레진 시멘트의 film thickness가 간접 복합 레진 수복물의 접착 효율에 미치는 영향에 관한 연구

이상혁,최기운,최경규 大韓齒科保存學會 2010 Restorative Dentistry & Endodontics Vol.35 No.2

본 연구는 여러 레진 시멘트의 film thickness에 따른 상아질과 간접 레진 수복물 간의 미세인장 결합 강도를 측정하고, 각 레진 시멘트의 중합 수축 및 굴곡 강도, 탄성 계수를 비교 분석하며, 접착 계면 및 파단면의 주사전자 현미경 관찰을 통하여 레진 시멘트의 film thickness가 레진 간접 수복물의 접착 효율에 미치는 영향을 평가하고자 시행하였다. 복합 레진형 레진 시멘트인 Variolink II와 Duo-Link, 접착형 레진 시멘트인 Panavia F와 Rely X Unicem의 4가지 레진 시멘트를 사용하였고, 각각의 시멘트를 film thickness에 따라 < 50 μm (control)의 대조군과 50 μm (T50), 100 μm (T100), 150 μm (T150)의 실험군으로 나누어 총 16개의 군으로 분류하였다. 데이터는 ANOVA와 Duncan’s multiple comparison test (p < 0.05)를 이용하여 통계 분석하였으며 다음과 같은 결론을 얻었다; 1. Variolink Ⅱ는 모든 film thickness에서 접착형 레진 시멘트보다 높은 결합 강도를 나타냈지만(p < 0.05), Duo-Link는 대조군을 제외하고는 통계학적 유의차가 없었다(p > 0.05). 2. Film thickness가 증가할수록 복합 레진형 레진 시멘트의 결합 강도는 유의성 있게 감소(p < 0.05)하는 경향을 보인 반면, 접착형 레진 시멘트는 통계학적 유의차가 없었다(p > 0.05). 3. Panavia F는 통계학적으로 유의성 있게 낮은 중합 수축량을 나타냈다(p < 0.05). 4. 굴곡 강도와 탄성 계수는 복합 레진형 레진 시멘트가 접착형 레진 시멘트보다 유의성 있게 높게 나타났다(p < 0.05). 5. FE-SEM 관찰 결과 결합 강도가 높은 복합 레진형 레진 시멘트는 균일한 접착층과 잘 발달된 resin tag 소견을 보였으나, 접착형 레진 시멘트는 불분명한 접착층과 resin tag 소견을 나타냈다. 파단면 관찰에서 복합 레진형 레진 시멘트는 혼합형 파괴 양상을 나타냈으나 접착형 레진 시멘트는 접착성 파괴 양상을 나타냈다. The purpose of this study was to evaluate the effect of film thickness of various resin cements on bonding efficiency in indirect composite restoration by measurement of microtensile bond strength, polymerization shrinkage, flexural strength and modulus, fractographic FE-SEM analysis. Experimental groups were divided according to film thickness (< 50 μm-control, 50 μm-T50, 100 μm-T100, 150 μm-T150) using composite- based resin cements (Variolink Ⅱ, Duo-Link) and adhesive-based resin cements (Panavia F, Rely X Unicem). The data was analyzed using ANOVA and Duncan’s multiple comparison test (p < 0.05). The results were as follows ; 1. Variolink Ⅱ showed higher microtensile bond strength than that of adhesive-based resin cements in all film thickness (p < 0.05) but Duo-Link did not show significant difference except control group (p > 0.05). 2. Microtensile bond strength of composite-based resin cements were decreased significantly according to increasing film thickness (p < 0.05) but adhesive-based resin cements did not show significant difference among film thickness (p > 0.05). 3. Panavia F showed significantly lower polymerization shrinkage than other resin cements (p < 0.05). 4. Composite-based resin cements showed significantly higher flexural strength and modulus than adhesive- based resin cements (p < 0.05). 5. FE-SEM examination showed uniform adhesive layer and well developed resin tags in composite-based resin cements but unclear adhesive layer and poorly developed resin tags in adhesive-based resin cements. In debonded surface examination, composite-based resin cements showed mixed failures but adhesive-based resin cements showed adhesive failures.

