• 제목/요약/키워드: Traumatic dental injuries

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A survey of the intravenous sedation status in one provincial dental clinic center for the disabled in Korea

  • Seok, Ujeong;Ji, Sangeun;Yoo, Seunghoon;Kim, Jongsoo;Kim, Seungoh;Kim, Jongbin
    • 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.

유치 함입 시 외상 치아의 예후에 영향을 미치는 요인 (Factors Influencing Prognosis of Traumatized Tooth in Primary Tooth Intrusion)

  • 채용권;한윤경;남옥형;김미선;이효설;김광철;최성철
    • 대한소아치과학회지
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    • 제46권1호
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    • pp.29-37
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    • 2019
  • 본 연구는 유치열에서 발생하는 함입성 손상의 특징을 조사하고 장기간의 추적 조사 기간 동안의 유치열 및 영구치열에 발생하는 합병증에 영향을 미칠 수 있는 요인을 평가하고자 하였다. 이를 위해 총 61명의 84개의 치아가 연구대상으로 선정되어 환자의 연령, 성별, 외상의 원인과 발생장소, 외상 치아의 손상 정도, 외상 발생 시 동반된 다른 손상, 치료방법, 추적조사 기간 중 유치열과 영구치열에 발생한 합병증이 조사되었다. 연령, 외상 치아의 손상 정도, 외상 발생 시 동반된 다른 손상의 종류가 유치 및 영구치의 예후에 미치는 영향을 확인하기 위해 조사된 자료는 카이제곱 검정과 Fisher의 정확검정으로 평가하였다. 유전치의 함입은 남아에게 여아보다 우세하게 나타났으며, 함입의 원인으로는 낙상의 빈도가 가장 높았다. 유전치의 함입은 집에서 가장 많이 발생했으며, 상악 유중절치에서 가장 많이 발생했다. 유치열에 발생한 함입의 중증도는 영구치열에 발생하는 후유증의 발생에 유의하게 영향을 미쳤다(p = 0.014). 유치의 함입성 손상에 연조직 손상이 동반된 경우, 다른 치주조직 손상이 동반된 경우 보다 합병증의 발생이 유의하게 적었다(p = 0.000).

원주기독병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구 (THE CHARACTERISTICS ON THE DENTAL EMERGENCY PATIENTS OF WONJU CHRISTIAN HOSPITAL FOR LAST 10 YEARS)

  • 문원규;정영수;이의웅;권호근;유재하
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권1호
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    • pp.34-42
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    • 2004
  • The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

Management of horizontal root fractures by fabrication of canine protected occlusion using composite resin

  • Shin, Joo-Hee;Kim, Ryan Jin-Young
    • Restorative Dentistry and Endodontics
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    • 제37권3호
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    • pp.180-184
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    • 2012
  • Traumatic injuries of the face often involve root fractures especially in anterior teeth. The prognosis and the treatment of the root fracture depend on the extent of the fracture line, general health and patient compliance. This case report outlines a new conservative trial treatment modality to stabilize the maxillary central incisors with horizontal root fracture on the cervical to middle third by fabricating canine guidance to remove loading on the traumatized maxillary central incisors during eccentric movements and thus inducing spontaneous healing of the fractured line between the fragments. Radiographs after thirty months showed adequate healing with no signs of pathological changes including root resorption, ankylosis or displacement. Long term follow-up revealed that vitality, stability and aesthetics were maintained and the patient was satisfied with the outcome.

뇌성마비 환자에서 함입된 상악 중절치의 외과적 재위치: 증례보고 (SURGICAL REPOSITIONING OF AN INTRUDED PERMANENT MAXILLARY INCISOR IN A CEREBRAL PALSY PATIENT: A CASE REPORT)

  • 이고은;이명연;이제호
    • 대한장애인치과학회지
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    • 제13권1호
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    • pp.43-46
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    • 2017
  • 본 증례는 함입 주소로 내원한 9세 4개월 뇌성마비 남환을 미다졸람 근주를 이용한 의식하 진정법으로 해당치아의 수술 적 재위치 및 근관치료를 시행하였다. 5년이 지난 현재 유착 소견 및 부분적인 치근흡수가 보이나 양호한 상태로 유지되고 있다. 뇌성마비 환자의 경우 치아 및 주위조직에 취약하며, 치료 시 적절한 행동조절 및 치료 방법을 선택하는 임상의의 노력이 필요하다.

Single-insertion technique for anesthetizing the inferior alveolar nerve, lingual nerve, and long buccal nerve for extraction of mandibular first and second molars: a prospective study

  • Joseph, Benny;Kumar, Nithin;Vyloppilli, Suresh;Sayd, Shermil;Manojkumar, KP;Vijaykumar, Depesh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권6호
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    • pp.403-408
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    • 2020
  • Objectives: Appropriate and accurate local anesthetic (LA) techniques are indispensable in the field of oral and maxillofacial surgery to obtain a satisfactory outcome for both the operating surgeon and the patient. When used alone, the inferior alveolar nerve block (IANB) technique requires supplemental injections like long buccal nerve block for extraction of mandibular molars leading to multiple traumatic experiences for the patient. The aim of this study was to anesthetize the inferior alveolar, lingual, and long buccal nerves with single-needle penetration requiring a minimal skillset such as administering a conventional IANB through introduction of the Benny Joseph technique for extraction of mandibular molars. Materials and Methods: This was a prospective study conducted in the Department of Oral and Maxillofacial Surgery, Kunhitharuvai Memorial Charitable Trust (KMCT) Dental College, Calicut, India. The duration of the study was 6 months, from June to November 2017, with a maximum sample size of 616 cases. The LA solution was 2% lignocaine with 1:100,000 adrenaline. The patients were selected from a population in the range of 20 to 40 years of age who reported to the outpatient department for routine dental extraction of normally positioned mandibular right or left first or second molars. Results: Of the 616 patients, 42 patients (6.8%) required re-anesthetization, a success rate of 93.2%. There were no complications such as hematoma formation, trismus, positive aspiration, and nerve injuries. None of the cases required re-anesthetization in the perioperative period. Conclusion: The Benny Joseph technique can be employed and is effective compared with conventional IANB techniques by reducing trauma to the patient and also requires less technique sensitivity.

