• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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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.

• 대한치과의사협회지
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• 제51권6호
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• pp.346-354
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• 2013

Early identification of maxillary canine impaction is very important, because of treatment duration time. Analysis used by 3-dimensional computed tomography is more important than before in treatment planning. The aim of this study was to analysis of factors associated with the treatment during time of forced eruption of the impacted maxillary canine using 3-dimensional computed tomography. 17 patients were analysed in Daejeon dental hospital of Wonkwang university(16 patients with unilateral impactions and 1 patient with bilateral impaction). In total, 18 maxillary impacted cannines were analysed by 3-dimensional computed tomography. The results obtained were as follow; 1. There was positive correlation between the age of patient and treatment duration time. 2. There was positive correlation between the distance of occlusal plane to cusp of maxillary impacted canine and treatment duration time, and negative correlation between the length of maxillary impacted canine and treatment duration time. 3. There was positive correlation between the angulation of midsagittal plane to axis of maxillary impacted canine and treatment duration time, and negative correlation between occlusal plane to axis of maxillary impacted canine and treatment duration time. In conclusion, age, tooth length, distance from the canine cusp tip to the occlusal plane, angulation of tooth axis to occlusal plane and midsagittal plane allow that we can predict treatment duration time.

• 대한소아치과학회지
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• 제31권3호
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• pp.406-411
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• 2004

영구 상악 절치의 매복은 매복이 흔한 제3대구치와 상악 견치에 비해서 드물지만 상악 중절치 미맹출을 주소로 내원한 학동기 아동에서 종종 관찰된다. 매복을 유발시키는 원인에 대해서는 많은 논란이 있으나 주 요인으로는 유치의 외상과 유치의 치근단 감염이 보고되고 있다. 특히 유치의 치근단 감염에 의한 매복설이 유력한데 병소의 압력에 의한 계승영구치의 회전, 변위등의 위치변화가 일어날 수 있다고 보고되고 있다. 매복치는 무엇보다도 조기에 발견하여 치료하는 것이 이로 인해 발생되는 부정교합이나 그 밖의 부작용을 예방할 수 있다. 일단 매복이 진단되면 방사선 검사를 통하여 위치 확인을 정확히 하는 것이 중요하며 치료에 앞서 전반적인 공간분석과 치료계획을 세워야 한다. 치료로는 교정적 견인, 또는 자가이식등이 있으며, 역위 매복된 경우가 아니라면 공간 확보만으로도 50%의 자발적 맹출을 보고하고 있다. 본 증례는 유치의 치근단 감염에 의해 역위 매복된 것으로 보이는 상악 중절치를 교정력을 이용해 정상적인 맹출로 바로 잡아준 결과 4-5개월만에 자발적으로 맹출하였기에 이에 보고하는 바이다.

• 대한두개안면성형외과학회지
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• 제19권1호
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• pp.60-63
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• 2018

Foreign body (FB) impaction in the maxillofacial area could be caused by knives, glass fragments, and vegetative materials. We present the rare case of a 62-year-old man with a large glass FB in the left cheek retained for over 40 years. He had traffic accident over 40 years ago and glass fragments impacted on his left cheek. Glass fragments were retained around the zygomatic arch with dimpled scar and unclear serous discharge, but other facial motor or sensory dysfunction was not observed. We confirmed three glass fragments with radiologic examination including plain radiograph and computed tomographic image. Under general anesthesia, impacted glass fragments were removed through the direct incision on the dimpled scar and the additional incision on the left lateral canthal area. Remnant FBs were not seen on an intraoperative C-arm radiograph. After 2 days of irrigation for inflammation control, the dimpled wound was sutured. The wound was healed without major complication and the original dimpled scar was much improved.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권5호
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• pp.318-325
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• 2022

Population aging and the usage of small devices in implant prosthetic procedures have led to many incidents of dental aspiration and ingestion. Various preventive measures have been introduced to prevent these accidents. However, accidents can occur at any time. Dental aspiration and ingestion lead to fatal consequences if the issue is not promptly and appropriately dealt with. Preparing a collaborative system for dealing with accidents before they occur can prevent further sequelae. This study involves ingestion and aspiration accidents that occurred during dental treatment: two ingestion cases and one aspiration case. All dental foreign bodies were removed according to the guidelines presented in our review. With the cooperation of other medical departments, the issues were quickly resolved. Simple and accurate protocols should be provided to all dentists and dental staff to respond to such dental emergencies. In addition, collaboration among other medical departments should be established before any accidental ingestion and aspiration events occur.

