• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.137-146
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• 2020

Background: Mandibular third molar removal is the most common surgical procedure encountered in oral and maxillofacial clinics. It also presents the greatest challenges and controversies for surgeons when surgical removal is considered. Furthermore, diverse anesthesia results and success rates are achieved after using the same concentrations of different solutions or the same amounts of local anesthetics. The purpose of this study was to examine the efficiency of using double-cartridge (3.4 ml) 4% lidocaine (high concentration) and 4% articaine with a 1:100000 epinephrine infiltration in the retromolar region for impacted lower third molar surgery. Methods: This double-blind study included 30 patients with symmetrically impacted lower third molars. The patients were randomly selected to receive 4% articaine on one side and 4% lidocaine on the other, as a local anesthetic for third molar surgery. The onset, duration of soft-tissue numbness, pulpal sensitivity, amount of additional local anesthetic needed, pain score during the surgical procedure, and duration of the operation were recorded. Results: The results of this research indicate that 86.7% of the operations in the 4% articaine group and 83.3% of those in the 4% lidocaine group were successful. Furthermore, the outcomes in both groups were not statistically significant (P > 0.05). Numbness onset occurred faster in the articaine group than it did in the lidocaine group. However, the duration of soft-tissue anesthesia and pain scores recorded immediately postoperatively were similar. Conclusion: It is concluded that 4% lidocaine and 4% articaine had a similar infiltration efficacy in the retromolar region and both local anesthetics are adequate for impacted lower third molar surgery. There were no statistically significant differences between the two local anesthetics regarding pain control and the duration of soft-tissue numbness during the procedure.

• Restorative Dentistry and Endodontics
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• 제35권6호
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• pp.436-444
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• 2010

연구목적: 이 연구는 근관치료 전문의에 의해 시행된 비외과적 근관치료의 임상적 성공률을 전향적으로 평가하고, 치료 성공율과 관련된 환자요인과 치아요인의 영향력을 평가하는 것을 목적으로 하였다. 연구 재료 및 방법: 비외과적 근관치료가 이루어진 441개 치아 중 175개의 치아를 1-2년 후 임상적 검진과 방사선촬영을 하였다. 결과: 치근단 방사선 병소의 유무로 평가된 비외과적 근관치료의 성공율은 81.1% 였다. 치아요인 중 재근관치료, 괴사된 치수, 치수병변에서 유래된 치은의 부종 또는 sinus tract, 그리고 치료 전 치근단 병변의 존재는 이변수분석에서 치료성공에 부정적 영향을 미치는 것으로 나타났다 (p < 0.05). 환자요인, 치아요인과 근관충전의 길이를 포함한 단계적 로지스틱 회귀분석에서는 치수병변에서 유래된 치은의 문제 (odds ratio [OR]: 4.4; p = 0.005), 치료 전 치근단 병변의 존재 (OR: 3.6; p = 0.011), 그리고 치근단에서부터 1-2 mm 짧은 근관충전 (OR: 9.6; p = 0.012) 이 치료 실패와 관련된 주요한 요인으로 나타났다. 결론: 치료 전 치근단 병변의 존재뿐만 아니라 치수병변에서 유래된 치은의 부종 또는 sinus tract의 존재는 비외과적 근관치료의 실패에 영향을 줄 수 있는 것으로 나타났다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.147-154
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• 2020

Background: Single inferior alveolar nerve block is ineffective in achieving adequate pulpal anesthesia in 30-80% of patients due to anatomical variations, local tissue pH, central sensitization, and several factors. Various supplementary techniques and combination of adjuvants with lignocaine are used to overcome these failures. Magnesium sulfate (MgSO₄), one such adjuvant, acts at the N-methyl-D-aspartate glutamate receptor resulting in effective anesthesia. The aim of this prospective, randomized, double-blind, clinical controlled trial was to evaluate the onset, anesthetic efficacy, duration and post-operative analgesia of 2% lignocaine with and without the addition of MgSO₄ in patients with symptomatic irreversible pulpitis and apical periodontitis. Methods: Fourty-two patients were randomly divided into three groups: 2% lignocaine (group 1) and 2% lignocaine with MgSO₄ (75 mg) and (150 mg) in groups 2 and 3, respectively. Pre-operative vitals and Heft Parker-Visual Analogue Scale (HP-VAS) pain scores were recorded. The onset of anesthesia, anesthetic efficacy, and duration of anesthesia were evaluated post administration of the local anesthetic solution. The post-operative analgesia was examined at intervals of 2, 6, 12, 24, and 48 h. Results: Administration of 150 mg MgSO₄ hastens the onset of anesthesia (1.29 min) and produces better anesthetic efficacy (3.29 HP-VAS) compared to group 2 (2.07 min and 9.14 HP-VAS) and group 1 (3.29 min and 35.79 HP-VAS), respectively. The duration of anesthesia was significantly higher in group 3 (247.07 min) compared to that of groups 2 and 1 (190 min and 110.21 min) with P < 0.05. Conclusion: Combining 75 mg or 150 mg of MgSO₄ with lignocaine is more effective than 2% lignocaine and 75 mg of MgSO₄ is adequate for endodontic procedures.

