• Journal of Oral Medicine and Pain
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• v.48 no.1
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• pp.31-36
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• 2023

This report presents the case of a 14-year-old male with rheumatoid arthritis (RA) in both temporomandibular joints (TMJs), in whom a bone scan and laboratory tests were used to confirm the diagnosis. The patient visited the Department of Orofacial Pain and Oral Medicine at the affiliation hospital with a complaint of a 1-year history of bilateral TMJ pain and sound. Clinical examination revealed bilateral TMJ and masseter muscle pain during mouth opening and palpation. Radiological examination revealed no significant morphological changes in either TMJ. The patient was prescribed medications at the first visit to address the pain, inflammation, and stiffness. A bone scan and laboratory tests were planned/scheduled for differential diagnosis between simple arthralgia and osteoarthritis. The bone scan revealed increased radiotracer uptake in both TMJs. The laboratory tests revealed a RA factor of 82.4 IU/mL, which is more than four times the normal range. The final diagnoses were bilateral TMJ early rheumatoid arthritis (ERA) and juvenile idiopathic arthritis. We created a stabilization splint and referred the patient to the Department of Rheumatology for further evaluation of the ERA. After fitting of the stabilization splint and giving instructions regarding its use, the patient has been receiving monthly follow-up checks for symptoms and undergoes follow-up blood tests every 3 months. About 14 months after the initial visit, the pain had significantly decreased from a Visual Analog Scale score of 5 to 1, and the RA factor decreased to 66.6 IU/mL. A regular follow-up check will continue until the end of growth.

• Restorative Dentistry and Endodontics
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• v.46 no.3
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• pp.31.1-31.13
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• 2021

Objectives: To evaluate postoperative pain after endodontic treatment of necrotic teeth using large intentional foraminal enlargement (LIFE). Materials and Methods: The sample included 60 asymptomatic necrotic teeth (with or without chronic apical periodontitis), and a periodontal probing depth of 3 mm, previously accessed and referred to perform endodontic treatment. After previous procedures, the position and approximate size of the apical foramen (AF) were determined by using an apex locator and K flexo-files, respectively. The chemomechanical preparation was performed with Profile 04 files 2 mm beyond the AF to achieve the LIFE, using 2.5 mL of 2.5% NaOCl at each file change. The filling was performed by Tagger's hybrid technique and EndoFill sealer. Phone calls were made to all the patients at 24, 48 and 72 hours after treatment, to classify postoperative pain. Statistical analysis was performed by different tests with a significance level of 5%. Results: Age, gender, periradicular status and tooth type did not influence postoperative pain (p > 0.05). Only 1 patient (1.66%) reported severe pain after 72 hours. Moderate pain was reported by 7, 4 and 3 patients after 24, 48 and 72 hours, respectively (p = 0.0001). However, paired analyses showed a statistically significant difference only between 24 and 72 hours (p = 0.04). Sealer extrusion did not influence the postoperative pain (p > 0.05). Conclusions: Acute or moderate postoperative pain was uncommon after endodontic treatment of necrotic teeth with LIFE.

• The Journal of Korean Physical Therapy
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• v.22 no.5
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• pp.49-56
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• 2010

Purpose: The aim of this study was to evaluate a possible role for cranial artery velocity in cervicogenic headache. Methods: We studied 13 patients with cervicogenic headaches (M=9, F=4, age=$24.50{\pm}3.50\;y$) these were compared to 20 normal subjects (M=10, F=10, age=$23.30{\pm}2.90\;y$). Cervicogenic headache patients were divided into two groups (a myofascial relaxation group, a placebo group). Pain levels were measured using a visual analog scale (VAS). Transcranial Doppler (TCD) ultrasound recordings were used to measure blood flow velocity in the cranial artery. Results: Cervicogenic headache patients exhibited a significantly lower blood flow velocity in the middle cerebral artery. The patients who received an intervention had a significantly higher blood flow velocity in the left middle cerebral artery, right vertebral artery and basilar artery. Compared to the placebo group, the myofascial relaxation group exhibited a significantly decreased level of pain. Conclusion: Cervicogenic headache is pain referred to the head from a source in the cervical spine. Manual therapy affect to cervical spine and soft tissue as well as the passage of these vessels and nerves to recover because it is thought to be able to help.

