• 구강회복응용과학지
• /
• 제33권1호
• /
• pp.1-6
• /
• 2017

보툴리눔 독소 주사는 이마, 눈가 주름치료 등 미용성형분야 뿐만 아니라 만성 편두통(chronic migraine), 근육긴장이상(dystonia), 경직(spasticity), 측두하악장애의 치료 등에 사용되어 왔다. 특히 보툴리눔 독소 주사는 만성편두통환자의 예방적 치료요법으로 현재까지 유일하게 승인된 요법이다. 기존에 잘 알려진 운동신경에서의 마비효과와는 달리, 편두통에 대한 작용기전은 감각신경에서 말초감작과 신경원성염증과 관련되는 substance P, CGRP, glutamate 등 비콜린성 신경전달물질의 유리를 차단하여 통증신호를 차단하는 역할을 한다는 가설이 제기되고 있다. 본 논문에서는 보툴리눔독소가 갖는 진통효과에 대한 고찰과 함께 이를 통하여 추후 만성편두통환자에 대한 주사법 개발에 대한 방향성을 제시하고자 한다.

• Journal of Oral Medicine and Pain
• /
• 제35권4호
• /
• pp.259-264
• /
• 2010

만성 궤양성 치은 병소는 편평태선, 양성점막유천포창, 심상성 천포창 등과 같은 다양한 질환에 의해 유발될 수 있으며 코티코스테로이드 약물요법이 주된 치료로 이용된다. 코티코스테로이드를 복용하는 경우 위장장애, 체중증가 등의 부작뿐만 아니라 장기 복용 시 골다공증, 당뇨 및 고혈압 발생 또는 악화, 부신기능 저하, 쿠싱증후군 등의 심각한 부작용이 발생 할 수 있어 병소가 국소 부위에 제한되어 발생하거나 전신증상을 동반하지 않는 경우 스테로이드 약물의 국소 도포가 만성 궤양성 치은 병소의 주된 치료로 이용되고 있다. 하지만 국소 스테로이드 치료를 구강 내에 사용하는 경우 타액 분비, 혀, 입술, 협점막 등의 움직임에 의해 도포한 약제가 소실되어 효과가 감소되고 병소가 넓은 부위에 분포하거나 구강 내 깊숙한 부위에 발생하는 경우 환자 스스로 약물을 도포하기가 용이하지 않으며, 질병에 이환 되지 않은 정상 점막에도 약제가 도포 되는 등의 단점이 있다. 국소 스테로이드 적용 방법의 단점을 극복하고 효과를 최대화함으로써 스테로이드 복용을 최소화할 수 있는 방법으로 스텐트를 이용한 스테로이드 밀폐 요법이 보고된 바 있으나 실제 임상에서 적극적으로 활용되지는 않고 있다. 따라서 만성 궤양성 치은 병소가 발생한 환자에게 스텐트를 이용한 국소스테로이드 치료를 시행하여 양호한 치료 효과를 보인 증례를 통해 그 효용성과 임상적 활용 방안을 알아보고자 한다.

• Journal of Oral Medicine and Pain
• /
• 제40권2호
• /
• pp.82-87
• /
• 2015

Methotrexate (MTX) is a chemotherapeutic agent that is used to treat a host of malignancies. But recently, MTX has also been used as a therapeutic agent for chronic inflammatory disorders such as rheumatoid arthritis, psoriasis, and systemic lupus erythematosus. However, MTX is an antimetabolite that affects rapidly dividing normal cells such as oral mucosal epithelial cells, gastrointestinal epithelial cells, and bone marrow cells-which explains why oral mucositis is often an initial manifestation of MTX toxicity. Because oral lesions are frequently initially presented in dental clinics, dentists should consider the possibility of adverse drug reactions in the differential diagnoses of oral lesions through a meticulous collection of patients' medical histories. In this report, we examine patients who suffered from oral ulcerative lesions upon diagnosis of MTX-induced oral mucositis. Then, we suggest approaches for the diagnosis and treatment of MTX-induced oral mucositis through a review of literature.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제20권5호
• /
• pp.263-269
• /
• 2020

