• Title/Summary/Keyword: Dental approaches

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Alveolar ridge preservation with an open-healing approach using single-layer or double-layer coverage with collagen membranes

  • Choi, Ho-Keun;Cho, Hag-Yeon;Lee, Sung-Jo;Cho, In-Woo;Shin, Hyun-Seung;Koo, Ki-Tae;Lim, Hyun-Chang;Park, Jung-Chul
    • Journal of Periodontal and Implant Science
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    • v.47 no.6
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    • pp.372-380
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    • 2017
  • Purpose: The aim of this prospective pilot study was to compare alveolar ridge preservation (ARP) procedures with open-healing approach using a single-layer and a double-layer coverage with collagen membranes using radiographic and clinical analyses. Methods: Eleven molars from 9 healthy patients requiring extraction of the maxillary or mandibular posterior teeth were included and allocated into 2 groups. After tooth extraction, deproteinized bovine bone mineral mixed with 10% collagen was grafted into the socket and covered either with a double-layer of resorbable non-cross-linked collagen membranes (DL group, n=6) or with a single-layer (SL group, n=5). Primary closure was not obtained. Cone-beam computed tomography images were taken immediately after the ARP procedure and after a healing period of 4 months before implant placement. Radiographic measurements were made of the width and height changes of the alveolar ridge. Results: All sites healed without any complications, and dental implants were placed at all operated sites with acceptable initial stability. The measurements showed that the reductions in width at the level 1 mm apical from the alveolar crest (including the bone graft) were $-1.7{\pm}0.5mm$ in the SL group and $-1.8{\pm}0.4mm$ in the DL group, and the horizontal changes in the other areas were also similar in the DL and SL groups. The reductions in height were also comparable between groups. Conclusions: Within the limitations of this study, single-layer and double-layer coverage with collagen membranes after ARP failed to show substantial differences in the preservation of horizontal or vertical dimensions or in clinical healing. Thus, both approaches seem to be suitable for open-healing ridge preservation procedures.

Effect of remifentanil on intraoperative fluid balance: a retrospective statistical examination of factors contributing to fluid balance

  • Ohara, Sayaka;Nishimura, Akiko;Tachikawa, Satoshi;Iijima, Takehiko
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.3
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    • pp.129-135
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    • 2020
  • Background: Postoperative fluid retention is a factor that causes delay in recovery and unexpected adverse events. It is important to prevent intraoperative fluid retention, which is putatively caused by intraoperative release of stress hormones, such as ADH (anti-diuretic hormone) or others. We hypothesized that intraoperative analgesia may prevent pathological fluid retention. We retrospectively explored the relationship between analgesics and in-out balance in surgical patients from anesthesia records. Methods: Anesthetic records of 80 patients who had undergone orthognathic surgery were checked in this study. Patients were anesthetized with either TIVA (propofol and remifentanil) or inhalational anesthesia (sevoflurane and remifentanil). During surgery, acetated Ringer's solution was infused for maintenance at a rate of 3-5 ml/kg/h at the discretion of the anesthetist. The perioperative parameters, including the amount of crystalloid and colloid infused, and the amount of urine and bleeding were checked. Furthermore, we checked the amount and administration rate of remifentanil during the surgical procedure. The correlation coefficient between the remifentanil dose and the in-out balance or the urinary output was analyzed using the Pearson correlation coefficient. The contributing factor to fluid retention, including urinary output, was statistically examined by means of multivariate logistic regression analysis. Results: A significant positive correlation was found between remifentanil dose and urinary output. Urinary output less than 0.04 ml/kg/min was suggested to cause positive fluid balance. Although in-out balance approaches zero balance with increase in remifentanil administration rate, no contributing factor for near-zero fluid balance was statistically picked up. The remifentanil administration rate was statistically picked up as the significant factor for higher urinary output (> 0.04 ml/kg/min) (OR, 2,644; 95% CI, 3.2-2.2 × 106) among perioperative parameters. Conclusions: In conclusion, remifentanil contributes in maintaining the urinary output during general anesthesia. Although further prospective study is needed to confirm this hypothesis, it was suggested that fluid retention could be avoided through suppressing intraoperative stress response by means of appropriate maintenance of remifentanil infusion rate.

