• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.23 no.1
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• pp.33-42
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• 2012

Background and Objectives : Dysarthria refers to speech disorder that causes difficulties in speech communication due to paralysis, muscle weakening, and incoordination of speech muscle mechanism caused by damaged central or peripheral nerve system. Pitch, strength and speed are influenced by dysarthria during detonation due to difficulties in muscle control. As evaluation items, alternate motion rate and diadochokinesis have been commonly used, and articulation is also an important evaluation items. The purpose of this study is to find acoustic characteristics on sound production of dysarthria patients. Materials and Methods : Research subjects have been selected as 20 dysarthria patients and 20 subjects for control group, and voice sample was composed of bilabial, alveolar sound, and velar sound in diadochokinetic rate, while consonant articulation test was composed of bilabial plosive, alveolar plosive, velar plosive. Analysis items were composed of 1) speaking rate, energy, articulation time of diadochokinesis, 2) voice onset time (VOT), total duration (TD), vowel duration (VD), hold of plosives. Results and Conclusions : The number of diadochokinetic rate of dysarthria was smaller than control group. Both control group and dysarthria group was highly presented in the order of /t/>/p/>/k/. Minimum energy range per cycle during diadochokinetic rate of dysarthria group was smaller than control group, and presented statistical significance in /p/, /k/, /ptk/. Maximum energy range was larger than control group, and presented statistical significance in /t/, /ptk/. Articulation time, gap, total articulation time during diadochokinetic rate of dysarthria group was longer than control group and presented statistical significance. The articulation time was presented in both control group and dysarthria group in the order of /k/>/t/>/p/, while Gap was presented in the order of /p/>/t/>/k/ for control group and /p/>/k/>/t/ for dysarthria group. VOT, TD, VD regarding plosives of dysarthria group were longer than control group. Hold showed large deviation compared to control group that had appeared due to declined larynx and articulation organ motility.

• Imaging Science in Dentistry
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• v.39 no.3
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• pp.149-156
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• 2009

Purpose : The purpose of this study was to develop a stent-based image guided surgery system and to apply it to oral and maxillofacial surgeries for anatomically complex sites. Materials and Methods : We devised a patient-specific stent for patient-to-image registration and navigation. Three-dimensional positions of the reference probe and the tool probe were tracked by an optical camera system and the relative position of the handpiece drill tip to the reference probe was monitored continuously on the monitor of a PC. Using 8 landmarks for measuring accuracy, the spatial discrepancy between CT image coordinate and physical coordinate was calculated for testing the normality. Results : The accuracy over 8 anatomical landmarks showed an overall mean of $0.56{\pm}0.16\;mm$. The developed system was applied to a surgery for a vertical alveolar bone augmentation in right mandibular posterior area and possible interior alveolar nerve injury case of an impacted third molar. The developed system provided continuous monitoring of invisible anatomical structures during operation and 3D information for operation sites. The clinical challenge showed sufficient accuracy and availability of anatomically complex operation sites. Conclusion : The developed system showed sufficient accuracy and availability in oral and maxillofacial surgeries for anatomically complex sites.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.6
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• pp.367-375
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• 2020

Background: Intraosseous anesthesia (IO) allows the anesthetic solution to be injected directly into the cancellous bone. The anesthetic solution immediately reaches the periapical region, and thus the axonal area of the nerve, where it can temporarily disable the sodium pump. The effect is felt almost without any time delay, and only a small amount of anesthetic solution is required. Methods: This study aims to investigate the efficacy of IO using the AnestoⓇ device after infiltration anesthesia (IA) and/or inferior alveolar nerve block anesthesia (IANB) failed to work in symptomatic irreversible pulpitis (hot tooth). The 33 patients included in the study were treated additionally with 1.7 ml articaine hydrochloride with 1:100,000 epinephrine hydrochloride (UltracainⓇ D-S, Sanofi-Aventis, Frankfurt, Germany) IO. Results: The electrical pulp test showed that 95.76% of the volunteers reacted positively to the combination of IANB or IA with the IO. In women, the additive IO was effective at 97.22%. In men, the IO led to pain elimination in 94.00% of cases. The duration of the IO was less than a quarter of an hour (13.03 min). The IO worked longer in women than in men (13.61 min vs. 12.33 min). Overall, more than every third tooth that needed trepanation was located in the posterior area of the mandible (36.4%). Treatment of hot teeth in this area was associated with an increased pulse rate and increased residual pain. There was a moderate correlation (Spearman-Rho [IRI] = 0.280) between the Visual Analog Scale (VAS) score and bone density, and a significant correlation (IRI = 0.612) between subjective residual pain and bone width. The IO resulted in a moderate, transient increase in the pulse rate by approximately 20 bpm. This is similar to the temporary increase in heart rate after conventional anesthesia techniques in non-preloaded patients and can be considered clinically irrelevant. Conclusion: IO with the AnestoⓇ device as an extension and deepening of local pain elimination is recommended for the treatment of hot teeth.

