The Journal of Korea Assosiation for Disability and Oral Health
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v.15
no.1
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pp.40-44
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2019
Moyamoya disease (MMD) is a chronic, occlusive cerebrovascular disease of unknown etiology characterized by progressive stenosis at the terminal portion of the internal carotid artery and an abnormal vascular network at the base of the brain. The clinical presentations of MMD include transient ischemic attacks (TIA), ischemic stroke, hemorrhagic stroke, seizures, headache, and cognitive impairment. MMD is the most important cause of stroke or TIA in children in East Asian countries. A 5-year-3-month old boy with MMD experienced cerebral infarctions five times. Cerebrovascular anastomosis surgery was performed on him four years ago. He had dysphagia, developmental delay, hemiplegia, and strabismus. Besides, a number of dental caries in primary dentition were identified during clinical oral examination. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation and underlying systemic disease. MMD is associated with various medical diseases requiring thoughtful consideration during dental treatment. Crying and hyperventilation in MMD patients may cause hypocapnia and have a cerebral vasoconstrictive effect. If dental treatment is required, control of pain and anxiety is very important. General anesthesia may be considered for dental treatment in uncooperative or very young patients with MMD.
Modern theories and concepts of occlusion for implants and natural teeth have originated in complete denture construction. Bilateral balanced occlusion as the occlusal scheme of choice has a long history in complete denture construction. The reason that occlusion has always been a consideration in the provision of removable prosthetics is because the adoption of good occlusal practice has a significant and immediate impact on the overall success of the treatment, as it affects denture stability. However, clinicians must remember that there are multiple ways, both successful and unsuccessful, to complete the restoration of a patient's occlusion. The goal is to meet the physiologic, functional, and esthetic needs of the individual patient while applying knowledge, accurate diagnosis, experience, clinical judgement, and attention to detail. This paper describes the features of an ideal occlusion in removable prosthodontics, why these features make it ideal for denture stability, and some technique for achieving these aims.
Transactions of the Korean Society of Mechanical Engineers A
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v.32
no.3
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pp.290-296
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2008
After scientific verification of the osteointegration of dental implants, the overall efficiency of dental implants has been generally accepted. Thus, implants now play a major role in the clinical treatment of an edentulous mandible, and in the prosthetic maintenance equipment for partial edentulous mandible patients. Yet, for the successful long-term maintenance of implants, careful consideration of the bio-mechanics is needed to ensure that the maximum stress in the mandible as a result of chewing is maintained under a critical value. Accordingly, this study focuses on reducing the maximum stresses in an implanted mandible, especially in the cortical bone. Thus, the stresses in the implant and mandible are analyzed using finite element packages, including I-DEAS and NISA II/DISPLAY III, using a local zooming technique for a concentrated stress analysis. In addition, the von-Mises stress and principal stress in the mandible are both checked to determine the best combination.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.44
no.5
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pp.232-236
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2018
Objectives: Hormonal changes during menopause alter a woman's susceptibility to some disorders. Information regarding the prevalence of temporomandibular disorder (TMD) in menopausal women is limited in the literature. In this study, the prevalence and severity of TMDs were compared between menopausal and non-menopausal women. Materials and Methods: The study included 140 women (69 premenopausal and 71 postmenopausal) 45 to 55 years of age that were examined in Shiraz Dental School, Shiraz in Iran. The Helkimo clinical dysfunction index (Di) was used to evaluate temporomandibular joint (TMJ) dysfunction. The data were analyzed using chi-square and Fisher's exact tests. Results: Occurrence of TMD was significantly higher in menopausal than non-menopausal women (P<0.001). All the TMD criteria based on Helkimo Di except range of mandibular movement were significantly more common in menopausal women. The range of mandibular movement was not significantly different between menopausal and non-menopausal women (P=0.178). Conclusion: The results from this study show that TMD can be considered more common and severe in menopausal than non-menopausal women. This finding indicates that, similar to other conditions in menopausal women such as arthritis and osteoporosis, TMD should be taken into consideration by dental and medical professionals.
