• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권2호
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• pp.131-134
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• 2008

Purpose: The objective of this study was to evaluate the clinical parameters in terms of the midazolam sedation in patients undergoing dental practice. Patients and Methods: Total 28 patients were included in this study. They received the dental practice in the daycare center and sedation was done with midazolam. The recorded variables were blood pressure, pulse rate, $SpO_2$, and patient's response. The differences between observations were analyzed with paired samples t-test. Results: The blood pressure was significantly decreased after the administration of midazolam and the systolic pressure was significantly increased at the start of operation (P<0.05). The pulse rate was significantly increased after lidocaine injection (P<0.001). The amnesic effect was shown 21 cases out of 28 cases (75%). Conclusions: The effect of midazolam on pulse rate was not significant. However, midazolam could decrease the blood pressure significantly. Therefore, the sedation with midazolam could be successfully used in the dental practice, particularly for the patients having the hypertension.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.39.1-39.7
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• 2018

Background: Patients with chronic ITP (idiopathic thrombocytopenia) frequently do not require comprehensive medication for daily life. Usually, it had been regarded that postoperative bleeding after a simple or surgical extraction is easily controlled by simple local measures even in patients with ITP. This lack of regular medication usage can sometimes lead practitioners or patients to underestimate the potential life-threatening risk of ITP. There had been no report on postoperative hemorrhage in a patient with ITP related to dental implant surgery. Case presentation: This report presented a life-threatening postoperative hemorrhage after dental implant surgery in an adult with chronic ITP and subsequent emergency management after severe bleeding and airway compromise. Conclusion: The presented case emphasizes the thorough hematological evaluation of the patients even for patients who do not take any specific medications for asymptomatic, chronic ITP.

• 한국치위생학회지
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• 제18권5호
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• pp.665-674
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• 2018

Objective: The purpose of this study was to reduce the burden on dental hygienists in performing dental hygiene processes in the clinic. This study systematically analyzed dental hygiene problems and dental hygiene planning according to the oral condition of patients by applying an oral health care program based on the dental hygiene process. Methods: This study analyzed influential factors of 17 dental hygiene problems and 12 dental hygiene plans according to the oral health index and charts of 185 patients. This study was approved by the Institutional Review Board (IRB No. 1041449-201801-HR-003) of Silla University. The frequency of dental hygiene problems and dental hygiene planning was analyzed and correlations among the oral health index, dental hygiene problems, and dental hygiene planning were analyzed. Results: The higher the bleeding on probing score was, the more scaling was planned. The higher the calculus rate was, the more air-jet and jaw joint disorder prevention education was planned. The higher the O'Leary index was, the more dietary education and air-jet was planned. The higher the Simplified Oral Hygiene Index was, the more air-jet and jaw joint disorder prevention education was planned. The higher the Periodontal Screening and Recording index was, the more scaling and professional tooth cleaning was planned (p<0.05). Conclusions: The burden of oral preventive duties on dental hygienists will be minimized by systematically establishing problems and planning of dental hygiene according to patients' oral health index scores. Therefore, it is expected that dental hygienist can actively use the dental hygiene process in oral health care programs.

• 대한치과교정학회지
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• 제42권4호
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• pp.201-206
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• 2012

Objective: To determine the changes in dental anxiety, state anxiety, and trait anxiety levels of patients and their parents after 3 months of active orthodontic treatment. Methods: We evaluated 120 patients and one parent of each patient. State Anxiety (STAI-S), Trait Anxiety (STAI-T), and Corah's Dental Anxiety Scale (DAS) were administered before orthodontic treatment (T1) and after 3 months of treatment (T2). Differences in scores between T1 and T2 were compared using paired-sample t-tests and the relationship between the scores of the DAS and the STAI were analyzed using a bivariate two-tailed Pearson correlation test. Results: Dental anxiety and state anxiety levels decreased among the patients after adjustment to orthodontic treatment (p < 0.001). However, 3 months of treatment was not sufficient to decrease the anxiety levels of parents (p > 0.05). Patient trait anxiety affected patient state anxiety and dental anxiety (p < 0.01). Additionally, a significant correlation was found between patient dental anxiety and parent dental anxiety (p < 0.05). Conclusions: Dental anxiety and state anxiety levels decrease after patients become familiar with their orthodontist and they became accustomed to orthodontic treatment. However, 3 months is not a sufficient length of time to decrease parental anxiety levels.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권5호
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• pp.301-304
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• 2018

Awake fiberoptic nasotracheal intubation is a useful technique, especially in patients with airway obstruction. It must not only provide sufficient anesthesia, but also maintain spontaneous breathing. We introduce a method to achieve this using a small dose of fentanyl and midazolam in combination with topical anesthesia. The cases of 2 patients (1 male, 1 female) who underwent oral maxillofacial surgery are reported. They received $50{\mu}g$ of fentanyl 2-3 times (total $2.2-2.3{\mu}g/kg$) at intervals of approximately 2 min. Oxygen was administered via a mask at 6 L/min, and 0.5 mg of midazolam was administered 1-4 times (total 0.02-0.05 mg/kg) at intervals of approximately 2 min. A tracheal tube was inserted through the nasal cavity after topical anesthesia was applied to the epiglottis, vocal cords, and into the trachea through the fiberscope channel. All patients were successfully intubated. This is a useful and safe method for awake fiberoptic nasotracheal intubation.

