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2017 대치 협회지표지 2017.7.27 3:14 PM 페이지1 mac001 in 2540DPI 100LPI ISSN 0376-4672 대 한 치 과 의 사 협 회 지 Vol.55 No.8 2017. 8 대한치과의사협회지 THE JOURNAL OF THE KOREAN DENTAL ASSOCIATION Vol.55 No.8 2017. 8 통권 제579호

The Journal of The Korean Dental Association August 2017 C O N T E N T S 515 527 541 512 574 579 581

News & News News &News News &News 512

www.kda.or.kr News & News News & News 513

T E L 2024-9290 F A X 468-4653 E-mail kdapr@chol.com

오리 도비라 2017.7.27 3:17 PM 페이지1 mac001 in 2540DPI 100LPI 1 김은경, 한원정, 김경아, 이완, 윤숙자, 황의환, 김규태, 허민석, 안창현, 안서영, 한진우, 정연화 성인과 소아에서 치과 파노라마방사선검사의 환자선량

ORIGINAL ARTICLE 1 ABSTRACT Patient dose in adult and pediatric dental panoramic radiography in Korea 1) Dept. of Oral and Maxillofacial Radiology, Dankook University College of Dentistry 2) Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Chonbuk National University 3) Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Won-Kwang University 4) Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Chonnam National University 5) Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University 6) Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University 7) Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Kyungpook National University 8) Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Gangneung-Wonju National University 9) Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University Eun-Kyung Kim 1), Won-Jeong Han 1), Kyoung-A Kim 2), Wan Lee 3), Suk-Ja Yoon 4), Eui-Hwan Hwang 5), Gyu-Tae Kim 5), Min-Suk Heo 6), Chang-Hyeon An 7), Seo-Young An 7), Jin-Woo Han 8), Yun-Hoa Jung 9) Objective: To suggest diagnostic reference levels (DRLs) for dental panoramic radiography in adults and children through the nationwide survey in Korea. Materials and Methods: Two hundred twelve dental institutions on a national basis were visited. The radiographic examination protocols were surveyed and their patient doses at the clinical exposure setting for adult and children (5- and 10-year old) were measured at 244 panoramic radiographic equipment. The measured DAP were analyzed and compared according to age group, the size of hospital, the type of radiographic system, the installation duration of equipment. Results: The mean exposure parameters were 70.1 kv, 9.2 ma, 14.4 second for adult and 66.6 kv, 7.9 ma, 13.8 second for 10- year old child and 65.5 kv, 7.3 ma, 13.7 second for 5-year old child. The mean and third quartile patient DAPs were 138.3 mgy cm 2 and 151.0 mgy cm 2 for adult, 99.5 mgy cm 2 and 104.8 mgy cm 2 for 10-year old child and 89.5 mgy cm 2 and 95.5 mgy cm 2 for 5-year old child. The mean patient dose at the university dental hospital was lower than that at the dental clinic (p<0.05). The mean patient dose of direct digital radiography type was higher than that of film-based type. However, the difference did not show statistically significance. Conclusion: DRLs for dental panoramic radiography in adult, 10- and 5-year old child were suggested to be 151 mgy cm 2, 105 mgy cm 2, and 96 mgy cm 2 in Korea based on this nationwide survey. panoramic radiography; diganostic reference level; adult; child 516

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케이스 도비라 2017.7.27 3:18 PM 페이지1 mac001 in 2540DPI 100LPI 1 김성종, 배은빈, 전영찬, 정창모, 윤미정, 이소현, 허중보 소수 잔존치를 가진 상악에 Bar와 Locator 를 이용한 임플란트 융합 국소의치 치료 증례 2 김홍석, 김수관, 오지수, 유재식, 신보수, 정경인 양측 하악 상행지 시상분할 골절단술 후 발생한 안면신경 마비: 증례보고

CASE REPORT 1 ABSTRACT Implant assisted removable partial denture using a few remaining maxillary teeth and locator bar system: A case report 1) Department of Prosthodontics, Dental Research Institute, Institute of Translational Dental Sciences, BK21 PLUS Project. School of Dentistry, Pusan National University Seong-Jung Kim 1), Eun-Bin Bae 1), Young-Chan Jeon 1), Chang-Mo Jeong 1), Mi-Jung Yun 1), So-Hyoun Lee 1), Jung-Bo Huh 1) * These authors contributed equally to this work. Treatment with removable partial denture is effective for partially edentulous patients who are unable to obtain sufficient retention and stability for functional and esthetic restoration. There are several cases reporting the improvement of retention and stability of the partial denture using a small number of implants. However, there are limited studies on the implant-assisted removable partial denture using a small number of remaining teeth and the bar locator system. The bar locator system has an advantage in that it could compensate the angle of insertion of removable prosthesis on implant with inconsistent placement angle due to anatomical constraints compared to when using the locator only. This case report describes the patient with Parkinson Øs disease who was treated with the Locator bar system using two previously placed implants and two remaining teeth on maxilla. No additional implants could be placed because of the medical and economic condition of the patients, and the angle of one of two implants could not be matched with the direction of the removable partial denture insertion. Considering the angle of the implants, the patient was treated with implant-assisted RPD using the Locator bar system and had satisfactory results in the aspect of esthetics, masticatory function, and oral hygiene maintenance. Key words : attachment, implant, implant-assisted RPD, removable partial denture, pekkton 528

