOH 처치군에서 불소와 레이저를 병행한 경우, 불소만 도포한 경우보다 탈횐된 법랑질의 깊이가 작았다 (p<0.05). 7. KOH 비처치군에서 탈회된 법랑질의 불소농도와 탈회깊이의 상관관계 (Spearman correlation coefficient: -0.6281)는 KOH 처치군 (Spearman correlation coefficient: -0.3792)에 비해 높은 음의 상관 관계를 보였고, 동일한 조건으로 불소도포 및 레이저 조사를 시행한 경우에 있어서 KOH 처리 여부에 따른 탈회법랑질 깊이의 유의차가 있는 경우 calcium fluoride의 형성량이 많았다. 이상의 실험결과로 미루어 보아 레이저 조사가 calcium fluoride의 형성량에 영향을 미치지 않았으나 레이저 조사의 영향으로 calcium fluoride의 용해가 감소하는 것으로 판단된다. 또한 불소도포 및 레이저 조사의 병행은 각각을 단독으로 처치한 경우에 비하여 치아 내산성 증가면에서 유리하므로 임상에서 불소도포주기 연장과 같은 유용한 결과를 얻을 수 있을 것으로 생각된다. Calcium fluoride. created by topical fluoride application, is the reservoir for fluoride ion regulated by pH in the oral environment. Therefore, the amount and the maintenance of calcium fluoride have an important role in preventing dental caries. The aim of this study is to evaluate the effect of Nd:YAG laser irradiaiton on the generation of calcium fluoride and the acid resistance of tooth enamel. The bovine anterior permanent teeth were prepared (n=276), and divided into following groups: no treatment(control), fluoride application alone, laser irradiation alone, laser irradiation after fluoride application, and fluoride application after laser irradiation. And each group was subdivided based on the application time of 1.23% acidulated phosphate fluoride (APF) (5 min and 30 min) and the irradiation energy of Nd:YAG laser (20J/㎠ and 40J/㎠). In case of fluoride application, each group was divided according to KOH treatment. Twenty three treatment conditions were made for this experiment and twelve specimens were assigned to each treatment condition. In each treatment condidtion, ten specimens were used for chemical analysis and two specimens were observed under SEM. In groups without treating KOH, fluoride content and the depth of enamel dissolved were measured using enamel biopsy technique. In groups with treating KOH, the amount of calcium fluoride was measured by the treatment with 1 M KOH for 24 hours and enamel biopsy was performed after KOH treatment. The results were analyzed by the fluoride content and the depth of enamel dissolved by enamel biopsy, amount and thickness of calcium fluoride, and the surface structures of enamel. The results are as follows: 1. In groups without treating KOH, the fluoride content of removed enamel showed a positive relationship with the energy density of laser when the laser irradiated before fluoride application. 2. In groups without treating KOH, the depth of enamel dissolved decreased more with the combined laser and fluoride treatment than with laser or fluoride treatment, except for the case of 20J/㎠ laser irradiation after 5 minute fluoride application (p<0.05). 3. The amount of calcium fluoride did not increased by laser treatment with no statistical significance(p>0.05). 4. The particle size of calcium fluoride increased in case of fluoride treatment after laser irradiation, compared with fluoride application alone. In case of laser treatment after fluoride application, the particle size of calcium fluoride increased and some of the particles fused as well. 5. There were no significant differences in the fluoride content of dissolved enamel between groups without treating KOH and control group, except for the case of laser irradiation after treatment of APF for 30 minutes (p>0.05). 6. In groups with treating KOH, depth of removed enamel in the groups of combined treatment with laser and fluoride was shallower than that in fluoride application groups (p<0.05). 7. In groups without treating KOH, the relationship between fluoride content and the depth of enamel dissolved showed more negative (Spearman correlation coefficient: -0.6281)than in groups with treating KOH (Spearman correlation coefficient: -0.3792). The greater amount of calcium fluoride could be found in case where there was a significant differences of the depth of enamel dissolved between groups with and without treating KOH. From these results, it can be concluded that laser seems to be a little effects on the amount of calcium fluoride formation, but has some effect on the lowering the solubility of calicium fluoride. As the combined treatment of laser and fluoride application showed more effective acid-resistant property, more extended recall period for fluoride application can be achieved with this combined treatment in the clinic.

HPLC를 사용한 쌀 중 잔류농약 동시분석법

최재천,이영자,김소희,최수영,최희주,정성욱,박흥재,김우성 한국환경과학회 2005 한국환경과학회지 Vol.14 No.4

A simple and sensitive analytical method based on RP-HPLC with UV detector(225 nm) and mobile phases using 0.1% phosphoric acid and acetonitrile was developed for simultaneous determination of quinclorac, bentazone, 2,4-D, bensulfuron-methyl, dymuron, capropamide, pencycuron, ethofenprox. This method was resulted in recovery of 78~ 96% with RSD 3.3~7.5%. LODs 0.12~0.84 and LOQs 0.34~1.20 ㎎/L. Calibration curves were linear with r of 0.9995~ 0.9999.

