Prophylactic removal of impacted third molars is a common procedure in dentistry, but the necessity of routine extraction is still controversial. When impacted third molars caused severe apical root resorption of the second molars, orthodontic traction of the third molars after extraction of the damaged second molars could minimize alveolar bone defect and preserve the patient's natural teeth. By well-planned orthodontic treatment, functional occlusion was established avoiding extraction of the impacted teeth and eliminating the possibility of a large bone defect after extraction.
Dentistry ; Molar* ; Molar, Third* ; Orthodontic Space Closure ; Root Resorption ; Tooth ; Tooth, Impacted ; Traction*

Langerhans cell histiocytosis (LCH) is characterized by proliferation of histiocyte-like cells (Langerhans cell histiocytes) with characteristic Birbeck granules, accompanied by other inflammatory cells. Treatments of LCH include surgery, chemotherapy, and radiotherapy. One of the representative forms of chemotherapy is intralesional injection of steroids. Surgical treatment in the form of simple excision, curettage, or even ostectomy can be performed depending on the extent of involvement. Radiotherapy is suggested in case of local recurrence, or a widespread lesion. This article shows the case of repetitively recurrent LCH of a 56-year-old man who had been through surgical excision and had to have marginal mandibulectomy and radiotherapy when the disease recurred. After the first recurrence occurred, lesions involved the extensive part of the mandible causing pathologic fracture, so partial mandibular bone resection was performed from the right molar area to the left molar area followed by the excision of the surrounding infected soft tissues. The resected mandibular bone was reconstructed with a segment of fibula osteomyocutaneous free flap and overdenture prosthesis supported by osseointegrated implants.
Curettage ; Denture, Overlay ; Drug Therapy ; Fibula ; Fractures, Spontaneous ; Free Tissue Flaps ; Histiocytosis, Langerhans-Cell* ; Humans ; Injections, Intralesional ; Mandible ; Middle Aged ; Molar ; Prostheses and Implants ; Radiotherapy ; Recurrence ; Rehabilitation* ; Steroids

PURPOSE: The purpose of the present retrospective cohort study was to investigate the incidence of sinus perforation during endodontic microsurgery and to assess healing of cases with sinus perforation. MATERIALS AND METHODS: Clinical and radiographic records were collected from patients who were treated with endodontic microsurgery in the Microscope Center of the Department of Conservative Dentistry at Yonsei University College of Dentistry, Seoul, Korea, between March 2001 and January 2016. To determine the incidence of sinus perforation, all cases involving maxillary premolar and molar teeth were assessed, and cases with perforation of maxillary sinus during the procedure were counted. To assess the outcome of the endodontic microsurgery, cases with sinus perforation were recalled at least 1 year after surgery. RESULT: Two hundred and forty-nine maxillary premolars and molars were treated with endodontic microsurgery. Among these cases, 16 cases had sinus perforations. Overall incidence of sinus perforation was 6.4%. Thirteen cases with sinus perforation were followed up for 1 year after endodontic microsurgery. Outcome assessment revealed that 2 of 13 cases with sinus perforation had failed. The success rate of endodontic microsurgery with sinus perforation was 84.6%. CONCLUSION: Endodontic surgery performed using microsurgical techniques decreases the risk of sinus perforation. Predictable outcomes of endodontic microsurgeries and healing of sinus membrane can be expected with adequate treatment steps and careful periodic follow-ups in cases with maxillary sinus perforations.
Bicuspid ; Cohort Studies ; Dentistry ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Maxillary Sinus* ; Membranes ; Microsurgery* ; Molar ; Retrospective Studies ; Seoul ; Tooth

