• Title/Summary/Keyword: Dental Local Anesthesia

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Delayed bleeding after implant surgery in patients taking novel oral anticoagulants: a case report

  • Kim, Chihun;Dam, Chugeum;Jeong, Jieun;Kwak, Eun-Jung;Park, Wonse
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.2
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    • pp.143-147
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    • 2017
  • The use of novel oral anticoagulants (NOACs) has increased in recent times in an effort to overcome the shortcomings of warfarin. They are being used primarily for the prevention of thrombosis caused by atrial fibrillation and offer the advantages of having fewer drug interactions than warfarin, no dietary restrictions, and no requirement for regular blood tests. Although there is reportedly less postoperative bleeding even if the drug is not discontinued during procedures that can cause local bleeding, such as dental procedures, no well-designed clinical studies have assessed postoperative bleeding associated with the use of these drugs. This article reports a case of a 74-year-old male patient who was taking rivaroxaban. The patient underwent a dental implant procedure after discontinuing rivaroxaban for one day and subsequently suffered delayed bleeding on postoperative day 6. Accordingly, this article also reports that the use of NOACs may also lead to delayed bleeding.

A case report and literature review of osseous choristoma on the tongue. (혀에서 골성 이소종(osseous choristoma)에 대한 증례 보고 및 문헌 고찰)

  • Park, Yun-Ha;Baek, Jin-A
    • The Journal of the Korean dental association
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    • v.56 no.10
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    • pp.548-554
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    • 2018
  • Choristoma is a growth of normal tissue that occurs at an abnormal region. In the oral cavity, osseous choristoma that has a normal bone feature mainly has been appeared. It is mainly occurred on the tongue. So, It can be found in dental practice or in discomfort in the mouth. Osseous choristoma in the oral cavity is extremely rare. But It can be treated excisional biopsy under local anesthesia. The prognosis is very good. This case is a report of osseous choristoma on the dorsal surface of the tongue. A 17-year-old female patient presented with a foreign body sensation of the tongue. A diameter of the mass is 0.7cm, and there is no pain. Panoramic radiographs showed a radiopaque image in the form of a double image. An excisional biopsy was performed and diagnosed as an osseous choristoma. 12 months after the resection, there were no signs of recurrence. Intraoral osseous choristoma is very rare, but it is clinically very simple and can be found in dental radiographs. We present this case because of Dentists who examine the oral cavity of the patient can easily diagnose the lesion and treat it by simple resection.

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Use of a botulinum toxin A in dentistry and oral and maxillofacial surgery

  • Park, Kyung-Soo;Lee, Chi-Heun;Lee, Jung-Woo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.3
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    • pp.151-157
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    • 2016
  • Botulinum toxin (BT) was the first toxin to be used in the history of human medicine. Among the eight known serotypes of this toxin, those currently used in medicine are types A and B. This review article mainly discusses BT type A (BTA) because it is usually used in dentistry including dental anesthesiology and oral and maxillofacial surgery. BTA has been used mainly in the treatment of temporomandibular joint disorder (TMD) and hypertrophy and hyperactivity of the masticatory muscles, along with being a therapeutic option to relieve pain and help in functional recovery from dental and oral and maxillofacial surgery. However, it is currently used broadly for cosmetic purposes such as reducing facial wrinkles and asymmetry. Although the therapeutic effect of BTA is temporary and relatively safe, it is essential to have knowledge about related anatomy, as well as the systemic and local adverse effects of medications that are applied to the face.

Histopathology and ultrastructural findings of pediatric sialolithiasis: a brief communication

  • Mustakim, Kezia Rachellea;Nguyen, Truc Thi Hoang;Eo, Mi Young;Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.2
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    • pp.125-129
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    • 2022
  • Sialolithiasis is a condition in which the salivary gland excretory duct is obstructed due to the formation of calcareous deposits and is uncommon in children compared to adults. The treatment modalities range from a conservative approach involving hydration to a surgical approach. Though several studies have analyzed the sialolith micromorphology structures, studies on pediatric sialoliths remain scarce. This brief communication aims to describe the sialolith micromorphology to understand the mechanism of mineralization and growth of pediatric sialoliths. A 6-year-old Korean female presented with swelling under her tongue. The intraoral examination revealed a painless yellowish hard mass beneath the tongue near the Wharton's duct which was suspected as a sialolith. After receiving the informed consent, the sialolithotomy was performed under local anesthesia. The obtained stone was analyzed through histopathology and transmission electron microscope examinations to understand the mechanism of mineralization and growth of pediatric sialolith. The micromorphology and growth processes of pediatric sialolith remain undescribed. More comprehensive microscopic studies are needed regarding their distinctive characteristics. By expanding knowledge about sialoliths micromorphology, development of new preventive, diagnostic and patient-tailored treatment methods of pediatric sialolithiasis will be enhanced.

