• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.2
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• pp.113-119
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• 2017

Background: The purpose of this study was to investigate the distribution of systemic diseases and medications in patients older than 65 years of age who visited the hospital for implant treatment, as well as to investigate basic information about surgical complications that may occur after insured implant treatment. Method: A total of 126 patients over 65 years of age were treated for implant surgery from October 1, 2013 to October 30, 2016. Electronic chart review was conducted to obtain medical records, which included sex, age, systemic diseases, medication(s) being taken, and control of the medications. Five patients were excluded due to lack of medical records giving information about systemic disease. Results: Of the 126 patients, 112 (88.9%) were taking medication due to systemic disease and 9 patients (7.1%) were not. The sex distribution was 71 women and 55 men and the highest proportion of patients were between 65 and 69 years old. The most common diseases were, from most to least frequent, hypertension, cardiovascular disease, diabetes, and osteoporosis. The drug groups that can cause major complications after dental treatment were classified as hemorrhagic, osteoporotic, and immunosuppressive agents, and were taken by 45 (35.7%), 22 (17.5%) and 4 (3.2%) patients, respectively. Conclusion: Given that 88.9% of the elderly patients who were eligible for insurance implant treatment had systemic disease, it is necessary to carefully evaluate patients' medical histories and their general conditions in order to prevent emergencies during implant surgery.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.181-184
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• 2015

Airway difficulties are a major concern for anesthesiologists. Even though fiberoptic intubation is the generally accepted method for management of difficult airways, it is not without disadvantages-requires patient cooperation, and cannot be performed on soiled airway or upper airways with pre-existing narrowing pathology. Additionally, fiberoptic bronchoscopy is not available at every medical institution. In this case, we encountered difficult airway management in a 71-year-old man with a high Mallampati grade and a thick neck who had undergone urologic surgery. Several attempts, including a bronchoscope-guided intubation, were unsuccessful. Finally, blind nasal intubation was successful while the patient's neck was flexed and the tracheal cartilage was gently pressed down. We suggest that blind nasal intubation is a helpful alternative in difficult airway management and it can be a lifesaving technique in emergencies. Additionally, its simplicity makes it a less expensive option when advanced airway technology (fiberoptic bronchoscopy) is unavailable.

• Imaging Science in Dentistry
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• v.42 no.2
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• pp.71-75
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• 2012

Purpose : Dental trauma is frequently unpredictable. The initial assessment and urgent treatment are essential for dentists to save the patient's teeth. Mobile-phone-assisted teleconsultation and telediagnosis for dental trauma could be an aid when a dentist is not available. In the present in-vitro study, we evaluated the success rate and time to transfer images under various conditions. Materials and Methods : We analyzed the image quality of cameras built into mobile phones based on their resolution, autofocus, white-balance, and anti-movement functions. Results : The image quality of most built-in cameras was acceptable to perform the initial assessment, with the autofocus function being essential to obtain high-quality images. The transmission failure rate increased markedly when the image size exceeded 500 kB and the additional text messaging did not improve the success rate or the transmission time. Conclusion : Our optimal protocol could be useful for emergency programs running on the mobile phones.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.4
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• pp.207-214
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• 2019

Objectives: Medically compromised patients often fear required dental surgical procedures that can increase the risk of medical emergency when combined with reduced tolerance for stress. A stress reduction protocol (SRP) helps doctors minimize treatment-related stress and improves patient management with minimum complications. Diabetes and co-morbid hypertension carry 4-fold risk of aggravation of cardiovascular emergencies and 7.2-fold risk of mortality. Diabetic neuropathy can result in difficult diagnosis of myocardial infarction and reduces chances of surviving a myocardial infarction compared with a non-diabetic person. The aim of the study was to assess the feasibility of a protocol for management of patients having both diabetes and hypertension who required minor oral surgery to minimize the rate of cardiovascular emergencies. Materials and Methods: A prospective study was conducted in 140 patients having both diabetes and hypertension who required minor oral surgical procedures. A systematic approachable protocol was designed for management of such patients. Results: Among 140 patients, 6 patients (4.3%) had cardiovascular complications, while 3 patients (1 with syncope and 2 with hypertension) did not require any intervention other than observation. Two patients were managed with aspirin and nitroglycerin, and 1 patient had possible myocardial infarction (overall incidence 0.7%) with chest pain, S-T segment elevation on electrocardiogram, and troponin level of 0.60 ng/mL. Conclusion: The proposed protocol helps to improve management of patients having both diabetes and hypertension. We recommend that patients with uncontrolled diabetes and uncontrolled hypertension and/or patients having history of cardiovascular complication should be treated in a medical facility with a readily available cardiology unit. This facilitates prompt response to emergency and instant implementation of treatment, helping to reduce morbidity and mortality.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.1
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• pp.21-29
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• 2023

