• Journal of Korean society of Dental Hygiene
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• v.9 no.3
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• pp.357-368
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• 2009

The purpose of this study was to examine the state of dental treatment among disabled patients by the type of disability. After the medical records of 531 disabled patients who received treatment at the pediatric dentistry in K university hospital, the following findings were given: 1. As for age distribution by year, the rate of patients aged 10 or down rose to 42.5 from 5.1 percent, and the 16-20 age group increased from 16.7 to 24.8 percent. But the rates of patients aged between 11 and 15 and aged 21 and up were on the rise(p<.05). 2. Concerning the type of disability by year, there was an increase in the number of patients with brain lesions, mental retardation, developmental disorder and Down's syndrome(p<.05). As to the number of dental caries by the type of disability, the patients with heart diseases had the most dental caries that numbered 8.49, followed by Down's syndrome, metal retardation, brain lesions, the other disabilities and developmental disorder. 3. In relation to dental treatment experiences by the type of disability, the patients with developmental disorder(57.5%) received the most dental treatment, followed by mental retardation, the other disabilities, brain lesions, Down's syndrome and heart diseases(p<.05). 4. Regarding general anesthesia experience by the type of disability, the patients with mental retardation(31.6%) were put under general anesthesia the most, followed by developmental disorder, brain lesions, the other disabilities, heart diseases and Down's syndrome(p<.05). In conclusion, nationwide efforts to nurture separate dental personnels responsible for the disabled, to expand relevant facilities and to improve the health care insurance are required to promote the oral health of disabled children.

• Journal of Oral Medicine and Pain
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• v.37 no.4
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• pp.213-219
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• 2012

Oral appliances are a primary treatment option for snoring and mild to moderate obstructive sleep apnea (OSA) and are considered as an alternative for patients with severe OSA who have failed continuous positive airway pressure (CPAP) or upper airway surgery. But it is true that OAs have varying degrees of effectiveness depending on different oral appliances and the efficacy of OAs are established in some but not all patients. New oral appliance, which is one of Adjustable Anterior Positioners, was developed by Dept of Oral Medicine, Dental School, Dankook University. This is a report for treating severe OSA patient with a failure of previous uvulopalatopharyngoplasty using a new Adjustable Anterior Positioner, followed by significant success of controlling OSA.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.5
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• pp.263-269
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• 2020

Fibromyalgia is a syndrome characterized by chronic pain in the skeletal system accompanied by stiffness, sleep disturbance, fatigue, and psychiatric problems, such as anxiety and depression. Fibromyalgia commonly affects orofacial health, presenting with a variety of oral manifestations, including temporomandibular disorder, xerostomia, glossodynia, and dysgeusia. Therefore, oral healthcare providers need to be aware of this clinical entity to effectively manage oral symptoms and provide proper oral self-care modification and education on the nature of fibromyalgia. This review focuses on the epidemiology, pathophysiology, clinical manifestation, diagnosis, orofacial concerns, and treatment of fibromyalgia.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.1
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• pp.47-51
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• 2017

Haddad syndrome, the association of Congenital Central Hypoventilation Syndrome (CCHS) and Hirschsprung's disease (HD), is a disease caused by mutation of PHOX2B gene. This disease, which occurs very rarely worldwide, is characterized by adequate ventilation during wakefulness and hypoventilation during sleep due to decreased ventilatory sensitivity. In this case report, we report a case of dental treatment under general anesthesia in a child with Haddad syndrome. A 3-year-old child with Haddad syndrome visited Seoul National University Dental Hospital for dental treatment. Dental treatment was planned under general anesthesia because of his medical condition. Treatment was successfully done without any postoperative complications. This case suggests that general anesthesia may be advantageous for dental treatment due to the risk of respiratory depression in a child with Haddad syndrome.

