• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.1
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• pp.17-23
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• 2015

Background: Dental injury as a result of oroendotracheal intubation during general anesthesia is very common. We report our experiences of using mouthguard to prevent dental injury during intubation based on our protocol. Methods: This retrospective study enrolled patients referred for preanesthetic evaluation, those patients with a history of any of the dental treatments to their anterior teeth listed on our fabrication protocol from January 1, 2009 to June 30, 2010. Results: No cases of dental trauma during oroendotracheal intubation were reported among the 202 patients who used a protective device. 66% of the patients had risk factors for hard tissue damage aged 10-40 years. At the ages of 40-70 years, the incidence of risk group for periodontal damage was higher. Conclusions: Preanesthetic consultation was effective for preventing dental injury, so preanesthetic questionnaire and proper dental consultation would be helpful.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.3
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• pp.157-163
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• 2012

Background: The major goal of dental management before and after liver transplantation is the prevention of bacteremia from an oral source that could lead to systemic infection. However dental treatment in liver transplant patients have the risk of infection and bleeding. so it is needed special dental consideration. Methods: 42 liver transplant candidates who visited department of Advanced General Dentistry in Yonsei University College of dentistry from March 1, 2010 to February 29, 2012 were selected. The clinical data of those patients were analyzed; coagulation status such as PT, INR, aPTT, platelet count before and 6 months after liver transplantation, dental infectious foci, time interval between dental visit and operation date of liver transplantation. Results: Before liver transplant, the patient's PT and INR was prolonged, and the platelet count was lower than normal range. But 6 months later from liver transplantation, most of the figures turned into a normal range. The dental infection foci were chronic periodontitis, dental caries, chronic apical periodontitis, root rest et al but we did extraction of 6 root rest before liver transplantation and postponed other treatment after liver transplantation due to bleeding and infection risk of patients. Because of insufficient interval between dental visit and operation date, 64.3% of patients could not finish the dental treatment. Conclusions: The patients before liver transplantation have the risk of bleeding. The treatment of those patient should be removal of only factors that can cause dental infections after transplantation and other treatment must be postponed until the stable period of the transplant that patient's condition has improved.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.2
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• pp.45-49
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• 2013

Foreign body indigestion during dental procedures is uncommon but sometimes associated with severe and life threatening morbidity. The dentist should decide whether multidisciplinary intervention is necessary and how urgently it has to be done. The active removal of foreign bodies depends on the size, shape, type and duration of impaction, along with the location in the gastrointestinal tract. In this report, we presented how to manage gastric foreign body related swallowing during dental procedure and investigated the predictive risk factors, precaution, and prompt management in foreign body ingestion.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.3
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• pp.173-177
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• 2023

Local anesthetics are an essential part of pain control during dental treatment. Despite its effectiveness and safety, patients should constantly be aware of potential adverse effects, including allergic reactions. Allergic reactions to amide-type local anesthetics (LAs), such as lidocaine and mepivacaine, are rare compared to those to ester-type LAs. Herein, we report the case of a patient with a history of allergy to lidocaine and mepivacaine, with symptoms of itching, diffuse erythema of the wrists and hands, dizziness, and pectoralgia. This case report emphasizes the importance of collecting medical and dental histories of patients is necessary, and how an allergy test in the allergy and clinical immunology department helps select safe LAs for patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.1
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• pp.9-17
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• 2023

Background: Dental evaluation and protection are important for preventing traumatic dental injuries when patients are under general anesthesia. The objective of the present study was to develop a questionnaire based on dentition-related risk factors that could serve as a valuable tool for dental evaluation and documentation. Methods: We developed a questionnaire for dental evaluation before administration of general anesthesia, investigated the association between patient-and-dentist responses and mouthguard fabrication, and assessed response agreement between 100 patients. Results: Protective mouthguards were fabricated for 27 patients who were identified as having a high risk of dental injury. There was a strong association between dentists' responses and mouthguard fabrication, depending on the general oral health status, use of ceramic prosthesis, presence of masticatory pain related to periodontal diseases, gingival edema, and implants (P < 0.05). Response agreement between patients and dentists for items related to dental pain, loss of dental pulp vitality, root canal therapy, dental trauma, aesthetic prosthesis, tooth mobility, and implant prosthesis was high (Cohen's kappa coefficient κ ≥ 0.6). Conclusions: A high agreement was observed between patient-dentist responses and a strong association with mouthguard fabrication for items pertaining to ceramic prosthesis, masticatory pain, and dental implants. Patients with a "yes" response to these items are recommended to undergo a dental evaluation and use a dental protective device while under general anesthesia.

