• Journal of Oral Medicine and Pain
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• v.36 no.3
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• pp.199-205
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• 2011

During root canal treatment, overinstrumentation with hand or mechanically driven files can perforate the mandibular canal, allowing the extrusion of endodontic sealers, dressing agents, and irrigant solutions out of the tooth and into the canal. The patient may report symptoms such as pain, hyperesthesia, hypoesthesia, anesthesia, dysesthesia and paresthesia. Such problems must be resolved as quickly as possible to avoid irreversible sequelae caused by certain neurotoxic materials that form part of endodontic sealants. Although there have been no controlled trials of treatment protocols involving endodontically related injuries to the inferior alveolar nerve, the normal therapeutic sequence for this complication is the control of pain and inflammation and, whenever possible, the surgical elimination of the cause. However, total resolution of pain and reduction in or disappearance of paraesthesia after a non-surgical management have been reported. Antiepileptic drugs such as gabapentin or pregabalin have been used for the treatment of neuropathic pain. This article describes a case of inferior alveolar nerve(IAN) damage after endodontic treatment of a mandibular right second molar and the treatment with non-surgical approach using prednisone and gabapentin medication, monitoring the patient's condition with clinical neurosensory examination and current perception threshold test(Neurometer).

• Journal of Korean Neurosurgical Society
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• v.37 no.1
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• pp.76-78
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• 2005

We report a rare case of cauda equina syndrome due to bilateral lumbar facet cyst. A 62-year-old woman has developed both legs sciatica 3 months prior to her visit, but recently motor weakness and voiding difficulty occurred. Lumbar magnetic resonance image showed bilateral lumbar facet cyst compressing and surrounding both L5 nerve root and accompanying spinal stenosis. Urgent decompressive laminectomy and cyst removal was performed. Although sciatica was relieved and motor weakness was recovered usefully. Voiding difficulty and dysesthesia were not improved.

• Journal of Korean Neurosurgical Society
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• v.49 no.3
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• pp.182-185
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• 2011

A case of radicular pain that resulted from a gas-filled intradural cyst in an 80-year-old male is described. Temporary improvement of radicular pain was observed after CT-guided aspiration. However, recurrent radicular pain led to surgical treatment. In this report, the authors document the radiologic and intraoperative features of a gas-filled intradural cyst that migrated into the nerve root, and propose an optimal treatment plan based on a review of the literature.

• Restorative Dentistry and Endodontics
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• v.1 no.1
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• pp.18-25
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• 1975

The author has experienced 8 cases of periapical lesion which were very closed to adjacent root tip. To avoid damage on neighboring nerve and blood supply polyvinyl tube was inserted through buccal window leaving a little pathological changes in involved area. The results are as follows: 1. The purpose to maintain adjacent tooth vitality was achieved by means of intubation in the lesion. 2. Swelling and pain after operation was rather lesser than routine apical surgery, because of drainage. 3. The total treatment period seems longer than that of routine apical amputation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.29.1-29.5
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• 2017

Background: The surgical extraction of the third molar is the most frequently encountered procedure in oral and maxillofacial surgery and is related with a variety of complications. This study examined the efficacy of intentional partial odontectomy (IPO) in the third molars which have no periapical lesions and are located near important anatomical structures such as inferior alveolar nerve. Methods: Seven patients (four males, three females, $39.1{\pm}11.6years$), who received IPO to reduce the risk of inferior alveolar nerve injury (IANI), were followed long-term. The treated teeth were horizontally impacted third molars in the mandibular left (n = 5) or mandibular right (n = 4) areas and were all ankylosed with the surrounding alveolar bone. During the IPO, the bone around the crown was removed to expose the crown, and then the tooth was resected at cement-enamel junction (CEJ). Any secondary trauma to the healthy root was minimized and remained intact after primary suture. Results: The mean follow-up time was $63.2{\pm}29.8months$, and all sites showed good bone healing after the crown removal. Also, sensory abnormality was not found in any patients after IPO. In one patient, the bone fragments erupted 4 months after IPO. In other patient, an implant placed on second molar site adjacent to the third molar that received IPO was explanted about 2 years after the patient's persistent discomfort. Conclusions: In case where high risk of IANI exists, IPO may be chosen alternatively to surgical extraction to reduce the risk of nerve damage.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.2
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• pp.81-97
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• 2021

