• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.379-385
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• 2009

The purpose of this study was to present basic data that is needed in comprehension of dysesthesia after mandibular nerve injury and grasp meaning. We analyzed medical records of 59 patients who were diagnosed as dysesthesia after mandibular nerve injury from January 2007 to July 2009. The results are summarized as follows. 1. The most frequent cause was implant surgery (59%) and the most frequent injured branch of mandibular nerve was inferior alveolar nerve(81%). 2. The period passed after nerve injury showed significant interrelationship with level of pain. Visual Analogue Scale(VAS) increased from 4.82 to 6.91 after 6 month. 3. The period passed after nerve injury did not show significant interrelationship with recovery of dysesthesia. But, when conservative treatment was offered at earlier stage, ratio of patients who showed recovery of symptom tended to increase. 4. In computed tomography, level of invasion into inferior alveolar nerve canal did not show significant interrelationship with level of pain and recovery of dysesthesia. Conclusively, in the patients with dysesthesia of mandibular nerve, inferior alveolar nerve injury by dental implant surgery dominated most significant problem. Although level of invasion into inferior alveolar nerve is the most important factor to initiation of dysesthesia, there are other various factors exert more influence on the level of pain or recovery of dysesthesia. Therefore, begining conservative therapy at earlier stage is encouraged. Also, because nerve injuries can occur without direct invasion into nerve canal, so leaving enough safe space from nerve canal is needed for prevention of indirect nerve injury.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.327-336
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• 2011

Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.

• Journal of Oral Medicine and Pain
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• v.30 no.4
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• pp.447-455
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• 2005

The purpose of this study was to examine the effect of Nd:YAG laser irradiation for sensory nerve conduction change. Nd:YAG laser was irradiated to mental region for 5 minutes with the parameters that 10 Hz and 20 Hz of 100 mJ/pulse. Target size of irradiation was 30 mm diameter of circle and target-tip distance was about 10 mm. Therefore, the power density were 212 $mW/cm^2$ and 424 $mW/cm^2$. Sensory nerve conduction was evaluated with $Neurometer^{\circled}$ CPT/C before and after Nd:YAG laser irradiation. As an outcomes, the current perception threshold(CPT) and pain tolerance threshold(PTT) were obtained. We made a comparison of these two values and the results were as follows. 1. There was no significant difference in CPT at 1W, 10 Hz and 2 W, 20 Hz Nd:YAG laser irradiation. 2. There was no significant difference in PTT at 10 Hz, 20 Hz of 100 mJ/pulse Nd:YAG laser. 3. There were no significant differences in CPT and PTT between 1 W, 10 Hz group and 2 W, 20 Hz group. Therefore, We can make a conclusion that Nd:YAG laser irradiation to mental region have no effect on mental nerve conduction in our study model.

• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.59-67
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• 2006

There exist patients complaining speech problem due to dysesthesia or anesthesia following dental surgical procedure accompanied by local anesthesia in clinical setting. However, it is not clear whether sensory problems in orofacial region may have an influence on motor speech abilities. The purpose of this study was to investigate whether transitory sensory impairment of mandibular nerve by local anesthesia may influence on the motor speech abilities and thus to evaluate possibility of distorted motor speech abilities due to dysesthesia of mandibular nerve. The subjects in this study consisted of 7 men and 3 women, whose right inferior alveolar nerve, lingual nerve and long buccal nerve was anesthetized by 1.8 mL lidocaine containing 1:100,000 epinephrine. All the subjects were instructed to self estimate degree of anesthesia on the affected region and speech discomfort with VAS before anesthesia, 30 seconds, 30, 60, 90, 120 and 150 minutes after anesthesia. In order to evaluate speech problems objectively, the words and sentences suggested to be read for testing speech speed, diadochokinetic rate, intonation, tremor and articulation were recorded according to the time and evaluated using a Computerized Speech $Lab^{(R)}$. Articulation was evaluated by a speech language clinician. The results of this study indicated that subjective discomfort of speech and depth of anesthesia was increased with time until 60 minutes after anesthesia and then decreased. Degree of subjective speech discomfort was correlated with depth of anesthesia self estimated by each subject. On the while, there was no significant difference in objective assessment item including speech speed, diadochokinetic rate, intonation and tremor. There was no change in articulation related with anesthesia. Based on the results of this study, it is not thought that sensory impairment of unilateral mandibular nerve deteriorates motor speech abilities in spite of individual's complaint of speech discomfort.

