A CLINICAL STUDY ON THE DENTAL EMERGENCY PATIENTS VISITING WONKWANG UNIV-HOSPITAL EMERGENCY ROOM

원광대학교병원 응급실에 내원한 치과 응급 환자에 대한 임상적 연구

Lee, Dong-Keun;Min, Seung-Ki;Yang, Chan-Young;Mun, Cheol;Kim, Jong-Gu
이동근;민승기;양찬영;문철;김종구

  • Published : 20020100

Abstract

This is a retrospective clinical study on 3,243 patients who had visited the Emergency Room of Wonkwang University Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 5 years from Jan. 1, 1996 to Dec. 31, 2000. The obtained results were as follows : The total number of patients was 3,243 and the ratio of sex was 1.86:1. The highest monthly incidence was shown in October and March to 19%, and the age distribution peaks was the 3rd decade(24.7%), followed by the 1st(21.7%) and the 4th decade(15.7%). The percentage of admission were 4.8%. The frequent cause of admission were facial bone fracture(70%), infection(16%), soft tissue injury(14%). Trauma(70.9%) was the most frequent cause in dental emergency patients, odontogenic infection(24.3%), oral hemorrhage and TMJ dislocation were next in order of frequency. About the cause for trauma, traffic accident was the most, and fall down, slip down injury and assault were followed. Soft tissue injury group(56%) was the most prevalent, followed by tooth injury group(27%) and facial bone injury group(17%). In facial bone injury group, the mandibular fracture(55%) showed the highest incidence followed by zygomaticomaxillary complex fracture, nasal bone fracture, maxilla fracture, and zygomatic arch fracture. In the mandibular fracture, symphysis(40%) was the most common location followed by condyle(29.4%), angle(22.1%), and body area(8.5%). Tooth fracture showed the highest incidence as 35% followed by subluxation(29%), avulsion(20%), and concussion(16%). In infection patients group, the ratio of admission was 5.8% and the major visiting cause was acute pulpitis(32.3%). The major treatment method was the incision and drainage(30%) followed by endodontic treatment(28%), curettage(22%), extraction(7.8%), and so forth. In TMJ dislocation group, the highest incidence age was 3rd decade and 4th decade(51%). In post-operative bleeding group, the major cause of bleeding was non-fulfillment of doctor's instruction and bleeding was almost stoped by only gauze biting.

Keywords

References

  1. Ahing CC, Davis BP : Compound comminuted complex fractures. J Oral Surg 32 : 415, 1974
  2. Irby WB : Current advances in oral surgery. Vol 1. CV Mosby Co pp. 214, 1974
  3. Hueke DF, Compton CP : Facial injuries in automobile Crashes. J Oral Maxillofac Surg 41 : 241, 1983
  4. Schultz RC : Facial injuries form automobile accidents : A study of 400 consecutive cases. Plast Reconst Surg 40 : 415, 1967
  5. Schultz RC : One thousand consecutive cases of major facial injury. Review of Surgery. pp 394, 1970
  6. Schultz RC, Oldham RJ : An overview of facial injuries. Surgical clinics of North America 57 : 987, 1977
  7. Schultz RC : Facial Injuries. 2nd Ed. Year book Medical Publishers 1977
  8. Schultz RC : Facial Injuries. 2nd Ed. Year book Medical Publishers 1977
  9. Kelly DE : A survey of facial fractures : Bellevue hospital 1948-1974. J Oral Surg 33 : 146, 1975
  10. Small EW : Survey of maxillofacial fractures. J Oral Surg 34 : 27, 1976
  11. Dingman RO, Natvig P : Surgery of facial fractures. WB Saunders Co 1973 : pp 133
  12. Nakamura T, Gross CW : Facial fracture : Analysis of five years of experience. Arch. Otolaryngol 97 : 288, 1978
  13. Turvey TA : Midfacial fractures : A retrospective analysis of 593 cases. J Oral Surg 35 : 887, 1977
  14. Ivy RH : Observation of fractures of the mandible. JAMA. 79 : 295, 1922
  15. Berkowitz R, Ludwing S, Johnson R : Dental trauma in children and adolescents. Clin Pediat 19 : 166, 1980
  16. Galea H : An investigation of dental injuries treated in and acute care general hospital. JADA 109 : 434, 1984
  17. Kim SS, Kim JB : Clinical study of facial injury. J Kor Oral Maxillofac Surg 9 : 171, 1983
  18. Kim SS : Clinical study of facial bone fracture. J Kor Oral Maxillofac Surg 7 : 127, 1981
  19. Park HS : A clinical study on facial bone fracture of Koreans. J Kor Oral Maxillofac Surg 9 : 99, 1983
  20. Yoon OK : Clinico-reontgenographic studies on fracture lines of the maxillofacial bones. J Kor Oral Maxillofac Surg 14 : 179, 1976
  21. Lee SC, Kim YK : A clinical study of facial bone fractures at Dept. of Oral and Maxillofacial surgery for the last 5 years
  22. Kim YS, Sim JY, Oh SH : The clinical study on facial bone fracture. 16 : 89-98, 1994
  23. Lee JW, Ro HS : Clinical study of facial bone fracture. J Kor Asso Maxillofac Plast Reconstr Srug 14 : 89-96. 1992
  24. Looby JP : Needs and values of a hospital dental service. J Oral Surg 16 : 471, 1958
  25. Sim HG, Lee EO : A clinical study on night time emergency patients of the dental hospital, Yonse Medial Center. J Kor Oral Maxillofac Surg 11 : 259, 1985
  26. Lee YO, Mun SH : Analysis of 334 case reports of mandibular fracture. J Kor Oral Maxillofac Surg 13 : 291, 1991
  27. Henny FA : Dentistry role in interdepartmental hospital relation. J Oral Srug 16 : 285, 1958
  28. Topaxian RG : Management of infections of the oral and maxillofacial regions. WB Saunders pp351, 1981
  29. Roitt IM : Immunology of oral diseases. 2nd ed. Blackwell scientific publications pp279, 1983
  30. Archer WH : Oral and maxillofacial surgery. 5th ed. WB sunders pp 419, 1975
  31. Kruger GO : Textbook of oral & Maxillofacial surgery. vol I. CV Mosby Co. pp40, 1984
  32. Rose LF, Kaye D : Internal medicine for dentistry. CV Mosby Co pp1, 1983
  33. Rose P, Baker II FJ, Barkin RM, Bracen GR, Dailey RH, Levy RC : Emergency medicine vol II. 2nd ed. CV Mosby Co pp27, 1988
  34. Conley JJ : Complications of head & neck surgery. WB Saunders pp66, 1979
  35. Kaban LB, Pogrel MA, Perrott DH : Complications in oral and maxillofacial surgery. WB Saunders pp47, 1997
  36. Malamed SF, Robbins KS : Medical emergencies in dental office. 3rd ed. CV Mosby Co pp299, 1993
  37. McCarthy FM : Medical emergencies in dentistry 3rd ed. WB Saunders pp93, 1982
  38. Fonseca RJ, Walker RV : Oral & Maxillofacial trauma. vol I. WB Saunders pp3, 1991
  39. Saviston DC : Textbook of surgery, 13th ed. WB Saunders, pp23, 1986
  40. Little JW, Falace DA, Miller CS, Rhodus NL : Dental management of the medically compromised patient 5th ed. CV Mosby Co pp79, 1997