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.

Background: Dental evaluation and protection are important for preventing traumatic dental injuries when patients are under general anesthesia. The objective of the present study was to develop a questionnaire based on dentition-related risk factors that could serve as a valuable tool for dental evaluation and documentation. Methods: We developed a questionnaire for dental evaluation before administration of general anesthesia, investigated the association between patient-and-dentist responses and mouthguard fabrication, and assessed response agreement between 100 patients. Results: Protective mouthguards were fabricated for 27 patients who were identified as having a high risk of dental injury. There was a strong association between dentists’ responses and mouthguard fabrication, depending on the general oral health status, use of ceramic prosthesis, presence of masticatory pain related to periodontal diseases, gingival edema, and implants (P < 0.05). Response agreement between patients and dentists for items related to dental pain, loss of dental pulp vitality, root canal therapy, dental trauma, aesthetic prosthesis, tooth mobility, and implant prosthesis was high (Cohen’s kappa coefficient κ ≥ 0.6). Conclusions A high agreement was observed between patient-dentist responses and a strong association with mouthguard fabrication for items pertaining to ceramic prosthesis, masticatory pain, and dental implants. Patients with a “yes” response to these items are recommended to undergo a dental evaluation and use a dental protective device while under general anesthesia.

A new bicyclic megastigmane derivative, (3S,6S)-amoreol (1), was isolated and determined along with twenty known compounds, dihydrosinapic acid (2), 2,6-dimethoxyterephthalic acid (3), 4-methoxybenzoic acid (4), 4-ethylbenzene-1,2-diol (5), ethylparaben (6), vanillic acid (7), ferulic acid (8), 3-(4-hydroxy-3-methoxyphenyl)propionic acid (9), ethyl dihydroferulate (10), dihydroconiferyl alcohol (11), 1,2-dihydrodendroarboreol B (12), 1,2-dihydropanaxydiol (13), panaxydiol (14), panaxytriol (15), (S)-cis-abscisic acid (16), (R)-trans-abscisic acid (17), (6R,9S)-blumenol C (18), (3S,5R,6S,7E)-5,6-epoxy-3-hydroxy-7-megastigmene-9-one (19), (+)-salicifoliol (20), imperatorin (21), indole-3-carboxaldehyde (22) from the by-product of ginseng berry extract. The structures of the isolated compounds were determined through spectroscopic techniques including UV, 1D-, and 2D NMR, CD, MS and optical rotation. The absolute configuration of 1 was elucidated based on the experimental and calculated electronic circular dichroism (ECD) spectra.

Glossectomy combined with radiotherapy causes different levels of tongue function disorders and leads to severe malocclusion, with poor periodontal status in cancer survivors. Although affected patients require regular access to orthodontic care, special considerations are crucial for treatment planning. This case report describes the satisfactory orthodontic management for the correction of severe dental crowding in a 43-year-old female 6  years after treatment for tongue cancer with total glossectomy combined with radiotherapy, to envision the possibility of orthodontic care for oral cancer survivors. Extraction was performed to correct dental crowding and establish proper occlusion following alignment, after considering the possibility of osteoradionecrosis. Orthodontic mini-implants were used to provide skeletal anchorage required for closure of the extraction space and intrusion of the anterior teeth. The dental crowding was corrected, and Class I occlusal relationship was established after 36 months of treatment. The treatment outcome was sustained after 15 months of retention, and long-term follow-up was recommended.

Background: This retrospective study investigated the incidence rate of accidental foreign body aspiration and ingestion according to patient sex, age, and dental department. This study aimed to verify whether the incidence rate is higher in geriatric than in younger patients and whether it is different among dental departments. Methods: Accidental foreign body aspiration and ingestion cases were collected from electronic health records and the safety report system of Yonsei University Dental Hospital from January 2011 to December 2017. The collected data included patients’ age, sex, medical conditions, treatment procedures, and foreign objects that were accidentally aspirated or ingested. The incidence rate was calculated as the number of accidental foreign body aspirations and ingestions relative to the total number of patient visits. Differences depending on the patients’ sex, age, and dental department were statistically identified. Results: There were 2 aspiration and 37 ingestion cases during the 7-year analysis period. The male to female incidence ratio was 2.8:1. The incidence rate increased with age and increased rapidly among those aged 80 years or older. Seven of the 37 patients with accidental foreign body ingestion had intellectual disability, Lou Gehrig’s disease, dystonia, or oral and maxillofacial cancer. The incidence rate was highest in the Predoctoral Student Clinic and the Department of Prosthodontics. The most frequently swallowed objects were fixed dental prostheses and dental implant components. Conclusion The incidence rate of accidental foreign body aspiration and ingestion differed according to patient sex, age, and dental department. Dental practitioners must identify high-risk patients and apply various methods to prevent accidental foreign body aspiration and ingestion in dental clinics. Inexperienced practitioners should be particularly careful.

