Association between perception of dry mouth and pre and post-wearing denture satisfaction in the Hansen people / 나학회지

OBJECTIVES: This study investigated on the severity of dry mouth in the hansen people and the association between dry mouth(low, moderate and high) with pre and post wearing denture satisfaction. METHODS: Data were obtained from a cross-sectional survey of 104 hansen people(mean age=69.3). Data were collected by means of a personal interview from April 30 through to Jane 20, 2014. Pre and post wearing denture satisfaction was measured by the 24-items and dry mouth was measured by the 4-items. The data was analysed with t-test, One-way ANOVA, and Logistic regression using the SPSS program. RESULTS: Regarding perception of dry mouth, the subjects achieved a mean of 6.13 out of a maximum 12 points. Scores were categorised as high(8~12), medium(5~7) or low(1~4) and the proportion were 24.5%(9.56), 42.2%(5.81) and 33.3%(4.00) respectively. Those who were older and had fewer natural teeth felt that their perception of dry mouth was more severe. A logistic regression analysis showed that the subjects perception of dry mouth had a significant impact on their gender (OR=2.73), comfort (OR=0.21), aesthetic appreciation (OR=7.56) satisfaction. CONCLUSIONS: Based on the findings, the perception of dry mouth has a significant and negative impact on denture satisfaction. These results suggest that oral health promotion should be considered various factors related dry mouth in the elderly with removable denture.

The effectiveness of maintenance care by non-surgical treatment on the periodontal disease in the people affected by leposy / 나학회지

BACKGROUND & OBJECTIVE: The purpose of this study is to prove the effectiveness of professional maintenance care to the periodontal disease by non-surgical approach with the toothpick method to improve the periodontal health. METHODS: The patients of this study were composed of 46 patients( 18 men and 28 women), suffering from chronic adult periodontitis, who had visited the department of dental clinic center. All of the subjects were over 50years old and be treated just by non-surgical method. Professional maintenance care using the toothpick method was performed every 3 months, and evaluations were also done after 1, 2, and 3 year-professional maintenance care based on the indices such as plaque index(O' Leary index), periodontal probing pocket depth, bleeding on probing, tooth mobility, the number of tooth loss, and the rate of tooth loss representing the state of periodontal health. RESULTS: 1. The longer the maintenance care, the more the effectiveness of controlling plaque. The rate of decrease in the dental plaque index was 1.5%, 4.2%, and 6.5% in 1, 2, and 3 year maintenance groups respectively(P>0.05). 2. The periodontal pocket depth decreased depends on the severity of periodontal pocket depth in all groups the maintenance years(P0.05). 4. Tooth mobility has decreased in the maintenance years, but did not show any difference statistically(P>0.05). 5. The number and the rate of tooth loss among the patients of 1year-maintenance group was 0.38, 1.44% respectively and that of 3 year-maintenance group was 0.44, 1.73% each. CONCLUSION: The results of this study mentioned above suggest that professional maintenance care should be operated effectively to prevent and to maintain the periodontal disease systematically on the purpose of proving the quality of life, and that it could be applied to the medical insurance system in other to try to make the most of the adult oral health care positively.

A study on the design of the removable partial denture in the identical master cast of the leprosy patient / 나학회지

