• Journal of Oral Medicine and Pain
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• 제24권1호
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• pp.59-67
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• 1999

Personality characteristics of TMD patients was studied through the SCL-90-R. III patients were subjected at the Orofacial Pain Clinic, Dept. of Oral Medicine, PNUH, from 1991 to 1996. All the TMD patients were divided and analyzied comparatively by the ways of duration of present illness, severity of symptoms, associated symptoms, traumatic contributing factor, history of treatment, treatment modality, response to therapy and treatment outcomes. The obtained results were as follows; 1. Mean value of T-scores on 9 basic scales in all the groups was within normal range. 2. There showed higher levels of T-scores in the chronic group, the unimproved group and the discontinued group. 3. T-scores in the patients with severe symptom, associated symptoms, and history of treatment revealed higher.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권6호
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• pp.403-408
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• 2020

Trigeminal neuralgia (TN) involves chronic neuropathic pain, characterized by attacks of repeating short episodes of unilateral shock-like pain, which are abrupt in onset and termination. Anticonvulsants, such as carbamazepine, are the gold standard first-line drugs for pharmacological treatment. Microvascular decompression (MVD) surgery is often the course of action if pharmacological management with anticonvulsants is unsuccessful. MVD surgery is an effective therapy in approximately 83% of cases. However, persistent neuropathic pain after MVD surgery may require reintroduction of pharmacotherapy. This case report presents two patients with persistent pain after MVD requiring reintroduction of pharmacological therapy. Although MVD is successful for patients with failed pharmacological management, it is an invasive procedure and requires hospitalization of the patient. About one-third of patients suffer from recurrent TN after MVD. Often, alternative treatment protocols, including the reintroduction of medications, may be necessary to achieve improvement. This case report presents two cases of post-MVD recurrent pain. Further research is lacking on the success rates of subsequent medication therapy after MVD has proven less effective in managing TN.

• Journal of Oral Medicine and Pain
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• 제40권1호
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• pp.3-9
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• 2015

The etiopathogenesis of burning mouth syndrome (BMS) seems to be complex and many patients probably involves interactions among local, systemic, and/or psychological factors in the pathophysiologic mechanism. Although there are controversies over whether the psychological factor is a cause or a result of BMS, several studies have supported strong relationships between psychological factors and chronic pain. It has been suggested that somatic complaints from unfavorable life experiences may influence both individual personality and mood changes; however, initiation of BMS symptoms is not necessarily correlated with stressful life events despite their elevated psychological stress. If the psychological distress is not a causal factor of BMS, it seems that BMS patients may be particularly vulnerable to psychological problems, primarily depression, anxiety, and hostility due to the characteristic entities of BMS such as chronic persistent pain itself. It seems likely that both physiological and psychological factors play a role in causing, perpetuating and/or exacerbating BMS; therefore, both two components of the patient's symptoms must be addressed. The acceptance of psychological factors by the patient is often an important element of BMS, management. The evaluation of psychological and emotional status of BMS patient enables clinicians to recognize prolonged negative and subclinical factors which can complicate the management of pain or indirectly perpetuate other physical factors. This evaluation improves the doctor-patient relationships, motivation, and compliance through a correct understanding of the clinical problem. Appropriate emotional and psychological evaluation may be required prior to developing a treatment plan in order to gain the successful treatment outcome.

• Journal of Oral Medicine and Pain
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• 제22권1호
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• pp.7-13
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• 1997

In order to evaluate the outcome of conservative treatment for acute or chronic closed lock, 127 patients were subjected at the Dept. of Oral Medicine, PNUH, from 1991. All the symptoms were analyzed and the results according to treatment modalities were compared before and after treatment. 1. Closed lock patients were more often seen in women of twenty and thirty. 2. The most common reasons for treatment were functional pain, limitation of mouth opening, restricted laterotrusion to non-effected side, deflection on opening but, on the contrary, noise was the least. 3. Most of closed lock patients were curedin six months. 4. Conservative treatment including stabilization splint produced better results. 5. Functional pain and limitation of mouth opening were relieved and maximumm comfortable opening was expanded, but joint noise decreased in the chronic and increased in the acute.

