한국 성인들의 편측 저작 성향에 관한 연구

김정석 고려대학교 임상치의학대학원 2009 국내석사

한국 성인들의 편측 저작 성향에 관한 연구 김정석 D.D.S 고려대학교 임상치의학 대학원 심미수복학과 (Director : 류재준 , D.D.S., M.S.D., Ph.D.) 2186명의 일반인에 대해서 편측저작선호와 연령, 성별, 치주질환에 대한 연관성을 평가하여 다음과 같은 연구결과를 얻었다. 1. 전체 연구대상에서 43.5%가 편측저작선호 비율을 보였다. 2. 편측저작선호 중에서 좌측보다 우측 편측저작선호의 비율이 더 높았다.(좌측19.0%, 우측 23.8%) 3. 남녀 편측저작선호비율은 남성이 39.3%, 여성이 46.7% 로 여자의 편측저작선호 양상이 더 높았다. 4. 증령에 따라서 편측저작선호 비율이 증가하였다. 5. 치주상태가 악화될수록 편측저작선호양상이 증가하였다. 5-1. 임상적 부착상실이 증가할수록 편측저작선호양상이 증가하였다. 5-2. 지역사회치주지수(CPI)가 커질수록 편측저작선호양상이 증가하였다. 6. 치주질환이 더 진행된 연구군에서 덜 진행된 연구군보다 편측저작선호 비율이 더 높았다. 6-1. 임상적 부착상실이 4∼8mm정도로 치주질환이 가장 심하게 진행된 연구군에서 그렇지 않은 연구군에 비해서 편측저작선호비율이 1.70배 더 높았다. 6-2. 지역사회치주지수가 4로 적극적인 치주치료가 필요한 연구군에서 4보다 낮은 모든 연구 군에 비해서 편측저작선호비율이 1.36배 더 높게 나타났다. 본 연구는 편측저작선호에 대한 원인을 규명하는 것보다는 국내에서 역학적으로 어느 정도의 편측 저작선호를 보이는지에 중점을 두었다. 국내에서 상대적으로 많은 연구개체를 대상으로 한 것이라는 점과 성별, 연령과 편측저작선호와의 상관성에 대한 초기 연구이며, 임상적 부착상실과 지역사회치주 지수등의 치주상태지수를 이용하여 치주상태에 대한 관련성을 보고하였다. Study on trends of preference chewing side in Korean adults Kim, Jung Suk, D.D.S. Esthetic Restorative Dentistry, Graduate School of Clinical Dental Medicine, Korea University. (Director : Professor Ryu, Jae Jun, D.D.S., M.S.D., Ph.D.) The correlation between preference chewing side with age, gender, and periodontal disease were evaluated upon 2186 adults. The results were as follows; 1. Among the total sample size, 43.5% showed a preference chewing side. 2. Right side chewing showed a higher percentage than the left. (left 19.0%, right 23.8%) 3. Females showed a higher percentage of preference chewing side than the males. (male 39.3%, female 46.7%) 4. The percentage of preference chewing side increased as the age increased. 5. The percentage of preference chewing side increased as the periodontal condition worsened. 5-1. The percentage of preference chewing side increased as the clinical attachment loss increased. 5-2. The percentage of preference chewing side increased as the CPI increased. 6. The percentage of preference chewing side increased as the periodontal disease progressed. 6-1. Compared to other groups, the percentage of preference chewing side increased 1.70 times in the most severe periodontal disease group with clinical attachment loss of 4∼8mm. 6-2. Compared to ther groups with CPI below 4, the percentage of preference chewing side increased 1.36 times in the group that needed active periodontal treatment with CPI of 4. The purpose of this study focused on the percentage of the preference chewing side in Korean adults rather than investigating on its cause. The sample size was relatively large and it served as a initial study on the correlation between preference chewing side with age and gender. The correlation to periodontal conditions using periodontal indices such as the clinical attachment loss and CPI were also reviewed.

