• Title/Summary/Keyword: Emergency dental treatment

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Syncope & Coma during Endodontic Treatment under Local Anesthesia in Multiple Medically Compromised Patient (다발성 전신질환자에서 국소마취하에 근관치료 중 유발된 실신과 혼수 치험 1예)

  • Yoo, Jae-Ha;Choi, Byung-Ho;Lee, Chun-Ui;Kim, Jong-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.2
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    • pp.164-171
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    • 2011
  • Altered consciousness may be the first clinical sign of a serious medical problem that requires immediate and intensive therapy to maintain life. There are many causes of the loss of consciousness in the dental office setting, such as, vasodepressor syncope, drug administration or ingestion, orthostatic hypotension, epilepsy, hypoglycemic reaction, acute adrenal insufficiency, cerebrovascular accident, hyperglycemic reaction, acute myocardial infarction, acute allergic reaction and hyperventilation. This is a case report of syncope and coma during endodontic treatment of a maxillary third molar under local infiltration anesthesia in multiple medically compromised patient. The main cause was thought to be hypoglycemic reaction. The patient was transferred to the medical emergency room and cared properly by the emergency medical physicians. The prognosis was good.

CASE REPORT OF PREMATURE CONTACT BY UNPROPER REDUCTION OF AVULSED TOOTH (탈구된 치아의 부적절한 재식으로 인한 조기접촉의 치험례)

  • Ra, Ji-Young;Kim, Dae-Eop;Yang, Yong-Sook;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.1-6
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    • 2005
  • Injury of permanent teeth by trauma usually occurs to $8{\sim}10\;years$ old children, in mixed dentition. Fracture, dislocation, intrusion, extrusion, avulsion are the common types of trauma in teeth. The injuries which teeth are dislocated from the alveolar sockets can be treated by reduction and fixation. In this case report two children visited Wonkwang University Dental Hospital after the emergency treatment of tooth injury by other medical institutes. In these cases the injured teeth were not reducted properly and showed premature contact. So the teeth were dislocated from the alveolar sockets intentionally and fixed again in the proper position. Unproper reduction can cause premature contact, delay of healing, difficulty of mastication, and malocclusion. For this reason emergency rooms or local dental clinics where patients with dental trauma can be examined first, must know well about the treatment procedure of the injured teeth and should be consulted to the profession when necessary.

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Use of Laryngeal Mask Airway in Sevoflurane Sedation for the Difficult Airway (Sevoflurane 흡입진정에서 어려운 기도관리를 위한 LMA 활용)

  • You, Tae-Min;Doh, Re-Mee;Song, Young-Gyun;Kim, Seung-Oh
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.4
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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.

Dental trauma trends in emergency care: a comparative analysis before, during, and after COVID-19

  • Woo-Jung Yang;Ji-Young Yoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.6
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    • pp.339-346
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    • 2023
  • Objectives: This analysis details the characteristics of dental trauma in South Korea during the coronavirus disease 2019 (COVID-19) (DC) pandemic and compares them in patients before and after COVID-19 (BC and AC, respectively). Materials and Methods: Data were collected from medical records of patients who visited Seoul National University Bundang Hospital's Emergency Dental Care Center during three 12-month periods: BC, DC, and AC (BC from March 1, 2019 to February 29, 2020; DC from March 1, 2020 to February 28, 2021; AC from March 1, 2022 to February 28, 2023). A retrospective review was conducted to investigate patient age, sex, time of visit, cause, and diagnosis. The study included 1,544 patients: 660 BC, 374 DC, and 510 AC. Results: Significant difference in age and sex was not observed among the three periods; 1-9 years of age was the largest group (38.3% in BC, 29.6% in DC, and 27.8% in AC), and the percentage of male patients was greater than of female patients (male proportion as 63.5% in BC, 67.4% in DC, and 64.9% in AC). The number of patients generally peaked at a Saturday night in spring (for BC: May, Saturday, 18:00-19:59; for DC: March, Saturday, 18:00-19:59; for AC: April as the second most (October as the most peaked), Saturday, 20:00-21:59). The primary etiology of the dental trauma was identical in the three periods: falls, followed by sports. The most frequent diagnosis was laceration, followed by tooth avulsion and jaw fracture. Conclusion: Significant differences were not found between the characteristics and patterns of dental trauma in the BC, DC, and AC periods. However, due to the pandemic and social distancing, activities decreased and associated dental trauma-related incidents declined.

Foreign body aspirations in dental clinics: a narrative review

  • Huh, Jin-Young
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.3
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    • pp.161-174
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    • 2022
  • Foreign body aspiration can produce a medical emergency. Obstruction of the airways can be life-threatening, and complications may develop in less-severe cases if it is left untreated. Although it is more prevalent in children by approximately three times, adults can still experience it, and it is more frequently related to healthcare in adults. Objects used in dental treatment are usually placed in the oral cavity and can be ingested or inhaled by accident. Dental treatment has been identified as an important cause of the misplacement of foreign bodies in the airway. However, few reports have been published on dentistry-related foreign body aspiration. This paper discusses the disease course, management, and clinical outcomes of foreign body aspiration, especially those associated with dentistry. The patient must be examined for respiratory distress. If the patient is unstable, urgent airway management and the maneuvers for removal should be performed. Radiographs and computed tomography can help identify and locate the object. The treatment of choice is often bronchoscopy, and both flexible and rigid endoscopes can be used depending on the situation. Preventive measures need to be implemented to avoid inhalation accidents given the potential consequences. Though the incidence is rare, healthcare levels need to be enhanced to avert morbidity and mortality. Radiological evaluation and bronchoscopy are vital for management.

