Full Mouth Rehabilitation with Modeless Implant Restoration using a Two-step Surgical Guide System: A Case Report

As digital dentistry has become widespread and increasingly popular in clinical practice, various attempts have been made to use digital technologies for dental treatment. Implant surgical guides that use these digital technologies have been widely used in recent implant surgeries. The seating and stability of implant surgical guides are essential to accurately transfer the planned surgery into the oral cavity. This case study aimed to explore the two-step surgical guide system to increase the stability of implant surgical guides for implant surgery in a patient with full extraction. In addition, this study attempted to report a clinical case in which fixed prosthetic restoration was completed by converting mucosal-supported surgical guides into tooth- and mucosal-supported surgical guides, and maintaining the vertical dimension through intraoral scanning.ope

A 5-year retrospective cohort study of denosumab induced medication related osteonecrosis of the jaw in osteoporosis patients

Denosumab has been suggested as a first-line therapy for osteoporotic patients. However, a standardized protocol for the prevention of denosumab induced medication-related osteonecrosis of the jaw (MRONJ) has not yet been established. The purpose of this study was to report denosumab induced MRONJ cases, and investigate the factors affecting the occurrence of MRONJ in patients who underwent denosumab and invasive dental treatment (especially tooth extraction) between October 2016 and March 2020. Four of the 98 patients developed MRONJ before and after tooth extraction. The participants were divided into two groups: receiving only denosumab (n = 51) and receiving bisphosphonate as first treatment and denosumab as second treatment (n = 47). There was no significant difference between groups in the occurrence of MRONJ and factors affecting MRONJ. Two out of 4 patients developed MRONJ regardless of invasive treatment after denosumab administration and proceeded with extraction; one patient developed MRONJ after denosumab administration and extraction. The other patient underwent a tooth extraction without osteoporosis treatment, and non-identified MRONJ developed after denosumab administration. MRONJ cases reported in this study show that MRONJ can develop as chronic inflammation without invasive dental treatment; therefore, implementing preventive dental treatment before initiating denosumab treatment is necessary to reduce the occurrence of MRONJ.ope

Comparison of Communication Skills in Dental Education between Korean and United States Dental Colleges

As the social interest in medical care has increased and the awareness and autonomy of patients have increased, the importance of communication skills with patients has been increasingly emphasized in providing high quality medical services. In medical education, such education has become an important area in medical school and lifelong medical education, with studies showing that communication skills can be improved through education and training, and that this learned communication skills can be maintained after becoming a doctor. The importance of communication education and research for dental college students is growing as practical examination on communication skills will also be introduced in dental license tests from 2021. Therefore, we aimed to find out the educational goals and educational methods of United States in which these studies are conducted and applied before our country, and compare them with Korean's current educational goals and methods, so that we can explore the desirable direction of education for dental college students in the future.ope

Analysis of the dentistry-related contents uploaded on YouTube Korea

Objective: Previous studies suggested the potential influence of YouTube videos regarding dentistry on the mass population. However, there was not any clear investigation for Korean population. We aimed to systemically analyze the type of the dentistry-related videos uploaded on YouTube Korea and the accounts used for uploading, and to assess their effect on the view count of the content. Methods: Classification, type of the accounts, and view count of the videos listed by the keyword ‘dentistry’ were analyzed, which were uploaded on YouTube Korea platform from September 2017 to April 2019. Kruskal-Wallis test with post hoc analysis was used to assess the effect of the classification of the videos and the type of accounts on the view count. Results: 1.026 videos were enrolled to the analysis. Primary classification of the videos was information/education, advertisement, life, news, child contents, autonomous sensory meridian response, broadcast, cartoon/game, humor, and music. Secondary classification of the videos was dental experience, advertisement, role-playing, information/education., humor, cartoon/game, child contents, life, and broadcast. Type of the accounts was dentistry associates, general public, media company, and government office (sorted by frequency). Subject of the most videos (93.6%) was general public. There was statistically significance in the view count of the videos according to the primary and secondary classifications, the account used for uploading, and target subject of the videos. Conclusion: Dentists and their associates should recognize the importance of YouTube platform and try to monitor and intervene the dentistry-related contents, considering its huge impact on the general public.ope

Analysis of Various Influencing Factors Related to Patient-Dentist Interaction Score

