• Journal of The Korean Dental Society of Anesthesiology
• /
• v.11 no.2
• /
• pp.125-132
• /
• 2011

Background: Adult patients with intellectual disabilities often strongly resist the anesthetic administration for dental procedures. This study aimed to evaluate the effect of midazolam premedication in improving the cooperation level of patients who are likely to be combative and irritated during general anesthesia (GA) induction. Methods: The patients who had received dental treatment under ambulatory GA for more than two times were included. And we selected 13 patients total that needed physical restraint or ketamine IM prior to induction at the first GA, and were prescribed midazolam tablet (7.5-15 mg) at the following GA. We reviewed pre-anesthetic records and anesthesia records, and evaluated cooperative levels of patients (4 levels scale) during anesthesia induction and recovery time retrospectively. Results: All 13 patients (Male 11, Female 2) had severe mental disabilities. The average age of the patients was 24 ${\pm}$ 7 (13-37) years and their average weight was 58 ${\pm}$ 16 (34-91) kg. At the first GA, 10 patients needed physical restraint prior to induction (level 3). And 3 patients were so poorly cooperative that the induction procedure was performed after intramuscular injection of ketamine (level 4). But after the midazolam intake, 7 patients were willing to receive the anesthetic induction (level 1, 2), and 6 patient needed physical restraint (P < 0.05). There were no statistical differences in the duration of general anesthesia and postoperative recovery. Conclusions: Oral intake of midazolam was effective in improvement of cooperation without any complications.

• The Journal of the Korean dental association
• /
• v.57 no.2
• /
• pp.52-63
• /
• 2019

Technological advances in contemporary medicine has discovered the causes of countless diseases and recorded a noticeable medical performance. As technology develops, the role of hospitals is expanding to include disease prevention of inpatients, on top of their fundamental role of treating diseases. Recently, hospitals are becoming more influential as they create environments to provide comfort and stability to patients. In this regard, contemporary hospitals are increasingly shifting their focus to create a patient-centric environment as well as develop into humanistic establishments. The same goes to dentists, as well. Since inpatients often have fear and frustration over treatment, hospitals should figure out the environmental factors that are more effective and relaxing for patients and design medical services to provide them. The patients' movement and spaces during their treatment were categorized by stages and collected for gazing information using eye tracking. It analyzed users' gaze information according to Heatmap analysis of distribution and frequency and was determined the presence or absence of stimuli on the components of space. This research is an advanced research to study and enhance treatment environment based on the analysis of patients' gazes. It attempted to create an opportunity to get closer to patient-centric environment by understanding the stimulants and obstacles and controlling the background settings.

• Journal of Korean society of Dental Hygiene
• /
• v.10 no.4
• /
• pp.717-725
• /
• 2010

Objectives : This study was to determine the level of occupational exposure and quality of life and to investigate the effect of variables related occupational exposure on quality of life in dental hygienists. Methods : A survey questionnaire was mailed to dental hygienists from April 4 to May 15, 2010. The subjects were 256(56.9%), who were worked in dental hospital and clinic with mean age of $29.59{\pm}7.30$. Quality of life was measured using the WHOQOL-BREF. It consists of 26 items, each with 5-point likert scale. Self control of occupational exposure was measured using the 3-items. The data were analyzed with chi-square, t-test, one-way ANOVA, pearson correlation coefficients and multiple regression using the SPSS WIN 17.0 program. Results : Regarding quality of life, the subjects was a mean of 90.73 out of a maximum 130 points. The level of self control occupational exposure a mean of 3.20 out of a maximum 5 points. Self control of occupational exposure, frequency of panorama radiography, work experience of radiography had a significant impact on quality of life in dental hygienists. Conclusions : Based on the findings, occupational exposure is negatively associated with quality of life in dental hygienists. These results suggest that health promotion program should be considered various factors related occupational exposure in dental hygienists.

• Journal of the Korea Convergence Society
• /
• v.6 no.4
• /
• pp.177-186
• /
• 2015

The present study analyzes the main factor having an effect on the convergence dental hygienist's self-esteem through the survey to them. A self-leadership and professional self-conception show meaningful result with higher score in the group with higher self-respect than that of lower one(p<.001). Also the higher hygienist's self-esteem, the higher clinic practice ability(p<.01). There is negative correlation with self-esteem in emotional labor(p<.01) and exhaustion(p<.01). However, the positive correlations are presented in self-leadership(p<.01), professional self-conception(p<.01) and clinic practice ability(p<.01) with self-respect. The factors influenced on self-esteem are clinic practice ability(p<.05) and exhaustion(p<.01). In results, the organized convergence program and education considering self-esteem in the hospital should be accomplished systemically to enhance the clinic practice ability of each hygienist.

