• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권4호
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• pp.171-183
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• 2023

Objectives: Understanding the lingual nerve's precise location is crucial to prevent iatrogenic injury. This systematic review seeks to determine the lingual nerve's most probable topographical location in the posterior mandible. Materials and Methods: Two electronic databases were searched, identifying studies reporting the lingual nerve's position in the posterior mandible. Anatomical data in the vertical and horizontal dimensions at the retromolar and molar regions were collected for meta-analyses. Results: Of the 2,700 unique records identified, 18 studies were included in this review. In the vertical plane, 8.8% (95% confidence interval [CI], 1.0%-21.7%) and 6.3% (95% CI, 1.9%-12.5%) of the lingual nerves coursed above the alveolar crest at the retromolar and third molar regions. The mean vertical distance between the nerve and the alveolar crest ranged from 12.10 to 4.32 mm at the first to third molar regions. In the horizontal plane, 19.9% (95% CI, 0.0%-62.7%) and 35.2% (95% CI, 13.0%-61.1%) of the lingual nerves were in contact with the lingual plate at the retromolar and third molar regions. Conclusion: This systematic review mapped out the anatomical location of the lingual nerve in the posterior mandible, highlighting regions that warrant additional caution during surgeries to avoid iatrogenic lingual nerve injuries.

• International Journal of Industrial Entomology and Biomaterials
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• 제48권1호
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• pp.1-12
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• 2024

Silk sericin, a natural protein from silkworm cocoons, is emerging as a multifunctional biomaterial in biomedicine, particularly in tissue engineering and wound healing. Recent studies have highlighted its biocompatibility, biodegradability, and potential for chemical modification, which allows it to be incorporated into various scaffold architectures. This review article synthesizes current research, including the development of sericin-based hydrogel scaffolds for tissue engineering and sericin's role in enhancing wound healing. Key findings demonstrate sericin's ability to refine scaffold porosity and mechanical strength, expedite tissue healing, and reduce bacterial load in wounds. The integration of sericin into novel bioactive dressings and its use in peripheral nerve injury repair are also discussed, showcasing its adaptability and efficacy. The convergence of these studies illustrates the broad applications of sericin, from scaffold design to clinical interventions, making it a promising material in regenerative medicine and tissue engineering, with the potential to improve patient outcomes significantly.

• 대한치과마취과학회지
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• 제9권1호
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• pp.30-35
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• 2009

Intravenous midazolam has been frequently used for the relief of anxiety in dental treatment. This is likely the result of the sedative and anterograde amnestic properties of midazolam that are mediated through $\gamma$-Aminobutyric acid agonism. Unfortunately, Paradoxical reactions to midazolam include agitation, talkativeness, confusion, disinhibition, aggression,violent behavior, act of self-injury and need for restraints. These occur in less than 1% of all patients receiving midazolam, may occur at variable times after administration and are difficult to predict and diagnose. Two women with severe anxiety for dental treatment experienced paradoxical reactions associated with the use of intravenous midazolam. We are reviewed the management and prevention of paradoxical reactions and its different etiology.

• 대한치과마취과학회지
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• 제12권2호
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• pp.121-123
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• 2012

Nasotracheal intubation is an essential procedure during general anesthesia for dental treatment. Fiberoptic intubation is best accomplished by those who perform it as part of their daily practice. But nasal approach of fiberoptic intubation has some complications such as epistaxis and laryngeal injury. Especially, epistaxis is common and it make fiberoptic intubation because of limited view. When the epistaxis obstruct the field of vision we have to withdraw the fiberoptic bronchoscope and consider the other method for securing the airway. We succeeded in securing the airway of patient who had epistaxis during the fiberoptic nasotracheal intubation without withdrawing the fiberoptic bronchoscope. We used blind intubation guided by light source placed the tip of fiberoptic bronchscope applied to lightwand intubation.

• Imaging Science in Dentistry
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• 제50권4호
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• pp.353-357
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• 2020

The canalis sinuosus (CS) and its accessory canals (ACs) are anatomical structures in the anterior maxilla. These structures are often neglected when planning implant surgery because their clinical significance is still not well-defined. After a retrospective evaluation of 194 patients rehabilitated with dental implants in the anterior maxilla, 3 patients were identified who presented unexpected chronic neurosensory disturbances without any clinical signs supportive of implant failure. Tomographic assessment using cone-beam computed tomography (CBCT) revealed the invasion of the CS and ACs by dental implants, which appeared to explain the patients' symptoms. The purpose of this report was to familiarize practicing dentists and specialists with the CS and its ACs. Unanticipated neurosensory symptoms after implant placement in the anterior maxilla justify the use of CBCT to rule out an injury to this neurovascular bundle.

