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Interstitial Vaginal Needle Implantation in Gynecological Tumors : Design and Construction of Applicator (부인과암에서 조직내 삽입 방사선치료 - Applicator의 고안 및 제작-)

  • Kang, Seung-Hee;Chun, Mi-Son;Kang, Hae-Jin;Jung, Chil;Son, Jeong-Hyae
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.167-175
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    • 1998
  • Purpose : It is not a simple task to achieve the ideal isodose curve with a standard vaginal applicator or sing1e plane needle impant in the paravaginal tissue when primary or recurrent gynecological neoplasms(cervical cancers, vaginal cancers and vulvar cancers) are treated as a boost following external beam radiotherapy. The authors introduce the development and construction of a simple, inexpensive, customized applicator for volume implant to maximize the radiation dose to the tumor while minimizing the dose to the rectum and the bladder. Materials and Methods : Nine patients underwent Ir-192 transperineal interstitial implantation for either recurrent(5 cases) or primary(3 cases) cervical cancers or primary vaginal cancer(1 case) between August 1994 and February 1998 at Ajou university hospital. First 3 cases were performed with a sing1e plane implant guided by digital palpation. Because of inadequate isodose coverage in the tumor volume in first 3 cases, we designed and constructed interstitial vaginal applicator for volume implant to improve tumor dose distribution and homogeneity while sparing the surrounding normal tissue. Our applicators consist of vaginal obturator and perineal template that made of the clear acrylamide and dental mold material$(Provil^{(R)})$. The applicators were customized individually according to the tumor size and its location Both HDR and LDR irradiation were given with these applicators accomodating 6 Fr needles(Microselectron Nucletron). The pretreatment planning prior to actual implant was performed whenever possible. Results : Needles can be inserted easily and evenly into the tumor volume through the holes of templates, requiring less efforts and time for the implant procedure. Our applicators made of materials available from commercial vendors. These have an advantage that require easy procedure, and spend relatively short time to construct. Also it was possible to fabricate applicators to individualize according to the tumor size and its location and to achieve the ideal isodose coverage. We found an accurate needle arrangement and ideal dose distribution through the CT scan that was obtained in 3 cases after needle implant. Three patients with primary cervical and vaginal cancers were controlled locally at final follow up. But all recurrent cases failed to do so. Conclusion : The authors introduce inexpensive, simple interstitial vaginal templates which were self-designed and constructed using materials available from commercial vendors such as acrylanide and dental mold material $(Provil^{(R)})$.

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A STUDY ON THE TRAUMATIC INJURY OF PATIENTS IN DEPARTMENT OF PEDIATRIC DENTISTRY, KANGNUNG NATIONAL UNIVERSITY DENTAL HOSPITAL (강릉대학교 치과병원 소아치과에 내원한 외상 환자에 대한 분석)

  • Kim, Dong-Won;Lee, Kwang-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.2
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    • pp.247-254
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    • 2001
  • There is a growing tendency for injury and it is essential to know about the epidemiology of the injured teeth for proper and timely treatment. Through empirical data analysis of 120 children who came to pediatric dentistry of Kangnung National University Dental Hospital, this study purposes to give an understanding about the injury and analyzes the frequency by children's sex and age, the number of injured teeth according to the area in the mouth, the types of injury, causes and places of injury, the frequency occurred by month and hour, the position of injured teeth, and the elapse of time. The main findings of this study are summarized as follows: 1. The frequency analysis by sex shows that the rate of boys is more likely to be higher than girls(1.6:1). 2. The frequency analysis by age shows that the ratio of children between aged 2~4 and 8~10 are high. 3. The number of injured teeth is generally one(51.7%). 4. Periodontal tissue injury is the main cause for the primary teeth. In case of permanent teeth, the ratio of hard tissue injury which is much increased than the case of the primary teeth, is similar to that of periodontal tissue injury. 5. The main cause of injury is fall for both dentition; In case of permanent dentition, the ratio of injury by sports is increased. 6. The place of injury for primary teeth is mainly home(38.8%); Street and school for permanent teeth(42.5% and 35%, respectively). 7. The frequency by month shows that the injury is most frequently occurred in July. 8. The frequency analysis by hour shows that injury for primary teeth mostly happens in the morning; in the afternoon for permanent teeth. 9. The position of injured teeth according to the area in the mouth is mainly maxilla anterior in both case of primary and permanent teeth and especially the ratio of central incisors is high, 10. More than half(59.2%) of patients came to the hospital within one day and the seriously injured were likely to come within one day than the slightly injured.