The upper and the lower master models of Class II mod.1 by the Kennedy of classification were duplicated to the dentists in the dental clinic Suncheon, and the status of the surveying procedure, the form and type of the major connector, the form and type of the direct retainer, the location and status of the indirect retainer, and the modification of abutment were surveyed and analyzed and were compared to the principles of the design rationale of the removable partial denture to evaluate whether or not each component of the removable partial denture framework designed by the dentists. The analyzed results were as follows: 1. The status with or without the surveying procedure was showed 7 cases(10.29%) and 61 cases(89.71%) respectively. 2. Single palatal strap, A-P bar, broad palatal plate, complete coverage palatal major connector, single palatal bar, U-shaped palatal connector, and the others without drawing of the major connector were 27 cases (38.57%), 25 cases(35.71%), 5 cases(7.01%), 4 cases(5.71%), 2 cases (2.86%), 1 cases(1.43%), 6 cases(8.57%) respectively in the design patterns of the maxillary major connectors, and lingual bar, linguoplate, and others without drawing of the major connector were 55 cases(80.88%), 11 cases(16.18%), 2 cases(2.84%), respectively in the pattern of the mandibular major connectors. 3. The direct retainer designed to the 1st bicuspid of the upper left and the lower right adjacent to the free-end edentulous area was that the design of bar clasp was 67.41% in the highest rate and that of Akers clasp was 23.36%. 4. The direct retainer designed to the 1st bicuspid of the upper right and the lower left was that the of Akers clasp was 56.62% in the highest rate and that of bar clasp was 33.82%. 5. The mesial rests of the 1st bicuspid of the upper left and the lower right adjacent to the free-end edentulous area were 77.46%, 66.20% respectively and the distal rests and mesial rests of the 1st bicuspid of the upper left and the lower right were 58.82%, 55.71%, 38.24%, 38.57% respectively and the mesial rests of the 2nd molar of the upper right and the lower left were 95.71%, 95.65% respectively, viewed from the location of the occlusal rest seat. 6. The cases without the design of the indirect retainer were 51.47% in the upper and the lower master models respectively. 7. The modification of abutments(surveyed crown) of upper and lower teeth were 8.82%, 8.82% respectively.

A Study on the fabrication request for the removable partial denture framework / 나학회지

The purpose of this study was to investgate and evaluate whether the recording information contained in the work authorization was performed properly and master casts were designed accurately according to the rationale and principles of the removable partial denture when the work authorization and the master casts were sent to the dental framework. the accurate recording of the work authorization sent to dental laboratory in Hwasun for removable partial denture framework, the normal form of the occlusal rest guiding plan of the surveyed crown using the surveyor, the location analysis of the occlusal rest seat, the design patten of the maxillary and mandibulary major connectors, the use of the surveyor on the master cast, the status of the secondary impression taken in the distal extension edentulous areas were investigated for this study. The following results were obtained : 1. In the status of the occlusal rest seat prepared in the abutment, the occlusal rest seat with normal form was 81.25%, 95.45%, that without form was 6.25%, 0.00%, respectively in Class I and Class II on the maxillary cast and the occlusal rest seat with normal form was 76.92%, 95.45%, that without form was 7.69%, 0.00% respectively in Class I and Class II on the mandibular cast. 2. In the status of the guiding plan, the guiding plan with the normal form was 79.17%, 86.36% that with abnormal form was 20.84%, 13.64% respectively in Class I and Class II on the maxillary cast and the guiding plan with normal form was 79.49%, 77.27%, that with abnormal form was 20.51%, 22.73% respectively in Class I and Class II on the mandibular cast. 3. The abutment splinting in the distal extension removable partial denture was 20.78%, 27.27%, respectively in Class I and Class II on the maxillary cast and was 25.64%, 13.64% respectively in Class I and Class II on the mandibular cast. 4. The location and form of the major connector delineated on the maxillary and mandibular master cast was 95.83%, 98.41% respectively. 5. The delineation and recording on the work authorization was incomplete as group II(73.33%), group I(14.07%), group III(12.59%) and group IV (0.00%) in investigating the contents of the work authorization. 6. Aker's clasp of the types of the direct retainer was nots used 72.22%, 74.60%, in the maxillary and mandibular casts respectively. 7. The location of the indirect retainer delineated on the maxillary and mandibular master cast was 51.43%, 50.82% respectively. 8. The types of metal used were mostly Cr-Co non-precious metal alloy and the cases using color coding on the drawing paper of work authorization were not observed. 9. The cases taking secondary impression in the distal extension removable partial denture were 45.71%, 52.46% respectively in the maxillary and mandibular master cast. 10. The delineation of tripoding or reference line on the master cast was not observed in surveying procedure.

