• Title/Summary/Keyword: Second molar impaction

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DIAGNOSIS AND TREATMENT PLAN OF MAXILLARY IMPACTED CANINE (상악매복견치의 진단 및 처치)

  • Kyung, Seung-Hyun;Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.23 no.2 s.41
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    • pp.165-177
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    • 1993
  • Upper canine is important because it protects and maintains the stability of the dental arch and also, joins the anterior with the posterior teeth. The incidence of impaction of upper canine is the second most frequent next to the third molar because it takes a long period of time to develop, and has a complicated path of eruption, and erupts lately. After the age of 10, clinical and radioglaphic examination can be used in revealing the possibility of impaction and efforts should be put to reduce the side effects. To prevent impaction, selective extraction of primary canine at the age of 8 to 9 could be considered and prolonged retention of primary canine in oral cavity should be avoided at this time. Once the impaction is iden, the first stage of the treatment is to lcocalize the lesion by radiographic examination and According to the severity, orthodontic traction or autotransplantation should be considered and comprehensive diagnosis and treatment plan of malocclusion should be established. Generally, labial impaction is due to arch length discrepancy and palatal impaction is due to malposition or morphologic pathosis of lateral incisors rather than arch length discrepancy. In surgical procedure, peridontal problems should be considered and the minimum amount of bone and soft tissue should be reduced and direct bonding method of many attachment methods should be recommended. Especially in traction of labially impacted canine, it should be guided to erupt through the keratinized zone and proper forced magnitude should be applied. The importance of periodontal condition should always be in mind following the patient education to mintain the good oral hygiene at each stage of treatment. Properly managed impacted canine can provide function and esthetic by proper diagnosis and treatment if extraction of canine is not indicated.

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Squamous Cell Carcinoma In Palatal Gingiva. A Case Report (상악 구개부 치은에 발생한 편평상피세포암의 증례보고)

  • Kim, Ok-Su;Chung, Hyun-Ju
    • Journal of Periodontal and Implant Science
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    • v.26 no.1
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    • pp.309-316
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    • 1996
  • Squamous cell carcinoma is the most common malignant tumor of the gingiva. Oral cancer accounts for 5 percent of all malignant tumors in the body, and 6 percent of these occur in the gingiva. We present one case of squamous cell carcinoma of the gingiva in 23-year-old female. She complained of gingival swelling and pain during mastication between left maxillary first molar and second molar. Since she had received scaling 2 years ago, food impaction occurred frequently in this site and an ulcerative lesion recurred several times. When she was referred from local clinic, she had a large, irregularly ulcerated lesion of palatal gingiva between left maxillary first molar and second molar, accompanying induration in center and slight elevation around ulcerative margin. The etiology could not be defined but we could diagnose by careful history taking and excisional biopsy of the recurrent ulcerative lesion. In addition, computed tomography and nuclear medicine imaging were undertaken. As a result, we finally diagnosed as moderately differentiated squamous cell carcinoma without metastases. It is concluded that if ulcerations do not respond to therapy in the usual manner, it should be biopsed and histologically evaluated for the definitive diagnosis and treatment.

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MANAGEMENT OF ECTOPICALLY ERUPTING PERMANENT MOLARS BY THE DEGREE OF IMPACTION (매복 정도에 따른 대구치 이소맹출의 치험례)

  • Lee, Ji-Hyun;Kim, Ji-Yeon;Park, Ki-Tae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.136-142
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    • 2010
  • Ectopic eruption is defined as the eruption of the tooth in an abnormal position or orientation. In the molar region, ectopic eruption may cause distal root resorption and premature exfoliation of the neighbor teeth and uncontrolled space loss is followed. Prolonged partial impaction of the permanent molar may also cause undetected caries or abscess formation of the neighbor teeth. While 66% of ectopically erupting permanent molars are corrected spontaneously without treatment, the treatment is necessary for the irreversible ectopic eruption cases. The optimal treatment approach depends on a number of factors including the clinical eruption status of the molar, amount of enamel ledge and the mobility of the neighbor tooth, and the presence of pain or infection. This case report presents the results of treatment of the ectopically erupting maxillary first permanent molars and mandibular second molars using elastic separators or modified Halterman appliance with or without surgical approach.

