• 대한치과마취과학회지
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• 제6권2호
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• pp.98-102
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• 2006

The purpose of this study was to evaluate the difference on pain intensity and discomfort between pressure-controlled injection system and conventional syringe injection technique from the patients undergoing oral and maxillofacial surgery. In a prospective, randomized, case-controlled study, 60 patients were divided into two groups (n=30 in each). In experimental group, pressure-controlled injection system was applied. In control group, conventional syringe injection system was applied. Pain rating score (PRS) and visual analogue scale (VAS) were assessed. The average of VAS in experimental group ($16.67{\pm}15.07$) was smaller than that of control group ($25.63{\pm}22.21$), though there were no significant differences (P=0.072). In PRS, fifteen patients (50.0%) of experimental group answered that they experienced mild pain. However sixteen patients (53.3%) of control group answered that they experienced intermediate pain. From the results, pressure-controlled injection system may be an effective method to reduce pain during the dental local anesthetic procedure.

• Journal of Oral Medicine and Pain
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• 제47권3호
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• pp.126-134
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• 2022

Purpose: This study aimed to propose an efficient treatment approach for infection with different candida species. Methods: Fifty-three patients who presented with a chief complaint of oral mucosal pain and exhibited positive candida culture findings were divided into two groups (Candida albicans and non-albicans). Pain, mucosal manifestations, salivary flow rates, durations of disease and treatment, and responses to treatment (nystatin and clonazepam) were investigated in both groups. Results: Patients in the C. albicans group exhibited more prominent clinical characteristics (erythematous lesions, tongue coatings, and hyperalgesia) than those in the non-albicans group. In total, 70% of patients in the non-albicans group showed no abnormalities in the oral mucosa. Patients in the C. albicans group showed increased resistance to nystatin treatment compared to those in the non-albicans group, especially with longer disease durations. The patients resistant to nystatin treatment showed positive responses to clonazepam. Conclusions: Patients with oral mucosal pain should be tested for the presence of Candida, even in the absence of mucosal abnormalities, especially those infected with non-albicans species. If no response to antifungal therapy is observed, treatment with clonazepam should be initiated, especially in patients infected with C. albicans.

• Journal of Oral Medicine and Pain
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• 제47권1호
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• pp.67-71
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• 2022

Subchondral cysts are frequently encountered in patients with temporomandibular joint osteoarthritis (TMJ OA), particularly in advanced stage. Subchondral cysts within osteoarthritis are typically lying adjacent to the joint surface where initial load bearing occurs during activity and have been associated with greater pain and disease progression. Although the etiology of these cysts remains uncertain, recently studies report that the induction of the subchondral bone mechanical stress caused subchondral cysts. Repeated overloading leads to further deterioration of subchondral bone which render subchondral bone structure more fragile, increase the risk of osteoarthritis progress. The purpose of this study was to assess the effect of conservative treatment and longitudinal osseous changes of a large subchondral cyst in a mandibular condyle in a symptomatic TMJ OA patient.

• 대한치과의사협회지
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• 제58권6호
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• pp.354-363
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• 2020

Patients often seek consultation with dentists for their temporomandibular disorders (TMD), especially for pain. Acute pains refer to pains that are of short duration. Common acute TMD are arthralgia and local myalgia. Diagnosis should be made based on careful history taking and clinical examination. Most acute TMD are well controlled by education, cognitive awareness training, and conservative treatment. The aggressive and irreversible treatments should not be applied. Acute TMD should be controlled in the early phase so as not to be proceed to chronic pain.

• 구강생물연구
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• 제42권4호
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• pp.269-271
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• 2018

Ankylosing spondylitis (AS) is a chronic inflammatory joint disorder characterized by sacroiliitis, spondylitis and enthesitis. Patients suffering from AS may also have extra-articular symptoms, such as uveitis, bowl disease, heart, lung, skin, bone and kidney involvement, but vary widely in severity and prevalence. Facial manifestation of AS include eye involvement and temporomandibular joint involvement. In this study, a case of an AS that mimicked dental pain was presented.

