• Title/Summary/Keyword: Dental practitioner

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Transbuccal versus transoral approach for management of mandibular angle fractures: a prospective, clinical and radiographic study

  • Khandeparker, Purva Vijay Sinai;Dhupar, Vikas;Khandeparker, Rakshit Vijay Sinai;Jain, Hunny;Savant, Kiran;Berwal, Vikas
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.3
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    • pp.144-150
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    • 2016
  • Objectives: We compared the transbuccal and transoral approaches in the management of mandibular angle fractures. Materials and Methods: Sixty patients with mandibular angle fractures were randomly divided into two equal groups (A, transoral approach; group B, transbuccal approach) who received fracture reduction using a single 2.5 mm 4 holed miniplate with a bar using either of the two approaches. Intraoperatively, the surgical time and the ease of surgical assess for fixation were noted. Patients were followed at 1 week, 3 months, and 6 months postoperatively and evaluated clinically for post-surgical complications like scarring, infection, postoperative occlusal discrepancy, malunion, and non-union. Radiographically, the interpretation of fracture reduction was also performed by studying the fracture gap following reduction using orthopantomogram tracing. The data was tabulated and subjected to statistical analysis. A P -value less than 0.05 was considered significant. Results: No significant difference was seen between the two groups for variables like surgical time and ease of fixation. Radiographic interpretation of fracture reduction revealed statistical significance for group B from points B to D as compared to group A. No cases of malunion/non-union were noted. A single case of hypertrophic scar formation was noted in group B at 6 months postsurgery. Infection was noted in 2 patients in group B compared to 6 patients in group A. There was significantly more occlusal discrepancy in group A compared to group B at 1 week postoperatively, but no long standing discrepancy was noted in either group at the 6 months follow-up. Conclusion: The transbuccal approach was superior to the transoral approach with regard to radiographic reduction of the fracture gap, inconspicuous external scarring, and fewer postoperative complications. We preferred the transbuccal approach due to ease of use, minimal requirement for plate bending, and facilitation of plate placement in the neutral mid-point area of the mandible.

IN VIVO EVALUATION OF ACCURACY OF TWO ELECTRONIC APEX LOCATORS (전자근관장 측정기의 정확도에 관한 연구)

  • Kim, Hee-Jung;Hong, Chan-Ui
    • Restorative Dentistry and Endodontics
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    • v.21 no.1
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    • pp.289-299
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    • 1996
  • It is necessary to measure the length of a root canal in order to attain a satisfactory prognosis after root canal therapy. There are several methods for determining root canal length, such as tactile sensation by the dental practitioner, the utilization of x-ray film, and electronic root canal measurement. Among these, the electrical measurement methods, in which the impedence between the oral mucous membrane and periodontal membrane is determined, have advantages of simplicity and accuracy. During root canal treatment, the root canal contains a solution of high electrical conductivity such as pus, blood, sodium hypochlorite and so on. Recently a new electronic root canal measurement device of frequency-dependent type has been developed, which is capable of measuring the length of root canal under moist conditions. Endex and Root ZX, which are frequency-dependent type, were evaluated for accuracy of measuring root canal length in vivo by stereomicroscope. The result were as follows ; 1. 82.5% of Endex and 87.5% of Root ZX measured in the range of ${\pm}0.5$ mm from the apical foramen and both showed 57.5 % in the range of 0.1 mm to 0.5 mm. 2. Endex showed significantly higher accuracy in vital teeth than nonvital teeth(p<0.05). But in case of Root ZX, there was no significant difference between vital and nonvital teeth. 3. As a result of this study, there was no significant difference in accuracy between Endex and Root ZX, and both devices showed file passes the apical foramen in more than half of the cases, and it is thought that this must be considered clinically.

