• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.5
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• pp.335-340
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• 2020

Objectives: This study sought to evaluate the efficacy of injecting botulinum toxin into the masseter and temporal muscles in patients with temporomandibular myofascial pain and sleep bruxism. Materials and Methods: The study was conducted based on a clinical record review of 44 patients (36 females and eight males; mean age, 35.70±12.66 years). Patients who underwent the injection of botulinum toxin into the masseter and temporal muscles for the management of temporomandibular myofascial pain and sleep bruxism were included in the study. Patients were diagnosed based on the Diagnostic Criteria for Temporomandibular Disorders. Sleep bruxism was diagnosed according to the criteria defined by the American Academy of Sleep Medicine. The values of the visual analogue scale (VAS) and range of jaw motion, including unassisted maximum mouth opening (MMO), protrusion, and right and left laterotrusion, were observed preoperatively and postoperatively at one-, three-, and six-month follow-up visits. Results: MMO, movements of the right and the left laterotrusion, and protrusion increased significantly (P<0.05), while VAS ratings decreased significantly at the three follow-up points relative to baseline values (P<0.05). Conclusion: Botulinum toxin is an effective treatment for patients with temporomandibular myofascial pain and sleep bruxism.

• Journal of Oral Medicine and Pain
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• v.46 no.1
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• pp.9-13
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• 2021

Herpes zoster is caused by reactivation and multiplication of a latent varicella-zoster virus infection. Reactivation can frequently occur in older adults and immunosuppressed individuals. It is hypothesized that this is related to an aging society and a corresponding increase in the number of people with underlying chronic diseases, such as cancer and diabetes, that lower immunity. Clinically, the patient complains of pain, and a vesicular rash presents on one side of the face up to the midline in the dermatomes associated with the affected ganglion. Herpes zoster of the oral mucosa is rare. When oral lesions do occur, they are most often concurrent with pathognomonic unilateral linear vesicular skin lesions, facilitating both clinical diagnosis and management of the condition. Cases limited to the oral mucous membrane alone are most unusual. Treatment includes antiviral agents and analgesics for pain control. Antivirals should be administered within 72 hours of onset. Early diagnosis and treatment are important to avoid complications, such as postherpetic neuralgia. The present case report describes the adequate management of a patient diagnosed with shingles which affected the right side of the face and oral cavity. In addition, a literature review is presented.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.2
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• pp.87-98
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• 2020

The aim of this study was to determine the efficacy of oral splints in reducing the intensity of pain in patients with temporomandibular joint dysfunction in both short and long-term treatment durations. Electronic databases, Cochrane Library, MEDLINE via PubMed, Web of Science, Egyptian Knowledge Bank, and EMBASE were searched for randomized controlled trials comparing different types of splints to non-occluding splints, behavioral therapy, pharmacotherapy, counseling, and no treatment. The risk of bias was assessed by using Cochrane risk of bias recommendations. Fixed and random effects were used to summarize the outcomes. The effect estimates were expressed as standardized mean differences (SMD) or risk ratios with a 95% confidence interval (CI). Subgroup analyses were carried out according to the treatment duration. Twenty-two studies met the inclusion criteria. A meta-analysis of short-term studies up to three months revealed no significant difference between the study groups. However, long-term studies exhibited a significant difference in pain reduction in favor of the control group. Total analysis revealed that the control group resulted in significant pain reduction (SMD 0.14, 95% CI 0.05-0.23, P=0.002, I²=0%). Oral splints are not effective in reducing pain intensity or improving function in patients with temporomandibular joint dysfunction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.6
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• pp.556-559
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• 2001

The aim of the present study was to evaluate the influences of epinephrine and pain on the changes of blood pressure and pulse rates in mandibular 3rd molar extraction. A total of 80 patients(aged between 10 and 30) without systemically compromised conditions were selected and divided into two groups(I, II). 2% lidocaine with 1:100,000 epinephrine was administered in group I (male 20, female 20), and 2% lidocaine without epinephrine was administered in group II (male 20, female 20). Systolic blood pressure and pulse rates were checked by a digital monitor during the pre-local anesthesia state(stage 1), 5 minute later in the post-local anesthesia state(stage 2), the extraction state(during odontectomy, stage 3), and during the post-suture state(stage 4). The measurement of pain perceived by patients was made using a three-point visual analog scale. The results suggest that local anesthetic with epinephrine is better at decreasing pain preventing the severe elevation of systolic blood pressure than local anesthetic without epinephrine. However, these results should be confirmed by additional studies on cardiac patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.6
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• pp.379-388
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• 2019

