• Journal of Dental Anesthesia and Pain Medicine
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• 제18권1호
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• pp.57-64
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• 2018

Major cardiac complication such as acute myocardial infarction can occur unexpectedly in patients without risk factors. We experienced cardiac arrest due to an unexpected acute myocardial infarction in a patient without any risk factors during head and neck reconstructive surgery. The patient was diagnosed with acute myocardial infarction after return of spontaneous circulation. With immediate percutaneous coronary intervention, the patient recovered without complications.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권2호
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• pp.125-128
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• 2018

In cases of a difficult intubation where numerous intubation methods, including laryngoscopy, have failed, yet oral intubation is still necessary, the method of tube exchange after fiberoptic nasal intubation may be attempted. Fiberoptic nasal intubation allows intubation to be performed relatively easily when the laryngeal view grade is poor. We report a case in which our attempt at oral intubation for total maxillectomy with laryngoscopy and fiberoptic oral intubation had failed due to an unexpected difficult airway; subsequently, we successfully completed the surgery by performing fiberoptic nasal intubation to secure the airway, followed by using a tube exchanger to exchange to an oral endotracheal tube.

• 대한심미치과학회지
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• 제23권2호
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• pp.95-104
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• 2014

This study is about the basis of satisfactions by patients : One is 'what factors of the marketing by dental medical service have an effect on consumers dental clinic' The other is 'what is the most important part when consumers choose the dental medical ser Seoul and Gyeonggi area unintentionally. Finally 446 people were analyzed. 6 general questions, 5 selective form questions when consumers choose the dental service, 11 satisfactions questions after treating and thought of reuse the dental service 6 (Likert scale) questions. Whether the choice of hospital dental marketing by dental analysis, both male and female hospital medical marketing and use of selected highly suggests that it does not respond. The resulting satisfaction analysis using the Hospital Dental Marketing consumer access to medical care, and then, a full explanation, comfort, quality and level, health care costs, treatment management, and symptom improvement were higher satisfaction with the item, select the dental healthcare after the analysis of the marketing of recycled doctors are otherwise subject the person selected from all entries equal to or higher than the average consumer satisfaction showed a higher medical doctor also higher reuse. Consequently, Through the use of marketing to choose the best dental healthcare need to providing quality care.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권5호
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• pp.295-300
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• 2019

Complex regional pain syndrome (CRPS) is rare, characterized by pain from diverse causes, and presents as extreme pain even with minor irritation. General anesthesia may be required for dental treatment because the pain may not be controlled with local anesthesia. However, treatment under general anesthesia is also challenging. A 38-year-old woman with CRPS arrived for outpatient dental treatment under general anesthesia. At the fourth general anesthesia induction, she experienced severe pain resulting from her right toe touching the dental chair. Anesthesia was induced to calm her and continue the treatment. After 55 minutes of general anesthesia, the patient still complained of extreme toe pain. Subsequently, two administrations for intravenous sedation were performed, and discharge was possible in the recovery room approximately 5 h after the pain onset. The pain was not located at the dental treatment site. Although the major factor causing pain relief was unknown, ketamine may have played a role.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.6.1-6.2
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• 2018

• 대한치과마취과학회지
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• 제12권2호
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• pp.115-119
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• 2012

Double outlet of right ventricle (DORV) refers to a congenital heart disease in which pulmonary and systemic circulation originates from the right ventricle. In the patient with DORV, it is important to maintain the balance between pulmonary and systemic circulation in anesthetic management. A 4-year-old boy with DORV, who underwent a Blalock-Taussig shunt operation, was transferred to the clinic with a chief complaint of multiple caries. Due to poor cooperability, it was impossible to treat the caries without sedation or general anesthesia. We planned to sedate him with consideration with detrimental effects associated with positive pressure ventilation for dental treatment. After a prophylactic administration of antibiotics, sevoflurane was administered through T-cannula site. Throughout the treatment, His blood remained stable around 80/40 mmHg, oxygen saturation remained around 91%. After 3 hour of sedation with sevoflurane (end-tidal sevoflurane con 1-1.8 vol%), he fully regained consciousness, and discharged from hospital without complications. In case of DORV patient, deep sedation with sevoflurane may be used as effective method of behavioral management during dental treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권2호
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• pp.77-83
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• 2015

