This article discusses the issues of benefit and risk associated with outpatient general anesthesia and deep sedation for the special need dental patients. The purpose of administering anesthesia for patients with special needs is to provide effect dental treatment. But there are many complications such as sore throat, nausea and vomiting, airway trauma, airway obstruction and hypoxic brain damages, etc. In order to decrease incidence of complication, before general anesthesia meticulous patient evaluation is much important. But, there are a number of factors that make it difficult to accurately assess the anesthetic risk for many people with special needs. These include limited medical workups, uncooperative behavior, and difficulties in postoperative cares, etc. But Judging from several years experience of many contries, it appears that the incidence of mortalities for people with special needs in dental setting is minimal and the incidence of morbidity is limited. In the long run, the delivery of general anesthesia and deep sedation for people with special needs can be considered a very safe and successful procedure.

The developmental disorder(intellectual disorder(ID) and autism spectrum disorder(ASD)) can severely impair a patient's ability to communicate and socialize. So they require physical management techniques, pharmacologic agents, and general anesthesia more than the normal at the dental clinic. The behavior therapy is a kind of the psychotherapy and is applied to the patient with behavioral problems. Seoul Dental Hospital for Disabled(SDHD) set up the Dental Behavior Clinic for the patients with developmental disorder and treated 32 patients with ID or ASD, blind. 18 patients were treated according to the ordinary plans, 14 patients stopped the treatment by different reasons. The various results of the treatment were produced by the kind or severity of the diseases, age and cooperation of the patients and the caregivers. Especially, the behavior therapist helped to figure out the characteristics of the patients and to make individualized treatment plans. In the future, it will be necessary to treat more patients and to make the dental behavior therapy objectify. And through the dental behavior therapy, it will be expected that the patients will become more cooperative to the dental clinic and can receive regular check-up peacefully, reducing the frequency of the general anesthesia.

저자는 Axenfeld-Rieger 증후군을 가지는 5세 8개월 연환에 대한 구강 및 두개 안면에 대한 임상적, 방사선학적 관찰을 통해 다음과 같은 지견을 얻었다. 1. 본 증례의 환아는 Axenfeld-Rieger 증후군의 전형적인 안과적, 구강적, 전신적 특징인 녹내장, 동공이상, 제탈장, 지연된 골령, 다수 치아 및 치배 결손, 상악 저성장 등을 보였다. 2. 이에 대한 주기적인 관찰과 적절한 시기의 치료개입이 중요하다. 3. 치과의사에 의한 조기진단이 녹내장 등에 의한 시력상실을 방지하기 위해 중요하다.

1. 러셀-실버 증후군 환아는 특징적인 소구증 및 유아기의 섭식 장애를 보이므로, 출생 후 필요시설소대 절제술을 고려해야 하며 특별히 고안된 구강위생 용품이 구강위생 증진에 도움이 될 수 있다. 2. 러셀-실버 증후군 환아의 우식 치료 시 개구량이 확보되지 않으므로 근육 이완을 위해 전신마취를 고려해야 하며, 소형의 핸드피스 및 버와 같은 기구들을 사용하여 접근하는 것이 치료를 수월케 하며 환아의 불편감을 감소시킬 수 있다.

이종골의 치아맹출에 대한 기존 문헌 및 동물실험 연구를 바탕으로, 자가골 및 동종골 이식이 어려운 구순구개열 환자에서 이종골(Bio-$Oss^{(R)}$)을 이식하여 성공적으로 매복된치아의 맹출을 유도하였고, 치근의 형성 및 치아의 골내 이동도 정상적으로 이루어졌다.

화학치료와 방사선 치료는 보존적이고 효과적인 항암치료 방법이다. 그러나 악골 및 치아의 성장이 완료되지 않은 성장기 아동의 경우에는 발육 장애를 유발할 수 있다. 환자 의 삶의 질 개선을 위해 이러한 부작용을 예방할 수 있는 방법이 모색되어야 할 것이다.

Trauma to the lips and tongue can occur by accidental self-biting after dental treatment. After local anesthesia, it is likely that the patient may feel painless even in biting the tongue. In case of young children and disabled patients, the dentists should be careful not to bite the tongue. In this report, we present a case of deep lingual laceration due to biting the tongue in the course of dental treatment under general anesthesia. A 33 year-old male was transferred to our hospital to treat tongue laceration. Before 2 hour on arrival, he had received dental care under general anesthesia at a dental hospital for the disabled because of cooperation difficulty and cerebral palsy. During recovery from general anesthesia, he tried to bite his own tongue involuntary. The doctors and nurses tried to prevent the patient from being injured. Despite these efforts, massive bleeding occurred from the injured sites of the tongue. Because we could not communicate with him, we decided to evaluate the extent of the injury and treat the injured sites under general anesthesia. The laceration wound was sutured for nearly 1 hr general anesthesia. During recovery we inserted mouth prop into the oral cavity to prevent further injuries from tongue biting. After full recovery from general anesthesia he didn't try to bite his tongue. After 4 hour admission, he was discharged without other complications.