• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.50-54
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• 2019

Muscular dystrophy (MD) is a heterogeneous group of inherited neuromuscular disorders, characterized by progressive muscle weakness. Severity of the disease ranges from mild to severe, and the disease is mostly caused by mutations in a number of genes. These genetic mutations cause lack of proteins which are essential for muscle cell stability. Muscle fibers are gradually replaced by fat and fibrous tissue. The muscles of the head and neck are affected in several types of MD that manifest as altered craniofacial morphology and dental malocclusion. A 3-year-10-month old, 15.0 kg boy with MD presented to Seoul National University Dental Hospital, Seoul, South Korea because of extensive carious teeth. A number of dental caries in primary dentition were identified during clinical oral examination. Due to dental anxiety and underlying systemic disease, general anesthesia was considered. General anesthesia was induced and maintained with intravenous anesthetics, propofol and remifentanil. Caries treatments - resin restoration, pulpectomy, zirconia crown restoration, stainless steel crown restoration - were performed. Under general anesthesia, successful dental procedure was done. Total intravenous anesthesia (TIVA) was performed instead of inhalation anesthesia in order to avoid risk of complications such as malignant hyperthermia and life-threatening rhabdomyolysis. With decreasing muscle function, plaque control becomes more difficult and leads to gingivitis. Especially, the open-mouth posture worsens gingivitis and can leads to malocclusions and problems in swallowing. Regular and periodic dental care is essential for maintaining oral health for patients with MD.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.1
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• pp.154-158
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• 2001

We tried to find out the information which can be drawn from the survey of general anesthesia in pediatric clinic at Seoul National University dental hospital from 1997 to 1999. The subjects were 37 patients Collected data were primary reasons for general anesthesia, preoperative physical status, age distribution, peformed dental treatment, complications, follow-up, and etc. Following were the results: (1) Most(97%) of patients treated under general anesthesia were handicapped and preoperative physical status was ASA Class I or Class II. (2) Majority(41%) of patients were between 11 and 15. (3) Average of 8.1teeth were restored and 3.3teeth were extracted. (4) In 32% of patients, there were mild complications. (5) 12(32%) of the patients responded to the six-month recall check.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.1
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• pp.28-32
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• 2017

Lennox-Gastaut syndrome (LGS) is a type of childhood epilepsy, and this syndrome can compromise dental treatment. LGS represents variable etiologies, multiple types of intractable seizures, and cognitive impairment in most patients. A 7-year-4-month old girl with LGS was referred to our hospital for dental treatment under general anesthesia. Clinically, the patient presented with multiple dental caries. The patient had been prescribed a ketogenic diet for the management of repetitive seizures. In addition, she experienced severe types of hypoxia during medical examination using chloral hydrate. Therefore, dental treatment was performed under general anesthesia. LGS patients have a high risk of seizure during dental treatment and can induce a lot of complications. Dental treatment under general anesthesia for LGS patients can be carried out careful preoperative evaluation and in cooperation with medical care.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.2
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• pp.237-242
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• 2002

Lowe syndrome, also known as oculocerebrorenal syndrome, is a rare genetic disorder involving eyes, kidney and nervous system, and occurs predominantly in mostly males. The patients with Lowe syndrome are characterized with prominent forehead, thin and sparse hair, protruding ears, congenital cataracts, glaucoma, mental retardation, stunted growth, hypotonia, decrease in muscle mass and tendon reflexes, renal tubular dysfunction, and metabolic bone disease. A 6-year-old boy with Lowe syndrome was admitted to our clinic, with multiple caries and a chief complaint of intermittent pain on the left mandibular molar area. Because of difficulty in management of behavior and his medical problem, general anesthesia was performed for dental care. No specific complication was noticed during dental treatment procedure under general anesthesia and also during periodic recall-checks. General anesthesia itself, however, could be a potentially life-threatening procedure due to patient's biomedical problems. When a dental procedure under general anesthesia is to be required in patient with Lowe syndrome, it may be advisable being teamed with physicians, and general anesthesia duration should be as short as possible.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.1-6
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• 2019

There are increasing number of patients having dental treatment under outpatient general anesthesia. There were researches that studied patients treated under outpatient general anesthesia in Chonbuk National University Dental hospital between 2005~2013. However, there has been an absence of research since 2013. Therefore, the aim of this research is to study cases regarding outpatient general anesthesia visiting Chonbuk National University hospital between 2014~2017 and analyze the trends of these patients. The medical records of 409 cases from January, 2014 to December, 2017 were reviewed. From the patients' charts, data on sex, residence, visiting dates, disability status, and types and number of treatments was collected and investigated. The number of cases has increased from 86 in 2014 to 140 in 2017. Among 409 cases, 275 cases(67.2%) had disabilities, with mental disabilities consisting most of the disabilities. 192 cases were aged under 20 years old mostly with no disabilities, 142 cases were 20~39 years old mostly with mental disabilities, and 75 cases were 40 years old or more mostly with physical disabilities. The conservative treatment was performed most frequently in both disabled and non-disabled patient groups. There was an increasing trend in the number of patients treated under outpatient general anesthesia, and more than half were disabled patients. In order to meet this demand, Chonbuk National University Dental Hospital increased the number of general anesthesia pracrice. To follow this trends, the implementation of safe outpatient general anesthesia system and cooperation among teams is needed to improve the quality of treatments.

