• Title/Summary/Keyword: Third molars

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Stress Analysis on the Splinted Conditions of the Two Implant Crowns with the Different Vertical Bone Level (치조골 높이가 다른 2개 임플란트 금관의 고정연결 조건에 따른 응력분석)

  • Jeon, Chang-Sik;Jeong, Sin-Young;Kang, Dong-Wan
    • Journal of Dental Rehabilitation and Applied Science
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    • v.21 no.2
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    • pp.169-182
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    • 2005
  • The purpose of this study was to compare the stress distribution around the surrounding bone according to the splinted and non-splinted conditions on the finite element models of the two implant crowns with the different vertical bone level. The finite element model was designed with the parallel placement of the two fixtures ($4.0mm{\times}11.5mm$) with reverse buttress thread on the mandibular 1st and 2nd molars. As the bone quality, the inner cancellous bone and the outer 2 mm cortical bone were designed, and the cortical and cancellous bone were assumed to be perfectly bonded to the implant fixture. The splinted model(Model 1) had 2 mm contact surface and the non-splinted model(Model 2) had $8{\mu}m$ gap between two implant crowns. Two group (Splinted and non-splinted) was loaded with 200 N magnitude in the vertical and oblique directions on the loading point position on the central position of the crown, the 2 mm and 4 mm buccal offset point from the central position. Von Mises stress value was recorded and compared in the fixture-bone interface in the bucco-lingual and mesio-distal sections. The results were as follows; 1. In the vertical loading condition of central position, the stress was distributed on the cortical bone and the cancellous bone around the thread of the fixture in the splinted and non-splinted models. In the oblique loading condition, the stress was concentrated toward the cortical bone of the fixture neck, and the neck portion of 2nd molar in the non-splinted model was concentrated higher than that of 1st molar compared to the splinted model. 2. In the 2 mm buccal offset position of the vertical loading compared to the central vertical loading, stress pattern was shifted from apical third portion of the fixture to upper third portion of that. In the oblique loading condition, the stress was distributed over the fixture-bone interface. 3. In the 4 mm buccal offset position of the vertical loading, stress pattern was concentrated on the cortical bone around the buccal side of the fixture thread and shifted from apical third portion of the fixture to upper third portion of that in the splinted and non-splinted models. In the oblique loading, stresses pattern was distributed to the outer position of the neck portion of the fixture thread on the mesio-distal section in the splinted and non-splinted models. Above the results, it was concluded that the direction of loading condition was a key factor to effect the pattern and magnitude of stress over the surrounding bone of the fixture under the vertical and oblique loading conditions, although the type with or without proximal contact did not effect to the stress distribution.

IMPACTED PREMOLARS AND MOLARS ASSOCIATED WITH DENTIGEROUS CYSTS IN CHILDREN (어린이에서 함치성 낭과 연관된 매복 소구치와 대구치의 치료)

  • Shin, Cha-Uk;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.718-724
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    • 2008
  • Tooth impaction is a frequently observed eruption anomaly in pediatric dental practice. Young patients with impacted or unerupted teeth have more prediction for dentigerous cyst formation. Dentigerous cyst presents radiographic features, unilocular or multilocular radioluscency. Cysts occur most frequently in the premolar region except third molar. Dentigerous cysts can grow to a considerable size, and large cysts may be associated with a painless expansion of the bone in the involved area. Extensive lesions may result in facial asymmetry, osseous destruction, root resorption of proximal teeth and displacement of associated tooth. The nature of the causative tooth influences the type of surgical treatment required for the dentigerous cyst. If the cyst is associated with a supernumerary or wisdom tooth, complete enucleation of the cyst along with extraction of tooth may be the first treatment choice. Otherwise, preservation of the associated teeth should be considered to prevent a young patient from psychological and mental trauma because of the loss of tooth. We should consider the degree of tooth displacement, osseous destruction and growth pattern of oromaxillofacial area when planning treatment. Thus a proper and logical treatment planning can help a proper growth and development of oromaxillofacial area and can save the patient from a psychological and mental trauma. This report describes 4 cases of the management of impacted premolars and molars associated with dentigerous cysts in children.