상아질에 레진코팅시 self adhesive 레진 시멘트와 간접수복용 복합레진간의 전단결합강도 변화에 관한 연구

홍지연 고려대학교 임상치의학대학원 2012 국내석사

Shear bond strength of a self-adhesive resin cement to resin-coated dentin Jee youn Hong, DDS Estheric Restoration Dentistry Graduate School of Clinical Dentistry, Korea University (Director: Professor Jae-Jun Ryu, DDS,MSD,PhD) ABSTRACT Purpose: The aims of this study were 1) to evaluate the effect of a resin coating on the shear bond strength of indirect composite restoration bonded to dentin with a self adhesive resin cement and 2) to compare the shear bond strength with that of a conventional resin cement. Materials and Methods: Thirty six extracted non-carious human molars were prepared: 1) the calculus and periodontal ligament were removed from the teeth. 2) the teeth were stored in normal saline 3) Occlusal enamel of each tooth was removed by using high-speed coarse diamond burs under water cooling. Finally 4) the teeth were flattened by 600 grits silicone carbide paper disks. They were divided into 3 groups: 12 for Unicem (group 1), 12 for Unicem with resin coating(group 2), and 12 for Panavia F(group 3). The dentin surfaces of group 1 and 3 were left uncoated, while the surfaces of group 2 were resin coated with a dentin bonding system, Clearfil SE bond and a flowable resin composite, Metafil flo. The specimens were temporarized for 24 hours. Indirect composite resin blocks (Tescera) were bonded to dentin by resin cements according to the manufacturer’s specifications: Unicem for group 1 and group 2, Panavia F for group 3. After 48 hours of water storage, shear bond strengths were measured by Universal testing machine with a cross head speed of 1mm/min. The data was analyzed with one-way analysis of variance and multiple comparison test(Tukey method). Results: The shear bond strengths of Unicem applied to resin coated dentin surfaces were significantly higher than those of Unicem and Panavia F used to uncoated dentin surfaces.(p<0.0001). Conclusion: Application of a resin coating to the dentin surface significantly improved the shear bonding strength of a self adhesive resin cement in indirect restoration. Thus, the resin coating technique could be highly recommended to supplement the weakness of self adhesive resin cements. Key word: self adhesive resin cement, Unicem, resin coating, shear bond strength, indirect composite resin restoration, Panavia F

비귀금속 합금 임플란트 보철물의 교합조정시 임플란트-골 계면에 전달되는 열에 관한 연구

양지수 고려대학교 임상치의학대학원 2012 국내석사

Study of heat transfer to the implant-bone interface induced by grinding of occlusal surface of implant nonprecious metal prosthesis Name : Jisu Yang, D.D.S., Department : Department of Esthetic Restorative Dentistry, Graduate school of Clinical Dentistry, Korea University. Thesis Advisor : Professor Jae-Jun Ryu. D.D.S., M.S.D, Ph.D Objective: The aim of this study is to verify amount and phase of heat transferred to implant-bone interface induced by grinding the surface of implant nonprecious metal prosthesis with comparing usefulness of cooling methods. Materials and methods: To manufacture thermometer, 16 K-type thermocouples were attached to internal fixation type implants and embedded into acrylic resin. 10 samples were made with dental nonprecious metal and abutment for casting which composes 3 concavo-convex occlusal side and they were connected to the implants with connecting screws, setting into constant-temperature water tank maintaining 37℃. During grinding the concavo-convex side of prosthesis for 30 seconds in three conditions-noncooling group, air pressure cooling group, water spray cooling group- temperatures were recorded at an interval of 0.05 second. Results were analyzed by 1-way ANOVA, and verified for further reference with Turkey HSD in 95% level of significance. Results: The temperature of implant-bone interface in noncooling group elevated over 47℃, significantly higher than other control groups (P<.05). The temperatures of air pressure cooling group and water spray cooling group were maintained under 47℃, and there were no significant difference between cooling methods. Grinding occlusal surface on implant nonprecious metal prosthesis may cause heat over critical temperature which could interrupt osseointegration. So it is important to do the procedure in cooling condition and both air pressure and water spray cooling method seems to be effective.