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THE COMPARATIVE STUDY ON THE SEDATIVE EFFECT OF DIFFERENT INTRAVENOUS MIDAZOLAM DOSAGES FOR PEDIATRIC DENTAL PATIENTS (소아환자의 Midazolam의 정맥투여 용량에 따른 진정 효과에 관한 비교연구)

  • Kim, Eun-Young;Kim, Jong-Soo;You, Seung-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.416-426
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    • 2005
  • Intravenous sedation have many advantages of rapid onset and recovery, ability of control sedation levels and duration through titration. Midazolam is most commonly used intravenous medication for sedation in pediatrics, endoscopy, oncologic procedures and so on. But in dentistry, midazolam intravenous sedation is usually for adult, and there are few reports for children. Todays, children who need sedation become more and older, intravenous sedation technique is going a matter of concern in pediatric dentistry. The purpose of this paper is to evaluate the efficacy of sedation and clinical success for different initial dosage of midazolam in intravenous sedation for pediatric dental patients. 16 healthy children (male 10, female 6), mean age $54.7{\pm}10.7$ months, who needed at least two separate treatment visits requiring local anesthesia were chosen for this study. Every children were taken 0.3mg/kg, maximum 5mg of midazolam by intramuscular route, and then 30~50% $N_2O-O_2$ for 10 minutes was given. On every visits, one of the following 2 different initial dosage was given by intravenous route : (1) Group I : 0.1mg/kg Midazolam (2) Group II : 0.2mg/kg Midazolam. Additional dosage was half of the first dose. Physiologic parameters (oxygen saturation, heart rate, respiratory rate, end-tidal carbon dioxide pressure) was recorded by ten procedure steps. Behavior was videotaped and rated using Ohio State University Behavioral Rating Scale and Automated Counting System by one investigator, blind to administered dosage. After the treatment, operator evaluated the clinical success. Physiologic parameters were stable and within normal range during treatment in both groups. The analyzed sedative effect, in behavioral evaluation, ratio of favorable Quiet was higher in group II, and clinical success rate of group II was better than group I. Induction time was rapid in group II, and recovery time was rapid in group I. And there was no statistically difference between two groups in every results.

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An Esthetic Restoration of the Missing Maxillary Anterior Teeth with the Rotational Path RPD: A Case Report (회전삽입로 국소의치를 이용한 심미적 상악 전치부 수복 증례)

  • Lee, Ji-Hye;Lim, So-Min;Jung, Hye-Eun;Park, Chan-Jin;Cho, Lee-Ra;Kim, Dae-Gon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.2
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    • pp.209-222
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    • 2011
  • Missing anterior teeth can be replaced using any of a number of methods. Patients may choose to replace missing teeth with a prosthesis that is either removable, fixed, or retained with implants. For patients faced with financial, anatomical, and/or esthetic limitations, the edentulous region can be restored successfully and esthetically with a properly designed and fabricated rotational path RPD. The rotational path RPD is a partial removable dental prosthesis that incorporates a curved, arcuate, or variable path of placement allowing one or more of the rigid components of the framework to gain access to and engage an undercut area. The rigid retainer must gain access to the infrabulge portion of the tooth by rotating into place. Either a minor connector or proximal plate provides retention through its intimate contact with a proximal tooth surface. A specially designed dovetails or asymmetric rest seats provides support and embracing effects. Correctly designed and fabricated rotational path RPD can provide improved esthetics, cleanliness, and retention. But rotational path RPDs are technique sensitive since the rotational path RPD has little margin of laboratory error that rigid retainers cannot be adjusted like conventional clasps can, RPD framework must be remade once the retention is lost. The sufficient understanding of the concept for the rotational path RPD is required for clinically successful treatment. This clinical report describes in detail the theoretical, laboratory considerations and the treatment of a patient with an anterior maxillary edentulous area treated by an AP path rotational RPD that had a difficulty in long term maintenance and describes another clinical case in which more reasonable treatment procedures were approached after analyzing the former case.

