• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.3
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• pp.205-213
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• 2017

Background: This study retrospectively investigated outcomes following dental implantation in patients with special needs who required general anesthesia to enable treatment. Method: Patients underwent implant treatment under general anesthesia at the Clinic for the Disabled in Seoul National University Dental Hospital between January 2004 and June 2017. The study analyzed medical records and radiographs. Implant survival rates were calculated by applying criteria for success or failure. Results: Of 19 patients in the study, 8 were males and 11 were females, with a mean age of 32.9 years. The patients included 11 with mental retardation, 3 with autism, 2 with cerebral palsy, 2 with schizophrenia, and 1 with a brain disorder; 2 patients also had seizure disorders. All were incapable of oral self-care due to serious cognitive impairment and could not cooperate with normal dental treatment. A total of 27 rounds of general anesthesia and 1 round of intravenous sedation were performed for implant surgery. Implant placement was performed in 3 patients whose prosthesis records could not be found, while 3 other patients had less than 1 year of follow-up after prosthetic treatment. When the criteria for implant success or failure were applied in 13 remaining patients, 3 implant failures occurred in 59 total treatments. The cumulative survival rate of implants over an average of 43.3 months (15-116 months) was 94.9%. Conclusion: For patients with severe cognitive impairment who are incapable of oral self-care, implant treatment under general anesthesia showed a favorable prognosis.

• Journal of the Korea Convergence Society
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• v.9 no.6
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• pp.261-269
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• 2018

The purpose of this study is to investigate the influences of ethical propensity, self-esteem and clinical satisfaction on major satisfaction in dental hygiene students. The study was conducted with third grade students in 3 dental hygiene colleges in Gyeongnam and Ulsan. The results were as follows : 1. Self-esteem showed high score in 'Before senior high school student' of the time of department selection, in 'Good' of oral health, in 'Outgoing' of personality and in 'Good' of family atmosphere. 2. Clinical practice satisfaction showed high score in 'Have' of part-time job experience in dental clinic. In case of major satisfaction, there were significantly different means with time of department selection and oral health. 3. The factors that influence to major satisfaction are self-esteem(${\beta}=.165$, p=.000) and clinical satisfaction(${\beta}=.630$, p=.000). It is important that making the curriculum to improve ethical propensity and self-esteem, clinical satisfaction for dental hygiene students.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.10
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• pp.4996-5002
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• 2013

This study was performed to identify the oral health behaviors and dental clinics satisfaction of Chinese students' studying in Korea. This research was based on self questionnaire survey which 195 Chinese students in Korea. An interview questionnaire was used to collect information on general characteristics and oral health behaviors. Also, to compare between adults who participated to Korea National Health and Nutrition Examination Survey and dental health conditions. The statistical analysis was done by using the SPSS 19.0 program. Chinese students in Korea brushing teeth average appeared to be 2.14, and Korean adults teeth brushing average appeared to be 2.81. So Korean adults brushing teeth appeared to be more higher than Chinese student in Korea(p<0.05). Chinese student in Korea appeared to be overall satisfaction for using domestic dental clinic was 3.77. For using domestic dental clinic, Chinese student in Korea tell that improvement they should consider was high costs(15.3%), difficulty with communication(8.6%), foreigner discrimination(5.7%) by order of this. Chinese student in Korea have to keep their dental health well and necessary to grow right habit of dental health through dental health education program to accomplish efficient education during staying in Korea to study.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.1
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• pp.13-20
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• 2010

This is the following report of the previous summary report 'Dental occlusion and relationship to TMD and systemic symptoms(I).' Among 5 representative theories about dental occlusion, stomatognathic system, and related systemic symptoms, this article will introduce two of them. Which are (1) Craniosacral mechanism and (2)Osteopathy. Brief history, definition, basic concepts, and the limitation of each theory are reviewed.