The purpose of this paper was to investigate the significance of splinted and non-splinted implant-supported restorations with an internal connection for multiple consecutively missing teeth. Upon examination of the effects of fixture-abutment connection, the distribution of occlusal load was favorable in splinted implant-prosthesis with an external connection, but effect of strain distribution was not significant in splinted implant-prosthesis with an internal connection. In splinted implant-prostheses for short implants, strain distribution was not affected by the method of retention. For cement-retained prostheses, the effect of strain distribution due to splinting was not significant. In clinical studies, non-splinted prostheses with an internal connection for multiple consecutively missing teeth showed high survival rate, mild marginal bone loss, and stable periodontal condition. However, failure to achieve optimal proximal contact between single-unit prostheses may lead to food impaction, and veneer fracture may be inevitable when the framework provides inadequate support in the proximal region. In conclusion, splinted implant-prosthesis is not an indication in all cases, and clinical consideration of its use should be based on the patient's oral condition, such as location and number of implants, formation of proximal contact, canine guidance, existence of parafunctional habit, and oral hygiene, when multiple consecutively missing teeth are replaced by internal connection type implant.
Obstructive sleep apnea (OSA) is a common sleep-breathing disorder associated with significant comorbidities and perioperative complications. This narrative review is aimed at comprehensively overviewing preoperative risk evaluation and perioperative management strategies for patients with OSA. OSA is characterized by recurrent episodes of upper airway obstruction during sleep leading to hypoxemia and arousal. Anatomical features, such as upper airway narrowing and obesity, contribute to the development of OSA. OSA can be diagnosed based on polysomnography findings, and positive airway pressure therapy is the mainstay of treatment. However, alternative therapies, such as oral appliances or upper airway surgery, can be considered for patients with intolerance. Patients with OSA face perioperative challenges due to difficult airway management, comorbidities, and effects of sedatives and analgesics. Anatomical changes, reduced upper airway muscle tone, and obesity increase the risks of airway obstruction, and difficulties in intubation and mask ventilation. OSA-related comorbidities, such as cardiovascular and respiratory disorders, further increase perioperative risks. Sedatives and opioids can exacerbate respiratory depression and compromise airway patency. Therefore, careful consideration of alternative pain management options is necessary. Although the association between OSA and postoperative mortality remains controversial, concerns exist regarding adverse outcomes in patients with OSA. Understanding the pathophysiology of OSA, implementing appropriate preoperative evaluations, and tailoring perioperative management strategies are vital to ensure patient safety and optimize surgical outcomes.
The prevalence of intrabony defects in patients with advanced periodontitis stages III and IV is high. These patients usually need both periodontal treatment and orthodontic therapy, including tooth movement through bone defects, to improve masticatory function, aesthetics, and overall quality of life. Clinical practice guidelines recommend periodontal regenerative surgical interventions to resolve these defects and propose initiating orthodontic tooth movement (OTM) once periodontal therapy goals have been met. Surgical interventions using various regenerative technologies like barrier membranes and enamel matrix proteins, combined or not with bone replacement grafts, have proven effective in regenerating lost periodontal tissues. However, the combination of periodontal and orthodontic treatments requires consideration of how periodontal regenerative therapies influence OTM. Studies suggest that regenerated bone may differ in density, composition, vascularity, and cellular activity, potentially affecting the speed and efficiency of OTM, and potential root resorption of moved teeth. Understanding the sequence and timing of implementing OTM after regenerative periodontal interventions is crucial due to their interlinked processes of bone resorption and formation. This narrative review aims to uncover scientific evidence regarding these combined treatments, examining the impacts of different regenerative technologies on OTM and delineating their advantages, limitations, and best practices.
The purpose of this study was to examine the awareness of dental patients using dental institutions about dental hygienists in an effort to help educate dental hygiene students to have the right image of dental hygienists. And it's also meant to provide education for dental hygienists to develop their own capabilities, attitude and values to render quality medical services to patients. The subjects in this study were the patients who visited dental clinics and hospitals to receive treatment. A self- administered survey was conducted from March 5 to April 13, 2010, in consideration of their general characteristics. The answer sheets from 204 respondents were gathered, and 197 answer sheets were analyzed except seven incomplete ones. A factor analysis was carried out to find out their general characteristics, and independent-samples t-test and one-way ANOVA were utilized to get statistical data on mean and standard deviation. A SPSS 12.0 program was employed to analyze all the collected data. And it's found that the largest number of the patients thought that the main duty of dental hygienists was to give treatment to patients, and they took a favorable view of their services. They weren't well aware of the process of nurturing dental hygienists and their curriculum, and they put a relatively strong confidence in their treatment and had relatively favorable experiences with them.
