• 제목/요약/키워드: comprehensive dental treatment

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New treatment method for pain and reduction of local anesthesia use in deep caries

  • Yun, Jihye;Shim, Youn-Soo;Park, So-Young;An, So-Youn
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제18권5호
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    • pp.277-285
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    • 2018
  • Chemo-mechanical caries removal methods are known to be more effective compared with conventional methods in pain reduction. $Carie-care^{TM}$, a chemo-mechanical caries removal agent, was introduced in 2010 but a systematic review of its efficacy has not yet been performed. The purpose of this study was to investigate the effectiveness of $Carie-care^{TM}$ on the outcomes of treatment of caries in children and adolescents. The primary outcome was pain while the secondary outcomes included complete caries removal (CCR), time, need for local anesthesia and behavioral response changes. A Comprehensive literature search was performed in PubMed, EMBASE, and the Cochrane Library up to 30 September 2018. The following keywords were used in the search: 'chemo-mechanical caries removal agent', 'dental caries', 'Carie-care', 'chemo-mechanical caries removal', 'chemo-mechanical caries excavation', other related keywords, and their combinations. From 942 studies identified, 16 were analyzed. Finally, 4 studies met the eligibility criteria and 260 teeth in 120 children and adolescents were included in this review. This review showed that $Carie-care^{TM}$ reduces pain during caries treatment but requires a longer time for effective treatment than conventional methods. Local anesthesia was not required in the Chemo-mechanical caries removal (CMCR) group. In addition, dental anxiety decreased compared to the control group, and co-operation was more positive. Therefore, it may be a useful alternative to conventional methods in children and adolescents, but further verification through additional studies is needed.

Suggestions for the Work of Dental Hygienists and a Reflection of Health Insurance Charges according to Demographic Changes

  • Lee, Myung-Jin;Oh, Sang-Hwan
    • 치위생과학회지
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    • 제20권1호
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    • pp.1-8
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    • 2020
  • Given that the demand for dental care for elderly individuals is expected to increase according to demographic changes, long-term roadmaps for the current health insurance system should be actively planned. The study aimed to investigate the health insurance system in Korea, compared to that of Japan, and suggest directions for the work of dental hygienists to provide basic data on efficient improvements in the health insurance system. Based on the collected data, the website was used to collect additional related data from Korea and Japan. The most common cause of death in Korea was malignant neoplasms, and most patients were hospitalized for diseases and disorders of the musculoskeletal system and connective tissue. Dental care covered by Korean medical insurance for individuals aged 65 years or older was treatment oriented, such as dentures and implants, while in Japan, treatment-intensive items, such as visiting a dental hygienist for guidance and provision of home-care professional oral hygiene treatment, were covered. The percentages of remaining teeth in Korea and the percentage of remaining 20 teeth were 68.9% in those aged 65 to 74 years and 51.2% in those aged 75 to 84 years in Japan. A strategy for promoting oral health among elderly individuals should be established, and a multilateral intervention approach is required to prevent oral problems from leading to deterioration of whole-body health. The role of dental hygienists in providing comprehensive assessment to elderly individuals is important. In order to provide systemic oral care, it is necessary to introduce oral care systems according to the national policy.

기관내삽관을 가진 장애환자의 치과치료를 위한 협의 진료 (MULTIDISCIPLINARY APPROACH FOR THE DENTAL TREATMENT OF A PATIENT HAVING TRACHEOSTOMY TUBE)

  • 차윤선;김지훈
    • 대한장애인치과학회지
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    • 제10권1호
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    • pp.38-42
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    • 2014
  • 본 증례에서는 특별한 주의가 필요한 장애인을 위한 효율적이고 전문적인 의료 전달을 위해 여러 과와의 협의를 통한 진료가 필요함을 알리고 있다. 특히 기관절개관을 가진 환자의 마취관리와 치과치료를 시행함에 있어서 전신상태 및 기관절개관에 대한 이해와 주의가 필요하다. 1. 충치치료를 주소로 내원한 22세 남환에서 기관내삽관의 활용을 통해 전신마취 하에서 치과치료를 성공적으로 전달하였다. 2. 환자는 발작의 위험성을 가지고 있었으며, 안전한 치과치료를 위해 전신마취를 행동조절의 방법으로 선택하였다. 3. 기관내삽관에는 여러 종류가 있으며, 그 중 전신마취 하에 호흡보조를 할 수 있는 종류는 커프를 가진, 이중내강의 형태로 된 관이다. 따라서, 기관내삽관을 가진 환자에서 전신마취 하 치과치료를 진행하기 위해서는 기관내삽관의 형태에 대한 적절한 평가 및 처치가 선행되어야 한다.

