In this study, recognized building-related health symptoms of various workers in dental college hospitals are surveyed and analyzed in order to improve indoor environment at dental college hospitals. We conducted a questionnaire survey for 682 workers in three dental college hospitals located in Seoul from Sep. 20 to Oct. 8, 2004. Most workers at dental hospitals complained about noise, poor ventilation, dusty environment, and air dryness. SBS symptoms score for subjects was 1.43${\pm}$0.74 (often feel) and major symptoms was throat, CNS, eye, and nose symptoms. Recognized Building-related health symptoms are significantly related to tasks, working experience, job-satisfaction, indoor environment recognition index, medical history, used to special material, and number of dental unit chair. Also working places and ventilation are significantly related to the symptom. Based on the results, it can be said that special dental treatment causes undesirable environment such as noise, dust, and bad odor. It is also related to recognized building related health symptoms reported by workers at dental hospitals. So managemental efforts are needed to improve indoor environment which is related by dental treatment.
Liver transplantation is definitive treatment for the patients suffering from hepatitis, severe liver cirrhosis and liver cancer. In these patients, systemic infections under immunosuppression may occur easily. Therefore, primary object of dental treatments before liver transplantation is absolute removal of oral infection source. In addition, comprehensive dental management plan is essential for success of liver transplantation. The present study has been performed to investigate decayed, missing and filled permanent teeth index(DMFT index), degree of oral hygiene, past medical history, need of dental treatment, completion of dental treatment need and time interval between dental visit and operation date of liver transplantation in liver transplant candidates. Obtained results were as follows; 1. Decayed teeth of the patients were 2.68, missing teeth were 4.02 and filled teeth were 3.42. DMFT index was 10.12. 2. Twenty percents of patients showed moderate to severe food impactions, 42.2% of patients had moderate to heavy calculus and 37.8% of patients displayed gingival inflammation with swelling. 3. Patients needed periodontal treatments more than any other dental treatments. Periodontal treatments were needed for 88.9% of patients, operative & endodontic treatments were 46.7% of patients and 33.3% of patients needed for oral & maxillofacial surgical treatments. 4. Among 90 patients, time interval between scheduled operation date of liver transplantation and dental visit was within 2 weeks for 32.2% of patients, within 1 week for 20.0% of patients. In conclusion, most liver transplant candidates needed dental treatments for removal of potential infection sources. However because of insufficient interval between dental visit and operation date, they had taken liver transplantation procedures without comprehensive dental management. Development of preventive and comprehensive dental management program is mandatory for these patients. Cooperative interdisciplinary management will play a positive role for successful liver transplantation.
Burning mouth syndrome(BMS) is defined as chronic, painful burning sensation in the oral mucosa. Treatments for BMS include medication and psychiatric interventions. Capsaicin, alpha-lipoic acid, and topical and systemic clonazepam showed more effective in reducing the symptoms of BMS in the previous studies. The purpose of this study is to evaluate of the therapeutic efficacy of systemic clonazepam in BMS and to elucidate the relationships between such a efficacy and various clinical features, including age, pain intensity, pain duration, previous dental history and condition of oral mucosa. A retrospective clinical records audit was performed of patients diagnosed with BMS between January 2011 and August 2012. Patients were prescribed 0.5 mg clonazepam two times daily. Pain was assessed by patients on an 11-point numeric rating scale (NRS; 0 to 10) before and 1-2 weeks after systemic administration of clonazepam. The efficacy of clonazepam was evaluated in terms of patient's age, initial pain intensity, pain duration, presence or absence of precipitating event, condition of the tongue, presence or absence of denture. A total of 50 patients (46 women, 4 men) were included in this study. The patients were divided into two or three groups according to above clinical features. The amount of mean NRS reduction in patients with severe initial pain was $3.33{\pm}2.74$, whereas that in patients with mild initial pain was $1.64{\pm}1.54$. The amount of mean NRS reduction in oldest patients was $3.53{\pm}1.94$ (${\geq}$70yrs), and those in another younger patients were $2.88{\pm}1.80$(< 60yrs) and $1.54{\pm}2.86$(60yrs ${\leq}$ age < 70yrs), respectively. It was concluded that the older patients and the patients with higher intensity of initial pain tend to show better efficacy of clonazepam. However, There were no statistically significant differences according to pain duration, presence or absence of precipitating events, tongue fissuring, and wearing dentures.
