치과병원 진료실 내에서 메티실린 또는 반코마이신 저항성 Staphylococcus aureus의 검출

민정희,박순낭,황호길,민정범,김화숙,국중기 대한치과보존학회 2007 Restorative Dentistry & Endodontics Vol.32 No.2

본 연구는 조선대학교 치과병원의 진료환경 및 진료요원으로부터 기회감염성 병원체로 알려진 methicillin 또는 vancomycin 저항성 황색포도상 구균 (methicillin- or vancomycin-resistant Staphylococcus aureus: MRSA or VRSA)의 존재 여부를 조사하여, 이를 광주지역 개원치과와 비교분석을 통해 현재 조선대학교 치과병원의 MRSA와 VRSA의 오염정도를 파악하고자 하였다. 이를 위해 진료실 환경 및 진료요원으로부터 분리한 S. aureus 균주들의 8종 항생제에 대한 감수성 조사를 시행하고, 기존에 알려진 항생제 내성 유전자 존재 여부를 PCR법을 이용하여 확인하였다. 그 결과, 조선대학교 치과병원의 진료요원에서 채취한 샘플 중 1개 (2.3%), 개원 치과에서는 2명 (10%)의 진료요원의 샘플에서 S. aureus가 분리되었으며, 진료환경에서는 두 곳 모두에서 S. aureus가 검출되지 않았다. 조선대학교 치과병원과 개원치과에서 분리된 S. aureus는 amoxicillin, penicillin G, ciprofloxacin, clindamycin, vancomycin에 내성을 보이며, oxacillin, cefuroxime에는 균주에 따라 감수성 또는 내성을 보였다. 조선대학교 치과병원에서 분리 된 S. aureus는 erythromycin과 clindamycin에 내성 유전자인 ermA가 존재 하였으며, 개원치과에서 분리된 3개의 S. aureus 중 2개에서 penicillin과 oxacillin에 내성 유전자 mecA가 존재하는 것으로 나타났다. Vancomycin 내성 유전자인 vanA, vanB는 어떠한 샘플에서도 검출되지 않았다. 이상의 결과를 종합할 때, 본 연구는 조선대학교 치과병원과 개원치과의 S. aurues 분포 및 MRSA 또는 VRSA의 존재여부를 조사하여 MRSA와 VRSA의 확산예방을 위한 치과진료 환경의 개선과 적절한 항생제 사용에 대한 기초 자료를 제공할 것으로 사료된다. The purpose of this study was to obtain the basic information for the improvement of dental environment by investigating the presence of methicillin- or vancomycin-resistant Staphylococcus aureus (MRSA or VRSA) isolated from dental health care workers (DHCWs) and environment of the Chosun University Dental Hospital (CUDH) and a private dental clinic (control group). Staphylococcus aureus (S. aureus) was isolated from anterior nares of 42 DHCWs and 38 sites, unit chairs, x-ray devices, computers, etc., at 10 departments of the CUDH and 20 DHCWs and 11 sites at the private dental clinic. S. aureus was isolated on mannitol salt agar plate and confirmed by PCR with S. aureus species-specific primer. Antimicrobial susceptibility test of clinical isolates of S. aureus against several antibiotics including methicillin (oxacillin) was performed by investigating minimum inhibitory concentration (MIC) using broth microdilution assay. In addition, PCR was performed to detect the methicillin- or vancomycin-resistant gene. The data showed that one strain of S. aureus was isolated from DHCWs of the CUDH and three strains of S. aureus was isolated from 3 samples of the private dental clinic, respectively. All of the isolates from the CUDH and the private dental clinic had resistance to penicillin G, amoxicillin and vancomycin and susceptibility to oxacillin and ciprofloxacin. The S. aureus strains were already obtained the resistance to penicillin G and amoxicillin. These results suggest that two dental clinics were under relatively safe environment.