• Anatomy and Cell Biology
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• v.57 no.1
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• pp.7-12
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• 2024

The pterygomandibular raphe (PMR) is a tendinous structure connecting the bucinator and the superior pharyngeal constrictor muscles. With its implications in the spread of oral cancer, the proper treatment of obstructive sleep apnea, and dental procedures, it is important to obtain a thorough understanding of the PMR. We reviewed the existing literature to compile the published information regarding its anatomy, embryology, imaging, variations, functions, pathologies, and clinical relevance of the pterygomandibular raphe.

• Journal of The Korean Dental Society of Anesthesiology
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• v.6 no.2 s.11
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• pp.113-120
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• 2006

Recently, sedation in dentistry is gaining more and more interests of dental practitioners. Moreover. 'dental sedation', 'sleep dentistry', or 'pain-free dental treatment' become everyday words familiar to ordinary persons. Sedation clinic in Hanyang University Medical Center was open on Mar 2006 as specialty clinic at department of dentistry. Our aim is performing comfortable and safe dental treatments for patients who have problems for routine dental treatments because of extreme fear and anxiety or for patients who are supposed to have stressful and painful time-consuming treatment, such as sinus elevation and bone graft for implant placement. Our sedation was focused on conscious sedation, especially intravenous sedation using midazolam alone in technique. In two series, the sedation protocol at our Sedation Clinic will be described in details and then, analysis of our cases will be presented to help beginners for sedation in dentistry.

• The korean journal of orthodontics
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• v.45 no.6
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• pp.308-321
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• 2015

Objective: The efficacy of mandibular advancement devices (MADs) in the treatment of obstructive sleep apnea (OSA) ranges between 42% and 65%. However, it is still unclear which predictive factors can be used to select suitable patients for MAD treatment. This study aimed to systematically review the literature on the predictive value of cephalometric analysis for MAD treatment outcomes in adult OSA patients. Methods: The MEDLINE, Google Scholar, Scopus, and Cochrane Library databases were searched through December 2014. Reference lists from the retrieved publications were also examined. English language studies published in international peer-reviewed journals concerning the predictive value of cephalometric analysis for MAD treatment outcome were considered for inclusion. Two review authors independently assessed eligibility, extracted data, and ascertained the quality of the studies. Results: Fifteen eligible studies were identified. Most of the skeletal, dental, and soft tissue cephalometric measurements examined were widely recognized as not prognostic for MAD treatment outcome; however, controversial and limited data were found on the predictive role of certain cephalometric measurements including cranial base angle, mandibular plane angle, hyoid to mandibular plane distance, posterior nasal spine to soft-palate tip distance, anterior nasal spine to epiglottis base distance, and tongue/oral cross sectional area ratio thus justifying additional studies on these parameters. Conclusions: Currently available evidence is inadequate for identification of cephalometric parameters capable of reliably discriminating between poor and good responders to MAD treatment. To guide further research, methodological weaknesses of the currently available studies were highlighted and possible reasons for their discordant results were analyzed.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.4
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• pp.811-824
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• 1998

The purpose of this study was to compare the clinical sedation effect of chloral hydrate and hydroxyzine combination, midazolam, triazolam when young children were sedated for dental treatment. The uncooperative 22 children aged, 25 to 52 months of age(ASA class I) and weighting between 11 and 17kg, participated in the study. Each patient was assigned randomly to receive chloral hydrate(50mg/kg) and hydroxyzine HCl(25mg), midazolam(0.5mg/kg), and triazolam(0.25mg) oral administration : alternative regimens were administered at next appointment. According to rating scale, sleep, crying, movement, and overall behavior response were checked for evaluation of the clinical sedation effect. Pulse rate and oxygen saturation were also measured for monitoring the patients during treatment period by pulse oximeter. The results were as follows: 1. In the evaluation of sedation effect, 90.9% in chloral hydrate and hydroxyzine combination and midazolam, and 77.3% in triazolam were rated "good" or "very good". 2. Sleep was demonstrated to be statistically significant increase in chloral hydrate and hydroxyzine combination group. Despite the fact that chloral hydrate and hydroxyzine group was in a deeper state of sleep, all the children were easily aroused. 3. There were no statistically significance among the three regimens with regard to cry ing, movement, overall behavior. 4. The adverse side effect was vomiting in one patient of chloral hydrate and hydroxyzine combination. There were no clinical sign of respiratory depression.

