• Title/Summary/Keyword: Dental procedure

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A retrospective analysis of outpatient anesthesia management for dental treatment of patients with severe Alzheimer's disease

  • So, Eunsun;Kim, Hyun Jeong;Karm, Myong-Hwan;Seo, Kwang-Suk;Chang, Juhea;Lee, Joo Hyung
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.4
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    • pp.271-280
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    • 2017
  • Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

Analysis of Factors affecting the Patient's Service Satisfaction in Kimhae Dental Hospital (김해 치과 의료기관의 치과진료 만족도 요인분석)

  • Seong, Mi Gyung;Park, Jeong Hee;Jang, Kyeung Ae;Choi, Jung Ok
    • Journal of dental hygiene science
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    • v.8 no.4
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    • pp.215-224
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    • 2008
  • In order to meet the medical demand according to the changing medical environment and to provide patients with quality dental treatment and improve treating environment by establishing reasonable management plan, with 149 patients for whom continuous dental health program has been applied, the degree of satisfaction with the dental treatment, and the influence factors on the satisfaction were investigated. Using the SPSS Ver. 13.0, mean value analysis were performed on the satisfactions with dental care service and the quality of dental care service according to general characteristics, and regression analysis were performed on the influence of general characteristics and the degree of satisfaction with dental care service on the satisfaction of dental treatment. The result of the multiple regression analysis revealed the human (staff), environment, and the procedure of treatment as the influence factors of the satisfaction with dental treatment. Systematic management and training should be implemented to improve the quality of dental care service and enhance the satisfaction.

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Premedication of Oral Midazolam for Smooth Anesthesia Induction of Uncooperative Patients (협조에 어려움을 보이는 장애인 환자에서 전신마취 전 경구 Midazolam 전투약의 효과 분석)

  • Lee, Brian Seong-Hwa;Seo, Kwang-Suk;Shin, Teo-Jeon;Kim, Hyun-Jeong;Han, Hyo-Jo;Chang, Ju-Hea
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.2
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    • pp.125-132
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    • 2011
  • Background: Adult patients with intellectual disabilities often strongly resist the anesthetic administration for dental procedures. This study aimed to evaluate the effect of midazolam premedication in improving the cooperation level of patients who are likely to be combative and irritated during general anesthesia (GA) induction. Methods: The patients who had received dental treatment under ambulatory GA for more than two times were included. And we selected 13 patients total that needed physical restraint or ketamine IM prior to induction at the first GA, and were prescribed midazolam tablet (7.5-15 mg) at the following GA. We reviewed pre-anesthetic records and anesthesia records, and evaluated cooperative levels of patients (4 levels scale) during anesthesia induction and recovery time retrospectively. Results: All 13 patients (Male 11, Female 2) had severe mental disabilities. The average age of the patients was 24 ${\pm}$ 7 (13-37) years and their average weight was 58 ${\pm}$ 16 (34-91) kg. At the first GA, 10 patients needed physical restraint prior to induction (level 3). And 3 patients were so poorly cooperative that the induction procedure was performed after intramuscular injection of ketamine (level 4). But after the midazolam intake, 7 patients were willing to receive the anesthetic induction (level 1, 2), and 6 patient needed physical restraint (P < 0.05). There were no statistical differences in the duration of general anesthesia and postoperative recovery. Conclusions: Oral intake of midazolam was effective in improvement of cooperation without any complications.

TREATMENT OF THE CHILD WITH LOWE SYNDROME UNDER GENERAL ANESTHESIA: A CASE REPORT (Lowe 증후군 환아의 전신마취를 이용한 치료증례보고)

  • Chang, Woo-Hyuck;Lee, Keung-Ho;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.2
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    • pp.237-242
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    • 2002
  • Lowe syndrome, also known as oculocerebrorenal syndrome, is a rare genetic disorder involving eyes, kidney and nervous system, and occurs predominantly in mostly males. The patients with Lowe syndrome are characterized with prominent forehead, thin and sparse hair, protruding ears, congenital cataracts, glaucoma, mental retardation, stunted growth, hypotonia, decrease in muscle mass and tendon reflexes, renal tubular dysfunction, and metabolic bone disease. A 6-year-old boy with Lowe syndrome was admitted to our clinic, with multiple caries and a chief complaint of intermittent pain on the left mandibular molar area. Because of difficulty in management of behavior and his medical problem, general anesthesia was performed for dental care. No specific complication was noticed during dental treatment procedure under general anesthesia and also during periodic recall-checks. General anesthesia itself, however, could be a potentially life-threatening procedure due to patient's biomedical problems. When a dental procedure under general anesthesia is to be required in patient with Lowe syndrome, it may be advisable being teamed with physicians, and general anesthesia duration should be as short as possible.

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Orbicularis oris muscle reconstruction and cheiloplasty with Z-plasty in a patient with a transverse facial cleft

  • Koh, Sung-Hyuk;Jeong, Yeon-Woo;Han, Jeong Joon;Jung, Seunggon;Kook, Min-Suk;Oh, Hee-Kyun;Park, Hong-Ju
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.55.1-55.7
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    • 2019
  • Background: Transverse facial clefts are Tessier's number 7 facial cleft among numbers 1-15 in Tessier's classification of craniofacial malformations, which varies from a simple widening oral commissure to a complete fissure extending towards the external ear. Case presentation: In a patient with a transverse facial cleft, to functionally arrange the orbicularis oris muscle and form the oral commissure naturally, we performed a surgical procedure including orbicularis oris muscle reconstruction and cheiloplasty with Z-plasty. Conclusion: We achieved good results functionally and esthetically by orbicularis oris muscle reconstruction and cheiloplasty with Z-plasty. The surgical modality of our anatomical repair and 3 months follow-up results are presented.

