• 치과방사선
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• 제22권1호
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• pp.149-160
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• 1992

The purpose of this study was to localize the inferior alveolar canals in relation to the root apices of the mandibular third molars, according to their positions and degrees of impaction using vertical tube shift technique. One hundred three mandibular third molars, from 95 persons consisted of 57 males and 38 females, were clinically and radiographically investigated. The mandibular third molars had no pericoronitis and periapical lesions, and showed an evidence of complete root formation. The obtained results were as follows: 1. In localiztion of the inferior alveolar canals in relation to the root apices of the mandibular third molars, the inferior alveolar canal was located at the buccal side of the root apices of mandibular third molar in 77.7%, below the root apices in 16.5%, and the lingual side of root apices in 5.8%. 2. The positions of the mandibular third molars according to the Winter's Classification were as follows; 36.9% in Class Ⅰ, 21.3% in Class Ⅱ, 14.7% in Class Ⅲ, 4.8% in Class Ⅳ, 1.9% in Class Ⅴ, 17.5% in Class Ⅵ, 2.9% in Class Ⅶ. In localization of the inferior alveolar canals in relation to the root apices of the mandibular third molars according to the Winter's Classification, 92.1 % of Class Ⅰ, 86.4% of Class Ⅱ, 80.0% of Class Ⅲ, and 100.0% of Class Ⅳ and Ⅴ were located at the buccal side. In Class Ⅵ, however, 33.3% was located at the buccal side, 44.5% below the root apices, and 22.2% at the lingual side. 3. The degree of impaction was revealed to be 53.4% in Degree Ⅰ, 36.9% in Degree Ⅱ, and 9.7% in Degree Ⅲ. In localization of the inferior alveolar canals in relation to the root apices of mandibular third molars according to degree of impaction, 98.2% of Degree Ⅰ was located at the buccal side. In Degree Ⅱ, 60.5% was located at the bucal side, 31.6% below the root apices, and 7.9% at the lingual side. In Degree Ⅲ, 30.0% was located at the buccal side, 40.0% below the root apices, and 30.0% at the lingual side.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권5호
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• pp.464-473
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• 2006

Purpose: This study was performed to evaluate relationship between the inferior alveolar nerve injury and the findings of panoramic and tomographic images for preventing inferior alveolar nerve injury after the 3rd molar extraction. Material and Method: From April, 2005 to June, 2005, The 190 patients who visited in the Department of Oral and Maxillofacia Surgery, Chonnam National University Hospital and the panoramic radiographies were taken for extraction of the mandibular third molar, was selected. Among 215 mandibular third molars, Scanora tomographic imagings were taken in the 90 teeth which were overlaped to the mandibular canal in the panoramic imagies. In panoramic radiographies, the angulation, the level, the root morphology, and the superimposition sign of the mandibular third molars with the mandibular canal were evaluated. In the tomographic radiographies, the location and distance of the mandibular third molar from the canal were also evaluated. The relationships between these findings and the inferior alveolar nerve injury were examined. Results: In the panoramic findings, the inferior alveolar nerve injuries were occurred in the darkened roots (5 molars, 7%), the uncontinuous radiopaque image (3 molars, 7%), and the depositioned mandibular canal (2 molars, 10%). In the tomographic findings of 90 molars, 20 molars also had the superimposition imagies. Five molars in those molars (25%) had the inferior alveolar nerve injury after extraction. There were 10 patients who had the inferior alveolar nerve injury. The sensory was began to be recovered in 9 patients, except 1 patient, within 2 weeks, then fully recovered within 3 months. Conclusion: These results indicate that the depth mandibular third molar and the superimposition sign may be related with the risk of the inferior alveolar nerve injury after extraction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권1호
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• pp.63-67
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• 2022

Controversies exist regarding the need for prophylactic extraction of mandibular third molars in patients who plan to undergo orthognathic surgery. An 18-year-old male patient was diagnosed with mandibular prognathism and maxillary retrognathism with mild facial asymmetry. He had a severely damaged mandibular first molar and a horizontally impacted third molar. After extraction of the first molar, the second molar was protracted into the first molar space, and the third molar erupted into the posterior line of occlusion. The orthognathic surgery involved clockwise rotation of the maxillomandibular complex as well as angle shaving and chin border trimming. Patients who are missing or have damaged mandibular molars should be monitored for eruption of third molars to replace the missing posterior tooth regardless of the timing of orthognathic surgery.

