• Title/Summary/Keyword: tooth split

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Hemodynamic changes and pain perception-related anxiety after experiencing an impacted-tooth removal: clinical practice outcome

  • Raocharernporn, Somchart;Boonsiriseth, Kiatanant;Khanijou, Manop;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.2
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    • pp.105-111
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    • 2017
  • Background: Dental fear is usually associated with hemodynamic changes. Fear of pain during the surgical removal of a lower impacted third molar might cause patients anxiety, thereby leading to avoidance of any future dental therapy. This study aimed to determine the effect of experiencing a surgical impacted-tooth removal on the pain perception-related anxiety and hemodynamic status. Method: Twenty-seven healthy patients aged 15-30 years (mean age, 24 years), for whom surgical removal of bilateral lower third molars was advised, were included. This prospective, randomized, controlled, split-mouth study involved operations on both sides of the mandibular arch, with a 1-month washout period in between. Blood pressure and heart rate were measured before the surgical procedure, during and after the injection, preoperatively, and postoperatively. Pain perception was evaluated using a 100-mm visual analog scale during the injection, preoperatively, and postoperatively after the numbness disappeared. Differences in the blood pressure, heart rate, and pain perception between the two appointments were analyzed using the paired t-test. For all statistical analyses, SPSS version 11.5 was used. Results: The mean pain perception values during the injection and preoperatively showed no significant differences between the two appointments (P > 0.05); however, significant differences in the blood pressure and heart rate were noted before the surgical procedure; preoperatively, the blood pressure alone showed a significant difference (P < 0.05). Conclusion: There was a significant decrease in the blood pressure and heart rate preoperatively; hence, experiencing a surgical impacted-tooth removal can reduce the subsequent preoperative anxiety in healthy patients.

Guided bone regeneration using K-incision technique

  • Cho, Young-Dan;Ku, Young
    • Journal of Periodontal and Implant Science
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    • v.48 no.3
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    • pp.193-200
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    • 2018
  • Purpose: The present study describes 3 patients with chronic periodontitis and consequent vertical resorption of the alveolar ridge who were treated using implant-based restoration with guided bone regeneration (GBR). Methods: After extraction of a periodontally compromised tooth, vertical bone augmentation using a K-incision was performed at the healed, low-level alveolar ridge. Results: The partial-split K-incision enabled soft tissue elongation without any change in buccal vestibular depth, and provided sufficient keratinized gingival tissue during GBR. Conclusions: Within the limits of this study, the present case series demonstrated that the novel K-incision technique was effective for GBR and allowed normal implant-based restoration and maintenance of a healthy periodontal condition. However, further long-term follow-up and a large-scale randomized clinical investigation should be performed to evaluate the feasibility of this technique.

The effects of desensitizing agents, bonding resin and tooth brushing on dentin permeability, in vitro (지각과민 처치제 후 접착레진 처리가 상아질 투과도에 미치는 영향)

  • Hong, Seung-Woo;Park, No-Je;Park, Young-Bum;Lee, Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.3
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    • pp.165-176
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    • 2014
  • Purpose: The effects of desensitizing agent are often for a short duration. One of the reasons is believed to be wear of desensitizing agent by tooth brushing. To reduce the wear and make the duration longer, dental bonding resin was applied and the changes of dentin permeability after toothbrushing were measured. Materials and methods: Extracted teeth free from caries were chosen. Coronal dentin discs with thickness of 1 mm were prepared. Using the split chamber device developed by Pashely, hydraulic conductance and scanning electron microscope images (SEM) were compared and contrasted before and immediately after the application of desensitizing agent and bonding resin and then after equivalent tooth brushing of 1 week, 2 weeks, and 6 weeks. Four commercially available desensitizing agents were used in this study; they were All-Bond 2, Seal & Protect, Gluma, and MS Coat. And Dentin/Enamel Bonding resin (Bisco Inc.) was used. The results of this study are as follows. Results: On all specimens, the hydraulic conductance decreased after the application of tooth desensitizing agent and bonding resin. Compared with the specimens treated only with desensitizer, the specimens treated with All-Bond 2, Gluma, MS Coat and plus D/E bonding resin had a little increase in hydraulic conductance after 1, 2 and 6-week tooth brushing. In case of Seal & Protect, the specimens showed the same result only after 6-week tooth brushing. On examination of SEM, the dentinal tubule diameter had decreased after treatment of desensitizing agents and bonding resin. And the specimens treated with All-Bond2, Seal&Protect, Gluma, MS Coat and plus D/E bonding resin had an significant decrease in diameter of dentinal tubule after 6-week tooth brushing. Conclusion: According to the results of this study, it is effective to use bonding resin after application of desensitizer in reducing the wear by tooth brushing and making the duration longer. In this study, just 6-week tooth brushing was performed, and it is not enough to regard it as a long-term data. So further study is needed and more perfect method for treating dentin hypersensitivity should be developed.