Participation of Peripheral P2X Receptors in Orofacial Inflammatory Nociception in Rats

The present study investigated the role of peripheral P2X receptors in inflammatory pain transmission in the orofacial area in rats. Experiments were carried out on male Sprague-Dawley rats weighing 220 to 280 g. Formalin (5%, 50 microL) and complete Freund's adjuvant (CFA, 25 microL) was applied subcutaneously to the vibrissa pad to produce inflammatory pain. TNP-ATP, a P2X(2,2/3,4) receptor antagonist, or OX-ATP, a P2X(7) receptor antagonist, was then injected subcutaneously at 20 minutes prior to formalin injection. One of the antagonists was administered subcutaneously at three days after CFA injection. The subcutaneous injection of formalin produced a biphasic nociceptive behavioral response. Subcutaneous pretreatment with TNP-ATP (80, 160 or 240 microg) significantly suppressed the number of scratches in the second phase produced by formalin injection. The subcutaneous injection of 50 microg of OX-ATP also produced significant antinociceptive effects in the second phase. Subcutaneous injections of CFA produced increases in mechanical and thermal hypersensitivity. Both TNP-ATP (480 microg) and OX-ATP (100 microg) produced an attenuation of mechanical hypersensitivity. However, no change was observed in thermal hypersensitivity after the injection of either chemical. These results suggest that the blockade of peripheral P2X receptors is a potential therapeutic approach to the onset of inflammatory pain in the orofacial area.

Subjective oral health perception of Hansen's disease in Sorokdo / 나학회지

The purpose of this study was to examine subjective oral health perception of Hansen's disease in Sorokdo. And the relationship of four categories (chewing ability, intraoral pain, intraoral othersysptom, and communication ability and social relationship) with clinical index was tried to clarify. The 460 subjects of Hansen's disease in Sorokdo was selected for oral examination and survey. The results are as follows: 1. 73.1% of Hansen's disease in Sorokdo recognized that their oral health is unwell. 2. 70% of total population recognized that they have limitation about chewing function, Especially, 35.9% of Hansen's disease feels chewing difficulty for standard foodstuffs as rice cake. 3. In intraoral pain, painful tooth was 76.3%, sensitive tooth was 43.2%. and temporomandiblular joint pain was 15.2%. 4. In intraoral other symptoms, tooth mobility was 71.3%, food impaction was 78.9% gingiavl bleeding was 96.8%, xerostomia was 62.8%, and halitosis was 84.2%. 5. 21.5% of Hansen's disease in Sorokdo has communication difficulty by teeth or denture problem, and 39.2% of them avoid relationship with other people.

Oral Infection Diagnosis and Treatment in Hansen's Patient / 나학회지

Dental infection which has been harmful to human for a long time occurs when the balance of three factors; host, environment and source of infection are broken and occurs especially when the balance of the resistance of the host and the toxin of bacteria are collapsed. Though dental-origin infection causes severe pain, it is commonly localized in gingiva, pulp and the surface of alveolar bone and as the decrease of its prevalence due to the development of antibiotics and the ease of treatment by a simple aids, there are no case that proper caution are made for the infection. Expecially in case of patient with infectious Hansen's disease(leprosy), as they have many other medical diseases, dental disease are mostly passed by. As oromaxillary infection can end up to death, though it is hard to treat a severly progressed myofascial space infection, general understanding about the reason, the pattern of spreading, treatment, prevention of it should be needed to make actual management in the situation of an doubtless developing of infection in patient treatment and situation of suspicious development of early myofascial space infection. Since last 5 years, 36% of the patients were hospitalized due to their dental infection and consistent advertising and treatment resulted in a gradual decrease of it.

