• Title/Summary/Keyword: 장애인구강관리

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DENTAL MANAGEMENT ASSOCIATED WITH ERUPTION DISORDERS IN A PATIENT WITH EHLERS-DANLOS SYNDROME : A CASE REPORT (Ehlers-Danlos syndrome 환아의 맹출장애 : 증례보고)

  • Jin, Dallae;Kim, Chong-Chul;Lee, Sang-Hoon;Kim, Jung-Wook;Kim, Young-Jae;Hyun, Hong-Keun;Shin, Teo-Jeon;Jang, Ki-Taeg
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.8 no.2
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    • pp.127-133
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    • 2012
  • Ehlers-Danlos syndrome (EDS), an inherited connective tissue disorder, is caused by mutations in genes encoding different types of collagen or collagen-processing enzymes. EDS most typically affects the joints, ligaments, skin, and blood vessels. Oral health may be severely compromised in EDS as a result of specific alterations of collagen in orofacial structures. Dental hard tissue defects, root dilaceration, pulp stones, ectopic or delayed eruption, impaction, and periodontal disease could be observed. Therefore, a number of tissue responses related to collagen and precautions should be anticipated when considering dental treatment in EDS. Long-term and comprehensive dental management is required. The purpose of this report is to describe a clinical case of eruption disorders in a patient with EDS.

Full Mouth Rehabilitation with a Overlay Denture (피개의치를 이용한 지적장애인의 완전구강회복)

  • Ko, Kyung-Ho;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.385-395
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    • 2012
  • This clinical report presents the case using overlay dentures to treat a patient with cleft lip and palate and malocclusion. This patient requires vigorous treatment such as orthodontic treatment and combined orthodontic/oral surgery procedures. Overlay denture can be used as an alternative treatment option. Intraoral and radiographic examinations were done. The vertical dimension of occlusion was evaluated for proper prosthetic procedures and the surveying in the diagnostic cast was done. Considering the tissue and teeth undercut, the alterations of teeth shape were done. Final preparation and impression was performed. After the evaluation of vertical dimension and occlusion with wax-denture, the dentures were polymerized. Clinical remounting and occlusal adjustment were done on the articulator. Overlay dentures were delivered and the patient was recalled for relining. The overlay dentures satisfied patient's esthetic and functional requirements and provided a stable occlusion. Overlay dentures in this case were a reversible and relatively inexpensive treatment for this patient, however the potential possibilities of caries and periodontal disease as a result of poor oral hygiene should be prevented with periodic recall.

DENTAL MANAGEMENT OF MULTIPLE CARIES IN ADOLESCENCE PATIENT WITH INTELLECTUAL DISABILITIES: CASE REPORTS (다발성 우식증이 있는 청소년 지적장애 환자의 치과적 관리 : 증례보고)

  • Lee, Mi So;Kim, Jea-gon;Yang, Yeon-mi;Lee, Dae-woo
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.23-28
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    • 2019
  • People with intellectual disabilities (ID) usually have poor oral health status and are susceptive to have more caries than general populations. Even when the patients get regular dental treatment, their dental conditions are usually not good for some additional factors. In this presentation, we show dental follow-up care of two patients who have multiple caries. The first case is a 16-year-old boy who has a unilateral facial paralysis with ID. As the lack of controlling of the muscles resulted in interfering with the self-cleansing, it would be associated with a higher incidence on the affected side. Endodontic treatment and caries treatment as restoration was performed. Due to loss of posterior occlusal support on right side, we planned to recover the right posterior relationship by full coverage restorations. In second case, a 20-year-old boy has been on a long-term follow up. Caries treatment, periodontal treatment, and prosthetic treatment were performed under several times of general anesthesia. He has been treated more than 8 years and gets a regular check at 1-month intervals, however, high dental caries susceptibility has been retained. These cases present that dentists should perform more aggressive treatment and be involved in providing better maintenance of patients with intellectual disabilities with multiple caries in adolescence. In other words, it is necessary to suggest a customized preventive strategy for patients with ID.

