• Journal of Dental Anesthesia and Pain Medicine
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• 제19권2호
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• pp.115-118
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• 2019

This case report aims to review complications that can occur during arthrocentesis and report an unusual complication observed in a 55-year-old man. The patient received arthrocentesis in an attempt to treat painful locking episodes of his right temporomandibular joint (TMJ). One hour after the operation, the patient experienced temporary facial paralysis in the area of the facial nerve and anesthesia of the lingual and alveolar inferior nerves. No persistent complications were detected during the postoperative follow-up. We suspected this complication occurred after anesthetic solution overflowed from a traumatic perforation in the joint capsule to the infratemporal area during the operation. To our knowledge, this complication has not been previously reported in the literature.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권1호
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• pp.81-85
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• 2021

Central venous catheter (CVC) insertion is commonly used in the operating room and intensive care unit to monitor central venous pressure and secure an intravenous route to deliver medications and nutritional support that cannot be safely infused into peripheral veins. However, CVC insertion may be associated with serious complications such as arterial puncture, hematoma, pneumothorax, hemothorax, catheter infections, and thrombosis. Several methods have been recommended to prevent these complications. Here we report a case of massive hemothorax caused by attempts of CVC insertion into the internal jugular vein and subclavian vein in a patient with multiple trauma. CVC placement should be performed or supervised by an experienced physician to decrease the incidence of CVC-related complications. CVC insertion under ultrasound guidance is recommended.

• 대한장애인치과학회지
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• 제6권2호
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• pp.116-119
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• 2010

Trauma to the lips and tongue can occur by accidental self-biting after dental treatment. After local anesthesia, it is likely that the patient may feel painless even in biting the tongue. In case of young children and disabled patients, the dentists should be careful not to bite the tongue. In this report, we present a case of deep lingual laceration due to biting the tongue in the course of dental treatment under general anesthesia. A 33 year-old male was transferred to our hospital to treat tongue laceration. Before 2 hour on arrival, he had received dental care under general anesthesia at a dental hospital for the disabled because of cooperation difficulty and cerebral palsy. During recovery from general anesthesia, he tried to bite his own tongue involuntary. The doctors and nurses tried to prevent the patient from being injured. Despite these efforts, massive bleeding occurred from the injured sites of the tongue. Because we could not communicate with him, we decided to evaluate the extent of the injury and treat the injured sites under general anesthesia. The laceration wound was sutured for nearly 1 hr general anesthesia. During recovery we inserted mouth prop into the oral cavity to prevent further injuries from tongue biting. After full recovery from general anesthesia he didn't try to bite his tongue. After 4 hour admission, he was discharged without other complications.

• 대한치과마취과학회지
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• 제14권3호
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• pp.167-172
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• 2014

Background: Propofol is the most commonly used anesthetic for sedation and target-controlled infusion (TCI) is useful for dental treatment. However, it is important to assess and maintain an adequate depth of sedation in patients with severe intellectual disabilities Therefore, in this study we aimed to evaluate the adequate propofol target concentration for dental treatment in severely intellectually disabled patients. Methods: We undertook retrospective review of the sedation records of severely intellectually disabled patients who underwent dental treatment under TCI propofol sedation from September 2011 to April 2012. We evaluated the initial target concentration, stabilized concentration of propofol and monitored vital signs, including BIS score using sedation records. Results: Total 20 patients (10 male and 10 female patients) were included in the study. Every participant was severely intellectually disabled. The mean sedation duration was $70{\pm}16$ (45-100) minutes. The initial propofol target concentration infusion amount was $2.7{\pm}0.45$ (2.0-3.0) mcg/ml. The propofol effect site concentration (Ce) was $2.6{\pm}0.7$ (1.0-4.0) mcg/ml. The average value of BIS was $52.6{\pm}13$ (28-81). During the treatment period, there were no severe complications. Conclusions: The average propofol Ce for deep sedation without any complications in intellectually disabled patients was 2.6 mcg/ml.

• The Journal of Advanced Prosthodontics
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• 제8권2호
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• pp.150-157
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• 2016

PURPOSE. The modified lateral-screw-retained implant prosthesis (LSP) is designed to combine the advantages of screw- and cement-retained implant prostheses. This retrospective study evaluated the mechanical and biological complication rates of implant-supported single crowns (ISSCs) inserted with the modified LSP in the posterior region, and determined how these complication rates are affected by clinical factors. MATERIALS AND METHODS. Mechanical complications (i.e., lateral screw loosening [LSL], abutment screw loosening, lateral screw fracture, and ceramic fracture) and biological complications (i.e., peri-implant mucositis [PM] and peri-implantitis) were identified from the patients' treatment records, clinical photographs, periapical radiographs, panoramic radiographs, and clinical indices. The correlations between complication rates and the following clinical factors were determined: gender, age, position in the jaw, placement location, functional duration, clinical crown-to-implant length ratio, crown height space, and the use of a submerged or nonsubmerged placement procedure. RESULTS. Mechanical and biological complications were present in 25 of 73 ISSCs with the modified LSP. LSL (n=11) and PM (n=11) were the most common complications. The incidence of mechanical complications was significantly related to gender (P=.018). The other clinical factors were not significantly associated with mechanical and biological complication rates. CONCLUSION. Within the limitations of this study, the incidence of mechanical and biological complications in the posterior region was similar for both modified LSP and conventional implant prosthetic systems. In addition, the modified LSP is amenable to maintenance care, which facilitates the prevention and treatment of mechanical and biological complications.

