BACKGROUND: The purpose of this study was to investigate the distribution of systemic diseases and medications in patients older than 65 years of age who visited the hospital for implant treatment, as well as to investigate basic information about surgical complications that may occur after insured implant treatment. METHODS: A total of 126 patients over 65 years of age were treated for implant surgery from October 1, 2013 to October 30, 2016. Electronic chart review was conducted to obtain medical records, which included sex, age, systemic diseases, medication(s) being taken, and control of the medications. Five patients were excluded due to lack of medical records giving information about systemic disease. RESULTS: Of the 126 patients, 112 (88.9%) were taking medication due to systemic disease and 9 patients (7.1%) were not. The sex distribution was 71 women and 55 men and the highest proportion of patients were between 65 and 69 years old. The most common diseases were, from most to least frequent, hypertension, cardiovascular disease, diabetes, and osteoporosis. The drug groups that can cause major complications after dental treatment were classified as hemorrhagic, osteoporotic, and immunosuppressive agents, and were taken by 45 (35.7%), 22 (17.5%) and 4 (3.2%) patients, respectively. CONCLUSION: Given that 88.9% of the elderly patients who were eligible for insurance implant treatment had systemic disease, it is necessary to carefully evaluate patients' medical histories and their general conditions in order to prevent emergencies during implant surgery.
Aged* ; Cardiovascular Diseases ; Delivery of Health Care* ; Dental Implants* ; Emergencies ; Female ; Humans ; Hypertension ; Immunosuppressive Agents ; Insurance* ; Korea* ; Male ; Medical History Taking ; Medical Records ; National Health Programs ; Osteoporosis ; Postoperative Complications ; Sex Distribution

BACKGROUND: Emergencies in dentistry can be classified as medical and dental. Medical emergencies occur mainly during dental treatment in patients with a systemic disease. Dental emergency departments are largely divided into dental emergency rooms located in dental college hospitals and medical emergency rooms located in medical institutions. This study aimed to analyze the characteristics of and provide help to dental emergency patients in a dental hospital. METHODS: Overall, 1806 patients admitted to a dental emergency room at Yonsei University Dental Hospital for 1 year were included. The data collection period was from October 1, 2014 to September 30, 2015. An investigator reviewed medical records from the electronic medical record (EMR) system and radiographs. RESULTS: The patients were 1,070 men and 736 women. The sex ratio was 1.45:1. The commonest age group was of 0–9 years, including 451 (25.0%) patients, followed by 20–29 years, including 353 (19.5%) patients, and 30–39 years, including 277 (15.3%) patients. Of the 108 patients transferred to the Severance emergency department, 81 had trauma, 19 were in pain, 4 were bleeding, and 4 had other complaints. Among chief complaints, 1,079 patients (60.3%) had trauma, 564 (31.5%) had pain, and 75 (4.2%) had bleeding. Twenty-three cases (1.3%) were caused by temporomandibular disorder (TMD). CONCLUSION: Dentists should be able to adequately assess patients in a dental emergency room and treat trauma, pain, and bleeding.
Data Collection ; Dentistry ; Dentists ; Electronic Health Records ; Emergencies ; Emergency Service, Hospital ; Female ; Hemorrhage ; Humans ; Male ; Medical Records ; Research Personnel ; Retrospective Studies ; Sex Ratio ; Temporomandibular Joint Disorders

The use of novel oral anticoagulants (NOACs) has increased in recent times in an effort to overcome the shortcomings of warfarin. They are being used primarily for the prevention of thrombosis caused by atrial fibrillation and offer the advantages of having fewer drug interactions than warfarin, no dietary restrictions, and no requirement for regular blood tests. Although there is reportedly less postoperative bleeding even if the drug is not discontinued during procedures that can cause local bleeding, such as dental procedures, no well-designed clinical studies have assessed postoperative bleeding associated with the use of these drugs. This article reports a case of a 74-year-old male patient who was taking rivaroxaban. The patient underwent a dental implant procedure after discontinuing rivaroxaban for one day and subsequently suffered delayed bleeding on postoperative day 6. Accordingly, this article also reports that the use of NOACs may also lead to delayed bleeding.
Aged ; Anticoagulants* ; Atrial Fibrillation ; Dental Implants ; Drug Interactions ; Emergencies ; Hematologic Tests ; Hemorrhage* ; Humans ; Male ; Rivaroxaban ; Thrombosis ; Warfarin

Ankylosed tooth is defined as 'the discontinuance of normal passive tooth eruption without any mechanical barrier'. Ankylosed tooth treatment is a challenge to dental clinicians. In treatment of maxillary molar ankylosis cases there are risks of oro-antral fistula, displacement of root fragments into the maxillary sinus, as well as the necessity for providing additional sinus bone augmentation for future implant placement. In this study, we suggested a new technique using a piezoelectric device and a lateral side approach to the maxillary sinus leading to the simultaneous removal of the ankylosed maxillary molar and sinus grafting for the purpose of implant site development.
Ankylosis ; Displacement (Psychology) ; Fistula ; Maxillary Sinus ; Molar ; Tooth ; Tooth Eruption ; Transplants

Issues related to the control of seizures and bleeding, as well as behavioral management due to mental retardation, render dental treatment less accessible or impossible for patients with Sturge-Weber syndrome (SWS). A 41-year-old man with SWS visited a dental clinic for rehabilitation of missing dentition. A bilateral port-wine facial nevus and intraoral hemangiomatous swollen lesion of the left maxillary and mandibular gingivae, mucosa, and lips were noted. The patient exhibited extreme anxiety immediately after injection of a local anesthetic and required various dental treatments to be performed over multiple visits. Therefore, full-mouth rehabilitation over two visits with general anesthesia and two visits with target-controlled intravenous infusion of a sedative anesthesia were planned. Despite concerns regarding seizure control, bleeding control, and airway management, no specific complications occurred during the treatments, and the patient was satisfied with the results.
Adult ; Airway Management ; Anesthesia* ; Anesthesia, General ; Anxiety ; Dental Clinics ; Dentition ; Gingiva ; Hemorrhage ; Humans ; Infusions, Intravenous ; Intellectual Disability ; Lip ; Mouth Rehabilitation* ; Mouth* ; Mucous Membrane ; Nevus ; Rehabilitation ; Seizures ; Sturge-Weber Syndrome*

