Parental Satisfaction with Ambulatory Anesthesia during Dental Treatment for Disabled Individuals and Their Preference for Same in Future

The purpose of this study was to survey parental satisfaction with ambulatory anesthesia during dental treatment in disabled patients. Factors associated with parental preference for general anesthesia during future dental treatment in such patients were also investigated. A questionnaire was mailed to the parents of 181 disabled individuals who underwent dental treatment under ambulatory anesthesia at Tokyo Dental College Suidobashi Hospital between 2012 and 2016. A total of 71 responses were received (39.2%). The mean patient age was 18 years, and disabilities included autism spectrum disorder, intellectual disability, cerebral palsy, and epilepsy. The items surveyed included dental treatment details, number of times patients received general anesthesia, type of anesthetic used, anesthesia induction method, durations of treatment and anesthesia, and the presence or absence of intraoperative or postoperative complications. Questionnaire items queried problems related to dental care, anesthesia history, preoperative anxiety, length of fasting period, induction of general anesthesia, nursing and hospital room environment, postoperative anxiety, overall evaluation, and whether the parent would prefer general anesthesia during future dental treatment. The patients were divided into 2 groups: those whose parents preferred general anesthesia during future dental treatment and those whose parents did not. The results revealed that, where disabled individuals had previously received general anesthesia during dental treatment, the parents were more likely to prefer general anesthesia during future dental treatment.

Erupted complex odontoma delayed eruption of permanent molar

Odontomas, benign tumors that develop in the jaw, rarely erupt into the oral cavity. We report an erupted odontoma which delayed eruption of the first molar. The patient was a 10-year-old Japanese girl who came to our hospital due to delayed eruption of the right maxillary first molar. All the deciduous teeth had been shed. The second premolar on the right side had erupted, but not the first molar. Slight inflammation of the alveolar mucosa around the first molar had exposed a tooth-like, hard tissue. Panoramic radiography revealed a radiopaque mass indicating a lesion approximately 1 cm in diameter. The border of the image was clear, and part of the mass was situated close to the occlusal surface of the first molar. The root of the maxillary right first molar was only half-developed. A clinical diagnosis of odontoma was made. The odontoma was subsequently extracted, allowing the crown of the first molar to erupt almost 5 months later. The dental germ of the permanent tooth had been displaced by the odontoma. However, after the odontoma had been extracted, the permanent tooth was still able to erupt spontaneously, as eruptive force still remained. When the eruption of a tooth is significantly delayed, we believe that it is necessary to examine the area radiographically. If there is any radiographic evidence of a physical obstruction that might delay eruption, that obstruction should be removed before any problems can arise. Regular dental checkups at schools might improve our ability to detect evidence of delayed eruption earlier.

Dental treatment for patients with physical or mental disability under general anesthesia at Tokyo Dental College Suidobashi Hospital

Dental treatment for patients with physical or mental disability is often performed under general anesthesia due to level of cooperation with treatment, type and location of treatment, time required, or number of times patient is required to attend hospital. University hospitals are receiving an increasing number of requests from local private dentists and dental clinics to provide dental care for patients with physical or mental disability which can only be performed under general anesthesia. We carried out a retrospective survey of the routes of referral and types of dental treatment carried out in such patients under general anesthesia at Tokyo Dental College Suidobashi Hospital. The survey covered a 5-year, 9-month period from April 2006 to December 2011, during which 163 patients, comprising 106 men and 57 women, were treated. Their age ranged widely, from 2 to 53 years, with a high proportion (118 patients, 72.4%) being minors aged under 20. Among the total number of patients, 69 (42.3%) had disorders associated with mental retardation. One hundred and two patients (62.6%) had been referred from other medical institutions, with a particularly high number coming from public dental clinics for patients specializing in such patients. Conservative restorative procedures were performed in most cases (59.4%), with composite resin restorations being particularly frequent. After treatment, many patients returned to their referring medical institutions, which were responsible for subsequent management, but information on the posttreatment status was not available for some patients. Tokyo Dental College Suidobashi Hospital frequently collaborates with local medical institutions, and the present results suggest the importance of improving such collaboration.

Changes of optical properties of retroreflector installed in LHD

This article describes changes of optical properties of retroreflectors installed on the inner wall of the vacuum vessel of the Large Helical Device. They were made of stainless steel and were used for a CO(2) laser polarimeter. The reflectivity for a CO(2) laser beam dropped up to 40% after the start of glow discharge cleanings and main plasma experiments. Then it decreased gradually. The reflectivity in a wavelength range shorter than 10 mum decreased significantly through one experimental campaign (about 4 months). On the other hand the reflectivity in a wavelength range longer than 50 mum was larger than 70%. Decrease in the reflectivity in the central region of mirrors was more significant (the reflectivity for visible beams became almost zero) than that in the edge. The distribution of the reflectivity along the radial direction is expected to be related to the shape of the retroreflector. The parallelism of the reflected beam to an incident one also deteriorated. The changes in the polarization angle and in the ellipticity of reflected light polarization were not observed from the visible to the far infrared range.

Bifurcation, birooted primary canines: a case report

A rare case of birooted primary canines is reported. A male patient aged 6 years 4 months of age presented with pain and swelling related to the upper right first primary molar. Radiographic examination revealed an incidental finding of bifurcation of the roots of all four primary canines. This represents a rare finding. The prevalence of birooted permanent canines in the Japanese population has been reported, but the prevalence of this abnormality of primary canines in other populations is unknown. This report discusses the findings in the context of the available literature. The possible aetiology, possible inferences for the developing dentition, and the need for careful assessment prior to root canal therapy or extraction are highlighted.