• Title/Summary/Keyword: 구강기능문제

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Oral health status and treatment need of institutionalized elderly patients (노인요양시설에 있는 노인환자의 구강실태 및 치료수요도)

  • Yang, Soon-Bong;Moon, Hong-Suk;Han, Dong-Hoo;Lee, Ho-Yong;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.455-469
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    • 2008
  • Statement of problems: In the area of dental care, the institutionalized elderly have placed the most vulnerable state, and we cannot find their subjective need of dental treatment because of the physical and mental disabilities, But we have no basic investigation of their oral health conditions. Purpose: The aims of the current study were to investigate the oral health status of institutionalized elderly patients who are in the least benefited side of dental service, and to analyze their dental treatment needs. Material and methods: The survey of the oral status was carried out on 758 institutionalized elderly, and 212 elderly who was more than 65 years old from D dental office, and it was based on the Guidelines of Oral Health Research of year 2000 in Republic of Korea. Results and conclusion: The DMFT index of the institutionalized elderly appeared higher than that of the same ages in control group, and it increased with age. The number of residual teeth of the institutionalized elderly appeared lower than that of the same ages in control group, and it decreased with age (P < .05). The number of fixed partial denture in institutionalized elderly was lower than that of the same ages in control group (P < .05). The percentage wearing removable partial denture was not significant between the elderly in institutions and the control group, and was not different according to age between the two groups. The percentage of institutionalized elderly wearing complete denture appeared lower than that of the same ages in control group, and it increased with age. The percentage of institutionalized elderly needing complete denture was higher than that of control group, and the percentage of elderly needing complete denture on the maxilla was higher than that of the mandible. 16.35% of the institutionalized elderly was living without denture in spite of their fully edentulous state. The need for complete denture increased rapidly with age. The number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teeth of institutionalized elderly were lower than that of the control group (P < .05). In institutionalized elderly, the number of residual teeth, the number of fixed partial dentures, and the percentage wearing removable partial dentures were higher in the mandible, and the percentage wearing complete dentures was higher in the maxilla (P < .05). The rate of institutionalized elderly needing prosthodontic treatment appeared to be 67.82%, where the number of occluding pairs of teeth was less than 10. When it is difficult to evaluate the subjective need of dental treatment as with the institutionalized elderly, estimation using the number of occluding pairs of teeth can be a useful indicator that can project treatment needs. For the oral health care of institutionalized elderly, it is essential to increase the awareness of nurses and caregivers who take care of them, about the importance of the oral health. Since the average life span and number of residual teeth are increasing gradually, the welfare policy should be changed to implementing regular dental examinations, preservative treatment forms and oral health control of dentulous patients where the traveling-treatment system and visit system are supplemented. And principles should be set that the present denture project of edentulous patients should be done by specialists who'll also be responsible for postmanagement. Through this research of institutionalized elderly, the oral health status which is worsened by aging could be confirmed. And the interest and positive participation of dental society on the elderly should come first in order to solve the rising treatment needs of the elderly patients.

Prosthetic rehabilitation of a patient with tongue cancer using palatal augmentation prosthesis and mandibular implant-retained overdenture: A case report (구개 증대 보철물과 임플란트 피개의치를 이용한 설암 환자의 보철수복 증례)

  • Kim, Ye-Jin;Lee, Young-Hoon;Ko, Kyung-Ho;Park, Chan-Jin;Cho, Lee-Ra;Huh, Yoon-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.4
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    • pp.317-322
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    • 2018
  • The tongue, especially its lateral part, is the most common site of oral tumors. Patients who undergo glossectomy for the treatment of tongue cancer may experience difficulty in proper functioning for pronunciation, chewing, swallowing, and oral hygiene maintenance; therefore, a palatal augmentation prosthesis can be used to restore function of the tongue. In this case, an implant overdenture was used in a patient who had residual ridge resorption and obliteration of alveololingual sulcus after undergoing glossectomy for tongue cancer treatment. In addition, a palatal augmentation prosthesis with a metal framework, support, and retention part was fabricated. The palatal vault was reduced, so that even with limited tongue movement, adequate tongue-palate contact could be achieved. After placement of the definitive prostheses, the patient showed improvement in the functions of chewing, swallowing, and pronunciation.

