• 제목/요약/키워드: Teeth extraction

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교정적 견인과 감압술에 의한 매복된 하악 제1대구치의 치험례 (Orthodontic Traction and Decompression Method in Treating Impacted Permanent Mandibular First Molars : Case Reports)

  • 지명관;이상호;이난영
    • 대한소아치과학회지
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    • 제42권3호
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    • pp.257-263
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    • 2015
  • 매복치는 유치열기보다 영구치열기에서 더 높은 빈도로 발생한다. 가장 흔하게 이환되는 치아는 상하악 제3대구치들이며, 하악 제1대구치의 매복은 비교적 드문 편이다. 매복치의 치료방법은 자발적 맹출을 위한 지속적인 검사, 외과적 노출술, 외과적 노출 후 아탈구, 교정적 견인, 그리고 외과적 재위치술 등이 있으며 이 모든 치료가 실패한다면 치아를 발거하는 것을 고려할 수 있다. 첫 번째 증례는 8세 남아로서 매복된 하악 제1대구치에 폐쇄장치를 이용한 감압술을 시행하였으며, 정기적인 검진을 통해 치아의 맹출이 관찰되었다. 두 번째 증례는 12세 남아로서 매복된 하악 제1대구치의 외과적 노출술을 시행 후 치아의 맹출이 관찰되지 않아 가철성 장치를 이용한 교정적 정출술을 시행하였으며 이 후 정상적인 치아의 맹출이 관찰되었다.

Evaluation of Tooth Movement and Arch Dimension Change in the Mandible Using a New Three-dimensional Indirect Superimposition Method

  • Oh, Hyun-Jun;Baek, Seung-Hak;Yang, Il-Hyung
    • Journal of Korean Dental Science
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    • 제7권2호
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    • pp.66-79
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    • 2014
  • Purpose: To analyze the amount and pattern of tooth movement and the changes in arch dimension of mandibular dentition after orthodontic treatment using a new three-dimensional (3D)-indirect superimposition method. Materials and Methods: The samples consisted of fifteen adult patients with class I bialveolar protrusion and minimal anterior crowding, treated by extraction of four first premolars with conventional sliding mechanics. After superimposition of 3D-virtual maxillary models before and after treatment using best-fit method, 3D-virtual mandibular model at each stage was placed into a common coordinate of superimposition using 3D-bite information, which resulted in 3D-indirect superimposition for mandibular dentition. The changes in mandibular dental and arch dimensional variables were measured with Rapidform 2006 (INUS Technology). Paired t-test was used for statistical analysis. Result: The anterior teeth moved backward, displaced laterally, and inclined lingually. The posterior teeth showed statistically significant contraction toward midsagittal plane. The amounts of backward movement of anterior teeth and forward movement of posterior teeth showed a ratio of 6 : 1. Although the inter-canine width increased slightly (0.8 mm, P<0.05), the inter-second premolar, inter-first molar, and inter-second molar widths decreased significantly with similar amounts (2.2 mm, P<0.05; 2.3 mm, P<0.01; 2.3 mm, P<0.001). The molar depth decreased (6.7 mm, P<0.001) but canine depth did not change. Conclusion: A new 3D-indirect superimposition of the mandibular dentitions using best-fit method and 3D-bite information can present a guideline for virtual treatment planning in terms of tooth position and arch dimension.

제 3대구치를 이용한 자가치아이식술의 장기적 예후 관찰 (Long-term evaluation of autotransplanted third molars)

