• Journal of Dental Anesthesia and Pain Medicine
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• 제23권4호
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• pp.221-228
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• 2023

Background: We assessed the relationship between patient age and remifentanil dosing rate in patients managed under general anesthesia with spontaneous breathing using low-dose remifentanil in sevoflurane. Methods: The participants were patients with an American Society of Anesthesiologists Physical Status of 1 or 2 maintained under general anesthesia with low-dose remifentanil in 1.5-2.0% sevoflurane. The infusion rate of remifentanil was adjusted so that the spontaneous respiratory rate was half the rate prior to the induction of anesthesia, and γ^H (㎍/kg/min) was defined as the infusion rate of remifentanil under stable conditions where the respiratory rate was half the rate prior to the induction of anesthesia for ≥ 15 minutes. The relationship between γ^H and patient age was analyzed statistically by Spearman's correlation analysis. Results: During dental treatment under general anesthesia using low-dose remifentanil in sevoflurane, a significant correlation was detected between γ^H and patient age. The regression line of y = - 0.00079 x + 0.066 (y-axis; γ^H, x-axis; patient's age) was provided. The values of γ^H provide 0.064 ㎍/kg/min at 2 years and 0.0186 ㎍/kg/min at 60 years. Therefore, as age increases, the dosing rate exhibits a declining trend. Furthermore, in the dosing rate of remifentanil when the patient's respiratory rate was reduced by half from the preanesthetic respiratory rate, the dosing rate provided was around 0.88 mL/h in all ages if the remifentanil was diluted as 0.1 mg/mL. EtCO₂ showed 51.0 ± 5.7 mmHg, and SpO₂ was controlled within the normal range by this method. In addition, all dental treatments were performed without major problems, such as awakening and body movement during general anesthesia, and the post-anesthetic recovery process was stable. Conclusion: General anesthesia with spontaneous breathing provides various advantages, and the present method is appropriate for minimally invasive procedures.

• Restorative Dentistry and Endodontics
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• 제49권2호
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• pp.13.1-13.7
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• 2024

Chronic osteomyelitis with proliferative periostitis, known as Garre's osteomyelitis, is a type of osteomyelitis characterized by a distinctive gross thickening of the periosteum of bones. Peripheral reactive bone formation can be caused by mild irritation or infection. Garre's osteomyelitis is usually diagnosed in children and young adults, and the mandible is more affected than the maxilla. The following is a case report of a 12-year-old female patient with Garre's osteomyelitis of the mandible due to an infection of a root canal-treated tooth. Without surgical intervention, the patient's symptoms were relieved through nonsurgical root canal re-treatment with long-term calcium hydroxide placement. A cone-beam computed tomography image obtained 6 months after treatment completion displayed complete healing of the periapical lesion and resolution of the peripheral reactive buccal bone. Due to the clinical features of Garre's osteomyelitis, which is characterized by thickening of the periosteum, it can be mistaken for other diseases such as fibrous dysplasia. It is important to correctly diagnose Garre's osteomyelitis based on its distinctive clinical features to avoid unnecessary surgical intervention, and it can lead to minimally invasive treatment options.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권6호
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• pp.438-444
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• 2021

Objectives: Loss of the interdental papilla is multi-factorial and creates a multitude of problems. Autogenous connective tissue/biomaterial-based regeneration has been attempted for decades to reconstitute the black space created due to the loss of papilla. The aim of this present study was to regenerate papillary recession defects using an amnion-chorion membrane (ACM) allograft and to evaluate the clinical outcome up to six months postoperatively. Materials and Methods: Twenty patients with 25 Nordland and Tarnow's Class I/II interdental papillary recession defects were treated with ACM and coronal advancement of the gingivo-papillary unit via a semilunar incision on the labial aspect followed by a sulcular incision in the area of interest. A photographic image analysis was carried out using the GNU Image Manipulation software program from the baseline to three and six months postoperatively. The black triangle height (BTH) and the black triangle width (BTW) were calculated using the pixel size and were then converted into millimeters. The mean and standard deviation values were determined at baseline and then again at three and six months postoperatively. The probability values (P<0.05 and P≤0.01) were considered statistically significant and highly significant, respectively. An analysis of variance and post hoc Bonferroni test were carried out to compare the mean values. Results: Our evaluation of the BTH and BTW showed a statistically and highly significant difference from the baseline until both three and six months postoperatively (P=0.01). A post hoc Bonferroni test disclosed a statistically significant variance from the baseline until three and six months postoperatively (P<0.05) and a non-significant difference from three to six months after the procedure (P≥0.05). Conclusion: An ACM allograft in conjunction with a coronally advanced flap could be a suitable minimally invasive alternative for papillary regeneration.

• 대한치과의사협회지
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• 제56권11호
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• pp.631-640
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• 2018

Nowadays computer-guided "flapless" surgery for implant placement using templates is gaining popularity among clinicians and patients. The advantages of this surgical protocol are its minimally invasive nature, accuracy of implant placement, predictability, less post-surgical discomfort and reduced time required for definitive rehabilitation. Aim of this study is to describe the digital implant protocol, thanks to which is now possible to do a mini-invasive static guided implant surgery. This is possible thanks to a procedure named surface mapping based on the matching between numerous points on the surface of patient's dental casts and the corresponding anatomical surface points in the CBCT data. With some critical points and needing an adequate learning curve, this protocol allows to select the ideal implant position in depth, inclination and mesio-distal distance between natural teeth and or other implants enabling a very safe and predictable rehabilitation compared with conventional surgery. It represents a good tool for the best compromise between anatomy, function and aesthetic, able to guarantee better results in all clinical situations.