Full mouth rehabilitation of the patient with severely worn dentition using monolithic zirconia prosthesis: A clinical report (치아 마모 환자에서 단일 구조 지르코니아를 이용한 완전 구강 회복 증례)

  • Kim, Tae-Yeon;Han, Jung-Suk;Kim, Sung-Hun;Yeo, In-Sung;Lee, Jai-Bong
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.2
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    • pp.140-145
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    • 2016
  • Excessive occlusal wear causes loss of tooth structure, occlusal plane disharmony, impaired function and esthetic problems. Although the decrease of occlusal vertical dimension may be compensated by the growth of alveolar bone and tooth eruption, minimal increase of occlusal vertical dimension may be required for esthetics and retention of prosthesis. In this case, a 44-year-old male patient visited Seoul National University Dental Hospital with chief complaint of severe tooth wear and shade disharmony. Based on assessment of diagnostic wax-up, 3 mm increase of occlusal vertical dimension was determined. Removable occlusal splint and interim prosthesis was used to ascertain patient's comfort and adaptation. After the adaptation period, definitive prosthesis fabricated with full-contour monolithic zirconia were delivered and the patient was recommended to wear a nightguard device for prosthesis protection. This report presents a case of full mouth rehabilitation with the elevation of patient's occlusal vertical height, resulting in satisfactory esthetics and functions.

Analysis of current nursing homes in Korea and to assess the role and prospect of dentists in comparison to Japanese long term care insurance system (한국노인요양시설 구강 위생 현황과 일본 노인요양보험법 비교를 통한 치과의사의 역할과 전망)

  • Shin, Ri-Hye;Bae, Hanna Eun-Kyong;Choi, Sung-Ho;Park, In-Im; Ohyama, Takashi;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.83-91
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    • 2008
  • Statement of problem: The introduction of "The Long-term Care Insurance System" (a public nursing care insurance scheme) is scheduled from July in 2008. Lately, the importance of oral health care had increased. Introduction and establishment of the methodology (nursing care procedure) based on professional dental knowledge is inevitable. Purpose: The purpose of this study was to rouse recognition of the importance of dental care in the long term elderly care in nursing homes, with implementation of the new insurance law. Material and methods: Visited two institutions for the elderly, Yudang Village and Sungjiwon located in Suwon city to investigate the present conditions in terms of (1) the detailsof the institution, (2) the activities concerning with dental care in the institution, and (3) the consciousness and recognition regarding dental care of the staffs. Results: In two institutions, under the present conditions, oral cleaning (including the cleaning of denture) for residents was operated with no professional advices and limited professional dental care. It was found that there was very little awareness of aspiration pneumonia. The members of staff however, did recognizethe necessity of professional maintenance and management of oral care in daily nursing care, and that many residents hold dental problems. They were very eager in introducing the methodology (nursing care procedure) in dental care in nursing homes.

Orthodontic upright treatment for mesioangular impacted lower second molar (근심경사 매복된 하악 제2대구치의 직립 치료)

  • Choi, Baekgue;Jeong, Dongkee;Lim, Sunghoon;Gang, Sungnam
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.1
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    • pp.25-33
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    • 2017
  • The lower $2^{nd}$ molar eruption is beginning to mesiolingually, then rotate to distobuccally so it has a tendency to be tilted and impacted mesially. Signs and symptoms of impacted $2^{nd}$ molar are similar to impacted $3^{rd}$ molar's. However, treatment plan for impacted $2^{nd}$ molar is different from that of impacted $3^{rd}$'s. The former is the preservation and uprighting of $2^{nd}$ molar so that it could act to recovery of mastication, symmetrical facial growth, maintaining the symmetry of dental arch, stable occlusion, while the latter is the extraction of tooth. If the uprighting treatment is planned, most proper protocol of treatment and the additional treatment opition should be applied with consideration for it's crown exposure, present of $3^{rd}$ molar which interrupt the uprighting process, extrusion of opposite tooth. Although it could not improve the esthetic result, it could prevent many dental problems. Therefore, uprighting for impacted lower $2^{nd}$ molar is meaningful treatment.

