• Journal of Dental Anesthesia and Pain Medicine
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• 제16권2호
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• pp.111-116
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• 2016

Background: Inferior alveolar nerve block (IANB) of the mandible is commonly used in the oral cavity as an anesthetic technique for dental procedures. This study evaluated the success rate of the first IANB administered by dental practitioners. Methods: Volunteer dental practitioners at Mahidol University who had never performed an INAB carried out 106 INAB procedures. The practitioners were divided into 12 groups with their advisors by randomized control trials. We recorded the success rate via pain visual analog scale (VAS) scores. Results: A large percentage of the dental practitioners (85.26%) used the standard method to locate the anatomical landmarks, injecting the local anesthetic at the correct position, with the barrel of the syringe parallel to the occlusal plane of the mandibular teeth. Further, 68.42% of the dental practitioners injected the local anesthetic on the right side by using the left index finger for retraction. The onset time was approximately 0-5 mins for nearly half of the dental practitioners (47.37% for subjective onset and 43.16% for objective onset), while the duration of the IANB was approximately 240-300 minutes (36.84%) after the initiation of numbness. Moreover, the VAS pain scores were $2.5{\pm}1.85$ and $2.1{\pm}1.8$ while injecting and delivering local anesthesia, respectively. Conclusions: The only recorded factor that affected the success of the local anesthetic was the administering practitioner. This reinforces the notion that local anesthesia administration is a technique-sensitive procedure.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권3호
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• pp.173-185
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• 2024

Background: Excessive fear of dental procedures leads to disruptive behavior during dental examinations and treatments. Dental examinations and treatments of these patients usually require additional techniques, such as sedation. The most commonly used techniques are inhalation of nitrous oxide, infusion of propofol with fentanyl, and premedication and infusion of midazolam. Methods: A prospective observational epidemiological study was conducted on patients who required sedoanalgesia techniques for dental exploration and procedures. The reasons for the inability of patients to cooperate (excessive fear or intellectual disability), age, sex, weight, systemic pathology, oral pathology, treatment performed, time of intervention, anesthetic technique performed, and occurrence of complications were recorded. Results: In total, 218 patients were studied. Sixty-five patients came for fear of dental treatment and 153 for presenting with a diagnosis of intellectual disability and not collaborating in the treatment with local anesthesia. The average age of all patients was 30.54±17.30 years. The most frequent oral pathologies found in patients with excessive fear were tartar (6.8%) and wisdom teeth (6.4%), followed by missing teeth (5%). In patients with disabilities, a combination of tartar and cavities appeared most frequently (41.3%), followed by cavities (15.6%). The most frequently used sedoanalgesia technique was the infusion of propofol with fentanyl in both groups of patients, followed by nitrous oxide. Conclusion: The combination of propofol and fentanyl was the most frequently used alternative in patients who were unable to collaborate because of intellectual disability or carry out longer or more complex treatments. Inhaled nitrous oxide and midazolam were the sedative techniques of choice for simpler oral treatments, such as tartrectomies, shallow obturations, and shorter interventions, or in younger patients.

• Journal of information and communication convergence engineering
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• 제17권4호
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• pp.274-278
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• 2019

It is important that students are provided opportunities to practice their skills in acquiring radiographic images. However, these opportunities are currently limited because of the risk of radiation exposure. To overcome this limitation, a new augmented reality-based radiography simulator was developed that enables students to practice radiographic techniques as part of self-directed learning without time and space constraints. Subsequently, cross-sectional images of a manikin phantom head obtained via computed tomography were reconstructed into a three-dimensional object. An image marker that could be recognized by a mobile device and could allow users to practice dental radiography techniques was devised. The three-dimensional object was augmented to the mobile device; consequently, among 106 stored dental radiographs on the device, a radiograph corresponding to specific imaging conditions was opened when users performed radiographic procedures. This technology could improve dental students' understanding of dental anatomy and contribute to improving their competency in acquiring dental radiographs.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권2호
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• pp.91-103
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• 2017

