• Title/Summary/Keyword: third molar extraction

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CARE OF ANXIETY DISORDER AND HYPERVENTILATION DURING REFRACTORY TOOTH EXTRACTION IN A PSYCHOLOGIC DISABLED PATIENT (정신장애 환자에서 난발치 중의 불안장애와 과환기 관리 : 증례보고)

  • Oh, Ji-Hyeon;Yoo, Jae-Ha;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.2
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    • pp.106-113
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    • 2014
  • Hyperventilation is produced by several distinct causes: anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The dental fears about acute pain, bleeding, needle, drill and dental surgery lead to the severe anxiety and increased blood catecholamine level. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the gentle care, a hyperventilation were occurred during the surgical extraction of impacted third molar with pericoronitis. We suggest that the dental patients with anxiety disorder must be attention for the manifestation of hyperventilation, especially in the psychologic disabled patient.

Osteomyelitis following extraction of lower third molar during pregnancy (임신 중 하악 제3대구치 발거후 발생한 골수염)

  • Lee, Sang-Bin;Huh, Kyung-Hoe;Yi, Won-Jin;Kim, Mi-Ja;Lee, Sam-Sun
    • Imaging Science in Dentistry
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    • v.38 no.3
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    • pp.177-182
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    • 2008
  • A 27-year-old female was referred to our hospital postpartum due to rapid aggravation of facial swelling. She was diagnosed with osteomyelitis on clinical, radiological, and histopathological examinations, but the possibility of malignancy was not excluded. Clinical signs and symptoms such as facial swelling and discomfort were improved with four months of antibiotics treatment. This is as case of an osteomyelitis progressed from infected extraction socket in a woman with physiological changes of pregnancy. Decreased immunological response, increased sex hormone and calcium regulatory hormones regulate the response of the bone infection. We report this case for helping the diagnosis of unusual from of osteomyelities in pregnancy and postpartum.

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Pretreatment characteristics of adolescents with Class II malocclusion treated by maxillary second molar extraction (상악 제2대구치를 발거하고 치료한 성장기 II급 부정교합 환자의 치료전 특성)

  • Kim, Jae-Hyung;Kim, Joeng-Il;Lim, Yong-Kyu;Lee, Dong-Yul
    • The korean journal of orthodontics
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    • v.35 no.3 s.110
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    • pp.182-195
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    • 2005
  • The purpose of this retrospective study was to estimate the pretreatment characteristics of growing patients with Class II malocclusion. who had been treated with maxillary second molar extractions The sample comprised of 51 subjects; 18 subjects were classified into the molar extraction group, and 33 subjects were treated without extraction and classified into the nonextraction group. Pretreatment lateral cephalograms were calculated and analyzed by independent t-test and stepwise discriminant analysis. In measurements for skeletal pattern, no anteroposterior measurements and proportions of various vertical dimensions were significantly different. and only some measurements such as $AB-MP(^{\circ)$, Na-We(mm), AVD (mm) were significantly different between the two treatment groups (p<0.05). In measurements for dentoalveolar pattern. some measurements, which were related to the position and angulation of the upper and lower permanent first molars, and the angulation of the upper third molars, were significantly different between the two treatment groups In particular, the maxillary second molar extraction group exhibited more mesial angulation of maxillary first molar to the occlusal plane.

Orthodontic Traction and Decompression Method in Treating Impacted Permanent Mandibular First Molars : Case Reports (교정적 견인과 감압술에 의한 매복된 하악 제1대구치의 치험례)

  • Jih, Myeongkwan;Lee, Sangho;Lee, Nanyoung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.3
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    • pp.257-263
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    • 2015
  • Impacted teeth occur at higher frequencies in permanent than primary dentition. The most frequently affected teeth are the maxillary and mandibular third molars, whereas it is quite uncommon for the mandibular first molar to be impacted. Treatment methods for impacted teeth include continuous examination for independent eruption, surgical exposure, subluxation after surgical exposure, orthodontic traction, and surgical repositioning. If all of these treatments fail, tooth extraction may be considered. In the first case study, an 8-year-old boy was treated with surgical exposure, after which he was fitted with an obturator. His mandibular first molar then erupted successfully. In the second case, we treated a 12 year-old boy using orthodontic traction. This study describes children with tooth eruption disorders of the mandibular first molar in mixed dentition, and reports acceptable results regarding treatment of the impacted teeth.

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.

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.

