ISSN : 0376-4672
Cardiac arrest can occur in dental clinics. All dental professionals should be trained to deal with emergency situations that is threatening life. Dental professionals should be familiar with the protocol which include basic life support, advanced life support and specific drugs to be administered in emergencies. Emergency can occur in any dental office without any warnings. Further, it has been noted in recent times there is an increase in a number of medico-legal cases due to rise in a number of death in the dental chair. This review article aims at briefing the basic life support required to manage the medical emergency having life-threatening potential.
Conceptually, the emergency is classified as an urgency and an emergency. The Urgency is not immediately life threatening, but could become so if not resolved promptly. So, it requires prompt patient care same as in the emergency situation. However, the emergency is immediately life threatening and requires immediate action, such as calling 119 and basic life support. Most medical emergencies in the dental clinic cases are urgencies. The incidence of true emergencies is approximately 1/1,000,000. Adequate managing medical urgencies are important because the chance of encountering medical emergencies in the dental clinic is high and higher these days especially because of rapidly aging Korean society. Many dentists indicate that many dentists feel difficulties to recognize and treat medical problems. This paper reviews the concept of medical emergencies and how to cope with commonly occurring urgencies in the dental clinic such as loss of consciousness, hypoglycemia, hyperventilation syndrome. The best treatment for medical urgencies and emergencies in the dental clinic is prevention. Also, it is required to make preparation for emergency situations such as CPR education for dentists and being well-acquainted with equipment and drugs for the emergency care as well as to systemic medical evaluation, patient monitoring, and sedations for controlling patient’s anxiety and pain. In this paper, simple algorithms based on guidelines for common urgencies in the dental clinic are suggested. In conclusion, every dentist has competencies to do the urgency care adequately and basic life support. Also, advanced cardiac life support is strongly recommended when sedation is performed in the clinic.
In a dental treatment, a dentist has to know the possibility to happen all kinds of the emergency and to prepare for managing that situation. Especially, the cardiac arrest is the most serious emergent problem. If the accident were happened, most dentists got embarrassed. The American Heart Association (AHA) is offering the Basic Life Support (BLS), Advanced Cardiopulmonary Life Support (ACLS) and Pediatric Advanced Life Support (PALS) programs for the healthcare who need to prepare the life threatening situation. The PALS is specialized to someone who participate in pediatric health-care field. This program is composed of three major emergency problems, such as respiratory emergencies, shock and cardiac arrests. The main concepts of the PALS are early recognition and systemic team approach. The purpose of this study was to introduce about PALS and to prepare response system for emergencies in the dental environment.
The modified ridge splitting/expansion technique combined with guided bone regeneration (GBR) for implant surgery is used to expand the narrow and atrophied edentulous alveolar ridge. Also, the simultaneous implant placement after ridge splitting/expansion technique can reduce the treatment and healing time. This case report includes three patients with a narrow edentulous alveolar ridge of the 2 to 4mm. All three patients underwent a fracture of thin buccal cortical bone plate, and these defects were corrected by the use of the guided bone regeneration (GBR). After 7 to 18 months, all surgical area was stable, and all implant showed a good healing state on the clinical and radiographic examination. In conclusion, though this surgical method is technique sensitive, the modified ridge splitting/expansion technique combined with GBR for implant surgery is recommended for a horizontal augmentation in the narrow edentulous alveolar ridge.
Objective: The objectives of this study were to measure pediatric organ and effective doses of cone-beam computed tomography (CBCT) for orthodontic analysis and to compare them to those of panoramic and lateral cephalometric radiography, the conventional radiography for orthodontic analysis. Materials and Methods: Alphard VEGA for CBCT, Planmeca Proline XC for panoramic radiography and Orthophos CD for cephalometric radiography were used for this study. Thermoluminescent dosimeter (TLD) chips were located at 24 anatomic sites of 10-year-old anthropomorphic phantom and exposed during CBCT (C-mode; 200 x 179 mm FOV), panoramic and lateral cephalometric radiographic procedures at the clinical exposure settings for 10-year-old patient. Pediatric organ and effective doses were measured and calculated using ICRP 2007 tissue weighting factors. Results: Effective doses of CBCT, panoramic radiography and lateral cephlometric radiography in pediatric clinical exposure settings were 292.5 μSv, 19.3 μSv, and 4.4 μSv respectively. The thyroid gland contributed most significantly to the effective dose in all the radiographic procedures. Conclusion: Effective dose of CBCT was about 12 times to conventional radiographic procedures for orthodontic analysis in pediatric patient. The use of CBCT for orthodontic analysis should be fully justified over conventional radiography and dose optimization to decrease thyroid dose is needed in pediatric patients.
Cyst is a closed sac, having a distinct membrane and division compared to the nearby tissue. Most cysts in the oro-maxillofacial area are odontogenic origin and found most commonly by oral and maxillofacial surgeons. Enucleation is considered as a definitive therapy in the management of these cysts. However, to select the treatment method for large cyst, consideration of position of the cyst, size and accessibility to main structure are needed. Marsupialization is a minimal invasive technique to treat large odontogenic cyst and tumor without damage to adjacent important structures. This study was undertaken to describe three cases of odontogenic cysts and tumors of jaws that were successfully treated with enucleation after marsupialization.