Development of Automative Program for Designing Involute Spur Gear (인볼류트 스퍼기어 설계용 자동화 프로그램 개발)

  • So, Jung-Duk;Jung, Sung-Won;Kwon, Soon-Goo;Park, Jong-Min;Choi, Won-Sik;Kim, Jongsoon;Kwon, Soon-Hong
    • Journal of the Korean Society of Manufacturing Process Engineers
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    • v.12 no.6
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    • pp.142-151
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    • 2013
  • This study develops an automation system for metallic mold design that is applicable in forging non-axial symmetric parts. The metallic mold design program is used to design the metallic mold using two-dimensional axial symmetric metallic molds and to predict the stress concentration using finite element analyses. Then, the program redesigns the metallic mold using variables such as the optimal split diameter, maximum allowable inner pressure, fit tolerance, and stress distribution, which are calculated using the metallic mold design program. When the involute spur gear is forged, stress concentration occurs on the tooth root bounded at the symmetric surface. The SCM4 material is suitable for metallic molds because the stress is less than the yield strength of the insert and it acts on the tooth root regardless of the inner pressure. The metallic mold for forging non-axial symmetric parts can be designed through adjusting the magnitude of the contact pressure. The program developed in this study can be applied to metallic mold designs in involute spur gears of forging, which is an ordinary non-axial symmetric part.

Clinical Evaluation After Periodontal Flap Surgery with/without Non-Surgical Periodontal Therapy (비외과적 치주처치의 선행 유무에 따른 치주 판막술 후 임상적 평가)

  • Sinn, Ho-Beom;Yun, Chang-Yup;Kim, Sang-Mok;Kim, Byung-Ock;Han, Kyung-Yoon
    • Journal of Periodontal and Implant Science
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    • v.31 no.1
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    • pp.233-242
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    • 2001
  • In the treatment of chronic adult periodontitis, scaling and root planing have been generally performed prior to periodontal flap surgery. The purpose of this study was to evaluate the clinical significance of nonsurgical periodontal therapy prior to periodontal flap surgery in patients with chronic adult periodontitis. Fifty six molars showing bilateral bony defects and 4-6mm periodontal pocket in twelve patients with chronic adult periodontitis were selected. By randomized split-mouth design, in one side, flap operation was performed 4 weeks after scaling and root planing, in the other group, flap operation was only performed without scaling and root planing. Probing pocket depth, gingival recession, clinical attachment level, gingival index, plaque index, and tooth mobility were measured at baseline, before flap operation and post-operation

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A new rationale for preservation of the mandibular third molar in orthognathic patients with missing molars

  • Baik, Un-Bong;Kim, Yoon-Ji;Chae, Hwa-Sung;Park, Je-Uk;Julian, Stefania;Sugawara, Junji;Lee, Ui-Lyong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.1
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    • pp.63-67
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    • 2022
  • Controversies exist regarding the need for prophylactic extraction of mandibular third molars in patients who plan to undergo orthognathic surgery. An 18-year-old male patient was diagnosed with mandibular prognathism and maxillary retrognathism with mild facial asymmetry. He had a severely damaged mandibular first molar and a horizontally impacted third molar. After extraction of the first molar, the second molar was protracted into the first molar space, and the third molar erupted into the posterior line of occlusion. The orthognathic surgery involved clockwise rotation of the maxillomandibular complex as well as angle shaving and chin border trimming. Patients who are missing or have damaged mandibular molars should be monitored for eruption of third molars to replace the missing posterior tooth regardless of the timing of orthognathic surgery.

