• Imaging Science in Dentistry
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• 제35권4호
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• pp.199-202
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• 2005

Purpose : To report the incidence of radiological findings from screening panoramic radiographs and verify the validity of the panoramic radiography for screening purposes. Materials and Methods : Six thousand one hundred and sixty panoramic radiographs taken from the patients visiting the Health Promotion Center of CNUH were selected for this retrospective study. Panoramic radiographs were examined into the following pathologic conditions : the presence of periodontal bone loss, dental caries, periapical radiolucencies, retained roots, impacted supernumerary teeth, impacted third molars, odontoma, cystic lesions other than radicular cyst, sialoliths, and mixed radiolucent-radiopaque lesions. Number of pathologic conditions and Prevalence values were recorded. Results: The prevalences of pathologic conditions were $72.9\%$ of periodontal bone loss, $32.2\%$ of dental caries, $11.9\%$ of periapical radiolucencies, $10.8\%$ of retained roots, $0.4\%$ of root fracture, $1.0\%$ of impacted supernumerary teeth, $1.0\%$ of impacted third molars, $0.06\%$ of odontoma, $0.08\%$ of cystic lesion other than radicular cyst, $0.2\%$ of prolonged retention of deciduous tooth, $0.1\%$ of sialolith, and $0.04\%$ of mixed radiopaque and radiolucent lesion. Conclusion : Although the panoramic radiograph should not be used to replace intraoral radiographic and clinical examinations, this study showed that many dental pathologic conditions could be detected on panoramic radiographs. The panoramic radiograph might serve as a diagnostic aid in dental health evaluation programs.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권5호
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• pp.326-328
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• 2022

Impacted mandibular third molar removal is the most common procedure performed by oral and maxillofacial surgeons. An array of alternative procedures have been suggested, like operculectomy in cases of pericoronitis and coronectomy in certain cases. However, these procedures pose several disadvantages, and we propose a relatively non-invasive 'straight lift technique'. This technique is specifically useful in straightening abnormally positioned mesioangular third molars as a substitute of complete removal. This can improve tooth function, eliminate the need for surgical intervention, and reduce the risk of complications associated with third molar removal.

• Imaging Science in Dentistry
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• 제47권3호
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• pp.149-155
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• 2017

Purpose: The classification of impacted maxillary third molars(IMTMs) facilitates interdisciplinary communication and helps estimate the degree of surgical difficulty. Thus, this study aimed to develop a 3-dimensional classification of the position and depth of impaction of IMTMs and to estimate their prevalence with respect to gender and age. Materials and Methods: This cross-sectional retrospective study analyzed images in sagittal and coronal cone-beam computed tomography (CBCT) sections of 300 maxillary third molars. The proposed classification was based on 3 criteria: buccolingual position (buccal, lingual, or central), mesial-distal position (mesioangular, vertical, or distoangular), and depth of impaction (low, medium, or high). CBCT images of IMTMs were classified, and the associations of the classifications with gender and age were examined using analysis of variance with the Scheffe post-hoc test. To determine the associations among the 3 classifications, the chi-square test was used (P<.05). Results: No significant association of the classifications with gender was observed. Age showed a significant relationship with depth of impaction (P=.0001) and mesial-distal position (P=.005). The most common positions were buccal(n=222), vertical(n=184), and low (n=124). Significant associations among the 3 tested classifications were observed. Conclusion: CBCT enabled the evaluation of IMTMs in a 3-dimensional format, and we developed a proposal for a new classification of the position and depth of impaction of IMTMs.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권1호
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• pp.9-17
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• 2020