Efficacy of arthrocentesis and lavage for treatment of post-traumatic arthritis in temporomandibular joints

  • Park, Joo-Young;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권3호
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    • pp.174-182
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    • 2020
  • Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.

상악 전치부 치관 파절의 보존적이고 심미적인 접근법: 파절편 재부착 (Conservative and esthetic approach in crown fracture of maxillay anterior tooth: tooth fragment reattachment)

  • 정경화;권은영;김소연;전혜미;손성애;박정길
    • 구강회복응용과학지
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    • 제35권2호
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    • pp.105-112
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    • 2019
  • 치관 파절은 영구치, 특히 치열에서 가장 노출된 위치에 존재하는 상악 전치에 가장 많이 발생하는 외상성 손상이다. 파절편 조각이 존재하고 상태가 양호한 경우 치관 파절을 치료하는 방법 중 하나는 원래 위치에 다시 파절편을 재부착하는 것이다. 이번 연구에서는 상악 전치에 발생한 치관 파절 증례를 파절편 재부착 술식으로 치료하였으며 심미적, 기능적으로 만족할만한 결과를 얻었기에 이를 보고하는 바이다.

유치와 영구치의 외상에 관한 연구 (A RETROSPECTIVE STUDY OF THE TRAUMATIC INJURIES IN THE PRIMARY AND PERMANENT TEETH)

  • 허수경;최남기;김선미;양규호;박지일
    • 대한소아치과학회지
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    • 제35권4호
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    • pp.642-651
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    • 2008
  • 본 연구는 2003년 1월부터 2007년 7월까지 전남대학교 병원 소아치과와 응급실에 치아 외상을 주소로 내원한 환자 570명(치아수: 1394개)을 대상으로 연령, 성별분포, 발생원인 및 장소, 손상 받은 치아의 위치 및 유형, 초진시 처치 등에 대한 조사를 통해 외상에 대한 적절한 진단과 치료에 도움이 되고자 시행하였다. 1. 성별에 따른 발생빈도는 1.9:1로 남자의 비율이 높았고, 나이에 따른 발생 빈도는 1세, $6{\sim}8$세, $17{\sim}18$세 때 높았다. 2. 외상의 원인은 유치열과 혼합치열에는 넘어진 경우가 가장 많았으며 영구치열에서는 교통사고와 싸움으로 인한 손상 빈도가 높았다. 외상을 입은 장소는 유치열은 집에서, 혼합치열, 영구치열에는 길에서 비율이 높았다. 3. 외상시 손상 받은 치아의 위치는 유치와 영구치 모두 상악 중절치의 비율이 높았다. 손상의 유형은 유치와 영구치 모두 치주조직의 손상이 많았는데, 유치는 아탈구, 진탕, 함입 순이었으며, 영구치는 아탈구, 진탕, 완전탈구 순이었다. 4. 초진시의 처치는 특별한 처치 없이 경과를 관찰하는 경우가 대부분이었으며, 유치는 33.1%, 영구치에서는 44.5%의 재 내원률을 보였다. 치주조직 손상 후 유치는 20.3%, 영구치는 26.6%의 치수 괴사율을 보였다.

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미완성된 근첨을 가진 영구치 치근 파절의 치유에 관한 증례 (TRAUMATIC ROOT FRACTURE IN YOUNG PERMANENT TEETH : A CASE REPORT)

  • 강선희;김대업;이광희
    • 대한소아치과학회지
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    • 제30권4호
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    • pp.576-580
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    • 2003
  • 7세 남아가 맹출 중인 상악 영구 중절치의 외상을 주소로 내원하였다. 환아의 우측 중절치는 아탈구와 치근 파절을 보였고, 좌측 중절치는 함입성 탈구와 치근 파절을 보였다. 두 치아는 정복 후 선부자에 의해 고정하였다. 이후 주기적인 검진을 시행하였다. 4년이 지난 현재, 우측 중절치는 방사선 사진에서 파절편 사이에 방사선 투과성이 보이지 않고 정상적인 치조백선을 보여 경조직으로 치유되는 양상을 보였다. 좌측 중절치는 파절편이 분리되어있고 근관이 점차 폐쇄되는 소견을 보이고 있어 골과 결합조직의 개입에 의한 치유 양상을 보이고 있다. 임상 검사에서 정상적인 동요도와 타진 반응을 보였고, 전기치수검사에 양성 반응을 보였다. 외상을 받은 치아의 예후는 외상의 유형, 환자의 연령, 치근의 발육단계, 변위의 정도 등에 의해 영향을 받는다. 본 증례는 개방근관을 가진 치아가 외상 후 우측 중절치는 석회화 조직으로 치유, 좌측 중절치는 골과 결합조직의 개입으로 치유되고 있는 양상을 보이고 있어 이를 보고하는 바이다.

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