• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.1
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• pp.51-59
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• 2016

The purpose of the present retrospective study was to analyze gender, age, awareness, etiology, and treatment choice in patients with failed eruption of the mandibular first molar. Radiographic material and dental records from 67 patients with 74 mandibular first molars with failed eruption treated during the years 2001-2014 were evaluated. As results, the prevalence of mandibular first molar with failed eruption was higher in males than females, and the average awareness age was 9.19 years old. The most common etiological cause was unknown, and the next most common causes were abnormal eruption pathway and odontogenic tumor in order. In this study, it is suggested that more dental education to children about the time of eruption of permanent tooth is required, and the importance of regular dental check-ups is emphasized during mixed dentition.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.2
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• pp.69-76
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• 2015

Background: There have been few studies on the effect of an elevated concentration of lidocaine hydrochloride in the surgical removal of an impacted lower third molar. This study aimed to examine the efficacy of 4% lidocaine along with 1:100,000 epinephrine compared to 2% lidocaine along with 1:100,000 epinephrine as inferior alveolar nerve block for the removal of an impacted lower third molar. Methods: This single-blind study involved 31 healthy patients (mean age: 23 y; range: 19-33 y) with symmetrically impacted lower third molars as observed on panoramic radiographs. Volunteers required 2 surgical interventions by the same surgeon with a 3-week washout period. The volunteers were assigned either 4% lidocaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine as local anesthetic during each operation. Results: We recorded the time of administration, need for additional anesthetic administration, total volume of anesthetic used. We found that the patient's preference for either of the 2 types of local anesthetic were significantly different (P < 0.05). However, the extent of pulpal anesthesia, surgical duration, and duration of soft tissue anesthesia were not significantly different. Conclusions: Our study suggested that inferior alveolar nerve block using 4% lidocaine HCl with 1:100,000 epinephrine as a local anesthetic was clinically more effective than that using 2% lidocaine HCl with 1:100,000 epinephrine; the surgical duration was not affected, and no clinically adverse effects were encountered.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.4.1-4.10
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• 2019

Background: The mandibular third molar (M3) is typically the last permanent tooth to erupt because of insufficient space and thick soft tissues covering its surface. Problems such as alveolar bone loss, development of a periodontal pocket, exposure of cementum, gingival recession, and dental caries can be found in the adjacent second molars (M2) following M3 extraction. The specific aims of the study were to assess the amount and rate of bone regeneration on the distal surface of M2 and to evaluate the aspects of bone regeneration in terms of varying degree of impaction. Methods: Four series of panoramic radiographic images were obtained from the selected cases, including images from the first visit, immediately after extraction, 6 weeks, and 6 months after extraction. ImageJ software^® (NIH, USA) was used to measure linear distance from the region of interest to the distal root of the adjacent M2. Radiographic infrabony defect (RID) values were calculated from the measured radiographic bone height and cementoenamel junction with distortion compensation. Repeated measures of analysis of variance and one-way analysis of variance were conducted to analyze the statistical significant difference between RID and time, and a Spearman correlation test was conducted to assess the relationship between Pederson's difficulty index (DI) and RID. Results: A large RID (> 6 mm) can be reduced gradually and consistently over time. More than half of the samples recovered nearly to their normal healthy condition (RID ≤ 3 mm) by the 6-month follow-up. DI affected the first 6 weeks of post-extraction period and only showed a significant positive correlation with respect to the difference between baseline and final RID. Conclusions: Additional treatments on M2 for a minimum of 6 months after an M3 extraction could be recommended. Although DI may affect bone regeneration during the early healing period, further study is required to elucidate any possible factors associated with the healing process. The DI does not cause any long-term adverse effects on bone regeneration after surgical extraction.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.303-308
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• 2011

