• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.1
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• pp.55-55
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• 2023

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.3
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• pp.217-226
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• 2022

Background: Intraosseous anesthesia is the process by which an anesthetic solution, after penetration of the cortical bone, is directly injected into the spongiosa of the alveolar bone supporting the tooth. This study aimed to compare the effectiveness of the traditional inferior alveolar nerve block (IANB) and computerized intraosseous anesthesia in the surgical extraction of impacted lower third molars, compare their side effects systemically by monitoring heart rate, and assess patients' a posteriori preference of one technique over the other. Methods: Thirty-nine patients with bilaterally impacted third molars participated in this study. Each patient in the sample was both a case and control, where the conventional technique was randomly assigned to one side (group 1) and the alternative method to the contralateral side (group 2). Results: The traditional technique was faster in execution than anesthesia delivered via electronic syringe, which took 3 min to be administered. However, it was necessary to wait for an average of 6 ± 4 min from the execution to achieve the onset of IANB, while the latency of intraosseous anesthesia was zero. Vincent's sign and lingual nerve anesthesia occurred in 100% of cases in group 1. In group 2, Vincent's sign was recorded in 13% of cases and lingual anesthesia in four cases. The average duration of the perceived anesthetic effect was 192 ± 68 min in group 1 and 127 ± 75 min in group 2 (P < 0.001). The difference between the heart rate of group 1 and group 2 was statistically significant. During infiltration in group 1, heartbeat frequency increased by 5 ± 13 beats per minute, while in group 2, it increased by 22 ± 10 beats per minute (P < 0.001). No postoperative complications were reported for either technique. Patients showed a preference of 67% for the alternative technique and 20% for the traditional, and 13% of patients were indifferent. Conclusion: The results identified intraosseous anesthesia as a valid alternative to conventional anesthesia in impacted lower third molar extraction.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.2
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• pp.131-136
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• 2016

Background: This study aimed to evaluate the patient's pain and quality of life after suture removal at either 3 or 7 days following the bilateral surgical extraction of impacted lower third molars. Methods: This study was a prospective, randomized controlled clinical trial carried out in 30 patients, who acted as their own control. Each patient required the bilaterally impacted mandibular third molars to be extracted. The impacted teeth were removed and the wound margins were approximated and sutured with black braided silk. The suture material was removed on day 3 on one side and on day 7 on the other. Each participant was asked to complete a questionnaire after the removal of the suture material on each designated day. Results: Regarding overall clinical symptoms, the mean VAS scores of male and female participants on day 3 were not significantly different from those on day 7. A significant difference was found in female participants, in that overall daily activity was better on day 7. There were significant differences in the ability to smile and laugh in both sexes and the ability to chew in the male participants was better on day 7. Conclusions: There were no significant differences in the patient's pain and quality of life between suture removal on day 3 or on day 7 following surgery to remove impacted lower third molars.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.5
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• pp.435-439
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• 2011

Ameloblastoma is an aggressive benign odontogenic epithelial tumour that may arise from the enamel organ, remnants of dental lamina, or the lining of an odontogenic cyst. It is usually categorized into solid or multicystic, unicystic, and peripheral types. Treatment ofameloblastomas include conservative methods such as marsupialisation, enucleation, and curettage; and radical treatments such as marginal or segmental resection. Radical treatments have resulted in lower recurrence rates; however, may also encounter esthetic, functional, and reconstructive problems. Unicystic ameloblastoma has been considered less aggressive and a lower recurrence tendency. Thus, many authors have recommended conservative treatment in cases of unicystic ameloblastoma. An 11 year-old boy presented with displaced second and third molars by luminal unicystic ameloblastoma in the mandible. Cyst enucleation, curettage, and third molar extraction were done. No signs of recurrence or esthetic problems such as facial asymmetry were seen radiologically and clinically, up to 8 years 2 months postoperatively.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.4
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• pp.229-238
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• 2017

Objectives: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. Materials and Methods: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study. The initial dose of MDZ was determined by body mass index (BMI) and weight. In the case of insufficient sedation at the beginning of surgery, additional doses were injected. During surgery, peripheral oxygen saturation, bispectral index score (BIS), heart rate, and blood pressure were monitored and recorded. The predictor variables were sex, age, BMI, sleeping time ratio, dental anxiety, Pederson scale, and initial dose of MDZ. The outcome variables were additional administration of MDZ, observer's assessment of alertness/sedation, intraoperative amnesia, and patient satisfaction. Descriptive statistics were computed, and the P-value was set at 0.05. Results: Most patients had an adequate level of sedation with only the initial dose of MDZ and were satisfied with the treatment under sedation; however, 19 patients needed additional administration, and 13 patients were unsatisfied. In multivariable logistic analysis, lower age (odds ratio [OR], 0.825; P=0.005) and higher dental anxiety (OR, 5.744; P=0.003) were related to additional administration; lower intraoperative amnesia (OR, 0.228; P=0.002) and higher BIS right before MDZ administration (OR, 1.379; P=0.029) had relevance to patient dissatisfaction. Conclusion: The preoperative consideration of age and dental anxiety is necessary for appropriate dose determination of MDZ in the minor oral surgery under IVS. The amnesia about the procedure affects patient satisfaction positively.