Each college of dentistry in Korea is examining and reorganizing its own curriculum to prepare students for the practical examination of the National Dental Licensing Examination. Conducting an assessment of students’ compe - tency of communication skills with standardized patients is the first attempt for the examination. Yonsei University College of Dentistry carried out the evaluation of communication attitude, communication written exam, and commu - nication skills practice with standardized patients for Third year predoctoral students. The purpose of this study is a) to find out the relationship between the variables measured in communication skills education and b) to make a new basis for the application of communication education and evaluation in dentistry . Based on the results of the study, the following suggestions for the operation of a dental communication curriculum can be drawn: First, the communication classes and the practice with standardized patients should be based on the wide support of the school. In addition, the patient-dentist interaction (PDI) should be practiced in the same way as practically possible by predoctoral students. Moreover, a space is required to allow predoctoral students to practice PDI. Second, the communication score given by the standardized patients was the most influential on the total score of PDI. This indicates that the communication practice with the standardized patients for the practical examination of the National Dental Licensing Examination is a meaningful process in the course of its communication education.ope

Foreign body aspiration and ingestion in dental clinic: a seven-year retrospective study

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.ope

구강내 수직 골절단술을 이용한 골격성 제 III급 부정교합의 선수술 후 하악골 골편 변위의 3차원적 분석

Dept. of Dentistry/박사The purpose of this study is to establish criteria on the predictability of preorthodontic orthognathic surgery (POGS) using intraoral vertical ramus osteotomy (IVRO) by measuring positional change of each bone segment immediately and 1-year after the surgery. Thirty-eight patients of skeletal Class III malocclusion who had two-jaw orthognathic surgery by the same surgeon were included in this study. The patients had menton deviation within 3 mm from skeletal midline, non-extraction orthodontic treatment, periodically taken multi-detector computed tomography (MD CT) data and no maxillofacial congenital abnormalities. Eight-teen patients who had orthodontic treatment prior to orthognathic surgery were included in the conventional surgery group (CS). Twenty patients who had surgery without presurgical orthodontic treatment were included in the preorthodontic orthognathic surgery group (POGS). Skeletal changes measured preoperatively (T0), two days after surgery (T1), and one year after surgery (T2) in two groups were compared using 3D CT. The results were as follows: 1. Proximal segment of mandible showed lateral (coronal, horizontal plane) and clockwise (sagittal plane) rotations, and mandibular condyle shifted in medial and anterior-inferior directions immediately after surgery. The movements returned to original positions, but not completely during the first year after the surgery. There was no significant difference between the two groups. 2. Posterior part of distal segment moved upward in the CS group, while both anterior and posterior part moved upward in the POGS group. Mandible rotated clock-wise in both groups. 3. The angle between distal segment and proximal segment 1 year after operation was greater in the CS group (9.1 ˚) compared to the POGS group (6.2 ˚). The rotation within matrix meant that POGS made the direction of the angle between two segments smaller compared to CS. 4. There was no significant difference of maxillary skeletal change between two groups. The maxillary second molars showed 1.2 mm, 1.32 mm intrusion during post-operative orthodontic treatment of POGS group. Based on the results above, the change of proximal segment in the cases of POGS with IVRO on a patient with skeletal Class III malocclusion was not different from CS. If active physiotherapy is conducted using the conventional method, the proximal segment can be adapted in the physiological location regardless of the change in the occlusion. As POGS accompanies the movement of the distal segment itself as well as the teeth movement during the postoperative orthodontic treatment, and does not have an anterior occlusal stop, a close observation is necessary in order to prevent a formation of rotation fulcrum in an undesired location.ope

Reliability of Anterior Nasal Spine as a Reference Point After LeFort I Surgery Using Three-Dimensional Analysis

To evaluate the stability of maxilla following orthognathic surgery, it is necessary to consider the positional change of various landmarks according to bone remodeling of the maxilla. This study aimed to evaluate the stability of the anterior nasal spine (ANS) as a reliable landmark after orthognathic surgery. Forty-seven patients with skeletal class III malocclusion who underwent bimaxillary orthognathic surgery were included. Skeletal changes were measured using cone-beam computerized tomography at 3 time points: preoperative (T0), 1-month postoperative (T1), and 12-month postoperative (T2). Linear changes of the 6 landmark points of the maxilla were measured in 3 directions: anteroposterior, vertical, and transverse. The data were analyzed with paired t tests, independent t tests, and multiple regression analysis. At 12-month postoperatively, the ANS showed mean (standard deviation) 1.23 (1.07) mm posterior movement ( P = 0.00), while other landmarks did not show positional changes, implying bony resorption of ANS. Multiple regression test showed surgical forward movements of ANS (T1-0) affect the postoperative backward changes (β = -0.05, P < 0.05). There was a negative correlation between the surgical movement and postoperative change of ANS by Pearson correlation test ( r = -0.38, P < 0.05). The ANS is not a reliable measurement point in three-dimensional superimposition after orthognathic surgery. Therefore, in studying the stability and positional change pattern after LeFort I surgery, it is not recommended to use ANS as a reference point, as changes can occur in the measurement point itself.restrictio

Synthesis of cell penetrating gene carrier for breast cancer-targeted therapy

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