CAD/CAM 세라믹 인레이에 대한 3종의 레진 시멘트의 전단결합강도에 관한 연구

백철우 고려대학교 임상치의학대학원 2012 국내석사

Objectives: The purpose of this study is to evaluate the bond strengths between the latest CAD / CAM Ceramic Inlay and various resin cements which are used primarily for esthetic restoration. Materials and methods: Cylindrical ceramic specimens (Height: 5mm diameter: 3mm) were fabricated by using Cerec3. Ninety extracted caries-free molars were prepared and divided into 3 groups. Occlusal enamel of each tooth was cut horizontally by using high speed diamond burs, and then the teeth were flattened by 600grits silicone carbide paper disks. Three different kinds of resin cement and dentin were bonded according to the manufacturer's instructions. Two of three resin cements used were self-adhesive resin cements[Unicem clicker?? (3M ESPE, USA), Biscem?? (Bisco, USA)]. The other one was etch-and rinse resin cement[Variolink Ⅱ?? (Ivoclar Vivadent, Liechtenstein)]. Variolink Ⅱ had several steps before cementation. The steps were total etching gel (37% phosphoric acid), Syntac primer, Syntac adhesive and heliobond, but Unicem clicker and Biscem did not have additional treatment. Thus, each specimen of a total 90 specimens were attached depending on the type of cement and divided into three groups. Half of each group were conducted thermocycling but the other half of them didn’t. Thermocycling performs in the 5 ~ 55 ℃ ,5000cycle. After implementation of each specimen, they were kept in normal saline 37 ℃, for 24 hours. Shear bond strength was measured by Universal testing machine with a cross head speed of 0.5mm/min. The results were analyzed statistically by t-test and one-way analysis of variance (ANOVA). Results: The shear bond strength of Unicem, ValiolinkⅡ were significantly influenced by thermocycling , Whereas Biscem was not influenced.(P<0.05) Before thermocyling, there were no significant differences in bond strength between Biscem, Unicem and Valiolink Ⅱ , but after thermocyling treatment , there was significant differences between Unicem and Valiolink Ⅱ. (P<0.05) Conclusion: Unicem, despite a slight decline in shear bond strength after thermocycling, showed the best bond strength. Biscem showed the smallest difference of shear bond strength before and after thermocycling. Variolink Ⅱ needs to be processed delicately by dentists because of the multiple steps involved which can provoke errors. SARC(self-adhesive resin cement) is enough to replace ETCH-AND-RINSE resin cement when bonding the CAD / CAM ceramic inlays with a tooth. Key words: Self-adhesive resin cement, Etch and rinse resin cement, Unicem, Biscem, Variolink Ⅱ, Shear bond strength, Thermocycling

코로로에스피가글액의 타액 내 세균 감소효과에 관한 연구

이건원 高麗大學校 2016 국내석사

- Abstract - Effect of Cololo SP gargling liquid on bacterial count in saliva Gun Won Lee, D.D.S. Esthetic Restoration Major, Graduate School of Clinical Dentistry, Korea University (Academic Advisor : Professor Jae Jun Ryu, D.D.S., M.S.D., Ph.D.) Introduction : The major reason of dental diseases such as dental caries or periodontal disease is the dental plaque formed by bacteria in the mouth. Prevention of dental disease is closely related with an achievement of sufficient plaque removal. Toothbrushing is a universal way of mechanical plaque removal. However, chemical method such as mouth rinse is additionally required to overcome limitation of mechanical methods. Chlorhexidine and Listerine, representative mouth rinses, have been demonstrated with anti-bacterial effect against bacteria in the mouth. However, burning sensation and side-effect have been reported if using them for a long time. Therefore, there has been an increasing necessity of an alternative of mouth rinse to overcome aforementioned issues. The purpose of this experiment is to compare the Listerine and saline solution and identify whether Cololo SP solution with an advantage over existing mouth rinse is effective in bacteria in the mouth. Materials and Methods : Cololo SP solution and Listerine were set as an experiment group, while saline solution was set as a control group. Total 21 participants (11 men and 10 women) were divided into three groups (A, B, C). Experiment was conducted on each group for three times. Experiment was conducted on group A in an order of Cololo SP solution, Listerine, and saline solution. As for group B, experiment was conducted in an order of Listerine, saline solution, and Cololo SP solution. As for group C, experiment was conducted in an order of saline solution, Cololo SP solution, and Listerine. 20mL of each of the mouth rinses was applied for three times a day. In addition, participants were instructed to use them for a minute after brushing their teeth for total ten days. In between each of the experiments, there was a period for not using mouth rinses for fourteen days. Saliva was collected before and after using mouth rinse (total six times). Results : There was no significant decrease of the bacterial load in the mouth on Cololo SP solution and Listerine on entire participants. There was a significant antimicrobial effect on Cololo SP solution among female participants (P<0.05). There was a significant antimicrobiologic activity in the mouth on Cololo SP solution among several participants (group A) (P<0.05), and there was a significant difference on the control group (P<0.05). Conclusion : Three types of mouth rinses have failed to effectively suppress the growth of the number of bacteria in the mouth. However, Cololo SP solution has represented a similar antimicrobial effect with other mouth rinses. In order to evaluate the clinical and microbiological effect of Cololo SP solution, further clinical studies are necessary to establish the effectiveness. Key words : antimicrobial activity, Cololo SP solution, Listerine, mouth rinse, oral bacteria.

