• Journal of Korean Dental Science
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• 제4권1호
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• pp.14-19
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• 2011

Purpose: The aim of our study was to evaluate natural recovery of neurologic injury after minor dental surgery based on subjective neurologic evaluation. Materials and Methods: From December 2005 through July 2009, 30 patients from Seoul National University Bundang Hospital were identified as having been treated with minor dental surgery. The patients were composed of 12 men and 18 women, with a mean age of 50.6 years. The median duration of this study was 62 weeks. Results: The patients were treated by implants (17 cases), tooth extractions (6 cases), bone grafts (4 cases), inferior alveolar nerve transpositions (2 cases) and periodontal surgery (1 case) prior to the occurrence of altered sensation. Areas of altered sensation after minor surgery included the lip (36.7%), chin (30.0%) and tooth (21.7%), and at final follow-up, there was no change of ranking. Altered sensations expressed by patients included numbness (33.3%), discomfort (22.9%), relieving sense (14.6%), tingling (14.6%) and itching (14.6%). There was no change of ranking of altered sensation at the last follow-up. Patients experienced the altered sensation always (47.8%), during tactile stimulation (26.1%), when chewing food (13.0%), and talking (13.0%). Mean visual analogue scale (VAS) was $3.43{\pm}2.84$ for pain and $6.64{\pm}2.72$ for paresthesia. VAS of pain was decreased significantly between the first visit and the end of follow-up, and paresthesia also showed a significant difference. Conclusion: Altered sensations may occur at any time after minor dental surgery, but we observed that natural recovery of altered sensation occurred as time went on.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권2호
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• pp.95-99
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• 2020

Various dental procedures, such as injection administration, surgical treatment, and endodontic treatment, can cause injury to the nerves. The most commonly injured nerves are the inferior alveolar and lingual nerves. This can manifest as altered sensation to the area of innervation of the injured nerve, such as the lower lip, chin, teeth, tongue, and mucosa. Altered sensations or loss of sensation are relatively infrequent complications in daily dental practice. Here, we report an uncommon case of altered sensation in the midfacial region caused by an endodontic procedure and discuss the need to consider local dental causes in the differential diagnosis of numbness in the facial region.

• Journal of Oral Medicine and Pain
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• 제41권3호
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• pp.118-125
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• 2016

Purpose: The aims of this study were to evaluate the clinical characteristics of patients with altered sensation and/or pain, and to determine outcome predictors affecting persistent neuropathy. Methods: Patients who complained an altered sensation or pain following trigeminal nerve trauma were involved in this study. To determine outcome predictors affecting persistent neuropathy, the patients were divided into two groups; transient vs. persistent, and the clinical phenotypes are compared between groups. Data were analyzed with t-tests, chi-square, and multiple regression analyses with 95% confidence interval and p<0.05 significance level. Results: A total of 111 patients were included: 23 with transient and 88 persistent groups. The panoramic result and pin-prick test score were statistically different between the groups. Radiating symptoms after blunt and pinprick stimuli were also significantly different between groups. The results revealed that the presence of a neurologic lesion in the panoramic view result, reduced sensation in the pinprick test, and radiation in the pinprick test could affect the persistent group. Conclusions: The presence of a neurologic lesion in panoramic view result and reduced sensation and radiating symptoms in the pin prick test would be defining features of one of the main clinical features of persistent neuropathy. These features could serve as outcome predictors diagnosing the permanent nerve injury in trigeminal nerve.

• 대한치과의사협회지
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• 제46권6호
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• pp.384-393
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• 2008