• Journal of Oral Medicine and Pain
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• 제33권3호
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• pp.257-267
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• 2008

정신신체질환은 개개인의 서로 다른 성격, 정서적 스트레스에 대한 반응과 기질적인 요소 등이 함께 반응하여 소화기계, 순환기계, 호흡기계 및 근골격계 등에 수많은 질환을 야기하며, 그 중에 만성통증도 역시 포함한다. 구강안면 영역의 증상으로 내원하는 이유 중 가장 많은 비율을 차지하는 것은 통증이며 증상에 영향을 주는 기여요인은 생물학적 요인, 행동요인, 환경요인, 사회요인, 정서요인, 인지요인 등을 포함한다. 이러한 기여요인은 개인의 성격, 인성에 좌우되어 증상의 경로에 영향을 미치게 된다. 통증에 있어 수면은 하나의 기여요인으로 작용하며, 통증은 수면장애를 가져오거나 악화시키기도 하며, 수면장애 역시 통증을 악화시킬 수 있다. 수면의 질의 저하는 정서적 스트레스를 가속화 시킬 수 있는 한 요인으로 작용할 수 있다. 이에 구강안면 영역에 증상을 보이는 환자에게 비교적 정확하고 간단하게 시행할 수 있는 수면의 질 평가 및 정신 검사를 필히 시행하여 평가해야 한다. 본 연구는 PSQI를 통한 수면의 질 평가와 간이정신진단검사(SCL-90-R)를 비교 평가하여 수면과 정서적, 심리적 상태와의 관계를 규명하고자 하였으며, 다음과 같은 결과를 얻었다. poor sleeper 는 남자가 18명, 여자가 1명이었으며, PSQI 총수면 지수는 남자에서 $6.11{\pm}2.38$, 여자에서 $4.67{\pm}2.18$로 나타났다. SCL-90-R 지수는 남녀간 차이를 보이지 않았고 poor sleeper에서 신체화(SOM), 강박증(O-C), 대인예민성(I-S), 불안(ANX), 공포불안(PHOB), 정신증(PSY)에서 유의성 있게 높은 평균치를 보였으며 전체 심도지수(GSI), 표출증상합계(PST)가 유의성 있게 높았다. 또한 수면의 질에 따른 SCL-90-R의 T-점수는 주관적 수면의 질이 나쁠수록 강박증(O-C), 대인 예민성(I-S)에서, 수면장애가 심할수록 편집증(PAR), 정신증(PSY), 표출증상합계(Positive symptom total, PST)가, 주간수면장애에서는 우울(DEP), 불안(ANX), 적대감(HOS), 공포불안(PHOB), 편집증(PAR), 전체 심도지수(GSI)에서 유의하게 높은 평균치를 보였다. 이와 같이 수면의 질과 정서적 상태는 서로 밀접한 연관성을 지닌다고 할 수 있으며, 이는 구강안면 영역의 만성 통증에 영향을 미치리라 생각된다. 이에 구강안면통증을 다루는 임상가들은 환자의 수면의 질과 정서적 상태에 대해 적절히 평가하는 것이 반드시 필요하며, 추후 구강안면통증에 있어 수면과 정서적, 심리적 인성관계에 대한 연구가 더 필요하리라 사료된다.

• Journal of Oral Medicine and Pain
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• 제32권3호
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• pp.329-336
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• 2007

치과임상에서 치통을 호소하는 환자를 흔히 접할 수 있다. 그리고 그 치통의 대부분은 치수조직이나 치주조직에서 기원한다. 이러한 치원성 치통은 일반적으로 치과치료로 효과적으로 치료 할 수 있다. 그러나 치과의사가 종종 당황하게 되고 진단에 곤란을 겪는 것은 연관통이 존재하기 때문이다. 치통을 올바르게 치료하기 위해서는 비치원성 치통의 가능성에 대한 고려가 가장 중요한 과정이라 생각할 수 있으며, 이러한 동통들의 원인을 찾기 위해서는 말초성 기전과 중추성 기전에 대한 이해가 필요하다. 정확한 진단과 합리적인 치료를 위해서는 두경부의 모든 구조물에 대한 고려와 평가가 수행되어야 하며, 구강 안면 동통 각각의 고유증상과 증후 특성에 대한 이해와 감별진단을 위한 보조진단방법 들을 바르게 이용할 수 있어야 한다. 저자는 치아에 연관통을 유발하였고 편두통의 증상과 유사한 소견을 나타낸 범부비동염의 증례 하나를 소개하고자 한다.

