• Journal of Dental Anesthesia and Pain Medicine
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• 제17권4호
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• pp.271-280
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• 2017

Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

• 한국임상보건과학회지
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• 제5권3호
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• pp.897-906
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• 2017

Purpose. In this study, the empowerment and job characteristics of dental hygienists by hospital type were identified and the relationships between empowerment and job characteristics were examined. Methods. The subjects were 156 working dental hygienists. A structured self-administered questionnaire was used to investigate the empowerment and job characteristics of dental hygienists. For empowerment and Job Characteristics, the scale developed by Spreitzer and Hackman and Oldham was used. Results. The results of this study showed that the degree of formation of empowerment for dental hygienists was the highest in general/university hospitals. All elements of job characteristics were closely correlated with empowerment, and hospital type was correlated with the determination of empowerment. Job characteristics influenced empowerment. This result suggests that the inherent jobs of dental hygienists did not change much by hospital type, but empowerment changed because the organizational characteristics changed according to hospital size. Conclusions. Therefore, considering the importance of the jobs of dental hygienists, hospitals need to form an organizational atmosphere that guarantee autonomy and promote a diversity of jobs.

• 한국치위생학회지
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• 제18권5호
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• pp.751-761
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• 2018

Objectives: The purpose of this study was to identify factors affecting choice of treatment hospital (i.e., determinants) and satisfaction with the treatment hospital, and to provide a more satisfactory and high-quality medical service for orthodontic patients. Methods: A questionnaire survey was conducted for approximately 1 month beginning in August 2017, involving patients who visited orthodontic dentistry clinics in Seoul and Gyeonggi-do. Multiple regression analysis was performed on the results to examine factors that affected satisfaction with orthodontic treatment. Results: The determinant of dental clinics was 3.90 points overall; hospital environment and facilities were highest at 4.05, followed by dental hygienist at 3.99, and dentist at 3.97. Factors influencing satisfaction with orthodontic treatment were positively influenced by dentists (p<0.01), medical procedures (p<0.01) and medical expenses (p<0.01). Conclusions: It is important to provide comfort and convenience to patients by simplifying hospital facility management, reception, and reservation procedures.

• Journal of Trauma and Injury
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• 제32권3호
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• pp.172-175
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• 2019

Although thoracic endovascular aortic repair (TEVAR) has grown to become the standard of care to treat blunt thoracic aortic injury (BTAI), the long-term effects of TEVAR are still unclear. We here present a 72-year-old man with BTAI due to a traffic accident. He successfully underwent TEVAR and was transferred to another rehabilitation hospital 2 months after the accident. However, 1 month later, he underwent gastroscopy with fever and hematemesis and was diagnosed with aorto-esophageal fistula (AEF). After being re-transferred to Niigata University Medical and Dental Hospital, we tried to convince him to undergo surgical treatment, but he strongly refused. He received palliative care and died due to rupture of the aortic pseudoaneurysm 3 days after the hospital transfer. Fatal complications like AEF may occur after TEVAR, so clinicians need to carefully follow patients who underwent TEVAR.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권5호
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• pp.305-308
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• 2018

An 87-year-old woman was referred for the extraction of residual teeth and removal of tori prior to prosthetic treatment. After surgery under general anesthesia, the surgical tape was removed to detach the bispectral index sensor and the hair cover. After the surgical tape was removed, skin injury occurred on the left side of her face. After epidermis repositioning and ointment application, a dressing was placed over the injury. Her wound was found to have healed completely on follow-up examination. Medical adhesive related skin injury (MARSI) is a complication that can occur after surgery and subjects at the extremes of age with fragile skin are at a higher risk for such injuries. Careful assessment of the risk factors associated with MARSI is an absolute necessity.

• 대한치과마취과학회지
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• 제7권2호
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• pp.135-138
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• 2007

Hallervorden-Spatz disease (HSD) is a rare autosomal recessive disorder associated with excessive iron deposition in the basal ganglia. In general, HSD is characterized by onset in first two decade of life and by the presence of extra-pyramidal dysfunction including dystonia, rigidity, choreoathetosis. Other associated features include gait and posture disturbance, intellectual decline, seizure, tremor, dysarthria. These signs and symptoms are progressive. MRI is often demonstrated hypodensity in the basal ganglia which is probably suggestive of accumulation of iron. There is no specific treatment for HSD and 45% of patients die before reaching the age of 20 years. The managements directed at specific symptoms are often helpful. Especially, some surgical procedures like pallidotomy and gastrostomy are performed under general anesthesia. There is special need for careful management because of numerous anesthetic challenges like difficulty in cooperation, life-threatening airway obstruction and possibility of aspiration. We report a successful anesthetic management in a patient with HSD for dental procedures.