Comparison of the SNR in the MR images on dental implant material (치아 임플란트 재료에 따른 자기공명영상의 SNR 비교)

  • Kim, Dong-Hyun;Ko, Seong-Jin;Ye, Soo-Young
    • Journal of the Institute of Convergence Signal Processing
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    • v.16 no.4
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    • pp.149-155
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    • 2015
  • Tooth implant is located in oral cavity and affects neck, skull base, and facail image. These magnetic inhomogeneities are usually frequency encoding direction which cause artifacts due to change of signal strength and geometric distortion. First, to evaluate signal to noise ratio (SNR) of magnetic resonance image caused by tooth implant this study uses meat phantom which is similar to human body and is consisted with fat, muscle, and water to measure signal to noise ratio. Second, signal to noise ratio by using custom-made fixed phantom is measured, and then signal to noise ratio size of different tooth implant types is compared and analyzed. The measured signal to noise ratio values of Brushite, HSA, Metal, and RBM for meat phantom were 2.76, 2.22, 1.88, and 1.57 on T1 SE, 1.88, 1.78, 1.65, and 1.79 on T2 FLAIR, 2.28, 2.25, 2.88, and 2.05 on T2 FSE, and 2.74, 1.94, 1.67, and 1.48 on T2 GRE. The measured signal to noise ratio values of Brushite, HSA, Metal, and RBM for fixed water phantom were 1.2, 1.06, 1.12, and 1.22 on DWI, 1.93, 1.87, 1.93, and 2.06 T1 SE, 1.83, 1.76, 1.82, and 1.92 on T2 FLAIR, 1.85, 1.79, 7.86, and 1.97 on T2 FSE, and 1.97, 1.93, 1.99, and 2.06 on T2 GRE. By considering through the results, patients and dentists need to consider some impacts from testing many aspects although their main purpose of having tooth implants is a dental restoration. Moreover, depending on the tooth implant characteristics of individual patients this study results can be used as baseline data when choosing test protocol.

The study on the cleft lip and/or palate patients who visited Dept. of Orthodontics, Seoul National University Dental Hospital during last 11 years (1988.3-1999.2) (최근 11년간 서울대학교병원 교정과에 내원한 순구개열 환자의 내원 현황에 관한 연구(1988.3 - 1999.2))