• Journal of the korean academy of Pediatric Dentistry
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• v.21 no.2
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• pp.525-532
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• 1994

The purpose of this report was to evaluate the effect of Dental Electronic Anesthesia on pain inhibition for clinical use. The subject for this study were 30 children whose Frankl behavioral rate is positive. The subjects was divided into two groups, the first group described by control group and the second group described by experimental group anesthetized with Dental Electronic Anesthetic device. And then three kind of treatments were done : extraction of deciduous teeth, application of rubber dam, cavity preparation for preventive resin restoration. 3M Dental Electronic Anesthesia System was used for this study : its electric impulse stimulate the skin surface by external electrode pads. The results were as follows. 1. Degree of the pain & the apprehension decreased in experimental group. 2. Degree of the pain & the apprehension showed statistical differences among three treatments procedures in the control group but, not showed statistical differences in the experimental group.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.4
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• pp.209-214
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• 2013

Multiple caries in a pediatric patient often requires dental treatment under general anesthesia, especially when the patient is suffering from a systemic disease. The patient was a 6-year-old boy with Marfan syndrome and needed extensive dental treatment. Marfan syndrome is an inherited disorder resulting from mutations in Fibrillin-1 gene. Patients are known to have mainly cardiovascular, ocular, and musculoskeletal problems. Although clinical symptoms of the syndrome are age-realted, thus hindering early diagnosis of the disease in young children, our patient had been confirmed by a gene study at a younger age. Medical history of the patient revealed moderate to severe mitral regurgitation and aortic root dilatation, which required mitral valve replacement surgery with a mechanical valve. As a result, the patient was taking warfarin post-operatively and changes in medication had to be made before the dental treatment. Also, prophyalctic antibiotics had to be given before the treatment for prevention of (to prevent the) infective endocarditis. With careful control of the medications and bleeding tendency, general anesthesia and the treatment were done successfully without any complications.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.8 no.2
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• pp.109-112
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• 2012

Epidermolysis bullosa (EB) is an inherited skin disease characterized by blister formation of the skin following just minor trauma or spontaneously. The main classification of EB is based on the localization of the blistering. In epidermolysis bullosa simplex, the blister formation is intraepidermal; in epidermolysis bullosa junctionalis the blister formation in the epidermal-dermal junction; in the dystrophic forms of EB blister formation is intradermal. Oral manifestations of recessive dystrophic EB are characterized by rampant caries, crowding, microstomia, ankyloglossia, vestibular obliteration. Dental therapy may be well provided to patient with recessive dystrophic EB by using general anesthesia especially in case of poor cooperation. A two years old girl with recessive dystrophic EB visited our clinic for rampant caries. She was hospitalized for severe anemia and fever, and we provided dental therapy under general anesthesia. Extraction of incisors and stainless steel crown restoration of primary molars were performed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.4
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• pp.181-192
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• 2023

Purpose: The development of assistive devices has allowed for the performance of capsule endoscopy in children. Anticipating the capsule's transit time could affect the efficacy of the investigation and potentially minimize the fasting period. This study determined the predictors of small bowel transit time for small-bowel capsule endoscopy in children and adolescents with inflammatory bowel disease. Methods: We retrospectively examined children and adolescents with inflammatory bowel disease who underwent capsule endoscopy by the age 18 at a Japanese tertiary care children's hospital. Small bowel transit time predictors were analyzed using multiple regression with explanatory variables. Results: Overall, 92 patients, aged 1-17 years, with inflammatory bowel disease (63 Crohn's disease and 29 ulcerative colitis cases) were examined for factors affecting small bowel transit time. In the simple regression analysis, diagnosis, age, height, weight, serum albumin, general anesthesia, and small intestine lesions were significantly associated with small bowel transit time. In the multiple regression analyses, serum albumin (partial regression coefficient: -58.9, p=0.008), general anesthesia (partial regression coefficient: 127, p<0.001), and small intestine lesions (partial regression coefficient: 30.1, p=0.037) showed significant associations with small bowel transit time. Conclusion: Hypoalbuminemia, the use of general anesthesia for endoscopic delivery of the capsule, and small intestine lesions appeared to be predictors of prolonged small bowel transit time in children and adolescents with inflammatory bowel disease. Expecting the finishing time may improve examination with a fasting period reduction, which benefits both patients and caregivers.

• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.1
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• pp.51-54
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• 2011

Wolff-Hirschorn syndrome is a condition that is caused by a deletion of genetic material near the end of the short (p) arm of chromosome 4. The major features of this disorder include a characteristic facial appearance, delayed growth and development, intellectual disability, and seizures. A 9-year-old girl was brought to the clinic with a chief complaint of dental examination. The child was diagnosed as WHS at Samsung medical center. The child was under Sodium valproate, Atrovastatin medication for epilepsy, hyperlipidemia and had a history of heart surgery. So prophylactic antibiotics were recommended. The child was mentally retarded and had seizure so it was difficult to manage her behavior effectively. Thus dental treatment was carried out under general anesthesia. For prompt sedation induction we used 8% sevoflurane shortly. This report presents the case of a 9-year-old girl with WHS, who has received treatment for extensive caries under general anesthesia.