• The Journal of the Korean dental association
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• v.21 no.6 s.169
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• pp.467-472
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• 1983

Thirty seven human maxillary third mooars were injected with china ink, decalcified, cleared, and used in vitro study to determine the number of root canals the frequency and location of lateral canals, canals per root, and frequency of apical deltas. The results were as follows: 1. Less than half of the examined teeth showed 3 roots and 3 canals. 2. The mesiobuccal root was ound to contain a single primary canal in 65.4% of the teeth examined and two canals in 34.6% of the teeth studed. 3. In mesiobuccal roots with two canals, the separated apical foramen appeared 30.8% of the specimen concerned, but no common apical foramen appeared. 4. Of the 106 canals studied, 46.2% of the canals were found to contain lateral canals and these ramifications were mainly located in the apical third of the root.

• The korean journal of orthodontics
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• v.49 no.3
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• pp.194-201
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• 2019

When a patient shows severe crowding, premolar extraction should be considered to provide required available space for alignment. If the third molars have already erupted and demonstrate a poor prognosis, third molar extraction and distalization of the posterior dentition can be used instead of premolar extraction to obtain space. Interproximal stripping (IPS) may also be used to gain space in cases of crowding. This case report describes the treatment of a 25-year-old man with severe crowding and mild lip protrusion. Although the crowding in the lower arch was severe enough to require first premolar extraction, distalization of the entire lower dentition with orthodontic mini-implants, extraction of the lower third molars, and IPS could successfully resolve the crowding and lip protrusion.

• 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.

• 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.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.1
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• pp.29-37
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• 2022

Background: Pain, edema, and trismus are predictable sequelae for surgical extraction of impacted mandibular third molars (M3M). The present study aimed to compare the anti-phlogistic potential of bromelain and aceclofenac in the reduction of post-surgical sequalae in the extraction of impacted M3M. Method: A randomized controlled, triple-blinded clinical study included 72 patients scheduled for surgical removal of impacted M3M under local anesthesia. Randomization was performed and subjects were equally allocated to groups A (control) and B (study), who intended to receive aceclofenac and bromelain, respectively. The primary outcome variables were pain, edema, and trismus evaluated on postoperative days 2 and 7 and compared with baseline values. The secondary variables evaluated were the quantity of rescue analgesics required and the frequency of adverse effects in both groups for 7 postoperative (PO) days. Data were analyzed with a level of significance of P < 0.05. Results: Group B demonstrated a significant decrease in the severity of edema and trismus compared to group A on both PO days 2 and 7 (P < 0.001). Bromelain demonstrated similar analgesic efficacy with an insignificant difference compared to aceclofenac (P > 0.05). Conclusion: The present study showed that the efficacy of bromelain was comparable to that of aceclofenac in reducing inflammatory complications following surgical removal of impacted M3M. Bromelain can be considered a safe and potent alternative to routinely used aceclofenac when addressing inflammatory outcomes after surgery.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.495-501
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• 2003

Impaction is defined as the cessation of the eruption of the tooth caused by a clinically or radiographically detectable physical barrier in the eruption path or by the ectopic position of tooth germ. Besides the third molars and the maxillary canines, the most common impacted tooth is the second premolar. The overall frequency of premolar impaction has been reported to be 0.5%. In some cases, orthodontic traction and surgical repositioning may be indicated. When impacted second premolar is involved with prolonged retained second primary molar, extraction of primary molar and space maintenance lead to eruption of second premolar. In these cases, all patients visited to department of pediatric dentistry of Kyungpook National University Hospital for the chief complaint of unerupted second premolar. Extraction of prolonged retained second primary molar and space management are tried for spontaneous eruption of impacted second premolar tooth. The results were as follows: 1. When impacted second premolar is involved with prolonged retained second primary molar, minimal treatment via elimination of primary molar leads to successful results. 2. Proper space management and periodic radiographic examination are required before eruption of second premolar. 3. Sufficient time must be allowed for confirm of tooth movement before orthodontic traction or surgical repositioning. 4. The result is more successful in incomplete root development.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.4
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• pp.404-411
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• 2012

