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Treatment Outcome and Prognosis of the Outpatients with Orofacial Pain (구강안면통증 환자의 치료결과와 예후에 관한 연구)

  • Choi, Sea-Hun;Kim, Ki-Suk;Kim, Mee-Eun;Lee, Dong-Ju;Jin, Sang-Bae
    • Journal of Oral Medicine and Pain
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    • v.31 no.2
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    • pp.155-165
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    • 2006
  • The purpose of this study was to evaluate treatment outcome and prognosis of the patients with orofacial pain disorders who visited for treatment in the Department of Oral Medicine, Dankook University Dental Hospital from January 2002 to December 2004. Orofacial pain disorders were categorized into TMD(myogenous, arthrogenous and muscle-joint combined TMDs), neuropathic pain disorder, oral soft tissue disease and complex condition simultaneously having more and two aforementioned categories and treatment period, method and treatment outcome were evaluated. The results of this study were as follows; 1. Average longevity of treatment period was the longest in the neuropathic pain, followed by soft tissue disease, complex conditions, arthrogenous TMD, muscle-joint combined TMD and myogenous TMD in order. 2. When treatment methods were largely categorized into pharmacologic, physical and oral appliance therapy, pharmacologic therapy was used the most frequently for the patients with neuropathic pain or oral soft tissue diseases, oral appliance therapy for those with arthrogenous TMD and physical therapy for those with myogenous TMD. 3. Of physical therapeutic methods used in our clinic, EAST and microwave was employed the most frequently in the patients with myogenous TMD, ultrasound for those with arthogenous TMD and LLLT for those with neuropathic pain or oral soft tissue disease. 4. In comparison with change of pain after treatment, there existed a tendency that pain from neuropathic pain disorders persisted while pain from TMD was getting better or totally disappeared. 5. Concerning the change of mouth opening range in the TMD subgroups, there was no significant difference among the subgroups but significant difference existed among opening ranges, indicating comfortable maximum mouth opening increased the most following treatment. Improvement of active range of mouth opening was the most considerable in those with disc displacement without reduction. It can be said on the basis of the findings from this study that various treatments currently used for the orofacial pain showed good results with TMD in regards with pain control and improvement of function, suggestive of favorable prognosis, while neuropathic pain or soft tissue disease was the clinical conditions difficult to resolve, requiring a long and persistent treatment.

Follow-up Study of Condylar Bone Changes using Cone Beam Computed Tomography in Patients with Osteoarthritis (측두하악장애 골관절염 환자에서 cone-beam CT를 이용한 관절면의 변화 추적 연구)

  • Ko, Chul-Hee;Kim, Byeong-Soo;Ko, Myung-Yun;Jeong, Sung-Hee;Ok, Soo-Min;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.33-45
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    • 2012
  • This study was designed to assess follow-up study of condylar bone changes using cone beam computed tomography in patients with osteoarthritis. The author performed clinical examination for osteoarthritis patients who visited Orofacial Pain Clinic, Department of Oral Medicine, Pusan National University Hospital. CBCT(Cone beam computed tomography) was taken for 228 joints in 114 subjects. After average 10 months, CBCT was retaken. A Oral medicine and Oral radiologist evaluated CBCT each other. Condyle bone changes were classified by no bone change, flattening, erosion, osteophyte and sclerosis. The obtained results were as follow. 1. The condylar bone changes of osteoarthritis in temporomandibular disorder were as follow: 1) The transitions of each types of condylar bone changes was maintained at the initial state of the majority. 2) The transition of erosion was distributed erosion, flattening, sclreosis, osteohyte in order. 3) The transition of flattening was distributed flattening, osteohyte, normal, sclreosis in order. 4) The transition of osteohyte was distributed osteohyte, erosion, sclreosis, flattening in order. 5) The transition of sclreosis was distributed sclreosis, osteohyte, erosion, normal in order. 2. The signs and symptoms according to transition of each types of condylar bone changes were as follow 1) In the transition of condylar bone changes from erosin to erosion, pain, noise, LOM and MCO had symptomatic improvement. In the transition of condylar bone changes from erosin to flattening, pain, LOM, MCO had symptomatic improvement. In the transition of condylar bone changes from erosin to no bony change, pain, noise, LOM had symptomatic improvement. In the transition of condylar bone changes from erosion to flattening than the maintenance of eosion, MCO had symptomatic improvement. 2) In the transition of condylar bone changes from flattening to flattening, pain, noise and MCO had symptomatic improvement. In the transition of condylar bone changes from flattening to sclerosis, LOM had symptomatic improvement. 3) In the transition of condylar bone changes from osteophyte to osteophyte, pain, LOM and MCO had symptomatic improvement.