• Restorative Dentistry and Endodontics
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• 제44권3호
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• pp.29.1-29.7
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• 2019

Endodontic microsurgery is defined as the treatment performed on the root apices of an infected tooth, which was unresolved with conventional root canal therapy. Recently, the advanced technology in 3-dimensional model reconstruction based on computed tomography such as cone beam computed tomography has opened a new avenue in application of personalized, accurate diagnosis and has been increasingly used in the field of dentistry. Nevertheless, direct intra-oral localization of root apex based on the 3-dimensional information is extremely difficult and significant amount of bone removal is inevitable when freehand surgical procedure was employed. Moreover, gingival flap and alveolar bone fenestration are usually required, which leads to prolonged time of surgery, thereby increasing the chance of trauma as well as the risk of infection. The purpose of this case report is to present endodontic microsurgery using the guide template that can accurately target the position of apex for the treatment of an anterior tooth with calcified canal which was untreatable with conventional root canal therapy and unable to track the position of the apex due to the absence of fistula.

• 대한치과보철학회지
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• 제60권3호
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• pp.283-292
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• 2022

임플란트를 이용한 고정성 보철 치료를 위해서는 보철 치료에 적합한 위치에 임플란트가 식립되어야 하며 이를 위해 guided implant surgery와 CAD-CAM을 활용한 보철물 제작이 최근 널리 사용되고 있다. 수술 시에는 surgical guide를 이용해 flapless 방식으로 최소침습 보철수복이 가능 하다. 본 증례의 환자는 86세 남성 환자로 기존 의치 사용 시 불편함으로 치료를 원하였다. 환자는 전신질환으로 인해 가철성 국소의치 사용이 어려워 상악은 총의치, 하악의 경우 임플란트 고정성 보철물 수복하였다. 전신질환으로 인해 높은 출혈 위험성을 가지므로 surgical guide를 사용해 flapless 방식으로 임플란트를 식립하였다. 최종적으로 상악 총의치 및 하악 나사 유지형 지르코니아를 보철물을 제작하였으며, 만족스러운 기능 및 심미 회복을 보였기에 보고하는 바이다.

• Restorative Dentistry and Endodontics
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• 제46권2호
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• pp.18.1-18.13
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• 2021

Composite resins are the most commonly used dental restorative materials after minimally invasive dental procedures, and they offer an aesthetically pleasing appearance. An ideal composite restorative material should have wear properties similar to those of tooth tissues. Wear refers to the damaging, gradual loss or deformation of a material at solid surfaces. Depending on the mechanism of action, wear can be categorized as abrasive, adhesive, fatigue, or corrosive. Currently used composite resins cover a wide range of materials with diverse properties, offering dental clinicians multiple choices for anterior and posterior teeth. In order to improve the mechanical properties and the resistance to wear of composite materials, many types of monomers, silane coupling agents, and reinforcing fillers have been developed. Since resistance to wear is an important factor in determining the clinical success of composite resins, the purpose of this literature review was to define what constitutes wear. The discussion focuses on factors that contribute to the extent of wear as well as to the prevention of wear. Finally, the behavior of various types of existing composite materials such as nanohybrid, flowable, and computer-assisted design/computer-assisted manufacturing materials, was investigated, along with the factors that may cause or contribute to their wear.

• 대한치과의사협회지
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• 제56권10호
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• pp.572-580
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• 2018

Adequate access cavity is the key to achieving endodontic success. The aims of the access cavity can be considered as follows: 1) Creation of a smooth unimpeded pathway for instruments to canal orifices 2) Removal of the entire roof of the pulp chamber in order to inspect the pulp floor, 3) Preservation of natural tooth substance consistent with the above. Recently, contracted endodontic cavities based on minimally invasive endodontics has introduced. This has the benefit of preserving the pericervical dentin more than traditional access cavity with achieving long-term success. However, some studies reported controversial results regarding root canal detection, instrumentation efficacy (noninstrumented canal area, hard tissue debris accumulation, canal transportation, and centering ratio) as well as fracture resistance. Therefore, further studies are required for accepting contracted access cavity, and modified form of traditional and contracted access cavity could be considered.

• 대한치과의사협회지
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• 제46권7호
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• pp.440-445
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• 2008

Dentinogenesis imperfecta is one of the most common autosomal dominant traits experienced in humans. It generally affects both the deciduous and permanent dentitions. There are 3 forms of dentinogenesis imperfecta that have been classified into type I(osteogenesis imperfecta associated), type II(hereditary opalescent dentin), and type III(Brandywine isolate opalescent dentin).1,2 The prevalence for all types of dentinogenesis imperfecta is approximately 1 per 8000 subjects. Early diagnosis and treatment are therefore, fundamental, aiming at obtaining a favourable prognosis since late intervention makes treatment more complex. This clinical report describes a treatment solution to the problems encountered by a dentinogenesis imperfecta patient with minimally invasive techniques.

• Journal of Korean Dental Science
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• 제14권1호
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• pp.46-50
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• 2021

This study describes a patient with insufficient vestibular depth who was operated with a vestibuloplasty using a non-eugenol-based non-zinc oxide oral dressing material. Partial thickness flap was elevated on recipient. After stabilization of apical positioned flap, the dressing material was applied on the recipient site with additional fixation by suture. The patient presented minimal discomfort such as in pain, food impaction and management of oral hygiene. Adequate vestibular depth without relapse was observed until 4 weeks after surgery. The vestibuloplasty with the oral dressing material may be an option for obtaining proper vestibular depth without complications.