  • 신동석;박진우;서조영;이재목
    • Journal of Periodontal and Implant Science
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    • 제39권4호
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    • pp.431-435
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    • 2009
  • Purpose: The purpose of this study is to evaluate the long term clinical and radiographic outcome and stability after transplantation of third molar with complete root formation. Methods: The subjects were 31 teeth (male 17, female 14, aged 22-55, average 39.9 yr old) of 31 patients who visited the department of periodontics and passed more than two years after autotransplantation procedure and still under regular check up. Modified success criteria of Chamberlin and Goerig was applied to determine the success of autotransplantation. Results: Three out of 31 teeth failed and resulted 90.3% of success rate. When compared according to sex, 15 out of 17 teeth had succeeded in male, 13 out of 14 succeeded in female. When compared the success rate according to cause of extraction, tooth loss due to caries and root fracture had all succeeded but 3 out of 24 had failed in tooth loss due to periodontal disease. When compared according to donor teeth, 12 out of 14 maxillary third molars and 16 out of 17 mandibular third molars had succeeded. Conclusions: In long term evaluation over two years, if appropriate surgical procedure and proper case selection is made, autotransplantation of the third molar with complete root formation can be the alternative choice that substitutes prosthetic or implant treatment and it is a functionally acceptable procedure.

Force changes associated with differential activation of en-masse retraction and/or intrusion with clear aligners

  • Zhu, Ye;Hu, Wei;Li, Shuo
    • 대한치과교정학회지
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    • 제51권1호
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    • pp.32-42
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    • 2021
  • Objective: To investigate the three-dimensional forces created by clear aligners on mandibular teeth during differential activation with en-masse retraction and/or intrusion in vitro. Methods: Six sets of clear aligners were designed for differential en-masse retraction and/or intrusion procedures in a first premolar extraction model. Group A0 was a control group with no activation. Groups A1-5 underwent different degrees of retractions and/or intrusions. Each group consisted of 10 aligners. Aligner forces were measured on a multi-axis force/torque transducer measurement system in real-time. Results: In the en-masse retraction groups (A1 and A2), lingual and extrusive forces were observed on the incisors; the canines mainly received distal forces; intrusive forces were seen on the second premolars; and the molars received mesial forces. In the en-masse retraction and intrusion groups (A3, A4, and A5), incisors also received lingual and extrusive forces; canines received distal and intrusive forces; mesial and extrusive forces were seen on the second premolars; and the second molars received distal and intrusive forces. The vertical forces on the incisors did not differ significantly among groups A1, A3, and A5. However, the vertical forces on the second premolars reversed from intrusion in group A1 to extrusion in groups A3 and A5. Conclusions: With clear aligners, the "bowing effect" is seen during en-masse anterior teeth retraction and can be partially relieved by performing en-masse retraction accompanied by anterior teeth intrusion. Vertical control of incisors remained unsolved during en-masse retraction, even when intrusive activation was added to the anterior teeth.

Anesthetic efficacy in vital asymptomatic teeth using different local anesthetics: a systematic review with network meta-analysis

  • Amy Kia Cheen Liew;Yi-Chun Yeh ;Dalia Abdullah ;Yu-Kang Tu
    • Restorative Dentistry and Endodontics
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    • 제46권3호
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    • pp.41.1-41.23
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    • 2021
  • Objectives: This study aimed to evaluate the efficacy of various local anesthesia (LA) in vital asymptomatic teeth. Materials and Methods: Randomized controlled trials comparing pulpal anesthesia of various LA on vital asymptomatic teeth were included in this review. Searches were conducted in the Cochrane CENTRAL, MEDLINE (via PubMed), EMBASE, ClinicalTrials.gov, Google Scholar and 3 field-specific journals from inception to May 3, 2019. Study selection, data extraction, and risk of bias assessment using Cochrane Risk of Bias Tool were done by 2 independent reviewers in duplicate. Network meta-analysis (NMA) was performed within the frequentist setting using STATA 15.0. The LA was ranked, and the surface under the cumulative ranking (SUCRA) line was plotted. The confidence of the NMA estimates was assessed using the CINeMA web application. Results: The literature search yielded 1,678 potentially eligible reports, but only 42 were included in this review. For maxillary buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than lidocaine 2% with epinephrine 1:100,000 (odds ratio, 2.11; 95% confidence interval, 1.14-3.89). For mandibular buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than various lidocaine solutions. The SUCRA ranking was highest for articaine 4% with epinephrine when used as maxillary and mandibular buccal infiltrations, and lidocaine 2% with epinephrine 1:80,000 when used as inferior alveolar nerve block. Inconsistency and imprecision were detected in some of the NMA estimates. Conclusions: Articaine 4% with epinephrine is superior when maxillary or mandibular infiltration is required in vital asymptomatic teeth.

