Investigation of the association between orthodontic treatment and temporomandibular joint pain and dysfunction in the South Korean population / 대한치과교정학회지

OBJECTIVE@#This study investigated the relationship between orthodontic treatment and temporomandibular disorders (TMD) in South Korean population.@*METHODS@#This study obtained data from the 2012 Korean National Health and Nutrition Examination Survey. The final sample size was 5,567 participants who were ≥ 19 years of age. Logistic regression analysis was performed to evaluate the relationship between orthodontic treatment and TMD.@*RESULTS@#Participants who underwent orthodontic treatment showed higher educational level, lower body mass index, reduced chewing difficulty, and reduced speaking difficulty. The adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) for orthodontic treatment and TMD were 1.614 (1.189–2.190), 1.573 (1.162–2.129) and 1.612 (1.182–2.196) after adjusting for age, sex and psychosocial factors. Adjusted ORs and their 95% CIs for orthodontic treatment and clicking were 1.778 (1.289–2.454), 1.742 (1.265–2.400) and 1.770 (1.280–2.449) after adjusting for confounding factors. However, temporomandibular joint pain and functional impairment was not associated with orthodontic treatment.@*CONCLUSIONS@#Temporomandibular joint pain and dysfunction was not associated with orthodontic treatment.

When do we need more than local compression to control intraoral haemorrhage?

OBJECTIVES: The aims of this study were to determine the effectiveness of local compression in patients presenting to the emergency room with intraoral bleeding and to identify when complex haemostatic measures may be required.MATERIALS AND METHODS: Five hundred forty patients who had experienced intraoral haemorrhage were retrospectively reviewed. The outcome variable was the haemostasis method used, i.e., simple (local compression with gauze) or complex (an alternative method after local compression has failed). Predictor variables were sex, age, American Society of Anesthesiologists (ASA) class, hepatic cirrhosis, bleeding disorder, use of antithrombotic agents, and site/cause of haemorrhage.RESULTS: The mean patient age was 48.9±23.9 years, 53.5% were male, 42.8% were ASA class II or higher, and 23.7% were taking antithrombotic agents. Local compression was used most often (68.1%), followed by local haemostatic agents, sutures, systemic tranexamic acid or blood products, and electrocautery. The most common site of bleeding was the gingiva (91.7%), and the most common cause was tooth extraction (45.7%). Risk factors for needing a complex haemostasis method were use of antithrombotic agents (odds ratio 2.047, P=0.009) and minor oral surgery (excluding extraction and implant procedures; odds ratio 6.081, P=0.001).CONCLUSION: A haemostasis method other than local compression may be needed in patients taking antithrombotic agents or having undergone minor oral surgery.

When do we need more than local compression to control intraoral haemorrhage?

OBJECTIVES@#The aims of this study were to determine the effectiveness of local compression in patients presenting to the emergency room with intraoral bleeding and to identify when complex haemostatic measures may be required.@*MATERIALS AND METHODS@#Five hundred forty patients who had experienced intraoral haemorrhage were retrospectively reviewed. The outcome variable was the haemostasis method used, i.e., simple (local compression with gauze) or complex (an alternative method after local compression has failed). Predictor variables were sex, age, American Society of Anesthesiologists (ASA) class, hepatic cirrhosis, bleeding disorder, use of antithrombotic agents, and site/cause of haemorrhage.@*RESULTS@#The mean patient age was 48.9±23.9 years, 53.5% were male, 42.8% were ASA class II or higher, and 23.7% were taking antithrombotic agents. Local compression was used most often (68.1%), followed by local haemostatic agents, sutures, systemic tranexamic acid or blood products, and electrocautery. The most common site of bleeding was the gingiva (91.7%), and the most common cause was tooth extraction (45.7%). Risk factors for needing a complex haemostasis method were use of antithrombotic agents (odds ratio 2.047, P=0.009) and minor oral surgery (excluding extraction and implant procedures; odds ratio 6.081, P=0.001).@*CONCLUSION@#A haemostasis method other than local compression may be needed in patients taking antithrombotic agents or having undergone minor oral surgery.