Background: In dentistry, pain is a factor that negatively affects treatments and drug use. The aim of this study was to evaluate the correlations of the postoperative analgesic use with pain catastrophizing and anxiety in patients who underwent removal of an impacted mandibular third molar. Methods: We recruited 92 patients who underwent the extraction of impacted mandibular third molar. In this study, the Pederson index was used to preoperatively determine the difficulty of surgical extraction. Patients were asked to note the number of analgesics used for 7 postoperative days. Patients were divided into two groups based on the Pain Catastrophizing Scale: low and high score groups. State-Trait Anxiety Inventory-trait and State-Trait Anxiety Inventory-state questionnaires were used to determine the anxiety levels of the patients. The obtained data were examined to evaluate the correlations of pain catastrophizing and anxiety with the postoperative analgesic use. Results: In this study, 92 patients, including 60 women and 32 men, were recruited. The analgesic use was higher in women than in men but with no significant difference (P > 0.05). Pain Catastrophizing Scale scores were higher in women than in men but with no significant difference (P > 0.05). The analgesic use was higher in patients with high pain catastrophizing than in those with low pain catastrophizing but with no significant difference (P > 0.05). State-Trait Anxiety Inventory-trait scores were higher in women than in men but with no significant difference. However, state-Trait Anxiety Inventory-state scores were significantly higher in women than in men (P < 0.05). Conclusion: The postoperative analgesic use may be higher in patients who catastrophize pain than in others. Knowing the patient's catastrophic characteristics preoperatively would contribute to successful pain management and appropriate drug selection.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.2
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• pp.121-127
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• 2017

Background: There are no studies regarding 4% articaine infiltration injection into the retro-molar area for an impacted lower third molar (LITM) surgery. This study aimed to evaluate the efficacy of infiltration using 1.7 ml (single cartridge: SC) of 4% articaine versus 3.4 ml (double cartridges: DC) of 4% articaine with 1:100,000 epinephrine in LITM surgery. Method: This study involved 30 healthy patients with symmetrical LITM. The patients were assigned to receive either a DC or SC of 4% articaine with 1:100,000 epinephrine as a local anesthetic for each operation. Onset, duration, profoundness, need for additional anesthetic administration, total volume of anesthetic used, vitality of the tooth, and pain score during operation were recorded. Results: The DC of 4 % articaine had a significantly higher success rate (83.3%) than did the SC (53.3%; P<0.05). The duration of soft tissue anesthesia was longer in the DC group. The intra-operative pain was higher in the SC group with a significant (P < 0.05) requirement for a supplementary local anesthetic. Conclusion: We concluded that using DC for the infiltration injection had a higher success rate, longer duration of anesthesia, less intra-operative pain, and a lower amount of additional anesthesia than SC in the surgical removal of LITM. We recommend that a DC of 4% articaine and a 1:100,000 epinephrine infiltration in the retro-molar region can be an alternative anesthetic for LITM surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.4
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• pp.375-380
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• 2007

The purpose of this study is to understand anxiety in patients undergoing third molar extraction and care patients of third molar extraction. The subjects in the study were Sixty-three patients who visited the department of dentistry at Pusan Paik Hospital from May 2006 to September 2006 and who underwent third molar extraction. Patients' anxiety(state anxiety and trait anxiety) to use Spielberger's state-trait anxiety inventory(STAI) were measured. They were asked to fill out STAI question paper immediately before third molar extraction(pre-extraction) and on the day after the extraction(post-extraction). And visual analog scale(VAS) to measure patient's postoperative pain on the day after extraction(postextraction day) was used. Then Differences in anxiety before and after extraction, between men and women, between the first and second extraction, with impacted versus non impacted third molar extraction, between extraction time and anxiety, and between postoperative pain and anxiety were evaluated. The anxiety status of patients undergoing third molar extraction could be quantitatively evaluated using the STAI-KYZ. There were significant difference before and after third molar extraction. Especially women and patients of more severe postoperative pain was more anxious. We need to alleviate patient's anxiety(especially women) and to control postoperative pain throughout the tooth removal process.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.395-400
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• 1999