Pattern of lip retraction according to the presence of lip incompetence in patients with Class II malocclusion

  • Mei Ling Fang;Sung-Hwan Choi;Yoon Jeong Choi;Kee-Joon Lee
    • 대한치과교정학회지
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    • 제53권4호
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    • pp.276-285
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    • 2023
  • Objective: The aim of this retrospective study was to compare changes in hard tissue and soft tissue after the four first premolars were extracted with anterior teeth retraction according to the presence or absence of lip incompetence. Methods: Patients who underwent the four first premolars were extracted with anterior teeth retraction were divided into competent (n = 20) and incompetent lip (n = 20) groups. Cephalometric measurements for hard tissue and soft tissue changes were performed pre-treatment and post-treatment. Results: In the competent group, the upper and lower lips retreated by 2.88 mm and 4.28 mm, respectively, and in the incompetent group by 4.13 mm and 5.57 mm, respectively; the differences between the two groups were significant (p < 0.05). A strong positive correlation between retraction of the upper lip and upper incisors was observed in both groups (p < 0.05), whereas a correlation between retraction of the lower lip and lower incisors was only found in the incompetent group. A simple linear regression analysis showed that the pattern of lip retraction following the retraction of the anterior teeth was more predictable in the incompetent group than in the competent group. Conclusions: These findings suggest that the initial evaluation of lip incompetence in patients with skeletal Class II is essential for the accurate prediction of the soft tissue changes following retraction of the anterior teeth in premolar extraction treatment. Therefore, sufficient explanation should be provided during patient consultations.

애완토끼에서 과잉성장된 하악치아의치신경치료 연구 (Nonvital Pulp Therapy of Elongation of Roots of Mandibular Cheek Teeth in Pet Rabbits)

  • 박천식;차세연;강민;김주리;정순욱;장형관
    • 한국임상수의학회지
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    • 제29권6호
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    • pp.474-482
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    • 2012
  • 애완 토끼의 치아는 정교하게 배열되고 정렬되어 서로 마모되면서 그 형태와 교합을 유지한다. 어떠한 요소이던 치아의 위치를 변화시키는 요소는 비록 작은 부분이라고 하더라도 부정교합을 일으키고 크라운의 과잉성장을 야기한다. 토끼의 후천적 치아질환과 부정교합은 치아 뿌리의 성장을 특징으로 한다. 이러한 현상은 애완토끼에게서 흔히 발생한다. 정상위치를 벗어난 치아 뿌리는 두개골을 관통하여 농양을 형성한다. 치아문제와 관련된 임상증상으로는 식욕저하, 유연, 치근농양, 과도한 눈물분비가 있다. 임상증상이 나타난 토끼들에게는 치신경 치료가 필요하다. 이 논문은 통증, 식욕부진, 유연, 과도한 눈물분비, 누낭염 증상으로 치신경 치료를 받은 토끼들의 외과적 절차와 수술후 회복과정을 간략하게 서술하였다. 31케이스 중 후천적 치아질환을 치료하기 위해 10마리의 토끼는 치신경 치료를 받았다. 치신경 치료는 치아 뿌리의 성장을 영구적으로 해결하기 위한 방법이다. Root canal 의 치수 조직을 제거한 후 식염수로 세척하였다. 이후 Guatta percha points와 IRM으로 치수강을 채웠다. 치신경 치료 후 10개중 8개의 케이스에서 예후가 좋았고, 토끼 보호자분들의 수술후 관리가 양호하였다. 본 결과를 통하여 하악 어금니의 치아 뿌리가 과잉성장한 케이스에서 치신경 치료가 수행될 수 있다는 것을 알 수 있었다.

