• Journal of The Korean Dental Society of Anesthesiology
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• v.7 no.1
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• pp.6-12
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• 2007

배경: 소아 진정 치료 시 서로 다른 용량의 chloral hydrate와 hydroxyzine을 복용 후 midazolam을 구강 점막 하 주사했을 때 행동 반응을 비교하였다. 방법: 총 32회 진정법을 통해 치과치료를 받은 30명의 나이 24-72개월, 체중 20 kg 미만의 미국 마취과학회 신체등급 I의 건강하지만 겁이 많고 협조가 안 되는 소아 환자를 대상으로 2개 치아이상의 보존 치료 및 발치를 필요로 하는 환자를 대상으로 하였다. 호흡기 질환이 있는 아이들은 이 연구에서 제외되었다. 연구 계획은 이대 목동 병원의 임상 실험 심사 위원회에 제출되었다. 1군은 chloral hydrate 50 mg/kg와 hydroxyzine 1 mg/kg 복용 후 점막 하 midazolam 0.2 mg/kg을 추가 투여했고 2군은 chloral hydrate 60 mg/kg와 hydroxyzine 1 mg/kg 복용 후 점막 하 midazolam 0.1 mg/kg을 주사 받았다. 50% nitrous oxide는 치료 중 두 군 모두 유지되었다. 전날 수면 시간과 약물 복용 태도를 기록하였으며 모든 치료 과정은 비디오로 촬영되었다. 맥박 산소 계측기를 이용하여 경피적 산소 포화도와 맥박수를 기록하였고 행동 반응은 Houpt scale을 이용하여 매 2분마다 40분 동안 기록되었다. 전반적인 행동 반응은 Houpt scale를 이용하여 평가되었다. 모든 자료는 SPSS 통계 프로그램을 이용하여 two sample independent t-test를 사용하였다. P 값은 0.05 미만인 경우를 통계학적으로 유의하다고 보았다. 결과: 두 군 간의 경피적 산소 포화도와 맥박수는 모두 정상 범위이며 유의한 차이가 없었다. 행동 반응 비교에서는 치료 처음 10분 동안 2군이 1군에 비해 점수가 높게 나왔으며(P < 0.05), 그 외에는 유의한 차이가 없었다. 전날 총 수면 시간과 약물을 복용하는 태도는 수면 치료 중의 행동 반응에 영향을 주지 않았다. 결론: Chloral hydrate 50 mg/kg 복용과 점막 하 midazolam 0.2 mg/kg은 chloral hydrate 60 mg/kg 복용과 점막 하 midazolam 0.1 mg/kg과 비교할 때 두 약물의 조합은 모두 소아 환자 수면 치료시 안전하고 효과적인 용량이다. Overall behavior와 Q (quiet)의 분포를 비교해 볼 때 두 군 모두 성공적인 진정효과를 기대할 수 있다.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.3
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• pp.352-358
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• 2020

Glanzmann's thrombasthenia (GT) is a rare, autosomal recessive inherited congenital disorder, characterized by impaired blood coagulation due to platelet dysfunction. It was first reported by the pediatrician Glanzmann in 1918. GT affects both males and females, and it is more common in regions of the Middle East, India, and France, where intermarriage is common. It has an incidence of about 1 in 1,000,000 people. In South Korea, according to the Division of Rare Diseases, Korea Centers for Disease Control and Prevention, around 200 cases have been reported in 2018. Clinical symptoms include petechia, ecchymosis, epistaxis, and gingival bleeding. The spontaneous loss of deciduous teeth can result in excessive bleeding with that blood transfusion should be considered. Preventing hemorrhages and hemostasis are most important factors in dental treatment. Local bleeding can be controlled by compression, but platelet transfusion can be required by prolonged bleeding. Pediatric dentists can minimize the gingival bleeding by control of the oral hygiene to prevent gingivitis and dental caries. The importance of oral hygiene and periodic recall check-up should be emphasized. During dental treatment, the examination and the treatment plan of patient should be modified to prevention of hemorrhages carefully. A 6-year-old girl with GT was referred for the treatment of dental caries, and resin restoration was performed under nitrous oxide inhalation sedation. After treatment, compression was required for the bleeding control.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.4
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• pp.348-356
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• 2012

