• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.2
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• pp.103-109
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• 2024

Teriparatide has been effective in treating people diagnosed with medication-related osteonecrosis of the jaw (MRONJ). However, its efficacy is not well established to be accepted as a standard of care. The objective of this paper was to investigate the efficacy of recombinant human parathyroid hormone for the treatment of MRONJ. We report three cases of MRONJ patients with osteoporosis as the primary disease who were treated with a teriparatide agent along with other adjunctive measures. Each patient was administered a teriparatide injection subcutaneously for 16 weeks, 36 weeks, or 60 weeks. Surgical intervention including partial resection, sequestrectomy, decortication, and saucerization took place during the teriparatide administration. Complete lesion resolution was identified clinically and radiographically in all three patients. In patients diagnosed with MRONJ, teriparatide therapy is an efficacious and safe therapeutic option to improve healing of bone lesions. These findings demonstrate that teriparatide in combination with another therapy, especially bone morphogenetic protein, platelet-rich fibrin, or antibiotic therapy, can be an effective protocol for MRONJ.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.5
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• pp.414-421
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• 2004

This is a reprospective study on the care of odontogenic infections in admission patients with geriatric diseases. The study was based on a series of 480 patients at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, From Jan. 1, 2000, to Dec. 31, 2002. The Obtained results were as follows: 1. The systemic malignant tumor was the most frequent cause of the geriatric diseases with odontogenic infectious diseases, and refractory lung disease, systemic heart disease, type II diabetes mellitus, cerebrovascular disease, bone & joint disease, senile psychologic disease were next in order of frequency. 2. Male prediction(57.5%) was existed in the odontogenic infectious patients with geriatric diseases. But, there were female prediction in senile psychologic disease, systemic heart disease and cerebrovascular disease. 3. The most common age group of the odontogenic infectious patient with geriatric disease was the sixty decade(47.9%), followed by the seventy & eighty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with geriatric disease, peak incidence was occurred as toothache(52.7%), followed by extraction wish, tooth mobility, oral bleeding, oral ulcer, fracture of restoration, gingival swelling in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis & periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(34.2%) was showed in primary endodontic treatment (pulp extirpation, occlusal reduction and canal opening drainage) and followed by scaling, incision & drainage, only drugs, pulp capping, restoration in order.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.12.1-12.9
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• 2020

Coronavirus is an enveloped virus with positive-sense single-stranded RNA. Coronavirus infection in humans mainly affects the upper respiratory tract and to a lesser extent the gastrointestinal tract. Clinical symptoms of coronavirus infections can range from relatively mild (similar to the common cold) to severe (bronchitis, pneumonia, and renal involvement). The disease caused by the 2019 novel coronavirus (2019-nCoV) was called Covid-19 by the World Health Organization in February 2020. Face-to-face communication and consistent exposure to body fluids such as blood and saliva predispose dental care workers at serious risk for 2019-nCoV infection. As demonstrated by the recent coronavirus outbreak, information is not enough. During dental practice, blood and saliva can be scattered. Accordingly, dental practice can be a potential risk for dental staff, and there is a high risk of cross-infection. This article addresses all information collected to date on the virus, in accordance with the guidelines of international health care institutions, and provides a comprehensive protocol for managing possible exposure to patients or those suspected of having coronavirus.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.1
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• pp.63-71
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• 2014

Extension of advanced odontogenic infection from deep neck fascial spaces into the mediastinum is heralded by chest pain, dyspnea, fever, and radiographic demonstration of mediastinal widening. The critical care should be done in a team approach by multiple medical and dental departments, such as, oral & maxillofacial surgery, otolaryngology, anesthesiology, chest surgery, and infection medicine. Especially, fluid & drug therapy, adequate incision & drainage and systemic supportive psychosedation care are important. But, acute hyperventilation can be produced by several distinct causes: severe anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The orofacial fears about acute pain, trismus, dysphagia, swelling and oral surgical treatment lead to the severe anxiety and increased blood catecholamine level by stress. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the care, hyperventilation was occurred during psychosedation and local anesthesia for incision and drainage of the masticatory fascial space abscess with deep neck infection & mediastinitis. We suggest that the dental patient with advanced odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.

