• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.6
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• pp.369-378
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• 2019

Background: Behavior guidance is a technique used to subdue inappropriate behavior by establishing communication that meets the needs of a child. This study aimed to measure the effectiveness of a mobile app (Little Lovely Dentist) compared to the tell-show-do (TSD) technique in managing anxious children during their first dental visit. Methods: Fifty children (30 boys and 20 girls) without any past dental experience, aged from 7 to 11 years, were randomly allocated into either the dental app group or the TSD group. The pre- and post-operative anxiety of children who underwent prophylactic cleaning was assessed both physiologically and subjectively using a heart rate measurement and the RMS pictorial scale, respectively. Results: The intragroup comparison of heart rate and RMS scores for children allocated to the dental app group was statistically significant (P value ≤ 0.001). However, a significant reduction only occurred in the RMS scores, but not the heart rate measurements, in the TSD group. Conversely, there was an increase in heart rates in the TSD group. Conclusion: Educating the child prior to a dental procedure using a smartphone application such as Little Lovely Dentist can significantly alleviate the anticipatory anxiety and engage children in dental treatment during their first visit.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.430-440
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• 2001

Orally administered chloral hydrate is often used, because of it's wide margin of safety and relatively few sideeffects. Hydroxyzine is an antihistamine with sedative and anti-emetic properties. It has been used in conjunction with chloral hydrate to reduce the incidence of nausea and vomiting. But, it's therapeutic drug concentration has not been established. The purpose of this study was to assess the sedative effect and physiologic parameter of hydroxyzine of different doses in sedating young pediatric dental patients. Fifty uncooperative children, mean age 33.2 months, who needed at least four separate restorative visits, requiring local anesthesia participated in this study. On every visit, one of the following 4 different sedative regimen was given (1) 70mg/kg CH (2) 70mg/kg CH and 1mg/kg HD (3) 70mg/kg CH and 2mg/kg HD (4) 70mg/kg CH and 3mg/kg HD. Physiologic parameter was recorded and behavior was videotaped and rated using Ohio State University Behavior Rating Scale by one investigator, blind to the dose. The analyzed sedative effect of combined oral administration of 70mg/kg chloral hydrate and 2mg/kg hydroxyzine was superior to the other regimens. Evidence of adverse effect was not detected or reported during and/or after the procedures.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.2
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• pp.210-216
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• 2002

Air abrasion technology can prepare enamel and dentin for bonding, similar to etching by acidic gels and solutions. Longer treatment can excavate pit and fissures, preparing the tooth for immediate placement of bonded resin materials. Although not appropriate for every clinical situation, the air abrasive technology minimizes heat, vibration and bone-conducted noise associated with conventional means of caries removal since the cutting is accomplished by air pressure. Also, patients treated with the air-abrasion technology rarely request anesthesia. Air abrasion technology was more effective in treating early carious lesions and stains compared to lesions where caries had already progressed to produce soft dentin and the strong air stream and noise caused by the evacuation system was a major discomfort to pediatric patients, and the experience and skillfulness of clinician should be required for accurate and proper tooth preparation.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.3
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• pp.455-462
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• 2002

Currently, the ages of the patients visiting dental hospital for dental care are becoming younger and the interest in the treatment for the handicapped and incapable of cooperation children increases. As a method for treatment of these patients, the sedation treatment is considered. A dental sedation using chloral hydrate and hydroxyzine of them were used widely and for a long time. In this study, the samples were consisted of incapable of cooperation or very young children required treatment of restoration under local anesthesia. Then, the vital signs were accessed in pediatric dental sedation using the combination of chloral hydrate and hydroxyzine. As a result of this study, the vital signs were little different in pediatric dental sedation using the combination of chloral hydrate and hydroxyzine. Simply, the respiration rate and pulse rate decreased according to sleeping of patients. Therefore, the sedation using the combination of chloral hydrate and hydroxyzine induced to appropriate sedation in incapable of cooperation or very young children with little effects of vital signs.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.2
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• pp.228-233
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• 2022

Arteriovenous malformations (AVMs) are rare congenital anomalies characterized by direct communication between arteries and veins that bypass the capillary bed. AVMs may not manifest clinically until late infancy or childhood. In particular, facial AVMs can cause urgent life-threatening dental events. A 5-year-old girl without a medical history visited the hospital because of spontaneous gingival bleeding around the posterior gingival area of the lower left 2nd primary molar. Angiography through the femoral approach under general anesthesia was performed for differential diagnosis and therapeutic option. The blood flow was effectively reduced after arterial embolization alone, and there was no evidence of recurrence at the 5-month follow-up. The present study reports that embolization of the affected vessels can be a more effective and safe method than surgical resection for the treatment of AVM during the growth period.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.93-97
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• 2012