• Journal of Oral Medicine and Pain
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• v.45 no.3
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• pp.56-64
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• 2020

Purpose: Temporomandibular disorders (TMD) is a mosaic of clinical signs and symptoms that can be regarded as a set of phenotypes that are affected by various factors including pain sensitivity, pain disability, sleep and psychological functioning. The aims of this study were to evaluate association of pain experience, sleep quality and psychological distress with different phenotypes of TMD patients. Methods: This retrospective study included a cohort (n=1,858; 63.8% for female, mean age=34.9±15.9 years) of patients with TMD. A set of self-administered questionnaires concerning pain interference (Brief Pain Inventory), pain disability (Graded Chronic Pain Scale), sleep quality (Pittsburg Sleep Questionnaire Index), psychological distress (Symptom Checklist-90 revised), and pain catastrophizing (Pain Catastrophizing Scale) were administered to all participants at the first consultation. All TMD patients were classified into four groups including TMD with internal derangement without pain (TMD_ID, n=370), TMD with joint pain (TMD_J, n=571), TMD with muscle pain (TMD_M, n=541) and TMD with muscle-joint combined pain (TMD_MJ, n=376). Results: The female ratio was particularly high in the group with TMD_MJ (p=0.001). The patients with muscle pain and both muscle and joint pain had longer symptom duration (p=0.004) and presented significantly higher scores in pain experience (p<0.001), subjective sleep quality (p<0.001), pain catastrophizing (p<0.001) and psychological distress (p<0.05) except for paranoid-ideation than the groups with only joint problems. Conclusions: The results of this study highlight the importance of multi-dimensional approach that consider pain disability, sleep quality, and psychological functioning in the management of TMD with muscle component. This study would contribute to a better understanding of interaction between heterogeneous TMD and multiple risk factors in order to build tailored treatment based on different phenotypes.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.2
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• pp.181-189
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• 2021

Purpose: The purpose of this study is to investigate the stress response and sleep state of the new patients who visit the hospital for prosthodontic treatment due to tooth loss to make reference to further treatment direction. Materials and methods: Examinations, consultations, and surveys were conducted on 236 patients (94 males, 142 females, and 24-86 years old), who newly registered at the department of prosthodontics at Pusan national university hospital, for 2 years from 2018. The number of remaining teeth, edentulous arch, possibility of mastication, and future prosthetic treatment directions were recorded. The visual analogue scale (VAS), stress response inventory (SRI) and Insomnia severity index (ISI) were used as tools to measure patient's subjective discomfort, stress response, and sleep status. Results: Among the entire prosthodontic patient group, the average value of 'fatigue' was significantly higher among the 7 items of SRI, and the value of 'aggression' was significantly lower (P<.001). There are a significant difference between the edentulous and full dentition in the oral discomfort value measured by VAS (P=.004). In cases where less than 20 teeth remain, mastication is impossible, and patients who are planning treatment with removable prostheses, VAS value and 'depression' and 'fatigue' values in SRI were higher than those in the reverse case (P<.05). The patients showed severe level in VAS value have high value of 'tension', 'somatization', 'depression', 'fatigue'and 'frustration'in SRI than non-serious patients (P<.05). Clinical insomnia occurred in 11.4% of all patients, and women had significantly lower sleep quality than men (P=.044). Patients with insomnia showed significantly higher scores on the VAS value and all 7 SRI items than those of normal sleepers (P<.05). Conclusion: The new prosthetics had high 'fatigue' value among the 7 items of SRI. The oral condition, number of residual teeth and mastication function and clinical insomnia affected oral discomfort and the stress response.