• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.2
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• pp.121-127
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• 2017

Background: There are no studies regarding 4% articaine infiltration injection into the retro-molar area for an impacted lower third molar (LITM) surgery. This study aimed to evaluate the efficacy of infiltration using 1.7 ml (single cartridge: SC) of 4% articaine versus 3.4 ml (double cartridges: DC) of 4% articaine with 1:100,000 epinephrine in LITM surgery. Method: This study involved 30 healthy patients with symmetrical LITM. The patients were assigned to receive either a DC or SC of 4% articaine with 1:100,000 epinephrine as a local anesthetic for each operation. Onset, duration, profoundness, need for additional anesthetic administration, total volume of anesthetic used, vitality of the tooth, and pain score during operation were recorded. Results: The DC of 4 % articaine had a significantly higher success rate (83.3%) than did the SC (53.3%; P<0.05). The duration of soft tissue anesthesia was longer in the DC group. The intra-operative pain was higher in the SC group with a significant (P < 0.05) requirement for a supplementary local anesthetic. Conclusion: We concluded that using DC for the infiltration injection had a higher success rate, longer duration of anesthesia, less intra-operative pain, and a lower amount of additional anesthesia than SC in the surgical removal of LITM. We recommend that a DC of 4% articaine and a 1:100,000 epinephrine infiltration in the retro-molar region can be an alternative anesthetic for LITM surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.5
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• pp.332-336
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• 2012

Purpose: The third molar extraction is one of the mostly performed procedures in the department of oral and maxillofacial surgery. In most of dental clinic or hospital, the third molar extraction used to be frequently performed in an office-based surgery, and most patients did not have specific medical history with young ages. Medical history taking are dependent on the only way by asking to the patients about their individual conditions. Therefore, as the specialists of the oral and maxillofacial surgery in the field of dentistry, we suggest a new policy that the preoperative lab must be performed routinely before extraction of the third molar. Methods: This study is based on 1,096 patients who have been managed with third molar extractions, from March 2008 to September 2011 by a single surgeon. The preoperative lab, including complete blood count, coagulation panel, chemistry and serology, was performed before any surgical procedures. The results were informed to the patients regardless of their abnormalities, and any abnormalities related to the surgical procedures, such as platelet count and coagulation factors, were checked and corrected safely. Results: Through the preoperative blood test, systemic diseases that the patients had not recognized before, such as anemia, leukopenia, fatty liver and chronic renal disease, were identified. Patients with acute or chronic leukemia, Hepatitis B, and HIV positive, were also detected as a small number. Also, the possibilities of the cross-infection between dentists and patients or between patients and patients, and any other emergency situations can be prevented; as well as the public health condition can be improved, too. The patients were satisfied with low cost preventive blood test and high quality of medical services. Conclusion: Therefore, routine medical lab testing, including history taking are needed before an office-based minor surgery, such as third molar extractions, and these results were suggested as a new policy in the field of dentistry.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.1
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• pp.19-25
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• 2018

Background: Third molar extraction is associated with considerable pain and discomfort, which is mostly managed with oral analgesic medication. We assessed the analgesic effect of benzydamine hydrochloride, a topical analgesic oral rinse, for controlling postoperative pain following third molar extraction. Methods: A randomized controlled trial was conducted in 40 patients divided into two groups, for extraction of fully erupted third molar. Groups A received benzydamine hydrochloride mouthwash and group B received normal saline gargle with oral ibuprofen and paracetamol. Oral ibuprofen and paracetamol was the rescue analgesic drug in group A. Patients were evaluated on the $3^{rd}$ and $7^{th}$ post-operative days (POD) for pain using the visual analogue score (VAS), trismus, total number of analgesics consumed, and satisfaction level of patients. Results: The VAS in groups A and B on POD3 and POD7 was $4.55{\pm}2.54$ and $3.95{\pm}1.8$, and $1.2{\pm}1.64$ and $0.95{\pm}1.14$, respectively and was statistically insignificant. The number of analgesics consumed in groups A and B on POD3 ($5.25{\pm}2.22$ and $6.05{\pm}2.43$) was not statistically different from that consumed on POD7 ($9.15{\pm}5.93$ and $10.65{\pm}6.46$). The p values for trismus on POD3 and POD7 were 0.609 and 0.490, respectively and those for patient satisfaction level on POD3 and POD7 were 0.283 and 0.217, respectively. Conclusions: Benzydamine hydrochloride oral rinses do not significantly reduce intake of oral analgesics and are inadequate for pain relief following mandibular third molar extraction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.1
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• pp.57-61
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• 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
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• v.15 no.2
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• pp.69-76
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• 2015

