Ameloblastic fibro-odontoma (AFO) is a rare odontogenic tumor, which occurs in young children before the age of 20 years. Radiologically, it is a well-defined radiolucent lesion containing radiopaque masses. Histopathologically, AFO is composed of odontogenic epithelium in a primitive-appearing connective tissue and hard tissue consisting of enamel and dentin. It is commonly found in the mandibular posterior region. AFO may be asymptomatic and is often associated with delayed tooth eruption. As it shows similar characteristics clinically and radiologically to odontoma, differential diagnosis through histopathological examination is important. Treatment of AFO is conservative enucleation, and teeth enclosed or associated with the lesion may require extraction. In this report, 2 young patients who visited our clinic with a chief complaint of delayed eruption were diagnosed as AFO with radiological and histopathological examination. After the surgery, the healing status was found to be favorable, and no evidence of recurrence was observed.
A number of experimental studies have been carried out in order to clarify the question as to how temporomandibular joint adapt to the changes of mandibular movement and occlusal equilibration. Recently, the studies on the interrelations between anatomical structure of temporomandibular joint and the state of occlusion have been actively performed in dentistry particularly in prosthodontic field. Author performed extraction of unilateral mandibular molars in 30 mature male rats, and observed histological changes of temporomandibular joint through the light microscope. Following results were obtained. 1. The loss of unilateral teeth gave rise to the changes in the location of condylar head, that is, interior displacement of condylar head in the extraction side and upper displacement in the non-extraction side. 2. Articular disk was compressed by the interior surface of condylar head, resulting in its extension below the condylar neck in the extraction side, and the histological arrangement of the compressed area showed irregular feature. 3. The extension of articular disk below the condylar neck was accompanied with the contraction of muscle fibers which were originated from the articular disk. 4. The cartilage layer of articular fossa to the exterior of the extraction side showed hypertropy. 5. Early in the experiment, the inernal extremity of condylar head of extract ion side showed bone resorption, and cartilage layer of condylar head showed hypertropy. At 12 weeks after experiment, the condylar surface showed flattened, and the cartilage layer of condylar head was replaced by the compact bone. 6. The articular disk showed the formation of pannus in the extraction side as well as in the non-extraction side. 7. The occlusal disturbance due to unilateral missing teeth has brought about the non-inflammatory retrogressive change and osteoarthrotic change late in the experiment.
The purpose of this study was to evaluate the effect of dexamethasone on the healing aspect of gingiva and alveolar bone after extraction. Extracted socket of 24 Sprague-Dawley rat was used. To extract easily and minimize injury, ${\beta}-APN$ 0.2g/kg/day soluted in mineral water was administrated for 5 days before extraction in both group. Ampicillin 1.5ml/kg i.m.,q.d, was administered for preventing infection after teeth extraction in both group, and dexamethasone 0.2mg/kg/day was injected for 3 days in experimental group.3 rats on each day was sacrificed on 1, 3, 7, 15 days after extraction. Histologic examination and the activity of osteoclasts by tartrate resistant acid phosphatase was observed. The results were as follows : 1. The Overall healing pattern was similar with both the experimental and control group, but in experimental group osseous healing was delayed. 2. The activity of osteoclasts was increased to day 3 and then decreased after day 3 in the experimental group. In comparison to the control group, the experimental group showed increased appearance to day 7 and then decreased appearance following day. 3. Regarding to the change of osseous tissue, the activity of osteoblasts was shown at day 7,but osteoclastic activity of the experimental group was less than that of the control group. The osteoclastic activity was statistically significant between two groups except day 7(p<0.05, p<0.01). In conclusion, the effects of dexamethasone for healing of extraction socket were considered as limiting the activity of osteoclasts, and the healing of extraction socket was delayed.
