• Title/Summary/Keyword: 구강내 통증

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Caspase-3 Expression in the Submandibular Gland of Rats under Restraint Stress (스트레스에 의한 백서 악하선 조직에서의 caspase-3 변화에 관한 실험적 연구)

  • Chung, Woon-Bong;Jung, Sung-Hee;Chun, Yang-Hyun;Lee, Jin-Yong;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.25 no.3
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    • pp.265-276
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    • 2000
  • 스트레스가 타액선 조직을 변형시키고 파괴시킬 수 있다는 것은 이미 보고된 바 있다. 이는 구속스트레스 시에 관찰되는 apoptosis에 의한 것인데, 이 과정에 관여하는 caspase-3는 세포의 DNA를 분절시킴으로서 apoptosis를 일으킨다고 알려진 세포내 단백효소이다. 이에 기존에 관찰되었던 구속 스트레스에 의한 apoptosis의 형태적 변화가 apoptosis를 유도하는 caspase-3와 어떠한 시기적 상관관계를 가지고 있는지를 구명하기 위하여 본 실험을 시행하였다. 웅성 백서 (Sprague-Dawley, 8주) 를 사용하여 실험 전 기간에 걸쳐 구속스트레스를 가한 후 30분, 1시간, 3시간, 6시간, 24시간, 3일, 5일, 7일에 희생시켰다. 그 후 실험동물의 악하선을 절취하여 동결절편을 제작한 후, caspase-3에 대한 형광항체로 면역형광법을 시행하여 관찰하였다. 1. 정상대조군에서는 caspase-3가 타액선 조직 전반에서 미약하게 관찰되었다. 2. 구속스트레스 부여 30분에서 caspase-3는 강반응을 보였고, 실험기간이 경과됨에따라 점차 6시간군에서 부터는 현저히 감소하였다. 3. Caspase-3는 구속 스트레스 30분에 도관과 선포세포 모두에서 발현되었으나, 선포세포에서는 조기에 급격히 소실되었고 도관세포에서는 전 실험 기간에 걸쳐 서서히 소실되었다. 이와 같은 연구 결과에서, 세포내 caspase-3는 조직의 형태적 변화가 나타나기 이전에 발현하는 것으로 보아 caspase-3는 형태적 변화를 예견할 수 있는 진단 지표로 사용될 수 있을 것으로 사료되며 이후 임상적으로 적용하기 위한 지속적인 연구가 필요할 것으로 생각된다.

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Analysis of Patients with Mandibular Nerve Damage after Root Canal Therapy (근관치료 후 발생한 하악신경 손상 환자에 대한 분석)

  • Lee, Ji-Soo;Song, Ji-Hee;Kim, Young-Gun;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.3
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    • pp.327-336
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    • 2011
  • Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.

Comparison of Bite Forces between Pre- and Post-Treatment in Patients with Temporomandibular Disorders (측두하악장애 환자의 치료 전후 교합력 비교)

  • Lee, Sang-Il;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.211-218
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    • 2007
  • The purpose of this study was to compare the maximum bite forces between pre- and post-treatment related to specific diagnostic groups of TMD including masticatory muscle disorder (MMD), disc derangement (DD), joint inflammation (JI) and osteoarthritis (OA). Bite force between pre- and post-treatment was compared in 36 patients with unilateral TMD, successfully-managed in the Department of Oral Medicine, Dankook University Dental Hospital, for this study. The ratio of men to women was 7:29 and their mean age of $28.1{\pm}13.7$ years. The patients were categorized, through clinical and radiographic examination, into aforementioned 4 groups; MMD (N=18), DD (N=6), JI (N=5) and OA (N=7). The maximum bite force measurements were done at the antagonizing canines and 1st molars using a bite force recorder. Paired t-test, ANOVA, Multiple Comparison t-tests were used for statistical analysis. The results of this study showed that the maximum bite force before treatment increased after TMD treatment, which was noticeable at the canines (p=0.001 and p=0.000 for the affected and unaffected sides, respectively). In comparison related to the diagnostic groups of TMD, patients with osteoarthritis of TMJ exhibited the lowest strength while those with inflammatory disorder of TMJ had the highest strength on the affected sides. Increase of bite force after treatment was also found in each group. Significant difference between pre- and post-treatment was found at canines on the affected sides in MMD (p=0.045) and DD groups (p=0.009) while on the unaffected sides in OA group (p=0.003). Conclusively, the reduced bite force due to TMD could be recovered by conservative TMD treatment and that the difference of bite forces between pre- and post-treatment was noticeable at the canines.

