• 대한치과의사협회지
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• 제11권3호
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• pp.171-175
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• 1973

A 9-year-old girl, in good health, presented a horizontal impaction of the upper left central incisor. History revealed that the patient had been involved in a trauma of the maxillary anterior portion during her childhood. This impacted tooth crown, which was exposed surgically, was bonded by plastic attachments of direct bonding system, and was carefully tried to induce on the dental arch. On the process of the orthodontic treatment the tooth was completely induced and in normal alignment on the arch. The treatment result was very satisfactory; color, vitality, and mobility were normal, periodontal support was good and the cosmetic result was excellent.

• 대한소아치과학회지
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• 제32권1호
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• pp.26-32
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• 2005

치아 매복이란 여러 가지 이유로 구강 점막이나 악골내에서 치아가 맹출하지 못하고 있는 상태를 의미한다. 상악 중절치 매복의 원인은 치아종, 과잉치, 공간의 상실, 선행유치의 만기잔존 또는 조기상실, 선행유치의 외상으로 인한 치관이나 치근의 기형, 치배의 이소위치 등이 있다. 매복된 상악 중절치의 경우, 측절치가 빠르게 근심으로 이동하여 공간을 상실하고, 정중선의 변이가 발생하며, 낭종을 형성할 가능성도 있다. 따라서, 매복치의 조기 진단과 그에 따른 적절한 처치가 즉각적으로 이루어져야 한다. 일반적으로 매복의 정도가 심하지 않거나, 각화조직에 의해 매복이 초래된 경우 외과적인 노출만으로도 맹출을 유도할 수 있지만, 외과적인 노출후에 일정기간의 관찰에도 맹출이 되지 않는다거나, 치아의 맹출 방향이 자가 교정될 수 없을 정도로 심하게 변위되어 있는 경우, 매복의 위치가 너무 심부에 있는 경우에는 교정적 견인을 시도하는 것이 바람직하다. 본 증례는 매복된 상악 중절치 중 일정기간의 주기적 관찰후 맹출이 기대되지 않았기에, 교정적으로 견인하여 치료하였으며, 치료후 다소의 지견을 얻었기에 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권2호
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• pp.167-170
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• 1994

The surgical removal of the wisdom teeth is obligate when forceps extraction fails or when the wisdom teeth are impacted. The surgical removal of impacted maxillary third molars is a commonly performed procedure usually associated with few complications & little morbidity. The most frequent complications are tooth root fracture, maxillary tuberosity fracture, tooth displacement into the maxillary sinus & oroantral fistula formation. A rarely reported complication is the displacement of a tooth into the infratemporal fossa. The method of prevention of this complication is by the placement of either a finger or periosteal elevator posterior to the tooth during extraction. To remove the displaced upper third molar is very difficult & has many complications, e.g., persistent bleeding & nerve damage. When the wisdom teeth is displaced, it is initially necessary to gain access to bone by developing a mucoperiosteal path of delivery is developed by additional bone removal or, preferably planned sectioning of the tooth. There are many approaching techniques to remove the displaced upper third molar. This following report describes the surgical technique of displaced upper third molar in the pterygopalatine fassa by the midpalatal ＆transpharyngeal approach.

• 대한치과교정학회지
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• 제37권2호
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• pp.159-163
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• 2007

심한 치근 만곡을 동반한 매복은 흔하지 않으며, 특히 상악 전치의 경우에 그러하다. 이는 외과적 노출과 교정적 견인이 임상적으로 매우 어려우며, 치근유착, 치근의 외흡수, 교정적 견인 후 치근 노출 등의 위험이 있을 수 있기 때문이다. 비록 성공적으로 치료된 증례라 하더라도 치은의 심미를 향상시키기 위하여 치주수술이 필요한 경우가 많다. 본 증례보고는 발육중인 만곡된 치근을 가진 역위 매복된 상악 중절치의 closed eruption technique를 이용한 교정 치험예를 소개하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권1호
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• pp.46-53
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• 2001

