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Hypoglossal nerve stimulation for treatment of obstructive sleep apnea (OSA): a primer for oral and maxillofacial surgeons

  • Hong, Sung ok;Chen, Yu-Feng;Jung, Junho;Kwon, Yong-Dae;Liu, Stanley Yung Chuan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.27.1-27.5
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    • 2017
  • The prevalence of obstructive sleep apnea (OSA) is estimated to be 1-5% of the adult population world-wide, and in Korea, it is reported at 4.5% of men and 3.2% of women (Age 40 to 69 years old). Active treatment of OSA is associated with decrease in insulin resistance, cardiovascular disease, psychosocial problems, and mortality. Surgical treatment of OSA has evolved in the era of neuromodulation with the advent of hypoglossal nerve stimulation (HGNS). We share this review of HGNS with our maxillofacial surgical colleagues to expand the scope of surgical care for OSA.

The Distribution of Implant Patients and the Type of Implant Site (임플란트 환자의 분포 및 식립부 유형)

  • Park, Ji-Eun;Yun, Jeong-Ho;Jung, Ui-Won;Kim, Chang-Seong;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.34 no.4
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    • pp.819-836
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    • 2004
  • Nowdays, the awareness of implant treatment has grown rapidly among dentists and patients alike in Korea, as it becomes a widely accepted treatment. The reason is that unlike crown and bridge or denture treatment, implant treatment helps preserve existing bone and improve masticatory functions. So, It is needed understanding about the type, distribution of implant patient. The following results on patient type and implant distribution were compiled from 4433 implant cases of 1596 patients treated at the periodontal dept. of Y University Hospital during 1992 to 2004. 1. There are no dissimilarities between men and women, with patients in their 40, 50s accounting for 52.5% of patients and 57.5% of implant treatments; the largest share of patients and implant treatments. 2. Mn. posterior area accounted for 54.9% of implant treatments followed by Mx. posterior area(27.6%), Mx anterior area(11.9%) and Mn anterior area(5.6%). 3. Partial edentulous patients treated by single crown and bridge-type prosthesis accounted for 97.5% and fully edentulous patient accounted for the remaining 2.5%. 4. The major cause of tooth loss is periodontal disease, followed by dental caries, trauma and congenital missing. Also, older people are more likely to suffer from tooth loss due to periodontal disease rather than dental caries. 5. In the distribution of bone quality for maxillae, type III was most, followed by type II, r type IV and r type I. As for mandible, type II was most, followed by type III, type IV and for type I. 6. In the distribution of bone quantity for maxillae, type C was most, followed by type B, type D, type A, and for type E. As for mandible, type B was 52% most, followed by type C, type D, type A and type E. 7. The majority of implants were those of 1O-14mm in length (85.2%) and regular diameter in width (64%). The results provided us with basic data on patient type, implant distribution, bone condition, etc. We wish that our results coupled with other research data helps assist in the further study for better implant success/survival rates, etc.

Bonding of the silane containing multi-mode universal adhesive for lithium disilicate ceramics

  • Lee, Hyun-Young;Han, Geum-Jun;Chang, Juhea;Son, Ho-Hyun
    • Restorative Dentistry and Endodontics
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    • v.42 no.2
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    • pp.95-104
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    • 2017
  • Objectives: This study evaluated the influence of a multi-mode universal adhesive (MUA) containing silane (Single Bond Universal, 3M EPSE) on the bonding of resin cement to lithium disilicate. Materials and Methods: Thirty IPS e.max CAD specimens (Ivoclar Vivadent) were fabricated. The surfaces were treated as follows: Group A, adhesive that did not contain silane (ANS, Porcelain Bonding Resin, Bisco); Group B, silane (S) and ANS; Group C, hydrofluoric acid (HF), S, and ANS; Group D, MUA; Group E, HF and MUA. Dual-cure resin cement (NX3, Kerr) was applied and composite resin cylinders of 0.8 mm in diameter were placed on it before light polymerization. Bonded specimens were stored in water for 24 hours or underwent a 10,000 thermocycling process prior to microshear bond strength testing. The data were analyzed using multivariate analysis of variance (p < 0.05). Results: Bond strength varied significantly among the groups (p < 0.05), except for Groups A and D. Group C showed the highest initial bond strength ($27.1{\pm}6.9MPa$), followed by Group E, Group B, Group D, and Group A. Thermocycling significantly reduced bond strength in Groups B, C, and E (p < 0.05). Bond strength in Group C was the highest regardless of the storage conditions (p < 0.05). Conclusions: Surface treatment of lithium disilicate using HF and silane increased the bond strength of resin cement. However, after thermocycling, the silane in MUA did not help achieve durable bond strength between lithium disilicate and resin cement, even when HF was applied.

