• Journal of Korean society of Dental Hygiene
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• v.9 no.3
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• pp.415-425
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• 2009

Objectives : In this study, the dental treatment satisfaction degree of the patients, who experienced the sleep dental treatment or non-sleep dental treatment, the revisit rate and the differences among the encouraging intention were compared and analyzed, and the primary factors through which the satisfaction degree of sleep dental treatment has influence on the revisits and the encouraging intention were analyzed, and the proposal was made on clinic management to raise qualitative medical service level on the basis of this study. Methods : The questionnaires filled out by the 202 users of a certain dental clinic located in Pohang-si, Gyeongbuk were analyzed. The frequency analysis and the crosstabulation analysis of the general characteristics of survey participants were carried out, and the satisfaction difference between the sleep dental treatment and the non-sleep dental treatment was identified with the t-test analysis. The multiple regression analysis were carried out to identify the factors through which the sleep dental treatment has influence on the through which the satisfaction degree of sleep dental treatment has influence on the satisfaction degree of the medical service and the revisited dentists. Results : In the medical service satisfaction degree in general, the sleep dental treatment had the higher meaningful value than the non-sleep dental treatment(p<0.05). In the case of the difference in satisfaction degree on each medical service factor, the satisfaction of the sleep treatment group was high in every case, but the meaningful difference showed up in the factors of waiting time, treatment procedure, revisit and the encouraging intention(p<0.01). The revisit to the sleep treatment dental clinic and the recommending dentist increased in proportion to the satisfaction degree of sleep dental treatment, and the Beta value appeared to be 0.337 at the influence of the subordinate variable(p<0.001). As for the influence on the sleep dental treatment satisfaction, the Beta value of the dental hygienist was the highest, marking the value at 0.375(p<0.01). As for the satisfaction of the patients who experienced the sleep dental treatment, the Beta value of the treatment fee was the highest, marking 0.352(p<0.001), in the multiple regression analysis of the revisit and the encouraging intention, and the 0.156 of dentist factor and the 0.152 of treatment procedure and waiting time showed lower regression coefficient(p<0.05). Conclusions : It is assumed that the satisfaction degree of sleep dental treatment, which is carried out as a new dental service has influence on the increase of revisit to the dental clinic as an important factor. But it was disclosed that the high level of treatment fee has the biggest influence on choice of revisit to the dental clinic. In the current medical charge system, the sleep dental treatment appeared to have a big influence on raising the quality of dentists, the satisfaction of patients, the revisit and encouraging intention, and also the roles of the dental hygienist was important. It is assumed that these facts are functioning as the factors that are linked to the increase of revisit and the encouraging intention.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.2
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• pp.59-67
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• 2023

General anesthesia may influence the postoperative sleep cycle; however, no clinical studies have fully evaluated whether anesthesia causes sleep disturbances during the postoperative period. In this scoping review, we explored the changes in postoperative sleep cycles during surgical procedures or dental treatment under general anesthesia. We compared and evaluated the influence of general anesthesia on sleep cycles and sleep disturbances during the postoperative period in adult and pediatric patients undergoing surgery and/or dental treatment. Literature was retrieved by searching eight public databases. Randomized clinical trials, observational studies, observational case-control studies, and cohort studies were included. Primary outcomes included the incidence of sleep, circadian cycle alterations, and/or sleep disturbances. The search strategy yielded six studies after duplicates were removed. Finally, six clinical trials with 1,044 patients were included. In conclusion, general anesthesia may cause sleep disturbances based on alterations in sleep or the circadian cycle in the postoperative period in patients scheduled for elective surgery.

• The Journal of the Korean dental association
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• v.53 no.12
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• pp.926-934
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• 2015

Obstructive sleep apnea (OSA), most common respiratory disorder of sleep, is characterized by intermittent partial or complete occlusions of the upper airway due to loss of upper airway dilating muscle activity during sleep superimposed on a narrow upper airway. Termination of these events usually requires arousal from sleep and results in sleep fragmentation and hypoxemia, which leads to poor quality of sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences. Untreated OSA may cause, or be associated with, several adverse outcomes, including daytime sleepiness, increased risk for motor vehicle accidents, cardiovascular disease, and depression. Various treatments are available, including non-surgical treatment such as medication or modification of life style, continuous positive airway pressure (CPAP) and oral appliance (OA). Skeletal surgery for obstructive sleep apnea (OSA) aims to provide more space for the soft tissue in the oropharynx to prevent airway collapse during sleep. Conventional surgical techniques include uvopalatopharyngoplasty(UPPP), genioglossus advancement (GA), and maxillomandibular advancement (MMA). Surgical techniques, efficacy and complications of skeletal surgery are introduced in this review.

