하악 제3대구치 발치의 결정에 관한 재고찰
Reconsideration of decision making for third molar extraction
박원서, 김진학, 강상훈, 김문기, 김봉철, 최지욱, 이상휘,
소속 상세정보
박원서 ( Park Won-Se ) - 연세대학교 치과대학병원 통합진료과
김진학 ( Kim Jin-Hak ) - 사과나무치과병원
강상훈 ( Kang Sang-Hoon ) - 국민건강보험공단 일산병원 구강악안면외과
김문기 ( Kim Moon-Key ) - 국민건강보험공단 일산병원 구강악안면외과
김봉철 ( Kim Bong-Chul ) - 연세대학교 치과대학 구강악안면외과학교실
최지욱 ( Choi Ji-Wook ) - 연세대학교 치과대학 구강악안면외과학교실
이상휘 ( Lee Sang-Hwy ) - 연세대학교 치과대학 구강악안면외과학교실
KMID : 0355620110370050343
Abstract
Introduction:Third molar extraction is one of the most common procedures in oral and maxillofacial surgery. The impacted third molar causes many pathological conditions, such as pericoronitis, caries, periodontitis, resorption of adjacent teeth, and cyst or tumors associated with impacted teeth. Extraction is often considered the treatment of choice for impacted lower third molars. On the other hand, imprudent extraction of deeply impacted third molars can cause permanent complications, such as inferior alveolar nerve damage. Therefore, guidelines for the extraction of lower third molars should be set to prevent embarrassing complications. This study examined the indication and current trends of the extracted lower third molars in the dental hospital of a dental college.
Materials and Methods : 557 extracted third molars were evaluated at the department of oral and maxillofacial surgery of Yonsei University. The chief complaint, diagnosis, age and degree of impaction were analyzed to determine the tendency for the extraction of asymptomatic lower third molars.
Results:The percentage of asymptomatic third molars was 40.8%. In cases of full impacted tooth or full erupted tooth, the percentage of asymptomatic teeth was more than 50% (52.4% and 54.3, respectively). Among those partially impacted teeth, 73.1% of them showed symptoms, such as pain, tenderness and swelling. In terms of age, pericoronitis was evident at a younger age, and dental caries/periodontitis was the main cause of removal in those aged over 50. Twenty nine cases (1.6%) had teeth associated with pathological changes
Conclusion:The incidence of pathological changes to the lower third molar was relatively low. Surgical extraction is recommended in cases of partially impacted teeth. In Korea, the incidence of asymptomatic third molar extraction was relatively higher than in European countries. More careful attention would be desirable to consider the risks and benefits of lower third molar extraction.
키워드
Third molar; Indication; Extraction; Asymptomatic
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