Oral health status of institutionalized elderly in Korea (노인장기요양시설 입소노인의 구강건강실태와 시사점)

  • Han, Dong-Hun;Kim, Nam-Hee;Ko, Seok-Min;Kwak, Jeong-Min;So, Jong-Seop;Lee, Seong-Keun;Lim, Soon-Ryun;Hwang, Ji-Young;Lee, Hye-Ju;Choi, Ho-Joon;Paek, Ji-Hyun;Kim, Yeon-Ju
    • The Journal of the Korean dental association
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    • v.53 no.10
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    • pp.688-695
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    • 2015
  • Purpose: The institutionalized elderly have placed the most vulnerable state, and the report about the oral health status of the institutionalized elderly was scarce. The aims of the current study were to investigate the oral health status of institutionalized elderly. Materials and methods: The survey of the oral health status was carried out on 487 institutionalized elderly from 4 longterm care facilities of Seoul metropolitan city, Gyunggi province, and Gangwon province in Korea. Results: The prevalence of dental caries, root caries, and dental calculus of the institutionalized elderly was 19.2%, 15.3%, and 23.7%, respectively. The percentage of edentulism among the institutionalized elderly was 26.2%. Those who had poor oral hygiene and tongue coating were 43.9% and 90.5%, respectively. The percentages wearing complete and removable partial denture on maxilla were 12.8% and 3.3%, respectively. The percentages wearing complete and removable partial denture on mandible were 7.8% and 5.6%, respectively. The percentages of institutionalized elderly needing complete and removable partial denture on maxilla were 29.7% and 27.2%, respectively. The percentages of institutionalized elderly needing complete and removable partial denture on mandible were 24.5% and 30.9%, respectively. Conclusion: The oral health stuatus of institutionalized elderly was poor. For the oral health promotion of elderly in longterm care facilities, it is essential to educate nurses and caregivers about the importance of the oral health and oral hygiene method.

A study on the correlation between the dental caries and dietary habits and snack intake of pre-school children (미취학 아동의 치아우식증과 식습관 및 간식섭취와의 관계)

  • Kang, Hyun-Sook;Jeong, Jeong-Hwa
    • Journal of Korean society of Dental Hygiene
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    • v.10 no.2
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    • pp.345-359
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    • 2010
  • Objectives : The purpose of this study was to correlation between the index of dental caries in primary teeth and the habits of diet and snack which are expected to influence on the index. The subjects of this study were 165 parents of the children who visited a pediatric dental hospital located in Gyeong-gi do from Jun. 15th to Sep. 26th, 2009, and the self-report questionnaire survey was performed. Methods : A questionnaire used in a previous study was revised and completed for this study and it consisted of 15 items on general characteristic, nine items on dietary habit, and five items on snack intake habit. The collected data was analyzed using SPSS program and findings are as follows Results : 1. The index of dental caries in primary teeth by ages was that children of four years old has 4~5 with 27.5%, children of five years old has 2~3 and 4~5 with 33.3% and children of six years old has 1 and 8~9 with 25.6%, showing a statistically significant(${\chi}^2$=37.72, p<.01). 2. The frequency of brushing teeth was found to have statistically significant negative correlation with the number of primary teeth with dental caries (${\chi}^2$=61.20, p<.001). 3. The frequency of taking snack was found to have statistically significant positive correlation with the number of primary teeth with dental caries (${\chi}^2$=51.42, p<.001). 4. The desirability of dietary habit was found to have statistically significant negative correlation with the number of primary teeth with dental caries (${\chi}^2$=36.51, p<.001). 5. The frequency of taking biscuit was found to have statistically significant positive correlation with the number of primary teeth with dental caries (${\chi}^2$=67.74, p<.001). 6. The frequency of taking bread was found to have statistically significant positive correlation with the number of primary teeth with dental caries (${\chi}^2$=29.63, p<.01). 7. The frequency of taking caramel and candy was found to have statistically significant positive correlation with the number of primary teeth with dental caries (${\chi}^2$=38.85, p<.001). 8. The frequency of taking soft drinks was found to have statistically significant positive correlation with the number of primary teeth with dental caries (${\chi}^2$=52.92, p<.001). 9. The frequency of taking ice-creams was found to have statistically significant positive correlation with the number of primary teeth with dental caries (${\chi}^2$=75.07, p<.001). Conclusions : Those findings show that the children with undesirable dietary habit and higher frequency of taking snack have higher index of dental caries in primary teeth, therefore, it is considered that the regular brushing teeth and establishment of desirable dietary habit are very important for keeping health oral cavity. It is recommended that the continuous concern and repeated learning are needed in house and group of rearing infants so that the children take foods of fruits which have function of self-purification than the food of carbohydrates which has high adhesion and level of sweetness.