• 한국치위생학회지
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• 제11권1호
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• pp.127-136
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• 2011

Objectives : The writer aimed to examine the dynamic aspect on damage and to be conducive to the swift cure according to right treatment to educate prevention of injury through surveying on the number of the damaged teeth given injury, tooth kind, type in damage, place and cause for being damaged, frequency by month and by time level, and location of the damaged tooth. Methods : Targeting 343 teeth of receiving injury in 201 patients who visited the department of pediatric dentistry, the department of preservation, and the oral and maxillofacial surgery in a dental hospital in Cheonan city from April 2007 to April 2009, by having the dental injury as the main reason, the following conclusions were obtained. Results : 1. Deciduous teeth were indicated to be the highest in imperfect luxation with 60.7%, and were indicated to be in order of crown fracture with 25.5%, root fracture with 12.4%, and perfect luxation with 1.4%. The permanent teeth were indicated to be the highest in crown with 58.1%, and were indicated to be in order of imperfect luxation with 27.3%, root fracture with 13.1%, and perfect luxation with 1.5%(p<0.001). 2. In case of deciduous teeth for a place with damage, the home was indicated to be the highest with 31.7%. The permanent teeth were indicated to be the highest(p<0.001) in the road and stairs with 40.4%. As to a cause for damage, both deciduous and permanent teeth were indicated to be the highest(p<0.001) in a cause for falling with 53.1% and 30.8%, respectively. 3. As for a treatment method, in case of deciduous teeth, the close observation was indicated to be the highest with 46.9%. In permanent teeth, the resin restoration was indicated to be the highest(p<0.001) with 22.2%. Dental injuries in deciduous teeth and permanent teeth are showing diverse aspects. Conclusions : It is important to arrange guidelines on cure of the damaged teeth by injury through continuing a dynamic research on these aspects. Also, the damage in deciduous teeth may have direct and indirect influence upon growth in successional permanent teeth. Thus, through careful treatment, the injury needs to be minimized. It is considered to be likely necessary for a right coping method when injury occurs, and above all, for enough prior education so that injury cannot occur.

• 대한장애인치과학회지
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• 제6권2호
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• pp.116-119
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• 2010

Trauma to the lips and tongue can occur by accidental self-biting after dental treatment. After local anesthesia, it is likely that the patient may feel painless even in biting the tongue. In case of young children and disabled patients, the dentists should be careful not to bite the tongue. In this report, we present a case of deep lingual laceration due to biting the tongue in the course of dental treatment under general anesthesia. A 33 year-old male was transferred to our hospital to treat tongue laceration. Before 2 hour on arrival, he had received dental care under general anesthesia at a dental hospital for the disabled because of cooperation difficulty and cerebral palsy. During recovery from general anesthesia, he tried to bite his own tongue involuntary. The doctors and nurses tried to prevent the patient from being injured. Despite these efforts, massive bleeding occurred from the injured sites of the tongue. Because we could not communicate with him, we decided to evaluate the extent of the injury and treat the injured sites under general anesthesia. The laceration wound was sutured for nearly 1 hr general anesthesia. During recovery we inserted mouth prop into the oral cavity to prevent further injuries from tongue biting. After full recovery from general anesthesia he didn't try to bite his tongue. After 4 hour admission, he was discharged without other complications.

• 대한치과마취과학회지
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• 제14권3호
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• pp.157-165
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• 2014

Background: Incisional site of surgical operation become transient ischemic state and then occur reoxygenation due to vasodilatation by inflammatory reaction, the productive reactive oxygen species (ROS) give rise to many physiologic results. Apoptosis have major role on elimination of inflammatory cell and formation of granulation tissue in normal wound healing process. Remifentanil can prevent the inflammatory response and can suppress inducible nitric oxide synthase expression in a septic mouse model. After cardiopulmonary bypass for coronary artery surgery, remifentanil can also inhibit the release of biomarkers of myocardial damage. Here we investigated whether remifentanil pretreatment has cellular protective effect against hypoxia-reoxygenation in HaCaT human keratinocytes, if so, the role of apoptosis and autophagy on this phenomenon. Methods: The HaCaT human keratinocytes were exposed to various concentrations of remifentanil (0.01, 0.05, 0.1, 0.5 and 1 ng/ml) for 2 h before hypoxia (RPC/HR group). These cells were cultured under 1% oxygen tension for 24h at $37^{\circ}C$. After hypoxia, to simulate reoxygenation and recovery, the cells were reoxygenated for 12 h at $37^{\circ}C$. 3-MA/RPC/HR group was treated 3-methyladenine (3-MA), autophagy inhibitor for 1h before remifentanil treatment. Cell viability was measured using a quantitative colorimetric assay with thiazolyl blue tetrazoliumbromide (MTT, amresco), showing the mitochondrial activity of living cells. To investigate whether the occurrence of autophagy and apoptosis, we used fluorescence microscopy and Western blot analysis. Results: The viability against hypoxia-reoxygenation injury in remifentanil preconditioning keratinocytes were increased, and these cells were showed stimulated expression of autophagy 3-MA suppressed the induction of autophagy effectively and the protective effects on apoptosis. Atg5, Beclin-1, LC3-II and p62 were elevated in RPC/HR group. But they were decreased when autophagy was suppressed by 3-MA. Conclusions: Remifentanil preconditioning showed the protective effect in human keratinocytes, and we concluded that autophagy may take the major role in the recovery of wound from hypoxia-reoxygenation injury. We suggest that further research is needed about the cell protective effects of autophagy.

