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Dental treatment of the patient with antiplatelet agent (항혈소판제를 투여받는 환자의 치과치료)

  • Park, Hongju
    • The journal of the Korean dental association
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    • v.57 no.10
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    • pp.606-612
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    • 2019
  • Antiplatelet agent is administered to the patients who have ischemic heart disease, transient cerebral infarction, as well as hypertension, etc. Antiplatelet agent prevents thromboembolism by inhibition of platelet aggregation by various mechanism. Due to that reason, patient who administered antiplatelet agent has bleeding tendency. Surgeon does not want to make a complication by bleeding during and after operation, and want to stop taking antiplatelet agent. However, It is very dangerous for the patient to stop antiplatelet agent. Local bleeding as a complication after operation is considered minor one, whereas thromboembolism is life threatening serious complication. Most dental intervention can be performed without withdrawal of antiplatelet agent. Dental intervention should be limited area, and surgeon should do active bleeding control.

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Two-dimensional and volumetric airway changes after bimaxillary surgery for class III malocclusion

  • Vaezi, Toraj;Zarch, Seyed Hossein Hosseini;Eshghpour, Majid;Kermani, Hamed
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.2
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    • pp.88-93
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    • 2017
  • Objectives: Any change in maxilla and mandible position can alter the upper airway, and any decrease in the upper airway can cause sleep disorders. Thus, it is necessary to assess airway changes after repositioning of the maxilla and mandible during orthognathic surgery. The purpose of this study was to evaluate linear and volumetric changes in the upper airway after bimaxillary surgery to correct class III malocclusion via cone-beam computed tomography (CBCT) and to identify correlations between linear and volumetric changes. Materials and Methods: This was a prospective cohort study. CBCTs from 10 class III patients were evaluated before surgery and three months after. The Wilcoxon one-sample test was used to evaluate the differences in measurements before and after surgery. Spearman's rank correlation coefficient was used to test the correlation between linear and volumetric changes. Results: The results show that the nasopharyngeal space increased significantly, and that this increase correlated with degree of maxillary advancement. No significant changes were found in volumes before and after surgery. A correlation was found between linear and volumetric oropharyngeal changes. Conclusion: Bimaxillary surgical correction of class III malocclusion did not cause statistically significant changes in the posterior airway space.

Influence of implant misplacement on the success of the final prosthesis: Subjective evaluation by a prosthodontist of dental implants placed by an oral and maxillofacial surgeon (임프란트 식립오류가 최종 보철물의 성공에 미치는 영향: 구강악안면외과의사에 의해 식립된 치과임프란트에 대한 보철의사의 주관적 평가)

  • Kim, Young-Kyun;Hwang, Jung-Won;Lee, Hyo-Jung;Yeo, In-Sung;Yun, Pil-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.6
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    • pp.437-441
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    • 2009
  • Purpose: In many cases, the erroneous placement of a dental implant brings about undesirable results. Here, the effect of dental implant placement on the success of the final prosthesis was evaluated from the point of view of the prosthodontist. Materials and Methods: All surgical operations were performed by the same oral surgeon with the same surgical protocol and all prosthodontic procedures were performed by the same prosthodontist. The problems faced by the prosthodontist, their causes, and their effect on prosthesis success were identified. The success of the final prostheses was evaluated by the same prosthodontist. Results: Only 53% (238 implants in 105 patients) of dental implants were not associated with prosthodontic problems. Multiple implant placement (more than three implants) was associated more frequently with prosthodontic problems. Conclusions: The data indicate that the satisfactory construction of a prosthesis is highly dependent on the placement of the dental implant in the best possible position. It is strongly recommended that the oral surgeon and the prosthodontist engage in pre-operative discussions to establish a top-down treatment plan, as this will improve implant placement and ultimately the success of the prosthesis.

Common pitfall of plastic surgeon for diagnosing cutaneous odontogenic sinus

  • Chang, Lan Sook
    • Archives of Craniofacial Surgery
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    • v.19 no.4
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    • pp.291-295
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    • 2018
  • Dental origins are a common cause of facial cutaneous sinus tracts. However, it can be easily overlooked or misdiagnosed if not suspected by a surgeon who is not familiar with dental origins. Cutaneous odontogenic sinuses are typically nodulocystic lesions with discharge and are most frequently located on the chin or jaw. This article presents two cases of unusual cutaneous odontogenic sinus presentations, as deep dimpling at the middle of the cheek. The patients were undergone surgical excision of sinus tract and dimpling immediate before and after treatment of causal teeth and the lesions resolved without recurrence. Surgeons should consider dental origins of facial dimpling lesions with discharge and provide appropriate treatment.

Local Anesthetics for Dental Procedure (치과시술에 사용되는 국소마취제)

  • Kim, Cheul Hong;Yoon, Ji Young
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.3
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    • pp.71-79
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    • 2013
  • Local pain management is the most critical aspect of patient care in dentistry. Local anesthesia is a reversible blockade of nerve conduction in an applied area that produces loss of sensation. The chemical agents used to produce local anesthesia stabilize neuronal membranes by inhibiting the ionic fluxes required for the propagation of neural impulses. Proper local anesthesia permits the dental surgeon to perform the necessary surgical procedure in a careful, gentle fashion that will be less stressful for both the operator and the patient. The improvements in agents for local anesthesia are probably the most significant advances that have occurred in dental science. Today's anesthetics are safe, effective, and can be administered with insignificant soft tissue damage and minimal concerns for allergic reactions. This article reviews the widely used local anesthetic agents for obtaining local anesthesia, and also discusses some frequently seen complications.

