• Title/Summary/Keyword: Depth of anesthesia

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THE CLINICAL AND MICROBIOLGICAL EFFECT OF CHLORHEXIDINE RINSE AND SUPRAGINGIVAL PLAQUE CONTROL ON ADULT PERIODONTITIS (Chlorhexidine용액 구강양치와 치은연상치태 제거의 임상 및 미생물학적 변화에 대한 연구)

  • Yoon, Hyung-Jin;Kang, Hyun-Koo;Shin, Hyung-Shik
    • Journal of Periodontal and Implant Science
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    • v.24 no.2
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    • pp.340-356
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    • 1994
  • The purpose of this study was to assess the clinical and microbiological effect of chlorhexidine rinse and supragingival plaque control following scaling and root planing on adult periodontal disease. 14 patients with adult periodontitis were selected for the study . They had not taken antibiotics for 6 months and history of dental treatment for 6 months before the study. Patients received a supragingival scaling and root planing under local anesthesia, plaque control group was subjected to professional plaque control 2 times for a period 2 week, chlorhexidine rinse group were subjected to twice daily 0.2% chlorhexidine rinse for a period 2 week. Clinical examination (plaque index, gingival index, probing pocket depth) and distribution of the bacteria morphology of subgingival plaque were monitored on baseline (0 week), 1 week, 2 week, 4 week and 6 week. The results were as follows : 1. Plaque index in chlorhexidine rinse group , plaque control group and control group was significantly reduced during all weeks (P<0.05). 2. Probing pocket depth was significantly reduced at 2, 4, 6 week (P<0.05) in chlorhexidine rinse group and control group, plaque control group was significantly reduced during all weeks (P<0.05). 3. Gingival index was significantly improved at 2, 4, 6 weeks(P<0.05) in chlorhexidine group and plaque control group, control group was significantly improved at 1, 2, 4 weeks (P<0.05). 4. Percentage of cocci was significantly increased at 1, 2, 4 and 6 weeks in chlorhexidine rinse group and control group, plaque control group was significantly increased at 2, 4 and 6 weeks(P<0.05). 5. Percentage of non-motile rods in all group were not significantly changed when compared with those of baseline (0 week) (P<0.05). 6. Percentage of motile rods was significantly reduced during all weeks (P<0.05) in chlorhexidine rinse group, plaque control group was significantly reduced at 2, 4, 6 weeks and 1, 2 and 4 weeks in control group. 7. Percentage of spirochetes was significantly reduced during all weeks (P<0.05), plaque control group was significantly reduced at 2, 4, 6 weeks and 1, 2, 4 weeks in control group. This results were suggested that clinical and microbiological effect of chlorhexidine rinse and supragingival plaque control following scaling and root planing on periodontal disease

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Effects Of Cultured Bone Cell On The Regeneration Of Alveolar Bone (배양골세포 이식이 치조골재생에 미치는 영향)

