근관 실러의 분류와 특성 비교

방난심,정복영,최동진,박원서,정지은,김기덕,곽은정 대한통합치과학회 2017 대한통합치과학회지 Vol.6 No.2

The aim of this review was to compare calcium hydroxide-based root canal sealers with various contemporary commercial sealers especially leakage / solubility aspect. An extensive search of the endodontic literature through pubmed was made to identify publications related to calcium hydroxide-based sealers, epoxy resin-based sealers, methacrylate resin-based sealers and bioceramic-based sealers. 1. All sealers leak in long-term evaluation (>60 days). (except MTA sealers, because they do not have long-term [>120 days] evaluation data yet.) 2. Some sealers have better short-term sealing ability (<30 days). (but, the result could be reversed in long-term evaluation and meaningless after some period, because all sealers leak eventually.) 3. Regardless of the type of sealers, leakage increases over time. 4. A lot of endodontic treatment failure cases are because of re-infection through various route. 5. It is very important for the long-term survival of endodontically treated teeth that installation of full coverage-type final restoration as soon as possible after endodontical treatment. (further research is required to estabilish the sealing ability of luting cement or core material) It seems right to use sealers that have best bacterial sealing ability during those period (about 20 days) until the installation of full coverage-type final restoration right after the endodontical treatment finished. In that case, calcium hydroxide-based sealers are very effective and efficient.

간접 수복물의 접착

방난심,김기덕,박원서,박혜정,정복영,이강희,이준형 대한통합치과학회 2014 대한통합치과학회지 Vol.3 No.2

Indirect restoration is commonly used in dental treatment and cementation of the restoration is one of the most important part in that procedure. Understanding the property of dental material in cementation and using it properly at each stage are the key factor to successful treatment. In this article, we studied about different type of adhesive, cement based on the established articles. In addition, we arranged about the considering factors in cementation procedure according to different restoration type.

상악측절치의 치내치 치험례

방난심,이재민,박원서,박혜정,정복영,김기덕,이강희 대한통합치과학회 2014 대한통합치과학회지 Vol.3 No.1

Dens invaginatus is a developmental variation resulting from the infolding of the dental papilla before calcification of the dental tissue. Permanent maxillary lateral incisors are most commonly affected. The most widely used classification system for dens invaginatus was described by Oehlers. The purpose of this paper was to describe treatments of 2 cases on Type II dens invaginatus with open apex. In the first case, the invaginated barrier was removed, apexification and nonsurgical endodontic treatment was performed. At the 8-month follow-up, no clinical symptoms or radiographic apical lesion were observed. In the second case, because of the morphologic variation, it was unable to clean and shape the root canal system. Thus, apical surgery was performed. After 5 months, no signs of sinus tract or radiographic apical lesion was observed. In these cases, satisfactory clinical and radiographic outcomes were observed. It is important to know about root canal anatomy for successful endodontic treatment of dens invaginatus.

Assessment of decontamination of gutta-percha cone and the change of surface texture after rapid chemical disinfection

방난심,정일영,유윤정,금기연,Pang, Nan-Sim,Jung, Il-Young,Yu, Yoon-Jung,Kum, Kee-Yeon The Korean Academy of Conservative Dentistry 2006 Restorative Dentistry & Endodontics Vol.31 No.2

