EQ-5D 지수를 활용한 만성질환별 삶의 질의 성별 및 연령에 따른 변화: 2017~2019년 국민건강영양조사 자료를 이용하여

채경준,박세호,송승아,이준규,홍종민,김남준 한국농촌의학.지역보건학회 2023 농촌의학·지역보건 Vol.48 No.2

Objectives: This study analyzed the decline in quality of life according to age in the chronic disease patient group, quantified it as a quantitative index, and compared it by sex and chronic disease. Methods: In the 2017-2019 Korea National Health and Nutrition Examination Survey database, 11,473 adults aged 19 years or older, excluding cancer patients, were analyzed for age-specific changes in the EQ-5D Index by chronic disease. The decline in quality of life according to age in patients with chronic diseases was analyzed by linear regression analysis while controlling for general characteristics. Then, linear regression analysis was performed according to sex. Results: In the case of the control group, the quality of life decreased by 0.0004 for every 1-year increase in age(P<0.001). By chronic disease, asthma(β=0.0019, P<0.001), arthritis(β=0.0017, P=0.002), thyroid disease( β=0.0016, P=0.015), dyslipidemia(β=0.0011, P=0.020), and hypertension(β=0.0009, P=0.027) mostly showed a greater decrease in quality of life than the control group. In addition, when divided into two groups by sex, hypertension(β=0.0012, P=0.029), thyroid disease(β=0.0041, P=0.038), and arthritis(β=0.0022, P<0.001) showed a significant decrease in quality of life only in male. Diabetes(β=0.0056, P=0.038), dyslipidemia( β=0.0022, P=0.001) significantly decreased quality of life only in female. Conclusions: Chronic disease had a negative impact on patients perception of quality of life, and the more severe the pain and activity limitation due to the chronic disease, the more severe it was. It also showed different patterns according to sex. Therefore, it is necessary to allocate more medical resources and provide policy support to prevent chronic diseases, which are serious social problems.

백서 두개골 결손부에서 항생제를 함유한 키토산 차단막의 골재생 유도 효과

채경준,김태균,정의원,이수복,정용식,이용근,김창성,채중규,조규성,김종관,최성호,Chae, Gyung-Joon,Kim, Tae-Gyun,Jung, Ui-Won,Lee, Soo-Bok,Jung, Yong-Sik,Lee, Yong-Keun,Kim, Chang-Sung,Chae, Jung-Kiu,Cho, Kyoo-Sung,Kim, Chong-Kwan,Choi, S 대한치주과학회 2005 Journal of Periodontal & Implant Science Vol.35 No.4

The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease as well as the reduction of signs and symptoms of progressive periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. There have been increasing interest on the chitosan made by chtin. Chitosan is a derivative of chitin made by deacetylation of side chains. Chitosan has been widely studied as bone substitution and membrane material in periodontology. Many experiments using chitosan in various animal models have proven its beneficial effects. Tetracycline has been considered for use in the treatment of chronic periodontal disease and gingivitis. The aim of this study is to evlauate the osteogenesis of tetracycline blended chitosan membranes on the calvarial critical size defect in Sprague Dawley rats. An 8mm surgical defect was produced with a trephine bur in the area of the midsagittal suture. The rats were divided into five groups: Untreated control group versus four experimental group. Four types of membranes were made and comparative study was been done. Two types of non-woven membranes were made by immersing non-woven chitosan into either the tetracycline solution or chitosan-tetracycline solution. Other two types of sponge membranes were fabricated by immersing chitosan sponge into the tetracycline solution, and subsequent freeze-drying. The animals were sacrificed at 2 and 8 weeks after surgical procedure. The specimens were examined by histologic analyses. The results are as follows: 1. Clinically the use of tetracycline blended chitosan membrane showed great healing capacity. 2. The new bone formations of all the experimental group, non-woven and sponge type membranes were greater than those of control group. But, there was no significant difference between the experimental groups. 3. Resorption of chitosan membranes were not shown in any groups at 2 weeks and 8 weeks. These results suggest that the use of tetracycline blended chitosan membrane on the calvarial defects in rats has significant effect on the regeneration of bone tissue in itself. And it implicate that tetracycline blended chitosan membrane might be useful for guided tissue regeneration.

