OBJECTIVES: This study aimed to understand the nationwide patterns of antibiotic prescription after tooth extraction in adult patients.MATERIALS AND METHODS: This study analyzed dental records from the National Health Insurance Service–National Sample Cohort (NHIS–NSC) database on 503,725 tooth extractions performed in adults (≥19 years) during 2011–2015. Patient sex, age, household income, systemic disease (diabetes mellitus and hypertension), type of dental institution, region of dental institution, year of prescription, and type of tooth extraction procedure were considered. The antibiotic prescription rate and broad-spectrum antibiotic prescription frequency were analyzed using chi-squared tests. Factors affecting the prescription of broad-spectrum antibiotics were evaluated using multivariate logistic regression analysis.RESULTS: The rate of antibiotic prescription after tooth extraction was 81.85%. Penicillin was most commonly prescribed (45.25%), followed by penicillin with beta-lactamase inhibitors (18.76%), metronidazole (12.29%), and second- to fourth-generation cephalosporins (11.52%). The proportion of broad-spectrum antibiotics used among all prescribed antibiotics was 45.88%.CONCLUSION: The findings of this study demonstrate that the rate of antibiotic prescription after tooth extraction is higher in Korea than in other countries. Furthermore, broad-spectrum antibiotics are used more frequently, which may indicate unnecessary drug prescription, an important contributor to antibiotic resistance.
Adult ; Anti-Bacterial Agents ; beta-Lactamase Inhibitors ; Cephalosporins ; Cohort Studies ; Dental Records ; Drug Prescriptions ; Drug Resistance, Microbial ; Family Characteristics ; Humans ; Korea ; Logistic Models ; Metronidazole ; National Health Programs ; Penicillins ; Prescriptions ; Tooth Extraction ; Tooth

OBJECTIVES: The primary objective of this study was to determine if the number of missing teeth could be predicted by oral disease pathogens, and the secondary objective was to assess whether deep learning is a better way of predicting the number of missing teeth than multivariable linear regression (MLR).METHODS: Data were collected through review of patient’s initial medical records. A total of 960 participants were cross-sectionally surveyed. MLR analysis was performed to assess the relationship between the number of missing teeth and the results of real-time PCR assay (done for quantification of 11 oral disease pathogens). A convolutional neural network (CNN) was used as the deep learning model and compared with MLR models. Each model was performed five times to generate an average accuracy rate and mean square error (MSE). The accuracy of predicting the number of missing teeth was evaluated and compared between the CNN and MLR methods.RESULTS: Model 1 had the demographic information necessary for the prediction of periodontal diseases in addition to the red and the orange complex bacteria that are highly predominant in oral diseases. The accuracy of the convolutional neural network in this model was 65.0%. However, applying Model 4, which added yellow complex bacteria to the total bacterial load, increased the expected extractions of dental caries to 70.2%.On the other hand, the accuracy of the MLR was about 50.0% in all models. The mean square error of the CNN was considerably smaller than that of the MLR, resulting in better predictability.CONCLUSIONS: Oral disease pathogens can be used as a predictor of missing teeth and deep learning can be a more accurate analysis method to predict the number of missing teeth as compared to MLR.
Bacteria ; Bacterial Load ; Citrus sinensis ; Dental Caries ; Hand ; Learning ; Linear Models ; Medical Records ; Methods ; Periodontal Diseases ; Periodontitis ; Pilot Projects ; Real-Time Polymerase Chain Reaction ; Tooth