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Effects of the root conditioning treatments after Nd:YAG laser irradiation on in vitro human gingival fibroblast attachment to root surfaces (Nd:YAG 레이저조사 후 치근의 처치방법들이 치근면 치은섬유아세포부착에 미치는 영향에 관한 연구)

  • Moon, Hye-Seong;Lim, Kee-Jung;Kim, Byung-Ock;Han, Kyung-Yoon
    • Journal of Periodontal and Implant Science
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    • v.26 no.3
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    • pp.701-713
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    • 1996
  • The purpose of this study was to evaluate the biocompatibility of the Nd:YAG lased root surface followed by root planing and/or tetracyline-HCI(T.C.-HCI) conditioning. $30,4mm{\times}4mm$ root segments were obtained from unerupted third molars and 21, periodontally involved root segments. The treatment groups were as follows : (1) healthy root cementum surface groups : 1) control(non-treated group), 2) lased only, 3) lased/root planed, and 4) lased/T.C.-HCI. (2) diseased root cementum surface groups : 1) control(root planed only), 2) lased/root planed, and 3) lased/root planed/T.C.-HCI. The specimens were treated with a Nd:YAG laser using a $320{\mu}m$ noncontact optic fiber handpiece with an energy setting of 1.5W($114.6J/cm^2$), 2.0W($152.9J/cm^2$), 5.0W($382J/cm^2$) for one minute. The fiber was held perpendicular to the petri dish(NUNC) 2cm apart in an attempt to expose the entire root segments equally. Human gingival fibroblasts were cultured from explants of normal interdental gingival tissue obtained during third morlar extraction. The attachment assay was performed with third-generation fibroblasts. The numbers of gingival fibroblasts attached to the root surface were counted on each specimen under the light microscope, and were statistically analyzed by the oneway ANOVA followed by Tukey's test in SPSS/PC+programs. The results were as follows : 1) In healthy root cementum surfaces, lased/root planed groups exhibited a significantly increased fibroblast attachment compared to controls, lased only, and lased/T.C.-HCI groups(p<0.05), 2) In diseased root cementum surfaces, laser treatment followed by root planing and/or T.C.HCl groups exhibited a increased tendency of fibroblast attachment compared to root planed only group. The results suggest that laser treatment followed by root planing and/or T.C.-HCl would appear necessary so as to render the root surface biocompatible.

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Spontaneous bone regeneration after surgical extraction of a horizontally impacted mandibular third molar: a retrospective panoramic radiograph analysis

  • Kim, Eugene;Eo, Mi Young;Nguyen, Truc Thi Hoang;Yang, Hoon Joo;Myoung, Hoon;Kim, Soung Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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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.

Expression of Periostin and S100A2 - S100A4 - Calcium Binding Proteins mRNA in Human Gingival Fibroblasts and Periodontal Ligament Fibroblasts (사람 치은섬유세포와 치주인대섬유모세포에서 Periostin과 S100A2-, S100A4-칼슘결합단백 mRNA의 발현)

  • Kim, Byung-Ock;Han, Kyung-Yoon;Choi, Young-Sun;Kim, Se-Hoon;Park, Byung-Gi;Kim, Heung-Joong;Park, Joo-Cheol
    • Journal of Periodontal and Implant Science
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    • v.31 no.1
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    • pp.109-122
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    • 2001
  • Gingival fibroblasts(GF) and periodontal ligament fibroblasts(PDLF) are the major cellular components of periodontal soft connective tissues, but the precise molecular biological differences between these cells are not yet known. In the present study, we investigated the expression of S100A4, S100A2 calcium-binding protein and osteoblast-specific factor 2(OSF-2, Periostin) mRNA in GF and PDLF in vitro through the process of reverse transcription-polymerase chain reaction(RT-PCR) and Northern blot analysis in each. Human GF and PDLF were isolated from the gingival connective tissue and the middle third of freshly extracted healthy third molars. They were cultured in Dulbecco's Modified Eagle Medium(DMEM) containing 10% fetal bovine serum and cells in the third passage were used in the experiments. After extracting total RNA from cultured cells, RT-PCR and Northern analysis were performed using S100A4-, S100A2- and Periostin-specific oligonucleotide primers and subcloned cDNA probes in each. In PT-PCR and Northern analysis, the expression of S100A4 and Periostin mRNA in GF was slightly detectable. Interestingly, the expression of S100A4 and periostin mRNA in PDLF was much higher than that in GF. On the other hand, S100A2 mPNA was highly expressed in both GF and PDLF. Since there was a marked difference of S100A4 and Periostin expression between GF and PDLF in vitro, these data suggest that S100A4 and periostin could be used as a useful marker for distinguishing cultured gingival fibroblasts and periodontal ligament cells.