Is aromatherapy associated with patient's dental anxiety levels? A systematic review and meta-analysis

  • Purohit, Abhishek;Singh, Abhinav;Purohit, Bharathi;Shakti, Prateek;Shah, Nidhi
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권4호
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    • pp.311-319
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    • 2021
  • The use of aromatherapy for the reduction of anxiety levels during dental treatment procedures has been well established in the literature; however, there is limited evidence regarding its efficacy. The present meta-analysis is an attempt to assess the association between the use of aromatherapy and anxiety levels among dental patients. A comprehensive search was conducted across Medline, Scopus, Web of Science, EBSCO host, Cochrane databases, and Google Scholar for studies evaluating aromatherapy and anxiety level among dental patients. PRISMA guidelines were followed for the meta-analysis. Randomized and cluster-randomized trials comparing aromatherapy with controls were included. The random-effects model was used to assess the mean differences in anxiety levels of patients visiting dental OPD. The significance value was set at P < 0.05. Six studies were identified that met the requirements for inclusion. Aromatherapy was significantly associated with reduction in patient anxiety levels during dental treatment (pooled mean difference: -3.36 [95% CI, -3.77 - -2.95, P = 0.00001). Low heterogeneity was noted between studies (I2 = 1%, P = 0.41) analyzed in the meta-analysis. High certainty of the evidence was obtained from the association between the use of aromatherapy and dental anxiety. This meta-analysis suggests that aromatherapy is effective in reducing dental anxiety. When used judiciously, the results of this work should encourage the use of aromatherapy to reduce patient anxiety levels during dental procedures

Novel dental anesthetic and associated devices: a scoping review

  • Kyung Hyuk Min;Zac Morse
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제24권3호
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    • pp.161-171
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    • 2024
  • The efficient management of pain and discomfort is essential for successful dental treatment and patient compliance. Dental professionals are commonly evaluated for their ability to perform treatment with minimal patient discomfort. Despite advancements in traditional local dental anesthesia techniques, the pain and discomfort associated with injections remain a concern. This scoping review aims to provide a comprehensive overview of the literature on novel dental anesthetics and associated devices designed to alleviate pain and discomfort during dental procedures. The Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews guidelines were used to prepare the review. Six databases and two sources of gray literature were searched. This review analyzed 107 sources from 1994 to 2023. Local anesthesia devices were grouped into computer-controlled local anesthetic delivery (CCLAD) systems, intraosseous anesthesia (IOA), vibratory stimulation devices, and electronic dental anesthesia (EDA). CCLAD systems, particularly the Wand and Single-Tooth Anesthesia, have been the most researched, with mixed results regarding their effectiveness in reducing pain during needle insertion compared to traditional syringes. However, CCLAD systems often demonstrated efficacy in reducing pain during anesthetic deposition, especially during palatal injections. Limited studies on IOA devices have reported effective pain alleviation. Vibrating devices have shown inconsistent results in terms of pain reduction, with some studies suggesting their primary benefit is during needle insertion rather than during the administration phase. EDA devices are effective in reducing discomfort but have found limited applicability. These findings suggest that the CCLAD systems reduce injection pain and discomfort. However, the evidence for other devices is limited and inconsistent. The development and research of innovative technologies for reducing dental pain and anxiety provides opportunities for interdisciplinary collaboration and improved patient care in dental practice.

Functional Anatomy of the Temporomandibular Joint and Pathologic Changes in Temporomandibular Disease Progression: A Narrative Review

