• Title/Summary/Keyword: Third molars

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Assessment of the proximity between the mandibular third molar and inferior alveolar canal using preoperative 3D-CT to prevent inferior alveolar nerve damage

  • Lee, Byeongmin;Park, Youngju;Ahn, Janghoon;Chun, Jihyun;Park, Suhyun;Kim, Minjin;Jo, Youngserk;Ahn, Somi;Kim, Beulha;Choi, Sungbae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.30.1-30.7
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    • 2015
  • Background: The inferior alveolar nerve (IAN) may be injured during extraction of the mandibular third molar, causing severe postoperative complications. Many methods have been described for evaluating the relative position between the mandibular third molar and the inferior alveolar canal (IAC) on panoramic radiography and computed tomography, but conventional radiography provides limited information on the proximity of these two structures. The present study assessed the benefits of three-dimensional computed tomography (3D-CT) prior to surgical extraction of the mandibular third molar, to prevent IAN damage. Methods: This retrospective study included 4917 extractions in 3555 patients who presented for extraction of the mandibular third molars. The cases were classified into three groups, according to anatomical relationship between the mandibular third molars and the IAC on panoramic radiography and whether 3D-CT was performed. Symptoms of IAN damage were assessed using the touch-recognition test. Data were compared using the chi-square test and Fisher's exact test. Results: Among the 32 cases of IAN damage, 6 cases were included in group I (0.35 %, n = 1735 cases), 23 cases in group II (1.1 %, n = 2063 cases), and 3 cases in group III (0.27 %, n = 1119 cases). The chi-square test showed a significant difference in the incidence of IAN damage between groups I and II. No significant difference was observed between groups I and III using Fisher's exact test. In the 6 cases of IAN damage in group I, the mandibular third molar roots were located lingual relative to the IAC in 3 cases and middle relative to the IAC in 3 cases. The overlap was ${\geq}2mm$ in 3 of 6 cases and 0-2 mm in the remaining 3 cases. The mean distance between the mandibular third molar and IAC was 2.2 mm, the maximum distance 12 mm, and the minimum distance 0.5 mm. Greater than 80 % recovery was observed in 15 of 32 (46.8 %) cases of IAN damage. Conclusions: 3D-CT may be a useful tool for assessing the three-dimensional anatomical relationship and proximity between the mandibular third molar and IAC in order to prevent IAN damage during extraction of mandibular third molars.

Comparison of panoramic radiography with cone beam CT in predicting the relationship of the mandibular third molar roots to the alveolar canal

  • Shahidi, Shoaleh;Zamiri, Barbod;Bronoosh, Pegah
    • Imaging Science in Dentistry
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    • v.43 no.2
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    • pp.105-109
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    • 2013
  • Purpose: Preoperative radiographic assessment of the mandibular third molars is essential to prevent inferior alveolar nerve damage during extraction. The purpose of this study was to assess the reliability of panoramic signs of association between the roots of teeth and the canal, and to compare the panoramic signs with cone beam computed tomography (CBCT) findings. Materials and Methods: CBCT images of 132 impacted mandibular third molars were evaluated to determine the association of the root to the canal. The CBCT findings were compared with the corresponding panoramic images. Logistic regression analysis was used to define the diagnostic criteria of the panoramic images. Results: Among the panoramic signs, loss of the cortical line was the most frequent radiographic sign predicting association (sensitivity: 79.31). Contact of the tooth with the canal was observed in all cases in which the loss of cortical line of the canal or darkening of the roots was found on the panoramic radiographs. Conclusion: Darkening of the roots and loss of the cortical line on panoramic radiographs might be highly suggestive of the risk of nerve injury.

