Purpose : The aim of this study was to compare surgical complications between simple implant placement and implant placement combined with complicated surgical procedures. We also evaluated prosthetic complications according to the specific types of prosthesis. Material and Method : A retrospective analysis of dental chart of patients who was performed implant therapy during the period from June 2003 to December 2005 was carried out. This study was performed on 408 patients (208 male, 200 female). In addition, 1671 implants were performed. Based on their medical record and radiographs, the authors evaluated surgical and prosthetic complications, surgical procedures accompanied at the time of implant, risk factors of implant failure etc. Result : Surgical complications were developed on 358 implants(21.4% on total placed implants) and wound dehiscence was most prevalent complication. On maxillary posterior area, surgical complications developed more frequently on implants with major surgery and showed a significant difference. And complication rate of implants accompanied with GBR was higher than that of simple implants placement and also showed significant difference. The implant supported prosthesis showed no statistical difference in the occurrence of complications according to the types of prosthesis, and food retention was the most common post-prosthetic complication. Also we speculated that length and width of implant showed significant correlation to the failure of implant primary osseointegration. Conclusion : Based on the result, clinician should provide more careful maintenance for patients with implant placement accompanied by complicated surgical procedure. And periodic maintenance for the patient is requested for long-term survival of implant therapy.
Maxillofacial war injures is specific representative of severe hard and soft tissue defect. This type of injuries were different from the trauma because it may be fatal. The purpose of this study was to evaluate the injury type base on the retrograde medical record in the 104 patients from Feb. 1991 to Aug. 1992 in Korea Veterans Hospital. The obtained results were as follows. 1. Among 104 cases, 51 cases(49.0%) were classified as mandibular defects only, and 53 cases (51.0%) were classified as maxillary with mandibular defect (combined). 2. The etiologic factors of injury were gunshot, artillery and grenade or shell: 33 cases, 14cases, and 10 cases respectively in Korea War, 19 cases, 5 cases, and 8 cases respectively in Vietnam War. 3. In 57 cases of mandibular partial defect, the angle area showed the highest frequencies, 18 cases(31.6%). 4. In 42 cases of mandibular segmental defect, the area between the 1st molar and the ascending ramus showed the highest frequencies. 17 cases(40.4%), and almost all cases were unilateral defect (40 cases, 95.0%) 5. Reconstruction method performed for segmental mandibular defect were wire or plate(15 cases, 35.7%) and soft tissue closure only(12 cases, 28.7%), respectively.
An observation and evaluation of the reproducibility of the mandibular movements has been a integral part of a test for mandibular function and dysfunction. After Pantographic Reproducibility Index(PRI) was introduced in dentistry, many authors have used the index for investigation of mandibular movement function, especially in condylar compartment. Howerer, the difficult and time-consuming work of instrumentation for getting the PRI has been a major obstacle in using pantograph. This study was performed to try a new mandibular reproducibility index, so-called BioEGN reproducibility index(BERI), calculated from mandibular trajectory recorded with BioEGN. 26 dental students without any signs and symptoms of temporomandibular disorders and 22 patients with temporomandibular disorders took part in this study and classed to control group and patients group, respectively. Pantronic and BioEGN were used to record and calculate the indices, PRI and BERI. PRI had only one value, but BERI had two values of outgoing and incoming movement in each scale. With two scales of small and large, as a result, BERI had four values in this study. PRI corresponded to BERI in small scale on outgoing total movements. The data were calculated and analyzed with SAS/stat program and the conclusion of this study were as follows : 1. In every scales, in each movement, BERI on outgoing movement in control group was lower than that in patients group, respectively, but BERI on incoming movement was only different in one side movement, that was, left excursion. 2. The difference between BERI on outgoing movement and BERI on incoming movement was only shown in small scale on total movements, not in each movement, in control group. However, there was generally a positive correlationship between BERI on outgoing movement and BERI on incoming movement in each movement in both groups. 3. Simple statistics of PRI was similar to that of BERI on total movements in small scale, but there was a negative correlation between PRI and BERI on total movements in large sclae only in patients group.
Oral medication is the most frequent treatment measure for follow up treatment, which is leading by childrens' parents for them. In medication for preoperational children, they tend to concentrate the result rather than the motivation or cause. So, they frequently refuse medication which has bitter taste. So this study was attempted to develop token economy program which promote children's medication and help their parents, and to evaluate its' effect to construct the experimental ground. This study was a quasi experimental study under the nonequivalent control group posttest only design. The subjects of this study were 36 children who were aged 3-6 years and admitted pediatric ward because of their respiratory disease. Token economy program was consisted of cartoon record paper with stickers which expresses the better medication is taken the more germs die, and gift was given for back up reinforcer. To evaluate this program, time for oral medication was measured to both experimental group and control group. To determine the effect of the program, the data were analyzed by the SAS 6.12 program with t-test. The results of this study were as follows: 1. Between experimental group and control group, there was no significant difference (t=-1.2411, P=0.2374). Therefore, the hypothesis of this study was rejected. In conclusion, the token economy program for follow up care didn't change the children's behavior of oral medication. But it was found that the cartoon on recording paper gave a pleasure to participated children. Parents who were in experimental group expressed their appreciation for token economy program. So it can be said that the token economy program for follow up care was effective in inducing the children's pleasure and parents' satisfaction even though it wasn't successful in experiment. If the measuring tools for token economy program was made with well planned design and high reliability, it can be improved the effectiveness of that To develope the theoretical bases of nursing care, the well planned programs and measuring tools for them should be developed.