2급 와동 수복 시 한국 치과 의사들의 복합레진 사용 실태 연구

신동호,박세은,양인석,장주혜,이인복,조병훈,손호현 대한치과보존학회 2009 Restorative Dentistry & Endodontics Vol.34 No.2

본 연구는 2008년 1월 현재 한국 치과의사들의 복합레진 사용 실태에 관한 설문 조사로서, 2급 와동을 수복하는 증례에서 치과의사의 면허 년도, 교육 배경 및 진료환경 등에 따라 수복재료의 선택, 복합레진의 사용여부 및 사용방법, 문제점 등을 비교하였다. 한국 치과의사들을 대상으로 2급 와동 수복에 관한 17 문항의 설문지를 제작하였다. 이 설문지는 시술자 정보 2급 와동의 수복으로 크게 2부분으로 나누어진다. 이 설문지는 대한치과의사협회를 통해 12.193 명의 치과의사들에게 E-메일로 발송되었다. 이 중 2.612개의 메일이 수신 확인되었고 840 개의 설문지가 작성되어 회신되었다. 수신 확인된 메일 수에 대한 회신된 메일 수의 비율 (회신율)은 32.2%이었고, 이 자료는 SPSS프로그램에서 카이제곱 분석을 이용하여 교차 분석하였다. 답변자의 비율은 면허년도를 기준으로 1998 ~ 2007년에 면허를 취득한 그룹 (한국 전체 치과의사의 33 3%, 추정 년령 26-35세)이 60.3%로 1997년 이전에 면허 취득한 그룹 (한국 전체 치과의사의 66.7%.추정 년령 36세 이상)의 39.7%보다 높은 것으로 나타났다. 또한 이들이 근무하는 병원은 개인의원 (77%)이 가장 많았고 남자 치과의사(79%)가 많았다. 복합레진 수복에 대한 지식은 학생 때 수업이나 학회, 세미나를 통하여 (83.4%) 얻은 것으로 나타났다. 2급 와동 수복 시 재료 선호도를 살펴보면 금인레이가 65.7%를 차지하고 있고 복합레진 직접 수복은 12.1%로 낮게 나타났다. 2급 와동의 복합레진 직접 수복 시 시술 방법에 있어서는 러버댐을 사용하지 않거나 잘 사용하지 않는 그룹의 비율(74.4%)이 더 많았고. 격벽법으로는 mylar strip (53.4%)이나 metal matrix (33.8%), Palodent svstem (6.5%)를 사용하였다. 충전은 적층법 (99.6%)을 사용하는 것으로 나타났으며, 시술 시 인접면 형성을 가장 어려워하였다.(57.2%). 2-step 접착시스템 (76%)이 3-step 접착시스템 (16%)보다 많이 사용되고 있었다. 사용하는 레진 제품으로는 Z250(20%)이 가장 많이 사용되고 있었다. The purpose of this study was to assess the current materials, methods and difficulties according to the year of licence and educational background of Korean dentists in Class Ⅱ direct composite resin restorations. Total 17 questions were included in the questionnaire. Questions were broadly divided into two parts first, operator's information and second the materials and methods used in Class Ⅱ posterior composite restoration. The questionnaire was sent to dentists enrolled in Korean Dental Association via e-mail. Total 12,193 e-mails were distributed to dentists. 2,612 e-mails were opened and 840 mails (32.2%) were received from respondents. The data was statically analyzed by chi-square test using SPSS(v 120.1 SPSS Inc. Chicago. IL USA). Male dentists among respondents was 79% 60.3% of the respondents acquired their licences recently (1998-2007) and 77% practiced in private offices 83.4% have acquired their knowledge through school lectures conferences and seminars. For the Class Ⅱ restorations gold inlays were preferred by 65.7% of respondents while direct composite resin restorations were used by 12.1% amalgam users were only 4.4% of respondents. For the restorative technique 74.4% of respondents didn't use rubber dam as needed. For the matrix. mylar strip (53.4%), metal matrix (33.8%) and Palodent system (6.5%) were used 99.6% of respondents restored the Class Ⅱ cavity by incremental layering. Obtaining of the tight interproximal contact was considered as the most difficult procedure (57.2%) followed by field isolation (21%). Among various bonding systems, 22. 6% of respondents preferred SE Bond and 20.2% used Single Bond. Z-250 was used most frequently among a variety of composite resins.

