• 대한치과마취과학회지
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• 제11권2호
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• pp.125-132
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• 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.

• 대한치과마취과학회지
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• 제14권3호
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• pp.167-172
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• 2014

Background: Propofol is the most commonly used anesthetic for sedation and target-controlled infusion (TCI) is useful for dental treatment. However, it is important to assess and maintain an adequate depth of sedation in patients with severe intellectual disabilities Therefore, in this study we aimed to evaluate the adequate propofol target concentration for dental treatment in severely intellectually disabled patients. Methods: We undertook retrospective review of the sedation records of severely intellectually disabled patients who underwent dental treatment under TCI propofol sedation from September 2011 to April 2012. We evaluated the initial target concentration, stabilized concentration of propofol and monitored vital signs, including BIS score using sedation records. Results: Total 20 patients (10 male and 10 female patients) were included in the study. Every participant was severely intellectually disabled. The mean sedation duration was $70{\pm}16$ (45-100) minutes. The initial propofol target concentration infusion amount was $2.7{\pm}0.45$ (2.0-3.0) mcg/ml. The propofol effect site concentration (Ce) was $2.6{\pm}0.7$ (1.0-4.0) mcg/ml. The average value of BIS was $52.6{\pm}13$ (28-81). During the treatment period, there were no severe complications. Conclusions: The average propofol Ce for deep sedation without any complications in intellectually disabled patients was 2.6 mcg/ml.

• 대한치과기공학회지
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• 제25권1호
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• pp.111-118
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• 2003

I measured the movement range on the hinge articulator and the movement range in an oral. And then I studied to analyze the gap. I got wax records by the movement on the hinge articulator, the movement in an oral and the movement on the hand articulating. I measured the distance of the cusp tips that are close to the mesial direction and the distal direction, the buccal direction and the lingual direction then I compared gaps. As I saw results on data, I knew that the hinge articulator represented the range of mandibular movement restrictively. I could find the decisive contradiction that the sliding movement finished on the hinge articulator although it did not finish in an oral. If the sliding movement does not reappear exactly, it brings a fatal failure to the dental prosthesis. In addition it is impossible that the hinge articulator restores the movement in an oral because the lateral condyle inclination and the horizontal condyle inclination are fixed previously. Therefore dental prosthesisses were made by the hinge articulator, they will interfere with a mastication. I have obtained the following results; 1. The distance of sliding movement on the hinge articulator showed shorter than the distance of sliding movement in oral. This means the increase of cusp inclination of the dental prosthesis that was made on the hinge articulator. Therefore, when the lateral movement occurs in oral, there is a possibility to become the premature as the increase of cusp inclination. 2. The results that were impressed records in oral and impressed records on the hand articulating have many congruities. I think that the simple crown etc. that were made by the hand articulating method except the long span bridge and the free end case that can not measure the vertical dimension exactly can represent similarly the mandibular movement. 3. If we want to represent the mandibular movement similarly, we have to use the articulator that can adjust the horizontal condyle inclination and the lateral condyle inclination at least.

• 한국치위생학회지
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• 제13권2호
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• pp.343-350
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• 2013

Objectives : The objective of this study is to analyze about learning styles and self-regulated learning strategies of dental hygiene students and to find methods that may increase learning outcomes by selecting effective learning methods. Methods : The subjects of this study are 524 dental hygiene students in region of chonbuk from May, 2012 to June, 2012. collected informations are analyzed with SPSS. Results : 1. 38.1%, assimilator is most of learning styles of dental hygiene students, followed by 29.7%, converger, 16.2%, diverger, 15.8%, accommodator. 2. 28.0%, converger and diverger are most of subjects whose grade score is between 2.0-2.9, 41.50%, accommodator is most of 3.0-3.4, and 41.61% accommodator is most of 3.5-3.9, and 28.0%, converger is most of subjects whose grade score is more than 4.0. this results has statistically signification(p<0.01). 3. $8.71{\pm}1.78$, assimilation strategy is most self-regulated learning strategies of dental hygiene students, followed by $8.26{\pm}1.94$, control strategy, $7.52{\pm}2.00$, memorization strategy. accommodator is most showed $7.82{\pm}2.24$, $9.13{\pm}1.74$, $8.71{\pm}2.20$ in memorization strategy, assimilation strategy, control strategy. 4. It is showed that assimilator is significantly related with satisfaction for major(p<0.01), accommodator is significantly related with academic records(p<0.05), and diverger is significantly negative related with academic records, through the results of the analysis of factors that affects learning styles. Conclusions : Organizing above results, It is considered that instructor needs to acknowledge learning styles of students through understanding about various learning styles of students, and may has to develop suitable teaching method for students based on that.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권3호
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• pp.205-213
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• 2017