• 대한치과의사협회지
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• 제57권11호
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• pp.654-663
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• 2019

This case report describes the management of a 30-year-old woman with hopeless mandibular first molars and right maxillary second premolar. The treatment plan included mandibular second and third molar protraction after extraction of mandibular first molars. Mini-implants were placed between roots of first and second premolar. Sliding mechanics with lever arm was used to prevent inclination of molars. A good functional occlusion was achieved in 38 months without clinically significant side effects. Most of the extraction space of mandibular first molar was closed by protraction of second and third molars. The skeletal Class II pattern was improved by counterclockwise rotation of mandible through reduction of wedge effect. Mandibular molar protraction with orthodontic mini-implants in adequate cases would be a great alternative to prosthetic implant and reduce the financial and surgical burden of patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권1호
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• pp.3-10
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• 2015

Objectives: We retrospectively evaluated the impact of mandibular third molars on the occurrence of angle and condyle fractures. Materials and Methods: This was a retrospective investigation using patient records and radiographs. The sample set consisted of 440 patients with mandibular fractures. Eruption space, depth and angulation of the third molar were measured. Results: Of the 144 angle fracture patients, 130 patients had third molars and 14 patients did not. The ratio of angle fractures when a third molar was present (1.26 : 1) was greater than when no third molar was present (0.19 : 1; odds ratio, 6.58; P<0.001). Of the 141 condyle fractures patients, the third molar was present in 84 patients and absent in 57 patients. The ratio of condyle fractures when a third molar was present (0.56 : 1) was lower than when no third molar was present (1.90 : 1; odds ratio, 0.30; P<0.001). Conclusion: The increased ratio of angle fractures with third molars and the ratio of condyle fractures without a third molar were statistically significant. The occurrence of angle and condyle fractures was more affected by the continuity of the cortical bone at the angle than by the depth of a third molar. These results demonstrate that a third molar can be a determining factor in angle and condyle fractures.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권1호
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• pp.19-27
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• 2020

Background: Surgical extraction of third molars is associated with postoperative pain and swelling at the extraction site. Pain is commonly managed using non-steroidal anti-inflammatory drugs (NSAIDs). Postoperative pain is usually moderate to severe in the first 12 h postoperatively and lasts for 3-5 days. However, with NSAIDs, these symptoms usually subside within 24 h. Diclofenac sodium and etodolac are NSAIDs, more selectively cyclooxygenase-2 inhibitors, with good analgesic efficacies. Methods: We compared the safety and analgesic efficacy of diclofenac sodium with etodolac peroral after surgical extraction of third molars in a double-blind, double-dummy, parallel-group study. The subjective pain improvement and pain relief after 2, 6, 24, 48, and 72 h using the visual analogue scale were measured as the study outcome. Results: Etodolac was equivalent to diclofenac sodium in pain alleviation at all postoperative time periods. No significant differences were found between diclofenac sodium and etodolac groups (P > 0.05). Both study medications were well tolerated and safe with mild adverse effects in only a few participants. Conclusion: Diclofenac sodium and etodolac are comparable in terms of analgesic efficacy and safety after surgical removal of third molars.

