• Title/Summary/Keyword: Impacted molars

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ORTHODONTIC TRACTION OF IMPACTED MANDIBULAR SECOND PRIMARY MOLAR (매복된 하악 제2유구치의 교정적 견인)

  • Kim, Min-Jung;Lee, Sang-Ho;Lee, Nan-Young;Jang, Hyang-Gil
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.3
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    • pp.303-308
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    • 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.

THE PROPERTIES OF ANTIBIOTIC AND NSAIDS ADMINISTRATION BEFORE EXTRACT OF THE IMPACTED MANDIBULAR THIRD MOLAR. (매복된 하악 제 3대구치 발거시 항생제 및 진통제 투여의 효용성)

  • Kil, Yong-Kab;Kang, Hee-In;Kim, Kyoung-Soo;Kim, Jae-Seong;Kwak, Myung-Ho;Seo, Hyun-Soo;Hong, Soon-Min;Park, Jun-Woo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.6
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    • pp.505-509
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    • 2009
  • Purpose: To evaluate the properties of antibiotic and NSAIDs administration before extract of the impacted mandibular third molar. Materials & Methods: No patient showed any sign of pain, inflammation, or swelling at the time of removal. A group of 50 patients was classified in Group 1(preemptive and oral medication was carried out for 3 days postoperatively, N=23) and Group 2(oral medication was carried out for 3 days postoperatively, N=27) subgroups. Clinical and radiologic factors were recorded for each case, and the rationale for assigning the patients to the groups was strictly random. The surgical technique was the same in all cases, and the follow-up period was 1 week. Parameters that were evaluated were infection, swelling, pain and differences in mouth opening. Results: We could not find any significant difference between the 2 groups regarding the evaluated parameters. Conclusion: The results of our study show that antibiotic and NSAIDs administration before the removal of lower third molars does not contribute to a decrease infection, swelling, pain or increase mouth opening. Therefore antibiotic and NSAIDs administration before the removal of lower third molars is not recommended for routine use.

Effects of Slow Programmable Cryopreservation on Preserving Viability of the Cultured Periodontal Ligament Cells from Human Impacted Third Molar

  • Kim, Jin-Woo;Kim, Tae-Yi;Kim, Ye-mi;Pang, Eun-Kyoung;Kim, Sun-Jong
    • Journal of Korean Dental Science
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    • v.8 no.2
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    • pp.57-64
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    • 2015
  • Purpose: This study was conducted to determine cell viability and differentiation capability of human periodontal ligament (PDL) cells and to elucidate the effects of cryopreservation on the activity of human third molar PDL cells by comparing PDL cells with and without cryopreservation. Materials and Methods: Human PDL fibroblasts obtained from immature third molars were cultured and divided into two groups. The experimental group was cryopreserved with a slow freezing rate of $0.5^{\circ}C/min$ from $4^{\circ}C$ to $-35^{\circ}C$ followed by plunging in liquid nitrogen at $-196^{\circ}C$ and cultured after fast thawing. The control group was cultured without cryopreservation. Cell viability, growth capacity and morphology were evaluated in both groups. Bivariate statistics were used to compare 2 groups and linear mixed model analysis was used to investigate the growth trends difference over time. Result: Cell viability and growth capacity were not significantly different between the 2 groups (P>0.05). Cultured cell of both groups showed fibroblast-like in appearance, and there were no significant differences in morphology between 2 groups. The mixed model analysis revealed no significant difference of growth capacity between 2 groups over time (${\beta}=-0.0009$; P=0.138). Conclusion: This study demonstrates that cryopreservation under control does not affect the biological properties of PDL cells, supporting the feasibility of autotransplantation of cryopreserved impacted third molars.

Cantilever-Type Traction Appliance for Mandibular First Permanent Molars with Eruption Disturbances (하악 제1대구치 맹출 장애에서 Cantilever-Type의 견인 장치를 활용한 맹출 유도)

  • Lim, Heejung;Lee, Eungyung;Jeong, Taesung;Shin, Jonghyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.2
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    • pp.229-236
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    • 2021
  • Eruption disturbances of the mandibular first molars can cause multiple problems in occlusal development although they are extremely rare. Early diagnosis and treatment are very important to prevent complications associated with eruption disturbances. The present case report describes the treatment of two cases of eruption disturbances of the mandibular first permanent molar. A fixed appliance composed of a cantilever spring with mandibular second deciduous molar as an anchor tooth was used to tract the impacted mandibular first permanent molar. The success of both cases shows that this novel traction appliance can be used to induce the eruption of an impacted mandibular first permanent molar within a short time in patients with intact mandibular second deciduous molar as an anchor tooth.

Radiographic evaluation before surgical extraction of impacted third molar to reduce the maxillary sinus related complication

  • Mi Hyun Seo;Buyanbileg Sodnom-Ish;Mi Young Eo;Hoon Myoung;Soung Min Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.4
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    • pp.192-197
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    • 2023
  • Objectives: Surgical extraction of maxillary third molars is routine in departments devoted to oral and maxillofacial surgery. Because maxillary third molars are anatomically adjacent to the maxillary sinus, complications such as oroantral fistula and maxillary sinusitis can occur. Here we explore the factors that can cause radiographic postoperative swelling of the maxillary sinus mucosa after surgical extraction. Materials and Methods: This retrospective study reviewed the clinical records and radiographs of patients who underwent maxillary third-molar extraction. Preoperative panoramas, Waters views, and cone-beam computed tomography were performed for all patients. The patients were divided into two groups; those with and those without swelling of the sinus mucosa swelling or air-fluid level in a postoperative Waters view. We analyzed the age and sex of patients, vertical position, angulation, number of roots, and relation to the maxillary sinus between groups. Statistical analysis used logistic regression and P<0.05 was considered statistically significant. Results: A total of 91 patients with 153 maxillary third molars were enrolled in the study. Variables significantly related to swelling of the maxillary sinus mucosa after surgical extraction were the age and the distance between the palatal cementoenamel junction (CEJ) and the maxillary sinus floor (P<0.05). Results of the analysis show that the relationship between the CEJ and sinus floor was likely to affect postoperative swelling of the maxillary sinus mucosa. Conclusion: Maxillary third molars are anatomically adjacent to the maxillary sinus and require careful handling when the maxillary sinus is pneumatized to the CEJ of teeth.