  • Jeong, Soon-Joon;Herr, Yeek;Park, Joon-Bong;Lee, Man-Sup;Kwon, Young-Hyuk
    • Journal of Periodontal and Implant Science
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    • v.26 no.1
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    • pp.1-26
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    • 1996
  • This study was performed to estimate the effects of cultured bone cell inoculated on porous type hydroxyaptite for the regeneration of the artificial alveolar bone defect. In this experiment 3 beagle dogs were used, and each of them were divided into right and left mandible. Every surgical intervention were performed under the general anesthesia by using with intravenous injection of Pentobarbital sodium(30mg/Kg). To reduce the gingival bleeding during surgery, operative site was injected with Lidocaine hydrochloride(l:80,000 Epinephrine) as local anesthesia. After surgery experimental animal were feeded with soft dietl Mighty dog, Frisies Co., U.S.A.) for 1 weeks to avoid irritaion to soft tissue by food. 2 months before surgery both side of mandibular 1st premolar were extracted and bone chips from mandibular body were obtained from all animals. Bone cells were cultured from bone chips obtained from mandible with Dulbecco's Modified Essential Medium contained with 10% Fetal Bovine Serum under the conventional conditions. Porous type hydroxyapatite were immerse into the high concentrated cell suspension solution, and put 4 hours for attachin the cells on the surface of hydroxyapatite. Graft material were inserted on the artificial bone defect after 3 days of culture. Before insertion of cellinoculated graft material, scanning electronic microscopic observation were performed to confirm the attachment and spreading of cell on the hydroxyapatite surface. 3 artificial bone defects were made with bone trephine drill on the both side of mandible of the experimental animal. First defect was designed without insertion of graft material as negative control, second was filled with porous replamineform hydroxyapatite inoculated with cultured bone marrow cells as expermiental site, and third was filled with graft materials only as positive control. The size of every artificial bone defect was 3mm in diameter and 3mm in depth. After the every surgical intervention of animals, oral hygiene program were performed with 1.0% chlorhexidine digluconate. All of the animals were sacrificed at 2, 4, 6 weeks after surgery. For obtaining histological section, tissus were fixed in 10% Buffered formalin and decalcified with Planko - Rycho Solution for 72hr. Tissue embeding was performed in paraffin and cut parallel to the surface of mandibular body. Section in 8um thickness of tissue was done and stained with Hematoxylin - Eosin. All the specimens were observed under the light microscopy. The following results were obtained : 1. In the case of control site which has no graft material, less inflammatory cell infiltration and rapid new bone forming tendency were revealed compared with experimental groups. But bone surface were observed depression pattern on defect area because of soft tissue invasion into the artificial bone defect during the experimental period. 2. In the porous hydroxyapatite only group, inflammatory cell infiltration was prominet and dense connective tissue were encapsulated around grafted materials. osteoblastic activity in the early stage after surgery was low to compared with grafted with bone cells. 3. In the case of porous hydroxyapatite inoculated with bone cell, less inflammatory cell infiltration and rapid new bone formation activity was revealed than hydroxyapatite only group. Active new bone formation were observed in the early stage of control group. 4. The origin of new bone forming was revealed not from the center of defected area but from the surface of preexisting bony wall on every specimen. 5. In this experiment, osteoclastic cell was not found around grafted materials, and fibrovascular invasion into regions with no noticeable foreign body reaction. Conclusively, the cultured bone cell inoculated onto the porous hydroxyapatite may have an important role of regeneration of artificial bone defects of alveolar bone.

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The effects of enamel matrix derivative on the healing of 1-wall intrabony defects in beagle dogs (성견의 1면 골결손부에서 법랑기질 유도체가 치주조직 치유에 미치는 영향)

  • Oh, Je-Ik;Choi, Seong-Ho;Lee, Seung-Won;Cho, Kyoo-Sung;Kim, Chong-Kwan;Chai, Jung-Kiu
    • Journal of Periodontal and Implant Science
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    • v.27 no.4
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    • pp.767-783
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    • 1997
  • Guided tissue regeneration, bone graft procedures, and application of growth factors have been used to regenerate lost periodontal tissues. Recently, enamel matrix derivative has been introduced into periodontal regeneration procedures in expectation of promoting new bone and cementum formation. The purpose' of this study was to evaluate the effect of enamel matrix derivative in 1-wall intrabony defects in beagle dogs. For this purpose, each dog was anesthesized using intravenous anesthesia and mandibular 1st, 3rd premolars were extracted. 2 months later, the 1-wall intrabony defects(mesio-distal width: 4mm, depth: 4mm) were created on the distal side of 2nd premolars and mesial side of 4th premolars. The control group was treated with debridement alone, and experimental group was treated with debridement and enamel matrix derivative application. The healing processes were histologically and histometrically observed after 8 weeks and the results were as follows : 1. The length of junctional epithelium was $0.94{\pm}0.80mm$ in the control group, $0.57{\pm}0.42mm$ in the experimental group, with no statistically significant difference between groups. 2. The connective tissue attachment was $1.36{\pm}0.98mm$ in the control group. $0.38{\pm}0.43mm$ in the experimental group, with statistically significant difference between groups(P<0.05). 3. The new cementum formation was $2.49{\pm}1.06mm$ in the control group, $3.59{\pm}0.74mm$ in the experimental group. with statistically significant difference between groups(P<0.05). 4. The new bone formation was $1.92{\pm}0.97mm$ in the control group, $2.32{\pm}0.59mm$ in the experimental group. with no statistically significant difference between groups. Within the limitation to this study protocol, enamel matrix derivative application in 1-wall intrabony defect enhanced new cementum formation. Although there was no statistically significant difference, enamel matrix derivative also seems to be effective in inhibition of apical migration of junctional epithelium and new bone formation.

