• Imaging Science in Dentistry
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• v.37 no.4
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• pp.217-220
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• 2007

Purpose: The purpose of this study was to compare the location of the mandibular canal in Class III malocclusion to its location in normal occlusion for adults. Materials and Methods: For this study 32 skeletal Class III patients and 26 normal patients were observed. Four measurements were taken on cross sectional tomography between the first and second molars: the distance from the mandibular canal to the inner surface of both the buccal and lingual cortices, the distance from the mandibular canal to the inferior border of the mandible, and the buccolingual width of the mandible. The buccolingual location of the canals was classified as lingual, central, or buccal. Each measurement was analyzed with an independent t test to compare Class III malocclusion to normal occlusion. Results: Compared to the control group, the prognathic group had a shorter distance from the canal to the inner surface of the lingual cortex and to the base of the mandible. A higher percentage of the canals were located lingually in the prognathic group. Conclusion: This study showed that the mandibular canal was located more lingually and inferiorly in prognathic patients than in patients with normal occlusion. These results could help surgeons to reduce injuries to the inferior alveolar nerve.

• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.27.1-27.9
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• 2020

Apical surgery for a mandibular molar is still challenging for many reasons. This report describes the applications of computer-guided cortical 'bone-window technique' using piezoelectric saws that prevented any nerve damage in performing endodontic microsurgery of a mandibular molar. A 49-year-old woman presented with gumboil on tooth #36 (previously endodontically treated tooth) and was diagnosed with chronic apical abscess. Periapical lesions were confirmed using cone-beam computed tomography (CBCT). Endodontic microsurgery for the mesial and distal roots of tooth #36 was planned. Following the transfer of data of the CBCT images and the scanned cast to an implant surgical planning program, data from both devices were merged. A surgical stent was designed, on the superimposed three-dimensional model, to guide the preparation of a cortical window on the buccal side of tooth #36. Endodontic microsurgery was performed with a printed surgical template. Minimal osteotomy was required and preservation of the buccal cortical plate rendered this endodontic surgery less traumatic. No postoperative complications such as mental nerve damage were reported. Window technique guided by a computer-aided design/computer-aided manufacture based surgical template can be considerably useful in endodontic microsurgery in complicated cases.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.6
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• pp.387-395
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• 2020

Background: The anterior-middle superior alveolar (AMSA) anesthetic technique has been reported to be a less traumatic alternative to several conventional nerve blocks and local infiltration for anesthesia of the maxillary teeth, their periodontium, and the palate. However, its anatomic basis remains controversial. The present study aimed to determine if the pattern of cortical and cancellous bone density in the maxillary premolar region can provide a rationale for the success of the AMSA anesthetic technique. Method: Cone-beam computed tomography scans of 66 maxillary quadrants from 34 patients (16 men and 18 women) were evaluated using a volumetric imaging software for cortical and cancellous bone densities in three interdental regions between the canine and first molar. Bone density was measured in Hounsfield units (HU) separately for the buccal cortical, palatal cortical, buccal cancellous, and palatal cancellous bones. Mean HU values were compared using the Mann-Whitney U test and one-way ANOVA with post-hoc analysis. Results: Cancellous bone density was significantly lower (P ≤ 0.001) in the palatal half than in the buccal half across all three interdental regions. However, there was no significant difference (P = 0.106) between the buccal and palatal cortical bone densities at the site of AMSA injection. No significant difference was observed between the two genders for any of the evaluated parameters. Conclusions: The palatal half of the cancellous bone had a significantly lower density than the buccal half, which could be a reason for the effective diffusion of the anesthetic solution following a palatal injection during the AMSA anesthetic technique.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.4
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• pp.260-264
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• 2013

Calcium hydroxide root canal filing paste (vitapex) is widely used as canal filling paste for infected canal. However, chemical burn is possible because of the high alkali base of calcium hydroxide. A 57-year old woman was admitted to our clinic for consistent dull pain and paresthesia in the left upper lip, zygoma and buccal cheek area, which developed during an endodontic treatment of the left lateral incisor. Radiographic finding showed radiopaque material, which exits from the left incisor root apex, and was within the left canine and first premolar buccal soft tissue. The overfilled Vitapex extended to the soft tissue was surgically curetted. The result of the surgical curettage was favorable. Though slight hypoesthesia on the upper lip was still remained, paresthesia on zygomatic and buccal cheek area was completely recovered. As far as we know, this is the first case report of infraorbital nerve damage from overfilled Vitapex material.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.1
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• pp.61-69
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• 2021

