• Title/Summary/Keyword: Surgical extraction

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Which factors are associated with difficult surgical extraction of impacted lower third molars?

  • Park, Kyeong-Lok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.5
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    • pp.251-258
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    • 2016
  • Objectives: The aim of this retrospective study was to investigate factors associated with increased difficulty in the surgical extraction of impacted lower third molars and to improve identification of difficult cases. Materials and Methods: A total of 680 patients who required 762 surgical extractions of impacted lower third molars from 2009 to 2014 were enrolled in the study. Demographic factors, clinical factors, radiographic factors, surgical extraction difficulty, and presumed causes of difficulty were collected. Data were statistically analyzed using IBM SPSS Statistics version 23. Results: Age, sex, depth of impaction, and blurred radiographic image influenced difficulty in surgical extraction. The position of the impacted tooth influenced surgical difficulty, especially when it was accompanied by other factors. Conclusion: It is challenging to design a reliable and practical instrument to predict difficulty in surgical extraction of impacted lower third molars. To identify very difficult cases, root investigation using computed tomography is advised when impacted tooth position suggests difficult extraction.

Surgical Extraction in Patient with McCune-Albright Syndrome: A Case Report

  • Dohee Kim;Jeong Joon Han;Hoon Myoung
    • Journal of Korean Dental Science
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    • v.16 no.1
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    • pp.99-103
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    • 2023
  • McCune-Albright syndrome (MAS) is a disease with clinical features such as fibrous dysplasia in which normal bone tissue is replaced with abnormal fibrous tissue, abnormalities in the endocrine system, and cafe-au-lait spots on the skin. Although MAS patients are generally known to have reduced bone healing ability, postoperative healing after invasive surgical extraction is still not clearly known due to its relatively rare occurrence. In this report, a 25-year-old female patient, who had been diagnosed with MAS and had a history of abnormal bone healing after fractures of her extremities, underwent surgical extraction of the mandibular third molar with surrounding bone removal. Postoperatively, the patient showed favorable soft tissue and bone healing at the surgical site without abnormal findings such as newly developed fibro-osseous lesions, postoperative infection, or osteomyelitis.

Comparison of safety and analgesic efficacy of diclofenac sodium with etodolac after surgical extraction of third molars: a randomized, double-blind, double-dummy, parallel-group study

  • Vaghela, Jitendra H.;Shah, Jigna H.;Patel, Jaladhi H.;Purohit, Bhargav M.
    • 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.

ACTIVE BLEEDING CARE DURING SURGICAL EXTRACTION OF MANDIBULAR THIRD MOLAR: REPORT OF TWO CASES (하악지치 발치 중 극심한 출혈 치험례)

  • Kim, Jong-Bae;Yoo, Jae-Ha;Moon, Seon-Jae;Kim, Seung-Beom
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.6
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    • pp.560-564
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    • 2001
  • The experienced surgeon can be surprised & challenged by the hazards of active bleeding during oral & maxillofacial surgical procedure, because of alterations in the surgical anatomy, bleeding disorders and surgical intervention of infected tissues. This is a report of two cases of active bleeding during surgical extraction of mandibular third molar, that had the pericoronitis, osteitis and adjacent neurovascular bundle in its apex. When the abrupt active bleeding was occurred during surgical extraction of mandibular third molar, pressure packing by hemostatie agent(bone wax) & wet gauze biting were applied into the extraction socket during 30 minutes. After 30 minutes, the wound was explored about the bleeding and active bleeding was then continued. In spite of repeated bleeding control method of the pressure dressing, the marked hemorrhage was generated continuously. Therefore, the author decised the bleeding as immediately uncontrollable hemorrhage and the pressure dressing was again applied for the more longer duration without wound closure. After 3 days, the pressure dressing was removed and iodoform gauze drainge was then established without the bleeding. The drain was changed as the interval of 3~5 days for prevention of infection & secondary hemorrhage and relatively good wound healing was then resulted in 6 weeks.

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New Technique of Intracorporeal Anastomosis and Transvaginal Specimen Extraction for Laparoscopic Sigmoid Colectomy

