Type III 치내치를 동반한 상악 측절치에 이환된 치근단 병소의 근관 치료

김기림,이제호,김성오,송제선,최병재,김승혜,최형준,Kim, Ki-Rim,Lee, Jae-Ho,Kim, Seong-Oh,Song, Je-Seon,Choi, Byung-Jai,Kim, Seung-Hye,Choi, Hyung-Jun 대한소아치과학회 2012 大韓小兒齒科學會誌 Vol.39 No.2

치내치는 치아 조직이 석회화되기 전에 법랑기가 치유두 내로 함입되어 형성된 발육성 기형이다. 가장 널리 통용되는 치내치의 분류법은 방사선 사진 상에서 함입(invagination)이 얼마나 치관에서 치근 쪽으로 연장되어 있는지에 따라 분류하는 Oehler's classification system이다. 그 중 Oehler's classification type III는 함입이 치근까지 연장되어 치주인대와 직접적으로 'pseudo foramen'을 통해 교통하는 경우를 말하며 대체로 치수와는 독립적으로 존재한다. Type III 함입을 통한 감염은 언제나 치주조직의 염증성 반응을 야기할 가능성이 있으며, 이처럼 'pseudo foramen' 주위로 염증성 병변이 발생한 경우 이를 'peri-invagination periodontitis'라 한다. 본 증례는 Oehler's type III 치내치를 갖는 상악 측절치의 'peri-invagination periodontitis'을 주소로 내원한 두 환자에게 각각 다른 치료적 접근을 통하여 양호한 결과를 얻었다. 치내치에 대한 처치 시 조기 진단과 예방적 치료를 통한 치수의 건강 유지가 매우 중요하나, 이미 치수까지 질환에 이환 되었을 경우 환아의 나이, 치근 성숙도, 함입의 종류, 염증의 치수 이환 여부 등을 고려하여 치료계획을 수립해야 한다. Dens invaginatus is a developmental anomaly resulting in a deepening or invagination of the enamel organ into the dental papilla prior to calcification of the dental tissues. The most widely used classification of dens invaginatus is the system described by Oehler categorizes invaginations into three classes as determined by how far they extend radiographically from the crown into the root. Oehler's classification type III is that the invagination extends through the root and communicates with the periodontal ligament. There is usually no communication with the pulp. In Type III lesions, any infection within the invagination can lead to an inflammatory response within the periodontal tissues giving rise to a 'peri-invagination periodontitis'. In the cases presented here, we treated two patients who were refered for 'peri-invagination periodontitis' on maxillary lateral incisor with Oehler's type III invagination by different approaches each, and they have shown satisfactory outcomes. Although there are several approaches to the management of dens invaginatus, the most important objective is to preserve the health of the pulp, which can be achieved by early diagnosis and the prophylactic treatment regardless of severity. When disease has developed, decision has to be made whether to treat the invagination and the pulp separately.

Axenfeld-Rieger 증후군과 연관된 치과적 이상

김기림(Ki-Rim Kim),이두영(Doo-Young Lee),김승혜(Seung-Hye Kim),이상휘(Sang-Hui Lee),최병재(Byung-Jai Choi),이제호(Jae-Ho Lee) Asia association of Disability and Oral health 2010 대한장애인치과학회지 Vol.6 No.2