• Journal of Korean Dental Science
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• 제11권2호
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• pp.86-91
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• 2018

Ameloblastomaa are odontogenic benign tumors with epithelial origin, which are characterized by slow, aggressive, and invasive growth. Most ameloblastomas occur in the mandible, and their prevalence in the maxilla is low. A 27-year-old male visited our clinic with a chief complaint of the left side nasal airway obstruction. Three-dimensional computed tomography showed left maxillary sinus filled with a mass. Except for the perforated maxillary left edentulous area, no invaded or destructed bone was noted. The tumor was excised via Le Fort I osteotomy. The main mass was then sent for biopsy and it revealed acanthomatous ameloblastoma. The lesion in the left maxillary sinus reached the ethmoidal sinus through the nasal cavity but did not invade the orbit and skull base. The tumor was accessed through a Le Fort I downfracture in consideration of the growth pattern and range of invasion. The operation site healed without aesthetic appearances and functional impairments. However, further long-term clinical observation is necessary in the future for the recurrence of ameloblastoma. Conservative surgical treatment could be the first choice considering fast recovery after surgery and the patient's life quality.

• The Journal of Advanced Prosthodontics
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• 제3권4호
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• pp.204-215
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• 2011

PURPOSE. The aim of this retrospective study is to analyze the relationship between local factors and survival rate of dental implant which had been installed and restored in Seoul Veterans Hospital dental center for past 10 years. And when the relationship is found out, it could be helpful to predict the prognosis of dental implants. MATERIALS AND METHODS. A retrospective study of patients receiving root-shaped screw-type dental implants placed from January 2000 to December 2009 was conducted. 6385 implants were placed in 3755 patients. The following data were collected from the dental records and radiographs: patient's age, gender, implant type and surface, length, diameter, location of implant placement, bone quality, prosthesis type. The correlations between these data and survival rate were analyzed. Statistical analysis was performed with the use of Kaplan-Meier analysis, Chi-square test and odds ratio. RESULTS. In all, 6385 implants were placed in 3755 patients (3120 male, 635 female; mean age $65{\pm}10.58$ years). 108 implants failed and the cumulative survival rate was 96.33%. There were significant differences in age, implant type and surface, length, location and prosthesis type (P<.05). No significant differences were found in relation to the following factors: gender, diameter and bone quality (P>.05). CONCLUSION. Related factors such as age, implant type, length, location and prosthesis type had a significant effect on the implant survival.

• 대한치과교정학회지
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• 제50권2호
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• pp.129-135
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• 2020

Objective: This study aimed to evaluate the immediate effects of mandibular posterior displacement on the pharyngeal airway space (PAS) by using cephalometric evaluations and to investigate how the surrounding structures are schematically involved. Methods: In this retrospective study, 38 subjects with functional Class III malocclusion and two lateral cephalograms were selected. The first lateral cephalogram was taken with the mandible in the habitual occlusal position, and the second in anterior edge-to-edge bite. Paired t-test was used to analyze changes in the PAS, hyoid bone, tongue, and soft palate, followed by mandibular posterior displacement. Pearson's correlation analysis was used to determine the relationship between the amount of mandibular posterior displacement and other variables. Results: A statistically significant decrease was observed in the PAS following mandibular posterior displacement. Along with mandibular posterior displacement, the tongue decreased in length (p < 0.001) and increased in height (p < 0.05), while the soft palate increased in length, decreased in thickness, and was posteriorly displaced (p < 0.001). The hyoid bone was also posteriorly displaced (p < 0.05). There was no correlation between the amount of mandibular posterior displacement and the measured variables. Conclusions: The PAS showed a statistically significant decrease following mandibular posterior displacement, which was a consequence of retraction of the surrounding structures. However, there were individual variances between the amount of mandibular posterior displacement and the measured variables.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권1호
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• pp.25-36
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• 2017

Purpose: The analysis of space configuration of dentistry through examining Korean dental history and comparison are necessary for the development of planning of the dental healthcare system. This study has been started in order to provide basic information for the planning of hospital architecture in dentistry. Methods: Literature review of space configuration and historical background in dentistry have been conducted. The changes of site plan and space configuration of Seoul National University, Yonsei University and Kyunghee University, School of Dentistry and Dental Hospital have been analyzed in dental history of Korea and corresponding spaces. Results: The result of this study can be summarized in three points. The first one is that space configuration of dentistry in Korea is different from that of West. The clinical treatment space had been started first and the education and research space was followed after a short interval. The second one is that the space configuration in School of Dentistry and Dental Hospital shows that dental space had differentiated and specialized to dental education and clinical space in a building. It had spatially divided and separated to the education and research complex and the dental hospital and it had a branch building. The third one is that the dental public health in Korea has not been actively applied until recently and it should be developed in a near future. Implications: It is necessary to analyze space configuration of other dental schools and their hospitals to develop the relationship between space and program in healthcare system.