비만(肥滿) CLINIC 내원환자(來院患者) 453 CASES에 대(對)한 임상적(臨床的) 고찰(考察)

  • An, Gyeong-Sun;Seong, Nak-Gi
    • Journal of Haehwa Medicine
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    • v.2 no.2
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    • pp.219-246
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    • 1993
  • In 1991, Obesity rate of South Korea has reached to 18.7%. Because of economical development, the pattern of diet is exchanged from carbohydrate to rich protein and fat. The more problem is not only obesity of adult but also one of little child. Obesity is induced to diabetes mellitus, hypertension, artherosclerosis, hyperlipoidemia. heart and C.V.A disease, etc. In Woman, special important ploblem is the complex of beauty about Woman's figure. In Oriental Medicine, the factor of obesity is mainly regarded as dampness. And there are many treatments and methods to body weight loss, but obesity patients dislike to use them because of their side effects and inconvenience, intolerance. Now ear acupuncture is applied on so many disease because of its easy handly, non-side effect and high efficiency in clinics. Here obesity acupuncture is used to ear and whole body acupuncture. Because they react eachother for lack point. Therefore, in order to investigate the effect of obesity acupuncture and develop non-drug, non-starvation etc, we analyzed 453 the cases of body weight loss patients treated with ear and whole body acupuncture in Oriental Medicine Hospital of Jeon-Ju Woo-Sug University from April.1.1992. to March.17. 1993. The results were summarized as follows. 1. Distribution of sex ; male (4.4%), Female(95.6%) 2. Distribution of age in descending order ; 30s, 20s, 40s, 10s, 50s, below 10s, abowe 60s. The 20s-30s are group made up 60.7% of the group. 3. Distribution of occupation in descending order; housewife, student, service, salaried, merchant, teacher, farmer, inoccupation. 4. Distribution of human coporal constitution in descending order : Tae-Eum-In, So-Eum-In, So-Yang-In. 5. Distribution of body height and weight, 155-164cm ; 71.1%, 60-70kg, 74.6% are majority. 6. Distribution of weight variation, 2-6kg(71.0%) is majority, also 13-14kg(0.4%). 7. Distribution of duration in descending order ; 1-3 years, 3-6 years, 1-12months, above 10 years but in success, 1-12 months, 1-3 years, 3-6 years, above 10 years. Therefore, we know that the shorter duration of obesity is, the more loss of body weight. 8. Past experiences to body weight loss; Yes(69.5%), No(30.5%). The success rate accordant with the past temporary experiences shows that the cases without experience is higher than the ones with experience. 9. In distribution of times(treatments), 10 times is top. The rate of body weight loss is the highest in 14 times. Therefore, I think that one would need at least 10 times. in order lose body weight 10. Distribution of body weight variation in treatments times is at 2 times(3-4kg loss), and surprisingly is 14kg loss at above 15 times. 11. Distribution of symptoms improvement, in descending order ; heavy sense in body, dec. of appetite, inc.of exercise, lumbago, edema, knee pain, inc.of urine, inc. of fullness sense, thirsty, disease of gynecology, white tung, chest burning, heart burning, dec.of tobacco, drink taste. motion sickness, allergy, water eczema, arthma, belching. 12. Distribution of snack; Yes(87.4%), No(78.6%) 13. Distribution of exercise; Yes(21.4%), No(78.6%) 14. Distribution of sleeping times, above 7 hours(79.0%) 15. Distribution of the reason to body loss, the complex of beauty(68.7%) is top. 16. Distribution of side effect in obesity acupuncture, constipation (17.4%) is top. 17. Distribution of method in body weight loss ; dietary treatment (31.1%), sauna(26.7%), exercise(19.7%), the center of body weight loss (15.0%) herb-med and starvation treatments (5.1%), hand-finger acupuncture (hand-foot acupuncture) is 1.6%, diet pill(0.3%), etc(0.6%).

