흡인성 폐렴의 예방을 위해서는 구강위생관리를 철저하게 실천하는 것이 매우 중요하므로 적절한 관리요령이 병원과 요양시설에 보급되어야 할 것이다. 잘못된 구강위생관리 방법이 행해진다면 그 자체가 흡인성 폐렴의 원인이 될 수 있기 때문이다. 의료 간호의 현장에서 효율적이고 효과적인 구강위생관리를 위해서는 이를 수행할 수 있는 치과의사와 치과위생사의 개입이 필수적이다. 노인요양시설의 치과촉탁의 제도의 시행이 가시화되고 있는 시점에서 우리 치과계에서는 위험성이 적으면서 구강위생과 구강기능을 지킬 수 있는 올바른 방법을 제안해야 하고, 물을 사용하지 않는 전문적 구강위생관리방법이야말로 오연의 위험을 감소시키면서 보다 안전하고 환자에 부담이 적은 전문적 구강위생관리 방법이라 사료된다. 쉽게 실천할 수 있는 방법이므로 앞으로 노인요양시설의 치과촉탁의 제도 시행 시 치과위생사, 치과의사에게 진정으로 도움이 되기를 바란다.

Purpose: The institutionalized elderly have placed the most vulnerable state, and the report about the oral health status of the institutionalized elderly was scarce. The aims of the current study were to investigate the oral health status of institutionalized elderly. Materials and methods: The survey of the oral health status was carried out on 487 institutionalized elderly from 4 longterm care facilities of Seoul metropolitan city, Gyunggi province, and Gangwon province in Korea. Results: The prevalence of dental caries, root caries, and dental calculus of the institutionalized elderly was 19.2%, 15.3%, and 23.7%, respectively. The percentage of edentulism among the institutionalized elderly was 26.2%. Those who had poor oral hygiene and tongue coating were 43.9% and 90.5%, respectively. The percentages wearing complete and removable partial denture on maxilla were 12.8% and 3.3%, respectively. The percentages wearing complete and removable partial denture on mandible were 7.8% and 5.6%, respectively. The percentages of institutionalized elderly needing complete and removable partial denture on maxilla were 29.7% and 27.2%, respectively. The percentages of institutionalized elderly needing complete and removable partial denture on mandible were 24.5% and 30.9%, respectively. Conclusion: The oral health stuatus of institutionalized elderly was poor. For the oral health promotion of elderly in longterm care facilities, it is essential to educate nurses and caregivers about the importance of the oral health and oral hygiene method.

The coverage of the National Health Insurance for the elderly is expanding to denture and implants. Although the National Long-Term Care Insurance was just being settled, Oral health service was not provided to the Elderly in Long-Term Care Facilities. The long-term care facilities had part-time facility doctors. However, there is no dentist in the long-term care facility because of lack of long-term care insurance-related legislations. The amendments of long-term care insurance-related legislations for the introduction of part-time facility dentists are needed because the elderly in long-term care facility are vulnerable to oral health. For the substantial management of the National Long-Term Care Insurance, the development of oral health service model for the elderly and education materials for the dental team will be needed. Also, adequate dental service fee of the National longterm care insurance will be needed.

South Korea's oral health care non-governmental organizations (NGOs) have played a crucial role in South-North relations, although a formal intergovernmental relationship is difficult to establish and also easily breaks down. Humanitarian assistance by NGOs in the oral health care sector is an area that receives wide support from South Korean society for its urgency and for its appeal to humanity. This humanitarian assistance started in the late 1990's and continued to grow until the late 2000's. This assistance continued throughout the tension between the two administrations that resulted in a radical decrease in overall assistance from South Korea to North Korea. However, concerns remain about the transparency and efficiency of NGO activities. In this article, the NGOs and their major activities are delineated, and South Korean legislation is examined. A current act, the Law on the Development of South and North Korean Relations serves as a basis for governmental regulation and support of NGO's. Humanitarian assistance in the oral healthcare area is directly related to the oral health of the North Korean people, and it should not be influenced by political changes. Long-term planning and close discussions between NGOs, their North Korean counterparts, and the South Korean government are needed. NGOs need to overcome their shortcomings such as a lack of expertise and shortage of financial support. For this, NGOs must improve their administration transparency and professionalism.

