• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.42.1-42.15
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• 2019

Botulinum toxin (BTX) is used in various ways such as temporarily resolving muscular problems in musculoskeletal temporomandibular disorders, inducing a decrease in bruxism through a change in muscular patterns in a patient's bruxism, and solving problems in patients with tension headache. And also, BTX is widely used in cosmetic applications for the treatment of facial wrinkles after local injection, but conditions such as temporomandibular joint disorders, headache, and neuropathic facial pain could be treated with this drug. In this report, we will discuss the clinical use of BTX for facial wrinkle, intraoral ulcer, and cranio-maxillofacial pain with previous studies and share our case.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.4
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• pp.253-263
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• 2017

Regardless of whether it is acute or chronic, the assessment of pain should be simple and practical. Since the intensity of pain is thought to be one of the primary factors that determine its effect on a human's overall function and sense, there are many scales to assess pain. The aim of the current article was to review pain intensity scales that are commonly used in dental and oral and maxillofacial surgery (OMFS). Previous studies demonstrated that multidimensional scales, such as the McGill Pain Questionnaire, Short form of the McGill Pain Questionnaire, and Wisconsin Brief Pain Questionnaire were suitable for assessing chronic pain, while unidimensional scales, like the Visual Analogue Scales (VAS), Verbal descriptor scale, Verbal rating scale, Numerical rating Scale, Faces Pain Scale, Wong-Baker Faces Pain Rating Scale (WBS), and Full Cup Test, were used to evaluate acute pain. The WBS is widely used to assess pain in children and elderly because other scales are often difficult to understand, which could consequently lead to an overestimation of the pain intensity. In dental or OMFS research, the use of the VAS is more common because it is more reliable, valid, sensitive, and appropriate. However, some researchers use NRS to evaluate OMFS pain in adults because this scale is easier to use than VAS and yields relatively similar pain scores. This review only assessed pain scales used for post-operative OMFS or dental pain.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.5
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• pp.281-291
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• 2020

Background: Corticosteroids have been widely used by oral surgeons for reducing swelling caused by wisdom teeth surgery. However, they have not been proven to decrease pain. This study was aimed at analyzing previous studies pertaining to corticosteroids and pain reduction following wisdom teeth surgery. Methods: The Science Direct, PubMed, and MEDLINE databases were searched for relevant journals according to a systematic search strategy (Patient Intervention Comparison Outcome Study). Randomized controlled trials published in English from 1998 to 2017 were extracted. Results: Twenty-seven articles were included, with a total of 36 comparative cases. Methylprednisolone and dexamethasone were the most commonly used corticosteroids. Intramuscular injections of corticosteroids were optimal for pain reduction, regardless of the time of administration. Conclusions: Corticosteroids can be used as an adjuvant for pain reduction following wisdom teeth surgery. Methylprednisolone and dexamethasone delivered via the intramuscular route is the best method for effective pain reduction. The ideal time for administration of corticosteroids is the preoperative period.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.1
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• pp.15-19
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• 2021

Objectives: The aim of this study was to evaluate correlations between anxiety and preoperative pressure pain assessments and postoperative pain and analgesic requirements in impacted lower third molar tooth surgery. Materials and Methods: This prospective study enrolled 60 patients who underwent impacted lower third molar surgery. The preoperative State-Trait Anxiety Inventory-I (STAI-I), pressure pain threshold, and pressure pain tolerance scores were measured. At 2, 4, 6, 12, and 24 hours, and at 6 days following surgery, the patients scored their pain on the visual analogue scale and recorded their analgesic drug usage. The data were evaluated, and the results were statistically analyzed. Results: Of the 60 patients, 38 were female. Mean age was 24.62±7.42 years. The study found no relationship between preoperative pressure pain assessments and postoperative pain (P>0.05). There was also no relationship observed between preoperative STAI-I scores and postoperative pain (P>0.05). However, there was a positive correlation between operation time and total medication taken (P<0.05). Conclusion: Preoperative pressure pain threshold, pressure pain tolerance, and anxiety level had no significant effects on postoperative pain and analgesic requirements in impacted lower third molar surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.2
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• pp.143-149
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• 2004

Background: Some clinical trials have reported that a new analgesic combination of tramadol and acetaminophen provides good efficacy in various pain models. For the more clinical uses of this agent, comparisons about the onset of analgesia and analgesic efficacy in the acute state of pain with the other drugs known as strong analgesics were needed. Purpose: The goal of this study was to compare the times to onset of analgesia and the other analgesic efficacy of 75 mg tramadol/650 mg acetaminophen and 20 mg codeine/500 mg acetaminophen/400 mg ibuprofen in the treatment of acute pain after oral surgery. Patients and Methods: Using a randomized, single-dose, parallel-group, single-center, and active-controlled test design, this clinical study compared the times to onset of analgesia using a two-stopwatch technique and the other analgesic efficacy of the single-dose tramadol/acetaminophen and codeine/acetaminophen/ibuprofen. These were assessed in 128 healthy subjects with pain from oral surgical procedures involving extraction of one or more impacted third molars requiring bone removal. From the time of pain development, the times to onset of perceptible and meaningful pain relief, pain intensity, pain relief, an overall assessment, and adverse events of the study medications were recorded for 6 hours. Results: The demographic distribution and baseline pain data in the two groups were statistically similar. The median times to onset of perceptible pain relief were 21.0 and 24.4 minutes in the tramadol/acetaminophen and codeine/acetaminophen/ibuprofen groups respectively and those to onset of meaningful pain relief were 56.4 and 57.3 minutes, which were statistically similar. The other efficacy variables such as mean total pain relief (TOTPAR) and the sum of pain intensity differences (SPID) were also similar in the early period after pain development and drug dosing. The safety of tramadol/acetaminophen was well tolerated and very comparable to that of codeine/acetaminophen/ibuprofen. Conclusions: In this acute dental pain model, the onset of analgesia and analgesic efficacy of tramadol/acetaminophen was comparable to that of codeine/acetaminophen/ibuprofen. These results showed that tramadol/acetaminophen was recommendable for fast and effective treatment in the management of postoperative acute pain.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.3
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• pp.135-141
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• 2019