PURPOSE: Laser treatment has become a popular method in implant dentistry, and lasers have been used for the decontamination of implant surfaces when treating peri-implantitis. This study was performed to evaluate the effects of an Erbium-doped:Yttrium-Aluminum-Garnet (Er:YAG) laser with different settings on machined (MA), sand-blasted and acid-etched (SA), and resorbable blast media (RBM) titanium surfaces using scanning electron microscopy and confocal microscopy. MATERIALS AND METHODS: Four MA, four SA, and four RBM discs were either irradiated at 40 mJ/20 Hz, 90 mJ/20 Hz, or 40 mJ/25 Hz for 2 minutes. The specimens were evaluated with scanning electron microscopy and confocal microscopy. RESULT: Four MA, four SA, and four RBM discs were either irradiated at 40 mJ/20 Hz, 90 mJ/20 Hz, or 40 mJ/25 Hz for 2 minutes. The specimens were evaluated with scanning electron microscopy and confocal microscopy. Result: The untreated MA surface demonstrated uniform roughness with circumferential machining marks, and depressions were observed after laser treatment. The untreated SA surface demonstrated a rough surface with sharp spikes and deep pits, and the laser produced noticeable changes on the SA titanium surfaces with melting and fusion. The untreated RBM surface demonstrated a rough surface with irregular indentation, and treatment with the laser produced changes on the RBM titanium surfaces. The Er:YAG laser produced significant changes on the roughness parameters, including arithmetic mean height of the surface (Sa) and maximum height of the surface (Sz), of the MA and SA surfaces. However, the Er:YAG laser did not produce notable changes on the roughness parameters, such as Sa and Sz, of the RBM surfaces. CONCLUSION: This study evaluated the effects of an Er:YAG laser on MA, SA, and RBM titanium discs using confocal microscopy and scanning electron microscopy. Treatment with the laser produced significant changes in the roughness of MA and SA surfaces, but the roughness parameters of the RBM discs were not significantly changed. Further research is needed to evaluate the efficiency of the Er:YAG laser in removing the contaminants, adhering bacteria, and the effects of treatment on cellular attachment, proliferation, and differentiation.
Bacteria ; Decontamination ; Dentistry ; Depression ; Freezing ; Lasers, Solid-State ; Methods ; Microscopy, Confocal* ; Microscopy, Electron, Scanning* ; Peri-Implantitis ; Surface Properties ; Titanium*

PURPOSE: Wnt signaling plays an essential role in the dental epithelium and mesenchyme during tooth morphogenesis. Deletion of the Wntless (Wls) gene in odontoblasts appears to reduce canonical Wnt activity, leading to inhibition of odontoblast maturation. However, it remains unclear if autonomous Wnt ligands are necessary for differentiation of dental pulp cells into odontoblast-like cells to induce reparative dentinogenesis, one of well-known feature of pulp repair to form tertiary dentin. MATERIALS AND METHODS: To analyze the autonomous role of Wls for differentiation of dental pulp cells into odontoblast-like cells, we used primary dental pulp cells from unerupted molars of Wls-floxed allele mouse after infection with adenovirus for Cre recombinase expression to knockout the floxed Wls gene or control GFP expression. The differentiation of dental pulp cells into odontoblast-like cells was analyzed by quantitative real-time polymerase chain reaction. RESULT: Proliferation rate was significantly decreased in dental pulp cells with Cre expression for Wls knockout. The expression levels of Osterix (Osx), runt-related transcription factor 2 (Runx2), and nuclear factor I-C (Nfic) were all significantly decreased by 0.3-fold, 0.2-fold, and 0.3-fold respectively in dental pulp cells with Wls knockout. In addition, the expression levels of Bsp, Col1a1, Opn, and Alpl were significantly decreased by 0.7-fold, 0.3-fold, 0.8-fold, and 0.6-fold respectively in dental pulp cells with Wls knockout. CONCLUSION: Wnt ligands produced autonomously are necessary for proper proliferation and odontoblastic differentiation of mouse dental pulp cells toward further tertiary dentinogenesis.
Adenoviridae ; Alleles ; Animals ; Dental Pulp* ; Dentin ; Dentinogenesis ; Epithelium ; Ligands ; Mesoderm ; Mice* ; Molar ; Morphogenesis ; NFI Transcription Factors ; Odontoblasts* ; Real-Time Polymerase Chain Reaction ; Recombinases ; Tooth ; Transcription Factors

