• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.4
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• pp.265-272
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• 2024

Effective pain management is crucial for the successful performance of various endodontic procedures. Painless treatments are made possible by anesthetizing the tooth to be treated using various nerve-block techniques. However, certain circumstances necessitate supplemental anesthetic techniques to achieve profound anesthesia, especially in situations involving a "hot tooth" in which intrapulpal anesthesia (IPA) is employed. IPA is a technique that involves the injection of an anesthetic solution directly into the pulp tissue and is often utilized as the last resort when all other anesthetic techniques have been unsuccessful in achieving complete pulpal anesthesia. This review focuses on the IPA procedure and the factors that influence its success. Additionally, the advantages, limitations, disadvantages, and future directions of IPA are discussed.

• Journal of Oral Medicine and Pain
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• v.41 no.3
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• pp.85-90
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• 2016

Purpose: The aim of this study was to develop an automated software to extract tooth and pulpal area from sectional cone-beam computed tomography (CBCT) images, which can guarantee more reproducible, objective and time-saving way to measure pulp/tooth volume ratio. Methods: The software program was developed using MATLAB (MathWorks). To determine the optimal threshold for the region of interest (ROI) extraction, user interface to adjust the threshold for extraction algorithm was added. Default threshold was determined after several trials to make the outline of extracted ROI fitting to the tooth and pulpal outlines. To test the effect of starting point location selected initially in the pulpal area on the final result, pulp/tooth volume ratio was calculated 5 times with different 5 starting points. Results: Navigation interface is composed of image loading, zoom-in, zoom-out, and move tool. ROI extraction process can be shown by check in the option box. Default threshold is adjusted for the extracted tooth area to cover whole tooth including dentin, cementum, and enamel. Of course, the result can be corrected, if necessary, by the examiner as well as by changing the threshold of density of hard tissue. Extracted tooth and pulp area are reconstructed three-dimensional (3D) and pulp/tooth volume ratio is calculated by voxel counting on reconstructed model. The difference between the pulp/tooth volume ratio results from the 5 different extraction starting points was not significant. Conclusions: In further studies based on a large-scale sample, the most proper threshold to present the most significant relationship between age and pulp/tooth volume ratio and the tooth correlated with age the most will be explored. If the software can be improved to use whole CBCT data set rather than just sectional images and to detect pulp canal in the original 3D images generated by CBCT software itself, it will be more promising in practical uses.

• Journal of Oral Medicine and Pain
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• v.14 no.1
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• pp.35-42
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• 1989

악구강계의 질환을 진단하고 치료후의 예후를 판정하기 위하여 maximal clenching시에 측정된 tooth contacts의 수와 분포가 이용되어 왔다. 그러나 maximal clenching시 반복된 tooth contacts의 측정은 저작근 피로등 문제점을 가지고 있다. 본연구는 건강한 성인 15명을 대상으로 maximal clenching 및 habitual clenching시 T-Scan system을 이용하여 치아접촉 수와 접촉시간을 측정, 비교 검토하여 habitual clenching을 이용한 방법이 Tooth contacts의 연구에 이용될 수 있는지를 확인 하는데 목적이 있으며, 연구결과는 다음과 같다. 1. Habitual clenching시 upright, semisupine position에서의 전측두근의 근활성은 maximal clenching시의 64.5%, 61.9% 및 73.3%로 나타났다. 2. Maximal clenching시 치아접촉 수와 접촉시간은 16.82개 및 0.429초로 나타났으며 habitual clenching시에는 11.65개 및 0.177초로 나타났다. 3. 치아접촉수와 접촉시간은 체위에 따라 크게 변화되지 않았다. 4. 치아접촉수와 접촉시간의 측정시에 habitual clenching을 이용하는 방법이 maximal clenching을 이용하는 방법보다 재현성이 더 높은 것으로 나타났다. 5. Tooth contacts의 연구시 habitual clenching을 기준으로 사용할 수 있다.

