• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.4
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• pp.309-313
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• 2010

The management of teeth in the line of a mandibular fracture is controversial despite the general agreement that most of these teeth can be preserved. Teeth should be retained if bony attachments are adequate for survival, the tooth is sound and important in maintaining fixation of the fractured segment of bone. Teeth should be removed if they are loose and interfere with the reduction of fragments, are devitalized and potentially a source of wound infection, are damaged beyond their usefulness or may become devital and interfere with healing by becoming infected. However, tooth removal will increase the level of trauma, extend the severity of the wound and require expensive prosthetic treatment. Therefore, it is very important to conserve infected teeth in the line of a mandibular fracture through early primary endodontic treatment (pulp extirpation, canal enlargement and canal opening drainage) and splinting. The basic principles underlying the treatment of pulpless teeth are those underlying general surgery. Therefore, debridement of the infected wound (pulp extirpation and canal enlargement), drainage (canal opening) and gentle treatment of the tissues (occlusal reduction and teeth splinting) are the principles of surgery. This is a representative case report of conservative care by the early endodontic drainage of infected teeth in the line of a mandibular fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.5
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• pp.471-477
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• 2001

Failure to use effective methods of reduction, fixation, and immobilization may lead to nonunion with osteomyelitis, owing to the compound nature of most fractures of the mandible. Nonunion results in fibrous pseudoarthrosis at the fracture site with instability that, once formed, does not improve spontaneously. Once the nonunion with osteomyelitis secondary to fractures has become established, intermaxillary fixation and drainage of infected tissue should be instituted as early as possible, because the fixation & drainage enhances the patient comfort and hinders ingress of microorganisms & debris by movement of bone fragments. The authors treated three cases of nonunion with osteomyelitis by intermaxillary fixation, incision & persistent drainage on the previous fistula site and endodontic drainage of infected teeth in the fracture site of mandible. The localization & sequestration of the infected bone around the fracture was better performed persistently by natural homeostatic mechanism in $8{\sim}10$ weeks and the bony union was then attained without bone grafting.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.3
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• pp.221-227
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• 2010

The most common local cause of active gingival bleeding is the vessel engorgement and erosion by severe inflammation. Abnormal gingival bleeding is also associated with the systemic disturbances. Hemorrhagic disorders in which abnormal gingival bleeding is encountered include the following: vascular abnormalities (vitamin C deficiency or allergy), platelet disorders, hypoprothrombinemia (vitamin K deficiency resulting from liver disease), and other coagulation defects (hemophilia, leukemia). There are many conventional methods for gingival bleeding control, such as, direct pressure, electrocoagulation, direct suture, drainage, application of hemostatic agents and crushing and packing. If the active continuous gingival bleeding is not stopped in spite of the application of all conventional bleeding control methods, the life of patient is threatened owing to upper airway obstruction, syncope, vomiting and hypovolemic shock. Therefore, the rapid and correct hemostatic method is very important in the emergency dental care. This is a case report of active gingival bleeding care via dental crown removal and emergency primary endodontic drainage as a last method in liver cirrhosis patient with advanced periodontitis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.2
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• pp.168-173
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• 2006

The side effects of head and neck radiation therapy include mucositis, xerostomia, loss of taste, radiation caries, oral infection, osteoradionecrosis and trismus. When a patient is arranged to begin head & neck radiotherapy, oral pathologic lesions are examined and managed for the prevention of oral complications. The advanced odontogenic infection should be especially controlled before the radiotherapy and the patient must be instructed for proper oral prophylaxis. Generally the more conservative treatments, such as, scaling, restoration, endodontic treatment, are the care of choice and dental extraction is performed in advanced periapical and periodontal pathologic conditions. If the dental extraction should be done, the radiotherapy consequently will be delayed until there is epithelium covering the extraction socket, leaving no exposed bone. The cancer patient with severe emotional stress pray for the early radiation therapy, in spite of possibility of the recurrent odontogenic infectious lesions. So, the authors attempted to do the early radiation therapy by the conservative endodontic drainage and surgical incision & drainage without extraction of the infected teeth, and resulted in relatively good prognosis without the severe side effects of head and neck radiotherapy.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.7 no.2
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• pp.107-114
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• 2011

Dental extraction is potentially stress-inducing in many disabled patient. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress, the stress reduction method was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk, (2) Complete medical consultation before dental therapy, (3) Schedule the patient's appointment in the morning, (4) Monitor and record preoperative and postoperative vital signs, (5) Use psychosedation during therapy, (6) Use adequate pain control during therapy, (7) Short length of appointment : do not exceed the patient's limits of tolerance, (8) Follow up with postoperative pain/anxiety control, (9) Telephone the risk patient later on the same day that treatment was given. Though the stress reduction method above was applied to the dental extraction in disabled patients with the advanced infected teeth, the complications(syncope, shock, bleeding & infection, etc.) may be occurred. For prevention of complications associated with the extraction, the authors treated the advanced infected teeth with endodontic drainage and incision & drainage before extraction. The final extraction and wound closure were then done after about 3 weeks.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.592-596
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• 2010