2007 Spring Scientific Meeting (the 127^(th)) of Korean Academy of Conservative Dentistry

korean academy of conservative dentistry 대한치과보존학회 2007 Restorative Dentistry & Endodontics Vol.32 No.3

COMPARISON OF OPERATIVE TECHNIQUES BETWEEN FEMALE AND MALE DENTISTS IN CLASS 2 AND CLASS 5 RESIN COMPOSITE RESTORATIONS

Chang, Juhea,Kim, Hae-Young,Son, Ho-Hyun 大韓齒科保存學會 2010 Restorative Dentistry & Endodontics Vol.35 No.2

This study aimed to assess whether the gender of the dental practitioner affects operative techniques in class 2 and class 5 resin composite restorations. In 2008, a nationwide survey was given to Korean dentists. Total 12,193 e-mails were distributed, 2,632 were opened by recipients, and 840 responses were collected. Of the respondents, 78.9% were male and 21.1% were female. The gender distribution in the age groups between respondents and the total population did not differ (p > 0.05). A chi-square test was used to compare technical differences between female and male dentists. A multiple logistic regression analysis was performed to assess the association between gender and operative techniques in resin composite restoration. For class 2 resin composite restoration, female dentists were 1.87 times more likely than male dentists to do multiple incremental fillings (four layers or more) and 2.72 times more likely than males to spend 30 minutes or more for the treatment (p < 0.05). For class 5 resin composite restoration, female dentists were 2.69 times more likely than their male counterparts to use a cavity base or liner, 1.83 times more likely to do multiple incremental fillings (four layers or more) and 1.63 times more likely to spend 20 minutes or more for the procedure (p < 0.05). The gender factor was influential to individual operative techniques in restorative treatment. 본 연구에서는 복합 레진을 이용한 2급/5급 와동의 직접수복에 있어서 치과의사의 성별에 따른 술식의 차이를 비교하였다. 2008년 대한치과의사협회에 등록된 치과의사 12,193명을 대상으로 이 메일을 통한 설문조사를 실시하였다. 이 메일 수신이 확인된 2,632명 중 840명이 응답하였으며 응답자의 남녀 비율은(남 78.9%, 여 21.1%) 전체 치과의사의 남녀 비율과 유의한 차이를 보이지 않았다(p > 0.05). Chi-square test 와 multiple logistic regression analysis 를 이용하여 남녀간 술식의 차이를 검증하였다. 2급 와동 수복에서 여자치과의사는 4회 이상의 적층 분할 수복을 하는 경향이 남자치과의사에 비해 1.87배 높았으며, 술식 당 30분 이상 소요하는 경향은 2.72배 높았다(p < 0.05). 5급 와동 수복에서 여자치과의사는 베이스를 사용하는 경향이 1.83배 높았으며, 술식 당 20분 이상 소요하는 경향은 1.63배 높았다(p < 0.05). 본 설문조사에 따르면 남녀 성별에 따라 복합 레진 수복 술식의 차이가 존재하는 것으로 나타났다.

치과용 심미 수복 재료들의 색상 연구를 통한 새로운 치과용 색체계의 제안

오윤정,박수정,김동준,조현구,황윤찬,오원만,황인남 대한치과보존학회 2007 Restorative Dentistry & Endodontics Vol.32 No.1

