• 치과방사선
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• 제28권1호
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• pp.205-213
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• 1998

This study was designed to reveal the correlationship between the internal derangement state of TMJ and clinical characteristics including pain and mandibular dysfunction. One hundred and twenty five subjects with TMJ signs and symptoms were chosen for two years. The level of pain and madibular dysfunction were evaluated by Visual Analog Scale(VAS) and Craniomandibular Index(CMI). The diagnostic categories of TMJ internal derangement were determined by arthrography and they included normal disc position, anterior disc displacement with reduction(ADDR), rotational disc displacement with reduction (RDDR), anterior disc displacement without reduction(ADDNR), and rotational disc displacement without reduction(RDDNR). Also disc perforation was used as a criteria to divide the diagnostic subgroups. The obtained results were as follows; 1. The patient distribution of each group was 5 in normal disc position(4％), 40 in ADDR(32％), 30 in RDDR(24％), 34 in ADDNR(27％), and 16 in RDDNR(13％). 2. Perforation was observed in 8％ of ADDR, 10％ of RDDR, 32％ of ADDNR, and 19％ of RDDNR. 3. CMI of non-reduction group was higher than that of reduction or normal group(p<0.05), but V AS showed no significant difference.4. CMI of perforation group was higher than that of non-perforation group in reduction group (p<0.05). 5. There were no significant differences of CMI and VAS between anterior disc displacement group and rotational disc displacement group in both reduction and non-reduction group. 6. CMI of RDDNR group was higher than that of RDDR group(p<0.05). 7. There were no significant difference of CMI and VAS between bilateral involvement group and unilateral involvement group(p<0.05).

• Clinical Pain
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• 제19권1호
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• pp.16-22
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• 2020

Objective: Recent studies have shown that repetitive peripheral magnetic stimulation (rPMS) reduces pain in various conditions. This pilot study aimed to investigate the effects of rPMS depending on the pain characteristics. Method: Adult patients aged 19~85 years evaluated at our institution between September 1, 2017 and February 28, 2018 for subacute to chronic musculoskeletal pain equivalent to a numeric rating scale of 3 or higher for at least one month were enrolled. Pain scores as determined using a numeric rating scale at baseline and at the end of treatment were set as the primary outcome. Additionally, we classified the pain into nociceptive, intermediate, or neuropathic pain using the PainDETECT questionnaire and compared the responsiveness to rPMS according to the type of pain. Results: The average pain scores significantly decreased after the 2-week rPMS treatment in all enrolled subjects (p<0.001). There was no statistically significant difference in pain reduction between groups divided by PainDETECT questionnaire. Conclusion: This study suggests that rPMS could safely relieve various types of pain.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권4호
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• pp.349-352
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• 2001

Dental laser provides many advantages to the clinicians. Those are excellent hemostatic effect, good operating sight, minimal adjacent tissue injury, reduction of postoperative swelling & pain, reduction of postoperative infection, reduction of scar tissue & contraction, etc. The purpose of this study is to observe how these advantages work after surgical extraction of impacted third molar. From march 2000 to july 2000, we have randomly divided the patients who had been surgically extracted unilateral impacted third molar into two groups. The first group comprised $CO_2$ laser illumination with 3 watts, defocusing & continuous mode, rotating motion for about 3 minutes after finishing of surgical extraction & suture. The other group patients were not irradiated. The medications in two groups were same. We measured pain, swelling and trismus three times(pre-operation, first day after operation, and 7th day after operation). The number of the patients who had measured three times all are 64, laser irradiated groups are 36 and non-irradiated groups are 28. The age ranged from 19 to 50, with a mean of 27.9 years. The operative time ranged from 3 minutes to 50 minutes, with a mean of 12.1 minutes. In the $CO_2$ laser group, the pain intensity of the 7th day after operation was still increased significantly comparing with that of the pre-operation and the distance which were measured for the swelling was different significantly. In the other group, the mouth opening limitation was still decreased significantly.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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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.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권5호
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• pp.277-285
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• 2018