This study was performed to evaluate horizontal and vertical characteristics according to lateral cephalometry of adult Korean skeletal Class II patients using a selected horizontal and vortical reference planes of Koreans. 60 males and 60 females consisting of freshman of Yonsei University from 1996 to 1997 and patients with history of orthognatic surgery at the Dental Hospital of Yonsei University with a skeletal Class II profile were chosen and compared with 70 males and 70 females with normal occlusion. The skeletal Class R group had the following conditions : 1. Profile composed of a retrognathic mandible or protrusive maxilla; 2. Class II molar and canine key; 3. ANB-greater than $4^{\circ}; 4$. Wits appraisal-greater than 1.0mm; Cephalometric analysis consisted of 22 skeletal, 25 soft tissue, 12 dental measurements. The results were as follows. 1. There was no considerable vortical measurement difference between the skeletal Class II malocclusion group and the normal occlusion group in skeletal analysis. But, some variations were found between the two groups in soft tissue analysis. 2. Mandibular length of the skeletal Class II malocclusion group was smaller than that of the normal occlusion group. Mandible was more posteriorly positioned in the Class II malocclusion group than in the normal occlusion group. 3. The length and antero-posterior position of the maxilla were not different between the Class II malocclusion and the normal occlusion group. 4. The antero-posterior position of the nose, upper lip and maxillary soft tissue, and nasolabial angle were not different between the two groups. 5. Mandibular soft tissue of the Class H malocclusion group was more posteriorly positioned than that of the normal. 6. The vertical measurements of the incisors(U1-HP, L1-HP) were bigger in the Class II malocclusion group than in the normal, but those of the molars(U6-HP, U6-MP) showed no significant difference between the two groups. 7 Classifying the skeletal Class II malocclusion group according to the antero-posterior position of both jaws, normally positioned maxilla and retruded mandible was 43.3%, both normally positioned maxilla and mandible 28.3%, both retruded maxilla and mandible 20.0%..
Study on growth change of dental arch is considered to both an important data in orthodontic diagonsis and treatment planning as well as analysis of treatment results , also, arch form is important in anthropology and dentistry, even more so in prosthodontics and orthodontics. In the field of orthodontics, studies on the functional aspect of upper and lower teeth and maintenance of stability of dentition and occlusion were carried out from the early days. Some of the early studies include explanation of growth change in dental arch from measuring directly fom human stroll, and afterwards, cephalometrics x-rays were introduced; accordingly, studies using cephalometric measurement and linear measurements of study models were often performed. By this method, arch width, arch depth and perimeters were measured, and growth change or dental arch was studied. The subject ror this study were sn children(boys and girls or ages from 3 yens to 12 years from Kang-won district and Seoul, who has no history of orthodontic treatment and who show healthy status and normal growth and development. Cephalometric x-ray, panoramic x-ray, and study model were taken for each subject consecutively for 2 years, and the subjects are still followed up. 400 pairs of study models from the past two years were used in this study; mesio-distal diameater of each tooth, intercanine width, intermolar width, canine depth, molar depth and arch perimeters were measured. Afterwards, mean value and each standard deviation of each age group and each gender were obtained, and representation graph were drawn. The following conclusion were obtained. 1. Intercanine width showed gradual increase until the age of 10-years and after that, showed no increase. 2. Intermolar width in upper arch showed gradual increase : intermolar width in lower arch showed no significant chang, and after the age of 9-years, showed increase. 3. Cainine arch depth showed relatively rapid increase after the age of 6-years, and this pattern was more obvious in lower arch. 4. Molar arch depth increased gradually in both archs and it decrease after the age of 10-years : this phenomenon was more prominent in the lower arch. 5. Arch perimeter showed gradual inerease and convert to plateau at the age of 10-years, after that, it decreased. this pattern was more prominent in lower arch.
