• The Korean Journal of Pain
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• v.11 no.1
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• pp.74-80
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• 1998

Background: Myprodol, a newly introduced combination analgesics with codeine, ibuprofen and paracetamol was evaluated in the dental surgery patients for its efficacy and side effects. Methods: Total 60 ASA I or II outpatients dental surgical patients were randomly assigned into three groups(n=20 each). After various oral procedures, one of three oral analgesics, myprodol, ibuprofen or codeine, was prescribed to each patients in double blind fashion for three days. Each patient was followed carefully by daily phone calls for verbal analog pain scale, side effects and patient's satisfaction level. Results: Demographic data and duration of surgery revealed no statistical differences in all three groups. Myprodol group showed better verbal analgesic scores consistently for the study period than ibuprofen or codeine group. Adverse effects were minimal. Patients' satisfaction level was high in all three groups. Conclusion: We conclude that myprodol is an excellent oral analgesic for day-surgery based dental procedure patients. This effect appears to be synergistic among different analgesics rather than additive.

• Journal of Oral Medicine and Pain
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• v.41 no.2
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• pp.72-75
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• 2016

Lichen planus is a chronic disease characterized by bilateral and multiple lesions on the skin or oral mucosa. Lichen planus is caused by immune mediated degeneration along the border between epithelium and connective tissue. The incidence of oral squamous cell carcinoma in patients diagnosed with oral lichen planus (OLP) is reported to be between 0.4%-5.6% in different studies and the World Health Organization has categorized lichen planus as "a potentially malignant disorder". However, the correlation between OLP and oral cancer still remains controversial as some reported that the reason for increased incidence of squamous cell carcinoma in OLP patient is misdiagnosis of dysplastic lesion as OLP. This report aims to discuss the correlation between OLP and oral cancer through a case of middle aged woman diagnosed with OLP who was successfully treated but developed squamous cell carcinoma 8 years later.

• The Journal of the Korean dental association
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• v.57 no.1
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• pp.18-25
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• 2018

Objectives: This study aimed to compare the postoperative pain and clinical performance after partial pulpotomy by using ProRoot MTA and Endocem MTA. Materials and Methods: Twenty-eight teeth requiring partial pulpotomy due to deep dental caries or traumatic injury were included in this study. After 2mm removal of exposed pulp and bleeding control, the ProRoot MTA or Endocem MTA was randomly adjusted to the exposed site. 1, 2, 4, and 12 weeks after the final restoration, the patients were recalled to check the postoperative pain or another unfavorable signs. Pearson's chi-square test was used for statistical analysis to evaluate any differences among tested materials. Results: 3 of 28 teeth showed postoperative pain and cold positive during follow-up period (10.7%). There were no statistically differences in pain occurrence between two tested materials (P > 0.05). Conclusions: In the limitations of this study, partial pulpotomy by using Endocem MTA showed the advantages of short setting time and lower postoperative pain incidence, allowing one visit treatment.

• Journal of Oral Medicine and Pain
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• v.41 no.4
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• pp.195-199
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• 2016

Central sensitization represents a functional change of second order neuron induced by continuous deep pain input and maintained by psychosocial factors. When afferent neurons are involved with central sensitization, secondary hyperalgesia can appear. Secondary hyperalgesia is an increased sensitivity to stimulation without a local cause. Reports on secondary hyperalgesia to heat stimuli are relatively rare compared to mechanical stimuli. And there were few reports of secondary hyperalgesia to heat stimuli in the oral cavity. We presented a case of secondary hyperalgesia to heat stimuli in the gingival area induced by continuous odontogenic pain with a review of the related literature.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.5
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• pp.253-260
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• 2019