Objectives: Dental or maxillofacial emergencies are uncommon during pregnancy, but if they occur, they are challenging to treat due to potential risks. The mother should not be denied necessary medical or dental care because of pregnancy. The aim of the study is to observe outcomes of pregnancy in patients requiring emergency minor oral surgical procedures during gestation and to determine the safety of the pregnant woman undergoing the procedure and the fetus. Materials and Methods: The study was conducted on 52 pregnant women requiring emergency oral surgical procedures. A standard treatment protocol for treatment of specific entities was followed. Close monitoring and observation were the primary goal of treatment. All patients were followed postoperatively until complete recovery from the surgical procedures and then until birth of the baby. A control group of 52 healthy pregnant patients who did not require oral surgical procedures was considered for statistical analysis. The measurements to calculate observation were fetal loss (spontaneous abortion), preterm birth, low-birth weight, or incidence of any congenital anomalies in the baby and its association with surgical procedures. Results: No fetal loss occurred in any of the cases. However, four patients experienced preterm birth and seven neonates exhibited low birth weights. No congenital abnormalities were discovered. In one instance, a patient who underwent surgery for a mandibular symphysis fracture under general anesthesia in the 31st week of pregnancy experienced labor pain on the fourth postoperative day, requiring an emergency Caesarean section. Conclusion: The results of our study demonstrate that, compared to the control group, minor emergency surgeries performed during pregnancy have no discernible negative effects on the fetus. These procedures can safely be performed by adhering to our described protocols.

• Korean Parent-Child Health Journal
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• v.6 no.2
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• pp.147-158
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• 2003

The purpose of this study was to investigate the situation of occurrence of disease and accidence of child care center. The subjects of this study were 17 public district child care centers, but only one center kept their health diary. Therefore, it became finally the only subject for this study. The data were collected through the analysis it's health diary and case reports for emergency. The collected data were analyzed by the number of cases, age and sex, types of case, and the emergency case were analyzed by age, background, types of accidents and follow up. The number of cases of disease and accident in 2002 were 572. In sexual difference, boys more have accident than girls. The teachers and the outsiders also frequently use the health care service. Smallpox and epidemic conjunctivitis were spreaded during winter and summer. In causes of accidents, 'accident by other child' were 98%. In emergency cases, 1 pierced wound, 1 dislocation, 2 dental emergencies, 4 eyeball contusion and bleedings and 2 burns were occurred. all the cases of emergency were performed follow up education. On the basis of above data, there will be needed to intensify health and safety subjects in curriculum for the teacher of child care, and health and safety education for child. Each child care centers must have health care manager and the network for emergency. To enhance the quality of child care service, government have to offer financial and systematical support.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.3
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• pp.393-399
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• 2018

The aim of this review is to introduce about the issue of benzocaine and methemoglobinemia. Through blocking the pain during dental treatment, fear and anxiety of patients will be reduced. Thus, anesthetic agent containing benzocaine is commonly used while controlling the pain of patients during treatment. However, on May 28, 2018, the Ministry of Food and Drug Safety reported a medication safety report about restricting the use of benzocaine-containing agents in infants under 24 months and children. Also, they recommended a cautious use to adolescents and adults to prevent methemoglobinemia (MHb). This report was published due to an advice from Food and Drug Administration (FDA) on May 23, 2018. When using agents containing benzocaine, dentists must consider the probability of MHb and prepare for early diagnosis and appropriate action. Since 1930s, methylene blue is known to cure MHb patients. Therefore, the proper use of methylene blue for emergencies and diagnosis methods for early diagnosis of MHb should be familiar to dentists planning for the use of topical anesthetic agents. Dentists should be trained for emergency situation of MHb caused by the use of benzocaine.