• 대한소아치과학회지
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• 제37권1호
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• pp.65-72
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• 2010

전신마취는 치과치료시 일반적인 방법으로 행동조절이 불가능한 환자 및 별도의 의학적 처치가 필요한 환자를 위한 행동조절법 중 하나로 연구, 발전되어 왔다. 이 중 통계적 연구는 치과치료를 위한 전신마취를 받는 환자들에게 보다 양질의 진료를 공하기 위한 기초 자료를 제공하는데 그 의의가 있다. 따라서 이에 대한 연구가 지속적으로 이루어져 왔으나, 아직 국내에 서는 다수의 환자를 대상으로 한 장기간의 연구가 부족한 실정이다. 이에 1997년 1월부터 2008년 8월말까지 연세대학교 치과병원 소아치과 및 장애인 클리닉에서 시행된 치과치료를 위한 전신마취 1196례(1135명) 중 기록이 양호한 1126례(1065명)를 대상으로 자료를 수집하여 다음과 같은 결과를 얻었다. 1. 연령범위는 1~66세로 5세 미만이 410명(38.5%)으로 가장 많았으며, 성별은 남성이 695명(65.3%)으로 여성보다 더 많았다. 2. 치료 내용은 통계상의 평균치로 볼 때 수복치료가 1인당 5.6개, 유치 및 영구치에 대한 치수치료와 근관치료가 2.3개, 기성금관이 2.5개, 발치가 1.6개였으며, 치료 시간은 평균 100분이었다. 3. 576명(53.3%)의 환자가 6개월 미만으로 재내원하였으며, 내원 횟수는 평균 4.3회였다. 4. 치과치료를 위한 전신마취를 받은 횟수는 1022명(95.9%)이 전신마취를 1회 받았으며 43명(4.1%)의 환자가 2회 이상 전신마취를 받았다. 따라서 전신마취하의 치과치료는 대부분의 치과치료를 한번에 시행할 수 있고 환자와 보호자의 스트레스를 최소화 할 수 있으며, 양질의 진료 환경을 제공함으로서 만족스러운 치료결과를 기대할 수 있는 장점이 있다. 그러나 구강 질환의 특성상 적절한 사후 관리가 이루어지지 않는다면 적절한 구강 건강을 유지하기 어렵다. 따라서 앞으로의 연구를 통해 전신마취하 과치료의 효율성을 향상시키고 그 이후의 체계적인 검진 계획을 확립하는 것이 중요하다.

• 대한장애인치과학회지
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• 제14권1호
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• pp.1-6
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• 2018

General anesthesia is an effective behavior management method for disabled patients or uncooperative children who have difficulty in cooperation. The objective of this study was to assess and analyze dental treatment under general anesthesia in department of pediatric dentistry at Pusan National University Dental Hospital for 5 years. One hundred and nine cases of general anesthesia from June 2013 to May 2018 were surveyed for this study. Patients' distribution, reasons for general anesthesia, treatment pattern, agents for general anesthesia, duration of treatment, and visiting route were assessed. The proportion of male was higher than female and age group of 5 to 9 was highest. Reasons for general anesthesia were handicapped situations with or without systemic disease(52%), operative treatment needs(13.2%), uncooperative(15%) and others(29.8%). Most used agents for general anesthesia were thiopental sodium and sevoflurane. Dental treatment under general anesthesia for handicapped and uncooperative children has been increasing. Therefore, it is important to improve the system and efficiency of general anesthesia to provide satisfactory treatment.

• 대한장애인치과학회지
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• 제9권1호
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• pp.1-10
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• 2013

This article discusses the provision of sedation for uncooperative special need dental patients. Most of dental treatments have been performed in these patients with the techniques of behavioral control. However, if this behavioral control fails during treatment, it is nearly impossible to treat them without either sedation or general anesthesia. Sedation is also beneficial for patients because it circumvent the aggravation of negative behaviors related to their stress during the treatment. Also, the morbidity and mortality related to dental sedation is relatively low. In this regard, the provision of sedation for people with special needs can be considered as a safe and necessary techniques for their treatment.

• 대한치과의사협회지
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• 제51권7호
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• pp.382-388
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• 2013

Inhalation sedation has may advantageous properties that make it a suitable choice for sedation in pediatric, disabled and many patients, either alone or in conjunction with other agents. We need review of Guideline on use of nitrous oxide for dental patients that make minimizing complication of sedation for safe and effective sedation. Conventionally, nitric oxide is used for inhalation sedation, nowadays sevoflurane can also be used due to easily titratable for controllable effect and less failure of sedation. Recently sevoflurane can be used to provide sedation as a sole agent in air or oxygen or in combination with nitrous oxide in dentistry.

