• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.2
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• pp.165-171
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• 2008

The aim of this study was to evaluate the incidence of panoramic radiological risk signs related with mandibular third molar extraction, and the relationship between these risk signs and inferior alveolar nerve (IAN) injury after tooth extraction. Cases were defined as 1000 mandibular third molars extracted by surgical approach at Samsung Medical Center during the period from March 2001 to December 2006. Seven radiological risk signs were assessed on the panoramic radiogram by three expert oral surgeons. Clinical demographic data and severity of IAN injury were examined on medical records. Bivariate analyses were completed to assess the relationship between radiological risk signs and IAN injury. The radiological risk signs showed in 381 cases(38.1%). The incidence of each radiological risk signs were; interruption of IAN white line, 152 cases(15.2%); deflected roots, 141 cases(14.1%); darkening root, 119 cases(11.9%); diversion of IAN, 57 cases(5.7%) ; IAN narrowing, 37 cases(3.7%); root narrowing, 17 cases(1.7%); dark and bifid apex, 10 cases(1.0%). The incidence of IAN injury in cases with risk signs were: in the case of any sign, 3.6%; interruption of IAN white line, 2.6%; deflected roots 5.7%; darkening root. 3.4%; diversion of IAN, 5.7%; IAN narrowing, 3.7%; root narrowing, 5.9%; dark and bifid apex, 0%. No IAN injury was showed in 619 cases without risk sign (p<0.05). In conclusion, the presence of panoramic risk signs was associated with an increased risk for IAN injury during mandibular third molar extraction, whereas the absence of risk signs was associated with a minimal risk of nerve injury.

• Journal of The Korean Dental Society of Anesthesiology
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• v.9 no.1
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• pp.24-29
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• 2009

When performing the inferior alveolar nerve block anesthesia, surgeon often faced a difficulty of the surgical operation due to the incomplete anesthesia. One of the reason is the variety of mandibular canal anatomy. Up to now, there are some reports of index cases about bifid mandibular canal among mandibular canal anatomic variation, and some classification is applied according to anatomical location and configuration. When surgical operation is performed involving mandible such as dantal implant treatment, extraction of an impacted third molar, sagittal split ramus osteotomy, etc, the position of mandibular canal should be considered. Bifid mandibular canal clinically causes troublesome cases of anesthesia when inferior alvelor nerve block, especially is performed extraction of an impacted third molar. Therefore, It is important for clinicians to recognize the presence of bifid canals on radiographys. Nowadays, the position of mandibular canal can be measured precisely by using Dental CT. It is not found by panorama image but is found by Dental CT sometimes. Among the patients, which take panorama and Dental CT simultaneously, for tooth extraction of lower impacted third molar in our department, we report the case that did not identifying in panorama but identifying it in Dental CT.

• Imaging Science in Dentistry
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• v.39 no.4
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• pp.209-212
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• 2009

Bifid mandibular canal can be an anatomic variation. This condition can lead to complication when performing mandibular anesthesia or during extraction of lower third molar, placement of implants and surgery in the mandible. Four patients underwent preoperative imaging for extraction of third molars using CBCT (CB Mercuray, Hitachi, Japan). The axial images were processed with CBworks program 2.1 (CyberMed Inc., Seoul, Korea). The branches for supplying the lower third molar were identified mainly on cross-sectional and panoramic images of CBCT. Since the location and configuration of mandibular canal variations are important in any mandibular surgical procedures, we report 4 cases of bifid mandibular canal with panoramic and the CBCT images.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.5
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• pp.407-408
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• 2021

Extraction of impacted third molars is a routine procedure performed by oral and maxillofacial surgeons. However, extractions in middle-aged or elderly individuals are not easy, and there are several factors that need to be considered. These factors include decreased healing potential and the risk of complications increasing with age. In addition, third molars can often be fully or deeply impacted in middle-aged individuals, and pathologic changes, such as cysts, caries, or periodontitis of the adjacent second molar, can develop. Furthermore, the rate of ankylosis and systemic disease increases after middle age. It is considered that these factors acting alone or in combination increase the difficulty of extraction.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.5
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• pp.281-291
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• 2020

Background: Corticosteroids have been widely used by oral surgeons for reducing swelling caused by wisdom teeth surgery. However, they have not been proven to decrease pain. This study was aimed at analyzing previous studies pertaining to corticosteroids and pain reduction following wisdom teeth surgery. Methods: The Science Direct, PubMed, and MEDLINE databases were searched for relevant journals according to a systematic search strategy (Patient Intervention Comparison Outcome Study). Randomized controlled trials published in English from 1998 to 2017 were extracted. Results: Twenty-seven articles were included, with a total of 36 comparative cases. Methylprednisolone and dexamethasone were the most commonly used corticosteroids. Intramuscular injections of corticosteroids were optimal for pain reduction, regardless of the time of administration. Conclusions: Corticosteroids can be used as an adjuvant for pain reduction following wisdom teeth surgery. Methylprednisolone and dexamethasone delivered via the intramuscular route is the best method for effective pain reduction. The ideal time for administration of corticosteroids is the preoperative period.