Fracture patterns and causes in the craniofacial region: an 8-year review of 2076 patients / 대한악안면성형재건외과학회지

BACKGROUND: For proper recovery from craniofacial fracture, it is necessary to establish guidelines based on trends. This study aimed to analyze the patterns and causes of craniofacial fractures. METHODS: This retrospective study analyzed patients who underwent surgery for craniofacial fractures between 2010 and 2017 at a single center. Several parameters, including time of injury, region and cause of fracture, alcohol intoxication, time from injury to surgery, hospitalization period, and postoperative complications, were evaluated. RESULTS: This study analyzed 2708 fracture lesions of 2076 patients, among whom males aged 10 to 39 years were the most numerous. The number of patients was significantly higher in the middle of a month. The most common fractures were a nasal bone fracture. The most common causes of fracture were ground accidents and personal assault, which tended to frequently cause more nasal bone fracture than other fractures. Traffic accidents and high falls tended to cause zygomatic arch and maxillary wall fractures more frequently. Postoperative complications—observed in 126 patients—had a significant relationship with the end of a month, mandible or panfacial fracture, and traffic accidents. CONCLUSIONS: The present findings on long-term craniofacial fracture trends should be considered by clinicians dealing with fractures and could be useful for policy decisions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40902-018-0168-y) contains supplementary material, which is available to authorized users.

Risk factor analysis of additional administration of sedative agent and patient dissatisfaction in intravenous conscious sedation using midazolam for third molar extraction

OBJECTIVES: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. MATERIALS AND METHODS: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study. The initial dose of MDZ was determined by body mass index (BMI) and weight. In the case of insufficient sedation at the beginning of surgery, additional doses were injected. During surgery, peripheral oxygen saturation, bispectral index score (BIS), heart rate, and blood pressure were monitored and recorded. The predictor variables were sex, age, BMI, sleeping time ratio, dental anxiety, Pederson scale, and initial dose of MDZ. The outcome variables were additional administration of MDZ, observer's assessment of alertness/sedation, intraoperative amnesia, and patient satisfaction. Descriptive statistics were computed, and the P-value was set at 0.05. RESULTS: Most patients had an adequate level of sedation with only the initial dose of MDZ and were satisfied with the treatment under sedation; however, 19 patients needed additional administration, and 13 patients were unsatisfied. In multivariable logistic analysis, lower age (odds ratio [OR], 0.825; P=0.005) and higher dental anxiety (OR, 5.744; P=0.003) were related to additional administration; lower intraoperative amnesia (OR, 0.228; P=0.002) and higher BIS right before MDZ administration (OR, 1.379; P=0.029) had relevance to patient dissatisfaction. CONCLUSION: The preoperative consideration of age and dental anxiety is necessary for appropriate dose determination of MDZ in the minor oral surgery under IVS. The amnesia about the procedure affects patient satisfaction positively.

Study for discriminating method of origin side vibration from non-symptomatic clicking group

PURPOSE: study for discriminating method of origin side vibration from non-symptomatic clicking group. MATERIALS AND METHODS: 60 joints vibrations of 30 subjects in non-symptomatic clicking group was recorded via subject's awareness, examiner's palpation and JVA analysis. Origin side vibration was discriminated with consideration for frequency spectrum, time delay and phase shift of waveforms, analysis of numeric values. RESULTS: There were all unilateral vibrations with JVA analysis and number of origin vibrations were 42. 11 pairs of vibrations showed time delay and phase shift and transferred side vibrations showed smaller values of total integral and bigger values of > 300 / 300 / < 300 ratio than the contra-lateral joint vibrations and there all ipsi-lateral vibrations were showed small values of total integral below 10 and hard to detect time delay and phase shift. So the features were used in discrimination of origin side vibrations. CONCLUSION: There should be all-around considerations for discrimination of origin side vibrations that is frequency spectrum, phase shift and time delay and analysis of numeric values.

EFFECTS OF HYPOXIA ON THE FORMATION OF OSTEOCLAST

Evaluation of TMJ sound on the subject with TMJ disorder by Joint Vibration Analysis

STATEMENT OF PROBLEM: Qualitative and semi-quantitative methods have been developed for TMJ sound classification, but the criteria presented are completely inhomogeneous. Thus, to develop more objective criteria for defining TMJ sounds, electroacoustical systems have been developed. We used Joint vibration analysis in the BioPAK system (Bioresearch Inc., Milwaukee, USA) as the electrovibratography. PURPOSE: The aim of this study was to examine the TMJ sounds with repect to frequency spectra patterns and the integral > 300 Hz / 300 / 300 / 300 /< 300 ratios as well as the frequency spectrums to decide the starting-point of the treatment for TMJ sounds.