수종의 의치상 레진의 세포독성에 관한 연구

박준서 高麗大學校 2016 국내석사

Cytotoxic Effects of Provisional Restoration Materials Jun Seo Park., D.D.S. Esthetic Restoration Major, Graduate School of Clinical Dentistry, Korea University (Academic Advisor : Professor Jae Jun Ryu, D.D.S., M.S.D., Ph.D.) Introduction : Self-curing resin used in temporary restoration is known to release various toxic by products during polymerization. This process is influenced by the kind of the resin used and the polymerization period. The purpose of this study is to examine the cytotoxicity of three types of self-curing resins and the changes in the cytotoxicity studies that appear over time. Materials and Methods : Three types of resins were used (PMMA, PEMA, and bis-acryl). Three groups of materials were divided into 18 specimens each, resulting 54 specimens (thickness: 2mm, diameter 10mm) total. Three conditions were established to study the change in toxicity over time (30 minutes, 24 hours, and one week). After the cell culture, the optical density was measured at a wavelength of 590nm using mouse fibroblast cells (N1H3T3) for cytotoxicity evaluation. Results : The experimental results showed a significantly higher cytotoxicity for PEMA component of SNAP(p<0.05), and the Alike and Protemp did not show significant differences(p>0.05). Protemp containing bis-GMA in the monomer, showed a lower cytotoxicity than Alike however this was not a significant difference(p>0.05). After comparing each group at 30 min, 24 hours and one week, all three types of self-curing resins showed no significant differences(p>0.05). Conclusion : Among three self-curing resins tested in this study, SNAP showed the highest cytotoxicity possible because PEMA contains long akyl chain. Protemp showed a low cytotoxicity because of their specific manufacture technique. The study concluded that the cytotoxicity of resins is not time dependent. Key words : poly(ethylmethacrylate), poly(methyl methacrylate), Bis-GMA, cell survival, cell adhesion, time factors.