Fibromyalgia is a syndrome characterized by chronic pain in the skeletal system accompanied by stiffness, sleep disturbance, fatigue, and psychiatric problems, such as anxiety and depression. Fibromyalgia commonly affects orofacial health, presenting with a variety of oral manifestations, including temporomandibular disorder, xerostomia, glossodynia, and dysgeusia. Therefore, oral healthcare providers need to be aware of this clinical entity to effectively manage oral symptoms and provide proper oral self-care modification and education on the nature of fibromyalgia. This review focuses on the epidemiology, pathophysiology, clinical manifestation, diagnosis, orofacial concerns, and treatment of fibromyalgia.

• 구강생물연구
• /
• 제42권4호
• /
• pp.269-271
• /
• 2018

Ankylosing spondylitis (AS) is a chronic inflammatory joint disorder characterized by sacroiliitis, spondylitis and enthesitis. Patients suffering from AS may also have extra-articular symptoms, such as uveitis, bowl disease, heart, lung, skin, bone and kidney involvement, but vary widely in severity and prevalence. Facial manifestation of AS include eye involvement and temporomandibular joint involvement. In this study, a case of an AS that mimicked dental pain was presented.

• Journal of Oral Medicine and Pain
• /
• 제23권4호
• /
• pp.403-418
• /
• 1998

The aim of this study was to measure effects of the following items to pain and pain behavior reaction in patients with chronic orofacial pain. Items that contribute to the first factor(Environmental Influences) measure environmental sources of information that may affect illness behavior; Second factro(Loss of Control) measure appraisals and attributions perceived to influence personal views aobut pain; Third factor(Health Care Avoidance) measures a variety of avoidant behaviors; Fouth factor(Past and Current Experiences) measures experiences with treatment); Fifth factor(Physiological Responsivity) measures physiological parameters that are experienced in association with pain; Sixth factor(Thoughts of Disease Progression) measures thoughts regarding the etiology and progression of disease in relation to pain. 150 patients that were consist of 40 male and 110 female were participated in this study. The obtained results of this study were as follows : 1. Environmental influences and loss of control scales were recorded high score in patients with chronic orofacial pain 2. "Physician's descriptions of what your pain will be like" and "Physician's facial expression when they ask about your pain" items from the environmental influences were recorded high score. These results indicated that responsibility of doctro is very important to the pain reaction behavior of patients. Also, items from thoughts regarding the etiology and progression of disease in relation to pain influenced to the pain reaction. 3. There were significant defferences on the "nurses' descriptions of what you pain will be like", "physician's and nurses' facial expression when they ask about your pain", "TV and radio", and "Literature" items from the environmental influences between male and female patients. 4. There were no significant differences on the each scale between arthrogenous and combitnation group and significant correlated with all 6 scales.

• Journal of Oral Medicine and Pain
• /
• 제41권4호
• /
• pp.145-154
• /
• 2016

Transcutaneous electrical nerve stimulation (TENS) is one of the representative physiotherapical modalities used for the treatment of various musculoskeletal disorders by the application of electrical stimuli. In dental practice, it has long been used in the treatment of acute and chronic orofacial pain conditions including temporomandibular disorders. TENS is the delivery of therapeutic electrical stimuli with a variety of electrical intensity, frequency and duration to stimulate peripheral nerve through surface electrodes with various form and placement. While controversy still remains over the clinical effectiveness and application of TENS, basic understanding of its electrical properties and the expected biological reactions is important to increase the therapeutic effect and decrease the risk of possible side effects. This review, therefore, focuses on basic understanding of TENS including its underlying mechanisms and stimulation parameters.

