• Title/Summary/Keyword: lower third molar

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THE CLINICAL STUDY ON THE EFFECT OF DEXAMETHASONE AND NAPROXEN TO THE SYMPTOMS AFTER REMOVAL OF IMPACTED LOWER THIRD MOLARS (Dexamethasone과 Naproxen 병용투여가 하악 제3대구치 발거 후 증상에 미치는 영향에 관한 임상적 연구)

  • Shin, Kwang-Ho;Lee, Jeong-Keun;Hwang, Byung-Nam
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.1
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    • pp.69-77
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    • 2001
  • PURPOSE : The Purpose of this study was to investigate the anti-inflammatory effect on combination dosage of dexamethasone and naproxen after removal of impacted 3rd molars. We evaluated postoperative pain, swelling, and mouth opening limitation quantitatively. PATIENTS AND METHODS : Removal of an impacted lower third molar was done under local anesthesia with 2% lidocaine to 239 healthy patients. We randomly gave experimental group 1.5mg dexamethasone and 200mg naproxen three times a day for postoperative 2days, and also gave control group 200mg naproxen alone three times a day for postoperative 2days. Swelling and pain were measured by visual analogue scale (VAS). Mouth opening limitation was measured by maximum interincisal opening length. We estimated these measurements in the first and second postoperative days. Differences between experimental and control group were investigated considering age, sex, BMI(body mass index), impacted type, surgical site(right or left), and operation time by independent student T-test. RESULTS : In general, swelling, pain, and mouth opening limitations were significantly reduced (p<0.01) by combination dose of dexamethasone and naproxen in postoperative one day. But there was no difference in pain on the second postoperative day. As variables being considered, in the postoperative pain, there was significant difference between experimental group and control group in only male, little bony removal group, left side extraction group. In case of postoperative swelling, there was no significant differences in male, adolescence, long operating time group (over 20 minutes), medium BMI group and right side extraction group. In case of postoperative mouth opening limitation, there was significant difference between only female and long operating time group (over 20 minutes). CONCLUSION : Variables being considered, postoperative swelling was more reduced by the combination dose of naproxen and dexamethasone than that of naproxen alone after removal of impacted 3rd molars. But there was varoius results in pain and mouth opening limitation.

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Primary intraosseous squamous cell carcinoma mimicking periapical disease: a case report

  • Choi, Yoon-Joo;Oh, Song-Hee;Kang, Ju-Han;Choi, Hwa-Young;Kim, Gyu-Tae;Yu, Jae-Jung;Choi, Yong-Suk;Hwang, Eui-Hwan
    • Imaging Science in Dentistry
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    • v.42 no.4
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    • pp.265-270
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    • 2012
  • Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare carcinoma, which arises within the jaws without connection to the oral mucosa and presumably develops from a remnant of odontogenic epithelium. We present a case of solid type PIOSCC in a 52-year-old male patient complaining of dull pain on his left lower molar. In this case, early stage PIOSCC mimicking a periapical lesion might lead to a one-year delay in treatment due to the misdiagnosis of osteomyelitis after extraction of the third molar. The clinical, radiological, and histologic features are described. In this case, there was initial radiographic evidence for PIOSCC mimicking a periapical lesion. Incautious radiographic interpretation and treatment procedures had delayed the correct diagnosis and resulted in extensive bony destruction during the patient's disease progression.

Acute Airway Obstruction Secondary to Lingual Hematoma after Lower Third Molar Extraction: A Case Report

  • Yi, Sangmin;Oh, Je-Seok;Youn, Gap-Hee;Chung, Kwang;Jung, Seunggon;Park, Hong-Ju;Oh, Hee-Kyun;Kook, Min-Suk
    • Journal of Korean Dental Science
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    • v.7 no.1
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    • pp.43-47
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    • 2014
  • Few dental procedures are potentially life-threatening. Note, however, that a dental extraction can result in preventable death. Severe post-extraction bleeding can occur, which may give rise to an alarming situation if there is any delay in detecting and managing the problem. The most immediate danger for a healthy patient with severe post-extraction hemorrhage is airway compromise. Acute airway obstruction from post-extraction hematoma is relatively uncommon, but it may occur with fatal consequences if there is any reluctance to maintain the airway clearance. Therefore, dentists and oral and maxillofacial surgeons should have clear understanding of the problem and measures to control it. Active bleeding that is not controlled by local measures in a dental office should be referred to the nearest hospital emergency department as soon as possible for appropriate management.