• Journal of Fisheries and Marine Sciences Education
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• v.26 no.2
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• pp.245-256
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• 2014

잉어, Cyprinus carpio와 동자개, Pseudobagrus fulvidraco의 상악 하악 수염을 조직학적으로 조사하였다. 동자개의 수염은 연골성 증축(axial rod of cartilage), 신경섬유다발(bundle of nerve fiber), 표피(epidermis), 평활근 층(smooth muscle layer) 및 미뢰(taste bud)로 구성되었으며, 잉어의 수염은 표피, 신경섬유다발, 혈관(blood vessel) 및 미뢰로 구성되었다. 수염 길이에서 잉어는 상악 바깥쪽 수염(second maxillary barbel)이 상악 안쪽 수염(first maxillary barbel) 보다 길게 나타났으며, 동자개는 하악 안쪽(inner mandibular barbel), 상악 위쪽(upper maxillary barbel), 하악 바깥쪽(outer mandibular barbel), 상악 아래쪽(lower maxillary barbel) 순으로 길게 나타났다(P<0.05). 미뢰의 수를 고려하였을 때, 동자개와 잉어간의 미각에 대한 유의적 차이가 없었다(P>0.05). 아울러, 두 어종의 모든 수염에서 수염 상부의 미뢰 수가 하부의 미뢰 수 보다 높게 나타났다(P<0.05). 본 연구 결과, 동자개의 수염은 딱딱하며 굴절성인 수염(flexible and stiff type)이었으며 잉어의 수염은 연하고 유연한 수염(tender and yielding type)으로 파악되었다.

• The Journal of the Korean dental association
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• v.19 no.11 s.150
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• pp.957-963
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• 1981

• Journal of Oral Medicine and Pain
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• v.36 no.2
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• pp.131-137
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• 2011

Current Perception Threshold (CPT) using Neurometer($Neurometer^{(R)}$ CPT/C) is thought as one of easy and noninvasive QST(qunatitative sensory testing) tools for A${\beta}$, A${\delta}$ and C fibers within a relatively short time. However, conflicts about its reliability still exist. This study aimed to evaluate the reliability of CPTs evaluation and find a way to increase its reliability. Two examiners separately tested CPTs at each side of the mandibluar nerve areas for ten healthy male adults (average age of 22.4 years) three times with an intervals of a week during three weeks. Mean CPTs were compared between the right and left sides of the mandibular nerve area and between the three examinations on the each side. While CPTs at 2000 Hz(A${\beta}$ fiber) showed statistically significant side differences in all three examinations (p<0.05), significant side difference was found in only one examination at 250 Hz(A${\delta}$ fiber) and no difference at 5 Hz(C fiber). Comparing CPTs on the each side of the mandibular nerve area, all examinations at all sensory nerve fibers showed the least CPTs at the 1st examinations. CPTs at 250 Hz(A${\delta}$ fiber) and 5 Hz(C fiber) were significantly different between the first and the following examinations (p<0.05) and there was no significant difference between 2nd and 3rd examinations. The results of this study indicated that CPTs at 250 Hz(A${\delta}$ fiber) and 5 Hz(C fiber) are reliable but CPTs at 2000 Hz(A${\beta}$ fiber) is not appropriate for evaluation of side differences in the mandibular nerve area. In addition, it is suggested that repeated examination be helpful to increase reliability of the CPT evaluation.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.4
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• pp.451-457
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• 2017

Bell's palsy is an acute-onset unilateral peripheral facial neuropathy. For patients with sequelae of facial paresis, the successful rehabilitation of fully edentulous arches is challenging. This case report described the treatment procedures and clinical considerations to fabricate complete dentures of a patient who showed unilateral displacement of mandible, unilateral chewing pattern and parafunctional jaw movement due to sequelae of Bell's palsy. Gothic arch tracing was used to record reproducible centric relation and lingualized occlusion was performed to provide freedom to move between centric relation and the patient's habitual functional area in fabricating satisfactory dentures in terms of function and esthetics.

• Journal of Oral Medicine and Pain
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• v.38 no.2
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• pp.143-147
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• 2013

Mouth opening limitation is generally caused by masticatory muscle or temporomandibular joint pain, disc dislocation without reduction, adhesion or ankylosis of the temporomandibular joint, and muscle contracture. But otorhinolaryngologic disease, neurologic and vascular disease, tumor, inflammation and infection may cause pain and mouth opening limitation which mimics temporomandibular disorders. Re-evaluation for possibilities of inflammation, infection and tumor should be in cases that do not show symptom improvement or appear with continuous aggravation despite of proper treatment. In this case, we report of medial pterygoid muscle pain and mouth opening limitation caused by periapical abscess of third molar spread to the pterygomandibular space.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.2
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• pp.171-178
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• 2012

Botulinum toxin type A (BoNT-A) has been applied successfully to treat chronic migraine, dystonia, spasticity and temporomandubular disorders(TMDs) as well as frontal wrinkle and glabella wrinkle. Recently it has been reported that BoNT-A, reversibly blocks presynaptic acetylcholine release, also inhibits the release of substance P, CGRP(calcitonin gene related peptide) and glutamate related to peripheral sensitization and neurogenic inflammation in sensory nerve, In this study we reviewed animal nerve injury model such as rat and rabbit and identify the analgesic effect and mechanism of nerve injury pain after dental treatment.