저자는 Axenfeld-Rieger 증후군을 가지는 5세 8개월 연환에 대한 구강 및 두개 안면에 대한 임상적, 방사선학적 관찰을 통해 다음과 같은 지견을 얻었다. 1. 본 증례의 환아는 Axenfeld-Rieger 증후군의 전형적인 안과적, 구강적, 전신적 특징인 녹내장, 동공이상, 제탈장, 지연된 골령, 다수 치아 및 치배 결손, 상악 저 성장 등을 보였다. 2. 이에 대한 주기적인 관찰과 적절한 시기의 치료개입이 중요하다. 3. 치과의사에 의한 조기진단이 녹내장 등에 의한 시력 상실을 방지하기 위해 중요하다. Axenfeld-Rieger syndrome is a rare autosomal dominant disorder characterized by various ocular and extraocular malformations. The incidence of Axenfeld-Rieger syndrome has been estimated to be 1 per 200,000. The syndrome is characterized by short body stature, delayed bone age, and deficient or arrested development of neural crest cells involving the anterior chamber of the eyes, facial bones, teeth, periumbilical skin, and cardiovascular system. This is a case of a 6 year-old girl, who came to the department of the pediatric dentistry, Yonsei University Dental Hospital, for evaluation and treatment of multiple congenital missing permanent teeth. The patient presented typical dental, craniofacial, and systemic features of Axenfeld-Rieger syndrome, such as glaucoma, oval pupil, heterochromatic iris, umbilical hernia, and delayed bone age. On the panoramic view, 3 primary teeth were missing and 13 permanent tooth germs were absent. On the lateral cephalograph, nderdevelopment of the maxilla and normal growth pattern of the mandible were confirmed. Periodic dental follow-up is planned for evaluation and interceptive treatment of her dental and craniofacial problems. Denture or removable space maintainer with a pontic is considered for esthetic and functional restoration. In addition, orthognathic surgery is also planned in future to prevent further midfacial skeletal deformation. Early diagnosis of Axenfeld-Rieger syndrome is very important to prevent exacerbation of complications, such as glaucoma and skeletal deformities.

교육시설의 적절한 빛환경 조성을 위한 G-SEED 차양 기준 적정성에 관한 연구 - 빛환경 시뮬레이션을 통한 비교검증 -

김기림(Kim, Ki Rim),이경선(Lee, Kyung Sun),조혜성(Cho, Hyesung) 대한건축학회 2023 대한건축학회논문집 Vol.39 No.2

자폐증 환자에서 함치성 낭종과 연관된 매복치의 처치

김기림(Ki-Rim Kim),송제선(Je-Seon Song),최병재(Byung-Jai Choi),김승혜(Seung-Hye Kim),이제호(Jae-Ho Lee) Asia association of Disability and Oral health 2011 International Journal of Disability and Oral Healt Vol.7 No.1

자폐증을 진단 받은 16세 남환이 하악 좌측 부위의 낭종 및 매복치를 주소로 내원하였다. 해당낭종은 함치성 낭종으로 최종 진단 되었으며 일일 입원 및 전신 마취 하에 낭종의 적출 및 매복치의 발거와 자가 이식을 시행 후 치근단 형성술 진행하였다. 2년 6개월 경과 관찰한 현재 주소 증상은 사라지고 재발 성향은 없으나, 치근단 염증 소견 및 발거 부위 공간 소실 등의 합병증이 관찰된다. 저자는 본 증례를 통해 다음과 같은 지견을 얻었다. 1. 함치성 낭종의 치료는 일반적으로 골 결손이 적고 매복치의 자발적 맹출을 유도할 수 있는 조대술이 추천된다. 2. 매복치의 자발적 맹출 가능성은 매복 깊이, 치축 각도, 환자의 나이, 치근 성숙도 등을 주의 깊게 고려하여 판단해야 한다. 3. 본 증례의 경우 매복치의 자발적 맹출 가능성이 낮으며 자폐증으로 인한 구강위생 불량, 저조한 협조도 등을 고려하여 적출술을 시행하였다. 4. 치료 계획 설정 시 일반적 요인뿐만 아니라 환자의 의과적, 전신적 병력에 따른 특별한 요구도 고려해야 한다. Autism is a developmental, neuropsychiatric disorder that begins in early childhood. A patient with autism seen in the dental office frequently may have many complications. Therefore, it may be needed to consider modified or alternative therapy for dental care of autistic patients. This is the case of a 16-year old boy who have autism. He came to the department of the pediatric dentistry, Yonsei University Dental Hospital, for evaluation and treatment of dentigerous cyst associated with impacted teeth(#33,34,35). Under daily hospitalization and general anesthesia, the cyst was enucleated with surgical extraction of #34 and autotransplantation of #33,35. And during the periodic dental followup, apexification of #33,35 was performed for periapical lesion and root maturity. At 2 year 6 months follow- up, now, bony healing was completed and there are some complications like external resorption of #33 and space loss of #34 area. Generally, the marsupialization has been widely recommended for treatment of dentigerous cyst. However, in this case, there is a little possibility of spontaneous eruption after marsupialization considering of patient’s age, location and angulation of the impacted tooth, root maturity. And there is necessity to choose the treatment that has low recurrence risk and needs short-term follow-up for autism. Above all, poor oral hygiene and lack of cooperation for decompression treatment is a matter of primary consideration. Consequently, enucleation of the cyst was chosen for the final treatment plan in this case. It is important to consider the conditions that affect the eruption of a dentigerous cyst-associated tooth to predict the successful eruption and special health care needs of the patient when the treatment plan is settled.