The effects of Hydroxyapatite nano-coating implants on healing of surgically created circumferential gap in dogs

채경준,임현창,최정유,정성민,이인섭,조규성,김종관,최성호 대한치주과학회 2008 Journal of Periodontal & Implant Science Vol.38 No.2

Purpose: The aim of this study is to compare the healing response of various Hydroxyapatite(HA) coated dental implants by Ion-Beam Assisted Deposition(IBAD) placed in the surgically created circumferential gap in dogs. Materials and methods: In four mongrel dogs, all mandibular premolars and the first molar were extracted. After an 8weeks healing period, six submerged type implants were placed and the circumferential cylindrical 2mm coronal defects around the implants were made surgically with customized step drills. Groups were divided into six groups : anodized surface, anodized surface with 150nm HA and heat treatment, anodized surface with 300nm HA and heat treatment, anodized surface with 150nm HA and no heat treatment, and anodized surface with 150nm HA, heat treatment and bone graft, anodized surface with bone graft. The dogs were sacrificed following 12 weeks healing period. Specimens were analyzed histologically and histomorphometrically. Results: During the healing period, healing was uneventful and implants were well maintained. Anodized surface with HA coating and 430゜C heat treatment showed an improved regenerative characteristics. Most of the gaps were filled with newly regenerated bone. The implant surface was covered with bone layer as base for intensive bone formation and remodeling. In case that graft the alloplastic material to the gaps, most of the coronal gaps were filled with newly formed bone and remaining graft particles. The bone-implant contact and bone density parameters showed similar results with the histological findings. The bone graft group presented the best bone-implant contact value which had statistical significance. Conclusion: Within the scope of this study, nano-scale HA coated dental implants appeared to have significant effect on the development of new bone formation. And additional bone graft is an effective method in overcoming the gaps around the implants. (J Korean Acad Periodontol 2008;38:373-384) Purpose: The aim of this study is to compare the healing response of various Hydroxyapatite(HA) coated dental implants by Ion-Beam Assisted Deposition(IBAD) placed in the surgically created circumferential gap in dogs. Materials and methods: In four mongrel dogs, all mandibular premolars and the first molar were extracted. After an 8weeks healing period, six submerged type implants were placed and the circumferential cylindrical 2mm coronal defects around the implants were made surgically with customized step drills. Groups were divided into six groups : anodized surface, anodized surface with 150nm HA and heat treatment, anodized surface with 300nm HA and heat treatment, anodized surface with 150nm HA and no heat treatment, and anodized surface with 150nm HA, heat treatment and bone graft, anodized surface with bone graft. The dogs were sacrificed following 12 weeks healing period. Specimens were analyzed histologically and histomorphometrically. Results: During the healing period, healing was uneventful and implants were well maintained. Anodized surface with HA coating and 430゜C heat treatment showed an improved regenerative characteristics. Most of the gaps were filled with newly regenerated bone. The implant surface was covered with bone layer as base for intensive bone formation and remodeling. In case that graft the alloplastic material to the gaps, most of the coronal gaps were filled with newly formed bone and remaining graft particles. The bone-implant contact and bone density parameters showed similar results with the histological findings. The bone graft group presented the best bone-implant contact value which had statistical significance. Conclusion: Within the scope of this study, nano-scale HA coated dental implants appeared to have significant effect on the development of new bone formation. And additional bone graft is an effective method in overcoming the gaps around the implants. (J Korean Acad Periodontol 2008;38:373-384)

상악에 식립된 Frialit-2 임플란트의 성공률에 대한 후향적 연구

채경준,정의원,김창성,심준성,조규성,김종관,최성호,Chae, Gyung-Joon,Jung, Ui-Won,Kim, Chang-Sung,Shim, June-Sung,Cho, Kyoo-Sung,Kim, Chong-Kwan,Choi, Seong-Ho 대한치주과학회 2005 Journal of Periodontal & Implant Science Vol.35 No.2