• Journal of Korean Dental Science
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• v.4 no.1
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• pp.14-19
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• 2011

Purpose: The aim of our study was to evaluate natural recovery of neurologic injury after minor dental surgery based on subjective neurologic evaluation. Materials and Methods: From December 2005 through July 2009, 30 patients from Seoul National University Bundang Hospital were identified as having been treated with minor dental surgery. The patients were composed of 12 men and 18 women, with a mean age of 50.6 years. The median duration of this study was 62 weeks. Results: The patients were treated by implants (17 cases), tooth extractions (6 cases), bone grafts (4 cases), inferior alveolar nerve transpositions (2 cases) and periodontal surgery (1 case) prior to the occurrence of altered sensation. Areas of altered sensation after minor surgery included the lip (36.7%), chin (30.0%) and tooth (21.7%), and at final follow-up, there was no change of ranking. Altered sensations expressed by patients included numbness (33.3%), discomfort (22.9%), relieving sense (14.6%), tingling (14.6%) and itching (14.6%). There was no change of ranking of altered sensation at the last follow-up. Patients experienced the altered sensation always (47.8%), during tactile stimulation (26.1%), when chewing food (13.0%), and talking (13.0%). Mean visual analogue scale (VAS) was $3.43{\pm}2.84$ for pain and $6.64{\pm}2.72$ for paresthesia. VAS of pain was decreased significantly between the first visit and the end of follow-up, and paresthesia also showed a significant difference. Conclusion: Altered sensations may occur at any time after minor dental surgery, but we observed that natural recovery of altered sensation occurred as time went on.

• Restorative Dentistry and Endodontics
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• v.44 no.4
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• pp.40.1-40.10
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• 2019

Objectives: This study aimed to assess the effect of DentalVibe on the level of pain experienced during anesthetic injections using 2 different techniques. Materials and Methods: This randomized crossover clinical trial evaluated 60 patients who required 2-session endodontic treatment. Labial infiltration (LI) anesthesia was administered in the anterior maxilla of 30 patients, while inferior alveolar nerve block (IANB) was performed in the remaining 30 patients. 1.8 mL of 2% lidocaine was injected at a rate of 1 mL/min using a 27-gauge needle. DentalVibe was randomly assigned to either the first or second injection session. A visual analog scale was used to determine participants' pain level during needle insertion and the anesthetic injection. The paired t-test was applied to assess the efficacy of DentalVibe for pain reduction. Results: In LI anesthesia, the pain level was 12.0 ± 15.5 and 38.1 ± 21.0 during needle insertion and 19.1 ± 16.1 and 48.9 ± 24.6 during the anesthetic injection using DentalVibe and the conventional method, respectively. In IANB, the pain level was 14.1 ± 15.9 and 35.1 ± 20.8 during needle insertion and 17.3 ± 14.2 and 39.5 ± 20.8 during the anesthetic injection using DentalVibe and the conventional method, respectively. DentalVibe significantly decreased the level of pain experienced during needle insertion and the anesthetic injection in anterior LI and mandibular IANB anesthesia. Conclusions: The results suggest that DentalVibe can be used to reduce the level of pain experienced by adult patients during needle insertion and anesthetic injection.

• Journal of Korean Dental Science
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• v.2 no.1
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• pp.31-38
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• 2009

With today's social and cultural personal interactions, greater leisure time and participation in sports activities, and growing traffic volume, the risk of physical trauma has increased markedly. This is a clinical and retrospective study of patients exposed to oral and maxillofacial trauma. We clinically observed 72 patients with trauma in the Department of Oral and Maxillofacial Surgery, Kyunghee University Dental Hospital, from June 2006 through November 2007. The following data was obtained: 1. The male:female ratio of patients having experienced physical trauma was 6.2:1, with most patients in their twenties. 2. Traffic accident (37.5%) was the most common cause of trauma. 3. The highest incidence of fracture occurred to the zygomatic arch(22.1%) among mid-facial fractures and angle(37.5%), symphysis(35.4%) in mandible fractures. 4. Open reduction (88.9%) was the most frequently used form of treatment. Closed reduction was performed on the remaining 11.1% of cases. 5. Teeth and alveolar bone damage occurred in 23.6% of all cases. 6. Other injuries that were related to mid-face fracture occurred in 27.8% of all cases. 7. Post-operative complications occurred in 31.9% of cases, and the highest complication was the nerve injury.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.6
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• pp.323-341
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• 2019

