• Journal of Korean Dental Science
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• v.2 no.2
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• pp.46-52
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• 2009

Objectives : The purpose of this study was to evaluate the significance of antibiotics in reducing postoperative infection rates and other complications following third molar surgery. Patients and methods : Two groups of patients underwent surgical extraction of third molars. The antibiotics group, n=21, received a third generation cephalosporin antibiotic for 5 days, starting from the day of surgery. The non-antibiotics group, n=26, didn't receive any antibiotics and only received analgesics to control postoperative pain. Body temperature and hematologic findings including WBC, neutrophils, lymphocytes and monocytes counts were compared between the two groups at three intervals, preoperatively, 24 hours and 7-10 days postoperatively. Pain and swelling during the follow up period were also recorded in both groups and compared in the second part of the study. Results : In the first part of the study, comparison of body temperature, CBC components (except WBCs) showed no significant difference between the two groups during the follow up period. All parameters were within the normal range at all intervals, which indicated absence of infection. In the second part, 38% of patients in the antibiotic group, compared to 54% of the non-antibiotics group, had one or more complications during the follow up period. However, three patients from the antibiotic group compared to one from the nonantibiotics group reported having a swelling of some degree. Conclusion : Based on our objective parameters (body temperature and CBC components), both groups showed no signs of infection during the follow up period. However, the results related to pain and swelling were less conclusive, probably due to small number of patients included in the study. Accordingly, we are unable to provide definite recommendations on antibiotics use in third molar surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.6
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• pp.528-532
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• 2010

Introduction: There are few reports on tooth eruption through Bio-Oss grafts. To our knowledge, there are no reports on whether teeth can erupt normally through the grafts. The aim of this study was to examine the effect of Bio-Oss grafts on tooth eruption in a canine model. Materials and Methods: In five 10-week-old dogs, the deciduous third mandibular molars in one jaw quadrant of each animal were extracted and the fresh extraction sockets were then filled with Bio-Oss particles (experimental side). No such treatments were performed on the contralateral side (control side). A clinical and radiological evaluation was carried out every other week to evaluate the eruption level of the permanent third mandibular premolars and compare the eruption levels between the two sides. Results: At week 4 after the experiment, the permanent third premolars began to erupt on both sides. At week 12, the crown of the permanent third premolar emerged from the gingiva on both sides. At week 20, the permanent third premolars on both sides erupted enough to occlude the opposing teeth. No significant differences were found between the control and experimental sides in terms of the eruption speed of the permanent third molars. Conclusion: These findings demonstrate that the grafting of Bio-Oss particles into the alveolar bone defects does not affect tooth eruption.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.40.1-40.7
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• 2019

Background: Through the analysis of clinical data, we attempted to investigate the etiology and determine the risk of severe iatrogenic lingual nerve injuries in the removal of the mandibular third molar. Methods: A retrospective chart review was performed for patients who had undergone microsurgical repair of lingual nerve injuries. The following data were collected and analyzed: patient sex, age, nerve injury side, type of impaction (Winter's classification, Pell and Gregory's classification). Ratios for the respective lingual nerve injury group data were compared with the ratios of the respective data for the control group, which consisted of data collected from the literature. The data for the control group included previous patients that encountered various complications during the removal of the mandibular third molar. Results: The lingual nerve injury group consisted of 24 males and 58 females. The rate of female patients with iatrogenic lingual nerve injuries was significantly higher than the control groups. Ages ranged from 15 to 67 years, with a mean age of 36.5 years old. Lingual nerve injury was significantly higher in the patient versus the control groups in age. The lingual nerve injury was on the right side in 46 and on the left side in 36 patients. There was no significant difference for the injury side. The distoangular and horizontal ratios were the highest in our lingual nerve injury group. The distoangular impaction rate in our lingual nerve injury group was significantly higher than the rate for the control groups. Conclusion: Distoangular impaction of the mandibular third molar in female patients in their 30s, 40s, and 50s may be a higher risk factor of severe lingual nerve injury in the removal of mandibular third molars.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.1
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• pp.9-17
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• 2020

