1.Change in Severity and Clinical Manifestation of MIS-C Over SARSCoV-2 Variant Outbreaks in Korea
Young June CHOE ; Eun Hwa CHOI ; Jong Woon CHOI ; Byung Wook EUN ; Lucy Youngmin EUN ; Yae-Jean KIM ; Yeo Hyang KIM ; Young A KIM ; Yun-Kyung KIM ; Ji Hee KWAK ; Hyukmin LEE ; June Dong PARK ; Yeon Haw JUNG ; Jin GWACK ; Sangwon LEE ;
Journal of Korean Medical Science 2023;38(30):e225-
Background:
There is difference in the incidence of multi-system inflammatory syndrome in children (MIS-C) in patients with different variants of severe acute respiratory syndrome coronavirus 2, however, little is known about the epidemiology in Asian countries. We investigated and compared the epidemiology of the MIS-C during omicron-dominant period with that of previous periods in South Korea.
Methods:
We obtained clinical, epidemiological and laboratory data on MIS-C cases from national MIS-C surveillance in South Korea. We defined pre-delta period as January 2020–May 2021; delta period as June 2021–December 2021; and omicron period as January 2022–April 2022. We describe the clinical characteristics and outcomes of MIS-C patients by period.
Results:
A total of 91 cases were assessed to be MIS-C cases. Number of MIS-C cases have increased from six cases during pre-delta period to 66 cases during omicron period, while the incidence rate (the number of MIS-C cases per 100,000 cases of reported coronavirus disease 2019) has decreased from 38.5 cases per 100,000 (95% confidence interval [CI], 14.1–83.9) during pre-delta period to 1.6 cases per 100,000 (95% CI, 1.2–2.0) during omicron periods. During pre-delta period, 66.7% and 100% had hypotension and gastrointestinal involvement, respectively; while during omicron period, 12.1% and 6.1% had such clinical manifestations. Fifty percent of pre-delta MIS-C patients were taken intensive care unit (ICU) cares, while 10.6% of patients during omicron periods were in ICUs.
Conclusion
Omicron period were associated with less severe clinical manifestation compared to pre-delta and delta periods. Although incidence rate of MIS-C was lower for the omicron period than pre-delta and delta periods, number of patients reported with MIS-C may pose a substantial clinical burden.
2.Pediatric Deaths Associated With Coronavirus Disease 2019 (COVID-19) in Korea
Eunjeong SHIN ; Young June CHOE ; Boyeong RYU ; Na-Young KIM ; Hyun Ju LEE ; Dong Hwi KIM ; Seong-Sun KIM ; Donghyok KWON ; Ki Wook YUN ; Su Eun PARK ; Eun Hwa CHOI ; Sangwon LEE ; Hyunju LEE
Journal of Korean Medical Science 2023;38(3):e21-
As of September 3, 2022, 5,388,338 coronavirus disease 2019 (COVID-19) cases and 46 deaths (3 in 2021 and 43 in 2022) were reported in children ≤ 18 years in Korea. Cumulative confirmed cases accounted for 67.3% of the population aged ≤ 18 years and case fatality rate was 0.85/100,000. Among 46 fatal cases, 58.7% were male and median age was 7 years.Underlying diseases were present in 47.8%; neurologic diseases (63.6%) and malignancy (13.6%) most common. Only four had history of COVID-19 immunization. COVID-19 associated deaths occurred at median 2 days from diagnosis (range: −1 to 21). Among COVID-19 deaths, 41.3% occurred before admission; 2 before hospital arrival and 17 in the emergency department. Among children whose cause was documented, myocarditis, respiratory and multiorgan failure were most common. COVID-19 associated death was seen early after diagnosis in children and public health policies to provide access to medical care for children with COVID-19 are essential during the pandemic.
3.Fabrication of CAD-CAM complete denture using existing provisional denture and digital facebow transfer
Jaehyeok RO ; Haemin BANG ; Sangwon PARK ; Hyun-Pil LIM ; Kwi-Dug YUN ; Chan PARK
The Journal of Korean Academy of Prosthodontics 2023;61(4):268-274
In this case, a CAD-CAM complete denture that can be easily remanufactured and reduced the number of visits was decided in consideration of the fact that it was difficult to visit the dental hospital and many existing dentures were lost because the patient was inpatient in a nursing hospital. In order to reflect the shape, vertical dimension, and maxillomandibular relationship of the existing provisional dentures adapted by the patient to the fabrication of the final denture, the existing provisional dentures were scanned and closed mouth impression was taken with the printed individual tray. After digital facebow transfer using UTS CAD and arranging artificial teeth in CAD software, the maxillary and mandibular complete dentures were fabricated by milling the denture base and artificial teeth at once with the monolithic disc.