• Korean Journal of Cleft Lip And Palate
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• v.15 no.2
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• pp.69-82
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• 2012

Our Team Approach consists of following five stages; (1) Peri-natal care until lip repair After ultrasound diagnosis, some obstetricians recommend the mother with CL/P fetus to undergo prenatal counseling in our CLP clinic. On the day the CL/P baby was born, our oral surgeon, nurse, and pedodontist visit the maternity clinic, and take counseling and take impression for a feeding plate. The cheiloplasty is performed in three months old. (2) From lip repair to palatal repair At one year of age, Otorhinolaryngologist checks middle-ear disease. Palatoplasty is carried out at 1.5 - 2 years old. (3) In deciduous and early mixed dentitions Speech is the most important issue in social life for the CL/P subjects, therefore the training of velopharyngeal function is essential. Orthodontist monitors dentofacial development from 5 years of age. In the case of severe maxillary under-growth or severe collapse, maxillary protractor or lateral expansion is indicative, respectively. In early mixed dentition, upper central incisor on the cleft area erupts with some torsion, and then the traumatic occlusion with tooth torsion must be corrected. (4) In mixed dentition Right before the eruption of upper canines, secondary bone grafting is performed. One year prior to the operation, maxillary fan-type expansion is carried out to correct the collapse of maxillary segments. Following the surgical operation, the erupted canine will be moved into the transplanted bone to avoid alveolar resorption. (5) In permanent dentition Final tooth alignment is carried out after eruption of second molars. Some cases may require orthognathic surgery after physical maturation. Prosthetic oral rehabilitation including the dental-implant is carried out after age eighteen.

• Journal of Korean society of Dental Hygiene
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• v.17 no.6
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• pp.1067-1080
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• 2017

Objectives: This study analyzed the perception towards clinical practice education content held by dental hygiene students in dental institutions and their perceived importance of dental hygienists' clinical duties. Methods: The subjects of this study were 182 dental hygienists who were working at dental institutions in Seoul, Gyeonggi, and Chungcheong areas. A survey was conducted with a self-administered questionnaire. In the questionnaire, the clinical practice contents were classified into observation, preparation, and performance, and the importance of clinical duty was measured with a 3-point scale. For the clinical practice contents and the importance of duty, descriptive statistics and chi-square test were performed, and the study results were analyzed using STATA 11.0. Results: With regard to clinical practice contents, observation was mainly performed in oral & maxillofacilal radiology, preventive dentistry, periodontal medicine and oral medicine. In primary care and infection control, practice and observation were mainly performed. In the department of orthodontics and pediatric dentistry, observation and preparation were mainly conducted, while in oral surgery, conservative dentistry observation, preparation and practice were all conducted. With regard to clinical practice contents according to the dental institution, there were statistically significant differences in the type of dental institution and the duty (p>0.05). In terms of the importance of dental hygienist's duty, infection control, toothbrushing education for each patient, removal of plaque, and patient education after surgery were considered important. Conclusions: For clinical practice of the dental hygiene department, the education contents should be standardized in accordance with the importance of the dental hygienist's duty, a protocol for operation of practice should be developed, and a method of standardization of evaluation should be sought in the future.

• Imaging Science in Dentistry
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• v.53 no.3
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• pp.217-220
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• 2023

Purpose: This pilot study was conducted to evaluate half-value layer (HVL) measurements obtained using a semiconductor dosimeter for intraoral radiography. Materials and Methods: This study included 8 aluminum plates, 4 of which were low-purity (less than 99.9%) and 4 high-purity (greater than 99.9%). Intraoral radiography was performed using an intraoral X-ray unit in accordance with the dental protocol at the authors' affiliated hospital: tube voltage, 60 kVp and 70 kVp; tube current, 7 mA; and exposure time, 0.10 s. The accuracy of HVL measurements for intraoral radiography was assessed using a semiconductor dosimeter. A simple regression analysis was performed to compare the aluminum plate thickness and HVL in relation to the tube voltage (60 kVp and 70 kVp) and aluminum purity (low and high). Results: For the low-purity aluminum plates, the HVL at 60 kVp (Y) and 70 kVp (Y) was significantly correlated with the thickness of the aluminum plate (X), with Y=1.708+0.415X (r=0.999, P<0.05) and Y=1.980+0.484X (r=0.999, P<0.05), respectively. Similarly, for the high-purity aluminum plates, the HVL at 60 kVp (Y) and 70 kVp (Y) was significantly correlated with the plate thickness(X), with Y=1.696+0.454X (r=0.999, P<0.05) and Y=1.968+0.515X (r=0.998, P<0.05), respectively. Conclusion: This pilot study examined the relationship between aluminum plate thickness and HVL measurements using a semiconductor dosimeter for intraoral radiography. Semiconductor dosimeters may prove useful in HVL measurement for purposes such as quality assurance in dental X-ray imaging.