• Journal of Oral Medicine and Pain
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• v.22 no.2
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• pp.383-394
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• 1997

The purpose of this study was to examine the anatomic changes in the upper airway with a dental orthosis. the effectiveness and side effects of orthosis in the treatment of snoring and obstructive sleep apnea. To meet this puppose a dental orthosis, designed to increase the size of the upper airway by advancing the mandible, was used in 42 patients (30 M, 12 F), aged 29 - 69 years, to treat snoring and varying decrees of obstructive sleep apnea. Cephalometric study of anatomic featured was made with and without a dental orthosis, and the evaluation of the effectiveness and side effects of orthosis was done by questionnaires. The obtained results were as follows : 1. All subjects were habitual snorers and 32 patients comp1ained the loudness of snoring as severe as be heard outside of the patient's room. 2. According to the degree of respiratory distirbance index(RDI) and aprea index(Al) from the polysomnograph in 34 patient, mild obstructive sleep apnea patients were 5, moderate 6 and severe 16. 3. Various anatomic changes in the upper airway with denta1 orthosis were as follows : (1) More superioly positioned hyoid bone ( p<0.001) (2) Enlarged oropharyngeal (superior p<0.01, middle p<0.01. inferior p<0.01) and hypopharyngeal (P<0.05) airway space. 4. According to the results of the changes of clinical syptoms after the usage of the dental orthosis acquired from questionnaires, there was significant improvement in the frequently, the loudness and the severity of snoring, cessation of breathing and awakening from the difficulty of breathing during sleep. 5. The effectiveness and side effects of dental orthosis by questionnaires were as follows ; (1) Dental orthosis satisfied almost all the patients (68±20%). (2) Snoring was improved in all the patients (73±19%). (3) Obstructive sleep aphea was improved in all the patients (61 ± 37%) (4) Sleepiness in the daytime was significantly improved (61 ±37%). (5) The sleep quality was significantly improved (61±37%). (6) The discomfort of the dental orthosis was minor (33±18%) and no serious complications were observed. 6. The dental orthosis is an effective treatment for the symptom of snoring, and it can also effectively treat varying degrees of obstructive sleep apnea.

• Journal of Korean society of Dental Hygiene
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• v.14 no.3
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• pp.343-351
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• 2014

Objectives : The purpose of the study is to investigate the influencing factors on the sleep quality in patients with fixed orthodontic appliances. This study intended to find out the improving measures of sleep quality in orthodontic patients. Methods : The subjects were 222 orthodontic patients in Busan. A self-reported questionnaire was filled out by the patients from June to August, 2012. Data were analyzed by SAS version 9.20 including frequency analysis, ANOVA, t-test, multiple regression analysis, and Duncan post-hoc test. Results : The quality of sleep in the patients at the initial stage of orthodontic treatment was influenced by ceramic orthodontic appliances, tooth extraction, Bite adjustment, disturbed sleep habits, and temporomandibular joint pain. Conclusions : The most important factors influencing on the sleep quality were the anxiety toward the treatment and tooth extraction at the initial stage of treatment. A more careful conversation and collaboration are needed in the orthodontic treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.71-76
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• 2017

Drug-induced sleep endoscopy (DISE) is used to identify areas of upper airway obstruction, which occurs when patients with obstructive sleep apnea (OSA) snore. DISE enables effective diagnosis and appropriate treatment of the obstruction site. Among surgical treatment methods for OSA, maxillomandibular advancement surgery (MMA) is performed to move a jaw forward; the surgery has a high success rate for OSA treatment. In DISE, anesthetics such as propofol and midazolam must be administered to induce snoring while the patient is deeply sedated for an accurate diagnosis to be made. When inducing deep sedation in a patient with OSA, airway obstruction may increase, causing oxygen saturation to drop; airway interventions are necessary in such cases. Effective DISE and MMA surgery can be performed by administering propofol through target-controlled infusion while monitoring the bispectral index (BIS).