Full mouth rehabilitation of a patient with worn dentition and loss of posterior support by vertical dimension reestablishment: a clinical report (구치부 상실과 과도한 교모가 있는 환자의 수직 고경 회복을 통한 전악 보철 수복)

  • Ryu, Jung-Hyun;Lee, Won-Sup;Lee, Cheol-Won;Lee, Su-Young
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.3
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    • pp.227-234
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    • 2018
  • Excessive teeth wear may result in the complications such as esthetic problems, hypersensitivity, and loss of vertical dimension. This clinical report focuses on the causes of severely worn dentition and the full-mouth rehabilitation of a patient with rheumatoid arthritis for 20 years. An interview, clinical and radiological examinations were performed to analyze the causes and decide the treatment plan. After delivery of the final prostheses, a night guard was used to protect the restorations and temporomandibular joints. The patient was satisfied esthetically and functionally.

Management of Lateral Pterygoid Myalgia with Diagnostic Local Anesthetic Injection: A Report of 2 Cases (진단적 국소마취 주사를 이용한 가쪽날개근 근육통의 치료 2 증례)

  • Im, Yeong-Gwan;Kim, Byung-Gook
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.275-281
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    • 2010
  • The lateral pterygoid muscle is one of the masticatory muscles basic to jaw function. Because of its deep location in the masticatory system, digital palpation of the muscle is usually difficult to perform and unreliable. Therefore, diagnosis of the myalgic disorders involving the lateral pterygoid muscle is a perplexing problem for clinicians. Local anesthetic injection can be a more effective method to examine the lateral pterygoid muscle for the purpose of discriminating the source of pain. Furthermore, immediate elimination of muscle pain facilitates stretching of the muscle in the full range. We report two cases of lateral pterygoid myalgia that were diagnosed and managed successfully through the use of intramuscular local anesthetic injection.

Full mouth rehabilitation with extremely worn dentition (심한 치아 마모 환자의 전악보철 수복 증례)

  • Cha, Hwa-Ryun;Yeom, Kyeong-Yeon;Lee, Yong-Sang;Kim, Na-Hong
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.3
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    • pp.238-244
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    • 2017
  • Pathologic attrition leads to pathologic damage on occlusal plane, functional disorders, occlusal disharmony, esthetic problems, pulpal lesion, temporomandibular joint (TMJ) disorder. In this case, treatment plan should be considered for possibility of vertical dimension loss, occlusal pattern, esthetics, phonetics, amount of vertical dimension increase. This case report was a 71-year-old man who had severely worn dentition. Full mouth rehabilitation was carried out with vertical dimension increase due to limited space for prosthesis. After evaluation of provisional restorations for patient's compliance, final restorations were fabricated and routine clinical assessments were made. This case presents that a satisfactory clinical result was achieved by restoring the worn dentition.

Full mouth rehabilitation using zirconia crown in severe worn dentition: a case report (마모가 심한 환자에서 지르코니아 크라운을 이용하여 전악 수복한 증례)

  • Park, Jung-Hyun;Sohn, Sang-Hyuk;Cho, Sung-Am
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.3
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    • pp.202-208
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    • 2016
  • The progressive attrition of teeth is a normal process by aging. However, excessive tooth wear with decreased vertical dimension of occlusion and collapse of occlusal plane may cause pathologic pulpal condition, occlusal disharmony and functional disorders. In this case, a patient with severely worn dentition was treated. Diagnostic wax-up was performed at the increased vertical dimension. After evaluation of provisional restorations for 12 weeks, final restorations were fabricated with zirconia crown and routine clinical assessments were made. Esthetically and functionally satisfactory results were obtained.

Surgical exposure of impacted tooth for orthodontic forced eruption : case report (교정적 견인을 위한 매복치의 수술적 노출 방법에 관한 증례보고)

  • Choi, Yongkwan
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.28 no.2
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    • pp.86-94
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    • 2019
  • Tooth impaction make various problems which are pathologic changes, functional defect and esthetic troubles. Sometimes impacted tooth are extracted. But surgical exposure of impacted tooth and orthodontic forced eruption are usually used a lot to solve these problems. Impacted tooth for orthodontic treatment has two impacted patterns 1) Simple impaction outside alveolar bone covered soft tissue, 2) Fully impaction under alveloar bone. So I introduce way to exposure of impacted tooth for orthodontic treatment with various cases and literatures.