• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.6.1-6.8
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• 2016

Background: Intravenous bisphosphonates have been used in metastatic breast cancer patients to reduce pathologic bone fracture and bone pain. However, necrosis of the jaw has been reported in those who received intravenous bisphosphonates. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is caused by dental extraction, dental implant surgery, and denture wearing; however, it occurs spontaneously. The purpose of this study was to report BRONJ in metastatic breast cancer patients. Methods: Consecutive 25 female patients were referred from the Department of Oncology from 2008 to 2014 for jaw bone discomfort. Staging of breast cancer, history of bisphosphonate infusion, etiology of BRONJ, and treatment results were reviewed. Average age of the patients was 55.4 years old (38-74). Twelve maxillae and 16 mandibles were involved. Conservative treatments such as irrigation, antibiotic medication, analgesics, and oral gargle were applied for all patients for the initial treatment. Patients who had sequestrum underwent debridement and primary closure. Results: The etiologies of BRONJ were dental extraction (19 cases), dental implant (2 cases), and endodontic treatment (1 case). However, three patients did not have any risk factors to cause BRONJ. Three patients died of progression of metastasis during follow-up periods. Surgical debridement was performed in 21 patients with success in 18 patients. Three patients showed recurred bone exposure and infection after operation. Conclusions: Prevention of the BRONJ is critical in metastatic breast cancer patients. Conservative treatment to reduce pain, discomfort, and infection is recommended for the initial therapy. However, if there is a sequestrum, surgical debridement and primary closure is the key to treat the BRONJ.

• Journal of Oral Medicine and Pain
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• v.21 no.1
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• pp.141-152
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• 1996

Oral Lichen Planus(OLP) is a idiopathic chronic inflammatory disease with more difficult to clear and higher recurrent rate than cutaneous lesions. But, there has been no estabilished theories about the proper treatment for OLP. The purpose of this study is to examine the clinical feature, relationship with systemic disease and dental treatment of OLP patients of Korea and to gain helpful information about clinical characteristics and treatment of OLP. The subjects chosen for the study were 54 patients who had visited Department of Oral Diagnosis & Oral Medicine at Yonsei University Dental Hospital Dental Hospital and diagnosed as OLP. Previous clinical records has been reviewed and questionnaires, oral examination, laboratory examination were done and recorded. The following results were obtained : 1. Of the 54 patients, 21 were men and 33 were women with an average age of 47.8 years. 2. The most common intraoral site was bilateral buccal mucosa, followed by unilateral buccal mucosa, gingiva, vesibule, lip mucosa, glossal mucosa, palatal mucosa and mouth floor. 3. The mixed, erosive and reticular form of OLP was most frequent(83.3%) clinical form. 4. OLP patients with liver disease were 5, and drug medication patients were 7. But, we could not find its evidence of association with OLP. 5. Associated events on onset of symptom were stress, denture wearing, dental treatemtn, and common cold. 6. Associated symptoms were dry mouth, tingling, sore throat, and altered taste perception. 30.8% of patients had no specific associated symptoms. 7. Aggravating factors of symptom were peppery food, hot food, fatigue, toothpaste, salty food, sour food, tension, and conversation. Reducing factors were cold food, sleeping. 69.2% of patients had no specific reducing factors. 8. There were no significant differences between normal papulation and OLP patients in CBC, SGOT< SGPT, Serum iron, Total iron binding capacity. 66.7% of subjects were positive response to fungus study for Candida Albicans. The incidence of stress and dental treatment on onset of symptom appeared high in OLP patients. Especially, high incidence of positive response to fungus study for Candida albicans, prescription of anti-fungal agents and dental treatment considerations may be helpful to treatment of OLP.

• Journal of Korean society of Dental Hygiene
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• v.12 no.5
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• pp.1059-1069
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• 2012