Background: Sometimes general anesthesia is required for dental surgery in pregnant women. Facial bone fractures or neck abscess should be treated immediately. Dental surgery, however, creates a stressful situation that can cause inflammation. Inflammatory responses are a well-known major cause of preterm labor and preterm birth. Here we demonstrate the effects of remifentanil on the factors related to preterm labor and its mechanism of action on amniotic-derived epithelial cells (WISH cells). Methods: WISH cells were exposed to lipopolysaccharide (LPS) for 24 h and co-treated with various concentrations of remifentanil. MTT assays were performed to measure cell viability. To explain the effects of remifentanil on the factors related to inflammation in WISH cells, activation of nuclear factor kappa B ($NF-{\kappa}B$) and p38 and the expression of interleukin $(IL)-1{\beta}$, tumor necrosis factor $(TNF)-{\alpha}$, cyclooxygenase (COX)2, and prostaglandin E $(PGE)_2$ were quantified using western blotting and RT-PCR, respectively. Results: Remifentanil did not affect WISH cell viability. In western blot analysis, co-treatment with remifentanil resulted in decreased phosphorylation of $NF-{\kappa}B$, and expression of COX2 and $PGE_2$ in LPS-induced inflammation, but the results were statistically significant only at low concentrations. Reduction of $IL-1{\beta}$ and $TNF-{\alpha}$ expression was also observed with RT-PCR. Conclusion: Co-treatment with remifentanil does not affect the viability of WISH cells, but reduces the expression of the factors related to inflammation, which can induce uterine contraction and preterm labor. These findings provide evidence that remifentanil may inhibit uterine contraction and preterm labor in clinical settings.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.2
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• pp.91-99
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• 2019

Background: The imbalance between osteoblasts and osteoclasts can lead to pathological conditions such as osteoporosis. It has been reported that opioid adversely affect the skeletal system, but it is inconsistent. Remifentanil is currently used as an adjuvant analgesic drug in general anesthesia and sedation. The aim of the present study was to investigate the effect of remifentanil on the osteoblast differentiation and mechanism involved in this effect. Methods: The C2C12 cells (mouse pluripotent mesenchymal cell line) were used as preosteoblast. Osteoblastic differentiation potency was determined by alkaline phosphatase (ALP) staining. C2C12 cell migration by remifentanil was evaluated using Boyden chamber migration assay. The expression of Runx2 and osterix was evaluated by RT-PCT and western blot analysis to investigate the mechanism involved in remifentanil-mediated osteoblast differentiation. Results: ALP staining showed that remifentanil increased significantly osteoblast differentiation. In Boyden chamber migration assay, C2C12 cell migration was increased by remifentanil. RT-PCR and western blot analysis showed that the expression of Runx2 and osterix was upregulated by remifentanil. Conclusions: We demonstrated that remifentanil increased osteoblast differentiation in vitro by upregulation of Runx2 and osterix expression. Therefore, remifentanil has the potential for assisting with bone formation and bone healing.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.6
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• pp.547-556
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• 2021

Background: This study aimed to determine the efficacy of Physics Forceps in pediatric dental extractions. Methods: This was a double-blind, randomized controlled trial with a parallel-arm design and identical allocation ratio (1:1). Children (n=104) were randomly divided into two groups for extraction of mandibular primary teeth (group I: Physics Forceps; group II: conventional forceps). The outcome variables assessed in the study were the time taken for extraction, pre- and postoperative anxiety (using RMS pictorial scale), incidence of fractured teeth, and postoperative pain on the first and third days (using the Wong-Baker faces pain scale). Results: A significant reduction (P < 0.001) in intraoperative time, anxiety, and incidence of tooth fracture was confined to group I. The pain significantly reduced from the first to the third postoperative day in both groups, but the mean reduction in RMS scores in the physics forceps group was far better than that in the conventional forceps group. Conclusion: Physics Forceps aid in extraction of primary teeth with minimal trauma to supporting structures, as well as reducing anxiety in the pediatric population.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.241-250
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• 2020