PURPOSE: This study examined the prevalence and risk factors of peri-implant disease after at least 7 years of dental implant loading.METHODS: A total of 111 patients with 218 dental implants were treated. The follow-up period for all implants was at least 7 years. The patients' dental records were collected and risk factors of peri-implant disease were investigated through logistic regression analysis.RESULTS: The overall implant survival rate was 95.87%, because 9 of the 218 implants failed. The prevalence of peri-implant mucositis and peri-implantitis was 39.7% and 16.7%, respectively. As risk factors, smoking and prosthetic splinting showed significant associations with peri-implantitis (P&0.05).CONCLUSIONS: Within the limits of this study, no significant correlations were found between any risk factors and peri-implant mucositis, but a significantly elevated risk of peri-implantitis was observed in patients who smoked or had splinted prostheses in 2 or more implants.
Dental Implants ; Dental Records ; Follow-Up Studies ; Humans ; Logistic Models ; Mucositis ; Peri-Implantitis ; Prevalence ; Prostheses and Implants ; Risk Factors ; Smoke ; Smoking ; Splints ; Survival Rate

The purpose of this retrospective study was to evaluate the survival rate of composite resin restorations in permanent first molars in pediatric patients focusing on the influence of risk factors related to patients and teeth.172 patients (6 – 12 years old) who had their permanent first molars restored with composite resin from July 2010 to July 2012 were investigated. From the dental records, the influence of the risk factors on the survival of restorations was assessed. Location of teeth, classification of cavities, patients' age and caries risk were included as risk factors in this study. The caries risks of patients were evaluated by the value of the decayed-missing-filled teeth index with the records of patients taken at 5 years old.Among 354 restorations, 272 restorations retained and 82 restorations were replaced. The overall cumulative survival rate at 5 years was 73.9%. The main reason for replacement of restorations was secondary caries (81.7%). Patients with older age group and with lower caries risk group showed higher survival rate of restorations. No statistically significant influence was detected between the survival rates and the possible risk factors : location of teeth, patients' age and caries risk. The survival rate of restorations was significantly affected by the classification of the cavities (p = 0.002).
Classification ; Dental Records ; Humans ; Molar ; Retrospective Studies ; Risk Factors ; Survival Rate ; Tooth

The purpose of this study was to analyze outpatient referral patterns of children in Jeonbuk National University Dental Hospital. All patients under 16 years old who were consulted from the external facilities were reviewed based on the electronic medical record of Jeonbuk National University Dental Hospital from 2015 to 2018.Total 720 boys and 460 girls with an average age of 7.4 years were referred from local dental clinic (85.2%) for treatment severity (90.2%). 3.2% of patients has disability with the highest number of intellectual disabilities. The patients were usually referred at the pre-treatment stage with higher rates if they had disability or medical problem. Referral rate by chief complaints was highest in surgery, followed by reparative treatment and orthodontic treatment. 2(nd) referrals in pediatric dentistry had a higher rate of referrals to minor surgery and pulp treatment than of first referrals. The time point of 2(nd) referral was relatively delayed with increased ratio of ‘during treatment’.These results suggest necessities of appropriate case selection and referral based reasonable criteria for pediatric dentist.
Child ; Dental Clinics ; Dentists ; Electronic Health Records ; Female ; Humans ; Intellectual Disability ; Jeollabuk-do ; Minor Surgical Procedures ; Outpatients ; Pediatric Dentistry ; Referral and Consultation

BACKGROUND: Patients with special health care needs are more likely to develop health problems, including dental problems. Dental treatments require a good level of communication with the patient. Therefore, in these patients, sedation and general anesthesia are an extremely humanistic approach for comfortable and successful treatment. In patients with special needs, there is no standard anesthetic approach due to varying clinical conditions. The aim of this study was to provide literature content about the anesthetic approaches used by us in patients with special needs. METHODS: The medical records of 710 patients with special health care needs treated under general anesthesia or sedation were reviewed retrospectively. Demographic data, the American Society of Anesthesiologists classification, Mallampati score, anesthesia duration, anesthesia type, anesthetic and analgesic agents used, dental treatment performed, secondary diseases, and complications in the perioperative period were recorded. Patients were evaluated under five groups: Down syndrome, other syndromes, psychiatric disorders, physical disabilities, and complicated medical story. RESULTS: Among the patients evaluated, 47.5% were females and 52.5% were males (mean age 15.76 ± 11.17 years), and general anesthesia and sedation were administered in 72.9% and 22.1% patients, respectively. The mean duration of anesthesia was 43.20 ± 35.85 min. Simple dental treatments were performed in all groups, and the most common complications were observed in the other syndromes group. CONCLUSION: Complications can be reduced by utilizing the appropriate anesthetic approach and taking serious precautions in patients with special needs.
Analgesics ; Anesthesia ; Anesthesia, General ; Classification ; Delivery of Health Care ; Dental Care ; Down Syndrome ; Female ; Humans ; Male ; Medical Records ; Perioperative Period ; Retrospective Studies

