치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰

조찬우,김지훈 대한소아치과학회 2017 大韓小兒齒科學會誌 Vol.44 No.4

The purpose of this research is analyzing present condition, and pursuing developmental direction of consultation to department of dentistry for medical inpatient with dental trauma. This research conducted a retrospective analysis of consultation to department of dentistry for medical inpatient at Wonju Severance Christian Hospital from March 2011 to February 2017. This research analyzed chief complaint and dental diagnosis, referring department, time of consultation after dental trauma, relation between hospitalization period and time of consultation after dental trauma, relation between dental trauma and admission in the medical department due to trauma, cause and age of dental trauma occurrence, treatment of dental trauma, and revisiting rate of inpatient with dental trauma after discharge. Among all the chief complaint and dental diagnosis, dental trauma was the highest. Among all the referring departments, departments of surgery were the highest. In relation to being delayed of consultation term after dental trauma, it turned out that there’s pretty high mutual relation between the hospitalization period and the consultation term after dental trauma, and the hospitalization period had the quantitative influence on the consultation term. Statistically, dental trauma and admission in the medical department due to trauma had significant relations. In case of those patients due to car accidents, they had dental trauma without exception. Statistically, patient’s group with dental trauma in hospital room was younger than patient’s group with dental trauma in non-hospital room. Statistically, dental trauma and treatment in hospitalization had no significant relations, and dental trauma and revisiting department of dentistry after discharge had no significant relations. For the child and adolescent inpatients hospitalized for car accidents, there is high possibility of accompanying dental trauma, and dental consultations can be delayed. For the young child inpatients, the possibility of dental trauma occurrence in hospital room is high. Moreover, treatments during hospitalization and revisiting department of pediatric dentistry after discharge are not performed well for inpatients with dental trauma. Regarding these results, it can be an alternative that improving of consultation system, dedicated workforce placement and having dental facilities and equipment in the hospital ward, education to medical doctor and dentist, communication between medical doctor and dentist. This research can be used as a study material of medical and dental departments, and it’s expected to be committed to developing of consultations to department of dentistry for child and adolescent inpatients with dental trauma. 본 연구의 목적은 치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰에 대한 본원의 현황을 분석하고 발전 방향을 모색하는 것이다. 이에 2011년 3월부터 2017년 2월까지 6년간 원주세브란스기독병원 의과에 입원한 소아청소년 환자의 치과 협진 의뢰에 대한 후향적 분석을 하였다. 조사 항목으로 협진 의뢰 주소와 치과적 진단명, 협진 의뢰과, 치과적 외상 후 협진 의뢰 시기, 입원 기간과 치과적외상 후 협진 의뢰 시기의 관계, 외상으로 의과에 입원하는 것과 치과적 외상 발생의 관계, 치과적 외상의 원인과 발생 나이, 치과적 외상에 대한 치료, 치과적 외상 환자의 퇴원 후 치과 외래 재내원 등이 있었다. 협진 의뢰 주소와 치과적 진단명에서 치과적 외상이 차지하는 비율이 가장 높았고, 협진 의뢰과는 외과 계열의 진료과가 가장 높은비율을 보였다. 입원 기간과 치과적 외상 후 협진 의뢰 시기는 양의 상관 관계를 보였다. 외상을 이유로 의과에 입원하는 것과 치과적외상 발생은 통계적으로 유의하게 연관이 있었고, 교통 사고로 인해 의과에 입원한 환자의 경우 100% 치과적 외상이 동반되었다. 입원실에서 발생한 치과적 외상 환자의 나이는 유의하게 적었다. 치과적 외상과 입원 중 치료, 치과적 외상과 퇴원 후 치과 외래 재내원은 각각 통계적으로 유의한 연관이 없었다. 교통 사고에 의해 의과에 입원한 소아청소년 환자에 대해서 치과적 외상이 동반될 가능성이 크고, 치과 협진 의뢰 시기가 지연될 수있다. 어린 소아 환자의 경우 입원실에서 치과적 외상의 발생 가능성이 크다. 또한, 치과적 외상 환자의 입원 중 치료와 퇴원 후 치과외래 재내원이 잘 이루어지지 않고 있다. 이와 같은 결과들에 대해 협진 의뢰 체계의 개선, 입원 병동 내 전담 인력 배치와 치과 시설및 장비 구비, 의과 주치의에 대한 교육, 주치의 간의 원활한 의사소통 등이 대안이 될 수 있다. 본 연구는 의과와 치과의 교육 및 연구자료로 활용되어 치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰에 관한 발전에 기여할 것으로 기대된다.

