• The Journal of Korea Assosiation for Disability and Oral Health
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• v.3 no.2
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• pp.80-86
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• 2007

A critical pathway (CP) defines the optimal care process, sequencing and timing of intervention by multi-disciplinary health care teams for a particular diagnosis and procedure. It plays an important role as a cost-effective health care delivery system and a tool for quality control of medical and dental services by means of standardizing medical practices. The aim of this study is to investigate the satisfaction of patients and medical/dental staff after implementation of a critical pathway for dental treatment of disabled children under general anesthesia and its cost effectiveness. Ten patients who underwent dental treatment under general anesthesia were included in the CP group between August and December 2006. The pre-CP group included 20 patients who underwent the same procedure from February 2003. The satisfaction of parent of child patient and medical staff members were compared between two groups. The parents' satisfaction was significantly improved after the implementation of CP and medical/dental staff members were highly satisfied with the usefulness of the critical pathway. In conclusion, the critical pathway for the dental treatment of disabled treatment under general anesthesia can highly improve the satisfaction of parents and medical/ dental staff members.

• Journal of Korean Dental Science
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• v.12 no.2
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• pp.58-65
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• 2019

Purpose: This study was aimed to investigate the possibility of utilizing smart device-based test (SBT) for competency evaluation in dental education and to analyze the student responses on overall competency evaluation using SBT method, in comparison to ubiquitous-based test (UBT). Materials and Methods: Questionnaire surveys have been conducted at Yonsei University College of Dentistry from 2015 to 2018 to obtain students' feedback on the application of SBT to competency evaluation. In addition, in order to supplement the competency evaluation procedure, considerations were explored by comparing the expected and actual difficulty of each item when preparing items for competency evaluation with SBT. Result: According to the survey results, student responses between the initial two years (2015 and 2016) differed from those in next two years (2017 and 2018). Students in 2017 and 2018 had more positive responses on competency evaluation with SBT. To determine the test validity, criterion-referenced evaluation was adopted to compare the data in 2017 and 2018 and slight differences in test difficulty in 2018 between the expected and actual difficulty of items were found. Conclusion: The results indicated that SBT was more appropriate for competency evaluation than UBT, based on four-year period of competency evaluation. The SBT was not affected by either the file size or the number of test-takers. Interestingly, students were not sensitive to test version of competency evaluation (paper-based test and SBT). This study suggests that the quality of the test items should be measured by continuous monitoring of the expected and actual difficulty of items for determining test validity. More detailed results and discussions of the findings are given for the development of test procedure and further potential research directions in dental education.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.2
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• pp.83-87
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• 2020

Foreign body (FB) ingestion is commonly seen in the ear nose and throat (ENT) field, with different presentations and sequelae. FBs can arrest in the upper aerodigestive tract or continue further down into either the airway tract to the bronchus or the digestive tract to the intestines. The pathway of an FB depends on the size and shape of the FB and how sharp its edges are. Since the 20th century, the use of disposable stainless-steel needles in the oral cavity has proven to be an effective and safe method for performing various intraoral procedures like dental infiltration or a root canal wash. Complications from their use are rare. Generally, dental needle breakages are caused by patients biting the needle, incorrect injection techniques, or inadequate preventative measures. The sudden movement of a patient during a procedure is one of the most common causes of breakage. Occasionally, needles are swallowed during dental procedures such as a root canal. Here, we report a case of a patient that swallowed a broken needle during a dental procedure. A few days later, the patient presented with neck pain, swelling, and a FB sensation. When the patient presented, she claimed that her symptoms had onset after consuming a meal containing duck meat. Initially, the patient was diagnosed as having ingested a duck bone. However, intraoperatively, the FB was discovered to be an injection needle that had migrated from the throat to the neck.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.3
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• pp.277-290
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• 2012

Dental implants are universal restorative method on edentulous site in oral cavity and generally recognized by patients as well as clinicians. Rapid bone resorption of labial portion of maxillary anterior area is performed due to dental trauma, chronic periodontitis, and so on. Accordingly, Implants on maxillary anterior alveolar ridge with narrow labiopalatal width would lead to bony defects of dehiscence or fenestration. In this case, guided bone regeneration procedure is used to augment maxillary anterior alveolar ridge. It can have mechanical and biological advantages to mix tissue adhesive with bone graft materials in guided bone regeneration procedure. In these cases, when the dehiscence or fenestration defects was occurred by dental implants on maxillary anterior alveolar ridge with narrow labiopalatal width, guided bone regeneration procedures were performed with various combination of particle bone graft materials(allograft, xenograft, and alloplast) mixed with fibrin glue, excepting autogerous bone. We reported that all of 4 cases showed favorable alveolar ridge augmentations.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.3
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• pp.199-204
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• 2017

Background: Anxiety control remains an important concern in dental practice. We evaluated the incidence, nature, and sequelae of complications during and after minor oral surgeries performed under intravenous midazolam and fentanyl sedation using the titration technique. Method: The medical records of patients who had undergone minor oral surgeries under moderate intravenous midazolam and fentanyl sedation at our institution between January 1, 2015 and December 31, 2015 were retrospectively evaluated. Age, sex, body mass index, medical history, American Society of Anesthesiologists (ASA) classification, indications for sedation, amount of sedative used, surgical duration, and recovery time were evaluated for all patients. Results: In total, 107 patients aged 9-84 years were included. ASA class I and class II were observed for 56.1% and 43.9% patients, respectively. Complications associated with sedation occurred in 11 (10.2%) patients. There were no serious adverse events. Oxygen saturation reached 95% during the procedure in six patients; this was successfully managed by stimulating the patients to take a deep breath. Two patients exhibited deep sedation and one exhibited paradoxical excitement. After the procedure, one patient experienced nausea without vomiting and one exhibited a prolonged recovery time. The surgical procedures were completed in all patients. Obesity was found to be significantly associated with sedation-related complications. Conclusion: Our results suggest that complications associated with intravenous midazolam and fentanyl sedation using the titration technique for minor oral surgeries are mostly minor and can be successfully managed with no prolonged sequelae.

