• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.1
• /
• pp.57-61
• /
• 2010

In the presence of acute pericoronitis of mandilbular third molar, antibiotic therapy and early incision and drainage are the method of choice, followed by definitive surgical extraction of the tooth as soon as it becomes subacute. If excision of the overlying tissues is decided on, it should be done adequately. All overlying tissues must be throughly excised, and the crown portion of the unerupted tooth should be completely exposed. After excision has been completed, the wound should be managed with a surgical dressing. This should be allowed to remain approximately 7 days. And then, surgical extraction of the impacted mandibular third molar can be done usually. In this operation, there are many complications, such as, postoperative bleeding, infection, trismus, dysphasia and paresthesia. The surgeon are discredited and medicolegal problem may be occurred in the presence of many distressed complications. Therefore, the relatively nonsurgical treatment is the method of choice. So, authors selected the conservative treatment methods of incision and drainage, primary endodontic drainage, operculectomy without surgical extraction of the mandibular third molars. The results were more favorable without the postoperative complication in Wonju old offender prison.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.19 no.4
• /
• pp.201-208
• /
• 2019

Background: After tooth extraction, pain due to dry socket and pain in the adjacent tooth are common. The aim of this study was to retrospectively analyze pain in the adjacent tooth after surgical extraction of the mandibular third molar. Methods: Postoperative pain due to dry socket, pain in the adjacent tooth, and pain from other causes were present. Group A included patents with dry socket alone; group B included patients with pain in the adjacent tooth alone; and group C included patients with both. The duration of symptoms was recorded. In addition, the prognosis of pain was divided into the complete improvement, improvement, maintenance, deterioration, and complete deterioration groups. Results: A total of 312 mandibular third molars were extracted from 13, 60, and 10 patients in groups A, B, and C, respectively. The mean duration of symptoms was 5 days in group A and B and 15.2 days in group C. There were statistically significant differences in the duration of symptoms between groups A and C and groups B and C. Conclusion: Pain in the adjacent tooth after third molar extraction can be caused by inflammatory reactions and pressure on this tooth. The pain caused by pressure on the periodontal ligament and alveolar bone results from the cytokines released by osteoclasts, which are responsible for bone destruction. However, pain from periodontal ligament damage caused by excessive pressure may be misunderstood as pulpal pain. Unconscious parafunctional habits, such as clenching and bruxism, could also be associated with post-extraction pain.

• The Journal of the Korean dental association
• /
• v.10 no.2
• /
• pp.129-130
• /
• 1972

The author have observed a case of supernumerary molar occurred in the buccally between second and third molar of the mandibular in 38 years old. The macroscopical findings were resembled to small second lower premalar.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.17 no.1
• /
• pp.163-171
• /
• 1987

The author has clinically and radiologically investigated 57 cases of odontogenic keratocyst in 47 patients consisted of 26 males and 21 females aged from.2 to 63 years, who were pathologically diagnosed as odontogenic keratocyst at infirmaries of dental colleges, Yonsei University and Seoul national university during 1965-1986. The results were as follows: 1. The peak incidence of the disease was on their teenagers (29.8%). The ratio of Male/Female was 1.23:1 and incidence rate of males showed higher than their counterpart. 2. The most frequent complaints were swelling in (65.9%) followed by pus discharge, unknown mass, pain, residual root. 3. The most common site was mandibular third molar and mandibular ramus region (15.8%) followed by mandibular body and ramus, mandibular third molar, mandibular anterior teeth. Incidence of this disease in mandible was higher than in maxilla. 4. The lesions not associated with adjacent teeth were (14.0%) and in the lesions associated with adjacent teeth (35.1%) showed root resorption, (50.9%) were without root resorption, (35.1%) showed tooth migration and (50.9%) were without tooth migration. 5. The border types of the lesions were scalloped type in (52.6%), smooth type in (47.4%) and morphological type were unilocular in (50.9%), multilocular in (49.1%). 6. The radiologic cyst type of the lesions were follicular type (42.1%) followed by primordial, unclassified odontogenic, residual, lateral periodontal, median mandibular, globulomaxillary type.

• Restorative Dentistry and Endodontics
• /
• v.49 no.1
• /
• pp.2.1-2.12
• /
• 2024

Objectives: This study aimed to determine the effects of 1-rooted mandibular second molar (MnSM) teeth on root canal anatomy complexities of the mandibular central incisor (MnCI), mandibular lateral incisor (MnLI), mandibular canine (MnCn), mandibular first premolar (MnFP), mandibular second premolar (MnSP), and mandibular first molar (MnFM) teeth. Materials and Methods: Cone-beam computed tomography images of 600 patients with full lower dentition were examined. Individuals with 1-rooted MnSMs were determined, and the complexity of root canal anatomy of other teeth was compared with individuals without 1-rooted MnSMs (Group-1; subjects with at least one 1-rooted MnSM, Group-2; subjects with more than a single root in both MnSMs). A second canal in MnCIs, MnLIs, MnCns, MnFPs, and MnSPs indicated a complicated root canal. The presence of a third root in MnFMs was recorded as complicated. Results: The prevalence of 1-rooted MnSMs was 12.2%, with the C-shaped root type being the most prevalent (9%). There were fewer complicated root canals in MnCIs (p = 0.02), MnLIs (p < 0.001), and MnFPs (p < 0.001) in Group 1. The other teeth showed no difference between the groups (p > 0.05). According to logistic regression analysis, 1-rooted right MnSMs had a negative effect on having complex canal systems of MnLIs and MnFPs. Left MnSMs were explanatory variables on left MnLIs and both MnFPs. Conclusions: In individuals with single-rooted MnSMs, a less complicated root canal system was observed in all teeth except the MnFMs.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.27 no.6
• /
• pp.560-564
• /
• 2001

