• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권1호
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• pp.49-57
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• 2006

Mandibular fractures have higher incidence rate compared to facial bone fractures because of relatively prominent form. Specially, mandibular angle fractures were known as common fracture site because of morphological anatomic structure. The mandibular third molar appears to be the most frequent impacted tooth. The mandibular third molar have influence on mandibular angle fractures according to it's eruption state. Also, the mandibular angle fracture including the third molar may influence on post operative infection whether the third molar is in impacted or extracted state when reduction of fracture site is operated. The presence or absence and degree of impaction of the mandibular third molar were assessed for each patient and were related to the occurrence of the mandibular angle fracture. The extraction or non extraction of the mandibular third molar were related to the occurrence of the post operative infection in the reduction of mandibular angle fractures. In the presence of mandibular third molar, the possibility of mandibular angle fractures were relatively common. When viewing the mandibular third molar at occlusal plane, the possibility of mandibular angle fractures were high in the class C group. The possibility of mandibular angle fractures were high in the mesial angulation and partial impaction. There was a statistically significant difference(P<0.05). In complete erupted mandibular third molar, the possibility of post operative infection occurs quite often, but there was no statistical significant difference(P>0.05). In the extracted or non extracted of mandibular third molar, the post operative infection showed no statistical significant difference(P>0.05). With the results mentioned above, mandibular third molar was significantly more susceptible to mandibular angle fracture. In the reduction of mandibular angle fracture, it was recommended that mandibular third molar should be extracted especially in case of pericoronitis, periodontitis and other infections.

• 대한치과의사협회지
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• 제56권2호
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• pp.113-119
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• 2018

Trifid mandibular canal (TMC) is one of the anatomical variation of mandibular canal with clinical importance. An extra mandibular canal may explain inadequate anesthesis and be damaged causing paresthesia or bleeding during mandibular surgery. CBCT with high-level spatial resolution is an useful tool for the detection of mandibular canal and its variation. The aim of this report is to present a case of trifid mandibular canal with CBCT images and to give information on this anatomical variation of mandibular canal.

• Imaging Science in Dentistry
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• 제49권3호
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• pp.213-218
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• 2019

Purpose: The aim of this study was to evaluate the relationship between the mandibular canal and impacted mandibular third molars using cone-beam computed tomography (CBCT) and to compare the CBCT findings with signs on panoramic radiographs(PRs). Materials and Methods: This retrospective study consisted of 200 mandibular third molars from 200 patients who showed a close relationship between the mandibular canal and impacted third molars on PRs and were referred for a CBCT examination of the position of the mandibular canal. The sample consisted of 124 females and 76 males, with ages ranging from 18 to 47 years (mean, $25.75{\pm}6.15$ years). PRs were evaluated for interruption of the mandibular canal wall, darkening of the roots, diversion of the mandibular canal, and narrowing of the mandibular canal. Correlations between the PR and CBCT findings were statistically analyzed. Results: In total, 146 cases(73%) showed an absence of canal cortication between the mandibular canal and impacted third molar on CBCT images. A statistically significant relationship was found between CBCT and PR findings (P<0.05). The absence of canal cortication on CBCT images was most frequently accompanied by the PR sign of diversion of the mandibular canal(96%) and least frequently by interruption of the mandibular canal wall(65%). Conclusion: CBCT examinations are highly recommended when diversion of the mandibular canal is observed on PR images to reduce the risk of mandibular nerve injury, and this sign appears to be more relevant than other PR signs.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권6호
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• pp.278-284
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• 2014

Objectives: This study used cone-beam computed tomography (CBCT) images to categorize the relationships between the mandibular canal and the roots and investigated the prevalence of nerve damage. Materials and Methods: Through CBCT images, contact and three-dimensional positional relationships between the roots of the mandibular third molar and the mandibular canal were investigated. With this data, prevalence of nerve damage according to the presence of contact and three-dimensional positional relationships was studied. Other factors that affected the prevalence of nerve damage were also investigated. Results: When the mandibular third molar and the mandibular canal were shown to have direct contact in CBCT images, the prevalence of nerve damage was higher than in other cases. Also, in cases where the mandibular canal was horizontally lingual to the mandibular third molar and the mandibular canal was vertically at the cervical level of the mandibular third molar, the prevalence of nerve damage was higher than in opposite cases. The percentage of mandibular canal contact with the roots of the mandibular third molar was higher when the mandibular canal was horizontally lingual to the mandibular third molar. Finally, the prevalence of nerve damage was higher when the diameter of the mandibular canal lumen suddenly decreased at the contact area between the mandibular canal and the roots, as shown in CBCT images. Conclusion: The three-dimensional relationship of the mandibular third molar and the mandibular canal can help predict nerve damage and can guide patient expectations of the possibility and extent of nerve damage.

