• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.2
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• pp.68-74
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• 2023

Objectives: Drug holidays are suggested to reduce the formation of osteonecrosis in patients under intravenous (IV) bisphosphonates (BPs) therapy. The objectives of this study are to evaluate the incidence of medication-related osteonecrosis of the jaw (MRONJ) following tooth extraction in cancer patients using IV BP, and to assess the effect of drug holiday on the development of MRONJ. Patients and Methods: A manuel search of the patient folders of Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hacettepe University was undertaken to identify cancer patients who used IV BPs and had at least one tooth extraction between 2012 and 2022. Patents' age, sex, systemic condition, the type of BP used, duration of BP used, number of tooth extraction, duration of drug holiday, localization of tooth extraction and incidence of MRONJ were recorded. Results: One hundred nine teeth were removed from 57 jaws in 51 patients. All tooth extractions were performed under perioperative antibiotic prophylaxis and with primary wound closure. The incidence of MRONJ was 5.3%. Stage 1 MRONJ developed in 3 patients (only one had a drug holiday). The median duration of drug holiday was 2 months. No significant difference between the patients with and without a drug holiday and MRONJ development was found (P=0.315). The mean age of patients developed MRONJ was 40.33±8.08 years. A statistically significant difference was found between age and MRONJ development (P=0.002). Conclusion: The effect of a short-term drug holiday on the development of MRONJ may be limited because BPs remain in bone tissue for a long time. Drug holidays should be applied with the approval of an oncologist with other preventive measurements.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.2
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• pp.135-139
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• 2003

A dentigerous cyst is an epithelium-lined sac that surrounds the crown of an unerupted tooth or odontoma. And the most common sites of this cyst are the mandibular and maxillary third molar and maxillary cuspid a areas. Clinically, expansion of bone with subsequent facial asymmetry, extreme displacement of teeth, severe root resorption of adjacent teeth and pain are all possible sequelae of this cyst. The standard treatment for a dentigerous cyst is enucleation and extraction of the involved tooth. But in large cysts, this can lead to functional, cosmetic and psychologic consequences to the patients. So recently, more conservative methods are used. We report 5 cases of dentigerous cysts in pediatric patient which were treated by a conservative approach, By this methods, we can preserve teeth and guide eruption of the teeth which are involved in cystic area.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.10 no.1
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• pp.30-45
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• 2001

In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.3
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• pp.257-263
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• 2015

Impacted teeth occur at higher frequencies in permanent than primary dentition. The most frequently affected teeth are the maxillary and mandibular third molars, whereas it is quite uncommon for the mandibular first molar to be impacted. Treatment methods for impacted teeth include continuous examination for independent eruption, surgical exposure, subluxation after surgical exposure, orthodontic traction, and surgical repositioning. If all of these treatments fail, tooth extraction may be considered. In the first case study, an 8-year-old boy was treated with surgical exposure, after which he was fitted with an obturator. His mandibular first molar then erupted successfully. In the second case, we treated a 12 year-old boy using orthodontic traction. This study describes children with tooth eruption disorders of the mandibular first molar in mixed dentition, and reports acceptable results regarding treatment of the impacted teeth.

• Journal of Korean Dental Science
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• v.7 no.2
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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.

• Journal of Periodontal and Implant Science
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• v.39 no.4
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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.

• The korean journal of orthodontics
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• v.51 no.1
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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.

• Restorative Dentistry and Endodontics
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• v.46 no.3
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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.

• The korean journal of orthodontics
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• v.53 no.4
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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.

• Journal of Veterinary Clinics
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• v.29 no.6
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• pp.474-482
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• 2012

Elongation of cheek teeth roots in pet rabbits is very common, and is associated with malocclusion followed by reduced appetite, salivation, periapical abscess, and epiphora. Conservative methods including medication, drainage, irrigation, tooth trimming, intraoral and extraoral extraction, surgical treatment of periapical abscessation, and diet control have been adapted as the only treatments to resolve elongation of teeth roots. However, remaining challenges include the long-term period of cure and recurrence. This study was performed to investigate the possibility of nonvital pulp therapy on elongation of the mandibular cheek teeth roots in pet rabbits. Thirty-one pet rabbits with dental problems due to root elongation were submitted. Ten pet rabbits among them were treated by nonvital pulp therapy procedures (group A), while the others were treated by conservative methods (group B). Appetite improved within 1-5 days after nonvital pulp therapy and the treatment was discontinued 1 month postoperatively in group A. Abscess occurred in another site not treated with nonvital pulp therapy in only two rabbits. Growth of the mandibular cheek teeth treated with nonvital pulp therapy stopped, resulting in malocclusion, intraoral inflammation from the enamel spur, and abscess of the teeth roots. In the group B rabbits treated with conservative therapy, partial drainage, long term medication, recurrent oral trimming and control of repeated oral inflammation occurred. Consequently, buccotomy or tooth extraction was performed in group B. Owners were satisfied with nonvital pulp therapy preventing dental root abscess and repeated troubles including inflammation and malocclusion and reduction of the treatment period. These results suggest that nonvital pulp therapy can be performed on pet rabbits with elongation of mandibular cheek teeth roots.