• Title/Summary/Keyword: 구강점막

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Case Report : Treatment of Burning mouth Syndrome Using a Removable Anti-Nociceptive Appliance (가철성 유해자극차단장치를 이용한 구강작열감증후군의 치료 증례)

  • Roh, Byung-Yoon;Ahn, Jong-Mo;Yoon, Chang-Lyuk;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.1-7
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    • 2012
  • Burning mouth syndrome(BMS) refers to a chronic orofacial pain disorder usually unaccompanied by mucosal lesions or other clinical signs. Tongue(anterior and lateral border) is found to be the most common site for the burning sensations in the oral cavity, and various oral sites may be affected including hard palate and lips. The etiology of this disorder remains poorly understood, but the various factors might be related with the pathogenesis of the BMS. These factors have been devided into local, systemic and psychological. Recently, there have been increasing reports that the pain of BMS may be neuropathic in origin. The complex and multifactorial etiology of BMS necessitates multidisciplinary approach for the management of these patients. Recently, several studies have reported that oral parafunctional habits could be related the pathogenesis of BMS, and tried to control the symptom of BMS with various methods. We reported the cases who had the symptom of burning mouth syndrome with removable anti-nociceptive appliance in the lower dentition.

Clinical Features Affecting the Efficacy of Systemic Clonazepam for Management of Burning Mouth Syndrome (구강작열감증후군의 치료를 위한 전신적 클로나제팜의 투여 시 환자의 임상적 특징에 따른 효능의 차이에 관한 연구)

  • Min, Bo-Kyong;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.37 no.3
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    • pp.161-167
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    • 2012
  • Burning mouth syndrome(BMS) is defined as chronic, painful burning sensation in the oral mucosa. Treatments for BMS include medication and psychiatric interventions. Capsaicin, alpha-lipoic acid, and topical and systemic clonazepam showed more effective in reducing the symptoms of BMS in the previous studies. The purpose of this study is to evaluate of the therapeutic efficacy of systemic clonazepam in BMS and to elucidate the relationships between such a efficacy and various clinical features, including age, pain intensity, pain duration, previous dental history and condition of oral mucosa. A retrospective clinical records audit was performed of patients diagnosed with BMS between January 2011 and August 2012. Patients were prescribed 0.5 mg clonazepam two times daily. Pain was assessed by patients on an 11-point numeric rating scale (NRS; 0 to 10) before and 1-2 weeks after systemic administration of clonazepam. The efficacy of clonazepam was evaluated in terms of patient's age, initial pain intensity, pain duration, presence or absence of precipitating event, condition of the tongue, presence or absence of denture. A total of 50 patients (46 women, 4 men) were included in this study. The patients were divided into two or three groups according to above clinical features. The amount of mean NRS reduction in patients with severe initial pain was $3.33{\pm}2.74$, whereas that in patients with mild initial pain was $1.64{\pm}1.54$. The amount of mean NRS reduction in oldest patients was $3.53{\pm}1.94$ (${\geq}$70yrs), and those in another younger patients were $2.88{\pm}1.80$(< 60yrs) and $1.54{\pm}2.86$(60yrs ${\leq}$ age < 70yrs), respectively. It was concluded that the older patients and the patients with higher intensity of initial pain tend to show better efficacy of clonazepam. However, There were no statistically significant differences according to pain duration, presence or absence of precipitating events, tongue fissuring, and wearing dentures.

The Killing Effect of Candida albicans on Hairless Mouse-2 Mouse Tissues by Non-Thermal Atmospheric Pressure Plasma (저온 상압플라즈마에 의한 Hairless Mouse-2 마우스 조직의 Candida albicans 사멸 효과)

  • Park, Sang-Rye;Kim, Gyoo-Cheon
    • Journal of dental hygiene science
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    • v.14 no.1
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    • pp.1-6
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    • 2014
  • The purpose of this study was to investigate the killing effect of Candida albicans on hairless mouse-2 (HRM-2) mouse tissues. We tested the effectiveness of a non-thermal atmospheric pressure plasma in killing C. albicans strains. The viability of C. albicans was determined by counting the colony forming units (CFU), after non-thermal atmospheric pressure plasma treatment. When non-thermal atmospheric pressure plasma was repeatedly treated on mouse skin which inoculated with C. albicans. The C. albicans cells were planted on skin tissue, and then the infected mouse tissue was exposed to non-thermal atmospheric pressure plasma for 0 sec, 60 sec, 180 sec and 300 sec. The death rate of C. albicans was increased in dependent with treatment times. The three times of non-thermal atmospheric pressure plasma at the interval of 10 minutes significantly showed the 6 log CFU/ml reduction of death rate on HRM-2 mouse tissues. Thus, non-thermal atmospheric pressure plasma could be used for the disinfection of C. albicans on oral surface.