INTERDISPLINARY CARE OF A PATIENT WITH APLASTIC ANEMIA : REPORT A CASE (재생불량성 빈혈 환자의 범학문적 접근 및 관리)

  • Lee, Young Eun;Park, Jae-Hong;Kim, Kwang Chul;Lee, Soo Eon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.9 no.2
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    • pp.98-102
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    • 2013
  • Aplastic anemia (AA) is a blood dyscrasia characterized by hypocelluar bone marrow and peripheral blood pancytopenia. Symptomatology depends on the severity of pancytopenia. Patients with AA are susceptible to infection because of agranulocytosis. Hemorrhage caused by thrombocytopenia can be fetal to these patients. Therefore dental procedure potentially can cause serious complications and should be applied with caution. A 6-year-old boy with moderate aplastic anemia was referred to treat dental caries. General dental procedure including resin filling, preformed crown, pulpectomy and extraction was performed under sedation. Combination of modalities such as platelet transfusion, oral hygiene instruction, and dental prophylaxis was also implemented. In this report, the dental and medical management of a patient with AA was presented. Interdisciplinary care should be administered to patients with AA.

국가적 수준의 치과의사 역량을 위한 치과마취과학의 교육역량과 치과의사국가고시 제고

  • Kim, Seung-Oh
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.1
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    • pp.1-9
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    • 2012
  • 치과마취학의 교육목표는 치과치료 시 적절한 환자평가와 함께 동통 및 불안을 관리하기 위한 약품선택과 치과치료를 위한 흡입법과 정맥주사를 이용한 의식하진정법과 언제, 어떻게, 어디로 전신마취를 의뢰하는지를 알아야 할 사항과 특히 의학적 병력을 가진 환자와 특별한 관리가 필요한 소아 노인 장애인의 전반적 이해와 치료 전 전신적 환자평가를 할 수 있는 능력과 치과진료 중 일어날 수 있는 의료적 응급 상황과 치과응급상황을 식별하고 인공소생술을 포함한 치과 치료 과정에서 발생할 수 있는 의학적 응급상황들에 적절한 관리를 할 수 있어야 한다. 치의학교육의 최소한의 질 보장을 위한 국가적 수준의 치과의사 역량체계를 구축함으로써 치의학교육의 질 향상을 위한 치과대학(원)의 변화를 자극하고, 치과의료와 의료인력의 질적 증진 및 치과의료행위의 최소수준을 보장하는데 있다. 하지만 현행 국가고시에 있어 치과마취과학은 구강외과 과목에 포함되어 위 기술한 치과마취과학의 교육목표를 달성하는 데 어려움이 있다. 그러므로 국가수준의 치의학교육의 질에 대해 제고하고 학교의 교육과정 변화와 개선에 적용하고 국시원의 새로운 과목의 도입과 실기시험을 통하여 치과마취과학의 교육목표를 달성하는 데 목적이 있다.

ANESTHETIC MANAGEMENT OF A PATIENT WITH DYSPHAGIA AND DENTAL PHOBIA FOLLOWING TONGUE CANCER SURGERY (설암 수술 후 구강 내 기능장애 및 치과공포증이 생긴 환자의 외래 마취관리 : 증례 보고)

  • Lee, Soo Eon;Seo, Kwang-Suk;Choi, Yoon-Ji;Kim, Hyun-Jeong;Chang, Juhea
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.2
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    • pp.97-100
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    • 2014
  • We experienced a case of dental treatment under general anesthesia in a 22-year-old female patient with dysphagia and dental phobia following partial glossectomy. She was diagnosed of squamous cell carcinoma of tongue and received surgical, radiation treatment two years ago. We report the experiences of anesthetic management for dental treatment in a patient with dysphagia and dental phobia following partial glossectomy.

The Oral Care Methodes for the Disabled (임상가를 위한 특집 3 - 장애인 구강관리법)

  • Lee, Hyo-Seol
    • The Journal of the Korean dental association
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    • v.49 no.12
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    • pp.749-757
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    • 2011
  • In the welfare law for the disabled in Korea, the disabled is defined as "the persons sho have significant limitations of daily or social life due to physical or mental disabilities over a long period." The number of registered domestic disabled person in 2008 survey was approximately 2.1 million. 90% of the disabled was caused by the aposteriori illness or accidents. So, in this aging society, the number of people with disabilities will increase even more. In general, people with physical and mental disabilities tend to have more oral diseases, but, are difficult to get treated. Therefore, a thorough oral care through individualized prevention is more important than ever. In this article, we review the oral care methods in dental office and home and in the hospital for the elderly and finally focus on a denture care method. According to this article, the dental professionals can be able to select and apply the oral care method in agreement with the characteristics of the disabilities. Particularly, it is important to prevent the aspiration pneumonia in the elderly in hospital.