• Journal of Korean society of Dental Hygiene
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• v.13 no.6
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• pp.987-993
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• 2013

Objectives : The aim of the study is to offer basic data that help to reduce dental fear by measuring adult dental fear level with DFS scale. Methods : The subjects were 300 persons including college students in W University and their parents in Jeollabuk-do Province. Data were collected by convenience sampling from May 1 to May 30, 2013. Results : 1. Dental clinic visit provoked pain in 99 people(47.4%). Oral examination and preventive treatment evoked pain in 13 people(6.2%). 2. Women tended to feel much pain than men. Both women and men felt the thrilling fear when a needle pricks the flesh. 3. Respondents having dental caries, gum bleeding, halitosis, shaking tooth, and painful tooth had a higher dental fear level. 4. The direct pain experience(p<0.001) had the greatest influence. The next influencing factor was the insufficient anesthesia(p<0.05). 5. The explanatory power that the pain experience has influence upon dental fear is $R^2$=0.151. Conclusions : The direct pain experience and the insufficient anesthesia experience have the great influence upon patients' dental fear level. Anesthetics and analgesics can be considered as one of the positive methods for pain control.

• 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.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.2
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• pp.105-111
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• 2017

Background: Dental fear is usually associated with hemodynamic changes. Fear of pain during the surgical removal of a lower impacted third molar might cause patients anxiety, thereby leading to avoidance of any future dental therapy. This study aimed to determine the effect of experiencing a surgical impacted-tooth removal on the pain perception-related anxiety and hemodynamic status. Method: Twenty-seven healthy patients aged 15-30 years (mean age, 24 years), for whom surgical removal of bilateral lower third molars was advised, were included. This prospective, randomized, controlled, split-mouth study involved operations on both sides of the mandibular arch, with a 1-month washout period in between. Blood pressure and heart rate were measured before the surgical procedure, during and after the injection, preoperatively, and postoperatively. Pain perception was evaluated using a 100-mm visual analog scale during the injection, preoperatively, and postoperatively after the numbness disappeared. Differences in the blood pressure, heart rate, and pain perception between the two appointments were analyzed using the paired t-test. For all statistical analyses, SPSS version 11.5 was used. Results: The mean pain perception values during the injection and preoperatively showed no significant differences between the two appointments (P > 0.05); however, significant differences in the blood pressure and heart rate were noted before the surgical procedure; preoperatively, the blood pressure alone showed a significant difference (P < 0.05). Conclusion: There was a significant decrease in the blood pressure and heart rate preoperatively; hence, experiencing a surgical impacted-tooth removal can reduce the subsequent preoperative anxiety in healthy patients.

• Journal of Oral Medicine and Pain
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• v.23 no.2
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• pp.193-209
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• 1998

In identifying bodies that are severely decayed or damaged, methods using fingerprints and various biochemical tests are known to have its limits. To overcome this, forensic odontological method which is based on the analysis of the cranium, tooth and dental restoration is used to enhance the accuracey of individual identification. For this reason, I have come to analysis of the dental materials that exists between the teeth that is perceived to have been previously restored and the one adjacent to it. By analyzing the constituents of gold crown-restored, non-precious metal-restored, gold inlay-restored and amalgam -restored teeth, and adjacent teeth using EDX(energy dispersive X-ray microanalysis) which was invented to analyze very small amount of elements, the nature of the restoration could be predicted and the results obtained were as follows. 1. Some of constitute of gold alloy was extracted from residual cement of gold crown restoration, but that was not extracted from the restored tooth and the one adjacent to it. 2. Some of constituents of non-precious metal alloy was extracted both in the residual cement on the tooth with no-precious metal restoration and in the tooth with the restoration itself. However, none of its constituents were found in the tooth adjacent to it. 3. Some of constituents of gold alloy were found in the residual cement of gold inlay, but they were not found in the restored tooth and the adjacent tooth. 4. Some of constituents of amalgam alloy were found both in tooth restored with amalgam and in the adjacent tooth. From the results obtained above, it is possible to utilize the data obtained from analyizing residual dental materials in a more effective way. This data compensates for the lost data due to any harm done to the restorations prior to individual identification and further enhances the accuracy. Therefore, it could be concluded that this process of analyzing residual dental materials could be beneficial to individual identification in the area of forensic odontoldogy.

