• Title/Summary/Keyword: 환자 불편감

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MESIODENS EXTRACTION OF A PATIENT WITH ROBINOW SYNDROME UNDER GENERAL ANESTHESIA (로비노 증후군(Robinow syndrome) 환자의 전신마취 하 과잉치 발치)

  • Park, Sung-Hee;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul;Jang, Ki-Taeg
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.1
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    • pp.1-5
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    • 2016
  • Robinow syndrome is skeletal dysplasia with both autosomal dominant and recessive inheritance patterns. It is characterized by short-limbed dwarfism, abnormalities in the head and face, as well as vertebral segmentation. A 2-year-7-month old boy with Robinow syndrome had visited Seoul National University Dental Hospital, for the evaluation of tooth palatal eruption on maxilla. He had micrognathia, delayed tooth eruption, cleft lip with bifid uvula. He also had an erupted mesiodens on the palatal side of maxillary primary incisors, which was tuberculated and 8mm in major diameter. The patient was scheduled for mesiodens extraction under general anesthesia. He was a young child with delayed development, so general anesthesia was inevitable. General anesthesia was induced and maintained with inhalation agent, Sevoflurane. There were no postoperative complications related to anesthesia and dental treatment. Robinow syndrome patients have craniofacial dysmorphism and eruption disorders. Therefore, he requires regular check-ups as well as dental managements.

Implant Supported Fixed Restoration for Maxillary Edentulism using CAD/CAM Guided Implant Surgery (NobelGuide$^{TM}$) and Immediate Loading (상악 완전 무치악 환자의 CAD/CAM 을 이용한 임플란트 식립(NobelGuide$^{TM}$) 및 즉시하중 후 고정성 보철수복 증례)

  • Huh, Yoon-Hyuk;Yi, Yang-Jin;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.423-439
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    • 2012
  • This case report described a technique utilizing a computer-aided design (CAD)/computer-aided machining (CAM) - guided surgical implant placement and prefabricated temporary fixed prosthesis for an immediately loaded restoration. The advantages of CAD/CAM guided implant procedures are flapless, minimally invasive surgery and shorter surgery time. With this technique, less postoperative morbidity and delivery of prosthesis for immediate function would be possible. A patient with an edentulous maxilla received 8 implants in maxilla using CAD/CAM surgical templates. Prefabricated provisional maxillary implant supported fixed prosthesis were connected immediately after implant installation. Provisional prosthesis was evaluated for aesthetics, function during 6 months. Definitive implant supported fixed porcelain fused metal bridges were fabricated.

Full mouth rehabilitation using orthodontic treatment and implants in patient with collapsed occlusion: A case report (붕괴된 교합을 가진 환자에서 교정치료와 임플란트를 이용한 전악 수복: 증례보고)

  • Ahn, Ayoung;Koak, Jai-Young;Heo, Seong-Joo;Kim, Seong-Kyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.439-447
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    • 2019
  • The distance between the natural teeth and the implants is an important factor in preserving the periodontal tissues and esthetics. And abnormal positional displacement and tilting of the teeth during restorative procedure may require intentional root canal treatment and may affect masticatory function. This report is to present a successful full mouth rehabilitation of a patient with uneven dentition and collapsed occlusion using orthodontic and implant treatment. The patient had no symptoms or discomfort of temporomandibular joint disorder such as pain or sound. The orthodontic treatment was continued until implant provisional prosthesis delivery. And the vertical height of occlusion was elevated 2mm on anterior basis for anterior teeth protection and esthetics. After the orthodontic treatment, the implant abutments and natural teeth were finally restored with porcelain-fused-to-metal crowns and bridges. Satisfactory function and esthetic outcomes are observed after 6months of follow up.

Management of prosthodontic patients with severe gag reflex using the questionaire and behavior technique: A case report (심한 구역반사를 보이는 환자에서 문진표와 행동 요법을 이용한 임플란트 고정성 보철 수복 증례)

  • Sohn, Changmo;Kim, Yu-Jin;Lee, Cheon-Seo;Choi, Na-Rae;Kwon, Eun-Young;Kim, So-Yeun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.3
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    • pp.333-340
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    • 2021
  • Although gag reflex is an essential function and a useful physiological defense mechanism, it can become an obstacle in a dental treatment. In this case, a questionnaire was designed and used in consultations to objectify the factors associated with gag reflex. Based on the questionnaire, various treatment protocols were planned, such as behavioral control, which is a systematic desensitization that adapts by placing dental instruments in the oral cavity, and habit control to eliminate vomiting habits after drinking. Except for the placement of the implant fixture under general anesthesia, all restoration procedures were performed in the outpatient clinic in the same manner as the conventional implant fixed prosthetic restoration. The systematic desensitization and behavior technique were repeated until the patient was able to endure discomfort and relieve gag reflex in dental treatment. The patient was successfully received the implant-fixed prosthetic restoration in the partial edentulous region.

