• Title/Summary/Keyword: 통증 양상

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Clinical Characteristics of Headache in Orofacial Pain Patients (구강안면통증 환자에서의 두통 양상의 분류)

  • Kang, Jin-Kyu;Ryu, Ji-Won;Kim, Seong-Taek;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.355-364
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    • 2006
  • Headache is a common disease which influences not only individually but also socially. Temporomandibular disorders(TMD) refers to pain and dysfunction within the temporomandibular joint(TMJ) and associated muscles. TMD is presented commonly, and 70% of population are found to have one or more related symptom. A number of studies have been conducted to verify the association between headache and TMD, and some authors have proposed that headache and TMD may be related. In this study, we studied the patterns of headache presented by the patients who visited the TMJ and Orofacial pain clinic. Among the patients participated in this study, tension type headache showed the highest prevalence(48.5%), followed by migraine without aura(15.0%), probable migraine(10.6%), migraine with aura(7.1%), probable tension type headache(4.8%), and other primary headaches(1.8%). The high prevalence of tension type headache may be due to the accompaniment of orofacial pain by pericranial muscle tenderness. Comparison of sex showed that the rate of migraine was higher in female than male(female to male ratio 35.8:25.3). In age analysis, the rate of migraine was high in the twenties(42.2%) and the thirties(40.0%). As the age increased, the rate of migraine decreased, and this trend was in accordance with the previous studies. The percentage of the patients who had previously received treatment was only 26.2%, and that of those who were aware of the diagnosis was merely 8.7%. Therefore, it is not common for headache patients to get treatment, however, since orofacial pain is often accompanied by headache, more systematic diagnosis as well as precise treatment would be necessary. Moreover, since TMD could induce and aggravate headache, proper evaluation and management of TMD would be essential for diagnosis and treatment of headache. In the future, more systematic and broad investigation on the influence of causative factors of TMD on headache as well as the change in headache pattern with the treatment of TMD would be required.

Nonodontogenic Toothache : Case Reports (비치성 치통의 치험 증례)

  • Yoon, Seung-Hyun;Choi, Jong-Hoon;Kim, Seong-Taek;Ahn, Hyung-Joon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.401-407
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    • 2008
  • The most common type of orofacial pain is toothache. However, many other types of pain which derived from nonodontogenic problems can mimic toothache. Nonodontogenic toothache is heterotopic pain that the site of pain is not in the same location of the source of pain. This differs from primary pain, in which the site of pain is the actual site which the pain originates. Heterotopic pain can be alleviated by direct treatment toward the source of pain. The common sources of nonodontogenic toothache include neuropathic pain, sinus pain, Myofascial pain, neurovascular pain and even cardiac pain and psychogenic pain. Thus, clinicians should have a thorough knowledge about causes of nonodontogenic toothache, and through pain history and examination of dental and nondental structures are needed. This case report is about some cases of nonodontogenic toothache, and it also emphasizes essential considerations for proper differential diagnosis and appropriate treatment.

Follow-up Study of Condylar Bone Changes using Cone Beam Computed Tomography in Patients with Osteoarthritis (측두하악장애 골관절염 환자에서 cone-beam CT를 이용한 관절면의 변화 추적 연구)

  • Ko, Chul-Hee;Kim, Byeong-Soo;Ko, Myung-Yun;Jeong, Sung-Hee;Ok, Soo-Min;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.33-45
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    • 2012
  • This study was designed to assess follow-up study of condylar bone changes using cone beam computed tomography in patients with osteoarthritis. The author performed clinical examination for osteoarthritis patients who visited Orofacial Pain Clinic, Department of Oral Medicine, Pusan National University Hospital. CBCT(Cone beam computed tomography) was taken for 228 joints in 114 subjects. After average 10 months, CBCT was retaken. A Oral medicine and Oral radiologist evaluated CBCT each other. Condyle bone changes were classified by no bone change, flattening, erosion, osteophyte and sclerosis. The obtained results were as follow. 1. The condylar bone changes of osteoarthritis in temporomandibular disorder were as follow: 1) The transitions of each types of condylar bone changes was maintained at the initial state of the majority. 2) The transition of erosion was distributed erosion, flattening, sclreosis, osteohyte in order. 3) The transition of flattening was distributed flattening, osteohyte, normal, sclreosis in order. 4) The transition of osteohyte was distributed osteohyte, erosion, sclreosis, flattening in order. 5) The transition of sclreosis was distributed sclreosis, osteohyte, erosion, normal in order. 2. The signs and symptoms according to transition of each types of condylar bone changes were as follow 1) In the transition of condylar bone changes from erosin to erosion, pain, noise, LOM and MCO had symptomatic improvement. In the transition of condylar bone changes from erosin to flattening, pain, LOM, MCO had symptomatic improvement. In the transition of condylar bone changes from erosin to no bony change, pain, noise, LOM had symptomatic improvement. In the transition of condylar bone changes from erosion to flattening than the maintenance of eosion, MCO had symptomatic improvement. 2) In the transition of condylar bone changes from flattening to flattening, pain, noise and MCO had symptomatic improvement. In the transition of condylar bone changes from flattening to sclerosis, LOM had symptomatic improvement. 3) In the transition of condylar bone changes from osteophyte to osteophyte, pain, LOM and MCO had symptomatic improvement.