Background: Placement of full-coverage restorations such as stainless steel crowns (SSCs) for pulpectomy treated primary molars is essential for successful outcomes. The tooth preparation process for SSCs can cause discomfort to gingival tissues since the crown should be seated 1 mm subgingivally. The purpose of this prospective trial was to compare the effectiveness of subgingival and transmucosal application of topical anesthetics on dental pain during SSC tooth preparation among 6- to 8-year-old children. Methods: A consecutive sample of 27 children, aged 6-8 years, who required an SSC after pulp therapy in primary molars were randomly divided into three groups. Group A received infiltration anesthesia before tooth preparation for SSC placement, whereas in Group B and C, only topical anesthesia was applied subgingivally and transmucosally. Wong-Bakers Faces pain rating scale (WBFPS) scores were recorded after tooth preparation. Faces, Legs, Activity, Cry and Consolability (FLACC) scores were evaluated by two blinded and calibrated investigators through video recordings of the patient during tooth preparation. Data were tabulated, and inter-group comparisons were performed using the Kruskal-Wallis and analysis of variance tests. Results: Out of the 27 participants, 48% were boys and 52% were girls, with an overall mean age of 6.83 years. Group A showed the least pain scores according to both the scales, followed by Group B and Group C. The pain intensity was statistically significant on both the pain scales with P = 0.003 for FLACC and P < 0.001 for WBFPS. Conclusion: Subgingival application of topical anesthesia reduced pain to a certain extent but not as effectively as infiltration anesthesia during SSC tooth preparation in primary molars. Transmucosal application of topical anesthesia did not reduce discomfort when compared to the other two interventions.

• Journal of Korean society of Dental Hygiene
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• v.12 no.3
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• pp.495-501
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• 2012

Objectives : Today, one of the most basically used procedures to dental patients is scaling for removing tartar. The purpose of this study is the effect of Happycaine during scaling for pain relief. Methods : This study was used self-questionnaire from 202 patients. SPSS 18.0 vision program was used for data analysis. Group A was used Happycaine, but group B wasn't used Happycaine. The degree of pain relief depending on use of Happycaine, was analyzed by Independent-two-sample t-test. Emotion and reaction during scaling was analyzed by mean and standard deviation. The results were as follows. Results : 1. 52.5% participants answered 'require scaling' and 12.9% answered 'required scaling very much'. so 65.4% participants recognized the need of scaling. 2. According to the experience of Happycaine during scaling, differences in pain was by Likert 5 pints scale, Group B's pain was higher than Group A's(p=0.000). 3. According to the experience of Happycaine during scaling, the mean of panic from Group B was a little higher than Group A(p=0.036). In case of cold symptom during scaling, Group B was significantly different(p=0.011). In Group B, pain from dental hygienists was significantly different (p=0.000). Group A was interested in Happycaine use in future scaling(p=0.004). Conclusions : As a result of this study, we recommend Happycaine during scaling in order to decrease mental burden and pain for patients.

• Journal of Oral Medicine and Pain
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• v.39 no.3
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• pp.96-99
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• 2014

Purpose: The objective of this retrospective pilot study was to evaluate the effectiveness of Gabapentin in patients with primary burning mouth syndrome (BMS). Methods: Ten subjects were diagnosed with primary BMS (8 women and 2 men). The mean age was 60.1 years. They had clinical examination to exclude local factors such as the presence of Candida species, xerostomia, lichen planus, etc. They also underwent hematological examination to exclude secondary BMS due to systemic disorders. Pain was assessed by patients on an 11-point numerical rating score system (0 to 10). Gabapentin was administered at a starting dose of 300 mg/day, slowly titrated up to maximum of 1,800 mg/day. All patients were treated for 4 weeks. Results: One half of the patients (n=5) obtained reduction in pain over the treatment period. Four patients reported no reduction in pain symptoms. One patient reported that symptoms were worsening. The average pain score before the treatment was 6.3 and after the treatment was 5.25. No significant relationship was detected between pretreatment and posttreatment pain score. Only one patient noted mild side effect (dizziness). Conclusions: This retrospective pilot study provides no preliminary evidence that Gabapentin has effect in the management of BMS. However, further research (well-designed, randomized, and controlled trial with large sample) would be needed to investigate the efficacy of Gabapentin in treatment of BMS.