• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.49-57
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• 2006

Mandibular fractures have higher incidence rate compared to facial bone fractures because of relatively prominent form. Specially, mandibular angle fractures were known as common fracture site because of morphological anatomic structure. The mandibular third molar appears to be the most frequent impacted tooth. The mandibular third molar have influence on mandibular angle fractures according to it's eruption state. Also, the mandibular angle fracture including the third molar may influence on post operative infection whether the third molar is in impacted or extracted state when reduction of fracture site is operated. The presence or absence and degree of impaction of the mandibular third molar were assessed for each patient and were related to the occurrence of the mandibular angle fracture. The extraction or non extraction of the mandibular third molar were related to the occurrence of the post operative infection in the reduction of mandibular angle fractures. In the presence of mandibular third molar, the possibility of mandibular angle fractures were relatively common. When viewing the mandibular third molar at occlusal plane, the possibility of mandibular angle fractures were high in the class C group. The possibility of mandibular angle fractures were high in the mesial angulation and partial impaction. There was a statistically significant difference(P<0.05). In complete erupted mandibular third molar, the possibility of post operative infection occurs quite often, but there was no statistical significant difference(P>0.05). In the extracted or non extracted of mandibular third molar, the post operative infection showed no statistical significant difference(P>0.05). With the results mentioned above, mandibular third molar was significantly more susceptible to mandibular angle fracture. In the reduction of mandibular angle fracture, it was recommended that mandibular third molar should be extracted especially in case of pericoronitis, periodontitis and other infections.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.4
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• pp.375-380
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• 2007

The purpose of this study is to understand anxiety in patients undergoing third molar extraction and care patients of third molar extraction. The subjects in the study were Sixty-three patients who visited the department of dentistry at Pusan Paik Hospital from May 2006 to September 2006 and who underwent third molar extraction. Patients' anxiety(state anxiety and trait anxiety) to use Spielberger's state-trait anxiety inventory(STAI) were measured. They were asked to fill out STAI question paper immediately before third molar extraction(pre-extraction) and on the day after the extraction(post-extraction). And visual analog scale(VAS) to measure patient's postoperative pain on the day after extraction(postextraction day) was used. Then Differences in anxiety before and after extraction, between men and women, between the first and second extraction, with impacted versus non impacted third molar extraction, between extraction time and anxiety, and between postoperative pain and anxiety were evaluated. The anxiety status of patients undergoing third molar extraction could be quantitatively evaluated using the STAI-KYZ. There were significant difference before and after third molar extraction. Especially women and patients of more severe postoperative pain was more anxious. We need to alleviate patient's anxiety(especially women) and to control postoperative pain throughout the tooth removal process.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.1
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• pp.10-14
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• 2003

Myofibroma is a rare spindle cell neoplasm that consists of myofibroblsasts. Although it was originally described as a multicentric tumor process affecting infants and young children, it is now recognized that most cases of the tumor are soliatary and that it can occur at any age. This case is a myofibroma involving the right mandibular body in a 9-year-old boy. Radiographic examination revealed a relatively well-demarcated radiolucent lesion surrounding the impacted right mandibular canine and first premolar crown. The histologic sections composed of interlacing bundles of spindle cells with tapered or blunt-ended nuclei admixed with a foci of hemangiopericytoma-like appearance. Immunohistochemical staining demonstrated a positive reaction to vimentin and smooth muscle actin, but they are negative for desmin and S-100. The presence of well circumscribed radiolucent solid lesion in children as observed in this case, differential diagnosis of myofibroma must be included. In this case, there was no recurrence 6 months after enucleation and eruption guide of the impacted tooth is ongoing now.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.4
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• pp.250-257
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• 2020

