• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권5호
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• pp.341-350
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• 2021

Dexamethasone has been used in oral and maxillofacial surgery for postoperative pain, swelling, and trismus following third molar surgeries. It is a potent and powerful drug that can alleviate the aforementioned postoperative sequelae. Dexamethasone is responsible for inhibiting the release of inflammatory mediators in the inflammation process to improve patient quality of life after surgical intervention. There are several available routes of administering dexamethasone. This article will help determine the suggested routes of administration, dosage, parameters, and dexamethasone timing for third molar surgeries.

• Imaging Science in Dentistry
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• 제52권2호
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• pp.231-238
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• 2022

Intraosseous xanthoma of the mandible is a rare benign disorder. A 17-year-old male patient presented with a suspected abscess in the right mandibular third molar, detected on a panoramic radiograph. The patient had no history of systemic or lipid-related metabolic diseases and complained of no specific symptoms or pain. A radiographic examination revealed a heterogeneous radiolucency extending from the apical to the distal aspect of the right mandibular third molar tooth germ. The lesion measured 9 × 16 × 24 mm (antero-posterior × mediolateral × supero-inferior) and showed a relatively well-defined, multilocular, foamy appearance with hyperostotic borders spreading to the inferior alveolar nerve canal. After excisional biopsy, a diagnosis of central xanthoma was made. The lesion recurred, and intraoral vertical ramus osteotomy was done near the lesion. For the treatment of xanthoma of the mandible, extensive and delicate surgical treatment under general anesthesia should be considered.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권5호
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• pp.464-473
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• 2006

Purpose: This study was performed to evaluate relationship between the inferior alveolar nerve injury and the findings of panoramic and tomographic images for preventing inferior alveolar nerve injury after the 3rd molar extraction. Material and Method: From April, 2005 to June, 2005, The 190 patients who visited in the Department of Oral and Maxillofacia Surgery, Chonnam National University Hospital and the panoramic radiographies were taken for extraction of the mandibular third molar, was selected. Among 215 mandibular third molars, Scanora tomographic imagings were taken in the 90 teeth which were overlaped to the mandibular canal in the panoramic imagies. In panoramic radiographies, the angulation, the level, the root morphology, and the superimposition sign of the mandibular third molars with the mandibular canal were evaluated. In the tomographic radiographies, the location and distance of the mandibular third molar from the canal were also evaluated. The relationships between these findings and the inferior alveolar nerve injury were examined. Results: In the panoramic findings, the inferior alveolar nerve injuries were occurred in the darkened roots (5 molars, 7%), the uncontinuous radiopaque image (3 molars, 7%), and the depositioned mandibular canal (2 molars, 10%). In the tomographic findings of 90 molars, 20 molars also had the superimposition imagies. Five molars in those molars (25%) had the inferior alveolar nerve injury after extraction. There were 10 patients who had the inferior alveolar nerve injury. The sensory was began to be recovered in 9 patients, except 1 patient, within 2 weeks, then fully recovered within 3 months. Conclusion: These results indicate that the depth mandibular third molar and the superimposition sign may be related with the risk of the inferior alveolar nerve injury after extraction.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.40.1-40.7
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• 2019

Background: Through the analysis of clinical data, we attempted to investigate the etiology and determine the risk of severe iatrogenic lingual nerve injuries in the removal of the mandibular third molar. Methods: A retrospective chart review was performed for patients who had undergone microsurgical repair of lingual nerve injuries. The following data were collected and analyzed: patient sex, age, nerve injury side, type of impaction (Winter's classification, Pell and Gregory's classification). Ratios for the respective lingual nerve injury group data were compared with the ratios of the respective data for the control group, which consisted of data collected from the literature. The data for the control group included previous patients that encountered various complications during the removal of the mandibular third molar. Results: The lingual nerve injury group consisted of 24 males and 58 females. The rate of female patients with iatrogenic lingual nerve injuries was significantly higher than the control groups. Ages ranged from 15 to 67 years, with a mean age of 36.5 years old. Lingual nerve injury was significantly higher in the patient versus the control groups in age. The lingual nerve injury was on the right side in 46 and on the left side in 36 patients. There was no significant difference for the injury side. The distoangular and horizontal ratios were the highest in our lingual nerve injury group. The distoangular impaction rate in our lingual nerve injury group was significantly higher than the rate for the control groups. Conclusion: Distoangular impaction of the mandibular third molar in female patients in their 30s, 40s, and 50s may be a higher risk factor of severe lingual nerve injury in the removal of mandibular third molars.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권1호
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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.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권6호
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• pp.339-347
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• 2018

Background: There are many techniques of inferior alveolar nerve block injection (IANBI); one among them is the computer-assisted intraosseous injection (CAIOI). Here we aim to evaluate the effectiveness of CAIOI with $Quicksleeper^{(R)}$ in mandibular third molar surgery. Methods: This study is a clinical, single-blind, randomized, split-mouth, controlled trial including 25 patients (10 males and 15 females, mean age 21 years). The patients underwent surgical removal of bilateral mandibular third molars with two different IANBI techniques. One side was injected using $Quicksleeper^{(R)}$, and the other side was injected using a conventional IANBI. Both techniques used one cartridge (1.7 ml) of 1:100,000 epinephrine 4% articaine. A supplementary injection was used if necessary. All volumes of anesthetic agent used were recorded. Statistical analysis was performed using paired t-test and Wilcoxon test. Results: This research showed that CAIOI has faster onset and shorter duration of action than IANBI (P < 0.05). The pain was similar in both techniques. In the CAIOI group, one-third of the cases could be completed without additional anesthesia. The remaining two-thirds required minimal supplementary volume of anesthesia. The success rates were 68% for CAIOI and 72% for IANBI, respectively. Conclusion: CAIOI is an advantageous anesthetic technique. It can be used as an alternative to conventional IANBI for mandibular third molar surgery.