외상성 교합으로 인한 어린이의 치주질환

최병재,고동현,김성오,이제호,손흥규 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.3

외상성 교합은 교합력의 결과로서 치주조직에 가해지는 손상이다. 주된 증상은 치아의 동요도이고, 통증, 타진에 민감, 열에 민감한 증상이 동반될 수 있으며 교합력에 의해 치아가 이동을 할 수도 있다. 만성으로 진행시 치아의 과도한 교모가 나타나며 방사선학적으로 치근막 공간의 비후, 치조백선의 비후, 치조골의 방사선 투과성, 치근흡수 등이 나타날 수 있다.외상성 교합은 치주질환의 원인과 관련되어 있다. 증가된 치아동요도를 야기하며 외상성 교합 자체는 치은염과 치주낭을 발생시키지 않으나 국소적 치태와 염증이 존재하고 있는 하에서 골소실, 치주낭이 발생할 수 있다. 치은퇴축은 외상성 반월, 맥콜스 팽윤, 스틸만 균열의 형태로 나타난다. 본 증례는 하악 유견치 부위의 치주질환을 주소로 내원한 5세 남아로서 상하악 유견치의 조기 접촉에 의해 하악 좌우측 유견치의 중증도의 동요도, 교합마모, 치은 퇴축, 치조골 파괴의 증상이 나타났기에 보고하는 바이다. Trauma from occlusion(TFO) is injury to the periodontal tissue as a result of occlusal forces. Mobility is a common clinical sign of occlusal trauma. In acute occlusal trauma, this may be accomanied by pain, tenderness to percussion, thermal sensitivity, and pathologic tooth migration. Chronic occlusal trauma may be marked by excessive wear and gingival recession. Radiographic finding include a widened periodontal ligament space, radiolucence and condensation of the alveolar bone, and root resorption. TFO is related to the pathogenesis of periodontal disease. It can cause increased tooth mobility. TFO itself does not initate or aggravate marginal gingivitis or initiate periodontal pockets. Active trauma can accelerate bone loss, pocket formation and gingival recession depending on the presence of local irritants and inflammation. Gingival recession associated with occlusal forces includes traumatic crescent, McCall's festoon and Stillman's cleft. TFO plays a minor role in the pathogenesis of early to moderate periodontitis. A 5-year-old male visited Yonsei University Pedodontics clinic with a chief complaint about gingival recession. Mobility, excessive wear, gingival recession were detected by clinical exam on the both mandibular deciduous canine. On the radiographic view, vertical alveolar bone loss was observed on both mandibular deciduous canine.

Silicone die를 이용한 교합면우식증의 composite resin inlay 치료증례

최병재,손흥규,김성오 大韓小兒齒科學會 1992 大韓小兒齒科學會誌 Vol.19 No.2

In the past, the goals of dental treatment were to relieve pain and to intercept disease processing. Nowadays, however, food, clothing and housing have been promoted and dental considerations for restoring esthetic and masticatory function have become increased. Therefore several esthetic restoration techniques for posterior teeth were developed : direct resin filling, porcelain inlay/onlay and composite resin inlay/onlay. The purposes of this article are to review the problems and the improvements of direct resin filling techniques on posterior teeth and to report a case of composite resin inlay technique with silicone materials on posterior tooth. The problems of conventional direct resin filling techniques are severe occlusal wear, microleakage from polymerization shrinkage, recurrent caries, poor proximal contact, isthmus fracture, postoperative sensitivity, poor radiopacity, ect. In order to solve these problems, complete polymerization on comnposite resin is needed. Therefore resin inlay technique is developed with additional light, heat and pressure curing. Although physical properties(wear resistence, tensile strength, etc.) have been improved with composite resin inlay technique, the procedures are complicated and time consuming. On this report, we improved the fabrication of composite resin inlay with silicone rubber base materials.

