• The Korean Journal of Pain
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• v.8 no.1
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• pp.164-167
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• 1995

Stellate ganglion block(SGB) is a widely used sympathetic block to diagnose or treat various painful conditions. We experienced a rare case who exhihited a contralateral Horner's syndrome following SGB. A 64-year-old female patient suffering from postherpetic neuralgia on mandibular branch of trigeminal nerve visited our pain clinic. She complained of severe burning and shooting pain on right side lower lip, ear and temporal area. We modified her previous medications and performed repeated right SGB daily, in combination with mandibular or mental and auriculotemporal nerve blocks twice a week. Her symptoms were progressively improved. A contralateral Horner's syndrome occured after the thirteenth SGB, which was performed under several attempts in the same manner and the same physician. She had no evidence of subarachnoid or brachial plexus blocks. She did not need any special treatment and returned home 2 hours later. Subsquent blocks were followed on ipsilateral Horner's syndromes.

• Imaging Science in Dentistry
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• v.50 no.2
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• pp.125-132
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• 2020

Purpose: The positions of the mandibular foramen (MnF) and the lingula affect the success rate of inferior alveolar nerve block. The objective of this study was to investigate aspects of the MnF and the lingula relevant for mandibular block anesthesia using cone-beam computed tomography (CBCT). Materials and Methods: Fifty CBCT scans were collected from a picture archiving and communications system. All scans were taken using an Alphard Vega 3030 (Asahi Roentgen Co. Ltd., Kyoto, Japan). Fifty-eight MnFs of 30 subjects were included in the study. The position of the MnF, the size of the MnF, the position of the lingula, the size of the lingula, and the shape of the lingula were measured and recorded. All data were statistically analyzed at a significance level of P<0.05. Results: The position of MnF was 0.1 mm and 0.8 mm below the occlusal plane in males and females, respectively. The horizontal position of the MnF was slightly anterior to the center of the ramus in males and in the center in females (P<0.05). The vertical position of the MnF was lower in females than in males(P<0.05). The MnF was an oval shape with a longer anteroposterior dimension. The height of the lingula was 9.3 mm in males and 8.2 mm in females. The nodular type was the most common shape of the lingula, followed by the triangular, truncated, and assimilated types. Conclusion: CBCT provided useful information about the MnF and lingula. This information could improve the success rate of mandibular blocks.

• 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 Oral Medicine and Pain
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• v.36 no.1
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• pp.71-79
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• 2011

Aim: Disc displacement without reduction of the temporomandibular joint (TMJ) has been managed by mandibular manipulation to reduce the displaced disc but with a low success rate. The purpose of this study was to determine whether auriculotemporal nerve block anesthesia had an effect on the reduction of the displaced disc and to analyze the factors that influenced the result. Methods: 112 patients were diagnosed with disc displacement without reduction and treated by mandibular manipulation. Disc was recaptured in 35 patients. Among the 77 patients with whom disc recapture had failed, the auriculotemporal nerve was blocked with a local anesthetic in the 49 patients (mean $age \;{\pm}\; SD\; =\; 34.4\;{\pm}\; 15.1$; male 24, female 25) and then mandibular manipulation was performed again. Factors including age, elapsed time from the onset, and opening amount were analyzed in association with disc reduction rate with the auriculotemporal nerve block. Results: Among 49 patients who did not respond to manipulation only, manual reduction with auriculotemporal nerve block anesthesia was successful in 19 patients (38.8%). Maximum unassisted opening amount significantly increased in the 19 patients with successful recapture of the disc ($mean \;{\pm}\; SD\; =\; 46.1 \;{\pm}\; 4.5\; mm$), in contrast to the limited opening amount of the 49 patients before local anesthesia of the auriculotemporal nerve ($mean \;{\pm}\; SD\; =\; 25.7 \;{\pm}\; 6.0\; mm$). Age, elapsed time after the onset, and preoperative opening amount were not associated with the reduction rate. Conclusion: The results of this study suggest that auriculotemporal nerve block anesthesia increases the reduction rate of the disc displacement without reduction of the TMJ when combined with mandibular manipulation, and such anesthesia should be applied at the first stage of manual treatment of disc displacement without reduction.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.1
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• pp.61-69
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• 2021

Background: Inferior alveolar nerve block (IANB) using lidocaine 2% is commonly used for anesthetizing primary mandibular molars; however, this technique has the highest level of patient discomfort compared to other local anesthesia techniques. Therefore, alternative anesthesia techniques are necessary. The aim of this study was to evaluate the efficacy of a single buccal infiltration of 4% articaine with IANB using 2% lidocaine, for the bilateral extraction of primary mandibular molars. Methods: The present study was conducted on 30 patients aged between 6 and 9 years, who required the extraction of bilateral primary mandibular molars. The patients were randomly divided into two groups as follows: In the first session, Group A received IANB with lidocaine 2% and group B received infiltration with articaine 4%. In the second session, another injection method was performed on the opposite side. The Wong-Baker Facial Pain scale (WBFPS), Face Leg Activity Cry, and Consolability (FLACC), and physiologic parameters were used to assess pain perception. Results: The independent t-test showed no statistically significant difference in blood pressure and heart rate before and after extraction (P > 0.05). The mean FLACC index in the lidocaine and articaine groups was 0.89 and 1.36, respectively; there was no statistically significant difference between them (P > 0.05). According to the results of the chi-square test, there was no statistically significant difference between the groups for WBFPS (P > 0.05). Conclusion: The articaine infiltration technique may be an alternative to the IANB for the extraction of primary mandibular molars.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.2
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• pp.39-44
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• 2013