• Journal of Korean Dental Science
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• 제9권2호
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• pp.69-73
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• 2016

Clinicians must be able to recognize post-extraction complications and treat them in a timely manner; complications that may potentially be life-threatening require special attention. Although arteriovenous malformation (AVM) is a very rare disorder, it may induce life-threatening hemorrhage during surgical intervention in the pertinent site. The present article examines the diagnosis and treatment modalities of AVM based on the case of a patient who was diagnosed with AVM with continuous bleeding after tooth extraction and who was successfully treated.

• 대한치과의사협회지
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• 제58권9호
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• pp.564-572
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• 2020

Implant treatment has long been established as the main stream for the recovery of lost teeth. Implant therapy, which began to be practiced under the concept of osseointegration, was performed on the completely healed bone, but implant placement immediately after extraction, which began to be introduced in the 1970s, began to become a widely used treatment modality since the 2000s. However, as with all other procedures, immediate implant placement is not omnipotent. If you are obsessed with the obsession that you need to provide quicker implant treatment to the patients, and if you do it as if you are being chased by time, it is the immediate implant placement that can lead to various embarrassing situations. In this article, to reduce complications, the author will look at some issues that need to be considered when placing implants immediately after extraction.

• Journal of Korean Dental Science
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• 제7권1호
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• pp.25-30
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• 2014

Subcutaneous emphysema and pneumomediastinum is a relatively uncommon phenomenon. It may occur secondary to dental treatment using high-speed air turbine handpieces, especially after extraction of tooth. Subcutaneous emphysema is often limited only to the areas of head and neck, but also can involve deeper structures. Thorough examination and conservative treatment of these problems are essential in preventing life-threatening complications such as airway obstruction and mediastinitis. The subject of this report is a 57-year-old woman with subcutaneous emphysema and pneumomediastinum during the extraction of maxillary third molar using high-speed air turbine handpiece. If there isn't any appropriate measure, severe complications may occur. Therefore it is important to be well-informed of proper diagnosis and treatment. This article shall present a case report with literature review.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권2호
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• pp.113-119
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• 2017

Background: The purpose of this study was to investigate the distribution of systemic diseases and medications in patients older than 65 years of age who visited the hospital for implant treatment, as well as to investigate basic information about surgical complications that may occur after insured implant treatment. Method: A total of 126 patients over 65 years of age were treated for implant surgery from October 1, 2013 to October 30, 2016. Electronic chart review was conducted to obtain medical records, which included sex, age, systemic diseases, medication(s) being taken, and control of the medications. Five patients were excluded due to lack of medical records giving information about systemic disease. Results: Of the 126 patients, 112 (88.9%) were taking medication due to systemic disease and 9 patients (7.1%) were not. The sex distribution was 71 women and 55 men and the highest proportion of patients were between 65 and 69 years old. The most common diseases were, from most to least frequent, hypertension, cardiovascular disease, diabetes, and osteoporosis. The drug groups that can cause major complications after dental treatment were classified as hemorrhagic, osteoporotic, and immunosuppressive agents, and were taken by 45 (35.7%), 22 (17.5%) and 4 (3.2%) patients, respectively. Conclusion: Given that 88.9% of the elderly patients who were eligible for insurance implant treatment had systemic disease, it is necessary to carefully evaluate patients' medical histories and their general conditions in order to prevent emergencies during implant surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권6호
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• pp.275-281
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• 2018

Objectives: Isolated mandibular fractures contribute to approximately 45% of maxillofacial traumas. Improper management of mandibular fractures can cause myriad potential complications and can lead to serious functional and aesthetic sequelae. The objective of the study is to design a stepwise approach for managing isolated mandibular fractures using open reduction and internal fixation (ORIF) with regional anesthesia on outpatient basis. Materials and Methods: Patients with isolated mandibular fractures presenting to the department of maxillofacial surgery were selected for ORIF under regional anesthesia based on occlusion, age, socioeconomic status, general condition, habits, and allied medical ailments. Standard preoperative, intraoperative, and postoperative protocols were followed. All patients were followed up for a minimum of 4 weeks up to a maximum of 1 year. Results: Of 23 patients who received regional anesthesia, all but one had good postoperative functional occlusion. One patient was hypersensitive and had difficulty tolerating the procedure. Two patients developed an extraoral draining sinus, one of whom was managed with local curettage, while the other required hardware removal. One patient, who was a chronic alcoholic, returned 1 week after treatment with deranged fracture segments after he fell while intoxicated. Conclusion: With proper case selection following a stepwise protocol, the majority of mandibular fractures requiring ORIF can be managed with regional anesthesia and yield minimal to no complications.