전이성 암종의 증상으로 발현된 numb chin syndrome 증례

임현대 대한노년치의학회 2022 대한노년치의학회지 Vol.18 No.2

Numb chin syndrome (NCS) is a sensory neuropathy characterized by numbness in the distribution of the inferior alveolar nerve or mental nerve. Benign as well as malignant diseases are known to cause NCS. If a dentist encounters NCS without a history of maxillofacial trauma or dental problems, they should keep in mind the relationship with malignant tumors. This report introduces the case of numbness and pain in chin area caused by metastasis and emphasizes the importance of diagnosis of NCS.

지역사회 거주 노인의 저작 기능 저하에 대한 평가 및 중재 방법: 탐색적 문헌고찰

김지훈,소종섭,정회인,강정현 대한노년치의학회 2023 대한노년치의학회지 Vol.19 No.1

Masticatory ability is an essential factor for sustaining quality of life and social and systemic well-being, particularly in elderly. Hence, early diagnosis and providing proper intervention for masticatory dysfunction is critical for preventing systemic frailty and establishing healthy aging. Several methods have been proposed to evaluate the objective masticatory function and the subjective masticatory satisfaction. Moreover, many previous studies reported the effects of diverse types of intervention for masticatory dysfunction. The aim of this study was to review some of the previously reported tests for evaluating masticatory function and intervention modalities.

하악과두 상방에 나타난 골증식체: 증례보고

송희정,박문수,한진우 대한노년치의학회 2023 대한노년치의학회지 Vol.19 No.1

Osteophytes, emerging at the articular surface, usually exhibit a bony growth toward the anterior or anterior-superior region of the mandibular condyle rather than progressing upwards. This specific manifestation, referred to as a central osteophyte, is uncommon and frequently co-occurs with localized erosive change on the articular surface. While the emergence of central osteophytes is often identified in the context of the knee joint, it's considered a relatively rare occurrence in the temporomandibular joint. We conducted a meticulous examination of both imaging and clinical findings, derived from a unique case of a central osteophyte in the mandibular condyle. By analyzing this unusual instance, we aim to contribute to knowledge about it, and ultimately improve diagnostic accuracy for practitioners.

CO2 Laser를 이용한 구강 백반증의 치료: 증례보고

강정현,김우현 대한노년치의학회 2023 대한노년치의학회지 Vol.19 No.1

Oral leukoplakia is one of the most common oral potentially malignant disorders and it has risk of malignant transformation. Hence, early diagnosis and treatment would be essential to minimize the loss of oral function and discomfort. Total resection would be recommended, but vaporization could be regarded as good alternative. The aim of this study is to investigate the prognosis of CO2 laser treatment on oral leukoplakia through the one case who visited tertiary University Hospital.

Considerations for Anticoagulation and Endocarditis Risk in Invasive Dental Procedures: Expert Approaches and Preventive Strategies

김현경,김성태,조영단 대한노년치의학회 2023 대한노년치의학회지 Vol.19 No.2

Cardiovascular diseases are globally prevalent conditions with high mortality and morbidity rates. As the elderly population increases, the proportion of individuals affected by these diseases is on the rise. In line, dentists frequently encounter patients taking anticoagulants for cardiovascular conditions and those at a higher risk of infective endocarditis due to heart valverelated issues. Dentists need to be mindful of considerations during invasive dental procedures. For individuals at a high risk of infective endocarditis, preventive antibiotic therapy, regular dental check-ups and oral hygiene management are essential. Although, temporary discontinuation of anticoagulant therapy has been done to reduce bleeding risk, it is recommended not to stop anticoagulation due to the increased risk of thromboembolic events, which can lead to death. Instead, employing local methods such as appropriate hemostatic agents is advisable.