Objectives This study was designed to identify the changes of autonomic nervous system (ANS) which was induced by acupuncture at the field of the auricular branch of the vagus nerve. Methods 30 healthy adults were selected and classified into two groups; experimental group, control group. After providing mental stress, acupuncture was applied at external ear in experimental group and no treatment executed in control group. The evaluation of ANS function was measured by heart rate variability (HRV). We statically analyzed the difference of HRV parameters which include mean heart rate (MHRT), standard deviation of all N-N intervals (SDNN), square root of the mean of the sum of the squares of differences between adjacent N-N intervals (RMSSD), total power (TP), low frequency power (LF), high frequency power (HF), LF/HF ratio. Results All subjects showed significant increase in SDNN, LF after stress stimulation (p<0.05). Immediately after intervention, MHRT was significantly decreased (p<0.001) and RMSSD, HF were significantly increased in experimental group (p<0.05). After the end of intervention, SDNN, HF, RMSSD, TP, LF were significantly increased in experimental group (p<0.01, p<0.05). And when comparing baseline HRV, SDNN, LF were significantly increased in control group (p<0.01) and SDNN, RMSSD, TP, LF were significantly increased in experimental group (p<0.05). In the subgroup analysis, normal balance of ANS group showed significant increase in TP, LF, SDNN, HF (p<0.01, p<0.05). Conclusions We suggested that acupuncture at external ear, region of the vagus nerve distribution could increase parasympathetic activity and cause changes and reregulation of the ANS.

• The Korean Journal of Pain
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• v.25 no.3
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• pp.191-194
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• 2012

Tarlov or perineural cysts are nerve root cysts found most commonly at the sacral spine level arising between covering layers of the perineurium and the endoneurium near the dorsal root ganglion and are usually asymptomatic. Symptomatic sacral perineural cysts are uncommon but sometimes require surgical treatment. A 69-year-old male presented with pain in the buttock. He was diagnosed as having a sacral cyst with magnetic resonance imaging. For the nonoperative diagnosis and treatment, caudal peridurography and block were performed. After the treatment, the patient's symptom was relieved. We suggest a caudal peridural block is effective in relieving pain from a sacral cyst.

• Journal of Korean Neurosurgical Society
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• v.58 no.1
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• pp.89-92
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• 2015

Rheumatoid arthritis (RA) is a chronic inflammatory disease involving multiple joints. The cervical spine is often affected, and cases involving atlantoaxial joint can lead to instability. Anterior atlantoaxial subluxation in RA patients can lead to posterior neck pain or occipital headache because of compression of the C2 ganglion or nerve. Here, we report the successful treatment of a RA patient with occipital radiating headache using pulsed radiofrequency therapy at the C2 dorsal root ganglion.

• The Korean Journal of Pain
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• v.7 no.2
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• pp.238-241
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• 1994

Aim of this study was to discover the projection area of the first cervical spinal nerve. Subcutaneous injection of wheat germ agglutinin-horseradish peroxidase(WGA-HRP) was done at five points of young dogs scalp and face. After two days of survival time, animals were sacrificed by perfusion through the left ventricle of the heart. Trigeminal ganglion, first and second cervical dorsal root ganglion, superior cervical ganglion, middle cervical ganglion and stellate ganglion were removed. Projection area of wheat germ agglutinin-horseradish peroxidase in vestigated into above ganglions. Projection into the first cervical dorsal root ganglion and stellate ganglion was not found. This experiment is deemed valuable for the study of neuronal connection on the central nervous system.

• Imaging Science in Dentistry
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• v.51 no.4
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• pp.373-382
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• 2021

Purpose: Cone-beam computed tomography (CBCT) reconstructions were analysed to elucidate factors affecting the anatomical relationship between tooth roots and the mandibular canal(MC). Materials and Methods: Images of 300 volumetric tomography scans of patients aged between 20 and 79 years old (167 women and 133 men) were analysed. The mean distances between 2,053 dental root apices and the internal border of the MC were obtained by measuring the horizontal and vertical distances on coronal CBCT images. The actual distance was then calculated mathematically with the Pythagorean formula. The statistical significance of differences between men and women was assessed using the Mann-Whitney test. Correlations with patient age were evaluated with the Spearman rank correlation coefficient. Results: The mean distances ranged from 2.17 mm, for single right third molar roots in women, to 8.02 mm for single left third molar mesiolingual roots in men. The mean distances measured for the mandibular right second molar mesial roots and the right second premolar roots were larger in men than in women. Age showed a significant positive correlation with the measured distances for mesial and distal roots of the first and second molar on both sides and the right third molar, mesiolingual roots of the left third molar, and single roots of the right third molar. Conclusion: The root-to-mandibular canal distance depended on age and the type of tooth. In 2 root types, this distance was impacted by sex.