OBJECTIVES: Osteoradionecrosis (ORN) is one of the most severe complications resulting from radiotherapy (RT) in patients with head and neck cancer (HNC). It is characterized by persistent exposed and devitalized bone without proper healing for greater than 6 months after a high dose of radiation in the area. To describe the profile and dental management of ORN in HNC patients undergoing RT in an oncological clinical research center. MATERIALS AND METHODS: A retrospective descriptive study was performed to analyze dental records from HNC patients with ORN treated at an oncological clinical research center from 2013 to 2017. A total of 158 dental records for HNC patients were selected from a total of 583 records. Afterwards, this number was distributed to three examiners for manual assessments. Each examiner was responsible for selecting dental records that contained an ORN description, resulting in 20 dental records. RESULTS: Mean patient age was 60.3 years with males being the most affected sex (80.0%). The most affected area was the posterior region of the mandible (60.0%) followed by the anterior region of the mandible (20.0%) and the posterior region of the maxilla (10.0%). The factors most associated with ORN were dental conditions (70.0%) followed by isolated systemic factors (10.0%) and tumor resection (5.0%). There was total exposed bone closure in 50.0% of cases. The predominant treatment was curettage associated with chlorhexidine 0.12% irrigation (36.0%). CONCLUSION: Poor dental conditions were related to ORN occurrence. ORN management through less invasive therapies was effective for the closure of exposed bone areas and avoidance of infection.
Chlorhexidine ; Curettage ; Dental Records ; Head and Neck Neoplasms ; Head ; Humans ; Jaw ; Male ; Mandible ; Maxilla ; Osteoradionecrosis ; Radiotherapy ; Retrospective Studies

OBJECTIVES: The objective of this study was to analyze 11 cases of subcutaneous emphysema associated with dental procedures from a single hospital and discuss approaches for accurate diagnosis and treatment of the condition. MATERIALS AND METHODS: The medical records of 11 patients who were treated for subcutaneous emphysema related to dental procedures between January 2009 and April 2017 were analyzed retrospectively. Patients with subcutaneous emphysema within the facial area or that spread to the neck and beyond, including the facial region, were assigned to two groups and compared in terms of age, sex, and durations of antibiotic use, hospitalization, and follow-up until improvement. The correlation between location of the origin tooth and range of emphysema spread was analyzed. RESULTS: The average durations of antibiotic use during conservative treatment and follow-up until improvement were 8.55 days (standard deviation [SD], 4.46 days) and 1.82 weeks (SD, 1.19 weeks), respectively. There was no intergroup difference in duration of antibiotic use (P=0.329) or follow-up (P=0.931). Subcutaneous emphysema was more common after dental procedures involving the maxilla or posterior region than after those involving the mandible or anterior region. There was no significant difference in air distribution according to location of the air orifice (maxilla, mandible, or both; P=0.106). CONCLUSION: Upon adequate conservative treatment accompanied by prophylactic antibiotic treatment considering the risk of infection, patients showed signs of improvement within a few days or weeks. There was no significant difference in treatment period between patients with subcutaneous emphysema localized to the facial region and those with subcutaneous emphysema spreading to the neck or beyond. These findings need to be confirmed by analysis of additional cases.
Dental Care ; Diagnosis ; Emphysema ; Follow-Up Studies ; Hospitalization ; Humans ; Iatrogenic Disease ; Mandible ; Maxilla ; Mediastinal Emphysema ; Medical Records ; Neck ; Retrospective Studies ; Subcutaneous Emphysema* ; Tooth

