• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.4
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• pp.400-408
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• 2019

The purpose of this study is to identify the most common canal type in primary molars and the correlation between their roots and canals. A comprehensive understanding of root canal morphology will lead to more successful root canal treatment. Computed Tomography (CT) images from 114 children (81 boys, 33 girls) aged 3 - 7 years were obtained. The locations and numbers of roots and canals were evaluated, and the relationship between root and canal parameters was determined. The most commonly observed canal morphology in primary maxillary molars were mesio-buccal, disto-buccal and palatal canal. Primary mandibular molars most frequently contain mesio-buccal, mesio-lingual, disto-buccal and distolingual canal. All the roots of the primary maxillary molars except for the mesio-buccal root, each had 1 canal while there were 2 canals observed in each root of primary mandibular molars. Without exception, all mesial roots in primary mandibular 2nd molars had 2 canals. In case when either the palatal root in a primary maxillary molar or the distal root in a primary mandibular molar was separated into 2 roots, each root seemed to have its own canal. Even though the disto-buccal and palatal roots were fused into 1 root in primary maxillary molars, this fused root had tendency to have 2 separate canals. Primary mandibular molars showed similar canal morphologies between left and right molars in the same patient, while the primary maxillary molars did not.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.1
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• pp.25-35
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• 2020

The purpose of this study is to evaluate the morphological characteristics of the roots and roots canals of primary molar teeth using Cone-Beam Computed Tomography (CBCT). A total of 68 CBCT images of children aged 4 - 5 years was used for this study. A total of 160 molar teeth were analyzed. Various parameters such as the number of roots and canals, length of root and root canal, and the angulation and shape of the roots were analyzed. All maxillary primary molars had 3 roots. The presence of 2 root canals in 1 root was only observed in the mesiobuccal root of maxillary primary second molars. Most mandibular primary molars had 2 roots, and most mesial roots had 2 root canals. Concerning the length of the roots, the palatal root of the maxillary primary molar was found to be longest whereas the distobuccal root was shortest. In mandibular primary molars, the mesial root was longer than the distal root. In maxillary primary molars, the palatal root had the greatest angulation whereas the distal root has the greatest in mandibular molars. The root and root canals of maxillary primary molars were more curved in shape whereas mandibular primary molars were straight.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.1
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• pp.61-69
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• 2021

Background: Inferior alveolar nerve block (IANB) using lidocaine 2% is commonly used for anesthetizing primary mandibular molars; however, this technique has the highest level of patient discomfort compared to other local anesthesia techniques. Therefore, alternative anesthesia techniques are necessary. The aim of this study was to evaluate the efficacy of a single buccal infiltration of 4% articaine with IANB using 2% lidocaine, for the bilateral extraction of primary mandibular molars. Methods: The present study was conducted on 30 patients aged between 6 and 9 years, who required the extraction of bilateral primary mandibular molars. The patients were randomly divided into two groups as follows: In the first session, Group A received IANB with lidocaine 2% and group B received infiltration with articaine 4%. In the second session, another injection method was performed on the opposite side. The Wong-Baker Facial Pain scale (WBFPS), Face Leg Activity Cry, and Consolability (FLACC), and physiologic parameters were used to assess pain perception. Results: The independent t-test showed no statistically significant difference in blood pressure and heart rate before and after extraction (P > 0.05). The mean FLACC index in the lidocaine and articaine groups was 0.89 and 1.36, respectively; there was no statistically significant difference between them (P > 0.05). According to the results of the chi-square test, there was no statistically significant difference between the groups for WBFPS (P > 0.05). Conclusion: The articaine infiltration technique may be an alternative to the IANB for the extraction of primary mandibular molars.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.1
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• pp.167-174
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• 2008

