• 한국치위생학회지
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• 제7권4호
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• pp.595-609
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• 2007

The purpose of this study was to classify the courses of the dental-hygiene curricula into several categories by field, to incorporate the subjects in the same category into an integrated course, and to suggest how to ensure the successful phase-in application of integrative education according to Ronald M. Harden's 11-stage integrative ladder model. The findings of the study were as follows: 1. When the existing curricula were analyzed, it's found that many credits were provided to the courses in the area of basic dentistry that offered both theory and practice. In particular, the subjects tested by the national examination were offered by every college. In the field of public oral health, the largest number of credits was allocated to theory of oral prophylaxis and practice courses. In clinical area, clinical practice, in the area of dental office management, dental insurance course was given the largest credit. There were 31 to 61 major subjects in the colleges, which indicated that the major subjects were segmented in detail. 2. It seemed necessary to incorporate the subjects in the field of basic dentistry into oral biology, and theory of oral prophylaxis/practice, preventive dentistry/practice, preclinical stage, emergency treatment and introduction to dental hygiene should be integrated in to clinical dental hygiene. The courses in clinical area should be combined into clinical dentistry, and in the field of medical management, dental insurance, hospital management and medical relation law should be incorporated into management of dental clinic. 3. In the 11-stage integrative ladder, the subjects in the same field could perfectly be incorporated as the stages advanced. Each of the subjects was less emphasized, and communication and joint plans among teachers who were respectively in charge of the courses were increasingly considered important. Specifically, there should be a consensus among the teachers in regard to the outline of teaching programs, order of education. objects and objectives of programs and what and how to evaluate.

• 대한심미치과학회지
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• 제29권1호
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• pp.35-53
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• 2020

상악전치부파절은 원인과 연령에 따라 다양한 임상 증상을 가지고 있습니다. 대부분 환자분들은 응급상황으로 내원하기 때문에 평소에 정확한 진단 기준을 가지고 환자를 치료한다면 심미적이고 기능적으로 만족스러운 결과를 얻을 수 있을 것입니다. 다른 부위보다 조심스러운 상악전치부파절치 치료 과정을, 제가 전에 치료했던 케이스로 한번 살펴보려고 합니다. 제가 치료한 케이스가 정답이 될 수는 없지만, 임상에서 유사한 증례를 치료하게 된다면 도움이 될 수 있기를 바랍니다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권3호
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• pp.162-165
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• 2016

We report a case of a morbidly obese man with an aortic aneurysm, in whom dental surgery was performed before elective cardiac surgery. His aortic aneurysm required emergency surgery. However, because of his morbid obesity, elective cardiac surgery was planned. Considering the high risk of infective endocarditis, dental surgery was required. Our patient was at a high risk of aortic rupture caused by hypertension and breathing difficulty in the supine position. Dexmedetomidine (DEX) is an anti-anxiety, sedative, and analgesic medicine that can stabilize circulatory dynamics and minimize blood pressure fluctuations. We administered intravenous DEX for sedation of the patient in Fowler's position. In conclusion, our understanding of the risk factors of DEX enabled us to perform safe invasive oral treatment.

• 대한치과의사협회지
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• 제52권7호
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• pp.425-431
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• 2014

Objectives : The purpose of our study was to evaluate penicillin as a still drug of choice for severe endodontic infection, by analyzing the antimicrobial susceptibilities from endodontic infections with swelling to figure out appropriate antibiotics as empirical treatment. Materials and methods : This study involved 18 patients who attended for emergency treatment because of facial or periapical swelling associated with root canal infections. Identification and antimicrobial susceptibility test of each pathogen were performed by Vitek2 Systems (bioM$\acute{e}$rieux, Marcy l'Etoile, France). Results : The most frequent bacteria was Streptococcus spp.(77%), and the resistance against penicillin was 35% in overall patients, followed by clindamycin and erythromycin (17%), which was much higher than previous studies. Conclusions : In our study, the higher resistance made penicillin alone not to be chosen as the first antibiotic drug for severe endodontic infections. Combinations with other drug, penicillin with wider spectrum of activity, or changing to other antibiotics was considered while remembering the increased risk of resistant microorganism.

