• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.1
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• pp.2-12
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• 2023

The current study aimed to explore the types and frequencies of uncommon complications associated with third molar extractions based on a scoping review of case reports and case series. The study used an electronic literature search based on PubMed and Embase up to March 31, 2020, with an update performed on October 22, 2021. Any case reports and case series that reported complications associated with third molar extractions were included. The types of complications were grouped and the main symptoms of each type of complication were summarized. A total of 51 types of uncommon complications were identified in 248 patients from 186 studies. Most types of complications were post-operative. In the craniofacial and cervical regions, the most frequent complications included iatrogenic displacement of the molars or root fragments in the craniofacial area, late mandibular fracture, and subcutaneous emphysema. In other regions, the most frequent complications include pneumomediastinum, pneumorrhachis, pneumothorax, and pneumopericardium. Of the patients, 37 patients had life-threatening uncommon complications and 20 patients had long-term/irreversible uncommon complications associated with third molar extractions. In conclusion, a variety of uncommon complications associated with third molar extractions were identified. Most complications occurred in the craniofacial and cervical regions and were mild and transient.

• The Journal of the Korean dental association
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• v.19 no.2 s.141
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• pp.175-180
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• 1981

The author has studied on extraction of the impacted lower third molar in terms of incision A designed by author, Extraction of those teeth is one of the critical problems involving all dentists and oral surgeons in connection with their professions. 128 patients aged 20-25 with the impacted lower third molar were divided into two groups extracted those teeth under incision A and B shown at the fig.1. And degree of swelling, pain complained, and clinical wound haling on 1,3 and 7 days after extraction of the teeth were observed and analyzed to evaluate which incision is better to extract those teeth. The results were summarized like follows: 1. Degree of swelling after extraction was less observed in extraction undertaken under incision A rather than that in incision B. 2. Patients extracted under incision A less complained pain than those extracted under incision B. 3. Clinical wound healing was better the patients extracted under incision A than those extracted under incision B.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.2
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• pp.166-171
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• 2006

Mucoepidermoid carcinoma is a common salivary gland tumor. It comprised 8% of all salivary gland tumor and originated mainly in parotid gland. Central mucoepidermoid carcinoma is rare. It comprised $2{\sim}3%$ of all mucoepidermoid carcinoma, but it occurs in the mandible two or three times more frequently than in the maxilla. Central Mucoepidermoid carcinoma are frequently associated with an odontogenic cyst, such as dentigerous cyst, in which mucous goblet cell would have neoplastic transformation. In May 2002, a 25 year-old male visits in our clinic, presented with a progressive facial swelling after surgical tooth extraction of left mandibular third molar at 1999 in the army. After incisional biopsy, the lesion was confirmed as mucoepidermoid carcinoma so we performed tumor resection and reconstruction surgery of mandible.

• Journal of Oral Medicine and Pain
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• v.44 no.1
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• pp.40-44
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• 2019

Third molar extraction, one of the important surgical treatments commonly practiced in dentistry, presents various symptoms after surgery ranging from temporary or mild symptoms to permanent or severe complications. However, oral burning pain, dysesthesia, parageusia, dry mouth, headache and pain in multiple teeth are not the common symptoms that patients often complain after dental extraction. Here, the authors report two cases who presented acute neuropathic symptoms mentioned above in the orofacial regions following third molar extraction. At the initial examination, the healing of the tooth sockets of two patients was normal. One patient was diagnosed as megaloblastic anemia associated with Vitamin $B_{12}$ deficiency and was referred to the Department of Hematology for assessing the underlying etiology of anemia. The laboratory test for the other patient revealed microcytic anemia related to iron deficiency. The patient with iron deficiency anemia was successfully treated with iron supplement. These two cases suggest that anemia, as an underlying systemic disease, may be a rare etiology explaining acute onset of peripheral neuropathy in the orofacial regions after third molar extraction and should be considered in the assessment of patients who report neuropathic symptoms after dental extraction.

• Imaging Science in Dentistry
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• v.41 no.3
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• pp.115-121
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• 2011

Purpose : This article is to describe a modified device for intraoral radiography which was developed to obtain reproducible radiographic images for assessment of distal osseous defects of the mandibular second molar (2 Mm) after impacted third molar (3 Mm) surgery. Materials and Methods : A commercial available alignment system for posterior region was modified by adding a reference gauge pin (millimetric) and threading a hollow acrylic cylinder at the ring of the radiographic positioner to attach the X-ray collimator. The design included customized resin acrylic stent for the occlusal surface of the 2Mm in maximum intercuspal position, individualizing the biteblock positioner. Periapical radiographs were taken before and after surgical extraction of 3 Mm, employing the radiographic technique of parallelism described by Kugelberg (1986) with this modified film holder and inserting the gauge pin on the deepest bone probing depth point. Results : This technique permitted to obtain standardized periapical radiographs with a moderate to high resolution, repeatability, and accuracy. There was no difference between the measurements on the pre- and post-operative radiographs. This technique allowed better maintenance of the same geometric position compared with conventional one. The insertion of the gauge pin provided the same reference point and localized the deepest osseous defect on the two-dimensional radiographs. Conclusion : This technique allowed better reproducibility in posterior radiographic records (distal surface of 2 Mm) and more accurate measurements of radiographic bone level by the use of a millimetric pin.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.6
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• pp.348-355
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• 2022

