• The Journal of Korean Academy of Prosthodontics
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• v.45 no.2
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• pp.228-239
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• 2007

Statement of problem: Following tooth loss, the edentulous alveolar process of maxilla is affected by irreversible reabsorption process, with progressive sinus pneumatization leads to leaving inadquate bone height for placement of endosseous implants. Grafting the floor of maxillary sinus by sinus lifting surgery and augmentation of autologous bone or alternative bone material is a method of attaining sufficient bone height for maxillary implants placement and has proven to be a highty successful. Purpose: This study was undertaken to clarify the morphometric characteristics of inferior maxillary sinus and alveolar process for installation of implants. Material and method: Nineteen skulls (37 sinuses, 10M / 9F) obtained from the collection of the department of anatomy and cell biology of Hanyang medical school were studied. The mean age of the deceased was 69.9 years (range 44 to 88 years). The distance between alveolar border and inferior sinus margin at each tooth, the height of alveolar process and the thickness of cortical bone of the outer and inner table of alveolar process and the inferior wall of maxillary sinus were measured. Results and Conclusion: 1. The septum of inferior maxillary sinus were observe 28 sides (76.%) and located at the third molar (52.6%) and the second molar (26.3%). The deepest points of inferior border of maxillary sinus were located the first or second molar. The distance between alveolar margin and the deepest point of inferior maxillary sinus is $9.7{\pm}4.9mm$. 2. The length of the outer table of alveolar process were $4.9\sim28.2mm$ and the shortest point was between the first and the second molors. The thickness of them were $0.9\sim3.2mm$. The length of the inner table of alveolar process were $7.4\sim25.8mm$ and the shortest point was between the first and the second molars. The thickness of the were $0.9\sim4.6mm$. The results of this study are useful anatomical data for installing of maxillary implants.

• Journal of Periodontal and Implant Science
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• v.51 no.4
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• pp.285-295
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• 2021

Purpose: The aims of the present study were 1) to quantitatively evaluate the extent of sinus pneumatization and 2) to determine the factors affecting sinus pneumatization. Methods: Based on implant treatment records, a list of patients who underwent implant placement on the posterior maxilla was obtained. Among them, patients with pre-extraction and post-extraction (before implant placement) panoramic radiographs were selected. After excluding radiographs with low resolution and image distortion, the radiographs before and after extraction were superimposed using computer software. Subsequently, the extent of sinus pneumatization (the vertical change of the sinus floor) was measured. Simple and multiple mixed models were used to determine the factors affecting sinus pneumatization. Results: A total of 145 patients were eligible for the present investigation. The average extent of sinus pneumatization was 1.56±3.93 mm at 176 tooth sites. Male sex, single tooth extraction, extraction of an endodontically compromised tooth, a class I root-sinus relationship, and sinus membrane thickening >10 mm favored pneumatization, but without statistical significance. The maxillary second molar presented the greatest pneumatization (2.25±4.39 mm) compared with other tooth types. This finding was confirmed in the multiple mixed model, which demonstrated a statistically significant impact of the extraction of a second molar compared with the extraction of a first premolar. Conclusions: Maxillary sinus pneumatization was 1.56±3.93 mm on average. The extraction of a second molar led to the greatest extent of pneumatization, which should be considered in the treatment plan for this tooth site.

• 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.

• Imaging Science in Dentistry
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• v.39 no.2
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• pp.69-73
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• 2009

Purpose: This study compared panoramic radiography and cone beam computed tomography (CBCT) for evaluating the relationship between the maxillary sinus floor and the roots of maxillary molars. Materials and Methods: Paired panoramic radiographs and CBCT images from 97 subjects were analysed. This analysis classified 388 maxillary molars according to their relationship to the maxillary sinus floor on panoramic radiograph and CBCT. Correlations between these two radiographic techniques were examined. Results: Maxillary molar roots that were separate from the sinus floor showed the same classification in 100% of the cases when using these two imaging techniques. The corresponding percentage for such roots that were in contact with the sinus floor was 75%. When roots overlapped the maxillary sinus floor on panoramic radiographs, only 26.4% of maxillary first molars and 60.0% of second molars showed protrusion of roots into the sinus with CBCT. Conclusion : The results of the study suggest that roots projecting into the sinus on panoramic radiographs require a three-dimensional image in order to analyze the proximity of their apex to the sinus floor. (Korean J Oral Maxillofac Radiol2009; 39 : 69-73)

• The Journal of Advanced Prosthodontics
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• v.12 no.1
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• pp.1-8
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• 2020

PURPOSE. To investigate the influence of crown material (lithium-disilicate, 3Y-TZP zirconia) and abutment type (rigid implant, resin tooth with artificial periodontium) on wear performance of their antagonist teeth and adjacent teeth. MATERIALS AND METHODS. A mandibular left first molar (#36) with adjacent human teeth (mandibular left second premolar: #35, mandibular left second molar: #37) and antagonistic human teeth (maxillary left second premolar: #25, maxillary left first molar: #26, maxillary left second molar: #27) was prepared simulating a section of the jaw. Samples were made with extracted human molars (Reference), crowned implants (Implant), or crowned resin tooth analogues (Tooth). Crowns (tooth #36; n = 16/material) were milled from lithium-disilicate (Li, IPS e.max CAD) or 3Y-TZP zirconia (Zr, IPS e.max ZirCAD, both Ivoclar Vivadent). Thermal cycling and mechanical loading (TCML) in the chewing simulator were applied simulating 15 years of clinical service. Wear traces were analyzed (frequency [n], depth [㎛]) and evaluated using scanning electron pictures. Wear results were compared by one-way-ANOVA and post-hoc-Bonferroni (α = 0.05). RESULTS. After TCML, no visible wear traces were found on Zr. Li showed more wear traces (n = 30-31) than the reference (n = 21). Antagonistic teeth #26 showed more wear traces in contact to both ceramics (n = 27-29) than to the reference (n = 21). Strong wear traces (> 350 ㎛) on antagonists and their adjacent teeth were found only in crowned groups. Abutment type influenced number and depth of wear facets on the antagonistic and adjacent teeth. CONCLUSION. The clinically relevant model with human antagonistic and adjacent teeth allowed for a limited comparison of the wear situation. The total number of wear traces and strong wear on crowns, antagonistic and adjacent teeth were influenced by crown material.

