Purpose: The aims of the present study were 1) to quantitatively evaluate the extent of sinus pneumatization and 2) to determine the factors affecting sinus pneumatization. Methods: Based on implant treatment records, a list of patients who underwent implant placement on the posterior maxilla was obtained. Among them, patients with pre-extraction and post-extraction (before implant placement) panoramic radiographs were selected. After excluding radiographs with low resolution and image distortion, the radiographs before and after extraction were superimposed using computer software. Subsequently, the extent of sinus pneumatization (the vertical change of the sinus floor) was measured. Simple and multiple mixed models were used to determine the factors affecting sinus pneumatization. Results: A total of 145 patients were eligible for the present investigation. The average extent of sinus pneumatization was 1.56±3.93 mm at 176 tooth sites. Male sex, single tooth extraction, extraction of an endodontically compromised tooth, a class I root-sinus relationship, and sinus membrane thickening >10 mm favored pneumatization, but without statistical significance. The maxillary second molar presented the greatest pneumatization (2.25±4.39 mm) compared with other tooth types. This finding was confirmed in the multiple mixed model, which demonstrated a statistically significant impact of the extraction of a second molar compared with the extraction of a first premolar. Conclusions: Maxillary sinus pneumatization was 1.56±3.93 mm on average. The extraction of a second molar led to the greatest extent of pneumatization, which should be considered in the treatment plan for this tooth site.
Park, Won-Jong;Park, Il Kyung;Shin, Kyung Su;Choi, Eun Joo
Journal of Dental Anesthesia and Pain Medicine
/
v.19
no.4
/
pp.201-208
/
2019
Background: After tooth extraction, pain due to dry socket and pain in the adjacent tooth are common. The aim of this study was to retrospectively analyze pain in the adjacent tooth after surgical extraction of the mandibular third molar. Methods: Postoperative pain due to dry socket, pain in the adjacent tooth, and pain from other causes were present. Group A included patents with dry socket alone; group B included patients with pain in the adjacent tooth alone; and group C included patients with both. The duration of symptoms was recorded. In addition, the prognosis of pain was divided into the complete improvement, improvement, maintenance, deterioration, and complete deterioration groups. Results: A total of 312 mandibular third molars were extracted from 13, 60, and 10 patients in groups A, B, and C, respectively. The mean duration of symptoms was 5 days in group A and B and 15.2 days in group C. There were statistically significant differences in the duration of symptoms between groups A and C and groups B and C. Conclusion: Pain in the adjacent tooth after third molar extraction can be caused by inflammatory reactions and pressure on this tooth. The pain caused by pressure on the periodontal ligament and alveolar bone results from the cytokines released by osteoclasts, which are responsible for bone destruction. However, pain from periodontal ligament damage caused by excessive pressure may be misunderstood as pulpal pain. Unconscious parafunctional habits, such as clenching and bruxism, could also be associated with post-extraction pain.
Kim, Eun-Suk;Lee, In-Kyung;Kang, Ji-Yeon;Lee, Eun-Young
Maxillofacial Plastic and Reconstructive Surgery
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v.37
/
pp.27.1-27.7
/
2015
The aim of this study was to evaluate the clinical relevance of autogenous fresh demineralized tooth (Auto-FDT) prepared at chairside immediately after extraction for socket preservation. Teeth were processed to graft materials in block, chip, or powder types immediately after extraction. Extraction sockets were filled with these materials and dental implants were installed immediately or after a delay. A panoramic radiograph and a conebeam CT were taken. In two cases, tissue samples were taken for histologic examination. Vertical and horizontal maintenance of alveolar sockets showed some variance depending on the Auto-FDT and barrier membrane types used. Radiographs showed good bony healing. Histologic sections showed that it guided good new bone formation and resorption pattern of the Auto-FDT. This case series shows that Auto-FDT prepared at chairside could be a good material for the preservation of extraction sockets. This study will suggest the possibility of recycling autogenous tooth after immediate extraction.