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Diagnosis and Treatment Planning in Severely Worn Dentition (심한 교모증 환자에서의 진단 및 치료계획 수립)

  • Jung, Jae-Hyun;Choi, Min-Ho;Park, Young-Rok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.19 no.3
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    • pp.239-245
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    • 2003
  • The occurrence and pattern of tooth wear are related to cultural, dietary, occupational, and geographic factors, Excessive occlusal wear can result in pulpal exposure, occlusal disharmony, functional inability. Surface loss can be differentiated into 3 general causal categories: i) mechanical loss, which includes attrition, ii) abrasion chemical loss including erosion, and finally iii) a proposed biomechanical category described as abfraction. Considering that mechanical wear is frequently asymptomatic, patients may have parafunctional habit. Structured clinical decision analysis in fixed prosthodontics, as other branches of dentistry do, allows the practitioner to consider the patient's problems more thoroughly based on the clinical data and extenuation factors. This discipline of decision making is intended to complement the experience level and educational background of the clinician in assisting the patient through the decision process. Additionally, CDA helps the clinician define not only the pre-existing condition of the patient prior to irreversible therapy, but also better treatment strategies for the patient over an extended period. The systematic nature of decision analysis stimulates the dentists to pay further attention to those factors, which is germane to the overall complexity of the case, and exclude factors, which have little influence on its final outcome. Further implementation of computerized databases, procedural outcome probabilities based on clinical and laboratory studies and the clinical experience of those who use it, may provide quite a promising future in the field of structured and formalized clinical decision analysis.

The Income and Cost Estimate for the Medical Clinic Services Based on Available Secondary Data (이차자료원을 활용한 의원 의료서비스 수입 및 비용 산출)

  • Kim, Sun Jea;Lim, Min Kyoung
    • Korea Journal of Hospital Management
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    • v.26 no.1
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    • pp.71-82
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    • 2021
  • Purpose: The purpose of this study is to estimate incomes and costs of the medical clinics by using secondary data. Methodology: The medical incomes and costs were estimated from 405 clinics operated by sole practitioner providing out-patient services among all clinics subject to the Medical Cost Survey on National Health Insurance Patients in 2017, excluding dental clinics and oriental medical clinics. The incomes and costs of the medical clinics were reflected with incomes and costs of health insurance benefits and were calculated by types of medical services (i.e., basic care, surgery, general treatment, functional test, specimen test and imaging test). The costs were classified as follows: labor costs, equipment costs, material costs and overhead costs. Secondary data was used to estimate the incomes and costs of the medical clinics. For allocation bases for costs for each type of the medical service, the ratio of revenue from health insurance benefits by types of medical services was applied. However, labor costs were calculated with the activity ratio by types of medical services and occupations, using clinical expert panel data. Finding: The percentage of health insurance income for all medical income was 73.1%. The health insurance cost per clinic was 401,864 thousand won. Labor cost accounted for the largest portion of the health insurance income was 191,229 thousand won (47.6%), followed by management cost was 170,018 thousand won (42.3%), materials cost was 35,434 thousand won (8.8%), and equipment costs was 5,183 thousand won (1.3%). Practical Implications: This study suggests a method of estimating incomes and costs of medical clinic services by using secondary data. It could efficiently provide incomes and costs to assess an appropriate level of the health insurance fee to the clinics.

Evaluation of color matching ability according to the color temperature and the experience of practitioner (색 온도 및 술자의 숙련도에 따른 비색 능력 평가 원저)

  • Kim, Ji-Hyun;Kim, Sun-Jai;Lee, Keun-Woo;Shim, June-Sung;Yoon, Joonho
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.4
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    • pp.299-304
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    • 2012
  • Purpose: The aim of this study is to investigate the effect of different experience level and different light source on shade selection ability comparing prosthodontist group and dental student group under 4,000 K and 5,500 K light. Materials and methods: After color difference of Vitapan 3D-master shade guides was measured, 3 sets of 5 shade tabs were selected with similar value but have different chroma (set a, b, c). Also 3 sets of 5 shade tabs were selected with similar chroma but have different values (set d, e, f). Under 4,000 K and 5,500 K light sources, ten prosthodontists and ten dental students were allowed to match in one set of 5 tabs the same shade tab with the tab which was originally selected in the other set of 5 tabs. Color differences of original tab and matched tab were measured by spectrophotometer and the shade selection ability was evaluated with those data. Evaluation of color difference value was performed in regard to different light conditions and different level of experience, followed by t-test with 95% confidence interval. Results: Color difference values under 4,000 K and 5,500 K light source were $1.62{\pm}2.0$, and $1.33{\pm}1.7$ respectively. In addition, color difference values of prosthodontist group and dental student group were $1.34{\pm}1.7$, and $1.61{\pm}2.0$ respectively. Difference of shade selection ability was not found under either different light sources (P=.398), or different experience level (P=.221). Conclusion: Level of experience did not affect on the shade selection ability when prosthodontists and dental students matched the shades with the same shade tab under the same light source.