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CASE REPORT 2 ABSTRACT Facial nerve palsy after bilateral sagittal split ramus osteotomy: case report Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University Hong-Seok Kim, Su-Gwan Kim, Ji-Su Oh, Jae-Seek You, Bo-Su Shin, Kyung-In Jeong BSSRO (bilateral sagittal split ramus osteotomy) is frequently performed to correct dentofacial deformity and malocclusion. Among its complications the incidence of post-operative facial nerve palsy is very rare, but it is one of the most serious complications. The case of a 21-year-old male patient who underwent facial nerve palsy after BSSRO is described. After surgical intervention and conservative therapy, the patient recovered his facial nerve function successfully. Key words : Facial nerve palsy, Orthognathic surgery, Bilateral sagittal split ramus osteotomy (BSSRO) 537

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Korean Dental Association ABSTRACT Application of dental microscope in endodontic treatment procedure. 1. Diagnosis Diagnosis of Crack, Direct pulp capping 2. Access opening Find the calcified canal orifice Removal of dentin shelf Obtaining the MB2 canal (MB2, MB3, DB2) 3. Perforation repair during endodontic treatment 4. Removal of the separated files 5. Open apex treatment 6. Void removal on CWT procedure 7. Re-endodontic treatment Removal of restorative material filled in pulp chamber Post removal Identification and removal of residual gutta-perch 8. Surgical endodontic treatment In each case will overview how to use a dental microscope. Pastel Dental Clinic Choi Sung Baik Key words : Dental microscope, Calcified canal, Perforation 542

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임상-1 최성백 2017.7.27 3:48 PM 페이지546 mac001 in 2540DPI 150LPI Korean Dental Association 임상가를 위한 특집 1 그림 10 그림 11 그림 12 그림 10. 근관 입구를 찾지 못해 과도하게 삭제된 와동저 그림 11. methylene blue로 와동 내면을 염색 그림 12. 수세 후 와동저에 진하게 보이는 부분이 근관 내지는 isthmus 그림 13 그림 14 그림 15 그림 13. MB1, MB2 근관 입구에 file이 진입되고 있는 상태 그림 14. DB 근관 입구에 file이 진입되고 있는 상태 그림 15. 근관 입구를 막고 있는 dentin shelf를 삭제 그림 16 그림 17 그림 16. dentin shelf가 조금 더 제거된 모습 그림 17. MB1, MB2, DB에 file이 진입되고 있는 상태 2> 근관입구는 확인되었지만 dentin shelf나 lingual shoulder가 존재하는 경우 direct access 가 어렵다. 구치부에서 이러한 경우 치과용 미세현미경 하에 546 대한치과의사협회지 제55권 제8호 2017 long shank bur로 dentin shelf를 삭제하여 direct access를 얻을 수 있다. 구치부에서 orifice 하방이나 전, 소구치 부위의 coronal 1/3는 gate-glidden drill이나 orifice

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Korean Dental Association ABSTRACT Essential of Endodontic microsurgery with the use of a Surgical Operating Microscope Department of Conservative Dentistry, College of Dentistry, Yonsei university Sunil Kim, D.D.S., Ph.D, Endodontic surgery is a procedure to treat apical periodontitis or abscess in cases that did not heal after nonsurgical treatment or retreatment. This might include situations with persistent intracanal infection after root canal treatment. Other reasons might be found in extraradicular infection, such as bacterial biofilm on the apical root surface or bacteria within the lesion. For many years, the treatment standard was the traditional approach with surgical burs and amalgam for root-end filling. Endodontic microsurgery is the most recent step in the evolution of endodontic surgery, applying not only ultrasonic tip and biocompatible filling materials but also incorporating high-power magnification and illumination. Although many studies have been published that advocate the use of modern technique, the traditional techniques are still widely used in the surgery community. The purpose of this study was to demonstrate the endodontic microsurgery procedure including the root-end preparation and filling with the use of a surgical operating microscope. Key words : Surgical operating microscope, root-end preparation, root-end filling 556

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Korean Dental Association ABSTRACT Management of Endodontic Perforation Department of Conservative Dentistry School of Dentistry, Kyung Hee University Ji-Hyun Jang, DDS, Ph.D Root canal perforations are defined as the communication between the pulp cavity, the periodontal tissue and alveolar bone. The occurrence of perforations during endodontic treatment is reported to range from 2.3%~12%, which is not a complication rarely happens. Perforations have iatrogenic or pathological etiologies that involve caries or resorption. It leads to inflammation and the destruction of periodontal fibers and alveolar bone, followed by periodontal defects. Mineral trioxide aggregate (MTA) is currently the most indicated material for repair of root perforation, because of its favorable biocompatibility and sealing ability. Using magnification with dental operating microscope enhance the accessibility and visibility to manage the root perforation. It is important to diagnose and repair perforations immediately if possible. Key words : Endodontic root perforation, Mineral trioxide aggregate, endodontic microscope 565

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