Purpose: The aim of this study was to develop an automated software to extract tooth and pulpal area from sectional cone-beam computed tomography (CBCT) images, which can guarantee more reproducible, objective and time-saving way to measure pulp/tooth volume ratio. Methods: The software program was developed using MATLAB (MathWorks). To determine the optimal threshold for the region of interest (ROI) extraction, user interface to adjust the threshold for extraction algorithm was added. Default threshold was determined after several trials to make the outline of extracted ROI fitting to the tooth and pulpal outlines. To test the effect of starting point location selected initially in the pulpal area on the final result, pulp/tooth volume ratio was calculated 5 times with different 5 starting points. Results: Navigation interface is composed of image loading, zoom-in, zoom-out, and move tool. ROI extraction process can be shown by check in the option box. Default threshold is adjusted for the extracted tooth area to cover whole tooth including dentin, cementum, and enamel. Of course, the result can be corrected, if necessary, by the examiner as well as by changing the threshold of density of hard tissue. Extracted tooth and pulp area are reconstructed three-dimensional (3D) and pulp/tooth volume ratio is calculated by voxel counting on reconstructed model. The difference between the pulp/tooth volume ratio results from the 5 different extraction starting points was not significant. Conclusions: In further studies based on a large-scale sample, the most proper threshold to present the most significant relationship between age and pulp/tooth volume ratio and the tooth correlated with age the most will be explored. If the software can be improved to use whole CBCT data set rather than just sectional images and to detect pulp canal in the original 3D images generated by CBCT software itself, it will be more promising in practical uses.
The purpose of this study was to analyze the reasons and mean age for tooth extraction among patients living in Busan city. The researcher observed 1,119 patients' teeth extracted due to dental caries, periodontal disease and other reasons. This study examined the reasons for tooth extraction by age, sex, and tooth-kind. The reasons for tooth extraction were dental caries, periodontal disease, eruption problems and others. The obtained results were as follows; 1. Among the reasons for tooth extraction, dental caries accounted for 25.9%, periodontal disease 56.5%. 2. Periodontal disease was the main reason for tooth extraction and continued throughout life irrespective of sex. However dental caries was remarkably increasing in those aged 30 years old and under. 3. In the extraction of permanent teeth, males outnumbered females while upper teeth did lower teeth. 4. Although the third molars were most extracted in all kinds of teeth, the main reasons for the extraction were eruption problem. 5. The mean age of the tooth extracted was 47.9 years in both sexes for the mandibular first molars and the mandibular first molars had the shortest life except third molars of total teeth. The mandibular canines had the longest life of total teeth. Because dental caries and periodontal disease are the main causes of tooth extraction in Korea, the dental health policy should be focused on the prevention and treatment of these two diseases in the government level.
To predict duration of orthodontic treatment of malocclusion, 304 male and female patients whose orthodontic treatment was finished in department of orthodontics, Infirmary of dental college, Chosun University were studied. The duration of treatment was studied according to types of malocclusion, beginning ages of treatment, Hellman's dental ages, the determination of tooth extraction, types of tooth extraction and types of orthodontic appliance. The following results were obtained. 1. The duration of treatment was 18 months in Class I malocclusion, 20 months in Class II malocclusion and 24 months in Class III malocclusion. 2. The more early treatment was done, the more duration of treatment was needed according to beginning age of treatment and Hellman's dental ages. 3. Treatment of tooth extraction case was needed for 78 days more than that of non-extraction case. 4. The duration of treatment with unilateral extraction of premolars was the shortest (598 days) and that with single arch extraction of premolars was the longest (685 days) according to types of tooth extraction. 5. The duration of treatment by removable appliance was the shortest (237 days) and the combination of removable appliance, headgear and full banded appliance was the longest (1425 days) according to types of orthodontic appliance. 6. The duration of treatment was 18 months in typical orthodontic treatment with 4 extraction of premolar and full banded appliance.
