• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권6호
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• pp.561-566
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• 2008

This is a retrospective clinical study on 2,955 patients who had visited the Emergency Room of Sang-gye Paik Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 4 years from Aug. 2002 to Dec. 2006. The obtained results were as follows. The total number of patients was 2,955 and the ratio of male to female was 1.72:1. The age distribution peak was the 1st decade (30.8%), followed by the 3rd decade (14.3%) and the 4th decade (14.0%). Trauma (62.3%) was the most frequent cause in dental emergency patients, pulpitis (13.0%) and infection patients were next in order of frequency. In trauma patients group, facial bone injury, tooth injury, soft tissue injury were included and soft tissue injury group was most prevalent, followed by tooth injury group and facial bone group. In total patient, the ratio of admission was 3.5%. We obtained the results of the distribution of primary emergency care in the traumatic injury, causal distribution of the jaw fracture, distribution of related medical department in multiple associated injuries, distribution of emergency care in infection, causal distribution and control methods of oral bleeding, distribution of TMJ disorder. The trauma patient group was major in the dental patients who had visited the emergency room, but other various groups were included. So we should analyze the pattern and the variation of the dental emergent patient to provide the proper treatment.

• 대한소아치과학회지
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• 제39권2호
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• pp.120-128
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• 2012

본 연구는 전라북도 지역 초등학교 교사에게 적합한 치아외상 교육내용 및 효과적인 전달 방법이 마련될 수 있도록 치아외상에 대한 지식수준을 파악하고 기존 연구에서 자세히 다루지 않았던 교육현황을 조사하는 데 그 목적이 있다. 전북지역 초등학교 교사 231명에게서 설문지를 통하여 자료를 수집하였으며 설문 문항은 응답자의 일반 사항, 치아외상 교육현황 및 태도, 사례를 통한 지식수준, 치아 보관 매체에 대한 질문으로 구성하였다. 조사 결과 치아외상 대처방법에 교육을 받은 교사는 15.2%에 불과하였고, 교사들을 대상으로 치아외상 대처방법에 대한 교육이 필요한지에 대한 질문에서는 97%가 필요하다고 대답하여 교사 스스로도 치아외상 교육의 필요성에 대해 공감하고 있었으며 교육 방식으로는 전문가에 의한 직접 교육을 선호하였다. 사례를 통한 평가에서는 문항 간에 다소 차이는 있었으나 응급상황시 적절히 대처하기에는 지식수준이 대체로 불충분한 것으로 나타났다. 따라서 향후 전라북도 초등교사들에게 적합한 교육방식과 교육내용을 객관적으로 분석하는 연구 및 교사들에게 알맞은 교육 프로그램의 개발 등이 필요하리라 사료된다.

• International Journal of Oral Biology
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• 제37권3호
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• pp.121-129
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• 2012

Previous clinical studies have demonstrated that gabapentin, a drug that binds to the voltage-gated calcium channel ${\alpha}2{\delta}1$ subunit proteins, is effective in the management of neuropathic pain, but there is limited evidence that addresses the participation of glial cells in the antiallodynic effects of this drug. The present study investigated the participation of glial cells in the anti-nociceptive effects of gabapentin in rats with trigeminal neuropathic pain produced by mal-positioned dental implants. Under anesthesia, the left mandibular second molar was extracted and replaced by a miniature dental implant to induce injury to the inferior alveolar nerve. Mal-positioned dental implants significantly decreased the air-puff thresholds both ipsilateral and contralateral to the injury site. Gabapentin was administered intracisternally beginning on postoperative day (POD) 1 or on POD 7 for three days. Early or late treatment with 0.3, 3, or 30 ${\mu}g$ of gabapentin produced significant anti-allodynic effect in the rats with mal-positioned dental implants. On POD 9, in the mal-positioned dental implants group, OX-42, a microglia marker, and GFAP, an astrocyte marker, were found to be up-regulated in the medullary dorsal horn, compared with the naive group. However, the intracisternal administration of gabapentin (30 ${\mu}g$) failed to reduce the number of activated microglia or astrocytes in the medullary dorsal horn. These findings suggest that gabapentin produces significant antinociceptive effects, which are not mediated by the inhibition of glial cell function in the medullary dorsal horn, in a rat model of trigeminal neuropathic pain.

• 대한치과마취과학회지
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• 제5권1호
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• pp.15-21
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• 2005

Autism is characterized with an abnormality of reciprocal social relatedness and of communication development. Also, autistic children show repetitive and stereotypical behavior pattern and deficiency of endurance against change. Dental problems related to autism are self-injury and trauma from accidents. Sometimes self-injury is due to discomfort resulting from restoration and local anesthesia. Also, gingivitis and multiple caries are common because of poor oral hygiene. Autistic children are anxious about visual and auditory stimuli because they don't understand the dental procedure. If the face of any changes in their daily life, their behavior becomes uncontrollable. In a setting such as the outpatient office, an autistic child's uncontrollable behavior makes it difficult to carry out proper treatment. If they need treatment under general anesthesia, it is very difficult to manage them in a ward as they are severly anxious about being admitted to a hospital. Therefore it is necessary to treat these children according to a specific management program under general anesthesia in an outpatient office. This case study reports of a 14 year old autistic teenager who although became uncontrollable because of the pain from multiple caries and from anxiety of the dental treatment eventually received treatment under general anesthesia and under conscious sedation in an outpatient office.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권3호
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• pp.183-190
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• 2020

Objectives: The purpose of this retrospective epidemiological study was to determine the etiology and pattern of maxillofacial injuries in a pediatric population. Materials and Methods: Data for pediatric maxillofacial trauma patients aged 12 years and younger who were registered at the Department of Pediatric and Preventive Dentistry, Dr. R. Ahmed Dental College and Hospital, Kolkata, India, were reviewed and examined. Patients who were treated between October 2016 and September 2018 were analyzed according to age, sex, cause of injury, frequency and site of facial fractures, and soft tissue injuries. The chi-square tests were carried out for statistical analyses with a significance level of 5%. Results: Of 232 patients with a mean age of 6.77±3.25 years, there were 134 males (57.8%) and 98 females (42.2%). The overall male to female ratio was 1.39:1. The most common causes of injuries were falls (56.5%) and motor vehicle accidents (16.8%). Incidence of falls decreased significantly with age (P<0.001). Dentoalveolar injuries (61.6%) and soft tissue injuries (57.3%) were more common than facial fractures (42.7%). Mandibular fractures (82.8%) were the most common facial fractures, and perioral or lip injuries were the most prevalent injuries in our patient population. There was a positive association between facial fractures and soft tissue injury (P<0.01) (odds ratio 0.26; confidence interval 0.15-0.46). Conclusion: Falls were the leading cause of maxillofacial trauma in our sample of children, and the most common site of fractures was the mandible.

• 대한치과의사협회지
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• 제42권2호통권417호
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• pp.150-157
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• 2004

Inverted maxillary incisor is that maxillary incisor rotates counterclockwise direction. The cause of this 'Inverted incisor' is the injury of the deciduous predecessor transmitted to the developing permanent tooth germ or displacement of permanent tooth crown portion from unknown origin. Dilaceration, defined as a distorted root from, may result from mechanical injury during eruption period or ectopic development of tooth germ. This article presents a case of an inverted and dilacerated maxillary right central incisor. Through orthodontic traction, the dilacerated and inverted incisor was successfully moved into the proper position.

• 대한치과의사협회지
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• 제54권11호
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• pp.874-879
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• 2016

Damage to the inferior alveolar nerve(IAN) is a relatively infrequent complication in endodontic treatment. However, endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve resulting in sensory disturbances such as pain, dysesthesia, paresthesia or anesthesia. Two mechanism(chemical neurotoxicity and mechanical compression) are responsible for the IAN injury. When absorbent materials overfilled, it can be treated as a non-surgical procedure. But early surgical intervention required when mechanical, chemical nerve damage expected. We report surgical removal of overfilled gutta-percha and IAN decompression through sagittal split osteotomy in case of dysesthesia after overfilling of endodontic material into the mandibular canal. Dysesthesia recovered 3 months after surgical treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권2호
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• pp.77-82
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• 2019

It is well known that trigeminal nerve injury causes hyperexcitability in trigeminal ganglion neurons, which become sensitized. Long after trigeminal nerve damage, trigeminal spinal subnucleus caudalis and upper cervical spinal cord (C1/C2) nociceptive neurons become hyperactive and are sensitized, resulting in persistent orofacial pain. Communication between neurons and non-neuronal cells is believed to be involved in these mechanisms. In this article, the authors highlight several lines of evidence that neuron-glial cell and neuron macrophage communication have essential roles in persistent orofacial pain mechanisms associated with trigeminal nerve injury and/or orofacial inflammation.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권2호
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• pp.95-99
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• 2020

Various dental procedures, such as injection administration, surgical treatment, and endodontic treatment, can cause injury to the nerves. The most commonly injured nerves are the inferior alveolar and lingual nerves. This can manifest as altered sensation to the area of innervation of the injured nerve, such as the lower lip, chin, teeth, tongue, and mucosa. Altered sensations or loss of sensation are relatively infrequent complications in daily dental practice. Here, we report an uncommon case of altered sensation in the midfacial region caused by an endodontic procedure and discuss the need to consider local dental causes in the differential diagnosis of numbness in the facial region.

• 대한치과마취과학회지
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• 제9권1호
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• pp.30-35
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• 2009

Intravenous midazolam has been frequently used for the relief of anxiety in dental treatment. This is likely the result of the sedative and anterograde amnestic properties of midazolam that are mediated through $\gamma$-Aminobutyric acid agonism. Unfortunately, Paradoxical reactions to midazolam include agitation, talkativeness, confusion, disinhibition, aggression,violent behavior, act of self-injury and need for restraints. These occur in less than 1% of all patients receiving midazolam, may occur at variable times after administration and are difficult to predict and diagnose. Two women with severe anxiety for dental treatment experienced paradoxical reactions associated with the use of intravenous midazolam. We are reviewed the management and prevention of paradoxical reactions and its different etiology.