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ISSN : 0376-4672
역사적으로 살펴보면 치의학은 의학과는 전혀 다른흐름으로 발전해왔다. 중세 시대 이발사들이 아픈 치아를 발치하는 치료에서부터 출발했던 치의학은 21세기에 이르러 임플란트에 이르는 첨단 치과치료 기술로발전해왔다. 그러나 지난 수백 년간 치의학을 지탱해온 공통의 패러다임은 진행된 구강질환을 치과의사의 눈으로 확인하고 이를 외과적으로 제거하고 충전하는“외과적 모형(surgical model)”이었다. 그러나 우리의 인접 분야인 의학의 경우, 의사의 육안이나 청각에의존하여 질병을 진단하던 시대는 이미 19세기 이전에 끝났다. 대부분의 질병의 자연사(naturalhistory) 과정을 살펴보면 육안으로 질병을 파악할수 있는 단계는 전체 과정 중 말기에 해당되는 경우가일반적이다. 그러므로 의과학에서는 질병을 육안으로탐지할 수 있는 수준보다 훨씬 이전의 초기 단계에서발견하기 위해서 다양한 영상 및 이화학적 진단기술을 개발해왔다.
Caries Management by Risk Assessment (CAMBRA), published by California Dental Association in 2003, is a customized caries care system that classifies individuals’ caries risk into 4 risk groups based on objective evidences and provides chemical treatments targeted for each caries risk level. However, this system was not only developed but also optimized for situation in the United States, resulting into many limitations to be used in Korea, and thus Korean CAMBRA (K-CAMBRA) that considers the clinical situation in Korea needs to be developed. K-CAMBRA includes various techniques that are newly developed in order to overcome the limitations. First, Q-ray, a new optical technology, is utilized in order to avoid the subjectivity of visual inspection during assessment of disease indicators and risk factors. Moreover, Cariview‚ that reflects the paradigm shift in cariology as a new form of caries assessment kit is used. In addition, considering the situation in Korea, where it is impossible to use high concentration fluoride product, Oral pack with a customized tray is added to increase the contact time of chemical substance. CAMBRA is believed to be the key clinical tool that overcomes the limitations of the paradigm of the conventional restorationbased surgical model of dentistry. Furthermore, it can be expected that Korean dentists can act as oral physicians who are able to control and care individuals’ caries risk rather than operative experts who only care about the outcome of caries.
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