• 한국치위생학회지
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• 제9권4호
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• pp.699-714
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• 2009

Objectives : This study was to examine factors affecting the job satisfaction of dental hygienists. Methods : The subjects in this study were dental hygienists who worked at dental hospitals, dental clinics and general hospitals in the city of Gwangju. A survey was conducted by mail from January 2 to March 2, 2007. Out of the collected data, 208 answer sheets were analyzed. Results : 1. The dental hygienists investigated got a mean of 3.20 on job satisfaction. Among the job satisfaction factors, relationship with patients ranked highest(3.79), followed by relationship with colleagues(3.62), working environments(3.39), future prospects(3.30), professional status (2.89), pay(2.82) and required workload(2.58). 2. Regarding links between general characteristics and job satisfaction, the older dental hygienists were more satisfied with professional status, pay, required workload and relationship with patients. By marital status, the married dental hygienists expressed better satisfaction at professional status than the unmarried ones. By education, those who were receiving college education or received the same or higher education were more gratified than the junior college graduates. By the total length of career, the dental hygienists whose length of career was longer were more gratified with professional status, future prospects and relationship with patients. By workplace, the dental hospital workers were more satisfied with working environments, and the general hospital employees were more gratified with pay. The dental hospital employees were better satisfied with future prospects as well. As to the impact of the length of career at the current workplace, there was a tendency that those who worked at their current workplaces for a longer time expressed better satisfaction with professional status, pay and relationship with patients. By monthly mean income, the larger income earners had a tendency to be better gratified with professional status, pay and relationship with patients. 3. The general characteristics that were selected as independent variables were identified as the factors that exercised an influence on the job satisfaction of the dental hygienists and made an about 14.0% prediction of it. Out of those factors, the total length of career and monthly mean income had a statistically significant impact on that. Conclusions : The above-mentioned findings suggested that out of the seven job satisfaction components, they gave the lowest marks to satisfaction level with pay. As a result of making a multiple regression analysis, it's found that job satisfaction was under the influence of the total length of career and monthly mean income. Therefore there should be an improvement in the pay system in order to boost the job satisfaction of dental hygienists, and they should be paid properly in accordance with total length of career.

• 대한치과의사협회지
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• 제48권1호
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• pp.38-44
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• 2010

Nowadays, medically compromised patients who could not receive dental treatments in the past are able to go through minor oral surgeries with adequate preoperative measures. Thorough understanding of the systemic disease and its complications is needed as well as the management them. Frequent complications of surgical procedures are bleeding, infection, delayed healing, systemic reactions by stress and they can be aggravated due to the patients' systemic conditions. Therefore, understanding of the systemic disease of patient visiting dental office and treatment modification according to the systemic status is needed. Also consultation to the medical doctor is imperative, through which perioperative risk and complications can be reduced. Among the high frequency complications of dental treatment of medically compromised patients, bleeding, infection, delayed healing, systemic reactions by stress will be discussed with the management of each one.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권4호
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• pp.235-239
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• 2015

The Combitube is an emergency airway-maintaining device, which can supply oxygen to dyspneic patients in emergency situations following two-jaw surgery. These patients experience difficulty in opening the mouth or have a partially obstructed airway caused by edema or hematoma in the oral cavity. As such, they cannot maintain the normal airway. The use of a Combitube may be favorable compared to the laryngeal mask airway because it is a thin and relatively resilient tube. A healthy 24-year-old man was dyspneic after extubation. Oxygen saturation fell below 90% despite untying the bimaxillary fixation and ambubagging. The opening of the mouth was narrow; thus, emergency airway maintenance was gained by insertion of a Combitube. The following day, a facial computer tomography revealed that the airway space narrowing was severe compared to its pre-operational state. After the swelling subsided, the patient was successfully extubated without complications.

• 한국치위생학회지
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• 제8권4호
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• pp.79-88
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• 2008

This study was done to investigate the negative word-of-mouth style and effect of communication with negative word-of-mouth from dental clinic patients. Data were collected from 223 dental clinic patients living in Seoul and GyeongGi-Do. The study was collected from October 15th to October 29th, 2007 with self-recording questionnaires. The results of this study were as follows. First of all, in the characteristic of relationships category, subject who were negative word-of-mouth was more 'persuader person' than others. The results showed that the general characteristics of subjects was effective factor of word-of-mouth. Secondly, the behavior scale which was based of negative word-of-mouth was not suitable of the satisfaction of dental clinic service. This results meant the low satisfaction of dental services haven't relation with negative word-of-mouth. Thirdly, 33% of people who have complaints spread negative word-of-mouth. Finally, the main reason of dissatisfaction was long-waiting time for dental clinic service. The results showed the adjustment of dental clinic system and staffs service will prevent negative word-of-mouth spread.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권4호
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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.