• Title/Summary/Keyword: Dental pain

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MANAGEMENT OF LESCH-NYHAN SYNDROME PATIENTS WITH SELF-MUTILATION BEHAVIOR USING THEIR TEETH : CASE REPORTS (레쉬니한 증후군(Lesch-Nyhan syndrome) 환자의 치아와 연관된 자해행동의 관리: 증례보고)

  • Lee, Ji-Mi;Lee, Sang-Ho;Lee, Nan-Young;Jih, Myeong-Kwan
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.14 no.2
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    • pp.97-101
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    • 2018
  • Lesch-Nyhan syndrome is a rare X-linked recessive genetic disorder. During purine metabolism, the hypoxanthine guanine phosphribosyl transferase (HGPRT) enzyme is deficient causing phosphoribosyl transferase to accumulate and resulting in excessive uric acid. Clinical symptoms include hypercalcemia, choreoathetosis, spasticity, mental retardation, and self-injury to lips, tongue or fingers. This results not only in pain caused by the self-injury but also secondary infection of the wound site and the esthetic damage of the soft tissue defect. Dental treatments include conservative methods using intraoral appliances such as soft mouthguards, fixed lip bumpers, and occlusal guards, and invasive methods such as extraction of all teeth or forming an artificial anterior open bite. We report two cases of Lesch-Nyhan syndrome patients with self-mutilation behavior; one was treated with a preservative method using a soft mouthguard, and the other was treated with extraction of all teeth.

Oral Health and Oral Health Behavior as Risk Factors for Depression (우울증에 대한 구강건강 및 관리행태 위험요인)

  • Lee, Kyung Hee
    • Science of Emotion and Sensibility
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    • v.24 no.3
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    • pp.17-26
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    • 2021
  • This study investigated the association between depression and oral health and the factors influencing depression in adults. Data on 13,199 people (male 5,793, female 7,406; age ≥19 years old) were extracted from the Korean National Health and Nutrition Examination Survey VIII (KNHANES VIII) (2016~2018) and analyzed using frequency, percentage, an x2 test, a T-test, and logistic regression analysis. Depression was defined as either a medical diagnosis or a score ≥10 on Patient Health Questionnaire-9. The probability of depression was found to be statistically different for general characteristics, such as gender, age, school grade, income, and drinking. The logistic regression analysis showed that the independent variables, general health awareness (OR=9.094, 95% CI 7.139~11.585) and oral health awareness (OR=1.936, 95% CI 1.465~2.560), were associated with depression, and speaking discomfort, chewing discomfort, oral pain (within 1 year), and prosthesis were found to increase depression probability. The depression probability was also was found to significantly increase by 1.81 times if brushing frequency was less that once a day, if people used dental floss (OR=1.42), and had to have an oral examination (OR=1.31). These results indicated that oral health and oral health behaviors are associated with the depression, with the influencing factors having oral health and behavior-related characteristics. Therefore, proper oral health and oral health risk factor behavior management programs should be developed to assist in reducing depression.

A study on the Shift of Burden of Proof in Medical Malpractice - Ruling of Jeonju Appellate Court 2017Na9346 - (의료과오소송에서의 증명책임에 대한 소고 -전주지방법원 2017. 7. 21. 선고 2017나9346판결-)

  • Lee, Soo-Kyoung;Yoon, Seok-Chan
    • The Korean Society of Law and Medicine
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    • v.22 no.2
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    • pp.49-79
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    • 2021
  • Due to defendant's wrongful act by implant surgery, plaintiff has been suffered serious damages to his face and teeth, and pain caused by establishing implanted teeth. Jeonju Appellate Court sentenced to pay future medical expenses and alimony to the plaintiff in compensation for breach of duty or torts. The ruling is designed to relieve the burden of proof because it is extremely difficult for non-experts to determine whether dentists violated their 'duty of care' or whether there was a causal relationship between damages to medial treatment. It was judged that if symptoms that contributed to the patient's significant outcome occurred during or after surgery, such symptoms could be presumed to have been caused by medical negligence if indirect facts were proven to be other than medical negligence. Originally, the shifting of burden of proof in Germany, has already been developed in medical malpractice case since 1940s. In order to guarantee the patients' right, §630h German Civil Code (BGB) - presumption of negligence in the realization of controllable risk- has been also legislated. BGH (Bundesgerichtshof) has been interested in ensuring that the principle of equality between patients and doctors. So, in this study, we wanted to refer to German precedent cases to analyzing Korean medical malpractice lawsuit. In particular, the decision could be significant in that it approaches closer to allows the shifting burden of proof in drastically growing dental malpractice cases. This is clearly confirmed in the judgment of the dentist's "fault" that "if indirect facts about the symptom or occurrence are proven to be cause other than medical negligence, such symptoms can be presumed to be due to medical negligence."

