• Journal of Dental Anesthesia and Pain Medicine
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• 제21권5호
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• pp.451-459
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• 2021

Background: Lignocaine with adrenaline is routinely used as a local anesthetic for dental procedures. Adrenaline was added to increase the duration of anesthesia. However, epinephrine containing a local anesthetic solution is not recommended in conditions such as advanced cardiovascular diseases and hyperthyroidism. Recently, ropivacaine has gained popularity as a long-acting anesthetic with superior outcomes. The goal of this study was to assess and compare the effectiveness of 0.75% ropivacaine alone and 2% lignocaine with adrenaline (1:80,000) in the removal of bilateral maxillary wisdom teeth using the posterior superior alveolar nerve block technique. Methods: This was a single-blind, randomized, split-mouth, prospective study assessing 15 systemically sound outpatients who needed bilateral removal of maxillary third molars. We randomly allocated the sides and sequences of ropivacaine and lignocaine with adrenaline administration. We evaluated the efficacy of both anesthetics with regard to the onset of anesthesia, intensity of pain, variation in heart rate, and blood pressure. Results: The onset of anesthesia was faster with lignocaine (138 s) than with ropivacaine (168 s), with insignificant differences (p = 0.001). There was no need for additional local anesthetics in the ropivacaine group, while in the lignocaine with adrenaline group, 2 (13.3%) patients required additional anesthesia. Adequate intraoperative anesthesia was provided by ropivacaine and lignocaine solutions. No significant difference was observed in the perioperative variation in blood pressure and heart rate. Conclusion: Ropivacaine (0.75%) is a safe and an adrenaline-free local anesthetic option for posterior superior alveolar nerve block, which provides adequate intraoperative anesthesia and a stable hemodynamic profile for the removal of the maxillary third molar.

• Restorative Dentistry and Endodontics
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• 제46권3호
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• pp.41.1-41.23
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• 2021

Objectives: This study aimed to evaluate the efficacy of various local anesthesia (LA) in vital asymptomatic teeth. Materials and Methods: Randomized controlled trials comparing pulpal anesthesia of various LA on vital asymptomatic teeth were included in this review. Searches were conducted in the Cochrane CENTRAL, MEDLINE (via PubMed), EMBASE, ClinicalTrials.gov, Google Scholar and 3 field-specific journals from inception to May 3, 2019. Study selection, data extraction, and risk of bias assessment using Cochrane Risk of Bias Tool were done by 2 independent reviewers in duplicate. Network meta-analysis (NMA) was performed within the frequentist setting using STATA 15.0. The LA was ranked, and the surface under the cumulative ranking (SUCRA) line was plotted. The confidence of the NMA estimates was assessed using the CINeMA web application. Results: The literature search yielded 1,678 potentially eligible reports, but only 42 were included in this review. For maxillary buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than lidocaine 2% with epinephrine 1:100,000 (odds ratio, 2.11; 95% confidence interval, 1.14-3.89). For mandibular buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than various lidocaine solutions. The SUCRA ranking was highest for articaine 4% with epinephrine when used as maxillary and mandibular buccal infiltrations, and lidocaine 2% with epinephrine 1:80,000 when used as inferior alveolar nerve block. Inconsistency and imprecision were detected in some of the NMA estimates. Conclusions: Articaine 4% with epinephrine is superior when maxillary or mandibular infiltration is required in vital asymptomatic teeth.

• The Korean Journal of Pain
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• 제9권1호
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• pp.83-88
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• 1996

This is a retrospective analysis of 158 patients who visted our Neuro-Pain clinic, April 1992 to March 1996, suffering from trigeminal neuralgia. Most patients received nerve blocks in its triggering peripheral branches of pain. All patients experienced pain relief for 3 months after initial successful nerve block. Twenty two patients complained of recurring pain within 4 to 32 months. Mean duration of pain relief was as follows: infraorbital nerve block 15.2 months, maxillary nerve block 16.8 months, and mandibular nerve block 23.4 months. Demographic and clinical characteristics of all patients were also evaluated. This study demonstrates that alcohol block is a safe and effective method of treating trigeminal neuralgia.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권2호
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• pp.167-172
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• 2009

The maxilla rarely undergoes necrosis due to its rich vascularity. Maxillary necrosis can occur due to bacterial infections such as osteomyelitis. viral infections such as herpes zoster and fungal infections such as mucormycosis, aspergillosis etc. Herpes zoster is a common viral infection, the oral soft tissue manifestations of which are widely known and recognized. Extremely rare complications such as osteonecrosis, and secondary osteomyelitis in maxilla were observed. But, reports of spontaneous tooth exfoliation and jaw osteonecrosis following herpes zoster infection in the distribution of the trigeminal nerve are extremely rare in the literature. We report a case of maxillary necrosis by herpes zoster in an uncontrolled diabetic patient. There was extensive necrosis of the buccal and palatal mucoperiosteum and exposure of the alveolar bone. This patient was successfully treated using a removal of necrotic bone and nasolabial flap. We briefly discuss different diseases which can lead to maxillary necrosis and a review. Analysis of the pathogenesis of herpes zoster and bone necrosis are discussed.