Restoration of implant-supported fixed dental prosthesis using the automatic abutment superimposition function of the intraoral scanner in partially edentulous patients (부분무치악 환자에서 구강스캐너의 지대주 자동중첩기능을 이용한 임플란트 고정성 보철물 수복 증례)

  • Park, Keun-Woo;Park, Ji-Man;Lee, Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.79-87
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    • 2021
  • The digital workflow of optical impressions by the intraoral scanner and CADCAM manufacture of dental prostheses is actively developing. The complex process of traditional impression taking, definite cast fabrication, wax pattern making, and casting has been shortened, and the number of patient's visits can also be reduced. Advances in intraoral scanner technology have increased the precision and accuracy of optical impression, and its indication is progressively widened toward the long span fixed dental prosthesis. This case report describes the long span implant case, and the operator fully utilized digital workflow such as computer-guided implant surgical template and CAD-CAM produced restoration after the digital impression. The provisional restoration and customized abutments were prepared with the optical impression taken on the same day of implant surgery. Moreover, the final prosthesis was fabricated with the digital scan while utilizing the same customized abutment from the provisional restoration. During the data acquisition step, stl data of customized abutments, previously scanned at the time of provisional restoration delivery, were imported and automatically aligned with digital impression data using an 'A.I. abutment matching algorithm' the intraoral scanner software. By using this algorithm, it was possible to obtain the subgingival margin without the gingival retraction or abutment removal. Using the digital intraoral scanner's advanced functions, the operator could shorten the total treatment time. So that both the patient and the clinician could experience convenient and effective treatment, and it was possible to manufacture a prosthesis with predictability.

Full mouth rehabilitation with fixed prostheses by increased vertical occlusal dimension using 3D printed splint in a patient with excessive tooth wear (과도한 치아 마모 환자의 3D 프린팅 교합안정장치를 이용한 수직 교합 고경 증가를 동반한 고정성 보철물 전악 수복 증례)

  • Se-Young Kim;Soo-Yeon Shin
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.3
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    • pp.215-226
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    • 2023
  • Severe wear of the anterior teeth facilitates the loss of anterior guidance, which protects the posterior teeth from wear during excursive movement. Additionally, when treating patients with collapsed occlusion due to multiple tooth loss and tooth wear, it is important to determine the presence of vertical dimension loss through accurate clinical and radiographic examinations and diagnostic wax-up. The patient of this case is a 44-year-old female patient who complained of overall tooth wear and loss of posterior teeth due to bruxism and clenching habits, visited the hospital with the address of restoring masticatory function and improving aesthetic appearance through prosthetic treatment. Through model analysis and diagnostic wax-up, an increase in vertical dimension was determined, and full mouth restoration with fixed prostheses was planned. The degree of adaptation to the vertical dimension was confirmed step by step using an occlusal splint designed with CAD (Computer aided design) software and 3-D (3-Dimensional) printed, and then restored with provisional restoration and after a 4-month adaptation period, the entire dentition was restored with metal ceramic crowns and implants. Through this procedure, satisfactory treatment results were obtained in terms of function and aesthetics.

Reliability of a Questionnaire for Evaluation of Dry Mouth Symptoms (구강건조증 증상 평가를 위한 설문지의 신뢰도에 관한 연구)

  • Lee, Jeong-Yun;Lee, Young-Ok;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.30 no.4
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    • pp.383-389
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    • 2005
  • Xerostomia is defined as a subjective complaint of dry mouth that may be perceived when there is insufficient mucosal wetting. However, the diagnosis and treatment of xerostomia is not that simple because of the fact that the subjective awareness of dry mouth is not always correlated with a diminution in the flow of saliva and there is always a difference between individuals in salivary flow rates needed for normal oral function. In the present study, the aim was to develop a questionnaire to evaluate the dry mouth symptoms and to analyze its reliability and usability as a diagnostic and analytic tool for xerostomia. The questionnaire which consists of 6 Visual Analogue Scale(VAS) type questions to evaluate the subjective oral dryness and 4 questions to evaluate behavior to avoid oral dryness was developed and administered twice with 1 week's interval to the healthy 88 young adults without dry mouth symptoms(44 males and 44 females; mean age was $25.6{\pm}3.1$ years in male and $24.3{\pm}2.1$ years in female). The results were as follows. 1 The intraclass correlation coefficients of 6 questions to evaluate the subjective oral dryness were as significantly high as 0.767 for the degree of oral dryness at other times of the day, 0.850 for the amount of saliva in the mouth, and 0.791 for the degree of effect on daily life due to oral dryness and as high as 0.563 for the degree of oral dryness at night or on awakening, 0.674 for the degree of oral dryness during eating, and 0.641 for the degree of difficulty in swallowing foods. 2. Cronbach's alpha value of 6 questions was 0.982. It can be concluded that the series of questions to evaluate the subjective oral dryness has high internal consistency. 3. Cohen's kappa values of 4 questions to evaluate behavior to relieve oral dryness were as significantly high as 0.850 for the frequency of keeping a glass of water at the bedside and as high as 0.506 the frequency of awakening during sleeping due to oral dryness, 0.419 for the frequency of sipping liquids to aid in eating dry foods, and 0.407 for the frequency of using a candy or chewing gum due to oral dryness. From the results, it can be concluded that the questionnaire consisting of 6 VAS type questions to evaluate the subjective oral dryness and 4 questions to evaluate behavior to relieve oral dryness has reliability of good to excellent level, and that the series of 6 VAS type questions has significantly high internal consistency to evaluate the subjective oral dryness.