4.Digital immediate implantation and aesthetic immediate loading on maxillary incisor displaced due to root fracture: a case report
Jieun SONG ; Songyi PARK ; Chan PARK ; Kwidug YUN ; Hyun-Pil LIM ; Sangwon PARK
Journal of Dental Rehabilitation and Applied Science 2023;39(4):267-275
To obtain better esthetic results when immediately placing a dental implant, the soft tissue surrounding the implant must be conditioned during healing of the extraction socket. To this end, the emergence profile can be customized through immediate restoration of the provisional prosthesis, and good clinical results can be obtained at the time of definitive restoration in the future, resulting in high patient satisfaction. In this case, horizontal root fracture occurred after trauma to both maxillary central incisors.Immediate implant placement and loading was planned considering aesthetics and alveolar bone condition. By taking an impression using a digital intraoral scanner, a digital diagnostic wax-up was performed to make a more aesthetic prosthesis without applying external force to the traumatized teeth. Based on this, the ideal placement location was determined and immediate implant placement was performed using a 3D printed surgical guide. The provisional prosthesis was restored 5 days after placement, and the definitive zirconia crown was restored through soft tissue conditioning and customization using the shape of the provisional prosthesis for 3 months.
5.Improvement of peri-implant complications through customized prosthesis restoration allowing soft tissue space: a case report
Jieun SONG ; Woohyung JANG ; Chan PARK ; Kwidug YUN ; Hyun-Pil LIM ; Sangwon PARK
Journal of Dental Rehabilitation and Applied Science 2023;39(4):260-266
The concept of ‘Implant Supracrestal Complex (ISC)’ was introduced as a way to determine the impact of implant prosthetic design form on both short-term clinical outcomes and the long-term prognosis of bone and soft tissues around the implant.Implant-prosthesis-abutment complex design forms, such as implant-abutment design, junction, and location, can have important implications for the stable and healthy long-term maintenance of the tissues around the implant. In this case, a customized concave abutment and a prosthesis with an emergence angle of about 30 degrees were restored to a patient suffering from chronic soft tissue inflammation and pain after restoration of an implant prosthesis. It was confirmed that the new prosthesis improved complications by allowing sufficient bone and soft tissue space, achieved appropriate soft tissue sealing, and maintained the longterm stability of the implant.
6.Esthetic restoration of maxillary anterior fixed prosthesis using a digital diagnostic wax-up: a case report
Eunji OH ; Songyi PARK ; Woohyung JANG ; Chan PARK ; Kwidug YUN ; Hyun-Pil LIM ; Sangwon PARK
Journal of Dental Rehabilitation and Applied Science 2023;39(2):89-95
Recently, computer-aided design and computer-aided manufacturing (CAD/CAM) environment have changed the clinician treatment method in the fabrication of prosthesis. The diagnostic wax-up by using digital technology simplifies the laboratory process and provides clinical efficiency and convenience. In this case, Digital diagnostic wax-up was superimposed on extra-oral photo to consider the patient’s facial appearance and utilized to produce the final prosthesis. It can be more efficient and esthetic than a diagnostic wax-up that was made only on a model. The digital diagnostic wax-up that superimposed on extra-oral photo not only visualizes the predicted outcome of prosthodontic treatment but also improves satisfaction and facilitates the communication between patient and dentist. We report aesthetically and functionally satisfactory results that obtained after restoration.