본 연구는 새로운 치과용 색체계 개발을 목적으로 현재 치과에서 사용되고 있는 Vita shade를 사용하는 9 제조사의 12종의 광중합형 복합레진과 1종의 치과용 도재의 색상을 diffuse/8° 수광 방식을 사용하는 분광색체계 (MiniScan XE plus, Model 4000S, Hunter Lab, USA)를 이용해 D65 표준광과 10도 관찰자 시야 하에서 CIE L^(*)a^(*)b^(*) 값을 측정하고 색상 범위를 분석하였다. 분석한 정보를 color sorting system을 응용한 CNU Cons Dental Color Chart의 색상 표현 방식인 T###에 치과용 수복 재료들의 범위를 적용하여 다음의 결과를 얻었다. 측정된 L^(*)a^(*)b^(*)값의 분포를 분석해 보면 L^(*)값은 80.40과 52.70 사이에, a^(*)값은 10.60과-3.60 사이에, 그리고 b^(*)값은 28.40과 2.21 사이에 분포한다. L^(*)값의 평균값은 67.40, 중앙값은 67.30이며, a^(*)값은 2.89와 2.91, b^(*)값은 14.30 과 13.90 이다. 이러한 분석을 토대로 CNU Cons Dental Color Chart의 T###의 첫 번째 숫자에 해당하는 L^(*)값의 각 숫자간의 차이는 2.0으로, 그리고 2번째 숫자인 a^(*)값의 각 숫자간의 차이는 1, 그리고 세 번째 숫자인 b^(*)값의 각 숫자간의 차이는 2로 정하였다. T555에 해당하는 L^(*)값의 범위는 66.0이상, 68.0미만으로, a^(*)값의 범위는 3이상 4미만으로, b^(*)값의 범위는 14이상 16미만으로 결정하였다. The purpose of this study is to develope new dental color-space system. Twelve kinds of dental composites and one kind of dental porcelain were used in this study. Disk samples (15 ㎜ in diameter, 4 ㎜ in thickness) of used materials were made and sample’s CIE L^(*)a^(*)b^(*) value was measured by Spectrocolorimeter (MiniScan XE plus, Model 4000S, diffuse/8° viewing mode, 14.3 ㎜ Port diameters, Hunter Lab. USA). The range of measured color distribution was analyzed. All the data were applied in the form of T### which is expression unit in CNU Cons Dental Color Chart. The value of L^(*) lies between 80.40 and 52.70. The value of a^(*) are between 10.60 and 3.60 and b^(*) are between 28.40 and 2.21. The average value of L^(*) is 67.40, and median value is 67.30. The value of a^(*) are 2.89 and 2.91 respectively. And for the b^(*), 14.30 and 13.90 were obtained. The data were converted to T### that is the unit count system in CNU-Cons Dental Color Chart. The value of L^(*) is converted in the first digit of the numbering system. Each unit is 2.0 measured values. The second digit is the value of a^(*) and is converted new number by 1.0 measured value. For the third digit b^(*) is replaced and it is 2.0 measured unit apart. T555 was set to the value of L^(*) ranging from 66.0 to 68.0, value of a^(*) ranging from 3 to 4 and b^(*) value ranging from 14 to 16.

고압-저온 보관에 따른 쥐 치아 치주인대세포의 활성도 평가

정진호,김진,최성호,김의성,박지용,이승종 大韓齒科保存學會 2010 Restorative Dentistry & Endodontics Vol.35 No.4