• 구강회복응용과학지
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• 제27권3호
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• pp.327-336
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• 2011

치과에서 임상적으로 신경병성 통증이 발생하는 경우는 주로 하악신경이 손상 받은 경우이며 그 원인으로는 발치, 인공치아매식, 악안면 수술, 치주치료 및 근관치료 등이 있다. 본 연구는 근관치료 후 발생한 하악신경 손상 환자의 신경병증의 원인과 증상에 따라 약물치료를 통해 개선된 정도를 분석해 보고자 하였다. 근관치료 후 발생한 이상감각 또는 통증을 주 증상으로 2004년부터 2011년까지 연세대학교 치과대학병원 구강내과에 내원한 환자 중 32명의 의료기록을 분석하였고, 약물치료를 시행한 경우 환자의 증상이 개선된 정도를 평가하였다. 초진시 감각저하 또는 감각부전의 증상을 호소한 총 32명의 환자 (남자 9명, 여자 23명, 평균나이 44세)를 분석하였다. 신경병증의 발생 원인은 근관치료 시 마취 (46.9%), 근관 내 적용한 약재에 의한 화학적 손상 (25%), 근관수술 (15.6%), 기타 원인이 불분명한 경우 (12.5%) 순으로 많았다. 처방된 약물은 스테로이드, 항경련제, 항우울제, 진통제 등이었고, 환자의 증상이 개선될 때까지 약물 용량은 조절되었으며, 약물 복용 기간은 1주일에서 11개월까지 다양하였다. 증상이 나타난 부위에 따라 하치조신경 손상으로 인한 증상을 나타내는 환자가 25명, 설신경 손상으로 인한 증상을 나타내는 환자가 7명이었으며, 약물치료 후 증상이 개선된 경우가 21명 (66%), 증상 개선이 미미하거나 없는 경우가 11명 (34%)이었다. 그 증상은 감각저하와 감각부전으로 분류하였고, 감각저하는 67%, 감각부전은 65% 개선을 보였다. 근관치료와 연관된 하악신경 손상으로 인해 신경병증이 발생된 경우 약물치료를 통한 증상 개선을 도모해 볼 수 있다. 다만, 신경병증의 종류와 회복 수준은 신경 손상의 원인, 정도와 손상 발생 후 치료 시기, 처치 방법 등에 의해 영향을 받으며, 각각의 변수에 따라 통증 강도나 회복 정도에 차이가 있을 것으로 예상되므로 향후 더 많은 개체 수에서 다양한 변수에 대한 정량적인 연구가 필요할 것으로 생각된다.

• Journal of Trauma and Injury
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• 제21권1호
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• pp.59-65
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• 2008

Purpose: The aim of this study was to evaluate the effect of overexpression of heat shock protein 70 (HSP70) on the expression of inducible nitric oxide synthase and on the concentration of nitric oxide and to determine the mechanism for the relationship between HSP70 and inducible nitric oxide synthase (iNOS) in sepsis. Methods: Experiments were performed on male Sprague-Dawley rats, and sepsis was induced by using cecal ligation and puncture (CLP). Glutamine (GLN) or saline was administered 1 h after initiation of sepsis. We acquired serum and lung tissues from the rats 12 h or 24 h after initiation of sepsis. We analyzed the concentration of nitric oxide, the expression of HSP70 in the lung, and the gene expression of iNOS in the lung. Results: In CLP+GLN, glutamine given after initiation of sepsis enhanced the expression of HSP70 in the lung at 12 h (CLP+GLN vs. CLP:: $47.19{\pm}10.04$ vs. $33.22{\pm}8.28$, p = 0.025) and 24 h (CLP+GLN vs. CLP: $47.06{\pm}10.60$ vs. $31.90{\pm}4.83$, p = 0.004). In CLP+GLN, glutamine attenuated the expression of iNOS mRNA in the lung at 12 h (CLP+GLN vs. CLP: $4167.17{\pm}951.59$ vs. $5513.73{\pm}1051.60$, p = 0.025) and 24 h (CLP+GLN vs. CLP: $9,437.65{\pm}2,521.07$ vs. $18,740.27{\pm}8,241.20$, p = 0.016) and reduced the concentration of nitric oxide in serum at 12 h (CLP+GLN vs. CLP: $0.86{\pm}0.48$ vs. $3.82{\pm}2.53{\mu}mol/L$, p = 0.016) and 24 h (CLP+GLN vs. CLP: $0.39{\pm}0.25$ vs. $1.85{\pm}1.70{\mu}mol/L$, p = 0.025). Conclusion: The overexpression of HSP70 induced by the administration of glutamine in sepsis attenuated the gene expression of iNOS and reduced the concentration of nitric oxide.