• The Journal of Advanced Prosthodontics
• /
• 제2권2호
• /
• pp.58-60
• /
• 2010

Presurgical prosthetic treatment planning is critical for the success of the implant prosthesis. Inadequate treatment plan, due to insufficient discussion between prosthodontist, and surgeon, may result in poor prognosis. A 26-year-old male patient was referred for prosthodontic treatment after implant was placed in the area of teeth #17,16, 22, 25 and 27, without adequate discussion nor the treatment planning between oral surgeon and prosthodontist. It was found that the patient had two hopeless teeth, and a severely resorbed alveolar ridge. Additional tooth extraction was needed and the type of definitive prosthesis was shifted from fixed type to removable one. Proper pre-surgical treatment planning is essential for the good prognosis. Implant-supported removable prosthesis on milled bars may be a useful treatment option in patients with incorrect angled placement on severely resorbed alveolar ridge.

• 대한치과의사협회지
• /
• 제15권2호
• /
• pp.107-110
• /
• 1977

Class I malocclusion is essentially a dental dysplasia. Rotations, individual tooth malpositions, missing teeth, tooth size discrepancies, etc., fall under this classification. There are two types of class I malocclusions. One is identified by and insufficient denture base to accommodate the teeth; the other has more denture base than tooth material, creating spaces in the arch. The tooth material-to denture base discrepancies may be slight, calling for only a little increase in arch length for alignment and the correction of minor rotations. Discrepancies may also be great, in which case it becomes necessary to reduce tooth material by extraction, so as to make the tooth material more in proportion to the size of the denture base. The author had attempted orthodontic treatment of a class I malocclusion case of 13-year old boy in which high canines and impacted mandibular second premolars were involved. The author obtained good results.

• Restorative Dentistry and Endodontics
• /
• 제40권3호
• /
• pp.236-240
• /
• 2015

Traumatic dental injury can result in avulsion of anterior teeth. In young patients, it is a challenge to the dental professional because after replantation, late complications such as ankylosis require tooth extraction. Although prosthetic and orthodontic treatment, and implant placement have been described as the options for intervention, autogenous tooth transplantation could be an effective procedure in growing patients if there is a suitable donor tooth available. This case presents the treatment of a patient who suffered a traumatic injury at 9 years old with avulsion of tooth 21, which had been replanted, and intrusion of tooth 11. Both teeth ankylosed; thus they were removed and autotransplantation of premolars was carried out. After transplantation, the tooth underwent root canal treatment because of pulpal necrosis. Orthodontic treatment began 3 months after transplantation and during 7 years' follow-up the aesthetics and function were maintained without signs of resorption.

• 대한구강악안면병리학회지
• /
• 제42권5호
• /
• pp.153-158
• /
• 2018

Complicated crown-root fractures are considered rare occurrences in young permanent dentition; however, they often present complicated and unpredictable treatment options. The most common treatment option for crown-root fractured teeth is reattachment of fractured segment, but if it is thought impossible to maintain, it should be extracted. However, when unfavorable crown-root fracture occurs in the adolescents, extraction of fractured teeth is expected to be poor due to excessive resorption of alveolar and prosthetic replacement cannot be performed immediately, various treatment options should be considered. This report suggests root submergence in the complex crown-root fracture in growing patients is performed and the functional and aesthetic results including preservation of the alveolar bone are obtained.

• Restorative Dentistry and Endodontics
• /
• 제43권4호
• /
• pp.44.1-44.9
• /
• 2018

Fusion and gemination are developmental anomalies of teeth that may require endodontic treatment. Fusion may cause various clinical problems related to esthetics, tooth spacing, and other periodontal complications. Additional diagnostic tools are required for the diagnosis and the treatment planning of fused tooth. The present case report describes a case of unilateral fusion of a supernumerary root to an upper permanent central incisor with large periapical lesion in which a conservative approach was used without extraction of supernumerary tooth and obturated with mineral trioxide aggregate to reach a favorable outcome.

