• Journal of Korean Dental Science
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• v.2 no.2
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• pp.46-52
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• 2009

Objectives : The purpose of this study was to evaluate the significance of antibiotics in reducing postoperative infection rates and other complications following third molar surgery. Patients and methods : Two groups of patients underwent surgical extraction of third molars. The antibiotics group, n=21, received a third generation cephalosporin antibiotic for 5 days, starting from the day of surgery. The non-antibiotics group, n=26, didn't receive any antibiotics and only received analgesics to control postoperative pain. Body temperature and hematologic findings including WBC, neutrophils, lymphocytes and monocytes counts were compared between the two groups at three intervals, preoperatively, 24 hours and 7-10 days postoperatively. Pain and swelling during the follow up period were also recorded in both groups and compared in the second part of the study. Results : In the first part of the study, comparison of body temperature, CBC components (except WBCs) showed no significant difference between the two groups during the follow up period. All parameters were within the normal range at all intervals, which indicated absence of infection. In the second part, 38% of patients in the antibiotic group, compared to 54% of the non-antibiotics group, had one or more complications during the follow up period. However, three patients from the antibiotic group compared to one from the nonantibiotics group reported having a swelling of some degree. Conclusion : Based on our objective parameters (body temperature and CBC components), both groups showed no signs of infection during the follow up period. However, the results related to pain and swelling were less conclusive, probably due to small number of patients included in the study. Accordingly, we are unable to provide definite recommendations on antibiotics use in third molar surgery.

• Journal of Oral Medicine and Pain
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• v.46 no.3
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• pp.75-83
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• 2021

Odontogenic infection in the oral and maxillofacial regions caused by bacteria (mostly of oral origin) is one of the most common diseases encountered by dentists. Localized infection can easily be treated with incision and drainage followed by antibiotics. Emergence of multidrug resistant (MDR) bacteria called "Superbacteria" has become one of the serious problems in modern society, due to its small window of opportunity for treatment and high casualty. The acronym "ESKAPE", encompassing the common and serious MDR pathogens stand for Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp. Literature search was performed in Medline, PubMed and Google Scholar ranging from 2012 to 2020. ESKAPE patient's infection period was longer than that of non-ESKAPE group, and the treatment method due to antibiotic resistance was also complicated. The purpose of this study is to investigate infection caused by ESKAPE pathogens in the oral and maxillofacial regions through literature review and to inform dental surgeons of the danger of ESKAPE pathogens and to suggest viable treatment options. Many studies worldwide reported infections associated with ESKAPE pathogens, but only limited number of studies targeted infection in oral and maxillofacial regions. Further research is required with more data on ESKAPE bacteria and their infection, especially in oral and maxillofacial regions.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.6
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• pp.474-480
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• 2005

We evaluated the need for prophylactic postoperative oral antibiotic medication in extraction of asymptomatic impacted mandibular third molars. All patient didn't show sign of pain, inflammation, swelling and trismus at the time of extraction. In the experimental group, oral antibiotic medication(Amoxicillin) was carried out for 5 days postoperatively. In the control group, the patients received no antibiotic medication. All groups didn't use antibiotic irrigation solution. Rule of group composition randomized. The surgical technique was the same in all cases. Parameters that were evaluated were infection, pain, facial swelling, trismus. We could not find any significant difference between the experimental and control groups.(P<0.05) The results of our study show that post operative oral prophylactic antibiotic medication after the extraction of impacted mandibular third molars does not contribute to less infection, pain, facial swelling and increased mouth opening after surgery. Therefore we suggest that prophylactic postoperative oral antibiotic medication is not needed in extraction of asymptomatic impacted mandibular third molars.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.5
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• pp.341-350
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• 2021

Dexamethasone has been used in oral and maxillofacial surgery for postoperative pain, swelling, and trismus following third molar surgeries. It is a potent and powerful drug that can alleviate the aforementioned postoperative sequelae. Dexamethasone is responsible for inhibiting the release of inflammatory mediators in the inflammation process to improve patient quality of life after surgical intervention. There are several available routes of administering dexamethasone. This article will help determine the suggested routes of administration, dosage, parameters, and dexamethasone timing for third molar surgeries.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.5.1-5.5
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• 2016

Background: This study clinically evaluated the effect of botulinum toxin type A (BTX-A) in the temporomandibular disorder (TMD) treatment using Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Methods: A total of 21 TMD patients were recruited to be treated with BTX-A injections on the bilateral masseter and temporalis muscles and were followed up by an oral and maxillofacial surgeon highly experienced in the TMD treatment. For each patient, diagnostic data gathering were conducted according to the RDC/TMD. Characteristic pain intensity, disability points, chronic pain grade, depression index, and grade of nonspecific physical symptoms were evaluated. Wilcoxon signed-rank test was applied for statistical analysis. Results: The results showed that more than half of the participants (85.7 %) had parafunctional oral habits such as bruxism or clenching. In comparison between pre- and post-treatment results, graded pain score, characteristic pain intensity, disability points, chronic pain grade, and grade of nonspecific physical symptoms showed statistically significant differences after the BTX-A injection therapy (p < 0.05). Most patients experienced collective decrease in clinical manifestations of TMD including pain relief and improved masticatory functions after the treatment. Conclusions: Within the limitation of our study, BTX-A injections in masticatory musculatures of TMD patients could be considered as a useful option for controlling complex TMD and helping its associated symptoms.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.29-35
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• 2017

