• Journal of Periodontal and Implant Science
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• 제27권3호
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• pp.443-457
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• 1997

The purpose of this study was to evaluate the effects of ethanolic extracts of Scutellaria Radix on the alveolar bone formation in the extract socket of rat. Thirty-six Sprague-dawley rats were used in this study. Mean body weight of rat was $130{\pm}5g$. Experimental animal were administered 0.4% ,${\beta}-aminopropionitril$(Sigma, USA) with the solid commercial food for 5 days. All the maxillary 1st molar of the rats were extracted by using of the tissue forcep under the general anesthesia with Pentobarbital sodium(Tokyo Chemical Co, Japan) injection into intraperitoneal space. All the extracted rats were divided into two group, experimental group which were feeded the solid food mixed ethanolic extracts of Scutellaria Radix, and control group which were feeded same food without reagent. At 1, 3, 5, 7, 9 and 14th days after tooth extraction, rats in both groups were serially sacrificed respectively. All the specimen were treated as usual method and prepared Hematoxylin-eosin stain for the light microscopic observation. The results were as follows : 1. Bone formation of extracted socket starts from the area on remained periodontal ligament than other area. 2. In the case of administration of the extracted Scutellaria Radix showed rapid healing process of connective tissue than non-administrated group. 3. In the case of administration of the extracted Scutellaria Radixshowed rapid osteogenesis than non-administrated With above results, it was concluded that ethanolic extracts of Scutellaria Radix may play a favorable role on the healing process of exatraction socket after extraction in rats. It was suggested that further study to evaluate the different concentration and administration method of ethanolic extracts of the Scutellaria Radix into same experimental model.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권5호
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• pp.277-288
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• 2019

Background: This study evaluated the efficacy of virtual reality (VR) distraction and counter-stimulation (CS) on dental anxiety and pain perception to local anesthesia in children. Methods: A prospective, randomized, single-blinded interventional clinical trial with a parallel design was used. Seventy children 7-11 years old who required local anesthesia (LA) for pulp therapy or tooth extraction were recruited and allocated to two groups with equal distribution based on the intervention. Group CS (n = 35) received CS and Group VR (n = 35) received VR distraction with ANTVR glasses. Anxiety levels (using pulse rate) were evaluated before, during, and after administration of local anesthesia, while pain perception was assessed immediately after the injection. Wong-Baker faces pain-rating scale (WBFPS), visual analog scale (VAS), and Venham's clinical anxiety rating scale (VCARS) were used for pain evaluation. Student's t-test was used to test the mean difference between groups, and repeated measures ANOVA was used to test the mean difference of pulse rates. Results: Significant differences in mean pulse rates were observed in both groups, while children in the VR group had a higher reduction (P < 0.05), and the mean VCARS scores were significant in the VR group (P < 0.05). Mean WBFPS scores showed less pain perception to LA needle prick in the CS group while the same change was observed in the VR group with VAS scores. Conclusions: VR distraction is better than CS for reducing anxiety to injection in children undergoing extraction and pulpectomy.

• Journal of Periodontal and Implant Science
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• 제51권4호
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• pp.276-284
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• 2021

Purpose: The aim of this randomized clinical trial was to assess whether chemical cleansing using a sulfonic/sulfuric acid gel solution (HBX) as an adjunct to scaling and root planing (SRP) resulted in a decrease in residual plaque and calculus in deep periodontal pockets compared to SRP alone. Methods: Fifty-six patients with 56 hopeless posterior teeth, scheduled for extraction due to severe periodontitis, were enrolled in this study. Each tooth was randomly assigned to 1 of the 2 experimental procedures. The test teeth were subjected to the irrigation of the subgingival area with HBX for 2 minutes, followed by SRP with hand and ultrasonic instruments for 14 minutes, and then extracted. The control teeth received only mechanical instrumentation before extraction. Residual biofilm was evaluated on photographs and measured as total area and percentage of root surface covered by remaining plaque (RP) or calculus (RC) after treatment. Results: The initial pocket depth (PD) and total subgingival root surface area were similar between the 2 treatment groups. After treatment, the total subgingival root area covered by RP and RC was statistically significantly larger (P<0.001) in the control group than in the test group. The test teeth showed a lower percentage of RP, but a higher percentage of RC than the control teeth (both P<0.001). Complete calculus removal was achieved in 42% of the control teeth surfaces and in 25% of the test teeth surfaces for a PD of 4 mm. Conclusions: The additional chemical cleansing with HBX resulted in a statistically significant improvement in bacterial plaque removal during SRP of deep pockets, but it was not effective in reducing calculus deposits.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권4호
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• pp.209-215
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• 2019

Background: Pain is an unpleasant sensation ranging from mild localized discomfort to agony and is one of the most commonly experienced symptoms in oral surgery. Usually, local anesthetic agents and analgesics are used for pain control in oral surgical procedures. Local anesthetic agents including lignocaine and bupivacaine are routinely used in varying concentrations. The present study was designed to evaluate and compare the efficacy of 0.25% and 0.5% bupivacaine for postoperative analgesia in infraorbital nerve block. Methods: Forty-one patients undergoing bilateral maxillary orthodontic extraction received 0.5% bupivacaine (n = 41) on one side and 0.25% bupivacaine (n = 41) on the other side at an interval of 7 d. The parameters evaluated for both the bupivacaine concentrations were onset of action, pain during procedure (visual analog scale score [VAS]), and duration of action. The results were noted, tabulated, and analyzed using the Wilcoxon signed rank test. Results: The onset of action of 0.5% bupivacaine was quicker than that of 0.25% bupivacaine, but the difference was not statistically significant (P = 0.306). No significant difference was found between the solutions for VAS scores (P = 0.221) scores and duration of action (P = 0.662). Conclusion: There was no significant difference between 0.25% bupivacaine and 0.5% bupivacaine in terms of onset of action, pain during procedure, and duration of action. The use of 0.25% bupivacaine is recommended.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권6호
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• pp.348-355
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• 2022

Objectives: To compare the vital sign stability and cost of two commonly used sedatives, midazolam (MDZ) and dexmedetomidine (DEX). Patients and Methods: This retrospective study targeted patients who underwent mandibular third molar extractions under intravenous sedation using MDZ or DEX. The predictor variable was the type of sedative used. The primary outcome variables were vital signs (heart rate and blood pressure), vital sign outliers, and cost of the sedatives. A vital sign outlier was defined as a 30% or more change in vital signs during sedation; the fewer changes, the higher the vital sign stability. The secondary outcome variables included the observer's assessment of alertness/sedation scale, level of amnesia, patient satisfaction, and bispectral index score. Covariates were sex, age, body mass index, sleeping time, dental anxiety score, and Pederson scale. Descriptive statistics were computed including propensity score matching (PSM). The P-value was set at 0.05. Results: The study enrolled 185 patients, 103 in the MDZ group and 82 in the DEX group. Based on the data after PSM, the two samples had similar baseline covariates. The sedative effect of both agents was satisfactory. Heart rate outliers were more common with MDZ than with DEX (49.3% vs 22.7%, P=0.001). Heart rate was higher with MDZ (P=0.000). The cost was higher for DEX than for MDZ (29.27±0.00 USD vs 0.37±0.04 USD, P=0.000). Conclusion: DEX showed more vital sign stability, while MDZ was more economical. These results could be used as a reference to guide clinicians during sedative selection.