The treatment pattern of pediatric dentistry has been changing recently, because of so many socioeconomic changes such as decrease of birth rates and prevalence of caries. The purpose of this study is to recognize the changing patterns in pediatric dental treatment and to help predict future direction for pediatric dentistry. Patients distribution and treatment pattern were examined in all new patients of the department of pediatric dentistry, Chosun University Dental Hospital and two pediatric local clinics in Gwang-ju, from 2005 to 2010. The number of new patients in recent 5 years has been increasing. There was a higher ratio of male patients. Age distribution has shown the percentage of 3~4 age group was highest. The hospital visit rate to Chosun University Dental Hospital was high, whereas the visit rate for local clinics was low. Dental caries showed the highest percentage in chief complaints, oral examinations have increased. The percentage of restoration treatment was highest, fluoride treatment had increased. In restorative treatment, the percentage of resin and GIC restoration was highest and amalgam restoration has decreased. The percentage of sedation treatment was decreased a little, Chosun University Dental Hospital showed a higher rate than local clinics.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.60-64
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• 2019

Swyer-James syndrome (SJS), also known as Swyer-James-MacLeod syndrome and unilateral hyperlucent lung syndrome, is rare acquired pulmonary disorder develops secondary to infectious etiologies in early childhood. Viral respiratory infection such as adenoviruses or Mycoplasma pneumoniae in infancy or early childhood rarely cause Swyer-James syndrome. It is generally characterized on radiographs by a unilateral small lung with hyperlucency and air trapping on expiration. In many cases unaffected lung tissue functions normally, compensating for affected lung portion. Preoperative assessment is needed to determinate individual's pulmonary function. A 4-year-old boy with Swyer-James syndrome visited Seoul National University Dental Hospital Department of pediatric dentistry for caries treatment. Clinical and radiographic examinations revealed multiple carious lesions on deciduous teeth. Considering patient's underling disease, age, and level of cooperation, dental treatment under general anesthesia was scheduled. Dental treatment was done with composite resin and stainless-steel crown. Since ventilation of Swyer-James syndrome patients was diminished because of airway obstruction, close monitoring of ventilation is necessary during dental treatment. Considering pulmonary pathology, general anesthesia rather than sedation is recommended when special behavior management is required for dental treatment. Swyer-James syndrome patients can tolerate general anesthesia and surgery well, according to several reports.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.2
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• pp.228-234
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• 2017

Hydrocephalus is a condition in which the volume of cerebrospinal fluid in the cerebral ventricles is abnormally elevated. Hydrocephalus patients may show macrocephaly and delayed development. Ventriculoperitoneal shunt is the most commonly used treatment but ventriculoatrial shunt is another treatment option. This report discusses the dental management process employed for a 7-year, 6-month old patient with ventriculoperitoneal shunt-treated hydrocephalus. This patient showed dental caries on the deciduous molars, facial swelling, macrocephaly and delayed development. Pulpectomy was performed on the deciduous molars under nitrous oxide sedation and mild protective stabilization. This patient did not appear to have any specific complications until the latest follow-up and was scheduled for the management of overall oral hygiene, development of permanent teeth, and craniofacial asymmetry through periodic follow-up. During dental treatment of shunt-treated patients, care should be taken to avoid applying excessive force to the catheter running along the patient's neck to prevent the displacement of the catheter. A referral to a neurosurgeon is recommended for patients with ventriculoatrial shunts for prophylactic antibiotics. As hydrocephalus patients grow, they may show craniofacial asymmetry or differences in the calcification of the permanent teeth, and require periodic oral and craniofacial assessment.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.2
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• pp.257-264
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• 2018

Osteopetrosis is characterized by impaired osteoclast function and increased bone density. Infantile osteopetrosis is a severe form of the disease and has characteristics such as diffusely sclerotic skeleton, pancytopenia, cranial nerve entrapment, infection susceptibility, and abnormal craniofacial appearance. Patients with infantile osteopetrosis often experience developmental delay, and may have a short life span. A 14-month-old girl with osteopetrosis presented to the department of pediatric dentistry. Incipient caries on deciduous incisors were observed. The patient revisited 4 years of age. Besides medical problems, oral complications such as growth retardation, narrow upper arch, crowding, dental caries, and abnormal tooth development were observed. After consultation with her pediatrician, dental treatments were performed on the deciduous molars under sedation after a prophylactic antibiotic injection. At a periodic follow-up, multiple deciduous teeth were treated and extracted, and oralrehabilitation with a removable partial denture was initiated. Patient with osteopetrosis are highly susceptible to infection because of their compromised immune system and problems associated with wound healing that lead to osteomyelitis or sepsis development. Active participation in dental care for sugar intake management and proper oral hygiene are obligatory.