Purpose: Several panoramic indices have been suggested to assess bone quality from the morphology and width of mandibular cortex on panoramic radiography. The purpose of this study was to compare dental implant failure group with control group in panoramic mandibular index (PMI), mandibular cortical index (MCI), and gonion index (GI) and to determine the effect of these panoramic indices on dental implant failure. Materials and Methods: A case-control study was designed. Test group (n=42) consisted of the patients who had their implants extracted because of peri-implantitis. Control group (n=139) consisted of the patients who retained their implants over one year without any pathologic changes and had been followed up periodically. They had dental implants installed in their mandibles without bone augmentation surgery from 1991 to 2001. The following measures were collected for each patients: 1) PMI, MCI, and GI were measured twice at one-week interval on preoperative panoramic views; and 2) age, sex, implant length, implant type, installed location, occluding dentition state, and complication were investigated from the chart record. Results: The PMI showed moderate level of repeatability. The intra-observer agreement of MCI and GI were good. There was statistically significant difference in PMI between two groups. There were significant different patterns of distribution of MCI and GI between two groups. Among the panoramic indices, PMI and MCI showed significant correlation with dental implant failure. Conclusion: Panoramic indices can be used as reference data in estimating bone quality of edentulous patients who are to have implants installed in their mandibles.
Mandibular rest position is very essential position because in that position, masticatory muscularture can be reciprocally coordinative and unstrained. So obtaining a good ability to establish and maintain rest position in non-functioning state is mandatory for treatment of patient with craniomandibular disorders. In general, many types of mandibulr movement exercise start from rest position and use the sense of muscle relearning, that is, muscle smoothness and relaxation, throughout the exercise period. In this study, 44 normal subjects for control group and 37 patients with craniomandibular disorders for experimental group participated and they were classified into 3 subgroups, respectively. One method to guide mandibular rest position was used for one subgroup, so theree methods were used for this study, 1)self-guided rest position without any education, 2) guided by Rocabado's tongue rest position, 3) guided through swallowing after Dawson's centric relation. To record electromyographic activity, Bioelectric processor EM2 (Myotronics, U.S.A.) was used. The numbers of sessions from start to stable resting electromyographic level and muscle activities in stable state were recorded and two recordings which were first and second, 3 days after first recording, were done, The data were processed with SPSS/PC+package. The obtained results were as follows : 1. Mean number of sessions in second recording were fewer than those in first recording in both groups. In comparison among 3 subgroups, mean number of sessions of subgroup guided through Dawson's method were fewer than those of other groups though it is not statistically significant. 2. There was a difference of mean number of sessions between control and experimental group in first recording, but in second recording there was no difference in any cases. 3. Mean value of muscle activity were generally not different without regard to group and method if once come to stable resting position level. Mean value of muscle activity of guided subgroups showed a tendency of decreasing in second recording than in first recording. However, in self-guided subgroup there was a inconsistent pattern. 4. The amounts of change in session number from first to second recording in control group were fewer than those in experimental group.
This study was performed to investigate influence of the changes of head posture on resting electromyographic (EMG) activity in anterior temporalis, masseter, sternocleidomastoid muscle and trapezius, and on status of occlusal contacts. For this study twenty-nine patients with temporomandibular disorders(TMD) and thirty dental students without any masticatory symptoms were selected as patients group and control group, respectively. EMG activity($\mu$V) at rest was observed in four kind of head postures such as natural or normal head posture(NHP), forward head posture(FHP), upward head posture(UHP), downward head posture(DHP), and in NHP and FHP, EMG activity with flat occlusal splint was also checked. BioEMG$^\textregistered$(Bioelectromyograph, Bioresearch Inc., USA) was used to record EMG activity in the above four muscles with eight locations on both sides. The author used T-Scan$^\textregistered$(Tekscan Co., USA) system to investigate the changes of oclusal contats on clenching in the four head postures about number, force, time(duration) and total left-right statistis(TLR, occlusal stability crossing left-right dental arch on clenching). For taking in upward or downward head posture, head was inclined $10^{\circ}$ upward or downward and CROM$^\textregistered$ (cervical-range-of motion, Performance attainment Inc., USA) was used to maintain same posture during the procedure. The results obtained were as follows : 1. For resting EMG activity, anterior temporalis did not show any difference by change of head posture, but masseter and sternocleidomastoid muscle showed higher value of EMG activity in FHP and UHP, and trapezius showed higher value of EMG activity in FHP and DHP. 2. EMG activity of trapezius was higher than that of any other muscles in NHP, FHP, and DHP, but in UHP, the activity was the lowest reversely. 3. Patients group showed higher EMG activity than control group did in all the muscles in NHP. And significant difference between the two groups were also observed in anterior temporalis in FHP, in sternocleidomastoid muscle in UHP, and in sterno-cleidomastoid muscle and trapezius in DHP with higher activity in patients group. 4. There was no change of EMG activity in NHp with splint, but EMG activity in anterior temporalis and masseter was decreased in FHP with splint. 5. In general, status of occlusal contacts was not changed with head posture in all subjects, and difference between patients group and control group was only noted for number and force of tooth contact in UHP and DHP with more value in control group. 6. Correlationship between EMG activity and number ad force of tooth contacts was shown negatively with regard to masseter in NHP, and trapezius in UHP and DHP.