• 대한장애인치과학회지
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• 제9권1호
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• pp.56-65
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• 2013

I participated in Academic Exchange Program(Action plan II) between KADH(Korean Association for Disability and Oral Health) and JSDH(Japanses Society for Disability and Oral Health) for 2 months from 3rd July 2012 to 2nd september 2012 in the Department of Hygiene and Oral Health, School of Dentistry, Showa University at Tokyo, Japan. I have observed their operation process and learned what dysphagia is and how it is consulted and taken care of as a therapy for patients with eating and swallowing disorders for two months in The department of special needs dentistry at Showa University Dental Hospital, Jonan Branch of Tokyo Metropolitan Kita Medical Rehabilitation Center for the Disabled, Smile Nakano Center, Tokyo metropolitan center for persons with disabilities in Lidabashi for one week, Eating and swallowing functional therapy workshop for disabled children, Tokyo metropolitan Tobu medical center for Persons with Developmental/Multiple Disabilities located in Minamisunamitchi for one week and on The 17-18th JSDR(Japanese Society of Dysphagia rehabilitation) in Sapporo. Through Action Plan II program, I learned how precious eating, drinking and swallowing with ease are and observed how they do and what they do as a dentist or a dental hygienist in Japan for dysphagia patients. Therefore, I want to present the dental approaches of children with dysphagia in Japan, based on my experience for two months.

• 대한소아치과학회지
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• 제42권1호
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• pp.102-111
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• 2015

진단기법의 급속한 발전으로 인해 타액은 의학과 치의학 분야에서 가장 중요한 진단 샘플로서의 가능성이 있다. 타액은 혈장과 비교할 때 다음과 같은 장점을 갖는다. 단순하고 비 침습적이며 큰 집단의 검사 시 경제적으로 이용할 수 있다. 샘플 채취 시 감염의 위험이 극히 적고, 임상적으로 샘플 채취가 어려운 어린이나 장애인, 불안한 환자에서 유용하게 사용될 수 있다. 이 종설은 타액의 진단적 이용 가능성에 대하여 고찰하고 최근의 연구에 대한 요약을 제공하고자 한다.

• 대한장애인치과학회지
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• 제11권2호
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• pp.76-80
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• 2015

장애인의 보건 수준이 높아지면서 치료보다는 예방의 관점에서의 구강 관리가 중요해지고 있다. 본 증례에서 소개된 다섯 명의 지적 장애를 지닌 환자들을 triazolam을 이용하여 경구 투여하여 치료하였다. Triazolam을 이용한 진정법은 장애인의 정기적인 구강 관리의 한 대안으로 고려해볼 수 있겠다.

• 대한치과마취과학회지
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• 제12권2호
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• pp.93-97
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• 2012

Background: Some disabled patients show insufficient cooperation during dental treatment, and general anesthesia in an outpatient setting can be successfully administered. To minimize post-anesthetic complications is an essential issue, and strict discharge protocols are required for the safety of the patients. Post-anesthetic follow-ups using telephone calls can be applied to improve the quality of the outpatient care system. The authors evaluated the post-operative condition of patients after dental treatment under general anesthesia. Methods: Total 143 patients and their caregivers included in this study. The patients received general anesthesia for dental treatment in Seoul National University Dental Hospital, Clinic for Persons with Disabilities from July, 2011 to April, 2012. Telephone calls were given to the patients or their caregivers to collect information about the patients' systemic condition and anesthesia-related complications. Results: Among 131 patients with responses of telephone calls, 87 patients (66.4%) reported no discomfort, while 44 patients (33.6%) presented post-anesthetic complications. A total of 20 patients reported mild fever, 10 patients had vomiting, and 7 patients had sore throat. Other complications included nausea, fatigue, nasal bleeding, skin sore, and body rash. Among the patients with the history of epilepsy, 63.6% showed post-anesthetic discomfort or complication (P = 0.027, ${\chi}^2$ test). Conclusions: One third of dental patients who received general anesthesia due to insufficientcooperation complained discomfort after discharged from outpatient anesthetic care.

• 대한치과마취과학회지
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• 제11권2호
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• pp.146-152
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• 2011

Background: Elderly patients with progressive dementia including Alzheimer's disease (AD) are more and more often scheduled to undergo general anesthesia for various pathologies including dental problem. But, there is high risk of deterioration of underlying mental diseases and other co-morbidities. So it is important to implement preventive strategies and take adequate measures to minimize negative perioperative events in these patients. Methods: We reviewed the 17 cases of 11 patients with AD who underwent ambulatory general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 68 (57-81) years. All of them were diagnosed with AD and some had hypertsnsion, bronchiectasis, urinary incontinence. For anesthesia induction, 3 cases (1 patient) was needed physical restraint, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (11 cases), propofol (3 cases) and sevoflurane (3 cases). All patients received nasotracheal intubation without difficulties. Mean total anesthetic time was 3 hour 44 min ${\pm}$ 60 min and staying time at PACU was 83 ${\pm}$ 34 min. All the patients except one who showed hypertension discharged without any complication. There was no death or long term hospitalization because of severe complications. Conclusions: If general anesthesia is needed, pertinent diagnostic tests and workup about other medical problems, and appropriate anesthetic planning are essential for safety.

• 대한장애인치과학회지
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• 제13권1호
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• pp.19-22
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• 2017

비골격성 전방부 개방 교합은 대부분 구강 주위 근육 기능의 부조화로 인한 것이기 때문에 근기능요법을 통한 치료가 추천된다. 그러나 근기능요법의 시행 시에는 환자의 협조도가 필수적이기 때문에, 협조도가 충분하지 못한 경우에는 습관 차단 장치를 적극적으로 활용하는 것이 도움이 될 수 있다. 습관 차단 장치를 단독으로 이용하는 것에 비하여 근기능요법을 병행할 수 있다면 장치 치료의 기간이 단축되고 치료 후의 안정성에도 좋은 결과를 가져올 수 있을 것으로 판단된다.