• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.5
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• pp.357-367
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• 2022

Background: Low-dose dexmedetomidine may be a suitable alternative to opioids for pediatric ambulatory procedures under general anesthesia (GA). However, the recovery profile remains unclear. Herein, we aimed to evaluate the effects of low-dose dexmedetomidine on the recovery profile of children. Methods: Seventy-two children undergoing ambulatory oral rehabilitation under GA were randomly and equally distributed into two groups (D and F). Group D received an infusion of dexmedetomidine 0.25 ㎍/kg for 4 min for induction, followed by maintenance of 0.4 ㎍/kg/h. Group F received an infusion of fentanyl 1 ㎍/kg over 4 min for induction, followed by maintenance at 1 ㎍/kg/h. The primary outcome was the extubation time. The secondary outcomes were awakening time, end-tidal sevoflurane (ET-Sevo) requirement, change in hemodynamic parameters, Richmond Agitation-Sedation Scale (RASS), Children's Hospital of Eastern Ontario pain scale (CHEOPS) score, length of PACU stay, and incidence of adverse events. Results: Statistically significant differences were observed in the recovery profile between the groups: the median time for extubation was 3.65 (3.44-6.2) vs. 6.25 (4.21-7) minutes in groups D vs. F (P=0.001), respectively, while the corresponding awakening times were 19 (18.75-21) and 22.5 (22-24) minutes, respectively (P < 0.001). The mean ET-Sevo was low in group D (1.1 vs. 1.2; P < 0.001). The heart rate was significantly low across all time points in group D, without resulting in bradycardia. The median RASS and CHEOPS scores were also significantly lower in group D. No significant differences were observed in the mean arterial pressure, incidence of adverse events, or length of PACU stay. Conclusion: Low-dose dexmedetomidine was more effective than fentanyl as an opioid substitute at providing a better recovery profile in pediatric ambulatory oral rehabilitation under GA. Dexmedetomidine also significantly reduced sevoflurane consumption without causing adverse events or prolonging hospital stay.

• The Journal of Advanced Prosthodontics
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• v.14 no.1
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• pp.1-11
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• 2022

PURPOSE. The maximum width between the mesial and distal labial transitional line angles, described as "esthetic width" herein, could significantly influence the visual perception of the teeth and smile. This study aimed to conduct biometric research on esthetic width and to explore whether regular distribution exists in the esthetic width of human teeth. MATERIALS AND METHODS. A total of 4,264 maxillary and mandibular anterior teeth were measured using the Geomagic studio software program. The proportions of maxillary to mandibular homonymous teeth and proportions between the adjacent teeth were calculated. Bilateral symmetry and the correlation between the esthetic and mesiodistal widths were both accounted for during the measurement procedures. RESULTS. The mean esthetic widths were 6.773 ± 0.518 mm and 4.329 ± 0.331 mm for maxillary and mandibular central incisors, respectively, 5.451 ± 0.487 mm and 5.008 ± 0.351 mm for maxillary and mandibular lateral incisors, respectively, and 3.340 ± 0.353 mm and 5.958 ± 0.415 mm for maxillary and mandibular canines, respectively. Except for the mandibular canines, no significant difference in esthetic width was found among homonymous teeth from the same jaw. A high linear correlation was found between the esthetic and mesiodistal widths of the same tooth, except for the maxillary canines. Esthetic width proportions among different tooth categories showed some regular patterns, which were similar to those of the mesiodistal width. CONCLUSION. Esthetic width is regularly distributed among the teeth in the Chinese population. This could provide an important reference for anterior dental restorations and dimension recovery in esthetic reconstruction of anterior teeth.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.2
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• pp.97-105
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• 2022