• Journal of Korean Dental Science
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• 제7권2호
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• pp.94-98
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• 2014

Numerous oral and maxillofacial surgeons have found facial space infections after tooth extraction. Most of these infections can be managed easily, but some of them could be life-threatening. Among the facial infections, temporal space infections are rare. Most temporal space infections could be observed as secondary to maxillary third molar infections, maxillary sinusitis, and maxillary sinus fractures. Note, however, that there are insufficient studies on temporal space abscess due to mandibular second molars, especially with acupuncture. A 74-year-old female came to our hospital with severe trismus and facial swelling on the right temporal, buccal, posterior auricular, and cervical regions. The patient had undergone extraction of tooth #47 secondary to dental caries by a general dentist about a month ago. After the dental procedure, the patient had been treated with acupuncture therapy around the right temporomandibular joint area at the oriental medicine clinic. We performed emergency incision and drainage under general anesthesia and started antibiotic treatment with IV ampicillin/sulbactam 3 g every 24 hours and vancomycin 1 g every 24 hours for 5 days. The patient's symptoms subsided and ultimately disappeared. Temporal space abscess after mandibular molar extraction is quite rare. In this case, the spreading mechanism against gravity is considered to be acupuncture therapy.

• 한국임상약학회지
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• 제30권3호
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• pp.206-208
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• 2020

An 80-year-old Korean woman who previously experienced penicillin allergy presented to a dental hospital for treatment of a fractured tooth. A dentist extracted the tooth and prescribed her A-cillin (amoxicillin hydrate) 250 mg orally 3 times a day for 3 days and Carol-F^® (ibuprofen arginine) orally 3 times a day for 3 days. She received the prescriptions, returned home, and took one dose of each drug. One hour later, she experienced hypertension, itching, shortness of breath, and was unable to move her tongue to pronounce words. Approximately 6 hours after drug administration, the symptoms persisted, and the patient was admitted to an emergency medical center (EMC). The patient was discharged from the EMC after a one-night stay in the hospital for symptomatic treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권3호
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• pp.163-181
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• 2017

In the field of orofacial surgery, a red blood cell transfusion (RBCT) is occasionally required during double jaw and oral cancer surgery. However, the question remains whether the effect of RBCT during the perioperative period is beneficial or harmful. The answer to this question remains challenging. In the field of orofacial surgery, transfusion is performed for the purpose of oxygen transfer to hypoxic tissues and plasma volume expansion when there is bleeding. However, there are various risks, such as infectious complications (viral and bacterial), transfusion-related acute lung injury, ABO and non-ABO associated hemolytic transfusion reactions, febrile non-hemolytic transfusion reactions, transfusion associated graft-versus-host disease, transfusion associated circulatory overload, and hypersensitivity transfusion reaction including anaphylaxis and transfusion-related immune-modulation. Many studies and guidelines have suggested RBCT is considered when hemoglobin levels recorded are 7 g/dL for general patients and 8-9 g/dL for patients with cardiovascular disease or hemodynamically unstable patients. However, RBCT is occasionally an essential treatment during surgeries and it is often required in emergency cases. We need to comprehensively consider postoperative bleeding, different clinical situations, the level of intra- and postoperative patient monitoring, and various problems that may arise from a transfusion, in the perspective of patient safety. Since orofacial surgery has an especially high risk of bleeding due to the complex structures involved and the extensive vascular distribution, measures to prevent bleeding should be taken and the conditions for a transfusion should be optimized and appropriate in order to promote patient safety.

• 대한치과기공학회지
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• 제28권1호
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• pp.177-198
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• 2006

This study purposed to offer basic data for safety education of the dental laboratory technology after the investigation of how much the students in the dept. of dental laboratory technology are aware of the danger of each instrument, equipment or laboratory procedure that they use during laboratory and how much they demand safety education for this. The objects for this study were 423 students who were in the dept. of dental laboratory technology. In this regard, four colleges which have the dept. of dental laboratory technology were randomly selected to do a questionnaire survey. SPSS 12.0 was used to analyze the collected data. The results were as follows: As for satisfaction with their major, the respondents answered Satisfied (59.1%), Average (35.5%) and Dissatisfied (5.4%). In terms of the production process of a partial denture, they considered casting, polishing the casting body, polishing denture and burn out were most dangerous in order. As for the production process of a full denture, what they regarded as the most dangerous in order was polishing denture, deflasking and wax wash. Regarding the laboratory procedures of porcelain material, casting, trimming casting body, polishing porcelain material and burn out were the most dangerous procedures that they perceived. With regard to materials for use, alcohol, polishing, metal and wire were the most dangerous ones they thought. As for the handling characteristics of each material, small towns showed a higher demand for safety of the handling characteristics of alcohol. In terms of school year and sex, juniors and girls had higher scores in the demand for safety of the handling characteristics of acid. Regarding the handling characteristics of each equipment and instrument, all of small towns, juniors and girls showed the highest demand for safety of the handling characteristics of alcohol lamps. With regard to scores in the demand for safety of other characteristics, all of small towns, juniors and girls had the highest demand for safety of emergency treatment. Concerning the demand for safety education by the completion of safety education, in terms of each material, highest was the demand for safety of acid from the group which completed safety education. In regard to equipments and instruments, when it came to the demand for safety of the handling characteristics of casting machine, the educated group's demand for safety of acid was higher. Regarding other characteristics, the group which was not educated gained higher scores in the demand for safety of emergency treatment. 11. In all areas(materials, machines and others), small towns, girls and juniors showed higher scores in the demand for safety. Based on the above results, it was found that when students conduct the laboratory of dental technology, they would think that many materials, instruments or equipments for use are very dangerous. However, safety education was not fully given to them. Regarding the scores in the damned for safety education, the highest was 4.16 and the lowest was 3.43, which suggests that the scores were generally very high. In this regard, it is necessary to continue delivering a systematic safety education of materials, equipments or instruments used during the laboratory of dental technology. Therefore, through the analysis of each material, instruments or facility used in every laboratory and each process, safety accident types and accident risk factors should be investigated to develop educational materials for this. Moreover, it is required to open safety education as a single course of study or insert safety contents of all materials and machines into the class of dental laboratory instrument or dental materials for the purpose of a systematic and thorough safety education to prevent a safety accident during laboratory.

