장애인 구강관리법

이효설(Hyoseol Lee) 대한치과의사협회 2011 대한치과의사협회지 Vol.49 No.12

In the welfare law for the disabled in Korea, the disabled is defined as “the persons sho have significant limitations of daily or social life due to physical or mental disabilities over a long period.” The number of registered domestic disabled person in 2008 survey was approximately 2.1 million. 90% of the disabled was caused by the aposteriori illness or accidents. So, in this aging society, the number of people with disabilities will increase even more. In general, people with physical and mental disabilities tend to have more oral diseases, but, are difficult to get treated. Therefore, a thorough oral care through individualized prevention is more important than ever. In this article, we review the oral care methods in dental office and home and in the hospital for the elderly and finally focus on a denture care method. According to this article, the dental professionals can be able to select and apply the oral care method in agreement with the characteristics of the disabilities. Particularly, it is important to prevent the aspiration pneumonia in the elderly in hospital.

고령장애인의 정의와 일반적, 치과적 특징

이효설(Hyoseol Lee) Asia association of Disability and Oral health 2011 International Journal of Disability and Oral Healt Vol.7 No.2

In Korea, the elderly is defined as the person aged over 65 and the disabled is defined as the person who is registered with Ministry of Health and Welfare. In 2008, the elderly with disabilities was about 770,000. Korea was already poised for an aging society in 2000 and is ahead of and aged society in 2018 and a super aged society in 2026. So, the number of the elderly with disabilities will continue to grow. Various oral diseases can be seen in the elderly with disabilities due to the systemic disease and impaired self oral care, in addition to the physiological aging. Particularly, we should be care for the aspiration pneumonia, which is the major cause of the death of the elderly. As a professional for the special care dentistry, we should understand the general and dental, individual characteristics of the elderly with disabilities and do proper oral care and treatment. Thereby, the quality of life of the patients might be improved.

Clinical Features and Correlation With Congenital Missing Teeth of Delayed First Permanent Molar

이명연,이효설,송제선,이제호,최병재,김성오,김승혜,Lee, Myeongyeon,Lee, Hyoseol,Song, Jeseon,Lee, Jaeho,Choi, Byungjai,Kim, Seongoh,Kim, Seunghye Korean Academy of Pediatric Dentistry 2017 大韓小兒齒科學會誌 Vol.44 No.1

국소적, 전신적 요인을 동반하지 않는 제1대구치의 맹출 지연은 해당 치아의 발육 지연을 동반한다. 본 연구의 목적은 제1대구치의 발육지연의 임상적 양상 및 동반하는 다른 치아의 발달 이상에 관하여 고찰하는 것이다. 국소적 요인이 없이 제1대구치 맹출 지연을 보이는 건강한 어린이 40명의 파노라마방사선 사진 분석을 시행하였다. 2명의 평가자가 Nolla 방법을 이용하여 해당 치아의 발육지연 여부, 해당 분악의 제2대구치 발육 이상 여부 및 제3대구치를 제외한 다른 치아의 선천적 결손 여부에 관하여 조사하였다. 제1대구치의 발육지연은 상악에서 호발하였고, 여성에게서 양측성 이환, 남성에게서 편측성 이환이 많이 관찰되었다. 제1대구치의 발육지연이 있는 환아는 유의하게 높은 선천적 결손치의 유병률을 보였으며, 이환된 분악의 제2대구치는 모두 발육 지연 혹은 선천적 결손의 이상을 보였다. 본 연구결과 제1대구치의 발육지연은 다른 치아의 선천적 결손과 밀접한 연관이 있는 것으로 나타났다. Delayed eruption of the first molar, without a generalized or localized cause, is usually associated with delayed development of the affected tooth. The aim of this study was to investigate the clinical features of the first permanent molar showing delayed development and eruption, and its association with developmental anomalies of other teeth. Panoramic radiographs of 40 healthy children showing delayed development and eruption of first permanent molars were analyzed. The clinical features of affected first molars and developmental anomalies of other teeth (except third molars) were evaluated. Delayed first molars were more frequent in the maxilla. The incidence of bilateral delayed development of first molars was greater than that of unilateral cases in female patients. In contrast, male patients showed unilateral delayed development of the first molar more frequently. A higher incidence of congenitally missing teeth was observed in patients with delayed first molar. In each case, delayed development or congenital absence was observed in the second molar adjacent to the delayed first molar. Overall, delayed first molar seems to be associated with congenital absence of additional teeth. Understanding the developmental mechanisms of this phenomenon requires further studies.

