• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.6
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• pp.507-525
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• 2021

Local anesthesia is indispensable in dentistry. Worldwide, millions of local anesthetic injections are administered annually, and are generally considered safe invasive procedures. However, adverse effects are possible, of which dentists should be aware of. This scoping review aimed to provide an extensive overview of the reported literature on the adverse effects of dental local anesthesia. The types of papers, what is reported, and how they are reported were reviewed. Additionally, the incidence and duration of adverse effects and factors influencing their occurrence were also reviewed. An electronic search for relevant articles was performed in PubMed and Embase databases from inception to January 2, 2020. The titles and abstracts were independently screened by two reviewers. The analysis was narrative, and no meta-analysis was performed. This study included 78 articles. Ocular and neurological adverse effects, allergies, hematomas, needle breakage, tissue necrosis, blanching, jaw ankylosis, osteomyelitis, and isolated atrial fibrillation have been described. Multiple adverse effects of dental local anesthesia have been reported in the literature. The results were heterogeneous, and detailed descriptions of the related procedures were lacking. Vital information concerning adverse effects, such as the dosage or type of anesthetic solution, or the type of needle used, was frequently missing. Therefore, high-quality research on this topic is needed. Finally, the adverse effects that are rarely encountered in real-world general practice are overrepresented in the literature.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.2
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• pp.87-96
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• 2022

This study aimed to assess the combined use of extraoral vibratory stimulation and extraoral cooling in reducing the pain (subjective and objective) of dental local anesthesia administration in children. PubMed, Cochrane Central Register of Controlled Trials, and Ovid SP databases were searched up to July 2021. Article titles were screened and full-text evaluations of the selected articles were performed. Finally, seven studies (391 children, aged 4 - 12 years) were included in this qualitative and quantitative analysis. The pooled data determined the combined effect of extraoral vibration and extraoral cooling as a single measure. Extraoral vibration or cooling alone were not compared. The measured primary and secondary outcomes were pain perception and subjective and objective pain, respectively. When compared with the control, extraoral vibration and cooling resulted in significant differences in the mean combined data for the variables, pain perception, and pain reaction. Children's subjective pain as measured by pain scores were reduced when extraoral vibration and cooling was used during local anesthesia administration (mean difference -3.52; 95% confidence interval [-5.06 - 1.98]) and objective pain (mean difference -1.46; 95% confidence interval [-2.95 - 0.02] ; mean difference -1.93; 95% confidence interval [-3.72 - 0.14]). Within the confines of this systematic review, there is low-quality evidence to support the use of combined extraoral vibration and cooling for reducing pain (subjective and objective) during intraoral local anesthesia administration in children.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.6
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• pp.527-545
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• 2021

The aim of this systematic review was to determine the success rate of nitrous oxide-oxygen procedural sedation (NOIS) in dentistry. A systematic digital search was conducted for publications or reports of randomized controlled trials evaluating the clinical performance of NOIS. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who met the inclusion and exclusion criteria accordingly. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool (RoB 2). A total of 19 articles (eight randomized clinical trials with parallel intervention groups and 11 crossover trials), published between May 1988 and August 2019, were finally selected for this review. The studies followed 1293 patients reporting NOIS success rates, with a cumulative mean value of 94.9% (95% CI: 88.8-98.9%). Thirteen trials were conducted on pediatric populations (1098 patients), and the remaining six were conducted on adults (195 patients), with cumulative efficacy rates of 91.9% (95% CI: 82.5-98.1%) and 99.9% (95% CI: 97.7-100.0%), respectively. The difference was statistically significant (P = 0.002). Completion of treatment and Section IV of the Houpt scale were the most used efficacy criteria. Within the limitations of this systematic review, the present study provides important information on the efficacy rate of NOIS. However, further well-designed and well-documented clinical trials are required and there is a need to develop guidelines for standardization of criteria and definition of success in procedural sedation. Currently, completion of treatment is the most used parameter in clinical practice, though many others also do exist at the same time. To maximize NOIS efficacy, clinicians should strictly consider appropriate indications for the procedure.

