• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.3
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• pp.135-141
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• 2023

Background: The limited studies on the effect of buffering on the clinical efficacy of articaine have reported controversial results. The purpose of this study was to clinically compare the pain of injection, anesthetic success, onset, and duration of pulpal anesthesia of buffered 4% articaine with epinephrine 1:100000 versus a non-buffered 4% articaine with epinephrine 1:100000 formulation for buccal infiltration of the mandibular first molar. Methods: Sixty-three volunteers were enrolled in the study. All volunteers received two injections consisting of a single mandibular first molar buccal infiltration with 1.8 ml of 4% articaine with epinephrine 1:100000 and 1.8 ml of 4% articaine with epinephrine 1:100000 buffered with 8.4% sodium bicarbonate. The infiltrations were applied in two separate appointments spaced at least one week apart. After injection of the anesthetic solution at the examined site, the first molar was pulp-tested every 2 min for the next 60 min. Results: Successful pulpal anesthesia was recorded in 69.8% of cases using non-buffered articaine solution and 76.2% of cases using buffered articaine solution, with no significant difference between the formulations (P = 0.219). The mean time of anesthesia onset for the volunteers with successful anesthetic outcome in both formulations (n = 43) was 6.6 ± 1.6 min for the non-buffered articaine solution and 4.5 ± 1.6 min for the buffered solution, which differed significantly (P = 0.001). In the same volunteers, the mean duration of pulpal anesthesia was 28.4 ± 7.1 min for non-buffered articaine solution and 30.2 ± 8.5 min for buffered articaine solution, with no significant difference between the formulations (P = 0.231). Considering the pain of injection, regardless of the anesthetic success, the mean values of VAS were 11.3 ± 8.2 mm for the non-buffered articaine solution and 7.8 ±6.5 mm for the buffered articaine solution, which differed significantly (P = 0.001 < 0.05). Conclusion: According to the present study, 4% articaine with epinephrine can benefit from buffering and provide better anesthetic behavior, with improved onset and less pain during injection.

• Restorative Dentistry and Endodontics
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• v.34 no.2
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• pp.137-144
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• 2009

The aim of this study was to investigate the shapes and diameters of the physiological foramen and anatomy of the root canal at 3mm from apex in mandibular first molars. Sixty mandibular first molars were randomly selected. The apical anatomy of 60 mandibular first molars was investigated by means of a stereo microscope (60x magnification). The results were as follows; 1. There was a high percentage of two physiological foramina in mesial (61.67%) and one foramen in distal(71.66%) roots of mandibular first molars. 2. There was a high frequency of accessory foramina in mesial roots with one foramen (26.07%). 3. The diameters of physiological foramen was as follows: - 0.329mm in single mesial foramen - 0.266mm in mesiobuccal foramen and 0.246mm in mesiolingual foramen - 0.375mm in single distal foramen - 0.291mm in distobuccal foramen and 0.237mm in distolingual foramen 4. The most common physiological foramen shape was oval (69.93%). 5. The incidence of isthmus in mesial root at 3mm from apex was 55%. The 3mm-sections contained a complete isthmus 31.66% and a partial isthmus 23.34%. 6. 3mm from the apex, the most common canal shape was oval (50.64%). Knowledge of the apical anatomy of mandibular first molar would be necessary for success of surgical and nonsurgical endodontic treatment.

• Journal of Korean Dental Science
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• v.3 no.2
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• pp.4-11
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• 2010

Purpose: This study aimed at examining the thickness of lateral cortical bone in the mandibular posterior body and the location of the inferior alveolar nerve canal as well as investigating the clinically viable bone grafting site(s) and proper thickness of the bone grafts. Subjects and Methods: The study enrolled a total of 49 patients who visited the Department of Oral and Maxillofacial Surgery at Kyung Hee University Dental Hospital to have their lower third molar extracted and received cone beam computed tomography (CBCT) examinations. Their CBCT data were used for the study. The thickness of lateral cortical bone and the location of inferior alveolar nerve canal were each measured from the buccal midpoint of the patients' lower first molar to the mandibular ramus area in the occlusal plane of the molar area. Results: Except in the external oblique ridge and alveolar ridge, all measured areas exhibited the greatest cortical bone thickness near the lower second molar area and the smallest cortical bone thickness in the retromolar area. The inferior alveolar nerve canal was found to be located in the innermost site near the lower second molar area compared to other areas. In addition, the greatest thickness of the trabecular bone was found between the inferior alveolar nerve canal and the lateral cortical bone. Conclusions: In actual clinical settings involving bone harvesting in the posterior mandibular body, clinicians are advised to avoid locating the osteotomy line in the retromolar area to help protect the inferior alveolar nerve canal from damage. Harvesting the bone near the lower second molar area is judged to be the proper way of securing cortical bone with the greatest thickness.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.47-53
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• 2017