PURPOSE: The aim of this study was to evaluate the rat periodontal ligament cell viability under 0℃/2 MPa condition up to one week using in vivo 3-(4,5-dimethylthiazol-2-y1)-2,5-diphenyltetrazolium bromide (MTT) assay. MATERIALS AND METHODS: As soon as 110 upper molar teeth of rats were extracted, they were stored in Hartman's solution under 0℃/2 MPa condition for 1, 2, 3, 4, and 7 days each. All specimens were treated with in vivo MTT assay and the value of optical density was measured by ELISA reader. These values were statistically analyzed by one-way ANOVA. RESULT: There was no statistical difference on MTT value between immediate and 1 day storage group. There were statistically significant differences between 1 day and 2 days tsorage, 2 and 3 days storage groups, respectively. Teeth of 3,4, and 7 days storage groups showed significantly lower MTT valuesc ompared with shorter period storage groups. CONCLUSION: When the MTT values were substituted in standard curve, 1 day storage group at 0℃/2 MPa condition showed 68% cell viability when compared with immediate group. It dropped to 13% at 2 days, and to less than 5% at 3 days or more.
Animals ; Cell Survival ; Enzyme-Linked Immunosorbent Assay ; Methods* ; Molar ; Periodontal Ligament* ; Rats* ; Tooth

In case of loss of many teeth due to dental caries or periodontal disease, improvement of masticatory function and aesthetics can be obtained through implant treatment. However, if the patient does not have a normal intercondylar relationship, it is difficult to achieve an ideal occlusal relationship with only prosthetic treatment. In particular, oral reconstruction with orthodontic treatment or orthognathic surgery is necessary for patients with mandibular prognathism. However, if the posterior occlusion collapses due to severe caries or periodontal disease, orthognathic surgery may be difficult. The occlusal vertical stop is very important for the stability of the mandibular position during occlusal reconstruction through orthognathic surgery. The patient in this case had posterior occlusion collapsed due to the caries of a large number of posterior teeth, and showed mandibular prognathism and long face. We planned a full arch restoration with orthognathic surgery and extracted the hopeless teeth. To secure the vertical stop required for orthognathic surgery, the implant was placed before surgery. After the orthognathic surgery and the final prosthesis application, the results were satisfactory for the improvement of the aesthetics and the restoration of the masticatory function.
Dental Caries ; Dental Implants ; Esthetics ; Humans ; Malocclusion ; Malocclusion, Angle Class III ; Orthognathic Surgery* ; Periodontal Diseases ; Prognathism* ; Prostheses and Implants ; Tooth*

PURPOSE: The purpose of this study was to evaluate the microleakage of various types of resin-bonded fixed partial dentures (RBFPDs) after artificial aging. MATERIALS AND METHODS: Forty models with missing first molar were fabricated using artificial resin teeth and were divided into four groups: Group A, conventional RBFPDs design; Group B, modified RBFPDs design; Group C, assembled 3-piece RBFPDs design; and Group D, assembled 3-piece RBFPDs with different occlusal rest positions. Half of the specimens underwent chewing simulation process (240,000 cycles, 50 N load, 1.7 Hz) and thermocycling (temperatures 5℃~55℃, dwelling time 30 seconds) and the remaining 20 specimens didn't receive any treatment. All the specimens were immersed in 2% methylene blue solution for 24 hours to evaluate microleakage, and were sectioned at the middle part of abutment teeth. To evaluate the microleaskage, a dye penetration was calculated. RESULT: With artificial aging, cyclic loading and thermocycling, a 3-piece RBPFD and a 2-piece RBPFD using original tooth undercuts have significantly lower microleakge (P<0.05) compared to the conventional design of RBPFD and modified RBPFD. CONCLUSION: Within the limit of this experiment, the assembled RBFPDs exhibited a smaller microleakage than the conventional RBFPDs, implying that the assembled RBFPDs can be more effective for reducing the dislodgement of the RBFPDs.
Aging ; Denture, Partial, Fixed* ; Denture, Partial, Fixed, Resin-Bonded ; In Vitro Techniques* ; Mastication ; Methylene Blue ; Molar ; Tooth