  • Yeon-Hee Lee
    • Journal of Korean Dental Science
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    • 제17권1호
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    • pp.14-35
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    • 2024
  • The temporomandibular joint (TMJ) is one of the most unique joints in the human body that orchestrates complex movements across different orthogonal planes and multiple axes of rotation. Comprising the articular eminence of the temporal bone and the condylar process of the mandible, the TMJ integrates five major ligaments, retrodiscal tissues, nerves, and blood and lymph systems to facilitate its function. Cooperation between the contralateral TMJ and masticatory muscles is essential for coordinated serial dynamic functions. During mouth opening, the TMJ exhibits a hinge movement, followed by gliding. The health of the masticatory system, which is intricately linked to chewing, energy intake, and communication, has become increasingly crucial with advancing age, exerting an impact on oral and systemic health and overall quality of life. For individuals to lead a healthy and pain-free life, a comprehensive understanding of the basic anatomy and functional aspects of the TMJ and masticatory muscles is imperative. Temporomandibular disorders (TMDs) encompass a spectrum of diseases and disorders associated with changes in the structure, function, or physiology of the TMJ and masticatory system. Functional and pathological alterations in the TMJ and masticatory muscles can be visualized using various imaging modalities, such as cone-beam computed tomography, magnetic resonance imaging, and bone scans. An exploration of potential pathophysiological mechanisms related to the TMJ anatomy contributes to a comprehensive understanding of TMD and informs targeted treatment strategies. Hence, this narrative review presents insights into the fundamental functional anatomy of the TMJ and pathological changes that evolve with TMD progression.

부산지역 일부 치과의원 내원환자의 구강건강 지식 및 인식과 실천수준 비교 (Comparison of knowledge, cognition and practice level on oral health care of the clients visiting dental clinic in Pusan area)

  • 김혜란;김동열;문덕환
    • 한국치위생학회지
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    • 제12권4호
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    • pp.647-654
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    • 2012
  • Objectives : To propose the data for prevention of oral health problems through assessment on the knowledge, cognition and practice about oral health care of the clients who visit dental clinics. Methods : The subjects were total 400 clients from the four dental clinics in Busan city. Their knowledge, cognition and performances about oral healthcare collected with questionnaire survey from February to March, 2011. The rate and mean compared by chi-square test, t-test, and ANOVA. Results : Mean level of their knowledge, recognition and practice were 72.5, 80.2, and 65.6, respectively. Theses levels were higher in women (p<0.01), in the group of higher interested (p<0.001), immediately treated (p<0.001), correct tooth brushing (p<0.05), toothbrushing educated (p<0.001), take regular scaling (p<0.001), use assistant hygiene items (p<0.001), instead no differences by age and education level. And, the rate of correct toothbrushing was higher as 1.24 (1.03~1.50) times in the group with higher knowledge level, the rate of immediate treatment and regular scaling were higher as 1.35 (1.07~1.70) times, and 2.26 (1.41~3.64) times in the group with higher recognition level, respectively. Conclusions : These results demonstrate that insufficient knowledge and recognition of oral health care are related to a lack of its practice. Though their primary goal of the visits was treatment, the clients' attention needed to raise the comprehensive knowledge and recognition levels for their oral health promotion, especially reach to the performance level rather than simple knowledge acquisition. And more, to achieve the efficient oral health promotion, the importance of early treatment and strengthened efforts for prevention should be emphasized.

지상보수교육강좌 1 - 중장년 성인교정환자의 구강상태 및 치료양태에 관한 연구; 젊은 성인교정환자와의 비교분석 (Oral Status of Middle-aged Orthodontic Patients and Their Treatment Modality; Comparison with Young-aged Adult Patients)

  • 이현정;김진영;조진형;황현식
    • 대한치과의사협회지
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    • 제48권5호
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    • pp.391-406
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    • 2010
  • Orthodontic treatment for middle-aged patients has become more commonplace with various reasons including improved socioeconomic status. Understanding of oral status and treatment modalities of middle-aged patients is mandatory for accurate diagnosis and proper treatment planning. This study investigated 100 consecutive patients aged 40s and 50s and 100 aged 20s who had been examined and diagnosed at the Department of Orthodontics, Chonnam National University Dental Hospital. The results were obtained as follows; 1. Gender distribution showed female outnumbered male patients in young-aged adult patients, but middle-aged patients showed similar male and female distribution. 2. The major concern seeking orthodontic treatment was esthetics not only in young-aged but also in middle-aged adult patients, and a number of middle-aged patients were concerned about oral health as well. 3. Considerable number of middle-aged patients were referred by other dental specialties while young-aged adult patients were more self-motivated for orthodontic treatment. 4. Middle-aged adult patients had more missing teeth and periodontal disease than young-aged adults. 5. The most frequently-observed problem was dental spacing in middle-aged patients while dental crowding in young-aged adult patients. Middle-aged patients showed higher prevalence of deep overbite and overjet while most of young-aged adults presented opposite direction of problem in overbite and overjet. 6. Limited orthodontic treatment was required rather than comprehensive treatment in middle-aged patients, and the most common tooth moving area was anterior part of dentition in case of limited treatment. Need of interdisciplinary therapy with other dental specialties was more common in middle-aged patients. 7. Intervention of specific technique such as invisible TP, passive bracketing, passive wire bonding, and lingual orthodontics was more required in middle-aged patients. Considering that middle-aged patients have different characteristics than young-aged adults, the results of the present study suggest that different treatment modalities are required in middle-aged orthodontic patients in order to manage them properly and efficiently.

