• 대한치과마취과학회지
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• 제12권1호
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• pp.25-31
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• 2012

We report a case of 15 year-old Jehovah's Witness patient with mild anemia who underwent a successful orthognathic two-jaw surgery. Jehovah's Witness patients refuse transfusion of blood or blood products even in life threatening situations. The use of recombinant human erythropoietin and iron supplement increased hemoglobin during preoperative period. Intraoperatively, meticulous surgical hemostasis, acute normovolemic hemodilution and induced hypotension enabled the completion of the operation without the use of blood products.

• 대한치과마취과학회지
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• 제12권2호
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• pp.125-129
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• 2012

Dental treatment under general anesthesia is considered for behavioral control of disabled patients who have severe anxiety or involuntary movement. However, in case of simple treatment, inhalation or intravenous sedation, which has earlier onset and recovery, is preferred. Conventionally, nitric oxide is used for inhalation sedation, nowadays sevoflurane can also be used due to easily titratable for controllable effect and less complications. In this case report, two patients with mental retardation required simple dental treatment. Deep sedation with inhaled sevoflurane were successfully employed and patients were discharged without any complications.

• Journal of Oral Medicine and Pain
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• 제22권2호
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• pp.373-381
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• 1997

The anxiety and depression level of new outpatients wert studied clinically by means of The Hospital Anxiety and Depression Scale(HAD). 64 males and 97 females were subjected at local dental clinic and also 6l male and 91 females were studied at the Dept. of Oral Medicine, PNUH, during period from 1996 to 1997 The obtained results were as follows : 1. Anxiety disorder was 17.76% in the new dental outpatients of university hospital and 13.66% in the local dental Clinic find depression disorder was 7.23% In the University hospital and 3.72% in the local dental clinic. 2. Mean values of depression and anxiety level were within normal range. 3. Anxiety level in female was significantly higher than that in male at the local dental clinic (p<0.05). 4. Anxiety and depression level in university hospital outpatients decreased in order of clerk, housewife and student(p<0.01). 5. The outpatients of university hospital with lower education level showed more anxious and depressed. 6. Anxiety and depression of unmarried group of new outpatients in university hospital was higher than that of married group. Through the above results, proper treatment plans will be demanded In the dental procedure, because psychologic 야sorders as anxiety and depression were included in the 25% of new outpatients of university hospital and 17% at local dental clinic.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권2호
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• pp.59-67
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• 2023

General anesthesia may influence the postoperative sleep cycle; however, no clinical studies have fully evaluated whether anesthesia causes sleep disturbances during the postoperative period. In this scoping review, we explored the changes in postoperative sleep cycles during surgical procedures or dental treatment under general anesthesia. We compared and evaluated the influence of general anesthesia on sleep cycles and sleep disturbances during the postoperative period in adult and pediatric patients undergoing surgery and/or dental treatment. Literature was retrieved by searching eight public databases. Randomized clinical trials, observational studies, observational case-control studies, and cohort studies were included. Primary outcomes included the incidence of sleep, circadian cycle alterations, and/or sleep disturbances. The search strategy yielded six studies after duplicates were removed. Finally, six clinical trials with 1,044 patients were included. In conclusion, general anesthesia may cause sleep disturbances based on alterations in sleep or the circadian cycle in the postoperative period in patients scheduled for elective surgery.

• Journal of Periodontal and Implant Science
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• 제48권5호
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• pp.326-333
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• 2018

Purpose: The present study investigated the outcomes of a newly-developed, simple, and practical nonsurgical treatment modality suitable for most forms of intrabony defects around failing dental implants using intrasulcular delivery of chlorhexidine solution and minocycline hydrochloride (HCl). Methods: Forty-five dental implants in 20 patients diagnosed with peri-implantitis were included. At baseline and the study endpoint, the probing pocket depth (PPD), clinical attachment level (CAL), and the presence of bleeding on probing (BOP) at 6 sites around each implant were recorded. The radiographic osseous defect morphology at the mesial or distal proximal aspect of each implant was classified as 1) narrow or wide and 2) shallow or deep. For a comparative analysis of bone changes according to the defect morphology, the distance from the implant shoulder to the most coronal bone-to-implant contact point (DIB) at the mesial and distal aspects of each implant was measured at baseline and the endpoint. Patients were scheduled to visit the clinic every 2-4 weeks for intrasulcular irrigation of chlorhexidine and delivery of minocycline HCl. Results: We observed statistically significant decreases in PPD, CAL, and BOP after treatment. At the endpoint, bone levels increased in all defects, regardless of the osseous morphology of the intrabony defect. The mean DIB change in deep defects was significantly greater than that in shallow defects. Although the mean bone gain in narrow defects was greater than in wide defects, the difference was not statistically significant. Conclusions: We propose that significant and sustainable improvements in both clinical and radiographic parameters can be expected when intrabony defects around dental implants are managed through a simple nonsurgical approach involving combined intrasulcular chlorhexidine irrigation and local delivery of minocycline HCl.

• 대한치과마취과학회지
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• 제11권2호
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• pp.125-132
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• 2011

Background: Adult patients with intellectual disabilities often strongly resist the anesthetic administration for dental procedures. This study aimed to evaluate the effect of midazolam premedication in improving the cooperation level of patients who are likely to be combative and irritated during general anesthesia (GA) induction. Methods: The patients who had received dental treatment under ambulatory GA for more than two times were included. And we selected 13 patients total that needed physical restraint or ketamine IM prior to induction at the first GA, and were prescribed midazolam tablet (7.5-15 mg) at the following GA. We reviewed pre-anesthetic records and anesthesia records, and evaluated cooperative levels of patients (4 levels scale) during anesthesia induction and recovery time retrospectively. Results: All 13 patients (Male 11, Female 2) had severe mental disabilities. The average age of the patients was 24 ${\pm}$ 7 (13-37) years and their average weight was 58 ${\pm}$ 16 (34-91) kg. At the first GA, 10 patients needed physical restraint prior to induction (level 3). And 3 patients were so poorly cooperative that the induction procedure was performed after intramuscular injection of ketamine (level 4). But after the midazolam intake, 7 patients were willing to receive the anesthetic induction (level 1, 2), and 6 patient needed physical restraint (P < 0.05). There were no statistical differences in the duration of general anesthesia and postoperative recovery. Conclusions: Oral intake of midazolam was effective in improvement of cooperation without any complications.