• The Journal of Advanced Prosthodontics
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• v.3 no.2
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• pp.101-105
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• 2011

Maxillofacial prosthodontics is an art and science which provides life like appearance to the person with facial deformity. Maxillofacial prosthetic rehabilitation for acquired defects has become more complex and sophisticated with advancement in techniques and materials. This case report describes the clinical and laboratory procedure for fabricating an auricular prosthesis for a patient with trauma related bilateral auricular deformity. Ear prosthesis was fabricated in two parts taking retention from external auditory canal.

• The Journal of the Korean dental association
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• v.37 no.7 s.362
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• pp.530-535
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• 1999

Detailed finishing of the occlusion is a clinical skill that has become difficult with the development of fixed appliances. Accuracy of bracket placement definitely improves with indirect technique, Several methods for the placement of orthodontic brackets on dental casts are currently used in the indirect bonding technique. These include attachment by means of bonding resins, adhesive tapes or sticky wax. This article presents the indirect procedures of our clinic, which use paste-paste chemically cured composites. Detailed laboratory and clinical procedure for dual tray method and other application of indirect bonding will be presented.

• The Journal of the Korean dental association
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• v.49 no.11
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• pp.670-678
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• 2011

Various sorts of dental devices for the dental treatment have been introduced and adopted during past several years. Dental Laser, among all devices, seems to be possible for applying to over the whole treatments and widely employed. Furthermore, this article is to introduce that Dental Laser is intended to care patients secured with the effectual treatment against Conventional procedures based upon its studies. The advantages of Dental Laser treatment-along with LLLT (Low Level Laser Therapy) effect, biostimulation effect, and minimal invasive technique - make the patients reduce their fear of the operation, lighten the inconvenience of post operation, and shorten the treatment period. In particular, it is worth considering that the use of laser-assisted therapies is associated with a marked reduction in the use of analgesics and anti-inflammatory medications compared with conventional procedures. This article is to state advantages and differences of Dental Laser treatment compared with Conventional procedures, and to emphasize to become well-acquainted with the precautions for safety and effective Dental Laser treatment. In case of operating Dental Laser with lack of the instructions, it will cause the unpredicted fatal results; therefore this treatment requires special care in its operation. Henceforward, it is anticipated that infinite treatment protocols will be introduced by applying Dental Laser, and this is to address the utilization of Dental Laser.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.70-73
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• 2019

Congenital panhypopituitarism is an uncommon condition, present from birth, characterized by the decreased secretion of most of the hormones produced by the pituitary. The purpose of this case report is to present a case about caries treatment of a 26-month-old female patient with congenital panhypopituitarism under general anesthesia. A 26-month-old girl with congenital panhypopituitarism visited Seoul National University Dental Hospital for caries treatment of anterior primary teeth. Because of the child's age and underlying systemic disease, dental treatment under general anesthesia was considered. Prior to the dental procedure, 30mg of cortisol was administered intravenously in order to prevent possible adrenal crisis by stressful events. The dental procedure was successfully performed under general anesthesia. This case report suggests that general anesthesia may be useful for the dental treatment with congenital panhypopituitarism. Hormone deficiency should be assessed prior to dental procedure and, if necessary, stress hormone replacement therapy should be considered.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.6
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• pp.407-414
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• 2017

Objectives: The study was designed to evaluate the efficacy of performing a second, repeat anterior maxillary distraction (AMD) to treat residual cleft maxillary hypoplasia. Materials and Methods: Five patients between the ages of 12 to 15 years with a history of AMD and with residual cleft maxillary hypoplasia were included in the study. Inclusion was irrespective of gender, type of cleft lip and palate, and the amount of advancement needed. Repeat AMD was executed in these patients 4 to 5 years after the primary AMD procedure to correct the cleft maxillary hypoplasia that had developed since the initial procedure. Orthopantomogram (OPG) and lateral cephalograms were taken for evaluation preoperatively, immediately after distraction, after consolidation, and one year postoperatively. The data obtained was tabulated and a Mann Whitney U-test was used for statistical comparisons. Results: At the time of presentation, a residual maxillary hypoplasia was observed with a well maintained distraction gap on the OPG which ruled out the occurrence of a relapse. Favorable movement of the segments without any resistance was seen in all patients. Mean maxillary advancement of 10.56 mm was achieved at repeat AMD. Statistically significant increases in midfacial length, SNA angle, and nasion perpendicular to point A distance was achieved (P=0.012, P=0.011, and P=0.012, respectively). Good profile was achieved for all patients. Minimal transient complications, for example anterior open bite and bleeding episodes, were managed. Conclusion: Addressing the problem of cleft maxillary hypoplasia at an early age (12-15 years) is beneficial for the child. Residual hypoplasia may develop in some patients, which may require additional corrective procedures. The results of our study show that AMD can be repeated when residual deformity develops with the previous procedure having no negative impact on the results of the repeat procedure.