• 대한치과교정학회지
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• 제23권4호
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• pp.493-501
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• 1993

It is the aim of this study to determine the impacts of radicular development of lower third molars on its eruption/impaction and to grope the prediction for eruption and/or impaction in advance. Three hundred and thirty cases of orthopantomogram were employed and classified as mesial root-dominant group, distal root-dominant group and Identical group according to the radicular development of lower third molars. This presentation has carried out the incipient mesial inclination, radicular development, impaction/eruption rate and changes of mesial inclination of the very teeth. Consequently the following summary and conclusions were drawn; Radicular development dominated mesial root than the distal and dominant mesial root invited higher potentialities for normal eruption. The mesial or honzontal impactions were detected on the distal root-dominant group. This analysis has been suggested the potential eruption/impaction of lower third molars were dependent upon the radicular development and the incipient mesial inclination.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권6호
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• pp.492-498
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• 2009

We sought to evaluate the relationship between the mandibular canal and impacted mandibular third molars by using dental cone beam computed tomograph(CBCT) for third molar surgery. A total of 111 patients(177 teeth) offered the images through CBCT and panoramic radiography for the extraction of the mandibular third molars. In CBCT, the accurate relationship between the third molar and the mandibular canal were evaluated. In panoramic radiographies, we evaluated the impacted level and superimposition sign of the mandibular third molar with the mandibular canal, and also, the radiopacity of the white line in the canal. Data were statistically analyzed and estimated by $X^2$-test. In CBCT finding, high prevalence of contact between the mandibular canal and roots occured in the deep impacted third molars, narrowing mandibular canals, bending mandibular canals and cases where the radiopacity of white line of canals were "absence" on panoramic images. It showed statistical significance (P<0.05). When evaluating the mandibular canal and the roots through the panoramic radiography for third molar extraction, it could be difficult to diagnosis accurately. Thus, it is required to have an accurate diagnostic approach through CBCT that could evaluated the location between mandibular canal and root.

• Journal of Periodontal and Implant Science
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• 제33권3호
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• pp.407-414
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• 2003

The aim of this study was to investigate the effect of third molar extraction on the periodontal status of the adjacent second molar. A total of 61 second molars in 31 adult periodontitis patients were examined. Among them, 27 second molars without adjacent third molars were included in the test group, and 34 second molars with third molar were included in the control group. Clinical parameters including plaque index, gingival index, and pocket depth and radiographic bone loss were measured around the second molar both in test and control group. The result showed that: (1) the mean plaque index and gingival index of control group were higher than these of the test group but the difference was not statistically significant, (2) the mean pocket depth of the control group was higher than the test group significantly at distal and buccal surface, (3) radiographic hone loss was greater in control group than test group significantly, (4) in Pearson correlation analysis between the age of extraction and radiographic bone loss in the test group, a positive relationship was shown(p<0.01). Within limitation of this study, it may be concluded that third molar extraction in periodontitis patients showed an improvement in periodontal status in contrast the patients group having third molar, therefore earlier a removal of third molar may minimize radiographic hone loss of the adjacent second molar.

• Imaging Science in Dentistry
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• 제42권3호
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• pp.121-127
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• 2012

Purpose: This study evaluated the association between cone beam computed tomography (CBCT) and panoramic radiographs in the assessment of a superimposed relationship between the mandibular canal and impacted third molars. Materials and Methods: The study samples consisted of 175 impacted third molars from 131 patients who showed a superimposed relationship between the mandibular canal and third molars on panoramic radiographs and were referred for the examination of the mandibular canal with CBCT. Panoramic images were evaluated for the darkening of the root and the interruption of the mandibular canal wall. CBCT images were used to assess the buccolingual position of the mandibular canal relative to the third molar, the proximity of the roots to the canal, and lingual cortical bone loss. The association of the panoramic and CBCT findings was examined using a Chi-square test and Fisher's exact test. Results: Panoramic radiographic signs were statistically associated with CBCT findings (P<0.01). In cases of darkening roots, lingual cortical bone loss or buccally positioned canals were more frequent. In cases in which the mandibular canal wall was interrupted on panoramic radiographs, contact or lingually positioned canals were more frequent. Conclusion: The results of this study suggest that contact between the mandibular third molar and canal and a lingually positioned canal could be more frequently observed in cases of the interruption of the white line of the mandibular canal and that there could be more lingual cortical loss in cases of darkening roots.