Chemo-mechanical caries removal methods are known to be more effective compared with conventional methods in pain reduction. $Carie-care^{TM}$, a chemo-mechanical caries removal agent, was introduced in 2010 but a systematic review of its efficacy has not yet been performed. The purpose of this study was to investigate the effectiveness of $Carie-care^{TM}$ on the outcomes of treatment of caries in children and adolescents. The primary outcome was pain while the secondary outcomes included complete caries removal (CCR), time, need for local anesthesia and behavioral response changes. A Comprehensive literature search was performed in PubMed, EMBASE, and the Cochrane Library up to 30 September 2018. The following keywords were used in the search: 'chemo-mechanical caries removal agent', 'dental caries', 'Carie-care', 'chemo-mechanical caries removal', 'chemo-mechanical caries excavation', other related keywords, and their combinations. From 942 studies identified, 16 were analyzed. Finally, 4 studies met the eligibility criteria and 260 teeth in 120 children and adolescents were included in this review. This review showed that $Carie-care^{TM}$ reduces pain during caries treatment but requires a longer time for effective treatment than conventional methods. Local anesthesia was not required in the Chemo-mechanical caries removal (CMCR) group. In addition, dental anxiety decreased compared to the control group, and co-operation was more positive. Therefore, it may be a useful alternative to conventional methods in children and adolescents, but further verification through additional studies is needed.

• The Korean Journal of Physiology and Pharmacology
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• 제20권1호
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• pp.129-136
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• 2016

This study was performed to investigate whether an intra-articular injection of transient receptor potential vanilloid 1 (TRPV1) receptor agonist, resiniferatoxin (RTX) would alleviate behavioral signs of arthritic pain in a rat model of osteoarthritis (OA). We also sought to determine the effect of RTX treatment on calcitonin gene-related peptide (CGRP) expression in the spinal cord. Knee joint inflammation was induced by intra-articular injection of monosodium iodoacetate (MIA, $8mg/50{\mu}l$) and weight bearing percentage on right and left hindpaws during walking, paw withdrawal threshold to mechanical stimulation, and paw withdrawal latency to heat were measured to evaluate pain behavior. Intra-articular administration of RTX (0.03, 0.003 and 0.0003%) at 2 weeks after the induction of knee joint inflammation significantly improved reduction of weight bearing on the ipsilateral hindlimb and increased paw withdrawal sensitivity to mechanical and heat stimuli. The reduction of pain behavior persisted for 3~10 days according to each behavioral test. The MIA-induced increase in CGRP immunoreactivity in the spinal cord was decreased by RTX treatment in a dose-dependent manner. The present study demonstrated that a single intra-articular administration of RTX reduced pain behaviors for a relatively long time in an experimental model of OA and could normalize OA-associated changes in peptide expression in the spinal cord.

• The Korean Journal of Pain
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• 제30권2호
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• pp.86-92
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• 2017

Osteoblasts, originating from mesenchymal cells, make the receptor activator of the nuclear factor kappa B ligand (RANKL) and osteoprotegerin (OPG) in order to control differentiation of activated osteoclasts, originating from hematopoietic stem cells. When the RANKL binds to the RANK of the pre-osteoclasts or mature osteoclasts, bone resorption increases. On the contrary, when OPG binds to the RANK, bone resorption decreases. Denosumab (AMG 162), like OPG (a decoy receptor), binds to the RANKL, and reduces binding between the RANK and the RANKL resulting in inhibition of osteoclastogenesis and reduction of bone resorption. Bisphosphonates (BPs), which bind to the bone mineral and occupy the site of resorption performed by activated osteoclasts, are still the drugs of choice to prevent and treat osteoporosis. The merits of denosumab are reversibility targeting the RANKL, lack of adverse gastrointestinal events, improved adherence due to convenient biannual subcutaneous administration, and potential use with impaired renal function. The known adverse reactions are musculoskeletal pain, increased infections with adverse dermatologic reactions, osteonecrosis of the jaw, hypersensitivity reaction, and hypocalcemia. Treatment with 60 mg of denosumab reduces the bone resorption marker, serum type 1 C-telopeptide, by 3 days, with maximum reduction occurring by 1 month. The mean time to maximum denosumab concentration is 10 days with a mean half-life of 25.4 days. In conclusion, the convenient biannual subcutaneous administration of 60 mg of denosumab can be considered as a first-line treatment for osteoporosis in cases of low compliance with BPs due to gastrointestinal trouble and impaired renal function.

• Journal of Oral Medicine and Pain
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• 제43권4호
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• pp.125-130
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• 2018