A Study on Enacting the Radiologic Technologist Act for the Civil Right to Health in Korea (건강권과 방사선사법 제정에 관한 고찰)

  • Lim, Chang-Seon
    • Journal of radiological science and technology
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    • v.30 no.4
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    • pp.313-320
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    • 2007
  • There are the Medical Radiation Health and Safety Act(the Patient Radiation Health and Safety Act, the Radiologic Technologist Act), the Medical Laboratory Technologist Act, the Physical Therapy Practice Act, and the Dental Hygienist Act, etc in America. However, Korea has only one Act for a medical radiologic technologist(including radiation therapy technologist, nuclear medicine technologist), medical laboratory technologist, physical therapist, occupational therapy examiner, dental hygienist, and so on. It is the Medical Technologist Act. Therefore, the Medical Radiation Health and Safety Act for a radiologic technologist(including radiation therapy technologist, nuclear medicine technologist) has to be enacted independently in Korea. It is the purpose of this Act to provide for the appropriate certification of persons using radioactive materials, equipment emitting ionizing radiation on humans or performing medical imaging for diagnostic and therapeutic purposes. In Korea, the radiologic technologist is a "fusion technologist" who is a person other than a licensed practitioner as a radiographer, radiation therapist, nuclear medicine technologist, computed tomography technologist, magnetic resonance technologist, mammographer, sonographer, medical dosimetrist, quality management technologist, etc. This Act will have some provisions related to the definitions, reserved title, scope of practice, specialized technologist, application for licensure, radiologic technology council, renewal, continuing education, the radiation control advisory commission, etc. This Act will ensure that quality radiation therapy treatments are delivered and that quality diagnostic information is presented for interpretation, which will lead to accurate diagnosis, treatment and cure. Accurate diagnosis can be provided only when a personnel is properly educated in technique, equipment operation and radiation safety. In the end, this Act will protect the civil right to health. By regulating the personnel responsible for performing those procedures, this Act will mean improved care for patients-higher quality images, improved accuracy, and less exposure to radiation.

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EFFECT OF RESIN MATRIX ON DEGREE OF CONVERSION AND FRACTURE TOUGHNESS OF DENIAL COMPOSITES (기질레진의 조성에 따른 복합레진의 물리적 성질에 관한 연구)

  • Lee, Yun-Shin;Choi, Kyoung-Kyu;Park, Sang-Jin
    • Restorative Dentistry and Endodontics
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    • v.27 no.1
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    • pp.77-86
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    • 2002
  • Current composites are made with dimethacrylate monomers and silane-treated silica microfillers, either alone or with silane treated glass fillers The main reasons for clinical failure of dental composites are secondary caries, wear and fracture. Most of practitioner want to get a composite which is more tougher under occlusal stress, less polymerization contraction, and better handling properties in application clinically. The aim of this study was to investigate the influence of resin matrix with various flows on the physical proper-ties such as fracture toughness and degree of conversion of the experimental resins. It was hypothesized that flexible or tough resin composites can be designed by judicious choice of monomer composition Various flow resin matrices containing Bis-GMA, UDMA, and TEG-DMA were made by altering the pro-portion of the monomers. After the unfilled resins were light-cured for different light intensity, the fracture toughness(K$_{1c}$) was measured according to ASTM standard using the single edge notched geometry, and degree of conversion(DC) was measured by FTIR. And experimental composites were formulated with variations in the proportion of silanated quartz and strontium glass fillers as 60, 75, and 77wt%. Also, the physical properties of composites with various filer contents were evaluated as same manner. All resulting data were compared by ANOVA/Tukeys test at 0.05 level. The results were as follows; 1. The degree of conversion of high flow resin containing less Bis-GMA was higher than that of low flow unfilled resin 2. While the degree of conversion of unfilled resin was increased according to light intensity for polymerization, there was no significant increase with moderate and high light intensity. Also, the fracture toughness was not increased by high light intensity. 3. The fracture toughness was high in the low flow unfilled resin containing higher contents of Bis-GMA. 4. There was a significant increase for fracture toughness and a tendency for degree of conversion to be reduced when the content of fillers was increased. 5. In the experimental composites, the flow of resin matrix did not affected on the fracture toughness, even, which was decreased as increase of viscosity. These results showed that the physical properties of a dental composite could be attributed to the flow of resin matrix with relative content of monomers. Specific combination of resin monomers should be designed to fulfil the needs of specific indication for use.

