• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.4
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• pp.284-290
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• 1998

The purpose of this study was to assess the soft tissue changes using twenty skeletal class III malocclusion patients who treated with bimaxillary surgery for the correction of dentofacial deformities. Patients were divided into two groups. One was impaction and advancement of maxilla with mandibular set-back (Group 1), the other was downward and advancement of maxilla with mandibular set-back (Group 2). Preoperative and postoperative one year cephalometric data were analyzed and compared. Results obtained were as follows: 1. The ratio of horizontal changes of soft tissue to hard tissue at Nt to ANS, Ls to UI, Li to LI, sPog to Pog were 1:0.60, 1:0.79, 1:0.47, 1:0.63 in group 1 respectively, and 1:0.59, 1:0.48, 1:0.83, 1:1.09 in group 2 respectively. Soft tissue changes were highly predictable at the upper lip, lower lip, and chin area. 2. The ratio of vertical changes of soft tissue to hard tissue at Nt to ANS, Li to LI were 1:0.72, 1:0.06 in group 1, and others showed no statistically significant difference. 3. The ratio of horizontal changes of Ls to hard tissue movements at LI(h) was 1:-0.82 in group 1 and at UI(h), LI(h) were 1:0.48, 1:0.01 in group 2. These ratios of group 1 were greater than those of group 2. 4. The direction of horizontal change of Li was the same as that of hard tissue change. The ratio of horizontal changes of Li to LI was 1:0.47 in group 1 and others showed no statistically significant difference. 5. The changes of upper lip thickness and length were -1.6mm, -1.4mm in group 1, and -1mm, -2.7mm in group 2. 6. The ratios of thickness of upper lip to ANS, UI, LI were 1:-0.83, 1:-0.37, 1:0.11 in group 1. There was similar trend in group 2, and there were no statistically significant difference. These results suggest that prediction of changes in soft tissue of upper lip, lower lip, and chin were 79%, 47%, and 63% in group 1, and 48%, 83%, and 109% in group 2. There was a tendency to decrease in thickness and increase in length of the upper lip.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.530-535
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• 2004

Objectives. The purpose of this study was to evaluate mandibular third molars as risk factors for angle fracture in a patient sample with fractured mandible. Materials and methods. The medical records and panoramic radiographs of 107 patients with mandibular fractures were examined. The presence and absence and degree of impaction of the lower third molar were assessed for each patient and related to the occurrence of fracture of the mandibular angle. Data were also collected for age, sex and mechanism of injury. Data were analyzed by a chisquare statistics and Student t test. Result. The incidence of mandibular angle fracture was found to be significantly greater when a lower third molar was present(p <0.05) especially at class III state.(p < 0.05)(by Pell & Gregory system) Of the 78 patients with a lower third molar, 46(58.97%) had angle fractures. Of the 29 without a lower third molar, 24(82.76%) had not angle fractures. Conclusion. The result of this study showed that the mandibular angle that have a lower third molar is more susceptible to fracture when exposed to an impact than an angle without an lower third molar.

• The korean journal of orthodontics
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• v.37 no.2 s.121
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• pp.159-163
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• 2007

Impaction with a severely dilacerated root is seldom reported, especially in the maxillary incisor. It is probably because of the high clinical difficulty associated with bringing the dilacerated tooth into proper position, and the high chance of failure due to ankylosis, external root resolution, and root exposure after orthodontic traction. Even the successful cases may need periodontal surgery to improve the unesthetic gingival shape. However, it has previously been reported that an impacted maxillary central incisor was successfully treated by proper crown exposure and orthodontic traction. This article presents a case of an invertedly impacted maxillary right central incisor with a developing dilacerated root, which was aligned into proper position after orthodontic traction composed of two stages of a closed eruption technique.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.3
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• pp.193-196
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• 2015

A fecaloma refers to a mass of accumulated feces that is much harder than a mass associated with fecal impaction. Fecalomas are usually found in the rectosigmoid area. A 10-year-old male with chronic constipation was admitted because of increasing abdominal pain. An abdominal computed tomography scan and a simple abdominal x-ray revealed rapidly evolving mechanical obstruction in the small intestine. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, surgical intervention may be needed. In this case, an emergency operation was performed and a $4{\times}3{\times}2.5cm$ fecaloma was found in the distal ileum. We thus report a case of ileal fecaloma inducing small bowel obstruction in a patient with chronic constipation, who required surgical intervention. When symptoms of acute small intestinal obstruction develop in a patient with chronic constipation, a fecaloma should be considered in differential diagnosis.

