• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.30.1-30.6
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• 2018

Background: The purpose of the present study was to investigate the differences in the position and shape of the anterior loop of the inferior alveolar nerve (ALIAN) in relation to the growth pattern of the mandibular functional subunit. Methods: The study was conducted on 56 patients among those who had undergone orthognathic surgery at the Gangnam Severance Hospital between January 2010 and December 2015. Preoperative computerized tomography (CT) images were analyzed using the Simplant OMS software (ver.14.0 Materialise Medical, Leuven, Belgium). The anterior and inferior lengths of ALIAN (dAnt and dInf) and each length of the mandibular functional subunits were measured. The relationship between dAnt, dInf, and the growth pattern of the mandibular subunits was analyzed. Results: The length of the anterior portion of ALIAN (dAnt) reached 3.34 ± 1.59 mm in prognathism and 1.00 ± 0.97 mm in retrognathism. The length of the inferior portion of ALIAN (dInf) reached 6.81 ± 1.33 mm in prognathism and 5.56 ± 1.34 mm in retrognathism. The analysis of Pearson's correlation coefficiency on all samples showed that the lengths of functional subunits were positively correlated with the loop depth. The length of the symphysis area in prognathic patients was positively correlated with the anterior loop depth (p = 0.005). Conclusions: Both the anterior and inferior length of ALIAN are longer in prognathic patients. Especially, it seems to be associated with the growth of the symphysis area.

• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.4
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• pp.283-288
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• 2006

There are several manners for surgical approaches to the mandibular condyle. With the retromandiular approach, the condyle and fracture are exposed directly and allow for good inspection and reduction. The retromandibular scar is very well camouflaged and practically invisible. The aim of this study was to evaluate clinical results of retromandibular approach for the reduction and fixation of fractured mandibular condyles. We described postoperative complications such as temporary facial nerve weakness involving the marginal mandibular branch, mouth opening limitation and malocclusion in 13 patients with mandubular condylar fractures; 11 subcondylar fractures and 2 condylar neck fractures. The follow-up period was longer than 6 months in all patients. The retromandibular approach was successful in all subcondylar fracture cases. 2 patients with condylar neck fracture had mouth opening limitation and temporary marginal nerve palsy longer than 3 months. But there were no cases of permanent nerve injury and malocclusion. Our findings indicate that retromandibular approach is an easy and safe technique for subcondylar fracture but not for condylar neck fracture.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.1
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• pp.249-256
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• 1998

Glial fibrillary acidic proteins (GFAP) are a group of intermediate filaments that are distributed in the cytoplasm of glial cells. GFAP immunoreactivity (GFAP-IR) increase after central and peripheral nerve injuries. The purpose of this study was to determine change of GFAP-IR in rat trigeminal ganglion satellite cells following the axotomy of inferior alveolar nerve(IAN). The immunohistochemistry was carried out using the avidin-biotin-peroxidase complex(ABC) method. 1. Control group : Astrocytes in central root of trigeminal ganglion had strong GFAP-IR, but satellite cells of trigeminal ganglion occasionally had GFAP-IR. The patterns of reactivity in satellite cells of trigeminal ganglion were not concenturated in any specific region of trigeminal ganglion. 2. Three day group after IAN axotomy : There were highly GFAP-IR in satellite cells of trigeminal ganglion in mandibular region. GFAP-IR in maxillary and ophthalmic regions were less intense compared to mandibular region. 3. Seven day group after IAN axotomy : GFAP-IR that were increased compared to control group were seen in the mandibular region. But GFAP-IR were less intense compared to three day group. These results suggest that GFAP-IR increase in specific region of trigeminal ganglion following peripheral axotomy. therefore we suppose that GFAP study offer research tool in trigeminal neuralgia.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.92-95
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• 1994

Most neoplasm of the floor of the mouth are squamous cell carcinoma. They originate from anterior midline floor of the mouth and penetrate into the sublingual gland. Invasion of the mandible is a late manifestation. Lymphatic spread is the submaxillary and subdigastric nodes and advanced lesions of them produce severe pain, The initial step in managing patients with cancer pain is the oncology therapy in the form of radiotherapy, surgery, or chemotherapy, alone or combined. When oncologic therapy is ineffective, the pain must be treated by systemic analgesic, psychologic, neurostimulating, regional analgesic,and meuroablative techniques. We successfully treated with gasserian ganglion block on the left side and mandibular nerve block on the right side with pure alcohol in the patient having severe submandibular, lower lip and tongue pain.

• Imaging Science in Dentistry
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• v.54 no.1
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• pp.115-120
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• 2024

Components derived from an infected lesion within the bone can spread through various passages in the mandible, particularly via the mental foramen. Radiologically, the spread of infection is typically nonspecific and challenging to characterize; however, multislice computed tomography (MSCT) can effectively detect pathological changes in soft tissues and the bone marrow space. This report describes the case of a 55-year-old woman who experienced mental nerve paresthesia due to a periapical infection of the right mandibular second premolar. MSCT imaging revealed increased attenuation around the periapical lesion extending into the mandibular canal and loss of the juxta-mental foraminal fat pad. Following endodontic treatment of the tooth suspected to be the source of the infection, the patient's symptoms resolved, and the previous MSCT imaging findings were no longer present. Increased bone marrow attenuation and obliteration of the fat plane in the buccal aspect of the mental foramen may serve as radiologic indicators of inflammation spreading from the bone marrow space.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.5
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• pp.287-294
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• 2018

Mandibular third molar extraction is commonly performed in dental clinics. However, the optimal method of anesthesia has not been established for this procedure. The conventional inferior alveolar nerve block is the most widely used method. However, its success rate is not high and it may lead to complications, such as aspiration and nerve injury. Therefore, various anesthesia methods are being investigated. Articaine has been proven to be efficacious in a number of studies and is being used with increasing frequency in clinical practice. In this review article, we will briefly review various local anesthesia techniques, anesthetics, and a computer-controlled local anesthetic delivery (CCLAD) system, which reduces pain by controlling the speed of drug injection, for mandibular third molar extraction.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.2
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• pp.93-96
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• 2015

Although inferior alveolar nerve block is one of the most common procedures performed at dental clinics, complications or adverse effects can still occur. On rare occasions, ocular disturbances, such as diplopia, blurred vision, amaurosis, mydriasis, abnormal pupillary light reflex, retrobulbar pain, miosis, and enophthalmos, have also been reported after maxillary and mandibular anesthesia. Generally, these symptoms are temporary but they can be rather distressing to both patients and dental practitioners. Herein, we describe a case of diplopia caused by routine inferior alveolar nerve anesthesia, its related physiology, and management.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.73-79
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• 2006

The management of mandibular prognathism and retrognathism was revoluted by the advent of the technique of bilateral sagittal split ramus osteotomy(BSSRO) as described by Obwegeser and Trauner in 1957. The BSSRO of the mandible has been used for nearly 50 years and has undergone numerous modifications and improvements. Most patients, treated by this surgical operation, express their satisfaction with improved facial esthetics, masticatory function and others. But several complications associated with BSSRO may appear. Especially among them, facial nerve palsy following BSSRO is rare but serious problem. We treated for facial nerve palsy following BSSRO by physical therapy, steroid therapy and surgical intervention and then the result was favorable. Therefore we would like to report a case about a patient with facial nerve palsy after BSSRO with a review of the literatures.

• 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.

• 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.