• Imaging Science in Dentistry
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• v.52 no.2
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• pp.141-153
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• 2022

Purpose: This study aimed to identify the prevalence and extension of the anterior loop (AL) of the mental nerve in different populations and according to different cone-beam computed tomography (CBCT) imaging settings. Materials and Methods: Medline/PubMed, Embase, Scopus, Web of Science, and ProQuest were searched. The main inclusion criterion was ALs evaluated in CBCT images. The quality of studies was assessed with the Joanna Briggs Institute risk of bias checklist. Subgroup analyses were conducted for sex, side, continent, voxel size, field of view, and type of CBCT-reconstruction images with a random-effects model. Results: Sixty-three studies with 13,743 participants (27,075 hemimandibles) were included. An AL was found in 40.6% (95% CI: 32.8%-48.9%, P<0.05) of participants and 36.0% (95% CI: 27.5%-45.5%, P<0.05) of hemimandibles, in 34.9% (95% CI: 25.1%-46.2%, P<0.05) of males and 34.5% (95% CI: 23.5%-47.4%, P<0.05) of females. The average length of ALs was 2.39 mm (95% CI: 2.07-2.70 mm, P<0.05). Their extension was 2.13 mm (95% CI: 1.54-2.73 mm, P<0.05) in males and 1.85 mm (95% CI: 1.35-2.36 mm, P<0.05) in females. Significant differences were observed regarding the prevalence and length of ALs among continents and for its measured length on different CBCT-reconstruction images, but not between other subgroups. Conclusion: AL was a relatively common finding. The voxel size and fields of view of CBCT devices were adequate for assessing AL; however, a 2-mm safety margin from anatomical structures(such as the AL) could be recommended to be considered when using CBCT imaging.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.2
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• pp.1-8
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• 2021

Objectives This study aimed to evaluate the effect of chuna manual therapy (CMT) for postpartum low back pain using a systematic review. Methods We performed a literature search using 12 electronic databases up to the end of September 2021. We included randomized controlled trials (RCTs) that evaluated the effect of CMT in the treatment of postpartum low back pain. The risk of bias was evaluated using the Cochrane risk-of-bias tool. Results Four randomized controlled trials were reported statistically significant effect in pain VAS, ODI and JOA of chuna manual therapy compared with moxibution, electro acupuncture, hyperthermia or usual care. As a result of assessing the risk of bias tool, most of the contents of the evaluation items were not identified, so it was evaluated as an uncertain risk. Conclusions CMT may be effective in treating postpartum low back pain. However, evidence was limited due to the small sample size, lack of well-designed RCTs and regional bias. Further well-designed studies are required to obtain stronger evidence.

• Journal of Hospice and Palliative Care
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• v.24 no.4
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• pp.214-225
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• 2021

Purpose: This study reviewed screening and assessment tools that are used to measure delirium in patients with cancer in hospice and palliative care settings and examined their psychometric properties. Methods: Four databases were searched for studies using related search terms (delirium, tools, palliative care, cancer, and others). The inclusion criteria were a) studies that included screening/assessment tools for measuring delirium in cancer patients receiving hospice/palliative care, and b) studies published in English or Korean. The exclusion criteria were a) studies that were conducted in an intensive care setting, and b) case studies, qualitative studies, systematic reviews, or meta-analyses. Results: Out of the 81 studies identified, only 10 examined the psychometric properties of tools for measuring delirium, and 8 tools were ultimately identified. The psychometric properties of the Memorial Delirium Assessment Scale (MDAS) were the most frequently examined (n=5), and the MDAS showed good reliability, concurrent validity, and diagnostic accuracy. The Delirium Rating Scale had good reliability and diagnostic accuracy. The Delirium Rating Scale-Revised 98 also showed good reliability and structural validity, but its diagnostic performance was not examined in hospice/palliative care settings. The Nursing Delirium Screening Scale showed relatively low diagnostic accuracy. Conclusion: The MDAS showed evidence of being a valid assessment tool for assessing delirium in patients with cancer in palliative care. Few studies examined the diagnostic performance of delirium tools. Therefore, further studies are needed to examine the diagnostic performance of screening/assessment tools for the optimal detection of delirium in patients with cancer in hospice/palliative care.