• Journal of dental hygiene science
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• v.15 no.3
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• pp.272-279
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• 2015

This study was conducted to provide baseline data which could suggest a direction of role based efficient integrated clinical education by avoiding duplicate of contents through analyzing clinical courses. Among the 7 clinical courses, orthodontics and periodontology were the most published subjects which were published in 5 kinds of books and dental materials was the least published subject which was published in 2 kinds of books on investigation of overlapping contents based on titles that appeared on chapters and verses of all textbooks for clinical courses. Dental implant was covered in 4 subjects such as oral maxillofacial surgery, prosthodontics, periodontology and dental materials which was the most number. Other overlapping contents were restoration treatment, occlusion and malocclusion, temporomandibular joint diseases, anesthesia sedation, tooth trauma, systemic disease and dental treatment, dental casting, isolation techniques, tooth bleaching, pulp protection, gingivitis periodontitis, tooth development, etc. Reviews of textbooks of clinical courses should be conducted in a detailed manner by systematic, various studies in order to improve quality of the textbooks.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.516-525
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• 2004

Mandibular symphyseal distraction osteogenesis is an alternative approach for correcting mandibular transverse deficiencies and dental crowding. The traditional approaches for these are extraction of teeth and arch expansion with traditional orthodontic treatment. Also extractions are usually unavoidable in patients with severe crowding. The purpose of this study is to evaluate the effect of mandibular symphyseal distraction osteogenesis by use of tooth-borne expansion appliance. All of 12 patients had been performed distraction osteogenesis. The surgical procedures were accomplished under local anesthesia and intravenous sedation in an ambulatory surgical setting using a routine distraction protocol. The latency period was 5 days or 7 days after symphyseal osteotomies. The rate & rhyth is a intermittent, 0.75mm or 1.0 mm per day and stabilized for 6, 8 weeks after distraction. The time of orthodontic tooth movement after distraction was variable from 2 weeks to 8 weeks (mean 3 weeks). All patients had been evaluated with study casts, plain periapical films, panorama radiograms before & after surgery. Mandibular symphyseal distraction osteogenesis increased mandibular arch width and corrected dental crowding, with paralleling tooth-borne movement, without proclination of the mandibular incisors.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.4
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• pp.338-347
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• 2001

Purpose: This is to review the cases of posterior maxillary segmental osteotomies to regain the interarch spaces for dental implants in the posterior mandible. Materials & Methods: Seven patients who presented with alveolar extrusion of upper posterior molars underwent segmental osteotomies by single-stage Kufner's buccal approach under the intravenous sedation and local anesthesia. The posterior maxillary cento-alveolar segments were repositioned upward using pre-fabricated palato-occlusal resin splints and immobilized with osteosynthesis microplates and screws. Dental implants were installated simultaneously. The regained spaces, tooth vitality, periodontal healing, relapse, tenderness on function, and complications including maxillary sinus involvements were evaluated periodically for over one year after the surgeries. Results: The single-tage procedures were completed within 80 minutes without any surgical complications. The posterior maxillary segments were repositioned upward to regain the interarch spaces ranging from 2.5 to 5.5mm. All teeth involved in the procedures keep their vitalities. The repositioned segments were maintained showing neither evidence of periodontal break-down nor tenderness to function. One patient whose segments had not been immobilized by osteosynthesis plate resulted in 2mm down-ward relapse in post-operative 8 months. A case of postoperative nasal bleeding from the posterior-lateral wall resulted in oroantral fistula and chronic maxillary sinusitis later. Conclusion: The extruded dento-alveolar segments of the posterior maxilla were repositioned properly by Kufner's one-stage segmental osteotomies. One microplate can be of help to keep the position until the osseous healing enough to support the masticatory force.

• Journal of Sensor Science and Technology
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• v.29 no.4
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• pp.249-254
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• 2020

It is difficult to control children who exhibit negative behavior in dental clinics. Various methods are used for preventing pediatric dental patients from being afraid and for eliminating the factors that cause psychological anxiety. However, when it is difficult to apply this routine behavioral control technique, sedation therapy is used to provide quality treatment. When the sleep anesthesia treatment is performed at the dentist's clinic, it is challenging to identify emergencies using the current breath detection method. When a dentist treats a patient that is under the influence of an anesthetic, the patient is unconscious and cannot immediately respond, even if the airway is blocked, which can cause unstable breathing or even death in severe cases. During emergencies, respiratory instability is not easily detected with first aid using conventional methods owing to time lag or noise from medical devices. Therefore, abnormal breathing needs to be evaluated in real-time using an intuitive method. In this paper, we propose a method for identifying abnormal breathing in real-time using an intuitive method. Respiration signals were measured using a 3M Littman electronic stethoscope when the patient's posture was supine. The characteristics of the signals were analyzed by applying the signal processing theory to distinguish abnormal breathing from normal breathing. By applying a short-time Fourier transform to the respiratory signals, the frequency range for each patient was found to be different, and the frequency of abnormal breathing was distributed across a broader range than that of normal breathing. From the wavelet transform, time-frequency information could be identified simultaneously, and the change in the amplitude with the time could also be determined. When the difference between the amplitude of normal breathing and abnormal breathing in the time domain was very large, abnormal breathing could be identified.