  • Yang, Won-Sik;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.29 no.4 s.75
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    • pp.467-481
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    • 1999
  • Cleft lip and/or palate is one of the most common congenital craniofacial anomalies. According to previous epidemiologic studies, incidence of cleft lip and/or palate has been increasing nowadays. However, there is no report about epidemiologic study of cleft lip and/or palate patients who visited dept. of orthodontics in Korea. So the purpose of this study was to provide the epidemiological characteristics and important basic clinical data for the diagnosis and the treatment of the cleft lip and/or palate patients. With the orthodontic and cleft charts, diagnostic models and X-ray films from 250 patients with cleft lip and/or palate who visited Dept. of Orthodontics, Seoul National University Dental Hospital during the last 11 years, the authors investigated patient's visiting yew, types of cleft, patient's gender, and Angle's classification of malocclusion, and surgery timing. The results were as follows ; 1. The number of cleft patients who visited Dept. of Orthodontics, SNUDH increased during 1988-1990 and then it declined until 1992. From 1993 to 1996, it showed a stationary trend. After 1997 it showed an overwhelmingly increasing trend. 2. In the cleft type, the ratio of cleft lip cleft lip and alveolus cleft palate : cleft lip and palate was 7.6:19.2:9.6:63.6. In cleft position, unilateral clefts were more than bilateral ones (cleft lip 79:21, cleft lip and alveolus 77:23, cleft lip and palate 75.5:24.5). In cleft side, left clefts were mote than right clefts (cleft lip 53.3:46.7 cleft lip and alveolus 59.5:40.5, cleft lip and palate 59.2:40.8). 3. In gender ratio, males were more than females in cleft lip (57.9:42.1), cleft lip and alveolus (68.8:31.2) and cleft lip and palate (76.1:23.9). But in cleft Palate females were more than males as 41.7: 58.3. 4. In the age groups, 7-12 year group was the most abundant as $52\%$, and then 0-6 year group ($20.4\%$), 13-18 year group ($17.2\%$), more than 18 yew group ($10.4\%$) were followed as descending order. 5. Most of the cleft lip repair surgeries were operated in 0-3 month ($60.3\%$) and 4-6 month ($17.9\%$). 6. The cleft palate repair surgeries were done in 1-2 year ($31.7\%$), 0-1 year ($25.6\%$), 2-3 year ($12.1\%$), more than 5 year ($11.6\%$) as descending order. 7. The lip scar revision surgeries were done before admission at elementary school in $60\%$. (4-6 you ($27.5\%$), 6-8 year ($19.6\%$), more than 10 year ($19.6\%$), 2-4 year ($13.7\%$) as descending order) 8. The rhinoplasties were done before admission at elementary school in $51.7\%$. (0-2 year ($7.1\%$), 2-4 year ($14.3\%$), 4-6 year ($21.4\%$), 6-8 year ($14.3\%$)). 9. The pharyngeal flap were done at 6 Y (72.5 months) after birth on average and there was even distribution of surgery timing. 10. In relationship between Angle's classification of malocclusion and cleft types, Class I was most abundant and Class III, Class II were followed as descending order in cleft lip group. But Class III was most abundant and Class I, Class II were followed as descending order in cleft lip and alveolus group, cleft palate group, and cleft lip and Palate group. The percentage of frequency in Class III malocclusion was overwhelmingly higher in cleft lip and palate group than any other groups. 11. Because the frequency of class III malocclusion was most prevalent in all age groups, anterior crossbite was the most common chief complaint of cleft patients.

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Comparative Clinical Study between Oriental Medicine and Oriental-western Medicine Treatment on Facial Nerve Paralysis (구안와사(口眼喎斜)에 대한 한의(韓醫) 및 한(韓)·서의(西醫) 협진(協診) 치료(治療)의 임상(臨床) 관찰(觀察))