Electrophysiological Analysis in Diabetic Patients with Abnormal Sensation and Pain (이상감각과 통증을 호소하는 당뇨병 환자의 전기생리학적 특징 분석)

  • Yang, Jiwon;Lee, Yeong-Bae
    • Science of Emotion and Sensibility
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    • v.19 no.4
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    • pp.111-118
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    • 2016
  • Patients with type 2 diabetes mellitus can complain of abnormal sensation and pain which derived from the peripheral nerve damage. Various words used to be describe abnormal sense and pain, such as sharp, hot, dull, cold, sensitive, and itch. To diagnose diabetic peripheral neuropathy, several screening instruments (Neuropathic Pain Scale, NPS; Michigan Neuropathy Screening Instruments, MNSI) and electrophysiological study can be used. In this study, we aim to analyze and compare the clinical and electrophysiological characteristics of 11 patients with diabetes mellitus and abnormal sense/pain (Disease Group, DG) and 10 patients with diabetes mellitus and normal sense (Control Group, CG). In addition, we aim to reveal correlation between NPS subscore and electrophysiological parameters. As a result, the scores of NPS and MNSI in DG were significantly higher. In nerve conduction study, median motor nerve and peroneal nerve showed significant functional change. Also, median motor nerve, posterior tibial nerve and sural nerve showed negative correlation as NPS subscore increased. These results mean increased pain can be associated with abnormal nerve function. It needs to be further explored for larger size of subjects to get confirmative results.

Evaluation of Temporomandibular Disorders with Tension-Type Headache by Gender (성별에 따른 측두하악장애 환자의 긴장성 두통 양상)

  • Ko, Seok-Ho;Kang, Soo-Kyung;Auh, Q-Schick;Hong, Jung-Pyo;Chun, Yang-Hyun
    • Journal of Oral Medicine and Pain
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    • v.34 no.3
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    • pp.303-316
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    • 2009
  • This study was designed to evaluate the Temporomandibular Disorders(TMD) with Tension-Type Headache(TTH) by gender. Patients with TMD and/or TTH visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study. Experimental group(n=60) is composed of TMD with TTH and control group(n=111) is composed of TMD without TTH. Evaluation list was pain quality, pain intensity, pain laterality, pain increase by routine physical activity and then it was analyzed statistically. The results were as follows ; 1. In the control group, pain quality was significantly different by gender(p=0.04). But, in the experimental group, pain quality was not significantly different by gender. 2. In the control group, pain intensity was not significantly different by gender. And, in the experimental group, pain intensity was not significantly different by gender. 3. In the control group, pain laterality was not significantly different by gender. And, in the experimental group, pain laterality was not significantly different by gender. 4. In the control group, pain increase by routine physical activity was not significantly different by gender. And, in the experimental group, pain increase by routine physical activity was not significantly different by gender. Therefore, it is considered that not temporomandibular disorder patients with tension-type headache but temporomandibular disorder patients without tension-type headache was influenced by gender in the pain quality.

Laryngeal Findings in Childhood without Hoarsenss as a Chief Complaints (애성이 주증상이 아닌 소아환자에서 후두질환의 소견)

  • 안철민;김현호;김희규;조진규
    • Proceedings of the KSLP Conference
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    • 1996.11a
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    • pp.80-80
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    • 1996
  • 음성은 일상생활에서 표현과 대화의 중요한 수단으로 쓰이는 것으로, 자기 표현이 어려운 영유아나 소아에서는 통증이나 배고픔, 불편함 등을 울음소리로서 표현하기도 한다. 이러한 음성을 이용한 말은 성장과정에서 주변으로부터 듣고 이를 흉내냄으로써 자기 나름대로의 독특한 음성양상을 갖게되는 것이고, 어린 시절 잘못된 발성습관은 후일 성인에서의 잘못된 발성양상으로 지속적인 음성질환을 나타낼 수 있을 것이다. 그러나 이러한 소아에서는 후두 검사가 어렵고, 또 음성변화가 왔을 때 후두의 악성질환이 드물며 보통 저절로 잘 치유되리라는 생각에 진단과 치료가 늦어지는 경우가 흔히 있게된다. (중략)

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Interaction between Pain Aspect and Sleep Quality in Patients with Temporomandibular Disorder (측두하악장애 환자에서의 통증양상과 수면과의 관계)

