• 대한소아치과학회지
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• 제37권3호
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• pp.368-373
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• 2010

상악 중절치는 저작시 음식물을 찢거나 자르는 기능 외에도 심미적으로 중요한 기능을 하며 상악 악궁의 형태 및 얼굴의 형태와도 관계가 있다고 알려져 있다. 그리고 발음을 하는데 있어서도 전치부는 매우 중요한 역할을 한다. 예후가 불량한 치아의 일반적인 치료는 발거 후 공간 유지장치를 하는 것이다. 그러나 혼합치열기에 있어 상악 영구 중절치의 발거는 치조골의 흡수, 불량한 심미성, 발음과 저작의 문제 등 여러 가지 합병증을 일으킬 수 있다. 이러한 이유로 상악 전치부의 치료는 보존적으로 행해져야 한다. 예후가 불량한 상악 전치부의 치료시 고려해야 할 사항으로는 환아의 나이, 성장 잠재력, 교합 관계, 구강 위생상태, 경제력 그리고 환아의 치료에 대한 협조도 등이 있다. 본 증례는 짧은 치근으로 인해 치아의 동요도가 있어 상악 좌측 중절치의 예후가 불안정함에도 불구하고 치아를 발거하지 않고 치료를 통해 상악 좌측 중절치를 정상 위치로 배열하고 보존하였다. 짧은 치근과 치아 회전으로 인한 추가적인 치근 흡수와 치아 동요도 증가 등 예후가 불안정하였지만 환아의 심리적 안정성, 나이, 심미성 등을 고려하여 보존적인 치료 후 양호한 결과를 얻었기에 이를 보고하는 바이다.

• 대한소아치과학회지
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• 제49권4호
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• pp.468-480
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• 2022

이 연구의 목적은 구개측 및 협측 변위를 보이는 상악 영구 견치에서 차단적 유견치 발치의 효과를 평가하고, 치료 결과에 영향을 미치는 임상적 및 방사선학적 인자를 분석하는 것이다. 상악 영구 견치의 맹출 경로가 근심 및 교합면 방향을 향하면서 치관의 일부가 인접치 치근과 중첩된 것으로 진단된 환자 중 해당 부위의 상악 유견치를 발치한 86명의 환자의 97개의 상악 영구 견치를 연구 대상으로 하였다. 97개의 변위된 상악 영구 견치 중 64개(66.0%)가 유견치 발치만으로 인접 측절치 치근에서 완전히 벗어났다. 상악 영구 견치의 협-구개측 변위 방향, 치관첨의 수평 및 수직적 위치, 치근단 폐쇄 여부, 유견치의 치근단 방사선투과상 여부, 인접 측절치의 쐐기모양 여부가 치료 결과에 유의미한 영향을 미쳤다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권1호
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• pp.37-41
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• 2017

Objectives: The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF). Materials and Methods: Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal. The complications of postoperative infection, postoperative nerve injury, bone healing, and changes in occlusion and temporomandibular joint were evaluated and analyzed using statistical methods. Results: In total, 49 patients had third molars in the fracture line and underwent ORIF surgery and perioperative IMF with an arch bar. The third molar in the fracture line was retained during ORIF in 39 patients. Several patients complained of nerve injury, temporomandibular disorder (TMD), change of occlusion, and postoperative infection around the retained third molar. The third molars were removed during ORIF surgery in 10 patients. Some of these patients complained of nerve injury, but no other complications, such as TMD, change in occlusion, or postoperative infection, were observed. There was no delayed union or nonunion in either of the groups. No statistically significant difference was found between the non-extraction group and the retained teeth group regarding complications after ORIF. Conclusion: If the third molar is partially impacted or completely nonfunctional, likely to be involved in pathologic conditions later in life, or possible to remove with the plate simultaneously, extraction of the third molar in the fracture line should be considered during ORIF surgery of the mandible angle fracture.

• 대한소아치과학회지
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• 제24권1호
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• pp.41-57
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• 1997

The present study investigated the effects of hyperbaric oxygen therapy on periodontal wound healing of replanted rat tooth. 80 rats (Sprague-Dawley strain) weighting $130{\pm}5gm$ were selected and divided into experimental and control group, each group consisting of 40 rats. Rats were administered 0.4% ${\beta}$-aminoproprionitrile for 5 days to achieve gentle tooth extraction. The maxillary first molars were extracted under anesthesia with pentobarbital, washed in sterile distilled water, treated with bacterial collagenase to remove collagen fibers on the root surfaces. After washing in water overnight, the mesial root surface were demineralized by application of citric acid, washed, dried and stored at $4^{\circ}C$. Immediately after tooth extraction and bleeding control, the treated molars extracted previously from other rats were replanted. The experimental group was exposed to hyperbaric oxygen at 2.5 atm. for 2 hrs. a day during experimental period. Eight animals of each group were sacrificed 1, 3, 6, 8, 10 days after reimplantation of teeth by intracardiac perfusion with 4% paraformaldehyde. The replanted molars and surrounding tissues were cut, demineralized, dehydrated and embedded in paraffin. Sections were stained with azan, toluidine blue and hematoxylin. Some other sections were stained by means of immunostaining achieved by the avidinbiotin complex method. The results as follows; 1. Experimental group showed fast healing of gingival epithelium. 2. Macrophage and newly formed blood vessels appeared early in the gingival connective tissue of experimental group. 3. Experimental group showed fast, abundant fibroblast proliferation and regularity of collagen fiber. 4. In both group, collagen was distributed along the collagen fiber. The distribution was strong and regular in the experimental group. 5. In the regenerated periodontal ligament of experimental group, fibers showed regular arrangement and invaded root surface fast.