Q-ray view를 이용한 유구치의 숨은 인접면 우식증 탐지

정연욱,이효설,최형준,이제호,최병재,김성오,Jeong, Younwook,Lee, Hyoseol,Choi, Hyungjun,Lee, Jaeho,Choi, Byungjai,Kim, Seongoh 대한소아치과학회 2015 大韓小兒齒科學會誌 Vol.42 No.3

본 연구는 Q-ray view (All in one Bio, Seoul, Korea)가 변연융선이 파괴되지 않은 유구치의 인접면 우식증을 적절히 탐지해 낼 수 있는지 알아보고자 하였다. 두 명의 소아치과의사가 3-9세 사이의 어린이 32명(평균연령 $5.6{\pm}1.3$세)의 유구치 인접면 100개를 시진, Q-ray view, DIAGNOdent (KaVo, Biberach, Germany), 디지털 치근단 방사선사진 촬영으로 평가하였다. 각 검사법과 실제 치료 시 관찰된 인접면 우식증의 진행 정도를 비교하였을 때, 법랑질 우식증에 대한 kappa값은 시진, Q-ray view, DIAGNOdent, 디지털 치근단 방사선사진 촬영 순으로 0.15, 0.10, 0.25, 0.68이었으며, 상아질 우식증에 대한 kappa값은 0.34, 0.56, 0.44, 0.70이었다. Q-ray view는 상아질까지 진행된 유구치의 숨은 인접면 우식증을 탐지하는 데 도움을 줄 수 있는 유용하고 간편한 보조장비가 될 수 있을 것으로 기대된다. The purpose of this study was to evaluate the ability of Q-ray view (All-in-one Bio, Seoul, Korea) in detection of proximal caries in primary molars with sound marginal ridges. Thirty two children aged 3-9 years (average $5.6{\pm}1.3$ years old) were chosen, and two examiners evaluated 100 proximal surfaces of primary molars with sound marginal ridges. The teeth were examined with; (a) visual examination, (b) Q-ray view, (c) DIAGNOdent (KaVo, Biberach, Germany) and (d) digital periapical radiography. Kappa statistic was used to assess the agreement between each examination method and the degree of caries progression. The kappa values for enamel caries were 0.15 (visual examination), 0.10 (Q-ray view), 0.25 (DIAGNOdent) and 0.68 (digital periapical radiography). The kappa values for dentinal caries were 0.34 (visual examination), 0.56 (Q-ray view), 0.44 (DIAGNOdent) and 0.70 (digital periapical radiography). Although Q-ray view showed low diagnostic ability in detection of enamel caries, it was effective in detection of hidden proximal caries extended into dentin. Q-ray view would be a useful and simple device which could aid pediatric dentists in detection of hidden proximal caries in primary molars especially when examining uncooperative children or disabled persons.

미취학 어린이에서 음파 칫솔과 일반 칫솔의 효과

신영섭,이효설,송제선,이제호,Shin, Youngseob,Lee, Hyoseol,Song, Jeseon,Lee, Jaeho 대한소아치과학회 2016 大韓小兒齒科學會誌 Vol.43 No.4

