• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권4호
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• pp.167-173
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• 2018

Objectives: Classification of the degree of postoperative nerve damage according to contact with the mandibular canal and buccal cortical bone has been studied, but there is a lack of research on the difference in postoperative courses according to contact with buccal cortical bone. In this study, we divided patients into groups according to contact between the mandibular canal and the buccal cortical bone, and we compared the position of the mandibular canal in the second and first molar areas. Materials and Methods: Class III patients who visited the Dankook University Dental Hospital were included in this study. The following measurements were made at the second and first molar positions: (1) length between the outer margin of the mandibular canal and the buccal cortical margin (a); (2) mandibular thickness at the same level (b); (3) Buccolingual $ratio=(a)/(b){\times}100$; and (4) length between the inferior margin of the mandibular canal and the inferior cortical margin. Results: The distances from the canal to the buccal bone and from the canal to the inferior bone and mandibular thickness were significantly larger in Group II than in Group I. The buccolingual ratio of the canal was larger in Group II in the second molar region. Conclusion: If mandibular canal is in contact with the buccal cortical bone, the canal will run closer to the buccal bone and the inferior border of the mandible in the second and first molar regions.

• Anatomy and Cell Biology
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• 제56권3호
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• pp.313-321
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• 2023

The details of the facial nerve pattern were clearly explained in the parotid gland (PG), lateral area of the face, and periorbital areas to prevent the unexpected outcome of medical intervention. However, it remains unclear whether information about the zygomatico-buccal plexus (ZBP) in the masseteric and buccal regions. Therefore, this study aimed to help clinicians avoid this ZBP injury by predicting their common location. This study was conducted in forty-two hemifaces of twenty-nine embalmed cadavers by conventional dissection. The characteristics of the buccal branch (BB) and the ZBP were investigated in the mid-face region. The results presented that the BB gave 2-5 branches to emerge from the PG. According to the masseteric and buccal regions, the BB were arranged into ZBP in three patterns including an incomplete loop (11.9%), a single-loop (31.0%), and a multi-loop (57.1%). The mean distance and diameter of the medial line of the ZBP at the corner of the mouth level were 31.6 (6.7) and 1.5 (0.6) mm respectively, while at the alar base level were 22.5 (4.3) and 1.1 (0.6) mm respectively. Moreover, the angular nerve arose from the superior portion of the ZBP at the alar base level. The BB formed a multiloop mostly and showed a constant medial line of ZBP in an area approximately 30 mm lateral to the corner of the mouth, and 20 mm lateral to the alar base. Therefore, it is recommended that physicians should be very careful when performing facial rejuvenation in the mid-face region.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권1호
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• pp.1-6
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• 2002

When bilateral sagittal split ramus osteotomy or mandibular angle reduction are carried out, we have to consider the position of inferior alveolar nerve. For bone splitting or resection using a saw or an osteotome, the bucco-lingual position of the inferior alveolar nerve plays an important role in the preventing perioperative complications such as paresthesia or anesthesia. Because it is rare to find literatures concerning the mean anatomic position of the inferior alveolar nerve in Koreans, we investigated 30 patients who underwent to take CT and orthopantomogram for implant surgery, and evaluated the bucco-lingual position and vertical relationship of the inferior alveolar nerve at the mandible. The results showed that the distance between inferior alveolar nerve and buccal plate was the farthest at mandibular second molar ($7.1{\sim}7.4mm$) and the nearest at mandibular angle area ($4.4{\sim}4.8mm$). But it was no statistical relationship between the bucco-lingual postion of inferior alveolar nerve on the CT and its vertical position on the OPT. In conclusion, the results suggest that a careful surgical procedure is needed at the mandibular angle area to avoid a nerve damage and there are sufficient bone materials at the mandibular second molar are for bilateral sagittal split ramus osteotomy or mandibular angle reduction or plate fixation. And OPT is not usefull for the evaluation of a relative bucco-lingual position of inferior alveolar nerve in relation to its vertical postion on the OPT.