Clinical Assessment and Cephalometric Characteristics of Patients with Condylar Resorption in Teenagers (10대 하악과두흡수 환자의 임상적 평가 및 악안면 골격형태에 대한 연구)

  • Chun, Yong-Hyun;Hur, Yun-Kyung;Jung, Jae-Kwang;Chae, Jong-Moon;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.35 no.1
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    • pp.61-73
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    • 2010
  • The aim of this study was to investigate clinical assessment and cephalometric characteristics in 10s patients with condylar resorption, who visited in the Department of Oral Medicine Kyungpook National University Hospital at 2006, by use of panorama, transcranial view and lateral cephalometric radiograph. The results were as follows; 1. Clinical assessment 1) Total number of patients were 59. Female was 47 and male was 12, Females were predominant and patient's age ranged from 12 to 19. 2) Most of the patients had Grade II condyle resorption. 3) The number of who had Class I occlusion was 27, which was the largest group. The number of patients with openbite was 20. Average overjet was 3.58mm and average overbite was 0.97mm. 4) Most of the patients had parafunctional habit. 5) The patients of showing the pain in condylar resortion was 41 and the case of not showing the pain was 18. 6) Treatment duration of 23 patients were less than 1 month, 28 patients were treated with supported therapy. 2. Cephalometric Characteristics 1) A 16-year-old female patients showed smaller SNA, SNB and larger articular angle significantly as compared with those of normal group. 2) A 17-year-old female patients showed smaller SN, SAr, TPFH, ramus height and larger SN-GoMe, FMA, articular angle significantly as compared with those of normal group. 3) Over 18 years old female patients showed smaller SN, SNB, TPFH, ramus height and larger ANB, FMA, SN-GoMe, LAFH, articular angle, gonial angle significantly as compared with those of normal group. 4) Over 18 years old male patients showed smaller SN, TPFH, ramus height and larger FMA, SN-GoMe, LAFH, articular angle, gonial angle significantly as compared with those of normal group. 5) There was no significant difference between 10s and normal group in mandibular body length.

Outcome of Conservative Treatment for Patients with Disc Displacement of Temporomandibular Joint (측두하악관절 원판변위 환자의 보존적 치료결과)

  • Kim, Kyung-Hee;Kim, Ik-Hwan;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.32 no.3
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    • pp.305-318
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    • 2007
  • To evaluate the treatment outcome after conservative treatment in patients with TMJ disc displacement which is the most common temporomandibular joint arthropathy, the subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital, diagnosed as TMDs and treated with conservative methods from 1994 to 2006 for 13 years. 88 patients with diagnosis of DD/cR and 60 patients with diagnosis of DD/sR were selected as the experimental group and 74 patients with diagnosis of masticatory muscle disorder (MMD) were selected as the control group. Subjective symptoms and clinical findings were investigated to evaluate and compare the subjects' status at the first visit and the last visit. The results were as follows; 1. Pain, noise, LOM and MCO measurements of DD/cR, DD/sR and MMD groups were markedly improved after conservative treatments including behavior therapy, physical therapy, medication and splint therapy. 2. At the first visit, high score of pain in MMD group, high score of noise and large MCO measurement in DD/cR group and high LOM score in DD/sR group were observed. At the last visit, high score of noise and increased MCO measurement in DD/cR group and high score of pain and LOM in DD/sR group were observed. 3. Among the patients who complained joint sound at their first visit, about 60% showed complete loss of joint sound after conservative treatment 4. DD/cR and DD/sR groups showed satisfactory outcomes after conservative treatments such as behavior therapy, physical therapy, medication and splint therapy while MMD group showed similar treatment outcome irrespective of the treatment modality used. 5. There was no difference in treatment outcomes after conservative treatments when the subjects were classified and compared according to gender, age group and chronicity. 6. MMD showed satisfactory prognosis in 10 treatments in less than 6 months while DD showed favorable prognosis in 10-20 treatments for 6 months to 2 years.