본 연구의 목적은 $L{\ddot{o}}e$ & Silness의 치태지수를 사용하여 음파 칫솔과 일반 칫솔의 효과를 비교하는 것이다. 연세대학교 치과대학병원 소아치과에 내원한 전신질환이 없는 3-6세 어린이 34명을 대상으로 교차설계, 연구자에 대한 눈가림법을 사용한 무작위 대조군 연구가 진행되었다. 연구 참여자는 2개의 군으로 무작위로 나누어져 음파 칫솔과 일반 칫솔을 번갈아 2주씩 사용하였고, 칫솔질 전후 구강위생상태를 $L{\ddot{o}}e$ & Silness의 치태지수를 사용하여 측정하여 차이를 비교하였다. 음파 칫솔 사용 후 $0.26{\pm}0.28$, 일반 칫솔 사용 후 $0.09{\pm}0.22$의 치태지수 감소를 보였고, 이는 통계학적으로 유의한 차이를 보였다(p < 0.05). 성별과 나이에 따른 음파 칫솔의 치태 제거 효과는 통계학적으로 유의한 차이를 보이지 않았다(p > 0.05). 연구 결과, 3-6세 어린이에서 음파 칫솔이 일반 칫솔에 비해 치태 제거 효과는 좋았고, 성별과 연령에 따른 치태 제거 효과의 차이는 나타나지 않았다. The purpose of this study is to compare the effectiveness of sonic and manual toothbrushes using the $L{\ddot{o}}e$ and Silness plaque index (PI). This was an examiner-blind, randomized study with a cross-over design. A total of 34 children (17 males and 17 females) aged 3-6 years were included. Subjects were randomly assigned to two groups: one group used the sonic brush for two weeks before using the manual brush for two weeks, while the other group used the manual brush for two weeks followed by the sonic brush. During each dental visit, plaque indices were recorded and compared to baseline. The results were analyzed using a paired t-test or Pearson correlation test (${\alpha}=0.05$). Thirty children (mean age 4.37 years) complied with the protocol and completed the study. The PI score was 0.09 lower compared to baseline after using a manual toothbrush and 0.26 lower after using the sonic brush. The reduction was statistically significantly greater in the sonic group (p < 0.05). In conclusion, the sonic toothbrush is more effective for reducing plaque than a manual toothbrush.

Three Dimensional Analysis of Primary Maxillary Central and Lateral Anterior Zirconia Crown

이정민(Jungmin Lee),이효설(Hyoseol Lee),남옥형(Okhyung Nam),김미선(Misun Kim),최성철(Sungchul Choi) 大韓小兒齒科學會 2016 大韓小兒齒科學會誌 Vol.43 No.2

This study was performed to compare the shape and dimension of anterior zirconia crowns to other pediatric crowns using a three-dimensional scanner to investigate adequate amount of tooth preparation. Primary central and lateral anterior zirconia crowns, stainless steel crowns and celluloid strip crowns were scanned by a three-dimensional scanner. Outer and inner surfaces of zirconia and stainless steel crowns, and outer surface of celluloid strip crowns were analyzed. In outer scanned images, all sizes of central and lateral size 1 zirconia crown had the largest labiolingual diameter among the three crowns. In inner scanned images, zirconia crown’s mesiodistal diameter was 0.7-1.0 mm smaller and crown length was approximately 1 mm shorter than those of stainless steel crowns. Zirconia crown’s labiolingual diameter was larger in central crowns whereas it was smaller in lateral crowns than that of stainless steel crowns. Recommended preparation required for zirconia crown is incisal 2.5-3.0 mm, mesiodistal 1.5-2.0 mm, labial 0.5-1.0 mm. Cingulum should be trimmed parallel to the long axis. No more lingual reduction is needed in central incisors whereas additional 0.5 mm reduction is suggested in lateral incisors. 본 연구는 전치부 지르코니아 전장관을 위한 적정 치아 삭제량을 조사하기 위해 3차원 스캐너를 이용, 지르코니아와 다른유치 전장관들의 크기와 형태를 분석하였다. 상악 좌측 유중절치, 유측절치 지르코니아 전장관과 금속관의 내/외면, 레진관의 외면을 스캔하여, 근원심경이 유사한 세종류의 전장관을 한 군으로 만들어 분석하였다. 외면에서 모든 중절치, 1번 측절치 지르코니아 전장관이 같은 군의 전장관 중 가장 큰 순설경을 나타냈다. 내면에서 지르코니아 전장관은 금속관에 비해 근원심경 0.7-1.0 mm, 치관길이는 1 mm 가량 작았으며, 순설경은 중절치에서는 더 컸으나 측절치에서는 더 작았다. 비교결과, 지르코니아 전장관은 절단면 2.5-3.0mm, 근원심 1.5-2 mm, 순면 0.5-1 mm, 설면결절을 장축에 평행하게삭제 후 측절치에서만 0.5 mm 설면삭제를 시행하는 것을 제안할 수 있다.