• 대한치과의사협회지
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• 제57권2호
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• pp.52-63
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• 2019

Technological advances in contemporary medicine has discovered the causes of countless diseases and recorded a noticeable medical performance. As technology develops, the role of hospitals is expanding to include disease prevention of inpatients, on top of their fundamental role of treating diseases. Recently, hospitals are becoming more influential as they create environments to provide comfort and stability to patients. In this regard, contemporary hospitals are increasingly shifting their focus to create a patient-centric environment as well as develop into humanistic establishments. The same goes to dentists, as well. Since inpatients often have fear and frustration over treatment, hospitals should figure out the environmental factors that are more effective and relaxing for patients and design medical services to provide them. The patients' movement and spaces during their treatment were categorized by stages and collected for gazing information using eye tracking. It analyzed users' gaze information according to Heatmap analysis of distribution and frequency and was determined the presence or absence of stimuli on the components of space. This research is an advanced research to study and enhance treatment environment based on the analysis of patients' gazes. It attempted to create an opportunity to get closer to patient-centric environment by understanding the stimulants and obstacles and controlling the background settings.

• Journal of Oral Medicine and Pain
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• 제49권3호
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• pp.49-56
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• 2024

Purpose: The aims were to investigate potential differences in clinical assessments among acute pain-related temporomandibular disorder (TMD) with different concordance value (CV) between number of self-reported painful site (NSP) and number of painful sites on palpation (NPP), and if it makes sense to treat them differently. Methods: A total of 61 patients were divided into three groups according to CV: 10 patients (concordance poor [CP]), 19 patients (concordance moderate [CM]), and 32 patients (concordance high [CH]). Clinical assessments were conducted using a standardized method in diagnostic criteria for temporomandibular disorders (DC/TMD). We compared collected information including sex, diagnosis, numerical rating scale (NRS), NPP, NSP, sleep duration, DC/TMD Axis II questionnaire, and perceived stress scale among three groups. Results: Among the clinical assessment, NRS, sleep duration, NPP, NSP, total scores of Oral Behaviors Checklist, Patient Health Questionnaire (PHQ)-15, PHQ-9 showed significant differences among 3 groups. NRS, NPP, NSP, PHQ-15, and PHQ-9 were higher in the CP group than in the CM and CH groups. Sleep duration was positively and NPP, NRS were negatively correlated with CV. Conclusions: While previous studies suggested differences between chronic and acute TMD in DC/TMD items, our findings propose the CV might be a key factor that could predict the severity and susceptibility of acute-TMD patients. However, Additional studies are required to determine whether their long-term prognosis was similar to that of chronic pain patients and what the response to treatment was among the three groups.

• 대한장애인치과학회지
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• 제5권1호
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• pp.12-17
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• 2009

Background : To do dental treatments successfully for dentally disabled patients who are unable to cooperate to procedures needs deep sedation (DS) or general anesthesia (GA). But there are some difficulties in selecting DS because of some disadvantages such as airway problem etc. But, if we select appropriate cases, DS would be better than GA. Methods : We reviewed total 238 cases of patients who had received dental treatments under GA or DS at the clinic for the disabled in Seoul National University Dental Hospital from November 2007 to February 2009. To compare anesthesia condition between DS and GA, we reviewed preanesthesia evaluation sheet, anesthesia or sedation records and PACU sheets retrospectively. Results : The number of DS cases was 25 (11%) and that of GA was 218 (89%). To maintain DS, intravenous propofol was infused with syringe pump (100%), and sevoflurane (134 cases) or propofol (13 cases) were used for sedation induction. Mean total treatment time for DS was 36 min and 2 hour 25 min for GA. The recovery time at PACU was 44 min for DS and 80 min for GA. There were no severe complications in DS, but 18 cases showed nausea and vomiting in GA. Conclusion : Deep sedation for disabled dental patients should be selected for effective behavioral control in conjunction with general anesthesia, considering duration and pain-evoking potentials of dental treatment and type and severity of patients' disabilities altogether.

• 한국병원경영학회지
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• 제22권4호
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• pp.24-32
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• 2017

Purpose: This study is to provide basic data for establishing successful organization management strategies of organizations by understanding rank systems and duty types of dental hygienists who work in dental hospitals. Methodology/Approach: The study conducted a survey and an interview survey two times targeting the entire dental hospitals. The first survey secured the response results of 113 hospitals in the result that conducted the survey targeting 190 dental hospitals in the whole country except 24 ones including dental college hospitals, dental hospitals affiliated with medical colleges or general hospitals, military dental hospitals, and dental hospitals for the disabled among the 214 ones which were registered in the Health Insurance Review & Assessment Service as of December 2015. The second survey conducted the interview survey targeting persons in charge of personnel management by selecting 34 dental hospitals with rank systems of 4 rank systems and above. Finding: The dental hospital has found that dental hygienists-centered human resources were composed. The number of ranks has found that 1 to 6 levels are shown and level 3 is highest. Titles of staff levels have found that 32 places are highest in order of 'employees