• The Journal of the Korean dental association
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• v.38 no.6 s.373
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• pp.549-557
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• 2000

ㆍPurpose: This study was performed to investigate the initial conservative treatment for TMD patients using careful counselling and medication prospectively. ㆍMaterials and Methods: Careful counselling and medication were performed in 51 TMD patients and 27 patients had follow-up check 2 months or more. Diagnosis of TMD was based on medical history and, physical and radiographic examination. TMD included masticatory disorder, internal derangement, degenerative joint disease, inflammatory joint disorder. and problems resulting from extrinsic trauma. All patients had chief complaints of TMJ pain, mouth-opening limitation. joint noise, and/or referred pain. We counselled and explained to the patient about the pathogenesis, etiologic factors, diagnosis and treatment plan for abut 10 minutes. We prescribed nonsteroidal anti-inflammatorv analgesic(Somalgen) and amitriptyline 10mg per day for 2 weeks. We informed the patient of the attention sheet and taught self-exercise of jaw. The patient were assessed by answering the questionnaire of subjective evaluation of TMD & maxillofacial pain. Questionnaire of an activity limitation. Questionnaire of a jaw function, and Questionnaire for the evaluation of TMD. ㆍResults: In questionnaire for the evaluation of TMD, 88.5% of 26 patients answered that the treatment was efficacious. 71.4% of 21 patients answered no problem in everyday life. There were significant differences between pretreatment and final follow-up in the evaluation of the subjective pain in the following sections: opening widely, chewing, resting, morning, masticatory muscle, and temporal portion(SAS program, paired T-test, P = 0.05). ㆍConclusions: Considerate counselling and proper medication could be significantly effectve in the initial treatment of TMD.

• Korean Journal of Acupuncture
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• v.23 no.2
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• pp.39-46
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• 2006

Objective & Methods: This study is performed to understand the interrelation between 'Foot yangmyung meridian-muscle' and 'muscular system'. We studied the literatures on Meridian-muscle theory, anatomical muscular system, myofascial pain syndrome and the theory of anatomy trains. Results & Conclusion: 1. It is considered that Foot yangmyung meridian-muscle includes extensor digitorum longus m., tibialis anterior m., quadriceps femoris m., rectus abdominis m., pectoralis major m., sternocleidomastoid m., platysma m., orbicular oris m., zygomaticus major m., zygomaticus minor m., masseter m., Gluteus medius m., and Obliquus externus abdominis m. 2. The symptoms of Foot yangmyung meridian-muscle are similar to the myofascial pain syndrome with referred pain of extensor digitorum longus m., tibialis anterior m., quadriceps femoris m., rectus abdominis m., obliquus abdominis m., masseter m. 3. Superficial frontal line in anatomy trains is similar to the pathway of Foot yangmyung meridian-muscle, and more studies are needed in anatomy and physiology to support the continuity of muscular system of Foot yangmyung meridian-muscle in aspect of anatomy trains.

• Imaging Science in Dentistry
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• v.48 no.1
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• pp.67-72
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• 2018

Historically, Eagle syndrome is a term that has been used to describe radiating pain in the orofacial region, foreign body sensation, and/or dysphagia due to a unilateral or bilateral elongated styloid process impinging upon the tonsillar region. Because elongated styloid processes-with or without associated Eagle syndrome-can present with various symptoms and radiographic findings, it can be challenging for healthcare practitioners to formulate an accurate diagnosis. Abnormal styloid anatomy can lead to a multitude of symptoms, including chronic orofacial/neck pain, thus masquerading as more commonly diagnosed conditions. In this report, we describe a patient who presented to our department with styloid process elongation and fracture. A careful history, physical examination, and a cone-beam computed tomography (CBCT) investigation led to the diagnosis. The patient was then referred for appropriate care. This case report demonstrates the utilization of CBCT in differentiating a fracture site from a pseudo-joint that might mimic a fracture.