PURPOSE: The purpose of this study was to evaluate the dental fear experienced among Korean adolescents and to identify the relevant factors. MATERIALS AND METHODS: In order to compare the level of dental fear depending on the subjects' previous experience, descriptive statistical analysis was performed. Gender- and grade-dependent evaluation was performed according to the presence of their previous dental visit and dental fear. Subjective oral health status was also investigated. In order to determine the factors affecting dental fear, logistic regression analysis was performed. RESULT: Among the total of 333 subjects who had experienced dental fear, females were found to experience 1.766 times greater dental fear than males (P=0.007). The worse subjective perception of their oral health was associated with increase in the experience of dental fear by 1.245-fold (P=0.047). CONCLUSION: The dental fear was likely to be formed during the visit to the dentist's office or through previous experience of dental treatment. Therefore in order to reduce the fear associated with dental treatment in adolescents, establishemnt of a proper environment in the dental clinic and a patient management program are necessitated.
Adolescent* ; Dental Anxiety* ; Dental Clinics ; Female ; Humans ; Logistic Models ; Male ; Oral Health

PURPOSE: The purpose of this study was to investigate the electrochemical characteristics of nanotubular Ti-25Nb-xZr ternary alloys for dental implant materials. MATERIALS AND METHODS: Ti-25Nb-xZr alloys with different Zr contents (0, 3, 7, and 15 wt.%) were manufactured using commercially pure titanium (CP-Ti), niobium (Nb), and zirconium (Zr) (99.95 wt.% purity). The alloys were prepared by arc melting in argon (Ar) atmosphere. The Ti-25Nb-xZr alloys were homogenized in Ar atmosphere at 1,000℃ for 12 hours followed by quenching into ice water. The microstructure of the Ti-25Nb-xZr alloys was examined by a field emission scanning electron microscope. The phases in the alloys were identified by an X-ray diffractometer. The chemical composition of the nanotube-formed surfaces was determined by energy-dispersive X-ray spectroscopy. Selforganized TiO₂ was prepared by electrochemical oxidation of the samples in a 1.0 M H₃PO₄+0.8 wt.% NaF electrolyte. The anodization potential was 30 V and time was 1 hour by DC supplier. Surface wettability was evaluated for both the metallographically polished and nanotube-formed surfaces using a contact-angle goniometer. The corrosion properties of the specimens were investigated using a 0.9 wt.% aqueous solution of NaCl at 36℃±5℃ using a potentiodynamic polarization test. RESULT: Needle-like structure of Ti-25Nb-xZr alloys was transform to equiaxed structure as Zr content increased. Nanotube formed on Ti-25Nb-xZr alloys show two sizes of nanotube structure. The diameters of the large tubes decreased and small tubes increased as Zr content increased. The lower contact angles for nanotube formed Ti-25NbxZr alloys surfaces showed compare to non-nanotube formed surface. The corrosion resistance of alloy increased as Zr content increased, and nanotube formed surface showed longer the passive regions compared to non-treatment surface. CONCLUSION: It is confirmed that corrosion resistance of alloy increased as Zr content increased, and nanotube formed surface has longer passive region compared to without treatment surface.
Alloys* ; Argon ; Atmosphere ; Corrosion ; Dental Implants* ; Freezing ; Ice ; Nanotubes ; Niobium ; Spectrum Analysis ; Titanium ; Water ; Wettability ; Zirconium