Objectives Aim of this study was to evaluate the clinical use and the efficacy of Frialit-2 implant system. Experimental Methods Fifty nine patients received placement of Frilalit-2 implants(137 implants) in their maxillary anterior and posterior sites(40 and 97 implants). Intraoral & clinical examination, chart review and radiographs were taken from each patient. Results 1. The total implant survival rate was 92.7% after a mean follow-up period of 19.9 months. 2. The implant survival rate placed in anterior region was 97.5%. 3. The implant survival rate placed in posterior region was 90.7%. 4. The implant survival rate placed in atrophic posterior maxilla with advanced technique (GBR, Sinus elevation) was 87.2%. 5. The implant survival rate placed in type N(D4) bone was 82%, while 95.7% in type III (D3), and 100% in type II(D2) bone. 6. Most of the failed implants(7 of 10) were removed during the maintenance stage after prosthodontic treatment. Conclusion It was concluded that Frialit-2 implant could be used satisfactorily in the esthetic anterior region, but the use in the posterior region, especially with poor bone quality and quantity, further studies are needed.

ITI TE? 임플란트의 단기 생존율 및 치유 양상에 대한 연구

채경준,정성민,정의원,조규성,채중규,김종관,최성호,김창성 대한치주과학회 2006 Journal of Periodontal & Implant Science Vol.36 No.3

The analysis of short term success rate and healing patterns of Implantium Implant

($Implantium^{(R)}$) implant의 단기 생존율 및 치유 양상에 대한 연구

채경준,정성민,정의원,조규성,채중규,김종관,최성호,김창성,Chae, Gyung-Joon,Chung, Sung-Min,Jung, Ui-Won,Cho, Kyoo-Sung,Chai, Jung-Kyu,Kim, Chong-Kwan,Choi, Seong-Ho,Kim, Chang-Sung 대한치주과학회 2006 Journal of Periodontal & Implant Science Vol.36 No.3

This study is an analysis of distribution of patients who installed Implantium implant in Yonsei University Dental Hospital and types of implant site for about 1 years recall check and success rate. 164 implants were installed to 52 patients in this study. It shows the conclusion below. 1. Patients at the age of 40s and 50s were 65% of all implant cases and average number of implant was 4 (man), and 2.7 (woman). 75 implants were operated on maxilla and 89 were mandible. 19 implants on anterior region and 145 implants on posterior region. 2. Most distribution of bone qaulity for implant site was type III(37.2%) and bone quantity was type C(61. 7%) 3. The majority of implants were those of 10, 12mm in length (85%) and regular diameter in width (48.8%). 4. 30 implants were installed with the advanced technique-GER, window opemng, osteotome technique. 5. Two implants were removed before prosthodontic treatment due to the osseointegraton failure. The success rate was 98.8% in 15.2 months follow up period and the marginal bone loss was 0.28mm. The results provided us with basic data on patient type, implant distribution, bone condition, and survival rate. Within the limit of present study, It was concluded that Implantium implant could be used satisfactorily in various clinical situations.

상악동 거상술을 이용하여 구치부에 식립된 $Br{\aa}nemark$ Ti-Unite와 ITI SLA 임플란트의 임상적 평가

홍성배,채경준,정의원,김창성,심준성,최성호,조규성,김종관,Hong, Seong-Bae,Chai, Gyung-Joon,Jung, UI-Won,Kim, Chang-Sung,Chim, Joon-Sung,Choi, Seong-Ho,Cho, Kyoo-Sung,Kim, Chong-Kwan 대한치주과학회 2005 Journal of Periodontal & Implant Science Vol.35 No.4

