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장애환자에서 과도한 감염치아 발치전 스트레스 감소법으로서 배농술의 효과 : 문헌적 고찰 및 증례보고

EFFECT OF DRAINAGE AS A STRESS REDUCTION METHOD BEFORE EXTRACTION OF ADVANCED INFECTED TEETH IN DISABLED PATIENTS : REVIEW OF LITERATURE & REPORT OF CASES

  • 유재하 (연세대학교 치과대학 구강악안면외과학 교실(원주기독병원)) ;
  • 최병호 (연세대학교 치과대학 구강악안면외과학 교실(원주기독병원)) ;
  • 이천의 (연세대학교 치과대학 구강악안면외과학 교실(원주기독병원)) ;
  • 김종배 (계명대학교 의과대학 동산의료원 치과(구강악안면외과))
  • Yoo, Jae-Ha (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital)) ;
  • Choi, Byung-Ho (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital)) ;
  • Lee, Chun-Ui (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital)) ;
  • Kim, Jong-Bae (Department of Dentistry(Oral and Maxillofacial Surgery), Dong San Medical Center, College of Medicine, Keimyung University)
  • 투고 : 2011.09.16
  • 심사 : 2011.12.08
  • 발행 : 2011.12.30

초록

Dental extraction is potentially stress-inducing in many disabled patient. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress, the stress reduction method was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk, (2) Complete medical consultation before dental therapy, (3) Schedule the patient's appointment in the morning, (4) Monitor and record preoperative and postoperative vital signs, (5) Use psychosedation during therapy, (6) Use adequate pain control during therapy, (7) Short length of appointment : do not exceed the patient's limits of tolerance, (8) Follow up with postoperative pain/anxiety control, (9) Telephone the risk patient later on the same day that treatment was given. Though the stress reduction method above was applied to the dental extraction in disabled patients with the advanced infected teeth, the complications(syncope, shock, bleeding & infection, etc.) may be occurred. For prevention of complications associated with the extraction, the authors treated the advanced infected teeth with endodontic drainage and incision & drainage before extraction. The final extraction and wound closure were then done after about 3 weeks.

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