• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.173-179
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• 2015

Issues related to the control of seizures and bleeding, as well as behavioral management due to mental retardation, render dental treatment less accessible or impossible for patients with Sturge-Weber syndrome (SWS). A 41-year-old man with SWS visited a dental clinic for rehabilitation of missing dentition. A bilateral port-wine facial nevus and intraoral hemangiomatous swollen lesion of the left maxillary and mandibular gingivae, mucosa, and lips were noted. The patient exhibited extreme anxiety immediately after injection of a local anesthetic and required various dental treatments to be performed over multiple visits. Therefore, full-mouth rehabilitation over two visits with general anesthesia and two visits with target-controlled intravenous infusion of a sedative anesthesia were planned. Despite concerns regarding seizure control, bleeding control, and airway management, no specific complications occurred during the treatments, and the patient was satisfied with the results.

• Journal of Korean Academy of Dental Administration
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• v.9 no.1
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• pp.32-37
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• 2021

Many approaches to local anesthesia have been studied in dentistry. In this study, we introduce a new local anesthetic method, "Point-Inject Technique (PIT)", and compare it with traditional injection techniques. The PIT method utilizes both the vasoconstrictive and antinociceptive properties of local anesthetics as well as the application of controlled pressure during injection, reducing the time to complete anesthesia. Fifty patients were selected as the experimental group who were anesthetized using PIT, and the other 50 patients were selected as the control group using the direct injection method with a carpool syringe. The PIT group received 0.25 cartridges of 2% lidocaine with 1:100,000 epinephrine. The control group received 1.5~2 cartridges of 2% lidocaine with 1:100,000 epinephrine. Both groups were asked to mark the intensity of the pain caused by anesthesia using the Numeric Pain Rating Scale. The average time to recover from anesthesia was 40 minutes in the experimental group and 90 minutes in the control group. Additionally, 96% of the experimental group reported feeling no pain, while 78% of the control group reported having some form of pain during injection. The PIT method reduced both the reported pain scores of patients as well as time to recover from local anesthesia than the widely-used syringe injection method.

• Journal of dental hygiene science
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• v.16 no.6
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• pp.458-463
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• 2016

This study aimed to assess changes in maximum bite force and psychological elements in patients with bruxism treated with botulinum toxin who visited the hospital with a chief complaint of masseter hypertrophy. From among the subjects with masseter hypertrophy as the chief complaint, 10 patients with and 10 without bruxism were selected. We measured bite force prior to botulinum toxin injection and at 2, 4, 8, and 12 weeks after the injection and assessed changes in psychological elements by using Symptom Checklist 90 Revision. The study results showed statistically significant differences in maximum bite force on both the right and left sides between the patients with and those without bruxism, according to periodic changes (p<0.05). Depression elements showed statistically significant changes in the patients with bruxism (p<0.05). In the bruxism and non-bruxism groups, the patients recovered from anxiety in accordance with the periodic changes (p<0.05). Our study results indicate that the patients with bruxism show significant changes in interpersonal sensitivity, depression, and anxiety according to the treatment periods, and that occlusal force and depression were significantly related. Therefore, when setting a treatment plan for bruxism, multilateral psychological elements must be considered, along with functional elements.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.4
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• pp.229-238
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• 2017

Objectives: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. Materials and Methods: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study. The initial dose of MDZ was determined by body mass index (BMI) and weight. In the case of insufficient sedation at the beginning of surgery, additional doses were injected. During surgery, peripheral oxygen saturation, bispectral index score (BIS), heart rate, and blood pressure were monitored and recorded. The predictor variables were sex, age, BMI, sleeping time ratio, dental anxiety, Pederson scale, and initial dose of MDZ. The outcome variables were additional administration of MDZ, observer's assessment of alertness/sedation, intraoperative amnesia, and patient satisfaction. Descriptive statistics were computed, and the P-value was set at 0.05. Results: Most patients had an adequate level of sedation with only the initial dose of MDZ and were satisfied with the treatment under sedation; however, 19 patients needed additional administration, and 13 patients were unsatisfied. In multivariable logistic analysis, lower age (odds ratio [OR], 0.825; P=0.005) and higher dental anxiety (OR, 5.744; P=0.003) were related to additional administration; lower intraoperative amnesia (OR, 0.228; P=0.002) and higher BIS right before MDZ administration (OR, 1.379; P=0.029) had relevance to patient dissatisfaction. Conclusion: The preoperative consideration of age and dental anxiety is necessary for appropriate dose determination of MDZ in the minor oral surgery under IVS. The amnesia about the procedure affects patient satisfaction positively.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.5 no.2
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• pp.100-103
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• 2009

