• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.1
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• pp.29-37
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• 2022

Background: Pain, edema, and trismus are predictable sequelae for surgical extraction of impacted mandibular third molars (M3M). The present study aimed to compare the anti-phlogistic potential of bromelain and aceclofenac in the reduction of post-surgical sequalae in the extraction of impacted M3M. Method: A randomized controlled, triple-blinded clinical study included 72 patients scheduled for surgical removal of impacted M3M under local anesthesia. Randomization was performed and subjects were equally allocated to groups A (control) and B (study), who intended to receive aceclofenac and bromelain, respectively. The primary outcome variables were pain, edema, and trismus evaluated on postoperative days 2 and 7 and compared with baseline values. The secondary variables evaluated were the quantity of rescue analgesics required and the frequency of adverse effects in both groups for 7 postoperative (PO) days. Data were analyzed with a level of significance of P < 0.05. Results: Group B demonstrated a significant decrease in the severity of edema and trismus compared to group A on both PO days 2 and 7 (P < 0.001). Bromelain demonstrated similar analgesic efficacy with an insignificant difference compared to aceclofenac (P > 0.05). Conclusion: The present study showed that the efficacy of bromelain was comparable to that of aceclofenac in reducing inflammatory complications following surgical removal of impacted M3M. Bromelain can be considered a safe and potent alternative to routinely used aceclofenac when addressing inflammatory outcomes after surgery.

• The Korean Journal of Pain
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• v.26 no.2
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• pp.177-180
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• 2013

Trigeminal neuralgia (TN) is characterized by recurrent paroxysms of unilateral facial pain that typically is severe, lancinating, and activated with cutaneous stimulation. There are two types of TN, classical TN and atypical TN. The pain nature of classical TN are the same as those described above, whereas atypical TN is characterized by constant, burning pain. We describe the case of a 49-year-old male presenting with right-sided facial pain. The patient was diagnosed with temporomandibular joint disorder at a dental clinic and was on medical treatment, but his symptoms worsened gradually. He was referred to our pain clinic for further evaluation. Radiologic evaluation, including MRI, showed a parapharyngeal tumor. For the relief of TN, a right mandibular nerve (V3) root block was performed at our pain clinic, and then he was scheduled for radiation and chemotherapy.

• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.159-165
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• 2000

Subsequent to an allogenic stem cell transplantation(ASCT) on patients with hematologic malignancy(AML, ALL, CML, multiple myeloma, lymphoma etc.), chronic GVHD(graft versus host disease), which is an immunological reaction, occurs. With treatment results from patients who were diagnosed with ALL(acute lymphocytic leukemia), undergone BMT(bone marrow transplantation) and showed oral and skin lesions due to GVHD, treatment of oral manifestations of leukemia and its general management were studied. 90% of patients with chronic GVHD show change in the oral mucosa causing oral manifestations such as leukoplakia, lichenoid change of the oral mucosa, mucosal atrophy, erythema, ulceration and xerostomia. In treating GVHD, extensive systemic immunosuppression cause bacterial, viral, fungal infection that are fatal, and even if the treatment is successful, the patient is already in a severe immunosuppressed state. Therefore, localized target therapy is preferred. In another words, topical application(rinse, cream, ointment etc.) of cyclosporin and steroid in treating oral chronic GVHD is highly recommended, and the use of PUVA(Psoralen Ultraviolet A) and thalidomide is reported to be effective. In treating such diseases, dental treatment to control pain and prevent secondary infection of oral manifestations is very important. To those patients with systemic diseases who show limited effect by general dental treatment, non-invasive treatment such as the dental laser, in addition to the use of drugs, may be necessary to actively treat pain and help the healing process. For greater results, new effective methods are to be developed for treatment.