Background: This study aimed to compare the pain levels during anesthesia and the efficacy of the QuickSleeper intraosseous (IO) injection system and conventional inferior alveolar nerve block (IANB) in impacted mandibular third molar surgery. Methods: This prospective randomized clinical trial included 30 patients (16 women, 14 men) with bilateral symmetrical impacted mandibular third molars. Thirty subjects randomly received either the IO injection or conventional IANB at two successive appointments. A split-mouth design was used in which each patient underwent treatment of a tooth with one of the techniques and treatment of the homologous contralateral tooth with the other technique. The subjects received 1.8 mL of 2% articaine. Subjects' demographic data, pain levels during anesthesia induction, tooth extractions, and mouth opening on postoperative first, third, and seventh days were recorded. Pain assessment ratings were recorded using the 100-mm visual analog scale. The latency and duration of the anesthetic effect, complications, and operation duration were also analyzed in this study. The duration of anesthetic effect was considered using an electric pulp test and by probing the soft tissue with an explorer. Results: Thirty patients aged between 18 and 47 years (mean age, 25 years) were included in this study. The IO injection was significantly less painful with lesser soft tissue numbness and quicker onset of anesthesia and lingual mucosa anesthesia with single needle penetration than conventional IANB. Moreover, 19 out of 30 patients (63%) preferred transcortical anesthesia. Mouth opening on postoperative first day was significantly better with intraosseous injection than with conventional IANB (P = 0.013). Conclusion: The IO anesthetic system is a good alternative to IANB for extraction of the third molar with less pain during anesthesia induction and sufficient depth of anesthesia for the surgical procedure.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권1호
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• pp.63-67
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• 2022

Controversies exist regarding the need for prophylactic extraction of mandibular third molars in patients who plan to undergo orthognathic surgery. An 18-year-old male patient was diagnosed with mandibular prognathism and maxillary retrognathism with mild facial asymmetry. He had a severely damaged mandibular first molar and a horizontally impacted third molar. After extraction of the first molar, the second molar was protracted into the first molar space, and the third molar erupted into the posterior line of occlusion. The orthognathic surgery involved clockwise rotation of the maxillomandibular complex as well as angle shaving and chin border trimming. Patients who are missing or have damaged mandibular molars should be monitored for eruption of third molars to replace the missing posterior tooth regardless of the timing of orthognathic surgery.

• 대한치과교정학회지
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• 제17권2호
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• pp.321-333
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• 1987

The purpose of this study was to observe the changes of the lower 3rd molars following the extraction of the lower 2nd molars by Lateral Cephalograms and Orthopantomograms. The subjects consisted of twenty malocclusion, 7 males 13 females, were 19 year 5 month old at the removal of the lower 2nd molars, 19 year 1 month old at the end of the orthodontic supervision after the removal of the lower 2nd molars (mean age) The obtained results were as follows, 1 It is recommended to extract the lower 2nd molars when the lower 3rd molars are Nolla's Stage 4 or 5 2 With the pre-extraction variables obtained by factor analysis, it was possible to predict the long axis of the lower 3rd molars after 2nd molar extraction. 3 There were no impacted 3rd molars.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권4호
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• pp.285-295
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• 2024

Background: In human dentition, the most commonly impacted teeth are the mandibular third molars (M3M). The removal or extraction of these teeth often causes anxiety in patients due to the perceived pain involved in the process. Therefore, pain must be effectively managed using anesthesia. The use of newer local anesthetic drugs can help minimize side effects and drug interactions. Traditionally, adrenaline is used as a vasoconstrictor along with lignocaine. When combined with lignocaine, the alpha agonists dexmedetomidine and clonidine can extend the duration of anesthesia, thereby reducing the need for additional pain-relieving medications. Methods: This study used a randomized, triple-blind, parallel-arm design. Sixty patients were screened, and 45 systemically healthy patients requiring unilateral surgical removal of impacted mandibular third molars with similar difficulty (moderate-to-difficult according to the Modified Pederson's Index) were included in the study. Patients were allocated into three groups as follows: Group A: 2% Lignocaine Hydrochloride with 1:100,000 Adrenaline, Group C: 2% Lignocaine Hydrochloride with 15 ㎍/mL Clonidine, and Group D: 2% Lignocaine Hydrochloride with 1 ㎍/mL Dexmedetomidine. The evaluated parameters were the time of onset of anesthesia, depth of anesthesia, hemodynamic parameters, and duration of postoperative analgesia. Results: Group D had a faster onset of action and prolonged duration of postoperative analgesia compared with Groups A and C. No statistically significant differences were observed between the three groups in terms of the depth of anesthesia and hemodynamic parameters. Conclusion: Group D exhibited a significantly more rapid onset of anesthesia than Groups A and C, and the postoperative analgesic effect in Group D was significantly prolonged (7.22 hours) compared with that in Groups A (4.54 hours) and C (2.1 hours). Patients receiving the Group D solution experienced an extended period of comfort without the need for analgesics for up to 7.22 hours post-procedure.