Many dental surgeries including implant surgery, orthognathic surgery etc, have possibility of neurologic injury. As neurosensory dysfunction has no definitive treatment modality and shows slow recovery, patients have discomforts and make the legal conflicts with surgeons. The purpose of this study was to survey the types and subjective evaluation of patients with neurosensory dysfuction after dental surgery. This study included 66 patients with postoperative neurosensory dysfunction who were operated at Seoul National University Bundang Hospital from Dec 2003 to Jun 2007. Male were 28 and female were 38. Age was from 17 to 74 years old. The results of subjective evaluation of neurosensory dysfunction were as followings. 1. The sites of the altered sensation were chin, lip, tooth, tongue and so on. 2. 40.7% of the patients didn't explain accurately about their symptoms. 29.2% of the patients expressed anesthesia and 26.2% mild discomfort. 3. The altered sensation was expressed mostly in touching, mastication and speaking. 52.3% of the patients suggested that their symptoms always existed. 4. Neuropathic pain existed in 44.6% of the patients. 48.3% of the patients suggested that pain was triggered by touching. Neuropathic pain always existed in 41.4% of the patients. 5. Patients showed negative responses on the question that they will take operations which cause the risk of neurosensory dysfunction in the future. The objective and subjective evaluation about the altered sensation after nerve injury nerver coincide. The subjective complaint can affect the result of treatment and daily life negatively.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권3호
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• pp.177-182
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• 2018

Paresthesia is an altered sensation of the skin, manifesting as numbness, partial loss of local sensitivity, burning, or tingling. The inferior alveolar nerve (IAN) is the third branch of the trigeminal nerve and is very important in dental treatment. IAN paresthesia may occur after various dental procedures such as simple anesthetic injections, surgical procedures, and endodontic treatment, and is reported to range from 0.35% to 8.4%. The altered sensation usually follows immediately after the procedure, and reports of late onset of nerve involvement are rare. This report presents a rare case of delayed paresthesia after dental surgery and discusses the pathophysiology of IAN delayed paresthesia.

• 대한인간공학회지
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• 제15권2호
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• pp.71-88
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• 1996

For understanding skin temperature based on clothing design from a viewpoint of comfortable wearing, the skin temperature, physiological reactions(body temperature, blood pressure and pulse) and physilolgical response(thermal sensation, comfort sensation and perceptive sweaty sensation) were measured on condition tha t5 naked healthy male exposed to serveral environmental temperatures,( $20{\pm}1.0^{\circ}C$ ,$28{\pm}1.0^{\circ}C$ and $32{\pm}1.0^{\circ}C$). As the results of this testing, the regional skin temperature was varied for 90min just after expose to those the environment but was generally stabilized for the nest 90min. It was proved the difference of the regional skin temperature at low temperature environmental($20{\pm}1.0^{\circ}C$) was larger than at high temperature environmental($32{\pm}1.0^{\circ}C$) and inder serveral environmental temperature,the degree of the regional skin was not equal. Except in case of the thigh, the front of all regional skin temperature turned out higher than the back of them. According to change of environmental temperature, body temperature and pulse were altered. In the pshycological response, 'thermal sensation-comfort sensation' was felt to 'slightly warm - comfortable' at $28{\pm}1.0^{\circ}C$of the environmental temperature, and 'perceptive sweaty sensation', wneh it was said 'sweat' at only $32{\pm}1.0^{\circ}C$ of it.

• KIEAE Journal
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• 제16권6호
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• pp.135-142
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• 2016

Purpose: The purposes of this paper are to investigate effects of indoor thermal environment on acoustical perception and effects of acoustics on indoor thermal perception, and to understand basic human perception on indoor environment. Method: Subjective assessment was performed in an indoor environmental chamber with 24 university students. Thermal conditions with PMV -1.53, 0.03, 1.53, 1.83 were simulated with a VRF system, a humidifier, a dehumidifier, and a ventilation system. Six noise sources - Cafe, Fan, Traffic, Birds, Music, Water- with sound levels of 45, 50, 55, 60 dBA were played for 2 minutes in random order. Temperature sensation, temperature preference, humidity sensation, humidity preference, noisiness, loudness, annoyance, and acoustic preference were assessed using bipolar visual analogue scales. The ANOVA and Turkey's post hoc test were used for data analysis. Result: Thermal environmental perceptions were not altered through 2 minutes noise exposure. Acoustical perceptions were altered by thermal conditions. The results were consistent with previous papers, however, the noise exposure time should be carefully considered for further development.