Delayed intentional replantation of periodontally hopeless teeth: a retrospective study

  • Lee, Eun-Ung;Lim, Hyun-Chang;Lee, Jung-Seok;Jung, Ui-Won;Kim, Ui-Sung;Lee, Seung-Jong;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • 제44권1호
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    • pp.13-19
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    • 2014
  • Purpose: The purpose of this study was to retrospectively evaluate the survival of periodontally hopeless teeth that were intentionally extracted and replanted after a delay and to compare the radiographic characteristics of the survival group with those of the failure group. Methods: The clinical and radiographic data from patients who underwent delayed intentional replantation between March 2000 and July 2010 were reviewed. Twenty-seven periodontally hopeless teeth were extracted and preserved in medium supplemented with antibiotics for 10-14 days. The teeth were then repositioned in the partially healed extraction socket and followed for 3 to 21 months. The radiographic parameters were analyzed using a paired t test and the cumulative survival rate was analyzed using Kaplan-Meier analysis. Results: Seven replanted teeth failed and the overall cumulative survival rate was 66.4%. In the survival group, the amount of bone loss was reduced from 68.45% to 34.66% three months after replantation. There was radiologic and clinical evidence of ankylosis with 5 teeth. However, no root resorption was found throughout the follow-up period. In the failure group, bone formation occurred from the bottom of the socket. However, a remarkable radiolucent line along the root of a replanted tooth existed. The line lengthened and thickened as time passed. Finally, in each case of failure, the tooth was extracted due to signs of inflammation and increased mobility. Conclusions: Delayed intentional replantation has many advantages compared to immediate intentional replantation and could serve as an alternative treatment for periodontally involved hopeless teeth. However, techniques for maintaining the vitality of periodontal structures on the tooth surface should be developed for improved and predictable results.

과잉치 발거시기에 따른 상악 중절치의 위치 변화 (Timing for Removal of Mesiodens in Relation to the Maxillary Cental Incisors)

  • 박기봉;이대우;김재환;양연미;김재곤
    • 대한소아치과학회지
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    • 제43권3호
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    • pp.246-253
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    • 2016
  • 과잉치의 발거시기는 조기발거와 지연발거로 나뉠 수 있으며 각각의 장단점이 있으며 특히 상악 중절치에 미치는 영향이 크다. 이 연구에서는 과잉치 발거 후 3개월 이상 추적관찰이 시행된 166명을 조사하여 최적의 과잉치 발거시기를 결정하고자 하였다. 환자의 나이가 어리고, 상악 중절치 미맹출 혹은 발육단계가 낮고, Hellman's dental stage상 낮은 단계에서 정중선 변위는 적게 일어났다. 정중이개와 상악 중절치의 회전, 추적 관찰 기간에 따른 변화는 통계적 유의성이 없었다. 상악 중절치가 아직 맹출하지 않은 경우라 하더라도 파노라마 방사선 사진을 촬영하여 정중선 변위가 보인다면 이른 시기에 과잉치를 발거할 필요가 있다. 이 연구는 상악 중절치의 위치 변위에 따라 과잉치의 발거시기를 결정하는 데에 도움을 줄 수 있을 것이다.

다수의 과잉 소구치를 가진 정신지체 환자의 치험례 (EXTRACTION OF MULTIPLE SUPERNUMERARY PREMOLARS IN MENTAL RETARDATION PATIENT : CASE REPORT)

  • 최해인;송제선;이효설;최병재;이제호
    • 대한장애인치과학회지
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    • 제9권2호
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    • pp.118-121
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    • 2013
  • 과잉 소구치는 장애 환자에서 교정적 문제를 일으켜 구강 위생 관리의 어려움을 초래할 수 있는데 발생 시기가 늦고 병리학적 문제의 발생 가능성이 낮으며 재발의 가능성이 높으므로 발거 시기를 전체 영구치열이 완전한 성숙을 이룬 후로 미루어야 하며 매복되어 있어 특이할 만한 합병증이 발견되지 않는 경우, 수술적 위험성을 감수하기보다는 남겨 두는 것을 추천한다.