Pre-emptive analgesia efficacy of piroxicam versus tramadol in oral surgery

  • Tejdeep, Muthuluri;Siddardha Gowtam, Chandrupatla;Ritesh, Rajan;Viveka V., Reddy;Dinesh K., Jhawar;Abhinand, Potturi
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.6
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    • pp.443-450
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    • 2022
  • Background: This double-blind randomized controlled trial (RCT) was conducted to evaluate the pre-emptive analgesia and anti-inflammatory efficacy of piroxicam compared with tramadol in patients undergoing oral surgery. Methods: Seventy-eight patients who required extraction of impacted mandibular third molars were randomized into three treatment groups of 26 patients each: group I received 100 mg of tramadol, group II received 20 mg of piroxicam, and group III received a placebo. Drugs were administered intramuscularly 30 min prior to the extraction procedure. Results: Pain intensity, time to first analgesic administration, total analgesic consumption, facial edema, and trismus were the outcomes of interest. The group receiving 20 mg of piroxicam showed significantly lower pain intensity, increased time to first analgesic, and reduced edema from preoperative to postoperative day seven than those in the tramadol and placebo groups. Conclusion: The findings of this study showed that piroxicam had significant pain relief efficacy after third molar surgery compared with that in tramadol.

Scaling pain and related factors in adults (성인의 스케일링 통증과 관련요인)

  • Jung, Eun-Seo;Joo, Yeon-Jin;Lee, Ga-Young;Choi, Yu-Kyung;Kim, Soo-Kyung
    • Journal of Korean society of Dental Hygiene
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    • v.18 no.1
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    • pp.77-92
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    • 2018
  • Objectives: The purpose of this study was to review depression and anxiety associated with pain during scaling procedures, and to establish measures for reducing scaling pain encompassing not only physical factors but also psychological aspects of patients. This study also attempts to reduce anxiety through proper patient education prior to scaling procedures. Methods: In Seoul, and Gyeonggi area from July 26, 2017 to August 19, 2017, there were 327 copies of questionnaire data collected, excluding 23 questionnaires with insufficient information such as missing entries. The following inductions were made based on data collected. Results: There are positive correlations between pain and depression, dental anxiety, trait anxiety, and state anxiety. Especially, stronger correlation is present between pain and dental anxiety. Depression (${\beta}=0.439$, p<0.001) is the most influential factor associated with pain. Next is dental anxiety (${\beta}=0.292$, p<0.001). Higher the depression and dental anxiety tend to increase pain over scaling procedure. This model is with adjusted explanatory power of 28.2%. Conclusions: The result demonstrates that there is a correlation between scaling pain and depression, dental anxiety, trait anxiety, and state anxiety. Especially, depression and dental anxiety were prominent factors in affecting scaling pain. Therefore, considering aforementioned-findings, a dental hygienist's positive attitude may help in reducing the pain of the patient during scaling procedures, by affecting the psychological state of the patient and reduce the anxiety through proper education prior to scaling procedures.

Corticotomy for Orthodontic Treatment in Adult (Corticotomy를 이용한 성인의 교정 치료)

  • Lee, Choong-Kook;Yang, Sung-Ik;Ryu, Young-Kyu;Son, Byung-Hwa
    • The Journal of the Korean dental association
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    • v.17 no.12 s.127
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    • pp.919-922
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    • 1979
  • Corticotomy is one of the orthognathic surgery for facilitating orthodontic treatment. The indications of the procedure, its planning consideration, surgical methods and the experiences gained in the use of corticotomy completed in the stage operation are presented.

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악하선배세관의 타석증치검례

  • Kim, Gyu-Sik
    • The Journal of the Korean dental association
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    • v.4 no.1
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    • pp.27-30
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    • 1963
  • The author have had a case of salivary stone in the anterior half of Wharton's duct in the left side. 1)The patient was 32-year=old Korean male .2)There was a history of severe pain at mealtime, pus discharging and marked swelling of the left submandibular region.3) The patient was sebmandibular region. 3)The paient was sedated with 100mg .of Seconal and anesthetized with 2% Xylocaine Hydrochloride. The surgical procedure was performed in the usual manner. 4)THhe stone was ellowish-white, single wheat-shaped and 9mm. by 3mm. in size.

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A STUDY OF DUPLICATING OCCLUSAL CONTOUR USING NEGATIVE INDEX (NEGATIVE INDES를 이용한 교합면 복제에 관한 연구)

  • Chang, Wan-Shik
    • The Journal of the Korean dental association
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    • v.19 no.2 s.141
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    • pp.159-162
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    • 1981
  • The author devised a simple technique for duplicating occlusal contour of natural teeth on the prepared abutments using hard stone index obtained from the study cast of natural teeth. Throughout this author devised method, the following advantages are studied. Firstly the dentist can obtain an ideal occlusal wax patterns which have arrived at the physiologic state through a long period of adjustment to various habits and functional movements. Secondly the construction procedure is simple, and thirdly it is easy to adjust wax pattern of nomal natural teeth which duplication is required.

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