본 연구의 목적은 첫째 임상에서 진료실에 노출된 가타파차 콘 표면의 오염 균종을 중합효소연쇄반응법 (polymerase chain reaction, PCR)을 이용해 동정하고, 둘째 이들 세균으로 오염시킨 가타파차 콘에 대해 2종의 소독제의 rapid sterilization 효과를 비교하였다. 또한 이들 소독제에 5분간 처리된 가타파차 콘 표면 성상의 변화를 주사전자현미경으로 관찰하였다. 진료실에 수 개월간 노출된 가타파차 콘 100개를 수거하여 배양지에 넣어 배양 후 universial primer를 사용한 PCR assay 를 통해 오염 균종을 동정하였다. 실험실 상에서 이 균종을 다시 배양하여 소독된 가타파차 콘에 접종하고 1주일간 배양한 후 2종의 소독제(5% NaOCl, 2% Chlorhexidine)에 1, 3, 5, 10 분간 담근 후 각 소독제의 종류와 적용시간에 따른 멸균 효과를 turbidity test 와 subculture 를 이용하여 평가하였다. 또한 각 소독제에 5분간 처리된 가타파차 콘 표면 성상의 변화를 주사전자현미경으로 관찰하였다. 중합효소연쇄반응법의 분석결과 17개의 가타 파차 콘이 오염된 것으로 나타났고 대부분이 Staphylococcus 계통이었으며, 2종의 소독제 모두 이들 균종에 대해 1분내에 멸균 효과를 나타냈다. 주사전자현미경상 NaOCl로 소독된 가타파차 콘 표면에는 cuboidal crystal 의 침전물이 전반적으로 관찰되었다. 본 연구 결과 2종의 소독제 모두 근관충전 전 가타파차 콘의 rapid sterilization 을 위해 유용하였으나 클로헥시딘으로 처리된 가타파차 콘이 크리스탈 침전물이 없는 좀더 깨끗한 표면을 갖는 것으로 나타났다. The purposes of this study were firstly to identify the microbial species on gutta-percha (GP) cones exposed at outpatient clinics using polymerase chain reaction, and secondly to evaluate the rapid sterilization effect of two chemical disinfectants at chair side. It also evaluated the alteration of surface texture of GP cones after 5-min soaking into two chemical disinfectants. A total of 100 GP cones from two endodontic departments were randomly selected for microbial detection using PCR assay with universal primer. After inoculation on the sterilized GP cones with the same microorganism identified by PCR assay, they were soaked in two chemical disinfectants: 5% NaOCl and 2% chlorhexidine for 1, 3, 5, and 10 minutes. The sterilization effect was evaluated by turbidity and subculture. The change of surface textures using a scanning electron microscope was also examined after 5 min-soaking in two chemical disinfectants. Results showed that four bacterial species were detected in 17 GP cones, and all the species belonged to the genus Staphylococcus. Two chemical disinfectants were effective in sterilization with just 1 minute soaking. On the SEM picture of NaOCl-soaked GP cone, a cluster of cuboidal crystals was seen on the cone surface. Present data demonstrate that two chemical disinfectants are useful for rapid sterilization of GP cone just before obturation at chair side, while CHX-soaked GP cone has cleaner surface without crystal precipitation than that of NaOCl-treated cone.

치과 공포를 갖고 있는 성인에서의 경구 및 아산화질소 복합 진정요법을 이용한 통합적 치과치료의 증례 보고

방난심,이재호,박원서,김기덕,임지영,정복영,김슬기 대한통합치과학회 2013 대한통합치과학회지 Vol.2 No.1

This case report represents to overview of the clinical guidance regarding patients with dental fear. A 43-year-old male patient visited the department of Advanced General Dentistry of Yonsei Dental Hospital for total oral examination and treatment. He had severe dental fear and needle phobia, so wanted general anesthesia or sedation during dental treatment. He got dental treatment under sedation with N2O inhalation and oral medication. He was monitored the vital sign of patient in every 5 minute during treatment procedures. We suggest a clinical guideline for the patient with severe dental fear using conscious sedation.

MTA의 특성과 임상적 적용

방난심,김동진,김기덕,곽은정,정복영,박원서,조진형 대한통합치과학회 2016 대한통합치과학회지 Vol.5 No.2

Mineral trioxide aggregate (MTA) is a calcium silicate-based cement commonly used in endodontic procedures involving pulpal regeneration and hard tissue repair, such as pulp capping, pulpotomy, apexogenesis, apexification, perforation repair, and root-end filling. Since MTA’s introduction in 1993, numerous studies have been published regarding various aspects of this material. The purpose of this paper was to review the composition, properties, biocompatibility, and to give evidence-based recommendation for the clinical use of these materials.

치수,치근단 질환의 진단

방난심,최석근,박원서,정복영,김현성,김기덕,천영재,정지은 대한통합치과학회 2019 대한통합치과학회지 Vol.8 No.2

The correct pulpal and periapical diagnosis is the key to all predictable endodontic treatment. This diagnosis should be based on medical and dental history, presenting symptoms, diagnostic tests and clinical findings. The classification of pulp and periapical diseases which uses terminology related to clinical findings is proposed. This will help clinicians understand the progressive nature of the pulp disease processes and direct them to the most appropriate and conservative treatment strategy for each condition. Based on this, it is important to make a diagnosis correctly and establish proper treatment plan to do right treatment. In the case of conservative or endodontic dentistry, accurate assessment of pulpal and periapical status is the most important thing should be done. The aim of this review is to understand exact method for diagnosing pulpal and periapical tissue status, to diagnose pulpal and periapical disease properly, and to establish right treatment plan.

