Mineral Trioxide Aggregate (MTA)의 생물학적 기전에 대한 고찰

김의성(Euiseong Kim),신수정(Su-Jung Shin) 대한치과의사협회 2010 대한치과의사협회지 Vol.48 No.11

Introduction: MTA has been stuided for more than 15 years since it was introduced and developed at Loma Linda University. The purpose of this review was to present the current publised papers regarding MTA’s biologic properties and to provide a deep insight into the material’s mechanisms of actions. Results: MTA has appeared to be biocompatible in many previous researches. In addition to that, it had a potential to increase cell reactions such as proliferation and differentiation. Recently, MTA like new endodontic materials has been introduced and marketed. Conclusions: On the basis of current evidences, MTA seems to be biocompatible. Meticulous studies need to be performed to adopt new endodontic materials into clinical applications.

[총설] 효과적인 근관세척액과 방법

김의성(Euiseong Kim),오남식(Nam-sik Oh),김일규(Il-Kyu Kim),오성섭(Seong-Seob Oh),최진호(Jin-Ho Choi) 대한치과의사협회 2000 대한치과의사협회지 Vol.38 No.10

Effect of Nd:YAG laser irradiation on adherence of retrograde filling materials

Minyoung Kim(김민영),Hyeon-cheol Kim(김현철),Sang Won Kwak(곽상원),Tai Cheol Yoon(윤태철),Euiseong Kim(김의성) 대한치과의사협회 2016 대한치과의사협회지 Vol.54 No.11

Background/Purpose: The purpose of this study was to evaluate the effect of Nd:YAG irradiation on adherence of retrograde filling materials (mineral trioxide aggregate [MTA] and Super-EBA) by micro-computed tomography (CT) measurement and to observe the dentinal surface after irradiation by scanning electron microscopy (SEM). Materials and methods: Forty retrofilling models using extracted human teeth were divided into four groups according to the material and method used: ProRoot MTA (MTA group), Super-EBA (EBA group), MTA with Nd:YAG laser irradiation (LMTA group), and Super-EBA with Nd:YAG laser irradiation (LEBA group). All specimens were stored in 100% humidity for 24 hours until micro-CT was performed. The gap volume of the tooth/material interface was measured using the CTAn program. In six samples, the laser-irradiated dentin surface was observed using SEM. Results: The mean percent difference in gap volume was not statistically significant between the Nd:YAG laser-irradiated groups and non-irradiated in both materials(P > 0.05). The gap volume in the MTA group was significantly lower than that in the EBA group (P < 0.05). Examination of the non-irradiated specimens by SEM showed patent dentinal tubules. In contrast, alterations in the texture of the dentin surface and obliteration of the dentinal tubules were evident in the Nd:YAG laser-irradiated specimens. Conclusion: In this study, changes in the dentinal surface after Nd:YAG irradiation did not affect adherence between the apical filling material and the dentin wall.

자가치아이식술 환자에서 중,단기 검진을 통한 치유 경과 및 실패원인에 대한 평가

정재용(Jaeyong Jung),김의성(Euiseong Kim),이승종(Seungjong Lee) 대한치과의사협회 2004 대한치과의사협회지 Vol.42 No.11

외과적 정출술을 이용한 치관-치근 파절치의 심미수복

방난심(Nansim Pang),김의성(Euiseong Kim) 대한치과의사협회 2004 대한치과의사협회지 Vol.42 No.9

만성 누공 및 치근단부 치석이 존재하는 상악 제1소구치의 치험례

정재용(Jae-Yong Jung),정일영(Il-Young Jung),김의성(Euiseong Kim) 대한치과의사협회 2003 대한치과의사협회지 Vol.41 No.9

금전장관 수복물을 통한 치수강 개방이 금전장관 수복물의 미세변연누출에 미치는 영향

김의성,정진호,김용근 大韓齒科保存學會 2002 Restorative Dentistry & Endodontics Vol.27 No.4

The marginal integrity of the crown can be broken during endodontic access cavity preparation due to the vibration of burs. Therefore, the purpose of this study was to evaluate the effect of endodontic access cavity preparation on the marginal leakage of full veneer gold crowns. 24 intact molars were mounted in acrylic resin blocks and prepared for crowns by a restorative dentist and crowns were cast with gold alloy. 20 Crowns were cemented with glass ionomer cement and 2 crowns were not cemented for positive control. 200 thermo-cycles from 5℃ to 50℃ with a travel time of 20s were completed. Then samples were randomly divided into 2 experimental groups of 9 each. Endodontic access preparation and zinc-oxide eugenol temporary fillings were done in Group 1. Teeth in Group 2 were not treated. Samples were coated with 2 layers of nail varnish and were immersed in 1% methylene blue dye for 20 hrs. Endodontic access was prepared in 2 samples, which were coated with nail varnish on all surfaces for negative control. After washing in running water, gold crowns were cut with a #330 bur. Four buccolingual sections. 2 mm apart, were cut from the central section of each tooth and were examined and scored under the microscope for dye leakage. Score 1: leakage to the cervical 1/3 of the axial wall, Score 2: leakage to the middle 1/3 of the axial wall, Score 3: leakage to the coronal 1/3 of the axial wall, Score 4: leakage to the occlusal surface. The median value for Group 1 is 4 and for Group 2 is 2. The result of this study showed that samples in Group 1 leaked more than those in Group 2. This finding was significant(P<0.001).