• The korean journal of orthodontics
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• v.54 no.3
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• pp.185-195
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• 2024

Objective: This study aimed to retrospectively analyze the prevalence of orthodontic problems and the proportion of patients who underwent orthodontic diagnosis among children aged 6 (n = 300), 7 (n = 400), and 8 (n = 400) years who had undergone panoramic radiography. Methods: Children were divided into five groups according to their chief complaint and consultation: conservative dentistry, oral and maxillofacial surgery, orthodontics, periodontics, and prosthodontics). Chief complaints investigated included first molar eruption, lack of space for incisor eruption, frequency of eruption problems, lack of space, impaction, supernumerary teeth (SNT), missing teeth, and ectropion eruption. The number of patients whose chief complaint was not related to orthodontics but had dental problems requiring orthodontic treatment was counted. The proportion of patients with orthodontic problems who received an orthodontic diagnosis was also examined. Results: Dental trauma and SNT were the most frequent chief complaints among the children. The proportion of patients with orthodontic problems increased with age. However, the orthodontic diagnosis rates based on panoramic radiographs among children aged 6, 7, 8 years were only 1.5% (6 years) and 23% (7 and 8 years). Conclusions: Accurate information should be provided to patient caregivers to correct misconceptions regarding the appropriateness of delaying orthodontic examination until permanent dentition is established.

• Hip & pelvis
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• v.36 no.2
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• pp.101-107
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• 2024

Treatment of femoral bone defects continues to be a challenge in revision total hip arthroplasty (THA); therefore, meticulous preoperative evaluation of patients and surgical planning are required. This review provides a concise synopsis of the etiology, classification, treatment strategy, and prosthesis selection in relation to femoral bone loss in revision THA. A search of literature was conducted for identification of research articles related to classification of bone loss, management of femoral revision, and comparison of different types of stems. Findings of a thorough review of the included articles were as follows: (1) the Paprosky classification system is used most often when defining femoral bone loss, (2) a primary-length fully coated monoblock femoral component is recommended for treatment of types I or II bone defects, (3) use of an extensively porous-coated stem and a modular fluted tapered stem is recommended for management of types III or IV bone defects, and (4) use of an impaction grafting technique is another option for improvement of bone stock, and allograft prosthesis composite and proximal femoral replacement can be applied by experienced surgeons, in selected cases, as a final salvage solution. Stems with a tapered design are gradually replacing components with a cylindrical design as the first choice for femoral revision; however, further confirmation regarding the advantages and disadvantages of modular and nonmodular stems will be required through conduct of higher-level comparative studies.

• The Journal of the Korean dental association
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• v.52 no.12
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• pp.762-770
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• 2014

Bony exostosis, one of the osseous deformities, could act as a contributing factor of periodontal disease since it makes proper tooth brushing difficult and causes traumatic ulcer. The purpose of this case report is to show improvement of periodontal health by removal of bony exostoses and creation of physiologic osseous form. A 58 year-old female patient with recurrent ulcer and pain on bony exostoses located on left maxillary palatal area and both mandibular buccal areas was treated. Exostoses were removed and physiologically positive osseous form was created following vertical grooving, radicular blending, flattening interproximal bone and gradualizing marginal bone. The patient showed no further recurring traumatic ulcer and bone exposure. Moreover, periodontal pocket was eliminated and food impaction was decreased. In conclusion, periodontal health could be achieved through removal of multiple bony exostoses and development of ideal osseous form.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.370-375
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• 1999

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.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.197-202
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• 1990

Mechanical obstruction of the common hepatic duct includes the following causes ; choledocholithiasis, sclerosis, cholangitis, pancreatic carcinoma, cholangiocarcinoma, postoperative stricture, primary hepatic duct carcinoma, enlarged cystic duct lymph nodes, and metastatic nodal involvement of the porta hepatis. Partial mechanical obstruction of the common hepatic duct caused by impaction of stones and inflammation surrounding the vicinity of the neck of the gallbladder had been reported on the "syndrome del conducto hepatico" in 1948 by Mirizzi. Nowadays, this disease was named by Mirizzi syndrome. Mirizzi syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. In a varient of Mirizzi's syndrome, the cause of the common hepatic duct obstruction was a primary cystic duct carcinoma rather than gallstone disease. A 71-year-old man was admitted with a four-day history of right upper quadrant abdominal pain. Past medical history was unremarkable. On physical examination, the patient had a temperature of $38^{\circ}C$, icteric sclera and right upper quadrant tenderness. Pertinent laboratory findings included WBC 18,000/$cm^2$;albumin 2.6g/dl(normal 3.9-5.1) ; SGOT 183u/L(normal 0-50) ; SGPT167u/L(normal 0-65) ; bilirubin, 8.2mg/dl(normal 0-1) with the direct bilirubin, 4.4mg/dl(normal 0-0.4). Ultrasonography revealed a dilated extrahepatic biliary tree. ERCP showed that the superior margin was angular and more consistent with a calculus causing partial CHD obstruction(Mirizzi syndrome). At surgery a diseased gallbladder containing calculi was found. In addition, there was two calculi partially eroding through the proximal portion of the cystic duct and compressing the common hepatic duct. A cholecystectomy and excision of common bile duct was performed, with Roux-en-Y hepaticojejunostomy. The postoperative course was uneventful.