PURPOSE: The purpose of this retrospective study with 4–12 years of follow-up was to compare the marginal bone loss (MBL) between external-connection (EC) and internal-connection (IC) dental implants in posterior areas without periodontal or peri-implant disease on the adjacent teeth or implants. Additional factors influencing MBL were also evaluated. METHODS: This retrospective study was performed using dental records and radiographic data obtained from patients who had undergone dental implant treatment in the posterior area from March 2006 to March 2007. All the implants that were included had follow-up periods of more than 4 years after loading and satisfied the implant success criteria, without any peri-implant or periodontal disease on the adjacent implants or teeth. They were divided into 2 groups: EC and IC. Subgroup comparisons were conducted according to splinting and the use of cement in the restorations. A statistical analysis was performed using the Mann-Whitney U test for comparisons between 2 groups and the Kruskal-Wallis test for comparisons among more than 2 groups. RESULTS: A total of 355 implants in 170 patients (206 EC and 149 IC) fulfilled the inclusion criteria and were analyzed in this study. The mean MBL was 0.47 mm and 0.15 mm in the EC and IC implants, respectively, which was a statistically significant difference (P < 0.001). Comparisons according to splinting (MBL of single implants: 0.34 mm, MBL of splinted implants: 0.31 mm, P=0.676) and cement use (MBL of cemented implants: 0.27 mm, MBL of non-cemented implants: 0.35 mm, P=0.178) showed no statistically significant differences in MBL, regardless of the implant connection type. CONCLUSIONS: IC implants showed a more favorable bone response regarding MBL in posterior areas without peri-implantitis or periodontal disease.
Alveolar Bone Loss ; Dental Implant-Abutment Design ; Dental Implants ; Dental Records ; Follow-Up Studies ; Humans ; Peri-Implantitis ; Periodontal Diseases ; Retrospective Studies ; Splints ; Tooth

PURPOSE: Oral lichen planus (OLP) is a chronic oral mucosal disease that has been recognized as an immune condition. The purpose of this study was to evaluate factors affecting the clinical outcomes of topical corticosteroid application on OLP lesions using dexamethasone gargle and ointment. METHODS: The charts of patients who were clinically diagnosed with OLP and treated with dexamethasone from July 2003 to August 2017 at the Section of Dentistry of Seoul National University Bundang Hospital were thoroughly evaluated to identify subjects who were suitable for this retrospective study. For each patient, age at the index date, gender, medical history, and dental records related to OLP lesions and dexamethasone treatment were reviewed. RESULTS: In total, 113 of the 225 patients were included in the present study. Among them, 79 patients were female (69.9%) and 34 were male (30.1%), with a mean age of 57.6 years. The average duration of dexamethasone treatment was 4.7 months and the mean follow-up period was 2.24 years. Improvements were observed within 1 year after dexamethasone treatment in most cases, and 17.7% of patients had a new OLP lesion after treatment. New OLP lesions were more frequently gingival than mucosal, although mucosal OLP lesions were more common than gingival OLP lesions in all age groups. In age- and gender-adjusted multivariate logistic regression, a history of malignant disease was found to be a significant factor affecting the formation of new lesions. Gingival OLP lesions and intermittent use of dexamethasone showed near-significant associations. In Kaplan-Meier failure analysis, history of malignancy, menopausal status, age, and the site of the OLP lesion were significant factors affecting clinical outcomes. CONCLUSIONS: The treatment outcomes of OLP were significantly influenced by age, history of malignancy, menopausal status, and the site of the OLP lesion, but not by factors related to dexamethasone treatment.
Dental Records ; Dentistry ; Dexamethasone ; Female ; Follow-Up Studies ; Humans ; Lichen Planus, Oral ; Logistic Models ; Male ; Retrospective Studies ; Seoul ; Survival Analysis