Background: This study retrospectively investigated outcomes following dental implantation in patients with special needs who required general anesthesia to enable treatment. Method: Patients underwent implant treatment under general anesthesia at the Clinic for the Disabled in Seoul National University Dental Hospital between January 2004 and June 2017. The study analyzed medical records and radiographs. Implant survival rates were calculated by applying criteria for success or failure. Results: Of 19 patients in the study, 8 were males and 11 were females, with a mean age of 32.9 years. The patients included 11 with mental retardation, 3 with autism, 2 with cerebral palsy, 2 with schizophrenia, and 1 with a brain disorder; 2 patients also had seizure disorders. All were incapable of oral self-care due to serious cognitive impairment and could not cooperate with normal dental treatment. A total of 27 rounds of general anesthesia and 1 round of intravenous sedation were performed for implant surgery. Implant placement was performed in 3 patients whose prosthesis records could not be found, while 3 other patients had less than 1 year of follow-up after prosthetic treatment. When the criteria for implant success or failure were applied in 13 remaining patients, 3 implant failures occurred in 59 total treatments. The cumulative survival rate of implants over an average of 43.3 months (15-116 months) was 94.9%. Conclusion: For patients with severe cognitive impairment who are incapable of oral self-care, implant treatment under general anesthesia showed a favorable prognosis.

• 대한치과의료관리학회지
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• 제8권1호
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• pp.24-29
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• 2020

With the advancement of information technology, the application of augmented reality (AR) in dentistry is an emerging research field of image-guided surgery and dental education. In addition, the digital approach to incorporating AR in dental practice management is considered to be feasible. A prototype is developed to apply AR to dental daily clinical practice in order to help dentists to access electronic dental records. This prototype delivers patients' information and related clinical data to dental clinicians directly without the need to search for the appropriate patients. Wearable AR devices are considered to be a convenient tool for practicing dentists because dental practitioners are not always able to use a computer during active clinical sessions, such as implant placement, root canal treatment, and patient-doctor communication. The use of AR to visualize passive transferred patient data would be valuable for practicing dentists.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권2호
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• pp.77-83
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• 2015

Background: To prepare for possible emergency situations during dental treatment, it is helpful to know how often and what kinds of emergencies may arise. This study set out to evaluate the incidences, causes, treatments, and outcomes of emergency situations in the outpatient clinic of a dental teaching hospital in Korea. Methods: We retrospectively reviewed the records of patients who had experienced an emergency situation and emergency response team activated in a selected outpatient clinic between November 2004 and November 2013. Specific information about the emergency cases was collected, including the patient characteristics and the frequency, types, treatments, and outcomes of the emergency situations. Results: We identified 35 instances of emergency situations in 2,890,424 patients (incidence = 0.012 per 10,000 outpatients). The number of cases was as follows: 10 (28.6%) in the Department of Periodontics, 10 (28.6%) in the Department of Oral and Maxillofacial Surgery, 6 (17.1%) in the Department of Oral and Maxillofacial Radiology, 4 (11.4%) in the Department of Prosthodontics, 2 (5.7%) in the Department of Conservative Dentistry, 2 (5.7%) in the Department of Pediatric Dentistry, and 1 (2.9%) in the Department of Orthodontics. Three (8.6%) of the emergency situations arose before treatment, 22 (62.9%) during treatment, 7 (20.0%) after treatment, and 2 (5.7%) in a patient's guardian. Conclusions: In accordance with the growing elderly population and more aggressive dental procedures, the number of emergency situations may increase in the future. We recommend that clinicians keep in mind airway management and the active control of emergency situations.

• Imaging Science in Dentistry
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• 제53권1호
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• pp.35-42
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• 2023

Purpose: This study investigated the current dental radiology reporting methods and the recording rate of 10 mandatory reporting items in Korea. Materials and Methods: An original online survey created using Google Forms was distributed to dental practitioners. The survey asked about the participants' age, experience, workplace, use of radiologic equipment, radiology reporting methods, and recording reporting items. Results: In total, 354 responses were analyzed. Radiologic reporting in dental charts was the most commonly used method for each modality. Four out of 10 mandatory items were recorded at a high rate, but the remaining 6 items had substantially lower recording rates, often below 50%. The participants who reported radiographic findings through other separate methods had higher item scores than those who wrote findings in dental charts(P<0.05). Conclusion: Radiologic societies and dental associations should encourage the use of separate reports for radiographic examinations. Education regarding radiology reports and the justification for reporting items should be reinforced in dental schools, training courses on radiology, and the continuing education curriculum.

