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뇌성마비환자의 전신마취 하 치과치료 후 혀 깨물기 손상 관리
신터전(Teo-Jeon Shin),서광석(Kwang-Suk Seo),김현정(Hyun-Jeong Kim),박성수(Sung Soo Park),김혜정(Hye-Jeong Kim),양소영(So-Young Yang) Asia association of Disability and Oral health 2010 대한장애인치과학회지 Vol.6 No.2
Trauma to the lips and tongue can occur by accidental self-biting after dental treatment. After local anesthesia, it is likely that the patient may feel painless even in biting the tongue. In case of young children and disabled patients, the dentists should be careful not to bite the tongue. In this report, we present a case of deep lingual laceration due to biting the tongue in the course of dental treatment under general anesthesia. A 33 year-old male was transferred to our hospital to treat tongue laceration. Before 2 hour on arrival, he had received dental care under general anesthesia at a dental hospital for the disabled because of cooperation difficulty and cerebral palsy. During recovery from general anesthesia, he tried to bite his own tongue involuntary. The doctors and nurses tried to prevent the patient from being injured. Despite these efforts, massive bleeding occurred from the injured sites of the tongue. Because we could not communicate with him, we decided to evaluate the extent of the injury and treat the injured sites under general anesthesia. The laceration wound was sutured for nearly 1 hr general anesthesia. During recovery we inserted mouth prop into the oral cavity to prevent further injuries from tongue biting. After full recovery from general anesthesia he didn’t try to bite his tongue. After 4 hour admission, he was discharged without other complications.
신터전(Teo Jeon Shin) Asia association of Disability and Oral health 2013 International Journal of Disability and Oral Healt Vol.9 No.1
This article discusses the provision of sedation for uncooperative special need dental patients. Most of dental treatments have been performed in these patients with the techniques of behavioral control. However, if this behavioral control fails during treatment, it is nearly impossible to treat them without either sedation or general anesthesia. Sedation is also beneficial for patients because it circumvent the aggravation of negative behaviors related to their stress during the treatment. Also, the morbidity and mortality related to dental sedation is relatively low. In this regard, the provision of sedation for people with special needs can be considered as a safe and necessary techniques for their treatment.
신터전(Teo Jeon Shin) 대한치과의사협회 2016 대한치과의사협회지 Vol.54 No.11
Managing uncooperative behaviors related to dental treatment is necessary for guiding children and adolescence to more favorable behaviors. The first approach should be controlling their behaviors using non-phamarcologic behavior management techniques. However, if this approach fails, it is helpful to control negative behaviors pharmacologically. Accordingly, sedation is frequently used to relieve anxiety related to dental treatment. Also, general anesthesia has been applied to the situations in which sedation is either ineffective or impossible to gain cooperation during treatment. This article discusses the pharmacology of widely used sedatives for children and adolescence and clinical considerations of managing uncooperative children and adolescence with the use of sedation. Furthermore, we recommend clinical indication of selecting general anesthesia rather sedation for the purpose of behavior management.
신터전(Teo Jeon Shin) 대한치과의사협회 2013 대한치과의사협회지 Vol.51 No.7
Sedation is frequently required to relieve anxiety in the field of dentistry. Among sedation techniques, oral sedation has been widely used because it is easy for administration and has a wide acceptability for dentists. This article discuss the pharmacology of oral sedatives and therapeutic considerations of these drugs, and finally how to manage apprehensive patients using oral sedation. Also, we recommend how pertinent drugs should be used to maintain an adequate level of sedation, not deep sedation
북한의 치의학 교육 시스템을 통해 고찰해 본 남북한 치의학교육 통합방향에 대한 시사점
신터전(Teo-Jeon Shin),한동헌(Dong-Hun Han),진보형(Bo-Hyoung Jin),김태일(Tae-Il Kim),이재일(Jae-Il Lee),김종철(Chong-Chul Kim) 대한치과의사협회 2015 대한치과의사협회지 Vol.53 No.10
There are big differences in dental education system between South Korea and North Korea. In North Korea, there is no college of dentistry and official license system and thus, dentists can treat a patient right after graduation from medical school. There are also positions such as paradentists capable of providing dental treatments, whereas such positions do not exist in South Korea. In this regards, in order to get ready for the United Korea, we need to establish a system designed to complement the differences in dentistry education and license system between South and North Korea. Such system would help to minimize the social cost in relation to the unification in near future.