The effect of music therapy at surgical extraction of mandibular impacted 3rd molars

PURPOSE: This research was intended to evaluate the sedative effect of the music by measuring the anxiety-level, the pain-level, the blood pressure, and the pulse rate in patients who were going through extraction of the mandibular impacted 3rd molar. MATERIALS AND METHODS: Patients were selected among those who visited St. Vincent's Hospital in Suwon for the surgical extraction of 3rd molar from April to May, 2007 and were divided into two groups : the first, experimental group consisting of 32 people was going through extraction with the music and the second, control group also consisting of 32 people was going through extraction without the music. The anxiety-level was measured by filling out Spielberger's State-Trait Anxiety questionnaire. The pain-level was measured by VAS (Visual analog Scale). The blood-pressure and the pulse rate were recorded at waiting period, preparation and anesthesia period, 5 minutes after anesthesia, beginning of extraction and every five minutes after extraction to the end of surgery. RESULTS: The anxiety-level was significantly lower in the experimental group than in the control group during the extraction procedure (p<0.01). The pain-level was significantly lower in the experimental group than in the control group (p<0.05). The mean systolic blood pressure was significantly lower in the experimental group than in the control group at the beginnig of extraction and 10 minutes after extraction (p<0.01, p<0.05 each). The mean diastolic blood pressure was significantly lower in the experimental group than the control group at 10 minutes after extraction (p<0.01). The mean of pulse rate was significantly lower at the beginning of extraction (p<0.05). CONCLUSION: The music therapy could offer not only the psychological stability but also the physiological stability during the surgical extraction of impacted 3rd molar.

Correlation between the observer's assessment of alertness/sedation and the EEG-entropy during propofol infusion for sedation under spinal anesthesia / 대한마취과학회지

BACKGROUND: For the patients undergoing propofol sedation under regional anesthesia, continuous monitoring of the hypnotic level is required for adequate sedation and rapid recovery. We evaluated the correlation between the observer's assessment of alertness/sedation (OAA/S) and the EEG-entropy. METHODS: We studied 40 patients who were scheduled for spinal anesthesia. Premedication with intramuscular midazolam 0.04 mg/kg was carried out 30 minutes before spinal anesthesia. When the anesthesia level was adequate for surgery but lower than T6, an infusion of propofol 10 mg/kg/h was started and this was decreased to 5 mg/kg/h after 1 minute. We measured the response entropy (RE), the state entropy (SE) and the OAA/S score. When the OAA/S score fell to 1, the infusion dose was decreased to half. After this, the infusion dose was decreased or increased to half or twice, respectively, to keep the OAA/S score at 2 or 3. RESULTS: The OAA/S was well correlated with the RE (Spearman's rho = 0.913) and also the SE (Spearman's rho = 0.915). With the increasing depth of sedation, there was a progressive decrease in the RE and SE (the OAA/S score/the mean of the RE/the mean of the SE = 5/98/89, 4/92/85, 3/85/78, 2/78/70, 1/66/59). CONCLUSIONS: EEG-entropy provided good information for monitoring the hypnotic level for the patients undergoing propofol sedation under spinal anesthesia.

The effect of hyaluronic acid on expression of extracellular matrix proteins and bone formation in rabbit mandibular distraction osteogenesis

