• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.6
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• pp.309-315
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• 2019

Objectives: The aim of this study was to evaluate the validity of the existing classification and difficulty index of impacted mandibular third molars in clinical situations and propose a more practical classification system. Materials and Methods: This study included 204 impacted mandibular third molars in 154 patients; panoramic x-ray images were obtained before tooth extraction. Factors including age, sex, and pattern of impaction were investigated. All impacted third molars were classified and scored for spatial relationship (1-5 points), depth (1-4 points), and ramus relationship (1-3 points). All variables were measured twice by the same observer at a minimum interval of one month. Finally, the difficulty index was defined based on the total points scored as slightly difficult (3-4 points), moderately difficult (5-7 points), very difficult (8-10 points), and extremely difficult (11-12 points). Results: The strength of agreement of the total points scored and difficulty index were 0.855 and 0.746, respectively. Most cases were classified as moderately difficult (73.0%). Although only 13 out of 204 cases (6.4%) were classified as extremely difficult, patients classified as extremely difficult were the oldest (P<0.05). Conclusion: For difficulty classification, the authors propose one more difficult category beyond the existing three-step difficulty index: the clinician should consider the patient's age in the difficulty index evaluation.

• 대한치과교정학회:학술대회논문집
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• 2005.11a
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• pp.70.1-70.1
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• 2005

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.4
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• pp.260-269
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• 2019

The prolonged neglect of the posterior teeth missing area may cause mesial drift, extrusion, unexpected movement of the adjacent teeth and alveolar bone loss with occlusion collapse. Therefore it is recommended to treat that area by the prosthesis as soon as possible after tooth missing. However, if orthodontic treatment is applied to move the remained teeth, it can create improved biomechanical dentoalveolar environment. The use of the third molars in teeth missing area provides advantages as optimizing of prosthesis size. However, crown shape, location, soundness of the third molar and possible of eruption failure should be considered. In this case report, two patients closed a second teeth missing site and reduced the size of the first and second teeth missing area for an implant by protraction of impacted third molars. This case reports the considerations for closing or reducing the posterior teeth space with protracting the third molars by comparing two patients.

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.61-68
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• 2002

The objective of this study was to determine the incidence and distribution of root fusion as well as its sexlinkage in maxillary and mandibular molars. One hundred fifty patients who had eight maxillary and mandibular molars (third molars excluded) were consecutively selected for the study subjects. The subjects provided a total of 1200 molars, i.e., 600 maxillary and 600 mandibular molars. A decision about root fusion was made on the radiographic examination. If a molar had one root and/or roots fused at any part in the root surface, it was considered as having root fusion. The results showed that : (1) 14.1 % of the maxillary molars and 5.8 % of the mandibular molars had a fused root, (2) the prevalence of root fusion in the male was 33 % and 56.4 % in the female, (3) 60 % in the male and 48.8 % in the female had bilaterally paired root fusion, (4) the root fusion was most frequently observed in the maxillary second molar position, but none in the mandibular first position in this study. Within limitations of this study, it can be concluded that, in management of molars with a furcation problem, treatment options such as hemisection and root amputation should be chosen after careful evaluation of root fusion. Further studies are needed to investigate a possible relationship between root fusion and periodontal disease progression.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.6
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• pp.657-664
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• 2008

Purposes: The aim of this study was to evaluate pulp healing, periodontal healing, root development of autotransplantation of immature third molars and show its viability in treatment of early loss of tooth in young patients Materials and methods: In this article we performed a retrospective study with 41 transplanted teeth in 36 patients. The Mean age at the time of surgery was 17 years(range $13{\sim}24$ years) and mean postoperative follow up period was 2.4 years(range $1{\sim}6$ years) We evaluated the survival rate, pulp healing, periodontal healing, root development of the above teeth Results: At the last examination 40 teeth among 41 transplants were still present so survival rate was 97.6%. The pulpal healing was found in 38 teeth of 41 transplants. The periodontal healing was found in 38 transplants. The continuous root development was seen in 38 transplants. Conclusions: From the above results, the autotransplantation of immature third molars was found to be a useful and reliable treatment method for early loss of teeth in adolescents and young adults.

• The Journal of the Korean dental association
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• v.47 no.4
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• pp.211-224
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• 2009

This retrospective study was to analyze the inferior alveolar nerve and lingual nerve damage after the removal of mandibular third molars. In this questionnaire study, the subjects chosen for this study were 2472 dentists who answered the questionnaire about numbness after the extraction of lower third molars. The data collected by E-mail and web site included the incidence of removal of the lower third molars, the incidence and the experience of numbness of the inferior alveolar nerve and lingual nerve, rate and duration of recovery, the influence in day life after the long-term sensory loss, the period and amount of the indemnity in the case of medical dispute. The results are summarized as follows. 1. The experience rate and the incidence rate of the inferior alveolar nerve numbness by oral surgeons in the past year were19.9% and 0.14%. Those of the lingual nerve by oral surgeon were 7.7% and 0.05%.2. The experience rate and the incidence rate of the inferior alveolar nerve numbness by the dentists except oral surgeons in the past year were 9.7% and 0.19%. Those of the lingual nerve by the dentists except oral surgeons were 5.5% and 0.11%.3. The recovery rate of the inferior alveolar nerve after 1 year and 2 years were 85.6% and 91.3%. The recovery rate of the lingual nerve after 1 year and 2 years were 84.8% and 89.3%.In conclusion, most of numbness may be recovered within 2 years. However the possibility of long term and persistent numbness should not be neglected. Therefore practitioner must inform the possibility of nerve injury and include this possibility in the consent forms.