Jihyun Lee,Teo Jeon Shin,Young-Jae Kim,Jung-Wook Kim,Ki-Taeg Jang,Sang-Hoon Lee,Chong-Chul Kim,Hong-Keun Hyun 대한치과의사협회 2016 대한치과의사협회지 Vol.54 No.6
Objectives: The aim of this study was to assess the morphologic characteristics of two types of stainless steel crowns (SSCs) for the first primary molar using a 3D scanner. Study design: Two types of SSCs, KIDS CROWN (KC) and 3M ESPE ND-96 (ND), for the first primary molars were scanned using a 3D scanner. The mesiodistal and buccolingual diameters at the height of the contour and the cervical margin, occlusocervical diameters on the mesial, distal, buccal, and lingual aspects were measured, and the crown shape ratio, the smooth surface crown height ratio, and the cervical convergence were calculated. Results: In the crown shape ratio of the mandibular SSC, KC was larger buccolingually compared with ND. In the smooth surface crown height ratio, ND was larger than KC in all of the maxilla and mesial, distal, and lingual aspects of the mandible. ND was more convergent to the cervical mesiodistally and buccolingually compared with KC. Conclusion: In the superimposed images of the maxillary SSC, the mesiolingual and distolingual line angles of KC were more prominent compared with ND. In the mandible, ND demonstrated higher cusps and more obvious buccal developmental lobes than KC. ND showed a larger cervical undercut than KC.
금관 수복치료 후 발생한 좌측 기관지 내로의 금관 흡인에 관한 증례보고
신터전,서광석,김현정,Shin, Teo-Jeon,Seo, Kwang-Suk,Kim, Hyun-Jeong 대한치과마취과학회 2010 Journal of Dental Anesthesia and Pain Medicine Vol.10 No.1
Foreign body aspiration (FBA) into the tracheobronchial tree could be life threatening requiringprompt intervention. Any objects placed in the oral cavity put patients at a risk of aspirating or swallowing the objects slipped or broken by physical injuries. Here, we report a case of 30 yr old patient with FBA during gold crown replacement was successfully treated with the use of the flexible bronchoscope. Case: A 30 yr old woman was admitted to Seoul National Dental Hospitalfor an amalgam restoration. She was scheduled to gold crown restoration for replacement of the damaged amalgam at #37 site. After performing crown lengthening procedure, the aspiration of gold crown occurred during the cementation of the crown. After aspiration, the patients complained of the subjective distress of respiration. Chest radiograph revealed that gold crown was enlodged to the left bronchus. Flexible fiberoptics was inserted to the bronchus to remove the aspirated crown. Fiberoptic assisted removal of the aspiratedcrown was successfully performed. After removal, there was no radiopaque material in the left bronchus on follow-up chest radiograph. Discussion: When aspiration of dental materials occurs, flexible fiberoptic can be used in the treatment of FBA. It is also very useful to take preventive management such as rubber dam, application of dental floss in dental procedure where there is high likelihood of FBA.
피에르 로빈 증후군 환아의 전신마취 하 치아우식 치료 증례 보고
류지연(Jiyeon Ryu),신터전(Teo Jeon Shin),현홍근(Hong-Keun Hyun),김영재(Young Jae Kim),김정욱(Jung-Wook Kim),장기택(Ki-Taeg Jang),김종철(Chong-Chul Kim),이상훈(Sang-Hoon Lee) Asia association of Disability and Oral health 2016 International Journal of Disability and Oral Healt Vol.12 No.2
저자는 소하악증으로 인해 기도유지가 어려우며 섭식 장애로 인한 다발성 우식을 보이는 피에르 로빈 증후군 환아의 증례를 보고하는 바이다. 환자는 소하악증 및 구개열, 심방중격 결손, 새끼 손가락의 측만지증(clinodactyly), 외사시(exotropia) 등의 증상을 동반하고 있었으며, 신체 발육이 매우 저하된 상태로 섭식 장애로 인한 구강내 침식 및 다발성 우식의 소견을 보이고 있었다. 환아는 가벼운 자폐 증상을 가지고 있으며 어린 나이로 협조를 구하기가 어려웠고 광범위한 치료가 필요한 상황이었으며 의식하 진정법시 하악의 발육 저하로 인한 기도 확보의 어려움이 예상되었기에 전신마취하 치과치료를 시행하였다. 피에르 로빈 증후군은 기도유지의 어려움과 섭식 장애로 구강위생 관리에 불리한 조건을 가지고 있지만 나이가 듦에 따라 점차 정상적인 하악의 성장이 이루어지므로 행동조절에 의한 일상적인 치과 처치도 가능할 것이다. Pierre Robin syndrome (PRS) is characterized by the triad of congenital mandibular hypoplasia, glossoptosis and cleft palate. Infant PRS patients are frequently suffering from upper airway obstruction, gastroesophageal reflux and growth retardation caused by above mentioned problems. We report a dental caries treatment of 3-year old girl with Pierre Robin syndrome with multiple caries. The cause of multiple caries was mainly presumed as patient’s eating habit caused by her general condition. She had some feeding problems and had history of gastric tube. She was still using milk bottle and took more than an hour to finish a meal. The treatment was performed under general anesthesia considering patient’s condition; mild autism, poor cooperation and respiratory problem due to micrognathia. Severely affected upper incisors were treated with pulp treatment and restored with zirconia crown for esthetic purpose. Lower incisors were treated with pulp treatment and restored with composite resin. Upper right first primary molar was restored with stainless steel crown and other primary molars were treated with composite resin. There were no postoperative complications. According to her parents, the patient’s compliance to oral hygiene management was greatly improved after the treatment since she was very pleased with the esthetic result and highly motivated by her looks. The treatment without sedation or general anesthesia would be possible once the airway is improved as the mandible grows.