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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Randomized, Double-blind, Comparative Clinical Trial on the Efficacy of 4% Articaine and 2% Lidocaine in Inferior Alveolar Nerve Block Anesthesia (하치조신경 전달마취 시 4% 아티카인과 2% 리도카인의 임상적 효과에 관한 비교연구)

  • Im, Tae-Yun;Hwang, Kyung-Gyun;Park, Chang-Joo;Kim, Kwang-Soo;Oh, Young;Han, Ji-Young;Shim, Kwang-Sup
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.10 no.1
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    • pp.1-6
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    • 2010
  • Background: Articaine, commercially available in South Korea from 2004, is widely being used for dental treatments. In the surgical extraction of impacted mandibular third molars, one of the most common procedures in oral and maxillofacial surgery, the anesthetic efficacy of 4% articaine and 2% lidocaine, both with 1:100,000 epinephrine, was compared. Methods: A randomized double-blind clinical trial was conducted of 80 patients for bilateral surgical extraction of mandibular third molars with informed consents. One operator carried out the routine surgical procedures using local anesthetic 4% articaine or 2% lidocaine with the same concentration of vasoconstrictor. Latency, duration of anesthesia and the amount of anesthetic solution were recorded. A visual analog scale (VAS) was used to evaluate the intraoperative pain. Results: The pain VAS scores reported similar anesthetic effect with both local anesthetics. Not in the latency of anesthesia and the amount of anesthetic solution, statistically significant difference was found in the mean duration of anesthesia. Conclusions: It was concluded that 4% articaine could offer better or at least the same clinical feasibility compared to 2% lidocaine, particularly in terms of the duration of the local anesthesia for common dental treatments.

The effect of melatonin on prevention of bisphosphonate-related osteonecrosis of the jaw: an animal study in rats

  • Yadegari, Afshin;Aminzadeh, Atousa;Seyyedkhamesi, Sam;Aminian, Maedeh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.4
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    • pp.266-274
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    • 2020
  • Objectives: Melatonin induces human stem cells, converts pre-osteoblasts to mature osteoblasts, and reduces the duration of this transition. However, melatonin itself prevents activation of osteoclasts. Here, we evaluate the role of melatonin in prevention of bisphosphonate-related osteonecrosis of the jaw. Materials and Methods: In this experimental-interventional study, 30 rats were evaluated in 3 groups. The first and second groups received saline and zoledronic acid, respectively, for 4 weeks and the third group received 4 weeks of zoledronic acid and 3 weeks of melatonin simultaneously. First-right-maxillary-molar extraction was performed for all animals, which were sacrificed after 4 weeks of recovery. The extraction sockets were examined histologically for the presence of osteonecrosis, number of osteoclasts and fibroblasts, severity of inflammation, and vascularization. Data were analyzed by chi-square, one-way ANOVA, Tukey, Kruskal-Wallis and Fisher's exact statistical tests (α=0.05). Results: Osteonecrosis was observed in 20%, 90%, and 70% of the first, second and third groups, respectively (P=0.008). The lowest number of osteoclasts and fibroblasts was seen in the third group. Conclusion: Melatonin may effectively prevent some undesirable side effects of bisphosphonates. However, further studies are required to confirm the results of this study.

EFFECT OF PATIENT'S BREATHING PATTERN ON THE STRESS CHANGES IN THIRD MOLAR EXTRACTION (제 3 대구치 발치시 환자의 호흡 패턴이 스트레스 변화 양상에 미치는 영향)

  • Rhee, Sang-Myung;Kim, Hyung-Wook;Park, Yang-Ho;Kim, Jin-Cheol;Park, Jun-Woo;Rhee, Sung-Jun;Nyamdorj, Selenge;Ahn, Jae-Mok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.485-493
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    • 2007
  • Purpose: Heart rate variability(HRV) is the clinical consequence of various influences of the autonomic nervous system(ANS) on heart beat. HRV can estimate the potential physiologic rhythm from the interval between consecutive beats(RR interval or HRV data). It is known as RSA which represents respiration-related HR rhythmic oscillation. Previous studies demonstrated a specific breathing pattern(0.1Hz, 6breaths/min) to improve a physiological body condition related to the stress. In this paper, the level of stress would be evaluated in terms of three phases of the dental treatment, combined with 6breaths/min. Methods: These phases include before, during and after tooth extraction or anesthesia or something.36 patients' stresses were assessed using HRV stress analyzer in each phase in Kangdong Sacred Heart Hospital, and Chuncheon Sacred Heart Hospital, Hallym University Medical Center from Jun. to Sept. of 2007. HRV 5-min data collected were analyzed in time-domain and frequency-domain to evaluate the activity of autonomic nervous system(ANS) which represents the level of stress. Results: All HRV parameters including HF(high frequency), LF(low frequency) and LF/HF ratio showned a significant change affecting the ANS balance. There was a 6.4% difference between R(LF/HF)s on general breathing pattern for balance of Autonomic nervous system, but on controlled breathing pattern, 0.1Hz, was made narrow till 1.4%. The activity of ANS has increased by 1.4% on general breathing pattern, and by 2.9% on controlled breathing pattern, 0.1Hz. Conclusion: After analysis of preoperative stress changes and effect of breathing pattern of 0.1 Hz on the stress in 36 patients who have undergone third molar extraction, following was concluded. In the preoperative stage, the sympathetic change was the greatest?after the?anesthetic injection, and stress was relieved by controlling the breathing pattern to a frequency of 0.1Hz.