Objectives : The purpose of this study was to examine the knowledge of orthodontic patients about oral health knowledge and their actual oral hygiene care, which affected the oral hygiene of orthodontic patients. It's specifically meant to provide information on the prevention of the possible side effects of orthodontic treatment and the promotion of the oral health of orthodontic patients. Methods : This study were 227 orthodontic patients of dental clinics specialized in orthodontics. The collected data were analyzed by the statistical package SPSS WIN 18.0. Results : 1.As for Oral health knowledge, they had the best knowledge about smoking and dental checkup among the subfactors of oral health knowledge. 2. As to actual oral hygiene care, what they did best was doing toothbrushing before sleeping and what they did worst was avoiding eating food injurious to teeth. 3. They scored highest in the right toothbrushing(3.85), the use of oral hygiene supplies(3.62), the prevention of periodontal diseases(3.13) in the subfactors of actual oral hygiene care. They scored lowest in dental checkup and diet(2.99). 4. There were significant differences among the patients in oral health knowledge according to age(F=2.95, p<.05). Those who received another treatment during orthodontic treatment had a better oral health knowledge than the others who didn't, and the gap between the two was statistically significant(t=2.26, p<.05). 5. There were differences among the patients in actual health hygiene care according to gender(t=2.71, p<.01), age(F=4.40, p<.01), educational experiences about oral hygiene care(t=3.06, p<.01) and experience of receiving another treatment during orthodontic treatment(t=2.56, p<.05). 6. There was a positive correlation between oral health knowledge and oral hygiene care(r=.261, p<.001). Conclusions :The above-mentioned findings suggest that more education of diet and toothbrushing should be provided for orthodontic patients to improve their oral health care.

• The korean journal of orthodontics
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• v.48 no.3
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• pp.143-152
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• 2018

Objective: This study examined cone-beam computed tomography (CBCT)-derived multiplanar-reconstructed (MPR) cross-sections to clarify the salient characteristics of patients with skeletal class III malocclusion with midface deficiency (MD). Methods: The horizontal and sagittal plane intersection points were identified for middle-third facial analysis in 40 patients in the MD or normal (N) groups. MPR images acquired parallel to each horizontal plane were used for length and angular measurements. Results: A comparison of the MD and N groups revealed significant differences in the zygoma prominence among female patients. The convex zygomatic area in the N group was larger than that in the MD group, and the inferior part of the midface in the N group was smaller than that in the MD group for both male and female patients. A significant difference was observed in the concave middle maxillary area among male patients. Conclusions: This study was conducted to demonstrate the difference between MD and normal face through MPR images derived from CBCT. Male patients in the MD group had a more flattened face than did those in the N group. Female patients in the MD group showed a concave-shaped lower section of the zygoma, which tended to have more severe MD. These findings indicate that orthognathic surgery to improve skeletal discrepancy requires different approaches in male and female patients.

• The Journal of Advanced Prosthodontics
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• v.14 no.3
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• pp.143-149
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• 2022

PURPOSE. Masticatory loading triggers active bone remodeling, altering alveolar bone mineral density (BMD). While dental implants are placed to bear masticatory loading, their influence on changing bone properties has not been fully investigated. Objective of this pilot study was to examine whether the dental implantation has an effect on BMD distribution of bone by comparing dentate, edentulous, and edentulous patients with implants. MATERIALS AND METHODS. Cone beam computed tomography (CBCT) images of 19 partially edentulous patients (Dent), 19 edentulous patients (Edent), and 16 edentulous patients who received implants in the mandible (Edent+Im), were obtained. CBCT images were also obtained from 5 patients within Edent+Im group, before implant placement and after implant loading. Basal cortical bone region of the mandible was digitally isolated. A histogram of gray levels proportional to BMD was obtained to assess mean, histogram standard deviation (HSD), fifth percentile of low and high values (Low₅ and High₅) of the BMD distribution. Multivariate analysis of variance and paired t-test were used to compare the BMD parameters among the 3 dental status groups and between pre- and post-implantation, respectively. RESULTS. Edentulous patients with implants had significantly greater HSD and High₅ values compared to edentulous patients (P < .013). All other comparisons were not significant (P > .097). Mean, HSD, and High₅ values significantly increased after receiving implants (P < .022). CONCLUSION. The current findings suggested that receiving dental implants promoted oral bone mineralization for edentulous patients. The longitudinal investigation could provide valuable information on understanding the effects of implantation on the behavior of oral bone quality.

• Journal of Korean society of Dental Hygiene
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• v.22 no.5
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• pp.411-416
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• 2022

Objectives: This study aimed to identify pathogenic microorganisms in the oral cavity of Alzheimer's dementia patients and recognize the necessity and importance of oral prevention management. Methods: The participants comprised 40 dementia patients aged 60 years or older and general patients who were using nursing care facilities in Gwangju from February to July 2017. Samples were collected with Eazyperio products for oral pathogenic microbial testing. Eighteen types of bacteria could be detected by analyzing Multiplex-Quantity Real Time polymerase chain reaction at a genetic testing agency. Results: The study comprised more women than men. Most participants were in their 80s. Statistically significant differences were observed in some oral pathogenic microorganisms. Conclusions: Pathogenic microorganisms could more easily proliferate in the oral cavities of Alzheimer's dementia patients than they could among general elderly participants due to a lack of awareness of oral hygiene and prevention management. To improve this, it is considered necessary to deploy oral health care professionals.