상아질 접착제 사용 여부에 따른 근관 밀폐효과의 비교

이민조,박상혁,최기운 大韓齒科保存學會 2005 Restorative Dentistry & Endodontics Vol.30 No.1

이 연구의 목적은 상아질 접착제의 사용 여부에 따른 근관 밀폐효과를 비교 평가하기 위해 40개의 단근치를 근관 성형 후 20개씩 두군으로 나누었다. 1군은 근관 충전시에 상아질 접착제를 사용하지 않았으며 2군은 상아질 접착제를 사용하였다. 근첨에서 1.5 mm (Level 1), 2.0 mm (Level 2), 2.5 mm (Level 3) 떨어진 부위의 평균 누출률을 측정하였다. 1. 두군의 평균 누출률은 치경부로 향하면서 감소하였다. 2. Level 1에서 1군과 2군의 평균 누출률은 차이가 없었다 (p > 0.05) .3. Level 2와 3에서 2군의 평균 누출률은 1군보다 낮았으며, 통계학적으로 유의차를 나타내었다 (p < 0.05) .연구결과 상아질 접착제를 사용하여 근관 충전하는 경우 치근단 누출을 감소시킬 수 있을 것으로 판단된다. The purpose of this study was to compare the sealing ability of root canal obturation with or without the use of dentin adhesive system. Forty extracted human teeth with one canal were selected and decoronated. The teeth were divided into two Groups. The obturation procedure of Group 1 was the same as that of Group 2 with the exception of dentin adhesive system. Group 2 were obturated with dentin adhesive system, AH-26, and gutta-percha. After obturation, the teeth were immersed in methylene blue solution for 84 hours. The teeth were sectioned horizontally at 1.5 mm (Level 1), 2.0 mm (Level 2) 2.5 mm (Level 3) from the root apex using a low speed microtome. Distance of dye-penetrated surface and total dentinal surface were measured using SigmaScan Pro 5.0, and the ratio of dye-penetrated distance to the total dentinal distance was analyzed statistically by Mann-Whitney U-test. 1. In both groups, the mean leakage ratio was decreased cervically. 2. At level 1, there was no significant difference between group 1 and group 2 (p > 0.05). 3. At level 2 and 3, group 1 showed significantly higher mean leakage ratio than group 2 (p < 0.05). The results suggest that using dentin adhesive system in root canal obturation procedure reduces the apical microleakage.

EDTA의 세정시간에 따른 근관 내 smear layer의 제거효과에 관한 연구

이자경,박상혁,최기운 大韓齒科保存學會 2006 Restorative Dentistry & Endodontics Vol.31 No.3

본 연구는 EDTA 용액의 적용 시간에 다른 도말층의 제거 효과를 비교하여 EDTA 용액의 최적 적용 시간을 알고자 시행되었다. 단근치 35개를 NaOCI 용액 하에서 근관 형성 후 대조군은 NaOCI 용액 5㎖로 2분간, 실험군은 30초군, 1분군, 2분군으로 세분하여 17% EDTA 용액 5㎖로 각각 30초, 1분, 2분간 세정하였다. 세정이 끝난 치근의 도말층 제거 정도와 상아 세관의 erosion 정도를 주사전자현미경을 이용하여 관찰한 결과는 다음과 같다. 1. 대조군: 도말층이 전혀 제거되지 않았다. 2. 실험군: 1) 중간⅓: 세 군 모두에서 도말층이 거의 완전히 제거되었고, EDTA 적용 시간이 증가할수록 erosion 발생 빈도가 증가하였다. 2) 치근단⅓: 2분군이 다른 두 군에 비해 도말층 제거 정도가 우수하였다. 따라서 erosion 발생을 최소화면서 도말층을 효과적으로 제거하기 위해서는 17% EDTA 용액을 2분간 사용하는 것이 적절한 것으로 사료된다. This study was to verify that the combined application of NaOCI and EDTA was more effective in removal of smear layer than the application of NaOCI alone. Furthermore it was aimed to find out the optimal time for the application of EDTA. Thirty five single rooted teeth were cleaned and shaped. NaOCI solution was used as an irrigant during instrumentation. After instrumentation, root canals of the control group were irrigated with 5㎖ of NaOCI for 2 minutes. 30 sec, 1 min, and 2 min group were irrigated with 5㎖ of 17% EDTA for 30 sec, 1 min, and 2 min respectively. Then the roots were examined with scanning electron microscopy for evaluating removal of smear layer and erosion of dentinal tubule. The results were as follows; 1. The control group: The smear layer was not removed at all. 2. The other groups: 1) Middle⅓: All groups showed almost no smear layer. And the erosion occurred more frequently as increasing irrigation time. 2) Apical⅓: The cleaning effect of 2 min group was better than the others. The results suggest that 2 min application of 17% EDTA should be adequate to remove smear layer on both apical⅓ and middle⅓.