비타민 및 무기질 섭취와 유치우식과의 관련성

김한나 ( Han Na Kim ),민지현 ( Ji Hyun Min ),김기림 ( Ki Rim Kim ) 한국치위생과학회 2014 치위생과학회지 Vol.14 No.3

This study aims to evaluate the influence of vitamin and mineral supplement intake, and degree of calcium and phosphorus intake on occurrence of dental caries in primary teeth. Research data was derived from the Fourth Korean National Health and Nutrition Examination Survey (KNHANES)and 1,139 Korean children of 3 to 6 years were selected as subject for this study. The dft index, nutrition factor including vitamin or mineral supplement intake and degree of intake for calcium (Ca) and phosphorus (P) were identified. Chi-square test was performed to assess the difference in socioeconomic status, oral health behavior and nutrition factor, including vitamin or mineral supplement intake and degree of intake for Ca and P. Linear regression analysis was performed to identify the relationship between the dft index and the related variables. As a result, the dft index was increased with the age. Significant differences in Ca intake was examined according to the sex, and P intake was different according to the sex in 3-year-old group. Among the 4-year-old children, the vitamin and mineral supplement takers had 1.206 less dft index than the non-takers. In conclusion, intake of Ca, P and vitamin/mineral supplement was not a pivotal factor to influence the incidence of primary teeth caries. However, significantly low dft index was observed from 4-year-old group who intake vitamin or mineral.

55~84세 한국 성인의 현존치아수와 구강기능의 관계

김한나 ( Han Na Kim ),김기림 ( Ki Rim Kim ),김진범 ( Jin Bom Kim ) 한국치위생과학회 2015 치위생과학회지 Vol.15 No.3

The purpose of this study is to analyze the factors of oral function associated with number of present teeth (NT) in Korean elderly adults. The research was designed as cross-sectional study using the data of the 4th Korea National Health and Nutritional Examination Survey, and the samples were selected by stratified clusters sampling. The subjects aged 55 to 84 years were 4,780 that joined the oral examination survey and questionnaires. The respective variables reflecting socioeconomic status, subjective health status and oral function factor were analyzed and their distributional differences were confirmed by complex sampling logistic regression analysis. Multivariable liner regression models considering covariates were applied to explain the associations between the number of present teeth and other variables. Gender, educated level, illegal dental treatment, self-rated oral health and oral functional factors, including chewing behavior and speaking behavior, were associated with the number of present teeth (p<0.05). Subjects with better self-rated oral health had more NT than those with worse. Subjects with worse speaking behaviors had less NT than those with better. Interventions aiming to enhance oral health in elderly adults should consider socioeconomic, demographic, and oral functional factors.

코골이와 수면무호흡증 환자의 임상적 특징과 치료계획

정재광(Jae-Kwang Jung),김기림(Ki-Rim Kim),변진석(Jin-Seok Byun),최재갑(Jae-Kap Choi) 대한치과의사협회 2015 대한치과의사협회지 Vol.53 No.4

Snoring and obstructive sleep apnea are the representative sleep disordered breathings, caused by the temporary and repetitive constriction or obstruction of upper airway during sleep. They present with excessively vibratory noise and repetitive cease of respiration. These disorders commonly result in sleep disturbance and the subsequent daytime sleepiness, chronic fatigue. Furthermore, they can cause the serious and extensive complications including increased risk of hypertension, cardiac arrhythmia, cardiovascular disease, cerebrovascular accident, neurocognitive disturbance, traffic and occupational accidents, type II diabetes, childhood growth interruption, awakening headache and finally, relatively increased mortality rate. Because appropriate therapeutic intervention is best way for patients to relieve their symptoms and prevent their possible complications, it is very important for dentists to recognize their own role and responsibility in diagnosis and treatment of these disorders. For this, the present article provides the understanding of the clinical features, possible complications, various treatment modalities, and suitable treatment strategies for snoring and obstructive sleep apnea.