• The Journal of the Korean dental association
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• v.53 no.4
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• pp.249-258
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• 2015

Snoring and obstructive sleep apnea are the representative sleep disordered breathings, caused by the temporary and repetitive constriction or obstruction of upper airway during sleep. They present with excessively vibratory noise and repetitive cease of respiration. These disorders commonly result in sleep disturbance and the subsequent daytime sleepiness, chronic fatigue. Furthermore, they can cause the serious and extensive complications including increased risk of hypertension, cardiac arrhythmia, cardiovascular disease, cerebrovascular accident, neurocognitive disturbance, traffic and occupational accidents, type II diabetes, childhood growth interruption, awakening headache and finally, relatively increased mortality rate. Because appropriate therapeutic intervention is best way for patients to relieve their symptoms and prevent their possible complications, it is very important for dentists to recognize their own role and responsibility in diagnosis and treatment of these disorders. For this, the present article provides the understanding of the clinical features, possible complications, various treatment modalities, and suitable treatment strategies for snoring and obstructive sleep apnea.

• The Journal of the Korean dental association
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• v.57 no.5
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• pp.279-287
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• 2019

Obstructive sleep apnea syndrome (OSAS) is characterized by obstructive events of the upper airway (UAW) during sleep, which can be associated with clinical signs and symptoms such as snoring, excessive daytime sleepiness, impaired memory, and fatigue. It is associated with many problems like psychosocial problems, physiologic alterations in the cardiovascular and respiratory systems as a result of hypoxia and repeated awakenings during sleep. Conservative treatments such as weight loss, sleep positioning, improvement of sleep hygiene, CPAP and MAD can be performed for the obstructive sleep apnea. However, their effect for the OSA is limited and differs by patient's individual properties. Accordingly, surgical reconstructions of the upper airway must be carried out for the treatment of OSA.

• The Journal of the Korean dental association
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• v.53 no.4
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• pp.238-248
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• 2015

Sleep related breathing disorders(SRBDs) are a group of diseases accompanied by difficulties in respiration and ventilation during sleep. Central sleep apnea, obstructive sleep apnea(OSA), sleep-related hypoventilation, and hypoxemia disorder are included in this disease entity. OSA is known to be the most common SRBDs and studies show its significant correlation with general health problems including hypertension, arrhythmia, diabetes, and metabolic syndrome. The diagnostic process of OSA is composed of physical examinations of the head and neck area and also the oral cavity. Radiologic studies including cephalography, CT, MRI, and fluoroscopy assist in identifying the site of obstruction. However, polysomnography(PSG) is still considered the gold standard for the diagnosis of OSA since it offers both qualitative and quantitative recording of the events during a whole night's sleep. The dentist who is trained in sleep medicine can easily identify patients with the risk of OSA starting from simple questions and screening questionnaires. Diagnosis is the first step to treatment and considering the high rate of under-diagnosis for OSA the dentist may play a substantial role in the diagnosis and treatment of OSA which will eventually lead to the well-being of the patient as a whole person. So the objective of this article is to assist dental professionals in gaining knowledge and insight of the diagnostic measures for OSA including PSG.

• Journal of Korean society of Dental Hygiene
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• v.14 no.3
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• pp.371-379
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• 2014

Objectives : The purpose of this study is to investigate the correlation between quality of sleep and dental fear in implant surgery patients. Methods : A self-reported questionnaire was filled out by 153 implant patients from December 2012 to February 2013 in dental clinics and hospitals in Busan and Changwon. Data were analyzed by descriptive analysis, t-test, ANOVA and multiple regression analysis using SAS version 9.20. Results : The quality of sleep in the implant patients was $41.0{\pm}6.0$. The systemic diseases influenced on the quality of sleep and dental fear also affected the quality of sleep. Conclusions : The results of the analysis of a relationship between the fear perception of dental implant surgery patients and the quality of their sleep showed that the patients with systemic diseases, the patients with a fear by the physical stimulation relating to implant treatment showed the low quality of sleep.