• Journal of Oral Medicine and Pain
• /
• 제42권2호
• /
• pp.49-52
• /
• 2017

Leukemia is a malignant disease characterized by uncontrolled clonal proliferation of white blood cells. It is classified depending on clinical course of disease (acute or chronic) and the primary hematopoietic cell line affected (myeloid or lymphoid). Leukemia is often associated with orofacial manifestations, such as oral bleeding, petechiae, oral ulceration, gingival enlargement, mucosal pallor and mental nerve neuropathy. However, trismus has been rarely reported as a sign of leukemia. We present a case of trismus caused by acute lymphoblastic leukemia and emphasize the importance of orofacial manifestations in the early diagnosis of leukemia.

• Journal of Oral Medicine and Pain
• /
• 제34권4호
• /
• pp.387-395
• /
• 2009

신경섬유 말단에서의 유해자극 인지과정에는 신경성장인자 (nerve growth factor [NGF])와 감각성 신경펩티드가 관여하고, 또한 이들은 중추신경계에도 광범위하게 분포되어 있다. 본 연구는 인체 혈액과 타액에서 NGF와 감각성 신경펩티드(substance P [SP], calcitonin gene-related peptide [CGRP])의 농도를 조사하여 다양한 구강안면통증 증상들과의 관계를 알아보고자 시행되었다. 67명의 구강안면통증 환자 (관절 통증, 치아 혹은 치주 통증, 점막 통증)와 36명의 건강한 성인에서 혈장과 안정시 전타액을 채취하여 효소면역분석법 (enzyme immunoassay)을 이용하여 NGF, SP, CGRP의 농도를 측정하였다. 만성통증척도 (Graded Chronic Pain Scale) 설문지를 이용하여 각 피실험자들의 통증강도를 조사하였으며 안정시 전타액의 타액분비율 또한 측정하였다. 관절 통증 환자군은 치아 통증 환자군, 점막 통증 환자군, 대조군 각각에 비하여 유의하게 높은 혈장 내 NGF 농도를 나타내었다. 치아 통증 환자군의 혈장 내 NGF 농도는 대조군에 비하여 유의하게 높았다. 치아 통증 환자군의 타액 내 SP 농도와 점막 통증 환자군의 타액 내 CGRP 농도 또한 대조군에 비하여 유의하게 높았다. 관절 통증 환자군의 혈장 및 타액 내 SP 농도는 통증 강도와 유의한 상관관계를 보였다. 치아 통증 환자군과 점막 통증 환자군에서, 혈장 내 SP 농도, 타액 내 SP 농도, 타액 내 CGRP 농도는 연령에 따라 증가하였다. 혈장과 타액에서의 신경성장인자와 신경펩티드 검사는 다양한 구강안면통증의 특성과 예후를 평가하는데 도움을 줄 수 있으리라 생각된다.

• Journal of Oral Medicine and Pain
• /
• 제24권4호
• /
• pp.467-477
• /
• 1999

Personality characteristics of orofacial pain patients was analyzed psychologically by means of the SCL-90-R. 36 TMD patients, 20 burning mouth syndrome(BMS) patients, 31 trigeminal neuralgia(TN) patients, 20 control I and 28 control II were subjected at Orofacial pain clinic, Department of Oral Medicine and Health Promotion Center, Pusan National University Hospital during the period from 1998 to 1999. The obtained results were as follows: 1. Mean values of T-scores on 9 basic scales in all the groups were within normal range. 2. The T-scores of SOM, O-C, ANX and HOS in TMD patient group were significantly higher than those in control I group, but there was no significant difference in all scales between TMD patient group and control II group. 3. The T-scores of SOM in BMS patient group was significantly higher than those in control I group, but there was no significant difference in all scales between BMS patient group and control II group. 4. The T-scores of SOM in TN patient group was significantly higher than those in control II group. 5. As compared with present and absent of the history of systemic diseases, there was no significant difference of the scales in TMD, BMS and TN patient groups but the T-scores of the patient groups with the history of systemic diseases tended to higher than those of the patient group without the history of systemic diseases. 6. As compared with acute and chronic groups, the T-scores of O-C, I-S, PAR, PSY in chronic BMS patient group were significantly higher than those in acute BMS patient.