Background: To prepare for possible emergency situations during dental treatment, it is helpful to know how often and what kinds of emergencies may arise. This study set out to evaluate the incidences, causes, treatments, and outcomes of emergency situations in the outpatient clinic of a dental teaching hospital in Korea. Methods: We retrospectively reviewed the records of patients who had experienced an emergency situation and emergency response team activated in a selected outpatient clinic between November 2004 and November 2013. Specific information about the emergency cases was collected, including the patient characteristics and the frequency, types, treatments, and outcomes of the emergency situations. Results: We identified 35 instances of emergency situations in 2,890,424 patients (incidence = 0.012 per 10,000 outpatients). The number of cases was as follows: 10 (28.6%) in the Department of Periodontics, 10 (28.6%) in the Department of Oral and Maxillofacial Surgery, 6 (17.1%) in the Department of Oral and Maxillofacial Radiology, 4 (11.4%) in the Department of Prosthodontics, 2 (5.7%) in the Department of Conservative Dentistry, 2 (5.7%) in the Department of Pediatric Dentistry, and 1 (2.9%) in the Department of Orthodontics. Three (8.6%) of the emergency situations arose before treatment, 22 (62.9%) during treatment, 7 (20.0%) after treatment, and 2 (5.7%) in a patient's guardian. Conclusions: In accordance with the growing elderly population and more aggressive dental procedures, the number of emergency situations may increase in the future. We recommend that clinicians keep in mind airway management and the active control of emergency situations.

• Journal of Oral Medicine and Pain
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• 제47권1호
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• pp.67-71
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• 2022

Subchondral cysts are frequently encountered in patients with temporomandibular joint osteoarthritis (TMJ OA), particularly in advanced stage. Subchondral cysts within osteoarthritis are typically lying adjacent to the joint surface where initial load bearing occurs during activity and have been associated with greater pain and disease progression. Although the etiology of these cysts remains uncertain, recently studies report that the induction of the subchondral bone mechanical stress caused subchondral cysts. Repeated overloading leads to further deterioration of subchondral bone which render subchondral bone structure more fragile, increase the risk of osteoarthritis progress. The purpose of this study was to assess the effect of conservative treatment and longitudinal osseous changes of a large subchondral cyst in a mandibular condyle in a symptomatic TMJ OA patient.

• 대한치과마취과학회지
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• 제14권1호
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• pp.11-15
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• 2014

Background: It is imperative that adequate sedation level should be maintained for safe and effective dental sedation. Cerebral state index (CSI) is a empirically derived parameter calculated from the processed electroencephalography (EEG). We investigated whether CSI can be used as a sedation depth indicator. Methods: We continuously recorded CSI and bispectral index (BIS) values from 10 healthy children aged 3.6 yr undergoing dental sedation. We also evaluated sedation level using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S). The correlation between CSI and BIS, or CSI and sedation score were sought a regression analysis. Results: There were good linearity between CSI values and sedation score. (r = 0.916, P < 0.001) The paired CSI and BIS values showed a significant correlation between the two values. (r = 0.895, P < 0.001) The difference between CSI and BIS values was not statistically significant at deep and conscious sedative levels. Conclusions: The CSI monitor can be easy to monitor sedation depth during dental sedation for children.

• The Journal of Advanced Prosthodontics
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• 제8권4호
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• pp.313-320
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• 2016

PURPOSE. The aim of this study was to evaluate the clinical findings and patient satisfaction on implant overdenture designed with Locator implant attachment or Locator bar attachment in mandibular edentulous patients. MATERIALS AND METHODS. Implant survival rate, marginal bone loss, probing depth, peri-implant inflammation, bleeding, plaque, calculus, complications, and satisfaction were evaluated on sixteen patients who were treated with mandibular overdenture and have used it for at least 1 year (Locator implant attachment: n=8, Locator bar attachment: n=8). RESULTS. Marginal bone loss, probing depth, plaque index of the Locator bar attachment group were significantly lower than the Locator implant attachment group (P<.05). There was no significant difference on bleeding, peri-implant inflammation, and patient satisfaction between the two denture types (P>.05). The replacement of the attachment components was the most common complication in both groups. Although there was no correlation between marginal bone loss and plaque index, a significant correlation was found between marginal bone loss and probing depth. CONCLUSION. The Locator bar attachment group indicates lesser marginal bone loss and need for maintenance, as compared with the Locator implant attachment group. This may be due to the splinting effect among implants rather than the types of Locator attachment.