치아상실 부위의 보철 치료방법에 따른 치료후의 만족도에 관한 연구

조연정,김종희,하승룡,최유성,이종혁 대한노년치의학회 2023 대한노년치의학회지 Vol.19 No.2

The purpose of this study was to understand the healthcare behaviors of implant and fixed partial denture patients and their medical information such as age, reasons for the treatment, and surgical area, and to measure the patient satisfaction before and after treatment. This study was conducted to provide accurate medical information to patients with tooth loss and to provide a basis for effective counseling. A survey has been conducted 300 adults aged 20 and older admitted at the Ajou university dental hospital who had lost at least one tooth. The patients’ demographic information and their dental factors have been analyzed by frequency analysis model. Changes in satisfaction from pre- to post-treatment were analyzed using paired t-tests. A t-test and one-way analysis of variance were used to examine the association between patients’ demographic information and their medical information. The association between treatment method and pre- and post-treatment satisfaction was analyzed using generalized linear model. Post-treatment satisfaction, depending on the treatment method, was higher for implants in mastication, facial and dental esthetics, and gingiva and teeth care. Satisfaction was slightly higher for patients with a fixed partial denture in pronunciation and psychological function, but there were no statistically significant differences. There were no statistically significant differences in mastication function, facial and teeth shape, and gingiva and teeth care, but there was a statistically significant difference in pronunciation function, and psychological function. There were no statistically significant differences in medical information affecting post-treatment satisfaction.

구강노쇠 진단과 관리를 위한 설압 평가와 중재

이정옥 대한노년치의학회 2023 대한노년치의학회지 Vol.19 No.1

Oral frailty is a process that accompanies the process of general frailty and appears before systemic frailty. Tongue pressure is one of the six predictors of oral frailty (① number of natural teeth, ② masticatory ability, ③ pronunciation ability, ④ tongue pressure, ⑤ subjective difficulty in eating rough food, and ⑥ subjective difficulty in swallowing). Recently, National Evidence-based healthcare Collaborating Agency and the Korean Society of Geriatric Dentistry drew an expert consensus on 'Diagnostic criteria and treatment of oral frailty in Korea'. We would like to share the latest information by organizing literatures related to ‘evaluation and intervention of lowering tongue pressure'. The standard value of the maximum isometric pressure for evaluating tongue pressure is 30kPa. Using a tongue pressure measuring device, tongue pressure is measured by the balloon probe located between tongue and palate. The force should be delivered for at least 3 seconds with the maximum force possible. Maximum value measured after triple measurements will be used for evaluation. In addition, traditional methods such as oro-motor test using tongue depressor can be used as a supplementary way. This method can comprehensively examine oral function, such as checking the shape, tension, coordination, and muscle strength of the tongue with the naked eye. The tools and intervention methods for the measurement and intervention of tongue pressure that have been developed so far are summarized and introduced. Tongue pressure intervention methods include tongue exercise and practice using instruments (Pecopanda®), and an appropriate intervention method should be applied according to the purpose and target. Generally recommended intervention period for progressive resistance training is 8-12 weeks.

골다공증 환자에게서 MRONJ(Medication-related osteonecrosis of the jaw)를 유발할 수 있는 국소위험인자에 대한 고찰

김훈민,이진호,손나리,안윤환,정찬우,이재일,성일용,손장호,하진희,조영철 대한노년치의학회 2022 대한노년치의학회지 Vol.18 No.1

Recently, many side effects such as bone necrosis have been reported during dental treatment for patients with osteoporosis as an underlying disease. In particular, osteoporosis is on the rise every year in menopause women and elderly patients, and occurs in connection with bisphosphonate medication. Such medication-related osteonecrosis of the jaw is often caused by surgical dental treatment, and it is difficult to cure when it occurs, so prevention is important. Surgical treatment may be required in the oral Preparation process for extraction or prosthetic repair due to periodontal disease, and for the successful treatment of osteoporosis patients, dentists should fully understand and pay attention to the treatment of osteoporosis patients.

