• Title/Summary/Keyword: Dental clinic for the disabled

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DENTAL TREATMENT OF A PEDIATRIC PATIENT WITH HOMOZYGOUS PROTEIN C DEFICIENCY: A CASE REPORT (동형접합성 단백 C 결핍 환아의 치과적 치험례)

  • Yoon, Mi;Kim, Seung-Oh;Kim, Jong-Soo;Yoo, Seung-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.2
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    • pp.207-212
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    • 2010
  • Protein C deficiency increases the risk of thrombosis due to the lack of anticoagulant factor protein C. Among the numerous congenital protein C deficiencies, homozygous protein C deficiency has an especially low protein C activity level, that it is almost undetectable. It is a rare disease with a probability of 1:250000~500000. The signs and symptoms of homozygous protein C deficiency include purpuric, necrotic dermatosis, ecchymosis, blindness, and thrombosis in central nervous system. A 4-year-old girl was brought to the clinic with a chief complaint of extensive caries. The child was under warfarin medication in order to prevent possible complications during dental treatment. We consulted the pediatric department. Without warfarin intake, serious complications may occur due to thrombosis during dental treatment. Therefore, certain warfarin dosage (INR 3~5) and fresh frozen plasma as a backup for excessive hemorrhage were recommended. This child was a severely disabled child with the loss of vision, and it was difficult to manage her behavior effectively. Thus, dental treatment was carried out under general anesthesia, where bleeding control would be also easier to achieve.This report presents the case of a 4-year-old girl with protein C deficiency, who has received dental treatment for extensive caries under general anesthesia.

Rheological characterization of thermoplasticized injectable gutta percha and resilon (열연화주입형 gutta percha와 resilon의 유변학적 특성)

  • Chang, Ju-Hea;Baek, Seung-Ho;Lee, In-Bog
    • Restorative Dentistry and Endodontics
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    • v.36 no.5
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    • pp.377-384
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    • 2011
  • Objectives: The purpose of this study was to observe the change in the viscoelastic properties of thermoplasticized injectable root canal filling materials as a function of temperature and to compare the handling characteristics of these materials. Materials and Methods: Three commercial gutta perchas and Resilon (Pentron Clinical Technologies) in a pellet form were heated in the Obtura-II system (Obtura Spartan) at $140^{\circ}C$ and $200^{\circ}C$, and the extrusion temperature of the thermoplasticized materials was measured. The viscoelastic properties of the materials as a function of temperature were evaluated using a rheometer. The elastic modulus G', viscous modulus G", loss tangent tan${\delta}$, and complex viscosity ${\eta}^*$ were determined. The phase transition temperature was determined by both the rheometer and a differential scanning calorimeter (DSC). The consistency of the materials was compared under compacting pressure at $60^{\circ}C$ and $40^{\circ}C$ by a squeeze test. Results: The three gutta perchas had dissimilar profiles in viscoelastic properties with varying temperature. The phase transition of softened materials into solidification occurred at $40^{\circ}C$ to $50^{\circ}C$, and the onset temperatures obtained by a rheometer and a DSC were similar to each other. The onset temperature of phase transition and the consistency upon compaction pressure were different among the materials (p < 0.05). Resilon had a rheologically similar pattern to the gutta perchas, and was featured between high and low-flow gutta perchas. Conclusions: The rheological characteristics of the thermoplasticized root canal filling materials changed under a cooling process. The dissimilar viscoelastic properties among the materials require different handling characteristics during an injecting and compacting procedure.

Psychosocial Impact of Chronic Orofacial Pain (만성 구강안면통증의 사회심리적 영향)

  • Yang, Dong-Hyo;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.397-407
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    • 2009
  • The aim of the study was to evaluate psychosocial impact of non-dental chronic orofacial pain (OFP) on daily living using the graded chronic pain (GCP) scale. It is also investigated the clinical profile such as demographics, event related to initiation of OFP and prior treatments for patients. During previous 6 months since September 2008, 572 patients (M:F=1:1.5, mean age=34.7 years) with non-dental OFP attended university-based specialist orofacial pain clinic (Dankook University Dental Hospital, Cheonan) to seek care although 63% of them already experienced related treatment for their OFP problem. They visited the most frequently general dental practitioner and orthopedic doctors due to their pain problem and medication was the most commonly employed modality. Most of the patients (89.2%) had TMD and the most common related event to initiation of their pain was trauma, followed by dental treatment. Almost half of the patients (46%) suffered from chronic pain(${\geq}6\;M$) and 40% of them exhibited relatively high disability due to chronic OFP. GCP pain intensity and disability days were significantly different for age and diagnosis (p<0.05) but not for gender and duration. GCP grades were affected by all the factors including gender, age, pain duration and diagnosis.(p=0.000) Female gender, elders, and long lasting pain were closely related to high disability. The patients with neuropathic Pain and mixed OFP rather than TMD were graded as being highly disabled. Conclusively, a considerable percentage of chronic OFP patients reports high pain-related disability in their daily, social and work activity, which suggest a need for psychosocial support and importance of earlier referral for appropriate diagnosis and tailored management.