상악 유측절치 부위의 유치 과잉치에 관한 증례보고

최병재,한효정,이제호,김성오,손흥규 大韓小兒齒科學會 2006 大韓小兒齒科學會誌 Vol.33 No.1

과잉치란 치배 형성기 이상으로 유치열기와 영구치열기에 정상보다 많이 발생하게 된 치아를 말한다. 유치 과잉치의 빈도는 0.03~1.9%로 상악 유측절치 부위에 호발하고 대부분은 정상 치아 형태로 맹출하며 정상 시기에 탈락하므로 보호자들이 인식하지 못하는 경우가 많다. 과잉치의 발생에 대해서는 현재 치판의 과활성으로 인해 제 3의 치배가 발생한다는 가설이 널리 받아들여지고 있고 유치과잉치가 발생할 경우 영구치열기에는 정상 또는 비정상적인 형태의 계승 과잉치가 존대한다고 보고된 바 있다. 유치 과잉치의 약 75%는 정상적으로 맹출하고 탈락하기 때문에 특별한 처치는 필요하지 않지만 계승 영구치 맹출에 영향을 주는지를 관찰하기 위하여 정기적인 구강 및 방선학적 검사가 필요하다. 본 두 증례의 경우 정상 치아 형태의 유치 과잉치가 유전치부 발육 공간을 이용하여 상악 유측절치 부위에 맹출하였고 방사선 사진 검사 결과 유치 과잉치 하방에 매복된 계승 과잉치가 관찰되었으므로 이에 보고하는 바이다. Most supernumerary primary teeth erupt in the primary lateral incisor region and are reported to occur in 0.03 to 1.9% in the primary dentition. Most parents fail to recognize them because of their normal shape, eruption and exfoliation. Several theories have been proposed for the etiology of hyperdontia and the dental lamina hyperactivity theory is most widely accepted. When a supernumerary primary tooth develops. it is reported that there also exists a supplemental or rudimentary form of a succedaneous supernumerary tooth. Supernumerary primary teeth do not need specific treatment as 75% of them erupt and exfoliate normally. Only periodic radiographic exams are necessary to find out whether there is any problem with the eruption of the succedaneous tooth. In the following two cases, a supplemental supernumerary primary tooth with a loss of the anterior developmental space was observed at the maxillary lateral incisor region. Radiographic examination revealed an impacted succedaneous supernumerary tooth at the palatal side of the supernumerary primary tooth.

감압술을 이용한 치근단 낭의 처치

김남혁,최병재,이제호,손흥규,김성오,최형준 大韓小兒齒科學會 2009 大韓小兒齒科學會誌 Vol.36 No.2

치근단 낭은 염증 등에 의한 자극으로 치수가 실활되어 치근단에 있는 상피로부터 형성되는 낭종으로 주된 기원은 말라세즈 상피잔사이지만 치은열구 상피나 상악동 이장 상피, 누공의 상피에 의한 것도 보고 되었다. 구강악안면 영역에서 가장 흔히 발생되는 낭종의 하나이지만 유치열기에서의 발생 빈도는 낮은 것으로 알려져 있다. 악골 내의 치성 낭종은 크기가 커지면서 주위 조직의 파괴나 구조의 변형을 초래할 수 있으며 유치의 경우에서는 후속 영구치배의 변위를 유발할 수 있다. 이런 큰 크기의 치성 낭종을 외과적으로 제거하면 해부학적 구조의 손상 및 안모의 변형, 치아흡수, 신경손상 등의 후유증을 일으킬 수 있으므로 조대술이나 감압술 후 적출하는 술식이 권장되고 있다. 이 증례는 하악 우측 부위의 동통을 주소로 연세대학교 치과대학병원 소아치과에 내원한 8세 남아로, 임상 및 방사선학적검사 결과 치수치료 후 기성금속관의 수복을 시행한 하악 우측 제1유구치의 치근단 하방에 방사선투과성 병변과 견치와 제1소구치의 변위를 발견하였다. 병소가 있는 하악 우측 제1유구치를 발거하였고, 조직학적 검사에서 치근단 낭으로 진단되었다. 감압술 및 공간유지장치를 시행하고 병소의 크기 변화와 하악 우측 견치와 제1소구치의 맹출 양상을 정기적으로 관찰한 결과 양호한 치유 양상과 정상적인 맹출을 보였기에 이를 보고하고자 한다. Radicular cyst is a true epithelium lined cyst formed when epithelium at the apex of a nonvital tooth is stimulated by inflammation. It is the most common type of cyst in the oral cavity, but its frequency is low in the primary dentition. Treatment of large-sized cyst aims at conservation of adjacent structure and allowance of proper eruption of the successive permanent teeth in the primary dentition. Considering these two aspects, marsupialization or enucleation following decompression is recommended as a treatment means for large-sized radicular cyst. In this case, 8-year old boy visited the pediatric dentistry department, Yonsei University Dental Hospital, with the chief complaint of pain on the lower right area. Clinical and radiographic examinations revealed periapical radiolucent lesion on #84, which had previous pulp treatment and restorated with the stainless steel crown. Dislocation of its successive tooth, #44, was also observed. #84 was extracted and sent for biopsy. Through histologic examination, it was diagnosed as radicular cyst. Following its extraction, removable space maintainer was delivered, which was also used as a decompressor. During periodic check-up for next 22 months, favorable healing of the lesion and eruption of the successive tooth were observed.