• Journal of Oral Medicine and Pain
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• 제39권2호
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• pp.69-77
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• 2014

Purpose: It aims to verify the applicability of existing age estimation methods derived from data of foreign population groups to Korean population groups. Moreover it is to suggest a new way applicable to practical age estimation on the basis of newly calculated regression formulae from data of Korean population groups and develop a subsidiarily applicable method to the existing method. Methods: Ratio of pulp cavity to dental crown was calculated by measuring the height and width of dental crowns and pulp cavities at the cervical line from 4,034 first and second upper molars, first and second upper premolars, first and second lower molars and first and second lower premolars on both left and right sides of 400 patients who had been treated in Dental Hospital of Yonsei University College of Dentistry, and regression equations were derived from the values of the ratio. Results: The equation with correlation coefficients the highest among females was as follows: age=$107.96-75.684{\times}{\sharp}17$ TCHI-$53.741{\times}{\sharp}26$ TCVI-$40.664{\times}{\sharp}45$ TCVI-$56.307{\times}{\sharp}46$ TCVI. Randomized anohter Korean female subjects (n=20) are applicated to the new equation. Mean of error of estimate is 10.322 years, standard deviation is 12.852 years. Minimum of error of estimate is 1.018 years, maximum is 21.365 years Conclusions: The error range of age estimation was found to be slightly wider when the existing regression formulae of Drusini were applied to Korean population groups. Also age estimation in females using the ratio of pulp cavity to dental crown measured with the length and width of dental crowns and pulp cavities from maxillomandibular molars was observed to have the highest reliability in the research. However, we consider that advanced equations of regression are needed to apply to both molars and premolars of males and females in the future.

• Restorative Dentistry and Endodontics
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• 제8권1호
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• pp.133-137
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• 1982

Radiography is one of the important tool adopted in daily dental practice and medical diagnosis. To visualize soft tissuechange various contrast media has Been introduced. Any cavity or space can be easily determined by increasing the X-ray absorption of the cavity using the radiopaque contrast media which widely employed in medical radiography to show much of the digestive, cardiovascular, pulmonary, and renal system. The essential part of any radiopaque medium is a heavy element that can absoarb most of the X-ray beam. The element must be noninjurious and easily eliminated. Both aqueous and oil suspensions of iodine containing compounds' are available to the dental profession, for example Lipiodol and Dionosil. The study was designed to determine toxic effect of Lipiodol to the vital pulp and to confirm visualization ioprovement in pulp canal. 1. Thin mixture of Calcium hydroxide and Lipiodol was applied to 19 deep vital cavities for 24 hours. Only one case complained slight pain for short time. 2. Cotton pellet over-saturated in Lipiodol was inserted in coronal chamber of which 6 were non vital and 5 were vital. The transference of Lipiodol was not noticed in every case after 24 hours. 5 cases with vital pulp tissue in the canals showed no clinical symptome. 3. Extracted 20 teeth were routinely prepared for endodontic treatment and applied Lipiodol in conjunction with cotton fiber as deep as midportion of the roots. After 24, hours the medicament reached to nearly the end of apex, but there were no evidence of penetration in dentine layer and migrate into ramified canal.

• Restorative Dentistry and Endodontics
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• 제24권4호
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• pp.657-665
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• 1999

The effects of application of mustard oil (MO), a small-fiber excitant and inflammatory irritant into the rat maxillary molar tooth pulp on arterial blood pressure and heat race, and electromyographic (EMG) activity of the jaw muscles were assessed in the anesthetized rats. In addition, Evans blue extravasation following pulpal MO application was measured. Application of MO into the tooth pulp produced a significant increase in mean arterial pressure and heat rate which gradually returned to baseline level. Application of MO into the tooth pulp induced a significant and short-lasting increase in EMG activity of digastric masseter and tongue muscle. Application of MO into the tooth pulp significantly increased the plasma extravasation of Evans blue dye. However, Application of mineral oil into the tooth pulp did not produce any significant changes in EMG activity of the digastric, masseter and tongue muscles, mean arterial pressure and heart rate, and plasma extravasation of Evans blue dye. These findings indicate that changes in arterial blood pressure, heart rate, jaw muscle activity and plasma extravasation accompanying noxious tooth pulp stimulation call be utilized as indirect measure of orofacial pain and inflammation.