  • Wang, Zheng;Zhang, Xing-Mao;Zhou, Hai-Tao;Liang, Jian-Wei;Zhou, Zhi-Xiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6733-6736
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    • 2014
  • Background: Despite the growing acceptance of laparoscopic colon surgery, an abdominal incision is needed to remove the specimen and perform an anastomosis. Recently, natural orifice specimen extraction (NOSE) and intracorporeal anastomosis have been proposed to minimize abdominal wall trauma and improve the quality of laparoscopic colon resections Objective: To evaluate the feasibility and safety of a new approach combining intracorporeal delta-shaped anastomosis and transvaginal specimen extraction for totally laparoscopic sigmoid colectomy. Materials and Methods: Mobilization of bowel and dissection of lymph nodes were performed laparoscopically. After both proximal and distal incisal edges about 10.0 cm distance from sigmoid neoplasm were transected with an Endoscopic Linear Cutter-Straight, a small incision about 1.0 cm was created on the each colon wall of the contralateral side of the mesentery. Then anvils of an Endoscopic Linear Cutter-Straight were inserted into each colon through the small incisions, and incision and anastomosis between the walls of each colon were performed with a linear stapler. A V-shaped anastomosis was made on the wall and the remnant openings was reclosed with the Endoscopic Linear Cutter-Straight. The culdotomy was enlarged with laparoscopic ultrasound dissector. Transvaginal extraction of specimens was accomplished through a wound protector. Results: Surgery was performed for 11 patients with sigmoid cancer. No intraoperative complications or conversions occurred. The mean operating time was 132 min. All the patients were treated laparoscopically without any postoperative complications. Conclusions: The procedures of intracorporeal delta-shaped anastomosis and transvaginal specimen extraction are safe and oncologically acceptable for selected colon cancer cases.

Radiographic evaluation before surgical extraction of impacted third molar to reduce the maxillary sinus related complication

  • Mi Hyun Seo;Buyanbileg Sodnom-Ish;Mi Young Eo;Hoon Myoung;Soung Min Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.4
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    • pp.192-197
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    • 2023
  • Objectives: Surgical extraction of maxillary third molars is routine in departments devoted to oral and maxillofacial surgery. Because maxillary third molars are anatomically adjacent to the maxillary sinus, complications such as oroantral fistula and maxillary sinusitis can occur. Here we explore the factors that can cause radiographic postoperative swelling of the maxillary sinus mucosa after surgical extraction. Materials and Methods: This retrospective study reviewed the clinical records and radiographs of patients who underwent maxillary third-molar extraction. Preoperative panoramas, Waters views, and cone-beam computed tomography were performed for all patients. The patients were divided into two groups; those with and those without swelling of the sinus mucosa swelling or air-fluid level in a postoperative Waters view. We analyzed the age and sex of patients, vertical position, angulation, number of roots, and relation to the maxillary sinus between groups. Statistical analysis used logistic regression and P<0.05 was considered statistically significant. Results: A total of 91 patients with 153 maxillary third molars were enrolled in the study. Variables significantly related to swelling of the maxillary sinus mucosa after surgical extraction were the age and the distance between the palatal cementoenamel junction (CEJ) and the maxillary sinus floor (P<0.05). Results of the analysis show that the relationship between the CEJ and sinus floor was likely to affect postoperative swelling of the maxillary sinus mucosa. Conclusion: Maxillary third molars are anatomically adjacent to the maxillary sinus and require careful handling when the maxillary sinus is pneumatized to the CEJ of teeth.

Development of Educational Content for Dental Extraction Skill Training Using Virtual Reality Technology (가상현실 기반의 치아발치 수기 훈련을 위한 교육콘텐츠 개발)

  • Park, Jong-Tae;Kim, Ji Hyo;Lee, Jeong-hyun
    • The Journal of the Korea Contents Association
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    • v.18 no.12
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    • pp.218-228
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    • 2018
  • The purpose of this study was to present a educational content developed for training of dental extraction skill in a virtual environment. The development of the content consists of five steps: learning content analysis, draw a design model, development, test of validity, rectification and complete of the content. We developed the virtual reality (VR) simulator with producing an animation of surgical stages on the 3D models of human face for simulating dental extraction procedure. The results of validity tests for the content were mean 4.81 (SD, 0.72) for interface validity and mean 4.66 (SD, 0.71) for content validity, which represents strong evidence for the validity of the content. The data of the study indicates that the educational content developed for training of dental extraction skill using VR technology can be suitable to improve surgical skill of dental extraction in clinical field. We expect that further development of the education contents based on the VR technology to improve various surgical skills in clinical field will be addressed in the future.

THE EFFECT OF MUSIC THERAPY AT SURGICAL EXTRACTION OF MANDIBULAR IMPACTED 3RD MOLARS (하악매복지치 발치 시 음악요법의 효과)