본 연구의 목적은 흰 쥐의 상악 대구치를 발거한 후 치주인대세포를 0°C/2 MPa고압-저온하에 1주간 보관시켜 MTT, WST-1 검색법을 이용하여 측정한 치주인대세포의 활성도를 저속 냉동법 (No Additional Pressure. 2,3 MPa). 급속 냉동법, (No Additional Pressure. 2 MPa), -5°C/90 MPa초고압 저온보존법과 비교하여 평가하는 것이다. 생후 4주된 암컷 Sprague-Dawley계 흰쥐의 상악 좌우 제 1,2대 구치를 발거하여 각 군 당 12개의 쥐 치아를 MTT, WST-1 검색에 이용하였다 실험군은 9개 군으로 대조군은 즉시 발치군이며, 각각 3 MPa. 2 MPa. NoAdditional Pressure (NAP)의 압력을 가한 후 4°C 에 서 -35°C 까지 -0.5°C/min 속도로 서서히 냉동시킨 뒤 -196°C 에 냉동한 저속 냉동군, 발치 후 동해방지제 처리과정을 거쳐 각각 2 MPa, NP의 압력을 가한 후, -196°c 의 액화질소에 넣어 냉동한 급속 냉동군, 발치 후 각각 2MPa,NP의 압력을 가한 후. 0°C에 보관한 저온 보존군, -5°C/90 MPa의 초고압 저온 보존군으로 나누었다. 보존액은 Fmedium을 사용했으며 통해방지제로 10% dimethylsulfoxide (DMSO) 를 사용하였다. 치근변을 단위면적으로 표준화하기 위해 MTT. WST-1 측정값을 Eosin 염색 후 530 nm에서 측정한 흡광도 값으로 나누었다. 통계 분석을 위해 one way ANOVA를 시행하였으며 사후 검정으로는 Tukey HSD 방법을 사용하였고 결과는 다음과 같다. 1. MTT 검색법 및 WST-1 검색법 결과 0°C/2 MPa 고압 저온 보존군이 즉시 발치군보다 세포 활성도가 낮았으나 통계적 유의차는 없었으며, 저속 압력 냉동군 (NP, 2 MPa, 3 MPa)과, 급속 압력 냉동군 (NP, 2 MPa). 저온보존군(0 °C/NP) 초고압 저온 보존군 (-5°C /90 MPa) 보다 통계적으로 유의차있게 높은 세포 활성도를 나타내었다 (p <0.05). 2. MTT검색법 및 WST-1 검색법 결과 -5°C/90 MPa 초고압 저온 보존군이 가장 낮은 세포 활성도를 나타내었으며, MTT 검사 결과에서는 모든 군에 대해 통계적으로 유의성 있는 결과를 보였다 (p <0.05). 위의 결과를 통해, 0°C/2 MPa (20기압) 의 고압 저온 보존법이 다른 급속 냉동 보관법 (2 MPa. NAP) 이 나 저속냉동보관법 (3. 2 MPa, NAP), -5°C/90 MPa 초고압 저온 보존법에 비해 우수한 쥐 치아의 치주인대세포의 활성도를 보여 차후 치아의 재이식시 치아보관을위한방법으로의 가능성을제시하였다. The purpose of this study was to evaluate the viability of periodontalligament cells of rat teeth after low temperature preservation under high pressure by means ofMTT assay, WST-1 assay. 12 teeth of SpragueDawley white female rats of 4 week-old were used for each group. Both side of the first and second maxillary molars were extracted as atraumatically as possible under tiletamine anesthesia. The experimental groups were group 1 (Immediate extraction) , group 2 (Slow freez ing under pressure of 3 MPa), goup 3 (Slow freezing under pressure of 2 MPa), group 4 (Slow freezing under no additional pressure), group 5 (Rapid freezing in liquid nitrogen under pressure of 2 MPa), group 6 (Rapid freezing in liquid nitrogen under no additional pressure), group 7 (low-temperature preservation at Ot under pressure of 2 MPa), group 8 (low-temperature preservation at 0˚C under no additional pres sure), group 9 (low-temperature preservation at -5 t under pressure of 90 MPa). F-medium and 10% DMSO were used as preservation medium and cryo-protectant. For cryo-preservation groups, thawing was performed in 37˚C water bath, then MTT assay , WST-1 assay were processed. One way ANOVA and Tukey HSD method were performed at the 95% level of confidence. The values of optical density obtained by MTT assay and WST-1 were divided by the values of eosin staining for tissue volume standardization. In both MTT and WST-1 assay, group 7 (0˚C/2 MPa) showed higher viability of periodontal ligament cells than other group (2-6, 8) and this was statistically significant (p <0.05), but showed lower viability than group 1, immediate extraction group (no statistical significance). By the results of this study, low-temperature preservation at Ot under pressure of 2 MPa suggest the possibility for long term preservation of teeth.

KISTI-ACOMS를 기반으로 한 대한치과보존학회 온라인논문투고관리시스템 개발

박재원,강무영 大韓齒科保存學會 2003 Restorative Dentistry & Endodontics Vol.28 No.6

Societies are important sources of new information for users. However. most of these societies still rely on traditional. or rather ancient methods for gathering and servicing the information. Furthermore. most of the societies are trying to electrify processes such as managing members and paper submission as well as the process managing the information for service but are limited due to financial and technical reasons. Therefore. KISTI(Korea Institute of Science and Technology Information) has developed the 『KISTI ACOMS(KISTI Article COntribution Management System)』 as part of the national project for automating the process of processing academic information by societies. in order to convert journals published by academic societies in Korea into an electronic form and make them accessible on the Internet. This system has been developed in the year 2001 and has since been distributed to societies free of charge. The number of societies requesting the service has risen recently. which prompted us to take more recommendations of the societies that adopt this system into account in expanding and standardizing the area of service being provided by the system.

