• Imaging Science in Dentistry
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• v.51 no.4
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• pp.373-382
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• 2021

Purpose: Cone-beam computed tomography (CBCT) reconstructions were analysed to elucidate factors affecting the anatomical relationship between tooth roots and the mandibular canal(MC). Materials and Methods: Images of 300 volumetric tomography scans of patients aged between 20 and 79 years old (167 women and 133 men) were analysed. The mean distances between 2,053 dental root apices and the internal border of the MC were obtained by measuring the horizontal and vertical distances on coronal CBCT images. The actual distance was then calculated mathematically with the Pythagorean formula. The statistical significance of differences between men and women was assessed using the Mann-Whitney test. Correlations with patient age were evaluated with the Spearman rank correlation coefficient. Results: The mean distances ranged from 2.17 mm, for single right third molar roots in women, to 8.02 mm for single left third molar mesiolingual roots in men. The mean distances measured for the mandibular right second molar mesial roots and the right second premolar roots were larger in men than in women. Age showed a significant positive correlation with the measured distances for mesial and distal roots of the first and second molar on both sides and the right third molar, mesiolingual roots of the left third molar, and single roots of the right third molar. Conclusion: The root-to-mandibular canal distance depended on age and the type of tooth. In 2 root types, this distance was impacted by sex.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.5
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• pp.225-232
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• 2014

Objectives: The purpose of this retrospective study is to find the differentiating characteristics of cystic and cystic-appearing lesions that involve the impacted mandibular third molar by analyzing panoramic radiographs and computed tomography images, and to aid the preoperative diagnosis. Materials and Methods: Eighty-one patients who had a mandibular cystic or cystic-appearing lesion that involved impacted mandibular third molar and underwent cyst enucleation were included in the study. The preoperative panoramic radiograph and computed tomography findings were analyzed in accordance to the histopathologic type. Results: Most of the cystic lesions containing the mandibular third molar were diagnosed as a dentigerous cyst (77.8%). The occurrence of mesio-distal displacement of the third molar was more frequent in the odontogenic keratocyst (71.4%) and in the ameloblastoma (85.7%) than in the dentigerous cyst (19.1%). Downward displacement was primarily observed in each group. Odontogenic keratocyst and ameloblastoma showed more aggressive growth pattern with higher rate of bony discontinuity and cortical bone expansion than in dentigerous cyst. Conclusion: When evaluating mandibular cystic lesions involving the impacted mandibular third molar, dentigerous cyst should first be suspected. However, when the third molar displacement and cortical bone absorption are observed, then odontogenic keratocyst or ameloblastoma should be considered.

• The korean journal of orthodontics
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• v.47 no.2
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• pp.142-147
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• 2017

The purpose of this study was to investigate immediate changes in the mandibular dentition after maxillary molar distalization using headgear in non-growing patients. Sixteen patients (mean age, $18.9{\pm}2.0$ years) with Class II molar relationship and crowding were included in the present study. To correct the molar relationship, headgear was used for maxillary molar distalization. Cone-beam computed tomography-generated half-cephalograms (CG Cephs) and dental casts were used to evaluate dental changes for each subject before and immediately after molar distalization using headgear. The mean duration that subjects wore the headgear was 6.3 months. CG Cephs showed that the first maxillary molars were distalized $4.2{\pm}1.6\;mm$ with $9.7^{\circ}{\pm}6.1^{\circ}$ of distal angulation. The intercanine, interpremolar, and intermolar widths of the mandible increased after maxillary molar distalization. The present study's results suggest that maxillary molar distalization using headgear induces a spontaneous response in the untreated mandibular dentition of non-growing patients.

• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.205-214
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• 2000

This study was performed to investigate the relationship between mandibular midline shift and anteroposterior first molar occlusal relation, and their effects on the mandibular height and the occlusal plane angle. For this study, 49 patients with temporomandibular disorders were selected. They did not show facial asymmetry and their facial midline coincide with maxillary dental midline. Upper and lower mandibular impression were taken and the casts were fabricated. Amount and direction of the mandibular midline shift and the anteroposterior shift between the two occluding first molars were measured on the casts. Several items related to height such as mandibular height from top of the articular surface of the condyle to curve changing point between antegonial notch and mandibular angle, condylar height which was the vertical distance from the articular surface to retroepicondyle of the condyle, and sigmoid height from the deepest point of sigmoid notch to the curve changing point and the occlusal plane angle were also measured on the panoramic and on the transcranial radiographs. Correlation between midline shift and anteroposterior first molar relation and comparison between right and left mandibular height by the midline shift and the first molar relation were analysed by SPSS windows program. The results of this study were as follows : 1. Mean amount of midline shift in the subjects with midline shift were 2.0mm for both side, respectively. The first molar relation of the ipsilateral side of midline shift showed Angle class II tendency and the contralateral side showed Angle class III tendency, which meant drift of the dentition to the side of the midline shift. 2. The occlusal plane angle on the panoramic radiograph were $13.0^{\circ}$ in right, and $12.5^{\circ}$ in left side, and their were no correlation between occlusal plane angle and mandibular midline shift and the first molar occlusal relation. 3. Angle's classification for both sides of the first molar relation were same in about half of all the subjects. Amount of deviation from class I first molar relation, however, were decreased in the contralateral side of observed side. 4. Mandibular height of the ipsilateral side to which mandibular midline shift showed tendency of lower than that of the contralateral side, and there was a tendency that the height was higher in class III subjects, then class II subjects, and lower in class I subjects. However, condylar height did not show any difference in the subjects with midline shift and also show no difference by the first molar occlusal relation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.1_2
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• pp.135-142
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• 1992

This study was performed to define the anatomical position of the mandibular canal and the findings during the sagittal split ramus osteotomy of the mandible. The mandibles of 20 adult Korean were used. The dimension of mandibular canal from the mandibular foramen to the 1st molar was measured at 4 specific coronal-sectional location by CT scan. The results were as follows ; 1. The distance from the mandibular canal to the medial aspect of the buccal cortical plate was greatest($4.5{\pm}1.1mm$) at 2nd molar area and was not significantly greater than at any other section. 2. Buccal cortex was thickest($3.8{\pm}0.9mm$) at 2nd molar and thinnest ($2.5{\pm}0.3mm$) mandibular foramen um 3. The distance from the mandibular canal to the medial aspect of the lingual cortical plate was not significant at any sections. 4. The distance from the mandible canal to the inferior border of mandible was greatest at the mandibular foramen($20.7{\pm}3.9mm$). The canal was located more closely to the inferior border at 1st, 2nd molar area 5. The diameter of the mandibular canal was between $2.5{\pm}0.3mm$ and $2.8{\pm}0.6mm$. 6. The total mandibular thickness was greatest($21.1{\pm}2.6mm$) at 2nd molar area and narrowest($17.2{\pm}3.2mm$) at mandibular foramen area.

• The korean journal of orthodontics
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• v.43 no.5
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• pp.218-224
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• 2013

Objective: To examine the effect of bite force on the displacement and stress distribution of orthodontic mini-implants (OMIs) in the molar region according to placement site, insertion angle, and loading direction. Methods: Five finite element models were created using micro-computed tomography (microCT) images of the maxilla and mandible. OMIs were placed at one maxillary and two mandibular positions: between the maxillary second premolar and first molar, between the mandibular second premolar and first molar, and between the mandibular first and second molars. The OMIs were inserted at angles of $45^{\circ}$ and $90^{\circ}$ to the buccal surface of the cortical bone. A bite force of 25 kg was applied to the 10 occlusal contact points of the second premolar, first molar, and second molar. The loading directions were $0^{\circ}$, $5^{\circ}$, and $10^{\circ}$ to the long axis of the tooth. Results: With regard to placement site, the displacement and stress were greatest for the OMI placed between the mandibular first molar and second molar, and smallest for the OMI placed between the maxillary second premolar and first molar. In the mandibular molar region, the angled OMI showed slightly less displacement than the OMI placed at $90^{\circ}$. The maximum Von Mises stress increased with the inclination of the loading direction. Conclusions: These results suggest that placement of OMIs between the second premolar and first molar at $45^{\circ}$ to the cortical bone reduces the effect of bite force on OMIs.

