• Journal of Korean Dental Science
• /
• v.9 no.1
• /
• pp.42-48
• /
• 2016

Prophylactic removal of impacted third molars is a common procedure in dentistry, but the necessity of routine extraction is still controversial. When impacted third molars caused severe apical root resorption of the second molars, orthodontic traction of the third molars after extraction of the damaged second molars could minimize alveolar bone defect and preserve the patient's natural teeth. By well-planned orthodontic treatment, functional occlusion was established avoiding extraction of the impacted teeth and eliminating the possibility of a large bone defect after extraction.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.24 no.3
• /
• pp.628-636
• /
• 1997

Impacted or unerupted permanent teeth have many problems in making a diagnosis and treatment plan in dental clinic. There are several methods to treat impacted teeth. The combination of surgical exposure and orthodontic traction is usually the treatment of choice in cases with impacted teeth. Two cases are reported, which were treated with surgical intervention and orthodontic movement. and one case is treated with orthodontic movement alone. To improve esthetic problem and maintain periodontal health, We should avoid loss of attached gingiva in surgical exposure, and excessive orthodontic force during the traction of the impacted tooth.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.23 no.3
• /
• pp.163-171
• /
• 2023

Background: Surgical extraction of impacted mandibular third molars is the most common procedure performed by oral surgeons. The procedure cannot be performed effectively without achieving profound anesthesia. During this procedure, patients may feel pain during surgical bone removal (at the cancellous level) or during splitting and luxation of the tooth, despite administration of routine nerve blocks. Administration of intraosseous (IO) lignocaine injections during third molar surgeries to provide effective anesthesia for pain alleviation has been documented. However, whether the anesthetic effect of lignocaine is the only reason for pain alleviation when administered intraosseously remains unclear. This conundrum motivated us to assess the efficacy of IO normal saline versus lignocaine injections during surgical removal of impacted mandibular third molars. The aim of this study was to assess the efficacy of IO normal saline as a viable alternative or adjunct to lignocaine for alleviation of intraoperative pain during surgical removal of impacted mandibular third molars. Methods: This randomized, double-blind, interventional study included 160 patients who underwent surgical extraction of impacted mandibular third molars and experienced pain during surgical removal of the buccal bone or sectioning and luxation of the tooth. The participants were divided into two groups: the study group, which included patients who would receive IO saline injections, and the control group, which included patients who would receive IO lignocaine injections. Patients were asked to complete a visual analog pain scale (VAPS) at baseline and after receiving the IO injections. Results: Of the 160 patients included in this study, 80 received IO lignocaine (control group), whereas 80 received IO saline (study group) following randomization. The baseline VAPS score of the patients and controls was 5.71 ± 1.33 and 5.68 ± 1.21, respectively. The difference between the baseline VAPS scores of the two groups was not statistically significant (P > 0.05). The difference between the numbers of patients who experienced pain relief following administration of IO lignocaine (n=74) versus saline (n=69) was not statistically significant (P > 0.05). The difference between VAPS scores measured after IO injection in both groups was not statistically significant (P >0.05) (1.05 ± 1.20 for the control group vs. 1.72 ± 1.56 for the study group) Conclusion: The study demonstrates that IO injection of normal saline is as effective as lignocaine in alleviating pain during surgical removal of impacted mandibular third molars and can be used as an effective adjunct to conventional lignocaine injection.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.47 no.2
• /
• pp.219-227
• /
• 2020

Tooth eruption involves a complex developmental process of tooth migration from the dental follicular origin to the final occlusion position in the oral cavity via the alveolar process. Disturbance of tooth eruption can occur at any point in a series of eruption stages; however, horizontal impaction of the mandibular first molar and primary retention of the primary mandibular second molar are rarely observed simultaneously. This study describes the treatment for two cases of horizontally impacted first molar with primary retention of primary molar. The primary retention of the primary mandibular second molar was extracted, and orthodontic traction was applied to the horizontally impacted primary mandibular first molar. Subsequently, displacement of the premolar tooth bud was improved and space regaining for eruption was achieved, guiding to normal eruption of the first molar.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.37 no.4
• /
• pp.512-518
• /
• 2010

The impaction of the maxillary permanent incisor is a common clinical problem and is mostly found at the "labial to the alveolar process." Surgical exposure and orthodontic treatment with fixed orthodontic appliances can be considered if normal eruption of the labillay impacted tooth is not expected. Surgical exposure of the impacted tooth, that is usually under the attached gingiva or is surrounded by alveolar bone through gingivectomy and removal of alveolar bone, may give a rise to complications such as diminution in the width of the attached gingiva, inflammation of the gingiva, and the loss of marginal alveolar bone. Therefore, closed eruption technique, which includes surgical exposure and orthodontic treatment with fixed orthodontic appliances followed by repositioning of surgical flap, is preferred. However, apically repositioned flap of the impacted tooth, which is beneath the movable submucosal area or is above the alveolar crestal area, can prevent unwanted exposures and facilitate successful tooth eruption. In this report, we described esthetic results of three patients with unerupted maxillary permanent incisor who were performed with an apically positioned flap without the loss of attached gingiva.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.36 no.4
• /
• pp.591-596
• /
• 2009

