• Journal of Dental Anesthesia and Pain Medicine
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• 제15권4호
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• pp.193-200
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• 2015

Background: During head and neck surgery including orthognathic surgery, mild intraoperative hypothermia occurs frequently. Hypothermia is associated with postanesthetic shivering, which may increase the risk of other postoperative complications. To improve intraoperative thermoregulation, devices such as forced-air warming blankets can be applied. This study aimed to evaluate the effect of supplemental forced-air warming blankets in preventing postanesthetic shivering. Methods: This retrospective study included 113 patients who underwent orthognathic surgery between March and September 2015. According to the active warming method utilized during surgery, patients were divided into two groups: Group W (n = 55), circulating-water mattress; and Group F (n = 58), circulating-water mattress and forced-air warming blanket. Surgical notes and anesthesia and recovery room records were evaluated. Results: Initial axillary temperatures did not significantly differ between groups (Group $W=35.9{\pm}0.7^{\circ}C$, Group $F=35.8{\pm}0.6^{\circ}C$). However, at the end of surgery, the temperatures in Group W were significantly lower than those in Group F ($35.2{\pm}0.5^{\circ}C$ and $36.2{\pm}0.5^{\circ}C$, respectively, P = 0.04). The average body temperatures in Groups W and F were, respectively, $35.9{\pm}0.5^{\circ}C$ and $36.2{\pm}0.5^{\circ}C$ (P = 0.0001). In Group W, 24 patients (43.6%) experienced postanesthetic shivering, while in Group F, only 12 (20.7%) patients required treatment for postanesthetic shivering (P = 0.009, odds ratio = 0.333, 95% confidence interval: 0.147-0.772). Conclusions: Additional use of forced-air warming blankets in orthognathic surgery was superior in maintaining normothermia and reduced the incidence of postanesthetic shivering.

• 대한치과마취과학회지
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• 제11권2호
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• pp.153-158
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• 2011

Midazolam is known to produce sedation as well as amnesia. Many articles reported about anterograde amnesia, but it is rare that articles about retrograde amnesia. The 61-year-old female patient (64 kg, 154 cm, ASA physical status I) was administered 3.02 mg (0.047 mg/kg) of midazolam during 2 hours. The patient's Modified Observer's Assesment of Alertness/Sedation Scale was 4. The patient who had been consciously sedated with midazolam, exhibited profound amnesia, both anterograde and retrograde after implantation. The patient's memory restoration was begun after 6 hours.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권2호
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• pp.216-219
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• 2008

Ameloblastoma is the most frequently accuring odontogenic tumor in mouth. The biologic behavior of this neoplasm is locally invasive tumor with a high rate of recurrence. But in case of unicystic ameloblastoma, it was known that the neoplasm can be treated by marsupialization and the recurrence rate is lower. In our clinic, we tried to treat one of ameloblastoma cases by marsupialization and finished the treatment by enucleation via intra-oral approach with sagittal ramus osteotomy. This is a report of that case about 29 years old female patient.

• Journal of Oral Medicine and Pain
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• 제46권3호
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• pp.84-87
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• 2021

Morsicatio buccarum is a condition caused by chronic cheek biting. It means frictional hyperkeratosis by repetitive cheek biting, which may be associated with obsessive compulsion. Clinically it presents as rough, shaggy, whitish, often peeling surface. We report a 9-year-old female patient who complained oral ulceration on both buccal mucosa. The initial diagnosis was oral candidiasis because of whitish plaques which were peeled off. Topical antifungal agent was ineffective and the symptom did not disappear. By incisional biopsy, she was diagnosed with morsicatio buccarum. A soft oral appliance was placed in the patient's oral cavity. Although morsicatio buccarum improved significantly when the appliance was used, the oral lesion had a tendency to recur, when the patient stopped using the appliance. In case of recurrence, cognitive behavioral therapy for obsessive-compulsive disorder is needed for the fundamental treatment.

• Journal of Oral Medicine and Pain
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• 제46권3호
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• pp.93-97
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• 2021

The limited mouth opening, also known as trismus, can result from temporomandibular joint disorders, infection, neoplasm, trauma, and abnormal anatomic structure like coronoid hyperplasia. Head and neck cancer patients often complain of limited mouth opening, which is usually induced by myofibrotic contracture of masticatory muscle. But clinicians should consider any reasons such as infection or cancer growth and metastasis if trismus gets worse or pain develops. We report the case of the patient, who was diagnosed with myxofibrosarcoma on nasal cavity. He had suffered from trismus after concurrent chemoradiotherapy. However, pain had developed and trismus had worsened. He was diagnosed with infratemporal space abscess and myositis of masticatory muscles.

• Journal of Oral Medicine and Pain
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• 제44권3호
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• pp.123-126
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• 2019

Vestibular schwannoma, also known as acoustic neuroma, is a rare benign brainstem tumor surrounding the vestibular division of the 8th cranial nerve. The presenting symptoms are hearing loss, tinnitus, and dizziness. Unabated growth can compress 5th (trigeminal nerve) and 7th (facial nerve) cranial nerve, which can cause nerve dysfunction such as orofacial pain, sensory abnormalities, or trigeminal neuralgia. We report a 51-year-old woman who presented with orofacial dysesthesia on her left side of the face with abnormal findings on 5th cranial nerve and 8th (vestibulocochlear nerve) cranial nerve examination. Brain magnetic resonance imaging scan revealed cerebellopontine angle tumor. She was referred to a neurosurgeon and diagnosed with vestibular schwannoma.