Background: This study aimed to compare the pain levels during anesthesia and the efficacy of the QuickSleeper intraosseous (IO) injection system and conventional inferior alveolar nerve block (IANB) in impacted mandibular third molar surgery. Methods: This prospective randomized clinical trial included 30 patients (16 women, 14 men) with bilateral symmetrical impacted mandibular third molars. Thirty subjects randomly received either the IO injection or conventional IANB at two successive appointments. A split-mouth design was used in which each patient underwent treatment of a tooth with one of the techniques and treatment of the homologous contralateral tooth with the other technique. The subjects received 1.8 mL of 2% articaine. Subjects' demographic data, pain levels during anesthesia induction, tooth extractions, and mouth opening on postoperative first, third, and seventh days were recorded. Pain assessment ratings were recorded using the 100-mm visual analog scale. The latency and duration of the anesthetic effect, complications, and operation duration were also analyzed in this study. The duration of anesthetic effect was considered using an electric pulp test and by probing the soft tissue with an explorer. Results: Thirty patients aged between 18 and 47 years (mean age, 25 years) were included in this study. The IO injection was significantly less painful with lesser soft tissue numbness and quicker onset of anesthesia and lingual mucosa anesthesia with single needle penetration than conventional IANB. Moreover, 19 out of 30 patients (63%) preferred transcortical anesthesia. Mouth opening on postoperative first day was significantly better with intraosseous injection than with conventional IANB (P = 0.013). Conclusion: The IO anesthetic system is a good alternative to IANB for extraction of the third molar with less pain during anesthesia induction and sufficient depth of anesthesia for the surgical procedure.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.6
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• pp.505-509
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• 2009

Purpose: To evaluate the properties of antibiotic and NSAIDs administration before extract of the impacted mandibular third molar. Materials & Methods: No patient showed any sign of pain, inflammation, or swelling at the time of removal. A group of 50 patients was classified in Group 1(preemptive and oral medication was carried out for 3 days postoperatively, N=23) and Group 2(oral medication was carried out for 3 days postoperatively, N=27) subgroups. Clinical and radiologic factors were recorded for each case, and the rationale for assigning the patients to the groups was strictly random. The surgical technique was the same in all cases, and the follow-up period was 1 week. Parameters that were evaluated were infection, swelling, pain and differences in mouth opening. Results: We could not find any significant difference between the 2 groups regarding the evaluated parameters. Conclusion: The results of our study show that antibiotic and NSAIDs administration before the removal of lower third molars does not contribute to a decrease infection, swelling, pain or increase mouth opening. Therefore antibiotic and NSAIDs administration before the removal of lower third molars is not recommended for routine use.

• Journal of Korean Dental Science
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• v.8 no.2
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• pp.57-64
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• 2015

Purpose: This study was conducted to determine cell viability and differentiation capability of human periodontal ligament (PDL) cells and to elucidate the effects of cryopreservation on the activity of human third molar PDL cells by comparing PDL cells with and without cryopreservation. Materials and Methods: Human PDL fibroblasts obtained from immature third molars were cultured and divided into two groups. The experimental group was cryopreserved with a slow freezing rate of $0.5^{\circ}C/min$ from $4^{\circ}C$ to $-35^{\circ}C$ followed by plunging in liquid nitrogen at $-196^{\circ}C$ and cultured after fast thawing. The control group was cultured without cryopreservation. Cell viability, growth capacity and morphology were evaluated in both groups. Bivariate statistics were used to compare 2 groups and linear mixed model analysis was used to investigate the growth trends difference over time. Result: Cell viability and growth capacity were not significantly different between the 2 groups (P>0.05). Cultured cell of both groups showed fibroblast-like in appearance, and there were no significant differences in morphology between 2 groups. The mixed model analysis revealed no significant difference of growth capacity between 2 groups over time (${\beta}=-0.0009$; P=0.138). Conclusion: This study demonstrates that cryopreservation under control does not affect the biological properties of PDL cells, supporting the feasibility of autotransplantation of cryopreserved impacted third molars.

