• Journal of Dental Anesthesia and Pain Medicine
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• 제22권6호
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• pp.457-464
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• 2022

Tracheostomy is a surgical procedure that is commonly used to treat upper airway obstruction. In particular, patients with head and neck cancer may require elective or emergency tracheostomy because of airway obstruction due to massive bleeding of the intraoral tumor mass and rapid growth of the tumor mass in the neck area. Here, we report four cases of tracheostomy in patients with head and neck cancer with narrowed airway space and difficulty in breathing. Based on these cases and a literature review, we recommend that oral and maxillofacial surgeons and dental anesthesiologists should cooperate closely and determine the appropriate timing to perform definitive airway management for such patients during palliative treatment, along with continuous evaluation of tumor location, risk of recurrence, and airway involvement.

• 한국치위생학회지
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• 제19권6호
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• pp.875-890
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• 2019

Objectives: This study aims to establish the concept of "dental assistance" within the dental field and to identify the scope of dental assistance, which can be utilized in order to distinguish the scope of work between jobs. Methods: The literature on dental hygienist work and dental assistance was reviewed, and the laws and precedents related to dental assistance were examined. Results: The criteria for judging the legitimacy of dental assistance included the following: whether the performance was conducted under the guidance and supervision of a doctor; whether there was a possibility of an aftereffect or side effects of the procedure; whether education was conducted within the curriculum; and whether it was evaluated in the national licensing examination. In addition, the work of the assistant in dental surgery and treatment is judged comprehensively by considering the type of dental surgery and treatment, invasive degree, necessity of expertise, and work proficiency of the dental hygienist. Therefore, it is suggested that dental hygienists may be of assistance for dental treatment/surgery because they meet the requirements of dental professionals, such as dental hygiene curriculum, national licensing examination, duties in the field of dentistry, and work proficiency. Conclusions: Dental assistance (including assistance in dental surgery) for dental treatment, dental/medical history taking, taking vital signs, and blood glucose monitoring should be permitted within the realm of dental hygienist work. Therefore, the actual expertise of dental hygienists should be reflected legally and the work of dental hygienists should be realized.

• 대한치과마취과학회지
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• 제12권4호
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• pp.235-241
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• 2012

Although sevoflurane sedation have the advantage of the reduction of anxiety and pain relief, difficult airway is attributed to increased agitation, tachycardia, desaturation, ventilation difficulty, sedation failure. In the sedation for dental treatment, we should pay more attention to the airway management because dental procedures take place in the mouth of airway unlike any other area. The layngeal mask airway (LMA) has become commonly used device for airway management during anesthesia for relatively short procedures, such as minor oral surgery and dental procedures. It can be inserted without use of a larygoscope and muscle relexants, and insertion is easy to achieve and generally takes less time than endotracheal intubation. The LMA is an excellent barrier against aspiration of saliva, blood within the surgical field but should not be used in patients at risk of aspiration In this study, we reported that after a failure of airway management in inhalation sedation, we performed the short-emergency dental treatment successfully, using a laryngeal mask.

• 대한소아치과학회지
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• 제42권3호
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• pp.226-232
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• 2015

소아 청소년치과에서 장애아동 및 청소년을 안전하고 효율적으로 치료하기 위해서는 여러 사람의 다양한 협조가 필요하다. 이 연구는 장애아동의 치과치료 시 자주 이용되는 의식하진정치료의 진료용 표준지침을 시범적으로 개발, 적용하고, 진료과정에 참여한 사람들의 만족도를 평가하기 위해 시행되었다. 의무기록 분석을 통하여 표준진료지침을 개발하고 치료과정에 적용한 후 환자, 보호자, 의료진 및 스탭의 만족도를 설문을 통하여 평가한 결과, 표준진료지침의 적용은 환자, 보호자 및 의료진과 보조자가 전반적으로 만족한 것으로 나타나 임상적 유용성이 높을 가능성을 암시하였다. 결론적으로 표준진료지침의 개발과 적용은 임상진료과정의 표준화를 통하여 진료에 대한 예측가능성을 높이고, 환자 안전에 대한 불안을 감소시켜 환자와 의료진의 만족도 향상과 진료의 질적 향상을 기대 할 수 있을 것이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권5호
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• pp.232-239
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• 2015

Objectives: The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated. Materials and Methods: Ninety-five patients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric stability was evaluated by serial CBCT images. Results: No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was $74.6%{\pm}8.4%$. Conclusion: Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want dental implants regardless of atrophic alveolar bone.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권1호
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• pp.47-56
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• 2018

Background: The purpose of this study is to investigate the effects of administration order when a sedative drug (midazolam) and an opioid analgesic drug (fentanyl) is applied for moderate intravenous (IV) sedation in dentistry. Methods: A retrospective chart review was conducted in one dental clinic during its transition from a midazolam-first to a fentanyl-first protocol for dental procedures requiring moderate IV sedation. Physiological parameters, drug administration times, patient recovery times, drug dosages, and patient recall and satisfaction were investigated for differences. Results: A total of 76 charts (40 midazolam-first and 36 fentanyl-first administrations), were used in the analysis. Administering midazolam first resulted in an average 4.38 min (52%) decrease in administration times (P < 0.001), and a decrease in procedural recollection immediately following the procedure (P = 0.03), and 24 to 48 hours later (P = 0.009). Administering fentanyl first required an average of 2.43 mg (29%) less midazolam (P < 0.001). No significant differences were found for change in vital signs, minimum oxygen saturation levels, recovery times, and patient satisfaction (P > 0.05). Oxygen saturation levels did not drop below 90% for either group; however, 5 cases in the fentanyl-first group fell to between 90% and 92%, compared with 0 cases in the midazolam-first group. Conclusions: The administration order of fentanyl and midazolam may have different effects on patients and the sedation procedure. Findings from this study should be used to facilitate discussion among dental practitioners and to guide additional research investigating this topic.