• 대한소아치과학회지
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• 제36권4호
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• pp.607-612
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• 2009

소아기의 악성 종양은 질병으로 인한 소아 사망의 가장 흔한 원인이다. 이에 대한 대표적인 치료 방법으로 항암 화학 요법과 방사선 요법의 단독 사용 혹은 이들의 병용을 들 수 있다. 그러나 이러한 치료 방법은 다양한 구강 내 합병증을 동반한다. 성인과 달리 소아 환자는 항암치료 시기에 일부 영구치가 활발한 발육단계에 있으므로 발육중인 치아에 치과적 합병증이 예상된다. 치과적 합병증의 정도는 화학약물의 종류, 용량 및 방사선 조사 빈도와 치료 당시 환자의 나이에 따라 달라진다. 본 증례들에서는 특정 영구치의 발육단계에 있는 만 1-4세경에 종양의 치료를 위해 항암 화학 요법과 방사선 치료를 받은 어린이 3명을 대상으로 치료 내용과 치아 발육 상황을 검토해 보았다. 이환된 치아의 수나 그 정도에 차이는 있으나, 각각의 환자에서 영구치 치배의 선천 결손, 왜소치, 치근 저형성 등 발육장애 관련 소견이 관찰되었다. 항암치료를 받은 병력이 있는 소아에 있어서 항암치료 이후에 나타날 수 있는 일반적인 구강 합병증 이외에 발육시기 동안 치아에 미치는 영향을 고려하여, 공간 문제를 포함하여 향후 발생 할 수 있는 다앙한 문제점 예방을 위한 장기적인 관찰과 관리가 필요할 것으로 생각된다.

• 대한소아치과학회지
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• 제23권3호
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• pp.593-600
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• 1996

본 증례의 혈우병 및 자폐증 환아의 치료를 통해 다음과 같은 결론을 얻었다. 1. 혈우병 환자의 내원시 내과의사나 소아과의사 및 혈액학자에게 의뢰를하여 출혈찬도 및 부족인자 보충 퉁에 관한 자문을 얻어야 한다. 2. 매우심한중증의 혈우병 환자이거나 외과적 수술등으로 인해 많은 출혈이 예상될 경우에는 포괄적인 환자 관리를위해 입원 치료를 해주어야 한다. 3. 자폐중으로인한 행동조절이 어렵거나 그외 다른 요인에 의해 행동조절이 불가능한 혈우병 환자의 경우 입원치료가 필요하다. 4. 치과 시술을 행할때에는 최소의 관혈적인 치과치료 행하도록 노력해야 하며, 응급 상황을 대비해서 국소적인 지혈방법을 습득해야 한다. 5. 치과 시술시 환자의 동통 완화 및 소염작용을 위한 약물 처치시에도 주의를 요한다. Non-steroidal anti-inflammatory drugs는 혈소판응집을 방해하기 때문에 동통완화를 위해서는 aspirin 대신에 acetaminophen을 사용하며, 소염효과를 위해서는 steroid 계통의 약물을 사용하며 ibuprofen, indomethacin, phenylbutazone 등의 약제 사용은 금한다. 6. 혈우병 환자라고해서 두려워하거나 치과 치료의 질을 변경해서는 안된다.