• Journal of Oral Medicine and Pain
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• v.44 no.2
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• pp.65-68
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• 2019

Temporomandibular disorders (TMD), involving the masticator system of temporomandibular joint (TMJ) and masticator muscle, can be characterized with the cardinal signs and symptoms of jaw pain, noises and limitation of mandibular range of motion. However, TMD requires differential diagnosis due to its heterogeneous characteristics with various causes despite the similar clinical profiles. Oral cancer involving TMJ and the masticator system, although infrequent, can be one of these causes and should be considered one of the most life-threatening disease mimicking TMDs. This report introduces a case of masticator space tumor originally diagnosed as TMD in a 73-year-old Korean female with previous history of brain tumor. The clinical signs and symptoms closely mimic that of TMD which may have disrupted differential diagnosis. We discuss here key points for suspecting TMDs of secondary origin, namely, that of cancer and the implications it has on dental clinicians.

• Journal of Korean society of Dental Hygiene
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• v.17 no.5
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• pp.911-919
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• 2017

Objectives: The baobab tree is a multipurpose, widely-used species with medicinal properties and numerous food uses. The aim of study was to evaluate the effect of oral administration of baobab on the formalin-induced inflammatory pain in rat model injected into the orofacial regions. Methods: Male Sprague-Dawley rats weighing 260-280 g were used. Pain in the orofacial region was induced using two models, 5% formalin was injected $50{\mu}l$ subcutaneously or $30{\mu}l$ in temporomandibular joint (TMJ), respectively. Rats were divided into 4 groups (n=6); formalin, formalin after distilled water (vehicle) or baobab (150, 300 mg/kg). The number of noxious behavioral responses with scratching the facial region was recorded for 9 successive 5-min intervals following formalin injection. Results:There was no significant difference in the first response to the pain between the formalin induced group and the drug administration group. However, in the secondary infusion group, all of the pain medication were responded (Bao 150, 300 mg/kg) (p<0.05). Conclusions:The results showed analgesic effect of baobab on formalin-induced orofacial inflammatory pain. This suggests that the natural product is an effective alternative to the postinflammatory pain control.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.4
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• pp.255-266
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• 2022

Background: A previous study reported the effectiveness and patient satisfaction in the dental emergency unit (DEU) of the Pitie Salpetrière Hospital in Paris before coronavirus disease 2019 (COVID-19). The same methodology was used during the COVID-19 pandemic to compare pain, anxiety, and patient satisfaction during the two periods. Methods: This prospective study was conducted in 2020 (NCT04354272) on adult patients. Data were collected on day zero (D0) on site and then by phone during the daytime on day one (D1), day three (D3), and day seven (D7). The primary objective was to assess the pain intensity at D1. Secondary objectives were to assess pain intensity at D3 and D7, anxiety intensity at D1, D3, and D7, and patient satisfaction. Patients were evaluated on a 0-10 numeric scale on D1, D3, and D7; mean scores were compared with non-parametric statistics (ANOVA, Dunn's). Results: A total of 445 patients were given the opportunity to participate in the study, and 370 patients consented. Seventy-one were lost during follow-up. Ultimately, 299 patients completed all the questionnaires and were included in the analysis. In the final sample (60% men, 40% women, aged 39 ± 14 years), 94% had health insurance. The mean pain scores were: D0, 6.1 ± 0.14; D1, 3.29 ± 0.16; D3, 2.08 ± 0.16; and D7, 1.07 ± 0.35. This indicates a significant decrease of 46%, 67%, and 82% at D1, D3, and D7, respectively, when compared to D0 (P < 0.0001). The mean anxiety scores were D0, 4.7 ± 0.19; D1, 2.6 ± 0.16; D3, 1.9 ± 0.61; and D7, 1.4 ± 0.15. This decrease was significant between D0 and D7 (ANOVA, P < 0.001). Perception of general health improved between D1 and D7. The overall satisfaction was 9.3 ± 0.06. Conclusion: DEU enabled a significant reduction in pain and anxiety with high overall satisfaction during COVID-19, which was very similar to levels observed pre-COVID-19 pandemic.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.4
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• pp.191-199
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• 2019