Background: Every patient who undergoes mandibular third molar surgery is concerned about post-operative pain. Indeed, previous researchers have used various methods to treat such pain. This study aimed to assess the effectiveness of sublingual injection of dexamethasone (8 mg) to treat post-operative pain after mandibular third molar surgery. Method: This was a randomized, double-blind, split-mouth, clinical trial, involving 48 healthy patients who required surgical removal of two mandibular third molars with similar bilateral positions. All operations were performed by the same experienced surgeon. The patients were randomized into a study group (8 mg dexamethasone injection) and a placebo group (normal saline injection). Both interventions were injected into the sublingual space immediately after local anesthesia, 30 min before the first incision. The study group received an 8 mg dexamethasone injection, while the placebo group received a normal saline injection. The wash period between the patients' two operations was 3 to 4 weeks. Pain was assessed by recording the number of analgesic tablets (rescue drug) consumed, as well as by noting the patients' responses to the visual analog scale (VAS) on the first, second, and third days after surgery. Results: The study group differed significantly from the placebo group in terms of VAS score and analgesic consumption. Conclusion: Dexamethasone (8 mg), injected sublingually, significantly eased post-operative pain after surgical removal of the mandibular third molar.

• The Journal of the Korean dental association
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• v.31 no.4 s.287
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• pp.295-304
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• 1993

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.1
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• pp.98-102
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• 2000

Ectopic eruption is out of a normal position by local eruption disturbance in the developing permanent molar. The prevalence of ectopic eruption is reported to be the between 2 and 6%, most often associated maxillary first permanent molar whereas, the occurrence for the mandibular is quite rare. The etiologic factors of ectopic eruption are inadequate arch length, lack of growth in the posterior region of the jaw, mesially inclined eruption path of first permanent molars, abnormally large first permanent molars, hereditary factor and a stainless steel crown which has been improperly restored. Ectopic eruption can be treated by the use of brass wire, separating elastics, distal disking and Humphrey appliance and the use of removable appliance and cervical traction headgear after extraction of the second primary molar. This case was that lower right first permanent molar was mesially tilted state by locking on the stainless steel crown of a lower right second primary molar. The stainless steel crown was removed and Humphrey appliance was set. Like this case, ectopic eruption could be happened by the stainless steel crown which improperly restored. In restoration of the stainless steel crown, selection of proper size, trimming and contouring are very important.

• The korean journal of orthodontics
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• v.21 no.2 s.34
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• pp.353-366
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• 1991

This study was performed to analyze the effects of forces to the alveolar bone by various molar uprighting spring such as helical uprighting spring. T-loop spring, Modified T-loop spring and open coil spring. The simplified two-dimensional photoelastic model was constructed with a lower left posterior quadrant containing the second molar, the first and second premolars and the canine, with the first molar missing. Several molar uprighting springs were fabricated from 0.017 by 0.022 inch blue Elgiloy and applied to the photoelastic model. Two-dimensional photoelastic stress analysis was performed, and the stress distribution was recorded by photography The results obtained were as follows; 1. In all the kinds of the springs, the center of rotation of the mandibular second molar was oserved at the apical 1/5-1/6 between the alveolar crest and the root apex. 2. In all the kinds of the spring, the stress induced in the mesial root surface of the mandibular second molar was relatively homogeneous but there was some difference in the magnitude of the stress. 3. In the kinds of the springs, the distal crown tipping moment of the second molar was increased in turn as open coil spring, helical uprighting spring, T-loop spring, and modified T-loop spring. 4. The largest extrusive force was occured in the T-loop spring, intrusive force was occured in Modified T-loop spring only, and the largest distal tipping force was occured in open coil spring. 5. In the T-loop spring with activation, the stress induced in the mesial root surface of the second molar was increased gradually from the root apex to the alveolar crest and highly concentrated in the alveolar crest.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.523-533
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• 2004