• 대한치과교정학회지
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• 제18권1호
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• pp.79-88
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• 1988

The purpose of this study was to investigate the factors which might be related to mandibular third molar eruption and to predict the possibility of whether or not it will be erupted. The material of this study was lateral cephalometric radiograms, pantomograms and dental casts obtained from 70 patients (19 males, 51 females) ranging in age from 18.0 to 32.1 years. They were devided into erupted group and impacted group of mandibular third molars. For the comparison of each group, a total of 20 measurement items were employed and the data were analyzed by means of computer statistical method. As a result of this study, the following conclusion can be made; 1. The longer mandibular body length and narrower mandibular ramus width, the higher eruption tendency of the lower third molar, but the degree of genial angle was not related to mandibular third molar eruption. 2. The lower percentage of posterior mandibular body height to anterior mandibular body height, the higher eruption tendency of the lower third molar. 3. The total tooth size, including the lower second molar, appeared to be larger in the impacted group than in the erupted group of the lower third molar. 4. The arch length discrepancy of the impacted group was more severe in contrast with the erupted group of the lower third molar.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권1호
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• pp.37-41
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• 2017

Objectives: The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF). Materials and Methods: Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal. The complications of postoperative infection, postoperative nerve injury, bone healing, and changes in occlusion and temporomandibular joint were evaluated and analyzed using statistical methods. Results: In total, 49 patients had third molars in the fracture line and underwent ORIF surgery and perioperative IMF with an arch bar. The third molar in the fracture line was retained during ORIF in 39 patients. Several patients complained of nerve injury, temporomandibular disorder (TMD), change of occlusion, and postoperative infection around the retained third molar. The third molars were removed during ORIF surgery in 10 patients. Some of these patients complained of nerve injury, but no other complications, such as TMD, change in occlusion, or postoperative infection, were observed. There was no delayed union or nonunion in either of the groups. No statistically significant difference was found between the non-extraction group and the retained teeth group regarding complications after ORIF. Conclusion: If the third molar is partially impacted or completely nonfunctional, likely to be involved in pathologic conditions later in life, or possible to remove with the plate simultaneously, extraction of the third molar in the fracture line should be considered during ORIF surgery of the mandible angle fracture.

• 치과방사선
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• 제11권1호
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• pp.51-58
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• 1981

The author examined 515 full mouth roentgenograms stored in the Dept. of Oral Radiology, College of Dentistry, Seoul National University. For evaluating the efficiency of the routine full mouth roentgenogram, each of abnormal conditions such as impacted teeth, missing, caries, crown, filling and apical lesions was observed. The results obtained were as follows; 1. Among 14.420 teeth examined, missing teeth were 174, impacted 16, caries 161 and treated 1,162. 2. The incidence of impacted third molar was close to 18.7 percent and the incidence of missing third molar was about 33.4 percent. 3. Among carious and treated teeth, 178 teeth (1.2%) were needed observation of root apex. And of these teeth, 119 teeth 0.8% were observed with apical lesion. 4. There is a considerable relation between the incidence or size of apical lesion and the accuracy of endodontical treat. 5. Among the teeth with apical lesion, upper and lower first molars were most frequent (about 41%), upper and lower canine were rare (about 1.7%).