Early implant failure: a retrospective analysis of contributing factors

  • Kang, Dae-Young;Kim, Myeongjin;Lee, Sung-Jo;Cho, In-Woo;Shin, Hyun-Seung;Caballe-Serrano, Jordi;Park, Jung-Chul
    • Journal of Periodontal and Implant Science
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    • v.49 no.5
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    • pp.287-298
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    • 2019
  • Purpose: The aim of this retrospective study was to determine the prevalence of early implant failure using a single implant system and to identify the factors contributing to early implant failure. Methods: Patients who received implant treatment with a single implant system ($Luna^{(R)}$, Shinhung, Seoul, Korea) at Dankook University Dental Hospital from 2015 to 2017 were enrolled. The following data were collected for analysis: sex and age of the patient, seniority of the surgeon, diameter and length of the implant, position in the dental arch, access approach for sinus-floor elevation, and type of guided bone regeneration (GBR) procedure. The effect of each predictor was evaluated using the crude hazard ratio and the adjusted hazard ratio (aHR) in univariate and multivariate Cox regression analyses, respectively. Results: This study analyzed 1,031 implants in 409 patients, who comprised 169 females and 240 males with a median age of 54 years (interquartile range [IQR], 47-61 years) and were followed up for a median of 7.2 months (IQR, 5.6-9.9 months) after implant placement. Thirty-five implants were removed prior to final prosthesis delivery, and the cumulative survival rate in the early phase at the implant level was 95.6%. Multivariate regression analysis revealed that seniority of the surgeon (residents: aHR=2.86; 95% confidence interval [CI], 1.37-5.94) and the jaw in which the implant was placed (mandible: aHR=2.31; 95% CI, 1.12-4.76) exerted statistically significant effects on early implant failure after adjusting for sex, age, dimensions of the implant, and type of GBR procedure (preoperative and/or simultaneous) (P<0.05). Conclusions: Prospective studies are warranted to further elucidate the factors contributing to early implant failure. In the meantime, surgeons should receive appropriate training and carefully select the bone bed in order to minimize the risk of early implant failure.

Foreign body aspiration during dental treatment under general anesthesia: A case report

  • Doh, Re-Mee
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.2
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    • pp.119-123
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    • 2019
  • Foreign body aspiration in dental clinics is the most common cause of respiratory emergencies. There are no reports on foreign body aspiration during dental treatment under stable general anesthesia because the patient neither has voluntary movements nor reflex actions. This is a case report on the fall of a prosthesis in the larynx, which occurs rarely under general anesthesia. During the try-in procedure, the prosthesis slid from the surgeon's hand and entered the retromylohyoid space, and while searching for it, it passed down the larynx to the endotracheal tube balloon, leading to a dangerous situation. The prosthesis was promptly removed using video-assisted laryngoscope and forceps, and the patient was discharged without any complications.

An Experimental Study Microvascular Patency by Micro-Arteriography Using Dental X-ray and Film (미세혈관 조영술에 의한 미세혈관 문합후의 혈류재개에 대한 실험적 연구)

  • Choung, Pill-Hoon
    • The journal of the Korean dental association
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    • v.23 no.1
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    • pp.73-81
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    • 1985
  • In the assessment of patency of a small vessel anastomosis, micro-arteriography using dental X-ray and film was used as a method of testing the patency of arterial anastomoses in the rat. Micro-arteriography could lead to an objective evaluation of the patency in End-to-End and End-to Side anastomoses. The method used in this study is easily accessible for Oral and Maxillo-facial surgeon to practice the microvascular anastomosis, and requires materials available in every dental clinic.

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Nasolabial and extended nasolabial flaps for reconstruction in oral submucous fibrosis

  • Qayyum, Muhammad Umar;Janjua, Omer Sefvan;Haq, Ehtesham Ul;Zahra, Rubbab
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.4
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    • pp.191-197
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    • 2018
  • Objectives: The objective of the study was to evaluate the results of nasolabial/extended nasolabial flaps as a modality for treatment of oral submucous fibrosis. Materials and Methods: Eleven patients of Stage III or IVa maximum interincisal opening were selected to be operated. Nasolabial/extended nasolabial flaps were done for both the sides. All of the flaps were done in a single stage and were inferiorly based. A similar flap harvest/surgical technique was utilized for all the cases. Results: The preoperative mouth opening ranged from 5 to 16 mm, with a mean of 10.09 mm. At 6 months the mouth opening ranged from 29 to 39 mm. Some of the complications encountered were poor scar, wisdom tooth traumatising the flap, decreased mouth opening due to non compliance and too much bulk. All of theses were managed satisfactorily. Conclusion: The nasolabial flap is a very reliable flap to restore the function of oral cavity. Important adjuvant measures are habit cessation, lifestyle changes, and aggressive physiotherapy.