• The Journal of Korea Assosiation for Disability and Oral Health
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• v.7 no.1
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• pp.25-28
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• 2011

Autism is a developmental, neuropsychiatric disorder that begins in early childhood. A patient with autism seen in the dental office frequently may have many complications. Therefore, it may be needed to consider modified or alternative therapy for dental care of autistic patients. This is the case of a 16-year old boy who have autism. He came to the department of the pediatric dentistry, Yonsei University Dental Hospital, for evaluation and treatment of dentigerous cyst associated with impacted teeth(#33,34,35). Under daily hospitalization and general anesthesia, the cyst was enucleated with surgical extraction of #34 and autotransplantation of #33,35. And during the periodic dental followup, apexification of #33,35 was performed for periapical lesion and root maturity. At 2 year 6 months follow- up, now, bony healing was completed and there are some complications like external resorption of #33 and space loss of #34 area. Generally, the marsupialization has been widely recommended for treatment of dentigerous cyst. However, in this case, there is a little possibility of spontaneous eruption after marsupialization considering of patient's age, location and angulation of the impacted tooth, root maturity. And there is necessity to choose the treatment that has low recurrence risk and needs short-term follow-up for autism. Above all, poor oral hygiene and lack of cooperation for decompression treatment is a matter of primary consideration. Consequently, enucleation of the cyst was chosen for the final treatment plan in this case. It is important to consider the conditions that affect the eruption of a dentigerous cyst-associated tooth to predict the successful eruption and special health care needs of the patient when the treatment plan is settled.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.2
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• pp.114-118
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• 2017

Sedation or general anesthesia is often required to offer dental treatment to patients with special needs. However, patients with ASA classification of III or higher are not indicated for moderate sedation and might be exposed to danger when treated at outpatient dental clinic. For this reason, it is recommended to treat those patients under general anesthesia. The dental team can supervise and monitor the whole procedures during treatment with an appropriately equipped facility. This case report describes the dental treatment of a 7-year-old girl with multiple disabilities. Preoperative evaluation including medical consultation was carried out thoroughly and dental treatment was performed under general anesthesia safely.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.2
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• pp.83-89
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• 2023

Background: With advances in safety measures for anesthesia, conscious sedation has gained popularity in the field of dentistry and has become essential in dental practice worldwide. However, in Tanzania, intravenous (IV) sedation is rarely practiced in the dental field. Therefore, we report the establishment of sustainable IV conscious sedation in dental practices and subsequently train local OMS residents in Tanzania. Methods: In 2019, intravenous conscious sedation was initiated at the University Dental Clinic of the Muhimbili University of Health and Allied Science (MUHAS), Tanzania. During the preparatory phase of the program, local oral and maxillofacial surgeons (OMSs) were given a series of lecture notes that concentrated on different aspects of IV conscious sedation in dentistry. During the on-site training phase, an oral surgeon from the United States joined the OMSs for case selection, IV-conscious sedation procedures, and patient follow-up. Patients were recruited from existing patient records at the MUHAS Dental Clinic. Results: The first conscious IV sedation program in dentistry was successfully launched at the University Dental Clinic in Tanzania. The local team of OMSs was trained on the safe administration of sedative agents (midazolam or ketamine) to perform various minor surgical procedures in a dental office. Nine patients with different ages, body masses, and medical conditions benefited from the training. No complications were associated with IV conscious sedation in the dental office. Conclusion: This was the first successful "hands-on" training on IV conscious sedation provided to OMSs in Tanzania. It laid the foundation for the sustainable care of patients with special needs requiring oral health-related care in the country.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.84-88
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• 2019

Malocclusion occurs more frequently in Special Health Care Needed (SHCN) patients than those in general. As caregiver's needs for orthodontic treatment tend to increase, the dentist should know how to decide the extent of treatment. This case report is about orthodontic treatment for two SHCN patients; one patient with cerebral palsy, and another patient with autism. A 10-year-old patient with cerebral palsy showed protrusion and rotation of maxillary anterior teeth. To resolve his chief complaints and make better oral hygiene, he underwent orthodontic treatment using micro tube appliances for 6 months. Another 11-year-old patient with autism had anterior crossbite and showed space deficiency of #13 and chronic gingivitis because of poor oral hygiene. She underwent orthodontic treatment with maxillary skeletal expander, facemask and AP expansion appliance. After 18 months we found positive overjet and ended the treatment. When giving SHCNs orthodontic treatment, the extent of treatment can be chosen according to the patient's cooperative ability and the traits of disabilities. Before initiating orthodontic treatment, the caregivers should be aware of their limitations of the treatment. Since oral hygiene is crucial factor in every dental treatment, education of oral hygiene process for the caregivers and SHCN patient must be done before the orthodontic treatment.