• Journal of Oral Medicine and Pain
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• 제47권3호
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• pp.161-166
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• 2022

Oral lichen planus (OLP) is a chronic oral mucosal disease affecting the buccal cheek, tongue, palate, lip, and gingival mucosa. Lesions in the gingiva make it difficult to control dental plaque due to pain. As a result, the disease is often accompanied by gingivitis or periodontitis. If OLP and dental plaque are not properly managed, the patient's periodontal condition will worsen. Thus, clinicians treating OLP should emphasize periodic visits and dental plaque control. Here, we report the management of a patient who struggled with OLP for 20 years and discuss the importance of periodic regular observations and active periodontal management.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권4호
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• pp.221-227
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• 2015

Background: Endotracheal intubation induces clinically adverse cardiovascular changes. Various pharmacological strategies for controlling these responses have been suggested with opioids being widely administered. In this study, the optimal effect-site concentration (Ce) of remifentanil for minimizing hemodynamic responses to fiberoptic nasotracheal intubation was evaluated. Methods: Thirty patients, aged 18-63 years, scheduled for elective surgery were included. Anesthesia was induced with a propofol and remifentanil infusion via target-controlled infusion (TCI). Remifentanil infusion was initiated at 3.0 ng/mL, and the response of each patient determined the Ce of remifentanil for the next patient by the Dixon up-and-down method at an interval of 0.5 ng/mL. Rocuronium was administered after propofol and remifentanil reached their preset Ce; 90 seconds later fiberoptic nasotracheal intubation was initiated. Non-invasive blood pressure and heart rate (HR) were measured at pre-induction, the time Ce was reached, immediately before and after intubation, and at 1 and 3 minutes after intubation. The up-and-down criteria comprised a 20% change in mean blood pressure and HR between just prior to intubation and 1 minute after intubation. Results: The median effective effect-site concentration ($EC_{50}$) of remifentanil was $3.11{\pm}0.38ng/mL$ by the Dixon's up-and-down method. From the probit analysis, the $EC_{50}$ of remifentanil was 3.43 ng/mL (95% confidence interval, 2.90-4.06 ng/mL). In PAVA, the EC50 and EC95 of remifentanil were 3.57 ng/mL (95% CI, 2.95-3.89) and 4.35 ng/mL (95% CI, 3.93-4.45). No remifentanil-related complications were observed. Conclusions: The $EC_{50}$ of remifentanil for minimizing the cardiovascular changes and side effects associated with fiberoptic nasotracheal intubation was 3.11-3.43 ng/mL during propofol TCI anesthesia with a Ce of 4 ug/mL.

• The Journal of Korean Physical Therapy
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• 제31권5호
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• pp.304-310
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• 2019

Purpose: This study examined the work-related musculoskeletal pain and quality of life of hospital workers. Methods: Self-reported questionnaires were sent to 350 hospital workers at Seoul and Gyeonggi-do, of which 341 were returned. The questionnaire had four items that covered the demographic information, areas of musculoskeletal problems, pain rating scale, and quality of life. The analysis was completed using descriptive statistic, and the differences between pain and demographic variables were identified using a chi-square test. The differences between the type of occupation and quality of life were analyzed by one-way analysis of variance and a Kruskal-Wallis test. Results: The 12-month prevalence of work-related musculoskeletal pain was 86.1% of physical therapists, 86.5% of occupational therapists, 77.1% of dental hygienists, and 75.8% of nurses. A significant difference in the general and work related variables was observed between the subject with a physical burden and type of occupation. The most affected pain sites of the physical therapist included low back, hand and wrist, shoulder, and neck. The occupational therapists included the hand and wrist, shoulder, neck, but the nurses and dental hygienists reported the shoulder, back, hand and wrist. A significant difference in the quality of life was noted between the subjects in physical therapists and dental hygienists and the subjects in the nurses and occupational therapists (p=0.00). Conclusion: These findings show that hospital workers appear to be high risk for work-related musculoskeletal pain, and the quality of life of physical therapists and nurses was higher than that of dental hygienists and occupational therapists.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권3호
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• pp.157-160
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• 2015

A patient with squamous cell carcinoma on the left mandible presented with symptoms similar to acute coronary syndrome just after surgery. The exact etiology was unclear, but following transthoracic echocardiogram, takotsubo cardiomyopathy was diagnosed. This is a rare, acute, and reversible form of heart failure, and the patient recovered completely within weeks. Related risk factors are believed to include extended surgery times and extended time under general anesthesia. Early recognition, followed by postoperative control of pain and anxiety are crucial to patient recovery.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권2호
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• pp.89-93
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• 2020

We experienced an unusual case of accelerated junctional rhythm with severe hypotension after infiltration of lidocaine containing epinephrine during dental surgery under general anesthesia. The patient's electrocardiogram exhibited retrograde P-waves following the QRS complex, which could be misinterpreted as ST-segment depression. As a temporary measure, administration of ephedrine restored the patient's blood pressure to normal levels. The importance of this case lies in its demonstration of an unexpected and serious side effect of commonly used epinephrine infiltration. This case also highlights the need for accurate interpretation of the electrocardiogram and comprehensive understanding of best practices for patient management.