일부 중학생들의 치아외상 대처방법에 대한 지식수준

김윤정 ( Yun Jeong Kim ),문상은 ( Sang Eun Moon ),곽정숙 ( Jung Suk Kwag ) 한국치위생학회(구 한국치위생교육학회) 2013 한국치위생학회지 Vol.13 No.3

Objectives : The purpose of this study was to investigate the knowledge of methods to deal with dental trauma in some middle school students. Methods : Among 375 middle school students, a total of 340 filled out the self-administered questionnaire (response rate of 90.7%). The data were analyzed statistically using chi-square analysis. Results : 32.9% of respondents received emergency care education of dental trauma. Knowledge by general information about dental trauma was not so different from the other questions. Tooth storage medium comprised 25.0% and 48.5% in milk and saline, respectively. Conclusions : In order to get the knowledge about emergency treatment of dental trauma in middle school students, it is necessary to develop the professional education program for middle school students.

악안면 외상 후 식립된 임플란트의 예후에 관한 연구

전하룡(Ha-Ryong Jeon),김종원(Jong-Won Kim),홍종락(Jong-Rak Hong),김창수(Chang-Soo Kim) 대한구강악안면외과학회 2006 대한구강악안면외과학회지 Vol.32 No.4

Purpose The purpose of this study was to evaluate the success rate of dental implant on post-traumatic region to rehabilitate missing teeth Patients and Methods 5 patients who had been treated due to maxillofacial trauma during 2000 to 2004 at samsung medical center were selected for this study. 22 dental implants were installed to them for restoring missing teeth. The success rate of these dental implants was evaluated with criteria by T. Albrektsson .We divided installed 22 implants into 2 categories. One category consisted rough surface implants group and smooth surface implants group. And the other category consisted more healing group and less healing group. The healing time was calculated from point of trauma. Results The success rate of dental implants is 68.2% that is lower than other studies because of poor vascularity of bone bed and mechanical stress according to trauma. Rough surface implants group and More healing group showed superior success rate to others. (P < 0.05) Conclusion We found that to increase success rate, it may need rough surface implants and longer healing period.

유치와 영구치의 외상 양상 및 치료에 대한 후향적 연구

김유정,김선미,최남기 大韓小兒齒科學會 2014 大韓小兒齒科學會誌 Vol.41 No.4

본 연구는 치아 외상의 양상과 외상 후 초진 시기의 지연이 치료에 미치는 영향에 대해 알아보고자, 2009년 1월부터 2013년 12월까지 전남대학교 치과병원 소아치과에 치아 외상을 주소로 내원한 환자 378명(외상 치아 940개)을 대상으로 기록을조사하여 다음과 같은 결과를 얻었다. 외상의 빈도는 남자가 여자보다 2배 더 높았다. 전체 외상의 원인은 넘어짐(36.5%)이 가장 많았고, 상악 중절치(66.9%)가 가장 많이 영향을 받았다. 유치에서 가장 흔한 외상 유형은 아탈구(43.9%)였고, 영구치에서는 단순 치관파절(30.9%)이었다. 전체 환자의 10%만이 외상 후 1시간 이내에 치과에 내원하였다. 유치에서 가장 흔한 초진 시 처치는 경과관찰(53.2%)이었고, 영구치는 근관치료(27.3%)였다. 영구치에서 초진 시기의 경과에 따라 근관치료 비율은 증가하였다. 이는외상 후 초진 시기가 늦어질수록 치수가 생활력을 잃을 가능성이 높아진다는 것을 알려준다. This study investigated the pattern and treatment of traumatic dental injury (TDI), with respect to the timeelapsed prior to the initial visit to the Department of Pediatric Dentistry, Chonnam National University DentalHospital for TDI, from January 2009 to December 2013. The dental trauma records of a total of 378 patients(940 traumatic teeth) were analyzed. The prevalence rate of dental trauma was twofold higher in males versusfemales. The principal cause of injury, among all participants, was falling (36.5%). The most commonly affectedteeth were the maxillary central incisors (66.9%). Subluxation (43.9%) represented the most common traumafor primary teeth, and uncomplicated crown fracture in permanent teeth (30.9%). Only 10% of patients visitedthe dental clinic within 1 hour of sustaining trauma. The principal treatment provided for primary teeth, duringthe initial clinical visit, was follow-up (53.2%); for permanent teeth it was root canal treatment (27.3%). Theprevalence of root canal treatment for permanent teeth increased commensurate with the time elapsed sinceinjury. These data suggest that delayed checkup following trauma may increase the risk of loss of pulp vitality.