• Journal of Korean society of Dental Hygiene
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• v.13 no.1
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• pp.38-44
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• 2013

Objectives : This study is to dental knowledge and awareness of special education teachers. Methods : This study is conducted with a total of 244 special education teachers in Dae Gu, Gyeong Buk, Gyeong Nam, Bu San city from 1st April to 30th April, 2011. Results : More healthy state of oral health reflected higher point of oral health behavior. In the correlation among the oral health knowledge, behavior and education, higher oral health knowledge reflected higher oral health behavior. In the obstacle factors against oral health education, 41.0% was in the lack of professionalism and understanding of oral health education. The majority method for oral health education was regular teaching and the oral health in charge of education was school nurse 67.1%. The most important point for improvement for oral health class enabled was oral health recognition of teachers about the importance of education. Conclusions : For improving the oral health of the disabled, it is needed to develop the educational program or awareness of oral health monitoring like applying fluorine by special education teachers and parents, including the necessity of various oral health education development suitable for the special education school to make awareness in the importance and necessity of oral health.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.4
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• pp.217-226
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• 2019

Background: We aimed to assess the dose needed to achieve the propofol effect-site concentration using target-controlled infusion in intellectually disabled patients and to detail the most effective method for achieving a safe level of consciousness without hemodynamic changes as well as detail any resulting adverse effects. Methods: We performed a retrospective review of sedation service records of 138 intellectually disabled patients (51, mental retardation; 36, autism; 30, brain lesion, 12 genetic diseases, 9 dementia) aged over 15 years and weighing over 30 kg. These patients had received propofol via target-controlled infusion in the special care dental clinic of Seoul National University Dental Hospital from May 2008 to September 2018 for restorative treatment (112), minor surgery (13), prosthodontics (7), periodontics treatment (5), and implant (1). Results: For all groups, the duration of dental treatments was $43{\pm}18$ minutes, total sedation time was $73{\pm}23$ minutes, and total BIS values was $57{\pm}12$. The propofol maintenance dosage values for each group were: mental retardation, $3{\pm}0.5(2-4){\mu}g/ml$; autism, $3.1{\pm}0.7(2-5){\mu}g/ml;$; brain lesion, $2.8{\pm}0.7(1.5-5){\mu}g/ml;$; genetic disease, $2.9{\pm}0.9(1-4){\mu}g/ml;$ and dementia $2.3{\pm}0.7(1-3.4){\mu}g/ml;$. Conclusions: The dementia group needed a lower dosage to reach a safe, effective propofol effect-site concentration than the other groups. Since there were no complications, deep sedation is a great alternative to general anesthesia for dental treatment of intellectually disabled patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.4
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• pp.245-254
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• 2018

Background: When performing dental treatment under general anesthesia in adult patients who have difficulty cooperating due to intellectual disabilities, anesthesia induction may be difficult as well. In particular, patients who refuse to come into the dental office or sit in the dental chair may have to be forced to do so. However, for adult patients with a large physique, physical restraint may be difficult, while oral sedatives as premedication may be helpful. Here, a retrospective analysis was performed to investigate the effect of oral sedatives. Methods: A hospital-based medical information database was searched for patients who were prescribed oral midazolam or triazolam between January 2009 and December 2017. Pre-anesthesia evaluation, anesthesia, and anesthesia recovery records of all patients were analyzed, and information on disability type, reason for prescribing oral sedatives, prescribed medication and dose, cooperation level during anesthesia induction, anesthesia duration, length of recovery room stay, and complications was retrieved. Results: A total of 97 patients were identified, of whom 50 and 47 received midazolam and triazolam, respectively. The major types of disability were intellectual disabilities, autism, Down syndrome, blindness, cerebral palsy, and epilepsy. Analyses of changes in cooperation levels after drug administration showed that anesthesia induction without physical restraint was possible in 56.0% of patients in the midazolam group and in 46.8% of patients in the triazolam group (P = 0.312). Conclusions: With administration of oral midazolam or triazolam, general anesthesia induction without any physical restraint was possible in approximately 50% of patients, with no difference between the drugs.