Background: No study has compared lidocaine with articaine, each at a concentration of 4% and combined with epinephrine. The purpose of this study was to compare the effectiveness of 4% lidocaine with that of 4% articaine, with a concentration of 1:100,000 epinephrine added to each, in an inferior alveolar nerve block for surgery on impacted lower third molars. Method: This study was conducted at the Faculty of Dentistry, Mahidol University in Bangkok, Thailand. The randomized, single-blind, comparative split-mouth study was carried out in patients with symmetrically impacted lower third molars, as identified on panoramic radiographs. Each patient underwent surgery for the removal of the lower third molars by the same surgeon under local anesthesia at two separate visits, 3 weeks apart. The onset and duration of local anesthesia, intra-operative pain, surgical duration, and number of additional anesthetics administered were recorded. Results: The subjective and objective onset of action for the local anesthetics showed statistically significant differences (P < 0.05). However, the intra-operative pain, surgical duration, duration of local anesthesia, and number of additional anesthetics administered did not show statistically significant differences. Conclusion: The use of 4% articaine for the inferior alveolar nerve block was clinically more effective in the onset of subjective and objective anesthesia as compared with the use of 4% lidocaine. Based on the pain scores from the visual analogue scale, 4% lidocaine provided more analgesia during the procedure, and patients noted less intra-operative pain than with 4% articaine; however, the difference was not clinically significant.

• Imaging Science in Dentistry
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• v.32 no.1
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• pp.49-53
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• 2002

Orofacial pain can be caused by intracranial disorders or can be musculoskeletal, vascular, internal derangemental, and neurologic in origin. The neurologic pain is derived from structural and functional disorders of nerve, and the trigeminal neuralgia is the typical manifestation. Trigeminal neuralgia is known from centuries ago, and is one of the most common pains in human. We present our experience with three patients who have trigeminal neuralgia. The first case is a 50-year-old female who had no specific evidence radiographically. Second is a 50-year-old male with microvascular compression on right trigeminal nerve. The third case is a 60-year-old female who had a neoplasm in cerebellopontine angle with associated mass effect.

• Imaging Science in Dentistry
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• v.54 no.1
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• pp.93-104
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• 2024

Chronic nonbacterial osteomyelitis(CNO) is histologically characterized by nonspecific osteitis. This inflammatory disorder, which lacks an infectious origin, typically presents with chronic pain and swelling at the affected site that can persist for months or even years. However, it is rare for CNO to affect the mandible. A 10-year-old girl presented with a primary complaint of pain in her left mandible. She had no significant medical or dental history. On examination, swelling was visible on the left buccal side, and imaging revealed radiolucent bone deterioration within the left mandible. This case report presents the radiological changes observed over a 12-year follow-up period. Variations in radiopacity, radiolucency, and periosteal reactions were noted periodically. This case highlights the radiological characteristics and findings that are crucial for the diagnosis of CNO, a condition for which no clear diagnostic criteria are currently available.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.4
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• pp.250-257
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• 2020

Objectives: Palatal infiltration is the most painful and uncomfortable anesthesia technique for maxillary impacted third molar surgery (MITMS). This approach could cause patients distress and aversion to dental treatment. The aim of this study was to evaluate the anesthetic efficacy of a buccal infiltration injection without a palatal injection in MITMS. Materials and Methods: This prospective research study was a crossover split mouth-randomized controlled trial. Twenty-eight healthy symmetrical bilateral MITMS patients (mean age, 23 years) were randomly assigned to two groups. Buccal infiltration injections without palatal injections were designated as the study group and the buccal with palatal infiltration cases were the control group, using 4% articaine and 1:100,000 epinephrine. The operation started after 10 minutes of infiltration. Pain assessment was done using a visual analogue scale and a numeric rating scale after each injection and extraction procedure. Similarly, the success rate, hemodynamic parameters, and additional requested local anesthetic were assessed. Results: The results showed that the pain associated with local anesthetic injections between both groups were significantly different. However, the success rates between the groups were not significantly different. Postoperative pain was not significant between both groups and a few patients requested an additional local anesthetic, but the results were not statistically significant. For hemodynamic parameters, there was a significant difference in systolic pressure during incision, bone removal, and tooth elevation. In comparison, during the incision stage there was a significant difference in diastolic pressure; however, other steps in the intervention were not significantly different between groups. Conclusion: We concluded that buccal infiltration injection without palatal injection can be an alternative technique instead of the conventional injection for MITMS.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.2
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• pp.180-183
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• 2009

Eagle's syndrome refers to a symptomatic elongation of the styloid process or calcification of the stylohyoid and stylomandibular ligaments that usually accompanies facial and pharyngeal pain, dysphagia, and foreign-body sensation in the throat. Making an accurate diagnosis is difficult as Eagle's syndrome can be accompanied with referred pain to various areas of head and neck. Treatment options for Eagle's syndrome include non-surgical and surgical methods. The surest and the most effective method for relieving the symptom is surgical removal or reduction of the elongated styloid process. The present study reports two cases of female whom were diagnosed as "Eagle's syndrome" and whose chief complain was foreign-body sensation and pain in the throat on movement. Surgical removal via transoral approach of the elongated styloid process is a safe surgical option with favorable results compared to extraoral approach.