Elongation of the styloid process (styloid syndrome, Eagle's Syndrome) is named after Eagle who insisted the styloid process as a cause of pain but distinguishable from the glossopharyngeal neuralgia. Eagle's syndrome is characterized by a dull nagging pharyngeal pain, a palpable hardness in the tonsillar fossa, radiopaque elongation and enlargement of the syloid process. This is to report two cases of Eagle's Syndrome. The clinical and radiological features, development and pathogenesis of the Eagle's Syndrome and pathologic findings of the calcified styloid ligaments were described with review of literatures. The external cervical approach to resect the enlarged calcified processes can be an option due to better visualization and accessbility, less infection at risk than intra-oral approach. The findings and results were as follows ; 1. The calcified styloid ligaments accompanied with throat pain were reseded in size of $5.5{\times}48mm(#1,\;Rt)$, $3.6{\times}5mm(#1,\;Lt)$, $5.2{\times}51mm(#2,\;Rt)$ and $3.1{\times}38mm(#2,\;Lt)$. 2. The submandibular approach to resect the calcified styloid process is of help to get better visibility and accessiblilty avoiding the injury to the deep cervial vital structures. 3. The resected styloid processes were examined histopathologically as the matured cortical bones with marrow structures or cartilagenous cells without any findings of neoplasmic changes. 4. The remained process did not show any noticeable regrowth in 3 years after surgical amputation.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.3
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• pp.137-146
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• 2020

Background: Mandibular third molar removal is the most common surgical procedure encountered in oral and maxillofacial clinics. It also presents the greatest challenges and controversies for surgeons when surgical removal is considered. Furthermore, diverse anesthesia results and success rates are achieved after using the same concentrations of different solutions or the same amounts of local anesthetics. The purpose of this study was to examine the efficiency of using double-cartridge (3.4 ml) 4% lidocaine (high concentration) and 4% articaine with a 1:100000 epinephrine infiltration in the retromolar region for impacted lower third molar surgery. Methods: This double-blind study included 30 patients with symmetrically impacted lower third molars. The patients were randomly selected to receive 4% articaine on one side and 4% lidocaine on the other, as a local anesthetic for third molar surgery. The onset, duration of soft-tissue numbness, pulpal sensitivity, amount of additional local anesthetic needed, pain score during the surgical procedure, and duration of the operation were recorded. Results: The results of this research indicate that 86.7% of the operations in the 4% articaine group and 83.3% of those in the 4% lidocaine group were successful. Furthermore, the outcomes in both groups were not statistically significant (P > 0.05). Numbness onset occurred faster in the articaine group than it did in the lidocaine group. However, the duration of soft-tissue anesthesia and pain scores recorded immediately postoperatively were similar. Conclusion: It is concluded that 4% lidocaine and 4% articaine had a similar infiltration efficacy in the retromolar region and both local anesthetics are adequate for impacted lower third molar surgery. There were no statistically significant differences between the two local anesthetics regarding pain control and the duration of soft-tissue numbness during the procedure.

• Journal of Oral Medicine and Pain
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• v.45 no.1
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• pp.17-21
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• 2020

Osteomyelitis of the jaw infected with Coagulase-Negative Staphylococci (CNS) is rarely reported in the Oral and Maxillofacial Region. Staphylococcus is a part of the normal body flora, but it may be cause severe infections and CNS are often described as the important pathogens in nosocomial infections. Although many studies on prevalence and antibiotics of Staphylococcus aureus have been done, but many of these studies focus only on Methicillin-resistant S. aureus and not on methicillin-resistant coagulase-negative Staphylococci (MRCNS). There was a less study about CNS or MRCNS infections in the Oral and Maxillofacial Region. This report describes a case of a 41-year-old male patient who developed osteomyelitis caused by MRCNS on condyle after open reduction and internal fixation and suggests guideline for the prevention of postoperative infection and appropriate recommendation for treatment and control.