Background: The fear of needle insertion and pain during anesthesia is a source of patient dissatisfaction in dentistry. Inferior alveolar nerve block (IANB) remains the most common type of block and is in itself painful. Computer-controlled local anesthetic delivery (CCLAD) has been proven to reduce the pain associated with injection of anesthetics in various blocks. However, the efficacy of CCLAD for IANB in adults remains unknown. Methods: Sixty-four adult patients requiring bilateral IANB were selected and divided into two groups: group A (50 patients receiving IANB via CCLAD) and group B (50 patients receiving IANB using a conventional cartridge syringe). Pain perception and patient comfort were assessed using the visual analog scale and the 5-point semantic scale, respectively. Results: The pain perception was compared between the two groups using the Mann-Whitney U-test, and the P value was 0.003. The patient comfort was also compared using the same test, and the P value was 0.484. Conclusion: A significant difference was observed in the pain perception of the patients during CCLAD. The patient comfort was grossly equal for both techniques.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.3
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• pp.159-165
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• 2019

Background: Dental procedures commonly involve the injection of local anesthetic agents, which causes apprehension in patients. The objective of dental practice is to provide painless treatment to the patient. The purpose of this study was to evaluate the effect of Low Level Laser Therapy (LLLT) in reducing the pain due to local anesthetic injection. Materials and Methods: A prospective, split-mouth study was conducted on 25 patients. In Condition A, LLLT was administered followed by the administration of a standard local anesthetic agent. Patients' perception of pain with use of LLLT was assessed based on a Visual Analogue Scale (VAS). In Condition B, LLLT was directed to the mucosa but not activated, followed by the administration of local anesthesia. VAS was used to assess the pain level without the use of LLLT. Results: Comparison between Condition A and Condition B was done. A P value < 0.001 was considered significant, indicating a definite statistical difference between the two conditions. Conclusion: In our study, we observed that LLLT reduced pain during injection of local anesthesia. Further multi-centric studies with a larger sample size and various modifications in the study design are required.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.3
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• pp.260-265
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• 2005

Patient-controlled analgesia (PCA) has been widely used for postoperative pain control in medical surgery parts. Conventional intramuscular analgesia (IMA) is also effective in postoperative pain control, but it has some disadvantages that depend on patients' perception of pain and the anxiety that they endure caused by the delay of the injection time. This study was conducted to assess the efficacy and postoperative outcomes of intravenous PCA compared to IMA injections in 36 patients (BSSRO). Three factors were compared: amount of pain in PCA and IMA group ; amount of pain according to the sex in PCA and IMA group and the amount of pain according to the analgesia use. Results of this study did not demonstrate a statistically significant difference in any of these, using a p value of 0.05. The results of this study were as follows. : 1. There was no statistically significant difference in VAS pain score between IMA group and PCA group. 2. There was no statistically significant difference according to the sex. 3. There was no statistically significant difference according to the amount of PCA. The history of PCA is about 30 years and many literatures have reported about its effects, complications, methods, advantages and disadvantages. So, this study has some limitations of small sample size to conclude the effects of PCA. But when the decision about the method for postoperative pain control has to be made, it should be made based on patient or physician preference and cost factors rather than on the trend.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.3
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• pp.134-138
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• 2013

Pain on the soft palate and pharynx can originate in several associated structures. Therefore, diagnosis of patients who complain of discomfort in these areas may be difficult and complicated. Pterygoid hamulus bursitis is a rare disease showing various symptoms in the palatal and pharyngeal regions. As such, it can be one of the reported causes of pain in these areas. Treatment of hamular bursitis is either conservative or surgical. If the etiologic factor of bursitis is osteophytic formation on the hamulus or hypertrophy of the bursa, resection of the hamulus is usually the preferred surgical treatment. We report on a case of bursitis that was managed successfully by surgical treatment and a review of the literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.44.1-44.7
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• 2019

Background: We evaluated the improvement of pain and the increase in mouth opening after temporomandibular joint arthrocentesis and the possible association with various factors such as previous splint treatment, medication, and diagnosis. Results: We studied 57 temporomandibular joint disorder patients who underwent arthrocentesis at Korea University Anam Hospital. These patients (24 males and 33 females, aged between 15 and 76 years) underwent arthrocentesis that was performed by one surgeon. The degree of mouth opening (assessed using the maximum mouth opening: MMO) and pain (assessed using the visual analog scale: VAS) were assessed pre- and post-arthrocentesis. The study also investigated whether treatment modalities other than arthrocentesis (medication and appliance therapy) were performed. Statistical analysis revealed that there was a significant difference in mouth opening and pain after temporomandibular joint arthrocentesis. Preoperative appliance therapy affected the results of arthrocentesis, but it was not statistically significant. With regard to pain relief, preoperative diagnosis did not show a significant difference. However, with regard to maximum mouth opening, patients with disc displacement without reduction with limited mouth opening (closed lock) showed the highest recovery (11.13 mm). Conclusion: The average of MMO increase after arthrocentesis was 9.10 mm, and patients with disc displacement without reduction with locking (closed lock) showed most recovery in maximum mouth opening and it was statistically significant. The average pain relief of patients after arthrocentesis was 3.03 in the VAS scale, and patients using anterior repositioning splint (ARS) preoperatively showed the most pain relief.