A study on the scope of future oriented work of dental hygienists (치과위생사의 미래지향적 업무 범위에 대한 고찰)

  • Ahn, Eunsuk;Kim, Sun-Mi;Kim, Bo-Ra;Jeong, Soon-Jeong;Hwang, Soo-Jeong;Han, Ji-Hyoung
    • Journal of Korean Academy of Dental Administration
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    • v.8 no.1
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    • pp.15-23
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    • 2020
  • The aim of this study is to identify future-oriented tasks for Korean dental hygienists based on a literature review. A literature search is performed using 14 keywords related to tasks carried out by dental hygienists, and included articles published from 2000 to 2019 in the databases KISS, RISS, DBpia, NDSL, Papersearch, Pubmed, and Google Scholar. Six reviewers assessed the titles and abstracts of articles, and an article was selected if the study was considered to cover future-oriented tasks for Korean dental hygienists. Based on the results six local studies and two foreign studies were used for literature review and data extraction. In total, 38 tasks were classified as future-oriented tasks of dental hygienists according to the following criteria: 1) tasks that were specifically referred to as future-oriented tasks, and 2) tasks that could be classified as future-oriented tasks although no specific reference was made. Of these, the most frequently mentioned tasks were measuring periodontal pocket depth, dental hygiene assessment, providing dietary advice, infiltration anesthesia, and root planing. These were extracted from five of the eight studies, including both local and foreign studies. Dental hygiene planning, emergency, emergency management, and smoking cessation were the next most common tasks based on four studies. Even though some of these future-oriented tasks for Korean dental hygienists are included in the dentistry curriculum, and are currently performed as clinical practice for dental hygienists. Nonetheless, the reference to the legal scope is unclear. It is necessary to reconsider the scope of tasks of dental hygienists to reflect changes in domestic and foreign dental care delivery, thereby contributing to the oral health promotion of the public, where safety is guaranteed under legal protection.

Buccal infiltration injection without a 4% articaine palatal injection for maxillary impacted third molar surgery

  • Sochenda, Som;Vorakulpipat, Chakorn;Kumar, K C;Saengsirinavin, Chavengkiat;Rojvanakarn, Manus;Wongsirichat, Natthamet
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.4
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    • pp.250-257
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    • 2020
  • Objectives: Palatal infiltration is the most painful and uncomfortable anesthesia technique for maxillary impacted third molar surgery (MITMS). This approach could cause patients distress and aversion to dental treatment. The aim of this study was to evaluate the anesthetic efficacy of a buccal infiltration injection without a palatal injection in MITMS. Materials and Methods: This prospective research study was a crossover split mouth-randomized controlled trial. Twenty-eight healthy symmetrical bilateral MITMS patients (mean age, 23 years) were randomly assigned to two groups. Buccal infiltration injections without palatal injections were designated as the study group and the buccal with palatal infiltration cases were the control group, using 4% articaine and 1:100,000 epinephrine. The operation started after 10 minutes of infiltration. Pain assessment was done using a visual analogue scale and a numeric rating scale after each injection and extraction procedure. Similarly, the success rate, hemodynamic parameters, and additional requested local anesthetic were assessed. Results: The results showed that the pain associated with local anesthetic injections between both groups were significantly different. However, the success rates between the groups were not significantly different. Postoperative pain was not significant between both groups and a few patients requested an additional local anesthetic, but the results were not statistically significant. For hemodynamic parameters, there was a significant difference in systolic pressure during incision, bone removal, and tooth elevation. In comparison, during the incision stage there was a significant difference in diastolic pressure; however, other steps in the intervention were not significantly different between groups. Conclusion: We concluded that buccal infiltration injection without palatal injection can be an alternative technique instead of the conventional injection for MITMS.

Effect of Inferior Alveolar Nerve Block Anesthesia on Taste Threshold (하치조신경 전달마취가 미각역치에 미치는 영향)