Mandibular first molar and primary molars usually have two roots, on the mesial and distal sides. Occasionally, these molars have an extra root located in the distolingual aspect. Prevalence of the 3-rooted first permanent molar shows ethnic variation, ranging from about 3% in Caucasian to about 20% in Mongoloid group, which includes Chinese, Japanese, Eskimo, American and Canadian Indians. The frequency of the mandibular molar with three roots decreases in the order of the first permanent molar, the second primary molar, and the first primary molar. If the mandibular first or second primary molar has an additional distolingual root, the adjacent molars, including the first permanent molar, posterior to it also may have it. Coronal morphologic change can occur in the mandibular first primary molars with three roots: the crown had more triangular-shape compared to the one with two roots, possibly affected by the presence of additional distolingual root. Clinically, exact diagnosis and treatment should be taken with those teeth for pulp canal treatment, extraction, and SS Cr.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.297-304
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• 2008

The purpose of this study was to evaluate a 3-Dimensional laser scanner for the space analysis after loss of a primary first molar. Six children with premature loss of a primary first molar were examined using study models taken before and after the extraction. The results were as follows: 1. There was no change in primary molar space after the extraction of a maxillary primary first molar However, 2 out of 3 children experienced primary molar space loss in extraction side of a mandibular primary first molar. 2. Arch width and arch perimeter showed no difference between initial and final model. 3. All primary canines did not show any changes in inclination. Maxillary primary second molars had similar changes in both extraction and control side. However, 2 out of 3 mandibular primary second molars in extraction side showed more lingual tipping compared to control side. Mandibular permanent first molars tipped more lingually in extraction side. 4. In angulation, primary canines showed nothing of significance. Mandibular primary second molars tipped more mesially in extraction side than in control side. Maxillary permanent first molars have increased distal angulation after extraction of primary first molars in both side.

• The korean journal of orthodontics
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• v.46 no.3
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• pp.171-179
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• 2016

Objective: The primary aim of the study was to generate new prediction equations for the estimation of maxillary and mandibular canine and premolar widths based on mandibular incisors and first permanent molar widths. Methods: A total of 2,340 calculations (768 based on the sum of mandibular incisor and first permanent molar widths, and 1,572 based on the maxillary and mandibular canine and premolar widths) were performed, and a digital stereomicroscope was used to derive the the digital models and measurements. Mesiodistal widths of maxillary and mandibular teeth were measured via scanned digital models. Results: There was a strong positive correlation between the estimation of maxillary (r = 0.85994, $r^2=0.7395$) and mandibular (r = 0.8708, $r^2=0.7582$) canine and premolar widths. The intraclass correlation coefficients were statistically significant, and the coefficients were in the strong correlation range, with an average of 0.9. Linear regression analysis was used to establish prediction equations. Prediction equations were developed to estimate maxillary arches based on $Y=15.746+0.602{\times}sum$ of mandibular incisors and mandibular first permanent molar widths (sum of mandibular incisors [SMI] + molars), $Y=18.224+0.540{\times}(SMI+molars)$, and $Y=16.186+0.586{\times}(SMI+molars)$ for both genders, and to estimate mandibular arches the parameters used were $Y=16.391+0.564{\times}(SMI+molars)$, $Y=14.444+0.609{\times}(SMI+molars)$, and $Y=19.915+0.481{\times}(SMI+molars)$. Conclusions: These formulas will be helpful for orthodontic diagnosis and clinical treatment planning during the mixed dentition stage.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.4
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• pp.283-309
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• 2021