소아에서 상하악골의 위치에 따른 상기도의 시상평면상 계측값의 연관성

김숙희,고미자,남옥형,김미선,이효설,김광철,최성철,Kim, Sookhee,Ko, Mija,Nam, Okhyung,Kim, Misun,Lee, Hyoseol,Kim, Kwangchul,Choi, Sungchul 대한소아치과학회 2018 大韓小兒齒科學會誌 Vol.45 No.3

The respiratory function is relevant to the craniofacial growth and orthodontic diagnosis. The size of the pharyngeal airway was measured in lateral cephalometric view in children visited Kyung Hee University Hospital from January 2015 to August 2017. A total of 74 healthy children (36 boys and 38 girls) aged 7 - 11 years (mean, 8.5 years) with a normodivergent facial pattern were divided into three groups according to anteroposterior jaw relation measuring A point-Nasion-B point (ANB) angle. Lateral cephalometric data were used to measure the airway dimensions. The dimensions of the middle airway were significantly lower, reducing the upper airway space, in large ANB angle group than in other children, suggesting that children with large ANB angle have narrower airway space than others. 본 연구는 소아에서 상하악의 전후방적인 골격적 위치 관계에 따른 기도의 너비를 평가하고자 하였다. 2015년부터 2017년 8월31일까지 경희대학교 치과병원 소아치과에 내원하여 측모두부방사선사진을 촬영한 소아 중 정상적인 안면골격의 수직적 성장 양상을 보이는 7세부터 11세(평균연령 8.5세) 어린이 74명(남아 36명, 여아 38명)을 A point-Nasion-B point (ANB) 각도에 따라 세 군으로 나누어 측모두부방사선사진 계측을 통해 기도 너비를 비교평가하였다. 중기도너비, 하기도너비 및 기능적교합평면상에서의 기도너비에서 통계적으로 유의한 차이를 보였으며, 큰 ANB각도를 지니는 군이 다른 군보다 기도너비가 더 작은 것으로 나타났다. 따라서 골격성 2급 부정교합을 지닌 소아들이 1급이나 3급 부정교합을 지닌 소아보다 기도너비가 더 작은 것으로 사료된다.

치과의사의 아동 학대 및 방임에 대한 인식과 신고 의무 태도

장다혜,채용권,이고은,남옥형,이효설,최성철,김미선,Da Hyeo Jang,Yong Kwon Chae,Ko Eun Lee,Ok Hyung Nam,Hyoseol Lee,Sung Chul Choi,Mi Sun Kim 대한소아치과학회 2023 大韓小兒齒科學會誌 Vol.50 No.1

In this study, the recognition of child abuse and neglect (CAN) and reporting attitudes of general dentists and pediatric dentists in Korea were estimated. A survey was conducted among dentists working at clinics or university hospitals, including interns and residents at dental hospital training institutions. The questionnaire, consisting of 32 questions and detailed questions, subdivided into 'general characteristics of respondents', 'CAN', 'CAN report', 'laws to CAN', 'countermeasures against CAN'. The survey was conducted using a messenger, and 176 respondents' answers were analyzed. The recognition of CAN showed high scores in the order of physical abuse, neglect, and emotional abuse. The positive attitude toward reporting CAN had a higher score than the negative attitude. Of the total respondents, 19 said they reported child abuse, and 18 said they were suspected of child abuse but hesitated to report it. Among the laws related to CAN, the protection measures for CAN reporters and the protocol for CAN showed low awareness. Since then, they have wanted to know how to find abused children and how to deal with them in education. This study is expected to be used as data to improve dentists' awareness and consciousness of CAN in the future.

COVID-19으로 인한 2020년 대한소아치과학회 첫 온라인 제61회 종합학술대회 및 제54회 전공의 학술대회에 대한 설문조사를 통한 분석 및 평가

허란,이고은,김미선,남옥형,이효설,최성철,Herr, Lan,Lee, Koeun,Kim, Mi Sun,Nam, Okhyung,Lee, Hyoseol,Choi, Sungchul 대한소아치과학회 2021 大韓小兒齒科學會誌 Vol.48 No.4