• Restorative Dentistry and Endodontics
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• v.39 no.3
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• pp.226-229
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• 2014

Orthodontic extrusion is usually performed by means of a fixed orthodontic appliance that utilizes arch wire attached to adjacent teeth and transfers the desired force by elastic from the wire to the root. However, clinicians often encounter cases where the bonding required for tooth traction is not possible because the adjacent teeth have been restored with ceramic or veneer. The purpose of this case report is to describe a modified orthodontic extrusion appliance that is useful when conventional orthodontic treatment is not possible. The modified appliance was fabricated using an artificial tooth, clear plastic sheeting, and a braided fiber-reinforced composite strip that covered adjacent teeth without bonding. It satisfied the esthetic and functional needs of the patient and established the optimal biologic width.

• The Journal of the Korean dental association
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• v.58 no.10
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• pp.640-648
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• 2020

The aim of this article is to provide major announcements within the last decade or so about possible medical emergencies in dentistry. This would be helpful to improve the knowledge on first aid suitable for dental environment. Syncope was the most common medical emergencies in dentistry. Medical emergency situations can be divided into urgency and true emergency. Urgency situations can be solved well if proper treatment is taken. However, even in an urgency, if the correct treatment is not performed, it may soon turn into an emergency. With the joint efforts of the Korean Dental Anesthesiology Society and the Korean Cardiopulmonary Resuscitation Association, dental advanced life support (DALS) has been prepared since 2015. Through 17 training experiences until January 2020, scenarios and textbooks were developed. Dentists and dental care teams need to be prepared to strengthen their competence as professionals and to increase their team-level response capabilities..

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.113-119
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• 2015

Background: The inferior alveolar nerve block (IANB) is the most common anesthetic techniques in dentistry; however, its success rate is low. The purpose of this study was to determine the correlation between IANB failure and mandibular skeletal characteristics Methods: In total, 693 cases of lower third molar extraction (n = 575 patients) were examined in this study. The ratio of the condylar and coronoid distances from the mandibular foramen (condyle-coronoid ratio [CC ratio]) was calculated, and the mandibular skeleton was then classified as normal, retrognathic, or prognathic. The correlation between IANB failure and sex, treatment side, and the CC ratio was assessed. Results: The IANB failure rates for normal, retrognathic, and prognathic mandibles were 7.3%, 14.5%, and 9.5%, respectively, and the failure rate was highest among those with a CC ratio < 0.8 (severe retrognathic mandible). The failure rate was significantly higher in the retrognathic group than in normal group (P = 0.019), and there was no statistically significant difference between the other two groups. Conclusions: IANB failure could be attributable, in part, to the skeletal characteristics of the mandible. In addition, the failure rate was found to be significantly higher in the retrognathic group.

• Imaging Science in Dentistry
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• v.48 no.3
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• pp.213-221
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• 2018

Purpose: The purpose of this study was to evaluate the relationship between masseter muscle thickness, facial morphology, and mandibular morphology in Korean adults using ultrasonography. Materials and Methods: Ultrasonography was used to measure the masseter muscle thickness bilaterally of 40 adults(20 males, 20 females) and was performed in the relaxed and contracted states. Facial photos and panoramic radiography were used for morphological analyses and evaluated for correlations with masseter muscle thickness. We also evaluated the correlations of age, body weight, stature, and body constitution with masseter muscle thickness. Results: In the relaxing, the masseter was $9.8{\pm}1.3mm$ in females and $11.3{\pm}1.2mm$ in males. In the contracted state, it was $12.4{\pm}1.4mm$ in females and $14.7{\pm}1.4mm$ in males. Facial photography showed that bizygomatic facial width over facial height was correlated with masseter muscle thickness in both sexes in the relaxed state, and was statistically significantly correlated with masseter muscle thickness in males in the contracted state. In panoramic radiography, correlations were found between anterior angle length and posterior angle length and masseter muscle thickness in females, and between body length and posterior angle length, between anterior angle length and body length, between ramal length and body length, and between body length and condyle length in males. Conclusion: Masseter muscle thickness was associated with facial and mandibular morphology in both sexes, and with age in males. Ultrasonography can be used effectively to measure masseter muscle thickness.

• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.1
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• pp.38-44
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• 2011

Despite all preventive efforts, aspiration of foreign body during clinical dental procedures occurs occasionally. Careful clinical physical examination, proper assessment of radiography and prompt emergency treatment can prevent any potentially serious consequences. In this report, we will report serial cases of foreign body in different situation from mild cases to severe cases and suggest some clinical guidelines to dental health care providers.