• Title/Summary/Keyword: Impacted molars

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Surgical and Orthodontic Treatment of Unicystic Ameloblastoma Related to an Impacted Molar Tooth in the Mandible: Case Report (낭종성 법랑모세포종으로 인하여 매복된 하악 구치의 교정-외과 치료: 증례보고)

  • Moon, Cheol-Hyun;Kim, Hyeon-Min;Park, Dae-Song;Kim, Dong-Woo;Lee, Sang-Chil;Kim, Sung-Yong;Lim, Ho-Yong;Yeom, Hak-Yeol
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.5
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    • pp.435-439
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    • 2011
  • Ameloblastoma is an aggressive benign odontogenic epithelial tumour that may arise from the enamel organ, remnants of dental lamina, or the lining of an odontogenic cyst. It is usually categorized into solid or multicystic, unicystic, and peripheral types. Treatment ofameloblastomas include conservative methods such as marsupialisation, enucleation, and curettage; and radical treatments such as marginal or segmental resection. Radical treatments have resulted in lower recurrence rates; however, may also encounter esthetic, functional, and reconstructive problems. Unicystic ameloblastoma has been considered less aggressive and a lower recurrence tendency. Thus, many authors have recommended conservative treatment in cases of unicystic ameloblastoma. An 11 year-old boy presented with displaced second and third molars by luminal unicystic ameloblastoma in the mandible. Cyst enucleation, curettage, and third molar extraction were done. No signs of recurrence or esthetic problems such as facial asymmetry were seen radiologically and clinically, up to 8 years 2 months postoperatively.

Validity of the vertical tube-shift method in determining the relationship between the mandibular third molar roots and the inferior alveolar nerve canal

  • Arora, Anjana;Patil, Bharati A.;Sodhi, Amandeep
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.2
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    • pp.66-73
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    • 2015
  • Objectives: To assess the validity of the vertical tube-shift method using intraoral periapical radiography (IOPAR) for determining the relationship between the mandibular third molar roots and the inferior alveolar nerve (IAN) canal in comparison with cone-beam computed tomography (CBCT). Materials and Methods: Fifty impacted mandibular third molars were analyzed using the IOPAR vertical tube-shift method and CBCT. The relationship of the IAN canal to the impacted mandibular third molar was recorded as buccal, lingual or in line with the apex and was compared with CBCT findings. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the vertical tube-shift method in depicting the relationship (buccal/lingual/in line with the apex) of the IAN canal to the third molar root apex was calculated. Results: The sensitivity and specificity PPV and NPV of the IOPAR vertical tube-shift technique was found to be highest for a lingual relationship (100%) followed by buccal (94.4%, 92.3%, 97.1%, and 85.7%) and in line with the apex relationship (88.9%, 95.0%, 80.0%, and 97.4%) of the IAN canal with the third molar root apex, respectively. A statistically significant association was observed between the IOPAR vertical tube-shift method and the CBCT with a P-value <0.01. Conclusion: The vertical tube-shift method can be used as an effective diagnostic tool in assessing the relationship of the IAN canal to the third molar root apex with high sensitivity, specificity, PPV, and NPV.

Comparative evaluation of salivary alpha amylase level for assessment of stress during third molar surgery with and without piano music and co-relation with pain catastrophizing scale: an in vivo study

  • Vaswani, Vibha;Shah, Sonal;Lakshmipriyanka, Manne;Waknis, Pushkar;Gupta, Deeisha;Jain, Kunal
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.4
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    • pp.235-239
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    • 2020
  • Objectives: Preoperative nervousness and anxiety are frequently encountered by individuals who undergo extractions of impacted wisdom teeth. The aim of the present study is to evaluate salivary alpha amylase (sAA) level in patients for assessment of stress during third molar surgery while listening to piano music and to determine its co-relation with pain catastrophizing scale (PCS). Materials and Methods: Seven patients (four males and three females) indicated for surgical extraction of bilaterally impacted mandibular third molars were included. Pre-surgical patient assessments were completed, and three samples of saliva were collected during surgery-one at baseline, one 30 minutes after commencement of surgery, and one after suturing. Assessment was performed on both sides separately with and without piano music, and the samples were assessed for sAA level and correlated with the patient's self-reported PCS. Results: Statistically significant results were obtained in patients who underwent surgical extraction while listening to piano music (P=0.046). The correlation of sAA level with PCS was not significant. Conclusion: Music demonstrated a beneficial effect on lowering the levels of stress and anxiety that a patient exhibits during any surgical procedure, and sAA can be a useful biomarker for similar assessments.

