• Title/Summary/Keyword: 구강 재활

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ORTHODONTIC APPROACH TO THE CEREBRAL PALSY PATIENT WITH MAXILLARY PROTRUSION IN THE MIXED DENTITION : A CASE (혼합치열기 뇌성마비환자의 상악전돌에 대한 교정치료 : 치험례)

  • Kim, Jongsoo;Jo, Anna;Kim, Jiyeon;Jeong, Taesung
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.43-46
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    • 2014
  • Cerebral Palsy is a genetic term referring to abnormalities of motor control caused by damage to a child's brain early in the course of development. Due to the impairment of balanced perioral muscle development, the prevalence of malocclusions in patients with cerebral palsy such as maxillary protrusion is high. But most clinicians may feel uncomfortable to treatment of these problems. Here a case report about mitigation of maxillary anterior teeth protruded in patient with cerebral palsy. 8y 4m old boy who have cerebral palsy visited our dental hospital. He showed severely protrusive maxillary anterior teeth with mouth breathing and could not close his mouth. He and his mother wanted to improve dental and facial esthetic problem. Specially designed or modified intraoral fixed appliance and rubber elastic chain was used in the therapy. Treatment carried out for 8 months and we could observe maxillary incisor angle was improved and mouth breathing habit was stopped. In conclusion, modified fixed appliance therapy for the patients with cerebral palsy might be useful. Continuous rehabilitation training of lips should be followed after treatment to correct imbalance of muscle tone.

Effects of Active Mandibular Exercise for Mouth Opening Limitation Patients after Maxillomandibular Fixation Release: A Non-Randomized Controlled Trial (악간고정 제거후 개구장애 환자에게 적용한 능동적 하악운동의 효과: 비무작위 대조군 설계)

  • Jang, Hyo Jin;Kim, Myung Hee
    • Journal of Korean Academy of Nursing
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    • v.48 no.1
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    • pp.26-37
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    • 2018
  • Purpose: The aim of this study was to evaluate the effects of active mandibular exercise (AME) in patients with limited mouth opening after maxillomandibular fixation (MMF) release. Methods: The study used a quasi-experimental, nonequivalent control group and a pre test-post test design. Sixty-two patients with Maxillomandibular Fixation Release were assigned to the experimental (n=31) or control group (n=31). The AME was performed in the experimental group for 4 weeks. The exercise AME consisted of maximal mouth opening, lateral excursion and protrusive movement. These movements were repeated ten times a day. After the final exercise of the day, the number of tongue blades used for mouth opening was noted. The effect of AME was evaluated after MMF release at different time intervals: a) immediately, b) after 1 week, c) after 2 weeks, d) after 4 weeks, and e) after 12 weeks. The exercise was assessed using the following criteria: a) mandibular movements, b) pain scores associated with maximal mouth opening, c) discomfort scores associated with range of movement, and d) daily life activities that involve opening the mouth. Results: The experimental group showed significant improvement regarding the range of mandibular movements (maximal mouth opening (F=23.60, p<.001), lateral excursion to the right side (F=5.25, p=.002), lateral excursion to the left side (F=5.97, p=.001), protrusive movement (F=5.51, p=.001)), pain score (F=39.59, p<.001), discomfort score (F=9.38, p<.001). Daily life activities that involve opening the mouth were more favorable compared to those in the control group. Conclusion: The AME in patients after MMF release is helpful for increasing mandibular movement range, decreasing pain and discomfort, and improving day life activities that involve opening the mouth. Therefore, AME is highly recommended as an effective nursing intervention.

Usefulness of the Salivagram for the Diagnosis of Brain Lesions in Patients with Aspiration Pneumonia (뇌병변 환자에서 흡인성 폐렴 진단을 위한 Salivagram의 유용성)

  • Oh, Shin Hyun;Choi, Yung Sook;Ro, Dong Wook;Nam-Koong, Hyuk;Kim, Jae Sam;Leee, Chang Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.48-52
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    • 2013
  • Purpose: Bed, living a long time is required in adult patients with brain lesions such as stroke, traumatic brain injury, and Parkinson's disease, causing pneumonia and respiratory diseases may be due to aspiration of food or saliva. In patients with recurrent pneumonia or pulmonary symptoms, there is a need to determine the possibility of pulmonary aspiration due to aspiration of saliva. Materials and Methods: Saliva due to aspiration pneumonia diagnosis in patients with brain lesions request for inspection to the Department of Nuclear Medicine, 10 patients (male 6, female 4) were included in this study. Patients were fasted before the test, $^{99m}Tc_{O4}$ 185 MBq (5 mCi) of less than 1 mL of solution was administered in the oral cavity. Administration and 20 minutes of dynamic imaging acquisition, and immediately after that the static images were acquired. Delayed scan after 2-4 hours if necessary. Results: Positivity rate of all 10 patients was 60%. In 4 patients showed positive reactions after the administration of oral cavity in a 20-minute dynamic imaging were able to confirm whether the aspiration. In the remaining 2 patients, four hours of additional delay tests were able to confirm whether the aspiration. Conclusion: Does not require changes in patient posture compared to the other checks that can be diagnosed with aspiration pneumonia. A simple test and takes less time. Therefore be useful in providing information for the diagnosis and treatment modality.