지역사회 거주 노인의 타액선 기능저하 (구강건조) 평가 및 중재

소종섭,정회인,강정현,김지훈 대한노년치의학회 2022 대한노년치의학회지 Vol.18 No.2

Salivary gland hypofunction (dry mouth) is the most common dysfunction in older adults. It causes a deterioration in oral health, mastication, and swallowing functions. It can also lead to systemic frailty. Early diagnosis and intervention are required to prevent oral and systemic frailty. This literature review introduced the salivary gland hypofunction assessment methods and interventions applicable in community-dwelling older adults. The study proposed an oral mucosal wetness test. The test uses an oral moisture-checking device as the primary test for assessment considering logistic aspects in application to the elderly in the community. The clinical oral dryness score (CODS) is an alternative test. The assessment method of oral mucosal wetness showed a significant correlation with salivary secretion rate. The CODS system is also significantly correlated with mucosal wettability, salivary secretion rate, and severity of oral dryness. Therefore, they have proven useful as test tools for assessing salivary gland hypofunction and oral mucosal wetting. The subjective questionnaire (xerostomia inventory) is also a useful tool for determining the severity of dry mouth and can be combined with other examination methods for salivary gland hypofunction such as oral mucosal wetness test or CODS. Essential interventions to salivary gland disfunction include drug coordination, prescription of artificial saliva, expert application of fluoride varnish, and salivary gland stimulation exercises. Careful consideration of other oral functions, such as occlusal force, tongue pressure, tongue movement, and oral hygiene management ability, is also required. Comprehensive intervention must be planned. Many studies have shown that the degradation of one function leads to that of another. Conversely, improving each function can improve other oral and integrated functions, such as masticatory and swallowing functions. The ultimate purpose of the intervention for salivary gland hypofunction in community-dwelling older adults is to improve and maintain oral functions—mastication, swallowing, and pronunciation. Therefore, interventions should include complex interventions such as oral exercise, tongue pressure enhancement training, oral hygiene, and interventions to improve salivary gland function. The intervention for individual salivary gland dysfunction should be planned with a comprehensive perspective for maintaining integrated oral function and contributing to the prevention and management of systemic frailty and its complications.

노인치의학 커리큘럼 가이드라인 제안: 교육주제와 표준역량 항목 중심으로

소종섭,고홍섭,강경리,강명신,고석민,하승룡,황지영,이상구,이성근 대한노년치의학회 2022 대한노년치의학회지 Vol.18 No.1

This study was conducted to propose guidelines for Korean geriatric dentistry education in response to changes in society in which the number of older persons is rapidly increasing. By referring to the American, European, and Japanese geriatric dentistry curriculum, the same or highly related items were integrated and reorganized, and new items were added considering the need for education. Through inter-researcher discussion, geriatric dentistry education topics and educational competency items were composed. A survey was conducted on the proposed items among educational experts at dental schools and executives of the Korean Academy of Geriatric Dentistry. After classifying the level of education required into basic or expert curriculum, educational guidelines based on education topics and educational competencies were presented. Educational topics consist of 54 didactic items and 2 practice items in 7 areas including <Public health issues> <Aging> <Aspects of Geriatric medicine> <Communication skills> <Logistic aspects> <Diagnosis & Treatment planning> <Therapy & Prevention>. The core competencies consisted of 83 items in 7 areas including <Understanding of aging> <Medical aspects> <Communication> <Logistic aspects> <Diagnosis, Treatment planning and Treatment> <Prevention and Care> <Public health aspects>. The subjects of socioeconomic aspects, aging, medical and pharmacological aspects in older people, and educational contents for functionally independent older people are mostly classified into the basic educational level. On the other hand, the topics of oral care and treatments, oral and maxillofacial functional rehabilitation, and management areas for frail and dependent older people mostly with sensory or cognitive problems were classified into the expert level. Currently, geriatric dentistry in Korea has been limited to the category of dental treatment for the functionally independent older adults who can visit outpatient clinics. The results of this study had significance in that it presents educational topics and competencies for the functionally frail and dependent older adults. The results of this study can be used for improving not only education curriculum for geriatric dentistry at each and every dental school but also continuing education programs, and will serve as basic and essential data for future research.