  • Tae, Il-Ho;Kim, Seong-Taek;Ahn, Hyung-Joon;Kwon, Jeong-Seung;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.33 no.2
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    • pp.205-218
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    • 2008
  • Interaction between pain and sleep has long been proved through many researches, and various studies are being conducted to identify its mechanism. However, these studies have targeted on patients with systemic disease, such as rheumatic disease and fibromyalgia. There are few researches on patients with orofacial pain including temporomandibular disorder(TMD). In this study, we studied interaction between pain aspect and sleep quality in 229 patients with TMD, who visited the TMJ and Orofacial pain clinic. Pittsburgh Sleep Quality Index(PSQI), Epworth sleepiness scale(ESS) questionnaire were surveyed and sleep-screening device was operated. PSQI showed that sleep quality in TMD patients with pain was poorer than that in TMD patients without pain. The ratio of poor sleeper was higher in TMD patients with pain. Especially, TMD patients with chronic pain showed obviously poorer sleep quality than TMD patients with acute pain. The result of ESS showed that patients with painful TMD showed more daytime sleepiness than painless TMD patients. The ratio of TMD patients with chronic pain who had daytime sleepiness was higher than TMD patients with acute pain, and the amount of daytime sleepiness was higher in the group of chronic pain. In TMD patients with chronic pain, only the poor sleeper(PSQI>5) presented mean ESS>10(diagnostic criteria of daytime sleepiness). There was no correlation between pain intensity and sleep quality or daytime sleepiness. The result of ApnealinkTM for screening of sleep related breathing disorder showed that only 1 patient presented AHI>5 among 19 participants. TMD patients with chronic pain presented poor sleep quality and excessive daytime sleepiness similar to other chronic pain patients. Evaluation of sleep state by questionnaire might be useful for diagnosis and management of TMD, because sleep disturbance decreases pain threshold and pain disturbs sleep. In addition, sleep-screening device would be useful for screening sleep related breathing disorder in dental clinic.

Clinical characteristics of sleep bruxism patients with idiopathic facial pain (특발성 안면 통증 환자에서 수면 이갈이의 임상적 특징)

  • Myung, Yangho;Seo, Jeong-Il;Kim, Bok Eum;Kim, Young Gun;Kim, Seong Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.2
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    • pp.81-87
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    • 2021
  • Purpose: To profile various clinical characteristics of sleep bruxism (SB) patients with idiopathic facial pain (IFP) in the orofacial region. Materials and Methods: We analyzed 28 SB patients among 210 patients with IFP complaints. The profiles were evaluated using patient charts including gender, age, pain duration, pain location, pain intensity and affected areas by pain. Results: SB with IFP occurred more often in females (85.7%) than males (14.3%). The mean age at presentation was 48.9 years. The most common IFP sites of SB patients were the right maxilla (28.6%) and the right mandible (25.0%). The pain complaints occurred mostly in 2 teeth or areas (50.0%), followed by 1 area (28.6%) and then in ≥ 3 teeth or areas (21.4%). The mean pain intensity was 5.9 on a visual analogue scale from 0 to 10. The pain was spontaneous in 20 patients (71.4%), and the mean pain duration was 24.4 months. Conclusion: Identification of clinical characteristics of SB patients with IFP could be useful in the diagnosis of various IFP patients and beneficial in decreasing unnecessary care to reduce IFP. Further studies with larger number of subjects and extended duration are required for more systemized diagnostic methods and development of future treatment guidelines.

Pain Recovery Pattern According to the Integrity after an Arthroscopic Rotator Cuff Repair (관절경하 회전근 개 봉합술 후 파열 정도에 따른 통증 회복 양상)

  • Kim, Ju-O;Sim, Sang-Don;Noh, Kyung-Hwan;Shon, Suk-June;Kim, Sul-Jun;Yang, Yun-Hyeok
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.155-160
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    • 2009
  • Purpose: The purpose of this study was to evaluate the pain recovery pattern according to the integrity and to analyze the factors affecting the progress and level of pain postoperatively. Materials and Methods: We examined 153 patients, who were treated with arthroscopic rotator cuff repair. 101 rotator cuff tears were full-thickness tear and 52 were partial tear. The mean follow up duration was 20 months (12~30 months). We evaluated the visual analogue scale, range of motion, ASES (American Shoulder and Elbow Surgeons), and UCLA (University of California at Los Angeles) scores preoperatively and postoperatively. We analyzed the pain recovery pattern between partial and full thickness tear using Student T-test and the factors affecting the progress and level of postoperative pain using multiple regression analysis. Results: The change patterns of visual analogue scale after arthroscpoic repair were similar regardless of the tear integrity. The VAS showed a continuous decreasing pattern, but increased at first 3 weeks postoperatively and at 7 weeks postoperatively, and then, decreased thereafter. The average VAS was ${\leqq}2$ points by postoperative 3 months. The factor affecting the pain score at 3 months was related to the preoperative limitation in forward flexion ($r^2=0.377$, p=0.021). Conclusion: There was no differences of the pain recovery pattern according to the integrity, and the factor affecting the progress of postoperative pain was preoperative angle of forward elevation. So, the appropriate preoperative rehabilitation protocol that can improve motions of the shoulder joint would help to improve the level of postoperative pain and functional recovery.

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