Changes of bite force and dynamic functional occlusion analysis after occlusal stabilization splint therapy in sleep bruxism patients: a pilot study (수면이갈이 환자에서 교합안정장치 사용 후 교합력 및 동기능적교합분석: 예비 연구)

  • Jaeyeon, Kim;Yiseul, Choi;Yool Bin, Song;Wonse, Park;Seong Taek, Kim
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.4
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    • pp.204-212
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    • 2022
  • Purpose: The aim of this study was to compare changes of bite force, occlusal contact area, and dynamic functional occlusion analysis after occlusal stabilization splint therapy during sleep for one month in a patient with bruxism. Materials and Methods: From October 2021 to July 2022, sleep bruxism of 30 patients who visited the Department of Oral Medicine at Yonsei University College of Dentistry Hospital were recruited. The participants were divided into two groups: using an occlusal stabilization splint during sleep (treatment; n = 15) and not using an occlusal stabilization splint (control; n = 15). Before using the occlusal stabilization splint and one month after, bite force, occlusal contact area and dynamic functional occlusion analysis (ratio of left/right bite forces, average bite forces, maximum bite forces, and maximum contact areas during lateral and anterior and posterior mandibular movements) were performed. Results: There was no difference in bite force and occlusal contact area between the treatment group using the occlusal stabilization splint and the control group not using the occlusal stabilization splint during sleep for one month. However, there were significant differences in the average bite force and maximum bite force in the lateral and anterior and posterior mandibular movements and the maximum contact areas in the anterior and posterior mandibular movements. Conclusion: The occlusal stabilization splint is helpful for sleep bruxism patients who lateral and anterior and posterior mandibular movements. In addition, further studies are needed a double-blind study with a large population.

Explaining Variance in Children's Recall of a Stressful Experience: Influence of Cognitive and Emotional Individual Differences (스트레스적 경험에 대한 아동 기억의 신뢰성과 인지 및 정서적 개인차 특성들과의 관계)

  • Seungjin Lee
    • Korean Journal of Culture and Social Issue
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    • v.19 no.3
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    • pp.343-365
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    • 2013
  • This study examined the effects of various individual differences on children's memory of a stressful experience. The participants for the current study were children (N=85) aged 4-9 years those who experienced a naturally occurring stressful experience from a dental procedure. There was overall negative relation between the level of stress and children's memory performance. However, more interestingly, the results of this study provided some further evidence that several cognitive (i.e., receptive language ability and working memory capacity) and emotional (i.e., children's general anxiety condition, children's self-report of pain and anxiety about the event) individual difference factors were associated with variations in children's remembering across ages. The results suggest that the relation between stress and children's memory might be impacted in part by children's various individual characteristics. Furthermore, the findings are discussed in the applied context that based on the results clinical and legal professionals can tailor interviews to best meet children's needs and capabilities, and create developmentally and individually sensitive guidelines for interviewing children in the legal system.

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Comparison of the effects of two different styles of orally prescribing prednisolone on postoperative sequelae of surgical extraction of an impacted mandibular third molar: a single-blind randomized study