High dose of QX-314 produces anti-nociceptive effect without capsaicin in rats with inflammatory TMJ pain

  • Yang, Kui-Ye;Kim, Min-Su;Kim, Eun-Kyung;Kong, Mi-Sun;Ahn, Jong-Soo;Lee, Jong-Hun;Ju, Jin-Sook;Ahn, Dong-Kuk
    • International Journal of Oral Biology
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    • v.38 no.4
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    • pp.135-140
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    • 2013
  • The present study investigated the effects of QX-314 on inflammatory pain of the temporomandibular joint (TMJ). Experiments were carried out on male Sprague-Dawley rats weighing 220-280 g. Under anesthesia, the TMJ of each animal was injected with $50{\mu}L$ of formalin (5%). The number of noxious behavioral responses, including rubbing or scratching of the facial region including the TMJ area, was recorded over 9 sequential 5 min intervals for each animal. Although 2.5% QX-314 did not affect formalin-induced nociceptive behavior, administration of 5% QX-314 with formalin significantly decreased the number of scratches produced by the formalin injection. Co-administration of capsaicin, a TRPV1 agonist, with 2.5% QX-314 produced significant anti-nociceptive effects whereas 2.5% QX-314 alone did not. However, the co-administration of capsaicin did not enhance the anti-nociceptive effects in the 5% QX-314-treated rats. Moreover, the co-administration of capsazepine, a TRPV1 antagonist, did not attenuate anti-nociceptive effects in the 5% QX-314-treated rats. These findings suggest that TRPV1 is effective in the transport of low but not high doses of QX-314. Moreover, a high dose of QX-314, which is not mediated by peripheral TRPV1 activity, may be viable therapeutic strategy for inflammatory pain in the TMJ.

The Anti-Bacterial Effect of Witch Hazel(Hamamelis virginiana) on Oral Pathogens (Witch hazel(Hamamelis virginiana)의 구강병원균에 대한 항균 효과)

  • Ryu, Seong-Yong;Ahn, Hyung-Joon;Kwon, Jeong-Seung;Park, Ju-Hyun;Kim, Jae-Young;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.33 no.2
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    • pp.159-166
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    • 2008
  • An ideal anti-bacterial medication for oral infection requires selective effect on pathogens causing dental caries and periodontal disease but not on normal flora. In addition, it should be less toxic for human and even for environment. This study was to seek such a natural anti-bacterial medication and thus anti-bacterial effect of Hamamelis virginiana was evaluated. Many recent researches on the anti-bacterial effect of natural plant extract and essential oil have reported that natural products can be used as medication for prevention and restrainment of dental caries, halitosis and periodontitis. It has been also reported that Hamamelis virginiana has anti-bacterial effect on Porphyromonas gingivalis, Fusobacterium nucleatum, Capnocytophaga gingivalis, Veilonella parvula, Eikenella corrodens, Peprostreptococcus micros, and Actinomyces odontolyticus. This study evaluated anti-bacterial effect of Hamamelis virginiana on Streptoccoccus mutans, Haemophylus actinomycetemcomitans, and Klebsiella pneumoniae to expand its anti-bacterial effect on other important oral pathogens and eventually to develop its oral care products or apply to clinical purpose. In this study, anti-bacterial tests for antibiotic disk susceptibility, minimal inhibitory concentration and minimal bactericidal concentration were performed to evaluate anti-bacterial effect of Hamamelis virginiana against Streptoccoccus mutans, Haemophylus actinomycetemcomitans, and Klebsiella pneumoniae. The results showed that Hamamelis virginiana has anti-bacterial effect on all pathogen strains tested in this study and furthermore Hamamelis virginiana possesses bactericidal effect other than bacteriostatic effect on Streptoccoccus mutans, Haemophylus actinomycetemcomitans, Klebsiella pneumoniae. This study indicates that a natural anti-bacterial medication for oral diseases can be developed using Hamamelis virginiana.

Electrochemical Detection of Lead and Cadmium in Human Saliva by Anodic Stripping Voltammetry (ASV) Analysis: A Pilot Study (양극 벗김 전압전류법 (Anodic stripping voltammetry: ASV)을 이용한 인체 타액 내 납과 카드뮴의 검출: 예비 연구)

  • Kim, Young-Jun;Kim, Cheul
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.347-355
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    • 2007
  • The aim of this study was to evaluate the differences of salivary lead (Pb) and cadmium (Cd) concentrations, using ASV analysis, after various pre-treatment procedures. 10 unstimulated whole saliva samples of non-exposed subjects to Pb and Cd were collected. Each sample was divided into 6 aliquots and centrifugation was performed in only 3 aliquots. After centrifugation, 3 different types of pre-treatment procedures were carried out. Also, these pre-treatment procedures were carried out for another 3 aliquots, without centrifugation. Pre-treated aliquots were analyzed electrochemically, by ASV. The results are as follows: 1. Mean concentration of Pb in saliva after centrifugation was significantly higher than that of non-centrifugation. 2. In the detection sensitivity of Pb in saliva, those of simple dilution technique by HCl and acid digestion technique by nitric acid were significantly higher than that of simple dilution technique by electrolyte. 3. Mean concentration of Cd in saliva after centrifugation was significantly higher than that of non-centrifugation. 4. In the detection sensitivity of Cd in saliva, those of simple dilution technique by HCl and acid digestion technique by nitric acid were higher than that of simple dilution technique by electrolyte. But, there were no significant differences between them.