Orthodontic patients are individuals that grow and develop ; therefore selection of the proper time for orthodontic treatment is considered to be one of most difficult and yet difficult factor. Since the development of cephalometric X-ray, amount and Pattern of craniofacial growth change with aging could be predicted and be came useful in the process of orthodontic treatment. The relationship between the mean values of cephalometric measurements and body height and weight was studied among the groups(boys and girls) of Korean children from the ages 6-years to 17-years. 409 boys and 437 girls with no abnormality in growth and development and no history of orthodontic treatment from the ages of 6 years to 17 years were chosen as subjects Cephaloment X-ray were taken for 3 years and hard tissue analysis based on Burstone's COGS, which was devided into measurements of 6 parts(Cranial base, Maxillar and Mandible, Dental measurements). The relationship between craniofacial growth and height & weight was studied. The following conclusions were obtained : 1. The maximum growth in the measurements of cranial base, N-Ar(FH), N-Ba(FH) corresponded with the age with the maximum increase in body height & weight in both boys and girls. 2. Genial angle gradually decreased with aging in both boys and girls. 3. N-ANS(L) showed greater amount of growth than ANS-Ne(L), and this had greater influence on facial profile. 4. N-A-$Pog^{\circ}$ decreased with aging, and mandibular growth exceeded maxillary growth in amount and rate. 5. Length of Y-axis Increased, but Y-axis to FH plane remained constant. This show that mandible grows at a constant angulation to cranial base. 6. As permanent teeth erupt, interincisal angle deceased.
The aim of this study was to investigate the impact of depression, somatization, and jaw disability on graded chronic pain of TMD using Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Ninety-three patients (17 men and 76 women, mean$\pm$SD age of 30.1$\pm$12.5 years) diagnosed with TMD based on RDC/TMD axis I criteria were administered RDC/TMD axis II history questionnaire. The relationships between depression, somatization, jaw disability, and each parameters of graded chronic pain (e.g. pain intensity, pain days, disability score, disability days, graded chronic pain scale) were analyzed by multiple regression analysis. The obtained results were as follows: 1. Among 93 TMD patients, the prevalence of low disability group of graded chronic pain scale was 42.0% and high disability group of graded chronic pain scale was 51.5%. 2. Depression did not show any significant influences on pain intensity, pain days, disability score, disability days, and graded chronic pain scale. 3. Somatization showed a significant effect on pain intensity (p<0.01), disability days (p<0.01), and graded chronic pain scale (p<0.01) except for both pain days and disability score. 4. Jaw disability also showed a significant effect on pain intensity (P<0.001), disability days (p<0.01), and graded chronic pain scale (P<0.001) except for both pain days and disability score. Somatization and jaw disability may closely relate to the pain intensity and degree of disability that TMD patients perceive. Therefore, comprehensive understanding of psychological profile and improvement of functional limitation of jaw movements in the patient should be considered to obtain an excellent outcome of chronic TMD management.
Understanding patients' expectation for health visits and providing appropriate care may increase patients' satisfaction with health care, leading to more positive treatment outcome. The study aimed to investigate expectations of the patients with temporomandibular disorders (TMD) at their first visit to university-based orofacial pain clinic and to evaluate any relation with duration of pain, presence of previous treatment, pain severity and pain interference. Inclusion criterion was patients aged over and 18 years old and diagnosed as TMD during 3 months' period from Aug to Nov 2010. They were asked to complete the questionnaires for patients' expectation and the Brief Pain Inventory (BPI) at waiting room prior to consultation. 322 TMD patients participated in the study(M:F=1:1.5, mean age=36 years old). The study indicated that the most important top 3 expectations were 'cure of pain', 'understanding their problem' and 'doctor-patient communication' in order. This finding was not affected by gender, duration and previous treatment history but affected by sub-category of TMD and BPI pain severity and pain interference. 'Pain relief' and 'understanding their problems' were relatively highlighted in the patients with muscle disorders and combination (joint-muscle) disorders of TMD than those with joint disorders who wanted communication and further investigation relatively more (p=0.000). While expectation for pain relief was expected more with increase of pain severity and interference, patients with mild level of pain severity and interference expected communication and further investigation relatively more (p=0.000, 0.017, respectively). Based on the results of the study, though pain relief was the primary concern for TMD patients suffering from pain, their satisfaction with care may be increased by explanation for etiology and mechanism of TMD to make them understand their problems better and doctor-patient communication and collaborative decision-making for treatment. Importance of patient-centered consultations and availability of written material or web sites for patient information should be stressed out.
