• Journal of the korean academy of Pediatric Dentistry
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• v.21 no.2
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• pp.439-455
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• 1994

The purpose of this study was to investigate the distribution of nerves in the periodontal ligament of a dog's primary teeth by each developing stage. The distribution of nerves in the periodontal ligament were investigated by means of immunohistochemistry for detection of neurofilament protein (NFP). The results were as follows: The NFP-immunoreactive nerve fibers were found to be densely distributed in the apical third of the periodontal ligament, while they were sparse in the coronal two third, in both primary and permanent teeth. In generally the density of distribution and degree of arborization of nerve fibers in periodontal ligament of primary teeth revealed a poor appearance compared with that of permanent teeth. Periodontal ligament in anterior teeth showed more abundant nerve innervation than posterior teeth, and the periodontal ligament of the bifurcation area in posterior teeth roots were not observed to have nerve fiber. The density of nerve distribution in the periodontal ligament of primary teeth was reduced according to the physiological root resorption and nerve fibers were not observed in the surrounding area on the root of the exfoliation stage in primary teeth. The distribution of nerve fibers in mucogingival tissue, was poor innervated according to the aging of the dogs. A more abundant distribution of nerve fiber was represented in the lingual mucogingival tissue than in the labial side. Most of the nerve endings in the periodontal ligament of primary teeth showed a tree-like appearance. However, the typical Ruffini-like nerve endings were not observed.

• Imaging Science in Dentistry
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• v.42 no.3
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• pp.121-127
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• 2012

Purpose: This study evaluated the association between cone beam computed tomography (CBCT) and panoramic radiographs in the assessment of a superimposed relationship between the mandibular canal and impacted third molars. Materials and Methods: The study samples consisted of 175 impacted third molars from 131 patients who showed a superimposed relationship between the mandibular canal and third molars on panoramic radiographs and were referred for the examination of the mandibular canal with CBCT. Panoramic images were evaluated for the darkening of the root and the interruption of the mandibular canal wall. CBCT images were used to assess the buccolingual position of the mandibular canal relative to the third molar, the proximity of the roots to the canal, and lingual cortical bone loss. The association of the panoramic and CBCT findings was examined using a Chi-square test and Fisher's exact test. Results: Panoramic radiographic signs were statistically associated with CBCT findings (P<0.01). In cases of darkening roots, lingual cortical bone loss or buccally positioned canals were more frequent. In cases in which the mandibular canal wall was interrupted on panoramic radiographs, contact or lingually positioned canals were more frequent. Conclusion: The results of this study suggest that contact between the mandibular third molar and canal and a lingually positioned canal could be more frequently observed in cases of the interruption of the white line of the mandibular canal and that there could be more lingual cortical loss in cases of darkening roots.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.327-336
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• 2011

Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.179-186
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• 2020

This systematic review aims to determine if a single buccal infiltration (without palatal infiltration in the maxilla and Inferior Alveolar Nerve Block in the mandible) with 4% articaine can induce adequate analgesia for the extraction of primary molars (Maxillary and Mandibular) in children. PubMed, Ovid SP, and Embase were searched for studies published between January 1990 and March 2020 with the relevant MeSH terms. Titles and abstracts were screened preliminarily, followed by the full-texts of the included studies. Five articles were included for this systematic review. The outcome investigated was "Procedural pain during the extraction of primary molars after injection with single buccal infiltration of 4% articaine in comparison to single buccal infiltration, double infiltration (buccal and palatal/lingual), and inferior alveolar nerve block with 2% lignocaine." Of the five studies that evaluated subjective pain during extraction, two reported no significant difference between the articaine and lignocaine groups, and the remaining three reported lower subjective pain during extraction in the articaine group. Only two studies evaluated objective pain scores during extraction, and both studies reported lower pain scores in the articaine group. There is insufficient evidence to justify the statement that a single buccal infiltration of 4% articaine alone is sufficient for the extraction of primary molars. Further evidence is required to justify the claim that palatal infiltrations and IANB can be replaced with the use of 4% articaine single buccal infiltration for the extraction of primary molars in children.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.2
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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 Dental Anesthesia and Pain Medicine
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• v.19 no.2
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• pp.115-118
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• 2019

This case report aims to review complications that can occur during arthrocentesis and report an unusual complication observed in a 55-year-old man. The patient received arthrocentesis in an attempt to treat painful locking episodes of his right temporomandibular joint (TMJ). One hour after the operation, the patient experienced temporary facial paralysis in the area of the facial nerve and anesthesia of the lingual and alveolar inferior nerves. No persistent complications were detected during the postoperative follow-up. We suspected this complication occurred after anesthetic solution overflowed from a traumatic perforation in the joint capsule to the infratemporal area during the operation. To our knowledge, this complication has not been previously reported in the literature.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.145-149
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• 2009

Sturge-Weber Syndrome is a rare congenital disorder and is characterized by port wine nevus following one or more divisions of trigeminal nerve, ocular involvement(eg, glaucoma) and neurologic involvement(eg, epilepsy, mental retardation). Oral menifestations include unilateral blood vessel expansion of the oral mucosa and gingiva, gingival hyperplasia, giant tooth, ipsilateral large tongue, blood vessel anomaly of maxilla or mandible and abnormal eruption sequence. This case report is about 8-year-old Sturge-Weber Syndrome patient presented violet discoloration on upper gingiva and buccal mucosa, gingival hyperplasia and abnormal eruption sequence. In this case, we performed lingual frenectomy and periodic oral hygiene management, and obtained satisfactory result.