Effect of Obesity and Psychological Stress on Oral Health (비만과 스트레스가 구강건강에 미치는 영향)

  • Kim, Soo-Hwa;Lee, Sun-Mi
    • Journal of dental hygiene science
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    • v.15 no.2
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    • pp.119-128
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    • 2015
  • The purpose of this study is to understand the effects of obesity and stress on oral disease in Korean adults by using the data of the Fifth Korea National Health and Nutrition Examination Survey. The subjects of this study are 4,627 adults at the age of 19 to 64, and the data were analyzed by using SPSS Windows ver.18.0. The results are as follows: Obesity was higher in men and the age of 40 to 64 than the other. And the group with lower education or lower income level tended to show significantly higher obesity (p<0.05). As for stress, women, the age of 19 to 39 and the subjects with higher academic career tended to indicate significantly higher stress (p<0.05). As for the effects of obesity on oral disease, there were no significant difference between body mass index (BMI) or waist-hip ratio (WHR) and oral disease but there was statistically significant difference between stress and temporomandibular joint disorder (TMD) (p<0.05). Even when the subjects with stress were obese or abdominally obese, there was no significant difference in oral disease (p>0.05). As to correlation among variables, there were correlations between BMI and WHR, stress and TMD, masticatory problems and periodontal disease or TMD (p<0.05). About the effects of general characteristics, obesity, and stress on oral disease, age was the variable influencing TMD, and age and abdominal obesity were the variables influencing masticatory problems (p<0.05). In this society, the environment surrounding individuals is fairly complex, and the concept of health including quality of life has more complex meaning than in the past. Various factors are influencing obesity and stress, and they are also influencing oral health and behaviors. Accordingly, it will be needed not only to make efforts to reduce obesity and stress but also to employ approaches from different perspectives to improve oral health.

Radiographic change of grafted sinus floor after maxillary sinus floor elevation and placement of dental implant (상악동저 거상술과 임플란트 식립 후 상악동저 변화에 대한 연구)

  • Cho, Sang-Ho;Kim, Ok-Su
    • Journal of Periodontal and Implant Science
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    • v.36 no.2
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    • pp.345-359
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    • 2006
  • Loss of maxillary molar teeth leads to rapid loss of crestal bone and inferior expansion of the maxillary sinus floor (secondary pneumatization). Rehabilitation of the site with osseointegrated dental implants often represents a clinical challenge because of the insufficient bone volume resulted from this phenomenon. Boyne & James proposed the classic procedure for maxillary sinus floor elevation entails preparation of a trap door including the Schneiderian membrane in the lateral sinus wall. Summers proposed another non-invasive method using a set of osteotome and the osteotome sinus floor elevation (OSFE) was proposed for implant sites with at least 5-6mm of bone between the alveolar crest and the maxillary sinus floor. The change of grafted material in maxillary sinus is important for implant survival and the evaluation of graft height after maxillary sinus floor elevation is composed of histologic evaluation and radiomorphometric evaluation. The aim of the present study was radiographically evaluate the graft height change after maxillary sinus floor elevation and the influence of the graft material type in height change and the bone remodeling of grafts in sinus. A total of 59 patients (28 in lateral approach and 31 in crestal approach) who underwent maxillary sinus floor elevation composed of lateral approach and crestal approach were radiographically followed for up to about 48 months. Change in sinusgraft height were calculated with respect to implant length (IL) and grafted sinus height(BL). It was evaluated the change of the graft height according to time, the influence of the approach technique (staged approach and simultaneous approach) in lateral approach to change of the graft height, and the influence of the type of graft materials to change of the graft height. Patients were divided into three class based on the height of the grafted sinus floor relative to the implant apex and evaluated the proportion change of that class (Class I, in which the grafted sinus floor was above the implant apex; Class II, in which the implant apex was level with the grafted sinus floor; and Class III, in which the grafted sinus floor was below the implant apex). And it was evaluated th bone remodeling in sinus during 12 months using SGRl(by $Br\ddot{a}gger$ et al). The result was like that; Sinus graft height decreased significantly in both lateral approach and crestal approach in first 12 months (p$MBCP^{TM}$ had minimum height loss. Class III and Class II was increased by time in both lateral and crestal approach and Class I was decreased by time. SGRI was increased statistically significantly from baseline to 3 months and 3 months(p<0.05) to 12 months(p$ICB^{(R)}$ single use, more reduction of sinusgraft height was appeared. Therefore we speculated that the mixture of graft materials is preferable as a reduction of graft materials. Increasing of the SGRI as time goes by explains the stability of implant, but additional histologic or computed tomographic study will be needed for accurate conclusion. From the radiographic evaluation, we come to know that placement of dental implant with sinus floor elevation is an effective procedure in atrophic maxillary reconstruction.