상아질 접착에서의 Chlorhexidine의 효과

방난심,박원서,조진형,김기덕,이난주,곽은정,정복영 대한통합치과학회 2016 대한통합치과학회지 Vol.5 No.2

This review examines the fundamental mechanism of dentin-resin bond degradation, considers the factors related with this event and furthermore, describes the more practical way to prevent the degradation followed by restoration failure. In spite of rapid development of dental adhesive, dentin-resin bond stability and durability are still major challenge to clinicians. Bacause dentin has unique environments, which are humid and moist, compared to enamel, it is difficult to acquire complete bond. Also presence of endogeneous matrix-metalloproteinases (MMPs) in dentin substrate plays a crucial role in the degradation. So, in order to prevent the degradation, complete infiltration of resin monomer to moist dentin substrate and inhibition of MMPs are essential in bonding process. There are multiple in vivo and in vitro reports showing that the durability and longevity of the dentin-resin bond interface is increased when nonspecific enzyme inhibitors, especially Chlorhexidine (CHX) are used. Among many synthetic inhibitors, chlorhexidine (CHX) is the most widely used MMPs-inhibitor because of its ‘substantivity’. Via its cationic-chelation mechanism, it inhibits MMPs (especially MMP-2, -9) effectively and consequently, reduces nanoleakage and increases bond stability. Also the use of CHX does not affect the immediate bond strength overall and gives no harm to mechanical properties of following adhesive resin. To sum up, the adoption of CHX is recommended as means of improving bond stability at this time.

광조사기의 최신지견

방난심,정복영,최석근,박원서,김기덕,정지은,신정훈 대한통합치과학회 2019 대한통합치과학회지 Vol.8 No.1

As dentin bonding systems develop, resin composites are widely used as restorative materials for anterior and posterior teeth. QTH(Quartz-Tungsten-Halogen), PAC (plasma arc curing) light, LED (light emitting diode) light and laser have been developed and used since UV light was first used for light curing of resin composite in 1970. However, failure to adequately polymerize the resin composite can lead to premature failure of the restoration due to fracture, secondary caries, or excessive wear of the restoration. This review summarizes the types and characteristics of the light curing unit, the photoinitiator of the composite resin, the appropriate light intensity and time of the light curing unit for resin polymerization, the irradiation distance, the polymerization mode, and the risk of blue light. It is possible to reduce the unpolymerization of the resin restoration and increase the longevity of the resin composite restoration by appropriately using light curing unit 상아질 접착 시스템이 발전함에 따라 레진컴포짓은 전치부 및 구치부 치아의 수복 재료로 널리 사용된다. 1970년대 초반 레진컴포짓의 중합에 UV light 이 처음 사용된 이래로 QTH (Quartz-Tungsten-Halogen), PAC (Plasma arc curing) light, LED (Light emitting diode) linght 및 레이저가 광조사기로 개발되어 사용되고 있다. 레진컴포짓은 적절히 중합되지 않으면 수복물의 파절, 이차 우식, 또는 수복물의 과도한 마모로 인한 수복물의 조기 실패를 초래할 수 있다. 이 종설은 광조사기의 종류 및 특성, 레진컴포짓의 광개시제, 레진컴포짓의 중합에 효과적인 광조사기의 광도와 조사시간, 조사 거리, 중합 모드 및 청색광의 위험성에 대한 내용을 정리하였으며 이를 통해 광조사기를 적절히 사용함으로써 미중합 레진을 줄여 수복물의 수명을 연장시키는데 목적이 있다.

Short-term chemical disinfection 후 가타파차 콘의 멸균 효과와 표면 성상 및 물성 변화의 평가

방난심,정일영,유윤정,금기연 대한치과보존학회 2006 Restorative Dentistry & Endodontics Vol.31 No.2

The purposes of this study were firstly to identify the microbial species on gutta-percha (GP) cones exposed at clinics using polymerase chain reaction, and secondly to evaluate the short-term sterilization effect of three chemical disinfectants. It also evaluated the alteration of surface texture and physical properties of GP cones after 5-min soaking into three chemical disinfectants. 150 GP cones from two endodontic departments were randomly selected for microbial detection using PCR assay with universal primer. After inoculation on the sterilized GP cones with the same microorganism identified by PCR assay, they were soaked in three chemical disinfectants: 5% NaOCl, 2% Chlorhexidine, and ChloraPrep for 1, 5, 10, and 30 minutes. The sterilization effect was evaluated by turbidity and subculture. The change of surface textures using a scanning electron microscope and the tensile strength and elongation rate of the GP cones were measured using an Instron 5500(Canton). Statistical analysis was performed. Four bacterial species were detected in 29 GP cones (19.4%), and all the species belonged to the genus Staphylococcus. All chemical disinfectants were effective in sterilization with just 1 minute soaking. On the SEM picture of NaOCl-soaked GP cone, a cluster of cuboidal crystals was seen on the cone surface. The tensile strength of NaOCl-soaked group was significantly higher than the other groups (p<0.05). Also, all disinfectants significantly increased the elongation rate of GP cones compared to the fresh GP cone (p<0.05). Present data demonstrate that three chemical disinfectants are useful for rapid sterilization of GP cone just before obturation. Short-term chemical disinfection 후 가타파차 콘의 멸균 효과와 표면 성상 및 물성 변화의 평가