측두하악관절장애 환자들의 임상적 특징 분석

이기호 고려대학교 임상치의학대학원 2017 국내석사

국내에서 측두하악관절장애(Temporomandibular disorders, TMD)환자들의 연령군, 성별 및 임상적 특성에 대한 대규모 연구는 아직 부족하여 국내 TMD 환자의 연령, 성별, 주관적 증상, 임상적 특성 등을 파악함으로써 TMD 환자 진료 및 관리에 필요한 기초정보를 생성할 필요성이 있다. 본 연구에서는 고려대학교 안암병원 치과에 방문한 환자들을 대상으로 인구학적 특성, 임상적 특성, 주관적 증상 등을 파악하여 TMD 환자의 진료 및 진단, 관리에 도움이 될 수 있는 기초정보를 조사하고자 하였다. 고려대학교 안암병원 치과에 2013년 3월부터 2016년 3월 사이 외래 방문하여 TMD 진단을 받은 914명의 환자(처음 외래 방문한 시점의 초진 차트와 환자 설문지 정보)에 대한 후향적 의무기록조사를 실시하였다. 환자 기초특성(연령, 성별), TMD 증상, 관련증상, 환자 임상특성, 저작습관, 정신적 요인, 동반질환 및 과거력을 조사하였다. 성별, 연령군, 이상기능, 동반질환 등 범주형 변수의 경우 빈도 및 분율을 파악하였고, 증상이환기간, 통증정도, 주변근육 촉진 시 통증이 있는 근육의 개수 등은 평균 및 표준편차를 파악하였다. 이상기능, TMD 객관적/주관적 증상유무의 성별 연령군 별 차이에 대해 카이제곱, 피셔의 정확검정 등 분율 검정을 실시하였고, 통증정도(VAS), 촉진 개수의 성별, 연령군 별, 이상기능여부별에 따른 차이에 대해 T검정을 실시하였으며, TMD 통증과 촉진 개수 간 관련성에 대한 Spearman 상관분석을 실시하였다. 연령군별 TMD 주관적 증상이나 정신적 요인 등 경향성에 대한 추세검정을 시행하였다. 환자의 연령은 20대가 가장 많고 30대, 50대, 60대 순서로 많았고 여성 환자가 전체의 57.4%로 남성 환자에 비해서 많았다. 이갈이와 이악물기는 남녀 차이가 없었고 편측저작은 여성에서 많았다. 관절잡음은 발생 후 평균 34.4개월 후에 내원하는 반면 통증은 발생 후 평균 12.5개월, 개구제한은 발생 후 평균 9.0개월 후 내원하였다. 이갈이, 이악물기, 편측저작의 구강습관과 연령, 성별은 TMD pain(VAS)와는 연관이 없었고, 관절잡음, 과두걸림이 있는 경우 TMD pain(VAS)가 증가하였다. 촉진 시 통증이 있는 근육의 수가 많은 경우도 TMD pain(VAS)가 증가하였다. 촉진 시 통증이 있는 근육의 수는 여성에서 많았다. 설문지 조사에서는 10, 20대에서 TMD 의 일반적인 증상이 많이 나타난다고 대답한 반면, TMD로 인해 불편감을 느끼는 경우는 50~70대에서 상대적으로 높게 나타났다. TMD 증상이 만성화되기 이전에 병원에 내원할 수 있도록 TMD 질환에 대한 홍보가 필요할 것으로 보이고, 노년층의 TMD 환자들이 점차 증가하는 추세이며, 질환으로 인한 불편감은 20, 30대에 비해 더 크게 느끼는 것을 고려해서 향후 노년층의 TMD에 대해 더 연구할 필요가 있다.

