• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.401-407
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• 2008

The most common type of orofacial pain is toothache. However, many other types of pain which derived from nonodontogenic problems can mimic toothache. Nonodontogenic toothache is heterotopic pain that the site of pain is not in the same location of the source of pain. This differs from primary pain, in which the site of pain is the actual site which the pain originates. Heterotopic pain can be alleviated by direct treatment toward the source of pain. The common sources of nonodontogenic toothache include neuropathic pain, sinus pain, Myofascial pain, neurovascular pain and even cardiac pain and psychogenic pain. Thus, clinicians should have a thorough knowledge about causes of nonodontogenic toothache, and through pain history and examination of dental and nondental structures are needed. This case report is about some cases of nonodontogenic toothache, and it also emphasizes essential considerations for proper differential diagnosis and appropriate treatment.

• Journal of dental hygiene science
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• v.17 no.6
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• pp.495-500
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• 2017

Hippophae rhamnoides L. (sea buckthorn) is a shrub wood that belongs to the bamboo tree family, and is rich in vitamin C, D, and E; it is referred to as a vitamin tree. It is mainly grown in the high mountains of Europe and Central Asia, and has been widely used in China and Russia as natural medicine. Recent studies have shown that it is effective in the treatment of cancer, liver diseases, cardiovascular diseases, and gastrointestinal diseases. However, results of studies on its effect on the regulation of pain are insufficient. In this study, we investigated the effect of sea buckthorn on the development and control of pain in two facial areas. The experimental animals included 7- to 8-week-old Sprague-Dawley rats (240~260 g). Formalin (5%), which is known as an inflammation inducer, was injected into the vibrissa pad or temporomandibular joints to induce orofacial acute pain. Rubbing or scraping of the region injected with formalin was regarded as a pain index, and the behavioral response was observed for 45 minutes after the injection. Sea buckthorn extract diluted to 150, 300 mg/kg (in 1 ml of distilled water) was orally administered 30 minutes prior to the acute pain. The facial pain behavior was effectively reduced in the 300 mg/kg group when compared to the control group (vehicle). Likewise, in an experiment in which formalin was injected into the temporomandibular joints, effective pain alleviation was confirmed at the same drug concentration. These results suggest that sea buckthorn extract may be useful in the development of therapeutic agents for acute inflammatory pain in the orofacial area and for controlling temporomandibular joint pain.

• Journal of dental hygiene science
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• v.15 no.4
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• pp.424-429
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• 2015

The aim of this study was to investigate whether peripheral or central administration of triptolide is involved in pain modulation in inflammatory orofacial pain. The inflammatory orofacial pain was induced by the injection of 5% formalin into right vibrissa pad of rats. The pain behavioral response was measured the number of grooming or scratching on the orofacial area for 9 successive 5 minutes intervals. Triptolide was administrated into the identified vibrissa pad (12.5, 25, $50{\mu}g/50{\mu}l$) or intracisternal space (0.01, 0.1, $1{\mu}g/10{\mu}l$) 10 min before formalin injection. The nociceptive responses were reduced in the 2nd phase (11~45 minutes), particularly 20, 30 minutes after fomalin injection following administration of triptolide into vibrissa pad (25, $50{\mu}g/50{\mu}l$). Intracisternal ($1{\mu}g/10{\mu}l$) administration of triptolide alleviated the formalin-induced pain behaviors in the 2nd phase, especially 25~40 minutes after formalin injection. Triptolide could be a promising analgesic agent in the treatment of inflammatory orofacial pain.

• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.387-395
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• 2009

Nerve growth factor (NGF) and sensory neuropeptides are involved in the process of nociception at peripheral nerve fibers and wide spread in central nervous system. The aims of this study were to investigate NGF and sensory neuropeptides (substance P [SP] and calcitonin gene-related peptide [CGRP]) levels in human plasma and saliva, and the associations between these sensory neuropeptides levels and chronic orofacial pain symptoms. NGF, SP, and CGRP levels in plasma and resting whole saliva samples collected from 67 orofacial pain patients (joint pain, dental or periodontal pain, mucosal pain) and 36 pain free control subjects were measured by enzyme immunoassay. The characteristic pain intensity of each subject was measured using the Graded Chronic Pain Scale and the flow rate of resting whole saliva was measured. Joint pain patients group showed significantly higher plasma NGF level compared to each of dental pain patients (p<0.01), mucosal pain patients (p<0.01), and control group (p<0.01). Plasma NGF level of dental pain patients group was significantly higher than that of control group (p<0.01). Saliva SP level of dental pain patients group (p<0.05) and saliva CGRP level of mucosal pain group (p<0.05) were significantly higher than that of control group. Plasma and saliva SP levels of joint pain patients was significantly associated with pain intensity (plasma: standardized coefficient=0.599, p<0.01, saliva: standardized coefficient=0.504, p=0.05). In dental pain patients group, plasma SP (standardized coefficient=0.559, p<0.01), saliva SP (standardized coefficient=0.520, p<0.01) and saliva CGRP (standardized coefficient=0.599, p<0.01) levels were significantly associated with age. In mucosal pain patients group, plasma SP (standardized coefficient=0.495, p<0.05), saliva SP (standardized coefficient=0.500, p<0.05), and saliva CGRP (standardized coefficient=0.717, p<0.01) levels were significantly associated with age. NGF and neuropeptides may play a role in the maintenance of various orofacial pain symptoms. The examination of those levels in plasma and saliva helps understanding the mechanism of orofacial pain, and furthermore, can be applied to the diagnosis and therapy of orofacial pain.

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.355-364
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• 2006

Headache is a common disease which influences not only individually but also socially. Temporomandibular disorders(TMD) refers to pain and dysfunction within the temporomandibular joint(TMJ) and associated muscles. TMD is presented commonly, and 70% of population are found to have one or more related symptom. A number of studies have been conducted to verify the association between headache and TMD, and some authors have proposed that headache and TMD may be related. In this study, we studied the patterns of headache presented by the patients who visited the TMJ and Orofacial pain clinic. Among the patients participated in this study, tension type headache showed the highest prevalence(48.5%), followed by migraine without aura(15.0%), probable migraine(10.6%), migraine with aura(7.1%), probable tension type headache(4.8%), and other primary headaches(1.8%). The high prevalence of tension type headache may be due to the accompaniment of orofacial pain by pericranial muscle tenderness. Comparison of sex showed that the rate of migraine was higher in female than male(female to male ratio 35.8:25.3). In age analysis, the rate of migraine was high in the twenties(42.2%) and the thirties(40.0%). As the age increased, the rate of migraine decreased, and this trend was in accordance with the previous studies. The percentage of the patients who had previously received treatment was only 26.2%, and that of those who were aware of the diagnosis was merely 8.7%. Therefore, it is not common for headache patients to get treatment, however, since orofacial pain is often accompanied by headache, more systematic diagnosis as well as precise treatment would be necessary. Moreover, since TMD could induce and aggravate headache, proper evaluation and management of TMD would be essential for diagnosis and treatment of headache. In the future, more systematic and broad investigation on the influence of causative factors of TMD on headache as well as the change in headache pattern with the treatment of TMD would be required.

• Journal of Oral Medicine and Pain
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• v.36 no.4
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• pp.253-259
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• 2011

Numb chin syndrome, is a rare neuropathy, characterized by facial and oral numbness restricted to the distribution of the mental nerve. Even though this neuropathy is uncommon, but this still has an important clinical meaning because it can be related with a malignancy. Because orofacial symptoms can even present the first clinical feature of a malignancy, dentists should pay careful attention to their meaning and importance to detect the malignant tumor early. Moreover, patients who present with a sudden numbness on chin should be investigated for the undiagnosed malignancy. In this report, we described a patient with stabbing orofacial pain and numbness of chin who was diagnosed with diffuse large B-cell lymphoma and placed the importance on the diagnosis of NCS.