• 대한치과의사협회지
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• 제19권2호통권141호
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• pp.181-185
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• 1981

In this study an attempt has been made to throw some light on the problem of the mandibular third molar on measurement made from 302 orthopantomograms of patients at the age of 8 to 20 years. The following conclusions were drawn on the basis of the present study. 1. The amount of growth from the lower first molar to the anterior border of the ramus from 8 years to 14 years was 7.9mm in the male and 7.5mm in the female. The growth from 15years 20 years was 4.5mm in the male and 2.6mm in the female. 2. The growth from the lower first molar to the posterior border of the ramus from 8 years to 14 years was 10mm in the male and 9.8mm in the female. The growth occurred after that was 5.8mm in the male and 2.0mm in the female. 3. The difference between A and C measurements for the various age groups remained fairly constant in the male and female.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권3호
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• pp.238-243
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• 2001

Purpose : The purpose of this study was to determine radiologic variables affecting extraction of impacted mandibular third molar. Materials and Methods : This study was investigated on 44 consecutive extractions of unilateral impacted mandibular third molars (Male;34, Female;10, Mean age;24.98, Age range;19-35). Fourteen radiologic variables, which were actual value except only one, were evaluated to establish their relation to the operation time. The Pearson correlation coefficient and Stepwise procedures for regression analysis were carried out. Results : Eight variables (depth, angulation, ramus width, relationship to the second molar, distal ramus depth, mesial ramus depth, mesial periodontal ligament width and follicle) showed a statistically significant relation to the operation time(Pearson correlation coefficient, p<0.05). Two variables, depth and mesial periodontal ligament width, showed the most powerful and just relation to the operation time($r^2$ = 0.349, p<0.05). Conclusion : This study shows that our results can help general practioner to estimate the operation time of extraction of impacted mandibular third molars by measuring two radiologic variables ; depth and mesial periondontal ligament width.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.29.1-29.10
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• 2019

Background: Reduction in postoperative complications is of vital considerations in impacted third molar teeth surgery. The aim of this study was to compare postoperative complications of impacted third molar surgeries for bone removal using laser, piezoelectric equipment, and conventional rotary instruments. Methods: To address the research purpose, the investigator designed the prospective double-blind clinical trial study. The sample size was determined 20 (40 teeth) by sampling formula in any kind of operation. The data of patients were obtained in the different periods in terms of pain, trismus, swelling, ecchymosis, and patient's satisfaction and then analyzed using SPSS 20 software via paired t test and Wilcoxon and McNemar's tests. Results: The pain immediately after surgery and 2 days and 7 days after surgery was higher in the laser group. The swelling immediately after surgery was more in the laser group but not significant. The amount of mouth opening immediately after surgery and 2 days and 7 days after surgery was significantly lower in the laser group than in the piezosurgery group. The total duration of surgery and duration of osteotomy were significantly longer in the laser group. The patient's satisfaction from surgery with piezosurgery was more than that with laser, but this difference was not significant. Conclusion: Due to the rising demand for impacted wisdom tooth surgery, the present study suggests that hard tissue laser surgery and piezosurgery can clear the future of impacted molar surgery, and these approaches are more efficient in reducing postoperative complications compared to the conventional surgeries.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권4호
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• pp.171-183
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• 2023

Objectives: Understanding the lingual nerve's precise location is crucial to prevent iatrogenic injury. This systematic review seeks to determine the lingual nerve's most probable topographical location in the posterior mandible. Materials and Methods: Two electronic databases were searched, identifying studies reporting the lingual nerve's position in the posterior mandible. Anatomical data in the vertical and horizontal dimensions at the retromolar and molar regions were collected for meta-analyses. Results: Of the 2,700 unique records identified, 18 studies were included in this review. In the vertical plane, 8.8% (95% confidence interval [CI], 1.0%-21.7%) and 6.3% (95% CI, 1.9%-12.5%) of the lingual nerves coursed above the alveolar crest at the retromolar and third molar regions. The mean vertical distance between the nerve and the alveolar crest ranged from 12.10 to 4.32 mm at the first to third molar regions. In the horizontal plane, 19.9% (95% CI, 0.0%-62.7%) and 35.2% (95% CI, 13.0%-61.1%) of the lingual nerves were in contact with the lingual plate at the retromolar and third molar regions. Conclusion: This systematic review mapped out the anatomical location of the lingual nerve in the posterior mandible, highlighting regions that warrant additional caution during surgeries to avoid iatrogenic lingual nerve injuries.