• International Journal of Oral Biology
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• v.43 no.4
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• pp.201-207
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• 2018

Porphyromonas gingivalis is among the major etiological pathogens of chronic periodontitis. The virulence mechanisms of P. gingivalis is yet to be identified as its activity is largely unknown in actual disease process. The purpose of this study is to identify antigens of P. gingivalis expressed only in patients with chronic periodontitis using a unique immunoscreening technique. Change Mediated Antigen Technology (CMAT), an antibody-based screening technique, was used to identify virulence-associated proteins of P. gingivalis that are expressed only during infection stage in patients having chronic periodontitis. Out of 13,000 recombinant clones screened, 22 tested positive for reproducible reactivity with rabbit hyperimmune anti-sera prepared against dental plaque samples acquired from periodontitis patients. The DNA sequences of these 18 genes were determined. CMAT-identified protein antigens of P. gingivalis included proteins involved in energy metabolism and biosynthesis, heme and iron binding, drug resistance, specific enzyme activities, and unknown functions. Further analysis of these genes could result in a novel insight into the virulence mechanisms of P. gingivalis.

• Journal of Korean society of Dental Hygiene
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• v.11 no.5
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• pp.717-727
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• 2011

Objectives : This study was purposed to estimate the level of oral health quality of life and the relationship between health-related factors and oral health quality of life in patients with successful dental implants. Methods : This questionnaire survey was conducted during the period from December 2009 to March 2010 with 126 patients confirmed successful dental implants in Busan. The oral health related quality of life and oral health-related factors were estimated with OHIP-14 and 8 oral health characteristics, respectively. Data analysis was performed with descriptive analysis, t-test, ANOVA, multiple regression analysis using SAS(ver 9.1) program. Results : The score of oral health quality of life in patients with successful dental implants was $12.25{\pm}7.82$. The scores of subscale of the oral health quality of life were $1.24{\pm}1.35$ in social disability, $1.60{\pm}1.37$ in handicap, $1.60{\pm}1.44$ in psychological disability, $1.70{\pm}1.38$ in functional limitation, $1.81{\pm}1.35$ in physical disability, $2.14{\pm}1.46$ in physical pain, $2.17{\pm}1.46$ in psychological discomfort, respectively. The related factors of oral health quality of life in patients with successful dental implants were absence of other type prosthesis and experience of tooth brushing education. Conclusions : The oral health related quality of life in patients with successful dental implants was relatively good condition. Social supports and chances for high quality denture and tooth brushing educations are needed to improve oral health related quality of life in patients with dental implants.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.2
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• pp.89-94
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• 2016

Anxiety and phobia in dental procedures are common deterrents for patients visiting the dental care unit. For these individuals, procedural sedation may aid in completion of dental treatments. In most cases, the patients are conscious during sedation, thereby allowing spontaneous ventilation. Intravenous sedation (IVS) is widely used during dental treatment to relieve patient anxiety. IVS is the most effective route of administration to achieve this goal, but it requires advanced training, more than that provided during undergraduate education. During IVS, rapid onset, repetitive drug administration, easy titration, and rapid recovery from sedation can be achieved. However, conscious sedation during IVS can result in deep sedation that can cause respiratory and cardiovascular depression. Therefore, the characteristics of intravenous sedatives should be known. The purpose of this review is to discuss the characteristics and usage of intravenous sedatives currently used for dental procedures.

• Journal of Technologic Dentistry
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• v.41 no.4
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• pp.305-317
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• 2019

Purpose: The purpose of this study is to provide basic data for the improvement of dental care service for patient care. Methods: The survey period was from December 10, 2018 to June 10, 2019. The subjects were 180 patients who were treated with dental implant in 20 dental hospitals and clinics in Daejeon and Gyeonggi province. A total of 145 questionnaires were analyzed except for 35 copies which were unreliable or difficult to analyze. Results: The most important care method for prolonging the life time of dental implant prosthesis was the highest rate of correct brushing (39.4%), and a majority in the subjects used oral hygiene products (91.0%). With regard to discomfort after dental implant prosthesis, food particles between the teeth showed the highest response (49.7%), and discomfort with gum infections and bleeding and reduced mastication increased significantly with age (p<0.05), whereas feeling of irritation decreased significantly with age (p<0.05). Conclusion: This study is meaningful in that it approached the perception and discomfort of prosthesis from the patients' point of view. It needs to establish the basic data to improve dental treatment service for patient care.