DISTRIBUTION OF AIRBORNE BACTERIA BY HANDPIECE AEROSOL CONDITIO (핸드피스 분무조건에 따른 부유세균 기균(氣菌) 의 분포)

  • Ko, Young-Han;Baik, Byeong-Ju;Kim, Jae-Gon;Yang, Yeon-Mi;Shin, Jeong-Geun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.628-634
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    • 2008
  • In recent years, cross-contamination has become one of the noticeable issues in dental clinic. Two major routes of contamination are the direct-contamination through blood and oral secretion and the indirect-contamination through dental office equipments. Especially, air-contamination through air-floating pollutant in a confined space like hospital, and also contamination through aerosol ejected from high-speed handpiece in a dental office was interested. The purpose of this study was to understand risk of bacterial infection through aerosol from handpiece in a dental office, which will help the practitioner with prevention of contamination during dental treatment. The main findings are as follows. 1. In a comparative test, the group using handpiece has higher bacterial number than the group not using handpiece with significant statistical difference(P<0.01). 2. The group using handpiece with rubber dam has lower bacterial number than the group using handpiecewithout rubber dam with significant statistical difference(P<0.01). 3. Comparing the group using drainage water with the group using distilled water as a handpiece water source results in 22.4 cfu and 17.0 cfu respectively but the difference is no statistically significant(P>0.05). 4. Measuring cfu at 0.5m and 1.5m distance, 0.5m distance showed higher bacterial number with statistical significance(P<0.01). 5. Classification of bacterial types showed the largest bacterial number came from gram-positive micrococcus(73.9%), and gram-negative micrococcus, gram-negative bacillus, and gram-positive bacillus follow in descending order.

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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.

A STUDY OF NEW-PATIENT DISTRIBUTION AND THE MOTIVES FOR VISITING IN THE DEPARTMENT OF PEDIATRIC DENTISTRY AT SEOUL NATIONAL UNIVERSITY DENTAL HOSPITAL (서울대학교 치과병원 소아치과에 내원한 신환 분포 및 내원 동기에 관한 연구)

  • Kim, Hyo-Jung;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Hahn, Se-Hyun;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.1
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    • pp.25-32
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    • 2011
  • The number of patients requesting services of pediatric dental clinics has been steadily increasing in South Korea. The pediatric dental clinics are comprised of hospital-based clinics and local clinics. The purpose of this study was to analyze new-patient distribution and to survey the motives for visiting the department of pediatric dentistry at Seoul National University Dental Hospital(SNUDH), utilizing questionnaires for parents from May to July 2010. The results are as follows: 1. Age distribution showed that 0-3 year-olds formed the largest group of 29.3%. The average age of patients was 6.2 years old. 2. In the surveys for the parents, the major reason for visiting SNUDH was the referral from other clinics(30.6%). 3. The 75% of patients previously visited other clinics before visiting SNUDH. 1) The greater number of patients(52%) visited general practitioner's clinic than pediatric specialists(48%). 2) More than 90% of the patients visited SNUDH after visiting other clinics for reassuring diagnosis and referrals. 3) The crucial deterring factor of being treated at SNUDH was difficult accessibility.