A safe, stable, and convenient three-dimensional device for high Le Fort I osteotomy

  • Sugahara, Keisuke;Koyachi, Masahide;Odaka, Kento;Matsunaga, Satoru;Katakura, Akira
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.32.1-32.4
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    • 2020
  • Background: Le Fort I osteotomy is a highly effective treatment for skeletal jaw deformities and is commonly performed. High Le Fort I osteotomy is a modified surgical procedure performed for improving the depression of the cheeks by setting the osteotomy higher than the conventional Le Fort I osteotomy. Developments in three-dimensional (3D) technology have popularized the use of 3D printers in various institutions, especially in orthognathic surgeries. In this study, we report a safe and inexpensive method of performing a high Le Fort I osteotomy using a novel 3D device and piezosurgery, which prevent tooth root injury without disturbing the operation field for patients with a short midface and long tooth roots. Results: A 17-year-old woman presented with facial asymmetry, mandibular protrusion, a short midface, and long tooth roots. We planned high Le Fort I osteotomy and bilateral sagittal split ramus osteotomy. Prevention of damage to the roots of the teeth and the infraorbital nerve and accurate determination of the posterior osteotomy line were crucial for clinical success. Le Fort I osteotomy using 3D devices has been reported previously but were particularly large in size for this case. Additionally, setting the fixing screw of the device was difficult, because of the risk of damage to the roots of the teeth. Therefore, a different surgical technique, other than the conventional Le Fort I osteotomy and 3D device, was required. The left and right parts of the 3D device were fabricated separately, to prevent any interference in the surgical field. Further, the 3D device was designed to accurately cover the bone surface from the piriform aperture to the infra-zygomatic crest with two fixation points (the anterior nasal spine and the piriform aperture), which ensured stabilization of the 3D device. The device is thin and does not interfere with the surgical field. Safe and accurate surgical performance is possible using this device and piezosurgery. The roots of the teeth and the infraorbital nerve were unharmed during the surgery. Conclusions: This device is considerably smaller than conventional devices and is a simple, low-cost, and efficient method for performing accurate high Le Fort I osteotomy.

Skeletal relapse and dental change during intermaxillary fixation after mandibular setback (외과적 하악 후퇴술 후 악간고정기간 중의 골격성 재발과 치열의 변화)

  • Chang, Chong-On
    • The korean journal of orthodontics
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    • v.29 no.4 s.75
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    • pp.457-466
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    • 1999
  • It has been reported that skeletal relapse and dental change after mandibular setback do occur not only after intermaxillary fixation(IMF) removal but also during IMF The side effects of skeletal relapse during IMF have clinical importance because they can cause many Postoperative orthodontic Problems. Generally, the Prevention of solid union between segments, compensatory tooth movement, anterior openbite, etc. have been cited as the side effects of jaw displacement. The purpose of this study was to evaluate the skeletal relapse and dental change during IMF. The material consisted of 28 patients who were treated by BSSRO(bilateral sagittal split ramus osteotomy), wire osteosynthesis, IMF for correction of mandibular prognathism. Through cephalometric analysis, the amount and direction of surgical movement, skeletal relapse and dental change during IMF were measured. The correlation between surgical movement and skeletal relapse, between skeletal relapse and dental changes were evaluated. The following conclusions were obtained; 1. Distal segment was repositioned backward and upward, proximal segment showed clockwise rotation during surgery. 2. During ]m, anterior portion of distal segment was displaced backward and posterior portion was displaced upward. Proximal segment was displaced upward with forward movement of p-Go(gonion of proximal segment). Backward surgical movement of p-GO was significantly correlated with forward displacement of p-Go. 3. Overjet and overbite were not changed during IMF. The compensatory tooth movements during IMF were characterized by retroclination of upper incisors md retroclination, extrusion of lower incisors. These compensatory tooth movements had statistically significant correlation with upward displacement of d-Go (gonion of distal segment).