  • Kang, Mi-Jung;Kim, Kee-Hyun;Hwang, Hyeon-Seo
    • Journal of Acupuncture Research
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    • v.17 no.1
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    • pp.55-66
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    • 2000
  • The following results have been obtaind after examing 72patients with facial paralysis who were hospitalzed and treated through the time period of December 1st, 1996 to November 30th, 1999 at the Department of Acupuncture and Moxibustion of Seoul Oriental Medicine, Kyungwon University. During the examination, those 72 patients were divided into two groups, and One group was treated by oriental-western treatment, the other group was treated by oriental treatment. Oriental treatments were acupuncture and moxibustion, herb medicine, physical treatment and hygienic treatment. The one of main western treatments is steroid therapy. The results were obtained as follows : 1. In regard to signs at the first medical examination, lacrimation was showed highest number and facial paralysis, dysgeusia, hyperacusis were showed in numerical order. 2. In regard to prescription of oriental herb medicine, Kamissangbotang(加味雙補湯) was prescribed in greatest numbers and Boyangwhanotang(補陽還五湯), Kamiboiktang(加味補益湯), Ligigepungtang(理氣祛風湯) were prescribed in numerical order. 3. In regard to treatment number, 10~19 times for treatment was showed highest number and 1~9 times, 20~29 times, 40~49 times were showed in numerical order . 4. In regard to mean treatment times about injury region and main sign, the effect of oriental-western treatment was showed as follows: lacrimal gland disorder, hyperacusis, dysgeusia, facial paralysis were treated for 15.1, 27, 13.2 and 21.4 times, repectively. The effect of oriental treatment was showed as follows: lacrimal gland disorder, hyperacusis, dysgeusia, facial paralysis were treated for 34.8, 22.1, 33.8 and 16.3 times, respectively. 5. In regard ta the effect of treatment about injury region and main sign, oriental-western treatment was showed as follows: cases of lacrimal gland disorder were showed 1 of excellent case, 1 of fair case, 5 of good cases. In hyperacusis patients, there was showed 1 of fair case. In dysgeusia patients, there was showed 1 of excellent case, 3 of fair cases, 1 of good case. In facial paralysis, there were showed 5 of fair cases. Oriental treatment was showed as follows: In lacrimal gland disorder, the excellent were 4 cases, the fair were 10 cases, the good were 3 cases and the poor were 4 cases, In hyperacusis, the fair were 5 cases, the poor 2 cases. In dysgeusia, the excellent were 4 cases, the fair were 1 case, the good were 1 case and the poor was 1 case, In facial paralysis, the excellent were 9 cases, the fair were 4 cases, the good 3 cases and the poor were 3 cases. 6. The effect of total treatment was as follows: 30 cases were showed fair effect, 19 cases were showed excellent effect, 13 cases were showed good effect and 10 cases were showed poor effect. 7. In regard to attack factor, overlabour was showed highest number and wind-cold, mental stress, trauma, ear disease, common cold, dental diseae, reason unknwon were showed in numerical order. 8. In regard to premonitory symptoms, non significant symptoms were in 38 cases, the pain of peri-stylomastoid region were in 38 cases and headache, dysaesthesia of periorbit, dysgeusia, stomatitis, eyelid tic were showed in numerical order. 9. In regard to sex, male were 33 cases and female were 39 cases. The distribution of age was disclosed that thirty, forty, fifty, seventy, sixty, twenty and below twenty years were revealed in turn. Sex and paralytic side were showed as follows: male-left were 15 cases, male-right were 18 cases, female-left were 19 cases and female-right were 19 cases. In regard to attack frequence in month, March was showed highest number and January, April, May, August, October, etc were showed in numerical order. In regard to attack frequence in season, spring was showed highest number and winter, summer, fall were showed in numerical order, but attack frequence between four seasons wasn't showed significant difference.

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A CLINICAL STUDY OF CONGENITAL MISSING TEETH (선천성 결손치에 관한 임상적 연구)

  • Jeong, Hae-Kyoung;Yang, Yeon-Mi;Kim, Jae-Gon;Baik, Byeong-Ju;Jung, Jin-Woo;Kim, Ha-Na;Kim, Mi-Ah
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.2
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    • pp.245-252
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    • 2009
  • The congenital missing of teeth is common, which takes place since the proliferation and differentiation are not allowed in that tooth bud fail to start development. The purpose of this study is to research incidence rate, number, and missing part of congenital missing teeth, and to study whether a person who has missing teeth has other abnormality of teeth or not. For this study, 1,520 subjects(aged 2.9$\sim$17) who had visited pediatric dentist department of Chonbuk national university dental hospital within 2 years were examined with an panoramic radiograph; exempting third molar missing state. The obtained results are as follows. 1. 8.88% among total subjects show missing teeth; male 9.05%, female 8.64% 2. The most frequently missing permanent teeth were the mandibular second premolars(22.3%). The most frequently missing primary teeth are mandibular lateral incisors(50%). 3. 43.3% patients have one permanent missing tooth, 34.3% have two, and 10.4% have more than six, respectively. In primary teeth, 86.7% patients have one missing tooth, and 13.3% have two missing teeth. 4. 18 patients(13.3%) have missing teeth as well as hyperdontia, while some patients have microdont, ectopic eruption, and fusion teeth.