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A Study on the Relationships between the Oral Health Activities and Oral Health Conditions of the Elderly (노인의 구강보건행위와 구강건강상태와의 관련성 조사 연구)

  • Gwon, Mi-Young;Young, Jin-Young
    • Journal of dental hygiene science
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    • v.6 no.4
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    • pp.271-276
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    • 2006
  • This study set out to analyze the relationships between the senior citizens' dental health activities and dental health conditions, to provide basic data to develop a program for their better dental health, and finally to search for the ways to improve their life quality through dental health care. The subjects were 142 senior citizens(58 were male and 84 were female) who were 65 years old or older and visited a dental hospital or clinic in the Seoul metropolitan area from April 17 to April 28, 2006. With the cooperation from the dentists, the investigators examined their dental conditions and conducted one-on-one interviews to collect the information about their demographic characteristics, dental health activities, and subjective dental health conditions. The collected data were analyzed with T-test, ANOVA and Pearson's correlation coefficient using the SPSS WIN 11.5 program. The analysis results were summarized as follows: First, 58 men(40.8%) and 84 women(59.2%) consisted of the subject group, where percentage of the female participants was bigger Those who were aged from 65 to 69 made the biggest age group in the subjects, accounting for 58.5% with 83. Second, those who had three dental caries or less and then didn't treat them or treated them(F) accounted for the biggest percentage with 117(82.4%) and 72(50.7%) respectively. As for the remaining teeth, the biggest number of them(40 subjects, 28.2%) had three or less remaining. Third, it turned out the female subjects had a higher level of dental health activities than their male counterparts(P = 0.00). As for living expenses, those who were paid salary or earned income themselves carried out their dental health activities in a higher level than those who lived on the benefit from the government(p = 0.02). Fourth, the subjects' subjective dental health conditions had negative correlations with their dental caries not treated. And there were positive correlations between their dental caries not treated and dental caries lost and between their dental caries treated and remaining teeth. Fifth, those subjects who earned their living expenses themselves had the most dental caries treated at 5.4(p = 0.02), and there was statistically significant difference with the numbers. Sixth, those subjects who brushed their teeth in their own manner had 11.8 teeth lost(p = 0.05), which was more than the number of those who brushed their teeth in other methods. And there was statistically significant difference among them. The remaining teeth were found most at 17.3(p = 0.00) among those who brushed their upper and lower teeth separately. In addition, those who visited the public health center often had significantly more teeth treated(4.3) than others(p = 0.00).

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Influence of Subjective Oral Health Interest and Recognition in Academic Boys' High School Students upon Oral Health Practice in Some Regions (일부지역 인문계 남자고등학생의 주관적 구강건강관심도와 인지도가 구강건강실천에 미치는 영향)

  • Lee, Hyun-Ok;Chun, Ju-Yean
    • Journal of dental hygiene science
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    • v.11 no.1
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    • pp.1-6
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    • 2011
  • The purpose of this study was to offer information in order to induce and practice forming right oral health habit by grasping oral health practice according to subjective oral health interest and recognition in Academic Boys' High School students. Targeting students of Academic Boys' High School where is located in Jeollabuk-do from May 20, 2010 to June 20, the self-administered questionnaire survey was carried out by convenience sampling. The following are the results that the collected data was carried out statistical analysis by using SPSS 12.0 program. 1. Among factors of oral health practice according to oral health interest level, toothbrushing was the highest with 3.89 points. It was in order of education and interest with 3.18 points, diet control with 2.93 points, a regular visit with 2.69 points, and the practice of oral hygiene device with 2.12 points. 2. Among factors of oral health practice according to subjective oral health recognition level, toothbrushing was the highest with 3.89 points. It was in order of education and interest with 3.17 points, diet control with 2.93 points, a regular visit with 2.69 points, and the practice of oral hygiene device with 2.12 points. 3. In correlation between subjective oral health recognition level and oral health practice factor, the more recognition of being healthy in the subjective oral health recognition level led to the higher oral health practice level(p<0.01). 4. As for influence of oral health practice factor upon subjective oral health recognition level, the subjective oral health recognition was high in a group of practicing toothbrushing(p<0.01) and of visiting dental clinic regularly(p<0.05).

A Comparative Study on Awareness the Dental Coordinator between Dental Hygienists and Dental Hygiene Students (치과위생사와 치위생과 학생의 치과코디네이터 인식 비교)