Background: The pentadecapeptide BPC-157 has been shown to have anti-inflammatory and wound healing effects on multiple target tissues and organs. Peptides have potent anti-inflammatory effects on periodontal tissues in rats with periodontitis. Few studies have investigated the effect of BPC-157 on pain after dental procedures or oral surgeries. The purpose of the present study was to investigate the antinociceptive effects of BPC-157 on postoperative incisional pain in rats. Methods: Sprague-Dawley rats were randomly divided into five groups: control (saline with the same volume), BPC10 (10 ㎍/kg of BPC-157), BPC20 (20 ㎍/kg of BPC-157), BPC40 (40 ㎍/kg of BPC-157), and morphine (5 mg/kg of morphine). A 1-cm longitudinal incision was made through the skin, fascia, and muscle of the plantar aspect of the hind paw in isoflurane-anesthetised rats. Withdrawal responses were measured using von Frey filaments at 0, 2, 6 h and 4, 7 d after incision. The formalin test was also performed to differentiate its anti-nociceptive effect from an inflammatory reaction or central sensitization. Pain behavior was quantified periodically in phases 1 and 2 by counting the number of flinches in the ipsilateral paw after injection with 30 µL of 5% formalin. Results: The threshold of mechanical allodynia was significantly increased in the BPC10, BPC20, BPC40 and morphine groups compared with that in the control group at 2 h. These increasing thresholds then returned to the levels of the control group. The BPC-157 group showed a much higher threshold at 4 days after incision than the control group. The thresholds of the BPC groups, except the morphine group, were normalized 7 days after incision. The flinching numbers of the BPC10, BPC20, BPC40 and morphine groups were significantly decreased in phase 1, but there was no decrease in the BPC-157 groups except the morphine group in phase 2. Conclusions: BPC-157 was effective only for a short period after incision. It was also effective during phase 1 but not during phase 2, as determined by the formalin test. BPC-157 might have a short antinociceptive effect, even though it has anti-inflammatory and wound healing effects.

• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.341-351
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• 2009

There is tremendous variability in the ways patients present with taste problems. Because of complex and multifactorial etiological background, it is not simple to evaluate patients with taste disorders. Accurate assessment of patients' status by prudent, thorough history taking and symptom analysis is the most essential for exact diagnosis of taste disorders. The aim of this study was to investigate the clinical characteristics of patients with taste problems as a primary complaint. Consecutive series of 50 patients (12 males and 38 females, mean age $53.6\;{\pm}\;14.7$ years) were included for the present study. All subjects were requested to complete a comprehensive questionnaire. Clinical evaluation procedures included oral examination, interview, questionnaire analysis, panoramic radiography, blood test and measurement of salivary flow rate. The obtained results were as follows: 1. Among the patients, 36 patients (72%) complained of oral mucosal pain or burning sensation. Of these patients, 18 patients (36%) were diagnosed as burning mouth syndrome. 2. Nineteen patients (38%) complained of subjective oral dryness. The flow rate of unstimulated whole saliva was less than 0.1 mL/min in 14 patients (28%) and 17 (34%) had a stimulated whole salivary flow rate of less than 0.5 mL/min. 3. Among the types of taste disorders, hypogeusia, the most frequently reported, was found in 25 patients (50%), dysgeusia in 18 patients (36%), phantogeusia in 15 patients (30%), hypergeusia in 10 patients (20%), and ageusia in 5 patients (10%). Nineteen patients (38%) reported more than one type of taste disorder and the most frequent combination was dysgeusia + hypogeusia (n=6, 12%). 4. Based on data from the medical and dental histories and examinations, the patients were assigned to 12 probable causal categories. Taste disorders due to oral mucosal diseases and idiopathic taste disorder were the most frequent (n=9; 18%, each), followed by psychogenic taste disorder (n=8; 16%), drug-induced taste disorder (n=7; 14%), and taste disorder due to dry mouth (n=6; 12%). These 5 categories of taste disorder accounted for 78% of all cases in this study.

• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.2
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• pp.72-81
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• 2024

Purpose: This study aimed to assess the marginal and internal fit of 3-unit monolithic zirconia fixed partial dentures (FPDs) fabricated via computer-aided design and computer-aided manufacturing (CAD/CAM) from solid working casts and removable die system. Materials and Methods: The tooth preparation protocol for a zirconia crown was executed on the mandibular right first premolar and mandibular right first molar, with the creation of a reference cast featuring an absent mandibular right second premolar. The reference cast was duplicated using polyvinyl siloxane impression, from which 20 working casts were fabricated following typical dental laboratory procedures. For comparative analysis, 10 FPDs were produced from a removable die system (RD group) and the remaining 10 FPDs from the solid working casts (S group). The casts were digitized using a dental desktop scanner to establish virtual casts and design the FPDs using CAD. The definitive 3-unit monolithic zirconia FPDs were fabricated via a CAM milling process. The seated FPDs on the reference cast underwent digital evaluation for marginal and internal fit. The Mann-Whitney U test was applied for statistical comparison between the two groups (α = 0.05). Results: The RD group showed significantly higher discrepancies in fit for both premolars and molars compared to the S group (P < 0.05), particularly in terms of marginal and occlusal gaps. Color mapping also highlighted more significant deviations in the RD group, especially in the marginal and occlusal regions. Conclusion: The study found that the discrepancies in marginal and occlusal fits of 3-unit monolithic zirconia FPDs were primarily associated with those fabricated using the removable die system. This indicates the significant impact of the fabrication method on the accuracy of FPDs.