In the case of the impacted teeth, the clinician has to consider development of tooth, site of impaction, eruption path, and cooperation of patient. Treatment options for the management of impacted teeth are separated into four categories: observation, intervention, orthodontic or surgical relocation and extraction. Autotransplantation may be defined as the transplantation of embedded, impacted or erupted teeth, from one site to another in the same individual into extraction site or surgically prepared sockets. Autotransplantation ensures preservation of natural tooth, induction of alveolar bone growth and root development, offers one of the fastest and most economically feasible means in the replacement of young patients' missing teeth. This case presents a malpositioned impacted mandibular premolar of an 11-year-old girl. It was thought that orthodontic traction was difficult because of its unfavorable impacted position. Therefore the tooth was treated by autotransplantation, we can observe good healing pattern during 12 months.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.3
• /
• pp.355-361
• /
• 2004

Impaction is generally defined as the lack of eruption of a tooth after the normal age for the eruption. An impacted tooth may appear blocked by another tooth, bone, or soft tissue, but cause of tooth impaction is often unknown. The clinician should consider the various treatment options available : (a) No treatment and observation, (b) surgical exposure and orthodontic traction (c) auto transplantation (d) extraction. These cases were about the patients with delayed eruption of maxillary central incisor. We surgically exposed impacted tooth and guided it into normal position by the orthodontic traction. Especially, in case 1, #21 was ectopic impacted state with root dilaceration. It is required to examine further root development and alignment of dentition serially.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.38 no.3
• /
• pp.303-308
• /
• 2011

Tooth impaction refers to situations in which the eruption is inhibited by some physical barriers in eruptive path and the tooth remains unerupted beyond the normal time of eruption. The etiology of impacted tooth is controversial, but ankylosis has been suggested probably as a leading role. Impacted primary molars may cause several problems such as space loss, tipping of adjacent teeth, supra-eruption of the antagonists, dislocation of succeeding premolar, cystic change and infection. As one of conventional treatments of impacted primary molars, early tooth extraction or surgical extraction following space regaining when there is space loss has been suggested. However, when they are in normal formation and not ankylosed, orthodontic traction following surgical exposure can be the choice of treatment. In this case, a 3-year-old boy was referred to the department of pediatric dentistry for the unerupted mandibular right second primary molar. After surgical removal of gingiva on the occlusal surface, orthodontic traction was performed. After treatment, we could get normal alignment of primary teeth and the opportunity for normal development of permanent teeth.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.35 no.3
• /
• pp.516-522
• /
• 2008

In the case of the impacted teeth, the clinician has to consider development of tooth, site of impaction, eruption path, and cooperation of patient. If there are genetic or general factors to effect the eruption of tooth, the clinician treats these first and then takes the early treatment for eruption guidance. If there are physical factors to intercept eruption, the clinician put them off first. However, if there are no factors to effect eruption of tooth and enough space for eruption, the clinician can consider extraction of deciduous teeth, forced eruption and surgical reposition. In case of surgical repositioning, proper time for root development, proper socket formation, and minimal trauma are important for success. This case presents displaced impacted maxillary central incisor with dilacerated root. The development of root is Nolla's stage 7, and the tooth was treated by surgical repositioning. We can observe no root resorption and good healing pattern.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.29.1-29.10
• /
• 2019

Background: Reduction in postoperative complications is of vital considerations in impacted third molar teeth surgery. The aim of this study was to compare postoperative complications of impacted third molar surgeries for bone removal using laser, piezoelectric equipment, and conventional rotary instruments. Methods: To address the research purpose, the investigator designed the prospective double-blind clinical trial study. The sample size was determined 20 (40 teeth) by sampling formula in any kind of operation. The data of patients were obtained in the different periods in terms of pain, trismus, swelling, ecchymosis, and patient's satisfaction and then analyzed using SPSS 20 software via paired t test and Wilcoxon and McNemar's tests. Results: The pain immediately after surgery and 2 days and 7 days after surgery was higher in the laser group. The swelling immediately after surgery was more in the laser group but not significant. The amount of mouth opening immediately after surgery and 2 days and 7 days after surgery was significantly lower in the laser group than in the piezosurgery group. The total duration of surgery and duration of osteotomy were significantly longer in the laser group. The patient's satisfaction from surgery with piezosurgery was more than that with laser, but this difference was not significant. Conclusion: Due to the rising demand for impacted wisdom tooth surgery, the present study suggests that hard tissue laser surgery and piezosurgery can clear the future of impacted molar surgery, and these approaches are more efficient in reducing postoperative complications compared to the conventional surgeries.