  • Mohammed Mousa H. Bakri;Faisal Hussain Alabdali;Rashed Hussain Mahzari;Thamer Jabril Rajhi;Norah Mohammed Gohal;Rehab Abdu Sufyani;Asma Ali Hezam;Ahtesham Ahmed Qurishi;Hamed Mousa Bakri;Fareedi Mukram Ali
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.1
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    • pp.27-34
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    • 2024
  • Objectives: Surgical intervention for removal of an impacted third molar can lead to significant pain and swelling. Corticosteroids show promise for mitigating postoperative sequelae across various surgical contexts. The use of corticosteroids following minor oral surgery, though controversial, has already been proven effective. However, little research has explored peroral prescription of corticosteroids despite its convenience for outpatients and for non-surgeons like implantologists and periodontists and others who don't have access to needle injections. The aim of this study was to address a void in the literature by comparing the effects of two styles of preoral administration of prednisolone after surgical removal of the mandibular third molar and to determine which style minimizes postoperative sequelae. Materials and Methods: A randomized, split-mouth clinical study was conducted to investigate the efficacy of two different styles of preoral prednisolone in mitigating postoperative sequelae following surgical extraction of impacted mandibular third molars. Fifteen participants were enrolled in the study. Random selection was used to determine the prescription style for the right and left mandibular arch. Group A included those who received a single dose of prednisolone 25 mg, while group B received prednisolone 5 mg postoperatively for a period of three days (5 mg three times/day on the first postoperative day, 5 mg twice/day on the second postoperative day; 5 mg once/day on the third postoperative day). Results: There was a significant difference in the distance between the corner of the mouth and tragus, which decreased with the time interval with respect to group B when compared to group A. Conclusion: The present study showed that a three-day tapered dose of prednisolone postoperatively was more effective in reducing post-extraction sequelae than a single-dose regimen.

Improvement of peri-implant complications through customized prosthesis restoration allowing soft tissue space: a case report (연조직 공간을 허용하는 맞춤형 보철 수복을 통한 임플란트 주위 합병증의 개선 증례)

  • Jieun Song;Woohyung Jang;Chan Park;Kwidug Yun;Hyun-Pil Lim;Sangwon Park
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.260-266
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    • 2023
  • The concept of 'Implant Supracrestal Complex (ISC)' was introduced as a way to determine the impact of implant prosthetic design form on both short-term clinical outcomes and the long-term prognosis of bone and soft tissues around the implant. Implant-prosthesis-abutment complex design forms, such as implant-abutment design, junction, and location, can have important implications for the stable and healthy long-term maintenance of the tissues around the implant. In this case, a customized concave abutment and a prosthesis with an emergence angle of about 30 degrees were restored to a patient suffering from chronic soft tissue inflammation and pain after restoration of an implant prosthesis. It was confirmed that the new prosthesis improved complications by allowing sufficient bone and soft tissue space, achieved appropriate soft tissue sealing, and maintained the long-term stability of the implant.

Efficacy of Self-manipulation Technique in the Treatment of Patients with Anterior Disc Displacement without Reduction (비정복성 관절원판 전방변위 환자의 치료에 있어서 자가 수조작술의 효과에 대한 연구)

  • Kim, Ju-Sik;Lee, Chae-Hoon;Kim, Young-Ku
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.441-447
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    • 2007
  • Internal derangement of the temporomandibular joint(TMJ) is defined as an abnormal relationship of the articular disc to the condyle. Mandibular manipulation is one of the conservative treatments to be considered first to manage the patients with anterior disc displacement without reduction. Mandibular manipulation is used to increase articular mobility and to restore the displaced disc into an anatomically normal position. While Farrar's technique has been popularly used, Minagi et al., Mongini and Suarez introduced the manipulation technique conducted by the patients themselves. But there is no study on the efficacy of self-manipulation technique, comparing with conventional one. The aim of this study was to investigate the efficacy of the conventional and self-manipulation technique, which was modified to complement the previously described technique by Minagi et al., in the treatment of patients with anterior disc displacement without reduction. TMD patients, who visited Department of Oral Medicine of Seoul National University Dental Hospital from December, 2002 to November, 2004 and were diagnosed as anterior disc displacement without reduction by TMJ magnetic resonance imaging (MRI) were enrolled. Conservative treatments including physical therapy, exercise, behavioral therapy, stabilization splint therapy, and manipulation therapy were done to every single patient until the symptomsimproved enough to discharge the patient. The charts were reviewed retrospectively according to the type of manipulation. In the results, patients whose maximum mouth opening was more than 40 mm was higher in the self-manipulation group(69.9%) than in the conventional manipulation group(42.9%). But difference between two groups was not significant. According to the fact that we decided to discharge the patients whentheir mouth opening increased to more than 40 mm and subjective symptoms such as pain and discomfort were improved as well, treatment period of discharged patients was significantly shorter in the self-manipulation group($29.2{\pm}12.3$ weeks) than in the conventional manipulation group ($61.0{\pm}38.0$ weeks) (p<0.01). In conclusion, in the treatment of TMD patients with anterior disc displacement without reduction, the self-manipulation technique which is performed by patients themselves is an effective treatment modality for increasing the range of mouth opening and shortening the total treatment period.