• Journal of Oral Medicine and Pain
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• v.40 no.3
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• pp.102-109
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• 2015

Purpose: The purpose of this study was to assess the association between sleep disturbances and personality type. Methods: Five hundred twenty-four college students in Gyeonggi-do completed the Myers-Briggs Type Indicator (MBTI) and a questionnaire and collected data were analyzed by SAS 9.4 program. Results: Extroversion (E) type, sensation (S) type, and perceiving (P) type had significantly higher prevalence of insomnia than introversion (I) type (p<0.05), intuition (N) type (p<0.05), and judging (J) type (p<0.001), respectively. Tooth grinding, snoring and insomnia appeared to occur more frequently in feeling (F) type than in thinking (T) type. Tooth clenching, tooth grinding and snoring seemed to occur more frequently in S type than in N type. Insomnia occurred significantly the most frequently in sensation-feeling (SF) type (p<0.05). Tooth grinding and snoring seemed to occur the most frequently in SF type. A significantly increased percentage of sensation-perceiving (SP) type demonstrated insomnia (p<0.001). Tooth clenching, tooth grinding and snoring seemed to occur the most frequently in sensation-judging (SJ) type. Sensitive or nervous type of personality had significantly higher prevalence of insomnia than relaxed or general type of personality (p<0.01). A significantly increased percentage of subjects with bad general health status showed insomnia (p<0.0001). Tooth clenching and snoring seemed to occur the most frequently in subjects with bad general health status. A significantly decreased percentage of normal weight subjects demonstrated tooth grinding (p<0.05). Snoring occurred significantly the most frequently in overweight subjects (p<0.001). Tooth clenching showed significant correlation with stress (p<0.01) and personality (p<0.05). Snoring showed significant correlation with stress (p<0.05) and body weight (p<0.001). Insomnia showed significant correlation with stress (p<0.0001), personality (p<0.01), and general health status (p<0.0001). Conclusions: Sleep disturbances including tooth clenching and insomnia were associated with personality type and it is desirable to manage them considering personality type.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.3
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• pp.160-165
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• 2017

Objectives: Dry socket may occur secondary to the removal of any tooth. However, most dry socket cases develop in the third molar region. Dry socket is multifactorial in nature and has been treated using various modalities with varying success rates. This study assessed the efficacy of platelet rich fibrin (PRF) in established dry socket. Materials and Methods: Ten patients of either sex aged from 41 to 64 years with established dry socket according to established criteria were treated using PRF. Evaluation was performed by observing the reduction of pain using visual analogue scale, analgesic tablet use over the follow-up period, and healing parameters. Results: Pain was reduced on the first day in all patients with decreased analgesic use. Pain was drastically reduced during follow-up on the first, second, third, and seventh days with a fall in pain score of 0 to 1 after the first day alone. The pain scores of all patients decreased to 1 by the first day except in one patient, and the scores decreased to 0 in all patients after 48 hours. Total analgesic intake ranged from 2 to 6 tablets (aceclofenac 100 mg per tablet) over the follow-up period of 7 days. Healing was satisfactory in all patients by the end of the seventh day. Conclusion: PRF showed early pain reduction in established dry socket with minimal analgesic intake. No patients had allergic reactions to PRF as it is derived from the patient's own blood. PRF showed good wound healing. Our study suggests that PRF should be considered as a treatment modality for established dry socket.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.62-67
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• 2011

Early eruption refers to an accelerated eruption of a tooth beyond the normal eruption period. The clinical findings of an early erupted tooth with little formation of crown and/or root include severe mobility, pain on chewing, hypocalcification of the enamel, and inclination, displacement, and rotation of the tooth. The radiographic findings include underdeveloped root and insufficient bone support. Early eruption of a permanent tooth can cause several complications such as chronic trauma, pain, edema, an increased rate of premolar impaction and tooth displacement and/or rotation. Therefore, when a permanent tooth erupts earlier than its normal eruption period with accompanying symptoms, appropriate treatments should be done as soon as possible. A female patient of age 7 without any systemic disease was referred from a local dental clinic with chief complaint of severe mobilities and pain in both upper first premolars. According to the clinical and radiographic examinations, the permanent teeth erupted earlier with barely formed roots, severe mobilities, edema, and pain. This case is to report the successful accomplishment of root formations and stabilization of teeth after applying intraoral fixed appliances using bands and spurs for 14 months.