Achieving profound anesthesia in mandibular molars with irreversible pulpitis is a tedious task. This review aimed at evaluating the success of buccal/lingual infiltrations administered with a primary inferior alveolar nerve block (IANB) injection or as a supplemental injection after the failure of the primary injection in symptomatic and asymptomatic patients with irreversible pulpitis in human mandibular molars. The review question was "What will be the success of primary and supplemental infiltration injection in the endodontic treatment of patients with irreversible pulpitis in human mandibular molars?" We searched electronic databases, including Pubmed, Scopus, and Ebsco host and we did a comprehensive manual search. The review protocol was framed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. We included clinical studies that evaluated and compared the anesthetic outcomes of primary IANB with primary and/or supplementary infiltration injections. Standard evaluation of the included studies was performed and suitable data and inferences were assessed. Twenty-six studies were included, of which 13 were selected for the meta-analysis. In the forest plot representation of the studies evaluating infiltrations, the combined risk ratio (RR) was 1.88 (95% CI: 1.49, 2.37), in favor of the secondary infiltrations with a statistical heterogeneity of 77%. The forest plot analysis for studies comparing primary IANB + infiltration versus primary IANB alone showed a low heterogeneity (0%). The included studies had similar RRs and the combined RR was 1.84 (95% CI: 1.44, 2.34). These findings suggest that supplemental infiltrations given along with a primary IANB provide a better success rate. L'Abbe plots were generated to measure the statistical heterogeneity among the studies. Trial sequential analysis suggested that the number of patients included in the analysis was adequate. Based on the qualitative and quantitative analyses, we concluded that the infiltration technique, either as a primary injection or as a supplementary injection, given after the failure of primary IANB, increases the overall anesthetic efficacy.

• Imaging Science in Dentistry
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• v.45 no.4
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• pp.205-211
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• 2015

Purpose: This study was performed to compare the accuracy of micro-computed tomography (CT) and cone-beam computed tomography (CBCT) in detecting accessory canals in primary molars. Materials and Methods: Forty-one extracted human primary first and second molars were embedded in wax blocks and scanned using micro-CT and CBCT. After the images were taken, the samples were processed using a clearing technique and examined under a stereomicroscope in order to establish the gold standard for this study. The specimens were classified into three groups: maxillary molars, mandibular molars with three canals, and mandibular molars with four canals. Differences between the gold standard and the observations made using the imaging methods were calculated using Spearman's rho correlation coefficient test. Results: The presence of accessory canals in micro-CT images of maxillary and mandibular root canals showed a statistically significant correlation with the stereomicroscopic images used as a gold standard. No statistically significant correlation was found between the CBCT findings and the stereomicroscopic images. Conclusion: Although micro-CT is not suitable for clinical use, it provides more detailed information about minor anatomical structures. However, CBCT is convenient for clinical use but may not be capable of adequately analyzing the internal anatomy of primary teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.2
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• pp.98-105
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• 2013

The purpose of this study was to investigate the mesiodistal widths at the cervical level of primary second molars in Korean children, and to compare them with commercial rubber dam clamps commonly used in pediatric dentistry. Dental casts of 115 primary and mixed dentition children were studied. Cervical mesiodistal width (C-MD) was measured at the clinical cervical level of each primary second molar from buccal and lingual sides using a digital caliper (Absolute, Mitutoyo, Kawasaki, Japan). The data were compared with mesiodistal widths of rubber dam clamps #203/204, #10/11, and #205 (Dentech, Japan). C-MDs of primary mandibular second molars were larger than those of primary maxillary second molars, and C-MDs at buccal sides were larger than those of lingual sides. All C-MDs showed statistically significant discrepancies to corresponding widths on clamps (p < 0.05). However the amount of discrepancy was mild in maxillary teeth, while up to 1 mm of discrepancy was shown in mandibular teeth. In conclusion, C-MDs measured in this study imply a relatively fair fit of #10/#11 or #203/#204 clamps on primary maxillary second molars, while suggesting our need for a better clamp with proper size for primary mandibular second molars.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.2
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• pp.187-191
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• 2016

Early loss of a primary second molar can cause mesial drift or tilting of the permanent first molar. We present a case of the early loss of the mandibular primary molars in a 5-year-old girl. The patient required extraction of the mandibular left primary first and second molars due to folliculitis on the successors. A flexible denture was used for eruption guidance of the permanent first molar and the recovery of masticatory function simultaneously.