• 대한한의학회지
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• 제16권2호
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• pp.447-452
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• 1995

The meridians pathway on the hand and neck studies connection with craniospinal nerve to obtain result fellowing items. 1. Large Intestine Meridian of Hand-yang ming, Small Intestine Meridian of Hand-tai yang. Triple Warmer Meridian of Meridian of Foot-tai yang, was hollow organs and its had connected branches of the trigeminal nerve and fasial nerve, cervical nerve plexus. 2. The Triple warmer meridian pathway around ear connection supersecial temporlal branch. zygomatic branch. buccal branch mandlibular branch, cervical branch of the fasial nerve. 3. The stomach meridian foot-yang ming orginate from the glabella of the frontal bone, and connection supraorbital, frontal branches of the opthalamic nerve in headach. 4. The original cell of the trigeminal nerve, and fasial nerve the medulla oblongata and pons.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권4호
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• pp.213-220
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• 2023

Background: Third molar extraction is the most commonly performed minor oral surgical procedure in outpatient settings and requires regional anesthesia for pain control. Extraction of the maxillary molars commonly requires both posterior superior alveolar nerve block (PSANB) and greater palatine nerve block (GPNB), depending on the nerve innervations of the subject teeth. We aimed to study the effectiveness of PSANB alone in maxillary third molar (MTM) extraction. Methods: A sample size comprising 100 erupted and semi-erupted MTM was selected and subjected to study for extraction. Under strict aseptic conditions, the patients were subjected to the classical local anesthesia technique of PSANB alone with 2% lignocaine hydrochloride and adrenaline 1:80,000. After a latency period of 10 min, objective assessment of the buccal and palatal mucosa was performed. A numerical rating scale and visual analog scale were used. Results: In the post-latency period of 10 min, the depth of anesthesia obtained in our sample on the buccal side extended from the maxillary tuberosity posteriorly to the mesial of the first premolar (15%), second premolar (41%), and first molar (44%). This inferred that anesthesia was effectively high until the first molars and was less effective further anteriorly due to nerve innervation. The depth of anesthesia on the palatal aspect was up to the first molar (33%), second molar (67%), and lateromedially; 6% of the patients received anesthesia only to the alveolar region, whereas 66% received up to 1.5 cm to the mid-palatal raphe. In 5% of the cases, regional anesthesia was re-administered. An additional 1.8 ml PSANB was required in four patients, and another patient was administered a GPNB in addition to the PSANB during the time of extraction and elevation. Conclusion: The results of our study emphasize that PSANB alone is sufficient for the extraction of MTM in most cases, thereby obviating the need for poorly tolerated palatal injections.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권2호
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• pp.66-73
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• 2015

Objectives: To assess the validity of the vertical tube-shift method using intraoral periapical radiography (IOPAR) for determining the relationship between the mandibular third molar roots and the inferior alveolar nerve (IAN) canal in comparison with cone-beam computed tomography (CBCT). Materials and Methods: Fifty impacted mandibular third molars were analyzed using the IOPAR vertical tube-shift method and CBCT. The relationship of the IAN canal to the impacted mandibular third molar was recorded as buccal, lingual or in line with the apex and was compared with CBCT findings. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the vertical tube-shift method in depicting the relationship (buccal/lingual/in line with the apex) of the IAN canal to the third molar root apex was calculated. Results: The sensitivity and specificity PPV and NPV of the IOPAR vertical tube-shift technique was found to be highest for a lingual relationship (100%) followed by buccal (94.4%, 92.3%, 97.1%, and 85.7%) and in line with the apex relationship (88.9%, 95.0%, 80.0%, and 97.4%) of the IAN canal with the third molar root apex, respectively. A statistically significant association was observed between the IOPAR vertical tube-shift method and the CBCT with a P-value <0.01. Conclusion: The vertical tube-shift method can be used as an effective diagnostic tool in assessing the relationship of the IAN canal to the third molar root apex with high sensitivity, specificity, PPV, and NPV.