• Journal of Periodontal and Implant Science
• /
• 제26권4호
• /
• pp.823-840
• /
• 1996

The purpose of this study was to evaluate the effect of dexamethasone on the healing aspect of gingiva and alveolar bone after extraction. Extracted socket of 24 Sprague-Dawley rat was used. To extract easily and minimize injury, ${\beta}-APN$ 0.2g/kg/day soluted in mineral water was administrated for 5 days before extraction in both group. Ampicillin 1.5ml/kg i.m.,q.d, was administered for preventing infection after teeth extraction in both group, and dexamethasone 0.2mg/kg/day was injected for 3 days in experimental group.3 rats on each day was sacrificed on 1, 3, 7, 15 days after extraction. Histologic examination and the activity of osteoclasts by tartrate resistant acid phosphatase was observed. The results were as follows : 1. The Overall healing pattern was similar with both the experimental and control group, but in experimental group osseous healing was delayed. 2. The activity of osteoclasts was increased to day 3 and then decreased after day 3 in the experimental group. In comparison to the control group, the experimental group showed increased appearance to day 7 and then decreased appearance following day. 3. Regarding to the change of osseous tissue, the activity of osteoblasts was shown at day 7,but osteoclastic activity of the experimental group was less than that of the control group. The osteoclastic activity was statistically significant between two groups except day 7(p<0.05, p<0.01). In conclusion, the effects of dexamethasone for healing of extraction socket were considered as limiting the activity of osteoclasts, and the healing of extraction socket was delayed.

• Imaging Science in Dentistry
• /
• 제39권3호
• /
• pp.109-113
• /
• 2009

Purpose : The purpose of this study was to examine the inferior expansion of the maxillary sinus floor following maxillary molar extraction. Materials and Methods : Cone beam computed tomographic images of 59 subjects were used to evaluate the height difference of the maxillary sinus floor between extraction sites and contralateral dentate sites. The height of the maxillary sinus floor was defined as the vertical distance to the Frankfort plane from the level of the anterior nasal spine to the most inferior point of the sinus floor. We examined the difference in sinus pneumatization according to the number of missing teeth and the vertical relationship of the molar roots to the sinus floor. Results : The inferior expansion of the maxillary sinus floor was $1.20{\pm}1.86\;mm$ on the maxillary first molar and $1.90{\pm}2.42\;mm$ on the maxillary second molar. Increased expansion was observed in cases where two proximate molars were extracted. There was no significant difference in sinus pneumatization following extraction according to the vertical relationship of the molar roots to the sinus floor. Conclusion : The results of this study confirm that sinus pneumatization occurs following maxillary molar extraction. In situations where pneumatization can affect treatment after molar extraction, three-dimensional radiography should be considered.

• 치과방사선
• /
• 제12권1호
• /
• pp.105-113
• /
• 1982

Because of the development of rampant caries, osteomyelitis and osteoradionecrosis that occur after radiation therapy of oral cancers, extraction of teeth at or near the malignant lesion has been done in the past. Few, however, have studied the radiation effect on the healing of extraction wounds. This study is concerned with the effect of Co-60 irradiation on the healing process of extraction wounds in rats. Fifty six, male, Spraque-Dawley rats are used. The right first molar of the mandible is extracted from all animals. They are divided into three experimental groups of 14 each and a control group of 14. Three experimental groups are irradiated respectively with 200 rad, 400 rad and 600 rad and a pair of rats in each group are killed on days 1, 3, 5, 7, 14, 21 and 28 after irradiation. Two animals from the control group are killed on the day when the experimental rats are killed. The irradiated hemimandibles are fixed in 10% neutral formalin, decalcified in 5% trichloroacetic acid, embedded in paraffin and sectioned. The sections are stained in hematoxylin and eosin, van Gieson, Masson's trichrome or silver nitrate. Results show that in general radiation effects on healing extraction wounds are dose dependent; i.e., the higher is the dose, the greater is the histologic changes observed: 1. Irradiation tends to retard blood clot organization and epithelial regeneration. 2. An increase in the number of giant cells and osteoclasts is noted after irradiation. 3. Formation of regenerating connective tissues around and within the extraction site is com- promised, and a clear reduction of primitive mesenchymal type connective cells is noted. 4. The healing process begins along the lateral aspect of the extraction socket in the control, while irregular histologic appearances of the brabecular pattern is present in the experimental rats.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제23권4호
• /
• pp.213-220
• /
• 2023