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CLINICAL STUDY OF COMPLICATIONS OF ORTHOGNATHIC SURGERY FOR THE DENTOFACIAL DEFORMITIES (악변형환자의 악교정수술시 합병증에 관한 연구)

  • Kim, Yeo-Gab;Lee, Sang-Chull;Lee, Baek-Soo;Kim, Byung-Ju
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.3
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    • pp.247-258
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    • 1994
  • We got this conclusion from an investigation about complications from 144 cases of 130 patients who were to be searched their personal records, admission chart, clinical laboratory sheet, anesthetic record, consult sheet and radiographic opinion. They had orthognathic surgery for maxillofacial deformity treatment at the department of oral and maxillofacial surgery in dental school of Kyung Hee university for 4 years and 10 months, from March 1989 to December 1993. 1. In the intraoperative phase, by the frequency of complication, blood vessel injury was found the most-22%, and then soft tissue injury, unfavorable osteotomy split, and there were some cases of tooth injury and inappropriate osteotomy. In the mandibular segmental osteotomy, blood vessel injury was found the most frequently-20 cases (27%), soft tissue injury, unfavorable osteotomy split were the second frequent cases, and then unfavorable fragment position was found. In the extraoral vertical ramus osteotomy and Le Fort I osteotomy also, blood vessel injury and nerve injury were found the most. 2. In the postoperative hospitalization phase, by the frequency of complication, hematoma (23%) was happened the most, except for that, lkie the complication that can be happened by adverse reaction of medicine or long hospital life. In the case of SSRO, there were 21 cases (20%) of hematoma, and this wal the most frequently case. In the case of EVRO, hematoma wasn't happened that much-2 case (4%). 3. In the follow up phase, relaps, numbness and TMJ dysfunction were happened. In mandibular surgery, the forward relapse percentage of point B, was 27% when used wire fixation on SSRO, was 15% by miniplate fixation on SSRO and was 7% on EVRO. In the case of SSRO, numbness was kind of high, comparing to ordinary surgery-12 cases(16 There were many difficulties in analyzing this data accurately, Although orthognathic surgery is done many times, only available date is from the "success" stories and data is not consistently recorded for the cases with complications. In this manner, much essential informantion is lost and overlooked. When data is charted including those cases that are seemingly insignificalt, we can have a much clearer understanding and more accurate guide on treatment protocols.

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THE INFLUENCE OF SMEAR LAYER UPON DENTIN DIFFUSION OF CALCIUM HYDROXIDE IN BOVINE TOOTH IN VITRO (우치의 근관에서 도말층의 존재가 수산화칼슘의 상아질 투과에 미치는 영향)

  • Kwon, Byeong-Goo;Yoon, Tai-Cheol;Park, Deong-Soo
    • Restorative Dentistry and Endodontics
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    • v.22 no.1
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    • pp.111-131
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    • 1997
  • Eighty two of extracted bovine mandibular incisors were sectioned transversely through the cementoenamel junction(CEJ) and instrumented to a size minimum-# 110 file at the working length by 5.25 % NaOCl irrigation. The roots in group 1 were received a final irrigation with 10ml of 17% EDTA followed by 10ml of 5.25% NaOCl, group 2, 10ml of 40% citric acid followed by 10ml of 5.25% NaOCl, group 3, 20ml of 5.25% NaOCl, and control group, 20ml distilled water. Canal walls of four roots in each group and control group were examined by SEM(x3000). Calcium hydroxide was placed into all experimental roots except control group. Each root was placed in nalgen bottle containing unbuffered distilled water. The pH level of the medium surrounding tooth was recorded at 0, one hour, and daily for 1week, then 14days, 21days, and 28days using pH electrode. At 1, 3, 7, 14, 21days, and 28days, four roots from each group were split longitudinally and the ratio change was recorded using spectroiluorometer. The results were followings : 1. The smear layer was totally removed from canal walls in group 1 and 2, but was observed in group 3 and control group. 2. The hydroxyl ion diffused more rapidly through radicular dentin when smear layer was removed from canal walls. 3. The hydroxyl ion derived from calcium hydroxide began to diffuse from the root canal to the exterior surface of the root at 1day, and continued to 1-2weeks. 4. The pH level of dentin near the CEJ was not different in all experimental group regardless of presence of smear layer. It is clinically advisable to place calcium hydroxide into root canal for 1-2weeks for the purpose of expectation of diffusion of hydroxyl ion. But, after the placement of calcium hydroxide into root canal, the consequent pH level of external root surface will be futher studied with respect to it's effect on the root and periodontium.

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