• Journal of Korean Dental Science
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• 제16권1호
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• pp.63-73
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• 2023

Purpose: Hyperdontia is a developmental disorder of the oral cavity. Mesiodens refers to the hyperdontia located between the maxillary central incisors. During the surgical procedure, the anesthetic method for pain control should be considered along with factors related to the surgery itself. The purpose of this study was to evaluate the effect of the impacted position of the mesiodens on the selection of sedation method and to suggest incisive foramen as a brief reference. Materials and Methods: This study included 126 patients who were scheduled for extraction of mesiodens. The selection criteria included patients with one palatally impacted inverted mesiodens accessible from the palatal gingival margin, and those with good cooperation potential in order to control for clinical information. Using cone beam computed tomography, vertical, horizontal, and palatal positional factors were measured, and the anesthetic method was determined by two examiners. The patients were grouped into vertical and horizontal groups based on the position of the incisive foramen. Data were statistically analyzed using the Mann-Whitney test, the chi-square test, and logistic regression analysis. Result: All positional factors differed between the outpatient and inpatient anesthetic groups. The vertical minimum distance from the alveolar ridge to the mesiodens (Va) and the minimum distance from the palatal surface to the crown tip of the mesiodens (Tc) were factors affecting the choice of anesthetic method. The distribution of the vertical and horizontal positional groups differed between the outpatient and inpatient anesthetic groups. Conclusion: The incisive foramen can be used as a brief reference to determine the appropriate anesthetic method. Referral for inpatient anesthesia may be a priority if they are in the V₂H₂ group with Va ≥5 mm, and Tc ≥6 mm, and outpatient sedation may be considered if they are in the V₁H₁ group with Va ≤1.5 mm, and Tc ≤2.5 mm.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권4호
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• pp.285-295
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• 2024

Background: In human dentition, the most commonly impacted teeth are the mandibular third molars (M3M). The removal or extraction of these teeth often causes anxiety in patients due to the perceived pain involved in the process. Therefore, pain must be effectively managed using anesthesia. The use of newer local anesthetic drugs can help minimize side effects and drug interactions. Traditionally, adrenaline is used as a vasoconstrictor along with lignocaine. When combined with lignocaine, the alpha agonists dexmedetomidine and clonidine can extend the duration of anesthesia, thereby reducing the need for additional pain-relieving medications. Methods: This study used a randomized, triple-blind, parallel-arm design. Sixty patients were screened, and 45 systemically healthy patients requiring unilateral surgical removal of impacted mandibular third molars with similar difficulty (moderate-to-difficult according to the Modified Pederson's Index) were included in the study. Patients were allocated into three groups as follows: Group A: 2% Lignocaine Hydrochloride with 1:100,000 Adrenaline, Group C: 2% Lignocaine Hydrochloride with 15 ㎍/mL Clonidine, and Group D: 2% Lignocaine Hydrochloride with 1 ㎍/mL Dexmedetomidine. The evaluated parameters were the time of onset of anesthesia, depth of anesthesia, hemodynamic parameters, and duration of postoperative analgesia. Results: Group D had a faster onset of action and prolonged duration of postoperative analgesia compared with Groups A and C. No statistically significant differences were observed between the three groups in terms of the depth of anesthesia and hemodynamic parameters. Conclusion: Group D exhibited a significantly more rapid onset of anesthesia than Groups A and C, and the postoperative analgesic effect in Group D was significantly prolonged (7.22 hours) compared with that in Groups A (4.54 hours) and C (2.1 hours). Patients receiving the Group D solution experienced an extended period of comfort without the need for analgesics for up to 7.22 hours post-procedure.

• 대한심미치과학회지
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• 제32권1호
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• pp.16-22
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• 2023