• Imaging Science in Dentistry
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• v.37 no.3
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• pp.133-138
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• 2007

Purpose: The purpose of this study was to evaluate the morphologic features of posterior edentulous mandible for Korean patients using cross-sectional CT images. Materials and Methods: Computed tomographic cross-sectional views taken in 2004 and 2005 at Seoul National University Dental Hospital were analyzed by an oral and maxillofacial radiologist. Four indices were measured to meet the purpose of this study: 1) the horizontal distance between the alveolar crest and mandibular canal (Type), 2) the angle of the mandibular long axis (Angle), 3) the bucco-lingual location of mandibular canal, and 4) the depth of the submandibular fossa. The averages and standard deviations of the measurements were compared according to the location (the first and second molar area) and sex of the patients. Results: Statistically significant difference was found in Type, Angle, and submandibular fossa depth between the first and second molar area (p<0.05). However, there was no significant difference between men and women in any of the measured indices. Most of the mandibular canals were located in lingual side of posterior mandible. Conclusion: More care should be taken when an implant is installed on the mandibular second molar area.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.6
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• pp.566-574
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• 2006

Purpose : This study was performed to provide an anatomical information of the mandibular ramus for the successful inferior alveolar nerve block. Three dimensional images were reconstructed from the computerized tomography (CT) and the anatomical evaluation of the mandibular ramus was done. Materials and methods : Sixty-four patients who had been taken the facial CT scans from 2000, Jan to 2003, June was selected. The patients who had the anterior or posterior teeth misssing, edentulous ridge, and jaw fracture were excepted. In the occulusal plane, the lingual surface angle (LSA) between the mid-sagittal plane and the mandibular molar lingual surface from the 2nd premolar to the 2nd molar, the inner ramal surface angle (IRSA), the maximum inner ramal surface angle (MxIRSA), and the outer ramal surface angle (ORSA) to the-mid sagittal plane were measured. The inner ramal surface angle in the ligular tip level (IRSA-L) and the outer ramal surface angle in the ligular tip level (ORSA-L), the ramal length (RL), and the anterior ramal length (ARL) were also measured in the lingular tip level. Results : In the lingular tip level, the mean IRSA-L and ORSA-L were $28.6{\pm}6.3^{\circ}$ and $17.9{\pm}4.9^{\circ}$ respectively. The larger was the IRSA, the larger was the ORSA. In the lingular tip level, the mean ramal length was 35.8${\pm}$3.4 mm. The larger was the IRSA-L, the shorter was the ramal length. On the lingular tip level, the mean anterior ramal length from anterior ramus to lingular tip was 19.6${\pm}$3.3 mm. when the ramal length was longer, the anterior ramal length was also longer. On the lingular tip level, there was positive correlation vetween the IRSA and the ORSA, negative correlation between the IRSA and the ramal length, and positive correlation between the ramal length and the lingular tip level to the anterior ramus. There was no statistical meaning of data between sex and age. Conclusion : In the clinical view of the results so far achieved, if the direction of needle is closer to posterior it is able to contact bone on lingular tip when the internal surface of ramus is wided outer.

• The Journal of Advanced Prosthodontics
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• v.16 no.4
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• pp.212-220
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• 2024

PURPOSE. This cone-beam computed tomography (CBCT) study aimed to analyze the anatomical characteristics of alveolar bone at mandibular first molar (MFM) and their implications for immediate implant placement surgery. MATERIALS AND METHODS. 100 patients with 140 MFMs were reviewed retrospectively. We first performed a 3D reconstruction of the patient's CBCT data to determine a reference plane with ideal implant placement and orientation. The following parameters of MFM region were analyzed: mesial-distal socket size (MDSS), buccal-lingual socket size (BL-SS), root furcation fornix to inferior alveolar nerve (IAN) distance (RF-I), interradicular bone thickness (IRB), mesial/distal root apex to the IAN distance (MRA-I/DRA-I), thickness of the buccal/lingual bone of the mesial root (MR-B/MR-L), thickness of the buccal/lingual bone of the distal root (DR-B/DR-L). RESULTS. The MD-SS of MFM was 8.74 ± 0.76 mm, and the BLSS was 8.26 ± 0.72 mm. The MR-B, DR-B was 1.01 ± 0.40 mm and 1.14 ± 0.50 mm, and the difference was statistically significant (P = .001). The values of the MR-L, DR-L were 2.71 ± 0.78 mm and 3.09 ± 0.73 mm, and the difference was also statistically significant (P < .001). The mean distance of RF-I was 15.68 ± 2.13 mm, and the MRA-I was 7.06 ± 2.22 mm, which was greater than that of DRA-I (6.48 ± 2.30 mm, P < .001). The IRB at 2 mm, 4 mm apical from the furcation fornix, and at apex level was 2.81 ± 0.50 mm, 3.30 ± 0.62 mm, and 4.44 ± 1.02 mm, respectively. CONCLUSION. There is relatively sufficient bone mass in interradicular bone in height, but an adequate width is lacking for the bone between the mesial and distal root after the extraction of the MFM for immediate implantation. The thickness of the MFM buccal bone is relative thin, especially for the mesial root.