Dental treatment of mentally challenged patients under general anesthesia is a series of challenging procedures not only for dental operators but also for dental anesthesiologists. Patients presenting with uncooperative behavior often resist the perioperative management for adesthestic administration. This case report suggests oral premedication as a conjuctive method for anestheitic induction. A 26-year-old male dental patient with autism was referred to dental treatment under general anesthesia. The patient refused to enter dental clinic office and was not able to receive preoperative assessment. In the day of operation, 15 mg of midazolam was given to the patient for oral premedication prior to anesthetic induction. Ater 20 minutes, the patient presented with drowziness and was transferred to the office. Anesthestic staff were able to achieve appropriate intravenous access and mask inhalation. The patient recieved 8 hrs long dental treatment and recovered in a noncomplicated way. Oral midazolam is commonly used to reduce anxiety for combative and irritated pateints. In this case, oral midazolam sedation was used as a preanesthetic management of a highly uncoopearive patient.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.1
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• pp.49-60
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• 2022

Background: Although dental sedation helps control anxiety and pain, side effects and serious complications related to sedation are gradually increasing. Due to the introduction of new drugs and sedation methods, insurance rates, legal regulations, drugs, and methods used for dental sedation are inevitably changed. In the Republic of Korea, National Health Insurance is applied to all citizens, and this study investigated changes in the use of sedatives using this big data. Methods: This study used customized health information data provided by the Healthcare Insurance Review & Assessment Service of Korea. Among patients with a record of use of at least one of eight types of sedatives for dental sedation between January 2007 and September 2019 were selected; the data of their overall insurance claims for dental treatment were then analyzed. Results: The number of patients who received dental sedation was 786,003, and the number of dental sedation cases was 1,649,688. Inhalational sedation using nitrous oxide (N₂O) accounted for 86.8% of all sedatives that could be claimed for drugs and treatment. In particular, it was confirmed that the number of requests for sedation using N₂O sharply increased each year. Midazolam showed an increasing trend, and in the case of chloral hydrate, it gradually decreased. Conclusion: According to our analysis, the use of N₂O and midazolam gradually increased, while the use of chloral hydrate gradually decreased.

• Journal of Industrial Convergence
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• v.22 no.5
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• pp.57-67
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• 2024

This study conducted to confirm the effect of college students' individual tendencies and psychological variables on the depth of chest pressure during CPR. For this, the depth of chest compression during CPR was measured after investigating individual tendencies, fatigue, performance confidence, and performance anxiety in 127 college students. Multiple linear regression analysis was performed using individual propensity and psychological variables as independent variables and chest compression depth as dependent variables to identify factors affecting chest compression depth. Pearson correlation analysis was performed to confirm the correlation between variables. As a result of the analysis, the higher the performance confidence, the deeper the chest compression depth, and the higher the performance anxiety, the lower the chest compression depth(p<0.05). The depth of chest pressure showed a positive correlation with individual tendencies, performance confidence, while it showed a negative correlation with fatigue and performance anxiety(p<0.01, p<0.05). Based on these results, it is necessary to increase performance confidence and lower performance anxiety in order to perform the correct chest compression depth. For this, various efforts such as program development, education and research are required.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.4
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• pp.221-225
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• 2014

External beam radiotherapy (EBRT) causes anxiety and claustrophobia in pediatric patients. To provide exact figures and radiation amounts, an appropriate sedation or anesthesia can be supplied. Alpha 2 agonist dexmedetomidine has been used for sedation and anesthesia in pediatric imaging. Dexmedetomidine has an advantage because it has minimal respiratory depression and no direct effects on myocardial function. We report repeated sedation with dexmedetomidine for 33 consecutive radiation therapies in 5 years old children.

• Journal of The Korean Dental Society of Anesthesiology
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• v.7 no.2
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• pp.126-130
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• 2007

Sedation is often indicated for the relief of anxiety for outpatient oral surgery. In combination with local anesthesia, it is safe and effective method of treatment. However, it is not always effective in allowing the physician to complete the planned oral surgery procedure. On occasion, a procedure is left unfinished due to patient combativeness and discomfort and hypertension in spite of increase in sedative doses. Episodic increases in blood pressure were most commonly caused by light anesthesia or sedation and by the patient's experience of pain during treatment. Female patient was 42 years old. blood pressure is 150/90 mmHg. Extraction and implant surgery was done under IV sedation. During seadtion, her blood pressure was increased (200/100 mmHg). Surgery was stopped. She was done monitoring blood pressure. The blood pressure was decreased to 130/90 mmHg. Sedation was failed due to significant hypertension. Blood pressure is seldom increased during sedation but we should evaluate the patient's medical history and know guideline for hypertension crisis.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.1
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• pp.65-69
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• 2018

Local anesthesia is administered to control pain, but it may induce fear and anxiety. Root planing is a non-surgical periodontal therapy; however, when it is performed in an extensive manner, some tissue removal is inevitable. Notably, this removal may be so painful that local anesthesia is required to be administered to the area scheduled for the treatment. Although patients tend to accept root planing easily, they frequently express a fear of local anesthesia. Intraosseous anesthesia (IA) is an intraosseous injection technique, whereby local anesthetic is injected into the cancellous bone supporting the teeth. A computer-controlled IA system (CIAS) exhibits multiple benefits, such as less painful anesthesia, reduced soft tissue numbness, and the provision of palatal or lingual, as well as buccal, anesthesia via single needle penetration. In this report, we present two cases of root planing that were performed under local anesthesia, using a CIAS.