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Relationship Between the Dose of Clodronate and Serum Level of Alkaline Phosphatase, Calcium, and Phosphate During Orthodontic Tooth Movement

  • Choi, Josefina;Baek, Seung-Hak;Chang, Young-Il
    • Journal of Korean Dental Science
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    • v.3 no.1
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    • pp.32-38
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    • 2010
  • Objective : To evaluate the relationship between the dose of Clodronate and serum level of alkaline phosphatase (ALP), calcium (Ca), and phosphate (PO4) during orthodontic tooth movement MaterialS and MethodS: A total of 18 sex-matched Wistar rats (weight=180~230g, mean age=8 weeks) were allocated into the 2.5mM Clodronate (2.5C) group, 10mM Clodronate (10C) group, or control group (n=6 for each group). After the application of a nickel-titanium closed coil spring (force of 60g) between the upper central incisors and first molars (UFM), 2.5C, 10C, or saline was injected every third day into the subperiosteum of the alveolar bone adjacent to UFM for the experimental and control groups. The animals were sacrificed 17 days later. Trunk blood was quickly collected into a heparinized tube and centrifuged at 2,000 rpm for 20 min. The plasma was used for the biochemical assays of the serum level of ALP, Ca, and PO4. Kruskall-Wallis test and Mann-Whitney test with Bonferroni correction were performed for the statistical analyses. Results : Dose-dependent increase in the level of ALP (P<0.01) and decrease in the level of Ca (P<0.001) were observed among the control, 2.5C, and 10C groups. Although there was no significant difference in PO4 between the 2.5C and 10C groups, the 10C group showed a significantly higher level of PO4 than the control group (P<0.01). Conclusion : Since Clodronate induced significant dose-dependent change in the serum level of ALP, Ca, and PO4 during orthodontic tooth movement, orthodontists should consider these biochemical markers not only as a diagnostic tool for bone turnover rate but also as a monitoring tool for orthodontic tooth movement.

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Effects of contamination by either blood or a hemostatic agent on the shear bond strength of orthodontic buttons

  • Gungor, Ahmet Yalcin;Alkis, Huseyin;Turkkahraman, Hakan
    • The korean journal of orthodontics
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    • v.43 no.2
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    • pp.96-100
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    • 2013
  • Objective: To evaluate the effects of contamination by either blood or a hemostatic agent on the shear bond strength (SBS) of orthodontic buttons. Methods: We used 45 freshly extracted, non-carious, impacted third molars that were divided into 3 groups of 15. Each tooth was etched with 37% phosphoric acid gel for 30 s. Human blood or the blood stopper agent was applied to the tooth surface in groups I and II, respectively. Group III teeth were untreated (controls). Orthodontic buttons were bonded to the teeth using light-curing composite resin. After bonding, the SBS of the button was determined using a Universal testing machine. Any adhesive remaining after debonding was assessed and scored according to the modified adhesive remnant index (ARI). ANOVA with post-hoc Tukey's test was used to determine significant differences in SBS and Fisher's exact test, to determine significant differences in ARI scores among groups. Results: ANOVA indicated a significant difference between groups (p < 0.001). The highest SBS values were measured in group III ($10.73{\pm}0.96$ MPa). The SBS values for teeth in groups I and II were significantly lower than that of group III (p < 0.001). The lowest SBS values were observed in group I teeth ($4.17{\pm}1.11$ MPa) (p < 0.001). Conclusions: Contamination of tooth surfaces with either blood or hemostatic agent significantly decreased the SBS of orthodontic buttons. When the contamination risk is high, it is recommended to use the blood stopper agent when bonding orthodontic buttons on impacted teeth.