The purpose of this experimental study was to evaluate aㅜd compare maxillary arch dimensional and positional changes between first and second premolar extraction groups. The Calorific Machine was used to illustrate tooth movement in three dimensions. The experimental teeth except the first or second premolars were embedded in artifical alveolar bone. The extraction space was closed using arch wires with bull loops into which 15 degree gable bends were placed. Before and after space closure, radiographs were taken in the sagittal and occlusal directions using occlusal films. The results showed greater mean maxillary incisor retraction and less anchorage loss in the maxillary first premolar extraction group than in the maxillary second premolar extraction group. Mesiopalatal rotation of anchor teeth was greater after extraction of a maxillary second premolar than a maxillary first premolar (P<.001).
Purpose : The purpose of this study was to examine the inferior expansion of the maxillary sinus floor following maxillary molar extraction. Materials and Methods : Cone beam computed tomographic images of 59 subjects were used to evaluate the height difference of the maxillary sinus floor between extraction sites and contralateral dentate sites. The height of the maxillary sinus floor was defined as the vertical distance to the Frankfort plane from the level of the anterior nasal spine to the most inferior point of the sinus floor. We examined the difference in sinus pneumatization according to the number of missing teeth and the vertical relationship of the molar roots to the sinus floor. Results : The inferior expansion of the maxillary sinus floor was $1.20{\pm}1.86\;mm$ on the maxillary first molar and $1.90{\pm}2.42\;mm$ on the maxillary second molar. Increased expansion was observed in cases where two proximate molars were extracted. There was no significant difference in sinus pneumatization following extraction according to the vertical relationship of the molar roots to the sinus floor. Conclusion : The results of this study confirm that sinus pneumatization occurs following maxillary molar extraction. In situations where pneumatization can affect treatment after molar extraction, three-dimensional radiography should be considered.
Cephalometric superimposition is unable to evaluate tooth movement along the occlusal plane and the errors of photographing and superimposition of the occlusogram is also inevitable. The purpose of the present study was to evaluate the rotational movements of the maxillary posterior teeth following space closure after extraction of maxillary first premolars. using 3D dental images. In 19 adult females. analysis of rotational movements of the maxillary posterior teeth was performed between the initial and final 3D dental images superimposed on the maxillary hard palate. The results showed a diversity of rotational movements of posterior teeth. The causes of various rotational movements may be different rotation of molars in each case at the beginning of treatment. individual characters of the dental arch and tooth morphology. The results of the study indicate that accurate evaluation of rotational movements of posterior teeth following space closure after extraction of premolars using 3D dental images can be obtained through the subdivision of tooth movement during the initial aligning, space closure and finishing stages.
Journal of the korean academy of Pediatric Dentistry
/
v.31
no.2
/
pp.267-272
/
2004
This case report describes an uncommon treatment method for crown-root fractured incisor with immature root. A 7-year-old girl was referred for treatment of crown-root fractured maxillary central incisor. The fracture line extended to 1/2 of the total tooth length with incomplete root formation. The prognosis of crown-root fracture is usually poor and extraction is usually undertaken. But, in the mixed dentition, extraction of maxillary permanent incisor results in many complications, such as resorption of alveolar bone, poor esthetics, pronunciation and mastication. Conservative therapy in the permanent dentition comprises of few treatment modalities; supragingival restoration, gingivectomy, orthodontic extraction of apical fragment, surgical extrusion of apical fragment with or without rotational replantation. However, in this case, these indications are not applicable, so intentional replantation with adhesive resin system is the treatment of choice. The tooth was followed-up for 12 months. Currently, there are no symptoms. Since this modality adopts the respective advantages of both intentional replantation and adhesive treatment, it might be the treatment of choice in cases of vertical crown-root fracture.
