• 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 Association of Oral and Maxillofacial Surgeons
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• v.34 no.6
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• pp.640-643
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• 2008

Distal caries of the second molar is common indication for the mandibular third molar surgery and there are no universally acceptable predictive criteria for distal caries of the second molar. To analyze the correlation of the distal caries of the second molar and the eruption state of the mandibular third molar using panoramic radiographs statistically and propose the acceptable guideline for preventive extraction of the mandibular third molar. 786 patients who were extracted the mandibular third molar from 2002 to 2006 at Samsung medical center were examined. The presence and absence of distal caries of mandibular second molar, age, gender, angulation, impaction degree, distance between distal cementoenamel junction of the second molar and mesial cementoenamel junction of the mandibular third molar were assessed. 79.6% of third molars had a mesial angulation of between $40^{\circ}$ and $80^{\circ}$. The mean age of third molar removal for distal caries of second molar was $33.86{\pm}9.81$. The prophylactic removal of a mesio-angular third molar about $40^{\circ}$ and $80^{\circ}$ could prevent distal cervical caries forming in the mandibular second molar.

• The korean journal of orthodontics
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• v.50 no.5
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• pp.324-335
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• 2020

Objective: To compare postoperative positional changes in the mandibular proximal segment between the conventional orthognathic surgery (CS) and the surgery-first approach (SF) using intraoral vertical ramus osteotomy (IVRO) in patients with Class III malocclusion. Methods: Thirty-eight patients with skeletal Class III malocclusion who underwent bimaxillary surgery were divided into two groups according to the use of preoperative orthodontic treatment: CS group (n = 18) and SF group (n = 20). Skeletal changes in both groups were measured using computed tomography before (T0), 2 days after (T1), and 1 year after (T2) the surgery. Three-dimensional (3D) angular changes in the mandibular proximal segment, condylar position, and maxillomandibular landmarks were assessed. Results: The mean amounts of mandibular setback and maxillary posterior impaction were similar in both groups. At T2, the posterior portion of the mandible moved upward in both groups. In the SF group, the anterior portion of the mandible moved upward by a mean distance of 0.9 ± 1.0 mm, which was statistically significant (p < 0.001). There were significant between-group differences in occlusal changes (p < 0.001) as well as in overjet and overbite. However, there were no significant between-group differences in proximal segment variables. Conclusions: Despite postoperative occlusal changes, positional changes in the mandibular proximal segment and the position of the condyles were similar between CS and SF, which suggested that SF using IVRO achieved satisfactory postoperative stability. If active physiotherapy is conducted, the proximal segment can be adapted in the physiological position regardless of the occlusal changes.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.10 no.1
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• pp.30-45
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• 2001

In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.363-372
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• 2003

Supernumerary teeth are found frequently in the dental office causing many dental complications. They are one of the many dental abnormalities that may occur during tooth development. Inversely impacted supernumerary teeth in the midpalatal area are especially important clinically because they occur with high frequency and many complications. Though many previous clinical and radiographical studies exist, the sample numbers were small and the evaluation of shape, location, and effects to its surrounding tissue may not be accurate due to the solitary use of intraoral radiographs or panoramic radiographs. Among the patients who visited department of pediatric dentistry, yonsei dental hospital, from July, 1998 to June, 2002, those with inversely impacted supernumerary teeth took computerized tomography for a more accurate diagnosis. Their dental chart, panoramic radiograph and computerized tomography were evaluated for this study. The number, form, convexity, location, distance, and complications of inversely impacted supernumerary teeth in the midpalatal area were recorded. This study show that when the supernumerary teeth is tuberculated with a curved root and is in close proximity to the adjacent teeth, it causes complications such as eruption disturbance, rotation, displacement of adjacent teeth, and diastema. Such factors must be considered in making decisions for diagnosis and treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.1
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• pp.1-9
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• 2018

The purpose of this study is to identify the factors affecting the treatment outcome after surgical-orthodontic treatment of the maxillary impacted incisors using multiple regression analysis. The study enrolled 83 patients who had surgical-orthodontic treatment in impacted maxillary central incisor between January 2005 and December 2015. Possible explanatory variables related to the prognosis of impacted incisor were age, gender, tooth developmental stage, height, position and angle of the teeth. The results of multiple regression analysis showed that as the height of the stem cell from apical papilla (SCAP) increased, the tooth length ratio increased by 0.345 units (p < 0.01). There was no statistically significant difference in gender, tooth development stage, distance and angle between the center line and the tooth, and the height of incisal tip of the tooth. In conclusion, the height of the SCAP of the impacted central incisor is factor affecting the tooth length after orthodontic traction.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.4
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• pp.402-413
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• 2022

The aim of this study was to identify factors that affect the treatment duration and to predict the duration of forced eruption in impacted maxillary canines using panoramic radiographs and cone-beam computed tomography. This retrospective study was performed by reviewing medical records and radiographs of 73 patients (93 impacted maxillary canines) from the age of 8 to 18 years who were treated with surgical and orthodontic interventions on impacted maxillary canines from January 2012 to December 2020 in Ajou University Dental Hospital. Stepwise multiple regression analysis showed that the distance between the canine cusp tip and the occlusal plane, mesio-distal location, bucco-palatal location, patient's age, and use of rapid palatal expansion are significant factors with regard to the duration of forced eruption. There was a statistically significant correlation of the treatment duration with the angulation between the axis of the canine and the occlusal plane and unilateral or bilateral impaction. It can be concluded that the duration of forced eruption in impacted maxillary canines could be shorter when the impacted canine is closer to the occlusal plane and located in the lateral incisor or canine area, buccal or middle, the patient is younger and uses rapid palatal expansion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.1
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• pp.27-34
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• 2024

Objectives: Surgical intervention for removal of an impacted third molar can lead to significant pain and swelling. Corticosteroids show promise for mitigating postoperative sequelae across various surgical contexts. The use of corticosteroids following minor oral surgery, though controversial, has already been proven effective. However, little research has explored peroral prescription of corticosteroids despite its convenience for outpatients and for non-surgeons like implantologists and periodontists and others who don't have access to needle injections. The aim of this study was to address a void in the literature by comparing the effects of two styles of preoral administration of prednisolone after surgical removal of the mandibular third molar and to determine which style minimizes postoperative sequelae. Materials and Methods: A randomized, split-mouth clinical study was conducted to investigate the efficacy of two different styles of preoral prednisolone in mitigating postoperative sequelae following surgical extraction of impacted mandibular third molars. Fifteen participants were enrolled in the study. Random selection was used to determine the prescription style for the right and left mandibular arch. Group A included those who received a single dose of prednisolone 25 mg, while group B received prednisolone 5 mg postoperatively for a period of three days (5 mg three times/day on the first postoperative day, 5 mg twice/day on the second postoperative day; 5 mg once/day on the third postoperative day). Results: There was a significant difference in the distance between the corner of the mouth and tragus, which decreased with the time interval with respect to group B when compared to group A. Conclusion: The present study showed that a three-day tapered dose of prednisolone postoperatively was more effective in reducing post-extraction sequelae than a single-dose regimen.