ISSN : 0376-4672
Cemento-osseous dysplasia (COD) is a fibro-osseous lesion of the maxilla and mandible, originating from a periodontal ligament. It resembles a periapical lesion such as a periapical abscess or a cyst in its early stage. Usually, the affected tooth is vital and without symptoms. A healthy 35-year-old female was referred to the endodontic department for evaluation and endodontic treatment of an amalgam restored mandibular first molar with an apical radiolucency. Since the tooth was sensitive to a cold stimulus, chronic apical periodontitis was suspicious at first sight. But after clinical and radiographic evaluations, multiple periapical COD involving vital teeth of the mandible was diagnosed. No specific treatment of COD was scheduled except for renewing the pre-existing restoration. The present case is a confusing case since COD was associated with an asymptomatic tooth. Knowledge of the clinical features related to pulp vitality tests and cone-beam computed tomography (CBCT) helps determine the differential diagno sis between COD and a periapical lesion.
MRONJ (medication related osteonecrosis of the jaw) is a disease characterized by necrosis of the jaw that occurs after administration of anti-resorptive or anti-angiogenic drugs. However, etiology and effective treatment methods of MRONJ are not yet clearly identified. In this study, a systematic review was conducted to investigate the effects of pentoxifylline and tocopherol on MRONJ. A total of 5 clinical studies using pentoxifyllie and tocopherol in MRONJ patients among the papers registered in Pubmed/medline were reviewed. Pentoxifyllie and tocopherol were used for therapeutic purposes in 32 patients, and the mean age was 68 years for men and 74.21 years for women. Of the 32 patients, 20 patients were stage 2, 11 patients were stage 3, and one patient was stage 0. In the most cases, the triggering factor was extraction. All patients com plained of pain in the lesion area before drugs administration. The average follow-up period was 10.6 months. After drugs administration, 29 patients (90.6%) showed improvement in symptoms in terms of bone exposure and pain. Administration of pentoxifylline and tocopherol in MRONJ may improve symptoms of pain and bone exposure. However, it seems that additional studies on the appropriate use and dose, timing and duration of administration are needed.
Objectives: Cemental tear is a specific type of root surface fracture that can lead to rapid periodontal attachment loss. Tooth associated with cemental tear show mobility of tooth, resorption of alveolar bone, and inflammation that persists even after root canal treatment. Cemental tears are difficult to diagnose when characteristic fractures are not observed on radiographs, and often misdiagnosis as periapical or periodontal lesions. refore, an accurate diagnosis is essential for suc cessful treatment of cemental tears and a multidisciplinary approach that involves both endodontic periodontal treatment, and periodontal surgery is required. The aim of this case report is to present the treatment and outcome of cemental tear which was managed with two differ ent surgical treatment regimes. In the first case, after conventional endodontic treatment, cemental fragment was removed through open flap surgery, and regeneration treatment was performed by guided tissue regeneration (GTR) and bone graft. In the second case, after conventional endodontic treatment, apicoectomy and removal of cemental fragments were performed through replantation of tooth, followed by guided tissue regeneration (GTR) and bone graft. In both cases, follow-up of more than 6 months was performed, symptoms subsided and recovery of periapical alveolar bone was observed on radiographs.
This study was conducted to measure patient safety of dental outpatients and to identify high-risk areas in dental care. A survey was conducted with 400 people aged 19-64 who had used a dental institution within the past 3 years. The Primary Care Patient Measure of Safety (PC-PMOS) questionnaire was used as a dental safety patient measurement tool. 19 domains and 46 questions of PC-PMOS were analyzed, and negative responses were classified into risk areas in dental care. 10 of the 46 items of PC-PMOS had a negative response rate of 20% or more. The questions with the highest percentage of dissatisfied were 'when they referred me to another hospital, there was a waiting list (50.9%)', 'if necessary, you could receive hospital services outside of the regu lar operating hours of the hospital (38.1%)'. The dental patient safety score was higher for male and for house holds with an average monthly income of 8 million won or more (p<0.05). Findings of this study suggest that it is necessary to prepare a dental patient safety management system in that patient safety management improves the quality of dental care. In addition, standardized dental patient safety management indicators are essential for monitoring and improvement of patient safety and quality in dentistry.
This study aimed to investigate occupational risk among dental practitioners and its associated factors. Ma- terials and Methods. A total of 505 dentists and other dental staff from Korean dental institutions were included in this study. A self-report questionnaire on demographic characteristics, perception and experience of occupa- tional hazards, the prevalence of chronic diseases, and type of musculoskeletal problems, were distributed to the participants. A logistic regression model was used to identify factors affecting the perception of occupational hazards. Results. Among the participants, 61.58% were dentists and 38.42% were dental staff (dental hygien- ists, dental technologists, and other office workers). Overall, 48.12% had a serious perception of occupational hazards, and 77.53% had experienced occupational hazards. The common occupational hazards encountered were stress (20.58%), exposure to hazardous materials (15.44%), and cross-infections (14.75%). Regardless of participants’ occupation and their perception of occupational hazards, musculoskeletal problems had the high- est prevalence (35.94%) (neck/shoulder pain [35.53%], lower back pain [24.74%], and wrist pain [19.07%]). Those with experience of occupational hazards and musculoskeletal problems were more likely to recognize occupational hazards (odds ratio 5.186 and 1.535, respectively; p<0.05). Conclusion. Approximately half of the dental workers were aware of the risk of occupational hazards. This study highlighted that the more the partici- pants experience occupational hazards, the more likely they are to recognize occupational hazards. The high prevalence of physical and mental occupational hazards indicates the need for preventive measures to reduce occupational risk in dental practices.
The aims of this study were to evaluate quality indicators that can be applied to the dental care delivery sys- tem in Korea. This study was performed with a three-step process. Firstly, authors searched for quality indica- tors developed in dentistry field. Among them, 80 quality indicators were selected as the indicators that used in dental institutions, and then 33-item preliminary list was extracted through evaluation by 9 experts consisted of dental clinicians and professors (college of dentistry and department of dental hygiene). Based on this 33-item preliminary list, a Delphi process was conducted twice by a stakeholder group consisting of 17 panels (dentists, dental hygienists, dental technicians, professors of dental colleges, and dental hygiene professors). Each item of the preliminary list was classified into 5 domains of importance, relevance, feasibility, reliability, and sensitiv- ity. The panels were asked to rate from 0 to 3-point (very unnecessary - very appropriate) to the 5 domains of all items. As a result, the sealant treatment item received the most consent, and the item of whether unnecessary antibiotics is prescribed received the lowest preference. Among the 33 items, the items that received a score of 2.5 or higher were sealant, brushing, fluoride application, caries prevention, periodontal management, regular check-up, continuity of treatment, and evaluation of current symptoms. This study was performed as basic re- search. Based on international consensus on the definition of the quality of oral health care, development of new measures is necessary to produce quality indicators that suitable for the dental setting in Korea.