General anesthesia is commonly used to facilitate dental treatment in patients with anxiety or challenging behavior, many of whom are children or patients with special needs. When performing procedures under general anesthesia, dental surgeons must perform a thorough pre-operative assessment, as well as ensure that the patients are aware of the potential risks and that informed consent has been obtained. Such precautions ensure optimal patient management and reduce the frequency of morbidities associated with this form of sedation. Most guidelines address the management of pediatric patients under general anesthesia. However, little has been published regarding this method in patients with special needs. This article constitutes a review of the current literature regarding management of patients with special needs under general anesthesia.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권1호
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• pp.61-64
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• 2017

Nasotracheal intubation is generally a useful maxillofacial surgery that provides good surgical access for intraoral procedures. When nasotracheal intubation is difficult, laryngeal mask airway (LMA) insertion can be performed, and the flexible $LMA^{TM}$ (FLMA) is also useful for anesthetic management. However, the FLMA provides limited access to the mouth, which restricts the insertion of instrumentation and confines the surgical field available. Here, we present our experience using the FLMA airway management for dental treatment cases involving difficulty with intubation.

• Journal of Oral Medicine and Pain
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• 제5권1호
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• pp.11-16
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• 1980

It is generally accepted that dental procedures can be the causes of dental anxiety, and dental anxiety is described as a significant influence on physical reactions, which may complacate the dental treatment, and there has been much emphasis in the control of it. So it is very useful for dentists to know the degree of anxiety of their patients for the treatment planning and prevention of unexpected emergent state which may be caused by severe anxiety. For the study of the degree of the dental anxiety, 1,041 patients of the Dept. of Oral Diagnosis of S.N.U. hospital and some private clinics were evaluated for dental anxiety by means of dental anxiety scale questionaire. The results were as follows : 1. The mean value of 517 male patients and 524 female patients were are $9.31\pm2.76 and 12.01\pm2.78$ in respective. 2. There was no significant alteration by age and educational backgrounds. 3. Four male patients and nineteen female patients achieved scores ranging from 17 to 20 which have been known to dental phobics.

• Journal of Korean Dental Science
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• 제16권1호
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• pp.1-8
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• 2023

Dental treatment for the disabled should be a customized that considers the characteristics and degree of cooperation of each disabled patient. There are additional considerations during implant treatment and tooth extraction in disabled patients. Since some brain lesion disorder or cardiac disease patients may be taking antiplatelet or anticoagulant medications, it is necessary to evaluate whether these medications should be discontinued before an invasive procedure. Precautions should be taken for patients with heart valve disease considering the risk of infective endocarditis, especially during invasive dental procedures. Moreover, disabled patients may have difficulty in following instructions and cautions. There are specific considerations for each stage of implant treatment in disabled patients. In the case of patients who are in the pre- or post-transplant state, it is necessary to assess their general condition and oral disease due to the risk of infection. Since disabled patients with various systemic diseases may visit the dental clinic, it is important to understand their characteristics and treatment process in order to flexibly adjust the dental treatment plan accordingly.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권6호
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• pp.303-315
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• 2023

Painless treatment determines the quality of pediatric dental care. Although local anesthesia has been used to manage pain in dentistry, children often cite traditional aspirating syringes as a symbol of fear and pain. Adequate pain control during dental procedures may help alleviate fear and anxiety and instill positive oral health attitudes in children. Newer approaches such as intranasal spray, centbucridine, jet injectors, buzzy devices, and acupressure have been developed to help dentists provide near-painless injections while reducing dental anxiety. This review aims to summarize newer approaches to alleviate pain and anxiety in children.

• 대한치과의사협회지
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• 제23권1호통권188호
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• pp.67-72
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• 1985

• 대한치과의사협회지
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• 제40권6호통권397호
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• pp.436-441
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• 2002

턱관절 장애와 관련된 안면통의 진단술식에는 턱관절 검진, 저작근, 두경부 검진, 교합분석과 같은 구강검사, 진단성 마취검사, 방사선검사 등이 있다. 여기에서는 가장 흔히 술자가 시행할 수 있고 간편한 술식을 중심으로 턱관절 검사와 저작근 검사, 그리고 두경부 근육애 대한 검사에 대하여 고찰키로 한다.