• Title/Summary/Keyword: Teeth extraction

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Sedative methods used during extraction of wisdom teeth in patients with a high level of dental anxiety

  • Seto, Mika;Furuta, Haruhiko;Sakamoto, Yumiko;Kikuta, Toshihiro
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.3
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    • pp.241-244
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    • 2011
  • Introduction: Intravenous sedation is performed to ensure smooth and safe surgery. Dental anxiety is a reaction to an unknown danger. The Spielberger's state-trait anxiety inventory (STAI) can be used to simultaneously evaluate the levels of state and trait anxiety. State anxiety is defined as subjective feelings of nervousness. This study assessed the presurgical anxiety using STAI and performed intravenous sedation for patients whose level of state anxiety was > stage IV. Based on our clinical experience, it is believed that higher doses of sedatives are needed to induce the desired levels of sedation in patients with a high level of state anxiety. Objectives: This study examined whether the sedative consumption of the patient with a high anxiety level increased. Patients and Methods: Patients with state anxiety scores of ${\geq}$51 were included in Group V, and those with state anxiety scores ranging from 42 to 50 were placed in Group IV. To induce sedation, intravenous access was established, and a bolus dose of 3.0 mg midazolam was administered intravenously. Sedation was maintained by administering a continuous infusion of propofol, which was aimed at achieving an Observer's Assessment of Alertness/Sedation scale of 10-12/20. In this study, midazolam was initially administered when the body movements appeared to occur or the blood pressure increased. This was followed by the administration of higher doses of propofol if low sedation was observed. Results: There were no significant differences in the patient demographics, duration of sedation, and doses of local anaesthetic agents between Groups IV and V. The midazolam dose and mean propofol dose needed to maintain comparable levels of sedation were significantly higher in Group V than in Group IV. Conclusion: In female patients, whose level of preoperative state anxiety is more than Stage V of STAI, a large quantity of sedatives is needed for intravenous sedation.

A CLINICAL AND BACTERIOLOGICAL EXAMINATION AND TREATMENT OF $PAPILLON-LEF\`{E}VRE$ SYNDROME ($Papillon-Lef\`{e}vre$ Syndrome의 임상 및 미생물학적 검사와 치료)

  • Baik, Byeong-Ju;Kim, Jae-Gon;Kim, Mun-Hyeon;Kim, Hyung-Seop;Song, Yo-Han
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.2
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    • pp.450-457
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    • 1998
  • The $Papillon-Lef\`{e}vre$ Syndrome(PLS), a disease with autosomal recessive inheritance, is characterized by diffuse hyperkeratosis of the palms and soles, mostly prepubertal periodontitis and premature loss of primary and permanent dentition. The etiology of the destruction of periodontal tissues has not been completely clarified. In recent years, two main factors are suggested to be responsible for tooth loss ; firstly, the presence of gram negative microorganisms in the periodontal pockets of the patients. The other factor suggested is cellular deficiency in chemotaxic and phagocytic function of neutrophylic granulocytes. Resent data suggestes that mechanical debridement in conjunction with antibiotic therapy may be successful in periodontal management of $Papillon-Lef\`{e}vre$ Syndrome, particularly if administered early. In this study, a $Papillon-Lef\`{e}vre$ Syndrome patient was studied clinically, radiologically, histopathologically and microbiologically. 5 years female patient with gingival swelling and destruction of periodontal structure on the whole dentition were examined and palmar and plantar hyperkeratosis were can be seen. On microbiological analysis, Actinobacillus actino-mycetemcomitans was performed. Concurrently, the children recieved extraction of maxillary anterior teeth and construction of removable prosthetis. The combination of professional oral hygiene care and antibiotic therapy improved the dermatologic and periodontal condition.

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IMPACTION OF MANDIBULAR CANINES (매복된 하악 견치의 치험례)

  • Jung, Young-Jung;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.2
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    • pp.278-283
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    • 2005
  • Impaction of mandibular canine is not common, and transmigration of mandibular canine is rare. Treatment of impacted canine can be removal of physical obstacle and periodic observation, surgical exposure of impacted tooth and orthodontic traction, autotransplantation, surgical extraction. Management of impacted canine depends on existence of physical obstacle, position and direction of impacted tooth, space available for canine eruption, stage of root development. Of the two case in this report, one case involved impaction of lower canine with odontoma and dentigerous cyst that is treated by surgical exposure and orthodontic traction. The other case involved transmigration of lower canine with supernumerary teeth. It was thought difficult to treat only by orthodontic treatment, so the impacted canine was transplanted to its normal position and orthodontic treatment was conducted.