Current Concepts in the Treatment of Maxillofacial Soft Tissue Trauma (악안면 연조직 외상치료의 최신지견)

  • Kim, Yongsoo
    • The Journal of the Korean dental association
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    • v.54 no.10
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    • pp.790-798
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    • 2016
  • The maxillofacial soft tissue trauma is one of the major causes to visit the emergency room. For the past few decades, however, the basic concept of the repairing the soft tissue wound have not been changed. Therefore, it could be worthwhile to remind the fundamental concepts and practical information belong to the soft tissue injury management. Among the many types of soft tissue trauma, laceration wound which is most frequently met in the clinic will be discussed in this review.

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Death according to sepsis due to facial cellulitis: A case report (안면부 봉와직염으로 인한 패혈증으로 사망한 증례)

  • Kim, Ji-Hong;Kim, Yeong-Gyun
    • The Journal of the Korean dental association
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    • v.38 no.12 s.379
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    • pp.1172-1177
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    • 2000
  • Eighty nine-year-old female patient admitted to our department via emergency room. On initial exam, she showed right facial swelling, irismus, pain, and poor oral hygiene. Tentative diagnosis was facial cellulitis. In spite of aggressive treatment such as antibiotic, incision and drainage, medically intensive therapy, she was dead with cardiopulmonary arrest and sepsis.

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Evaluation of Bleeding After Denal Extraction in Patients Taking Single Antiplatelet Treatment

  • Kim, Jae Jin;Kim, Hak Kyun
    • International Journal of Oral Biology
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    • v.40 no.3
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    • pp.147-150
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    • 2015
  • The purpose of this study was to evaluate the effect of single antiplatelet treatment on delayed bleeding, in patients undergoing dental extraction. A total of 154 teeth were extracted in 94 patients with ongoing antiplatelet treatment, who were taking single antiplatelet of either aspirin or clopidogrel. All patients underwent simple dental extraction; local hemostasis was performed with gauze-biting, suturing, and/or application of a local hemostatic agent. Delayed bleeding was recorded in 5 teeth out of a total of 154 teeth after extraction, the incidence of postoperative delayed bleeding being 3.2%. The bleeding was controlled by the patients themselves, through application of pressure with additional gauze-biting. No one visited the doctor or emergency room for hemostasis. These results confirmed that patients taking single antiplatelet drugs may have teeth extracted safely without interruption of the antiplatelet treatment.

Remote digital monitoring during the retention phase of orthodontic treatment: A prospective feasibility study

  • Sangalli, Linda;Savoldi, Fabio;Dalessandri, Domenico;Visconti, Luca;Massetti, Francesca;Bonetti, Stefano
    • The korean journal of orthodontics
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    • v.52 no.2
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    • pp.123-130
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    • 2022
  • Objective: To evaluate if a remote digital monitoring system added at the end of orthodontic treatment could positively influence the retention phase by reducing the occurrence of misfit of removable appliances, number of emergency appointments (EA), and orthodontic relapse. Methods: Twenty-seven patients who completed active orthodontic treatment were divided into the study and control groups. In addition to the standard chairside follow-up appointments at month 1 (T1), month 3 (T2), month 6 (T3), the study group patients were monitored using Dental Monitoring® with monthly intra-oral scans. Occurrence of misfit of removable retainers, number of EAs, and intercanine width change were recorded for both groups. Differences in EAs and retainer fit were assessed using the chi-square test. Intra-group and inter-group differences in the intercanine width were assessed with Friedman test and Mann-Whitney U test, respectively (α = 0.05). Results: The study group showed a significantly lower occurrence of misfit of removable retainers (p = 0.027) compared to the control group. No significant inter- and intra-group difference was found in the EAs and intercanine width change at each time-point. Conclusions: Integrating remote monitoring systems, such as Dental Monitoring®, to the retention phase of the orthodontic treatment may lower the occurrence of misfit of removable retainers. However, a small sample size and a short observation period limit the strength of this evidence. These preliminary results tentatively suggest that remote monitoring technologies may be beneficial, especially during the COVID-19 pandemic, when the regularity of in-office visits might be disrupted.

Cardiopulmonary Resuscitation and Pediatric Advanced Life Support for Pediatric Dentist (소아치과의사를 위한 심폐소생술과 소아고급생명구조술)

  • Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.2
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    • pp.243-255
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    • 2017
  • Cardiopulmonary resuscitation (CPR) is an emergency treatment that stimulates blood circulation and breathing when the function of the heart stops or stops breathing. CPR can be divided by basic life support (BLS) and advanced life support (ALS). BLS involves the use of chest compression to force the blood flow to the main organs, rescue breathing to improve the breathing to the respiratory failure patient and the use automated external defibrillator (AED). The categories of advanced life support include advanced cardiovascular life support (ACLS) for adult and pediatric advanced life support (PALS) for children. In the treatment of dental care for children, which is extremely difficult to deal with, and for a variety of reasons, the use of sedation is considered to treat the children who are unlikely to cooperate with dentistry. This is why there is an increasing possibility of an emergency situation involving cardiac arrest. PALS includes the BLS, and it presents a systematic algorithm to treat respiratory failure, shock and cardiogenic cardiac arrest. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is necessary to be able to immediately implement professional skills in emergency situations.