• Restorative Dentistry and Endodontics
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• 제7권1호
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• pp.41-45
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• 1981

A 19-year-old Korean woman presented with left mandibular dental pain and swelling. Periapical radiolucencies were associated with the mandibular left first molar, second molar and the mandibular right second molar. The mandibular right second molar root developed incompletely and has the open apex. Clinical examination revealed worn accessory occlusal cusps of premolars. A diagnosis of dens evaginatus with associated periapical lesion secondary to pulpal necrosis was made. The root canal of the lower right second premolar was sealed with Calcium hydroxide paste for apexification. About two months later Calcium hydroxide paste was removed and the canal was resealed with new Calcium hydroxide paste. After four months the canal was sealed permanently with guttapercha and zinc oxide-eugenol sealer. The root canals of the lower left premolars were irrigated every week with 3.5% NaOCl solution for and half month. And the canals were sealed with gutta-percha and ZOE sealer. Preventive endodontic treatment for the lower right first premolar was undertaken.

• Restorative Dentistry and Endodontics
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• 제24권1호
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• pp.180-186
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• 1999

Eugenol has been reported to reduce odontogenic pain and is known to have a structure similar to capsaicin, a potent stimulant of certain nociceptors. We have hypothesized that the analgesic effect of eugenol may be due, in part, to inhibition of capsaicin-sensitive nociceptors. To test this hypothesis, we evaluate whether eugenol inhibits capsaicin-sensitive release of immunoreactive calcitonin generated peptide(iCGRP) from bovine dental pulp. Freshly extracted bovine incisors were transported to the lab. on ice, Spilitted and pulp tissue was removed. The tissue was chopped into 200${\mu}m$ slices. Dental pulp was superfused(340 ${\mu}l/min$) in vitro with oxygenated Kreb's buffer. Eugenol and vehicle(0.02% 2-hydroxyl-${\beta}$-cyclodextrin) were administered prior to stimulation of pulp with capsaicin and iCGRP was measured by RIA. The results were as follows: 1. Administration of eugenol has no effect on basal release of iCGRP. 2. In the vehicle treated group, capsaicin evoked a 2.5-fold increase over basal iCGRP levels. 3. Administration of eugenol(600 ${\mu}M$) reduced capsaicin evoked release of iCGRP by more than 40%(153.4${\pm}$41.1% vs 258.9${\pm}$21.7%). 4. 2-hydroxylpropyl-${\beta}$-cyclodextrin of less than 0.02% is found to be an effective vehicle to dissolve eugenol without evoking iCGRP release from dental bovine pulp. These data indicate that eugenol inhibits pulpal capsaicin-sensitive fibers and suggest that intracanal medicament of eugenol may relieve pain, in part, by this mechanism.

• Journal of Oral Medicine and Pain
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• 제39권4호
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• pp.119-126
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• 2014

This review provides an overview of the most commonly used dental age estimation techniques which focus on radiological methods in Korean adults. The literature from 1995 through July 31, 2014, was searched, using PubMed, for publications in English language. In PubMed, the keywords 'tooth' OR 'dental' AND 'pulp' AND 'age estimation' were searched. Inclusion criteria was comprised of the following: the subjects were living adults and dental radiography (excluded computed tomography [CT] and cone-beam CT) was used to measure the pulpal size. Twenty articles that met the criteria were selected. The method of age estimation using dental radiographs for measuring pulp and tooth size was represented in all studies. The methods were assorted into three categories generally; Kvaal's, Ikeda's and Cameriere's methods. Those methods had certain limitations such as large error range and low correlation coefficient depending on populations, type of employed teeth and particular method. Various techniques and many studies have been published for age estimation from human teeth using dental radiographs, but those techniques showed various predictability and reliability. Therefore, future studies on larger samples with well-distributed age group using not only existing techniques but new techniques are necessary for deriving convincing results.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권3호
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• pp.161-165
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• 2015

Long QT syndrome (LQTs) is a rare congenital disorder of the heart's electrical activity. Patients with LQTs are at increased risk of developing fatal ventricular arrhythmias. Elevated levels of sympathetic stimulation can exacerbate this risk. Successful behavior management is indispensable in the treatment of patients with LQTs. However, many drugs involved in pharmacologic behavior management are known to adversely affect the QT interval. Therefore, careful selection of a sedative drug is essential in avoiding such incidences. A 10-year-old boy with a known diagnosis of LQTs required restorative treatment due to dental caries at the permanent molar. He required sedation since treatment was painful and dental phobia can trigger sympathetic stimulation, creating a dangerous situation for patients with LQTs. Therefore, the treatment was performed over two sessions under moderate sedation involving propofol combined with nitrous oxide. Restorative treatment was successful without any complications under sedation with a target-controlled infusion (TCI) of propofol. There was no significant QT prolongation during pulpal treatment. Propofol TCI may be a good candidate for sedation in patients with LQTs.