• The Korean Journal of Physiology
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• v.25 no.1
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• pp.87-99
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• 1991

In order to elucidate whether capsaicin applied topically acts as a pain-producing subastance or as a tastant, neuronal activities of the chorda tympani nerve(CN), lingual nerve(LN), solitary tract nucleus(STN), and trigeminal nucleus(TGN) were recorded while thermal and taste stimuli, and capsaicin were being applied topically, and algesics intra-arterially to the tongue of cats anesthetized with ${\alpha}-chloralsoe$. In addition, the STN neurons were examined after wheat germ agglutinin-horseradish peroxidase(WGA-HRP) was applied to the CN. The CN fibers responded to taste and thermal stimuli, algesics, and capsaicin. Responses to capsaicin were significantly correlated with those to taste and thermal stimuli. The LN fibers mainly responded to mechanical and thermal stimuli, algesics, and capsaicin. Responses to capsaicin were significantly correlated with those to algesics. The STN neurons responded to taste and thermal stiumli, algesics, and capsaicin. Responses to capsaicin were significantly correlated with those to taste and thermal stiumli in somewhat different fashion from those of the CN fibers. The TGN neurons mainly responded to mechanical stimuli, algesics, and capsaicin. Correlations between responses to capsaicin and any others were not significant. After WGA-HRP was applied to the CN, the STN neurons which receive input from the CN were identified largely in the medio-ventral portion to the solitary tract. These results suggest that capsaicin produce taste as well as pain sensation. Sensory information evoked by capsaicin can be conveyed to the STN, especially medio-ventral portion, via the CN as gustatory information on the one hand, and to the STN or TGN via the LN as noxious information on the other. In addiation, the noxious information may be conveyed to the STN via the CN.

• Imaging Science in Dentistry
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• v.39 no.2
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• pp.89-92
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• 2009

Purpose: To assess the angle between mandibular canal and occlusal plane at each posterior tooth region and location of mental foramen on the panoramic radiographs. Materials and Methods: This study analysed 46 half-mandibles of panoramic radiographs. Inferior border of mandibular canal was traced. Occlusal plane was drawn from lingual cusp tip of the first premolar to distolingual cusp tip of the second molar. Perpendicular line from occlusal plane was drawn at each tooth region and then tangential lines were drawn from the crossing points at canal. the angle between occlusal plane and tangential line was measured. The location of mental foramen was also studied. According to the location of mental foramen, radiographs were divided into M (mesial) group and D (distal) group on the basis of the second premolar. and then inter-group analysis about mandibular canal angle was done. Results: The angles of mandibular canals were -17.7$^{\circ}$, -9.5$^{\circ}$, 8.2$^{\circ}$, 22.3$^{\circ}$, and 39.2$^{\circ}$at first premolar, second premolar, first molar, second molar, and third molar, respectively. The commonest position of the mental foramen was distal to the second premolar. Inter-group comparison showed statistically significant difference at the second premolar and the first molar(p<0.001). Conclusion: The knowledge of mandibular canal angle and location of mental foramen can help understanding the course of mandibular canal. (Korean J Oral Maxillofac Radiol 2009; 39: 89-92)

• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.59-67
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• 2006

There exist patients complaining speech problem due to dysesthesia or anesthesia following dental surgical procedure accompanied by local anesthesia in clinical setting. However, it is not clear whether sensory problems in orofacial region may have an influence on motor speech abilities. The purpose of this study was to investigate whether transitory sensory impairment of mandibular nerve by local anesthesia may influence on the motor speech abilities and thus to evaluate possibility of distorted motor speech abilities due to dysesthesia of mandibular nerve. The subjects in this study consisted of 7 men and 3 women, whose right inferior alveolar nerve, lingual nerve and long buccal nerve was anesthetized by 1.8 mL lidocaine containing 1:100,000 epinephrine. All the subjects were instructed to self estimate degree of anesthesia on the affected region and speech discomfort with VAS before anesthesia, 30 seconds, 30, 60, 90, 120 and 150 minutes after anesthesia. In order to evaluate speech problems objectively, the words and sentences suggested to be read for testing speech speed, diadochokinetic rate, intonation, tremor and articulation were recorded according to the time and evaluated using a Computerized Speech $Lab^{(R)}$. Articulation was evaluated by a speech language clinician. The results of this study indicated that subjective discomfort of speech and depth of anesthesia was increased with time until 60 minutes after anesthesia and then decreased. Degree of subjective speech discomfort was correlated with depth of anesthesia self estimated by each subject. On the while, there was no significant difference in objective assessment item including speech speed, diadochokinetic rate, intonation and tremor. There was no change in articulation related with anesthesia. Based on the results of this study, it is not thought that sensory impairment of unilateral mandibular nerve deteriorates motor speech abilities in spite of individual's complaint of speech discomfort.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.30.1-30.7
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• 2015