Journal of the Korea Academia-Industrial cooperation Society
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v.15
no.4
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pp.2150-2159
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2014
This study was designed to investigate the status of orthodontic treatment and facial plastic surgery among 389 patients who visited dental clinics located in Seoul and Gyeonggi Province. After the collection of data, an analysis was carried out using a spss statistical program. The analysis results are as follows. the level of satisfaction with orthodontic treatment from patients with experience of the orthodontic treatment turned out to be high(p<0.01). Women considered 3.01 to 4 million won to be reasonable cost for orthodontic treatment (p<0.05), which is higher cost recognized by men, and patients with experience of orthodontic treatment recognized 19 to 24 months as the proper orthodontic treatment period(p<0.01). In addition, women showed higher figures than men in their awareness on the need for orthodontic treatment checkups(p<0.001), and facial plastic surgery experience (p<0.01). With respect to the part of the face on which they hoped to have plastic surgery, eye plastic surgery was higher in women (p<0.01), and nose surgery turned out to be higher in patients with experience of orthodontic treatment(p<0.05). Meanwhile, women considered the eye as the most important part among other facial areas (p<0.001), and they recognized that dentist should perform plastic surgery on both jaws among facial areas(p<0.01). In conclusion, the dental medical staff should provide consultations and operate treatment systems in consideration of gender differences and needs of dental patients. In the case of orthodontic treatment for the improvement of facial appearance, especially double jaw surgery which is closely related to the oral function, professional dental medical staff needs to perform the operation, considering the special oral environment. In addition, it is determined that provision of relevant medical information and promotion of dental service is required to provide patients with correct knowledge about orthodontic treatment and facial plastic surgery.
Objectives : This study aimed to determine self-esteem and oral health impact profile (OHIP) of orthodontic patients to get data necessary for the process of consultation, education, and treatment for those patients who hoped to get orthodontic therapy in order to see effects of orthodontic therapy on personal life in consideration of general characteristics of those patients under orthodontic therapy. methods : A self-administered questionnaire was used among 232 outpatients under orthodontic therapy from October to November 2009, obtaining the following results. Results : 1. As for general characteristics of respondents, those under 19 years of age constituted 46.6%; the unmarried comprised 85.8%; and students constituted 53.4%. 2. Most respondents were getting orthodontic therapy for beauty (41.8%) and dental health (40.5%). Family (54.3%) contributed to their decision to get orthodontic therapy; parents or siblings (62.5%) were bearing the treatment expenses. 3. Females were getting orthodontic therapy for an aesthetic purpose (50.3%), and male for the purpose of dental health (44.6%) (P<0.01). 4. OHIP was slightly higher among males ($4.10{\pm}0.61$) than among female ($4.00{\pm}0.78$), and was highest among those 19 years old and under ($4.17{\pm}0.67$); the older they were, the lower it was significantly (P<0.05). Most of them were earning 3 to 4 million won ($4.22{\pm}0.72$); the married ($4.05{\pm}0.74$) constituted higher percentage. As for occupation, students ($4.13{\pm}0.66$) comprised the highest percentage. 5. Self-esteem was higher among males ($3.83{\pm}0.47$) than among females ($3.80{\pm}0.50$), and was highest among those 25 to 29 years old ($3.92{\pm}0.46$). Most of them were earning more than 5 million won ($3.91{\pm}0.42$), which was statistically significant (P<0.01). The married ($3.91{\pm}0.54$) constituted higher percentage than the unmarried ($3.80{\pm}0.48$); office managers ($3.95{\pm}0.55$) comprised the highest percentage. 6. As for correlation between variables effecting OHIP of orthodontic patients, there was negative correlation in age (r=-0.225) and positive correlation in occupation (r=0.122). As for correlation between variables effecting self-esteem of orthodontic patients, there was negative correlation in occupation (r=-0.130) and positive correlation n income (0.126), while there was positive correlation (r=0.202) between OHIP and self-esteem of orthodontic patients. Conclusions : Younger orthodontic patients who were students showed higher OHIP, and professionals earning more showed higher self-esteem. Orthodontic patients with higher OHIP showed higher self-esteem. Therefore, it is necessary to develop a program based on OHIP and self-esteem in consulting and treating orthodontic patients; since it is considered that orthodontic therapy will improve appearance, enhance self-confidence, and have positive effects on interpersonal relationships and quality of living, researches are necessary on constant changes in psychological properties.
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