Orthodontic upright treatment for mesioangular impacted lower second molar (근심경사 매복된 하악 제2대구치의 직립 치료)

  • Choi, Baekgue;Jeong, Dongkee;Lim, Sunghoon;Gang, Sungnam
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.1
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    • pp.25-33
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    • 2017
  • The lower $2^{nd}$ molar eruption is beginning to mesiolingually, then rotate to distobuccally so it has a tendency to be tilted and impacted mesially. Signs and symptoms of impacted $2^{nd}$ molar are similar to impacted $3^{rd}$ molar's. However, treatment plan for impacted $2^{nd}$ molar is different from that of impacted $3^{rd}$'s. The former is the preservation and uprighting of $2^{nd}$ molar so that it could act to recovery of mastication, symmetrical facial growth, maintaining the symmetry of dental arch, stable occlusion, while the latter is the extraction of tooth. If the uprighting treatment is planned, most proper protocol of treatment and the additional treatment opition should be applied with consideration for it's crown exposure, present of $3^{rd}$ molar which interrupt the uprighting process, extrusion of opposite tooth. Although it could not improve the esthetic result, it could prevent many dental problems. Therefore, uprighting for impacted lower $2^{nd}$ molar is meaningful treatment.

Cantilever-Type Traction Appliance for Mandibular First Permanent Molars with Eruption Disturbances (하악 제1대구치 맹출 장애에서 Cantilever-Type의 견인 장치를 활용한 맹출 유도)

  • Lim, Heejung;Lee, Eungyung;Jeong, Taesung;Shin, Jonghyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.2
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    • pp.229-236
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    • 2021
  • Eruption disturbances of the mandibular first molars can cause multiple problems in occlusal development although they are extremely rare. Early diagnosis and treatment are very important to prevent complications associated with eruption disturbances. The present case report describes the treatment of two cases of eruption disturbances of the mandibular first permanent molar. A fixed appliance composed of a cantilever spring with mandibular second deciduous molar as an anchor tooth was used to tract the impacted mandibular first permanent molar. The success of both cases shows that this novel traction appliance can be used to induce the eruption of an impacted mandibular first permanent molar within a short time in patients with intact mandibular second deciduous molar as an anchor tooth.

Relationship between Interdental Papilla Existence & Distance from Interdental Alveolar Crest to Contact Point in the Posterior Dentition of Korean adults (한국인 구치열에서 치간유두 존재와 치아접촉점과 치간골 거리와의 관계)

  • Kim, Hyun-Chul;Jeon, Yong-Seon;Chang, Moon-Taek;Kim, Hyung-Seop;Park, Jung-Mi
    • Journal of Periodontal and Implant Science
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    • v.31 no.3
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    • pp.625-631
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    • 2001
  • The anatomic structure around interproximal area plays an important role not only in the natural teeth, but also in the implant. The loss of papilla can lead to cosmetic deformity, phonetic problem, food impaction on the anterior dentition, and masticatory problem, food impaction and proximal caries on the posterior dentition. The purpose of this study was to evaluate the relationship between interdental papilla existence and distance from contact point to alveolar crest in Korean posteior dentition. 45 Korean adult patients(31males, 14 females) participated in this study. Measurements were carreid out total 126 interproximal areas, 18 first premolar, 31 second premolar, 40 first molar, and 37 second molar areas. Papilla index was recorded as suggested by Jemt. Distance between contact point and alveolar crest measrued by Florida $probe^{R}$, after flap elevation. Each distance was measured 10 times by every 0.1mm unit. The results showed that the mean Papilla index 1.37 and mean distance between contact point and alveolar crest was 7.44mm. The correlation between the Papilla index and distance was high negative correlation(Pearson correlation=-0.47), and it was statistically significant(P=0.000) When the distance between contact point and alveolar crest was 5mm, the loss of papilla was appeared almost in half cases. When the distance was 6mm, the papilla loss was present 95%, when 7mm, the papilla loss was 100%.

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UNERUPTED PRIMARY MOLAR (미맹출 유구치에 관한 증례)

  • Han, Yeon-Sun;Choi, Byung-Jai;Kim, Seong-Oh;Lee, Chong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.3
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    • pp.444-449
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    • 2002
  • The term 'impaction' is used to designate a tooth which remains unerupted in the jaw beyond the time at which it should normally be erupted. The main causal factors are local (lack of space, ectopic positions of teeth, supernumerary teeth, cyst, the occurrence of infectious process in the eruption path, traumatic facial injury etc.). Systemic and genetic disorders, however, may have primary failure of eruption and retarded eruption as additional symptoms (cleidocranial dysplasia, osteopetrosis etc.). Most cases of impacted teeth reported in the literature are of permanent teeth. The absence of primary teeth occur rarely whereas impaction of second primary molars is more numerous than all other impactions. Impaction due to primary failure of eruption must be distinguished from the secondary infraocclusion. The etiology of impaction of primary teeth is probably related to early ankylosis of primary teeth, but it is not clear. Failure of eruption of primary teeth may cause a number of complications, such as interference with development and eruption of succedaneous teeth, formation of cyst, and damage to adjacent teeth. This study is to report cases of primary failure of eruption in the primary dentition.