A Roentgenographic Study on the Growth and Development of Mandibular Permanent Teeth (하악영구치 발육에 대한 방사선학적 연구)

  • Woo-Cheon Kee;Kwang-Woo Lee;Byung-Kook Kim
    • Journal of Oral Medicine and Pain
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    • v.13 no.1
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    • pp.53-60
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    • 1988
  • The authors have studied the growth and development of mandibular permanent teeth in order to the make basic data that are necessary to determine the forensic age. The 631 subjects whose ages range from 3 years to 18 years were selected to analyze calcification degree of mandibular teeth. The results were as follows: 1. There were significant differences between adjacent ages, except 14-15 years and 17-18 years. 2. In each tooth, these were differences between adjacent ages from 3 years to 10 years, except central incisor and third molars. 3. All teeth were almost completely developed at the age of about 14 years, except second and third molars. 4. In each tooth, there were the widest significances between adjacent ages in premolars.

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A CLINICAL STUDY OF PERIAPICAL LESIONS (치근단 병소의 임상적 연구)

  • Kim, Sang-Woo;Woo, Soon-Seop;Yoo, Im-Hak;Lee, Young-Soo;Shim, Kwang-Sup
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.232-237
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    • 2001
  • The purpose of this study was to find the clinical features of periapical lesions. A total of 130 periapical lesions which were obtained from biopsy and diagnosed histopathologically as periapical cyst, periapical abscess, and periapical granuloma at the Department of Dentistry in Hanyang University Hospital were throughly analysed according to the distribution and incidence of age, sex, location, and so on. The following results were obtained : 1. Out of 130 periapical lesions, 88 cases(67.7%) were periapical cysts, 30 cases(23.1%) were periapical abscesses, and 12 cases(9.2%) were periapical granulomas. 2. The periapical lesions occurred most frequently in the third decade, and followed by the fourth, fifth, sixth, and second decade. The periapical cysts occurred most frequently in the third decade(26.1%), the periapical granulomas in the fourth decade(33.3%) the periapical abscesses in the sixth decade(26.7%). 3. The periapical lesions were more frequent in men than in women with the ratio of men to women of 1.4 : 1. The radio of men to women of periapical cysts was 1.6 : 1, that of periapical granulomas was 0.5 : 1, and that of periapical abscesses was 1.3 : 1. 4. The periapical lesions were more frequent in maxilla than in mandible with the ratio of 1.2 : 1. The ratio of maxilla to mandible of periapical cysts was 1.5 : 1, that of periapical granulomas was 0.5 : 1, that of periapical abscesses was 1 : 1. 5. The most commonly involved location of the periapical lesions was maxillary anterior teeth(40.8%), and followed by mandibular molars, mandibular premolars, and mandibular anterior teeth and maxillary molars. The most frequent location of the periapical cysts was maxillary anterior teeth(48.9%), that of periapical granulomas was mandibular molars(50.0%), that of periapical abscesses was mandibular molars(40.0%).

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Effect of Naringin to Dental Caries and Periodontal Disease (Bioflavonoid naringin이 치아 우식증과 치주 질환 억제에 미치는 효과)

  • 김가영
    • Journal of Food Hygiene and Safety
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    • v.12 no.2
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    • pp.102-106
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    • 1997
  • The purpose of this study was to evaluate the bioflavonoids naringin on dental caries and periondontal disease in the albinorat. Twenty-five-day-old-male rats were fed the experimental diets for 42 days in this work at the end of the 42-day experimental period. The tooth surfaces were examined under a dissecting microscope. The sulcular caries lesions were recorded : the first molars were more affected than the second and third molars. Alveolar bone loss was measured on the buccal and lingual aspects of each molar: three site measurements (mesialpoint midpoint and distalpoint) were taken on the first molars. The results showed that the bioflavonoids, naringin had beneficial effects in the prevention of periodontal disease.