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A study on the scope of future oriented work of dental hygienists (치과위생사의 미래지향적 업무 범위에 대한 고찰)

  • Ahn, Eunsuk;Kim, Sun-Mi;Kim, Bo-Ra;Jeong, Soon-Jeong;Hwang, Soo-Jeong;Han, Ji-Hyoung
    • Journal of Korean Academy of Dental Administration
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    • v.8 no.1
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    • pp.15-23
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    • 2020
  • The aim of this study is to identify future-oriented tasks for Korean dental hygienists based on a literature review. A literature search is performed using 14 keywords related to tasks carried out by dental hygienists, and included articles published from 2000 to 2019 in the databases KISS, RISS, DBpia, NDSL, Papersearch, Pubmed, and Google Scholar. Six reviewers assessed the titles and abstracts of articles, and an article was selected if the study was considered to cover future-oriented tasks for Korean dental hygienists. Based on the results six local studies and two foreign studies were used for literature review and data extraction. In total, 38 tasks were classified as future-oriented tasks of dental hygienists according to the following criteria: 1) tasks that were specifically referred to as future-oriented tasks, and 2) tasks that could be classified as future-oriented tasks although no specific reference was made. Of these, the most frequently mentioned tasks were measuring periodontal pocket depth, dental hygiene assessment, providing dietary advice, infiltration anesthesia, and root planing. These were extracted from five of the eight studies, including both local and foreign studies. Dental hygiene planning, emergency, emergency management, and smoking cessation were the next most common tasks based on four studies. Even though some of these future-oriented tasks for Korean dental hygienists are included in the dentistry curriculum, and are currently performed as clinical practice for dental hygienists. Nonetheless, the reference to the legal scope is unclear. It is necessary to reconsider the scope of tasks of dental hygienists to reflect changes in domestic and foreign dental care delivery, thereby contributing to the oral health promotion of the public, where safety is guaranteed under legal protection.

Reconstruction of Congenital Absence of Vagina using Vulvoperineal Fasciocutaneous Flap: A Case Report (외음회음 근막피부피판을 이용한 선천성 질결여증의 재건례)

  • Kim, Mi-Sun;Kim, Chul-Han;Lee, Yong-Sek;Kang, Sang-Gue;Tark, Min-Sung
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.831-834
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    • 2010
  • Purpose: Congenital absence of the vagina is a rare case. It occurs as a result of Mullerian duct aplasia or complete androgen insensitivity syndrome. The reconstructive modality includes skin graft, use of intestine and various methods of flap. We report a patient who underwent vulvoperineal fasciocutaneous flap to reconstruct congenital absence of the vagina, while the external genitalia and ovaries are normal. Methods: A 26-year-old woman presented with vaginal agenesis. Under general anesthesia, a U-shaped incision was made between the urethral meatus and the anus. The new vaginal pocket was created up to the level of the peritoneal reflection between the urinary structures and the rectum. Next, the vulvoperineal fasciocutaneous flaps were designed in a rectangular fashion. Flap elevation was begun at the lateral margin which the adductor longus fascia was incised and elevated, and the superficial perineal neurovascular pedicle was invested by the fascial layer. The medial border was then elevated. A subcutaneous tunnel was created beneath the inferior of the labia to rotate the flaps. The left vulvoperineal flap was rotated counterclockwise and the right was rotated clockwise. The neovaginal pouch was formed by approximating the medial and lateral borders. The tubed neovagina was then transposed into the cavity. Results: In 3 weeks, the vaginal canal remained supple After 6 weeks, the physical examination showed normalappearing labia majora and perineum with an adequate vaginal depth. A year after the operation, the patient had a 7 cm vagina of sufficient width with no evidence of contractures nor fibrous scar formation. The patient was sexually active without difficulty. Conclusion: Although many methods were described for reconstruction of vaginal absence, there is not a method yet to be approved as a perfect solution. We used the vulvoperineal fasciocutaneous flap to reconstruct a neovagina. This method had a following merits: a single-stage procedure, excellent flap reliability, the potential for normal function, minimal donor site morbidity and no need for subsequent dilatation, stents, or obturators. We thought that this operation has a good anatomic and functional results for reconstruction of the vagina.

