• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.6
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• pp.347-355
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• 2023

Background: Eye movement desensitization and reprocessing (EMDR) therapy has been reported to be very efficacious for treating post-traumatic stress disorder (PTSD) and other anxiety-related conditions. However, a review of the literature reveals the sparse use of this therapy in the field of pediatric dentistry. This study aimed to evaluate anxiety trends in pediatric dental patients during local anesthesia and extraction with and without EMDR therapy. Methods: Children in the age range of 8-12 years who required dental extractions were assigned randomly into two groups: an EMDR group (group 1) and a routine behavior management therapy group (group 2; receiving more traditional interventions such as tender love and care behavioral modeling, and distraction). Anxiety scores were recorded at four levels using the visual facial anxiety scale (VFAS) preoperatively, after therapy, after the administration of local anesthesia (LA), and after extraction. Results: Reduced anxiety was observed after the delivery of EMDR therapy, after LA administration, and post-extraction in the EMDR group compared to pre-operative anxiety scores of anxiety (P < 0.001; unpaired Student's t and Mann-Whitney U tests). In the control group, mild reductions in anxiety after routine behavior management therapy were observed, accompanied by spikes in anxiety levels after LA and extractions. Conclusion: EMDR therapy was found to be valuable for reducing anxiety among pediatric dental patients during tooth extraction procedures.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.233-240
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• 2020

Background: Palatal injection of local anesthetics is the most painful injection. To obviate the need for palatal injections, local anesthetic agents with diffusibility are being investigated. Hence the present study was designed to analyze the anesthetic efficacy of 2% lidocaine hydrochloride (HCl) with 1:100,000 adrenaline and 4% articaine hydrochloride (HCl) with 1:100,000 adrenaline using single buccal infiltration for the extraction of maxillary premolars. Methods: A prospective, double-blind, crossover, randomized clinical study was performed on 60 consecutive systemically healthy patients with an age range of 15-30 years, requiring extraction of asymptomatic bilateral maxillary premolars for orthodontic purposes. They received 1ml buccal infiltration of 4% articaine HCl with 1:100,000 adrenaline on one side and 2% lidocaine HCl with 1:100,000 adrenaline on the other side. The extraction procedure on either side was scheduled 14 days apart. Parameters assessed were the time of onset of anesthesia, intraoperative discomfort, hemodynamic parameters, and the duration of analgesia. Analysis of the data was done using the Mann-Whitney test, the Wilcoxon test, the Kruskal-Wallis ANOVA test, and the chi-square test. Statistical significance was established at P < 0.05. Results: Articaine showed a faster time of onset and longer duration of analgesia than lidocaine. However, the difference in the intraoperative discomfort and hemodynamic parameters was statistically insignificant. Conclusion: Within the limitations of the study, it can be concluded that the extraction of maxillary premolars can be performed with a single buccal infiltration of 2% lidocaine HCl with 1:100,000 adrenaline, which is one of the most commonly used local anesthetic agent.

• Journal of Dental Rehabilitation and Applied Science
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• v.16 no.2
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• pp.93-104
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• 2000

Orthodontic treatment in conjunction with second-molar extraction has been a controversial issue among orthodontists over many decades. The aim of this study was to investigate the treatment effects of upper second molar extraction cases. The sample included 19 upper second molar extraction orthodontic cases(ten Angle's Class I's and nine Class II's, average age=13Y 6M) cared at Kyung-Hee University Department of Orthodontics. Lateral cephalometric radiographs were taken before and immediately after treatment. Seventy-nine points were digitized on each cephalogram and 38 cephalometric parameters were computed comprising 22 angular measurements, 13 linear measurements, and 3 facial proportions. The data obtained from each malocclusion group were analyzed by paired t-test. The statistical results disclosed that there was no significant change in skeletal pattern after treatment except for that accountable by growth while there was statistically significant change in dentoalveolar and soft tissue patterns. There were no significant changes in Bjork sum, posterior facial height /anterior facial height and lower anterior facial height /anterior facial height. No significant changes in anteroposterior position of maxilla and palatal plane were manifested. Although facial axis and lower facial height was slightly increased and the mandible was rotated backward and downward, there was no remarkable change in the mandibular plane. There were statistically significant changes in distal movement of upper first molar, molar key correction and overjet reduction while there was no change in the occlusal plane. The upper lip was slightly retracted simultaneously with slight increase in nasolabial angle. These results signify that distalization of upper dentition with the second molar extraction does change occlusal relationship without gross modifications in the craniofacial skeletal configurationson. Henceforth the second molar extracted would be recommended to treat severe anterior crowding and protrusion with minor skeletal discrepancy.