• Journal of Periodontal and Implant Science
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• v.38 no.2
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• pp.225-230
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• 2008

Purpose: Many clinical studies have reported that higher success rates are achieved with teeth that have immature roots than other autotransplanted teeth that have more immature root. However, based on date published recently, the success rate of autotransplantation of teeth with complete root formation was higher. The purpose of this study was to examine the long term(2 to 6 years follow-up) success rate of autotransplantation of third molar with complete root formation and to discuss some conditions and prerequisites for success. Materials and Methods: 26 sites of 24 patients aged 26 to 55 (mean age 40.8) were autotransplanted with third molars with complete root formation. These cases were followed for 2 to 6 years after surgery. The success criteria included (1) no discomfort during functioning (2) absence of progressive root resorption and alveolar bone resorption. Result: Of 26 teeth 5 teeth were failed, therefore success rate is 81%(21/26 teeth). The results suggested that higher success rate is acquired from (1) extraction socket due to dental caries (2) mandibular recipient site (3) patient younger than 40 years old. Autotransplantation of third molar to replace molars with advanced periodontal disease also showed considerably high success rate(84%). Conclusion: With appropriate case selection, autotransplantation of third molar with complete root formation remains a viable alternative for replacing a missing molar tooth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.5
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• pp.326-328
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• 2022

Impacted mandibular third molar removal is the most common procedure performed by oral and maxillofacial surgeons. An array of alternative procedures have been suggested, like operculectomy in cases of pericoronitis and coronectomy in certain cases. However, these procedures pose several disadvantages, and we propose a relatively non-invasive 'straight lift technique'. This technique is specifically useful in straightening abnormally positioned mesioangular third molars as a substitute of complete removal. This can improve tooth function, eliminate the need for surgical intervention, and reduce the risk of complications associated with third molar removal.

• Imaging Science in Dentistry
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• v.35 no.4
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• pp.199-202
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• 2005

Purpose : To report the incidence of radiological findings from screening panoramic radiographs and verify the validity of the panoramic radiography for screening purposes. Materials and Methods : Six thousand one hundred and sixty panoramic radiographs taken from the patients visiting the Health Promotion Center of CNUH were selected for this retrospective study. Panoramic radiographs were examined into the following pathologic conditions : the presence of periodontal bone loss, dental caries, periapical radiolucencies, retained roots, impacted supernumerary teeth, impacted third molars, odontoma, cystic lesions other than radicular cyst, sialoliths, and mixed radiolucent-radiopaque lesions. Number of pathologic conditions and Prevalence values were recorded. Results: The prevalences of pathologic conditions were $72.9\%$ of periodontal bone loss, $32.2\%$ of dental caries, $11.9\%$ of periapical radiolucencies, $10.8\%$ of retained roots, $0.4\%$ of root fracture, $1.0\%$ of impacted supernumerary teeth, $1.0\%$ of impacted third molars, $0.06\%$ of odontoma, $0.08\%$ of cystic lesion other than radicular cyst, $0.2\%$ of prolonged retention of deciduous tooth, $0.1\%$ of sialolith, and $0.04\%$ of mixed radiopaque and radiolucent lesion. Conclusion : Although the panoramic radiograph should not be used to replace intraoral radiographic and clinical examinations, this study showed that many dental pathologic conditions could be detected on panoramic radiographs. The panoramic radiograph might serve as a diagnostic aid in dental health evaluation programs.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.496-504
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• 2011

Introduction: This study compared the alveolar bone density of the mandible according to gender, age and position using Cone-beam computed tomography (CT). Materials and Methods: The maxillofacial CT scan data was obtained from 60 Korean patients. In addition, the alveloar bone density of 5 males and 5 females with normal occlusion aged from 10 to 70 years was measured at the buccal cortical bone, cancellous bone and lingual cortical bone, as well as at the position of the incisors, canines, premolars and molars. Results: The age-specific mean bone density was highest in patients in their third decade. The buccal cortical bone of the molars showed the highest bone density. Males in their fifties and sixties had a higher bone density in the cancellous bone in the region of the premolars and the buccal cortical bone of the molars, respectively, than females but there was no significant difference between males and females in the other parts. The cancellous bone density was highest in those in their twenties and thirties, and tended to decline up to their seventh decade. Conclusion: These results revealed a significantly different bone density according to gender, age and position in the Korean population. In addition, it is possible to predict the bone density based on these results.