Background: The inferior alveolar nerve (IAN) may be injured during extraction of the mandibular third molar, causing severe postoperative complications. Many methods have been described for evaluating the relative position between the mandibular third molar and the inferior alveolar canal (IAC) on panoramic radiography and computed tomography, but conventional radiography provides limited information on the proximity of these two structures. The present study assessed the benefits of three-dimensional computed tomography (3D-CT) prior to surgical extraction of the mandibular third molar, to prevent IAN damage. Methods: This retrospective study included 4917 extractions in 3555 patients who presented for extraction of the mandibular third molars. The cases were classified into three groups, according to anatomical relationship between the mandibular third molars and the IAC on panoramic radiography and whether 3D-CT was performed. Symptoms of IAN damage were assessed using the touch-recognition test. Data were compared using the chi-square test and Fisher's exact test. Results: Among the 32 cases of IAN damage, 6 cases were included in group I (0.35 %, n = 1735 cases), 23 cases in group II (1.1 %, n = 2063 cases), and 3 cases in group III (0.27 %, n = 1119 cases). The chi-square test showed a significant difference in the incidence of IAN damage between groups I and II. No significant difference was observed between groups I and III using Fisher's exact test. In the 6 cases of IAN damage in group I, the mandibular third molar roots were located lingual relative to the IAC in 3 cases and middle relative to the IAC in 3 cases. The overlap was ${\geq}2mm$ in 3 of 6 cases and 0-2 mm in the remaining 3 cases. The mean distance between the mandibular third molar and IAC was 2.2 mm, the maximum distance 12 mm, and the minimum distance 0.5 mm. Greater than 80 % recovery was observed in 15 of 32 (46.8 %) cases of IAN damage. Conclusions: 3D-CT may be a useful tool for assessing the three-dimensional anatomical relationship and proximity between the mandibular third molar and IAC in order to prevent IAN damage during extraction of mandibular third molars.

• Imaging Science in Dentistry
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• v.38 no.3
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• pp.169-176
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• 2008

Purpose : To assess the diagnostic accuracy and value in an imaging technique field through the comparison of cone beam computed tomography and conventional panoramic radiography in assessing the topographic relationship between the mandibular canal and impacted third molars. Materials and Methods : Participants consisted of 100 patients offered the images through cone beam computed tomography and panoramic radiography. PSR-$9000^{TM}$ Dental CT system (Asahi Roentgen Ind. Co., Ltd, Japan) was used as the unit of cone beam computed tomography. CE-II (Asahi Roentgen Ind. Co., Ltd, Japan) and Pro Max (Planmeca Oy, Finland) were used as the unit of panoramic radiography. The images obtained through panoramic radiography were classified into 3 types according to the distance between mandibular canal and root of mandibular third molar. And they were classified into 4 types according to the proximity of radiographic feature. The images obtained through cone beam computed tomography based on the classification above were classified into 4 types according to the location between the mandibular canal and the root and were analyzed. And they were classified into buccal, inferior, lingual, and between roots, according to the location between mandibular canal and root. The data were statistically analyzed and estimated by $X^2$-test. Results : 1. There was no statistical significance according to 3 types (type I, type II, type III) through CBCT. 2. The results of 4 types (type A, type B, type C, type D) through CBCT were as high prevalence of CBCT 1 in type A, CBCT 2 in type B, CBCT 3 in type C, and CBCT1 in type D and those of which showed statistical significance (P value=0.03). 3. The results according to location between mandibular canal and root through CBCT recorded each 49, 25, 17, 9 as buccal, inferior, lingual, between roots. Conclusion : When estimating the mandibular canal and the roots through the panoramic radiography, it could be difficult to drive the views of which this estimation was considerable. Thus it is required to have an accurate diagnostic approaching through CBCT that could estimate the location between mandibular canal and roots.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.4
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• pp.283-309
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• 2021