Propidium monoazide와 real-time PCR을 이용한 살아있는 Enterococcus faecalis의 선택적인 검출

김신영,이승종,김의성,서덕규,송윤정,정일영 大韓齒科保存學會 2008 Restorative Dentistry & Endodontics Vol.33 No.6

세균의 검출에 있어서 polymerase chain reaction (PCR) 방법은 기존의 plate counting과 달리 빠르게 세균을 검출할 수 있다. 하지만 세균이 죽은 후에도 DNA는 장기간 존재할 수 있기 때문에, DNA에 기초한 분석은 살아있는 세균과 죽은 세균을 구분할 수 없다. 최근에 DNA extraction전에 propidium monoazide (PMA)를 처리하여 살아있는 세균만 선택적으로 검출하는 방법이 제시되었다. PMA는 손상된 세포막만 통과하여 죽은 세포의 DNA와 빛 노출 하에서 결합하여 PCR이 증폭되는 것을 막는다. Enterococcus faecalis는 근관치료의 실패에 있어서 중요한 원인이 되는 세균으로 제시되어 왔다. 그리고 Chlorhexi-dine (CHX)은 E. fecalis의 제거에 있어서 효과적인 약제임이 밝혀졌다. 이번 실험의 목적은 세균 수의 측정에 있어서, PMA 처리와 real-time PCR 방법의 적용 가능성을 기존의 plate counting과 비교하여 알아보는 것이다. 또한 E. faecalis에 대한 2% CHX의 살균 효과를 PMA 처리 후 real-time PCR 방법을 사용하여 알아보는 것이다. 실험 방법으로 먼저 살아있는 세균과 죽은 세균을 다른 비율로 섞어서 PMA를 처리한 후 real-time PCR을 시행하여 PMA가 빛 노출 하에서 죽은 세균의 DNA와 결합하는 효과를 나타내는지 알아보았다. 다음으로 PMA처리 후 real-time PCR 방법을 이용하여 살아있는 세균의 양을 측정한 것을 plate counting으로 얻은 CFU와 비교하였다. 마지막으로 2% CHX의 처리시간을 다르게 하였을 때 E. faecalis에 대한 살균 효과를 PMA 처리 후 real-time PCR방법을 사용하여 알아보았다. 실험 결과로 살아있는 E. faecalis의 비율이 감소할수록 Ct value는 증가하였다. 그리고 PMA 처리 후 real-time PCR방법을 이용하여 세균의 양을 측정한 것과 plate counting으로 얻은 CFU사이에는 Optical density (OD) 값이 1.0일 때까지는 상관관계가 있었다. 하지만 OD 값이 1.5일 때는, PMA를 처리한 후 real-time PCR을 시행했을 때 측정된 살아있는 세균의 양이 감소하였음에 반해서 plate counting에 의한 CFU는 계속 증가하였다. 마지막으로 2% CHX을 오래 적용할수록 살아있는 E. faecalis의 상대적인 양이 감소하는 것을 PMA 처리와 real-time PCR 방법을 이용해 확인하였다. Polymerase chain reaction (PCR) can detect bacteria more rapidly than conventional plate counting. However DNA-based assays cannot distinguish between viable and dead cells due to persistence of DNA after cells have lost their vitality. Recently, propidium monoazide (PMA) treatment has been introduced. The purpose of this study is to evaluate the applicability of the PMA treatment and real-time PCR method for cell counting in comparison with plate counting and to evaluate the antibacterial efficacy of 2% CHX on E. faecalis using PMA treatment in combination with real-time PCR. Firstly, to elucidate the relationship between the proportion of viable cells and the real-time PCR signals after PMA treatment, mixtures with different ratios of viable and dead cells were used. Secondly, relative difference of viable cells using PMA treatment in combination with real-time PCR was compared with CFU by plate counting. Lastly, antibacterial efficacy of 2% CHX on E. faecalis was measured using PMA treat-ment in combination with real-time PCR. The results were as follows : 1. Ct value increased with decreasing proportion of viable E. faecalis. 2. There was correlation between viable cells measured by real-time PCR after PMA treatment and CFU by plate counting until Optical density (OD) value remains under 1.0. However, viable cells measured by real-time PCR after PMA treatment have decreased at 1.5 of OD value while CFU kept increasing. 3. Relative difference of viable E. faecalis decreased more after longer application of 2% CHX.