• Imaging Science in Dentistry
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• v.42 no.4
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• pp.237-242
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• 2012

Purpose: The objectives of this study were to survey the radiographic exposure parameters, to measure the patient doses for intraoral dental radiography nationwide, and thus to establish the diagnostic reference levels (DRLs) in intraoral dental X-ray examination in Korea. Materials and Methods: One hundred two intraoral dental radiographic machines from all regions of South Korea were selected for this study. Radiographic exposure parameters, size of hospital, type of image receptor system, installation duration of machine, and type of dental X-ray machine were documented. Patient entrance doses (PED) and dose-area products (DAP) were measured three times at the end of the exit cone of the X-ray unit with a DAP meter (DIAMENTOR M4-KDK, PTW, Freiburg, Germany) for adult mandibular molar intraoral dental radiography, and corrections were made for room temperature and pressure. Measured PED and DAP were averaged and compared according to the size of hospital, type of image receptor system, installation duration, and type of dental X-ray machine. Results: The mean exposure parameters were 62.6 kVp, 7.9 mA, and 0.5 second for adult mandibular molar intraoral dental radiography. The mean patient dose was 2.11 mGy (PED) and 59.4 $mGycm^2$ (DAP) and the third quartile one 3.07 mGy (PED) and 87.4 $mGycm^2$ (DAP). Doses at university dental hospitals were lower than those at dental clinics (p<0.05). Doses of digital radiography (DR) type were lower than those of film-based type (p<0.05). Conclusion: We recommend 3.1 mGy (PED), 87.4 $mGycm^2$ (DAP) as the DRLs in adult mandibular molar intraoral dental radiography in Korea.

• The Journal of the Korean dental association
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• v.47 no.4
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• pp.211-224
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• 2009

This retrospective study was to analyze the inferior alveolar nerve and lingual nerve damage after the removal of mandibular third molars. In this questionnaire study, the subjects chosen for this study were 2472 dentists who answered the questionnaire about numbness after the extraction of lower third molars. The data collected by E-mail and web site included the incidence of removal of the lower third molars, the incidence and the experience of numbness of the inferior alveolar nerve and lingual nerve, rate and duration of recovery, the influence in day life after the long-term sensory loss, the period and amount of the indemnity in the case of medical dispute. The results are summarized as follows. 1. The experience rate and the incidence rate of the inferior alveolar nerve numbness by oral surgeons in the past year were19.9% and 0.14%. Those of the lingual nerve by oral surgeon were 7.7% and 0.05%.2. The experience rate and the incidence rate of the inferior alveolar nerve numbness by the dentists except oral surgeons in the past year were 9.7% and 0.19%. Those of the lingual nerve by the dentists except oral surgeons were 5.5% and 0.11%.3. The recovery rate of the inferior alveolar nerve after 1 year and 2 years were 85.6% and 91.3%. The recovery rate of the lingual nerve after 1 year and 2 years were 84.8% and 89.3%.In conclusion, most of numbness may be recovered within 2 years. However the possibility of long term and persistent numbness should not be neglected. Therefore practitioner must inform the possibility of nerve injury and include this possibility in the consent forms.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.1
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• pp.29-37
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• 2022

Background: Pain, edema, and trismus are predictable sequelae for surgical extraction of impacted mandibular third molars (M3M). The present study aimed to compare the anti-phlogistic potential of bromelain and aceclofenac in the reduction of post-surgical sequalae in the extraction of impacted M3M. Method: A randomized controlled, triple-blinded clinical study included 72 patients scheduled for surgical removal of impacted M3M under local anesthesia. Randomization was performed and subjects were equally allocated to groups A (control) and B (study), who intended to receive aceclofenac and bromelain, respectively. The primary outcome variables were pain, edema, and trismus evaluated on postoperative days 2 and 7 and compared with baseline values. The secondary variables evaluated were the quantity of rescue analgesics required and the frequency of adverse effects in both groups for 7 postoperative (PO) days. Data were analyzed with a level of significance of P < 0.05. Results: Group B demonstrated a significant decrease in the severity of edema and trismus compared to group A on both PO days 2 and 7 (P < 0.001). Bromelain demonstrated similar analgesic efficacy with an insignificant difference compared to aceclofenac (P > 0.05). Conclusion: The present study showed that the efficacy of bromelain was comparable to that of aceclofenac in reducing inflammatory complications following surgical removal of impacted M3M. Bromelain can be considered a safe and potent alternative to routinely used aceclofenac when addressing inflammatory outcomes after surgery.

• The korean journal of orthodontics
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• v.14 no.1
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• pp.47-52
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• 1984

A girl aged 13 years 1 month, had a Angle's Class 1 malocclusion, characterized by severe aterior crowding, high canine, and loss of the upper and lower left first molars on account of dental caries. This patient underwent ${\frac{4}{4}}$extraction and multibonded system was used. After 20 Months, anterior crowding and high canine was corrected, and the extraction space as closed on both arch. The upper and lower left 2nd molars occupied the first molar spaces instead of the first polars. After 6 Months from debanding, band spaces were disappeared and the third molars were upting normally.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.2
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• pp.173-178
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• 2021

Inferior alveolar nerve (IAN) injury is usually caused by stretching or crushing of the neurovascular structures and postoperative intra-alveolar hematoma or edema after dental procedures. This results in paresthesia in the ipsilateral chin, lip (vermilion border, skin, and mucosa), and labial or buccal alveolar mucosa of the mandibular anterior teeth. However, there are no reports of sensory alterations in the teeth, especially tooth hypersensitivity, after IAN injury. I report a case in which paresthesia of the lower lip and hypersensitivity of the lower anterior teeth occurred simultaneously after the removal of the third molar that was located close to the IAN. In addition, I discuss the reasons for the different sensory changes between the tooth and chin (skin) after nerve injury from a neurophysiological point of view. Since the dental pulp and periodontal apparatus are highly innervated by the inferior alveolar sensory neurons, it seems necessary to pay attention to the changes in tooth sensitivity if IAN injury occurs during dental procedures.