• Journal of Korean Dental Science
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• v.7 no.1
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• pp.25-30
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• 2014

Subcutaneous emphysema and pneumomediastinum is a relatively uncommon phenomenon. It may occur secondary to dental treatment using high-speed air turbine handpieces, especially after extraction of tooth. Subcutaneous emphysema is often limited only to the areas of head and neck, but also can involve deeper structures. Thorough examination and conservative treatment of these problems are essential in preventing life-threatening complications such as airway obstruction and mediastinitis. The subject of this report is a 57-year-old woman with subcutaneous emphysema and pneumomediastinum during the extraction of maxillary third molar using high-speed air turbine handpiece. If there isn't any appropriate measure, severe complications may occur. Therefore it is important to be well-informed of proper diagnosis and treatment. This article shall present a case report with literature review.

• Journal of Korean Dental Science
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• v.3 no.2
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• pp.4-11
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• 2010

Purpose: This study aimed at examining the thickness of lateral cortical bone in the mandibular posterior body and the location of the inferior alveolar nerve canal as well as investigating the clinically viable bone grafting site(s) and proper thickness of the bone grafts. Subjects and Methods: The study enrolled a total of 49 patients who visited the Department of Oral and Maxillofacial Surgery at Kyung Hee University Dental Hospital to have their lower third molar extracted and received cone beam computed tomography (CBCT) examinations. Their CBCT data were used for the study. The thickness of lateral cortical bone and the location of inferior alveolar nerve canal were each measured from the buccal midpoint of the patients' lower first molar to the mandibular ramus area in the occlusal plane of the molar area. Results: Except in the external oblique ridge and alveolar ridge, all measured areas exhibited the greatest cortical bone thickness near the lower second molar area and the smallest cortical bone thickness in the retromolar area. The inferior alveolar nerve canal was found to be located in the innermost site near the lower second molar area compared to other areas. In addition, the greatest thickness of the trabecular bone was found between the inferior alveolar nerve canal and the lateral cortical bone. Conclusions: In actual clinical settings involving bone harvesting in the posterior mandibular body, clinicians are advised to avoid locating the osteotomy line in the retromolar area to help protect the inferior alveolar nerve canal from damage. Harvesting the bone near the lower second molar area is judged to be the proper way of securing cortical bone with the greatest thickness.

• The Journal of the Korean dental association
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• v.32 no.1 s.296
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• pp.56-57
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• 1994

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.60.1-60.6
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• 2019

Background: The lingual nerve plays an important role in multiple functions, including gustatory sensation and contact sensitivity and thermosensitivity. Misdiagnosed conservative treatments for serious lingual nerve (LN) injuries can induce the patient to serious mental disability. After continuous observation and critical diagnosis of the injury, in cases involving significant disruption of lingual nerve function, microneurosurgical reconstruction of the nerve is recommended. Direct anastomosis of the torn nerve ends without tension is the recommended approach. However, in cases that present significant gaps between the injured nerve ends, nerve grafts or conduits (tubes of various materials) are employed. Recently, various reconstruction materials for peripheral nerves were commercially offered especially in the USA, but the best method and material is still unclear in the world. There currently exists no conventional protocol for managing LN neurosensory deficiency in regard to optimal methods and the timing for surgical repair. In Japan, the allograft collagen nerve for peripheral nerves reconstruction was permitted in 2017, and we tried to use this allograft nerve and got a recommendable result. Case presentation: This report is a long-term abandoned torn LN reconstructed with allograft nerve induced by the lower third molar extraction. Conclusions: In early sick period, with the exact diagnosis, the LN disturbance should be managed. In a serious condition, the reconstruction with allograft nerve is one of the recommendable methods.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.2
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• pp.108-115
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• 2020

Objectives: Kinesiology tape (KT) creates a pulling force on the skin, thus improving blood and lymph flow by alleviating hemorrhage and congestion of lymphatic fluid. The authors hypothesized that the use of KT could be beneficial for the management of complications after head and neck surgery and designed this study to evaluate the effects of KT on swelling, pain, and trismus after enucleation of mandibular dentigerous cysts with third molar extraction. Materials and Methods: Forty patients who underwent enucleation of a dentigerous cyst with extraction of the mandibular third molar were selected. The patients were randomized into two groups (n=20 each): a KT group, where KT was applied after surgery in addition to basic postoperative care, and a control group, where patients received basic postoperative care without KT application. Swelling, pain, and trismus were evaluated before surgery (T0) and on postoperative days 1 (T1), 2 (T2), and 3 (T3). Cyst volume, gauze weight for assessing bleeding, and operation time were recorded. Results: There was a significant difference between the two groups in the change in swelling up to T1 and the change in swelling between T1 and T2. The maximum swelling in the KT group was significantly less than that in the No-KT group and maximum swelling appeared faster in the KT group than in the No-KT group. Both groups showed a mild pain response but there was no significant difference between the two groups. There was no significant difference on interincisal distance change between the two groups. There were no correlations between cyst volume, bleeding, operation time, and maximum swelling. Conclusion: KT can effectively manage facial swelling after oral and maxillofacial surgeries such as cyst enucleation and third molar extraction, thus improving postoperative patient satisfaction levels and quality of life.