• 대한소아치과학회지
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• 제41권1호
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• pp.18-26
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• 2014

심한 불안이나 불수의적인 움직임으로 행동조절이 어려운 소아와 장애인의 치과치료를 위해 깊은 진정법이 고려된다. 응급 치과진료에 있어 세보플루란 흡입을 이용한 깊은 진정이 빠른 유도와 회복으로 인해 선호된다. 2013년 1월부터 2013년 10월까지 세보플루란을 이용한 깊은 진정을 받은 소아와 장애인 121명을 대상으로 조사분석하였다. 깊은 진정법을 사전 계획한 환자군과 소아외상이나 장애인의 특성 등으로 응급으로 시행한 환자군을 비응급 세보플루란진정군과 응급 세보플루란진정군으로 나누었다. 비응급 세보플루란진정을 받은 환자는 95명이었고 응급 세보플루란진정을 받은 환자는 26명이다. 두 군간에 성별, 나이, 진정법을 시행한 이유, 유도방법, 진정시간 및 치료시간, 치료내용, 진료과를 비교분석하였다. 비응급 세보플루란진정은 소아와 장애인의 행동조절에 안전하고 효과적으로 사용되었고 응급 세보플루란진정은 외상을 입은 어린 소아환자의 짧고 간단한 치료에 유용하게 사용되었다. 세보플루란을 이용한 깊은 진정은 점차적으로 전신마취의 사용을 줄이고 소아와 장애인 환자의 응급 치과진료에 유용한 방법이었다.

• 대한치과마취과학회지
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• 제13권3호
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• pp.95-102
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• 2013

Background: Sedation or outpatient general anesthesia is a necessary method for a successful dental treatment for children and the disabled who have a difficulty of cooperation. The aim of this study was to assess the patients who had dental treatment under sedation or outpatient general anesthesia at department of pediatric dentistry, Chonnam national university dental hospital and Gwangju dental clinic for the disabled. Methods: 875 patients who had sedation from January 2009 to September 2013 and 88 patients who had outpatient general anesthesia after May 2011 were assessed for this study. Patient's distribution and treatment patterns were examined. Results: The number of patients has been increasing in both sedation and outpatient general anesthesia. In case of sedation, the proportion of male patients was higher and 4-6 years age group was the highest. Most patients have resided in Gwangju buk-gu and the percentage of restorative treatment was the highest. In case of outpatient general anesthesia, the proportion of male patients was higher than that of sedation. Two groups, 10-19 and 20-29 years age, consisted most of patient. Most patients have resided in Gwangju buk-gu and Jeollanam-do, and the percentage of periodontic and preventive treatment was the highest. Conclusions: Sedation or outpatient general anesthesia for dental treatment has been increasing for children and the disabled who have a difficulty of cooperation. Therefore, it is important to improve treatment environment under sedation and general anesthesia through continuous research and studies.

• 대한장애인치과학회지
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• 제3권1호
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• pp.6-10
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• 2007

Many disabled patients need extensive dental treatment because they have much difficulty in maintaining their oral hygiene. However, because they are not cooperative and not manageable, they require physical restraints, drug induced sedation or general anesthesia. General anesthesia is useful in control of the patients who cannot be treated in other ways. Additionally, general anesthesia provides more safe environment for medically compromised patients. The aim of the present study was to investigate a kind of disorder, sources of referral, preoperative oral condition, experience of dental visit, and performing general anesthesia or not of 930 disabled patients in Kyung-Hee University dental hospital for 30 years.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권3호
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• pp.203-208
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• 2016

Background: In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. Methods: This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Results: Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5-8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was $132.7{\pm}77.6min$, and the mean duration of treatment was $101.9{\pm}71.2min$. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Conclusions: Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권4호
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• pp.283-288
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• 2016

Background: Sevoflurane sedation in pediatric and disabled patients has the advantage of faster induction and recovery compared to general anesthesia, as well as minimum influence on the respiratory and cardiovascular functions, and airway protective reflexes. This study aimed to evaluate the clinical efficacy of sevoflurane sedation used in dental treatment at one provincial dental clinic center for the disabled. Methods: We investigated patients' gender, age, reasons for undergoing sedation, medication history prior to treatment, duration of anesthesia, treatment length, type of treatment, and yearly patterns, for 387 cases of dental treatment performed using sevoflurane sedation from January 2013 to October 2016. Results: We analyzed 387 cases (215 male patients, 172 female patients). Male patients aged 20 year or older accounted for 39.0% of all patients, marking the highest proportion. Patient's lack of cooperation was the most common reason for performing dental sedation. Prosthetic treatment was the most frequently practiced, accounting for 174 treatment cases. The mean lengths of the entire treatment and of the dental procedure were 55.2 min and 39.8 min, respectively. Conclusions: Sevoflurane sedation has the advantage of fast anesthesia induction and recovery compared to general anesthesia; therefore, it can be used efficiently to induce anesthesia in pediatric and disabled patients during short dental procedures, enabling stable treatment of these patients.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권2호
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• pp.123-129
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• 2016