Tooth impaction is defined as a failure of tooth eruption resulting from the physical obstacles in the eruption path or the abnormal position of the tooth germ. Impaction of mandibular second molar is relatively rare, and it may incite pathologic conditions such as dental caries, periodontitis, or root resorption of adjacent first molar. Thus, early diagnosis and treatment is recommended. In the first case, a 10-year-old male patient, was treated by brass wire to separate the bilaterally impacted mandibular second molars. In the second case, a 12-year-old female patient, was treated with Humphrey appliance for impacted mandibular left second molar, which was detected during a periodical dental examination. In the third case, a 17-year-old female patient with impacted mandibular right second molar, was treated by uprighting spring with mini-implant anchorage around premolar area. In the last case, an 18-year-old male patient, was treated with mini-implant placed on the ramus of mandible connected to the orthodontic buttons bonded on impacted mandibular left second molar by elastic thread.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.1
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• pp.19-27
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• 2020

Background: Surgical extraction of third molars is associated with postoperative pain and swelling at the extraction site. Pain is commonly managed using non-steroidal anti-inflammatory drugs (NSAIDs). Postoperative pain is usually moderate to severe in the first 12 h postoperatively and lasts for 3-5 days. However, with NSAIDs, these symptoms usually subside within 24 h. Diclofenac sodium and etodolac are NSAIDs, more selectively cyclooxygenase-2 inhibitors, with good analgesic efficacies. Methods: We compared the safety and analgesic efficacy of diclofenac sodium with etodolac peroral after surgical extraction of third molars in a double-blind, double-dummy, parallel-group study. The subjective pain improvement and pain relief after 2, 6, 24, 48, and 72 h using the visual analogue scale were measured as the study outcome. Results: Etodolac was equivalent to diclofenac sodium in pain alleviation at all postoperative time periods. No significant differences were found between diclofenac sodium and etodolac groups (P > 0.05). Both study medications were well tolerated and safe with mild adverse effects in only a few participants. Conclusion: Diclofenac sodium and etodolac are comparable in terms of analgesic efficacy and safety after surgical removal of third molars.

• The korean journal of orthodontics
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• v.23 no.4 s.43
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• pp.493-501
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• 1993

It is the aim of this study to determine the impacts of radicular development of lower third molars on its eruption/impaction and to grope the prediction for eruption and/or impaction in advance. Three hundred and thirty cases of orthopantomogram were employed and classified as mesial root-dominant group, distal root-dominant group and Identical group according to the radicular development of lower third molars. This presentation has carried out the incipient mesial inclination, radicular development, impaction/eruption rate and changes of mesial inclination of the very teeth. Consequently the following summary and conclusions were drawn; Radicular development dominated mesial root than the distal and dominant mesial root invited higher potentialities for normal eruption. The mesial or honzontal impactions were detected on the distal root-dominant group. This analysis has been suggested the potential eruption/impaction of lower third molars were dependent upon the radicular development and the incipient mesial inclination.

• The korean journal of orthodontics
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• v.48 no.6
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• pp.405-411
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• 2018

Objective: This study was performed to investigate the rate of tooth movement and histological characteristics of extraction sockets those were subjected to corticotomy. Methods: A split-mouth randomized controlled trial experiment was designed. Thirty-two adult, male Wistar rats were divided into 2 groups: healing extraction socket (H) and recent extraction socket (R); these groups were randomly classified into 4 subgroups (0/7/21/60 days). The first maxillary molar was extracted on 1 side and 2 months were allowed for complete bone healing; then, the corresponding molar was extracted on the other side and surgical intervention was performed at the mid-alveolar point of the first maxillary molar. Ten grams of continuous force was applied. The outcomes measured were rate of tooth movement, percentage of periodontal space and histological evaluation. The rate of tooth movement was calculated as the measured distance divided by the duration of molar movement. Histomorphometric evaluations were performed on the second and third maxillary molars. The Wilcoxon signed rank test was used to compare differences between the two groups. Results: There were no significant differences in the rates of tooth movement between H and R groups at any of the 4 time points. The histological appearance and percentage of periodontal space between the R and H groups also demonstrated no significant differences. Conclusions: The rates of orthodontic tooth movement into recent and healed socket sites did not differ between the groups. Histological analysis of tooth movement revealed regional acceleration during every time period.