• Journal of Korean Dental Science
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• v.9 no.2
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• pp.69-73
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• 2016

Clinicians must be able to recognize post-extraction complications and treat them in a timely manner; complications that may potentially be life-threatening require special attention. Although arteriovenous malformation (AVM) is a very rare disorder, it may induce life-threatening hemorrhage during surgical intervention in the pertinent site. The present article examines the diagnosis and treatment modalities of AVM based on the case of a patient who was diagnosed with AVM with continuous bleeding after tooth extraction and who was successfully treated.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.5
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• pp.287-294
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• 2018

Mandibular third molar extraction is commonly performed in dental clinics. However, the optimal method of anesthesia has not been established for this procedure. The conventional inferior alveolar nerve block is the most widely used method. However, its success rate is not high and it may lead to complications, such as aspiration and nerve injury. Therefore, various anesthesia methods are being investigated. Articaine has been proven to be efficacious in a number of studies and is being used with increasing frequency in clinical practice. In this review article, we will briefly review various local anesthesia techniques, anesthetics, and a computer-controlled local anesthetic delivery (CCLAD) system, which reduces pain by controlling the speed of drug injection, for mandibular third molar extraction.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.117-126
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• 1995

In order to evaluate objectively the level of tension and relaxation in dental practices, the author used Biotrainer(BF-102R), one of the GSR biofeedback apparatus, to examine 119 dental outpatients on their changes of GSR due to infection, preparation, extraction and readjustment. The obtained results were as follows : 1. There were no differences in the baseline GSR between the control group and the patient groups. 2. Changes in GSR by practices were significantly larger than the baseline GSR. 3. GSR in female was larger than that in male 4. While the GSR after injection, preparation and extraction revealed lower level, the GSR after readjustment revealed higher level. 5. Most of subjects just after injection, preparation and extraction were more frequent in decrease of GSR and those just after readjustment more were frequent n increase of GSR. 6. Type 1,2(increase in skin resistance) showed greater in injection, preparation and extraction group, while type 3(decrease in skin resistance) did in readjustment group.

• Journal of Korean Dental Science
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• v.7 no.1
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• pp.25-30
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• 2014

Subcutaneous emphysema and pneumomediastinum is a relatively uncommon phenomenon. It may occur secondary to dental treatment using high-speed air turbine handpieces, especially after extraction of tooth. Subcutaneous emphysema is often limited only to the areas of head and neck, but also can involve deeper structures. Thorough examination and conservative treatment of these problems are essential in preventing life-threatening complications such as airway obstruction and mediastinitis. The subject of this report is a 57-year-old woman with subcutaneous emphysema and pneumomediastinum during the extraction of maxillary third molar using high-speed air turbine handpiece. If there isn't any appropriate measure, severe complications may occur. Therefore it is important to be well-informed of proper diagnosis and treatment. This article shall present a case report with literature review.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.2
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• pp.109-113
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• 2003

The inferior alveolar nerve provides unilateral innervation to the dentition, labial mucosa and skin from about commissure to the mental protuberance. Injury to this nerve resulting in sensory impairment can be a distressing problem to some patients. The causes of this problem include trauma, extraction, implant surgery and any maxillofacial surgery and generally the altered sensation is temporary. The surgical procedure has been the most common treatment for this condition but it has some complications. The antidepressants and anticonvulsants have been effective to the treatment of trigeminal dysesthesia. This case report suggests that the use of antidepressants and anticonvulsants is an alternative method to treat the paresthesia after implant surgery or extraction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.5
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• pp.281-283
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• 2015

Extraction of an impacted third molar is one of the most frequently performed techniques in oral and maxillofacial surgery. Surgeons can suffer numerous external injuries while extracting a tooth, with percutaneous injuries to the hand being the most commonly reported. In this article, we present a case involving a percutaneous injury of the surgeon's femoral region caused by breakage of the fissure bur connected to the handpiece during extraction of the third molar. We also propose precautions to prevent such injuries and steps to be undertaken when they occur.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.1
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• pp.49-57
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• 2020

Objectives: This study aimed to understand the nationwide patterns of antibiotic prescription after tooth extraction in adult patients. Materials and Methods: This study analyzed dental records from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) database on 503,725 tooth extractions performed in adults (≥19 years) during 2011-2015. Patient sex, age, household income, systemic disease (diabetes mellitus and hypertension), type of dental institution, region of dental institution, year of prescription, and type of tooth extraction procedure were considered. The antibiotic prescription rate and broad-spectrum antibiotic prescription frequency were analyzed using chi-squared tests. Factors affecting the prescription of broad-spectrum antibiotics were evaluated using multivariate logistic regression analysis. Results: The rate of antibiotic prescription after tooth extraction was 81.85%. Penicillin was most commonly prescribed (45.25%), followed by penicillin with beta-lactamase inhibitors (18.76%), metronidazole (12.29%), and second- to fourth-generation cephalosporins (11.52%). The proportion of broad-spectrum antibiotics used among all prescribed antibiotics was 45.88%. Conclusion: The findings of this study demonstrate that the rate of antibiotic prescription after tooth extraction is higher in Korea than in other countries. Furthermore, broad-spectrum antibiotics are used more frequently, which may indicate unnecessary drug prescription, an important contributor to antibiotic resistance.