7.Fabrication of maxillary complete denture and mandibular implant retained overdenture using CAD-CAM system and Monolithic disc:a case report
Jaehyeok RO ; Haemin BANG ; Woohyung JANG ; Chan PARK ; Hyun-Pil LIM ; Sangwon PARK ; Kwi-Dug YUN
Journal of Dental Rehabilitation and Applied Science 2023;39(2):96-103
Fabrication of dentures using CAD/CAM system has the advantage of reducing the number of patient visits and reducing errors during laboratory work. After the extraction of maxillary residual teeth, this patient changed to a completely edentulous state and the stability and retention of the existing mandibular complete denture were insufficient due to the absorption of the mandibular residual ridge, so the restoration of the mandibular implant retained overdenture and maxillary complete denture were planned.By digitizing the concept of BPS (Biofunctional prosthetic system) that uses the patient’s functional movement in closed mouth technique, the vertical dimension was taken by Gnathometer CAD and digital facebow transfer was performed using UTS CAD. In this case, fabrication of maxillary complete denture and mandibular implant-retained overdenture using monolithic disc and CAD/ CAM system demonstrated favorable denture retention, stability, and support and the patient is satisfied with improved functions and esthetic of dentures.
8.Using treatment denture and digital technology in patient with unstable mandibular movement: a case report
Eunji OH ; Woohyung JANG ; Chan PARK ; Kwidug YUN ; Hyun-Pil LIM ; Sangwon PARK
Journal of Dental Rehabilitation and Applied Science 2023;39(3):168-175
Long-term use of inappropriate prosthesis often results in habitual closure or irregular mandibular movements. In that case, guide to the stable centric position is difficult. Therefore, by using a treatment denture, the muscles and TMJ should be stabilized and the jaw relation should be acquired with the treatment position. Compared to the conventional method, digital technology in fabrica-tion complete denture has the advantage of reproducing a stable tooth arrangement in cases of difficult tooth alignment, minimiz-ing laboratory errors and reducing denture fabrication time. Therefore, in this case, the final denture was fabricated by digitally re-producing the stable treatment position, vertical dimension, and lip support with a treatment denture, and satisfactory results wereobtained.
9.Usage of digital technique to facilitate communication between dentist, dental lab technician, and patients in diagnosis and restoration for maxillary anterior implant: a case report
Haemin BANG ; Woohyung JANG ; Chan PARK ; Kwi-Dug YUN ; Hyun-Pil LIM ; Sangwon PARK
Journal of Dental Rehabilitation and Applied Science 2022;38(1):42-51
Esthetic restoration of maxillary anterior implant heavily depends on the direction of installation of implant fixture. In patients with malpositioned implant, it is crucial to communicate the limitations of prosthetic outcome with the patient before starting on a restoration. To facilitate the communication, three-dimensional virtual representation by superimposing facial and intraoral digital scans with Computed Tomography (CT, dicom file) was used for visualization of the limitations of prosthesis. Through digital diagnostic wax-up, the profile of right maxillary anterior incisor implant was expected to be protrusive, which the patient was not satisfied with. Since the patient already had done root canal treatment on left maxillary anterior incisor due to previous trauma, a new prosthetic design including both right and left maxillary anterior incisors was presented to the patient. The second design was chosen and his comments were delivered to dental lab. The patient was satisfied with the new prosthesis, aesthetically and functionally.
10.Fabrication of complete denture using digital technology in patient with mandibular deviation: a case report
Eunsu LEE ; Juyoung PARK ; Chan PARK ; Kwi-Dug YUN ; Hyun-Pil LIM ; Sangwon PARK
Journal of Dental Rehabilitation and Applied Science 2022;38(1):34-41
Recently, digital technology and computer-aided design/computer-aided manufacturing (CAD/CAM) environment have changed the clinician treatment method in the fabrication of dentures. The denture manufacturing method with CAD/CAM technology simplifies the treatment and laboratory process to reduce the occurrence of errors and provides clinical efficiency and convenience. In this case, complete dentures were fabricated using stereolithography (SLA)-based 3D printing in patient with mandibular deviation. Recording base were produced in a digital model obtained with an intraoral scanner, and after recording a jaw relation in the occlusal rim, a definitive impression was obtained with polyvinyl siloxane impression material. In addition, facial scan data with occlusal rim was obtained so that it can be used as a reference in determination of the occlusal plane and in arrangement of artificial teeth during laboratory work. Artificial teeth were arranged through a CAD program, and a gingival festooning was performed. The definitive dentures were printed by SLA-based 3D printer using a Food and Drug Administration (FDA)-approved liquid photocurable resin. The denture showed adequate retention, support and stability, and results were satisfied functionally and aesthetically.

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