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Effect of Orthodontics Patients' Orthodontics Characteristics on the Living Quality Related to Oral Health (OHIP) (교정환자의 교정치료 특징이 구강건강관련 삶의 질(OHIP)에 미치는 영향)

  • Yoon, Sung-Uk;Oh, Na-Rae;Jeong, Mi-Ae
    • The Journal of the Korea Contents Association
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    • v.14 no.3
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    • pp.250-258
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    • 2014
  • The purpose of this study was to promote effective health management of orthodontics patients by determining the effect that the factors related to orthodontics would have on the Oral Health Impact Profile (OHIP), and the subjects of this study was the local residents of Gangwon-do Province. The mean score of OHIP for the subjects was 2.97, while the mean score of physical factor was 3.01. The mean score of psychological factor was found to be 2.93. Thus, the orthodontics was found to have more influence on psychological factor. The item that had the greatest influence among the 10 items of Oral Health Impact Profile was found to be the question, "Have you ever felt shy due to your dental shape?" which had the mean score of 2.66. The characteristics that had significant effect on OHIP among general characteristics were found to be the age, religion, occupation, income, smoking or non-smoking status(p<0.05). In terms of the age, the age of 20 or less had the greatest effect with the mean score of 2.53. In relation to the occupation, the production/sales occupation had an influence with the mean score of 2.56 (p<0.05). Those with income exceeding KRW 4 million were found to have the mean score of 2.83 and 2.78. It turned out that the smokers had greater effect compared to the non-smokers in relation to the smoking/non-smoking status as the income was higher (p<0.05). The characteristics of orthodontics were manifested as the health perception in relation to Oral Health Impact Profile (OHIP) (p<0.05). Regarding the reason why they underwent the orthodontics, the 'uncomfortable feeling in chewing' was found to have the mean score of 2.69 and 2.67 (p<0.05). Regarding the orthodontics period, 1 to 2 years were found to have the mean score of 2.80 and 2.74, thus having an influence (p<0.05). In relation to the regret/non-regret over orthodontics, those who indicated that they regretted were found to have the mean score of 2.65 and 2.60 (p<0.05). Analysis of the relationship between Characteristics of orthodontic treatment and OHIP, orthodontic treatment reasons, oral health awareness, whether orthodontic treatment regret showed a statistically significant correlation. it is considered necessary to make constant efforts to help orthodontics patients, both physically and psychologically, in the course of treatment and improve their quality of lives.

SEDATION EVALUATION USING BIS INDEX ASSESSMENT WITH AND WITHOUT THE ADDED SUBMUCOSAL MIDAZOLAM (점막하 Midazolam의 병용투여 시 BIS 분석을 이용한 진정 평가)

  • Lee, Young-Eun;Park, Mi-Kyung;Kim, So-Young;Kim, Yun-Hee;Jung, Sang-Hyuk;Baek, Kwang-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.1
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    • pp.91-98
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    • 2007
  • The aim of this study was to examine the difference of the depth of sedation using the Bispectral index assessment with and without the added submucosal Midazolam to oral Chloral hydrate and Hydroxyzine for pediatric patients. Twenty seven sedation cases were performed in this study Selection criteria included good health(ASA I), 2 to 6 years of age, the need for sedation to receive dental treatment including anesthesia, and restorative procedure over at least two teeth. Patients were randomly classified into one group taking oral Chloral hydrate(60 mg/kg) and Hydroxyzine(1 mg/kg) and the other group recieving Chloral hydrate(60 mg/kg), Hydroxyzine(1 mg/kg) and submucosal Midazolam(0.1 mg/kg). Nitrous Oxide(50%) was used for both group during sedation. Patients were monitored using a pulse oximeter and a Bispectral monitor. A behavior scale was rated as quiet(Q), crying(C), movement(M), or struggling(S) every 2 minutes watching a recorded videotape. Analysis showed a significant difference in mean Bispectral index and SD during sedation across two groups(P<0.001). The group of patients injected with submucosal Midazolam in addition to oral Chloral hydrate and Hydroxyzine showed a lower mean Bispectral index and a narrower SD. PR and SpO2 for both groups remained within the normal values. Submucosal Midazolam improved the sedation quality by deepening sedation depth without compromising safety and enabled the sedation pattern to be kept more stable.

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