Single-channel electroencephalography and its associations with anxiety and pain during oral surgery: a preliminary report

  • Jabur, Roberto de Oliveira;Goncalves, Ramon Cesar Godoy;Faria, Kethleen Wiechetek;Semczik, Izabelle Millene;Ramacciato, Juliana Cama;Bortoluzzi, Marcelo Carlos
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.2
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    • pp.155-165
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    • 2021
  • Background: This study aimed to assess the course of anxiety and pain during lower third molar (LTMo) surgery and explore the role of mobile and single-channel electroencephalography under clinical and surgical conditions. Methods: The State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), and Interval Scale of Anxiety Response (ISAR) were used. The patient self-rated anxiety (PSA), the pain felt during and after surgery, EEG, heart rate (HR), and blood pressure (BP) were assessed. Results: The Attention (ATT) and Meditation (MED) algorithms and indicators evaluated in this study showed several associations. ATT showed interactions and an association with STAI-S, pain during surgery, PSA level, HR, and surgical duration. MED showed an interaction and association with DAS, STAI-S, and pain due to anesthesia. Preclinical anxiety parameters may influence clinical perceptions and biological parameters during LTMo surgeries. High STAI-Trait and PSA scores were associated with postoperative pain, whereas high STAI-State scores were associated with more pain during anesthesia and surgery, as well as DAS, which was also associated with patient interference during surgery due to anxiety. Conclusions: The findings suggest that single-channel EEG is promising for evaluating brain responses associated with systemic reactions related to anxiety, surgical stress, and pain during oral surgery.

Management of rare ectopic teeth eruption: case series

  • Olutayo, James;Ibrahim Kayode Suleiman;Mukhtar Modibbo Ahmad;Hector Oladapo Olasoji
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.2
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    • pp.86-90
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    • 2023
  • Objectives: An ectopic tooth is a rare eruption of a tooth out of the normal dental apparatus and occurs commonly with the third molar. Thus, in this study, we reported a case series of ectopic teeth in rare jaw locations and highlight the associated pathology and our experience in the surgical management. Patients and Methods: All cases of ectopic tooth managed at the Department of Oral and Maxillofacial Surgery, University of Maiduguri Teaching Hospital from January 2011 to December 2020 were reviewed. The information retrieved includes biodata, location of the ectopic tooth, signs, symptoms, type of tooth and associated pathology, surgical approach and complications. Results: Ten cases of ectopic teeth were identified over the study period. This comprised 80.0% males with a mean age was 23.3 years. The antrum and lower border of the mandible accounted for 50.0% and 40.0% of the ectopic locations, respectively. Dentigerous cyst was the most associated pathology (70%) and usually presented with pain and swelling. Surgical intervention predominantly via the intraoral route was performed if indicated. Conclusion: Ectopic teeth are rare and not always associated with pathology. A high index of suspicion and radiological investigation are necessary for diagnosis. A more extensive multi-center study is however recommended to determine the prevalence of ectopic teeth other than the third molar.

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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Free gingival graft for the increase of peri-implant attached keratinized mucosa decreased after guided bone regeneration (골 유도 재생술 후 감소된 임플란트 주위 부착 각화 점막 증대를 위한 유리 치은 이식술 증례)

  • Kim, Deug-Han;Ji, Suk;Pang, Eun-Kyoung
    • Journal of Periodontal and Implant Science
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    • v.38 no.4
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    • pp.723-728
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    • 2008
  • Purpose: During guided bone regeneration procedures for the augmentation of deficient alveolar ridge, primary closure of flap is necessary. For primary flap closure, flap is repositioned coronally and the zone of attached keratinized mucosa may decreased. The need for attached keratinized mucosa around dental implants is still controversial, but sufficient peri-implant attached keratinized mucosa would be beneficial for functional and esthetic aspects. This case report presents three cases that demonstrated free gingival graft for increasing the zone of peri-implant attached keratinized mucosa which was decreased after guided bone regeneration. Materials and Methods: In first case, maxillary incisors were extracted and guided bone regeneration was performed simultaneously. Because the membrane was exposed at 3 weeks after operation, the membrane was removed and free gingival graft was performed for primary flap closure. Free gingival graft was performed again at implant placement for the increase of attached keratinized mucosa. In second case, guided bone regeneration was performed on lower right first molar area, and implant was placed with free gingival graft. In third case, lower right molar area showed insufficient attached keratinized mucosa after implant placement with guided bone regeneration. When abutments were connected, free gingival graft with apically positioned flap was performed. Result: In these three cases, the zone of attached keratinized mucosa around dental implants was decreased after guided bone regeneration. And the increase of peri-implant attached keratinized mucosa could be obtained effectively by free gingival graft. Conclusion: Free gingival graft could be a effective treatment method increasing the zone of attached keratinized mucosa which was decreased after guided bone regeneration procedures.