The Diagnosis and Treatment of Bruxism (이갈이의 진단 및 치료)

  • Jeong-Seung, Kwon;Jung, Da-Woon;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.1
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    • pp.87-101
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    • 2012
  • Bruxism is extensively defined as a diurnal or nocturnal parafunctional habit of tooth clenching or grinding. The etiology of bruxism may be categorized as central factors or peripheral factors and according to previous research results, central factors are assumed to be the main cause. Bruxism may cause tooth attrition, cervical abfraction, masseter hypertrophy, masseter or temporalis muscle pain, temporomandibular joint arthralgia, trismus, tooth or restoration fracture, pulpitis, trauma from occlusion and clenching in particularly may cause linea alba, buccal mucosa or tongue ridging. An oral appliance, electromyogram or polysomnogram is used as a tool for diagnosis and the American Sleep Disorders Association has proposed a clinical criteria. However the exact etiology of bruxism is yet controversial and the selection of treatment should be done with caution. When the rate of bruxism is moderate or greater and is accompanied with clinical symptoms and signs, treatment such as control of dangerous factors, use of an oral appliance, botulinum toxin injection, pharmacologic therapy and biofeedback therapy may be considered. So far, oral appliance treatment is known to be the most rational choice for bruxism treatment. For patients in need of esthetic correction of hypertrophic masseters, as well as bruxism treatment, botulinum toxin injection may be a choice.

The Relationship between Pain Perception Scale and Keratinization Rate of Oral Mucosa to Nd-YAG Laser Stimulation in Burning Mouth Syndrome Patients (구강작열감 증후군 환자에서 Nd-YAG 레이저 조사에 대한 구강점막 부위의 통증 인지도와 점막세포 각화도와의 관계)

  • Kim, Ji-Yeon;Kim, Byung-Gook;Chung, Sung-Su
    • Journal of Oral Medicine and Pain
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    • v.26 no.2
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    • pp.161-171
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    • 2001
  • In order to determine how oral mucosal change relates to inducing factors of burning mouth syndrome, the difference in pain perception scale and keratinization rate between burning mouth syndrome patients and normal subjects were investigated. Twenty patients (13 female, 7 male, mean age: 59 years), presenting in the Department of Oral Medicine, Chonnam National University Hospital were participated in this study. All subjects had been complaining of constant oral burning pain for more than a year, none took any strong analgesics, and none had oral mucosal lesions. Twenty volunteers (11 females, 9 males, mean age: 25 years) were also participated in this study as a control group. The control subjects had never had any symptoms of oral burning pain. A thermal stimulation using a Nd-YAG laser and cytological smear were carried out to anterodorsal part of tongue, tip of tongue, the left buccal mucosa, the lower lip mucosa and the chief complaint site. Stimulation of the dorsum of left hand was also carried out to contrast the mucosal area of burning mouth syndrome subjects and the control subjects. The laser output power could be adjusted from 0.75W to 4W. The pain perception scale of the burning mouth syndrome subjects were lower than in control subjects in the chief complaint area, the anterodorsal part of tongue and the buccal mucosa(p<0.01). The keratinization rate of burning mouth syndrome subjects, however, was higher keratinization rate than in normal subjects in the same area and lower lip mucosa(p<0.001). From above results, the anterodorsal part of tongue is the most appropriate site to use diagnostic laser stimulation. The higher level of keratinization and the lower level of thermal pain perception of the burning mouth syndrome subjects are explained as a protective mechanism against xerostomia and burning sensations. The application of Nd-YAG laser stimuli and cytological smear to oral mucosal surface could therefore be usefully employed as appropriate and standardized diagnostic tools for chronic orofacial pain subjects.

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Minimally Invasive Laser-Assisted Biopsy of the Oral Lesions for Oral Graft-Versus-Host Disease after Hematopoietic Stem-Cell Transplantation (조혈줄기세포이식후 발생한 이식편대숙주병의 구강병소에 대한 최소침습적 레이저조직생검 증례)

  • Kim, Yun-Mi;Yun, Hee-Jung;Kim, Hyun-Sil;Kim, Kee-Deog;Jung, Bock-Young;Pang, Nan-Sim;Park, Won-Se
    • Journal of Oral Medicine and Pain
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    • v.37 no.3
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    • pp.147-154
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    • 2012
  • Hematopoietic stem-cell transplantation (HSCT) is a treatment for immune deficiency, autoimmune diseases, and hematopoietic malignancies. The main complication of allogenic HSCT is graft-versus-host disease (GVHD). Oral mucosal biopsy is needed for a definitive diagnosis and treatment planning of GVHD, but this procedure causes bleeding and bacteremia in a poor general condition. We evaluated the efficacy of laser-assisted biopsy as a minimally invasive treatment. Three cases were described in this article. All patients' medical records, clinical photographs, and histopathologic findings were reviewed. All patients felt comfortable and no severe complications occurred. The quality of the obtained biopsy material was adequate for a definitive diagnosis of GVHD. Laser-assisted, minimally invasive biopsy of the oral mucosa does not cause bleeding, and it reduces the chances of infection, bacteremia, and postoperative scarring compared to the usual histopathologic biopsy procedure. It would thus be advantageous to use this procedure to biopsy GVHD patients.