Hemodynamic changes and pain perception-related anxiety after experiencing an impacted-tooth removal: clinical practice outcome

  • Raocharernporn, Somchart;Boonsiriseth, Kiatanant;Khanijou, Manop;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.2
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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.

Effects of pain catastrophizing and anxiety on analgesic use after surgical removal of impacted mandibular third molars

  • Altan, Ahmet;Akkoc, Sumeyra;Erdil, Aras;Colak, Sefa;Demir, Osman;Altan, Halenur
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.6
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    • pp.379-388
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    • 2019
  • Background: In dentistry, pain is a factor that negatively affects treatments and drug use. The aim of this study was to evaluate the correlations of the postoperative analgesic use with pain catastrophizing and anxiety in patients who underwent removal of an impacted mandibular third molar. Methods: We recruited 92 patients who underwent the extraction of impacted mandibular third molar. In this study, the Pederson index was used to preoperatively determine the difficulty of surgical extraction. Patients were asked to note the number of analgesics used for 7 postoperative days. Patients were divided into two groups based on the Pain Catastrophizing Scale: low and high score groups. State-Trait Anxiety Inventory-trait and State-Trait Anxiety Inventory-state questionnaires were used to determine the anxiety levels of the patients. The obtained data were examined to evaluate the correlations of pain catastrophizing and anxiety with the postoperative analgesic use. Results: In this study, 92 patients, including 60 women and 32 men, were recruited. The analgesic use was higher in women than in men but with no significant difference (P > 0.05). Pain Catastrophizing Scale scores were higher in women than in men but with no significant difference (P > 0.05). The analgesic use was higher in patients with high pain catastrophizing than in those with low pain catastrophizing but with no significant difference (P > 0.05). State-Trait Anxiety Inventory-trait scores were higher in women than in men but with no significant difference. However, state-Trait Anxiety Inventory-state scores were significantly higher in women than in men (P < 0.05). Conclusion: The postoperative analgesic use may be higher in patients who catastrophize pain than in others. Knowing the patient's catastrophic characteristics preoperatively would contribute to successful pain management and appropriate drug selection.

The efficacy of an elevated concentration of lidocaine HCl in impacted lower third molar surgery

  • Ping, Bushara;Kiattavorncharoen, Sirichai;Saengsirinavin, Chavengkiat;Im, Puthavy;Durward, Callum;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.2
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    • pp.69-76
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    • 2015
  • Background: There have been few studies on the effect of an elevated concentration of lidocaine hydrochloride in the surgical removal of an impacted lower third molar. This study aimed to examine the efficacy of 4% lidocaine along with 1:100,000 epinephrine compared to 2% lidocaine along with 1:100,000 epinephrine as inferior alveolar nerve block for the removal of an impacted lower third molar. Methods: This single-blind study involved 31 healthy patients (mean age: 23 y; range: 19-33 y) with symmetrically impacted lower third molars as observed on panoramic radiographs. Volunteers required 2 surgical interventions by the same surgeon with a 3-week washout period. The volunteers were assigned either 4% lidocaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine as local anesthetic during each operation. Results: We recorded the time of administration, need for additional anesthetic administration, total volume of anesthetic used. We found that the patient's preference for either of the 2 types of local anesthetic were significantly different (P < 0.05). However, the extent of pulpal anesthesia, surgical duration, and duration of soft tissue anesthesia were not significantly different. Conclusions: Our study suggested that inferior alveolar nerve block using 4% lidocaine HCl with 1:100,000 epinephrine as a local anesthetic was clinically more effective than that using 2% lidocaine HCl with 1:100,000 epinephrine; the surgical duration was not affected, and no clinically adverse effects were encountered.

Comparison of panoramic radiography with cone beam CT in predicting the relationship of the mandibular third molar roots to the alveolar canal

  • Shahidi, Shoaleh;Zamiri, Barbod;Bronoosh, Pegah
    • Imaging Science in Dentistry
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    • v.43 no.2
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    • pp.105-109
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    • 2013
  • Purpose: Preoperative radiographic assessment of the mandibular third molars is essential to prevent inferior alveolar nerve damage during extraction. The purpose of this study was to assess the reliability of panoramic signs of association between the roots of teeth and the canal, and to compare the panoramic signs with cone beam computed tomography (CBCT) findings. Materials and Methods: CBCT images of 132 impacted mandibular third molars were evaluated to determine the association of the root to the canal. The CBCT findings were compared with the corresponding panoramic images. Logistic regression analysis was used to define the diagnostic criteria of the panoramic images. Results: Among the panoramic signs, loss of the cortical line was the most frequent radiographic sign predicting association (sensitivity: 79.31). Contact of the tooth with the canal was observed in all cases in which the loss of cortical line of the canal or darkening of the roots was found on the panoramic radiographs. Conclusion: Darkening of the roots and loss of the cortical line on panoramic radiographs might be highly suggestive of the risk of nerve injury.