• 대한치과의사협회지
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• 제52권12호
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• pp.753-761
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• 2014

Purpose: This study was performed to examine distribution of accessory mandibular canal and its characteristics in mandibular third molars. Materials and methods: A total of 251 subjects (166 males and 85 females) having mandibular third molars bilaterally were included in the study. Cone-beam computed tomographic images were reviewed for bifid or trifid accessory mandibular canal. The prevalence of accessory mandibular canal was evaluated according to gender, side and its branching type. Proximity and crosssectional position of accessory mandibular canal to mandibular third molar was analyzed. Results: Accessory mandibular canals were found in 66 (26.3%) of 251 patients and 86 (17.1%) of 502 hemi-mandibles. Gender and sides showed no statistically significant differences in prevalence. Retromolar canal (46.1%) was the most common branching type. Proximity of accessory canal to mandibular third molars showed mean distance of 2.8 mm from third molar and a statistically significant difference was found among types of accessory canal. Dental canal was the closest to tooth among branching types and closer to tooth than main canal. On cross-sectional view, accessory canal was generally located on buccal side of mandibular third molar. Conclusion: Accessory mandibular canal was common and well detected with cone-beam computed tomography. Their localization is significant in all anesthetic and surgical procedures involving mandibular third molars.

• Imaging Science in Dentistry
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• 제37권4호
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• pp.197-203
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• 2007

Purpose: To provide diagnostic information by evaluation of the positional relationship between the mandibular third molar and the mandibular canal. Materials and Methods: Eighty-nine mandibular third molars were classified as mesioangular, horizontal, vertical, distoangular groups. The distances between the mandibular third molar and the mandibular canal were measured in cone-beam computed tomographs. The height and width ratios of distances from the mandibular third molar and the mandibular canal to the mandibular inferior border and to the lingual cortical plate were calculated. Results: The vertical and buccolingual distances between the mandibular third molar and the mandibular canal were 0.03 mm, 2.96 mm in the mesioangular, 0.37 mm, 3.38 mm in the horizontal, -1.50 mm, 1.38 mm in the vertical, -1.10 mm, 4.20 mm in the distoangular group. There were significant differences in vertical (P < 0.05), but not in buccolingual (P>0.05). The height and width ratios of distances on the mandibular third molar were 47.1 %, 36.1 % in the mesioangular, 47.4%, 34.4% in the horizontal, 37.0%, 46.7% in the vertical, 40.9%, 37.4% in the distoangular group. There were significant differences between the mesioangular and the vertical group, and the horizontal and the vertical group in height ratio (P < 0.05), and also between the mesioangular and the vertical group in width ratio (P < 0.05). The height and width ratios of distances on the mandibular canal showed no significant differences between groups (P > 0.05). Conclusion : The mesioangular group showed the nearest distance between the mandibular third molar and the mandibular canal vertically. The root apex of the mandibular third molar was positioned more buccally in the vertical group than in the mesioangular group.

• 치과방사선
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• 제10권1호
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• pp.41-46
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• 1980

The mandibular canal must be considered carefully during the surgical treatment, especially surgical extraction of the impacted tooth and intraosseous implant, because it contains the important inferior alveolar nerve and vessels. The author investigated the curvature of the mandibular canal and its relation to the mandibular molars and positional realtion between the mental foramen and the mandibular premelors in orthopantomogram. The materials consisted of 441 orthopantomograms divided four groups; Group Ⅰ consisted of 56 males and 44 females from 1 to 6 years of age, Group Ⅱ consisted of 58 males and 45 females from 7 to 12 years of age, Group Ⅲ consisted of 65 males and 33 females from 13 to 18 years of age, Group Ⅳ consisted of 86 males and 54 females over 19 years of age. The results were as followings; 1. The curvature of mandibular canal was 144.50° in Group Ⅰ, 144. 29° in Group Ⅱ, 148.11° in Group Ⅲ, 147.33° in Group Ⅳ. 2. The curvature of mandibular canal was located most frequently on the area between mandibular 1st molar and mandibular 2nd molar in Group Ⅰ (42%) and on the mandibular 2nd molar area in Group Ⅱ (54%), Group Ⅲ (59%), Group Ⅳ (53%). 3. The position of mental foramen was most frequently below the mandibular 1st premolar in Group Ⅰ (58%), between the mandibular 1st premolar and the 2nd premolar in Group Ⅱ (62%), Group Ⅲ (47%), and below the mandibular 2nd premolar in Group Ⅳ (58%).