소아청소년의 외상성 치아손상

박재홍(Jae-Hong Park) 대한치과의사협회 2013 대한치과의사협회지 Vol.51 No.8

It is well known that the majority of dental injuries occur in children and adolescent. An injury to the teeth can have serious and long-term consequences, leading to their discoloration, malformation, or possible loss. The emotional impact of such an injury can be far reaching. The majority of dental injuries in the primary and permanent dentitions involve the anterior teeth, especially the maxillary central incisors. Concussion, subluxation, and luxation are the commonest injuries in the primary dentition, while uncomplicated crown fractures are commonest in the permanent dentition. If it is decided to preserve a traumatized primary tooth, it should be carefully observed for clinical and radiographic signs of pulpal or periodontal complications. Radiographs are also examined closely to disclose any damage to the permanent successor. The intervals between reexaminations should be individualized depending on the severity of trauma, the expected type of complications and the age of the patient. Most complications are observed within the first year of the trauma. However, the follow-up evaluation of permanent teeth should continue until treatment of all complications is completed, or until a lost or extracted permanent tooth has been adequately replaced. It is important that the dentist and the other members of the dental team are well prepared to meet the many complex and challenging problems in the care of dental emergencies.

Long-term Prognosis of Pulpal Status of Traumatized Teeth Exhibiting Contradictory Results between Pulp Sensibility Test and Ultrasound Doppler Flowmetry: A Retrospective Study

Ahn, So-Yeon,Kim, Dohyun,Park, Sung-Ho Elsevier 2018 JOURNAL OF ENDODONTICS - Vol.44 No.3

<P><B>Abstract</B></P> <P><B>Introduction</B></P> <P>In this retrospective study, we investigated long-term (over 3 years) follow-up results of teeth that exhibited contradictory results between the pulp sensibility test (thermal or electric pulp test) and ultrasound Doppler flowmetry (UDF) until 1 year after trauma to inspect the prognosis of the pulp.</P> <P><B>Methods</B></P> <P>Data were collected from the records of trauma patients in our hospital between February 2012 and May 2015. The teeth that had continuously shown contrasting results on the pulp sensibility test and UDF until 1 year after trauma were chosen for the study. Cases with follow-up records of more than 3 years after trauma were finally included, and a retrospective chart review was performed.</P> <P><B>Results</B></P> <P>Data from 343 teeth in 147 patients who visited the hospital with traumatic dental injuries were examined. Among these, 13 teeth from 7 patients were included, and the record of each case was reviewed. All the subjects showed negative responses on the pulp sensibility test and positive responses on UDF until 1 year after trauma. Ultimately, 8 of the 13 teeth recovered pulp sensibility. Two teeth failed to recover pulp sensibility and became symptomatic; root canal treatment was performed on the teeth. The remaining 3 teeth belonged to patients suffering from nerve damage; therefore, the pulp sensibility test was not feasible.</P> <P><B>Conclusions</B></P> <P>Based on this study, UDF can be effectively used for the evaluation of pulpal status in traumatized teeth.</P>

지연된 출혈로 밝혀진 경증 혈우병 A에 대한 증례 보고

송제선(Je Seon Song),최병재(Byung-Jai Choi),김성오(Seong-Oh Kim),이제호(Jae-Ho Lee),손흥규,김형준(Hyung Jun Kim),최형준(Hyung-Jun Choi) Asia association of Disability and Oral health 2008 International Journal of Disability and Oral Healt Vol.4 No.2

Hemophilia A is an X-linked disorder resulting from a deficiency in factor Ⅷ. Hemophilia A is classified into severe, moderate, and mild forms. A 12-month old boy visited for uncontrolled bleeding on the upper labial frenum area. Spontaneous bleeding occurred about 13 days ago. We sutured the wound. However, the patient returned after 6 days with large hematoma formation. Consultation to the hematologist and laboratory examination were carried out. Activated PTT was elongated and factor Ⅷ was only 6%. He was diagnosed as mild hemophilia A. Fresh frozen plasma (FFP) was provided and hemostasis was achieved. At 5-day check-up, no more bleeding was observed. For the management of prolonged bleeding in hemophilia A patient, not only local hemostatic measures, but factor Ⅷ replacement therapy, antifibrinolytics, and Desmopressin are also available. Mild hemophilia A often occurs without either familial or medical history. It is often first detected by dental trauma.

