• Title/Summary/Keyword: 치수염 통증

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Pulpitis pain relief by modulating sodium channels in trigeminal ganglia (삼차신경절의 나트륨 채널 조절을 통한 치수염 통증 완화 효과)

  • Kyung-Hee Lee
    • Journal of Korean society of Dental Hygiene
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    • v.24 no.3
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    • pp.219-227
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    • 2024
  • Objectives: The pulp is the center of the tooth containing nerves and blood vessels. The condition in which the pulp becomes inflamed due to caries or periodontitis is called pulpitis. Pulpitis is a difficult-to-treat disease and causes peripheral nerve tissue changes and severe pain; however, the relationship between neuronal activity and voltage-gated sodium channel 1.7 (Nav1.7) expression in the trigeminal ganglion (TG) during pulpitis has not been well studied. In this study, we found that experimentally induced pulpitis activates Nav1.7 expression in the periphery, leading to neuronal overexpression in the TG. Thus, we sought to identify ways to regulate this process. Methods: Acute pulpitis was induced in rat maxillary molars by treating the pulp with allyl isothiocyanate (AITC). Three days later, in vivo optical imaging was used to record and compare neural activities in the TG. Western blotting was used to identify molecular changes in terms of the expression of extracellular signal-regulated kinase (ERK), c-Fos, transient receptor potential ankyrin 1 (TRPA1), and collapsin response mediator protein-2 (CRMP2) in the brain stem. Results: The results confirmed the neurological changes in the TGs of the pulpitis model, and histological and molecular biological evidence confirmed that increased Nav1.7 expression induced by pulpitis leads to pain. Furthermore, selective inhibition of Nav1.7 resulted in changes in neural activity, suggesting that pulpitis induces increased Nav1.7 expression, and that effective control of Nav1.7 could potentially reduce pain. Conclusions: The inhibition of overexpressed Nav1.7 channels may modulate nociceptive signal processing in the brain and effectively control pain associated with pulpitis.

The Diagnosis and Treatment of Bruxism (이갈이의 진단 및 치료)

  • Jeong-Seung, Kwon;Jung, Da-Woon;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.1
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    • pp.87-101
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    • 2012
  • Bruxism is extensively defined as a diurnal or nocturnal parafunctional habit of tooth clenching or grinding. The etiology of bruxism may be categorized as central factors or peripheral factors and according to previous research results, central factors are assumed to be the main cause. Bruxism may cause tooth attrition, cervical abfraction, masseter hypertrophy, masseter or temporalis muscle pain, temporomandibular joint arthralgia, trismus, tooth or restoration fracture, pulpitis, trauma from occlusion and clenching in particularly may cause linea alba, buccal mucosa or tongue ridging. An oral appliance, electromyogram or polysomnogram is used as a tool for diagnosis and the American Sleep Disorders Association has proposed a clinical criteria. However the exact etiology of bruxism is yet controversial and the selection of treatment should be done with caution. When the rate of bruxism is moderate or greater and is accompanied with clinical symptoms and signs, treatment such as control of dangerous factors, use of an oral appliance, botulinum toxin injection, pharmacologic therapy and biofeedback therapy may be considered. So far, oral appliance treatment is known to be the most rational choice for bruxism treatment. For patients in need of esthetic correction of hypertrophic masseters, as well as bruxism treatment, botulinum toxin injection may be a choice.

Evaluation of Dental Terminology System Using GRAIL: A Pilot Study (GRAIL을 이용한 치의학 용어 체계의 평가)