공기주입형 의복의 보온력 측정 및 다운재킷의 보온력과의 비교

김영빈 ( Yung Bin Kim ),장원 ( Won Jang ),김기림 ( Ki Rim Kim ),김시연 ( Si Yeon Kim ),백윤정 ( Yoon Jeong Baek ),이주영 ( Joo Young Lee ) 한국의류학회 2015 한국의류학회지 Vol.39 No.1

This study investigated the thermal insulation of an air-cell pack embedded jacket and down jackets tounderstand the potential of air-cell pack as a filler for winter outdoor wear. A thermal manikin measuredthe thermal insulation of the following jackets: HD (heavy down jacket, total weight (Tw) 750g, goosedown weight (Dw) 350g), LD (light down jacket, Tw 560g, Dw 140g), AF (air-cell pack embedded jacket,Tw 490g, trunk goose down in LD was replaced to air cell), F (film jacket, Tw 469g, but removed the airin the air-cell pack from the AF), and Control (control jacket, Tw 438g, removed the air-cell pack film fromthe F). Thermal insulations of each experimental condition were measured in a static standing posture. Totalthermal insulations (IT) were 1.29clo (HD), 1.23clo (LD), 1.16clo (AF), 1.20clo (F), and 1.08clo (Control). Body regional thermal insulation was higher in the chest and back than in the abdomen and hip in allconditions. The results suggest that an economical and versatile outdoor jacket with superior thermal insulationwill be feasible if the air volume is properly controlled in air-cell pack embedded jackets in considerationof regional different distribution and used in combination with film and down.

Polycan-Calcium Gluconate 복합제에 의한 염증인자의 감소 효과

김지혜 ( Ji Hye Kim ),김기림 ( Ki Rim Kim ),진혜정 ( Hye Jung Jin ),임상욱 ( Sang Uk Im ),송근배 ( Keun Bae Song ),최연희 ( Youn Hee Choi ) 한국치위생과학회 2014 치위생과학회지 Vol.14 No.2

The aim of this study was to examine the effect of polycan-calcium gluconate complex on the levels of immune and inflammatory mediators in gingival crevicular fluid and serum from patients with periodontitis. A total of 39 patients with periodontitis took placebo (placebo group) or polycan-calcium gluconate complex (treatment group) twice a day for 4 weeks. At baseline and 4 weeks, gingival crevicular fluid (GCF) and blood was collected from each subjects. The secretion level of interleukin (IL)-1β in GCF was measured by enzyme-linked immunosorbent assay (ELISA). Western blot analysis was conducted to determine the expression of matrix metalloproteinase (MMP)-8 and tumor necrosis factor (TNF)-α in GCF. Serum samples were analysed for MMP-8 by ELISA and C-reactive protein (CRP) by turbidimetric immuno assay. MMP-8 and TNF-α were significantly decreased in the treatment group at 4 weeks. The level of IL-1β in the treatment group was significantly lower than those of the placebo group. No differences were observed in CRP levels. Taken together, these data indicate that taking of polycan-calcium gluconate complex led to reduction of inflammatory biomarkers in serum and GCF of periodontitis patients.

어린이에서 구강내 아말감 제거 후 요중 수은농도 변화

진혜정 ( Hye Jung Jin ),사공준 ( Joon Sa Kong ),송근배 ( Keun Bae Song ),전은숙 ( Eun Suk Jeon ),김기림 ( Ki Rim Kim ),최연희 ( Youn Hee Choi ) 한국치위생과학회 2015 치위생과학회지 Vol.15 No.2

The objective of this study is to estimate the relationship between amalgam removal and urinary mercury levels. To measure urinary mercury concentration, urine of participants was collected at baseline, immediately, 24 hours and 48 hours after removal of amalgam restorations. The statistical analysis was performed using IBM SPSS Statistics ver. 20.0. The overall mean urinary mercury concentration at baseline, immediately, 24 hours and 48 hours after removal of amalgam restorations was 2.77, 2.75, 2.95 and 4.00 mg/g creatinine, respectively. Logistic regression model shows that the gender leads to increased odds of high urinary mercury concentration in children (odds ratio, OR=1.99), even after adjusting for high amalgam surfaces (OR=1.23) and fish consumption (OR=1.26) at the baseline. Our findings suggest that mercury exposure from dental amalgam adversely impact health and therefore are a health risk.