• Journal of Korean society of Dental Hygiene
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• v.11 no.5
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• pp.659-670
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• 2011

Objectives : The purpose of this study was to examine the state of oral health care among special school personnels in an attempt to provide some information on the improvement of the oral health care of students with disabilities who would be under the first hand influence of school personnels. Methods : The subjects in this study were personnels who were selected by random selection in five different special schools located in the city of Jeonju, North Jeolla Province. A self-administered survey was conducted in person from July 5 to 14 after the purpose of this study was explained. Results : 1. Concerning their general characteristics, the level of oral health knowledge was high in the personnel whose career is 5 years more, and the younger personnels had a better oral health knowledge, and the men were more knowledgeable than the women. 2. As to oral health education experience, the rate of the respondents who ever received oral health education stood at 35.3 percent. In relation to the frequency of oral health education, the biggest group that accounted for 58.2 percent received that education once. As for the route of education, the largest group that represented 52.7 percent received that education at dental hospitals or clinics. In relation to satisfaction with oral health education, the greatest group that accounted for 38.5 percent were dissatisfied with that education. 3. As for an intention of receiving oral health education in the future, the biggest group that accounted for 60.9 percent intended to receive that education if they would have free time, and the largest group that represented 47.7 percent believed that oral health education should be conducted by dental hygienists. 4. Concerning their general characteristics, the level of oral health promotion behavior according to age in both bushing and supplies of oral health care was high in forties-1.89 point and 3.33 point, and that in regular visit to a dental clinic was the highest in twenties for 2.58 point, and that in dietary control was the highest in twenties for 2.59 point. 5. Their oral health knowledge had a significant positive correlation to their toothbrushing, regular dental clinic visit and dietary control that were the subfactors of oral health promotion behavior. 6. As for the impact of oral health promotion behavior on oral health knowledge, toothbrushing exerted the greatest influence on that(${\beta}$=0.306, p<0.001). Conclusions : Appropriate institutional measures should be taken to let dental hygienists who are expert in oral health care provide incremental oral health care for students and adults with disabilities in educational institutions and facilities for the disabled, and the development of oral health education programs is urgently required to offer systematic oral health education for not only students with disabilities but their teachers and guardians.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.1
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• pp.25-33
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• 2017

The lower $2^{nd}$ molar eruption is beginning to mesiolingually, then rotate to distobuccally so it has a tendency to be tilted and impacted mesially. Signs and symptoms of impacted $2^{nd}$ molar are similar to impacted $3^{rd}$ molar's. However, treatment plan for impacted $2^{nd}$ molar is different from that of impacted $3^{rd}$'s. The former is the preservation and uprighting of $2^{nd}$ molar so that it could act to recovery of mastication, symmetrical facial growth, maintaining the symmetry of dental arch, stable occlusion, while the latter is the extraction of tooth. If the uprighting treatment is planned, most proper protocol of treatment and the additional treatment opition should be applied with consideration for it's crown exposure, present of $3^{rd}$ molar which interrupt the uprighting process, extrusion of opposite tooth. Although it could not improve the esthetic result, it could prevent many dental problems. Therefore, uprighting for impacted lower $2^{nd}$ molar is meaningful treatment.

• Journal of Periodontal and Implant Science
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• v.43 no.2
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• pp.58-63
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• 2013

Purpose: The aim of this study was to measure the peri-implant bone length surrounding implants that penetrate the sinus membrane at the posterior maxilla and to evaluate the survival rate of these implants. Methods: Treatment records and orthopantomographs of 39 patients were reviewed and analyzed. The patients had partial edentulism at the posterior maxilla and limited vertical bone height below the maxillary sinus. Implants were inserted into the posterior maxilla, penetrating the sinus membrane. Four months after implant insertion, provisional resin restorations were temporarily cemented to the abutments and used for one month. Then, a final impression was taken at the abutment level, and final cement-retained restorations were delivered with mutually protected occlusion. The complications from the implant surgery were examined, the number of failed implants was counted, and the survival rate was calculated. The periimplant bone lengths were measured using radiographs. The changes in initial and final peri-implant bone lengths were statistically analyzed. Results: Nasal bleeding occurred after implant surgery in three patients. No other complications were found. There were no failures of the investigated implants, resulting in a survival rate of 100%. Significantly more bone gain around the implants (estimated difference=-0.6 mm, P=0.025) occurred when the initial residual bone height was less than 5 mm compared to the >5 mm groups. No significant change in peri-implant bone length was detected when the initial residual bone height was 5 mm or larger. Conclusions: This study suggests that implants penetrating the sinus membrane at the posterior maxilla in patients with limited vertical bone height may be safe and functional.