Stafne bone cavity and cone-beam computed tomography: a report of two cases

  • Venkatesh, Elluru
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.3
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    • pp.145-148
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    • 2015
  • In 1942 Stafne reported 35 asymptomatic, radiolucent cavities that were unilaterally located in the posterior region of the mandible between the mandibular angle and the third molar, and below the mandibular canal. The term Stafne bone cavity (SBC) is now used for such asymptomatic lingual bone depressions of the lower jaw. Since then there have been many reports of SBCs but very fews tudies have used cone-beam computed tomography (CBCT) for their diagnosis. The aim of this paper is to describe the clinical and radiological characteristics of two cases of SBCs and the importance of limited CBCT in confirming the diagnosis.

Comparative Study for the Anesthetic Efficacy between Articaine HCl and Lidocaine HCl during the Surgical Extraction of Bilateral Mandibular Impacted Third Molars (하악 매복 제3대구치 발치 시 Articaine HCl과 Lidocaine HCl의 국소마취 효능에 대한 비교연구)

  • Lee, Won-Young;Seo, Kwang-Suk;Kim, Hyun-Jeong;Yum, Kwang-Won;Park, Chang-Joo
    • 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.

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FINITE ELEMENT ANALYSIS OF MANDIBULAR STRESSES AND DENTURE MOVEMENTS INDUCED BY OVERDENTURES (Overdenture 하에서 하악응력 및 의치의 변위에 관한 유한요소법적 분석)

  • Kim, Joung-Hee;Chung, Chae-Heon;Cho, Kyu-Zong
    • The Journal of Korean Academy of Prosthodontics
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    • v.28 no.1
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    • pp.63-94
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    • 1990
  • The purpose of this study was to analyze the displacement and the magnitude and the mode of distribution of the stresses in the lower overdenture, the mucous membrane, the abutment tooth and the mandibular supporting bone when various denture base materials, such as acrylic resin and 0.5mm metal base, and various denture base designs were subjected to different loading schemes. For this study, the two-dimensional finite element method was used. Mandibular arch models, with only canine remaining, were fabricated. In the first denture base design, a space, approximately 1mm thick, was prepared between the denture and the dome abutment. In the second denture base design, contact between the denture and the dome abutment was eliminated except the contact of the occlusal third of the abutment. In order to represent the same physiological condition as the fixed areas of the mandible under loading schemes, the eight nodes which lie at the mandibular angle region, the coronoid process and the mandibular condyle were assumed to be fixed. Each model was loaded with a magnitude of 10 kgs on the first molar region(P1) and 7 kgs on the central incisal region (P2) in a vertical direction. Then the force of 10 kgs was applied distributively from the first premolar to the second molar of each model in a vertical direction(P3). The results were as follows. : 1. When the testing vertical loads were given to the selected points of the overdenture, the overdenture showed the rotatory phenomenon, as well as sinking and the displacements of alveolar ridge, abutment and lower border of mandible under the metal base overdenture were less than those under the acrylic resin overdenture. 2. The maximum principal stresses(the maximum tensile stresses) being considered, high tensile stresses occured at the buccal shelf area, the posterior region of the ridge crest and the anterior border region of the mandibular ramus. 3. The minimum principal stresses(the maximum compressive stresses) being considered, high compressive stresses occured at the inferior and posterior border region of the mandible, the mandibular angle and the posterior border region of the mandibular ramus. 4. The vertical load on the central incisal region(P2) produced higher equivalent stress in the mandible than that on any other region(P1, P3) because of the long lever arm distance from the fixed points to the loading point. 5. Higher equivalent stresses were distributed throughout the metal base overdenture than the resin base overdenture under the same loading condition. 6. The case of occlusal third contact of the abutment to the denture produced higher equivalent stresses in the abutment, the mandibular area around the abutment and the overdenture than the case of a 1mm space between the denture and the abutment. 7. Without regard to overdenture base materials and designs, the amounts and distribution patterns of equivalent stresses under the same loading condition were similar in the mucous membrane.

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