Tooth impaction refers to situations in which the eruption is inhibited by some physical barriers in eruptive path and the tooth remains unerupted beyond the normal time of eruption. The etiology of impacted tooth is controversial, but ankylosis has been suggested probably as a leading role. Impacted primary molars may cause several problems such as space loss, tipping of adjacent teeth, supra-eruption of the antagonists, dislocation of succeeding premolar, cystic change and infection. As one of conventional treatments of impacted primary molars, early tooth extraction or surgical extraction following space regaining when there is space loss has been suggested. However, when they are in normal formation and not ankylosed, orthodontic traction following surgical exposure can be the choice of treatment. In this case, a 3-year-old boy was referred to the department of pediatric dentistry for the unerupted mandibular right second primary molar. After surgical removal of gingiva on the occlusal surface, orthodontic traction was performed. After treatment, we could get normal alignment of primary teeth and the opportunity for normal development of permanent teeth.

• Imaging Science in Dentistry
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• v.44 no.1
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• pp.61-65
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• 2014

Purpose: This study was performed to evaluate the position of impacted mandibular third molars in different skeletal facial types among a group of Iranian patients. Materials and Methods: A total of 400 mandibular third molars in 200 subjects with different types of facial growth were radiographically investigated for their positions according to their types of facial growth on the basis of the ${\beta}$ angle. The subjects were divided into three groups (class I, II, and III) according to ANB angle, representing the anteroposterior relationship of the maxilla to the mandible. Meanwhile, the subjects were also divided into three groups (long, normal, and short face) according to the angle between the stella-nasion and mandibular plane (SNGoGn angle). ANOVA was used for statistical analysis. Results: The mean ${\beta}$ angle showed no significant difference among class I, II, and III malocclusions (df=2, F=0.669, p=0.513). The same results were also found in short, normal, and long faces (df=1.842, F=2, p=0.160). The mesioangular position was the most frequent one in almost all of the facial growth patterns. Distoangular and horizontal positions of impaction were not found in the subjects with class III and normal faces. In the long facial growth pattern, the frequency of vertical and distoangular positions were not different. Conclusion: In almost all of the skeletal facial types, the mesioangular impaction of the mandibular third molar was the most prevalent position, followed by the horizontal position. In addition, ${\beta}$ angle showed no significant difference in different types of facial growth.

• Imaging Science in Dentistry
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• v.30 no.1
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• pp.80-86
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• 2000

A 37-year-old male with the complaint of intermittent gingival swelling and dull pain associated with the food impaction of the mandibular third molar area was referred to our department of Chonbuk National University Hospital. The dental history of the patient showed that he had extracted the maxillary left third molar without complications two years ago. Intraoral and panoramic radiographs showed diffuse increased radiopacity of the maxilla and mandible. The trabecular pattern was obliterated. Postero-anterior skull and lateral skull radiographs showed thickening of cortical bone and diffuse increased radiopacity of the skull. Additional radiographs showed similar changes in the lumbar spine, clavicles, iliac bone and femur. However, no evidence of osteomyelitis was observed clinically and radiographically. Laboratory findings showed normal values of serum calcium, phosphorus, and alkaline phosphatase. Based on the radiographic examinations and the laboratory findings, final diagnosis was made as a benign osteopetrosis.

• The Journal of the Korean dental association
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• v.57 no.6
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• pp.326-332
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• 2019

Extraction treatment has been used for a long time to treat crowding or lip protrusion patients and still extraction decision is the most difficult and important decision during diagnosis and treatment planning. If the amount of crowidng is severe, premolar extraction is often considered. Because of their location, premolar extractions would seem to allow for the most straightforward relief of crowding and the improvement of soft tissue profile. But patients and their parents often prefer nonextraction approach if possible and such a preference gives us serious question about the boundary of nonextraction treatment. Because Orthodontic Mini-Implant (OMI) become popular these days, distalization of posterior teeth can be obtained easily without patient's compliance. For this reason, many orthodontists are trying to treat crowding patient with nonextraction than before. But sometime, unexpected side effects are observed including unesthetic profile, impaction of second molar and long treatment time. All the tools for space gaining - extraction, arch expansion, molar distalization and interproximal enamel reduction - have their limitations and indications. Possible side effects and limitations should be carefully considered during the treatment planning. Although Korean patients usually require extraction more often than US or European patients, more knowledge about the tools for space gaining would help us to decrease the rate of extraction and the problems during treatment of crowding patients.