• Journal of Radiation Protection and Research
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• v.48 no.1
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• pp.15-19
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• 2023

Background: Cone beam computed tomography (CBCT) is a specialized medical equipment and plays a significant role in the diagnosis of oral and maxillofacial diseases and abnormalities; however, it is attributed to risk of exposure of ionizing radiation. The aim of the study was to estimate and determine the amount of scattered radiation dose to the thyroid gland in dental CBCT during maxilla and mandible scan. Materials and Methods: The average scattered radiation dose for i-CAT 17-19 Platinum CBCT (Imaging Sciences International) was measured using a Multi-O-Meter (Unfors Instruments), placed at the patient's neck on the skin surface of the thyroid cartilage, with an exposure parameter of 120 kVp and 37.07 mAs. The surface entrance dose was noted using the Multi-O-Meter, which was placed at the time of the scan at the level of the thyroid gland on the anterior surface of the neck. Results and Discussion: The surface entrance dose to the thyroid from both jaws scans was 191.491±78.486 µGy for 0.25 mm voxel and 26.9 seconds, and 153.670±74.041 µGy from the mandible scan, whereas from the maxilla scan the surface entrance dose was 5.259±10.691 µGy. Conclusion: The surface entrance doses to the thyroid gland from imaging of both the jaws, and also from imaging of the maxilla and mandible alone were within the threshold limit. The surface entrance dose and effective dose in CBCT were dependent on the exposure parameters (kVp and mAs), scan length, and field of view. To further reduce the radiation dose, care should be taken in selecting an appropriate protocol as well as the provision of providing shielding to the thyroid gland.

• Korean Parent-Child Health Journal
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• v.4 no.1
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• pp.35-55
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• 2001

Recently attention has been focused on the effects of early intervention, or its lack, on both normal and preterm infants. Particularly numerous studies suggest that premature infants are not necessarily understimulated but instead are subjected to inappropriate stimulation. Developmental support and sensory stimulation have become clinical opportunities in which nursing practice can impact on the neurobehavioral outcome of premature infants. Developmental care has been widely accepted and implemented in neonatal intensive care units across the country. Increasingly, attention and concern in caring for low-birth-weight infants and premature infants has led clinicians in the field to explore the effects of a complex of interventions designed to create and maintain a developmentally supportive environment; to provide age-appropriate sensory input; and to protect the infant from inappropriate, excessive and stressful stimulation. The components of developmental care include modifications of the macro-environment to reduce NICU light and sound levels, care clustering, nonnutritive sucking, and containment strategies, such as flexed positioning or swaddling. Sensory stimulation of the premature infants is presented to standardize the modification of a developmental intervention based on physiologic and behavioral cues. The most appropriate type of stimuli are those that are sensitive to infant cues. Evaluation of infant physiological and behavioral responds to specific intervention stimuli may help to identify more appropriate interventions based on infants' cues. A critical question confronting the clinician is that of determining when the evidence supporting a change in practice is sufficient to justify making that change. There are acknowledged limitations in the current studies. Many of the studies examined had small sample sizes; used nonprobability sampling; and used a phase lag design, which introduces the possibility of threats to internal validity and limits the generalizability of the results. Although many issues regarding the effects of developmental interventions remain unresolved, the available research base documents significant benefits of developmental care for LBW infants in consistent outcomes, without significant adverse effects. Particularly, although the individual studies vary somewhat in the definition of specific outcomes measured, instrumentation used, time and method of data collection, and preparaion of the care providers, in all studies, infants receiving the full protocol of individualized developmentally supportive care had improvements in some aspect of four areas of infant functioning: level of respiratory or oxygen support, the establishment of oral feeding; length of hospital stay, and infant behavioral regulation. In summary, based on the available literature, individualized developmental intervention should be incorporated into standard practice in neonatal intensive care. And this implementation needs to be coupled with ongoing research to evaluate the impact of an individualized developmental care programs on the short- and long-tenn health outcomes of LBW infants.

• The Journal of the Korean dental association
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• v.51 no.12
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• pp.630-636
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• 2013

During the past decade, the use of osseointegrated implants as a foundation for prosthetic replacement of missing teeth has become highly predictable and successful. SPT(Supportive Periodontal Therapy) identified as regular visits to the therapist for periodontal control and maintenance in a well-organized scheme, the number of appointments per year following a pre-designed subject-tooth/implant-site risk assessment method. Peri-implant disease was a frequent finding in subjects having natural healthy dentition and in subjects without periodontitis. Supportive periodontal program were found to be strongly related to implant survival. This study demonstrates that regular maintenance reduces the risk for peri-implant inflammation significantly as compared with irregular maintenance. This underlines the value of the SPT in enhancing the long-term outcomes of implant therapy, particularly in subjects affected by periodontitis, in order to control reinfection and limit biological complications. It is highly recommended to maintain implant patients under a strict supportive periodontal treatment protocol that might contribute to implant survival, and regular maintenance reduces the risk for periimplant inflammation significantly as compared with irregular maintenance. Ideally, patients may be informed on the beneficial effect of a regular patient-related post-therapy care before implant insertion.