Comparison of microtensile bond strength on non-carious cervical lesions according to biofilm removal method (생체막 제거 방법에 따른 비우식성 치경부 병소의 미세인장강도 비교)

  • Sung, Kun-Hwa;Min, Jeong-Bum;Park, Tae-Young
    • The Journal of the Korean dental association
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    • v.58 no.11
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    • pp.683-689
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    • 2020
  • Dentin surface of non-carious lesion is usually attached with oral biofilm. The biofilm should be removed before application of restorative material, because it may reduce the bond strength of adhesive system. The aim of this study was to evaluate the microtensile bond strength, when the biofilm was removed with brush or bur. Twenty extracted human third molars were sectioned horizontally to obtain dentin surface. Specimen were divided randomly into four group. Biofilm formation was performed in three group, except for Group 1 (negative control). Biofilm was removed as follows: Group 3, using ICB brush; Group 4, using lowspeed round bur #2. Group 2 (positive control) was not removed Biofilm. And in all four groups, the adhesive system (Optibond FL, Kerr) was applied to etched dentin surface, and resin composite was built up in three 1mm increments. After 24 hour storage in distilled water, the teeth were perpendicularly sectioned to obtain beams (1 × 1 mm2). Microtensile bond strength was measured and the data were statistically analyzed using one-way ANOVA and Tukey's post hoc test (p<0.05). Group 4 showed the highest microtensile bond strength (p<0.05), Group 3 showed no significant improvements when compared to Group 1. Group 2 showed lowest microtensile bond strength (p<0.05). When restoring a non-carious cervical lesion, it is essential to remove the biofilm present on the dentin surface. In addition, in the method of removing the biofilm, both the brush removal method and the bur removal method were effective.

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MULTIDISCIPLINARY APPROACH FOR THE DENTAL TREATMENT OF A PATIENT HAVING TRACHEOSTOMY TUBE (기관내삽관을 가진 장애환자의 치과치료를 위한 협의 진료)

  • Cha, Yoon-Sun;Kim, Ji-Hun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.38-42
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    • 2014
  • A tracheostomy tube serves as airway management for patients whose respiration is impeded due to inflammation, tumor, or traumatic events. If the patients who have tracheostomy tube, visit dental clinic for dental treatments, we should consider the underlying general condition of patients and then make treatment plans according to their state. A 22-Year old male patient, who had tracheostomy tube on his neck, came to our department for comprehensive dental treatment. Mild mental retardation was observed and he was taking anti-convulsant drugs for the prevention of epileptic seizure. Multiple advanced dental caries, hopeless teeth, and impacted third molars were also observed by clinical and radiographic examination. Due to the risk of epileptic seizure and low cooperativity to tolerate the treatment, general anesthesia was recommended by physician, and the anti-convulsant drug was administrated during procedure. In this case, we aimed to report the multidisciplinary approach for the dental treatment of patient having a tracheostomy tube.

DENTAL MANAGEMENT OF A PATIENT WITH KABUKI SYNDROME : A CASE REPORT (가부키 증후군(Kabuki syndrome) 환자의 치과적 관리의 치험례)

  • Kang, Him Chan;Nam, Ok Hyung;Kim, Mi Sun;Choi, Sung Chul;Kim, Kwang Chul;Lee, Hyo-Seol
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.2
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    • pp.104-107
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    • 2017
  • Kabuki syndrome is characterized by typical facial features (elongated palpebral fissures with eversion of the lateral third of the lower eyelid; arched and broad eyebrows; short columella with depressed nasal tip; large, prominent, or cupped ears), minor skeletal anomalies, persistence of fetal fingertip pads, mild to moderate intellectual disability, and postnatal growth deficiency. A 6-year-old male with kabuki syndrome was referred from the local dental clinic for left facial swelling and dental caries on all primary molars. He was treated for acute periapical abscess with incision and drainage under physical restraint, and left maxillary second primary molar was extracted. Other caries treatment was performed under general anesthesia. As the syndrome involves many different medical problems, special cares should be considered. Dental treatment should be carried out in comprehensive consultation system.