  • Park, Il-Soon;Lee, Kyeong-Hee;Youn, Hye-Jeong
    • Journal of dental hygiene science
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    • v.10 no.2
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    • pp.63-69
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    • 2010
  • The purpose of this study was to examine the business awareness of dental coordinators and preferred working condition according to educational period, to suggest what improvements should be made. A survey was conducted for a year and four months from March 2007 to June 2008, and the collected data were analyzed, which made use of ${\chi}^2$(Chi-square) test, t-test. The findings of the study were as follows: 1. In regard to preferred conditions of employment, a dental hospital (42.0%) was most preferred by the incumbent dental hygienists investigated, followed by a dental clinic(29.4%). The largest number of the students who took dental coordinator courses had a liking for a dental hospital(41.9%), followed by university hospital and general hospital(29.0%)(p<0.001). 2. As for perception of dental coordinator, all the dental hygienists were aware of that occupation, and most of the students(81.9%) were cognizant of it(p<0.001). Concerning the necessity of that occupation, the students who felt the need for that(94.8%) outnumbered the dental hygienists who did(85.2%)(p<0.05). 65.9 percent of the dental hygienists and 84.5 percent of the students looked upon a dental hygienist as the best occupation that also could serve as a dental coordinator(p<0.01). 3. Concerning a favorite type of work including an official title, the dental hygienists wanted to work as the chief of counseling section the most(34.1%), and the largest group of the students hoped to become a section chief or team leader(35.2%). In regard to the most integral field of work, the dental coordinators(51.1%) and students(65.8%) attached the most importance to counseling(p<0.05). 4. The dental hygienists were better gratified than the students in every regard(p<0.001). The former($4.00{\pm}0.41$) looked at that occupation in a better way than the students($3.81{\pm}0.50$) as well(p<0.01). The abovementioned findings suggested that it would be advisable to provide dental hygienists with a certain level of a clinical career with education in order to ensure the success of dental coordinator education.

A Study on the Estimation of the Number of Dental Hygienist and Their Practice (치과위생사 인력추계와 업무범위에 관한 고찰)

  • Shin, Sun-Jung;Son, Jung-Hee;Choi, Yong-Keum;Ryu, Da-Young;Ma, Deuk-Sang
    • Journal of dental hygiene science
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    • v.7 no.1
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    • pp.25-30
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    • 2007
  • The objective of this study is to suggest the utilization of educated dental hygienist as the solution to the problem of supply and demand in dental clinics that has been brought up recently. Through document research and National Health Personnel Licensing Examination Board homepage, we estimated the number of dental hygienist and the condition of employment as well as gotten a grasp of the current activities carried out by dental hygienists. Furthermore, through discussion of researchers, suggested reform bills to guarantee and extend the work of dental hygienists as well as to train dental assistant. The findings were as follows: As the result of the estimation of dental hygienist, in the year 2009, two dental hygienists structure will be formed in each dental clinic. Currently the practice ratio of non-law activities of dental hygienists is high and in order to increase the practical use of dental hygienists, there is a need to reform bills that guarantee and extend the work of dental hygienists. In order to train new labors, there is a need for cautious consideration to distinguish the activities of existing trained labors, reforming of bills, and considering from various other sectors. From present point of view, solving the problem of existing trained dental hygienists, researching for the plan of utilizing dental hygienists and carrying it into practice must be the priority.

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A Study on Actual Conditions for Prevention of Infections by Dental Hygienists (치과위생사의 감염 예방 실태 조사)

  • Nam, Young-Shin;Yoo, Jung-Sook;Park, Myung-Suk
    • Journal of dental hygiene science
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    • v.7 no.1
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    • pp.1-7
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    • 2007
  • This study aimed to provide basic information on dental hygienists' practicing the prevention of infections by figuring out their actual conditions in dental clinics. The subjects of the study were the dental hygienists who participated in the continuing medical education of Incheon & Gyeonggi-do association and Seoul city association in October and November 2005 and the self-administered surveys were used for the prevention of infections. The results were as below. 1. In terms of education experiences of infection prevention, those who answered "there were" were 72 persons (42.9%) and those who followed the educational route for infection prevention were "through the in-house education from the hospital" and they were 42 persons (58%), which were highest. 2. In terms of the injury experiences, those who answered "there were" were 147 persons (87.5%) and the number of annual injury out of 147 persons with injury experiences was 7.7 time. For the tools that were damaged, 125 persons (75%) damaged the "explorer," which was highest. 3. For the experiences of being infected with contagious diseases, those who answered "there were" were 6 persons (3.6%) and there were four persons for "hepatitis B", one person for "rubella" and one person for "TB." 4. The questions with high practice scores were as in the following: "2. I wash my hands after conducting medical examinations (1.86 points)," "7. I always close the lid of a shot of Novocain after doing local anesthesia (1.86 points)" and "20. I separate and collect the wastes and give them to those who treat accumulated materials (1.85 points)". Meanwhile, the questions with low practice scores were as below: "16. I change my medical gowns (doctor wears) once a day (0.24 point)" and "I wash my medical gowns every time after examining patients with contagious diseases (0.52 points)." 5. The question with high knowledge was as below: "1. The contagion during the dental treatment is determined by source of infection, infection methods, infection routes and the host that is prone to infection (0.95 point)" and the question with the lowest knowledge was "5. HBV(hepatitis B) is destroyed after adding 95oC of heat for more than 5 minutes (0.27 points)." 6. The question with the highest organization-related factors was "I am always ready to use a mask, gloves, etc. if necessary" (0.89 points)" and the question with the lowest score was "There is a guideline that I can refer when I am exposed to dangerous situations related to the contagion in my workplace (0.33 point)." 7. In terms of the equipment conditions of protectors in medical environments, 168 persons for (disposable) mask (100%), 167 persons for disposable gloves (Latex) (99.4%), which meant that most of them were equipped with them. On the contrary, 108 persons (64.3%) are equipped with the protectors for frontal faces, which is the lowest and 165 persons (98.2%) said that they had autoclave in their disinfecting and sterilizing devices.

