• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.6
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• pp.309-315
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• 2019

Objectives: The aim of this study was to evaluate the validity of the existing classification and difficulty index of impacted mandibular third molars in clinical situations and propose a more practical classification system. Materials and Methods: This study included 204 impacted mandibular third molars in 154 patients; panoramic x-ray images were obtained before tooth extraction. Factors including age, sex, and pattern of impaction were investigated. All impacted third molars were classified and scored for spatial relationship (1-5 points), depth (1-4 points), and ramus relationship (1-3 points). All variables were measured twice by the same observer at a minimum interval of one month. Finally, the difficulty index was defined based on the total points scored as slightly difficult (3-4 points), moderately difficult (5-7 points), very difficult (8-10 points), and extremely difficult (11-12 points). Results: The strength of agreement of the total points scored and difficulty index were 0.855 and 0.746, respectively. Most cases were classified as moderately difficult (73.0%). Although only 13 out of 204 cases (6.4%) were classified as extremely difficult, patients classified as extremely difficult were the oldest (P<0.05). Conclusion: For difficulty classification, the authors propose one more difficult category beyond the existing three-step difficulty index: the clinician should consider the patient's age in the difficulty index evaluation.

• Journal of Korean Dental Science
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• v.9 no.2
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• pp.63-68
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• 2016

Pressure root resorption can be observed during the eruption of permanent dentition, especially of the maxillary canines (affecting lateral incisors) and mandibular third molars (affecting mandibular second molars). Since the cause of root resorption of the adjacent affected teeth is evident, treatment simply involves extraction of the impacted tooth. However, there have been few reports on the prognosis of the remaining resorbed tooth, as dentists often choose to extract them when damage due to root resorption is observed. We report a case involving a tooth that was severely resorbed due to pressure from an adjacent impacted tooth. After extraction of the impacted tooth, the remaining tooth retained vital pulp and survived as a functional tooth.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.2
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• pp.226-232
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• 2010

Incidence of tooth impaction varies from 5.6 to 18.8% of the population. Failure of eruption of the first and second permanent molars is rare; the prevalence in the normal population is 0.01% in case of the first permanent molar, and 0.06% in case of the second permanent molar. Permanent molars are particularly important for providing sufficient occlusal support and co-ordinating facial growth. Failure of eruption of permanent molars may result in various complications such as decrease in vertical dimension, posterior open bite, extrusion of antagonistic teeth, resorption and inclination of adjacent teeth, formation of cyst and so on. Treatment options of impacted teeth are periodic observation, surgical exposure, surgical exposure with subluxation, orthodontic relocation, and surgical extraction before prosthetic treatment. Early diagnosis and treatment are important, because delayed treatment induces various problems such as decreased spontaneous eruptive force, decreased successful percentage, increased treatment period, increased various complications. Prevalence of the failure of mandibular first molars is rare but eruptive guidance before extraction of impacted teeth is necessary due to importance of permanent molars. We reported two cases of surgical exposure of impacted mandibular first molar. In these cases, we could observe different result of the impacted mandibular first molar after surgical exposure.

• The korean journal of orthodontics
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• v.17 no.2
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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 the korean academy of Pediatric Dentistry
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• v.36 no.4
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• pp.613-618
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• 2009

Impacted molars are not usual with the prevalence rate of less than 1%, however problems such as infraocclusion, extrusion of the opposite tooth and lack of space are caused. If molars are impacted, radiographic check-up and observations are needed as they play an important role in skeletal development and mastication. Causes of impaction are underdevelopment of roots, supernumerary teeth, cysts, odontomas, ankylosis and etc. In our first case, we present impacted molar which was surgically exposed and orthodontically traded. As the developmental state of the root was less than half at first visit, we observed until the root was 2/3 in its length and traction was carried out. The second case is orthodontic traded molar with compleate enucleation of the existing cysts. When trading impacted molars, direct bonding of attachments to the tooth and light continuous forces are recommended so as to ankylosis, external absorption and periodontal attachment loss avoid. Fixed appliances tract the teeth on arch and obtain eruption spaces without patient's cooperation. We report surgically exposed and orthodontically traded molars which resulted in good occlusion and patients satisfaction.