Effects of Midazolam with Sevoflurane Insufflation Sedation on Concomitant Administration in Pediatric Patients : A Preliminary Study (소아환자의 세보플루란 흡입진정시 미다졸람 병용 투여의 효과에 관한 예비연구)

  • Chi, Seongin;Kim, Jongsoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.4
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    • pp.283-291
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    • 2014
  • Patients with extreme anxiety who are unable to cope with dental treatment under non-pharmacological behavioral management method may require sedation, or other forms pharmacological behavioral management method. The aim of this retrospective study was to investigate the effect of concomitant administration of 0.1 mg/kg intramuscular midazolam with or without sevoflurane insufflation sedation on sedation depth and cardiopulmonary function in pediatric patients. We analysed the records of anesthesia on patients who received dental treatment under deep sedation using sevoflurane insufflation from January 2013 to March 2014. Thirty-six children, aged 3 to 6 years, undergoing dental treatment were sedated using either sevoflurane insufflation alone (Group S, n = 18) or a combination of intramuscular injection of 0.1 mg/kg midazolam plus sevoflurane insufflation (Group SM, n = 18). Upon comparison, the average entropy value of group SM was lower than that of group S, but there were no statistically significant difference between the two groups (p > 0.05). The average heart rate and mean arterial pressure of group SM were higher than those of group S (p < 0.05). Concomitant intramuscular injection of 0.1 mg/kg midazolam with sevoflurane insufflation sedation is not sufficient to enhance the quality of sedation.

Identification of an effective and safe bolus dose and lockout time for patient-controlled sedation (PCS) using dexmedetomidine in dental treatments: a randomized clinical trial

  • Seung-Hyun Rhee;Young-Seok Kweon;Dong-Ok Won;Seong-Whan Lee;Kwang-Suk Seo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.1
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    • pp.19-35
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    • 2024
  • Background: This study investigated a safe and effective bolus dose and lockout time for patient-controlled sedation (PCS) with dexmedetomidine for dental treatments. The depth of sedation, vital signs, and patient satisfaction were investigated to demonstrate safety. Methods: Thirty patients requiring dental scaling were enrolled and randomly divided into three groups based on bolus doses and lockout times: group 1 (low dose group, bolus dose 0.05 ㎍/kg, 1-minute lockout time), group 2 (middle dose group, 0.1 ㎍/kg, 1-minute), and group 3 (high dose group, 0.2 ㎍/kg, 3-minute) (n = 10 each). ECG, pulse, oxygen saturation, blood pressure, end-tidal CO2, respiratory rate, and bispectral index scores (BIS) were measured and recorded. The study was conducted in two stages: the first involved sedation without dental treatment and the second included sedation with dental scaling. Patients were instructed to press the drug demand button every 10 s, and the process of falling asleep and waking up was repeated 1-5 times. In the second stage, during dental scaling, patients were instructed to press the drug demand button. Loss of responsiveness (LOR) was defined as failure to respond to auditory stimuli six times, determining sleep onset. Patient and dentist satisfaction were assessed before and after experimentation. Results: Thirty patients (22 males) participated in the study. Scaling was performed in 29 patients after excluding one who experienced dizziness during the first stage. The average number of drug administrations until first LOR was significantly lower in group 3 (2.8 times) than groups 1 and 2 (8.0 and 6.5 times, respectively). The time taken to reach the LOR showed no difference between groups. During the second stage, the average time required to reach the LOR during scaling was 583.4 seconds. The effect site concentrations (Ce) was significantly lower in group 1 than groups 2 and 3. In the participant survey on PCS, 8/10 in group 3 reported partial memory loss, whereas 17/20 in groups 1 and 2 recalled the procedure fully or partially. Conclusion: PCS with dexmedetomidine can provide a rapid onset of sedation, safe vital sign management, and minimal side effects, thus facilitating smooth dental sedation.