The effect of improperly contoured and poor fitting restorations to patient with oral lichen planus: periodontal and prosthetic treatment (구강 내 불량한 보철물 수복이 편평태선에 미치는 영향에 대한 치주, 보철적 접근)

  • Shin, Jin-Beom;Cho, Jin-Hyun;Lee, Cheong-Hee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.4
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    • pp.371-377
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    • 2015
  • Oral lichen planus (OLP) is a common mucocutaneous disease, which presents as bilateral or multiple lesions. The several factors are implicated in etiology of OLP such as dental restorations, systemic disease, drugs and stress. Especially the influence of dental restorations and plaque control for OLP has been the interest in dentistry. This case is about OLP patient having poor contoured and ill-fitting metal ceramic restorations. The patient in this study has suffered from OLP for a long time, particularly after restoration of metal ceramic restorations on both posterior teeth of maxilla and mandible. This study reported that OLP lesion recovered effectively by improving the contour and fitness of restorations with plaque control.

Incidence and Factors Influencing Oral Mucositis in Patients with Hematopoietic Stem Cell Transplantation (조혈모세포이식 환자의 구강 점막염 발생실태와 영향요인)

  • Jo, Kwan Suk;Kim, Nam Cho
    • Journal of Korean Academy of Nursing
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    • v.44 no.5
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    • pp.542-551
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    • 2014
  • Purpose: This study was done to examine the incidence of oral mucositis in hematopoietic stem cell transplantation patients and to identify factors influencing oral mucositis and patient outcomes according to severity. Methods: In this retrospective study, data were collected from electronic medical records of 222 patients who had received hematopoietic stem cell transplantation. Oral mucositis was evaluated using WHO's assessment scale. Data were analyzed using Chi-square test, Fisher exact test, Spearman's correlation, Ordinal logistic regression, ANOVA and Kruskal-Wallis test. Results: A total of 69.8% of the patients evaluated developed oral mucositis (grade II and over). As a results of ordinal regression, factors influencing oral mucositis severity were found to be diagnosis, type of transplantation, oxygen inhalation and the number of antiemetics administration before transplantation. The severity of oral mucositis was found to increase the days of hospitalization, days of TPN administration, days of using antibiotics and the number and dosage of analgesics. Conclusion: The results would help predict severity of oral mucositis in hematopoietic stem cell transplantation patients and suggest that provision of appropriate nursing assessment and oral care would improve patient outcomes.

Three Cases of Erythema Multiforme Developed during Deflazacort Therapy in Children with Nephrotic Syndrome (소아 신증후군 환자에서 데플라자코트 치료 중 발생된 다형 홍반 3례)

  • Lee, Seung Jin;Kang, Bong Hwa;Cho, Min Hyun
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.123-127
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    • 2014
  • Erythema multiforme (EM) is an acute mucocutaneous disorder involving the skin, mouth, eyes, and genital organs. It is classified into EM minor and EM major according to the involvement of the mucosal membrane. Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN) belong to EM major. Compared to EM minor, SJS presents with more severe and progressive symptoms, and has a higher mortality rate. Corticosteroids are used in the treatment of EM. We report three cases of EM (two cases of EM minor and one case of SJS) that developed during treatment with oral corticosteroid (deflazacort; $Calcort^{(R)}$) in children with nephrotic syndrome.

Review about effects of sleep disturbances on Burning mouth syndrome (수면장애가 구강작열감 증후군에 미치는 영향에 대한 고찰)

  • Lim, Hyun-Dae;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.38 no.4
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    • pp.313-318
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    • 2013
  • The aim of this study was to the relationship between sleep disturbances and Burning mouth syndrome(BMS). BMS presents as a chronic burning sensation in the oral mucous membrane that is frequently associated with sleep disturbances. BMS is considered neuropathic pain condition with dysfunction of small diameter afferent sensory fiber. A review of the studies reveals, BMS suggested peripheral and cental nervous system changes. Sleep disruption or Rem sleep deprivation cause an inhibition of opioid protein synthesis and a reduced affinity of ${\mu}$ and ${\delta}$ opioid receptors. Let me say that sleep disturbances suggest a risk factor For BMS and support to evaluate as a part of BMS treatment. Further study will be required to ascertain the relationship between distruption of sleep continuity or Rem sleep deprivation and BMS and the evidence of altered neurochemical degeneration of BMS.