  • Ahn, Young-Joon;Kim, Seung-Whan;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.177-185
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    • 2007
  • Iatrogenic injury following dental treatments and the use of local anesthetics may cause taste disorders. The aims of this study were to investigate quantitative and qualitative changes of taste due to unilateral inferior alveolar nerve block anesthesia and further to evaluate potential effects on taste function related to anesthesia or hypoesthesia of inferior alveolar nerve, possibly occurring after dental procedure. 30 healthy volunteers in their twenties participated in this study (male to female = 1:1, mean age of $24.0{\pm}1.8$ years). Each subject received inferior alveolar nerve block anesthesia on his or her right side with 2% lidocaine HCl containing 1:100,000 epinephrine. Before and after anesthesia, electrogustometric test and chemical localized test for salty, sweet, sour and bitter tastes were performed on the eight sites in the oral cavity; right and left anterior and lateral tongue and circumvallate papilla of the tongue and soft palate. Unilateral inferior alveolar nerve anesthesia produced elevation of electrical taste threshold and reduction of intensity ratings for all 4 tastes (salty, sweet, sour and bitter) over anterior and lateral tongue and circumvallate papilla on the ipsilateral side (p<0.05). Contralateral sides exhibited decreased intensity ratings for salty and sweet taste (p<0.05) on anterior and lateral tongue while there was no significant difference in electrogustometric testing. Based on the results of this study, it is assumed that unilateral local anesthesia on inferior alveolar nerve can affect chorda tympani and glossopharyngeal nerves on the same side, leading to taste deficits. Taste intensity on the contralateral side may, in part, be deteriorated as well.

Removal of Maxillary Mesiodentes of Patient with Molar-Incisor Hypomineralization (MIH) (Molar-Incisor Hypomineralization에 이환된 환자의 상악 정중과잉치 발거)

  • Bae, Sangyong;Ra, Jiyoung;Lee, Jewoo
    • The Korean Journal of Oral and Maxillofacial Pathology
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    • v.42 no.6
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    • pp.183-187
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    • 2018
  • The supernumerary tooth which is extra tooth in comparison to normal dentition is one of the developmental problems. The most common type of supernumerary tooth is mesiodens which may cause several complications like delayed eruption, crowding, spacing et al. Moral Incisor Hypomineralization (MIH) describes the clinical appearance of enamel hypomineralization of systemic origin affecting one or more permanent first molars that associated frequently with affected incisors. We report a case of a 6 - year - old boy who visited our clinic for removal of mesiodentes. The patient was diagnosed by mesiodentes and MIH by clinical examination and radiographic examination. Under local anesthesia, Mesiodentes were removed surgically. The demarcated opacities, a feature of MIH, were observed in the removed mesiodentes. After removal of mesiodentes, the maxillary central incisors erupted normally and in order to manage the teeth affected MIH, follow-up and fluoride varnish application were done every 3 months.

Sedation with dexmedetomidine in elderly patients during dental surgery: a retrospective case series

  • Seto, Mika;Kita, Ryosuke;Kondo, Seiji
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.3
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    • pp.152-157
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    • 2019
  • Objectives: The number of elderly patients with systemic basal disease requiring invasive dental treatment has increased. Appropriate prediction of surgical invasiveness and combined use of psychosedation are thought to contribute to safe whole-body management. Dexmedetomidine (DEX) exhibits analgesic and anti-anxiolytic properties and causes mild respiratory depression. Studies regarding DEX use in elderly non-intubated patients are scarce. We aimed to use retrospective data to determine an effective dose of DEX to induce adequate sedation in elderly patients undergoing invasive dental surgery under local anesthesia. Materials and Methods: One hundred two patients aged 70 to 96 years were presumably appropriately controlled with sedation. DEX was administered at an initial loading dose of 2.0 to $3.1{\mu}g/kg/hr$ for 10 minutes. We divided the patients into five groups by age and compared their blood pressures and heart rates. Results: In all five groups, blood pressure decreased suddenly at approximately 15 and 20 minutes after DEX administration. A marked decrease in blood pressure was noted in patients aged 75 to 79 years. Conclusion: For elderly patients aged 75 years and above, the initial loading dose of DEX needs to be reduced to lower than half that required for young and middle-age adults.

Anaphylactic Shock Caused by the Epidurally-Administered Hyalurinidase

  • Lee, Hae-Kwang;Choi, Eun-Joo;Lee, Pyung-Bok;Nahm, Francis Sahngun
    • The Korean Journal of Pain
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    • v.24 no.4
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    • pp.221-225
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    • 2011
  • Hyaluronidase is an enzyme that has temporary and reversible enzymatic effects on the matrix of connective tissue. When added to local anesthetics in pain treatments, it enhances their infiltration and dispersal into tissues. It is widely used in anesthesia for ocular, dental, and plastic surgery. Reports of drug hypersensitivity to hyaluronidase are rare and are usually confined to peribulbar or retrobulbar anesthesia during ophthalmic surgery. However, few reports exist on adverse drug reaction after epidural injection. We have observed two patients experiencing anaphylactic shock caused by hyaluronidase following epidural injection. Most of the patients with a hypersensitivity to hyaluronidase had one previous uneventful injection containing hyaluronidase, implying that sensitization had taken place. However, hypersensitivity occurring at the first administration is possible. A positive skin test can help establish the diagnosis. Although rare, the possibility of an allergic reaction to hyaluronidase should be considered even in patients with no known previous exposure.