• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.1
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• pp.1-8
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• 2020

Behaviour management and dental procedures performed in very young, pre-cooperative, highly anxious, or medically disabled children are challenging tasks. Various drugs and methods have, however, been introduced to facilitate treatment for this patient population. Midazolam is a benzodiazepine used as an adjunct to behavior management techniques in the dental treatment of pediatric patients. Midazolam can be used as a safe and effective drug for conscious sedation, general anesthetic premedication, and treatment of seizures during dental procedures. Nevertheless, further research involving pediatric patients would be beneficial.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.3
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• pp.217-222
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• 2016

Dental treatment is often performed under general anesthesia or sedation when an intellectually disabled patient has a heightened fear of treatment or has difficulty cooperating. When it is impossible to control the patient due to the severity of intellectual disability, conscious sedation is not a viable option, and only deep sedation should be performed. Deep sedation is usually achieved by propofol infusion using the target controlled infusion (TCI) system, with deep sedation being achieved at a slightly lower concentration of propofol in disabled patients. In such cases, anesthesia depth monitoring using EEG, as with a Bispectral Index (BIS) monitor, can enable dental treatment under appropriate sedation depth. In the present case, we performed deep sedation for dental treatment on a 27-year-old female patient with mental retardation and severe dental phobia. During sedation, we used BIS and a newly developed Anesthetic Depth Monitor for Sedation (ADMS$^{TM}$), in addition to electrocardiography, pulse oximetry, blood pressure monitoring, and capnometry for patient safety. Oxygen was administered via nasal prong to prevent hypoxemia during sedation. The BIS and ADMS$^{TM}$ values were maintained at approximately 70, and dental treatment was successfully performed in approximately 30 min.

• Journal of Environmental Health Sciences
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• v.44 no.5
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• pp.452-459
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• 2018

Objectives: We aimed to examine whether dental waste was being managed adequately at different types of dental institutions in City D in South Korea. Methods: The staff responsible for disinfection at 101 dental offices and clinics (six dentistry departments of general hospitals, 12 dental hospitals, and 83 dental clinics) was interviewed. Results: Solid suction pump waste was handled appropriately at four of the general hospital dentistry departments (66.7%), six dental hospitals (50.0%), and 15 dental clinics (18.1%). Solid spittoon waste was handled appropriately at four general hospital dentistry departments (66.7%), seven dental hospitals (58.3%), and 14 dental clinics (16.9%). Developer and fixer were handled appropriately by a subcontractor at two general hospital dentistry departments (100.0%), five dental hospitals (100.0%), and 24 dental clinics (75.0%). Impression materials were handled appropriately at four general hospital dentistry departments (66.7%), six dental hospitals (50.0%), and 11 dental clinics (13.3%). The plastic covers of intra-oral radiography films were handled appropriately at five general hospital dentistry departments (100.0%), eight dental hospitals (72.7%), and 22 dental clinics (30.1%). Conclusion: South Korea must implement detailed and specialized guidelines for the disposal of solid and general medical waste from dental institutions. Moreover, waste disposal training should be provided annually, and not only once every three years.

• Korea Journal of Hospital Management
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• v.16 no.4
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• pp.1-16
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• 2011

The purpose of this study is to examine impacts of servant leadership perception of dental hygienists on organizational commitment, job satisfaction and turnover intention as strong predictors of turnover rate. These data were collected from the structured questionnaire survey, from April 1 through April 30, 2011, to 383 people among those in the field of dental hygiene affairs, working for nine dental hospitals or twenty-four dental clinic under two dental university hospital in capital area. The principal findings of this research are as below; First, servant leadership perception had a significantly positive influence on job satisfaction and organizational commitment. Also servant leadership perception of dental hygienists had a significantly negative influence on turnover intention. Second, job satisfaction and organizational commitment of dental hygienists has a negative influence on turnover intention. Third, servant leadership perception of dental hygienists were revealed as a meaningful effects ones on job satisfaction and organizational commitment, but they didn't have meaningful effect on turnover intention. However, we can understand that servant leadership perception have indirect effect on turnover intention via job satisfaction and organizational commitment. This result indicates that the managers of dental hospital and clinic should perceive that the consistent management effort to improve servant leadership can increase job satisfaction, and finally will increase the organizational commitment that means the loyalty to organization. In short, hospital operators and managers should examine each manager's qualification, type and style of leadership in the hospital organization, and they must develop lasting programs for effective education and training for developing characteristics of leadership are in needed to have managers with appropriate managerial mind to respective post and status.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.105-109
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• 2012