The purpose of this study was to evaluate the alveolar bone surface following root separation angle in the mandibular second molars. The fifty mandibular second molars(which were extracted) were selected, and the alveolar bone surface following root separation angle of the selected teeth were evaluated. The results were obtained as follows; 1. The root separation angle of fifty mandibular second molars were divided into three groups. The first $group(10-20^{\circ})$ was made up of ten teeth, the second $group(20-30^{\circ})$ was made up of fifteen teeth, and the third group(30-40$^{\circ}$) was made up of twenty-five teeth. 2. The mean root separation angle was $28.1^{\circ}$. The mean alveolar bone rate on the mesial surface of the mesial root was 44.27%, on the distal surface of the mesial root was 36.52%, on the mesial surface of the distal root was 33.45%, and on the distal surface of the distal root was 25.28%. 3. The mean alveolar bone rate on the distal surface of the mesial root, which composed the root separation area, was 32.95% in the first group, 36.06% in the second group, and 38.22% in the third group. The mean alveolar bone rate in the mesial surface of the distal root was 31.40% in the first group, 31.93% in the second group, and 35.18% in the third group. 4. The positive correlation was found between the root separation angle and the alveolar bone rate in the root separation area.(P<0.05) Although the mandibular second molar is a very important tooth in the oral cavity, its treatment and diagnosis is very difficult due to the variation of its root form. When periodontal disease involves the mandibular second molar, the result of this study assists in its treatment and diagnosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.2
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• pp.147-153
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• 2017

This study assessed the association between ectopic eruption of the maxillary first permanent molar and skeletal malocclusion in 5- to 10-year-old children. As subjects, 786 children who attended the Wonkwang University Dental Hospital for orthodontic diagnosis were included. Children with unerupted first permanent molars or fully erupted second permanent molars were excluded. The study group demonstrated ectopic eruption of the maxillary first permanent molar, while the control group did not. Cephalometric radiographs taken between January 2003 and August 2015 were analyzed. Skeletal class III malocclusion was detected in 57.0% of the study group, which differed significantly from that in the control group (p<0.05). The SNA, ANB angles, and A to N-perpendicular distance were significantly smaller, whereas the A-B plane angle and APDI were significantly greater in the study group than in the control group (p<0.05). The SNB and mandibular plane angles were not significantly different between the groups. Thus, maxillary undergrowth is a risk factor for ectopic eruption of the maxillary first permanent molar.

• The korean journal of orthodontics
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• v.50 no.4
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• pp.268-277
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• 2020

This case report demonstrates two different uprighting mechanics separately applied to mesially tipped mandibular first and second molars. The biomechanical considerations for application of these mechanisms are also discussed. For repositioning of the first molar, which was severely tipped and deeply impacted, a novel cantilever mechanics was used. The molar tube was bonded in the buccolingual direction to facilitate insertion of a cantilever from the buccal side. By twisting the distal end of the cantilever, sufficient uprighting moment was generated. The mesial end of the cantilever was hooked over the miniscrew placed between the canine and first premolar, which could prevent exertion of an intrusive force to the anterior portion of the dentition as a side effect. For repositioning of the second molar, an uprighting mechanics using a compression force with two step bends incorporated into a nickel-titanium archwire was employed. This generated an uprighting moment as well as a distal force acting on the tipped second molar to regain the lost space for the first molar and bring it into its normal position. This epoch-making uprighting mechanics could also minimize the extrusion of the molar, thereby preventing occlusal interference by increasing interocclusal clearance between the inferiorly placed two step bends and the antagonist tooth. Consequently, the two step bends could help prevent occlusal interference. After 2 years and 11 months of active treatment, a desirable Class I occlusion was successfully achieved without permanent tooth extraction.