Smear layer 처리에 따른 미세누출에 대한 연구

이정민,박상혁,최기운 대한치과보존학회 2006 Restorative Dentistry & Endodontics Vol.31 No.5

본 연구는 도말층 제거 여부에 따른 근관 밀폐효과를 평가하기 위해 단근관 치아를 3% NaOCI 하에서 Ni-Ti file을 이용하여 crown-down 법으로 근관 형성 후 최종세정제로 NaOCI을 사용한 군과 EDTA를 사용한 군, 6개월 보관한 NaOCI-6군과 EDTA-6군으로 분류하였다. Continuous wave법으로 근관 충전 시행 후 색소 침투를 시행한 다음 해부학적 근첨에서 1.5 mm(Level l), 3.0 mm(Level 2), 4.5 mm (Level 3)에서 수평절단 하여 누출률을 측정하였다. 1. 모든 실험군에서 평균 누출률은 치근단부에서 치경부로 갈수록 감소하였다. 2. NaOCI 군의 누출률이 EDTA 군보다 level l, 2, 3에서 높게 나타났으나 level l에서만 통계학적 유의차를 보였다 (p<0.05). 3. NaOCI-6 군의 누출률이 EDTA-6 군보다 Level l, 2, 3에서 높게 나타났으나 level l에서만 통계학적 유의차를 보였다 (p<0.05). 4. NaOCI-6 군의 누출률이 NaOCI 군에 비해 Level l, 2, 3에서 증가하였으나 level l에서만 통계학적 유의차를 보였다 (p<0.05). 5. EDTA-6 군의 누출률이 EDTA 군에 비해 Level l, 2, 3에서 증가하였으나 통계학적 유의차는 없었다. 6. 주사전자현미경 관찰 결과 NaOCI 군과 NaOCI-6 군은 도말층이 제거되지 않아 상아세관내로 sealer 및 근관충전 재가 침투하지 못한 반면, EDTA 군과 EDTA-6 군에서는 도말층이 제거되고 상아세관내로의 sealer와 근관충전 재의 침투가 관찰되었다. 이상의 연구결과 EDTA를 이용하여 도말층을 제거한 경우 근관충전 즉시와 6개월 후 치근단 1/3 부위의 근단부 미세누출을 감소시킬 수 있을 것으로 사료된다. The purpose of this study was to compare the sealing ability of root canal obturation with or without the treatment of smear layer. Eighty extracted human teeth with one canal were selected. Instrumentation was performed with crown-down technique. After instrumentation, root canals of the NaOCI group and NaOC1-6 group were irrigated with 3% NaOCI. EDTA group and EDTA-6 group were irrigated with 17% EDTA. Then all teeth were obturated using continuous wave obturation technique. NaOCI group and EDTA group were immersed in methylene blue solution for 84hours. NaOCI-6 group and EDTA-6 group were immersed in methylene blue solution for 6months. The teeth were sectioned at 1.5 mm (Level 1), 3.0 mm (Level 2) and 4.5 mm (Level 3) from the root apex. The length of dye-penetrated interface and the circumferential length of canal at each level were measured using Sigma-Scan Pro 5.0. 1. The mean leakage ratio was decreased cervically. 2. NaOCI group showed higher mean leakage ratio than EDTA group at each level. But there was significant difference at level 1 only (p<0.05). 3. NaOCI-6 group showed higher mean leakage ratio than EDTA-6 group at each level. But there was significant difference at level 1 only (p<0.05). 4. NaOCI-6 group showed higher mean leakage ratio than NaOCI group at each level. But there was significant difference at level 1 only (p<0.05). 5. EDTA-6 group showed higher mean leakage ratio than EDTA group at each level. But there was no significant difference. 6. In NaOCI group and NaOCI-6 group, scanning electron micrographs of tooth sections generally covered with smear layer. In EDTA group and EDTA-6 group, tooth sections showing the penetration of sealers to opened dentinal tubules. The results suggest that removal of smear layer was effective to reduce the apical microleakage of the root canal.