The Survey of Dentists: Updated Knowledge about Basic Life support and Experiences of Dental Emergency in Korea

  • Cho, Kyoung-Ah;Kim, Hyuk;Lee, Brian Seonghwa;Kwon, Woon-Yong;Kim, Mi-Seon;Seo, Kwang-Suk;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.1
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    • pp.17-27
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    • 2014
  • Background: Various medical emergency situations can occur during dental practices. Cardiac arrest is known to comprise approximately 1% of emergency situation. Thus, it is necessary for dentists to be able to perform cardiopulmonary resuscitation (CPR) to increase the chance of saving patient's life in emergency situation. In this paper, we conducted a survey study to evaluate to what extent dentists actually understood CPR practice and if they had experience in handling emergency situations in practice. Method: The survey was done for members of the Korean Dental Society of Anesthesiology (KDSA), who had great interest in CPR and for whom survey-by-mail was convenient. We had selected 472 members of the KDSA with a dental license and whose office address and contact information were appropriate, and sent them a survey questionnaire by mail asking about the degree of their CPR understanding and if they had experience of handling emergency questions before. Statistical analyses -frequency analysis, chi-square test, ANOVA, and so on- were performed by use of IBM SPSS Statistics 19 for each question. Result: Among 472 people, 181 responded (38.4% response rate). Among the respondents were 134 male and 47 female dentists. Their average age was $40.4{\pm}8.4$. In terms of practice type, there were 123 private practitioners (68.0%), 20 professors (11.0%), 16 dentists-in-service (8.8%), 13 residents (specialist training) (7.2%) and 9 military doctors (5%). There were 125 dentists (69.1%) who were specialists or receiving training to be specialist, most of whom were oral surgeon (57, 31.5%) and pediatric dentists (56, 30.9%). There were 153 people (85.0%) who received CPR training before, and 65 of them (35.9%) were receiving regular training. When asked about the ratio of chest pressure vs mouth-to-mouth respiration when conducting CPR, 107 people (59.1%) answered 30:2. However, only 27.1% of them answered correctly for a question regarding CPR stages, C(Circulation)- A(Airway)- B(Breathing)- D(Defibrillation), which was defined in revised 2010 CPR practice guideline. Dentists who had experience of handling emergency situations in their practice were 119 (65.6%). The kinds of emergency situations they experienced were syncope (68, 37.6%), allergic reactions to local anesthetic (44, 24.3%), hyperventilation (43, 23.8%), seizure (25, 13.8%), hypoglycemia (15, 8.3%), breathing difficulty (14, 7.8%), cardiac arrest (11, 6.1%), airway obstruction (6, 3.3%), intake of foreign material and angina pectoris (4, 2.2%), in order of frequency. Most respondents answered that they handled the situation appropriately under the given emergency situation. In terms of emergency equipment they had blood pressure device (70.2%), pulse oximetry (69.6%), Bag-Valve-Mask (56.9%), emergency medicine (41.4%), intubation kit (29.8%), automated external defibrillator (23.2%), suction kit (19.3%) and 12 people (6.6%) did not have any equipment. In terms of confidence in handling emergency situation, with 1-10 point scale, their response was $4.86{\pm}2.41$ points. The average point of those who received regular training was $5.92{\pm}2.20$, while those who did not was $4.29{\pm}2.29$ points (P<0.001) Conclusion: The result showed they had good knowledge of CPR but the information they had was not up-to-date. Also, they were frequently exposed to the risk of emergency situation during their dental practice but the level of confidence in handling the emergency situation was intermediate. Therefore, regular training of CPR to prepare them for handling emergency situation is deemed necessary.