Distraction osteogenesis is a new bone formation technique. There is a advantage of the environmental adaptation when distraction force is applied to the gap between osteotomy lines. But it has a disadvantage of long-term wearing of the appliance and long consolidation period. Therefore we make an effort to reduce it and repair normal function. Extracellular matrix proteins have a function to control the cellular growth, migration, shape and metabolism. In these, hyaluronic acid is a member of polysaccharide glycosaminoglycans (GAGs) and has a important function as bone formation and osteoinduction property. PURPOSE: In this experimental study in rabbit mandibular distraction osteogenesis, we investigated the bone enhancing property of hyaluronic acid and the expression of extracellular proteins such as osteocalcin and osteonectin. MATERIALS AND METHODS: The experimental study was carried out on 24 Korean male white rabbits (both mandibular body, n=48). Distraction group was divided to distraction experimental (A, n=16) and distraction control (B, n=16) by the application of hyaluronic acid (Hyruan, LGCI, Seoul, Korea). Normal control group (C, n=16) was only osteotomized. After 5 days latency, distraction devices were activated at a rate of 1.4 mm per day (0.7 mm every 12hours) for 3.5 days. Animals were sacrificed at postoperative 3, 7, 14, and 28 days. HandE stain and immunohistochemical stain was done on decalcified section. Additionally RT-PCR analysis was done for the identification of the expression of osteocalcin and osteonectin. RESULTS: The bone formation in distraction experimental group was much more than that in distraction and normal control group at postoperative 28 days. In immunohistochemical stain, osteocalcin was enhanced at only postoperative 14 days, but osteonectin was not different at each post-operation days. In RT-PCR analysis, osteocalcin was not different at each post-operation days, but osteonectin was strongly expressed in distraction experimental group at postoperative 7 days. The expression of osteocalcin and osteonectin was elevated during the healing period. CONCLUSION: We found the good bone formation ability of hyaluronic acid in distraction osteogenesis through the immunohistochemistry and RTPCR analysis to osteocalcin and osteonectin, known as a bone formation marker. The application of hyaluronic acid in distraction osteogenesis is a method to reduce the consolidation period.

Expression of osseointegration-related genes around titanium implant: BMP2, BMP4

The expression of TGF-beta1, IGF-I, bFGF in distraction osteogenesis according to different distraction rates in rabbit's mandible

Expression of TGF-betaand IGF-I during osseointegration of titanium implant

Expression of BMP-2, -4 during distraction osteogenesis in the rabbit mandible

Distraction osteogenesis(DO) is defined as a gradual mechanical process of mechanical stretching two vascularized bone surface apart with a critical rate and rhythm such that new bone forms within the expanding gap, reliably bridges the gap, and ultimately remodels to normal structure. DO has become a mainstay in bone tissue engineering and has significantly improved our armamentarium for reconstructive craniomaxillofacial procedures. But the molecular and biological mechanisms that regulate the formation of new bone during distraction osteogenesis are not completely understood. BMPs are potent osteoinductive agents. Our hypothesis was that BMPs, especially BMP-2 and BMP-4, might play an importent role in the signaling pathways that link the mechanical forces created by distraction to biological responses and in promting new bone formation. Using a rabbit's mandible, we investigated the expression of BMP-2, -4 at different time points during distraction osteogenesis. The purpose of this study is to research the pattern of expression of BMP-2, -4 in new bone formation during distraction osteogenesis of the rabbit mandible. The experimental group was applied gradual distraction (0.7mm a day by twice a day, 4.9mm in total, for 7 days) and the control group was carried out osteotomy alone. They were examined clinically, histologically, and by RT-PCR analysis. On 3 days after osteotomy, the high level of expression of BMP-2, -4 was detected. But, the expression of BMP-4 was decreased during latency period. As distraction was started, its expression was increased and maintained till postoperative 28days. In control group, the expression of BMP-4was remarkably decreased till postoperative 14 days. On the other hand, the expression of BMP-2 was no difference between experimental group and control group. The expression of BMP-4 was maintanined at high level during the entire experimental period in both group. These findings suggested that excellent bone formation during distraction osteogenesis is associated with enhanced expression of BMP-4 genes by mechanical tension stress.

Displacement of a lower third molar into the lateral pharyngeal space

The displacement of an entire tooth into the adjacent anatomical area is an uncommon complication of a tooth extraction. We encountered a 23-year-old woman who had previously undergone surgery under local anesthesia to remove the lower third molar about 12 weeks prior and the upper third molar was extracted 2 days prior to visiting this hospital. Upon admission, she complained of a swallowing discomfort and a mouth opening limitation. Panoramic radiograph and a CT scan revealed a displacement of the entire tooth into the lateral pharyngeal space. The tooth was retrieved via the transoral approach under general anesthesia. The removed tooth had an indentation formed by a dental bur. Therefore, it was concluded that the tooth displaced into the lateral pharyngeal space was the lower third molar. This report describes an unusual case of a third molar that was displaced into the lateral pharyngeal space with a review of the relevant literature.