• Journal of Oral Medicine and Pain
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• 제46권4호
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• pp.136-142
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• 2021

Purpose: Oral and facial sensation is affected by various factors, including trauma and disease. This study assessed the clinical profile of patients diagnosed with sensory dysfunction and investigated their sensory perception using simple qualitative sensory tests. Methods: Based on a retrospective review of the medical records, we analyzed a total of 68 trigeminal nerve branches associated with sensory dysfunction in 52 subjects. We analyzed the frequency and etiology of sensory dysfunction, and the frequency of different types of sensory perception in response to qualitative sensory testing using tactile and pin-prick stimuli. Results: The inferior alveolar nerve branch was the most frequently involved in sensory dysfunction (88.5%). Third molar extraction (36.5%) and implant surgery (36.5%) were the most frequent etiological factors associated with sensory dysfunction. Hypoesthesia was the most frequent sensory response to tactile stimuli (60.3%). Pin-prick stimuli elicited hyperalgesia, hypoalgesia, and analgesia in 32.4%, 27.9%, and 36.8%, respectively. A significant association was found between the two kinds of stimuli (p=0.260). Conclusions: Sensory dysfunction frequently occurs in the branches of the trigeminal nerve, including the inferior alveolar nerve, mainly due to trauma associated with dental treatment. Simple qualitative sensory testing can be conveniently used to screen sensory dysfunction in patients with altered sensation involving oral and facial regions.

• The Korean Journal of Pain
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• 제37권2호
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• pp.107-118
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• 2024

Nociplastic pain by the "International Association for the Study of Pain" is defined as pain that arises from altered nociception despite no clear evidence of nociceptive or neuropathic pain. Augmented central nervous system pain and sensory processing with altered pain modulation are suggested to be the mechanism of nociplastic pain. Clinical criteria for possible nociplastic pain affecting somatic structures include chronic regional pain and evoked pain hypersensitivity including allodynia with after-sensation. In addition to possible nociplastic pain, clinical criteria for probable nociplastic pain are pain hypersensitivity in the region of pain to non-noxious stimuli and presence of comorbidity such as generalized symptoms with sleep disturbance, fatigue, or cognitive problems with hypersensitivity of special senses. Criteria for definitive nociplastic pain is not determined yet. Eight specific disorders related to central sensitization are suggested to be restless leg syndrome, chronic fatigue syndrome, fibromyalgia, temporomandibular disorder, migraine or tension headache, irritable bowel syndrome, multiple chemical sensitivities, and whiplash injury; non-specific emotional disorders related to central sensitization include anxiety or panic attack and depression. These central sensitization pain syndromes are overlapped to previous functional pain syndromes which are unlike organic pain syndromes and have emotional components. Therefore, nociplastic pain can be understood as chronic altered nociception related to central sensitization including both sensory components with nociceptive and/or neuropathic pain and emotional components. Nociplastic pain may be developed to explain unexplained chronic pain beyond tissue damage or pathology regardless of its origin from nociceptive, neuropathic, emotional, or mixed pain components.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권6호
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• pp.482-487
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• 2004

Aims: This study was designed to determine the incidence of altered sensation in patients undergoing orthognathic surgery. Method: Seventy two patients who underwent orthognathic surgery between January, 1999 and December, 1999 constituted the study group. Seven patients were excluded because of lack of follow up. Sixty five patients were followed using objective and subjective neurologic testing during the period immediately following operation, 1 month, 2 months, 6 months, and 1 year postoperatively. Age ranged from 17 to 38 years, with a mean of 24.5 years. Male patients were 21, female 44. Twenty eight bilateral sagittal splitting ramus osteotomy(BSSRO) of mandible were performed, 35 BSSRO with genioplasty, 2 genioplasties. Information on the degree of intraoperative nerve encounter was obtained from the surgical reports in 47 patients and was divided into the following three categories: (1) the nerve was not encountered in 23 patients; (2) the nerve was exposed in 11 patients; (3) the nerve was exposed and repositioned from the proximal segment in 13 patients. Results: Four patients reported altered nerve sensation of lower lip and/or chin(6.2%) at final follow up. Two patients underwent BSSRO and the other two patients BSSRO with genioplasty. Three of the patients underwent nerve exposure during the operation. Conclusion: We suggest that the nerve exposure during the operation might be partly responsible for nerve dysfunction after orthognathic surgery.