Most of the dental treatments have been routinely performed under the local anesthesia and the effectiveness has also been proved safe. However, even not frequently dentists face some complications associated with the local anesthesia. In this report, the experience of the paresthesia after mental nerve block anesthesia for an implant placement of the mandibular premolar was presented to raise awareness of the complications related with local anesthetic procedure and to discuss about the causes, the proper treatments and the preventive approach of the paresthesia.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.30.1-30.7
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• 2017

Background: The positions of the mandibular lingula and foramen have been set as indexes for inferior alveolar nerve (IAN) block and ramus osteotomies in orthognathic surgery. This study aimed to evaluate the anatomical structures of mandibular ramus, especially the mandibular lingula and foramen, by analyzing the cone-beam computed tomography (CBCT) data of young adults. Methods: We evaluated 121 sides of hemi-mandibular CBCT model of 106 patients (51 male and 55 female patients; 18 to 36 years old). All the measurements were performed using the 2- and 3-dimensional rulers of $OnDemand3D^{(R)}$ software. Results: Statistical analysis of the data revealed that there was no significant difference in the mandibular angle between the genders. The mandibular lingula was found to be located at the center of ramus in males, but a little posterior in relation to the center in females. The mandibular lingula was rarely located below the occlusal plane; however, the position of the mandibular foramen was more variable (84.3% below, 12.4% above, and 3.3% at the level of the occlusal plane). Conclusions: The results of this study provide a valuable guideline for IAN block anesthesia and orthognathic surgery. CBCT can be considered effective and accurate in evaluating the fine structures of the mandible.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.2
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• pp.105-110
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• 2018

Background: A stellate ganglion block (SGB) causes increased blood flow in the maxillofacial region, exhibiting the potential for regenerative effects in damaged tissue. The focus of this study was to understand the efficacy of SGB for regenerative effects against nerve damage. A rat model of the superior cervical ganglion block (SCGB) was created instead of SGB, and facial blood flow, as well as sympathetic nervous system function, were measured. Methods: A vertical incision was made on the left side of the neck of a Wistar rat, and a 5-mm resection of the superior cervical ganglion was performed at the back of the bifurcation of the internal and external branches of the left common carotid artery. Blood flow in the skin at the mandibular angle and mean facial temperature were measured using a laser-Doppler blood flow meter and a thermographic camera, respectively, over a 5-week period after the block. In addition, the degree of ptosis and miosis were assessed over a period of 6 months. Results: The SCGB rat showed significantly higher blood flow at the mandibular angle on the block side (P < 0.05) for 3 weeks, and significantly higher skin temperature (P < 0.05) for 1 week after the block. In the SCGB rat, ptosis and miosis occurred immediately after the block, and persisted even 6 months later. Conclusions: SCGB in rats can cause an increase in the blood flow that persists over 3 weeks.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.5
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• pp.273-280
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• 2023

Background: Intraoral local anesthesia is essential for delivering dental care; however, injection of this local anesthetic is perceived as the most painful and distressing agent for children, parents, and healthcare providers. Reducing pain as much as possible is essential to ensure smooth subsequent treatment procedures, especially in pediatric dentistry. In clinical practice, oral sucrose administration has been reported to decrease the pain during heel lance and cold pressor tests in neonates and children. This study aimed to determine whether the prior administration of a 30% sucrose solution reduced the pain related to inferior alveolar nerve block in children. Methods: A total of 42 healthy children aged 7-10 years requiring dental treatment of mandibular molars involving inferior alveolar nerve block were recruited. The participants' demographic details were recorded, height and weight were measured, and the anesthetic injection was delivered after receiving the respective intraoral sucrose solution and distilled water by the intervention (group 1) and control (group 2) group participants for 2 min. The subjective pain perceived during injection was measured using an animated emoji scale. The pain scores between the groups were compared using the Mann-Whitney U test. Results: The median pain score and range for the intervention and control groups were 4 (2 - 6) and 6 (4 - 8), respectively, and statistically significant differences (P < 0.001) were observed in the intervention group. Age, sex, height, and weight did not influence the analgesic effect of the sucrose solution. Conclusion: Oral administration of sucrose may relieve pain associated with inferior alveolar nerve block in children.

• The Korean Journal of Pain
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• v.27 no.1
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• pp.81-85
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• 2014

Postherpetic neuralgia (PHN) is one of the most difficult pain syndromes to treat. Invasive treatments may be considered when patients fail to obtain adequate pain relief from noninvasive treatment approaches. Here, we present three cases of PHN in the mandibular branch treated with ultrasound-assisted mental nerve block and pulsed radiofrequency treatment. None of the patients had adequate pain relief from the medical therapy, so we performed the mental nerve block on the affected side under ultrasound assistance. Two patients showed satisfactory pain relief continuously over 12 months without any further interventions, whereas one patient only had short-term pain relief. For the patient had short-term pain relief we performed pulsed radiofrequency treatment (PRFT) on the left mental nerve under ultrasound assistance. After PRFT, the patient had adequate pain relief for 6 months and there was no need for further management.