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DENTAL CARIES TREATMENT IN FEEDING PROBLEM PATIENT WITH CONGENITAL ESOPHAGEAL ATRESIA : A CASE REPORT (선천성 식도폐쇄를 가진 식이장애 환아의 치아우식 치료 증례 보고)

  • Heo, Seon-Jae;Lee, Mi-Yeon;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.1
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    • pp.6-10
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    • 2016
  • Esophageal atresia is the abnormal development of the esophagus that connects the mouth to the stomach. This birth defect results in the incomplete connection of the esophagus to the stomach causing an inability to swallow properly and breathing difficulties. Surgery is the only treatment for esophageal atresia. Patients undergone an esophageal reconstruction usually suffer from gastroesophageal reflex. A 5-year old boy with congenital esophageal atresia and Sciwitar syndrome visited Seoul National University Dental Hospital because generalized excessive loss of tooth structure. The patient had history of multiple operations for reconstruct esophagus. He had little food intake experience thought oral and had difficulty to swallowing. The patient was generalized severe erosive and decayed state. For patient, the dental procedure under general anesthesia was scheduled due to the multiple caries with erosion and poor cooperation. Under general anesthesia, pulpectomy and restoration as well as extraction was performed. Gastroesophageal reflex is potentially serious condition, with various extraesophageal adverse effects such as dental erosion. To prevent progression of dental caries, dietary counselling and oral hygiene instruction should be reinforced. Also, restorations to erosive teeth will maintain esthetics and function and preserve pulp vitality.

A Systemic Review of Positive Behavior Support Intervention Studies on Problem Behaviors of Children With Autism Spectrum Disorders: Focusing on Korean Single-Subject Research Design (자폐스펙트럼장애 아동의 문제행동에 대한 긍정적 행동지원 중재 연구의 체계적 고찰: 단일대상연구 설계를 중심으로)

  • Yoo, Yung-Mee;Choi, Yoo-Im
    • Therapeutic Science for Rehabilitation
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    • v.10 no.4
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    • pp.7-24
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    • 2021
  • Objective : This study examined the characteristics of the literature involving a single-subject research design among positive behavior support intervention studies to improve problem behavior in children with autism spectrum disorders and assess the quality level. Methods : This is a literature study, and the targets of analysis were nine single-subject research papers published between 2011 and 2020. The subject papers were analyzed by dividing them into general characteristics and the qualitative levels according to the content of the research method. Results : Analysis of analyzing the contents of the study showed that the subjects were preschool and elementary school-age children at the same ratio. Furthermore, the study design involved mostly the middle and multiple baseline designs among the behaviors. All papers presented social validity, intervention fidelity, and observer reliability. Problem behaviors included self-injury and aggression behaviors, disturbing behaviors, and seat break-away behaviors, while the most dependent variables were measured through partial interval recording. As a result of confirming the intervention effect, the effect was confirmed in intervention, maintenance, and generalization. All analysis studies showed high-quality levels. Conclusion : This study confirmed the content and qualitative level of the thesis that applied the single-subject research design among positive behavior support intervention studies for problem behaviors of children with autism spectrum disorders. Positive behavior support intervention, an evidence-based intervention for children with autism spectrum disorders, was confirmed an effective intervention for autism spectrum disorders.

Treatment Pattern of Patients with Neuropathic Pain in Korea (한국인 신경병성 동통 환자의 치료 양태 연구)

  • Han, Sung-Hee;Lee, Ki-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.197-205
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    • 2009
  • The purpose of this study was to investigate the treatment pattern of patients with neuropathic pain (NeP) in Korea through computerized database of Health Insurance Review and Assessment Service (HIRAS) over three years' period from 2003 to 2005. The results showed that the numbers of treatment visits were the highest for diabetic neuropathy (DN), followed by postherpetic neuralgia (PHN) and trigeminal neuralgia (TN) in order. Top 3 specialties for treatment visits due to NeP conditions were neurology, neurosurgery and anesthesiology. While cost of a treatment visit was higher in anesthesiology and emergency clinics compared to other clinics, there was a tendency to increase costs for visits to clinics of rehabilitation medicine and family medicine over the three years. Cost of dental visits was relatively high for TN, atypical facial pain (AFP) and atypical odontalgia (AO). Surgeries frequently applied to patients with NeP were sympathetic plexus or ganglion block, block of peripheral branch of spinal nerve and cranial nerve or its peripheral branch block. Most common prescribed medication were anticonvulsants, anti-inflammatory analgesics and anti-psychotic drugs while anti-inflammatory analgesics were overwhelmingly frequently prescribed for AO and glossodynia. Based on the results of this study, NeP disorders more relevant to dentists were AO, TN and AFP, TN of which seems to be the most important in terms of patients' number and cost for treatment visits. This indicates that dentists, especially oral medicine specialists should actively participate in management of TN, AO and AFP and share relevant information with patients and community.