• Imaging Science in Dentistry
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• v.52 no.3
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• pp.289-294
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• 2022

Purpose: This study aimed to evaluate the diagnostic performance of panoramic images compared to cone-beam computed tomography (CBCT) imaging for maxillary third molar (M3)-associated external root resorption (ERR), and to identify the risk factors of ERR on panoramic images. Materials and Methods: The study population was composed of all patients who underwent panoramic imaging at Dankook University Dental Hospital from May to October 2019. In total, 397 cases of maxillary M3s in 247 patients(147 men and 100 women) were included. The diagnostic accuracy of ERR in panoramic images compared to CBCT images was evaluated using the chi-square test. To identify risk factors for ERR, dental records and panoramic findings were evaluated by logistic regression analysis. Results: The diagnostic accuracy of ERR on panoramic images was 0.79 compared to CBCT images (P<0.05). Superimposition of M3s onto second molars (M2) was associated with an approximately 33 times higher risk of ERR than separated M3s(P<0.05). Impacted M3s showed a 5 times higher risk of ERR than erupted M3s(P<0.05). Conclusion: ERR related to M3s is a common clinical condition, and superimposition of M3 onto M2 on panoramic images was the most important risk factor for ERR. It seemed that CBCT examinations for maxillary M3s might be indicated for ERR diagnosis especially if panoramic radiographs show superimposition of M3 onto M2. Impaction itself was also a risk factor, and it should be carefully examined.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.2
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• pp.217-223
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• 2005

The term 'impaction teeth' is used to designate a tooth which remains unerupted in jaw beyond the time at which it should normally be erupted. Most cases of impacted teeth reported in the literature are permanent teeth. The impaction of primary teeth occur rarely whereas impaction of second primary molars is more numerous than all other impactions. Failure of eruption of primary teeth may cause a number of complications, such as interference with development and eruption of successive permanent teeth, malocclusion, cystic change of tooth follicle. The clinican should consider the various treatment option available (a) No treatment and observation, (b) surgical extraction (c) space regainer. Proper treatment plan should be established after thought consideration of impacted tooth and it's relation with successive permanent tooth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.5
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• pp.343-348
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• 2011

Introduction: Third molar extraction is one of the most common procedures in oral and maxillofacial surgery. The impacted third molar causes many pathological conditions, such as pericoronitis, caries, periodontitis, resorption of adjacent teeth, and cyst or tumors associated with impacted teeth. Extraction is often considered the treatment of choice for impacted lower third molars. On the other hand, imprudent extraction of deeply impacted third molars can cause permanent complications, such as inferior alveolar nerve damage. Therefore, guidelines for the extraction of lower third molars should be set to prevent embarrassing complications. This study examined the indication and current trends of the extracted lower third molars in the dental hospital of a dental college. Materials and Methods: 557 extracted third molars were evaluated at the department of oral and maxillofacial surgery of Yonsei University. The chief complaint, diagnosis, age and degree of impaction were analyzed to determine the tendency for the extraction of asymptomatic lower third molars. Results: The percentage of asymptomatic third molars was 40.8%. In cases of full impacted tooth or full erupted tooth, the percentage of asymptomatic teeth was more than 50% (52.4% and 54.3, respectively). Among those partially impacted teeth, 73.1% of them showed symptoms, such as pain, tenderness and swelling. In terms of age, pericoronitis was evident at a younger age, and dental caries/periodontitis was the main cause of removal in those aged over 50. Twenty nine cases (1.6%) had teeth associated with pathological changes Conclusion: The incidence of pathological changes to the lower third molar was relatively low. Surgical extraction is recommended in cases of partially impacted teeth. In Korea, the incidence of asymptomatic third molar extraction was relatively higher than in European countries. More careful attention would be desirable to consider the risks and benefits of lower third molar extraction.