Achieving profound anesthesia in mandibular molars with irreversible pulpitis is a tedious task. This review aimed at evaluating the success of buccal/lingual infiltrations administered with a primary inferior alveolar nerve block (IANB) injection or as a supplemental injection after the failure of the primary injection in symptomatic and asymptomatic patients with irreversible pulpitis in human mandibular molars. The review question was "What will be the success of primary and supplemental infiltration injection in the endodontic treatment of patients with irreversible pulpitis in human mandibular molars?" We searched electronic databases, including Pubmed, Scopus, and Ebsco host and we did a comprehensive manual search. The review protocol was framed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. We included clinical studies that evaluated and compared the anesthetic outcomes of primary IANB with primary and/or supplementary infiltration injections. Standard evaluation of the included studies was performed and suitable data and inferences were assessed. Twenty-six studies were included, of which 13 were selected for the meta-analysis. In the forest plot representation of the studies evaluating infiltrations, the combined risk ratio (RR) was 1.88 (95% CI: 1.49, 2.37), in favor of the secondary infiltrations with a statistical heterogeneity of 77%. The forest plot analysis for studies comparing primary IANB + infiltration versus primary IANB alone showed a low heterogeneity (0%). The included studies had similar RRs and the combined RR was 1.84 (95% CI: 1.44, 2.34). These findings suggest that supplemental infiltrations given along with a primary IANB provide a better success rate. L'Abbe plots were generated to measure the statistical heterogeneity among the studies. Trial sequential analysis suggested that the number of patients included in the analysis was adequate. Based on the qualitative and quantitative analyses, we concluded that the infiltration technique, either as a primary injection or as a supplementary injection, given after the failure of primary IANB, increases the overall anesthetic efficacy.

• The Korean Journal of Physiology and Pharmacology
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• v.1 no.6
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• pp.809-816
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• 1997

The present study was designed to investigate whether endogenous nitric oxide(EDNO) is involved in submandibular vasodilation and salivation induced by parasympathetic nerve stimulation. Effects of $N^w$-nitro-L-arginine-methyl ester (L-NAME) which blocks the synthesis of EDNO from L-arginine on the submandibular vasodilation and salivation induced by chords stimulation or administration of various vasodilators were examined in anesthetized cats. Effect of L-NAME on $K^+$ efflux induced by carbachol was also examined using the excised submandibular slice in vitro. In the submandibular slices, acetylcholine$(10^{-5}\;mol/L)$ or vasoactive intestinal polypeptide$(VIP,\;10^{-5}\;mol/L)$ increased $NO_2$ contents, which was Prevented by pretreatment with L-NAME. Salivary secretion in response to the chords stimulation$(3\;V,\;1\;msec,\;10{\sim}20\;Hz)$ was completely blocked by treatment with atropine(1 mg/kg). Increased blood flow response to the low frequency(1, 2, 5 Hz) stimulation was significantly reduced, whereas the blood flow induced by the higher frequency(10,20 Hz) stimulation was not affected. Lingual-arterial infusion of L-NAME(100 mg/kg) significantly diminished the vasodilatory and salivary responses to the chorda stimulation at all stimuli frequencies used. Intra-arterial infusion of L-NAME(100 mg/kg markedly diminished the vasodilatory responses to acetylcholine$(5\;{\mu}g/kg)$, VIP$(5\;{\mu}g/kg)$ or bradykinin$(5\;{\mu}g/kg)$. In the excised submandibular slice, $K^+$ efflux in response to carbachol$(10^{-5}\;mol/L)$ was significantly decrease by pretreatment with L-NAME$(10^{-5}\;mol/L)$. In the isolated submandibular artery precontracted with phenylephrine$(10^{-5}\;mol/L)$, the vasorelaxation induced by ACh$(10^{-7}\;mol/L)$ was reversed into a contraction by methylene blue$(10^{-4}\;mol/L)$. These results suggest that EDNO may play an important role in vasodilation and secretion of the submandibular gland.