유한요소법을 이용한 치근단절제술후 근첨의 응력분포에 관한 연구

이세준,최호영,민병순,박상진,최기운 大韓齒科保存學會 1998 Restorative Dentistry & Endodontics Vol.23 No.1

The purpose of this study is to evaluate the distribution of stress in the root end resected teeth. The finite element method was used to compare stresses along the root and retrograde filling material in seven two-dimensional models of mandibular 2nd premolar. Each model was endodontic treatment and gold crown restoration. Each model divided with amagam corerestoration or gold casting post restoration. Thus each model divided with shape of root end resection, depth of retropreparation and exposure length of root in the bony cavity. The seven models were classified as in the table 1 below. ◁표참조▷ A load of 500N was applied 45°diagonally on the lingual slope of the buccal cusp. These models were analyzed with two dimensional finite element methods. The results of this study were as follows : 1. The maximum tensile stress along the inner canal wall was shown on the model 7. 2. When the model 1 was compared with the model 5, the maximum tensile stress along the inner canal wall showed the model 1. 3. Less equivalent stress was shown on the model 6 and more equivalent stress was shown on the model 4. 4. More shear stress was shown on the retrograde filling material of the model 7. 5. The models with increased length of exposed root in the bony cavity demonstrated a gradual increase to the tensile stress in X direction which occurred approximately a boundary between the bone and exposed root in the bony cavity. 6. The model which had a case of matching the apex of post and a boundary between the bone and exposed root in the bony cavity demonstrated more increase tensile stress in X direction than other models.

급성 백혈병 관해유도요법후 발생한 다발성 비장농양 1예

이홍기,김선운,박경동,이현성,주영돈,손창학 인제대학교 2000 仁濟醫學 Vol.21 No.1

Splenic abscess is a rare illness. Its incidence has ranged from 0.14 to 0.7 % in various autopsies conducted in the US. Even in the most recently published articles, diagnosis was made only in autopsies in 37 % of the cases. While splenic abscess may arise occasionally from contiguous spread of infection or direct trauma to the spleen, usually it develops with hematogenous spread or infection. But, bacterial endocarditis is the most common cause. RUQ pain of abdomen developed in only half of series. Splenomegaly, fever and leucocytosis was also present. When splenic abscesses are being considered in a differential diagnosis, CT scan of the abdomen has been the most sensitive diagnostic tool. Streptococcal species are the most common bacterial isolates from splenic abscesses, S. aureus is the next most common. Salmonella species are seen commonly in patients with sickle cell hemoglobinopathy. Because of the high mortality related for splenic abscess, the treatment of choice is splenectomy with adjunctive antibiotics. However, percutaneous drainage has been successful alternative. We reported a 19-years old female patient who had splenic abscess after remission induction chemotherapy of acute leukemia, successfully treated with splenectomy.

심장으로 전이된 악성 흑색종의 고식적 절제 1예

이경수,이현희,연태진,남기병,김동운,조명찬 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.9

경남 일부 지역 간흡충 감염 주민에 대한 혈청 생화학검사 소견 분석

손운목,조영표,김기진,김미영,이종욱,박도흠 한국건강관리협회 1999 건협 Report Vol.2 No.-

풍선 도뇨관을 이용한 식도 둔형 이물제거

김기운,김시영,이종서,김철,정윤석 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: In most cases of a foreign body in the esophagus, an ENT specialist is consulted, which may be time consuming if not evaluated in a timely fashion. The patients are admitted to the hospital and sent to the operating room, where they are placed under anesthesia and the object is removed by using an esophagoscope. Methods: A prospective randomized trial was conducted during the period from January 1998 to June 2000. All patients presenting to emergency department with blunt objects in the esophagus were included. In one group, with fluoroscopic guidance, a Foley catheter was placed to remove the blunt foreign bodies. And in the other group, we removed them by using the esophagoscpe. We used the t-test for statistical analysis in this study. Results: Total number of patients enrolled in this study was 38.22 patients were enrolled in the Foley Catheter removal group, and the remaining 16 were enrolled in the esophagoscope removal group. The success rate for the Foley catheter was 21/22(95.5%), and that for the esophagoscope was 15/16(93.8%). The average time of removal for the Foley catheter group was 0.70± 0.28 hours while that for the esophagoscope group was 5.96 ± 2.22 hours. One side effect, nonfatal hypoxia, was noted in the Foley catheter removal group. The average cost for the Foley catheter group were 78,800 won(approximately 600 US dollars) while that for the esophagoscope group took 722,800 won(approximately 600 US dollars). Conclusion: In our study, we found that the success rate for removing blunt foreign bodies from the esophagus by using a simple Foley catheter was high, also the Foley catheter was a time saving and cost effective procedure with an excellent safety profile.

잡견에서 Rapid Atrial Pacing에 의한 심방의 전기적 재현성과 이의 회복

남기병,김동운,차성일,이석재,홍종면,임승운,나기정,조명찬 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.6