The predictable outcome of implant placement in the atrophic maxilla with sinus floor elevation procedure(osteotome sinus floor elevation technique and window opening technique) is well documented. Aim of this study was to evaluate the efficacy of $Br{\aa}nemark$ Ti-Unite implant system and ITI SLA implant system placed in the atrophic posterior maxilla with sinus floor elevation procedure. Eighty patients received placement of $Br{\aa}nemark$ Ti-Unite implants(195 implants) in their atrophic posterior Maxilla with sinus floor elevation procedure(153 osteotome sinus floor elevation technique and 42 window opening procedure). Fifty patients received placement of ITI SLA implants(83 implants) in their atrophic posterior Maxilla with sinus floor elevation procedure(77 osteotome sinus floor elevation technique and 6 window opening procedure). Chart review were taken from each patient. The total failed implants were seven and the total implant survival rate was 96.4% in $Br{\aa}nemark$ Ti-Unite system. The total failed implants were one and the total implant survival rate was 98.8% in ITI SLA system. The implant survival rate with osteotome technique was 96% and 97.6% with window opening in $Br{\aa}nemark$ Ti-Unite system. The implant survival rate with osteotome technique was 98.7% and 100% with window opening. The implant survival rate with osteotome technique was 96% and 97.6% with window opening in ITI SLA system. The results of this evaluation show that the placement of $Br{\aa}nemark$ Ti-Unite system as well as ITI SLA system is a reasonable treatment option for patients with the atrophic posterior maxillary area.

Influence of the Sonic Power Toothbrush on Reduction of Gingival inflammation and on the Amount of interleukin-6, Prevotella intermedia and Actinobacillus actinomycetemcomitans in Periodontal Pocket

홍지연,채경준,정성원,엄유정,최성호,김종관,Hong, Ji-Youn,Chae, Gyung-Joon,Jung, Sung-Won,Um, Yoo-Jung,Choi, Seong-Ho,Kim, Chong-Kwan The Korean Academy of Periodontoloy 2007 Journal of Periodontal & Implant Science Vol.37 No.2

세균성 치태는 치은의 염증과 치주 조직 파괴를 동반하는 치주염의 주요한 인자로서 치주 조직 건강을 유지하기 위하여 적절한 치태 조절이 필요하다. 본 논문의 목적은 12주 동안 만성 초기 및 중등도 치주염 환자에서 치은염에 대한 임상 지수의 감소, interleukin-6 (IL-6) 농도와 치주질환 원인균인 Prevotella intermedia (P. intermedia), Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans)에 대한 소니케어 전동 칫솔의 효과를 일반 칫솔과 비교해 보고자 하는 데 있다. 총 82명의 환자를 선택하였으며, 30명은 일반 칫솔, 52명은 소니케어 전동 칫솔 군으로 분류하여 칫솔질 교육을 실시하였다. 전악을 전치부와 구치부로 나누어 초진, 1, 4, 12주에서의 치태, 치은 지수 및 탐침 시 출혈 여부를 조사하였으며, 가장 깊은 치주낭 탐침을 보이는 치아 3개를 선택하여 탐침 깊이와 부착 정도를 측정하였고, 선택된 치아에서 초진, 1, 12주에 채취된 샘플을 통해 치은열구액 내의 IL-6 농도와 P. intermedia, A. actinomycetemcomitans의 CT값을 추가적으로 조사하여 다음과 같은 결과를 얻었다. 1 소니케어 전동 칫솔과 일반 칫솔군 모두 치은 염증을 나타내는 임상 지수 (치태지수, 치은지수, 탐침 시 출혈)는 12주 기간 동안 유의한 감소 (p<0.05)를 보였으나, 전동 칫솔 군에서 통계학적으로 더욱 유의하게 (p<0.05) 나타났다. 2. 전치부를 제외한 구치부 치아에서 소니케어 전동 칫솔군은 12주 기간 동안 탐침 시 출혈의 감소가 통계학적으로 유의하게 (p<0.05) 나타났다. 3. 가장 깊은 치주낭 탐침 깊이를 보이는 3개의 선택된 치아에서 치주낭 탐침 깊이와 부착 정도는 두 군 모두 초진에 비해 유의한 감소 (p<0.05)를 보였다. 퍼센트 변화 비교에서 치주낭 탐침 깊이는 소니케어 전동 칫솔군이 $18.47{\pm}10.05%$, 일반 칫솔군이 $14.19{\pm}8.16%$로, 부착 정도는 소니케어 전동 칫솔군이 $24.26{\pm}12.51%$, 일반 칫솔군이 $15.65{\pm}9.92%$로 각각 나타났으나, 군 간 통계적 유의차는 보이지 않았다. 4. 치은열구액의 IL-6 농도는 두 군 모두 12주 기간 동안 통계적으로 유의한 감소 (p<0.05)를 나타내었다. 퍼센트 변화 비교에서 전동 칫솔군은 51%, 일반 칫솔군은 37%로 각각 나타났으나, 군 간 통계적 유의차는 보이지 않았다. 5. Prevotella intermedia, Actinobacillus actinomycetemcomitans의 관찰에서 두 군 모두 유의한 차이는 없었다. 위 결과를 통해 본 연구에서는 소니케어 전동 칫솔의 사용이 일반 칫솔에 비하여 만성 초기 및 중등도 치주염 환자에서 치태의 제거, 치은 염증 및 임상 지수의 감소에 유의한 효과가 있으며 IL-6의 감소 경향에도 효과가 있음을 관찰하였다.