The clinical dentistry system and research tendency of dentistry in North Korea has a difference with South Korea. In North Korea, preventive dentistry has been developed, and government of North Korea clame a free medical service to all the people. And there are tendency that Korean medicine(Oriental medicine) is applied to clinical dentistry in North Korea. Research tendency of dentistry in North Korea have a difference from South Korea. Articles of dentistry in North Korea have some freatures. Terminology of dentistry is writtened in original Korean developed uniquely in North Korea. Recent articles of dentistry in North Korea have a reference from english articles, and it is different that reference articles in the past were from Chinese or Russian articles. In order to get ready for the United Korea, we need to know the feature of dentistry in North Korea, and increase an academic exchange between South and North Korea.

There are big differences in dental education system between South Korea and North Korea. In North Korea, there is no college of dentistry and official license system and thus, dentists can treat a patient right after graduation from medical school. There are also positions such as paradentists capable of providing dental treatments, whereas such positions do not exist in South Korea. In this regards, in order to get ready for the United Korea, we need to establish a system designed to complement the differences in dentistry education and license system between South and North Korea. Such system would help to minimize the social cost in relation to the unification in near future.

The objective of this study was to identify bisphosphonate-related osteonecrosis of the jaw (BRONJ) awareness and experience level of patients by medical doctors who prescribes bisphosphonate being used, analyze dental examination referral reality and to utilize its result as basic education data for early diagnosis of BRONJ and its prevention. The study was carried out through a self-administered questionnaire distributed among a sample 192 residents and specialists. They belonged to family medicine, internal medicine and orthopedics of 6 tertiary medical centers located in Seoul. The survey consisted of 22 questions; general characteristics, bisphosphonate therapy, awareness of BRONJ, implementation level of dental examination referral. Among 192 medical doctorss, 78.1% (n=150) showed awareness of BRONJ. Only 8.9% (n=17) had correct response in all 5 BRONJ knowledge questions. Dental examination referral by medical doctors was implemented in below 30% of the total patients. At the time of bisphosphonate administration, specialist of oncology most highly recognized necessity of dental examination referral and it was represented in the order of endocrinology, rheumatology, family medicine, orthopedics specialists. As recognition of medical doctors for BRONJ and implementation level of dental referral were represented to be low, it is considered that enhancement of BRONJ recognition for medical doctors and development of high accessible education program for increasing implementation rate of dental examination referral would be required.

Objectives: This study compared the mechanical efficacy of sonic activated and passive ultrasonic irrigation for removing intracanal medicament from a simulated root canal under controlled conditions. Materials and Methods: Thirty simulated root canal in resin blocks were randomly divided into 3-groups. The canals were enlarged using ProTaper files and K3XF (#30/0.06). After cleaning and drying, canals were filled with Calcipex. Overfilled materials were wiped out and measured their weight to the unit of 1/10mg. After one week storage in 100% humidity $37^{\circ}C$ temperature, canals were irrigated using 20mL of saline with one of following methods according to the designated groups (n = 10). For group-NI, 30-gauge nickel-titanium irrigation needle was used. During irrigation with every 5mL, needle was moved in-and-out with 4-mm amplitudes. EndoActivator and ultrasonic tip were used for group-EA and group-UT respectively for 20 seconds after every 5mL irrigation using needle. Then the weight was measured again to calculate the weight of residual remnants. The data were analyzed by one-way ANOVA and Duncan's post-hoc test at a significance level of 95%. Results: The weight of the residual medicaments were $3.62{\pm}0.81mg$, $2.84{\pm}0.28mg$, and $2.73{\pm}0.90mg$ for group-NI, -EA, and -UT, respectively. Group-EA and group-UT had no significant differences to remove intracanal medicament and left significantly less amount of paste than group-NI (p < 0.05). Conclusions: Under the controlled conditions of this study, the sonic activation and PUI have similar mechanical efficacy for removing intracanal medicament.