Occlusal Analysis of the Patients with Temporomandibular Disorders Using T-Scan II System (T-Scan II 시스템을 이용한 측두하악장애 환자의 교합 분석)

  • Yang, Dong-Hyo;Lee, Won-Seop;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.32 no.1
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    • pp.105-111
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    • 2007
  • Correlation between occlusal contact pattern and TMD have been hypothesized and partially investigated but results are controversial and not conclusive. The purposes of this study were to compare right-to-left difference of occlusal contact pattern, through contact points, contact force and occlusal balance, in the patients with unilateral TMD and also to evaluate its change related with TMD treatment. 36 patients with unilateral TMD from Department of Oral Medicine in Dankook University Dental Hospital were selected in this study (M:F=7:29, mean age of $29.2{\pm}14.8$ years). A computerized T-Scan II system (Tekscan, INC., USA) was employed for occlusal analysis and the simultaneity and occlusal balance through the number of tooth contact and magnitude of contact force were determined before and after TMD treatment. The number of contact points and contact force was more on the unaffected side than the affected side before treatment (p=0.056 and p=0.060, respectively) while significant difference between both sides was not found after treatment. The number of contact points and contact force on the affected sides significantly increased after treatment (p=0.038 and p=0.052), but the unaffected sides exhibited no significant difference between before and after treatment. In addition, sides difference in relative contact force decreased from about 27% to about 12% after TMD treatment (p=0.001). According to the results of this study, it is likely that unilateral TMD impairs right-to-left occlusal balance and that conservative TMD treatment alleviates the imbalance, subsequently leading to more symmetrical occlusal condition with increased contact points and force.

Effect of Auriculotemporal Nerve Block Anesthesia on Manual Reduction of Disc Displacement without Reduction of the Temporomandibular Joint (악관절의 비정복성관절원판변위의 수조작 정복에 대한 이개측두신경 전달마취의 효과)

  • Kim, Sook-Young;Kim, Ji-Yeon;Hong, Su-Min;Kim, Byung-Gook;Park, Byung-Ju;Im, Yeong-Gwan
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.71-79
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    • 2011
  • Aim: Disc displacement without reduction of the temporomandibular joint (TMJ) has been managed by mandibular manipulation to reduce the displaced disc but with a low success rate. The purpose of this study was to determine whether auriculotemporal nerve block anesthesia had an effect on the reduction of the displaced disc and to analyze the factors that influenced the result. Methods: 112 patients were diagnosed with disc displacement without reduction and treated by mandibular manipulation. Disc was recaptured in 35 patients. Among the 77 patients with whom disc recapture had failed, the auriculotemporal nerve was blocked with a local anesthetic in the 49 patients (mean $age \;{\pm}\; SD\; =\; 34.4\;{\pm}\; 15.1$; male 24, female 25) and then mandibular manipulation was performed again. Factors including age, elapsed time from the onset, and opening amount were analyzed in association with disc reduction rate with the auriculotemporal nerve block. Results: Among 49 patients who did not respond to manipulation only, manual reduction with auriculotemporal nerve block anesthesia was successful in 19 patients (38.8%). Maximum unassisted opening amount significantly increased in the 19 patients with successful recapture of the disc ($mean \;{\pm}\; SD\; =\; 46.1 \;{\pm}\; 4.5\; mm$), in contrast to the limited opening amount of the 49 patients before local anesthesia of the auriculotemporal nerve ($mean \;{\pm}\; SD\; =\; 25.7 \;{\pm}\; 6.0\; mm$). Age, elapsed time after the onset, and preoperative opening amount were not associated with the reduction rate. Conclusion: The results of this study suggest that auriculotemporal nerve block anesthesia increases the reduction rate of the disc displacement without reduction of the TMJ when combined with mandibular manipulation, and such anesthesia should be applied at the first stage of manual treatment of disc displacement without reduction.