치과위생사 교육과정 연구 (A Study on Curriculum of Dental Hygienists)

  • 박일순
    • 한국치위생학회지
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    • 제4권2호
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    • pp.193-207
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    • 2004
  • The aims of the study are as following : First, define and clarify the role and function of the dental hygienist. Second, based on thai definition, present an improved dental hygienist curriculum, improving their special competence. This study seeks to present a way for promoting role of dental hygienists as independent specialists, rather than as auxiliaries, contributing to better dental service in the process. The research was pursued by surveying by questionnaire those directly related to dental hygiene. They are 58 professors of dental hygiene, 164 dentists, 253 dental hygienists and 496 dental hygiene students, selected by the method of simple random sampling. Due to the small size of the sample, professors' group was analysed only through frequency and probabilities. For groups with larger samples(dentists, dental hygienists, dental hygiene students), methods of chi square(${\chi}^2$) tests, frequency analysis and one-way ANOVA were used in their analysis. Conclusions of the study are as following : First, role and function of the dental hygienist was defined and clarified. According to the analysis of the survey, main role of the dental hygienists as perceived by 62.9% of dentists was supporting treatments and managing patients and facility. This perception by dentists differs significantly to perception of other groups, which saw main role of dental hygienists as preventive dental treatment and dental hygiene education. Also, only 20.2% of dental hygienists perceived patients and facility management as their main role. This divergence of perception between groups weakens speciality competence of dental hygienists. To strengthen dental hygienists' speciality competence, preventive dental treatment and dental hygiene education must be defined as main role of dental hygienists. Furthermore, role of dental hygienists can be categorized into cooperative and auxiliary role. Second, in order to strengthen speciality competence of dental hygienists, their education must be augmented with curriculum emphasizing cooperative role. Specifically, courses on preventive dental treatment, dental hygiene education and dental X-ray photography must become compulsory, as well as becoming more comprehensive and organized. Also, training in schools and hospitals must be focused on those subjects. In addition, courses concerning auxiliary role must be incorporated into optional courses and more pedagogical courses are needed to widen students' career choices. Third, practical relevance of national dental hygienist certification examination must be heightened. In the survey, all groups gave negative response to questions concerning practical relevance of national dental hygienist certification test. Specifically, contents of the tests must be changed to test participants' competence in the cooperative area. Also, the test itself must be strengthened by adding practical examination to the certification scheme, as well as having more difficult examinations.

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Clinical management of a fused upper premolar with supernumerary tooth: a case report

  • Cho, Kyu-Min;Jang, Ji-Hyun;Park, Sang-Hyuk
    • Restorative Dentistry and Endodontics
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    • 제39권4호
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    • pp.319-323
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    • 2014
  • In dentistry, the term 'fusion' is used to describe a developmental disorder of dental hard tissues. In the permanent dentition, fusion of a normal tooth and a supernumerary tooth usually involves the incisors or canines. However, a few cases of fusion involving premolars have also been reported to date. We present a rare case in which fusion of the maxillary left second premolar and a supernumerary tooth in a 13-year-old girl was diagnosed using cone beam computed tomography (CBCT, Alphard-3030, Asahi Roentgen Ind. Co., Ltd.). The tooth was bicuspidized after routine nonsurgical root canal treatment, and the separated teeth underwent appropriate restoration procedures. The second premolar and supernumerary tooth remained asymptomatic without any signs of inflammation after a follow-up period of 9 years. Identification of anatomical anomalies is important for treatment in cases involving fusion with supernumerary tooth, and therefore the microscopic examinations and CBCT are essential for the diagnosis. Fused teeth can be effectively managed by the comprehensive treatment which includes both endodontic and periodontal procedures.