• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.1
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• pp.43-46
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• 2017

Patients with cerebral palsy have higher risk of traumatic dental injuries because of clinical characteristics, such as, ataxia, large overjet and lip incompetency. Especially, intrusive luxation has rare occurrence but higher incidence of complications. It can be treated by expecting re-eruption, orthodontic reposition, and surgical reposition. Clinicians should be aware of management and follow-up in dealing with cerebral palsy patients who are exposed by intrusive luxation, due to their involuntary movement. This case report describes a 9-year-old male patient with cerebral palsy and epilepsy who experienced intrusion of maxillary permanent central incisor. After one-month follow-up, waiting for spontaneous eruption, pulp necrosis on maxillary permanent central incisor had proceeded. Therefore, surgical reposition with resin wire splint and apexification was performed under conscious sedation with midazolam. After two months, removal of resin wire splint was done. Gutta percha filling and composite resin restoration were performed after sixteen months. During five-year follow-up ankylosis and partial root resorption were observed. But there was no significant complications.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.3 no.1
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• pp.1-5
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• 2007

Patients of mental disorder have more missing teeth than general population because of the difficulty of oral hygiene management. In addition, especially Down syndrome patients etc., congenital dental problems develop more frequently. Therefore, prosthetic rehabilitation treatments for missing teeth in mental disorder patients are required more urgently. In other words, a removable partial denture may be very difficult for such patients to wear and manage. So in this review article we reviewed implant therapeutic modes for mental disorder patients based on previous reports. It should be understood that implant treatments are not impossible for mental disorder patients, and if implants could be a good method that could provide them good quality care, so implant should be included in treatment plans before surgery. Before surgery it should be evaluated that patients ability to manage themselves their ability to manage themselves should be evaluated and also should be evaluated whether general anesthesia or sedative treatment is required for the treatment, and whether their cooperation is good enough.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.1
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• pp.20-27
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• 2007

Eugenol is commonly used in dentistry for the sedation of toothache, pulpitis, and dental hyperalgesia. This study was performed to investigate the apoptotic effect of eugenol to human osteosarcoma (HOS) cells and the potential use of this compound in osteosarcoma cells. Eugenol showed the apoptotic effect in HOS cells in dose- and time-dependent manner. Fragmentation and condensation of DNA were showed by TUNEL assay, Hemacolor stain and Hoechst stain. In the DNA electrophoresis analysis, cells showed DNA degradation characteristic of apoptosis with a ladder pattern of DNA fragments. Apoptosis-related factors were analyzed by western blotting. Cells treated with eugenol showed caspase-3, PARP, lamin A and DFF-45 cleavage. Eugenol treatment induced caspase-3 cleavage and activation. Cleavages of PARP, DFF-45 and lamin A were accompanied with activation of caspase triggered by eugenol in HOS cells. Though this study needs more investigations, these results suggest that eugenol induce apoptosis via caspase dependent pathway in HOS cells and eugenol may constitute a potential antitumor compound against osteosarcoma cells.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.2
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• pp.66-71
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• 2016

Intellectual disability is accompanied by a high incidence of congenitally absent teeth and supernumerary teeth, and is observed more frequently than are disorders of location and order during delayed eruption, when accompanied by other symptoms. Furthermore, it is associated with a higher occurrence of dental anomalies such as conical teeth, microdontia, and amelogenesis imperfecta. As it is difficult to obtain adequate cooperation from patients with intellectual disabilities, physical restraint and conscious sedation using medication and general anesthesia can be considered. Reshaping of conical teeth with resin composite may be helpful to rehabilitate patients with oligodontia and a conical tooth shape. Diagnostic wax-up and a silicone matrix formed the basis for the successful reconstruction of the anterior teeth. This case describes the treatment of a patient with intellectual disability who had oligodontia and conical-shaped incisors. Under general anesthesia, the patient was treated using direct composite resin restoration.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.1
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• pp.17-26
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• 2016

The use of a rubber dam is a useful technique for protecting patients and operators, producing good results when treating children and adolescent patients. Despite its many advantages, some children and adolescent patients have negative feelings and sometimes express its discomfort. The purpose of this study was to evaluate the patients' preferences for rubber dam use and the associated factors that may affect it. A survey was conducted targeting patients aged 4-18 years old who visited the pediatric dental clinic, the restorative dental clinic, or the student treatment dental clinic of ${\bigcirc}{\bigcirc}$ University Dental Hospital, and were treated using a rubber dam without sedation. We collected questionnaires through electronic medical records. Most children and adolescent patients showed positive attitudes towards using rubber dams. The group with a short treatment time and the group with past knowledge or experience of rubber dam use showed more positive attitudes towards rubber dams (p < 0.05), while no significant difference was found among factors such as gender, age, procedure, anesthetics, treatment site, and operator (p > 0.05).