The common local causes of active gingival bleeding are the vessel engorgement and erosion by severe inflammation and injury to hypervascularity lesion. Abnormal gingival bleeding is also associated with systemic bleeding disorders (liver disease, leukemia etc.). There are many conventional methods for gingival bleeding control, such as, direct pressure, packing, electrocoagulation, tight suture and application of hemostatic agents. If the continuous gingival bleeding is not stopped in spite of the all local application methods, the medical consultation should be obtained for systemic condition care and the major feeding arterial embolization. This is a case report of severe gingival bleeding and periodontitis control in a patient with liver cirrhosis and oral metastatic lesion of hepatocellular carcinoma. The bleeding lesion was placed in left buccal mucosa and gingiva of the left mandibular molars. The control methods were dental crown removal, primary endodontic drainage, gingival sulcus drainage and maxillary arterial embolization with medical consultation.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.1
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• pp.31-37
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• 2014

The general local cause of gingival bleeding is the vessel engorgement and erosion by odontogenic infection. Abnormal gingival bleeding is also associated with systemic causes. Bleeding disorders in which continuous gingival bleeding is encountered include the followings : vascular abnormalities, platelet disorders, hypoprothrombinemia and other coagulation defects. There are classic methods for gingival bleeding control, such as, direct pressure, electrocoagulation, suture, crushing and application of hemostatic agents. If the continuous gingival bleeding is not stopped in spite of the conventional methods, the life of patient is threatened owing to upper airway obstruction, syncope, vomiting and hypovolemic shock. Therefore, the rapid and correct hemostatic method is very important in the emergency condition. This is a case report of continuous gingival bleeding control by primary endodontic drainage & suture in a disabled patient with systemic bleeding disorders.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.4
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• pp.280-285
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• 2012

From the standpoint of general guidelines of a dentist, the following conditions should be considered before replanting a permanent tooth. The avulsed tooth should be without advanced periodontal disease. The alveolar socket should be reasonably intact in order to provide a seat for the avulsed tooth. The extra-alveolar period should be considered, i.e. periods exceeding. 2 hours are usually associated with marked root resorption. But, the above mentioned regulations are often difficult to keep in the actual situation of the medical emergency room, owing it to the delay of primary medical care in multiple trauma patients. The successful cases have been reported with minimal root resorption in the long-term periods, in spite of extra-alveolar periods of several hours and combined alveolar bone fracture. This is a case report regarding the effect of endodontic drainage in delayed replantation after a prolonged extra-alveolar period of the avulsed teeth with alveolar bone fracture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.5
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• pp.457-463
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• 2001

In the unconscious patient with general muscle rigidity, the natural teeth can be luxated and then bite wounds may be occurred around lip, owing to the pathologic involuntary self-biting habit. If the forceful biting is generated continuously, the teeth may be avulsed and aspirated into the aerodigestive tract with the infection of biting wound. For the prevention of pulmonary aspiration of the teeth and wound infection, the biting teeth should be cared before the fact. The authors treated the teeth as endodontic drainage with removal of the crown or iodoform gauze drainage into the socket with extraction of the teeth. The prognosis was more favorable without biting wounds.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.5
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• pp.330-337
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• 2003

This is a retrospective study on the care of odontogenic infections in admission patients with major bleeding disorders. The study was based on a series of 514 patients treated at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, from Jan. 1, 2000, to Dec. 31, 2002. The obtained results were as follows : 1. The cardiovascular disease was the most frequent cause of the systemic diseases with major bleeding disorders, and liver disease, cerebrovascular disease and renal failure were next in order of frequency. But, there was the most frequent dental consultation in the liver disease, owing to the many odontogenic infectious diseases. 2. Male prediction (66.3%) was almost existed in the odontogenic infectious patients with major bleeding disorders. But, there was slight female prediction (53.4%) in the cardiovascular disease. 3. The most common age group of the odontogenic infectious patients with major bleeding disorders was the fifty decade(27.2%), followed by the forty, sixty & thirty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with major bleeding disorder, peak incidence was occurred as toothache (42.2%), followed by intraoral bleeding, ulcer pain, dental extraction in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis and periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(44.2%) was showed in primary endodontic drainage(pulp extirpation, occlusal reduction & canal opening drainage) and followed by the incision & drainage, the medications & oral hygiene instruction, scaling, indirect pulp capping in order.