파절선 관찰 도중 발생한 피하기종: 증례보고

김민영,박성호,신유석,김의성 大韓齒科保存學會 2011 Restorative Dentistry & Endodontics Vol.36 No.6

피하기종은 치과치료 시 나타날 수 있는 합병증의 하나로서, 발치, 근관치료, 수복치료 등과 연관되어 발생할 수 있다. 피하 로 유입된 공기는 부종과 염발음을 일으키며 일반적으로는 주변 결합조직에 의해 그 범위가 한정되나 많은 양의 압축공기가 유 입될 경우 근막공간을 통해 중격동, 흉막공간, 심지어 후복막에까지 영향을 미칠 수 있어 생명을 위협하는 합병증으로 발생할 수도 있다. 이번 증례는 파절선을 관찰하던 도중에 피하기종이 발생한 환자에 대한 증례로서 그 원인과 관리, 예방법에 관해 고찰해보고자 한다. The development of subcutaneous emphysema is a well-known complication that has been reported after dental extraction, endodontic treatment, or restorative preparation. Gaseous invasion, leading to swelling, crepitus on palpation, is commonly restricted to the connective tisssues immediately adjacent to the entry site. However, the use of compressed air- and water-cooled turbines may allow large amounts of air and water to be driven through the fascial planes into the mediastinum, pleural space, or even the retroperitoneum. This case report is about the patient who presented with subcutaneous emphysema that occurred after fracture line inspection. Possible cause, treatment, and prevention of emphysema will be discussed.

Gutte-percha 또는 Resilon을 사용한 근관충전이 상아세관 내의 Enterococcus faecalis에 미치는 영향

지상욱,김의성,,정일영,유윤정 大韓齒科保存學會 2005 Restorative Dentistry & Endodontics Vol.30 No.5

목적은 근관충전이 상아세관 내에 남아있는 세균에 미치는 영향을 알아보고 가터퍼차와 resilon의 밀폐 능력을 상아세관 내에 남아있는 세균의 생존 여부를 통하여 비교하는 것이다. 발치된 우전치로 치아시편에 E. faecalis를 접종하고 제1군은 음성대조군, 제 2군은 양성대조군, 제3군은 ZOE 계통의 근관전색제와 가터퍼차, 제 4군은 레진 계통의 근관전색제와 가터퍼차, 제 5군은 레진 계통의 근관전색제와 resilon으로 근관 충전하였다. 각 시편은 1, 2, 3주 및 4주간 보관한 뒤 round bur로 근관 내를 삭제하여 얻은 상아질을 배양하고 혼탁도를 측정하였다. 1. Nail varnish로 상아세관을 완전히 밀폐한 경우, 상아세관 내의 E. faecalis의 수는 가터퍼차 및 resilon으로 근관 충전 한 경우보다 통계적으로 유의차 있게 감소하였다 (p<0.05). 2. 레진 계통의 근관전색제와 resilon으로 근관충전 한 군에서는 시간의 흐름에 따라 상아세관 내의 E. faecalis의 수가 유의차 있게 감소하였다(p<0.05). 3. 가터퍼차와 resilon으로 근관충전한 군 사이에 상아세관 내에 남아 있는 E. faecalis의 생존 정도는 통계학적 유의차가 없었다 (p>0.05). The purpose of this study was to observe the effect of canal filling on the bacteria left in the dentinal tubules and to compare the sealing ability between Gutta-percha and Resilon. The bovine dentin block models were prepared. E. faecalis was inoculated to dentin blocks and incubated. The dentin blocks were divided into 5 groups. Group 1 was the negative control. Group 2 was the positive control. Group 3 was filled with ZOE based sealer and Gutta-percha, Group 4 with resin based sealer and Gutta-percha, and Group 5 with resin based sealer and Resilon. After 24 hour, the blocks were incubated at 37℃ for 1, 2, 3 and 4 weeks on BHI agar plates. The internal dentin portion of the blocks was removed using ISO 027, 029, 031, 035 round burs and the dentin chips were incubated at 37℃ for 24 hour. Following incubation, the optical density of the medium was measured. The data were statistically analysed using repeated measures ANOVA and one-way ANOVA and one-way ANOVA. The results were as follows, 1. There was statistically significant reduction in the number of E. faecalis of the group where dentinal tubules were completely sealed with nail varnish in comparison with the groups obturated with gutta-percha or resilon (p < 0.05). 2. In group 5, the number of E. faecalis in the dentinal tubules decreased significantly with time (p<0.05), whereas in Group 3 and 4, there was no reduction in its number (p>0.05). 3. Under the conditions of this experiment, E. faecalis survived up to 4 weeks after obturation with gutta-percha or resilon (p>0.05).