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SURGICAL REPOSITIONING OF AN IMPACTED INCISOR IN MIXED DENTITION (매복된 중절치의 재식)

  • Choi, Su-Mi;Lee, Keung-Ho;Choi, Yeong-Chul;Park, Jae-Hong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.687-692
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    • 2005
  • Delayed eruption of a maxillary incisor results in midline shift, the space occupied by adjacent teeth and different levels of alveolar height. Extraction or surgical/orthodontic therapy is the most common treatment for a impacted maxillary incisor. Surgical repositioning provides another option for treatment of this problem. The advantages of this approach include immediate esthetic improvement, use of a single and simplified surgical procedure, simple and short orthodontic therapy, a normal gingival margin and the possibility of the developing root adapting to the new position. Autotransplantation of an immature tooth provides for possible adaptation of the developing root apex to the new position. A root with an open apex has good chance of pulp revascularization after transplantation.

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TREATMENT OF PALATAL ABSCESS OF ODONTOGENIC ORIGIN IN CHILDREN: CASE REPORTS (소아에서 발생한 치성 기원 구개 농양의 치험례)

  • Ryu, Jae-Ryang;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.4
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    • pp.421-426
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    • 2011
  • Most of the intraoral infections origin in odontogenic infection. Odontogenic infection spreads out along the least resistant path. In maxilla, the thickness between periapical area and cortical bone is narrower on the buccal side than the palatal side. So infection usually spreads out along the buccal side rather than the palatal side. The failure of root canal treatment more frequently occurs on the buccal root compared to the palatal root. So the palatal abscess is rarer than the buccal abscess. It is difficult to differential diagnosis palatal abscess from salivary gland tumors, benign neural tumors and cysts on the palate. Therefore, when the palatal swelling is observed in children, you need to prevent the systemic spread of infection by early diagnosis of the odontogenic palatal abscess. In these cases, the patient who complained of the pain in deciduous teeth and the palatal swelling was diagnosed with odontogenic palatal abscess. The patient was treated with extraction and antibiotic medication. The palatal abscess was resolved, and we report after treatments.

NOONAN SYNDROME : A CASE REPORT (누난 증후군 : 증례보고)

  • Lee, Soo-Eon;Choi, Sung-Chul;Kim, Kwang-Chul;Na, Sung-Sik;Park, Jae-Hong
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.2
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    • pp.123-126
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    • 2011
  • Noonan syndrome (NS) is a developmental disorder characterized by dysmorphic facial features in association with short stature, mental retardation and congenital heart disease. NS may be sporadic or inherited as an autosomal dominant or recessive trait. The children with NS usually have ocular hypertelorism, downslanting palpebral fissures, low-set ears and a webbed neck, chest deformity. In addition, oral features include micrognathia, high arched palate, dental malocclusion, dental anomalies and rarely, cleft palate. The phenotype of NS bears similarities to that of Turner syndrome. However, NS occurs in both males and females with a normal sex chromosome 46, XX and 46, XY constitution. This case presents the intermittent treatment of an 8-year-old girl who was referred from a local clinic for the extraction of supernumerary teeth and treatment of dental caries. The focus of this case report is the oral aspects on NS and particularities of the dental treatment in subjects affected by this genetic disease.

Supraeruption as a consideration for implant restoration

  • Lee, Bo-Ah;Kim, Byoungheon;Kim, Young-Taek
    • Journal of Periodontal and Implant Science
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    • v.50 no.4
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    • pp.260-267
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    • 2020
  • Purpose: The aim of this study was to compare the prevalence, amount, and rate of supraeruption of the maxillary second molar according to sex, age, and history of periodontitis. Methods: Data were collected retrospectively from the charts and panoramic radiographs of 65 patients who were scheduled to undergo implant placement at the site of the mandibular second molar. The amount of supraeruption of the maxillary second molar and the alveolar bone level of the neighboring teeth were measured on digital panoramic radiographs. The prevalence was evaluated in each group, and univariate and multivariate logistic regression analyses were used to identify factors influencing the prevalence of supraeruption. The amount and the rate of supraeruption were compared between pairs of groups using the Mann-Whitney U test. For all tests, P values <0.05 were considered to indicate statistical significance. Results: Supraeruption occurred in 78% of the patients. The prevalence of supraeruption was affected by sex, age, and history of periodontitis. The mean amount of supraeruption was 0.91 mm and the mean rate of supraeruption was 0.14 mm/month. The amount and the rate of supraeruption showed no significant differences according to sex, age, or the distance from the cementoenamel junction to the alveolar bone crest (P>0.05). Conclusions: These results show that the amount of supraeruption on the maxillary second molar was similar to the thickness of the enamel on the occlusal surface. When a single implant is scheduled to be placed on the mandibular second molar, supraeruption of the antagonist should be considered.