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CORRECTION OF ECTOPIC ERUPTION WITH BILATERAL ANCHORAGE : REPORT OF CASES (양측성 고정원을 이용한 이소 맹출의 치료에 대한 증례 보고)

  • Ahn, Sung-Ihn;Shun, Ye-Kyung;Shim, Youn-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.2
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    • pp.446-452
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    • 1999
  • Ectopic eruption of the first permanent molar means the first permanent molar assumes an atypical path of eruption resulting in premature atypical resorption of the second primary molar. If the reversible eruption does not occur, early loss of the second primary molars results in space loss, mesial tipping of the first permanent molar, impaction of the second premolar, buccal segment crowding and overeruption of opposing tooth. The main objectives of treatment are (1) to prevent loss of the second deciduous molars so it can continue to serve as a space maintainer and (2) to regain lost arch length, allowing the second premolar to erupt into normal position. The optimal treatment approach depends on a number of factors including the clinical eruption status of /6/, the change in position of /6/, the amount of enamel ledge of /E/ entrapping /6/, the mobility of /E/, and the presence of pain or infection. Unilateral appliance to correct the mesial angulation of ectopic permanent first molars, as in the majority of the appliance designs, would produce a resultant force that would further enhance the space loss. A bilateral support similar to the holding arch design is recommended to maximize the anchorage. These case reports present the successful result of preserving space for the second premolar in treatment of ectopic eruption of the first permanent molar using Halterman appliance with bilateral anchorage on patients visiting department of pediatric dentistry in Samsung Medical Center.

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Risk factors for external root resorption of maxillary second molars associated with third molars

  • Choi, Jinwoo
    • Imaging Science in Dentistry
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    • v.52 no.3
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    • pp.289-294
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    • 2022
  • Purpose: This study aimed to evaluate the diagnostic performance of panoramic images compared to cone-beam computed tomography (CBCT) imaging for maxillary third molar (M3)-associated external root resorption (ERR), and to identify the risk factors of ERR on panoramic images. Materials and Methods: The study population was composed of all patients who underwent panoramic imaging at Dankook University Dental Hospital from May to October 2019. In total, 397 cases of maxillary M3s in 247 patients(147 men and 100 women) were included. The diagnostic accuracy of ERR in panoramic images compared to CBCT images was evaluated using the chi-square test. To identify risk factors for ERR, dental records and panoramic findings were evaluated by logistic regression analysis. Results: The diagnostic accuracy of ERR on panoramic images was 0.79 compared to CBCT images (P<0.05). Superimposition of M3s onto second molars (M2) was associated with an approximately 33 times higher risk of ERR than separated M3s(P<0.05). Impacted M3s showed a 5 times higher risk of ERR than erupted M3s(P<0.05). Conclusion: ERR related to M3s is a common clinical condition, and superimposition of M3 onto M2 on panoramic images was the most important risk factor for ERR. It seemed that CBCT examinations for maxillary M3s might be indicated for ERR diagnosis especially if panoramic radiographs show superimposition of M3 onto M2. Impaction itself was also a risk factor, and it should be carefully examined.

Bilateral supernumerary maxillary fourth and fifth molars: A clinical case report and literature review

  • Adib Al-Haj, Husain;Daphne, Schonegg;Fabienne Andrina, Bosshard;Silvio, Valdec
    • Imaging Science in Dentistry
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    • v.52 no.4
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    • pp.429-434
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    • 2022
  • Supernumerary teeth that are present in the molar region may be evident based on crowding and impaction, but most cases are asymptomatic and discovered as incidental findings during routine radiological examinations. This article reports the case of a 29-year-old woman who presented with a severe feeling of pressure in the region of the maxillary third molars that had been increasing in intensity for weeks. A clinical examination revealed crowding of the maxillary anterior teeth despite the completion of orthodontic treatment and an erupted third molar with localized gingivitis in the second quadrant. A radiographic examination revealed bilateral supernumerary maxillary fourth and fifth molars, so cone-beam computed tomography was performed to locate the supernumerary teeth precisely for a preoperative diagnosis and comprehensive treatment planning. This report presents the radiological and surgical case management of a rare case of bilateral supernumerary molars and reviews the literature regarding epidemiology and treatment options.