PURPOSE: The purpose of this study was to evaluate the relationship between masseter muscle thickness, facial morphology, and mandibular morphology in Korean adults using ultrasonography. MATERIALS AND METHODS: Ultrasonography was used to measure the masseter muscle thickness bilaterally of 40 adults (20 males, 20 females) and was performed in the relaxed and contracted states. Facial photos and panoramic radiography were used for morphological analyses and evaluated for correlations with masseter muscle thickness. We also evaluated the correlations of age, body weight, stature, and body constitution with masseter muscle thickness. RESULTS: In the relaxing, the masseter was 9.8±1.3 mm in females and 11.3±1.2 mm in males. In the contracted state, it was 12.4±1.4 mm in females and 14.7±1.4 mm in males. Facial photography showed that bizygomatic facial width over facial height was correlated with masseter muscle thickness in both sexes in the relaxed state, and was statistically significantly correlated with masseter muscle thickness in males in the contracted state. In panoramic radiography, correlations were found between anterior angle length and posterior angle length and masseter muscle thickness in females, and between body length and posterior angle length, between anterior angle length and body length, between ramal length and body length, and between body length and condyle length in males. CONCLUSION: Masseter muscle thickness was associated with facial and mandibular morphology in both sexes, and with age in males. Ultrasonography can be used effectively to measure masseter muscle thickness.
Adult ; Body Constitution ; Body Weight ; Female ; Humans ; Male ; Masseter Muscle ; Photography ; Radiography, Panoramic ; Ultrasonography ; Young Adult

BACKGROUND: Proper education regarding inhaler usage and optimal management of chronic obstructive pulmonary disease (COPD) is essential for effectively treating patients with COPD. This study was conducted to evaluate the effects of a comprehensive education program including inhaler training and COPD management. METHODS: We enlisted 127 patients with COPD on an outpatient basis at 43 private clinics in Korea. The patients were educated on inhaler usage and disease management for three visits across 2 weeks. Physicians and patients were administered a COPD assessment test (CAT) and questionnaires about the correct usage of inhalers and management of COPD before commencement of this program and after their third visit. RESULTS: The outcomes of 127 COPD patients were analyzed. CAT scores (19.6±12.5 vs. 15.1±12.3) improved significantly after this program (p<0.05). Patients with improved CAT scores of 4 points or more had a better understanding of COPD management and the correct technique for using inhalers than those who did not have improved CAT scores (p<0.05). CONCLUSION: A comprehensive education program including inhaler training and COPD management at a primary care setting improved CAT scores and led to patients' better understanding of COPD management.
Animals ; Cats ; Disease Management* ; Dry Powder Inhalers ; Education* ; Humans ; Korea ; Metered Dose Inhalers ; Nebulizers and Vaporizers* ; Outpatients ; Primary Health Care ; Pulmonary Disease, Chronic Obstructive*

Digital dentistry has influenced many dental procedures, such as three-dimensional (3D) diagnosis and treatment planning, surgical splints, and prosthetic treatments. Patient-specific protective appliances (PSPAs) prevent dental injury during endotracheal intubation. However, the required laboratory work takes time, and there is the possibility of tooth extraction while obtaining the dental impression. In this technical report, we utilized new digital technology for creating PSPAs, using direct intraoral scanners and 3D printers for dental cast fabrication.
Dentistry ; Diagnosis ; Intubation, Intratracheal* ; Printing, Three-Dimensional* ; Splints ; Tooth Extraction

BACKGROUND: The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control. METHODS: Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT). RESULTS: The study enrolled 144 patients (mean age, 56.7±16.7 years). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from 16.6±4.6 to 20.0±3.9 (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%). CONCLUSION: This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.
Adult ; Asthma* ; Education* ; Humans ; Nebulizers and Vaporizers ; Pamphlets ; Physicians, Primary Care ; Primary Health Care*

Education has been known to essential for management of chronic airway diseases. However the real benefits remain unclear. We evaluated the effectiveness of an organized educational intervention for chronic airway diseases directed at primary care physicians and patients. The intervention was a 1-month education program of three visits, during which subjects were taught about their disease, an action plan in acute exacerbation and inhaler technique. Asthma control tests (ACT) for asthma and, chronic obstructive pulmonary disease (COPD) assessment tests (CAT) for COPD subjects were compared before and after education as an index of quality of life. Educational effectiveness was also measured associated with improvement of their knowledge for chronic airway disease itself, proper use of inhaler technique, and satisfaction of the subjects and clinicians before and after education. Among the 285 participants, 60.7% (n = 173) were men and the mean age was 62.2 ± 14.7. ACT for asthma and CAT in COPD patients were significantly improved by 49.7% (n = 79) and 51.2% (n = 65) more than MCID respectively after education (P < 0.05). In all individual items, knowledge about their disease, inhaler use and satisfaction of the patients and clinicians were also improved after education (P < 0.05). This study demonstrates the well-organized education program for primary care physicians and patients is a crucial process for management of chronic airway diseases.
Adult ; Aged ; Aged, 80 and over ; Asthma/pathology ; Disease Management ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Nebulizers and Vaporizers ; *Patient Education as Topic ; Patient Satisfaction ; Primary Health Care ; Pulmonary Disease, Chronic Obstructive/*pathology ; Quality of Life ; Respiration ; Young Adult