• Imaging Science in Dentistry
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• v.35 no.4
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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.

• Imaging Science in Dentistry
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• v.42 no.3
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• pp.121-127
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• 2012

Purpose: This study evaluated the association between cone beam computed tomography (CBCT) and panoramic radiographs in the assessment of a superimposed relationship between the mandibular canal and impacted third molars. Materials and Methods: The study samples consisted of 175 impacted third molars from 131 patients who showed a superimposed relationship between the mandibular canal and third molars on panoramic radiographs and were referred for the examination of the mandibular canal with CBCT. Panoramic images were evaluated for the darkening of the root and the interruption of the mandibular canal wall. CBCT images were used to assess the buccolingual position of the mandibular canal relative to the third molar, the proximity of the roots to the canal, and lingual cortical bone loss. The association of the panoramic and CBCT findings was examined using a Chi-square test and Fisher's exact test. Results: Panoramic radiographic signs were statistically associated with CBCT findings (P<0.01). In cases of darkening roots, lingual cortical bone loss or buccally positioned canals were more frequent. In cases in which the mandibular canal wall was interrupted on panoramic radiographs, contact or lingually positioned canals were more frequent. Conclusion: The results of this study suggest that contact between the mandibular third molar and canal and a lingually positioned canal could be more frequently observed in cases of the interruption of the white line of the mandibular canal and that there could be more lingual cortical loss in cases of darkening roots.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.6
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• pp.474-480
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• 2005

We evaluated the need for prophylactic postoperative oral antibiotic medication in extraction of asymptomatic impacted mandibular third molars. All patient didn't show sign of pain, inflammation, swelling and trismus at the time of extraction. In the experimental group, oral antibiotic medication(Amoxicillin) was carried out for 5 days postoperatively. In the control group, the patients received no antibiotic medication. All groups didn't use antibiotic irrigation solution. Rule of group composition randomized. The surgical technique was the same in all cases. Parameters that were evaluated were infection, pain, facial swelling, trismus. We could not find any significant difference between the experimental and control groups.(P<0.05) The results of our study show that post operative oral prophylactic antibiotic medication after the extraction of impacted mandibular third molars does not contribute to less infection, pain, facial swelling and increased mouth opening after surgery. Therefore we suggest that prophylactic postoperative oral antibiotic medication is not needed in extraction of asymptomatic impacted mandibular third molars.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.41-45
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• 2004

In the normal growth and development of the mandible, the molar tooth buds distal to the first permanent molar have a mesial inclination. This inclination is usually self-correcting, but, unfortunately, this self-correction does not always occur. The first case is about, 14-year-old female patient with familial history of lower second molar impaction. Her lower second molars were both impacted, and she was treated with sectional wires and open-coil springs. The second case, 14-year-old male, we treated his impacted #47 with Halterman appliance. The third case, 11-year-old male, his both mandibular second molars were impacted during full-fixed orthodontic treatment. They were treated with brass wire, sectional wire and open-coil spring.

• Journal of The Korean Dental Society of Anesthesiology
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• v.4 no.1 s.6
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• pp.13-16
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• 2004

Background: Articaine, a new amide-type local anesthetic, was recently commercially available in Korea. The purpose of this study was to compare the anesthetic efficacy between articaine HCl and lidocaine HCl for the surgical extraction of bilateral mandibular impacted third molars. Patients and Methods: Forty young and healthy patients with bilateral impacted third molars were selected with permission. Randomly, one side of impacted third molar was operated under local anesthesia using 4% articaine and the other side under 2% lidocaine after 1 or 2 week recovery time. Intraoperative pain was evaluated via 0-10 cm visual analog scale (VAS) by both the patient and operator immediately after the operation. After 1 day and 7 days, the complications of local anesthesia were checked. Results: The pain VAS scores in articaine group, evaluated by both the patient and operator, were lower than those in lidocaine group, but they were not statistically significant (P = 0.44 and 0.54, respectively). The incidence of complications of local anesthesia between articaine and lidocaine was similar. Conclusion: In this study, articaine showed at least equal efficacy compared to lidocaine. The further dose-controlled study with more pharmacokinetic parameters will be needed.