[ $GARR{\grave{e}}'s$ ] OSTEOMYELITIS IN CHILDREN (어린이의 악골에 발생한 $Garr{\grave{e}}'s$ osteomyelitis)

  • Kim, Shin;Jeong, Tae-Sung;Kim, Hong-Ryoul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.3
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    • pp.533-538
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    • 1998
  • [ $Garr{\grave{e}}'s$ ] osteomyelitis is a chronic form of osteomyelitis in which periosteum is thickened with peripheral reactive bone formation. Carl $Garr{\grave{e}}$ first reported localized periosteal thickening as a response to mild stimuli. In dental literatures, Pell et al. first reported $Garr{\grave{e}}'s$ osteomyelitis in jaws. This disease frequent occurs in youngsters and usually in mandible. It usually results in hard swelling over the jaws with little or no pain. Palpation reveals a localized bony swelling lesion. In radiographic findings, it usually reveals laminated periosteal thickening on lesion. The treatment of $Garr{\grave{e}}'s$ osteomyelitis usually consists of elimination of the sources of infection, i.e., either extraction of an infected teeth or root canal therapy. Two children were admitted with the chief complaint of intraoral swelling on lower deciduous molar areas which was diagnosed as $Garr{\grave{e}}'s$ osteomyelitis. The root canal therapy and antibiotic therapy were performed and prognosis was checked. From these case studies, some results were obtained as follows : With the aid of root canal therapy and antibiotic administration, the size of periapical lesions was reduced, the mandible with bony swelling recovered its normal shapes radiographically, and the permanent tooth germs resumed sound development.

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ORTHODONTIC TREATMENT OF THE DISPLACED UNERUPTED MAXILLARY CANINE : CASE REPORT (변위된 미맹출 상악 견치의 교정 치험례)

  • Lim, Hye-Jeong;Choi, Nam-Ki;Kim, Seon-Mi;Yang, Kyu-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.543-549
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    • 2005
  • The maxillary canine is especially important as it has the longest root, provides guidance for lateral movement of the mandible and masticatory function and is a key in esthetics due to its position. Maxillary canine has the longest time to develop and a complex route from the place of formation to the site of eruption, and so it is prone to impaction more than other teeth. The clinician should consider the various treatment options : (a) No treatment and observation, (b) surgical exposure and orthodontic traction (c) autotransplantation (d) extraction. Surgical exposure of the canine and orthodontic treatment to bring the tooth into the line of occlusion is considered the most desirable approach. This case presents the results of treatment for impacted maxillary canine by surgical exposure and orthodontic tooth movement.

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Full mouth rehabilitation of a patient with severe periodontitis using immediate loading after computer aided flapless implant surgery (심한 치주질환을 가진 환자에서 computer aided flapless surgery와 즉시 부하를 통한 전악 구강 회복 증례)

  • Kang, Seong hun;Choi, Yeon jo;Ryu, Jae jun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.1
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    • pp.46-55
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    • 2018
  • Oral rehabilitation of a patient having severe periodontitis with alveolar bone resorption and periodontal inflammation presents a challenge to clinicians. However, if appropriate implant placement according to the bone shape is selected, unnecessary bone grafting or soft tissue surgery can be minimized. In recent years, using cone beam CT and software, it has become possible to operate the planned position with the surgical guide made with 3D printing technology. This case was a 70 years old female patient who required total extraction of teeth due to severe periodontitis and performed a full-mouth rehabilitation with an implant - supported fixed prosthesis. During the surgery, the implant was placed in a flapless manner through a surgical guide. Immediate loading of the temporary prosthesis made by CAD/CAM method before surgery was done. Since then, we have produced customized abutments and zirconia prostheses, and have reported satisfactory aesthetic and functional recovery.