  • Jeaun, Hea-Sil;Chun, Ki-Hong;Lee, Soon-Young;Lee, Jeong-Keun;Song, Hyun-Chul
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.266-275
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    • 2008
  • Purpose: This research was intended to evaluate the sedative effect of the music by measuring the anxiety-level, the pain-level, the blood pressure, and the pulse rate in patients who were going through extraction of the mandibular impacted 3rd molar. Materials and methods: Patients were selected among those who visited St. Vincent's Hospital in Suwon for the surgical extraction of 3rd molar from April to May, 2007 and were divided into two groups : the first, experimental group consisting of 32 people was going through extraction with the music and the second, control group also consisting of 32 people was going through extraction without the music. The anxiety-level was measured by filling out Spielberger's State-Trait Anxiety questionnaire. The pain-level was measured by VAS (Visual analog Scale). The blood-pressure and the pulse rate were recorded at waiting period, preparation and anesthesia period, 5 minutes after anesthesia, beginning of extraction and every five minutes after extraction to the end of surgery. Results: The anxiety-level was significantly lower in the experimental group than in the control group during the extraction procedure (p<0.01). The pain-level was significantly lower in the experimental group than in the control group (p<0.05). The mean systolic blood pressure was significantly lower in the experimental group than in the control group at the beginnig of extraction and 10 minutes after extraction (p<0.01, p<0.05 each). The mean diastolic blood pressure was significantly lower in the experimental group than the control group at 10 minutes after extraction (p<0.01). The mean of pulse rate was significantly lower at the beginning of extraction (p<0.05). Conclusion: The music therapy could offer not only the psychological stability but also the physiological stability during the surgical extraction of impacted 3rd molar.

Efficacy and safety of 2% lidocaine HCl with 1:200,000 epinephrine (1:200,000 에피네프린 리도카인의 소개)

  • Karm, Myong-Hwan
    • The Journal of the Korean dental association
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    • v.56 no.1
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    • pp.42-48
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    • 2018
  • INTRODUCTION The most commonly impacted tooth is the third molar. An impacted third molar can ultimately cause acute pain, infection, tumors, cysts, caries, periodontal disease, and loss of adjacent teeth. Local anesthesia is employed for removing the third molar. This study aimed to evaluate the efficacy and safety of 2% lidocaine with 1:80,000 or 1:200,000 epinephrine for surgical extraction of bilateral impacted mandibular third molars. METHODS Sixty-five healthy participants underwent surgical extraction of bilateral impacted mandibular third molars in two separate visits while under local anesthesia with 2% lidocaine with different epinephrine concentration (1:80,000 or 1:200,000) in a double-blind, randomized, crossover trial. Visual analogue scale pain scores obtained immediately after surgical extraction were primarily evaluated for the two groups receiving different epinephrine concentrations. Visual analogue scale pain scores obtained 2, 4, and 6 h after administering an anesthetic, onset and duration of analgesia, onset of pain, intraoperative bleeding, operator's and participant's overall satisfaction, drug dosage, and hemodynamic parameters were evaluated for the two groups. RESULTS There were no statistically significant differences between the two groups in any measurements except hemodynamic factors (P > .05). Changes in systolic blood pressure and heart rate following anesthetic administration were significantly greater in the group receiving 1:80,000 epinephrine than in that receiving 1:200,000 epinephrine ($P{\leq}01$). CONCLUSION The difference in epinephrine concentration between 1:80,000 and 1:200,000 in 2% lidocaine liquid does not affect the medical efficacy of the anesthetic. Furthermore, 2% lidocaine with 1:200,000 epinephrine has better safety with regard to hemodynamic parameters than 2% lidocaine with 1:80,000 epinephrine. Therefore, we suggest using 2% lidocaine with 1:200,000 epinephrine rather than 2% lidocaine with 1:80,000 epinephrine for surgical extraction of impacted mandibular third molars in hemodynamically unstable patients.

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Methodological validation of measuring Hanwoo hair cortisol concentration using bead beater and surgical scissors

  • Nejad, Jalil Ghassemi;Ataallahi, Mohammad;Park, Kyu-Hyun
    • Journal of Animal Science and Technology
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    • v.61 no.1
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    • pp.41-46
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    • 2019
  • Different methodologies in hair cortisol extraction may alter the final output. Thus finding the standard methodology according to a laboratory facilities is pivotal. This study was carried out to validate the feasibility of two methods of grinding hair for cortisol extraction in Korean native (Hanwoo) cattle. Hair from nine cattle including mature cows, heifers, and calves were assigned to one of the following methods for grinding hair; 1) using bead beater (BB) and 2) using surgical scissors (SS). Hair samples (> 1 g) were harvested from forehead of each individual twice (first and second measurement) to validate the results. To improve the accuracy of the obtained data, each sample was duplicated into two wells during enzyme immunoassay (EIA) analysis. Overall comparison of hair cortisol concentration (HCC) showed that the data within the range (out of the range) of standards provided by the EIA kit were 88.9% (11.1%) and 66.7% (33.3%) for BB compared with SS, respectively. In the first measurement, application of BB was tended to show higher (p = 0.056) amount of HCC compared with SS. In the second measurement application of BB showed higher (p = 0.0028) amount of HCC compared with SS. Among the cattle, calves showed higher HCC using BB compared with SS (p < 0.05). Application of BB in hair grinding methodology for Hanwoo cattle may improve cortisol extraction in comparison to application of SS method, with more consistency. Thus, it would be the preferable method to use.