Pancreatic Cancer in Universiti Sains Malaysia Hospital: A Retrospective Review of Years 2001-2008

  • Norsa'adah, Bachok;Nur-Zafira, Azemi;Knight, Aishah
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2857-2860
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    • 2012
  • Pancreatic cancer is usually detected late and has a high mortality rate. Since little is known about this cancer in Malaysia, a review of all cases admitted to Universiti Sains Malaysia Hospital was conducted to identify the epidemiological distribution and assess survival. A list of pancreatic cancer patients in 2001-2008 was obtained from the Hospital Record Department. Only cases confirmed by radio-imaging or histo-pathology examination were included. We excluded those with incomplete medical records. Kaplan-Meier and Cox proportional hazard approaches were used for data analysis. Only 56 cases were included with a mean (SD) age of 49.6 (16.0) years, with 60.7% males and 82.1% of Malay ethnicity. Previous history included cholelithiasis in 23.2%, diabetes mellitus in 16.1%, previous laparotomy in 10.7%, chronic pancreatitis in 7.1%, alcohol drinking in 5.4% and positive family history in 3.6%. The common presenting history included 67.9% loss of appetite, 66.1% loss of weight, 58.9% jaundice and 46.4% abdominal pain. Tumour staging was: 21.5% stage l, 17.8% stage ll, 3.6% stage lll and 57.1% stage lV. The median (95% CI) survival time was 3.4 (0.5, 6.3) months and significant prognostic factors were duration of symptoms (HR 0.97; 95% CI: 0.95, 0.99; p value 0.013), ascites (HR 2.64; 95% CI: 1.28, 5.44; p value 0.008) and Whipple surgery (HR 4.20; 95% CI: 2.27, 7.76; p value <0.001). The history of presenting complaints was short and the majority presented at late stages of the disease, thus the median survival time was very poor.

Prevalence of periodontitis and associated risk factors in Korean adults: Korean National Oral Health Survey 2006

  • Choi, Youn-Hee;Baek, Hye-Jin;Song, Keun-Bae;Han, Ji-Youn;Kwon, Ho-Jang;Lee, Sang-Gyu
    • Journal of Periodontal and Implant Science
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    • v.39 no.sup2
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    • pp.261-268
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    • 2009
  • Purpose: To estimate the prevalence of periodontitis in Korean adults and to examine the associations between periodontitis and known risk factors. Methods: Using Korean National Oral Health Survey 2006 data, a total of 4,263 people who had taken oral examination, interviewed by questionnaire, and aged 18 or older were sampled. The prevalence of periodontitis measured by Community Periodontal Index (CPI) was calculated and the differences in prevalence according to known risk factors (age, sex, monthly income, education, residential area, tooth-brushing frequency, regular dental visit, smoking, and diabetes) were examined with chi-square test. Logistic regression analysis was performed to see the effects of each risk factor on the risk of having periodontitis. All statistical approaches were reflected national sampling design using Survey procedures in SAS 9.1. Results: The overall prevalence of periodontitis in Korean adults was 10.3%. There existed statistically significant differences in crude prevalence for periodontitis according to the all risk factors. In logistic regression, older age groups (O.R.:2.94-3.71), people living in rural area (O.R.:1.87), and current smokers (O.R.:1.77) were significantly prone to have periodontitis. People who earned monthly income of more than 2 million Korean won (O.R.:0.64) and brushed their teeth two or more times per day (O.R.:0.60-0.62) had significantly lower risk of having periodontitis. Conclusions: About 10% of Korean adults had periodontitis in 2006. People who were older, living in rural region, in lower income status, smoking, less tooth brushing were more likely to have periodontitis.

A Case Report of Prosthetic Rehabilitation for Skeletal Class III Malocclusion Patient (골격성 III 급 부정교합을 가진 환자의 보철수복을 통한 기능 및 심미적 회복)

  • Son, Mee-Kyoung;Chung, Chae-Heon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.3
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    • pp.349-357
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    • 2010
  • Physical factors and intra- and extra-oral factors of a patient have to be considered in order to decide a treatment plan for the skeletal class III malocclusion patient. Most of cases, the pre-prosthodontic treatment requires the orthodontic approaches and maxillofacial surgery. However, in some cases, patients' economic or medical condition makes impracticable situation for the orthodontic or surgical intervention. For those cases, the compromised prosthetic treatment which provides more stable and persistent occlusal stabilization is recommended. In this case report, a woman patient has a skeletal class III maxillomandibular relationship and misses multiple teeth. The prosthetic treatment without orthodontic and surgical intervention is performed due to her physical problem. The functional and esthetic results are achieved by the fixed prosthesis.