• Korean Journal of Bronchoesophagology
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• v.14 no.1
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• pp.23-28
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• 2008

Background and Objectives : Traditionally, the excision of submandibular gland (SMG) has been commonly used for treatment of calculi in the proximal duct or gland parenchyma. Over the last 10 years several new minimally invasive techniques including lithotripsy, sialendoscope were introduced in the treatment of sialolithiasis. But these have some limitation on large, infected calculi. The aim of this study is to assess the intraoral treatment of submadibular stones. Subjects and Method : The records of one hundred and seventy-three patients who underwent intraoral removal of submadibular sialolithiasis between June 1, 1989 and July 31, 2006 were retrospectively reviewed. Results : Stone location was distal to the edge of the mylohyoid muscle in 127 patients and proximal to gland in 48 patients (mean size of sialoliths, 7.1mm [range 3.0-25mm]). The complete removal of stones was observed in 170 (97.1%) patients regardless of size and location. Recurrence of lithiasis was found in 8 patients (then treated with intraoral removal in 5 patientsand resection of SMG (submandibular glands) in 3 patients). Acalculous sialadenitis in 9 patients (5.1%) and cyst formation in 2 patients (1.1%) was found. But no evidence of postoperative complications including hemorrhage, fistula, damage to lingual nerve were found. Conclusion : The intraoral removal of submandibular stone is useful in preservation of submandiblar function and effective in palpable stones regardless of location, size.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.1
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• pp.9-17
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• 2020

Background: This study aimed to compare the pain levels during anesthesia and the efficacy of the QuickSleeper intraosseous (IO) injection system and conventional inferior alveolar nerve block (IANB) in impacted mandibular third molar surgery. Methods: This prospective randomized clinical trial included 30 patients (16 women, 14 men) with bilateral symmetrical impacted mandibular third molars. Thirty subjects randomly received either the IO injection or conventional IANB at two successive appointments. A split-mouth design was used in which each patient underwent treatment of a tooth with one of the techniques and treatment of the homologous contralateral tooth with the other technique. The subjects received 1.8 mL of 2% articaine. Subjects' demographic data, pain levels during anesthesia induction, tooth extractions, and mouth opening on postoperative first, third, and seventh days were recorded. Pain assessment ratings were recorded using the 100-mm visual analog scale. The latency and duration of the anesthetic effect, complications, and operation duration were also analyzed in this study. The duration of anesthetic effect was considered using an electric pulp test and by probing the soft tissue with an explorer. Results: Thirty patients aged between 18 and 47 years (mean age, 25 years) were included in this study. The IO injection was significantly less painful with lesser soft tissue numbness and quicker onset of anesthesia and lingual mucosa anesthesia with single needle penetration than conventional IANB. Moreover, 19 out of 30 patients (63%) preferred transcortical anesthesia. Mouth opening on postoperative first day was significantly better with intraosseous injection than with conventional IANB (P = 0.013). Conclusion: The IO anesthetic system is a good alternative to IANB for extraction of the third molar with less pain during anesthesia induction and sufficient depth of anesthesia for the surgical procedure.

• International Journal of Oral Biology
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• v.37 no.4
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• pp.153-159
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• 2012

The effects of the an immunosuppressive drug cyclosporine A (CsA), on the salivary gland are largely unknown, even though clinical trials for the stimulation of salivation using CsA have been attempted. Cyclophilin A (CypA) is known to be a binding protein for CsA. CypA has cell proliferation and tissue matrix change activities. In our present study, the presence of CypA in the gland and effects of CsA on CypA expression were investigated by immunohistochemistry, immunoblotting and RT-PCR analyses. CypA was immunohistochemically detected in various kinds of ducts in the submandibular glands of Sprague Dawley rats. The CypA mRNA level was highest at postnatal day 1 and gradually decreased in a time-dependent manner up to adulthood. The expression of CypA increased after a 10 day subcutaneous administration of CsA in postnatal day 1 rats. Surgical sections of the chorda-lingual nerve with impaired salivation showed no changes in CypA expression. A cell proliferation assay using PCNA anti-serum showed increased cell division following CsA treatment. These results suggest that CsA and CypA may act on ductal cells to regulate saliva composition rather than salivation levels.