Background: Some disabled patients show insufficient cooperation during dental treatment, and general anesthesia in an outpatient setting can be successfully administered. To minimize post-anesthetic complications is an essential issue, and strict discharge protocols are required for the safety of the patients. Post-anesthetic follow-ups using telephone calls can be applied to improve the quality of the outpatient care system. The authors evaluated the post-operative condition of patients after dental treatment under general anesthesia. Methods: Total 143 patients and their caregivers included in this study. The patients received general anesthesia for dental treatment in Seoul National University Dental Hospital, Clinic for Persons with Disabilities from July, 2011 to April, 2012. Telephone calls were given to the patients or their caregivers to collect information about the patients' systemic condition and anesthesia-related complications. Results: Among 131 patients with responses of telephone calls, 87 patients (66.4%) reported no discomfort, while 44 patients (33.6%) presented post-anesthetic complications. A total of 20 patients reported mild fever, 10 patients had vomiting, and 7 patients had sore throat. Other complications included nausea, fatigue, nasal bleeding, skin sore, and body rash. Among the patients with the history of epilepsy, 63.6% showed post-anesthetic discomfort or complication (P = 0.027, ${\chi}^2$ test). Conclusions: One third of dental patients who received general anesthesia due to insufficientcooperation complained discomfort after discharged from outpatient anesthetic care.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.732-736
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• 2006

Purpose : Numerous methods exist for diagnosing nonpalpable testis in treatment of cryptochidism. However, there is no clinically established data for the rational diagnostic tool of nonpalpable testis in terms of expenses. We tried to establish a current conventional diagnostic course of nonpalpable testis. We then evaluated the efficacy of ultrasonography, physical examination under general anesthesia and laparoscopy for diagnosing nonpalpable testis. Methods : Between March 2000 and February 2005, 103 boys(129 testes) with undescended testes were treated in our department. There were 31 testes(24.0%) that were not palpable at physical examination. These patients were evaluated with ultrasonography and repeated physical examination under general anesthesia. In the cases where testes could not be detected with ultrasonography and physical examination under general anesthesia, laparoscopy was performed to diagnose nonpalpable testis. Results : In 31 cases of nonpalpable testis, 13 testes were detected with ultrasonography and 15 testes became palpable with physical examination under general anesthesia. All of the remaining 16 nonpalpable testes were confirmed with laparoscopy. Conclusion : Physical examination under general anesthesia was superior to ultrasonography in making a diagnosis of nonpalpable testis. Ultrasonography and physical examination under general anesthesia could reduce the incidence of diagnostic laparoscopy. Therefore, it is recommended that ultrasonography, physical examination under general anesthesia and laparoscopy must be performed conventionally in order to diagnose nonpalpable testis.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.2
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• pp.215-224
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• 2018

The practice pattern of pediatric dentistry has been changing for the last several decades. This change might be influenced by several factors such as development in dental materials and socioeconomic changes. The purpose of this study was to analyze the changing trends of patient distribution and treatment pattern of pediatric dentistry. Patient distribution and practice trends from 2006 to 2015 at the department of pediatric dentistry of Seoul National University Dental Hospital were reviewed. From 2006 to 2015, the proportion of new patient increased from 12.49% to 20.56%. The average age of new patients decreased. In 2006, restorative treatment had highest percentage, followed by preventive treatment, orthodontic treatment, surgical treatment, and pulp treatment. In 2015, preventive treatment had highest percentage, followed by restorative treatment, orthodontic treatment, surgical treatment and pulp treatment Frequency of general anesthesia increased more than 5 times for last 10 years. The proportion of insurance treatment decreased until 2009, and after 2010 it increased steadily.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.2
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• pp.157-161
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• 2017

In sedation via the submucosal route, the drug is administered through the maxillary buccal submucosa. It is time saving, effective, and safe. Patients with autism, a mental disorder, often find it hard to make relationships with other people. These patients display a strong resistance to dental treatment and sedation. This study reports a successful case of behavioral management during dental treatment, using sedation via the submucosal route. The patient was strongly resistant to sedation via the oral, intramuscular, and intravenous routes. The drug used was 9 mg (0.1 mg/kg) of midazolam. Through this case report, we reaffirm the significance of sedation via the submucosal route, and expect that it will be used more frequently for patients with autism, who display behaviors that are difficult to manage, patients with other disabilities, and children.

• The Korean Journal of Oral and Maxillofacial Pathology
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• v.42 no.6
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• pp.183-187
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• 2018

The supernumerary tooth which is extra tooth in comparison to normal dentition is one of the developmental problems. The most common type of supernumerary tooth is mesiodens which may cause several complications like delayed eruption, crowding, spacing et al. Moral Incisor Hypomineralization (MIH) describes the clinical appearance of enamel hypomineralization of systemic origin affecting one or more permanent first molars that associated frequently with affected incisors. We report a case of a 6 - year - old boy who visited our clinic for removal of mesiodentes. The patient was diagnosed by mesiodentes and MIH by clinical examination and radiographic examination. Under local anesthesia, Mesiodentes were removed surgically. The demarcated opacities, a feature of MIH, were observed in the removed mesiodentes. After removal of mesiodentes, the maxillary central incisors erupted normally and in order to manage the teeth affected MIH, follow-up and fluoride varnish application were done every 3 months.