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SKELETAL MATURITY AND MANDIBULAR THIRD MOLAR DEVELOPMENT IN CLASS III MALOCCLUSION (III급 부정교합 어린이의 수완부 골성숙과 하악 제3대구치 발육에 대한 연구)

  • Kang, Keun-Young;Yang, Kyu-Ho;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.235-242
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    • 2008
  • The purpose of this study was to investigate the relationship of the skeletal maturity of hand-wrist and the development of mandibular third molar in subjects with class I and class III malocclusion. The subjects used in this study were 304 children(149 boys, 155 girls) with class I malocclusions and 308 children( 153 boys, 155 girls) with class III malocclusions, ranged from 8 to 15 years of age. Hand-wrist radiographs and panoramic radiographs were used to evaluate the stage of skeletal maturity and teeth development. Fishman's method for the skeletal maturity stages of the hand-wrist and new six-developmental-stage method for the calcification stages of mandibular third molars were analyzed. The results were as follows : 1. In subjects with class I and class III malocclusion, skeletal maturity of the hand-wrist occured earlier in females than in males(p<0.05), while the calcification stages of mandibular third molars were no significant gender differences. 2. There were no significant differences between the groups, when comparing the skeletal maturity stages of the hand-wrist and the calcification stages of mandibular third molars between subjects with the class I and the class III malocclusion. 3. The correlation coefficients between the calcification stages of mandibular third molars and the skeletal maturity stages of the hand-wrist in subjects with class I and class III malocclusion showed a high interrelationship(p<0.01). 4. The correlation coefficients between the calcification stages of mandibular third molars and chronological age in subjects with class I and class III malocclusion showed a high interrelationship (p<0.01). As a result, there were no significant differences between class I and class III malocclusion group for skeletal maturity of the hand-wrist and third molar development.

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The use of digital periapical radiographs to study the prevalence of alveolar domes

  • Xambre, Pedro Augusto Oliveira Santos;Valerio, Claudia Scigliano;Cardoso, Claudia Assuncao e Alves;Custodio, Antonio Luis Neto;Manzi, Flavio Ricardo
    • Imaging Science in Dentistry
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    • v.46 no.3
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    • pp.179-184
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    • 2016
  • Purpose: In the present study, we coined the term 'alveolar dome' and aimed to demonstrate the prevalence of alveolar domes through digital periapical radiographs. Materials and Methods: This study examined 800 digital periapical radiographs in regard to the presence of alveolar domes. The periapical radiographs were acquired by a digital system using a photostimulable phosphor (PSP) plate. The ${\chi}^2$ test, with a significance level of 5%, was used to compare the prevalence of alveolar domes in the maxillary posterior teeth and, considering the same teeth, to verify the difference in the prevalence of dome-shaped phenomena between the roots. Results: The prevalence of alveolar domes present in the first pre-molars was statistically lower as compared to the other maxillary posterior teeth (p<0.05). No statistically significant difference was observed in the prevalence of alveolar domes between the maxillary first and second molars. Considering the maxillary first and second molars, it was observed that the palatal root presented a lower prevalence of alveolar domes when compared to the distobuccal and mesiobuccal roots (p<0.05). Conclusion: The present study coined the term 'alveolar dome', referring to the anatomical projection of the root into the floor of the maxillary sinus. The maxillary first and second molars presented a greater prevalence of alveolar domes, especially in the buccal roots, followed by the third molars and second pre-molars. Although the periapical radiograph is a two-dimensional method, it can provide dentists with the auxiliary information necessary to identify alveolar domes, thus improving diagnosis, planning, and treatment.