Objectives: To compare the vital sign stability and cost of two commonly used sedatives, midazolam (MDZ) and dexmedetomidine (DEX). Patients and Methods: This retrospective study targeted patients who underwent mandibular third molar extractions under intravenous sedation using MDZ or DEX. The predictor variable was the type of sedative used. The primary outcome variables were vital signs (heart rate and blood pressure), vital sign outliers, and cost of the sedatives. A vital sign outlier was defined as a 30% or more change in vital signs during sedation; the fewer changes, the higher the vital sign stability. The secondary outcome variables included the observer's assessment of alertness/sedation scale, level of amnesia, patient satisfaction, and bispectral index score. Covariates were sex, age, body mass index, sleeping time, dental anxiety score, and Pederson scale. Descriptive statistics were computed including propensity score matching (PSM). The P-value was set at 0.05. Results: The study enrolled 185 patients, 103 in the MDZ group and 82 in the DEX group. Based on the data after PSM, the two samples had similar baseline covariates. The sedative effect of both agents was satisfactory. Heart rate outliers were more common with MDZ than with DEX (49.3% vs 22.7%, P=0.001). Heart rate was higher with MDZ (P=0.000). The cost was higher for DEX than for MDZ (29.27±0.00 USD vs 0.37±0.04 USD, P=0.000). Conclusion: DEX showed more vital sign stability, while MDZ was more economical. These results could be used as a reference to guide clinicians during sedative selection.

• Archives of Craniofacial Surgery
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• v.20 no.6
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• pp.376-381
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• 2019

Background: This study was conducted to determine the relationship between third molar (M3) and mandibular fracture. Methods: Patients with unilateral mandibular angle or condyle fractures between 2008 and 2018 were evaluated retrospectively. Medical records were reviewed regarding the location of fractures, and panoramic radiographs were reviewed to discern the presence and position of ipsilateral mandibular third molars (M3). We measured the bony area of the mandibular angle (area A) and the bony area occupied by the M3 (area B) to calculate the true mandibular angle bony area ratio (area A-B/area A×100). Results: The study consisted of 129 patients, of which 60 (46.5%) had angle fractures and 69 (53.5%) had condyle fractures. The risk of angle fracture was higher in the presence of M3 (odds ratio [OR], 2.2; p< 0.05) and the risk of condyle fracture was lower in the presence of M3 (OR, 0.45; p< 0.05), than in the absence of M3. The risk of angle fracture was higher in the presence of an impacted M3 (OR, 0.3; p< 0.001) and the risk of condyle fracture was lower in the presence of an impacted M3 (OR, 3.32; p< 0.001), than in the presence of a fully erupted M3. True mandibular angle bony area ratio was significantly lower in the angle fractures than in the condyle fractures (p= 0.003). Conclusion: Angle fractures had significantly lower true mandibular angle bony area ratios than condyle fractures. True mandibular angle bony area ratio, a simple and inexpensive method, could be an option to predict the mandibular fracture patterns.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.1
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• pp.46-52
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• 2002

Purpose : We examined the relationships between the root curvatures of the mandibular third molars and their locations on the mandible, so that it might be contributed to elucidate the origin of the formation and development of the Korean mandibular third molar and help many clinicians to treat the mandibular third molars. Materials and Methods : Panoramic radiographs of 237 patients who had been treated at Korea University Ansan Hospital from March, 2000 to April, 2001 and had bilateral mandibular third molars were examined and analyzed. Results : There was no statistically significant difference between men and women (p<0.05). But there were significantly fewer subjects with bilateral curved roots in bilateral third molars regardless of their status (p<0.01) and were statistically significant differences between the groups with bilateral curved roots in the mandibular third molars with same status and with unilateral curved roots in the mandibular third molars with different status and between the groups with unilateral curved roots in the mandibular third molars with same status and with bilateral curved roots in the mandibular third molars with different status(p<0.05). Subjects with bilateral curved roots in the mandibular third molars with bilateral partial impacted status and with bilateral curved roots in the mandibular third molars with bilateral complete eruption status were significantly fewer (p<0.01) and subjects with the mandibular third molars with partial impacted and complete impacted status and with the mandibular third molars with complete erupted and partial impacted status had significantly fewer bilateral curved roots (p<0.05). Conclusions : When we postulate that it is genetic and environmental factors that affect the root formation, it seems that environmental factors have more effects on the formation of the mandibular third molars than on that of the mandibular first and second molars

• Archives of Craniofacial Surgery
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• v.18 no.2
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• pp.73-75
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• 2017

The management of mandibular angle fractures is often challenging and results in the highest complication rate among fractures of the mandible. In addition, the optimal treatment modality for angle fractures remains controversial. Traditional treatment protocols for angle fractures have involved rigid fixation with intraoperative maxillomandibular fixation (MMF) to ensure absolute stability. However, more recently, non-compression miniplates have gained in popularity and the use of absolute intraoperative MMF as an adjunct to internal fixation has become controversial. In this article, the history of, and current trends in, the treatment of mandibular angle fractures will be briefly reviewed. In addition, issues regarding the management of the third molar tooth will be discussed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.3
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• pp.238-243
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• 2001

Purpose : The purpose of this study was to determine radiologic variables affecting extraction of impacted mandibular third molar. Materials and Methods : This study was investigated on 44 consecutive extractions of unilateral impacted mandibular third molars (Male;34, Female;10, Mean age;24.98, Age range;19-35). Fourteen radiologic variables, which were actual value except only one, were evaluated to establish their relation to the operation time. The Pearson correlation coefficient and Stepwise procedures for regression analysis were carried out. Results : Eight variables (depth, angulation, ramus width, relationship to the second molar, distal ramus depth, mesial ramus depth, mesial periodontal ligament width and follicle) showed a statistically significant relation to the operation time(Pearson correlation coefficient, p<0.05). Two variables, depth and mesial periodontal ligament width, showed the most powerful and just relation to the operation time($r^2$ = 0.349, p<0.05). Conclusion : This study shows that our results can help general practioner to estimate the operation time of extraction of impacted mandibular third molars by measuring two radiologic variables ; depth and mesial periondontal ligament width.