  • Kim, Young-Jun;Lee, Jon-Ki;Kim, Myeng-Ki;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.26 no.3
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    • pp.189-204
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    • 2001
  • 본 연구는, 기존의 나열식 분류체계의 문제점을 극복할 수 있는 GRAIL을 이용하여 두경부의 해부학적 구조물들 및 구강 악안면 영역의 주요 질병들과 관련된 치의학 개념들의 모델을 구축한 뒤, 완성된 치의학 개념 모델이 두경부의 해부학적 구조물들 및 구강 악안면 영역의 주요 질병들을 잘 표현할 수 있는지와 기존의 GRAIL 모델이 지닌 특징에 잘 부합하는지를 평가하고자 시행되었다. 서울대학교 치과병원 내원 환자 중 포괄적인 치과 치료 병력을 지닌 환자 150명의 치과 의무기록을 내용별로 분석하고, 각종 치의학 교과서와 기존의 의학용어 분류체계에서도 모델 구축에 필요한 치의학 용어를 선택하였다. 이들 자료를 바탕으로, GRAIL 모델 구축을 진행하고 구축된 모델을 평가할 수 있는 소프트웨어 프로그램인 'KnoME'에서 치의학 개념 모델을 구축하고 평가하여, 다음과 같은 결론을 얻었다. 1. 환자 150명의 치과 의무기록을 내용별로 분석한 결과, 우선적으로 모델 구축이 필요한 치의학 용어로는, 해부학적 구조물의 경우 치아, 치은, 악관절, 입술, 턱, 혀 등의 순서로 나타났으며, 구강악안면 영역의 병소에서는 치아 우식증, 치주염, 치은염, 악관절 장애, 매복 지치, 치경부 마모 등의 순서로 나타났다. 2. GRAIL을 이용하여 치아, 치주조직, 구강점막조직, 치아 우식증, 치수 및 치근단 병소, 치주질환, 구강점막질환의 모델 구축을 시행한 결과, 치의학 개념간의 다양한 관계가 대다수 잘 표현되었다. 그러나, 구강 악안면 영역의 해부학적 구조물에 대한 공간 정의의 한계성과 구강 악안면 질환의 진행 양상에 있어서 표현의 어려움이 관찰되었다. 이러한 부분은 GRAIL을 치의학 분야에 적용할 때, 극복해야 할 한계로 나타났다. 3. 치의학 개념들에 관한 다양한 질의를 시행한 후 그 응답 내용을 평가한 결과, 완성된 모델 내에서 치의학 개념의 자동적인 분류가 이루어 졌으며, 다양한 목적의 검색이 가능하였다. 이와 같은 사실로 미루어 보아서, 완성된 모델은 기존의 GRAIL 모델의 특성에 잘 부합되는 것으로 생각되었다.

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The Oral Disease of Inpatient with the Systemic Disease (전신질환으로 입원한 환자의 구강내과 진료실태)

  • Yoo, Sang-Hoon;Jung, Sung-Hee;Auh, Q-Schick;Hong, Jung-Pyo;Chun, Yang-Hyun
    • Journal of Oral Medicine and Pain
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    • v.33 no.1
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    • pp.15-26
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    • 2008
  • Purpose : To investigate the actual conditions of diagnosis and treatment of oral medicine inpatient with systemic disease. Methods : A total of 110 subjects, inpatient due to systemic disease for diagnosis and treatment of oral disease was requested to answer the medical history and dental treatment record. Results : Systemic disease is composed of Non-insulin-dependent diabetes mellitus 26%, Cerebral infarction 25.2%, Intracerebral hemorrhage, Polyarthrosis, Coxarthrosis 4.7%, Nerve root and plexus disorders, Hypertensive heart and renal diseases, Ankylosing spondylitis 2.4%. Chief complain of oral disease is composed of toothache 28.6%, routine check 23%, tooth mobility 8.7%, hypersensitivity 7.1%, periodontal bleeding 6.4%. Oral disease is composed of Gingivitis and periodontal diseases 28.9%, Dental caries 17.1%, Diseases of pulp and periapical tissues 15.1%, Diseases of salivary glands 10.5%, Other diseases of hard tissues of teeth 8.6%, Within Normal Limit 5.3%. Treatment of oral disease is composed of periodontal treatment 17.95%, rejection of treatment 16.67%, medication for halitosis & dry mouth 13.46%, extraction 12.18%, prosthetic treatment 8.97%. Chief complain in oral medicine is composed of oral soft tissue problem 6.4%, craniomandibular disorders 5.6%, halitosis 4%, total 16%. Conclusion : These findings indicate that inpatient due to the systemic disease is significantly correlated to the oral disease. The patients of oral disease interrelationship between inpatient and outpatient of systemic disease should be validated by future research.