• Research in Community and Public Health Nursing
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• v.13 no.4
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• pp.595-607
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• 2002

The objectives of this study were to identify the phenomena of school health nursing at schools in Korea and to contribute to building a school health domain of International Classification for Nursing Practice. A retrospective method was used in this study to develop ICNP during the period from July to October 200l. The procedure of the study involved choosing nursing phenomena using preliminary terms from the reports on the field of school health nursing practice documented by nursing students in 10 different nursing colleges. The detail procedures of the study were as follows. 1) Choosing nursing phenomena by using preliminary terms 2) Choosing the characteristics of school health nursing practice from the selected nursing phenomena 3) In order to make a consensus regarding the appropriate characteristics of phenomena. 15 study group members re-categorized the nursing phenomena through 5 times of cyber meetings and 3 times of formal meetings. 4) To verify each characteristic, 5 community nursing faculties and 25 school health nurses participated in the procedure to give scores on nursing characteristics. 5) Classification of the definite nursing phenomena and characteristics. Following the 5 step procedures, school health nursing phenomena were categorized into human and environmental domains. Human domains were classified into human behavioral and functional domains. Environmental domains were classified into physical and psychosocial domains. The essential characteristics of each phenomena were selected when it obtains the mean score of 3.0 or over at the related characteristics. The human behavioral domain consisted of 7 phenomena including risk for spinal disorder, inadequate dietary habit, inadequate weight control, smoking and substance abuse, inadequate stress management, inadequate sex related coping strategies and inadequate accident management. The human functional domain consisted of 6 phenomena including inadequate eye care and visual management, risk for respiratory disorder, inadequate dental health care, inappropriate infectious disease control, risk for gastrointestinal disorder, and lack of sexual identity. The physical environmental domain consisted of 6 phenomena including risk for incident at inside classroom, risk for incident at outside classroom, risk for incident around school, risk for exposure to hazardous facilities around school. inadequate garbage and disposal management, and inadequate physical environment for learning. The psychosocial domain included impaired social interaction at school. Each phenomenon was composed of 2 to 8 characteristics and all phenomena will include a total number of 85 characteristics. The phenomena of school health nursing in Korea partially confirmed school health architecture of ICNP. Further study on verification of school health nursing phenomena in Korea needs to be done to support the findings of this study through review of literature on nursing classifications or field studies.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.3
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• pp.263-269
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• 2011

The digital impression technique has been developed for more precise restorations and convenient procedures in prosthodontic treatment compared to the conventional impression technique. Along with the utilization of CAD/CAM, the introduction of digital impression technique actualizes the digitalization of dental treatments. This case is to compare two different prostheses introducing each procedure in detail; one from CAD/CAM after taking digital impression and the other from the conventional technique. A 22-year-old female visited the clinic with the chief complaint of correction of discoloration and shape on maxillary right central incisor. Due to the trauma 8 years ago, the tooth was endodontically treated with post and resin core. The treatment was planned and the procedures were conducted under the patient's consent to treat the tooth with all ceramic crowns in two different ways for comparison. In conclusion, both prostheses presented clinically acceptable results with comparing the internal fitness of two all ceramic crowns. The prosthesis from digital impression, however, showed more errors in respect of internal fitness.

• The Journal of Korean Academy of Prosthodontics
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• v.18 no.1
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• pp.15-35
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• 1980