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.2
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• pp.134-144
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• 2014

The aim of this study was to investigate changes in treatment patterns within pediatric dentistry departments by analyzing the distribution of patients and treatment trends. To that end, treatment charts based on electronic medical records (EMR) from the Yonsei University Dental Hospital from 2008 to 2012 were collected and analyzed. The results showed a decrease in the number of new patients and patients cared for by non-specialists, while the number of foreign patients has increased. The under 2 years-old group accounted for a large portion of new patients. Dental caries, dental trauma, and malocclusion ranked as the top complaints. In terms of restoration treatment, the proportion of patients receiving composite resin, amalgam, and sealant has decreased, whereas self-curing glass ionomer and preventive resin restoration have increased. Single-visit endodontic treatment has been increasing, with a decreasing trend in multi-visit endodontic treatment. The rate of conservative pulp treatment, such as pulp capping and pulpotomy, has increased. For reducing patient anxiety, treatments under sedation have increased, especially with the use of nitric oxide. This investigation into the latest treatment trends and patient characteristics is expected to help pediatric dentists to make appropriate treatment plans.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.2
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• pp.87-91
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• 2016

Pierre Robin syndrome (PRS) is characterized by the triad of congenital mandibular hypoplasia, glossoptosis and cleft palate. Infant PRS patients are frequently suffering from upper airway obstruction, gastroesophageal reflux and growth retardation caused by above mentioned problems. We report a dental caries treatment of 3-year old girl with Pierre Robin syndrome with multiple caries. The cause of multiple caries was mainly presumed as patient's eating habit caused by her general condition. She had some feeding problems and had history of gastric tube. She was still using milk bottle and took more than an hour to finish a meal. The treatment was performed under general anesthesia considering patient's condition; mild autism, poor cooperation and respiratory problem due to micrognathia. Severely affected upper incisors were treated with pulp treatment and restored with zirconia crown for esthetic purpose. Lower incisors were treated with pulp treatment and restored with composite resin. Upper right first primary molar was restored with stainless steel crown and other primary molars were treated with composite resin. There were no postoperative complications. According to her parents, the patient's compliance to oral hygiene management was greatly improved after the treatment since she was very pleased with the esthetic result and highly motivated by her looks. The treatment without sedation or general anesthesia would be possible once the airway is improved as the mandible grows.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.5
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• pp.357-367
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• 2022

Background: Low-dose dexmedetomidine may be a suitable alternative to opioids for pediatric ambulatory procedures under general anesthesia (GA). However, the recovery profile remains unclear. Herein, we aimed to evaluate the effects of low-dose dexmedetomidine on the recovery profile of children. Methods: Seventy-two children undergoing ambulatory oral rehabilitation under GA were randomly and equally distributed into two groups (D and F). Group D received an infusion of dexmedetomidine 0.25 ㎍/kg for 4 min for induction, followed by maintenance of 0.4 ㎍/kg/h. Group F received an infusion of fentanyl 1 ㎍/kg over 4 min for induction, followed by maintenance at 1 ㎍/kg/h. The primary outcome was the extubation time. The secondary outcomes were awakening time, end-tidal sevoflurane (ET-Sevo) requirement, change in hemodynamic parameters, Richmond Agitation-Sedation Scale (RASS), Children's Hospital of Eastern Ontario pain scale (CHEOPS) score, length of PACU stay, and incidence of adverse events. Results: Statistically significant differences were observed in the recovery profile between the groups: the median time for extubation was 3.65 (3.44-6.2) vs. 6.25 (4.21-7) minutes in groups D vs. F (P=0.001), respectively, while the corresponding awakening times were 19 (18.75-21) and 22.5 (22-24) minutes, respectively (P < 0.001). The mean ET-Sevo was low in group D (1.1 vs. 1.2; P < 0.001). The heart rate was significantly low across all time points in group D, without resulting in bradycardia. The median RASS and CHEOPS scores were also significantly lower in group D. No significant differences were observed in the mean arterial pressure, incidence of adverse events, or length of PACU stay. Conclusion: Low-dose dexmedetomidine was more effective than fentanyl as an opioid substitute at providing a better recovery profile in pediatric ambulatory oral rehabilitation under GA. Dexmedetomidine also significantly reduced sevoflurane consumption without causing adverse events or prolonging hospital stay.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.1
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• pp.97-101
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• 2010

The practice pattern of pediatric dentistry in the university dental hospital has been changing for the last several decades, due to socioeconomic changes, developments in dental materials and increasing number of private pediatric dental clinics. The purpose of this study is to survey the changing patterns of pediatric dental treatment in the university dental hospital and to present the future direction for pediatric dentistry. Patient distribution and practice trends were reviewed based on the OCS (order communication system) records of the department of pediatric dentistry, Seoul National University Dental Hospital from 2001 to 2008. Results were as follows; 1. The number of patients increased up to 2005 and decreased in 2006, and has remained constant up to 2008. 2. The proportion of preventive and orthodontic treatment increased and the proportion of restorative and pulpal treatment decreased. 3. In restorative treatment, amalgam restoration decreased and resin restoration increased. 4. Frequency of sedation decreased in 2006, 2007 and increased in 2008. 5. Frequency of general anesthesia increased up to 2008.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.3
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• pp.537-542
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• 1997

Chloral hydrate is one of the most widely used sedative agents to control the difficult-to-treat young age group in the dental clinic. The normal onset time of oral Chloral hydrate is 30-45 minute with some variations. We are often frustrated see the patient still awake and cry with agitation even after far more than the normal onset time. In such a case, the patient has to be rescheduled for another sedation visit with different agents and/or routes which greatly disappoints the guardians. This case report presents a sedative regimen that can possibly help the clinician complete scheduled treatment without postponement. We have tried additional administration of Midazolam intranasally to 22 patients of those who failed to respond properly to the initial dose(50-75mg/kg) of oral Chloral hydrate. The average age and weight of the patients was 34.2 months(22-61 mos.) and 15.2 kg(10-17 kg) respectively. Half of the regular dose of Midazolam(0.1mg/kg) was administered intranasally. using needless syringe in 42 cases without notable resistance of the patient. The onset was very rapid in most cases and colud proceed the treatment under the constant monitoring by Pulse oximeter. All the planned procedures could be completed in 93.2 % (69.4% of 'Good' plus 23.8% of 'Fair' rating)with only 6.8 %('Poor' rating) of failure rate. Evidence of adverse effect was not detected or reported during and/or after the procedures.