Comparative study of analgesia with bupivacaine 0.25% versus 0.5% for third molar removal under general anesthesia

  • Dhanrajani, Parmanand;Chung, Patrick
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.2
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    • pp.117-122
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    • 2016
  • Background: The aim of this study was to compare the effectiveness and duration of action of two concentrations of bupivacaine with adrenaline for postoperative pain in patients undergoing surgical removal of four third molars under general anesthesia. Methods: Sixty patients undergoing surgical removal of four wisdom teeth received bupivacaine 0.5% (n = 30) or 0.25% (n = 30). The severity of pain in the immediate recovery period and at 2 and 24 h after surgery was recorded using the visual analogue scale. Differences were assessed by box and whisper plot and the Student's t-test. Results: The analgesic effects of the 0.25% and 0.5% doses were significantly different (P = 0.022) at 30 min after surgery but not after 2 and 24 h. The difference of mean of 0.25% and 0.5% was much higher after 0.5 h but less after 2 and 24 h. Conclusions: Bupivacaine 0.5% was statistically better for pain control during the immediate postoperative period, but there was no significant difference in pain control between the two dose strengths at 2 and 24 h after surgery.

Electromyographic studies on the masseter and temporal muscles during exchange of the deciduous teeth (유치 교환기의 교근 및 측두근의 근전도 연구)

  • Lee, Jong-Heun
    • The Korean Journal of Physiology
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    • v.3 no.1
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    • pp.33-44
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    • 1969
  • Electoromyographic studies were performed on the action of the muscles of the temporomandibular joints following exfoliation of the deciduous teeth. The subjects examined, being 50 children. between the age of 6 and 13 years, divided into 5 groups. They were; 1) Deciduous dentition were complete in the first group. 2) Deciduous incisors were missing in either upper or lower jaw in the second group. 3) Deciduous canine and molars were missing in the left side of either upper or lower jaw in the third group. 4) Deciduous canine and molars were missing in the right side of either upper or lower jaw in the fourth group. 5) Permanent dentition completed in the fifth group(except third molars). Electromyogram was recorded with 4 channel polygraph (Grass model VII modified for 7P3). Electrodes which were the cup-typed gold discs, 9 millimeters in the diameter, were located on the anterior, middle and posterior lobes of the temporal muscles, and also on the superficial and deep layers of the masseter muscles. Paired electrodes were held by electrode cream so that they were pressed on the skin surface at right angle, adhesive tape being used to anchor them. The distance of the pair electrodes was about 5 millimeters. The results obtained were as follow: 1) In rest position of mandible; All groups showed slight, electrical activities in the muscles involved, but in the middle lobe of temporal muscle they were slightly higher. 2) In molar occlusion of mandible; High activity-anterior lobe of temporal muscle and superficial layer of masseter muscle. Moderate activity-deep layer of masseter muscle. Low activity-middle and posterior lobes of masseter muscle. There were no differences among the first, the second and the fifth groups. In the third group the muscle activity was weaker than that of the right, and in the fourth group opposite characteristics was revealed. 3) In incisal bite of mandreble; Hight activity-superficial layer of masseter muscle. Modertae activity-deep layer of masseter muscle. Low activity-anterior, middle and posterior lobes of temporal muscle. The first, the third, the fourth and the fifth groups showed no differences but the second group showed less activity than those of others. 4) In protrusion of mandible; High activity-deep layer of masseter muscle Moderate activity-superficial layer of masseter muscle. Low activity-anterior, middle and posterior lobes of temporal muscle. In the first, the fourth and the fifth groups, there were no differences in the activities, but the second group showed less activity than the others. 5) In retrusion of mandible; High activity-deep layer of masseter muscle. Moderate activity-superficial layer of masseter muscle. Low activity-anterior, middle and posterior lobes of temporal muscle. In the first, the third, the fourth and the fifth groups, there were no differences but the second group showed less activity than the others. 6) In lateral excursion of the mandible (either direction); High activity-posterior lobe of temporal muscle. Moderate activity-anterior and middle lobes of temporal muscle. Low activity-superficial and deep layers of masseter muscle. The muscle action potentials were weaker than those of the right side in the third group and vice ver'sa in the fourth group. 7) In chewing movement; Temporal muscle activities were higher than those of masseter, especially in the middle lobe of temporal muscle the activity was highest. Right side muscle activities were higher than those of the left in the third group and, on the contrary, the left side was dominant over the right in the fourth group.

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