Evaluation of the effect of blood contamination on the compressive strength of MTA modified with hydration accelerators

Kaveh Oloomi,Eshaghali Saberi,Hadi Mokhtari,Hamid Reza Mokhtari Zonouzi,Ali Nosrat,Mohammad Hossein Nekoofar,Paul Michael Howell Dummer 大韓齒科保存學會 2013 Restorative Dentistry & Endodontics Vol.38 No.3

Objectives: This study was performed to evaluate the effect of blood contamination on the compressive strength (CS) of Root MTA (RMTA) modified with Calcium chloride (CaCl2) and Disodium hydrogen phosphate (Na2HPO4) as setting accelerators over time. Materials and Methods: A total of 110 cylindrical specimens of RMTA were divided into 6 experimental groups as follows: Group1, RMTA, Group 2, RMTA modified with CaCl2 (RMTA-C), Group 3, RMTA modified with Na2HPO4 (RMTA-N), Group 4, RMTA contaminated with blood, Group 5, RMTA-C contaminated with blood, Group 6, RMTA-N contaminated with blood. The CS of specimens in all groups was evaluated after 3hr, 24 hr, and 1 wk. In the modified groups (groups 2, 3, 5, and 6) the CS of five specimens per group was also evaluated after 1 hr. Results: Blood contamination significantly reduced the CS of all materials at all time intervals (p < 0.05). After 3hr, the CS of specimens in the RMTA groups (with and without blood contamination)was significantly lower than those in the RMTA-C and RMTA-N groups (p < 0.05). The CS values were not significantly different at the other time intervals. In all groups,the CS of specimens significantly increased over time (p < 0.05). Conclusions: Blood contamination decreased the CS of both original and accelerated RMTA.

Flexural strength and microstructure of two lithium disilicate glass ceramics for CAD/CAM restoration in the dental clinic

Suk-Ho Kang,Juhea Chang,Ho-Hyun Son 大韓齒科保存學會 2013 Restorative Dentistry & Endodontics Vol.38 No.3

Objectives: There has been a growing interest in glass ceramic systems with good esthetics, high fracture resistance and bonding durability, and simplified fabrication techniques using CAD/CAM. The aim of this study is to compare flexural strength before and after heat treatment of two lithium disilicate CAD/CAM blocks, IPS e.max CAD (Ivoclar Vivadent) and Rosetta SM (Hass), and to observe their crystalline structures. Materials and Methods: Biaxial flexural strength was tested according to ISO 6872with 20 disc form specimens sliced from each block before and after heat treatment. Also, the crystalline structures were observed using field-emission scanning microscopy (FE-SEM, Hitachi) and x-ray diffraction (XRD, Rigaku) analysis. The mean values of the biaxial flexural strength were analyzed by the Mann-Whitney U test at a significance level of p = 0.05. Results: There were no statistically significant differences in flexural strength between IPS e.max CAD and Rosetta SM either before heat treatment or after heat treatment. For both ceramics, the initial flexural strength greatly increased after heat treatment, with significant differences (p < 0.05). The FE-SEM images presented similar patterns of crystalline structure in the two ceramics. In the XRD analysis,they also had similar patterns, presenting high peak positions corresponding to the standard lithium metasilicate and lithium disilicate at each stage of heat treatment. Conclusions: IPS e.max CAD and Rosetta SM showed no significant differences in flexural strength. They had a similar crystalline pattern and molecular composition.

The relationship between the level of salivary alpha amylase activity and pain severity in patients with symptomatic irreversible pulpitis

Fatemeh Ahmadi-Motamayel,Shahriar Shahriari,Mohammad Taghi Goodarz,Abbas Moghimbeigi,Mina Jazaeri,Parisa Babaei 大韓齒科保存學會 2013 Restorative Dentistry & Endodontics Vol.38 No.3

Objectives: Assessment of dental pain severity is very challenging in dentistry. Previous studies have suggested that elevated salivary alpha amylase may contribute to increased physical stresses. There is a close association between salivary alpha amylase and plasma norepinephrine under stressful physical conditions. The aim of this study was to evaluate the relationship between pain severity and salivary alpha amylase levels in patients with symptomatic irreversible pulpitis. Materials and Methods: Thirtysix patients (20 females and 16 males) with severe tooth pain due to symptomatic irreversible pulpitis were selected. The visual analogue scale (VAS) score was used to assess the pain severity in each patient. Unstimulated whole saliva was collected, and the level of alpha amylase activity was assessed by the spectrophotometric method. Statistical analysis was performed using SPSS 13. Results: The level of alpha amylase was significantly increased in the saliva in association with pain severity assessed by VAS. The salivary alpha amylase was also elevated with increased age and in males. Conclusions: There was a significant correlation between the VAS pain scale and salivary alpha amylase level, which indicates this biomarker may be a good index for the objective assessment of pain intensity.