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open access
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ISSN : 0376-4672
This article discusses how to conduct treatment planning and decision making in special needs dentistry. Special needs patients often lack cooperative ability during dental treatment and have a deteriorated oral health status. To overcome the limitation in communication with special needs patients and solve their complicated dental problems, dentists need to have extensive preoperative information about the patients and their caregivers. Treatment procedures should be organized in a patient-centered and cost-effective manner. Additionally, clinical outcomes need to be predicted taking into consideration of the patients' condition. The clinical experience of committed dentists is another factor that enhances the benefits of extensive treatment in special needs patients with many limitations. The insightful treatment decision-making of dentists will contribute to improving the oral health of special needs patients despite the various obstacles.
Individuals with special needs include those with behavioral issues, developmental disorders, cognitive disorders, congenital or genetic disorders, or systemic disease. These conditions may place them at increased risk for oral diseases. Dental management of patients with special needs require in-depth understanding of the background of disability and available behavioral guidance theories. Therefore dental team members need more training in the theory and practice of behavior management principles, which might lead to a clinical experience that is more respectful of the dignity and independence of patients with special needs. The dental professional should be flexible to modify the behavior management approach according to the individual patients needs. Also a family/care-giver centered approach based on their preferences and concerns, the patient's challenging behaviors, and related medical problem can serve to improve the treatment planning and oral health management of dental patients with special needs. This article focuses on uncooperative behavior and behavior management, which help practicing dentists to understand their role in the care of patients with special needs.
Swallowing disorders or dysphagia, which are difficulties with the act of swallowing, can occur at different phases such as oral, pharyngeal, and esophageal phase in the swallowing process. These disorders can be caused by structural, functional abnormalities or psychological problems. Dentists can actively provide patients suffering from dysphagia with comprehensive professional care, especially from the cognitive stage of food to the pharyngeal stage of the swallow. Many cases of dysphagia can be improved with careful managements based on dental professionals' knowledge, including meticulous evaluation of masticatory and swallowing functions, training on eating and swallowing, and fabrication of palatal or lingual augmentation prosthesis. The important thing is that prevention of these disorders through the oral health care instruction and planned follow-up dental visit at periodic intervals in order to manage the problems caused by anatomical, functional, and psychological reason.
A questionnaire-based survey was done to evaluate the patients’ perception on the use of Rubber Dam (RD) for the tooth isolation during dental treatment. Total 106 questionnaire were gathered and the data were analyzed according to the patients’ gender, age, previous experience of RD. The 96% of total patients reported no experience of RD in their previous treatment. The first advantage of RD was selected as the protection of irrigant and medication into the oral cavity and the disadvantage was selected as saliva gathering during treatment. 98% of patients want to use RD for the next treatment and 99% remarked that the RD is essential for the dental treatment. Based on the surveyed data, majority of the patients highly satisfied with the RD use and they want to use RD and may consider the use of RD for the selection of dental clinic.
PURPOSE: The aim of this study was to evaluate the influence of the oxide layer removal process in the Co-Cr-Mo (CCM) abutment after casting procedure on the prosthesis settlement and screw stability. MATERIALS AND METHODS: CCM abutments of four different interface conditions (CCM-M; machined, CCM-O; oxide layer formed, CCM-B; blasted, CCM-P; polished after blasted) and gold abutment (Gold-C; Cast with type III Gold alloy) were used. The initial settling values of abutments were evaluated according to the difference of implant-abutment length when the tightening torques were applied at 5 Ncm and 30 Ncm, and the settling values of abutments caused by loading were evaluated according to the difference of implantabutment length before and after loading with 250 N, 100000 cycle. The loss ratios of removal torque for abutment screws were evaluated according to the difference in value of removal torques under 30 Ncm tightening torque applied before and after cyclic loading. RESULTS: The CCM-P and CCM-B group showed a higher initial settling value compared with the Gold-C group (P<.05), while the Gold-C group showed the highest settling values caused by loading (P<.05) and no significant differences were observed for between CCM groups (P>.05). The loss ratio of removal torque values for the CCM-B, CCM-P groups did not differ significantly from that of the Gold-C group (P>.05). CONCLUSION: Even though the oxide layer was removed by different methods, CCM abutment with internal conical connection structure showed lower abutment settling and similar screw loosening after cyclic loading compared with gold abutment.