Purpose: The etiology of temporomandibular disorders (TMDs) is complex and multifactorial including trauma, anatomical, pathophysiological, social and psychological factors. Psychological factors can induce or sustain TMDs in various ways. And psychological problems, such as anxiety and depression can be occurred due to TMDs. Therefore, evaluation of psychological factors in patients with TMDs is important. Although disc displacement (DD) is crucial in clinical situation, most of studies have focused on the relationship of psychosocial factors and myofascial pain. And also, Subtypes of DD can cause different degrees of discomfort, it is necessary to evaluate the psychological states of the patients according to the subtype. The Hospital Anxiety Depression Scale (HADS) is one of the self-report questionnaire to evaluate the psychological factors. HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D) are assessed through 14 questions. The purpose of this study was to evaluate anxiety and depression assessed by HADS in patients diagnosed with subtypes of DD according to diagnostic criteria for TMDs. Methods: Four hundred thirty nine patients were diagnosed as one of the subtypes of DD. One hundred fourty nine subjects with no symptoms were set as control groups. All of them answered the HADS for Koreans. The cut-off score for anxiety and depression was set a score of 8. The chi-square test was performed to evaluate association between DD and anxiety/depression. Results: There was a significant difference in HADS-D between five groups (p<0.01). However, there was no significant difference in HADS-A. All the DD groups showed a significant difference in HADS-D compared with the control group except the DD without reduction without limited opening group. The DD without reduction with limited opening group showed the highest rates in HADS-D (40.4%). Conclusions: Based on the above results, it is necessary to consider the depression in treatment of the patients with DDs.

• 대한간호학회지
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• 제15권1호
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• pp.76-96
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• 1985

Postoperative pain is one of the most frequently occurred pain in hospitals, but it has been underestimated because it is only a part of postoperative physiological Process and may disappear in time. It is necessary that nurses me the relaxation technique, planning and implementing by themselves independently, to reduce this postoperative pain. This study is aimed at showing the effect of relaxation technique on reduction of postoperative pain, and exploring the factors influencing postoperative. pain Fifty-seven patients with abdominal surgery who admitted in attacked D Medical Center to K University in Daegu have been studied. Of them twenty-nine were experimental group and the remaining twenty-eight were control group. This study has been conducted for collecting data through interviews and observation from August 23 to October 24, 1984. The tools of this study were two kinds: Postoperative Pain Scale is obtained from a review of references by the researcher, and relaxation technique, designed to use postoperative setting adequately, is also obtained from a review of references by the researcher. After confiriming no significant differences between the two groups, the hypotheses were statistically verified by x²-test, t-test, and pearson Correlation Coefficient. The results of this study are summerized as follows; ＊ The nam hypothesis that the experimental group who use relaxation technique will have less degree of postoperative pain than the control group who don't use relaxation technique is devided into three sub-hypotheses. 1. The first sub-hypothesis that the experimental group will have less score of postoperative pain than control group was accepted (t=7.810, p <.01). Even with controlling pain threshold, showing difference in some degree between the two groups, the experimental group has less score of postoperative pain than the control group. Therefore this confirms the acceptance of the first sub-hypothesis more strongly. 2. The second sub-hypothesis that the expermental group will have less frequency of analgesics than the control group is accepted (x²=9.85, p <.01). 3. The third sub-hypothesis that the experimental group will have less variation of pulse, respiration, and blood pressure between pre End post operative periods than the control group is rejected. So this hypothesis is reverified through comparing the variation of pulse, respiration, and blood pressure between pre and post changing Position to measure the pure effect of relaxation technique. pulse and respiration is significantly lowered in the experimental group (t=7.209, p<.01, t=3.473, p<.01), but systolic and diastolic blood pressure is not different significantly between the two groups (t= 1.309, p＞.05, t=1. 727 p>.05). Therefore the third sub-hypothesis is partially accepted. Conclusively, the researcher thinks that it is necessary that nurses should provide patients with relaxation technique to reduce postoperative pain, and to increase independence of nursing.

• The Korean Journal of Pain
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• 제19권2호
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• pp.152-158
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• 2006

Background: Complex regional pain syndrome (CRPS) is a painful, disabling disorder for which no proven treatment has been established. The purpose of this investigation was to assess the evidence of the efficacy of spinal cord stimulation (SCS) in the management of pain in CRPS patients. Methods: Between March 2004 and June 2006, 11 patients with CRPS were treated with SCS. The visual analog scale (VAS) score for pain (0⁣-10) and pain disability index (PDI) were obtained in all patients prior to treatment, and 1, 3 and 6 months post-implantation. Results: All 11 patients, 5 men and 6 women, with a median age and duration of CRPS of 44 years and 48.8 months, respectively, successfully received a lead implantation for SCS. The mean VAS pain score prior to the treatment was 85.5 out of 100 mm. After SCS implantation, the mean VAS pain scores were 49.5, 57.0 and 56.0 at 1, 3 and 6 months after the procedure, respectively. The mean pain score for allodynia was decreased by 50%, with a significant reduction of the PDI also observed after the treatment. Conclusions: Our current study suggests that SCS implantation is a safe and effective method in the management of CRPS patients.