The prevalence of supernumerary teeth is between $1{\sim}3%$. Of these, $90{\sim}98%$ occur in the maxilla with particular predilection for the premaxilla, preceded by mandibular third premolars, mandibular forth molars and maxillary paramolars. The most common ones occur in the maxillary anterior region, they may occur singly between the central incisors(mesiodens), or they may be double(mesiodentes). Maxillary anterior supernumeraries may erupt into the oral cavity or remain unerupted. It is found that approximately 25% are erupted, while the rest are unerupted. They are usually a small tooth with a cone-shaped crown and a short root. They may cause delayed eruption, median diastema, bodily displacement or rotation of the adjacent permanent teeth. Occasionally they may lead to the developement of dentigerous cyst or primordial cyst, or eruption into nasal cavity. In this study, 109 supernumeraries surgically extracted from premaxilla in 84 patients are analysed. The results are as follows : 1. Sex distribution of male and female is 2.2 : 1. 2. Almost cases are in pediatric age from 5 to 12 years old (87%). 3. Problems with supernumeraries are tooth malpositon, diastema, delayed eruption, eruption to nasal cavity and cyst formation. 4. Of 109 supernumeraries, 16(15%) are erupted into oral cavity, 92(84%) are impacted, and 1(1%) is erupted into nasal cavity. 5. Of 84 patients, 59(70%) have one supernumeray while 25(30%) have two supernumeraries. 6. Of 109 supernumeraries, 96(88%) are found within the region of the central incisors. 7. Of 109 supernumeraries, 94(86%) are vertically impacted, 11(10%) are horizontally impacted, 3(3%) are labiopalatally impacted and 1(1%) is impacted in nasal cavity. 8. Of 84 patients, we used palatal flap in 67(80%), labial flap in 6(7%), both flaps in 4(5%) and no flap in 7(8%). And incisive nerve was cut in 33(49%) of 67 palatal flaps. 9. Extration with ostectomy was done in 72 supernumeraries(66%), without ostectomy in 37 teeth(34%). 10. Extraction with tooth sectioning was done in 21 supernumeraries(19%), without tooth sectioning was done in 88 teeth(81%). 11. We used local anesthesia in 70 patients(83%) and general anesthesia in 14 ones(17%).

• 대한소아치과학회지
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• 제27권3호
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• pp.394-399
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• 2000

치아종은 치아 조직의 비정상적인 과성장으로 인해 형성되는 외배엽성 상피세포와 중배엽성 세포로 이루어진 혼합종양이라고 정의되며 양성 치성 종양 중에서 가장 흔한 질환이다. 최근 연구에 따르면 치아종은 신생물(neoplasm)보다는 형태와 조직 분화가 다양한 양상을 보이는 형성이상이나 과오종으로 보고 있다. 치아종은 복합 치아종(Compound Type), 복잡 치아종(Complex Type) 그리고 법랑아 섬유치아종(Ameloblastic fibroodontoma)으로 구분하고 있다. 복합 치아종은 치아와 유사한 형태를 띠고 있으며 전체 발생 비율의 약 2/3를 차지하고 있다. 복잡 치아종은 치성 조직의 비조직화된 형태로서 악골에 고르게 분포되어 발생하고 있다. 법랑아 섬유치아종의 발생은 드물다. 치아종의 병인으로는 외상, 감염, 유전 혹은 치아 발육의 유전적 조절을 방해하는 돌연변이 유전자 등이 언급되고 있다. 치아종은 종종 다양한 맹출 장애와 치아 위치에 있어 문제를 유발할 수 있다. 따라서 치아종의 가장 빈번한 발견 요인으로서는 유치의 만기 잔존과 더불어 영구치의 매복이 있다. 치아종으로 인한지연 맹출과 감별 진단해야 할 것으로서는 과잉치, 만곡치, 법랑 진주 그리고 유치의 조기 상실 등이 있다. 치아종으로 인한 매복 치아의 치료 방법으로는 우선 치아종을 제거한 후 매복 치아의 자발적 맹출을 기대하는 것이다. 이때 매복된 치아의 자발적 맹출을 기대하기 위해선 악골내 충분한 맹출 공간을 평가한 후 공간의 확보와 치근 발육이 진행중이라는 전제 조건이 수반되어야 한다. 만일 치아종을 제거한 후에도 불구하고 매복 치아의 맹출이 이루어지지 않을 경우에는 매복 치아의 노출 후 교정적 부착장치를 위치시킨 후 강제 견인한다. 본 증례는 치아종으로 인해 영구 계승치가 매복된 환아에게서 매복치의 외과적 노출 시행 후 교정적 치료방법을 사용해 비교적 양호한 결과를 얻었기에 보고하는 바이다.