• 대한치과교정학회지
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• 제41권3호
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• pp.211-218
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• 2011

Objective: This case report describes orthodontic treatment of contracted mandibular arch using a trombone appliance. Methods: A 14-year-old girl with Class II division 2 malocclusion, retroclined maxillary incisors, and buccally displaced maxillary canines required dental expansion in 3 spatial directions to correct the contracted maxillary and mandibular arches. In the initial phase of treatment, the maxillary arch was expanded and distalized using a quad-helix appliance and cervical headgear. Following the expansion and leveling of the maxillary arch, a trombone appliance was used to expand the mandibular arch. On correction of the mandibular arch and provision of sufficient space to level the mandibular teeth, fixed orthodontic treatment phase was initiated. Results: A trombone appliance proved effective in correcting the contracted mandibular arch. Because of labiolingual and transversal expansion, the mandibular dental arch perimeter was increased by 7.4 mm; the misalignment of the mandibular teeth was corrected successfully. Conclusions: A trombone appliance may serve as an appropriate clinical alternative for treating moderate mandibular arch crowding caused by the contraction of the dental arch.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권2호
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• pp.161-167
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• 2006

Objectives: Pericoronitis was the most common indication for mandibular third molar surgery and there are no universally acceptable predictive criteria for pericoronitis occurrence. This study was designed to analyze the correlation of the pericoronitis and the eruption state of the mandibular third molar using panoramic radiographs statistically. Materials and Methods: 218 patients whose chief complaint was the extraction of the mandibular third molar were examined. The presence and absence of pericoronitis, age, sex, position of extraction site, angulation, impaction degree, position to the anterior border of mandibular ramus, distance between distal cementoenamel junction of second molar and mesial cementoenamel junction of the mandibular third molar were assessed. Then the correlation of pericoronitis and the eruption state of the mandibular third molar were analyzed by Student's t-test and chi-square test. Results: There was no correlation between Pericoronitis and age, sex, position of the mandibular third molar. The angulation(P=0.005), impaction degree(P=0.043), relation with anterior border of mandibular ramus(P=0.003), distance between distal cementoenamel junction of second molar and mesial cementoenamel junction of the mandibular third molar(P<0.05) were correlated with pericoronitis. Conclusions: The occurrence of the pericoronitis can be predicted by the eruption state of the mandibular third molar such as angulation, impaction degree, relation with anterior border of mandibular ramus, distance between distal cementoenamel junction of second molar and mesial cementoenamel junction of third molar.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권1호
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• pp.82-88
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• 2005

Treatment methods of mandibular condylar fracture were conservative and surgical method. Surgical method of mandibular high condylar fracture was very difficult because approach and internal fixation of small size fracture fragment were difficult. So there is a tendency to select conservative method over surgical method for guiding a stable occlusion and avoiding TMJ disorder and growth disturbance, minimizing pain and deviation during function. But, in case of mandibular high condylar fracture patient who has no biting teeth on posterior teeth area, guiding a stable occlusion and conservative functional treatment were very difficult. In this case, patient was 62years old male. He had fracture of mandibular symphysis, right mandibular body, left mandibular high condyle. We treated the patient for mandibular symphysis and right mandibular body fracture area with surgical method. But left mandibular high condylar fracture area was difficult to treat with surgical method. So we selected a conservative functional method on left mandibular high condylar fracture area. We intended recovery of vertical dimension and stable occlusion with implantation of immediate provisional implant on maxillar and mandibular posterior teeth area, and temporary crown. And then patient did mandibular functional movement and his mandibular function was recoverd.