• Journal of Technologic Dentistry
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• v.11 no.1
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• pp.65-70
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• 1989

The development of the lobe pattern in the human dentition plays a part in the form and function of each individual teeth. In order to determin the morphological categories used to describe the occlusal surfaces of the maxillary and mandibular molars, the variation of the developmental grooves which separate each lobe in the molars was examined and analysed. The obtained conclusions were as follow. 1. Most of the maxillary first molars with more distinct and more developmental grooves than the other molars but in most cases of the third molar, a heart-shaped outline due to poorly developed or abscent distolingual cusp was most frequent and in this case the third molar had the 3 cusps separated by the central developmental groove and the buccal developmental groove. 2. In most cases, the mandibular first molar had the 5-cusp type that the groove patter resembles a Y, the second molar the 4-cusp type arranged in such a way that the buccal and lingual developmental grooves meet the central developmental groove at right angle on the occlusal surface and many instances of the mandibular third molars had the 5-cusp thpe with a+groove pattern which separatess the mesiolingual cusp from the distobuccal cusp and the 4-cusp type with a+groove pattern. 3. The maxillary and mandibular third molar were most variable in the developmental groove.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.4
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• pp.213-220
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• 2023

Background: Third molar extraction is the most commonly performed minor oral surgical procedure in outpatient settings and requires regional anesthesia for pain control. Extraction of the maxillary molars commonly requires both posterior superior alveolar nerve block (PSANB) and greater palatine nerve block (GPNB), depending on the nerve innervations of the subject teeth. We aimed to study the effectiveness of PSANB alone in maxillary third molar (MTM) extraction. Methods: A sample size comprising 100 erupted and semi-erupted MTM was selected and subjected to study for extraction. Under strict aseptic conditions, the patients were subjected to the classical local anesthesia technique of PSANB alone with 2% lignocaine hydrochloride and adrenaline 1:80,000. After a latency period of 10 min, objective assessment of the buccal and palatal mucosa was performed. A numerical rating scale and visual analog scale were used. Results: In the post-latency period of 10 min, the depth of anesthesia obtained in our sample on the buccal side extended from the maxillary tuberosity posteriorly to the mesial of the first premolar (15%), second premolar (41%), and first molar (44%). This inferred that anesthesia was effectively high until the first molars and was less effective further anteriorly due to nerve innervation. The depth of anesthesia on the palatal aspect was up to the first molar (33%), second molar (67%), and lateromedially; 6% of the patients received anesthesia only to the alveolar region, whereas 66% received up to 1.5 cm to the mid-palatal raphe. In 5% of the cases, regional anesthesia was re-administered. An additional 1.8 ml PSANB was required in four patients, and another patient was administered a GPNB in addition to the PSANB during the time of extraction and elevation. Conclusion: The results of our study emphasize that PSANB alone is sufficient for the extraction of MTM in most cases, thereby obviating the need for poorly tolerated palatal injections.

• The Journal of the Korean dental association
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• v.56 no.2
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• pp.84-93
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• 2018

Purpose: This study evaluated the apical root canal system of maxillary second molars, in which conventional endodontic treatment had failed. Materials and Methods: One hundred eighteen extracted endodontically failed maxillary second molars were examined to investigate the root canal morphology using clinical photographs. High-resolution cross-sectional images at the 3mm level from the root apices were taken to evaluate the anatomic variations and canal cleanliness. The incidence of anatomic variations and canals containing debris were evaluated statistically. Results: One (0.85%) maxillary second molar had four separate roots, while 52 (44.07%) had three separate roots. The remaining 65 (55.08%) showed 6 different types of fusion in their roots. As the number of fused roots increased from none to three, the incidence of isthmuses in the cross-sectional images increased significantly from 43.40% to 76.92% in 2-root fusion and 88.46% in 3-root fusion. In addition, the occurrence of less-cleansed canals increased from 22.64% to 38.46% and 53.85%, respectively (p<0.05). Sixty four teeth (54.24%) had 3 canals while 38(32.2%) had additional canals; most of them were located in the MB roots (81.58%). Seventy six (64.41%) had isthmuses in the apical region and 58 out of 76 were located in MB roots. Condlusions: Logistic analysis indicated that the less division of roots was associated significantly with the occurrence of insufficient cleaning during endodontic treatment (OR=1.765, p<0.05), while the presence of an additional canal showed no association.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.1
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• pp.63-67
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• 2022

Controversies exist regarding the need for prophylactic extraction of mandibular third molars in patients who plan to undergo orthognathic surgery. An 18-year-old male patient was diagnosed with mandibular prognathism and maxillary retrognathism with mild facial asymmetry. He had a severely damaged mandibular first molar and a horizontally impacted third molar. After extraction of the first molar, the second molar was protracted into the first molar space, and the third molar erupted into the posterior line of occlusion. The orthognathic surgery involved clockwise rotation of the maxillomandibular complex as well as angle shaving and chin border trimming. Patients who are missing or have damaged mandibular molars should be monitored for eruption of third molars to replace the missing posterior tooth regardless of the timing of orthognathic surgery.

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