Resin Selaer의 복합레진 수복물 미세누출 감소 효과에 대한 영향

이종룡 가톨릭대학교 대학원 2004 국내석사

우리나라 성인들의 치아우식증에 대한 인지실태 연구

김정무 고려대학교 임상치의학대학원 2007 국내석사

연구 목적: 본 연구는 우리나라 3대 만성질환 가운데 하나인 치아우식증의 인지실태를 조사하여 인지실태를 파악하고 그에 따른 인지실태 향상 방안을 제시하여 구강질환 예방에 필요한 기초자료를 제공하고자 한다. 연구대상 및 방법: 서울, 경기, 강원지역에 위치한 치과의원, 치과병원, 대학병원에 치과진료를 위하여 내원한 20대 이상의 성인 남녀 약 400명을 대상으로 치아우식증 인지실태에 관한 설문조사를 실시한다. 설문지는 총 42문항으로 일반적 특성 및 사회경제학적 요인(11문항), 식생활 습관요인(4문항), 구강보건 인식(6문항), 치아우식증 인식(8문항), 치아우식증 예방(13문항)으로 구성되어 있다. 설문조사 이전에 본 연구의 취지를 설명하여 이해한 치과의사에게 우편으로 설문지를 발송하여 치과진료 시 연구대상에게 직접 작성하도록 하였으며, 작성된 설문지는 우편으로 회수하였다. 설문조사 기간은 2006년 12월~2007년 1월에 걸쳐 이루어졌으며, 응답이 누락되었거나 불성실한 설문지를 제외하고 총 336부를 통계분석에 사용하였다. 모든 자료는 빈도와 %를 제시하였고, 변수 간의 관련성은 교차분석(χ2-test)을 실시하였다. 치아우식증 인지에 미치는 영향은 단변량 회귀분석(Univariate logistic regression analysis)과 다중로지스틱 회귀분석(Multiple Logistic Regression Analysis)을 실시하여 인지향상을 위한 방안을 제시하였다. 자료의 분석은 SPSS program 12.0을 이용하여 분석하였으며, p<0.05 수준에서 검증을 실시하였다. 결과: 구강보건 인식에서는, 구강보건 상태에 대하여 걱정을 하고 있었으며, 구강보건의 중요성에 대하여 대부분이 중요하다고 응답하였던 반면에, 대부분이 정기적인 치과검진을 실시하고 있지 않는 것으로 나타났다. 치아우식증에 대하여 들어본 적이 없는 사람이 많았고, 대부분이 인지를 못하고 있는 것으로 나타났다. 치아우식증을 경험한 사람들의 주된 정보경로는 치과이었으며, 치과에서 정보를 얻은 사람이 다른 경로를 통하여 정보를 얻은 사람과 비교하여 치아우식증의 정의에 대하여 정확히 인지하고 있는 것으로 나타났다(p=0.008). 치아우식증 인지에 영향을 미치는 요인분석인 단변량 로지스틱 회귀분석(Univariare logistic regression analysis)을 실시한 결과, 연령에서 20대가 40대 이상(기준변수)보다 치아우식증을 정확히 인지할 가능성[OR(95%CI)]이 2.06(1.16-3.66)(p=0.000), 직업구분의 경우 전문직이 기타(농업포함: 기준변수)보다 치아우식증을 정확히 인지할 가능성이 5.49(2.52-11.93)(p=0.000)로 나타났으며, 이 결과는 통계적으로 유의한 관련성이 있었다. 또한 의료보장의 경우, 직장보험이 기타(공교보험, 의료보호, 미 가입 포함: 기준변수)보다 치아우식증을 정확히 인지할 가능성이 1.95(1.03-3.71)(p=0.003), 구강상태의 경우 매우건강은 매우 나쁨(기준변수)과 비교하여 치아우식증을 정확히 인지할 가능성은 6.40(1.57-26.03)(p=0.002)으로 나타났으며, 이 결과 역시 통계적으로 유의한 관련성이 있었다. 결론: 치아우식증의 예방에 필요한 기초적인 대책으로 치아우식증의 정확한 인지를 위하여 치과에 근무하는 전문가를 통하여 정부차원에서의 치아우식증의 정의나 증상, 예방방법 등과 같은 내용의 교육이나 홍보와 같은 대책이 필요하며, 성인들의 연령층은 20대 이상, 전문직 이외의 직종, 직장보험 이외의 의료보장 가입자, 구강상태가 나쁜 사람을 대상으로 집중적인 예방대책이 실시가 필요함을 알 수 있었다. Abstract A Study of Recognition Condition to Dental Caries in Korean Adults Jung Moo Kim, D.D.S. Supervising Professor: Jae Jun Ryu, D.D.S., PhD. Department of Esthetice Restorative Dentistry Graduate School of Clinical Dentistry Korea University This study aims at examining the actual condition of recognition of dental caries, one of the three most important chronic diseases, presenting a scheme to improve the recognition, and providing basic data necessary to prevent oral diseases. A survey was conducted on the actual conditions of recognition of dental caries for about 400 people twenty and over, regardless of gender, who visited dental clinics, dentist's offices, and university hospitals in Seoul, Gyeonggi Province, and Gangwon Province for dental treatment. The questionnaire consisted of a total of 42 questions about general properties and socio-economic factors(11), eating habits (4), recognition of dental health(8), recognition of dental caries(8), and prevention of dental caries(13). Prior to the survey, questionnaires were sent by mail to dentists who had been explained of and understood the purport of this study; then, they asked subjects to complete a questionnaire personally during dental treatment and the completed questionnaires were returned by mail. The survey was conducted between December 2006 and January 2007 and a total of 336 copies were used for statistical analysis with exception of those with an omitted or insincere answer. All data were provided with frequency and percentage and Chi-square analysis(χ2-test) was carried out for relevance between variables. Univariate logistic regression analysis and multiple logistic regression analysis were carried out to see effects on recognition of dental caries to present a scheme to improve the recognition. Data were analyzed using an SPSS program 12.0 and tested at the p<0.05 level. As for recognition of dental health, they were concerned about conditions of dental health and most of them thought of dental health as important, while most of them failed to have a dental examination regularly. Many of them had never heard of dental caries and most of them failed to recognize it. People who experienced dental caries had a dental clinic as a main information channel; people who obtained information from a dental clinic recognized the definition of dental caries more accurately than those obtaining information through other channels(p=0.008). Univariate logistic regression analysis for effects on recognition of dental caries demonstrated that possibility of subjects in their twenties recognizing dental caries more accurately than those in their forties(standard variable) Odds ratio(95% confidence Interval) was 2.06(1.16-3.66)(p=0.000), with the possibility of professionals recognizing the disease more accurately than those with other kinds of occupation(including farmers: standard variable) 5.49(2.52-11.93) (p=0.000), showing statistically significant relevance. As for medical security, possibility of work insurance being related to more accurate recognition of dental caries than others(including public insurance, medical insurance, and uninsured: standard variable) was 1.95 (1.03-3.71)(p=0.003), with the possibility of subjects whose dental state was very good recognizing dental caries more accurately than those whose dental state was very bad(standard variable) 6.40(1.57-26.03) (p=0.002), showing statistically significant relevance. As fundamental measures necessary to prevent dental caries, such measures as education or public relation about definition, symptoms, and prevention of dental caries at the governmental level through experts working at a dental clinic are necessary to have accurate recognition of the disease; intensive preventive measures were necessary for those in their twenties and over, who were other than professionals, who were insured for medical security via other than work insurance, and whose dental state was bad. Key words: Dental caries, actual condition of recognition of dental caries, Prevent oral diseases