Background: The objective of the present study was to examine the status of patients who had received dental treatment under intravenous (IV) sedation at Chungnam Dental Clinic for the Disabled in Korea from its inception to the present time, and to review the analysis results. Methods: Retrospective analysis was performed on 305 cases of patients who had received dental treatments under IV sedation between January 2011 and May 2016. The analysis examined the patient's sex, age, primary reason for IV sedation, duration of anesthesia and dental treatment, type of dental treatment performed, number of clinical departments involved in the dental treatment and level of multidisciplinary cooperation, and annual trends. Results: Most dental treatments using intravenous sedation were performed on medically disabled patients or dentally disabled patients with an extreme gag reflex or dental phobia. The mean duration of IV sedation was 72.5 min, while the mean duration of treatment was 58.0 min. The types of dental treatments included surgical treatment (n = 209), periodontal treatment (n = 28), prosthodontic treatment (n = 28), restorative treatment (n = 23), implant surgery (n = 22), endodontic treatment (n = 9), reduction of temporomandibular joint dislocation (n = 1), and treatment of traumatic injuries (n = 1), with treatments mostly performed on adult patients. Conclusions: With increasing demand for minimally painful treatment, cases using IV sedation are on an upward trend and are expected to continue to increase.

• 대한치과마취과학회지
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• 제13권1호
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• pp.9-12
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• 2013

General anesthesia has been developed in dentistry as a type of management technique to sedate patients who may be uncontrollable or require medical consideration. However, emergency treatment for controlling pain before general anesthesia could be required due to the time for medical evaluation for general anesthesia. There is a greater possibility of developing complications under extended waiting period. A disabled patient who needs dental treatment under general anesthesia underwent pretreatment with intramuscular injection of midazolam and $N_2O-O_2$ inhalation sedation in these cases report.

• 대한소아치과학회지
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• 제40권1호
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• pp.28-39
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• 2013

전신마취 및 진정법은 소아 및 장애인에게 성공적 치과치료를 위해서 필수불가결하다. 이 연구의 목적은 충남장애인구강진료센터에 치과치료를 위해 시행된 전신마취와 진정법의 실태를 평가하기 위함이다. 2011년 1월부터 2012년 9월까지 전신마취, 세보플루란진정 및 정주진정을 받은 소아와 장애인 426명을 대상으로 조사분석하였으며 389명이 전신마취, 20명이 세보플루란진정 그리고 17명이 정주진정하에서 치과진료를 받았다. 전신마취의 비율이 두 진정법에 비해 높았다. 세보플루란진정은 소아환자의 외상처럼 짧고 간단한 치료에 유용하게 사용되었다. 정주진정은 공포와 불안을 가진 치과적장애환자에게 선택되었다. 세보플루란과 정주진정은 점차적으로 전신마취의 사용을 줄이고 치과적장애환자를 위한 유용한 방법이었다.

• 대한장애인치과학회지
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• 제9권1호
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• pp.25-29
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• 2013

Most of disabled people face hardness in caring their general oral hygiene by themselves. So that, they are once involved in dental caries or periodontal disease, they have much bigger chance of aggressive progress. Therefore preventive dentistry is more important to disabled one than non-disabled. They need to be checked with routine periodic dental examination and by that, oral disease must be found at initial stage. We selected 37 patients from newly visited 237 patients who had dental treatment at the free dental clinic, Gangnam district, Seoul, between 2000 and 2001. This study is a comparative evaluation of first 2 years' treatment records of selected 37 patients (male 28, female 9) with that of their last 2 years. 24 of 37 have mental retardation, 9 have autistic disorder, 2 have auditory disorder, 1 has brain disorder and 1 has crippled disorder. Their dental treatment records categorized by 4 level; score 4 stands for endodontic treatment, score 3 stands for general conservative treatment, score 2 stands for preventive treatment, such as sealant and score 1 stands for routine check. In first 2 years of treatment, average score was 2.85 which score means approximately general conservative treatment. And that of last 2 years was 1.44, which means routine check. In early time of their visit, they will receive the treatment due to their chief complaint. And after that early time, they can have a routine check so that they can be treated before the disease get worse. The patient's oral health can remain decent only by a simple treatment.

• 한국치위생학회지
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• 제9권3호
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• pp.357-368
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• 2009

The purpose of this study was to examine the state of dental treatment among disabled patients by the type of disability. After the medical records of 531 disabled patients who received treatment at the pediatric dentistry in K university hospital, the following findings were given: 1. As for age distribution by year, the rate of patients aged 10 or down rose to 42.5 from 5.1 percent, and the 16-20 age group increased from 16.7 to 24.8 percent. But the rates of patients aged between 11 and 15 and aged 21 and up were on the rise(p<.05). 2. Concerning the type of disability by year, there was an increase in the number of patients with brain lesions, mental retardation, developmental disorder and Down's syndrome(p<.05). As to the number of dental caries by the type of disability, the patients with heart diseases had the most dental caries that numbered 8.49, followed by Down's syndrome, metal retardation, brain lesions, the other disabilities and developmental disorder. 3. In relation to dental treatment experiences by the type of disability, the patients with developmental disorder(57.5%) received the most dental treatment, followed by mental retardation, the other disabilities, brain lesions, Down's syndrome and heart diseases(p<.05). 4. Regarding general anesthesia experience by the type of disability, the patients with mental retardation(31.6%) were put under general anesthesia the most, followed by developmental disorder, brain lesions, the other disabilities, heart diseases and Down's syndrome(p<.05). In conclusion, nationwide efforts to nurture separate dental personnels responsible for the disabled, to expand relevant facilities and to improve the health care insurance are required to promote the oral health of disabled children.