Background: Inferior alveolar nerve block (IANB) using lidocaine 2% is commonly used for anesthetizing primary mandibular molars; however, this technique has the highest level of patient discomfort compared to other local anesthesia techniques. Therefore, alternative anesthesia techniques are necessary. The aim of this study was to evaluate the efficacy of a single buccal infiltration of 4% articaine with IANB using 2% lidocaine, for the bilateral extraction of primary mandibular molars. Methods: The present study was conducted on 30 patients aged between 6 and 9 years, who required the extraction of bilateral primary mandibular molars. The patients were randomly divided into two groups as follows: In the first session, Group A received IANB with lidocaine 2% and group B received infiltration with articaine 4%. In the second session, another injection method was performed on the opposite side. The Wong-Baker Facial Pain scale (WBFPS), Face Leg Activity Cry, and Consolability (FLACC), and physiologic parameters were used to assess pain perception. Results: The independent t-test showed no statistically significant difference in blood pressure and heart rate before and after extraction (P > 0.05). The mean FLACC index in the lidocaine and articaine groups was 0.89 and 1.36, respectively; there was no statistically significant difference between them (P > 0.05). According to the results of the chi-square test, there was no statistically significant difference between the groups for WBFPS (P > 0.05). Conclusion: The articaine infiltration technique may be an alternative to the IANB for the extraction of primary mandibular molars.

• Restorative Dentistry and Endodontics
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• v.46 no.3
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• pp.41.1-41.23
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• 2021

Objectives: This study aimed to evaluate the efficacy of various local anesthesia (LA) in vital asymptomatic teeth. Materials and Methods: Randomized controlled trials comparing pulpal anesthesia of various LA on vital asymptomatic teeth were included in this review. Searches were conducted in the Cochrane CENTRAL, MEDLINE (via PubMed), EMBASE, ClinicalTrials.gov, Google Scholar and 3 field-specific journals from inception to May 3, 2019. Study selection, data extraction, and risk of bias assessment using Cochrane Risk of Bias Tool were done by 2 independent reviewers in duplicate. Network meta-analysis (NMA) was performed within the frequentist setting using STATA 15.0. The LA was ranked, and the surface under the cumulative ranking (SUCRA) line was plotted. The confidence of the NMA estimates was assessed using the CINeMA web application. Results: The literature search yielded 1,678 potentially eligible reports, but only 42 were included in this review. For maxillary buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than lidocaine 2% with epinephrine 1:100,000 (odds ratio, 2.11; 95% confidence interval, 1.14-3.89). For mandibular buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than various lidocaine solutions. The SUCRA ranking was highest for articaine 4% with epinephrine when used as maxillary and mandibular buccal infiltrations, and lidocaine 2% with epinephrine 1:80,000 when used as inferior alveolar nerve block. Inconsistency and imprecision were detected in some of the NMA estimates. Conclusions: Articaine 4% with epinephrine is superior when maxillary or mandibular infiltration is required in vital asymptomatic teeth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.5
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• pp.578-581
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• 2008

Schwannoma named neurinoma, peripheral glioma, perineural fibriblastoma and Neurilemmoma is a ectodermal benign neoplasm which originates from schwann cell or neuro axons. It usually develops in peripheral systems of sensory nerves of gastrointestinal tract, oral cavity, and bone. It occurs more frequently in soft tissue than hard tissue, and is extremely rare in intraoral area. We report a case of Schwannoma that showed large mass on buccal cheek with Rt. midfacial swelling, pain, tenderness to palpation and involvement with maxillary branch of trigeminal nerve. We present this case and review the literature.