Objectives: Palatal infiltration is the most painful and uncomfortable anesthesia technique for maxillary impacted third molar surgery (MITMS). This approach could cause patients distress and aversion to dental treatment. The aim of this study was to evaluate the anesthetic efficacy of a buccal infiltration injection without a palatal injection in MITMS. Materials and Methods: This prospective research study was a crossover split mouth-randomized controlled trial. Twenty-eight healthy symmetrical bilateral MITMS patients (mean age, 23 years) were randomly assigned to two groups. Buccal infiltration injections without palatal injections were designated as the study group and the buccal with palatal infiltration cases were the control group, using 4% articaine and 1:100,000 epinephrine. The operation started after 10 minutes of infiltration. Pain assessment was done using a visual analogue scale and a numeric rating scale after each injection and extraction procedure. Similarly, the success rate, hemodynamic parameters, and additional requested local anesthetic were assessed. Results: The results showed that the pain associated with local anesthetic injections between both groups were significantly different. However, the success rates between the groups were not significantly different. Postoperative pain was not significant between both groups and a few patients requested an additional local anesthetic, but the results were not statistically significant. For hemodynamic parameters, there was a significant difference in systolic pressure during incision, bone removal, and tooth elevation. In comparison, during the incision stage there was a significant difference in diastolic pressure; however, other steps in the intervention were not significantly different between groups. Conclusion: We concluded that buccal infiltration injection without palatal injection can be an alternative technique instead of the conventional injection for MITMS.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.2
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• pp.95-102
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• 2016

Background: Surgery on the lower impacted third molar usually involves trauma in the highly vascularized loose connective tissue area, leading to inflammatory sequelae including postoperative pain, swelling, and general oral dysfunction during the immediate post-operative phase. This study aimed to investigate the effectiveness of preoperative injection of a single dose of 8 mg dexamethasone for postoperative pain control in lower third molar surgery. Methods: A controlled, randomized, split-mouth, prospective study involving lower third molar surgery was performed in 31 patients. The randomized sampling group was preoperatively injected, after local anesthesia, with a single dose of dexamethasone (8 mg in 2 ml) through the pterygomandibular space; 2 ml of normal saline (with no dexamethasone) was injected as a placebo. Results: The pain VAS score was significantly different on the day of the operation compared to the first post-operative day (P = 0.00 and 0.01, respectively), but it was not significantly different on the third and seventh postoperative day between the control and study groups. There was a significant reduction in swelling on the second postoperative day, and a difference between the second postoperative day and baseline value in the study group (P < 0.05). Trismus was highly significantly different on the second postoperative day and between baseline and second postoperative day between the groups (P = 0.04 and 0.02, respectively). Descriptive statistics and independent-samples t- test were used to assess the significance of differences. Conclusions: Injection of 8 mg dexamethasone into the pterygomandibular space effectively reduced the postoperative pain and other postoperative sequalae.

• Imaging Science in Dentistry
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• v.51 no.1
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• pp.9-16
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• 2021

Purpose: The purpose of this study was to analyze the reliability of 7 panoramic radiographic signs for predicting proximity of the root apices of mandibular third molars to the mandibular canal using cone-beam computed tomography and to correlate these findings with the Pell and Gregory and the Winter classification systems. Materials and Methods: An observational, cross-sectional, descriptive study was conducted on 74 patients with bilateral impacted mandibular third molars. Four panoramic radiographic signs were observed in the tooth root (darkening, deflection, and narrowing of the root apices, and bifid apices), and another 3 in the mandibular canal (diversion, narrowing, and interruption of the mandibular canal). Cone-beam computed tomography images were analyzed to identify disruption and diversion of the mandibular canal and root deflection. Results: Binary logistic regression showed that only 4 of the 7 panoramic radiographic signs were able to predict proximity of the root apices of the mandibular third molars to the mandibular canal: darkening of the root, deflection of the root, narrowing of the root, and interruption of the mandibular canal(P<0.05). Conclusion: Darkening, deflection, and narrowing of the root, in tandem with the interruption of the mandibular canal on panoramic radiographs, indicate that cone-beam computed tomography should be performed when planning the extraction of impacted mandibular third molars. Proximity between mandibular third molars and the mandibular canal is correlated with the Winter classification.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.1
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• pp.115-122
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• 2018

Noonan syndrome is characterized by distinctive facial features, short stature, and congenital heart disease. It is a congenital genetic disorder with a prevalence of between 1/1,000 and 1/2,500 in both genders. An 11-year-old boy with Noonan syndrome visited the hospital with an ectopically positioned tooth. A pulmonary stenosis was diagnosed and his growth and development were delayed. In many cases of this diseases there is obvious hemostasis, which he was not experiencing. His facial appearance showed characteristic features of Noonan syndrome. The patient showed a dental class II relationship, labioversion of the upper anterior teeth, and a shallow overbite. Radiographic examination revealed that the upper right canine was ectopically positioned, which led to root resorption of the upper right lateral incisor. A lateral cephalometric radiograph revealed a craniofacial pattern that was within normal limits. Surgical opening and button attachment on the impacted upper right canine were performed and traction was applied on the impacted tooth using a removable appliance. This patient was mildly affected by Noonan syndrome and showed some dental problems. However, few studies have reported the oral characteristics of Noonan syndrome despite its high incidence. Thus, this case report describes the oral features and management of Noonan syndrome.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.3
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• pp.217-225
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• 2001