티타늄임프란트의 두가지 표면처리방식에 대한 골반응-양극산화 표면,IBAD HA 코팅 표면

이인구 고려대학교 임상치의학대학원 2006 국내석사

이 연구의 목적은 기계절삭면(machined surface) 티타늄임프란트에 양극산화법(Anodic oxidation)으로 표면처리한 대조군과 대조군의 표면처리 후에 부가적으로 IBAD(ion-beam 증착법)방법에 의해 HA(Hydroxyapatite)를 코팅한 실험군을 골막하에 식립하여 골반응에 대한 유의성을 평가하는 것이다. 도너스 형태의 골막하 임프란트를 제작하여 반을 자른 후 각각 실험군과 대조군에 해당하는 표면처리를 시행한 후 30마리의 백서 두정부골막하에 식립하여 4주, 6주 및 8주가 경과한 후 광학현미경과 전자현미경으로 시편 주변부위를 관찰하였다. 사육기간동안 골막하 임프란트의 초기 고정성이 확보되지 않아 많은 시편에서 골접촉보다는 섬유성 결합조직으로 고정됨을 관찰할수 있었다. 특히 대조군의 시편에선 대부분 섬유성결합조직으로 고정성이 확보되었고 미약한 골반응만이 관찰되었다. 관찰기간이 지나도 골반응의 진보를 관찰할수 없었다. 그러나 각 주별로 실험군의 시편에서 진행되는 골반응이 관찰되었고 8주 시편에서는 임프란트와 골의 직접골접촉(bone to implant contact)이 관찰되었다. 조직과 임프란트사이를 TEM으로 관찰했을 때 실험군에서 골모세포내의 세포질은 풍부한 과립형질내세망(rER)이 관찰되었으나 대조군에선 미약했다. 결론적으로 양극산화법 표면처리 위에 HA를 IBAD방법으로 코팅한 시편에서 양극산화 시편보다 더 뚜렷한 골 반응이 관찰됐다. 백서 두정부 골막하임프란트의 초기고정성이 부족한 상황에서 상대적으로 나은 골 반응이 관찰된 것은, 골 친화성이 있는 HA를 얇고 결점 없이 적절한 용해율로, 또 강한 결합강도로 코팅한 IBAD표면처리 방법이 임상적으로도 초기고정이 부족한 상황에서의 표면처리방법으로 고려해 볼 수 있는 표면처리 방법이라고 사료된다. Purpose of study-This study was undertaken to evaluate bone response of ion beam-assisted deposition(IBAD) of hydroxyapatite(HA) on the anodized surface of subperiosteal titanium implants. Material and methods-Two half doughnut shape subperiosteal titanium implants were made. The control group was treated with Anodized surface treatment and the test group was treated with IBAD of HA on control surface. Then two implants inserted together into the subperiosteum of the skull of 30 white rats and histological response around implant was observed under LM(light microscope) and TEM(transmission electron microscope) on 4th, 6th and 8th week. Results-Many subperiosteal implants were fixed with fibrous connective tissue not with bony tissue because of weak primary stability. The control group observed poor bone response and there was no significant change at any observation time. However the test group showed advanced bone formation and showed direct bone to implant contact under LM on 8th week. The test group observed much rER in the cell of osteoblast but the control group showed little rER under TEM. Conclusions-The test group showed better bone formation than the control group at the condition of weak primary stability. With these results IBAD surface treatment method on Anodized surface, may be good effect at the condition of weak primary stability.