Journal of the korean academy of Pediatric Dentistry
/
v.34
no.1
/
pp.162-168
/
2007
Impaction of the maxillary central incisor may cause social, esthetic, and functional problems in children. There are various means of treatment for the inverted maxillary central incisor, such as extraction, surgical opening followed by orthodontic traction surgical repositioning or intra-alveolar autotransplantation prior to extraction. In this case, we surgically repositioned the inverted maxillary central incisor to normal semi-erupted position in a 5-year-old boy The developmental stage of the inverted tooth was Nolla's 6.5, which indicates formation of less than one third of the root. After surgical reposition, we did follow-up for 21 months, expecting spontaneous growth Unfortunately, poor prognosis was noted further root was not observed. Such failure seems to originate from possible injury on Hertwig's epithelial root sheath by surgical trauma. We performed surgical repositioning to retain the tooth instead of extraction. However, arrest of root development occurred which is one of the critical complications. In order to increase the success rate of the surgical reposition procedure, minimal surgical trauma is required as well as selection of adequate indication and decision of proper time of treatment considering the stage of root development.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.32
no.4
/
pp.334-347
/
2006
The aim of this study is to evaluate the reasonableness of the medical fee on oral and maxillofacial surgery field according to surgeon's opinions and actual conditions. The medical fee has significant influence on hospital income, the supply and distribution of medical manpower, quality and facilities of medical services. Questionnaire survey was sent to 86 oral and maxillofacial surgeons who worked more than 3 years in general hospital. Among them, 25 doctors replied the 109 answers survey and the average of treatment time and physician work relative value on each category was calculated. And the health insurance cost (that has been applied since 2003) was compared with the questionnaire results. And finally we investigated items that health insurance system did not include in oral and maxillofacial field but actually performed in oral and maxillofacial surgery clinic. The result was that the medical fee did not properly reflect physician work relative value of actual treatments. In case of complicated extraction, work relative value needed 3.5 times enhancement of present value. For simple impacted tooth extraction 1.8 times, for impacted tooth extraction including odontomy 1.7 times, and for fully impacted tooth more than 2/3 of it located into the alveolar bone, 1.8 times enhancement needed. In respect of the present physician work relative value, hemimandibulectomy with neck lymph node dissection for the malignancy is appropriated as 3.3 times of open reduction and internal fixation for the mandibular fracture, but the questionnaire result showed 25 times discrepancy. In conclusion, this research shows the need for intervention that health insurance included items and legal relative medical value must act in union with treatment in clinic to reduce the imbalance between them.
To evaluate the efficacy of antibiotic administration in the impacted mandibular third molar extraction the author investigated 107 patients requiring extraction of the lower third molar who visited at the Department of oral and maxillofacial Surgery, Chosun Dental Hospital and were healthy without medical problems and had no signs and symptoms of infection around the lower third molar. The patients were divided into 4 groups according to the method of antibiotics administration: 13 patients without antibiotics administration(group 1), 30 patients with only intravenous injection of $Cefazoline^{(R)}$ 2.0g 30 minutes before the procedure(group 2), 39 patients with intravenous injection of $Cefazoline^{(R)}$ 2.0g 30 minutes before the procedure and oral administration of follow-up dosages of $Augmentin^{(R)}$ for 1 day(group 3), and 25 patients with intravenous injection of $Cefazoline^{(R)}$ 2.0g 30 minutes before the procedure and oral administration of follow-up dosages of $Augmentin^{(R)}$ for 3 day(group 4). Infection rates after extraction were calculated and compared according to gender, the age of the patients, the level of impaction, and also compared between four groups. The results were as follows. 1. The overall infection rate was 8.4%. 2. The infection rate was higher in male(11.9%) than in female(4.2%), but there were statistically no significant differences between them. 3. Infection rate was lower in patients under age 30(7.2%) than in patients over age 30(12.5%), but there were statistically no significant between them. 4. Infection rate was higher in patients with complete bony impacted tooth(11.1%) than in patients with partial bony impacted tooth(6.5%), but there were statistically no significant differences between them. 5. Infection rate was 7.7% in group 1, 10.0% in group 2, 10.3% in group 3, 4.0% in group 4 and there were statistically no significant differences between groups. In summary, it is more important to extract the impacted lower third molar under aseptic condition and to minimize the injury of tissue if possible than to administer the preventive antibiotics in reducing the infection rate in healthy patients without medical problems who had no signs and symptoms of infection around the lower third molar.
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