• Journal of Periodontal and Implant Science
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• v.42 no.2
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• pp.39-44
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• 2012

Purpose: Special care is necessary to avoid invading important anatomic structures during surgery when presurgical planning is made based on radiographs. However, none of these types of radiography represents a perfect modality. The purpose of this study was to determine the reliability of presurgical planning based on the use of two types of radiographic image (digital panoramic radiography [DPR] and cone-beam computed tomography [CBCT]) by beginner dentists to place implants, and to quantify differences in measurements between radiographic images and real specimens. Methods: Ten fresh cadavers without posterior teeth were used, and twelve practitioners who had no experience of implant surgery performed implant surgery after 10 hours of basic instruction using conventional surgical guide based on CBCT or DPR. Two types of measurement error were evaluated: 1) the presurgical measurement error, defined as that between the presurgical and postsurgical measurements in each modality of radiographic analysis, and 2) the measurement error between postsurgical radiography and the real specimen. Results: The mean presurgical measurement error was significantly smaller for CBCT than for DPR in the maxillary region, whereas it did not differ significantly between the two imaging modalities in the mandibular region. The mean measurement error between radiography and real specimens was significantly smaller for CBCT than for DPR in the maxillary region, but did not differ significantly in the mandibular region. Conclusions: Presurgical planning can be performed safely using DPR in the mandible; however, presurgical planning using CBCT is recommended in the maxilla when a structure in a buccolingual location needs to be evaluated because this imaging modality supplies buccolingual information that cannot be obtained from DPR.

• Journal of the Korean Society of School Health
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• v.21 no.1
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• pp.33-41
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• 2008

Purpose : The purpose of this study was to provide the basic data for p lanning oral health education in elementary schol. Methods conducted using a postal, self-administered questionnaire. A questionnaire containing 19 questions about oral health education which was provided by health teachers in elementary schol was used for data colle ction. Total response rate was 64.3% (119 out of 185). Results : Oral health education except one through textbooks was conduc of which taught oral health themselves. The contents of oral he alth education through special clas was mainly focusing on the tothbrushing method, dental caries, and the use of fluo ride. Acording to the grades clasified by the level of education, the order was the 3rd, 1st, and 2nd grade, which mea ns that the lower grades got more training than the h was acquired through the internet (72.2%), health-related organizations or academies (51.5%). Also, materi als for oral health education were obtained from health-related organizations or academies (67%), self-productio n (49.5%). According to the data during the past 5 years it was found that 13.4% health teachers had oral health-related that more traing neded to be conducted from 89.7% health tea chers. The most dificult problem in oral health education were insufficient time (56.7%). Conclusion : For effective oral health education, there needs a developmen t of targeted goal to achieve a systemic oral health education for each grades as wel as a ned for as health teachers to eficiently acquire knowledge and materials for oral health education, it is necessary to hold regular workshops for health teachers, and develop and distribute appro priate educational materials.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.2
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• pp.99-103
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• 2017

The primary responsibility for the oral hygiene of the disabled is usually the parents. Dental care of the disabled is early detection and recovery of lesions and continuous management. For this to be successful it is necessary to use diagnostic tool that can detect the early stages of dental caries which is difficult to detect with the naked eye. It is also important to educate and motivate the caregivers on oral hygiene management. Quantitative Light-induced Fluorescence-Digital (Billuminator, Inspektor Researh Systems BV, Amsterdam, The Netherlands), which provides overall caries inspection and visual information, can be useful for caregiver education. A 3-year-old girl who was hospitalized with Pallister-Killian syndrome, Hypothyroidism visited our clinic with chief complaint of rugged upper incisors. This girl had multiple dental caries and oral hygiene was very poor. Periodic QLF-D images were taken to provide caregiver education and oral hygiene management was improved. A 13-year-old girl with cerebral palsy visited our clinic for regular check up. Using QLF-D, we explained to the parents that there is a need for treatment of dental caries, and education of oral hygiene management was conducted. Improvement of oral hygiene in the disabled can be achieved through caregiver education. QLF-D is a diagnostic device that can detects early caries by irradiating light in the visible ray area to the teeth. It can also detects microleakage of restoration, plaque and calculus without disclosing agent. Clinicians can use the QLF-D to perform a general oral examination for the disabled. Also, QLF-D can be used to store visual information and educate caregivers. The accumulation of information using QLF-D makes it possible to provide feedback on oral care of parents, which is more advantageous for caregivers education.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.4
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• pp.146-153
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• 2014