• Journal of Oral Medicine and Pain
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• 제31권1호
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• pp.27-36
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• 2006

개인식별에서 치과적 방법의 유용성과 중요도에 대해서는 잘 알려져 있다. 그러나 우리나라에서 개인의 신원확인을 위하여 법치의학적 방법을 이용한 포괄적 자료에 대하여는 발표된 예가 드물다. 본 논문은 2002년에서 2005년까지 국립과학수사연구소 법치의학실로 의뢰된 신원불상 변사자의 개인식별건을 분석하여 법치의학적 방법의 활용성에 대하여 연구하였다. 그 결과 4년 동안 법치의학실로 의뢰된 신원불상 변사자 관련 개인식별 건은 405건으로 전체 의뢰 493건의 약 82%에 이르렀다. 두개골을 비롯한 유골이 전체 의뢰되는 건과 치아나 상, 하악만으로 연령감정을 의뢰한 건은 각각 2002년에 58건과 42건, 2003년에 52건과 37건, 2004년에 91건과 27건, 2005년에 78건과 20건이었다. 2005년에는 개인식별을 위해 유골 전체에 대한 종합적 검사를 의뢰하는 건이 연령감정만 의뢰하는 건보다 4배에 이르렀다. 두개골과 사진을 겹치는 중첩법에 의한 동일인 식별은 접수된 24건 중 15건에서 활용되었고 나머지 9건에서는 유전자 검사로만 결과가 판정되었다. 법치의학적 방법에 의한 개인식별을 위하여 23건이 접수되었으며, 그 결과 9건이 동일인으로 판정되었고, 7건은 배제되었으며, 동일인으로 추정되는 4건에서는 유전자 검사 결과로 보완되어 확인되었으며, 3건은 의뢰된 자료가 충분하지 않았다. 법치의학적 방법에 의하여 신원이 확인된 신원불상 변사자 수는 2002년 9%에서 2005년 46%로 증가되었다. 개인식별에 있어서 법치의학적 방법은 지문이나 유전자검사와는 달리 일반인과 경찰에 비교적 덜 알려진 측면이 있으나, 점차 중요성에 대한 인식이 높아지고 있다. 치과기록이나 방사선 사진 등에 관한 정보가 잘 보존됨으로써 법치의학적 개인식별의 활용성이 점차 증가하고 있다. 유전자처럼 혈연 관계를 증명하는 것이 아니라 본인의 기록으로 남아있는 자료에 대한 비교 분석이기 때문에 분석이 용이하고 신속하며, 유전자 검사에 비해 고가의 장비를 필요로 하지 않고 비용이 저렴하다는 장점이 있다. 또한 뼈 조직이나 조직이 부패되어 핵 유전자의 추출이 어려울 때 이용되는 미토콘드리아 유전자의 개인식별률이 높지 않은 단점을 보완할 수 있다. 그러므로 개인식별에 있어서 유전자 분석과 두개골 사진 중첩법의 단점을 극복할 수 있는 법치의학적 방법의 활용성과 중요도는 더 증가될 것이다. 향후 개인식별률을 높이기 위하여 경찰과 법의학자와의 긴밀한 협조가 중요하며, 가출자와 실종자의 치과기록과 변사자의 치아기록을 전산자료화 할 수 있도록 관련 법과 체계의 확립이 시급한 실정이다.

• 대한치과마취과학회지
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• 제11권2호
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• pp.133-140
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• 2011

Background: Dental treatment under outpatient general anesthesia is an option for disabled person, children and dentally disabled person who have the difficulty of cooperating voluntary with dental care. The aim of this study was to access the patients who had dental management under general anesthesia at Chungnam dental clinic for the disabled. Methods: This survey is consisted of 114 severely disabled and dentally disabled person who undergone dental treatment under general anesthesia from January to June 2011. Data were collected by individual dental and anesthesia records. Results: Of the 114 patients studies, the 45 patients was the dentally disabled and the 69 patients was the severely disabled. Rate of dental treatment among male patients was higher than among female patients. The dentally disabled was an similar age distribution. In the severly disabled, above 13-year-old was higher than below 12-year-old. The most popular induction method of general anesthesia was sevoflurane inhalation after induced sedative effect of nitrous oxide inhalation. The severly disabled who had definitely negative behavior was applied inhalation of high concentration sevoflurane. Conclusions: Chungnam Dental clinic for the disabled provide dental management for the disabled and the dentally disabled.