THE EFFECT OF MUSIC THERAPY AT SURGICAL EXTRACTION OF MANDIBULAR IMPACTED 3RD MOLARS (하악매복지치 발치 시 음악요법의 효과)

  • Jeaun, Hea-Sil;Chun, Ki-Hong;Lee, Soon-Young;Lee, Jeong-Keun;Song, Hyun-Chul
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.266-275
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    • 2008
  • Purpose: This research was intended to evaluate the sedative effect of the music by measuring the anxiety-level, the pain-level, the blood pressure, and the pulse rate in patients who were going through extraction of the mandibular impacted 3rd molar. Materials and methods: Patients were selected among those who visited St. Vincent's Hospital in Suwon for the surgical extraction of 3rd molar from April to May, 2007 and were divided into two groups : the first, experimental group consisting of 32 people was going through extraction with the music and the second, control group also consisting of 32 people was going through extraction without the music. The anxiety-level was measured by filling out Spielberger's State-Trait Anxiety questionnaire. The pain-level was measured by VAS (Visual analog Scale). The blood-pressure and the pulse rate were recorded at waiting period, preparation and anesthesia period, 5 minutes after anesthesia, beginning of extraction and every five minutes after extraction to the end of surgery. Results: The anxiety-level was significantly lower in the experimental group than in the control group during the extraction procedure (p<0.01). The pain-level was significantly lower in the experimental group than in the control group (p<0.05). The mean systolic blood pressure was significantly lower in the experimental group than in the control group at the beginnig of extraction and 10 minutes after extraction (p<0.01, p<0.05 each). The mean diastolic blood pressure was significantly lower in the experimental group than the control group at 10 minutes after extraction (p<0.01). The mean of pulse rate was significantly lower at the beginning of extraction (p<0.05). Conclusion: The music therapy could offer not only the psychological stability but also the physiological stability during the surgical extraction of impacted 3rd molar.

ORTHODONTIC TREATMENT OF AN IMPACTED MANDIBULAR FIRST MOLAR USING MINIPLATE AS A SKELETAL ANCHORAGE: A CASE REPORT (Miniplate를 골격성 고정원으로 이용한 매복된 하악 제1대구치의 교정치료 증례)

  • Jang, Yoon-Hyoung;Kim, Eun-Young;Kim, Kwang-Chul;Park, Jae-Hong;Lee, Baek-Soo;Choi, Sung-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.2
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    • pp.246-251
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    • 2010
  • Impactions can occur because of malpositioning of the tooth bud or obstruction in the path of eruption. However, the exact mechanism is still unknown. The impaction of mandibular first molar is rare with prevalence rates of 0.01~0.25%, but it is important to deimpact the tooth as soon as possible to avoid complications such as dental caries, root resorption, and periodontal problems on the adjacent teeth. Several biomechanical strategies have been proposed for uprighting mesially tipped mandibular first molars. However, most of these have had problems with movement of the anchorage unit because of the reciprocal force. The recent development of skeletal anchorage system(SAS) allows direct application of precise force systems to the target tooth or segment, producing efficient tooth movement in a short time. In this case, an impacted mandibular left first molar with dilacerated roots was treated with a miniplate, which provided skeletal anchorage to upright the tooth. The miniplate was installed in the mandibular ramus, and 10 months after the application of orthodontic force, the impacted tooth was exposed in the oral cavity and uprighted. At this point, the mandibular left first molar was included in the orthodontic appliance with fixed mechanotherapy, the tooth could achieve a normal occlusion. Therefore, the use of SAS simplified the orthodontic procedures and reduced the orthodontic treatment period, and had few side effects.

