• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권1호
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• pp.37-42
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• 2010

Purpose: The mental foramen (MF) is an important anatomical structure during local anesthesia and surgical procedures in terms of achieving effective mental nerve blocks and avoiding injuries to the neurovascular bundles. Thus, understanding the anatomic features of the mandibular canal and accessory mental foramen in Korean could contribute to the surgical anatomic assessment. This study was to elucidate frequency, position and course of AMF (accessory mental foramen) in Korean using 3D cone beam computed tomography. Materials and Methods: The CBCT (Conbeam computed tomography) DICOM data (Alphard, Asahi, Japan) from 540 patients in korean were analyzed. We investigated images of 3D CBCT using Ondemand (CyberMed, Korea) software program on the incidence and anatomical characteristics of accessory foramen. Results: The accessory mental foramina were found in 17 patients. Accessory mental foramina exist predominantly in the apical area of the second premolar and posteroinferior area of the mental foramen. The accessory branches of the mandibular canal showed common characteristics in the course of gently sloping posterosuperior direction in the buccal surface area. The size of most AMF was obviously smaller than that of MF. Conclusion: We could identify frequency, position and course of AMF (accessory mental foramen) by the anatomical study of the accessory mental foramen using 3D cone beam CT in Korean.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권2호
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• pp.141-148
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• 2010

The bilateral sagittal split ramus osteotomy (BSSRO) is preferred method of surgical correction for mandibular prognathism, retrognathism and asymmetry. This technique performed from primarily an intraoral incision to avoid a scar. After forward movement of the distal segment of the mandible, healing of bone by primary or secondary intention is easily accomplished through large areas of cancellous bony overlap. When rigid fixation is used for the BSSRO, it is possible to open the mouth during the immediate post-operative period because it promotes the healing process. Although this surgical procedure has been well-documented, the incidence of postoperative trigeminal neurosensory disorder in the region of the inferior alveolar nerve and the mental nerve remains one of the major complication. However, evaluation of objective methods for sensory recovery patterns is insufficient although most patients find their sensory return. Neurometer electrodiagnostic device performs automated neuroselective sensory nerve conduction threshold evaluation by determining current perception threshold (CPT) measures. The purpose of this study was to evaluate the sensory recovery patterns of inferior alveolar and mental nerve over time. Nerve examination with a neurometer was performed in 30 patients undergoing the BSSRO at pre-operative, post-operative 1-, 2-, 4- week, and 2-, 3-, 4-, 5-, 6- month follow-up visits after the osteotomy to compare the differences of nerve injury and recovery patterns after the BSSRO with or without genioplasty and sensory recovery patterns associated with the kind of nerve fiber.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권6호
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• pp.347-353
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• 2023

This case report presents inferior alveolar nerve (IAN) repositioning as a viable approach for implant placement in the mandibular molar region, where challenges of severe alveolar bone width and height deficiencies can exist. Two patients requiring implant placement in the right mandibular molar region underwent nerve transposition and lateralization. In both cases, inadequate alveolar bone height above the IAN precluded the use of short implants. The first patient exhibited an overall low alveolar ridge from the anterior to posterior regions, with a complex relationship with adjacent implant bone level and the mental nerve, complicating vertical augmentation. In the second case, although vertical bone resorption was not severe, the high positioning of the IAN within the alveolar bone due to orthognathic surgery raised concerns regarding adequate height of the implant prosthesis. Therefore, instead of onlay bone grafting, nerve transposition and lateralization were employed for implant placement. In both cases, the follow-up results demonstrated successful osseointegration of all implants and complete recovery of postoperative numbness in the lower lip and mentum area. IAN repositioning is a valuable surgical technique that allows implant placement in severely compromised posterior mandibular regions, promoting patient comfort and successful implant placement without permanent IAN damage.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.814-820
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• 2020

Objective : Trigeminal neuralgia (TN) is a severe neuropathic condition that affects several elderly patients. It is characterized by uncontrolled pain that significantly impacts the quality of life of patients. Therefore, the condition should be treated as an emergency. In the majority of patients, pain can be controlled with medication; however, other treatment modalities are being explored in those who become refractory to drug treatment. The use of the trigeminal nerve block with a local anesthetic serves as an excellent adjunct to drug treatment. This technique rapidly relieves the patient of pain while medications are being titrated to effective levels. We report the efficacy and safety of percutaneous trigeminal nerve block in elderly patients with TN at our outpatient clinic. Methods : Twenty-one patients older than 65 years with TN received percutaneous nerve block at our outpatient clinic. We used bupivacaine (1 mL/injection site) to block the supraorbital, infraorbital, superior alveolar, mental, and inferior alveolar nerves according to pain sites of patients. Results : All patients reported relief from pain, which decreased by approximately 78% after 2 weeks of nerve block. The effect lasted for more than 4 weeks in 12 patients and for 6 weeks in two patients. There were no complications. Conclusion : Percutaneous nerve block procedure performed at our outpatient clinic provided immediate relief from pain to elderly patients with TN. The procedure is simple, has no serious side effects, and is easy to apply.