• Journal of Oral Medicine and Pain
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• 제19권2호
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• pp.169-180
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• 1994

The aim of this study was to compare pain descriptions in common dental patients with those in patients with Temporomandibular disorders(TMDs). The study sample consisted of 104 common dental patients and 74 patients with TMDs, and their chief complaint was pain, Subjects were classified common dental pain group and TMDs pain group, respectively. All the subjects completed Korean Pain Rating Scale(KPRS) on first visit. KPRS contains 90 pain terms, which divided into 20 subclasses in 3 dimensions. Each subclass contains 3-6 pain terms. each patient had chosen only one term from each subclass. If there was no proper term, subject could pass the subclass without completion. Words chosen were categorized into sensory, affective, miscellaneous and total dimension. Thereafter they were processed and analyzed by SPSS/PC+ statistical package program with respect to rank values, scale values, number of words chosen and frequency of each subclass. The obtained results of this study were as follows : 1. Total mean number of words chosen was 7.6. 2. Chronic patients groups with Temporomandibular disorders had chosen more freuently from the subclasses in affective dimension than the patients in acute common dental pain group. 3. Frequency of affective dimension was higher in chronic patients groups with Temporomandibular disorders than that of acute patients group with Temporomandibular disorders. 4. Chronic patients group with Temporomandibular disorders had higher frequency in constrictive pressure pain, traction pressure pain, dull pain and fatigue-related pain terms than acute common dental patients group. 5. Acute patients group with Temporomandibular disorders had higher frequency in traction pressure pain and dull pain terms but had lower frequency in chemical pain, peripheral nerve pain and cold pain terms than acute common dental patients groups. 6. There were high positive correlation between the scale- and rank-value in the pain rating index.

• The Korean Journal of Pain
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• 제37권4호
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• pp.288-298
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• 2024

Nerve growth factor (NGF) is a neurotrophic protein that has crucial roles in survival, growth and differentiation. It is expressed in neuronal and non-neuronal tissues. NGF exerts its effects via two types of receptors including the high affinity receptor, tropomyosin receptor kinase A and the low affinity receptor p75 neurotrophin receptor highlighting the complex signaling pathways that underlie the roles of NGF. In pain perception and transmission, multiple studies shed light on the effects of NGF on different types of pain including inflammatory, neuropathic, cancer and visceral pain. Also, the binding of NGF to its receptors increases the availability of many nociceptive receptors such as transient receptor potential vanilloid 1, transient receptor potential ankyrin 1, N-methyl-D-aspartic acid, and P2X purinoceptor 3 as well as nociceptive transmitters such as substance P and calcitonin gene-related peptide. The role of NGF in pain has been documented in pre-clinical and clinical studies. This review aims to shed light on the role of NGF and its signaling in different types of pain.

• Journal of Oral Medicine and Pain
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• 제23권4호
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• pp.361-368
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• 1998

In order to evaluate the clinical features of the rcurred patients with temporomandibular disorders, 52 patients were subjected at the Dept. of Oral Medicine, PNUH from 1985 through 1996. As related to gender, duraton and diagnosis, Ll the relate factors-multiple diagnosis, emotinal problem, history of treatment, parafunctional habit, life distrubance, and trauma were analyzed. The obtained results were as follows : 1. The patients with multiple diagnosis were 83 percent and more often seen in women, chronic group and muscle-joint disorder group. 2. Duration of retreatment in chronic group and muscle-joint disorder was longer. 3. The patients with oral parafunctional habits were 89 percent and more often seen in women, chronic gorup, muscle-joint disorder group. 4. the Recurred patients showed 46 percent in history treatment, 42 percent in life distrubances, 39 percent in macrotrauma and 12 percent in emotional problem.

• Journal of Oral Medicine and Pain
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• 제43권1호
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• pp.16-20
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• 2018

Graft-versus-host disease (GVHD) is frequent complications of hematopoietic stem cell transplantation. In the chronic GVHD (cGVHD), the oral cavity is the most commonly affected region. The clinical manifestations include erythema, ulceration, lichenoid-hyperkeratotic change in oral mucosa, dry mouth, and limitation of mouth opening. The initial treatment strategy of oral cGVHD patients is topical corticosteroid therapy in various formulation. However, corticosteroid resistance appears in some patients. We report a case of a 25-year-old male patient with oral cGVHD, who has resistance to topical corticosteroid medication, treated with 0.03% tacrolimus ointment and low-dose doxycycline. The patient showed subjective and objective improvement without side effect.