• Restorative Dentistry and Endodontics
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• 제22권1호
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• pp.278-290
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• 1997

The purposes of this study were to evaluate and compare the pulpal anesthesia induced by an inferior alveolar nerve block and that by Gow-Gates technique, and to investigate the relationship between pulpal anesthesia and intraoral soft tissue responses. After one side of mandibule was anesthetized with inferior alveolar nerve block or Gow-Gates technique using 2 % lidocaine with 1 : 100,000 epinephrine in 19 volunteers of ages between 24 and 29 (16 males and 3 females, average age 25.9 yrs.), electric pulp tests were done on the canine teeth of the anesthetized side and contralateral one before, at 1 min, continued at every 5 minutes until 60 min, and every 10 minutes until 100 min after completion of local anesthetic injection. Degree of pulpal anesthesia was classified as anesthetic failure, possible anesthesia and complete anesthesia by the criteria based on the thresholds to electric pulp test of contralateral canine and the currents of the electric pulp tester. Subjective signs on the lower lip and tongue were checked and prick-pin tests were done on the buccal gingiva of the first molar, buccal and lingual gingiva of the canine tooth at 5, 10 and 20 min after the completion of anesthetic injection. Thresholds to electric pulp test, degree of pulpal anesthesia and relationship between the pulpal anesthesia and soft tissue responses were analyzed with SPSS, paired t-test, Wilcoxon matched-pairs signed-ranks test and correlation analysis. The results were as follows : No significant differences were found in the peak thresholds to electric pulp test, in the induction time to it and in the depth of pulpal anesthesia between inferior alveolar nerve block and Gow-Gates technique (p>0.05). There was no significant relationship between pulpal anesthesia and soft tissue responses in both inferior nerve block and Gow-Gates technique.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권5호
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• pp.325-329
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• 2020

Classic anesthetic techniques for the inferior alveolar nerve, lingual nerve, and long buccal nerve blockade are achieved by estimating the intended location for anesthetic deposition based on palpation, inspection, and subsequent correlation for oral anatomical structures. The present article utilizes computed tomography (CT) data to 3D print a guide for repeatable and accurate deposition of a local anesthetic at the ideal location. This technical report aims to anatomically define the ideal location for local anesthetic deposition. This process has the potential to reduce patient discomfort, risk of nerve damage, and failed mandibular anesthesia, as well as to reduce the total anesthetic dose. Lastly, as robotic-based interventions improve, this provides the initial framework for robot-guided regional anesthesia administration in the oral cavity.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권2호
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• pp.173-178
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• 2021

Inferior alveolar nerve (IAN) injury is usually caused by stretching or crushing of the neurovascular structures and postoperative intra-alveolar hematoma or edema after dental procedures. This results in paresthesia in the ipsilateral chin, lip (vermilion border, skin, and mucosa), and labial or buccal alveolar mucosa of the mandibular anterior teeth. However, there are no reports of sensory alterations in the teeth, especially tooth hypersensitivity, after IAN injury. I report a case in which paresthesia of the lower lip and hypersensitivity of the lower anterior teeth occurred simultaneously after the removal of the third molar that was located close to the IAN. In addition, I discuss the reasons for the different sensory changes between the tooth and chin (skin) after nerve injury from a neurophysiological point of view. Since the dental pulp and periodontal apparatus are highly innervated by the inferior alveolar sensory neurons, it seems necessary to pay attention to the changes in tooth sensitivity if IAN injury occurs during dental procedures.

• 대한두경부종양학회지
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• 제23권1호
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• pp.63-66
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• 2007

The differential diagnosis of lesions in buccal area include lipoma, neurofibromas, epidermoid cyst, salivary ducts calculus, hemangioma, lymphadenopathy. Accessory parotid glands is defined as salivary gland tissue adjacent to the parotid duct, but separated from the body of parotid and it may be found in approximately 20% of human parotid glands. The appearance of an accessory parotid tumor is rare, with a reported frequency of 7.7% of all parotid neoplasm. Angiomyoma, which is also termed angioleiomyoma, is a rare solitary subcutaneous tumors arising from the vascular smooth muscle. It often occur in the extremities and is rarely found in buccal area. We present 2 cases of rare tumor in buccal mass and resected surgically without facial nerve palsy.