• Restorative Dentistry and Endodontics
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• v.21 no.1
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• pp.375-384
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• 1996

The purpose of this study was to investigate the functional involvement of sympathetic nerve in the control of the microcirculation in the dental pulp with the aim of elucidation of the involvement of neuropeptides and sympathetic nerve in neurogenic inflammation. Experiments were done on the 7 cats anesthetised with sodium pentobarbital, and sympathetic nerve to the' dental pulp was stimulated electrically (10 Hz, 4 V, 1.5 ms, 3.5 mins). Ana-adrenoceptor antagonist phentolamine and a neuropeptide Y antagonist D-myo-inositol-1,2,6-trisphosphate (PP56) were injected close intra-arterially into the dental pulp without changing the systemic blood pressure. The probe of laser Doppler flowmeter was placed on the buccal surface of ipsilateral canine teeth to the stimulation, and pulpal blood flow was measured. Stimulation of the sympathetic nerve decreased pulpal blood flow by $55.24{\pm}7.74\;%$ (mean${\pm}$SEM, n = 13). Stimulation of the sympathetic nerve following the injection of the ${\alpha}$-adrenoceptor antagonist phentolamine ($0.1{\mu}g$/kg) caused decrease of pulpal blood flow by $14.35{\pm}3.43%$ (mean${\pm}$SEM, n=5). Phentolamine attenuated the sympathetic nerve-induced pulpal blood flow decrease by $74.02{\pm}9.32%$ (mean${\pm}$SEM) Stimulation of the sympathetic nerve following the injection of the neuropeptide Y antagonist PP56 (2.3 mg/kg) caused decrease of pulpal blood flow by $30.64{\pm}7.92%$ (mean${\pm}$SEM, n=6). PP56 attenuated the sympathetic nerve-induced pulpal blood flow decrease by $44.37{\pm}11.01%$ (mean${\pm}$SEM). These data provide evidences of the co-contribution of nerepinephrine and neuropeptide Y on the sympathetic nerve-induced vasoconstriction in the feline dental pulp. In addition, they show functional evidences that sympathetic nerve plays an active role in controlling the microcirculation of the dental pulp.

• Korean Journal of Veterinary Research
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• v.38 no.3
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• pp.474-487
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• 1998

The present study was undertaken to investigate the morphological characteristics of trigeminal nerve in the Korean native goat by macroscopic methods. Trigeminal nerve was originated from the lateral side of pons, and extended shortly forward to form trigeminal ganglion at the opening of oval foramen. Thereafter this nerve was divided into maxillary, mandibular and ophthalmic nerve. Ophthalmic nerve gave off the zygomaticotemporal branch, frontal nerve, frontal sinus branch, and was continued as the nasociliary nerve. Maxillary nerve gave rise to the zygomaticofacial branch, accessory zygomaticofacial branch, communicating branch with oculomotor nerve, pterygopalatine nerve, caudal superior alveolar branch, malar branch and was continued as the infraorbital nerve. Mandibular nerve was divided into the masseteric nerve, buccal nerve, lateral pterygoid nerve, medial pterygoid nerve, nerve to tensor tympani m., auriculotemporal nerve, and furnished the inferior alveolar nerve and lingual nerve as terminal branches. The course and distribution of the trigeminal nerve in the Korean native goat appeared to be similar to that in other small ruminants such as sheep and goat. But the main differences from other small ruminants were as follows : 1. There was no accessory branch of the major palatine nerve. 2. The caudal superior alveolar branch was directly branched from the maxillary nerve. 3. The communicating branch with oculomotor nerve was originated from maxillary nerve or common trunk with zygomaticofacial branch. 4. The malar branch arose from the maxillary nerve at the rostral to the origin of the caudal superior alveolar branch. 5. The inferior alveolar nerve originated in a common trunk with the lingual nerve. 6. The mylohyoid nerve arose at the origin of the inferior alveolar nerve. 7. The zygomaticotemporal branch was single fascicle, and gave off lacrimal nerve and cornual branch. 8. The base of horn was provided by the cornual branches of zygomaticotemporal branch and infratrochlear nerve of nasociliary nerve.

• Restorative Dentistry and Endodontics
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• v.1 no.1
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• pp.18-25
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• 1975

The author has experienced 8 cases of periapical lesion which were very closed to adjacent root tip. To avoid damage on neighboring nerve and blood supply polyvinyl tube was inserted through buccal window leaving a little pathological changes in involved area. The results are as follows: 1. The purpose to maintain adjacent tooth vitality was achieved by means of intubation in the lesion. 2. Swelling and pain after operation was rather lesser than routine apical surgery, because of drainage. 3. The total treatment period seems longer than that of routine apical amputation.