• Journal of Korean Dental Science
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• v.15 no.1
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• pp.31-50
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• 2022

Purpose: This study was to investigate the types of imaging modalities, analytical methods for age estimation, and the age of the subjects in research on age estimation using dental radiography through a scoping review, and to investigate the overall trends in age estimation studies. Materials and Methods: A scoping review was designed according to the Arksey and O'Malley guidelines and the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Three electronic databases were used as search sources (Medline, Embase, and Cochrane Library). Studies were classified according to the three main components of the research question. "What are the imaging modalities, analytical methods, and target age in dental imaging-based age estimation studies?" Result: The final 198 studies were selected by two reviewers. The most common imaging modality used in studies was panoramic radiography (69.7%), and studies using cone-beam computed tomography have increased over time. Analytical methods for age estimation were 62.6% in studies based on tooth development and 26.3% in studies using pulp/tooth ratio. The subject age was 27.8% for children and 27.3% for adults. Studies conducted in all age groups comprised the smallest category (5.2%). Conclusion: Panoramic radiography has been the most used types of imaging modalities for age estimation, and the most common analytical method was analysis of tooth development. Most studies targeted specific ages, and very few involved all age groups. Dental age estimation studies should be carried out with appropriate consideration of the imaging modality that is analyzed, the methods that are used, and the age that is targeted.

• Journal of the Korea Society of Computer and Information
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• v.27 no.7
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• pp.35-48
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• 2022

In this study, it propose a proof theory method for expressing and reasoning knowledge in a multiagent environment. Since this method determines logical results in a mechanical way, it has developed as a core field from early AI research. However, since the proposition cannot always be proved in any set of closed sentences, in order for the logical result to be determinable, the range of expression is limited to the sentence in the form of a clause. In addition, the resolution principle, a simple and strong reasoning rule applicable only to clause-type sentences, is applied. Also, since the proof theory can be expressed as a meta predicate, it can be extended to the metalogic of the proof theory. Metalogic can be superior in terms of practicality and efficiency based on improved expressive power over epistemic logic of model theory. To prove this, the semantic method of epistemic logic and the metalogic method of proof theory are applied to the Muddy Children problem, respectively. As a result, it prove that the method of expressing and reasoning knowledge and common knowledge using metalogic in a cooperative multiagent environment is more efficient.

• The Journal of Internal Korean Medicine
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• v.43 no.4
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• pp.720-737
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• 2022

Objectives: To compare the effectiveness and safety of East Asian traditional medicine treatments (EATMT) versus conventional management in patients following heart valve replacement surgery. Methods: We searched several databases, including the Korean Studies Information Service System, PubMed, China National Knowledge Infrastructure, and Citation Information by NII. The search range included randomized controlled trials from each first issue until June 27, 2021. Two review authors independently extracted the data. We assessed the risk of systematic errors by evaluating risk domains using the "Risk of bias" tool. Results: We included 5 trials in the review. In the EATMT, the investigators reported significant improvements in reshaping of the heart structure: left ventricular end diastolic diameter (MD -4.43, 95% CI -6.06 to -2.79; 130 participants; 2 studies; high evidence). Comparisons with usual care revealed a significant decrease in gastrointestinal complications rate (OR 0.30, 95% CI 0.20 to 0.47; 503 participants; 2 studies; high evidence). We assessed 4 studies as having a low risk of bias and 1 study as having a high risk of bias. Conclusion: This systematic review suggests that East Asian traditional medicine interventions may be effective in preventing and alleviating complications, but we found evidence of important trade-offs between known benefits and known adverse effects in cardiac dysfunction and inflammation following heart valve replacement. Consequently, additional high-quality studies should be conducted.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.2
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• pp.95-103
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• 2022

Objectives This study was conducted to assess the effect of chuna manual therapy after hip arthroplasty. Methods We searched across 9 electronic databases (PubMed, Cochrane Library, Wangfang data, China National Knowledge Infrastructure [CNKI], Oriental Medicine Advanced Searching Integrated System [OASIS], National Digital Science Library [NDSL], Korean Medical Database [KMBASE], Koreanstudies Information Service System [KISS], Research Information Sharing Service [RISS]) to find randomized controlled clinical trials for chuna manual therapy after hip arthroplasty. Results On inclusion criteria, 11 appropriate studies were included and analyzed. The deep vein thrombosis incidence of the chuna manual therapy group was statistically lower than the conventional treatment group (p=0.0002). Chuna manual therapy significantly improved the Harris hip score compared with conventional treatment (p<0.00001). Also, chuna manual therapy combined with herbal fumigation therapy significantly elevated the hip joint function score of Harris hip score compared with the conventional therapy group (p<0.00001). Conclusions The systematic review showed that chuna manual therapy had significant effects on hip arthroplasty. Nonetheless, considering the high risk of bias and geographic bias, further research with well-designed studies is required to support the effectiveness of chuna manual therapy.