• Korean Journal of Acupuncture
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• v.26 no.4
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• pp.135-144
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• 2009

Objective : The Meridian sinew is one of the meridian subsystems, which includes muscles distributed on the twelve meridian. This study was performed to understand which muscle is falling under 'Foot lesser yin meridian sinew'. Methods : We have studied the literatures on meridian sinew theory and searched muscles which correspond to 'Foot lesser yin meridian sinew' in anatomical muscular system. And we researched myofascial pain syndrome about the symptoms of the muscles falling under 'Foot lesser yin meridian sinew'. Lastly we compared 'Foot lesser yin meridian sinew' with 'Deep Frontal Line' - one of the anatomical trains. Results & Conclusion : 1. It is considered that 'Foot lesser yin meridian sinew' includes flexor digitorum brevis muscle, abductor hallucis muscle, medial head of gastrocnemius muscle, flexor digitorum longus muscle, adductor muscle, iliopsoas muscle, erctor spinae muscle. 2. The symptoms of 'Foot lesser yin meridian sinew' are similar to the myofascial pain syndrome with referred pain of the muscles falling under 'Foot lesser yin meridian sinew'. 3. 'Deep frontal line' is similar to 'Foot lesser yin meridian sinew', but not exactly in neck & pelvic muscles.

• Journal of Oral Medicine and Pain
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• v.44 no.1
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• pp.40-44
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• 2019

Third molar extraction, one of the important surgical treatments commonly practiced in dentistry, presents various symptoms after surgery ranging from temporary or mild symptoms to permanent or severe complications. However, oral burning pain, dysesthesia, parageusia, dry mouth, headache and pain in multiple teeth are not the common symptoms that patients often complain after dental extraction. Here, the authors report two cases who presented acute neuropathic symptoms mentioned above in the orofacial regions following third molar extraction. At the initial examination, the healing of the tooth sockets of two patients was normal. One patient was diagnosed as megaloblastic anemia associated with Vitamin $B_{12}$ deficiency and was referred to the Department of Hematology for assessing the underlying etiology of anemia. The laboratory test for the other patient revealed microcytic anemia related to iron deficiency. The patient with iron deficiency anemia was successfully treated with iron supplement. These two cases suggest that anemia, as an underlying systemic disease, may be a rare etiology explaining acute onset of peripheral neuropathy in the orofacial regions after third molar extraction and should be considered in the assessment of patients who report neuropathic symptoms after dental extraction.

• Journal of Oral Medicine and Pain
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• v.44 no.3
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• pp.127-132
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• 2019

Septic arthritis of the temporomandibular joint (TMJ) is an uncommon disease caused by microbial pathogens through hematogenous infection, local spread, or iatrogenic infection. As the symptoms have an insidious onset, the early stage of septic arthritis is often confused with other diseases. A 49-year-old man was referred for increasing preauricular pain, swelling, and restricted mouth opening. He had been initially diagnosed as having a conventional temporomandibular joint disorder and trigeminal neuralgia and had been treated for the same. Imaging studies including panoramic view, lateral tomography, computed tomography with contrast enhancement, and magnetic resonance imaging were performed. Erosive bone change with displacement of the involved condyle, diffuse swelling of adjacent soft tissue, and fluid collection in the joint space were noted. Needle aspiration of the joint space and bacterial culture confirmed the diagnosis of septic arthritis of the TMJ and he was treated with antibiotic therapy and surgical drainage. Clinicians should always consider the diagnosis of septic arthritis of the TMJ in patients with preauricular pain or swelling.

• Clinical Pain
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• v.19 no.1
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• pp.45-48
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• 2020

Angioleiomyoma is an infrequent benign smooth muscle tumor that arises from smooth muscle cells of arterial or venous walls in the tunica media layer. It would be found in the dermis, the subcutaneous tissue, or the superficial fascia of the anywhere in the body and is most often seen in the lower extremities. The typical lesion is a small, slowly growing, round, but firm and mobile nodule. We report a case of angioleiomyoma located on the anterior aspect of the elbow, which was mistaken for extradigital glomus tumor after history taking, physical examination. With point tenderness and worsening sharp pain in cold exposure for several years, the patient was referred for a further evaluation, and the lesion was 5 mm sized well-circumscribed mass in the anterior elbow with vascular signals on color and power Doppler by ultrasonography and finally diagnosed as angioleiomyoma following complete excision and histological evaluation.