A Study on the Efficacy and Compliance of Oral Appliances according to the Severity of Apnea in the Treatment of Snoring and Obstructive Sleep Apnea (코골이와 폐쇄성수면무호흡증 환자에서 무호흡 심도에 따른 구강내 장치의 치료효과 및 환자의 적응도에 관한 연구)

  • 안홍균;이광호;정성창
    • Journal of Oral Medicine and Pain
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    • v.23 no.4
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    • pp.419-432
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    • 1998
  • The purpose of this Study was to examine the efficacy and compliance of a mandibular advancement device(MAD) according to the severity of sleep apnea in the snorers and obstructive sleep apnea patients. Fifty-four patients (45 males, 9 females, aged 20 - 68years ) who visited Seoul National Uiversity Dental Hospital(SNUDH) to seek for the treatment of snoring and sleep apnea were classified into four groups according to the results of the nocturnal polysomnography and they were instructed to wear MAD regularly which was designed to increase the size of the upper airway by advancing the mandible. The evaluation of the efficacy and compliance of the MAD according to the severity of apnea and the duration after the usage of MAD ( 1week, 1month, 3months, 6months, 12months) was made by using quesionnaires mad in Department of Oral Medicine and Oral diagnosis, SNUDH. The obtained results were as follows : 1. All subjects results were habitual snoreres and 43 patients(79.6%) complained the loudness of snoring that can be heard out of the room. 2. Apnea index(AI) of the total subjects was mean 29.4$\pm$26.9 and respiratory disturbance index(RDI)was mean 37.6$\pm$28.0. And there was nodifference in the efficacy and the compliances of MAD according to the severity of apnea. 3. The severityi of apnea by the questionnaires significantly corresponded with the results of nocturnal polysomnography, and this fact potentiated the diagnostic value of the questionnaire. 4. after the usage of MAD, there was significant improvement in the frequency of snoring, the loudness of snoring, frequency of apnea, daytime sleepiness nad the refreshment after sleep(p<0.001) regardless of the apnea index(AI) and respiratory distrubance index(RDI). 5. The degree of the satisfaction with MAD was mean 74.4$\pm$18.4% and that of the discomfort with the MAD was 31.4$\pm$19.6%. But there was no serious complication in occlusion and temporomandibular joint with the usage of MAD and the duration of the discomfort was mean 3.3$\pm$2.2 weeks. 6. Forty-one patients(75.9%) continued the usage of MAD but thirteen patients(24.1%) stopped the use of MAD because of the discomforts and insufficient results with it.

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A Pilot Study for Thermal Threshold Test of Trigeminal Nerve Injuries (삼차신경손상의 온도역치검사에 대한 예비연구)

  • Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.243-250
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    • 2012
  • Trigeminal nerve injuries due to invasive dental procedures such as implant surgery and extraction is one of the most serious issues in dentistry and may provoke medico-legal problems. Thus, for objective and reliable assessment of nerve injury, a need of QST (quantitative sensory testing) is emphasized and thermal threshold test is an essential part of QST, reported to have acceptable reliability in the orofacial region. This pilot study aimed to evaluate thermal thresholds for limited cases of trigeminal nerve injures. The study investigated 18 clinical cases with trigeminal nerve injuries who visited Department of Oral Medicine, Dankook Univeristy Dental Hospital during the period from May 2011 to Oct 2012. Thermal thresholds was measured by Thermal Sensory Analyzer, TSA-II (Medoc, Israel). Their CDT(cold detection threshold) was significantly decreased in the affected sides compared to the unaffected sides. Other parameters such as WDT(warm detection threshold), CPT(cold pain threshold) and HPT(heat pain threshold) did not show statistical difference between the affected and unaffected sides. Further researches are required to compare thermal thresholds relative to types of nerve deficits such as thermal hyper- or hypoesthesia and hyper- or hypoalgesia for larger sample.