Dysphagia and Oral Function in Chronic Stoke Patient: 3 Months Follow up Study (만성 뇌졸중 환자의 시간에 따른 삼킴 기능 변화)

  • Im, Ikjae;Ko, Myoung-Hwan
    • 재활복지
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    • v.22 no.1
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    • pp.141-156
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    • 2018
  • The purpose of this study was to examine changes in the swallowing function with chronic stroke patient. Ten chronic stroke patients with dysphagia followed up for 3 months. Eight normal age match subjects were also participated. A total of 18 participated in this study and they were classified into two groups (stroke patient group and normal control group). Participants underwent videofluoroscopic swallowing examination. The swallowing function was evaluated over time. Oral transit duration, pharyngeal transit duration, laryngeal response duration, Modified Barium Swallowing Impairment Profile ($MBSImP^{TM(c)}$), and Functional Oral Intake Scale (FOIS) were applied. Chronic stroke patient group were showed significantly longer oral transit duration, pharyngeal transit duration and laryngeal response duration than normal control group at baseline. After 3 months in stroke patient group, the mean oral components score of MBSImP (1~5) significantly decreased and the mean score on FOIS increased compared to baseline. In conclusion, oral swallowing function and oral intake function improved by the 3 month evaluation. These results describe changes in swallowing function with chronic stroke patients over time and provide basic informations to understand dysphagia.

Comparison of Dental Outcomes after General Anesthesia According to the Follow-up Pattern in Special Health Care Needs Patients (장애인 환자의 전신마취 하 치과 치료 후 정기검진 패턴에 따른 치과치료 결과 비교)

  • Kim, Jihyun;Nam, Okhyung;Kim, Misun;Lee, Hyoseol;Choi, Sungchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.2
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    • pp.145-150
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    • 2016
  • Special Health Care Needs (SHCN) patients need regular follow-up because of high incidence and severity of oral disease. The aim of this study was to evaluate the dental treatment outcomes of SHCN patients according to follow-up patterns. SHCN patients who were treated under general anesthesia (GA) at Kyung Hee University Dental Hospital from 2006 to 2014 were included in this study. The final samples comprised of 53 patients that were divided into regular (33 patients) and irregular (20 patients) follow-up groups according to their follow-up patterns. The type of dental treatment after GA during the follow-up periods were compared. In the irregular group, aggressive treatment including endodontic, prosthetic treatment, and extraction were predominant, compared with the regular group (p < 0.05). In addition, all patients who had dental treatment under GA in follow-up periods were in the irregular group (p < 0.05). In conclusion, the results of this study provide the importance of regular follow-ups with SHCN patients and emphasize responsibilities of dentists for educating patients and their guardians.

DENTAL MANAGEMENT OF A PATIENT WITH PRADER-WILLI SYNDROME : A CASE REPORT (Prader-Willi syndrome 환자의 치과 치료 : 증례보고)

  • Lee, Myeong-Yeon;Jung, Younwook;Kim, Seong-Oh;Choi, Hyung-Jun;Son, Heung-Kyu;Lee, Hyo-Seol
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.26-30
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    • 2014
  • Prader-Willi syndrome (PWS) is a rare neurodevelopmental disease caused by abnormality of chromosome 15q11-13. The estimated prevalence of PWS is 1/10,000-30,000. Most common features of this disease are feeding problems characterized by poor sucking habit related with neonatal or infantile hypotonia and obesity due to early childhood hyperphagia involved with lack of satiety. In the orodental findings, enamel hypoplasia, rampant caries, delayed eruption, poor oral hygiene, hypodontia, supernumerary teeth, increased tooth wear, decreased salivary flow and change in saliva composition were reported. This case report describes the dental treatment of 3-year-9-months-old male patient with PWS. Periodic check-ups and conservative treatments were followed, however, rapid dental caries progression caused by estimating hyposalivation was observed. Because of lack of patient cooperation, dental procedures were performed under general anesthesia.