Purpose: To observe the histopathological changes following irradiation on the wound healing after tooth extraction in the rachitic rats. Materials and Methods: In order to carry out this study, the rats were divided into four groups: Group 1 (normal diet/non-irradiation group), Group 2 (normal diet/irradiation group), Group 3 (rachitogenic diet/non-irradiation group), and Group 4 (rachitogenic diet/irradiation group). Rachitic changes were induced with rachitogenic diet No. 2 (high calcium, low phosphorus, and Vitamin D deficient diet) for 5 weeks. After the extraction of both maxillary first molars of the rats in Group 2 and 4, the head and neck of the rats were irradiated with single absorbed dose of 10 Gy. The rats were sacrificed at the 1st, 5th, 10th, and 15th day after tooth extraction. The specimens including the extraction wound were sectioned, stained with the hematoxylin-eosin and Masson's trichrome method and examined under the light microscope. Results: In the Group 2, the amount of newly formed bone trabeculae on the periphery of extraction socket and osteoblastic activity were reduced. In the Group 3, epithelial fusion was not revealed on the 5th day after toothe extraction and growth rate of osteoid formation was reduced. In the Group 4, necrotized tissue at the outer surface of extraction socket and destructive changes on the alveolar bones were noted on the 10th day. Epithelial fusion was not revealed and large amounts of osteoclast were noted on alveolar bone on the 15th day. Conclusion: The healing process of wound after tooth extraction was retarded by irradiation and especially in the rachitic rats.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.49
no.2
/
pp.68-74
/
2023
Objectives: Drug holidays are suggested to reduce the formation of osteonecrosis in patients under intravenous (IV) bisphosphonates (BPs) therapy. The objectives of this study are to evaluate the incidence of medication-related osteonecrosis of the jaw (MRONJ) following tooth extraction in cancer patients using IV BP, and to assess the effect of drug holiday on the development of MRONJ. Patients and Methods: A manuel search of the patient folders of Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hacettepe University was undertaken to identify cancer patients who used IV BPs and had at least one tooth extraction between 2012 and 2022. Patents' age, sex, systemic condition, the type of BP used, duration of BP used, number of tooth extraction, duration of drug holiday, localization of tooth extraction and incidence of MRONJ were recorded. Results: One hundred nine teeth were removed from 57 jaws in 51 patients. All tooth extractions were performed under perioperative antibiotic prophylaxis and with primary wound closure. The incidence of MRONJ was 5.3%. Stage 1 MRONJ developed in 3 patients (only one had a drug holiday). The median duration of drug holiday was 2 months. No significant difference between the patients with and without a drug holiday and MRONJ development was found (P=0.315). The mean age of patients developed MRONJ was 40.33±8.08 years. A statistically significant difference was found between age and MRONJ development (P=0.002). Conclusion: The effect of a short-term drug holiday on the development of MRONJ may be limited because BPs remain in bone tissue for a long time. Drug holidays should be applied with the approval of an oncologist with other preventive measurements.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.42
no.5
/
pp.251-258
/
2016
Objectives: The aim of this retrospective study was to investigate factors associated with increased difficulty in the surgical extraction of impacted lower third molars and to improve identification of difficult cases. Materials and Methods: A total of 680 patients who required 762 surgical extractions of impacted lower third molars from 2009 to 2014 were enrolled in the study. Demographic factors, clinical factors, radiographic factors, surgical extraction difficulty, and presumed causes of difficulty were collected. Data were statistically analyzed using IBM SPSS Statistics version 23. Results: Age, sex, depth of impaction, and blurred radiographic image influenced difficulty in surgical extraction. The position of the impacted tooth influenced surgical difficulty, especially when it was accompanied by other factors. Conclusion: It is challenging to design a reliable and practical instrument to predict difficulty in surgical extraction of impacted lower third molars. To identify very difficult cases, root investigation using computed tomography is advised when impacted tooth position suggests difficult extraction.
Purpose: Alveolar bone develops with tooth eruption and is absorbed following tooth extraction. Various ridge preservation techniques have sought to prevent ridge atrophy, with no superior technique evident. Collagen has a long history as a biocompatible material. Its usefulness and safety have been amply verified. The related compound, atelocollagen, is also safe and displays reduced antigenicity since telopeptides are not present. Materials and Methods: The current study evaluated whether the $Rapiderm^{(R)}$ atelocollagen plug (Dalim Tissen, Seoul, Korea) improves tissue healing of extraction sockets and assessed the sequential pattern of bone regeneration using histology and microcomputed tomography in six beagle dogs. To assess the change of extraction socket, hard tissues were examined 2, 4, 6, and 8 weeks after tooth extraction. Result: The experimental groups showed better bone fill with slow remodeling process compared to the control groups although there was no statistical difference between groups. Conclusion: The atelocollagen seems to have a tendency to slow bone remodeling in the early phase of healing period and maintain remodeling capacity until late phase of remodeling. Also, use of atelocollagen increased the bone-to-tissue ratio compared to healing of untreated extraction socket.
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