• Imaging Science in Dentistry
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• 제52권4호
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• pp.429-434
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• 2022

Supernumerary teeth that are present in the molar region may be evident based on crowding and impaction, but most cases are asymptomatic and discovered as incidental findings during routine radiological examinations. This article reports the case of a 29-year-old woman who presented with a severe feeling of pressure in the region of the maxillary third molars that had been increasing in intensity for weeks. A clinical examination revealed crowding of the maxillary anterior teeth despite the completion of orthodontic treatment and an erupted third molar with localized gingivitis in the second quadrant. A radiographic examination revealed bilateral supernumerary maxillary fourth and fifth molars, so cone-beam computed tomography was performed to locate the supernumerary teeth precisely for a preoperative diagnosis and comprehensive treatment planning. This report presents the radiological and surgical case management of a rare case of bilateral supernumerary molars and reviews the literature regarding epidemiology and treatment options.

• Imaging Science in Dentistry
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• 제53권2호
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• pp.137-144
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• 2023

Purpose: This study aimed to evaluate the anatomic circle around the impacted lower third molar to show, document, and correlate essential findings that should be included in the routine radiographic assessment protocol as clinically meaningful factors in overall case evaluation and treatment planning. Materials and Methods: Cone-beam computed tomographic images of impacted lower third molars were selected according to specific inclusion criteria. Impacted teeth were classified according to their position before assessment. The adjacent second molars were assessed for distal caries, distal bone loss, and root resorption. The fourth finding was the presence of a retromolar canal distal to the impaction. Communication with the dentist responsible for each case was done to determine whether these findings were detected or undetected by them before communication. Results: Statistically significant correlations were found between impaction position, distal bone loss, and detected distal caries associated with the adjacent second molar. The greatest percentage of undetected findings was found in the evaluation of distal bone status, followed by missed detection of the retromolar canal. Conclusion: The radiographic assessment protocol for impacted third molars should consider a step-by-step evaluation for second molars, and clinicians should be aware of the high prevalence of second molar affection in horizontal and mesioangular impactions. They also should search for the retromolar canal due to its associated clinical considerations.

• 대한치과교정학회지
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• 제50권5호
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• pp.293-303
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• 2020

Objective: To investigate the three-dimensional (3D) surgical accuracy between virtually planned and actual surgical movements (SM) of the maxilla in two-jaw orthognathic surgery. Methods: The sample consisted of 15 skeletal Class III patients who underwent two-jaw orthognathic surgery performed by a single surgeon using a virtual surgical simulation (VSS) software. The 3D cone-beam computed tomography (CBCT) images were obtained before (T0) and after surgery (T1). After merging the dental cast image onto the T0 CBCT image, VSS was performed. SM were classified into midline correction (anterior and posterior), advancement, setback, anterior elongation, and impaction (total and posterior). The landmarks were the midpoint between the central incisors, the mesiobuccal cusp tip (MBCT) of both first molars, and the midpoint of the two MBCTs. The amount and direction of SM by VSS and actual surgery were measured using 3D coordinates of the landmarks. Discrepancies less than 1 mm between VSS and T1 landmarks indicated a precise outcome. The surgical achievement percentage (SAP, [amount of movement in actual surgery/amount of movement in VSS] × 100) (%) and precision percentage (PP, [number of patients with precise outcome/number of total patients] × 100) (%) were compared among SM types using Fisher's exact and Kruskal-Wallis tests. Results: Overall mean discrepancy between VSS and actual surgery, SAP, and PP were 0.13 mm, 89.9%, and 68.3%, respectively. There was no significant difference in the SAP and PP values among the seven SM types (all p > 0.05). Conclusions: VSS could be considered as an effective tool for increasing surgical accuracy.

• 대한치과교정학회지
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• 제50권5호
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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 Association of Oral and Maxillofacial Surgeons
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• 제36권2호
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• pp.119-124
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• 2010

Introduction: Surgical extraction of third molar is one of the most frequently performed procedures in oral and maxillofacial surgery unit as the impacted wisdom teeth could cause various complications. Even though, however, extraction of the impacted wisdom teeth is an obligation for the reason of possible complication even for general practitioners, it has been avoided. Various factors concerning surgical extraction of impacted third molar are considered: general condition of patients, relationship with relative anatomies, aspects of impaction, surgeon's skill. Materials and Methods: The consideration and crossing analysis of these factors with 2,463 patients who visit Dankook University dental hospital to extract those impacted third molar. Results: 1. Gender doesn't affect. 2. Medical problems have more complications. 3. There are more complications in high difficulty index (DI) impacted teeth. 4. When inferior alveolar canal overlap mandibular third molar, complication rate is 26.92%. 5. The most common complication was swelling and pain. 6. There is no statistical difference between the incidence of complication and surgeon's experience. Conclusion: In regard to these results, it seems that clinical or radiological examination can predict potential complications of wisdom teeth, and it is helpful to bear in mind the fact.