Evaluation of Sonic Toothbrush on the Reduction of Clinical Parameters, Interleukin-1, MMP-8 and Periodontal Pathogens in Incipient to Moderate Periodontitis

유호선,채경준,홍지연,최성호,김종관 대한치과의사협회 2008 대한치과의사협회지 Vol.46 No.12

Daily plaque removal with toothbrush is an important component of oral hygiene program to prevent and treat periodontal diseases.1-4) Although it has been reported that both manual and electric toothbrushes are effective in removing supragingival plaque and reducing clinical signs of gingival inflammation, several recent studies reported that electric toothbrushes show superiority to manual brushes.5-11) The Sonicare® toothbrush utilizes solid-state electronics to create sonic-frequency bristle movement with 520 brush strokes per second. This rapid bristle movement creates dynamic activities in surrounding fluids in addition to its scrubbing plaque-removing activity. It has been suggested that these fluid forces lift and disperse plaque bacteria from tooth surfaces about 2-3 mm beyond the physical reach of the bristles.12-15) Furthermore, in vitro experiments have shown that low-amplitude acoustic energy such as that generated by the Sonicare® brush has structural and metabolic effects on oral bacteria, which may retard their ability to form plaque by disrupting bacterial adherence properties.16) Increased levels of bacterial pathogens common in periodontal pockets are known to be associated with an elevated biochemical inflammatory response that promotes bone resorption. Understanding the process of periodontal pathogenesis in terms of the biochemical pathway prompted by greater than normal levels of bacteria and mitigating the subsequent effects is a primary component of periodontal therapy.17-20) The most potent pro-inflammatory cytokine stimulating bone resorption is interleukin-1 (IL-1).21,22) IL-1 is a pleiotropic cytokine having multiple biological activities including stimulation of osteoclast recruitment and activation. IL-1 also stimulates fibroblast to produce matrix metalloproteinases (MMPs) important for the degradation of non-mineralized extracellular tissue. Several studies have reported increased levels of inflammatory mediators, such as IL-1 and prostaglandin E2 (PGE2), in gingival crevicular fluids (GCFs) from diseased sites exhibiting periodontal bone loss when compared with healthy sites. Furthermore, GCF from diseased sites has been shown to stimulate bone resorption in vitro to a higher degree than GCF from healthy sites. One important factor responsible for this bone resorbing activity seems to be IL-1.21-24) Matrix metalloproteinases (MMPs) are enzymes activated by IL-1 and are involved in tissue destruction and regeneration.15) A complex cascade involving both host and microbial derived proteinases mediates extracellular matrix degradation during periodontal disease. In this regard, the host-derived MMPs are thought to play a key role. Enhanced activity of these enzymes is a consequence of microbial induced inflammation in the periodontal tissues. Polymorphonuclear leukocyte (PMN)-derived MMPs (MMP-8, MMP-9) are the main proteinases related to tissue destruction and remodeling events in periodontal diseases.23) Traditional clinical measurements such as assessments of probing pocket depth, attachment level, gingival inflammation and microbial plaque yield only historic information about periodontal status. By directly analyzing the changes in the levels of MMPs and IL-1 in GCF, we can associate parameters of inflammation with clinical parameters of tissue destruction. Among several methods that have been applied to detect periodontopathogenic microorganisms, nucleic acid-based methods using DNA probes can give insight on changes in bacterial counts in the periodontal pocket.24) Objectives of this study were to assess the effects of the Sonicare® toothbrush on clinical parameters [Probing Pocket Depth (PPD), Plaque index (PI), Gingival index (GI), Bleeding on probing (BOP), Clinical attachment level (CAL)] and to evaluate the changes in MMP-8, IL-1 and the reduction of 4 bacterial species (PG, TF, SS, AV) testing 16S rRNA at 3 sites of selected