• 치과방사선
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• 제21권2호
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• pp.367-375
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• 1991

The clinical and radiographic features of 1,171 mesiodenses were studied with periapical radiograms and/or pantomograms in 942 persons visited the Department of Oral Radiology, School of Dentistry, Kyung Hee University during January 1980 to December 1989. The obrained results were as follows; 1. The incidence of mesiodens was higher in males (75.4%) than in females (24.6%). 2. In number of mesiodenses per individual, a single mesiodens was found to be 75.9%, 2-mesiodenses to be 23.8%, and 3-mesiodenses to be 0.2%. 3. In mesiodenses according to erupted and impacted status, the erupted mesiodens was found to be 16.5%, the impacted mesiodens in the interdental alveolar bone to be 66.6%, and in the region below root apex to be 16.9%. 4. In impacted mesiodenses according to direction of tooth crown, the inverted impaction was found to be 68.8%, the vertical impaction to be 15.1%, and the angulated impaction to be 16.1%. Among the impacted mesiodenses, a palatally located impaction was 87.5%, a middle 4.9%, and a labially 7.6%. 5. In mesiodenses according to shape of the tooth crown, a incisor-like type was found to be 1.6%, a canine-like type to be 6.8%, a conical type to be 79.2%, and a tuberculated type to e 12.4%. 6. In effect of mesiodens on adjacent tooth, non-specific influences were found to be 73.4%, crowding to be 0.3%, diastema to be 11.8%, rotation to be 5.7%, delayed eruption to be 3.8%, root resorption to be 2.6%, and dentigerous cyst to be 2.4%.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권2호
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• pp.105-111
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• 2017

Background: Dental fear is usually associated with hemodynamic changes. Fear of pain during the surgical removal of a lower impacted third molar might cause patients anxiety, thereby leading to avoidance of any future dental therapy. This study aimed to determine the effect of experiencing a surgical impacted-tooth removal on the pain perception-related anxiety and hemodynamic status. Method: Twenty-seven healthy patients aged 15-30 years (mean age, 24 years), for whom surgical removal of bilateral lower third molars was advised, were included. This prospective, randomized, controlled, split-mouth study involved operations on both sides of the mandibular arch, with a 1-month washout period in between. Blood pressure and heart rate were measured before the surgical procedure, during and after the injection, preoperatively, and postoperatively. Pain perception was evaluated using a 100-mm visual analog scale during the injection, preoperatively, and postoperatively after the numbness disappeared. Differences in the blood pressure, heart rate, and pain perception between the two appointments were analyzed using the paired t-test. For all statistical analyses, SPSS version 11.5 was used. Results: The mean pain perception values during the injection and preoperatively showed no significant differences between the two appointments (P > 0.05); however, significant differences in the blood pressure and heart rate were noted before the surgical procedure; preoperatively, the blood pressure alone showed a significant difference (P < 0.05). Conclusion: There was a significant decrease in the blood pressure and heart rate preoperatively; hence, experiencing a surgical impacted-tooth removal can reduce the subsequent preoperative anxiety in healthy patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권1호
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• pp.77-82
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• 2011

A long-term follow-up study of a case of impacted teeth associated with a large dentigerous cyst in the left maxilla is presented. The patient was a 30-year-old man who had a large dentigerous cyst in the premaxilla and left posterior maxilla, which impacted the canine and supernumerary tooth. This is one of the most prevalent types of odontogenic cysts associated with an erupted or developing tooth, particularly the mandibular third molars. The other teeth commonly affected in order of frequency are the maxillary canines, maxillary third molars and rarely, the central incisor. Radiographically, the cyst appears as huge ovoid well-demarcated unilocular radiolucency with a sclerotic border and causes ectopic displacement of the inferior border of the maxillary sinus without destruction. Dentigerous cysts may grow unnoticed to such extensive sizes as to occupy a considerable portion of the maxillary sinus. These cysts appear to be associated with a supernumerary tooth in the maxillary anterior incisors region called the mesiodens and impacted canine. The present case report describes the surgical enucleation of a dentigerous cyst involving the permanent maxillary left canine and mesioden. After surgery, left maxillary sinus recovered their normal size and apposition of bone was observed around the apex of the posterior teeth. During the subsequent years, there was no recurrence of the cystic lesion but the inflammation was evoked in the anterior maxilla after 42 months. This complication appeared to have correlated with bony healing in the enucleation site of the cyst. We report the healing status of a huge dentigerous cyst in the maxilla for 5 years with a review of the relevant literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권4호
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• pp.334-338
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• 2009

Supernumerary teeth are extra teeth or tooth-like structures which may have either erupted or unerupted in addition to the 20 deciduous teeth and the 32 permanent teeth. Clinicians sometimes confront unerupted supernumerary teeth where implants would be placed. Many clinicians consider immediate placement of implant into an extracted socket as an effective technique compared to the conventional method of waiting several months for bone healing, because of the advantages such as reduction of treatment period, preservation of alveolar bone and soft tissue, etc. We could hardly find the case of immediate placement of implant after extraction of impacted supernumerary teeth and permanent teeth together. Therefore we report the case of immediate implantation following extraction of impacted supernumerary teeth and poor periodontal conditioned permanent teeth.