Korean dentist’s new mission was extended in dental practice field since the National Liberation Day of Korea. Modern dentistry development were due to the introduction of american dentistry, the development of Military dentistry, the unified academic activities koreans dental Association and improvement of korean dentist system. Modern dentistry development factors were as follows, First, Seoul National University’s professors have been sent for studying abroad since May 1954. Thanks to this advanced system, each dental department established branch academy. Researchers and academic activities were increased in Seoul National University, Second, from January 1954, the military started training program to the korean dentists in the United States, and also the korean dentists were sent to the US Army hospital in korea for practical training courses (On the Job Training) so they could get chances to learn the advanced dentistry. During the korean war, the oral surgery dentists enlarged treatments to the maxillofacial field. Third, korean Dental academy meeting, special lectures and tables clinic from 1947 were contributing to the development of modern dentistry in the transmission of knowledge and skills. Since 1955 “Dentistry(齒學)” with a focus on the translation of foreign literature also developed modern dentistry. Since 1958 the International dental conference could broaden dental knowledge, it also provided opportunities to communicate with the world dentistry. On Oct 11, 1962, revised the Articles of association in Korean Dental academy and korean dental association unified meeting and enhanced the conferences. Improvement of korean dentist system in 1964 unified the dentists as new dentist education. Articles, case reports, review articles and academic meetings of korean dental association from 1946 to 1969 analyzed to demonstrate the development of korean modern dentistry, The titles and lectures were classified according to department and they were organized by topic.
This clinical report describes an orthodontic-prosthodontic interdisciplinary treatment for a patient with multiple missing teeth and unilateral scissors bite. A 47-year-old female presented with multiple missing posterior teeth, anterior large overjet, deep bite, and posterior scissors bite on the right premolar area. Periodontal therapy was performed and followed by orthodontic treatment. The maxillary anterior teeth were initially aligned, then two implants were placed for the left mandibular molars to increase occlusal vertical dimension. The scissors bite between the right maxillary and mandibular premolars were corrected using the miniscrews as an anchorage. Other implants were placed for the right maxillary and mandibular molars after the occlusal planes and occlusal relationship were harmonized. The patient adapted well to altered vertical dimension without any specific problems including peri-implant marginal bone loss. Interdisciplinary approach resolve the complex orthodontic-prosthodontic problems and concluded in successful results.
The purpose of this study was to evaluate the oral health promotion of the disabled persons by voluntary dental services in Ulsan Metropolitan City. Two dentists taken a calibration training for national oral health survey examined the oral health status of 473 disabled persons from two special schools for the disabled children and adolescents, a residential facility and a gymnasium for the disabled persons in 2009-2010. The surveyed disabled persons in the age range was from 7 to 74 years old. Voluntary dentists, oral hygienists and other civilian volunteers had supplied with the oral health care services to the disabled persons at dental clinics of special schools for the disabled children and adolescents, and a dental clinic supported from Nam-Gu Public Health Center in Ulsan Metropolitan City since 1997. The obtained data from these surveys were analyzed with the SPSS statistical package. Among subjects aged 12-14 years, subjects with decayed, missing and filled teeth (DMFT) in permanent dentition was 46.9%; subjects with untreated decayed teeth, 17.2%. The number of decayed, missing and filled teeth in permanent dentition was 1.36. The proportion of decayed components of DMFT score was 28.00%; proportion of missing components of DMFT score, 1.43%; proportion of filled components of DMFT score, 70.57%. The proportion of filled components of DMFT score among disabled persons of all age group in Ulsan were evaluated to be a similar level to non-disabled citizens in Ulsan from 2010 Korean National Survey. The oral health care programs for disabled persons by voluntary services of dental professionals and other civilians are evaluated to be effective for the oral health promotion of disabled persons in Ulsan.
This article discusses accomplishments and historical implications of American missionary dentist W.J. Scheifley and the first Korean dental department, which was established in 1915 in Korea. W.J. Scheifley, with Christian service mind and mission as a dentist, applied to American Protestantic missionary dentist overseas. The dental department in the Severance Union Medical College introduced the scientistic dental education of America, facilitated research on the dental condition of the Korean people, and ran independent dental clinic. W.J. Schiefley criticised the profit-seeking attitude of Japanese dentists and denturist(=“IPCHISA”, in Korean pronunciation) and emphasized on the significance of Oral Health. He did all kind of dental treatments with advanced equipments like X-ray machine, and managed the collective oral health care for missionaries overseas. He trained medical students and assistants of the dentists with the goal of producing Korean dentists, but he failed due to the Dentist law introduced by Japanese colonial administration that interfered with producing Korean dentists. However, O.R. Avison’s proposal of the establishment of dental schools stimulated the establishment of Kyungsung dental school, which provided the basis for the Dental department in the Severance Union Medical College becoming special training institution for Korean Dentists.