Expression of osteonectin on distraction osteogenesis in the rabbit mandible

Distraction osteogenesis has been thought to be promising technique for replacing bone graft in maxilla and mandible. The purpose of this study was to investigate the expression of osteonectin on distraction osteogenesis. Sixteen rabbits were used for this experiment. Osteotomy was performed between premolar and mental foramen. On the experimental group, distraction device was connected to the respective bone segments. On the control group, bone segments were fixed using plate and screws after osteotomy. Distraction was carried out at the rate of 0.7mm per day to obtain a 4.9mm elongation on the experimental group. After 3 days, 7 days, 14 days, and 28 days two rabbits of each group were sacrificed. The results obtained from this study were as follow : Experimental group was observed that the gaps between the distracted bone edges were occupied by new bone. Expression of Osteonectin were detected throughout the experiment in both groups and Expression of Osteonectin were markedly increased during distraction and consolidation period in experimental group than control group. From these results, it could be stated that distraction was shown to improve and accelerate bone formation and mechanical stress like distraction has considerable effects on osteonectin.

Expression of type I, type II collagen on distraction osteogenesis in the rabbit mandible

The purpose of this experiment was to examine the histological changes and the pattern of expression of type I, II collagen in the elongated area by distraction osteogenesis in the rabbit mandible. Sixteen rabbits weighing 2.5kg-3kg were used for this experiment. Experimental group was distracted at the rate of 0.7mm, twice/day for 7days, and control group was only osteotomized. After 5 days latency, osteotomic site is distracted for 7days. Consolidation period is 28days. The animal was sacrificed at the 3rd, 7th, 14th, 28th day after the operation. The distracted bone was examined by histological analysis and RT-PCR analysis. The results were summarized as follows: 1. Experimental group was observed that the gaps between the distracted bone edges were occupied by new bone. 2. Expression of Type I collagen were detected throughout the experiment in both groups and Expression of Type I collagen were markedly increased during distraction and consolidation period in experimental group than control group. 3. Expression of Type II collagen were detected throughout the experiment in both groups and expression of Type II collagen were maintained at high level during distraction and consolidation period in experimental group than control group. From these results, in contrast to type II collagen, type I collagen seemed to be more expressed by mechanical stimuli during distraction and consolidation period. The predominent mechanism of new bone formation in the distraction gap was intramembranous bone formation, but some of the regenerated bone was formed by endochondral ossification.

The relationship between clinical and MRI findings in patients with TMJ disoders at St. Vincent's hospital

Chemically induced osteomyelitis in the mandible: A case report

Current review of molecular biology in distraction osteogenesis

Distraction osteogenesis is a well-established clinical treatment for limb length discrepancy and skeletal deformities. Appropriate mechanical tension-stress is believed not to break the callus but rather to stimulate osteogenesis. In contrast to fracture healing, the mode of bone formation in distraction osteogenesis is primarily intramembranous ossification. Although the biomechanical, histological, and ultrastructural changes associated with distraction osteogenesis have been widely described, the basic biology of the process is still not well known. Moreover, the molecular mechanisms in distraction osteogenesis remain largely unclear. Recent studies have implicated the growth factor cascade is likely to play an important role in distraction. And current reserch suggested that mechanical tension-stress modulates cell shape and phenotype, and stimulates the expression of the mRNA for bone matrix proteins. This article presents the hypotheses and current research that have furthered knowledge of the molecular biology that govern distraction osteogenesis. The gene regulation of growth factors and extracellular matrix proteins during distraction osteogenesis are discussed in this article. It is believed that understanding the biomolecular mechanisms that mediate distraction osteogenesis may guide the development of targeted strategies designed to improve distraction osteogenesis and accelerate bone healing.