Full mouth rehabilitation of a panfacial fracture patient with bilateral condylar fracture (다발성 안면골절환자의 교합회복 증례)

  • Park, Go-Woon;Cha, Min-Sang;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.2
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    • pp.159-169
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    • 2014
  • Panfacial fractures require complex multidisciplinary approaches for treatment. Functional stability of bilateral condylar-disc complex should be the goal of the treatment. A patient with complex clinical panfacial fractures, including a bilateral condylar fractures visited our clinic. Facial asymmetry, insufficient vertical space and multiple missing teeth of the patient were major problems. Closed reduction and splint treatment were tried for stable condylar position. A functional and esthetic rehabilitation was accomplished by using implants and full mouth rehabilitaion. Potential possibilities of unstable occlusion should be prevented with night guard and periodic occlusal adjustment.

THE GRAFT HEIGHT CHANGES AFTER SINUS AUGMENTATION PROCEDURES USING DEPROTEINIZED BOVINE BONE MINERAL AND BETA-TRICALCIUM PHOSPHATE - A RETROSPECTIVE COMPARATIVE STUDY USING PANORAMIC RADIOGRAPHY (탈단백 우골과 제3인산칼슘을 이용한 상악동 골이식 후 이식재의 높이 변화 - 파노라마 방사선 사진을 이용한 후향적 대조 연구)

  • Kim, Jong-Sik;Park, Tae-Il;Seo, Hyun-Soo;Song, Yun-Jung;Hong, Soon-Min;Choi, Mee-Ra;Park, Jun-Woo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.4
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    • pp.468-474
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    • 2008
  • Purpose: Previous clinical investigations of sinus floor augmentation have demonstrated repneumatization of grafted sinus. The aim of this study is to evaluate and compare the height changes of sinus floor after grafting with deprotenized bovine bone mineral (DBBM) and beta tricalcium phosphate (TCP). Materials and methods: 34 sinuses in 28 patients were augmented with 100% DBBM or 100% TCP through lateral approaches. Sinusgraft height was measured before, immediately after, and 6 months after bone graft with panoramic radiography. Result: After 6 months, the decreases of graft heights were 14.53% for DBBM group and 15.15% for TCP group. There was no statistically significant difference. Discussion and Conclusion: Long-term stability of sinus-graft height represents an important factor for implant success. After the uses of DBBM and TCP for maxillary sinus floor augmentations, acceptable graft height maintenances were observed.

Green Synthesis to Develop Iron-Nano Formulations and Its Toxicity Assays

  • Kulkarni, Smital;Mohanty, Nimain;Kadam, Nitin N.;Swain, Niharika;Thakur, Mansee
    • Journal of Pharmacopuncture
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    • v.23 no.3
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    • pp.165-172
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    • 2020
  • Objectives: In the past few years, herbal medicines have gained popularity over synthetic drugs because of their natural source and minimal side effects which has led to a tremendous growth of phytopharmaceuticals usage. With the development of nanotechnology, it provides alternative approaches to overcome several limitations using nano-formulations. In spite of considerable quantity of antianemic preparations with different iron forms available, currently additives are used and represented in modern pharmaceutical market. Iron deficiency anemia is a major global public health problem which particularly affects pregnant women, children and elderly persons. The situation is complicated because of disadvantages and drug side effects from existing antianemic medicines. There is a great demand for the development of new antianemic preparations. Green synthesis of iron oxide nanoparticles, possess high potential in this field. Methods: Our study focuses on developing green synthesis of iron oxide nanoparticles (IONPs) of 10-50 nm with spherical shape where different dosages were used -1 mg/kg, 10 mg/kg and 100 mg/kg for exposure in Wistar albino female rats for 28 days. The toxicity was assessed using various parameters such as measurements of the rat body and organ mass, hematology, biochemical evaluation and histopathological examinations. Results: No significant differences were observed in body and organ weights. Hematological indices also indicated no significant differences whereas biochemical factors showed increase in levels of direct bilirubin and globulin of medium as well as high dose and SGPT levels were increased only in high dose. The major organs (heart, kidney and liver) showed histopathological alterations in 10 and 100 mg/kg whereas brain showed only in 100 mg/kg. Conclusion: The toxicity of IONPs was found to be more significant when the concentration was increased; however, low doses can be used for further investigation as an antianemic preparation.