Investigation of Factors Contributing to Childhood Soft-Tissue Injuries in the Face (소아의 안면 연부조직 손상에 관한 연구)

  • Sim, Mi-Jung;Sohn, In-A
    • Journal of Digital Convergence
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    • v.11 no.8
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    • pp.219-225
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    • 2013
  • The purpose of this study was to retrospectively investigate the contributing factors in facial soft tissue injuries among children. A record-based analysis was carried out on 126 patients with facial lacerations who visited I hospital in the dept of plastic surgery from April 2010 to May 2011. Through all age group showed a significant difference in incidence rate for male and female.(p<.05). Overall, 49% of injuries occurred outdoors and the most frequent cause of injury was slip-down (42%), followed by being struck (40%). In general, the frequency of injuries peaked summer(30.2%) and increased between 12pm and 4pm. 105 patients (83.3%) arrived at the emergency room within an hour. The forehead(26%) was the most commonly injured area. The depth of soft tissue injuries was mostly subcutaneous(54%), and 1~2cm was the length of injury with the highest incidence(46%). Most children (40%) needed local anesthesia and only 4 children (1.53%) suffered associated fractures. Facial injuries require special attention because of their potential threat in inducing permanent scar or disfigurement. For the safety of children, the preventive measures to reduce facial soft tissue injuries must be improved.

Effects of Anesthetics on Somatosensory Evoked Potentials (SEPs) in Dogs (마취제가 개의 Somatosensory Evoked Potentials (SEPs)에 미치는 영향)

  • Hong, Yeon-Jung;Jeong, Seong-Mok;Nam, Tchi-Chou
    • Journal of Veterinary Clinics
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    • v.19 no.3
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    • pp.277-282
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    • 2002
  • This study was designed to evaluate the effects of anesthetics on waveform of SEPs and to authorize possible anesthetic protocol for measurement of the somatosensory evoked potentials (SEPs). Thirteen anesthetic methods were used. The SEPs were recorded on two channels (between the 5th and 6th lumbar vertebra as the channel 1 and between the 11th and 12th thoracic vertebra as the channel 2) following stimulation of posterior tibial nerve. ID analyze SEPs wave, latency and conduction velocity were measured. Among thirteen anesthetic methods, standard SEPs waveforms were observed in dogs anesthetized with following six methods: Acepromazine + Thiepfntal Na + Isoflurane, Acepronazine + Propofol + Isoflurane, Diazepam + Xylazine, Xylazine + Ketamine, Acepromazine + Propofol infusion and Propofol infusion. Above six methods could be used with sufficient anesthetic depth. The differences of latency and conduction velocity among six groups were minimal compared to general waveform of SEPs. These results indicate that the six anesthetic methods can be used for recording SEPs in the dog. In particular, Diazepam + Xylazine and XylaBine + Ketamine as injectable anesthesia are considered more convenient than other four methods in veterinary medicine.

SEDATION EVALUATION USING BIS INDEX ASSESSMENT WITH AND WITHOUT THE ADDED SUBMUCOSAL MIDAZOLAM (점막하 Midazolam의 병용투여 시 BIS 분석을 이용한 진정 평가)

  • Lee, Young-Eun;Park, Mi-Kyung;Kim, So-Young;Kim, Yun-Hee;Jung, Sang-Hyuk;Baek, Kwang-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.1
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    • pp.91-98
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    • 2007
  • The aim of this study was to examine the difference of the depth of sedation using the Bispectral index assessment with and without the added submucosal Midazolam to oral Chloral hydrate and Hydroxyzine for pediatric patients. Twenty seven sedation cases were performed in this study Selection criteria included good health(ASA I), 2 to 6 years of age, the need for sedation to receive dental treatment including anesthesia, and restorative procedure over at least two teeth. Patients were randomly classified into one group taking oral Chloral hydrate(60 mg/kg) and Hydroxyzine(1 mg/kg) and the other group recieving Chloral hydrate(60 mg/kg), Hydroxyzine(1 mg/kg) and submucosal Midazolam(0.1 mg/kg). Nitrous Oxide(50%) was used for both group during sedation. Patients were monitored using a pulse oximeter and a Bispectral monitor. A behavior scale was rated as quiet(Q), crying(C), movement(M), or struggling(S) every 2 minutes watching a recorded videotape. Analysis showed a significant difference in mean Bispectral index and SD during sedation across two groups(P<0.001). The group of patients injected with submucosal Midazolam in addition to oral Chloral hydrate and Hydroxyzine showed a lower mean Bispectral index and a narrower SD. PR and SpO2 for both groups remained within the normal values. Submucosal Midazolam improved the sedation quality by deepening sedation depth without compromising safety and enabled the sedation pattern to be kept more stable.

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