Autotransplantation of Premolars and Esthetic Rehabilitation in a Traumatized Teenage Patient with Challenging Oral Problems: A Case Report

고준희,박호원,이주현,서현우 대한소아치과학회 2020 大韓小兒齒科學會誌 Vol.47 No.2

The loosely structured periodontal ligament and low mineralized bone surrounding erupting teeth provide minimal resistance to an extrusive force. The maxillary central incisors are the most frequently avulsed due to trauma. The prognosis of replanted teeth is affected by extra-alveolar period and conditions. Implant-supported restorations are contraindicated in adolescent patients with poor prognosis traumatized teeth. Autotransplantation of premolar to the anterior region provides a viable treatment alternative. This case report describes the autotransplantation of premolars and esthetic rehabilitation in a teenage patient with traumatized incisors, poor oral hygiene, and severe crowding. Comprehensive and long-term treatments were performed to improve complex and challenging oral problems.

치과 병원 응급실에 내원한 환자의 주소에 따른 분류와 연구

유태민,박경주 대한구강악안면병리학회 2012 대한구강악안면병리학회지 Vol.36 No.6

The rise of medical knowledge and awareness of the importance of dental and stomatognathic system increase the patients who visit dental emergency room. The chief complaints of patients who visited the emergency room varies from a pain, trauma, hemorrhag. The purpose of this study was to classify dental emergency patients by chief complaint and to analyze in indiviual group and to provide more effective emergency dental care. This study was carried out with 1129 patients visiting emergency room of the dankook university dental hospital from 7/2011 to 6/2012. Dental emergency patients was classified trauma, pain, hemorrhage group by chief complaint and studied mothly, the day of the week, time, age distribution and cause of the individual group. The chief complaint of visiting emergency room were trauma 660 people (58.5%), pain 347 people (30.7%), hemorrhage 96 (8.5%), other 26 patients (2.3%). The monthly distribution was observed in May (12.8%), March (10.5%), September (10.2%). The trauma patients were frequent in the spring and early summer but painful patients visited in September (12.7%) and May (11.8%) in March (11.2%). The peak age group was 20 to 29 years(20.9%), followed by 0 to 9 years(19.4%), 40 to 49years (15.2%,). In trauma group the peak age was under the age of 10 (31.7%), followed by 10 to 19 years (18.8%), 20 to 29 years (17.1%) . However, in pain group, peak age was 20 to 29 years (26.8%) followed by 40 to 49 years(21.3%), 30 to 39 years (19.6 %). The most common cause of trauma were subluxation(16.5%),laceration13.7%), uncomplicated crown fracture(12.05%) and in pain group was pulpal origin(46.1%), followed by periodontal origin(20.7%), post op pain(8.9%). Undefined pain or neuralgia were 7.9%. The most common cause of hemorrhage was post extraction(66.7%), post operation(16.7%), spontaneous bleeding due to periodontitis(12.5%). In conclusion, the trauma, pain were different in monthly distribution and the peak age of patients. Dental emergeny doctor should understand pattern of indiviual emergency group and perform proper diagnosis and treatment for more effective emergency care.

단독 치과 병원 치과응급실 내원 환자의 임상적 분석

금기천,팽준영,최보영,최정구,오세리,이준,최문기,권경환,오승환,민승기,Keum, Ki-Chun,Paeng, Jun-Young,Choi, Bo-Young,Choi, Jung-Gu,Oh, Se-Ri,Lee, Jun,Choi, Moon-Ki,Kwon, Kyung-Hwan,Oh, Seung-Hwan,Min, Seung-Ki 대한악안면성형재건외과학회 2009 Maxillofacial Plastic Reconstructive Surgery Vol.31 No.1

Dental emergency varies from toothache to trauma of oromaxillofacial area. Recently, the number of emergency cases after dental treatment is increasing because surgical treatments such as implant installation rise. Dental emergency patients have been looking for emergency room of general hospital and they could be treated only when the dentist of night duty exists. Although there are many analyses on the dental emergency patients visiting general hospitals, research on the dental treatment only has not been provided enough. We anticipated different aspects between the dental emergency patients visiting independent dental hospital and general hospitals. We analyzed dental emergency patients' chief complaints and received procedures for almost 1-year period in Won-Kwang dental hospital in Dae-jeon where there had been no dental emergency settings. With this 1574 patients' result, we tried to find appropriate treatment plans regarding dental emergency patients occurring at night and holidays.