Background: Third molar extraction is the most commonly performed minor oral surgical procedure in outpatient settings and requires regional anesthesia for pain control. Extraction of the maxillary molars commonly requires both posterior superior alveolar nerve block (PSANB) and greater palatine nerve block (GPNB), depending on the nerve innervations of the subject teeth. We aimed to study the effectiveness of PSANB alone in maxillary third molar (MTM) extraction. Methods: A sample size comprising 100 erupted and semi-erupted MTM was selected and subjected to study for extraction. Under strict aseptic conditions, the patients were subjected to the classical local anesthesia technique of PSANB alone with 2% lignocaine hydrochloride and adrenaline 1:80,000. After a latency period of 10 min, objective assessment of the buccal and palatal mucosa was performed. A numerical rating scale and visual analog scale were used. Results: In the post-latency period of 10 min, the depth of anesthesia obtained in our sample on the buccal side extended from the maxillary tuberosity posteriorly to the mesial of the first premolar (15%), second premolar (41%), and first molar (44%). This inferred that anesthesia was effectively high until the first molars and was less effective further anteriorly due to nerve innervation. The depth of anesthesia on the palatal aspect was up to the first molar (33%), second molar (67%), and lateromedially; 6% of the patients received anesthesia only to the alveolar region, whereas 66% received up to 1.5 cm to the mid-palatal raphe. In 5% of the cases, regional anesthesia was re-administered. An additional 1.8 ml PSANB was required in four patients, and another patient was administered a GPNB in addition to the PSANB during the time of extraction and elevation. Conclusion: The results of our study emphasize that PSANB alone is sufficient for the extraction of MTM in most cases, thereby obviating the need for poorly tolerated palatal injections.

• 대한소아치과학회지
• /
• 제35권3호
• /
• pp.532-538
• /
• 2008

Lesch-Nyhan 증후군은 드물게 나타나는 X 염색체 열성 유전 질환으로 purine의 대사 장애를 보이는 질환이다. Purine의 대사 장애는 대사에 관여하는 효소인 hypoxanthine guanine phosphoribosyl transferase의 결손 또는 활성 감소로 인하여 나타나며, 요산의 과다 생산에 의한 요산과다혈증, 요산과다뇨증 등의 신장계 증상과 정신지체, 무도증 등의 신경학적 장애를 보이고, 구강이나 손가락에 대한 자해를 나타낸다. 이 중 자해 행위는 입술과 혀, 손가락을 깨무는 경우가 흔하고, 심하면 혀와 손가락이 완전히 절단될 수도 있다. 이 경우 자해로 인한 통증뿐 아니라, 연조직 결손으로 인한 심미적인 문제와 상처 부위로의 2차 감염이 발생할 수 있다. 이러한 Lesch-Nyhan 증후군 환자에서 자해를 막기 위해 여러 방법이 사용되고 있는데, 이 중 치과적으로 접근하는 방법으로는 마우스 가드나 lip bumper 등의 장치를 이용하는 방법과 해당 치아들을 모두 발거하는 방법, 악교정 수술을 통해 개방 교합을 형성해 주는 방법 등이 있다. 본 증례는 13세 9개월의 Lesch-Nyhan 증후군 환아로서 자해에 의해 혀에 심각한 외상을 가한 경우로 마우스 가드를 이용한 보존적인 방법을 사용하였으나 계속적으로 혀에 외상을 가해 하악 전치 뿐 아니라 구치까지 발거하여 치료하였다.