코로나바이러스감염증-19로 인해 2020년 대한소아치과학회 제61회 종합학술대회 및 제54회 전공의 학술대회가 처음으로 온라인으로 진행되었다. 이번 학술대회는 ZOOM 플랫폼을 이용해 주최측의 독자적인 운영으로 진행되었다. 온라인 학술대회의 만족도 분석 및 평가를 위해 학회 참석자들을 대상으로 Google Forms을 이용해 무기명 설문조사를 시행하였다. 첫 온라인 학술대회 인만큼 학회 전 사전접속 테스트를 이용해 학회의 원활한 진행을 도왔으며, 그 결과, 사전접속 테스트가 도움이 되었을 경우 그렇지 않은 경우에 비해 온라인 학회에 만족할 가능성이 높았다. 첫 온라인 전공의 학술대회 또한 전공의 발표자들과 연자들에게 큰 호응을 얻어냈다. 온라인 학술대회는 종식 시기를 가늠할 수 없는 전염성 코로나바이러스감염증-19의 사회적 거리두기 및 방역수칙을 잘 반영한 좋은 선택이었다. The 61^st Korean Academy of Pediatric Dentistry congress was hosted online for the first time in 2020 due to coronavirus disease-19. The congress was operated using the ZOOM platform. The aim of this paper is to analyze and evaluate the overall satisfaction and feedbacks from congress participants via anonymous Google Forms online survey. A test meeting was previously organized before the actual congress to facilitate the smooth process and the participants overall showed high satisfaction. Members who participated in test meeting compared to those who did not, found it significantly helpful, which contributed overall higher satisfaction with the online congress. Abstracts were accepted from the current pediatric dentistry residents and the oral presentations were also held online for the first time. The presenters and the judges were overall very satisfied. In an unguaranteed situation of termination of coronavirus disease-19, the decision to conduct an online congress was a favorable option.

실시간 중합효소연쇄반응 방법을 이용한 새로운 치아우식 활성 검사법의 유효성

권도윤,김희진,남옥형,김미선,최성철,김광철,이효설,Kwon, Doyoun,Kim, Heejin,Nam, Okhyung,Kim, Misun,Choi, Sungchul,Kim, Kwangchul,Lee, Hyoseol 대한소아치과학회 2018 大韓小兒齒科學會誌 Vol.45 No.3

Periogen is a new caries activity test using real-time polymerase chain reaction. The aim of this study was to assess the validity of Periogen by evaluating the correlation with dmft, dmfts indices and comparing with Cariview and caries risk assessment tool (CAT). 83 children under 6 participated in this study. Dmft, dmfts indices and CAT were collected through an examination of oral health status. Plaque samples for Periogen and Cariview were collected and manipulated according to the manufactures' instructions. The correlation coefficient of Periogen, Cariview and CAT with the dmfts index were 0.38, 0.56 and 0.66 in each (p < 0.01). The sensitivity of Periogen, Cariview and CAT were 43%, 76% and 95% and specificity were 80%, 72% and 74% respectively. Area under curve under the receiver operating characteristic curves in each method indicated 0.69, 0.81 and 0.85. CAT and Cariview were more effective in evaluation the risk of dental caries than Periogen so far. To be used Periogen clinically, more improvements for higher validity were needed. Periogen은 실시간 PCR 방법을 이용한 우식활성 검사법으로, 치아우식 유발균에 대한 정량적인 분석을 통해 개개인의 치아우식 위험도를 평가한다. 이 연구는 소아에서 Periogen과 치아우식 경험 지수(dmft, dmft indices)와의 상관성을 평가하고, 기존의 치아우식 위험 검사법인 Cariview, 치아우식 평가 도구(Caries Assessment Tool)와 비교할 목적으로 시행되었다. 만 6세 미만 83명의 소아를 대상으로 실험이 진행되었다. 시진을 통해 치아우식 경험 지수(dmft, dmft indices)가 기록되었으며, 간단한 설문 조사를 통해 CAT 평가 시행되었다. Periogen, Cariview는 제조사의 지시에 따라 치아우식 위험도 평가 시행되었다. 그 결과 Periogen, Cariview 그리고 CAT는 dmfts index와 상관계수가 각각 0.38, 0.56, 0.66을 보여 모두 중등도의 상관관계를 보였다(p < 0.01). Periogen, Cariview 그리고 CAT의 민감도와 특이도 분석의 경우, 민감도는 각각 43%, 76%, 95%를 보였으며, 특이도는 각각 80%, 72%, 74%를 보였다. ROC 곡선의 곡선하면적(AUC)는 각각 0.69, 0.81, 0.85를 보였다. Periogen의 경우 다른 기존의 두 가지 검사법에 비해 치아우식 위험도 평가에 있어 더 낮은 유효성을 보였다. 따라서 임상적으로 사용되기 위해서는 더 나은 유효성을 위한 개량이 필요할 것으로 보인다.