THE ERUPTION GUIDANCE OF AN IMPACTED DILACERATED MAXILLARY CENTRAL INCISOR (변위 매복된 상악 중절치의 맹출유도)

  • Kang, Keun-Young;Yang, Kyu-Ho;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.550-556
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    • 2005
  • Tooth impaction is defined as a cessation of the eruption of a tooth at the level of the oral mucosa or alveolar bone by any causes. Any tooth in the dental arch can be impacted, but the teeth frequently involved in a descending order are the mandibular and maxillary third molars, the maxillary canines, the mandibular and maxillary second premolars, and the maxillary central incisors. In these teeth, impaction of maxillary incisor occurs in about 0.1-0.5% and major causes are trauma, supernumerary teeth and periapical inflammation of primary maxillary incisor. Delayed eruption of a maxillary central incisor results in midline shift, the space's being occupied by an adjacent tooth and different levels of alveolar height. Treatment options are observation, surgical intervention, surgical exposure and orthodontic traction, transplantation and 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. At the completion of traction, the maxillary central incisor was positoned fairly within the arch and complications such as root resorption were not observed.

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Extraction of mandibular third molars: relationship of preoperative anxiety with body mass index, serum high-sensitivity C-reactive protein levels, and visual analog scale scores and predictors of postoperative complications

  • Eunjee Lee;Yu-Jin Jee;Jaewoong Jung;Mu Hang Lee;Sung ok Hong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.5
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    • pp.252-261
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    • 2023
  • Objectives: Patients undergoing oral surgery exhibit high anxiety, which may elevate their cortisol levels and affect postoperative recovery. Overweight patients are often encountered in the dental clinic due to the increasing prevalence of overweight. We aimed to investigate the relationships between preoperatively assessed body mass index (BMI), serum cortisol and high-sensitivity C-reactive protein (hs-CRP) levels, and visual analog scale (VAS) scores and preoperative anxiety in patients undergoing mandibular third molar (MM3) extraction and to identify predictors of postoperative complications. Patients and Methods: We analyzed 43 patients (age, 20-42 years) undergoing MM3 extraction. At the first visit, patients completed the Modified Dental Anxiety Scale (MDAS) and Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaires. Their BMI and VAS scores were also calculated. The participants underwent blood tests 1 hour before MM3 extraction. On the first postoperative day, the participants' VAS scores and serum hs-CRP levels were reevaluated. Results: We found that BMI was significantly correlated with preoperative VAS scores. Further, BMI and preoperative hs-CRP levels were significantly correlated among women and patients undergoing extractions of fully impacted MM3s. No correlations were found between serum cortisol and other variables. The preoperative MDAS and VAS scores were significantly positively correlated, especially among patients undergoing extractions of fully impacted MM3s. Multiple linear regression showed that BMI and the eruption status of the MM3 were significant predictors of postoperative hsCRP levels and VAS scores, respectively. Conclusion: In MM3 removals, patients with higher BMI showed elevated hs-CRP and higher VAS scores before surgery. Patients with higher anxiety among those undergoing extractions of fully impacted MM3s showed higher preoperative VAS scores. The two main predictors of postoperative complications were BMI and MM3 eruption status.

Comparison of the effects of two different styles of orally prescribing prednisolone on postoperative sequelae of surgical extraction of an impacted mandibular third molar: a single-blind randomized study