Purpose: This study compares and evaluates the efficacy of graft materials after maxillary sinus bone grafts with autogenous tooth bone graft material (AutoBT), demineralized freeze-dried bone allograft (DFDBA) and deproteinized bovine bone mineral (DBBM). Methods: The study involved 30 sinuses in 26 patients who visited the Division of Oral and Maxillofacial Surgery, Department of Dentistry in Ajou University Hospital and received either AutoBT, DFDBA or DBBM with sinus elevation using the lateral window technique. Sinus graft height was measured before, immediately after, and six months after bone graft with panoramic radiography and the height changes of the sinus floor was compared according to the graft materials. Results: After six months, the decrease ratio of graft heights were 13.57% for AutoBT group, 14.30% for DFDBA group, and 11.92% for DBBM group. There was no statistically significant difference. Conclusion: The new maxillary sinus floor formed by the upper border of bone graft material, can repneumatize after the maxillary sinus elevation. Thus, long-term stability of sinus graft height represents an important factor for implant success. We found that the three graft materials for sinus elevation do not differ significantly and all three graft materials showed excellent resistance to maxillary sinus repneumatization. However, due to the special circumstances of the maxillary sinus and small sample, the actual difference between the three graft materials may not have been detectable. Therefore further study needs to be conducted for more reliable study results.

• Restorative Dentistry and Endodontics
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• v.22 no.2
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• pp.739-750
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• 1997

Treatment of root perforation elicits special considerations due to its blood-contaminated circumstances. It is known that conventional dental restorative materials are all leaking. Calcium sulfate is the material which react with water to become chemically set. This study, therefore, was performed to develop a new compound containing calcium sulfate and to evaluate its physical and biological characteristics. Three materials were used, IRM, calcium sulfate, calcium sulfate-hydroxyapatite compound. The composition of the calcium sulfate-hydroxyapatite compound was basically 50 % of calcium sulfate and 50 % of hydroxyapatite mixed with guajacol. The materials were mixed in conventional way and underwent four physical test procedures, setting time, solubility test, compressive strength, and marginal leakage test. All materials were evaluated under the scanning electron microscope to examine the marginal sealing ability. Animal experiment was also performed to test the materials' tissue response. Twenty-four dog's premolars were tested with either furcation perforations or apical retro-fillings. From the results, we found that calcium sulfate possess the good marginal sealing ability. However, calcium sulfate creates many voids which is caused by crystal thrusting action when it reacts with water. It seemed that the voids caused disintegration of the material which eventually lead to tissue reaction. By compounding calcium sulfate and hydroxyapatite, we were able to obtain the better physical properties but it showed larger marginal gap between the material and the root surface. Within the six weeks observation period, both IRM and calcium sulfate-hydroxyapatite compound showed good tissue responses in animal experiment. It is concluded that calcium sulfate would be the material of choice in root perforation repair, but the physical property needs to be further improved.

• Journal of Periodontal and Implant Science
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• v.51 no.3
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• pp.179-188
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• 2021

Purpose: Due to the difficulty of the hygienic care and sanitary management of abutment teeth and subpontic areas associated with fixed dental prostheses (FDPs), intrabony defects occur and accelerate due to the accumulation of plaque and calculus. This study aimed to evaluate the efficacy of regenerative periodontal surgery for intrabony defects associated with FDPs. Methods: The study inclusion criteria were met by 60 patients who underwent regenerative treatment between 2016 and 2018, involving a total of 82 intrabony defects associated with FDPs. Periodontal osseous lesions were classified as 1-, 2-, and 3-wall intrabony defects and were treated with an enamel matrix derivative in combination with bone graft material. The changes in clinical (pocket probing depth [PPD] and clinical attachment level [CAL]) and radiographic (defect depth and width) outcomes were measured at baseline and at 6, 12, and 24 months. Results: Six months after regenerative treatment, a significant reduction was observed in the PPD of 1-wall (P<0.001), 2-wall (P<0.001), and 3-wall (P<0.001) defects, as well as a significant reduction in the CAL of 2-wall (P<0.001) and 3-wall (P<0.001) intrabony defects. However, there was a significant increase in the CAL of 1-wall intrabony defects (P=0.003). Radiographically, a significant reduction in the depth of the 3-wall (P<0.001) defects and a significant reduction in the width of 2-wall (P=0.008) and 3-wall (P<0.001) defects were observed. The depth decreased in 1-wall defects; however, this change was not statistically significant (P=0.066). Conclusions: Within the limitations of the current study, regenerative treatment of 2- and 3-wall intrabony defects associated with FDPs improved clinical and radiological outcomes. Additional prospective studies are necessary to confirm our findings and to assess long-term outcomes.