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Efficiency Study of 2D Diode Array Detector for IMRT Quality Assurance (2D 어레이 다이오드 검출기를 통한 IMRT 계산선량의 정확성 평가 및 효용성 연구)

  • Kim, Tae-Ho;Oh, Seung-Jong;Kim, Min-Joo;Jung, Won-Gyun;Chung, Jin-Beom;Kim, Jae-Sung;Kim, Si-Yong;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.22 no.2
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    • pp.61-66
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    • 2011
  • In this study, we evaluated the effect of grid size on dose calculation accuracy using 2 head & neck and 2 prostate IMRT cases and based on this study's findings, we also evaluated the efficiency of a 2D diode array detector for IMRT quality assurance. Dose distributions of four IMRT plan data were calculated at four calculation grid sizes (1.25, 2.5, 5, and 10 mm) and the calculated dose distributions were compared with measured dose distributions using 2D diode array detector. Although there was no obvious difference in pass rate of gamma analysis with 3 mm/3% acceptance criteria for the others except 10 mm grid size, we found that the pass rates of 2.5, 5 and 10 mm grid size were decreased 5%, 20% and 31.53% respectively according to the application of the fine acceptance criteria, 3 mm/3%, 2 mm/2% and 1 mm/1%. The calculation time were about 11.5 min, 4.77 min, 2.95 min, and 11.5 min at 1.25, 2.5, 5, and 10 mm, respectively and as the grid size increased to double, the calculation time decreased about one-half. The grid size effect was observed more clearly in the high gradient area than the low gradient area. In conclusion, 2.5 mm grid size is considered acceptable for most IMRT plans but at least in the high gradient area, 1.25 mm grid size is required to accurately predict the dose distribution. These results are exactly same as the precious studies' results and theory. So we confirmed that 2D array diode detector was suitable for the IMRT QA.

Intensity Modulated Radiation Therapy Commissioning and Quality Assurance: Implementation of AAPM TG119 (세기조절방사선치료(IMRT)의 Commissioning 및 정도관리: AAPM TG119 적용)

  • Ahn, Woo-Sang;Cho, Byung-Chul
    • Progress in Medical Physics
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    • v.22 no.2
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    • pp.99-105
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    • 2011
  • The purpose of this study is to evaluate the accuracy of IMRT in our clinic from based on TG119 procedure and establish action level. Five IMRT test cases were described in TG119: multi-target, head&neck, prostate, and two C-shapes (easy&hard). There were used and delivered to water-equivalent solid phantom for IMRT. Absolute dose for points in target and OAR was measured by using an ion chamber (CC13, IBA). EBT2 film was utilized to compare the measured two-dimensional dose distribution with the calculated one by treatment planning system. All collected data were analyzed using the TG119 specifications to determine the confidence limit. The mean of relative error (%) between measured and calculated value was $1.2{\pm}1.1%$ and $1.2{\pm}0.7%$ for target and OAR, respectively. The resulting confidence limits were 3.4% and 2.6%. In EBT2 film dosimetry, the average percentage of points passing the gamma criteria (3%/3 mm) was $97.7{\pm}0.8%$. Confidence limit values determined by EBT2 film analysis was 3.9%. This study has focused on IMRT commissioning and quality assurance based on TG119 guideline. It is concluded that action level were ${\pm}4%$ and ${\pm}3%$ for target and OAR and 97% for film measurement, respectively. It is expected that TG119-based procedure can be used as reference to evaluate the accuracy of IMRT for each institution.