Any fracture passing through the socket of a teeth is compounded intraorally, even if the fracture is not displaced and the tooth is firm in its socket. Before the advent of antibiotic therapy the danger of infection in a compounded fracture posed severe problems in treatment. Infection is reduced by antibiotic therapy but prolonged use of antibiotics is not justified in an attempt to save a tooth which might eventually be sacrificed. There is still controversy in the management of third molar in mandibualr angle fracture, particulary in regard to their retention or removal at the time of fracture treatment. So we surveyed the 159 patients who were treated with open reduction of mandibular angle fracture containing third molar in fracture line, and compared with the postoperative infection rate depending on time intervals between injury and operation, eruption state of third molar, non-extraction or extraction of third molar related to eruption state, non-extraction or extraction of third molar related to condiition of third molar and its surrounding periodontium and were to propose treatment guidline of third molar in mandibular angle fracture The results obtained were as follows : 1. There were no statistical significance between the time from injury to operation and postoperative infection. 2. There were no statistical significance between eruption state of third molar and postoperative infection. 3. In case of retention of the third molar, there were no statistical significance between eruption state of third molar and postoperative infection, but in case of extraction, postoperative infection was high rate in complete impacted cases. 4. There were no statistical significance between non-extraction or extraction of third molar and postoperative infection depending on condition of third molar. There are no difference in infection rate statistically according to the time from injury to operation, eruption state and condition of third molar, but retention of third molar revealed lowered infection rate in completely impacted cases. By terms of the manegement of third molar, we should extract or preserve third molar in the line of the mandibular angle fracture according to possibility of infection.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.2
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• pp.164-171
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• 2015

This study was aimed to retrospectively evaluate the clinical findings and treatments of odontomas in the Korean demographic group. The subject of the present study included 75 odontomas in 74 patients who received treatment from Chonbuk National University Dental Hospital between April 2005 and March 2014. The average age of the subjects were 10.3 years old (range 3 - 23 years old). 42 (56.8%) males and 32 (43.2%) females were in the present study. It was found that compound odontomas were about 4 times more common than complex odontomas. Odontomas equally occurred in both maxillary and mandible. The impaction of permanent teeth (73.3%) was the most common complication of odontomas on adjacent teeth. Most odontomas (96.0%) were surgically removed either to induce spontaneous eruption or to guide orthodontically to occlusion. When the impacted tooth could not be naturally or forcefully erupted to occlusion, it was extracted. Early detection and treatment of odontomas would increase the possible preservation of the impacted tooth by eliminating the source of disturbance. Therefore, this study recommends that periodic radiographic examination from birth until the eruption of the permanent third molar to prevent possible hindrance to the teeth eruption.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.645-650
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• 2004

Calcifying odontogenic cyst(COC) is a rare developmental odontogenic cyst, which shows diverse classification and terminology. Cystic epithelial lining of COC is composed of basal cell layer of columnar cells and overlying layer of stellate reticulum. In the epithelium, ghost cells that might induce adjacent mesenchymal tissue to develop dental organ are shown characteristically. In spite of low rate of recurrence, we have to get a histopathological examination so that odontogenic lesions may recur without fully curettage of lining epithelium. 7-year-old male child came pediatric dentistry in wonkwang university dental hospital in order to check the delayed eruption of left maxillary central incisor. Radiographic examination revealed a well-defined radiopaque mass, overlapping impacted left central and lateral incisor crown. Enucleated mass was tooth-like features and also had epithelium lining. Results of histopathologic procedure, we saw the lots of ghost cell and proliferating hard dental tissues. Also we saw the cystic epithelium cells. It revealed diagnosis of the COC associated complex odontoma. For this reason one should consider of COC when patients present odontoma-like lesion with impacted tooth.