The purposes of this study were to compare psychological profiles, to investigate the differences in the clinical characteristics, and to compare treatment outcomes between myogenous pain and arthrogenous pain subgroups of temporomandibular disorder (TMD) based on Research Diagnostic Criteria for Temporomandibular disorders (RDC/TMD). Two hundred and fifty two patients diagnosed as TMD were divided into three groups based on the RDC/TMD axis I diagnostic guidelines; myogenous pain group, arthrogenous pain group, and mixed pain (both myogenous pain and arthrogenous pain) group. RDC/TMD history questionnaire was administered to each patient and depression, somatization, jaw disability, pain intensity, disability days, and graded chronic pain scale were analyzed. Bruxism, clenching, insomnia, headache, and unilateral chewing were assessed in a standardized TMD dysfunction questionnaire and the duration of onset, chronicity of pain, treatment period, the effectiveness of the treatment, and improvement of symptoms also analyzed. Myogenous pain group had higher depression (p=0.002), and somatization scales (p<0.001) than the arthrogenous pain group. Mixed pain group showed higher pain intensity (p=0.008), disability days (p<0.001), graded chronic pain scale (p=0.005), somatization (p<0.001), and depression scores (p=0.002) than the arthrogenous pain group. Jaw disability did not show any significant differences among the three groups (p=0.058). Arthrogenous pain group reported more limitation of mouth opening than myogenous pain group (p=0.007). Duration of onset showed that the arthrogenous pain group had lowest prevalence of chronicity among three groups (p=0.002). Mixed pain group patients showed lowest symptom improvements among three groups (p=0.007). Multiple linear regression analysis results showed that the treatment effectiveness was significantly associated with somatization score (${\beta}$=-0.251, p=0.03).
In the field of dentistry, there existed relatively few emergency patients or patients who need intensive care and thus had low medical dispute rates. However, these days, there is a general tendency of increased medical disputes. Although many medical disputes are caused by medical accidents of the dentists, because dental assistants are also lawfully involved in practicing dentistry, there is a possibility of medical disputes or medical accidents caused by dental assistants. Therefore, the role of the dental assistants cannot be ignored. This study consists of a survey given to dental hygienists currently working in general hospitals, dental hospitals and private dental clinics. Following is the results of the analysis of 275 respondents' backgrounds, medical disputes rates including patients' complaints, their understanding of medical regulations and their general understanding of overall dental practice and medical disputes. 1. 251 of 274(91.6%) respondents doubted the risk of medical accident and dispute. 2. 81(29.5%) dental hygienist experienced complaint from patients. They have been working in the private dental clinic, the rate of this experience was high. 3. 349 case of 1805(19.3%) the complaints by patients, highest percentage among its category, were those regarding dental fees and poor service. 4. 129 case of 1805(7.1%) patients' complaints, highest percentage among it's subcategory, were those regarding the absence of explanations of precautions or request of agreements before dental treatment. 5. 252 of 267 (94.4%) dental hygienists chart after a scaling treatment. However, only 55(20.7%) dental hygienists chart the fact of explaining the precautions. 6. 6(2.2%) dental hygienists do not inspect patients' medical history, if patients don't mention it. 7. 104 of 274(38.0%) dental hygienists responded to be capable of administering first aid treatment. 8. 115(41.8%) dental hygienists have a first aid kit and equipment. 9. In case of medical dispute, 268(97.8%) dental hygienists respond that, charting plays a big role in resolving the dispute. 10. In case of medical dispute, 272(93.3%) dental hygienists respond that, explanation and agreement before treatment have an important role in settlement of dispute 11. Only 160(58.4%) dental hygienists responded correct answer that the duration of keeping medical records is 10 years. 12. 124(45.3%) respondents thought that it is legal for a dental hygienist to take a panoramic dental X-ray, 71(25.9%) respondents thought that it is legal practice cervical resin treatment by dental hygienist, and 37(13.5%) respondents thought that it is legal extract primary teeth by dental hygienist. 13. 24(18.76%) respondents thought that it doesn't matter to tell patient's state to others 14. 272(99.27%) responded that receiving education for the prevention of medical disputes was needed and of them, 61.0% thought it was urgent. 15. 186(64.2%) has never had classes regarding the prevention of medical disputes while in school and 212(77.4%) has not had the same type of classes after graduating from school. 16. 256(93.4%) responded that there will be even more of an increased number of medical disputes. Among them, 83.3% of respondents though that due to the increased opportunity of acquiring information through the internet and mass media. The study shows that 29.5 percentage of dental hygienists have experienced the medical disputes and complaints and they are lack of recognition of medical regulations and dental hygienist's official duty. So, there is a big potential of the percentage to increase. Therefore, the correct understanding of explaining precautions and requesting agreement before dental treatments and performing them are mandatory. Moreover, classes regarding the prevention and counterplans of medical disputes need to be widely offered.
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