Park, Jinyoung;Lee, Jae-Yeol;Hwang, Dae-Seok;Kim, Yong-Deok;Shin, Sang-Hun;Kim, Uk-Kyu;Song, Jae-Min
Maxillofacial Plastic and Reconstructive Surgery
/
제41권
/
pp.49.1-49.8
/
2019
Background: The purpose of this study was to review the clinical features of oromaxillofacial infections in patients presenting to a hospital emergency ward, to identify the key factors affecting the requirement for hospitalization, and the potential risk factors predisposing to a prolonged length of hospital stay. Methods: A retrospective medical record review of the 598 patients treated for oromaxillofacial infection from 2013 to 2017 at the oral and maxillofacial surgery department, Yangsan Pusan National University Hospital, was conducted. The following information was collected from each patient: sex, age, past medical history, site of infection, etiology, admission or outpatient care, level of C-reactive protein (mg/dL), fascial spaces involved, treatment method, and duration of hospitalization. Chi-squared tests were used to identify risk factors, which were further analyzed using multivariable logistic regression. Results: A total of 606 patients were eligible for inclusion in the study, of which eight were excluded due to having incomplete charts; thus, 598 patients were included: 55% were male, mean patient age was 47.1 ± 19.9 years, and 12.9% of patients were diabetic. Furthermore, 71.2% of patients had infection originating in the mandible; the most common tooth of origin was lower posterior, and 29.8% of patients were hospitalized. Risk factors for hospital admission were elderly patients with concurrent disease, elevated C-reactive protein level, and multiple-space infection in the oromaxillofacial area. The duration of hospitalization was correlated with both diabetes and age. Conclusions: The requirement for hospital admission is determined by the severity of the infection; even severe infections, once treated with appropriate surgery, have no relation to the length of hospital stay. The important risk factors for increased duration of hospitalization are diabetes mellitus and older age. The understanding of risk factors associated with a prolonged hospital stay during the treatment of oromaxillofacial infection will aid in treatment planning as well as highlight the importance of adequate diabetes control in patients at risk of such infection.
본 연구는 소년원학교 학생의 치아우식증, 치주조직 상태와 구강건강에 대한 실태 및 인식도를 조사하기 위해 경기도 지역 소년원학교에 수용되어 있는 13~20세 남녀 청소년 342명의 우식, 상실, 충전 치아 수와, 상하악 좌우 제1대구치와 상악 우측 중절치, 하악 좌측 중절치의 출혈/치석/치주낭 존재 유무를 검사하였으며, 구강건강에 대한 인식도에 대한 설문조사를 시행하여 다음과 같은 결과를 얻었다. 1. 2006년 국민구강건강실태 조사와 비교할 때, 일반청소년에 비해 소년원학교 학생의 우식 치아, 우식경험 영구치, 출혈, 치석, 천치주낭을 보이는 치아 수가 많았다. 2. 여자가 남자보다 우식경험 영구치 수가 많았으나(p<0.05),건전 치주조직을 보이는 치아 수는 많고, 천치주낭을 보이는 치아 수는 더 적었다(p<0.05). 3. 여자가 남자보다 자신의 구강건강이 나쁘다고 생각하는 비율이 높았으며(p<0.05), 대다수(79.2%) 청소년이 구강건강이 중요하다고 응답하였다. 4. 소년원학교 학생의 71.5%가 치과치료에 대한 불안이 있다고 응답하였으며, 여자가 남자보다 그 비율이 높았다(p<0.05).
Objectives : The purpose of this study was to attempt to lay the foundation for the development of oral health programs geared toward promoting the oral health of low socioeconomic class children. Methods : The subjects of this study have been investigated for the use of children to 96 local children's center. Questionnaire for research purposes are described in more detail under the coordination of child care teachers to students, students to be able to record. The survey was conducted at the Health center. Analyzed the data collected by SPSS 18.0. Results : The findings of the study were as follows: The children were influenced by habits of having a snack in dental caries experience. Higher intake of bread and a lot of children more probability of dental caries experience. I've found a lot of sweet-food intake eleven cakes or fruits and vegetables that children prefer higher dental caries experience was low. Conclusions : Education on dietary behavior for low-income children was necessary because of the high correlation of the relationship between dietary habits and dental caries and diet.
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