The experienced surgeon can be surprised & challenged by the hazards of active bleeding during oral & maxillofacial surgical procedure, because of alterations in the surgical anatomy, bleeding disorders and surgical intervention of infected tissues. This is a report of two cases of active bleeding during surgical extraction of mandibular third molar, that had the pericoronitis, osteitis and adjacent neurovascular bundle in its apex. When the abrupt active bleeding was occurred during surgical extraction of mandibular third molar, pressure packing by hemostatie agent(bone wax) & wet gauze biting were applied into the extraction socket during 30 minutes. After 30 minutes, the wound was explored about the bleeding and active bleeding was then continued. In spite of repeated bleeding control method of the pressure dressing, the marked hemorrhage was generated continuously. Therefore, the author decised the bleeding as immediately uncontrollable hemorrhage and the pressure dressing was again applied for the more longer duration without wound closure. After 3 days, the pressure dressing was removed and iodoform gauze drainge was then established without the bleeding. The drain was changed as the interval of 3~5 days for prevention of infection & secondary hemorrhage and relatively good wound healing was then resulted in 6 weeks.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.29 no.3
• /
• pp.157-162
• /
• 2003

Background : The surgical removal of impacted mandibular third molar can result in considerable pain, swelling, and dysfunction that patient are incapable of work for several days. Factors contributing to post operative swelling, trismus and pain are complex. There is no question but that the procedure of surgically removing an impacted mandibular third molar is inherently a traumatic one and that some sequelae related to the inflammation response are expected. Meticulous surgical technique will minimize the sequelae of inflammation but will not prevent them. In an effort to minimize these sequelae the use of steroid was instituted. Patients and Methods : Present study was to investigate the effect of one preoperative steroid injection in the masseter muscle to the patients(male 9, female 11) who needed prophylactic removal of bilateral, symmetrical, impacted wisdom teeth in the mandible on the complaint like swelling, trismus and pain. through Double-Blind test. Results : 1. After 24 hours investigation, preoperative steroid injection had significantly reduced swelling with 39% and trismus with 57.5%. 2. $7^{th}$ post operative day investigation, reduced swelling and trismus had shown, however, not significant. 3. There wasn't major difference from the group who took preve-ntive steroid in the visual analogue scale, the first analgesic intake time and the pain period. 4. There wasn't any adverse reaction of steroid for 20 patient From the above result, If the patients are not contraindication to steroid and pronounced post operative reaction can be expected the use of steroid to the surgical removal of impacted mandibular third molar is recommended.

• Imaging Science in Dentistry
• /
• v.51 no.1
• /
• pp.9-16
• /
• 2021

Purpose: The purpose of this study was to analyze the reliability of 7 panoramic radiographic signs for predicting proximity of the root apices of mandibular third molars to the mandibular canal using cone-beam computed tomography and to correlate these findings with the Pell and Gregory and the Winter classification systems. Materials and Methods: An observational, cross-sectional, descriptive study was conducted on 74 patients with bilateral impacted mandibular third molars. Four panoramic radiographic signs were observed in the tooth root (darkening, deflection, and narrowing of the root apices, and bifid apices), and another 3 in the mandibular canal (diversion, narrowing, and interruption of the mandibular canal). Cone-beam computed tomography images were analyzed to identify disruption and diversion of the mandibular canal and root deflection. Results: Binary logistic regression showed that only 4 of the 7 panoramic radiographic signs were able to predict proximity of the root apices of the mandibular third molars to the mandibular canal: darkening of the root, deflection of the root, narrowing of the root, and interruption of the mandibular canal(P<0.05). Conclusion: Darkening, deflection, and narrowing of the root, in tandem with the interruption of the mandibular canal on panoramic radiographs, indicate that cone-beam computed tomography should be performed when planning the extraction of impacted mandibular third molars. Proximity between mandibular third molars and the mandibular canal is correlated with the Winter classification.

• Journal of Periodontal and Implant Science
• /
• v.36 no.2
• /
• pp.489-502
• /
• 2006

The purpose of this study was to determine the relationship between the third molar and periodontal status of the adjacent second molar. Fifty patients who had four maxillary and mandibular second molars were consecutively selected for the study subjects. The subjects provided a total of 200 molars, i. e., 100 maxillary and 100 mandibular molars, and classified the groups as follows; third molars that are normally erupted are control group, that are impacted are test 1 group, that are simply extracted are test 2 group, that are surgically extracted are test 3 group. Probing depth, plaque index, gingival index and mobility were measured. The results were as follows. 1. In mesial probing depth, there was no significantly difference. In distal probing depth, there was a significantly difference between control group and test 1 & 3 group in maxilla and between control & test 2 group and test 1& 3 group in mandible(p<0.05). 2. In buccal probing depth, there was a significantly difference between test 2 group and test 3 group in mandible. In lingual probing depth, there was a significantly difference between control group and test 1 & 3 group in mandible(p<0.05). 3. In plaque index, there was a significantly difference between test 1 group and test 2 group in maxilla, between test 1 group and control & test 2 group in mandible(p<0.05). 4. In gingival index, there was a significantly difference between control group and test 1 & 3 group in mandible. In mobility, there was no significantly difference(p<0.05). As a result of this study, the second molars adjacent to the third molars that are impacted or surgically extracted had poor prognosis, so impacted third molars should be extracted in early time and the second molars are actively treated for periodontal health.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.50 no.1
• /
• pp.27-34
• /
• 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.