• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권4호
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• pp.184-191
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• 2023

Germectomy is a surgical method most typically performed in young adults. The indications for treatment are controversial. The purpose of this review was to determine the correct indications for germectomy and to discuss the advantages and disadvantages of the procedure. We reviewed the surgical techniques (anesthetic methods, patient preparation, and flap designs) and complications. Germectomy for orthodontic purposes is a common indication for surgical removal of tooth germ among young patients. Several studies have supported removal at an earlier age to produce fewer surgical complications. Several surgical techniques have been described in the literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권1호
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• pp.21-29
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• 2023

Objectives: Dental or maxillofacial emergencies are uncommon during pregnancy, but if they occur, they are challenging to treat due to potential risks. The mother should not be denied necessary medical or dental care because of pregnancy. The aim of the study is to observe outcomes of pregnancy in patients requiring emergency minor oral surgical procedures during gestation and to determine the safety of the pregnant woman undergoing the procedure and the fetus. Materials and Methods: The study was conducted on 52 pregnant women requiring emergency oral surgical procedures. A standard treatment protocol for treatment of specific entities was followed. Close monitoring and observation were the primary goal of treatment. All patients were followed postoperatively until complete recovery from the surgical procedures and then until birth of the baby. A control group of 52 healthy pregnant patients who did not require oral surgical procedures was considered for statistical analysis. The measurements to calculate observation were fetal loss (spontaneous abortion), preterm birth, low-birth weight, or incidence of any congenital anomalies in the baby and its association with surgical procedures. Results: No fetal loss occurred in any of the cases. However, four patients experienced preterm birth and seven neonates exhibited low birth weights. No congenital abnormalities were discovered. In one instance, a patient who underwent surgery for a mandibular symphysis fracture under general anesthesia in the 31st week of pregnancy experienced labor pain on the fourth postoperative day, requiring an emergency Caesarean section. Conclusion: The results of our study demonstrate that, compared to the control group, minor emergency surgeries performed during pregnancy have no discernible negative effects on the fetus. These procedures can safely be performed by adhering to our described protocols.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권1호
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• pp.32-36
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• 2014

Preoperative surgical simulation in orthognathic surgery has progressed in recent years; the movement of the mandible can be anticipated through three-dimensional (3D) simulation surgery before the actual procedure. In this case report, the mandible was moved to the intended postoperative occlusion through preoperative surgical 3D simulation. Right-side condylar movement change was very slight in the surgical simulation, suggesting the possibility of mandibular surgery that included only left-side ramal osteotomy. This case report describes a patient with a mild asymmetric facial profile in which the mandibular menton had been deviated to the right and the lips canted down to the left. Before surgery, three-dimensional surgical simulation was used to evaluate and confirm a position for the condyle as well as the symmetrical postoperative state of the face. Facial asymmetry was resolved with minimal surgical treatment through unilateral intraoral vertical ramus osteotomy on the left side of the mandible. It would be a valuable complement for the reduction of the surgical treatment if one could decide with good predictability when an isolated intraoral vertical ramus osteotomy can be done without a compensatory osteotomy on the contralateral side.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권5호
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• pp.361-366
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• 2020

Guided bone regeneration (GBR) is a surgical procedure that utilizes bone grafts with barrier membranes to reconstruct small defects around dental implants. This procedure is commonly deployed on dehiscence or fenestration defects ≥2 mm, and mixing with autogenous bone is recommended on larger defects. Tension-free primary closure is a critical factor to prevent wound dehiscence, which is critical cause of GBR failure. A barrier membrane should be rigidly fixed without mobility. If the barrier is exposed, closed monitoring should be utilized to prevent secondary infection.

• Imaging Science in Dentistry
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• 제40권4호
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• pp.171-178
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• 2010

Purpose : The purpose of this study is to develop a surgical stent for dental implant procedure that can be easily applied and affordable by using cone beam computerized tomography (CBCT). Materials and Methods : Aluminum, Teflon-PFA (perfluoroalkoxy), and acetal (polyoxymethylene plastic) were selected as materials for the surgical stent. Among these three materials, the appropriate material was chosen using the CBCT images. The surgical stent, which could be easily placed into an oral cavity, was designed with chosen material. CBCT images of the new surgical stent on mandible were obtained using Alphard-3030 dental CT system (Asahi Roentgen Co., Ltd., Kyoto, Japan). The point of insertion was prescribed on the surgical stent with the multiplanar reconstruction software of OnDemand3D (CyberMed Inc., Seoul, Korea). Guide holes were made at the point of insertion on the surgical stent using newly designed guide jig. CBCT scans was taken for the second time to verify the accuracy of the newly designed surgical stent. Results : Teflon-PFA showed radiologically excellent image characteristics for the surgical stent. High accuracy and reproducibility of implantation were confirmed with the surgical stent. Conclusion : The newly designed surgical stent can lead to the accurate implantation and achieve the clinically predictable result.