A Study of Perceived Discomfort of The Patients Under Local Anesthesia - Centering Around the Development of Measures - (국소마취 수술환자의 불편감에 관한 연구 - 도구개발을 중심으로 -)

  • Lee, Gyeong Sug;Kim, Mi Ja;Park, Sun Mi;Paek, Sun Young;Lee, Yang Sug;Bae, Sang Do;Choi, Jung Hoon
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.6-17
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    • 2000
  • Background : This study was attempted to provide a basic information necessary for the development of measures evaluating perceived discomfort of the patients under local anesthesia and the developments of nursing intervention and nursing standard. Method : The study subjects were a convenience sample of 100 surgical patients under local anesthesia. The researcher visited the patients directly and explained the purpose of the study to them. Then they were asked to fill out questionnaires which were developed and structured by the researcher, under their prior permission. Out patient's data were collected at recovery room after operation. Results : Factor analysis on measures evaluating the patients under local anesthesia showed that the measures consisted of eight factors including "explanation", "humane treatment", "motion limitation", "pain", "no togetherness", "waiting", "the environment of operating room", and "unkindness". When analyzing each of the factors regarding their degree of contribution to perceived discomfort, it was found that "waiting" was highest in terms of the degree. According to general chara-cteristics of the sampled patients, the factor of "explanation" contributed to perceived discomfort more in male patients than female ones. Regarding parts of medical examination, the patients of otorhinolaryngology felt perceived discomfort most because of the factor of "pain". Conclusion : To relieve perceived discomfort the patients under local anesthesia require providing individually systematized nursing services which can reduce perceived discomfort according to each of the factors. In doing so, an unlimited attention and much effort should be given to realize CQI reaching the dimension of increase in comfort as well as decrease perceived discomfort.

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Effects of ASPAN's Evidence-based Clinical Practice Guidelines for Promotion of Hypothermia of Patients with Total Knee Replacement Arthroplasty (슬관절 전치환술 환자의 저체온 관리를 위한 ASPAN의 근거기반 임상실무 가이드라인 적용 효과)

  • Yoo, Je Bog;Park, Hyun Ju;Chae, Ji Yeoun;Lee, Eun Ju;Shin, Yoo Jung;Ko, Justin Sangwook;Kim, Nam Cho
    • Journal of Korean Academy of Nursing
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    • v.43 no.3
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    • pp.352-360
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    • 2013
  • Purpose: In this study an examination was done of the effects of the American Society of PeriAnesthesia Nurses (ASPAN) Evidence-Based Clinical Practice Guidelines on body temperature, shivering, thermal discomfort, and time to achieve normothermia in patients undergoing total knee replacement arthroplasty (TKRA) under spinal anesthesia. Methods: This study was an experimental study with a randomized controlled trial design. Participants (n=60) were patients who underwent TKRA between December 2011 and March 2012. Experimental group (n=30) received active and passive warming measures as described in the ASPAN's guidelines. Control group (n=30) received traditional care. Body temperature, shivering, thermal discomfort, time to achieve normothermia were measured in both groups at 30 minute intervals. Results: Experimental group had slightly higher body temperature compared to control group (p=.002). Thermal discomfort was higher in the experimental group before surgery but higher in the control group after surgery (p=.034). It decreased after surgery (p=.041) in both groups. Time to achieve normothermia was shorter in the experimental group (p=.010). Conclusion: ASPAN's guidelines provide guidance on measuring patient body temperature at regular intervals and on individualized and differentiated hypothermia management which can be very useful in nursing care, particularly in protecting patient safety and improving quality of nursing.

Life-threatening Airway Edema after Arthroscopic Repair of Massive Rotator Cuff Tear - A Case Report - (관절경하 광범위 회전근 개 파열 수술 후 발생한 치명적인 기도 부종 - 증례 보고 -)

  • Moon, Young-Lae;Yu, Byung-Sik;So, Keum-Young;Lim, Kyung-Joon;Kang, Jeong-Hoon
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.136-139
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    • 2007
  • Shoulder arthroscopic surgeries are an accepted technique for many shoulder disease and have many advantages over open surgeries. To date, shoulder arthroscopic surgery have been rare complications that compromise patient airway, caused by the leakage of irrigation fluid out of the shoulder joint space into the surrounding soft tissues and then the neck and the pharynx. This report presents a case of life-threatening airway obstruction due to extra-articular saline collection during arthroscopic rotator cuff repair. In concluding we should hourly check the patient's neck swelling undergoing shoulder arthroscopic surgery, because anesthetized patients cannot complain of the airway problem may progress until it becomes life-threatening.