Background: Patients with special health care needs are more likely to develop health problems, including dental problems. Dental treatments require a good level of communication with the patient. Therefore, in these patients, sedation and general anesthesia are an extremely humanistic approach for comfortable and successful treatment. In patients with special needs, there is no standard anesthetic approach due to varying clinical conditions. The aim of this study was to provide literature content about the anesthetic approaches used by us in patients with special needs. Methods: The medical records of 710 patients with special health care needs treated under general anesthesia or sedation were reviewed retrospectively. Demographic data, the American Society of Anesthesiologists classification, Mallampati score, anesthesia duration, anesthesia type, anesthetic and analgesic agents used, dental treatment performed, secondary diseases, and complications in the perioperative period were recorded. Patients were evaluated under five groups: Down syndrome, other syndromes, psychiatric disorders, physical disabilities, and complicated medical story. Results: Among the patients evaluated, 47.5% were females and 52.5% were males (mean age $15.76{\pm}11.17$ years), and general anesthesia and sedation were administered in 72.9% and 22.1% patients, respectively. The mean duration of anesthesia was $43.20{\pm}35.85$ min. Simple dental treatments were performed in all groups, and the most common complications were observed in the other syndromes group. Conclusion: Complications can be reduced by utilizing the appropriate anesthetic approach and taking serious precautions in patients with special needs.

• Journal of Oral Medicine and Pain
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• v.40 no.4
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• pp.146-154
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• 2015

Purpose: The purpose of present study was to develop a method for assessing the chronological age of Korean adults based on the relationship between age and size of pulp cavity using dental radiographs of mandibular first molars. Methods: A total of 325 dental radiographs of Korean adults with known age and gender were selected for the study (199 males and 126 females) which were taken in the period between January 2009 and June 2014 at the Pusan National University Dental Hospital. The measurements were carried out on both orthopantomographs (OPGs) and intraoral periapical radiographs of mandibular first molar and the following ratios were calculated: pulp chamber floor height ratio (F/L), pulp chamber ceiling height ratio (R/L), and pulp chamber depth ratio (D/L). Results: The ratios of measurements on intraoral periapical images of mandible first molar generally produce more reliable data than the measurements on OPGs. The pulp chamber floor height ratio and pulp chamber thickness ratio showed significant correlation with age, whereas the pulp chamber ceiling height ratios showed weak correlation with age. It was found that the best correlations between the ratios and age were found for pulp chamber thickness ratios (r=-0.731 to -0.751). The multiple regression models were derived using 3 ratios that were significantly correlated with age. The determination coefficients ($R^2$) of the models ranged from 0.556 to 0.596. Conclusions: Our results indicate that the pulp chamber thickness and pulp chamber floor height in mandibular first molar are an age-dependent variable in adults which can be used to estimate age with reasonable accuracy. The higher image quality of dental radiographs will probably narrow the age estimation error and improve dental age estimation.

• Journal of Oral Medicine and Pain
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• v.39 no.4
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• pp.119-126
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• 2014

This review provides an overview of the most commonly used dental age estimation techniques which focus on radiological methods in Korean adults. The literature from 1995 through July 31, 2014, was searched, using PubMed, for publications in English language. In PubMed, the keywords 'tooth' OR 'dental' AND 'pulp' AND 'age estimation' were searched. Inclusion criteria was comprised of the following: the subjects were living adults and dental radiography (excluded computed tomography [CT] and cone-beam CT) was used to measure the pulpal size. Twenty articles that met the criteria were selected. The method of age estimation using dental radiographs for measuring pulp and tooth size was represented in all studies. The methods were assorted into three categories generally; Kvaal's, Ikeda's and Cameriere's methods. Those methods had certain limitations such as large error range and low correlation coefficient depending on populations, type of employed teeth and particular method. Various techniques and many studies have been published for age estimation from human teeth using dental radiographs, but those techniques showed various predictability and reliability. Therefore, future studies on larger samples with well-distributed age group using not only existing techniques but new techniques are necessary for deriving convincing results.

• Restorative Dentistry and Endodontics
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• v.23 no.1
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• pp.461-467
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• 1998

A survey has been made of the reasons for the replacement of 318 resin restorations in selected dental practices in Korea. Secondary caries and discoloarations were the main reason for replacement of composite restorations, followed by discoloration, fracture of restoration, loss of anatomic form and pain sensitivity. The estimated 50% survival time for the surveyed restorations was 3.3 years.