• The Journal of the Korean dental association
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• v.49 no.6
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• pp.321-326
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• 2011

Neuropathic pain is caused by functional abnonnalities of structural lesions in the peripheral or central nervous system, and occurs without peripheral nociceptor stimulation. Trigeminal neuropathy always pose differential location difficulties as multiple diseases are capablc of producing them: they can be the result of traumatism, tumors, or diseases of the connective tissue, infectious or demyelinating diseases, or may be of idiopathic origin. There are a number of mechanisms described as causing neuropathy. They can be described as ectopic nerve activity, neuroma, ephatic trasmission, change of sodium channel expression, sympathetic activity, central sensitization, and alteration in central inhibition systems. More than I mechanism may be active to create individual clinical presentations. In order to provide better pain control, the mechanism-based approach in treating neuropathic pain should be familiar to physicians.

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.4
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• pp.416-421
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• 2019

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare, autosomal recessive disorder; affected patients are characterized by inability to feel pain and to sweat over the entire body, as well as by mental retardation. Because, in the oral examination, no specific findings on soft or hard tissue may be found except possible lesions due to self-mutilation, early recognition and diagnosis are essential for these patients. Pediatric dentists must be aware of the clinical manifestations and treatment considerations related to uncontrolled body temperature, tactile hyperesthesia and lack of pain reflex. In this case report, dental management of CIPA was suggested by presenting a 6-year follow-up of young patient.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.6
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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 Korean society of Dental Hygiene
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• v.21 no.6
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• pp.731-740
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• 2021

Objectives: The purpose of this study was to examine the effects of oral and mental health status on temporomandibular joint disorders (TMDs) and the effects of TMD symptoms on quality of life using data from the 5th 2012 National Health and Nutrition Examination Survey. Methods: A total of 1,154 people were selected as subjects for the study. Temporomandibular joint (TMJ) sounds (672 persons), TMJ pain (227 persons), and TMJ dislocation (255 persons) were the factors studied. The complex sample chi-square test was performed to compare demographic characteristics according to the three groups of TMD symptoms. Complex sample logistic regression analysis was performed to confirm the effect of oral and mental health status on TMDs, and complex sample linear regression analysis was performed to check the effect of TMDs on the quality of life (EQ-5D). Results: After adjusting for demographic characteristics, those without TMJ sound symptoms had lower pain/discomfort (OR: 0.055, CI: -0.095 to -0.016) and anxiety/depression (OR: 0.053, CI: -0.092 to -0.014). Those without TMJ pain had lower pain/discomfort (OR: 0.119, CI: -0.192 to -0.046) and anxiety/depression (OR: 0.071, CI: -0.137 to -0.004). Pain/discomfort (OR: 0.063, CI: -0.125 to -0.001) was lower in those without TMJ dislocation symptoms. After adjusting for mental health status, pain/discomfort (OR: 0.088, CI: -0.161 to -0.014) was found to be lower in those without TMJ pain symptoms (p<0.05). Conclusions: Based on the results of this study, the treatment of TMDs, oral health, and also mental health, is needed to improve the quality of life.

• Sleep Medicine and Psychophysiology
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• v.29 no.1
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• pp.9-14
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• 2022

Dental sleep medicine is an up-and-coming discipline of dentistry, more specifically an offshoot of oral medicine. It traditionally focuses on sleep-related breathing disorders, such as snoring and obstructive sleep apnea. However, everyday practice shows that also other sleep disorders touch on dentistry, including orofacial pain, xerostomia, and bruxism. Therefore, a new definition has been formulated for dental sleep medicine as following; 'Dental sleep medicine is the discipline concerned with the study of the oral and maxillofacial causes and consequences of sleep-related problems'. It is this article's aim to further introduce the emerging discipline of dental sleep medicine to all professionals working in sleep medicine. This article briefly describes the different dental sleep disorders with special focus on the more remarkable associations between orofacial pain and sleep.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.4
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• pp.201-208
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• 2019

Background: After tooth extraction, pain due to dry socket and pain in the adjacent tooth are common. The aim of this study was to retrospectively analyze pain in the adjacent tooth after surgical extraction of the mandibular third molar. Methods: Postoperative pain due to dry socket, pain in the adjacent tooth, and pain from other causes were present. Group A included patents with dry socket alone; group B included patients with pain in the adjacent tooth alone; and group C included patients with both. The duration of symptoms was recorded. In addition, the prognosis of pain was divided into the complete improvement, improvement, maintenance, deterioration, and complete deterioration groups. Results: A total of 312 mandibular third molars were extracted from 13, 60, and 10 patients in groups A, B, and C, respectively. The mean duration of symptoms was 5 days in group A and B and 15.2 days in group C. There were statistically significant differences in the duration of symptoms between groups A and C and groups B and C. Conclusion: Pain in the adjacent tooth after third molar extraction can be caused by inflammatory reactions and pressure on this tooth. The pain caused by pressure on the periodontal ligament and alveolar bone results from the cytokines released by osteoclasts, which are responsible for bone destruction. However, pain from periodontal ligament damage caused by excessive pressure may be misunderstood as pulpal pain. Unconscious parafunctional habits, such as clenching and bruxism, could also be associated with post-extraction pain.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.4
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• pp.237-240
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• 2023

Dolichoectasia of the intracranial arteries is a rare condition characterized by elongated and tortuous arteries due to progressive destruction of the vessel walls. Although most patients present with cerebrovascular accidents, our patient presented with intractable facial pain along the distribution of the trigeminal nerve. Clinical examination revealed involvement of the 5th, 7th, and 8th cranial nerves, and subsequent MRI showed dolichoectasia of the left basilar artery. The patient experienced symptomatic relief after a trial of carbamazepine along with botulinum toxin injections.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.1
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• pp.35-37
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• 2015

Atypical facial pain (AFP) is a type of facial pain which does not fulfill any other diagnosis. It has several features such as no objective signs, no obvious explanation of the cause and poor response to treatments. We report a case of a female patient with AFP on the left maxillary area. The pain was increased by cold innocuous stimulation and thermography showed that the temperature on the painful area was significantly decreased. The pain was successfully alleviated by stellate ganglion block (SGB). Therefore, SGB can be effectively used to treat AFP.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.3
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• pp.159-163
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• 2016

Orofacial pain is a common complaint of patients that causes distress and compromises the quality of life. It has many etiologies including trauma, interventional procedures, nerve injury, varicella-zoster (shingles), tumor, and vascular and idiopathic factors. It has been demonstrated that the sympathetic nervous system is usually involved in various orofacial pain disorders such as postherpetic neuralgia, complex regional pain syndromes, and atypical facial pain. The stellate sympathetic ganglion innervates the head, neck, and upper extremity. In this review article, the effect of stellate ganglion block and its mechanism of action in orofacial pain disorders are discussed.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.6
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• pp.357-362
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• 2023

Trigeminal neuralgia (TN) is neuropathic pain that affects the trigeminal nerve branches. Facial pain experienced by patients with TN is typically intense and excruciating. The second and third branches (maxillary and mandibular) are commonly affected. This case report focuses on the potential treatment options for acute TN attacks involving these branches. The proposed approach involves extra-oral peripheral blocks using local anesthetics. Pain levels were measured using a visual numeric scale (VNS) with potential side effects and other relevant documented information. The patients showed responses from high pain levels to almost complete remission (from 8 to 2 and from 10 to 2 on the final VNS), with no significant side effects. This technique provides immediate pain relief and complements oral medications by offering comfort and confidence until the desired drug effect is achieved.