Comparison of arch form between Koreans and Egyptians (한국인과 이집트인의 치열궁 형태 비교)

  • Jang, Kab-Soo;Suk, Kyung-Eun;Bayome, Mohamed;Kim, Yoon-Ji;Kim, Seong-Hun;Kook, Yoon-Ah
    • The korean journal of orthodontics
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    • v.40 no.5
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    • pp.334-341
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    • 2010
  • Objective: The purpose of this study was to evaluate morphologic differences in the mandibular arch between Egyptian and Korean subjects. Methods: The Egyptian sample consisted of 94 mandibular casts (35 Class I, 32 Class II and 27 Class III). The Korean sample consisted of 462 mandibular casts (114 Class I, 119 Class II, and 135 Class III). The most facial portion of 13 proximal contact areas was digitized from photocopied images of the mandibular dental arches. Clinical bracket points were calculated for each tooth. The subjects were grouped according to arch form to compare the frequency distribution of the 3 arch forms between the ethnic groups in each Angle classification. Results: Egyptians had significantly narrower intermolar and intercanine widths ($p$ < 0.001), and shallower intermolar and intercanine depths ($p$ < 0.001) than Koreans. There was an even frequency distribution of the 3 arch forms within the Egyptian group ($p$ = 0.46). However, in the Korean group, the most frequent arch form was the square arch form (46.7%), while the frequency of the tapered arch form was significantly lower (18.8%). Conclusions: These results might provide helpful information in evaluating morphologic differences between ethnic groups in selection of preformed superelastic archwires.

Effect of Intermittent Parathyroid Hormone Administration on the Microstructure of Jaw Bone in the Ovariectomized Rats

  • Kang, Kang-su;Kim, Kun-hyoung;Heo, Hyun-a;Park, Suhyun;Pyo, Sung-woon
    • Journal of Korean Dental Science
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    • v.8 no.2
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    • pp.65-73
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    • 2015
  • Purpose: Parathyroid hormone (PTH) therapy has drawn attention, as an alternative to anti-resorptive drugs since PTH accelerates bone density by anabolic action. The purpose of this study was to identify the effect of intermittent PTH administration on jaw bones of rat undergone bilateral ovariectomy. Materials and Methods: Nine female Sprague-Dawley rats were divided into three groups. PTH group was ovariectomized (OVX) to induce osteoporosis and PTH $30{\mu}g/kg$ was administered 1 week after the surgery. In OVX group, ovariectomy was performed and only vehicle was administered by subcutaneous injection 3 times per week. Control group was subjected to sham surgery. The animals were sacrificed 8 weeks after the surgery and specimens were obtained from ilium and upper and lower jaw bones. Histological investigation was carried out by using an optical microscope and micro-computed tomography was taken to examine structural property changes in each bone sample. Result: In the ilium, the bone volume ratio (bone volume/total volume, BV/TV) of PTH, OVX and control groups was $53.75%{\pm}7.57%$, $50.61%{\pm}12.89%$, $76.20%{\pm}5.92%$ (P=0.061) and bone mineral density (BMD) was $1.12{\pm}0.09$, $0.88{\pm}0.48$, $1.38{\pm}0.07g/cm^3$ (P=0.061). In the mandible, BV/TV of PTH, OVX and control groups was $64.60%{\pm}12.17%$, $58.26%{\pm}9.63%$, $67.54%{\pm}14.74%$(P=0.670) and BMD was $1.21{\pm}0.17$, $1.19{\pm}0.13$, $1.27{\pm}0.18g/cm^3$ (P=0.587). In the maxilla, BV/TV of PTH, OVX and control groups was $61.19%{\pm}8.92%$, $52.50%{\pm}11.22%$, $64.60%{\pm}12.17%$ (P=0.430) and BMD was $1.20{\pm}0.11$, $1.11{\pm}0.16$, $1.21{\pm}0.17g/cm^3$ (P=0.561). No statistically significant difference was found in any variables in all groups. Histological observation revealed that the ilium in OVX group demonstrated sparsely formed trabecular bones compared with other groups. However, upper and lower trabecular bones did not present significant differences. Conclusion: Intermittent administration of PTH appears to affect the microstructure of rat jaw bones, but statistical significance was not found. However, the measurements in this study partly implicated the possible anabolic effect of PTH in vivo.

