• Title/Summary/Keyword: Extraction of primary molar

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SURGICAL APPROACH TO THE INFRAOCCLUDED TEETH BY USING SPACE REGAINING TREATMENT (저위교합 유구치에서의 공간확장술을 이용한 외과적 접근)

  • Bang, Seok-Yun;Kim, Eun-Jung;Kim, Hyun-Jung;Kim, Young-Jin;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.531-536
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    • 2005
  • Infraclusion may be defined as teeth that stop their relative occlusal movement in the dental arches during or after the period of active eruption and then remain under the occlusal plane. Delayed exfoliation, malocclusion, increased susceptibility to dental caries and periodontal disease of both the neighboring teeth and retained molar, and dislocation of the successor are the consequencces of infraclusion of primary molars. Therefore, early diagnosis and appropriate treatments are necessary. The therapeutic approach of the infracluded teeth varied from preservation to extraction. The teeth with simple infraclusion without any signs of interference with occlusal and jaw development may be examined periodically with follow-up check and radiographically. However, if the infracluded tooth interferes with normal eruption of successor or shows any sign of delayed resorption, or the tipping of adjacent teeth or supraeruption of opposing teeth is expected, the teeth inflicted should be extracted and appropriate measures should be provided in order to maintain the normal development of occlusion and dentition. The adjacent teeth which have been collapsed over a infracluded deciduous teeth can disturb the arch length perimeter. In such cases, surgical approach might be necessary, although it would be difficult when teeth are severly leaned. However, an easier surgical access have been obtained by space regaining procedures, in young patients whose arch length has been shortened due to the infracluded teeth.

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Effects of National Dental Screening on Dental Caries Experience, Treatment, and Cost in Children (국가 구강검진이 어린이의 치아우식 경험, 치료 및 비용에 미치는 영향)

  • Lee, Jonghyung;Lee, Hangil;Son, Donghyun;Kim, Jihun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.3
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    • pp.248-256
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    • 2020
  • This study aimed to evaluate the effects of national dental screening for children in Korea in the aspects of prevention of dental caries, the number of treatments related to dental caries, and cost of dental care. The study used the national cohort data on children health screening provided by National Health Insurance Service, and analyzed 32,937 1st dental screening, 22,608 2nd dental screening, 13,708 3rd dental screening, and 241,043 cases from the dental care of 27,944 children born in year 2008 and 2009. The decayed-filled teeth index and decayed-filled person rate, calculated from the results of the 2nd and 3rd dental screening, decreased as the number of preceding dental screening increased. Glass ionomer and amalgam restoration, pulp treatment of primary teeth and extraction of primary canine and molar were shown to decrease as the number of examined dental screening increased, and the total cost of dental care covered by national health insurance also decreased as the number of dental screening increased. In conclusion, national dental screening for children is an efficient and economical oral health care method that prevents dental caries and lowers the possibility of dental caries related treatment, thereby reducing cost of dental care.

Clinical characteristics and recurrence-related factors of medication-related osteonecrosis of the jaw

  • Kang, Mong-Hun;Lee, Dong-Keon;Kim, Chang-Woo;Song, In-Seok;Jun, Sang-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.5
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    • pp.225-231
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    • 2018
  • Objectives: The purpose of this study was to investigate the demographic and clinical characteristics of patients with medication-related osteonecrosis of the jaw (MRONJ) and to elucidate factors affecting recurrence in surgical treatment. Materials and Methods: A total of 51 patients who were diagnosed with MRONJ were analyzed according to demographic and clinical features and treatment results through a retrospective chart review from 2013 to 2017 in the Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul in Korea. Results: Alendronate composed the majority of medication doses (55.6%), followed by ibandronate (20.0%), risedronate (15.6%), and zoledronate (6.7%). Forty patients (88.9%) were given oral medication, and five patients (11.1%) were intravenously treated, and the mean duration of medication use was $61.1{\pm}42.9$ months. A total of 10 patients (22.2%) had a drug holiday before MRONJ-induced dental treatment lasting an average of $6.8{\pm}7.0$ months. MRONJ occurred 2.7 times more in the mandible, with 41 cases (73.2%) occurring in the mandible and 15 cases (26.8%) occurring in the maxilla, and the prevalence of affected posterior parts (premolar-molar) was six times greater than that of the anterior parts (incisor-canine) (48 cases vs 8 cases, 85.7% vs 14.3%). The most common dental cause of MRONJ was tooth extraction (69.6%). Regarding recurrence, there was no statistical difference in recurrence rate according to either site or stage. However, recurrence occurred in 4 out of 34 cases (11.8%) in the primary closure group and 9 out of 20 cases (45.0%) in the secondary healing group, and there was a statistical difference with respect to closure technique. Conclusion: The identified risk factors in patients taking bone resorption inhibitors can aid dental clinicians in ensuring prevention and proper treatment of MRONJ.

Does dexmedetomidine combined with levobupivacaine in inferior alveolar nerve blocks among patients undergoing impacted third molar surgery control postoperative morbidity?

  • Patil, Shweta Murlidhar;Jadhav, Anendd;Bhola, Nitin;Hingnikar, Pawan;Kshirsagar, Krutarth;Patil, Dipali
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.2
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    • pp.145-153
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    • 2022
  • Background: Postoperative analgesia (POA) is an important determinant of successful treatment. Dexmedetomidine (DEX) has recently gained attention as a promising adjuvant to local anesthetics (LA). The present study aimed to evaluate the efficacy and safety of levobupivacaine (LB) as an adjuvant during inferior alveolar nerve block (IANB) in the extraction of lower impacted third molars (LITM). Methods: A prospective, randomized, placebo-controlled, triple-blind, parallel-arm, and clinical study was performed on 50 systemically healthy participants who required removal of an asymptomatic LITM. Using a 1:1 distribution, the participants were randomized into two groups (n = 25). Group L (control group) received 1.8 mL of 0.5% LB and 0.2 mL normal saline (placebo) and Group D (study group) received a blend of 1.8 mL of 0.5% LB and 0.2 mL (20 ㎍) DEX. The primary outcome variable was the duration of POA and hemodynamic stability, and the secondary variable was the total number of analgesics required postoperatively for up to 72 h. The participants were requested to record the time of rescue analgesic use and the total number of rescue analgesics taken. The area under the curve was plotted for the total number of analgesics administered. The pain was evaluated using the visual analog scale. Data analysis was performed using paired students and unpaired t-test, Mann-Whitney U test, Chi-square test, and receiver operating characteristic analysis. Statistical significance was set at P < 0.05. Results: The latency, profoundness of anesthesia, and duration of POA were statistically significant (P < 0.05). The differences between mean pain scores at 6, 12, 24, 48, and 72 h were found to be significant (each P = 0.0001). Fewer analgesics were required by participants in group D (2.12 ± 0.33) than in L (4.04 ± 0.67), with a significant difference (P = 0.0001). Conclusion: Perineurally administered LA with DEX is a safe, effective, and therapeutic approach for improving latency, providing profound POA, and reducing the need for postoperative analgesia.