• Journal of Society of Preventive Korean Medicine
• /
• v.10 no.2
• /
• pp.147-158
• /
• 2006

The purpose of this paper is to review the empirical study results of conversion factors(unit prices) for relative values of health care services in the national health insurance system and establish optimal classification of health care institutions for feasible contract of conversion factors between National Health Insurance Corporation(NHIC) and provider groups, based on legal backgrounds and types of health care service delivery system. some empirical research evidences shows the validity of applying multiple conversion factors to annual contract for reimbursement in the national health insurance. Policy recommendations suggest that clinic, hospital, general hospital, tertiary hospital, dental clinic, oriental medical clinic, pharmacy, and public health centers would be a basic category of provider groups for a meaningful price contract between the NHIC and providers.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.42
• /
• pp.11.1-11.8
• /
• 2020

Background: The purpose of this study is to compare the skeletal stability of two-jaw surgery via surgery-first approach with conventional two-jaw surgery in facial asymmetry patients by measuring the skeletal changes after surgery from a three-dimensional analysis. From January 2010 to January 2014, 40 patients with facial asymmetry who underwent two-jaw surgery in Pusan National University Hospital were included in this study. They were classified into experimental group (n = 20) who underwent two-jaw surgery via surgery-first approach and control group (n = 20) who underwent conventional two-jaw surgery. After selection of 24 landmarks and the construction of horizontal and sagittal, coronal reference planes, changes in 10 linear measurements and 2 angular measurements were compared between the surgery-first approach and conventional groups in the preoperative, immediate postoperative, and postoperative periods. The paired t test and Student t test were used for statistical analysis. The mean and standard deviation of the measurement were calculated for the experimental and control groups. Results: The statistical analysis showed that changes in skeletal measurements were similar between the surgery-first approach and conventional groups, according to each period. However, U1-SRP measurement showed statistically significant changes in surgery-first approach groups at postsurgical change (T1 to T2). Also, the mean treatment duration in the treatment group was 15.9 ± 5.48 months whereas that in the control group was 32.9 ± 14.05 months. Conclusion: In facial asymmetry patients, similar results were observed in the postoperative skeletal stability when 2-jaw surgery via surgery-first approach was compared with conventional 2-jaw surgery. However, significant lateral deviation of upper incisor midline was observed. In addition, a shorter average treatment duration was observed. To stabilize the unstable occlusion after surgery, increased wearing of the stent and proactive rubber guidance will be needed.

• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.25 no.2
• /
• pp.68-78
• /
• 2016

Recently, digital technology has become increasingly prevalent in the dental clinic. Using a milling machine for clinic, it is possible to produce provisional restoration inside the clinic. This can promote large clinical cases such as full mouth rehabilitation with the help of a tabletop scanner, which is capable of semi-adjustable articulator equipment, and a powerful dental CAD software with excellent user convenience. In this case report, a full-mouth rehabilitation was done with digital technology to a 55 year-old female patient, who has lost vertical dimension through the attrition, and has got inclined occlusal plane with unplanned and repeated dental reconstruction. Through the design and milling of the provisional restoration in the clinic and the duplication of these provisionals by double scanning technique, a good functional and esthetic result could be achieved.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.10 no.2
• /
• pp.61-67
• /
• 2014

The aim of this study was to analyze the clinical characteristics of patients with cognitive and behavioral impairments receiving dental treatment under general anesthesia (GA-dental treatment). From August 2007 to April 2014, information was collected from 475 patients who received GA-dental treatment at the Clinic for Persons with Disabilities, Seoul National University Dental Hospital. The demographic factors (gender, age, disability, medication, GA history, residency type, caregiver, meal type, oral hygiene maintenance, and cooperation level) and dental status (operating duration, DMFT, malocclusion, periodontal disease, tooth defect, and treatment protocol) of the patients were evaluated. DMFT and malocclusion levels were compared among the patients with ANOVA and Sheffe's post-hoc test, and chi-square test, respectively. The correlation between the demographic characteristics and dental status of the patients were analyzed with the Pearson's correction test. The mean age of the patients was 27.1 (7 - 83) years and they had intellectual disabilities (55.4%), developmental disorders (17.9%), brain disorders (16.6%), neurocognitive disorders (4.6%), or others (5.5%). The mean DMFT (DT) was 8.6 (5.2) with a significant difference among the disability types (p<0.05). The incidence of malocclusion was higher in patients with intellectual disabilities and brain disorders than in the other types (p<0.05). The operation time ($191.4{\pm}91.2min$) was correlated with decayed or endodontically-treated teeth (p<0.05). Special needs patients requiring GA-dental treatment showed unfavorable oral conditions. Dental practitioners experience time restrictions and additional costs under a GA setting. Treatment planning and decision-making can be efficiently facilitated by evaluating the clinical characteristics of the patients.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.22 no.3
• /
• pp.360-363
• /
• 2000

Osteochondroma is a benign tumor that is frequently developed in axial skeleton but rare in TMJ. 61-year old female patient visited local dental clinic with left TMJ crepitus on chewing, trismus and hearing discomforts. She was referred with a tentative diagnosis of TMD. We performed clinical and radiographic examination and could observe large radiopaque lesion at left TMJ. Excisional operation was performed. It was diagnosed finally with a osteochondroma.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.17 no.4
• /
• pp.271-280
• /
• 2017

Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.