A study of the mandibular canal in digital panoramic radiographic images of a selected Korean population (한국인의 디지털파노라마 방사선영상에서 하악관에 관한 연구)

  • Kim, Jae-Duk;Kim, Jin-Soo
    • Imaging Science in Dentistry
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    • v.37 no.1
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    • pp.9-14
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    • 2007
  • Purpose : To determine the more valuable information to detect the mandibular canal and the mental foramen in panoramic radiographs of a selected Korean population for the implant. Materials and Methods : This study analysed 288 panoramic radiographic images of patients taken at the Dental hospital of Chosun University retrospectively. Indirect digital panoramic X-ray machine (ProlineXC, PLANMECA, Finland) with processing by using Directview $CR950^@$ (Kodak, U.S.A.) and Direct digital panoramic X-ray machine (Promax, PLANMECA, Finland) were used for all exposures. All images were converted into Dicom format. Results : The common position of the mental foramen was in line with the longitudinal axis of the second premolar (68.1%). The mental foramen was symmetrical in 81.8% of cases. The mandibular canal was not identified at anterior portion and discontinued with the mental foramen in 27.8% of all cases, in 42.4% identified with lower border line continued with the mental foramen, in 14.6% with both upper and lower border lines, and in 15.3% unilaterally identified with lower border line. Conclusion : Clinicians can estimate the upper border line of the mandibular canal from the confirmation of the mental foramen and the lower border line of the mandibular canal symmetrically on the panoramic radiography taken in adjusted midsaggital plane of patient's head.

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A RETROSPECTIVE MULTICENTER CLINICAL STUDY OF INSTALLED US II / SS II IMPLANTS AFTER MAXILLARY SINUS FLOOR ELEVATION (상악동저 거상술 후 Osstem Implant (US II / SS II)의 다기관 후향적 임상연구)

  • Kook, Min-Suk;Park, Hong-Ju;Kim, Su-Gwan;Kim, Young-Kyun;Cho, Yong-Seok;Choi, Gab-Lim;Oh, Young-Hak;Oh, Hee-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.341-349
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    • 2008
  • Purpose: The purpose of this study was to evaluate the $Osstem^{(R)}$ implants (US II/SS II implants) through the retrospective study for the clinical success rate during the installation of the $Osstem^{(R)}$ implants (US II/SS II implants) by using of the procedures of maxillary sinus floor elevation. Materials and methods: The current study was researched in the 6 medical institutions: Chonnam National University, Chosun University, Pusan DaeDong Hospital, Bundang Seoul National University Hospital, Ap-Seon Clinic, and All Clinic. Based on the total number of 116 patients whose treatment was the installation of the US II/SS II implants with the procedures of the maxillary sinus floor elevation, they were conferred on the dental records of the patients under the joint consultation of the 6 medical institutions. On the dental recording charts, there were included in as the following; the name of the institutions, gender, age, with or without smoking or drinking, with or without the generalized diseases, the height of the alveolar bone on the operational sites, elapsed edentulous state period, the state of the opposed or adjacent teeth, the methods of the maxillary sinus floor elevation, secondary time period for surgery, the lengths, types, and diameters of implants, with or without bone transplantation or the types of bone, postoperative current bone height, current adjacent soft tissue state of the implants, with or without the success of the installations of the implants. We have done our survey with the clinical and radiolographical examinations and dental questionaries. The success and survival rate of the implants was evaluated. Results 1. Total number of the patients with the installation of the US II implants were 62. The 252 numbers of US II implants were installed on the 89 maxillary sinuses. The patient's mean age was 54.1 years old and there were 36 men and 27 women. 2. Total number of patients with the installation of SS II implant were 57. The 165 numbers of SS II implants were planted on the 80 maxillary sinuses. Their mean age was 48.7 years old and there were 37 men and 20 women. 3. The follow-up period was 30.7 months(21-49 mon) on average. The vertical bone loss of installed implants after the procedures of the maxillary sinus elevation was 1.1 mm on average in SS II and 1.3 mm on average in US II. There existed no statistical significance on each group. The mean enlarged bone height after the maxillary sinus floor elevation was 8.2 mm. 4. For the procedures of the maxillary sinus elevation, the Lateral approach technique occupied 87.1%, which was the most used one. In addition, the most frequently used transplanted bone was autogenous bone only which was 72.7% during the maxillary sinus floor elevation. 5. The complication of maxillary sinus floor elevation were perforation of sinus membrane, disesthesia on doner site, exposure of cover screw and exposure of maxillar bone. 6. The survival rate of US II and SS II after maxillary sinus floor elevation was 99.2% and 95.8%, respectively. And the success rate of US II and SS II after maxillary sinus floor elevation was 97.6% and 89.7%, respectively. Conclusion : On the evaluation of the analysis of our study, both US II and SS II implants showed the excellent clinical results by use of the procedures of maxillary sinus floor elevation.