teeth with moderate chronic periodont... Daily plaque removal with toothbrush is an important component of oral hygiene program to prevent and treat periodontal diseases.1-4) Although it has been reported that both manual and electric toothbrushes are effective in removing supragingival plaque and reducing clinical signs of gingival inflammation, several recent studies reported that electric toothbrushes show superiority to manual brushes.5-11) The Sonicare® toothbrush utilizes solid-state electronics to create sonic-frequency bristle movement with 520 brush strokes per second. This rapid bristle movement creates dynamic activities in surrounding fluids in addition to its scrubbing plaque-removing activity. It has been suggested that these fluid forces lift and disperse plaque bacteria from tooth surfaces about 2-3 mm beyond the physical reach of the bristles.12-15) Furthermore, in vitro experiments have shown that low-amplitude acoustic energy such as that generated by the Sonicare® brush has structural and metabolic effects on oral bacteria, which may retard their ability to form plaque by disrupting bacterial adherence properties.16) Increased levels of bacterial pathogens common in periodontal pockets are known to be associated with an elevated biochemical inflammatory response that promotes bone resorption. Understanding the process of periodontal pathogenesis in terms of the biochemical pathway prompted by greater than normal levels of bacteria and mitigating the subsequent effects is a primary component of periodontal therapy.17-20) The most potent pro-inflammatory cytokine stimulating bone resorption is interleukin-1 (IL-1).21,22) IL-1 is a pleiotropic cytokine having multiple biological activities including stimulation of osteoclast recruitment and activation. IL-1 also stimulates fibroblast to produce matrix metalloproteinases (MMPs) important for the degradation of non-mineralized extracellular tissue. Several studies have reported increased levels of inflammatory mediators, such as IL-1 and prostaglandin E2 (PGE2), in gingival crevicular fluids (GCFs) from diseased sites exhibiting periodontal bone loss when compared with healthy sites. Furthermore, GCF from diseased sites has been shown to stimulate bone resorption in vitro to a higher degree than GCF from healthy sites. One important factor responsible for this bone resorbing activity seems to be IL-1.21-24) Matrix metalloproteinases (MMPs) are enzymes activated by IL-1 and are involved in tissue destruction and regeneration.15) A complex cascade involving both host and microbial derived proteinases mediates extracellular matrix degradation during periodontal disease. In this regard, the host-derived MMPs are thought to play a key role. Enhanced activity of these enzymes is a consequence of microbial induced inflammation in the periodontal tissues. Polymorphonuclear leukocyte (PMN)-derived MMPs (MMP-8, MMP-9) are the main proteinases related to tissue destruction and remodeling events in periodontal diseases.23) Traditional clinical measurements such as assessments of probing pocket depth, attachment level, gingival inflammation and microbial plaque yield only historic information about periodontal status. By directly analyzing the changes in the levels of MMPs and IL-1 in GCF, we can associate parameters of inflammation with clinical parameters of tissue destruction. Among several methods that have been applied to detect periodontopathogenic microorganisms, nucleic acid-based methods using DNA probes can give insight on changes in bacterial counts in the periodontal pocket.24) Objectives of this study were to assess the effects of the Sonicare® toothbrush on clinical parameters [Probing Pocket Depth (PPD), Plaque index (PI), Gingival index (GI), Bleeding on probing (BOP), Clinical attachment level (CAL)] and to evaluate the changes in MMP-8, IL-1 and the reduction of 4 bacterial species (PG, TF, SS, AV) testing 16S rRNA at 3 sites of selected teeth with moderate chronic periodontitis follo...

임상포스터 발표 : 치주치료후 발생하는 치아 민감성에 대한 HA첨가 치약의 민감성 예방 효과

김민수,채경준,최성호,채중규,김종관,조규성 대한치주과학회 2007 대한치주과학회 학술대회자료집 Vol.2007 No.2