The purpose of this study was to investigate stresses in the various components of fixed partial dentures restoring the posterior teeth of the lower jaw, and to measure quantitatively the effects of certain modifications in structural design on the stresses in the restorations using two-dimensional photoelasticity. Two-dimensional photoelastic methods were used in this study. Several models of fixed partial dentures were constructed. Shoulder less margins and anatomic occlusal reduction were incorporated in Model 1. Rounded shoulders and flat occlusal reduction were incorporated in Model 2, while Model 3 was a cantilever fixed partial denture. Other similar fixed partial dentures were constructed with V and U notches deliverately included in the region of the fixed joints for comparative reasons. The birefringent materials used in this study were PSM-1 and PSM-5 in standard sheets. PSM-1 was used for constructing the substructure, and PSM-5 was used in making the components of the fixed partial dentures. The two materials were used in the construction of composite photoelastic models. Improved artificial stone was used to represent dental cement in luting the composite photoelastic models. Static loading procedures were used at preplanned sites to represent occlusal loads in the mouth. 35 mm color and B/W film were used to record isochromatics in accordance with photoelastic procedures. Data reduction was performed using the grid method, which helped in, the mathematical integration procedure (Shear difference method) to separate the principal stresses. The results were as follows. 1. Fixed partial dentures do not function in bending as a symmetrical beam. Alternate areas of tension and compression were demonstrated when multiple contact loading was used. 2. The weakest part in posterior fixed partial dentures is the fixed joint. 3. (1) Models I and modified Model I were loaded on the pontic using a 50 pound vertical static load. The shear stress near the posterior fixed joint in Model 1 (U notches) was+129.4 p.s.i., and at the same fixed joint in modified Model 1 (V notches) was+239.4 p.s.i. The concentration of stress in fixed joint was reduced by 50% when U notches replaced the V notches. (2) Modified Model 2 was loaded using a multiple contact loader at a total load of 125 pounds. The difference between the principal stresses (${\sigma}_1-{\sigma}_2$), shear stress, at the V notches was+600 p.s.i., and at the U notches was+3l7 p.s.i. The shear stress was reduced by 50% when U notches replaced the V notches. V-grooves at the fixed joints should be avoided, and should be replaced by regular shaped U-grooves. 4. Cantilever fixed partial dentures had much higher stresses at the fixed joint than fixed partial dentures that were attached at both ends.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.4
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• pp.385-395
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• 2012

This clinical report presents the case using overlay dentures to treat a patient with cleft lip and palate and malocclusion. This patient requires vigorous treatment such as orthodontic treatment and combined orthodontic/oral surgery procedures. Overlay denture can be used as an alternative treatment option. Intraoral and radiographic examinations were done. The vertical dimension of occlusion was evaluated for proper prosthetic procedures and the surveying in the diagnostic cast was done. Considering the tissue and teeth undercut, the alterations of teeth shape were done. Final preparation and impression was performed. After the evaluation of vertical dimension and occlusion with wax-denture, the dentures were polymerized. Clinical remounting and occlusal adjustment were done on the articulator. Overlay dentures were delivered and the patient was recalled for relining. The overlay dentures satisfied patient's esthetic and functional requirements and provided a stable occlusion. Overlay dentures in this case were a reversible and relatively inexpensive treatment for this patient, however the potential possibilities of caries and periodontal disease as a result of poor oral hygiene should be prevented with periodic recall.

• Health Policy and Management
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• v.17 no.3
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• pp.1-25
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• 2007

Relative value scales introduced in 2001 remarkably improved health insurance fee schedule, but current relative value scales have many problems. In the beginning the government intended to introduce 'resource based relative value scales(RBRVSs)' like USA, but political adjustment of RBRVS studied in 19.17 weakened the relationship between relative value scale and resource consumption. So unbalance of health insurance fees are existing till now. Also relative value was not divided to physician work and practice expense, and malpractice fee was not divided separately. To correct the unbalance of current relative value scales, the refinement project of health insurance relative value scales started in 2003. The project team divided relative value scales into three components, which are physician work, practice expense, malpractice fee. Physician work was studied by professional organizations like Korean medical association. To develop the practice expense relative value, project team organized clinical practice expert panels(CPEPs) composed of physicians, nurses, and medical technicians. CPEPs constructed direct expense data like labor costs, material costs, equipment costs about each medical procedures. The practice expense relative values of medical procedures were developed by the allocation of the institution level direct & indirect costs according to CPEPs direct costs. Institution level direct & indirect costs were collected in 21 hospitals, 98 medical clinics, 53 dental clinics, 78 oriental clinics, and 46 pharmacies. The malpractice fee relative values were developed through the survey of malpractice related costs of hospitals, clinics, pharmacies. Putting together three components of relative values in one scale, the final relative values were made. The final relative values were calculated under budget neutrality by medical departments, that is, total relative value score of a department was same before and after the revision. but malpractice fee relative value scores were added to total scores of relative values. So total score of a department was increased by the malpractice fee relative value score of that department This project failed in making 'resource based' relative value scales in the true sense of the word, because the total relative value scores of medical departments were fixed. However the project team constructed the objective basis of relative value scale like physician's work, direct practice expense, malpractice fee. So step by step making process of the basis, the fixation of total scores by the departments will be resolved and the resource based relative value scale will be introduced in true sense.