• Archives of Plastic Surgery
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• 제34권6호
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• pp.777-784
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• 2007

Purpose: For a minor degree of mandibular prognathism, mandibular anterior segmental osteotomy (ASO), usually extracting the bilateral premolars, has been performed frequently to correct malocclusion of the anterior teeth. Preoperative planning using cephalometry and a dental model is very important for such a orthognathic surgery. Depending on the specific preoperative mock surgery with the dental model, ASO, with ipsilateral unitooth extraction, is defined to be feasible and performed for ten patients. The comparisons of its preoperative and postoperative analysis of clinical photographs, dental casts, and lateral cephalograms, for soft tissue profiles, skeletal and dental relationships are described in the following, and its clinical applications are noted. Methods: From March 1, 2004, to March 31, 2006, We performed 10 mandibular ASO by extraction of ipsilateral unitooth to improve their lower facial profiles and the lip relationships. Patient age ranged from 19 to 33 years, with a mean age of 25.6 years. Two were males and eight were females. Results: All patients were satisfied with aesthetic and occlusal changes postoperatively. Significant and persistent decrease in the SNB and interincisal angle were observed in the postoperative cephalometries. The soft tissue profiles also were improved and near Ricketts's esthetic line. Other combined procedures include nine genioplasties, two rhinoplasties, and one blepharoplasty. One patient complained of transient unilateral inferior mental nerve paresthesia. There were no other significant complications or relapses throughout the follow-up period(6-20 months). Conclusion: Mandibular ASO, extracting the ipsilateral unitooth, was performed for ten patients to correct mild mandibular prognathism. The amount of setback of the mandibular anterior portion was 2 to 3 mm, and satisfactory results were obtained combined with genioplasties.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권6호
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• pp.492-498
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• 2009

We sought to evaluate the relationship between the mandibular canal and impacted mandibular third molars by using dental cone beam computed tomograph(CBCT) for third molar surgery. A total of 111 patients(177 teeth) offered the images through CBCT and panoramic radiography for the extraction of the mandibular third molars. In CBCT, the accurate relationship between the third molar and the mandibular canal were evaluated. In panoramic radiographies, we evaluated the impacted level and superimposition sign of the mandibular third molar with the mandibular canal, and also, the radiopacity of the white line in the canal. Data were statistically analyzed and estimated by $X^2$-test. In CBCT finding, high prevalence of contact between the mandibular canal and roots occured in the deep impacted third molars, narrowing mandibular canals, bending mandibular canals and cases where the radiopacity of white line of canals were "absence" on panoramic images. It showed statistical significance (P<0.05). When evaluating the mandibular canal and the roots through the panoramic radiography for third molar extraction, it could be difficult to diagnosis accurately. Thus, it is required to have an accurate diagnostic approach through CBCT that could evaluated the location between mandibular canal and root.

• 대한치과교정학회지
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• 제23권2호
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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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권4호
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• pp.235-239
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• 2020

Objectives: Preoperative nervousness and anxiety are frequently encountered by individuals who undergo extractions of impacted wisdom teeth. The aim of the present study is to evaluate salivary alpha amylase (sAA) level in patients for assessment of stress during third molar surgery while listening to piano music and to determine its co-relation with pain catastrophizing scale (PCS). Materials and Methods: Seven patients (four males and three females) indicated for surgical extraction of bilaterally impacted mandibular third molars were included. Pre-surgical patient assessments were completed, and three samples of saliva were collected during surgery-one at baseline, one 30 minutes after commencement of surgery, and one after suturing. Assessment was performed on both sides separately with and without piano music, and the samples were assessed for sAA level and correlated with the patient's self-reported PCS. Results: Statistically significant results were obtained in patients who underwent surgical extraction while listening to piano music (P=0.046). The correlation of sAA level with PCS was not significant. Conclusion: Music demonstrated a beneficial effect on lowering the levels of stress and anxiety that a patient exhibits during any surgical procedure, and sAA can be a useful biomarker for similar assessments.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권2호
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• pp.131-136
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• 2016

Background: This study aimed to evaluate the patient's pain and quality of life after suture removal at either 3 or 7 days following the bilateral surgical extraction of impacted lower third molars. Methods: This study was a prospective, randomized controlled clinical trial carried out in 30 patients, who acted as their own control. Each patient required the bilaterally impacted mandibular third molars to be extracted. The impacted teeth were removed and the wound margins were approximated and sutured with black braided silk. The suture material was removed on day 3 on one side and on day 7 on the other. Each participant was asked to complete a questionnaire after the removal of the suture material on each designated day. Results: Regarding overall clinical symptoms, the mean VAS scores of male and female participants on day 3 were not significantly different from those on day 7. A significant difference was found in female participants, in that overall daily activity was better on day 7. There were significant differences in the ability to smile and laugh in both sexes and the ability to chew in the male participants was better on day 7. Conclusions: There were no significant differences in the patient's pain and quality of life between suture removal on day 3 or on day 7 following surgery to remove impacted lower third molars.

• Imaging Science in Dentistry
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• 제42권3호
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• pp.147-154
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• 2012

Purpose: This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. Materials and Methods: The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. Results: The periapical radiographs of 564 teeth showed that the average root resorption was $1.39{\pm}1.27$ ($8.24{\pm}7.22$%) and $1.69{\pm}1.14$ mm ($10.16{\pm}6.78%$) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (p<0.001). Allergic condition was a significant factor at p<0.01. Age at the start of treatment, large overjet, and history of facial trauma were also factors significantly associated with root resorption (p<0.05). There was no statistically significant difference in root resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. Conclusion: These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration.