• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.4
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• pp.710-716
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• 1998

It is one of difficulties to control children who show definitely negative behavior in dental clinic. In such a case, the pharmacologic management has been used to provide quality care, minimize the extremes of disruptive behavior, promote a positive psychologic response to treatment and patient welfare and safety. Deep sedation can be defined as a controlled, pharmacologically-induced state of depressed consciousness from which the patient is not easily aroused which may be accompanied by a partial loss of protective reflexes. In this retrospective report, the sedation records of 200 pediatric dental patients of ASA Class I & II who were not successfully treated under conscious sedation were used for analysis. Most frequently used regimen of deep sedation was the co-medication of midazolam(0.3mg/kg), enflurane(1.0-2.0 vol%) and 50-70% $N_2O_2$. The average age and weight of the patients was 4.6 yr (S.D: 2.72) and 18.7kg(S.D: 6.35) respectively. The average operative time was 52 minutes and midazolam (0.1-0.2cc) was additionally administered intranasally to prolong the operative time as needed. The episodes of untoward side effects were reported during and/or after the procedure in 58 patients. Serious adverse reactions such as cyanosis or laryngospasm were even reported in 7 patients but without mortality. Deep sedation is a very effective way of completing the dental treatments for those who failed to respond well to the conscious sedation. This technique has many practical advantages over general anesthesia case but the demands for the rigid monitoring criteria limit its use in general practice setting. The continuous efforts to improve the safety of the medication and the technique are required for the benefits of the patients and parent.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.4
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• pp.763-770
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• 1997

The air abrasive technique is a non-mechanical method by which teeth are treated before restoration and stains and calculi are removed from tooth surfaces using the kinetic energy of small particles. The air abrasive technique in dentistry was first introduced in the 1950's with as instrument called 'Airdent'. But, as the main restorative materials of the period were amalgam and gold, and the instrument's inability to control the flow of particles caused the particles to be spread throughout the clinics, widespread use was not possible. In the 1990's, as these techincal problems were solved and more interest in new restorative materials rose in an effort to preserve sound tooth structure, new developements took place in instruments related to the air abrasive technique. The air abrasive technique produces less pressure, vibration and heat that might cause patient discomfort and facilitates the preservation of sound tooth structure. It also reduces the need for anesthesia and is less harmful to the pulp. Other advantages include increase in dentin bonding strength of composite resin, lower possibility of saliva contamination and maintenance of a dry field. But there is not direct contact between the nozzle and the tooth, the operator cannot use his or her tactile sense and must rely solely upon visual input. Other disadvantages are: the tooth preparation depends on the operator's ability; alpha-alumina particles, after bouncing off the tooth surface, cause damage to dental mirrors; the equipment is expensive and takes up a certain amount of space in the clinic. The author conducted case report using the air abrasive technique on patient visiting the Department of Pediatric Dentistry at Seoul National University Dental Hospital and arrived at the following conclusions. 1. The tooth preparation capability of different air abrasive devices varied widely among manufacturers. 2. It was more effective in treating early caries lesions and stains compared to lesions where caries had already progressed to produce soft dentin. 3. The cold stream and noise caused by the evacuation system was a major cause of discomfort to pediatric patients. 4. As there is no direct contact with tooth surface when using the air abrasive technique for tooth preparation, considerable experience and skill is required for proper tooth preparation.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.1
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• pp.65-72
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• 2010

General anesthesia has been researched and developed in dentistry as on type of management technique to sedate patients who may be uncontrollable or require medical consideration. There has been continuous research into this area, but analysis of large set of patients over a sustained period of time is lacking. Thus, this study analyzes the records of patients who received general anesthesia at the Yonsei University Dental Hospital Department of Pediatric and Clinic for the Disabled. 1. Patient's age ranged from 1 to 66, with under 5 being the largest group with 410 members(38.5%). The study included more men than women, with 695 male members(65.3%). 2. Type of dental procedure performed were as follows(per person) : 5.6 Dental restoration; 2.3 Endodontic treatment of deciduous and primary teeth; 2.5 preformed crowning; and 1.6 extractions. Procedures took an average of 100 minutes. 3. 1022 patients(95.9%) received dental care under general anesthesia once and 43 patients(4.1%) received dental care under general anesthesia two or more times. Dentistry under general anesthesia has the many benefit. However, without appropriate post-treatment care, it is difficult to maintain good oral health. Therefore, it is important to improve the efficiency and safety of general anesthesia through future research.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.1
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• pp.92-101
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• 2003

Under this thesis, 235 patients with dental problems treated under general anesthesia at the Pediatric Dentistry Clinic of Yonsei Dental College were surveyed and their age distribution, reasons for taking general anesthesia, duration of anesthesia, duration of dental procedure, dental treatment peformed and complications were analyzed. A questionnaire survey was also conducted to analyze degrees of anxiety and satisfaction among their parents according to the parents' age, educational background and experience of general anesthesia, as well as the patients' age and past dental history. Following are the results. 1. When the patients were treated under general anesthesia, the degree of anxiety of their mothers was higher than that of their fathers. It appeared that the higher the parents' educational background was, the less their anxiety. 2. The higher the parents' educational level was, the higher the degree of satisfaction after treatment under general anesthesia. 95 cases (87.2%) responded that they would accept such treatment again, if needed. From the result, dental treatment under general anesthesia causes anxiety for parent but the parent's satisfaction level was high. And that was the way gives good quality of dental service to unmanagable patients.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.2
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• pp.243-255
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• 2017

Cardiopulmonary resuscitation (CPR) is an emergency treatment that stimulates blood circulation and breathing when the function of the heart stops or stops breathing. CPR can be divided by basic life support (BLS) and advanced life support (ALS). BLS involves the use of chest compression to force the blood flow to the main organs, rescue breathing to improve the breathing to the respiratory failure patient and the use automated external defibrillator (AED). The categories of advanced life support include advanced cardiovascular life support (ACLS) for adult and pediatric advanced life support (PALS) for children. In the treatment of dental care for children, which is extremely difficult to deal with, and for a variety of reasons, the use of sedation is considered to treat the children who are unlikely to cooperate with dentistry. This is why there is an increasing possibility of an emergency situation involving cardiac arrest. PALS includes the BLS, and it presents a systematic algorithm to treat respiratory failure, shock and cardiogenic cardiac arrest. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is necessary to be able to immediately implement professional skills in emergency situations.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.1
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• pp.99-107
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• 2017

In the management of ankylosed primary molars, early diagnosis, proper treatment, and thorough follow-ups are very important. Untreated infraocclusion due to ankylosis has a negative impact on normal occlusal development, and may cause problems. There are many treatment options on infraoccluded deciduous molars, such as periodic observation, conservative method, restoration, and space regaining via extraction of the teeth. In this case report, two 6-year-old girls were diagnosed with ankylosed maxillary second primary molar and displaced tooth germ of the second premolar. Early surgical removal of the ankylosed primary molar was considered as a treatment approach. The long-term follow-up shows normal eruption of a succeeded permanent premolar.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.3
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• pp.378-385
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• 2018

Mandibular fractures occur with high incidence among various fractures in maxillofacial region in children. Jaw fractures in children should be approached differently than in adults because bone growth continues throughout childhood. As far as displacement of the fragment is not severe, or if it is condyle that is fractured, closed reduction and additional intermaxillary fixation can be considered. Functional exercise is also required to prevent ankylosis of temporomandibular joint. Several complications, particularly malocclusion and facial asymmetry due to growth disturbances, can occur after condylar fractures. If growth disturbances take place after mandibular fractures, catch-up growth may occur in some patients, thus, periodic observation is necessary. In case of persistent growth disturbances, functional devices may be used to prevent severe facial asymmetry. This case report describes the long-term follow-up of two patients with facial asymmetry after mandibular fracture.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.1
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• pp.57-64
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• 2022

Additional dentition images are needed because the dentitions are distorted in cone-beam computed tomography (CBCT) due to streak artifacts and non-uniformity of the x-ray beam. The purpose of this study is to evaluate the feasibility of improving the dentition image of CBCT scan with intraoral scanner instead of plaster models. Maxilla images from plaster models, two intraoral scanners, and CBCT of 20 patients aged 12 to 18 were used in this study. With one of the intraoral scanners, the full arch was scanned by three segments and combined into a complete full arch. Virtual skull-dentition hybrid images from intraoral scanners were superimposed with the images from plaster models to evaluate the coordinate value difference and distance at reference points. The results showed that the coordinate value difference and distance were smallest with segmented intraoral scan, which showed only 2 ㎛ distance. Intraoral scan may provide good dentition images for virtual skull-dentition images.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.2
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• pp.77-83
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• 2015

Background: To prepare for possible emergency situations during dental treatment, it is helpful to know how often and what kinds of emergencies may arise. This study set out to evaluate the incidences, causes, treatments, and outcomes of emergency situations in the outpatient clinic of a dental teaching hospital in Korea. Methods: We retrospectively reviewed the records of patients who had experienced an emergency situation and emergency response team activated in a selected outpatient clinic between November 2004 and November 2013. Specific information about the emergency cases was collected, including the patient characteristics and the frequency, types, treatments, and outcomes of the emergency situations. Results: We identified 35 instances of emergency situations in 2,890,424 patients (incidence = 0.012 per 10,000 outpatients). The number of cases was as follows: 10 (28.6%) in the Department of Periodontics, 10 (28.6%) in the Department of Oral and Maxillofacial Surgery, 6 (17.1%) in the Department of Oral and Maxillofacial Radiology, 4 (11.4%) in the Department of Prosthodontics, 2 (5.7%) in the Department of Conservative Dentistry, 2 (5.7%) in the Department of Pediatric Dentistry, and 1 (2.9%) in the Department of Orthodontics. Three (8.6%) of the emergency situations arose before treatment, 22 (62.9%) during treatment, 7 (20.0%) after treatment, and 2 (5.7%) in a patient's guardian. Conclusions: In accordance with the growing elderly population and more aggressive dental procedures, the number of emergency situations may increase in the future. We recommend that clinicians keep in mind airway management and the active control of emergency situations.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.3
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• pp.183-191
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• 2012

In most persons with disabilities had poor oral hygiene because of less attention and ability to perform a dental care. So the increased prevalence and severity of dental disease were common oral state. Although most persons with disabilities need a adequate dental treatment, it is often very difficult to treat because of noncooperativity and involuntary muscle movements. Dental treatments under sedation and general anesthesia were make to provide a high-quality dental service because of decreased anxiety and fear associated dental treatment in persons with disabilities. The dental professionals must be able to select and apply the proper sedation methods in agreement with the characteristics of the disabilities, general conditions, sedation experience and capacity of dentist, type and time of dental treatment, equipments of dental clinic, consent of patient's protector. The proshodontic treatment procedures, such as abutment preparation, dental impression taking process, try-in process of prosthesis and adjustment of occlusion, are difficult even for patients without disabilities. Those procedures are more difficult to patients with disability because it's too hard to control breathing and muscle. In this report, we performed prosthetic dentistry procedures to three patients with disabilities under dental sedation and general anesthesia.