Background: Local anesthetics alone or in combination with adjuncts, such as oral medications, have routinely been used for pain control during endodontic treatment. The best clinical choice amongst the vast numbers of agents and techniques available for pain control for irreversible pulpitis is unclear. This network meta-analysis combined the available evidence on agents and techniques for pulpal anesthesia in the maxilla and mandible, in order to identify the best amongst these approaches statistically, as a basis for future clinical trials. Methods: Randomized trials in MEDLINE, DARE, and COCHRANE databases were screened based on inclusion criteria and data were extracted. Heterogeneity was assessed and odds ratios were used to estimate effects. Inconsistencies between direct and indirect pooled estimates were evaluated by H-statistics. The Grading of Recommendation, Assessment, Development, and Evaluation working group approach was used to assess evidence quality. Results: Sixty-two studies (nine studies in the maxilla and 53 studies in the mandible) were included in the meta-analysis. Increased mandibular pulpal anesthesia success was observed on premedication with aceclofenac + paracetamol or supplemental 4% articaine buccal infiltration or ibuprofen+paracetamol premedication, all the above mentioned with 2% lignocaine inferior alveolar nerve block (IANB). No significant difference was noted for any of the agents investigated in terms of the success rate of maxillary pulpal anesthesia. Conclusion: Direct and indirect comparisons indicated that some combinations of IANB with premedication and/or supplemental infiltration had a greater chance of producing successful mandibular pulpal anesthesia. No ideal technique for maxillary anesthesia emerged. Randomized clinical trials with increased sample size may be needed to provide more conclusive data. Our findings suggest that further high-quality studies are required in order to provide definitive direction to clinicians regarding the best agents and techniques to use for mandibular and maxillary anesthesia for irreversible pulpitis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.1
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• pp.1-9
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• 1995

We observed 117 orthognathic surgery cases with dentofacial deformity for 8 years from Jan. 1986 to Dec. 1993. The ratio of male female was 1 : 1.4 and the mean age was 23.0 years ranged from 16 to 35 years. The most dominant group was related to mandibular prognathism (75.0%). Surgery method were divided into 88 cases of mandible surgery, 6 cases of maxilla surgery and 23 cases of two jaw surgery. Sagittal split osteotomy were performed on 84 cases (71.8%). Rigid fixation was increased after 1989 and total percent of rigid fixation was 66%. We used autotransfusion method from 1992 to all orthognathic surgery patient. Lower lip numbness caused by Inferior alveolar nerve injury is the most common problem after operation, and it was 63 cases (53.8%) of total operation cases. In our clinic, we performed 5 cases of re-operation because of segment malalignment, condylar sag, and fixation instability.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.5
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• pp.329-334
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• 2009

Objective: To evaluate the ratio between bone-contact length and inter-segmental length of the rigid fixation screw used in bilateral sagittal split ramus osteotomy (BSSRO) for mandibular setback. Material and Methods: Records of 40 patients with Class III malocclusion were selected. 20 of them had BSSRO, while the other 20 had BSSRO with maxillary LeFort I osteotomy. All of the patients had three noncompressive bicortical screws inserted at the gonial angle through transcutaneous approach. Two screws were inserted antero-posteriorly above inferior alveolar nerve and one screw was inserted below. The lengths of bone-contact and that of inter-segmental part were measured using cone-beam computed tomography. Ratio between these two measured lengths was calculated. Results: Both bone-contact and inter-segmental lengths were longer in BSSRO group than in BSSRO with maxillary LeFort I osteotomy group. Ratio of bone-contact to inter-segmental length was lower in BSSRO group than in BSSRO with Lefort I group. Both bone-contact and inter-segmental lengths were longer at the antero-superior position than at the inferior position. However, their ratio showed little difference. Conclusion: This study suggest that stability of screws in BSSRO group was greater than in BSSRO with Lefort I group. Stability of screws at the antero-superior position was greater than at the inferior position. Ratio of bone-contact to inter-segmental lengths was 0.2 in average.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.2
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• pp.250-256
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• 2018

Dental avulsion, defined as the complete displacement of a tooth from the alveolar bone with consequent loss of the blood and nerve supply, was reported as one of the most severe dental injuries. Avulsion can cause tissue ischemia, which leads to pulp necrosis. Apexification is a conventional treatment method that induces an apical calcified barrier in immature roots with pulp necrosis. However, root development characterized by an increase in the root thickness and length cannot be achieved by apexification. The purpose of this case report was to describe the radiographic and clinical outcomes of regenerative endodontic treatment for the avulsed and necrosed permanent tooth with an immature root after replantation in a 5-year-old girl; the treatment was performed using a mixture of ciprofloxacin, metronidazole and cefaclor, CollaTape and Biodentine.