• Journal of The Korean Dental Society of Anesthesiology
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• v.4 no.1 s.6
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• pp.13-16
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• 2004

Background: Articaine, a new amide-type local anesthetic, was recently commercially available in Korea. The purpose of this study was to compare the anesthetic efficacy between articaine HCl and lidocaine HCl for the surgical extraction of bilateral mandibular impacted third molars. Patients and Methods: Forty young and healthy patients with bilateral impacted third molars were selected with permission. Randomly, one side of impacted third molar was operated under local anesthesia using 4% articaine and the other side under 2% lidocaine after 1 or 2 week recovery time. Intraoperative pain was evaluated via 0-10 cm visual analog scale (VAS) by both the patient and operator immediately after the operation. After 1 day and 7 days, the complications of local anesthesia were checked. Results: The pain VAS scores in articaine group, evaluated by both the patient and operator, were lower than those in lidocaine group, but they were not statistically significant (P = 0.44 and 0.54, respectively). The incidence of complications of local anesthesia between articaine and lidocaine was similar. Conclusion: In this study, articaine showed at least equal efficacy compared to lidocaine. The further dose-controlled study with more pharmacokinetic parameters will be needed.

• Imaging Science in Dentistry
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• v.47 no.3
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• pp.149-155
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• 2017

Purpose: The classification of impacted maxillary third molars(IMTMs) facilitates interdisciplinary communication and helps estimate the degree of surgical difficulty. Thus, this study aimed to develop a 3-dimensional classification of the position and depth of impaction of IMTMs and to estimate their prevalence with respect to gender and age. Materials and Methods: This cross-sectional retrospective study analyzed images in sagittal and coronal cone-beam computed tomography (CBCT) sections of 300 maxillary third molars. The proposed classification was based on 3 criteria: buccolingual position (buccal, lingual, or central), mesial-distal position (mesioangular, vertical, or distoangular), and depth of impaction (low, medium, or high). CBCT images of IMTMs were classified, and the associations of the classifications with gender and age were examined using analysis of variance with the Scheffe post-hoc test. To determine the associations among the 3 classifications, the chi-square test was used (P<.05). Results: No significant association of the classifications with gender was observed. Age showed a significant relationship with depth of impaction (P=.0001) and mesial-distal position (P=.005). The most common positions were buccal(n=222), vertical(n=184), and low (n=124). Significant associations among the 3 tested classifications were observed. Conclusion: CBCT enabled the evaluation of IMTMs in a 3-dimensional format, and we developed a proposal for a new classification of the position and depth of impaction of IMTMs.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.4
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• pp.213-220
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• 2023

Background: Third molar extraction is the most commonly performed minor oral surgical procedure in outpatient settings and requires regional anesthesia for pain control. Extraction of the maxillary molars commonly requires both posterior superior alveolar nerve block (PSANB) and greater palatine nerve block (GPNB), depending on the nerve innervations of the subject teeth. We aimed to study the effectiveness of PSANB alone in maxillary third molar (MTM) extraction. Methods: A sample size comprising 100 erupted and semi-erupted MTM was selected and subjected to study for extraction. Under strict aseptic conditions, the patients were subjected to the classical local anesthesia technique of PSANB alone with 2% lignocaine hydrochloride and adrenaline 1:80,000. After a latency period of 10 min, objective assessment of the buccal and palatal mucosa was performed. A numerical rating scale and visual analog scale were used. Results: In the post-latency period of 10 min, the depth of anesthesia obtained in our sample on the buccal side extended from the maxillary tuberosity posteriorly to the mesial of the first premolar (15%), second premolar (41%), and first molar (44%). This inferred that anesthesia was effectively high until the first molars and was less effective further anteriorly due to nerve innervation. The depth of anesthesia on the palatal aspect was up to the first molar (33%), second molar (67%), and lateromedially; 6% of the patients received anesthesia only to the alveolar region, whereas 66% received up to 1.5 cm to the mid-palatal raphe. In 5% of the cases, regional anesthesia was re-administered. An additional 1.8 ml PSANB was required in four patients, and another patient was administered a GPNB in addition to the PSANB during the time of extraction and elevation. Conclusion: The results of our study emphasize that PSANB alone is sufficient for the extraction of MTM in most cases, thereby obviating the need for poorly tolerated palatal injections.

• The Journal of the Korean dental association
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• v.50 no.9
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• pp.566-573
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• 2012

Purpose : This study evaluated the impact of the presence and aspect of mandibular third molars to the mandible angle fracture or condyle fractures in Korean. Materials and Methods : A retrospective study was designed for patients attending the division of Oral and Maxillofacial Surgery, Kang-dong sacred heart hospital for treatment of mandibular fracture from January 2006 to September 2010. The primary variable was the presence of mandibular third molar and the secondary variable was the aspects of third molar impaction. Mandibular third molars were classified by the impaction depth and the available space as Pell & Gregory system. Outcome variables were the presence of mandibular angle fracture or condyle fracture. Also the source of trauma, age, sex were studied. Hospital charts, radiographs were used for study. Statistic analysis was done with descriptive statistics, the X2-test, linear-by-linear association. P value under 0.05 was considered significant statistically. Results : The number of involved patients was 86. The ratio of male to female patients was about 9:1 for angle fracture and 7:3 for condyle fracture. The most common source of trauma was assault for angle fracture and fall down for condyle fracture. The presence of mandibular third molar increased frequency of angle fracture and decreased condyle fracture with larger impaction depth. But available space of mandibular third molar did not show high association with angle or condyle fractures. Conclusion: Preventive extraction of mandibular third molar is recommended for patients with high risk of angle fracture. Male patients at their third decade or martial artists, police officer could be the case. But it is not recommended for patients with low risk of angle fracture and high risk of condyle fracture relatively. Elder female patients without any symptom on their third molar could be the case.