• Proceedings of the KAOM Conference
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• 2004.10a
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• pp.2-8
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• 2004

• Journal of dental hygiene science
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• v.14 no.2
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• pp.240-247
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• 2014

Acaiberry (Euterpe oleracea Mart.) is widely diffused in amazon and is known that has high antioxidant capacity and potential anti-inflammatory activities. The aim of this study was to evaluate analgesic effects of acaiberry in formalin-induced orofacial pain through p38 mitogen-activated protein kinases (p38 MAPK) and nicotinamide adenine dinucleotide phosphate 4 (NOX4) pathway. Rats were divided into 5 groups (n=6); formalin (5%, $50{\mu}L$), formalin after saline (vehicle) or acaiberry (16, 80, 160 mg/kg, intraperitoneally). The nociceptive response was investigated all of groups, p38 MAPK or NOX4 were analysed at dose of 80 mg/kg of acaiberry in rat's medulla oblongata and adrenal gland. Results indicated that acai berry produced analgesic effect in a dose-dependent manner and significantly reduced formalin-induced nociceptive response at 15~40 min. Acaiberry (80 mg/kg) decreased the increased p38 MAPK activation and NOX4 expression in medulla oblongata and adrenal gland. Based on these results, acaiberry is believed to be useful for modulation of orofacial pain and its treatments because of its anti-inflammatory and antioxidative effects.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.9
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• pp.5708-5715
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• 2014

The effects of korean red ginseng (KRG) extracts on orifacial pain control in terms of the systemic inflammatory response and pharmacological effects as health supplements were investigated. The experimental group were divided into three groups, the control group (n=6), formalin (5%, $50{\mu}{\ell}$) injection group (n=6), and formalin (5%, $50{\mu}{\ell}$) injection added KRG administrated group (4.5 ml/kg, n=6). The KRG administrated group prior to the formalin injection significantly attenuated the behavioral response compared to that of the control group. Pain reduction was suppressed mainly from 15 min to 30 min. The KRG administrated rats showed significantly reduced p38 MAPK, iNOS and Nrf2 expression in the brain and medulla oblongata according to Western blot analysis. These findings suggest that KRE may have a useful effect on orificial pain control functions by preventing the p38 MAPK pathway.

• Journal of Oral Medicine and Pain
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• v.33 no.2
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• pp.205-218
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• 2008

Interaction between pain and sleep has long been proved through many researches, and various studies are being conducted to identify its mechanism. However, these studies have targeted on patients with systemic disease, such as rheumatic disease and fibromyalgia. There are few researches on patients with orofacial pain including temporomandibular disorder(TMD). In this study, we studied interaction between pain aspect and sleep quality in 229 patients with TMD, who visited the TMJ and Orofacial pain clinic. Pittsburgh Sleep Quality Index(PSQI), Epworth sleepiness scale(ESS) questionnaire were surveyed and sleep-screening device was operated. PSQI showed that sleep quality in TMD patients with pain was poorer than that in TMD patients without pain. The ratio of poor sleeper was higher in TMD patients with pain. Especially, TMD patients with chronic pain showed obviously poorer sleep quality than TMD patients with acute pain. The result of ESS showed that patients with painful TMD showed more daytime sleepiness than painless TMD patients. The ratio of TMD patients with chronic pain who had daytime sleepiness was higher than TMD patients with acute pain, and the amount of daytime sleepiness was higher in the group of chronic pain. In TMD patients with chronic pain, only the poor sleeper(PSQI>5) presented mean ESS>10(diagnostic criteria of daytime sleepiness). There was no correlation between pain intensity and sleep quality or daytime sleepiness. The result of ApnealinkTM for screening of sleep related breathing disorder showed that only 1 patient presented AHI>5 among 19 participants. TMD patients with chronic pain presented poor sleep quality and excessive daytime sleepiness similar to other chronic pain patients. Evaluation of sleep state by questionnaire might be useful for diagnosis and management of TMD, because sleep disturbance decreases pain threshold and pain disturbs sleep. In addition, sleep-screening device would be useful for screening sleep related breathing disorder in dental clinic.