• Journal of Acupuncture Research
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• 제26권5호
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• pp.57-63
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• 2009

Objectives : Since the Front Points are treated as response zone, it can be used for the diagnosis and treatment of disease in viscera and bowels. Jeonjung($CV_{17}$) is the Front Point of SIMPO, it is related with cardiovascular, neuro-psychiatrical disease in aspect of Oriental Medicine. This research is for clarifying relations with palpation of the Jeonjung($CV_{17}$) and autonomic nerve system by comparing HRV and SRI(Stress Reaction Index). Methods : This study was proceeded for three months, from June 2009 to September 2009. Among 31 healthy volunteers, 13 subjects who complained the pressure pain around Jeonjung($CV_{17}$) are classified pressure pain group and 18 subjects who had no pain around Jeonjung($CV_{17}$) as normal group. All subjects had their HRV(SA-2000E: Medicore Co..Ltd. Korea) and SRI measured at visit. We studied the difference of HRV between two groups.(Statistics by Student t-test, p<0.05) Results : LF normalization of the pressure pain group were significantly higher than those of the normal group. HF normalization of the pressure pain group were significantly lower than those of the normal group. Compared with those of the normal group, total SRI of the pressure pain group were low but it's not significant. Conclusions : The results of HRV of the pressure pain group show that pressure pain around Jeonjung($CV_{17}$) is related to mental stress and autonomic disturbance.

• Imaging Science in Dentistry
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• 제52권2호
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• pp.141-153
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• 2022

Purpose: This study aimed to identify the prevalence and extension of the anterior loop (AL) of the mental nerve in different populations and according to different cone-beam computed tomography (CBCT) imaging settings. Materials and Methods: Medline/PubMed, Embase, Scopus, Web of Science, and ProQuest were searched. The main inclusion criterion was ALs evaluated in CBCT images. The quality of studies was assessed with the Joanna Briggs Institute risk of bias checklist. Subgroup analyses were conducted for sex, side, continent, voxel size, field of view, and type of CBCT-reconstruction images with a random-effects model. Results: Sixty-three studies with 13,743 participants (27,075 hemimandibles) were included. An AL was found in 40.6% (95% CI: 32.8%-48.9%, P<0.05) of participants and 36.0% (95% CI: 27.5%-45.5%, P<0.05) of hemimandibles, in 34.9% (95% CI: 25.1%-46.2%, P<0.05) of males and 34.5% (95% CI: 23.5%-47.4%, P<0.05) of females. The average length of ALs was 2.39 mm (95% CI: 2.07-2.70 mm, P<0.05). Their extension was 2.13 mm (95% CI: 1.54-2.73 mm, P<0.05) in males and 1.85 mm (95% CI: 1.35-2.36 mm, P<0.05) in females. Significant differences were observed regarding the prevalence and length of ALs among continents and for its measured length on different CBCT-reconstruction images, but not between other subgroups. Conclusion: AL was a relatively common finding. The voxel size and fields of view of CBCT devices were adequate for assessing AL; however, a 2-mm safety margin from anatomical structures(such as the AL) could be recommended to be considered when using CBCT imaging.

• The Korean Journal of Physiology and Pharmacology
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• 제27권1호
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• pp.39-48
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• 2023