• Imaging Science in Dentistry
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• 제52권4호
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• pp.359-364
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• 2022

Purpose: The aim of this study was to investigate the prevalence of infraorbital canal protrusion in an Egyptian subpopulation using cone-beam computed tomography and to describe its radiographic representation. Materials and Methods: This retrospective cross-sectional study was conducted using the records of 77 patients and 123 maxillary sinuses. The full lengths of the sinuses were visible for the detection of infraorbital canal protrusion. The infraorbital canals were classified into 3 types based on their relation to the sinus. If the septum was present, its length and its distance from the sinus floor were measured. Qualitative and quantitative variables were described as percentages and means with standard deviations, respectively. Results: The infraorbital canal most commonly presented as the normal confined type (detected in 78.1% of sinuses), whereas the suspended (or protruded) variant was found in 14.6% of the examined sinuses. The septal length ranged from 0.9 to 5.1 mm, with a mean of 2.8±1.1 mm. The distance to the sinus floor ranged from 5.2 to 29.6 mm depending on the sinus shape and size. Conclusion: The present study indicates that protrusion of the infraorbital canal is not rare, and surgeons that use the maxillary sinuses as corridors for their procedures must be more cautious, especially in the upper lateral confines of the sinus.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권2호
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• pp.74-77
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• 2015

Objectives: Transpositioning of the inferior alveolar nerve to prevent injury in lower jaw has been advocated for orthognathic, pre-prosthetic and for implant placement procedures. However, the concept of infra-orbital nerve repositioning in cases of mid-face fractures remains unexplored. The infraorbital nerve may be involved in trauma to the zygomatic complex which often results in sensory disturbance of the area innervated by it. Ten patients with infraorbital nerve entrapment were treated in similar way at our maxillofacial surgery centre. Materials and Methods: In this article we are reporting three cases of zygomatico-maxillary complex fracture in which intra-operative repositioning of infra-orbital nerve into the orbital floor was done. This was done to release the nerve from fractured segments and to reduce the postoperative neural complications, to gain better access to fracture site and ease in plate fixation. This procedure also decompresses the nerve which releases it off the soft tissue entrapment caused due to trauma and the organized clot at the fractured site. Results: There was no evidence of sensory disturbance during their three month follow-up in any of the patient. Conclusion: Infraorbital nerve transposition is very effective in preventing paresthesia in patients which fracture line involving the infraorbital nerve.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권5호
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• pp.578-581
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• 2008

Schwannoma named neurinoma, peripheral glioma, perineural fibriblastoma and Neurilemmoma is a ectodermal benign neoplasm which originates from schwann cell or neuro axons. It usually develops in peripheral systems of sensory nerves of gastrointestinal tract, oral cavity, and bone. It occurs more frequently in soft tissue than hard tissue, and is extremely rare in intraoral area. We report a case of Schwannoma that showed large mass on buccal cheek with Rt. midfacial swelling, pain, tenderness to palpation and involvement with maxillary branch of trigeminal nerve. We present this case and review the literature.

• Imaging Science in Dentistry
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• 제34권4호
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• pp.215-218
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• 2004

Neurilemmoma is a benign tumor of the nerve sheath that arises on cranial and spinal nerve roots as well as along the course of peripheral nerves. A case of a neurilemmoma that arose in the left infratemporal fossa of a 29-year-old male was presented. Plain radiographs, enhanced computed tomography scan, and magnetic resonance imaging demonstrated a large, well-circumscribed, heterogeneously enhanced mass with extension into the pterygopalatine fossa. Displaced by the large mass, bowing-in of the posterior maxillary antral wall was noted and a provisional diagnosis of a benign soft tissue tumor was made. The mass was completely excised and a diagnosis of neurilemmoma was confirmed.

• Journal of Oral Medicine and Pain
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• 제45권2호
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• pp.44-47
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• 2020

The case of pseudo-aneurysm of internal maxillary artery (IMA) in oral and maxillofacial region is known to be very rare. The etiology of this case was regarded as IMA injury by radiofrequency ablation (RFA) and such incidence was not reported previously. One case of false aneurysm in the IMA was referred from local dental clinic to our department. Left facial swelling was observed with severe trismus immediately after radiofrequency procedure for masseteric nerve block in local dental clinic. Despite of medication and surgical intervention, the swelling did not subside and there was massive bleeding and pulsation on one of the follow ups. The traumatic vascular disorder was suspected and finally diagnosed with angiography and treated by embolization procedure. RFA targeting masseteric nerve or trigeminal ganglion may cause traumatic injury to adjacent anatomic structures such as IMA, resulting in pseudo-aneurysm. Clinicians must be aware of potential damages of RFA. Angiography enables the solid diagnosis for pseudo-aneurysm, and selective embolization can be optimum treatment method.

• 수산해양교육연구
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• 제26권2호
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• pp.245-256
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• 2014

잉어, Cyprinus carpio와 동자개, Pseudobagrus fulvidraco의 상악 하악 수염을 조직학적으로 조사하였다. 동자개의 수염은 연골성 증축(axial rod of cartilage), 신경섬유다발(bundle of nerve fiber), 표피(epidermis), 평활근 층(smooth muscle layer) 및 미뢰(taste bud)로 구성되었으며, 잉어의 수염은 표피, 신경섬유다발, 혈관(blood vessel) 및 미뢰로 구성되었다. 수염 길이에서 잉어는 상악 바깥쪽 수염(second maxillary barbel)이 상악 안쪽 수염(first maxillary barbel) 보다 길게 나타났으며, 동자개는 하악 안쪽(inner mandibular barbel), 상악 위쪽(upper maxillary barbel), 하악 바깥쪽(outer mandibular barbel), 상악 아래쪽(lower maxillary barbel) 순으로 길게 나타났다(P<0.05). 미뢰의 수를 고려하였을 때, 동자개와 잉어간의 미각에 대한 유의적 차이가 없었다(P>0.05). 아울러, 두 어종의 모든 수염에서 수염 상부의 미뢰 수가 하부의 미뢰 수 보다 높게 나타났다(P<0.05). 본 연구 결과, 동자개의 수염은 딱딱하며 굴절성인 수염(flexible and stiff type)이었으며 잉어의 수염은 연하고 유연한 수염(tender and yielding type)으로 파악되었다.