• 치위생과학회지
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• 제9권1호
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• pp.43-52
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• 2009

본 연구는 치위생과 임상실습과정 동안의 수행경험정도를 파악하고 학습과정과 실습현장의 특성을 반영한 실습 프로그램의 개발과 프리셉터(Preceptor)제도의 도입방안을 위한 기초자료를 마련하고자 하였다. 8개 종합병원에서 실습하는 치위생과 학생 150명과 종합병원에 근무하는 치과위생사 58명을 대상으로 다음과 같은 결과가 나왔다. 1. 관찰 경험과 수행경험에서 기본진료 영역이 가장 높았고, 예방치과 업무에서 가장 낮은 관찰경험도가 나타났고 수행경험에서는 환자관리 업무, 예방치과, 치주과 업무 영역에서 낮은 수행 경험을 나타냈다. 2. 병원별로는 기본진료 업무영역에서 가장 높은 관찰 실습경험과 수행실습경험을 나타내었고, 위와 마찬가지 전문성을 요하는 업무영역에서는 낮은 실습 경험도를 나타냈다. 3. 치과위생사의 임상실습활동 내용의 중요도에 대한 인식에서는 3년차 이상의 치과위생사의 인식도가 전체적으로 높은 것으로 나타났다.

• 대한장애인치과학회지
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• 제6권2호
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• pp.84-93
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• 2010

The developmental disorder(intellectual disorder(ID) and autism spectrum disorder(ASD)) can severely impair a patient's ability to communicate and socialize. So they require physical management techniques, pharmacologic agents, and general anesthesia more than the normal at the dental clinic. The behavior therapy is a kind of the psychotherapy and is applied to the patient with behavioral problems. Seoul Dental Hospital for Disabled(SDHD) set up the Dental Behavior Clinic for the patients with developmental disorder and treated 32 patients with ID or ASD, blind. 18 patients were treated according to the ordinary plans, 14 patients stopped the treatment by different reasons. The various results of the treatment were produced by the kind or severity of the diseases, age and cooperation of the patients and the caregivers. Especially, the behavior therapist helped to figure out the characteristics of the patients and to make individualized treatment plans. In the future, it will be necessary to treat more patients and to make the dental behavior therapy objectify. And through the dental behavior therapy, it will be expected that the patients will become more cooperative to the dental clinic and can receive regular check-up peacefully, reducing the frequency of the general anesthesia.

• 대한치과마취과학회지
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• 제9권1호
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• pp.24-29
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• 2009

When performing the inferior alveolar nerve block anesthesia, surgeon often faced a difficulty of the surgical operation due to the incomplete anesthesia. One of the reason is the variety of mandibular canal anatomy. Up to now, there are some reports of index cases about bifid mandibular canal among mandibular canal anatomic variation, and some classification is applied according to anatomical location and configuration. When surgical operation is performed involving mandible such as dantal implant treatment, extraction of an impacted third molar, sagittal split ramus osteotomy, etc, the position of mandibular canal should be considered. Bifid mandibular canal clinically causes troublesome cases of anesthesia when inferior alvelor nerve block, especially is performed extraction of an impacted third molar. Therefore, It is important for clinicians to recognize the presence of bifid canals on radiographys. Nowadays, the position of mandibular canal can be measured precisely by using Dental CT. It is not found by panorama image but is found by Dental CT sometimes. Among the patients, which take panorama and Dental CT simultaneously, for tooth extraction of lower impacted third molar in our department, we report the case that did not identifying in panorama but identifying it in Dental CT.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권3호
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• pp.195-204
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• 2024

Background: Distraction is a technique used to divert a patient's attention from unpleasant procedures. This study aimed to evaluate the effectiveness of kaleidoscopy, virtual reality, and video games in reducing anxiety and pain during invasive dental procedures in children. Methods: Sixty-six children aged 6 to 9 years were randomly assigned to three groups during local anesthesia administration: Group 1 (kaleidoscope), Group 2 (virtual reality), and Group 3 (mobile video games). The anxiety of the children was evaluated using physiological measures (heart rate) at three different time points: before, during, and after the procedure. The Raghavendra, Madhuri, and Sujata pictorial scale was used as a subjective measure before and after the procedure. Subjective measures of pain were assessed using the Wong-Baker Faces Pain Scale. The data were statistically analyzed using the Kruskal-Wallis and Wilcoxon signed-rank tests. Results: In the intergroup comparison, there were no statistically significant differences in the physiological measures of anxiety scores between the three groups before, during, and after distraction. Raghavendra, Madhuri, and Sujata pictorial scale scores were assessed before and after distraction, but no statistically significant differences were observed. Among the three groups, the children in Group 2 showed a significant reduction in pain scores. Conclusion: Compared with kaleidoscopes and video games, virtual reality is a promising distraction technique for reducing dental fear, anxiety, and pain during local anesthesia administration in children.