Spinal nerve injury causes mechanical allodynia and structural imbalance of neurotransmission, which were typically associated with calcium overload. Storeoperated calcium entry (SOCE) is considered crucial elements-mediating intracellular calcium homeostasis, ion channel activity, and synaptic plasticity. However, the underlying mechanism of SOCE in mediating neuronal transmitter release and synaptic transmission remains ambiguous in neuropathic pain. Neuropathic rats were operated by spinal nerve ligations. Neurotransmissions were assessed by whole-cell recording in substantia gelatinosa. Immunofluorescence staining of STIM1 with neuronal and glial biomarkers in the spinal dorsal horn. The endoplasmic reticulum stress level was estimated from qRT-PCR. Intrathecal injection of SOCE antagonist SKF96365 dose-dependently alleviated mechanical allodynia in ipsilateral hind paws of neuropathic rats with ED₅₀ of 18 ㎍. Immunofluorescence staining demonstrated that STIM1 was specifically and significantly expressed in neurons but not astrocytes and microglia in the spinal dorsal horn. Bath application of SKF96365 inhibited enhanced miniature excitatory postsynaptic currents in a dosage-dependent manner without affecting miniature inhibitory postsynaptic currents. Mal-adaption of SOCE was commonly related to endoplasmic reticulum (ER) stress in the central nervous system. SKF96365 markedly suppressed ER stress levels by alleviating mRNA expression of C/ EBP homologous protein and heat shock protein 70 in neuropathic rats. Our findings suggested that nerve injury might promote SOCE-mediated calcium levels, resulting in long-term imbalance of spinal synaptic transmission and behavioral sensitization, SKF96365 produces antinociception by alleviating glutamatergic transmission and ER stress. This work demonstrated the involvement of SOCE in neuropathic pain, implying that SOCE might be a potential target for pain management.

• Journal of Acupuncture Research
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• 제26권5호
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• pp.49-56
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• 2009

Objectives : The purpose of this study was to assess the effect of Hwangryunhaedok-tang pharmacopuncture at $CV_{17}$ for reducing mental stress using power spectrum analysis of the heart rate variability(HRV). Methods : 30 healthy volunteers(control group: 15, experimental group: 15) participated in this study. After instrumentation and 5-minutes rest period, mental stress by operation was provided for 5-minutes. HRV was recorded before and after the mental stress. And then the control group rested for 15-minutes. The experimental group was injected Hwangryunhaedok-tang pharmacopuncture at $CV_{17}$ and rested for 15-minutes. And then HRV was recorded. Results : In simple rest group, LF norm and HF norm showed a significant change after mental stress. In pharmacopuncture group, LF norm, HF norm and LF/HF showed a significant change after mental stress. But there were no significant difference between two groups(p>0.05). In pharmacopuncture group, LF norm, HF norm and LF/HF showed a significant change after pharmacopuncture injection. There were significant difference between two groups(p<0.01). Conclusions : The result suggests that Hwangryunhaedok-tang pharmacopuncture at $CV_{17}$(Jeonjung) can regulate and prevent the alteration of autonomic nerve system due to mental stress.

• Journal of Acupuncture Research
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• 제27권2호
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• pp.51-58
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• 2010

Objectives : The purpose of this study was to assess the effect of $PC_6$ moxibustion treatment for reducing mental stress using power spectrum analysis of the heart rate variability(HRV). Methods : 20 healthy volunteers(simple rest group : 10, moxibustion treatment group : 10) participated in this study. After instrumentation and 5-minutes rest period, mental stress by operation was provided for 5-minutes. HRV was recorded before and after the mental stress. And then the simple rest group rested for 15-minutes. The moxibustion treatment group was treated by $PC_6$ moxibustion and rested for 15-minutes. And then HRV was recorded. Results : In simple rest group, LF norm and HF norm showed a significant change after mental stress. In moxibustion treatment group, LF, HF, LF norm, HF norm and LF/HF showed a significant change after mental stress. But there were no significant difference between two groups(p>0.05) except HF. In moxibustion treatment group, LF, LF norm, HF norm and LF/HF showed a significant change after moxibustion treatment. There were significant differences between two groups(p<0.05). Conclusions : The result suggests that $PC_6$ moxibustion treatment can regulate and prevent the alteration of autonomic nerve system by mental stress.

• 동의생리병리학회지
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• 제19권3호
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• pp.596-599
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• 2005

Human health is affected by not only physical conditions but also mental and social well-being. Changes of human emotions show up as gestures, facial expressions and sweating. Human emotions are affected by such automatic nerve system functions as blood pressure, blood circulation speed, heart beats, pupillary reflex, fluid transfusion, muscular contraction and digestive organs, all of which influence the holistic diseases. The Oriental Medicine sees from a perspective of unity of divinity and men that human life activities are united in terms of their physical and mental functions. From such a perspective, human Five Organs are linked with Five Mental(五神) and Seven Emotions(七情), while they are affected by each other, influencing the life activities both directly and indirectly. Based on Confucianism, Sa-Sang Theory argues that human emotions can be categorized into four energy states and therefore, that human diseases and physiological conditions there of may be determined differently depending on the Four Energies(四氣). There seems to be some common points between Sa-Sang Theory and the conventional Oriental Medicine in that human emotions affect individuals' health conditions, so there seems to be much room for mutual complementation.