상악 전치부 임플란트 수복의 성공에 있어서 심미적인 요소는 매우 중요한 부분입니다. 하지만 심미적인 결과를 얻는 것은 쉬운 일이 아니며 특히 치주염으로 인해 치조골 소실이 심하게 발생한 경우라면 더욱 그러합니다. 상악 전치부의 경우, 발치 직후부터 시작되는 치주 조직의 위축이 심미적 수복을 방해하므로 이를 최소화하기 위해 발치 즉시 임플란트를 시행하기도 합니다. 하지만 치조골 소실이 심한 경우 발치 즉시 식립은 심미적 실패를 가져올 가능성이 있고, 이런 결과는 돌이킬 수 없는 문제를 야기합니다. 그래서 치조제 보존술(Alveolar ridge preservation)을 시행하고 이후에 임플란트를 식립하는 방법으로 접근하기도 합니다. 2019년 JCP에 발치 후 임플란트 식립 시기와 발치와 처치에 대한 유럽치주학회의 consensus가 수록되어 있는데 여기서도 '심미적으로 중요한 부위에서 순측 치조골의 소실이 심하게 발생한 경우 치조제 보존술을 고려해야 한다고 언급하고 있습니다. 치조제 보존술을 하게 되면 primary closure가 어렵기 때문에 open membrane technique으로 이차치유를 유도하거나 FGG, CT graft를 시행하게 됩니다. 하지만 이차 치유 과정은 골재생에 부정적인 영향을 줄 수 있고, 연조직 이식은 환자와 술자에게 부담이 될 수 있습니다. 반면 치조골 결손이 심한 발치와에 있는 육아 조직(Granulation tissue)을 이용하게 되면 연조직 이식 없이도 primary closure를 얻을 수 있습니다. 또한 육아 조직에 조직 재생에 도움이 될 수 있는 줄기세포가 함유되어 있다는 연구들이 있습니다. 이를 근거로 치조골 및 연조직 결손이 심한 상악 전치부 치아를 육아 조직을 이용한 치조제 보존술을 통해 임플란트 수복을 시행하였습니다. 결손이 심한 발치와임에도 불구하고 비교적 심미적인 임플란트 수복 결과를 얻을 수 있었습니다.

• Imaging Science in Dentistry
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• 제43권2호
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• pp.105-109
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• 2013

Purpose: Preoperative radiographic assessment of the mandibular third molars is essential to prevent inferior alveolar nerve damage during extraction. The purpose of this study was to assess the reliability of panoramic signs of association between the roots of teeth and the canal, and to compare the panoramic signs with cone beam computed tomography (CBCT) findings. Materials and Methods: CBCT images of 132 impacted mandibular third molars were evaluated to determine the association of the root to the canal. The CBCT findings were compared with the corresponding panoramic images. Logistic regression analysis was used to define the diagnostic criteria of the panoramic images. Results: Among the panoramic signs, loss of the cortical line was the most frequent radiographic sign predicting association (sensitivity: 79.31). Contact of the tooth with the canal was observed in all cases in which the loss of cortical line of the canal or darkening of the roots was found on the panoramic radiographs. Conclusion: Darkening of the roots and loss of the cortical line on panoramic radiographs might be highly suggestive of the risk of nerve injury.

• 대한치과의사협회지
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• 제46권5호
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• pp.308-314
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• 2008

The risk of temporomandibular joint disorder (TMD) can be increased during dental treatment due to excessive mouth opening and change of occlusion. The aim of this study is to find the relationship between dental treatment and TMD in the patients who developed TMD after dental treatment. The subjects of this study were 21 patients, who developed TMD after dental treatment and were treated with active TMD therapy in Seoul National University Bundang Hospital from June 2003 to February 2007. The subjects were examined with preceding dental treatment, symptom, diagnosis, treatment method of TMD and prognosis of TMD. The obtained results were as follows. 1. Preceding dental treatments were : Implant treatment, 14 cases ; Tooth extraction, 3 cases and others. 2. TMD symptoms were : pain on TMJ, 12cases : Sound on TMJ, 3cases ; Mouth opening limitation, Headache and others. 3. Diagnoses of TMD were : Synovitis and/or capsulitis, 10 cases ; 8 cases of Internal derangement and others. 4. Most TMD were treated by stabilization splint. 5. Prognoses of TMD were : Improvement, 6cases ; sustained 11 cases. In conclusion, the risk of TMD is increased during implant treatment. Prognoses of TMD after dental treatment were bad. It might be that these patients were non-cooperative and have distrust of dental treatment. Because the overloading on TMJ is possible in dental treatment of patients with underlying TMD, prior explanation and knowledge TMJ treatment are very important in these cases.