• 대한치과보철학회지
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• 제45권3호
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• pp.389-400
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• 2007

Statement of problem. Use of the conventional dental impression procedure is problematic in patients who have difficulty opening their mouth, difficulty breathing through their nose or tendency to gag. Purpose. It is necessary to make individual trays more comfortable for patients during impression taking procedure. It was reported at the KAP Annual Meeting 2001 Seoul that an improved impression technique was suitable for this purpose. In this study, the accuracy of the improved dental impression method for implant was compared with the conventional dental impression method. Material and methods. An oral simulator was made from clear acrylic resin block which had similar form of edentulous ridge. For setting up the standard, five fixtures were installed on it. Study casts were made using two kinds of impression techniques. One was the conventional method that was taken using silicone impression material and an individual resin tray under connection of inter-fixture relation. The other was the improved method in which was the connection of the impression coping and the thermoformed polymethyl methacrylate tray. In addition, two different study casts were made from the improved impression body. The coordinates of the fixture on the study model were measured by three-dimensional coordinate measuring equipment. Then the distances between each fixture were calculated and compared with that of oral simulator. Accuracy of the each impression method was also assessed. Results. The differences of inter-fixture dimension between study casts and simulator in the improved impression technique showed $0.014{\pm}0.016mm$ and $0.017{\pm}0.022mm$, respectively and that of the conventional method was $0.017{\pm}0.014mm$. There was no significant difference between the improved impression technique and conventional method. Conclusion. The improved impression technique is useful for multiple support implants.

• 구강회복응용과학지
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• 제36권4호
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• pp.262-271
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• 2020

변연골 하방으로까지 파절선이 연장된 치아를 수복하기 위해 파절선의 노출 및 생물학적 폭경의 재확립을 위한 삭제형 골수술을 동반한 외과적 치관 연장술을 고려해 볼 수 있다. 그러나 이 술식은 특히 전치부에서 심미성을 훼손시킬 수 있다. 따라서 지지골과 치은을 희생시키지 않으면서 파절선을 치조와 하방에서 상방으로 위치 시킬 수 있는 교정적 정출술이 권장된다. 이 술식은 생물학적 폭경의 재확립과 더불어 수복물을 건전한 치아 구조에 위치할 수 있도록 해 준다. 또 다른 대안으로, 교정적 정출술 보다 방법이 간단하며 시간이 적게 소요되고 한번의 술식만으로 정출이 완료되는 외과적 정출술도 고려해 볼 수 있다. 외과적 정출술을 이용할 경우 구강내 교정 장치를 위치시키고 조정하기 위해 환자가 치과에 여러번 방문할 필요가 없다. 본 연구에서는 상악 중절치에서 치관-치근 파절이 발생한 경우 교정적 정출술 또는 외과적 정출술을 통한 다각적 방법을 병용함으로써 성공적으로 수복한 증례를 보고하고자 한다.

• 한국치위생학회지
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• 제16권5호
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• pp.759-766
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• 2016

Objectives: The purpose of the study was to investigate the impact of dental fear on the oral health related quality of life in teenagers. Methods: A self-reported questionnaire by Likert 5 point scale was completed by 900 high school students in J area from March 10 to April 20, 2014. The questionnaire consisted of general characteristics of the subjects, dental fear survey, and oral health related quality of life. Data were analyzed by t-test and One-way ANOVA using SPSS 12.0 program. Results: Oral symptoms had no significant differences in mother's education and family economic status. Emotional well-being factors had no significant difference in age, religion, school performance, and family economic strength. Dental fear was closely related to emotional well-being, Oral symptoms, social stabilities, functional limit and mental stabilities. Explanation power of the model was 29.1%. Conclusions: It is very important to explain the dental fear procedure to teenagrers before dental surgery and this will enhance the oral health related quality of life in teenagers.

• 대한치과마취과학회지
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• 제12권1호
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• pp.11-16
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• 2012

Background: The purpose of this study was to evaluate the safety and effectiveness of intravenous ketamine-midazolam sedation in uncooperative children and disabled people undergoing dental procedures. Methods: From September 2009 to January 2012, total 114 intravenous deep sedation were carried out using midazolam and ketamine at pediatric dentistry in Wonkwang University Daejeon Dental Hospital. Patients' dental charts and sedation records were retrospectively reviewed. Results: 103 cases were enrolled, divided into four groups. There were 22 children under five in group 1, 14 children over six years with severe anxiety in group 2, 34 disabled person in group 3 and 33 children over six years with surgical procedure in group 4. Carries treatment (56 cases) was the most common dental treatment. The highest ketamine usage was 4.15 mg/kg, the longest duration of dental treatment was 41.6 minutes in children under five group. Nausea and vomiting (16 cases) was the most common side effect. Conclusions: Intravenous ketamine-midazolam sedation appears safe and effective for uncooperative children and disabled person undergoing dental procedures. But, emesis is a common side effect of ketamine occurring with increasing age.