• 대한치과의사협회지
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• 제54권11호
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• pp.874-879
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• 2016

Damage to the inferior alveolar nerve(IAN) is a relatively infrequent complication in endodontic treatment. However, endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve resulting in sensory disturbances such as pain, dysesthesia, paresthesia or anesthesia. Two mechanism(chemical neurotoxicity and mechanical compression) are responsible for the IAN injury. When absorbent materials overfilled, it can be treated as a non-surgical procedure. But early surgical intervention required when mechanical, chemical nerve damage expected. We report surgical removal of overfilled gutta-percha and IAN decompression through sagittal split osteotomy in case of dysesthesia after overfilling of endodontic material into the mandibular canal. Dysesthesia recovered 3 months after surgical treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.464-472
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• 1994

Surgical removal of the submandibular gland via intraoral approach was performed. The surgical procedure to be used for removal of submandibular gland had been performed via extraoral approach for many centuries. Disadvantages of extraoral technique are the esthetic distress due to an external scar, residual inflammation in Wharton's duct, and neurological complications. Indications of intraoral approach are unlimited in surgical cases of submandibular gland. Advantages of intraoral approach are esthetic satisfaction due to no remaining scars, preservation of adjacent anatomical structures and preservation of lower facial contour. This paper describes the surgical technique of the submandibular gland excision through an intraoral approach and variable incision lines tried. In 7 cases, excellent results were obtained after removal of the submandibular gland through an intraoral approach.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.137-146
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• 2020

Background: Mandibular third molar removal is the most common surgical procedure encountered in oral and maxillofacial clinics. It also presents the greatest challenges and controversies for surgeons when surgical removal is considered. Furthermore, diverse anesthesia results and success rates are achieved after using the same concentrations of different solutions or the same amounts of local anesthetics. The purpose of this study was to examine the efficiency of using double-cartridge (3.4 ml) 4% lidocaine (high concentration) and 4% articaine with a 1:100000 epinephrine infiltration in the retromolar region for impacted lower third molar surgery. Methods: This double-blind study included 30 patients with symmetrically impacted lower third molars. The patients were randomly selected to receive 4% articaine on one side and 4% lidocaine on the other, as a local anesthetic for third molar surgery. The onset, duration of soft-tissue numbness, pulpal sensitivity, amount of additional local anesthetic needed, pain score during the surgical procedure, and duration of the operation were recorded. Results: The results of this research indicate that 86.7% of the operations in the 4% articaine group and 83.3% of those in the 4% lidocaine group were successful. Furthermore, the outcomes in both groups were not statistically significant (P > 0.05). Numbness onset occurred faster in the articaine group than it did in the lidocaine group. However, the duration of soft-tissue anesthesia and pain scores recorded immediately postoperatively were similar. Conclusion: It is concluded that 4% lidocaine and 4% articaine had a similar infiltration efficacy in the retromolar region and both local anesthetics are adequate for impacted lower third molar surgery. There were no statistically significant differences between the two local anesthetics regarding pain control and the duration of soft-tissue numbness during the procedure.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권2호
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• pp.105-111
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• 2017

Background: Dental fear is usually associated with hemodynamic changes. Fear of pain during the surgical removal of a lower impacted third molar might cause patients anxiety, thereby leading to avoidance of any future dental therapy. This study aimed to determine the effect of experiencing a surgical impacted-tooth removal on the pain perception-related anxiety and hemodynamic status. Method: Twenty-seven healthy patients aged 15-30 years (mean age, 24 years), for whom surgical removal of bilateral lower third molars was advised, were included. This prospective, randomized, controlled, split-mouth study involved operations on both sides of the mandibular arch, with a 1-month washout period in between. Blood pressure and heart rate were measured before the surgical procedure, during and after the injection, preoperatively, and postoperatively. Pain perception was evaluated using a 100-mm visual analog scale during the injection, preoperatively, and postoperatively after the numbness disappeared. Differences in the blood pressure, heart rate, and pain perception between the two appointments were analyzed using the paired t-test. For all statistical analyses, SPSS version 11.5 was used. Results: The mean pain perception values during the injection and preoperatively showed no significant differences between the two appointments (P > 0.05); however, significant differences in the blood pressure and heart rate were noted before the surgical procedure; preoperatively, the blood pressure alone showed a significant difference (P < 0.05). Conclusion: There was a significant decrease in the blood pressure and heart rate preoperatively; hence, experiencing a surgical impacted-tooth removal can reduce the subsequent preoperative anxiety in healthy patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권4호
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• pp.279-285
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• 2021

Objectives: Wound healing is an integral part of any surgical procedure. Appropriate wound closure is critical to any successful surgical procedure, especially intraoral procedures. Various factors aid in wound healing, both pharmacological and non-pharmacological. Dehydrated human amniotic/chorionic membrane (dHACM) is an emerging bioinert material that contains anti-inflammatory properties, angiogenetic properties, osteogenic potential, and various growth factors. The purpose of this study was to evaluate the efficacy of wound healing properties of dHACM in bilateral alveoloplasty patients. Materials and Methods: A prospective split-mouth study was conducted on 10 patients. Site A received sutures with dHACM and site B was sutured without dHACM. Wound healing was assessed with the Landry, Turnbull, and Howley Index. Results: Sites A and site B were compared. A P<0.05 and a test value of 22 was obtained, indicating a statistical difference between the two sites. Conclusion: Our study showed better healing with dHACM than without.