The gag reflex is a physiological reaction, but, an exaggerated gag reflex can be a severe limitation not only to treat dental caries but also to do oral exam. Procedures such as surface anesthesia of the palate and pharyngeral area, sedation, or general anesthesia can be options as behavioral management. But, there are no golden rule for the sever gag reflex patients. We present a case report of propofol intravenous sedation using TCI pump for simple dental treatment. A 44-year-old man, who had past history of general anesthesia for dental treatment because of severe gag reflex, was scheduled intravenous sedation for simple dental treatment. After 8 hour fasting he entered the clinic for persons with disabilities. We explained about intravenous deep sedation and got informed consent. First, we kept intravenous catheter (22G) in the arm and started monitoring ECG, non-invasive blood pressure, pulse oximetry and end-tidal $CO_2$ through nasal cannula. We started propofol infusion with TCI pump at the target concentration of 3 mcg/ml. The patient became sedated, but he showed involuntary movement during dental treatment, so we increased the target concentration to 4 mcg/ml. We finished the dental treatment without complications during 30 min. And after 40 min recovery room stay he was discharged without any complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.38.1-38.9
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• 2018

Background: Fibrous dysplasia (FD) is a benign bone lesion characterized by the progressive replacement of normal bone with fibro-osseous connective tissue. The maxilla is the most commonly affected area of facial bone, resulting in facial asymmetry and functional disorders. Surgery is an effective management option and involves removing the diseased bone via an intraoral approach: conservative bone shaving or radical excision and reconstruction. Case presentation: This case report describes a monostotic fibrous dysplasia in which the patient's right midface had a prominent appearance. The asymmetric maxillary area was surgically recontoured via the midfacial degloving approach under general anesthesia. Follow-up photography and radiographic imaging after surgery showed the structures were in a stable state without recurrence of the FD lesion. Furthermore, there were no visible scars or functional disability, and the patient reported no postoperative discomfort. Conclusions: In conclusion, the midfacial degloving approach for treatment of maxillary fibrous dysplasia is a reliable and successful treatment option. Without visible scars and virtually free of postoperative functional disability, this approach offers good exposure of the middle third of the face for treatment of maxillary fibrous dysplasia with excellent cosmetic outcomes.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.4
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• pp.235-239
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• 2015

The Combitube is an emergency airway-maintaining device, which can supply oxygen to dyspneic patients in emergency situations following two-jaw surgery. These patients experience difficulty in opening the mouth or have a partially obstructed airway caused by edema or hematoma in the oral cavity. As such, they cannot maintain the normal airway. The use of a Combitube may be favorable compared to the laryngeal mask airway because it is a thin and relatively resilient tube. A healthy 24-year-old man was dyspneic after extubation. Oxygen saturation fell below 90% despite untying the bimaxillary fixation and ambubagging. The opening of the mouth was narrow; thus, emergency airway maintenance was gained by insertion of a Combitube. The following day, a facial computer tomography revealed that the airway space narrowing was severe compared to its pre-operational state. After the swelling subsided, the patient was successfully extubated without complications.

• Restorative Dentistry and Endodontics
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• v.43 no.1
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• pp.13.1-13.7
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• 2018

Dental erosion is frequently overlooked in clinical practice. The management of erosion-induced damage to the dentition is often delayed, such that extensive occlusal rehabilitation is required. These cases can be diagnosed by a careful clinical examination and a thorough review of the patient's medical history and/or lifestyle habits. This case report presents the diagnosis, categorization, and management of a case of gastro-esophageal reflux disease-induced palatal erosion of the maxillary teeth. The early management of such cases is of utmost importance to delay or prevent the progression of damage both to the dentition and to occlusal stability. Non-invasive adhesively bonded restorations aid in achieving this goal.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.6
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• pp.547-556
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• 2021

Background: This study aimed to determine the efficacy of Physics Forceps in pediatric dental extractions. Methods: This was a double-blind, randomized controlled trial with a parallel-arm design and identical allocation ratio (1:1). Children (n=104) were randomly divided into two groups for extraction of mandibular primary teeth (group I: Physics Forceps; group II: conventional forceps). The outcome variables assessed in the study were the time taken for extraction, pre- and postoperative anxiety (using RMS pictorial scale), incidence of fractured teeth, and postoperative pain on the first and third days (using the Wong-Baker faces pain scale). Results: A significant reduction (P < 0.001) in intraoperative time, anxiety, and incidence of tooth fracture was confined to group I. The pain significantly reduced from the first to the third postoperative day in both groups, but the mean reduction in RMS scores in the physics forceps group was far better than that in the conventional forceps group. Conclusion: Physics Forceps aid in extraction of primary teeth with minimal trauma to supporting structures, as well as reducing anxiety in the pediatric population.

• The Journal of the Korean dental association
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• v.53 no.1
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• pp.28-35
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• 2015

To overcome shortcoming of autogeneous, allogenic, xenogenic and alloplastic bone grafts, various growth factors related to bone regeneration have been identified and developed. Among them, rhBMP-2 is regarded as the most potent osteoinductive growth factor and it can trigger the differentiation of mesenchymal stem cells to osteogenic cells for accelerated new bone formation And several commercial products of rhBMP-2 are available in Korea. It is applied to maxillary sinus augmentation, guided bone regeneration and preservation of extraction socket. In this review, the development, action mechanism and clinical applications of rhBMP-2 will be described.