Background: There have been few studies on the effect of an elevated concentration of lidocaine hydrochloride in the surgical removal of an impacted lower third molar. This study aimed to examine the efficacy of 4% lidocaine along with 1:100,000 epinephrine compared to 2% lidocaine along with 1:100,000 epinephrine as inferior alveolar nerve block for the removal of an impacted lower third molar. Methods: This single-blind study involved 31 healthy patients (mean age: 23 y; range: 19-33 y) with symmetrically impacted lower third molars as observed on panoramic radiographs. Volunteers required 2 surgical interventions by the same surgeon with a 3-week washout period. The volunteers were assigned either 4% lidocaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine as local anesthetic during each operation. Results: We recorded the time of administration, need for additional anesthetic administration, total volume of anesthetic used. We found that the patient's preference for either of the 2 types of local anesthetic were significantly different (P < 0.05). However, the extent of pulpal anesthesia, surgical duration, and duration of soft tissue anesthesia were not significantly different. Conclusions: Our study suggested that inferior alveolar nerve block using 4% lidocaine HCl with 1:100,000 epinephrine as a local anesthetic was clinically more effective than that using 2% lidocaine HCl with 1:100,000 epinephrine; the surgical duration was not affected, and no clinically adverse effects were encountered.

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

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.3
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• pp.155-158
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• 2022

Objectives: The aim of this study was to observe the relationship between impacted mandibular third molars and development of temporomandibular joint (TMJ) disorders. Knowledge of the factors that have an adverse effect on the TMJ is necessary for proper diagnosis, treatment, and prognosis of TMJ disorders. Materials and Methods: The study was performed on 80 patients aged between 20 and 60 years with impacted mandibular third molars, over a period of two months. The patients were examined clinically and radiologically to determine the type of impaction and detect the associated TMJ symptoms or disorders. Results: In the 80 patients, 63.8% (51/80) of TMJ disorders were found in the horizontal group, 46.3% (37/80) in the mesioangular group, 42.5% (34/80) in the distoangular group, and 30.0% (24/80) in the vertical group of impacted mandibular third molars. Conclusion: The study concluded that type of impacted mandibular third molar is factor in the development of temporomandibular disorders.

• The Journal of the Korean dental association
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• v.41 no.1 s.404
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• pp.42-47
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• 2003

Dental professions recommend that mandibular impacted third molar be extracted for the prevention of osteomyelities crneoplasm or for the treatment of halitosis. Even the possibility of emergence of unexpected halitosis after the preventive extraction exists, there are few studies describing the unexpected halitosis. This study intended to measure the emergence of halitosis after extraction of mandibular impacted third molar. Thirty-eight patients who visited Daejin Medical Center participated in this study. Halitosis was objectively measured using Halimeter in 3 intervals-before, after I day, after 7 days. Third factors, scaling and gender, which may influence the halitosis were analyzed with stratification. This study finds that in general halitosis decreased after 1 day but increased after 7 days. Scaling was helpful in decreasing halitosis and women have less severe halitosis than men. The effects of time interval(p<0.05), gender(p=0.836), and scaling(p=0.7929) on the severity of halitosis were not statistically significant. However, since this study's patients are neither a representative sample nor a random sample, all data interpretation was focused on clinical significance instead of conventional statistical significance. Clinical significance of this study's findings are: 1) scaling should be conducted in advance, 2) men should be notified of the higher possibility of halitosis.

• The Journal of the Korean dental association
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• v.4 no.1
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• pp.41-43
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• 1963

A rare case of a fused teeth on the side of upper left third molar was observed from a 28 years old Korean male. The characteristics were as follows: 1)The upper third molar fusrd with the suppernumerary tooth .2)The crown part of the fused teeth were separated and the root were fused. 3)On the x-ray finding. the pulp chamber was two , but it had only one pulp canal.

• The korean journal of orthodontics
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• v.24 no.3 s.46
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• pp.695-707
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• 1994

This study investigates the effects of third molar on the occlusal plane in Angle's class El malocclusion with possibilities of posterior crowding and the interrelationships of occlusal plane inclinations to other skeletal patterns. Above investigations might showed that considerations should be given to third molars with possibilities of posterior crowding in establishing diagnosis and treatment plans for Angle's class III malocclusion patients. The following conclusions were obtained 1. In events of third molars causing possible posterior crowding, maxillary third molars showed more mesial inclinations than second molars, and compared to those with third molar missing cases, first molars were more mesially inclined and displaced more inferiorly from the palatal plane and OP-MP was increase , thus the occlusal plane was less steep. 2. In events of third molars causing possible posterior crowding, the anglulation between AB line and mandibular plane was decreased and ANB showed negative values. Thus chin points were more protruded, ramus were more anteriorly displaced, and increase in lower facial height, genial angle, effective mandibular length and mandibular plane angle were observed. This in all caused more vertical opening and more severe skeletal disturbance. 3. OP-MP was increased as the maxillary first molars were more inferiorly displaced from the palatal plane. As this angle was increased mandibular planes were more inferiorly inclined and LFH, genial angle, effective mandibular length were more increased and mandibular ramus was more anteriorly placed. 4. As the maxillary first molars were more inferiorly placed from the palatal plane, more increased OP-MP/PP-MP ratio made the occlusal plane less steep. As OP-MP/PP-MP was increased, mandibular ramus was more anteriorly placed and made longer, and facial angle and effective mandibular length were increased.