  • Mohammed Mousa H. Bakri;Faisal Hussain Alabdali;Rashed Hussain Mahzari;Thamer Jabril Rajhi;Norah Mohammed Gohal;Rehab Abdu Sufyani;Asma Ali Hezam;Ahtesham Ahmed Qurishi;Hamed Mousa Bakri;Fareedi Mukram Ali
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.1
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    • pp.27-34
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    • 2024
  • Objectives: Surgical intervention for removal of an impacted third molar can lead to significant pain and swelling. Corticosteroids show promise for mitigating postoperative sequelae across various surgical contexts. The use of corticosteroids following minor oral surgery, though controversial, has already been proven effective. However, little research has explored peroral prescription of corticosteroids despite its convenience for outpatients and for non-surgeons like implantologists and periodontists and others who don't have access to needle injections. The aim of this study was to address a void in the literature by comparing the effects of two styles of preoral administration of prednisolone after surgical removal of the mandibular third molar and to determine which style minimizes postoperative sequelae. Materials and Methods: A randomized, split-mouth clinical study was conducted to investigate the efficacy of two different styles of preoral prednisolone in mitigating postoperative sequelae following surgical extraction of impacted mandibular third molars. Fifteen participants were enrolled in the study. Random selection was used to determine the prescription style for the right and left mandibular arch. Group A included those who received a single dose of prednisolone 25 mg, while group B received prednisolone 5 mg postoperatively for a period of three days (5 mg three times/day on the first postoperative day, 5 mg twice/day on the second postoperative day; 5 mg once/day on the third postoperative day). Results: There was a significant difference in the distance between the corner of the mouth and tragus, which decreased with the time interval with respect to group B when compared to group A. Conclusion: The present study showed that a three-day tapered dose of prednisolone postoperatively was more effective in reducing post-extraction sequelae than a single-dose regimen.

Propofol and Fentanyl Compared with Midazolam and Morphine for Conscious Sedation During Surgical Extraction of Bilateral Mandibular Impacted Third Molars (양측 하악 매복지치 동시 발치를 위한 의식하 진정의 비교 연구: Propofol, Fentanyl과 Diazepam, Morphine)

  • Kim, Young-Kyun;Chae, Byung-Kook;Choi, Hyun-Kyu
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.3 no.2 s.5
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    • pp.87-91
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    • 2003
  • Background: The purpose of this study was to compare the availability of propofol and fentanyl (P + F) with diazepam and morphine (D + M) for intravenous conscious sedation during third molar surgery. Methods: Forty patients without systemic disease were operated under IV conscious sedation administered by either of the two techniques. Monitoring consisted of continuous observation of pulse rate, blood pressure, oxygen saturation, and the respiratory rate and were recorded every 15 minutes. Cooperation score was measured 5 and 15 minutes after induction of IV sedation. Following the operation, the surgeon and patients completed questionnaires including pain visual analog scale, amnesia, and side effects. Results: The P + F group was significantly more cooperative than the D + M group. The side effects of D + M group included pain on injection, nausea/vomiting and abdominal pain. The side effects of P + F group included talkativeness, nausea/vomiting, temporary apnea, pain on injection and vertigo. Conclusions: In this study, there were following benefits in the P + F group; more cooperative status and less pain perception. But respiratory depression developed in some patients.

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ROENTENOGRAPHIC STUDY OF THE MANDIBULAR CANAL (하악관에 대한 X선학적 연구)

  • Ahn Hyung Kyu
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.10 no.1
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    • pp.41-46
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    • 1980
  • The mandibular canal must be considered carefully during the surgical treatment, especially surgical extraction of the impacted tooth and intraosseous implant, because it contains the important inferior alveolar nerve and vessels. The author investigated the curvature of the mandibular canal and its relation to the mandibular molars and positional realtion between the mental foramen and the mandibular premelors in orthopantomogram. The materials consisted of 441 orthopantomograms divided four groups; Group Ⅰ consisted of 56 males and 44 females from 1 to 6 years of age, Group Ⅱ consisted of 58 males and 45 females from 7 to 12 years of age, Group Ⅲ consisted of 65 males and 33 females from 13 to 18 years of age, Group Ⅳ consisted of 86 males and 54 females over 19 years of age. The results were as followings; 1. The curvature of mandibular canal was 144.50° in Group Ⅰ, 144. 29° in Group Ⅱ, 148.11° in Group Ⅲ, 147.33° in Group Ⅳ. 2. The curvature of mandibular canal was located most frequently on the area between mandibular 1st molar and mandibular 2nd molar in Group Ⅰ (42%) and on the mandibular 2nd molar area in Group Ⅱ (54%), Group Ⅲ (59%), Group Ⅳ (53%). 3. The position of mental foramen was most frequently below the mandibular 1st premolar in Group Ⅰ (58%), between the mandibular 1st premolar and the 2nd premolar in Group Ⅱ (62%), Group Ⅲ (47%), and below the mandibular 2nd premolar in Group Ⅳ (58%).

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