Issues related to the control of seizures and bleeding, as well as behavioral management due to mental retardation, render dental treatment less accessible or impossible for patients with Sturge-Weber syndrome (SWS). A 41-year-old man with SWS visited a dental clinic for rehabilitation of missing dentition. A bilateral port-wine facial nevus and intraoral hemangiomatous swollen lesion of the left maxillary and mandibular gingivae, mucosa, and lips were noted. The patient exhibited extreme anxiety immediately after injection of a local anesthetic and required various dental treatments to be performed over multiple visits. Therefore, full-mouth rehabilitation over two visits with general anesthesia and two visits with target-controlled intravenous infusion of a sedative anesthesia were planned. Despite concerns regarding seizure control, bleeding control, and airway management, no specific complications occurred during the treatments, and the patient was satisfied with the results.
Adult ; Airway Management ; Anesthesia* ; Anesthesia, General ; Anxiety ; Dental Clinics ; Dentition ; Gingiva ; Hemorrhage ; Humans ; Infusions, Intravenous ; Intellectual Disability ; Lip ; Mouth Rehabilitation* ; Mouth* ; Mucous Membrane ; Nevus ; Rehabilitation ; Seizures ; Sturge-Weber Syndrome*

Tumors metastasizing from distant regions to the oral and maxillofacial region are uncommon, comprising only 1%-2% of all malignancies. Cholangiocarcinoma is a malignancy that arises from cholangiocytes, which are epithelial cells that line the bile ducts. These cancers are difficult to diagnose and have a poor prognosis. In this paper, we report a rare case of mandibular metastasis of cholangiocarcinoma diagnosed at the primary site and discuss the radiographic findings observed in this case.
Bile Ducts ; Cholangiocarcinoma* ; Epithelial Cells ; Mandible ; Neoplasm Metastasis* ; Prognosis

Local anesthetics are an essential part of pain control during dental treatment. Despite its effectiveness and safety, patients should constantly be aware of potential adverse effects, including allergic reactions. Allergic reactions to amide-type local anesthetics (LAs), such as lidocaine and mepivacaine, are rare compared to those to ester-type LAs. Herein, we report the case of a patient with a history of allergy to lidocaine and mepivacaine, with symptoms of itching, diffuse erythema of the wrists and hands, dizziness, and pectoralgia. This case report emphasizes the importance of collecting medical and dental histories of patients is necessary, and how an allergy test in the allergy and clinical immunology department helps select safe LAs for patients.

Purpose: This study aimed to develop an animal model suitable for coronectomy research. Materials and Methods: Eighteen Sprague-Dawley rats were divided into six groups: incisor control (InC), incisor flap (InF), incisor non-flap (InNF), molar control (MC), molar flap (MF), and molar non-flap (MNF). Coronectomy was not performed in the control groups (InC and MC). In the incisor (In) groups, coronectomy was performed on the mandibular incisors, with flap elevation in the InF group and without flap elevation in the InNF group. In the molar (M) groups, coronectomy was performed on the maxillary first molar, with flap elevation in the MF group and without flap elevation in the MNF group. The incisor groups were sacrificed on day 7, and the molar groups on days 7 and 14. Clinical healing, tooth movement, and histological and immunohistochemical analyses were performed. Results: InF and InNF groups showed tooth eruption similar to or the same as that before coronectomy, whereas the MF and MNF groups’ roots moved slowly. In InF and InNF groups, the pulp at the maturation zone was mineralized, but apical pulp vitality was maintained. MF and MNF groups showed bacterial infection and inflammation on day 7, with mineralization on day 14; however, apical pulp vitality was maintained. The MF group showed varied healing patterns, whereas the MNF group had consistent results across individuals. Conclusion Both incisors and molars are meaningful models for coronectomy. However, for consistent experimental results, coronectomy without flap elevation on the maxillary first molar is recommended.

Purpose: This study aimed to develop an animal model suitable for coronectomy research. Materials and Methods: Eighteen Sprague-Dawley rats were divided into six groups: incisor control (InC), incisor flap (InF), incisor non-flap (InNF), molar control (MC), molar flap (MF), and molar non-flap (MNF). Coronectomy was not performed in the control groups (InC and MC). In the incisor (In) groups, coronectomy was performed on the mandibular incisors, with flap elevation in the InF group and without flap elevation in the InNF group. In the molar (M) groups, coronectomy was performed on the maxillary first molar, with flap elevation in the MF group and without flap elevation in the MNF group. The incisor groups were sacrificed on day 7, and the molar groups on days 7 and 14. Clinical healing, tooth movement, and histological and immunohistochemical analyses were performed. Results: InF and InNF groups showed tooth eruption similar to or the same as that before coronectomy, whereas the MF and MNF groups’ roots moved slowly. In InF and InNF groups, the pulp at the maturation zone was mineralized, but apical pulp vitality was maintained. MF and MNF groups showed bacterial infection and inflammation on day 7, with mineralization on day 14; however, apical pulp vitality was maintained. The MF group showed varied healing patterns, whereas the MNF group had consistent results across individuals. Conclusion Both incisors and molars are meaningful models for coronectomy. However, for consistent experimental results, coronectomy without flap elevation on the maxillary first molar is recommended.