• Restorative Dentistry and Endodontics
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• v.39 no.2
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• pp.132-136
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• 2014

The presence of radix entomolaris (RE) in a mandibular first molar is a common occurrence in certain ethnic groups, but the presence of RE in a mandibular second molar is a rare occurrence. In the present case, RE was identified from preoperative radiographs and confirmed using cone-beam computed tomography (CBCT). The access cavity was modified to locate the RE. Cleaning and shaping were performed with nickel-titanium rotary instruments. Obturation was completed with gutta-percha cones using AH Plus (Dentsply Detrey GmbH) as sealer. From the CBCT axial images, the RE was determined to have a Type III curvature by the De Moor classification, Type B separate RE by the Carlsen and Alexandersen classification, and radiographically, a Type i image by the Wang classification. The presence of RE in the mandibular second molar makes it essential to anticipate and treat the distolingual root canal. This case report highlights the usefulness of CBCT for assessing RE in the mandibular second molar, which can help the clinician in making a confirmatory diagnosis and assessing the morphology of the root canal.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.207-213
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• 1998

Purpose : This study attempted to relate the incidence of fractures at the mandibular angle with the presence and state of eruption of lower third molars, and to find out the real risk factors for angle fractures in the states of lower third molars. Materials and Methods : Medical records and radiographs of 395 patients with mandibular fractures were retrospectively reviewed. The presence and states of third molars were assessed for each patients and related to the occurrence of angle and other mandibular fractures. Results : Of 395 patients with mandibular fractures, 142 had angle fractures. The incidence of angle fractures was found to be significantly greater when partial erupted lower third molars were present and it had a definite role for risk factors for angle fractures. But there were no clear relationship between the incidence of angle fracrtures and states of without, fully erupted lower third molars. Furthermore, the states of patial and unerupted lower third molar had an effect on bony segment displacement. Conclusions : This study provides clinical evidence to suggest that patial erupted third molar teeth weaken the mandibular angle both quantitatively and qualitatively.

• Imaging Science in Dentistry
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• v.45 no.4
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• pp.221-226
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• 2015

Purpose: This study evaluated the prevalence of distolingual roots in mandibular molars among Koreans, the root canal system associated with distolingual roots, and the concurrent appearance of a distolingual root in the mandibular first molar and a C-shaped canal in the mandibular second molar. Materials and Methods: Cone-beam computed tomographic images of 264 patients were screened and examined. Axial sections of 1056 mandibular molars were evaluated to determine the number of roots. The interorifice distances from the distolingual canal to the distobuccal canal were also estimated. Using an image analysis program, the root canal curvature was calculated. Pearson's chi-square test, the paired t-test, one-way analysis of variance, and post-hoc analysis were performed. Results: Distolingual roots were observed in 26.1% of the subjects. In cases where a distolingual root was observed in the mandibular molar, a significant difference was observed in the root canal curvature between the buccolingual and mesiodistal orientations. The maximum root canal curvature was most commonly observed in the mesiodistal orientation in the coronal portion, but in the apical portion, maximum root canal curvature was most often observed in the buccolingual orientation. Conclusion: The canal curvature of distolingual roots was found to be very complex, with a different direction in each portion. No correlation was found between the presence of a distolingual root in the mandibular first molar and the presence of a C-shaped canal in the mandibular second molar.

• 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.