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Kato C, Watari I, Aida J, Ono T. Factors associated with the eruption of the impacted maxillary third molars after second molar extraction. Am J Orthod Dentofacial Orthop 2022; 162:636-644.e4. [PMID: 35843763 DOI: 10.1016/j.ajodo.2021.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/01/2021] [Accepted: 05/01/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION In orthodontic treatment, the space left after extracting the maxillary second molar (MxM2) may be filled by the eruption of the impacted third molar (MxM3). However, little is known about the factors associated with the eruption of the impacted MxM3. We aimed to characterize the clinical factors associated with the time taken for MxM3 eruption after MxM2 extraction. METHODS We analyzed factors associated with late MxM3 eruption (>500 days after MxM2 extraction) in 84 molars. Prespecified risk factors were entered into logistic regression models to estimate odds ratios (ORs). RESULTS The median duration between MxM2 extraction and MxM3 eruption was 302 days (interquartile range, 140-424). Significant factors associated with late MxM3 eruption included the proximity of the MxM3 root to the maxillary sinus floor (OR, 51.72), the distance between the occlusal plane of the MxM3 and the apical third of the MxM2 roots (OR, 16.56), MxM3 angulation and depth of ≥20° (OR, 5.58), ANB angle of <2° (OR, 9.05), and ≥1.5 mm distal movement of the maxillary first molar (MxM1) from its original position at the time of MxM2 extraction and MxM3 eruption (OR, 12.9). The probability of late MxM3 eruption was 0% (0 out of 30) with no risk, 6.9% (2 out of 29) with 1 risk factor, and 52% (13 out of 25) with ≥2 risk factors. CONCLUSIONS We identified 5 clinical factors associated with late MxM3 eruption after MxM2 extraction. The probability of late MxM3 eruption increased as the number of present risk factors increased. These findings can be used for risk stratification during orthodontic treatment.
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Affiliation(s)
- Chiho Kato
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Ippei Watari
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Ono
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Selvido DI, Wongsirichat N, Arirachakaran P, Rokaya D, Wongsirichat N. Surgical Management of Impacted Lower Second Molars: A Comprehensive Review. Eur J Dent 2022; 16:465-477. [PMID: 35016240 PMCID: PMC9507580 DOI: 10.1055/s-0041-1739443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Impacted lower second molars (ILM2) are rarely reported in the literature, but various studies have been done for its treatment. Apart from solely orthodontic approaches, different surgical management techniques were reported to have successful outcomes. Surgical intervention of ILM2 can help expose the tooth for further orthodontic purposes, simplifying complex treatment methods, and reducing treatment time. This review illustrates the comprehensive evaluation and updated methods of surgical uprighting, repositioning, and transplantation of ILM2 with future directions for better understanding and treatment planning in the clinical setting. The successful outcome of surgical intervention depends on case selection, root development of ILM2, careful surgical manipulation, and adherence to sound biological principles.
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Affiliation(s)
- Diane Isabel Selvido
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Nattharin Wongsirichat
- Department of Preventive Dentistry, Division of Orthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Pratanporn Arirachakaran
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Dinesh Rokaya
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Natthamet Wongsirichat
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
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Aslan BI, Akarslan ZZ, Karadağ Ö. Effects of Angle class II correction with the Forsus fatigue resistant device on mandibular third molars : A retrospective study. J Orofac Orthop 2021; 82:403-412. [PMID: 33666713 DOI: 10.1007/s00056-021-00281-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 02/02/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The goal was to evaluate the effects of Angle class II malocclusion treatment using the Forsus fatigue resistant device (FRD, 3M, St. Paul, MN, USA) on the position and angulation of mandibular third molars and retromolar space. PATIENTS AND METHODS In all, 58 class II patients (mean age 13.6 ± 1.8 years) treated with the FRD (FRD group) were compared with 51 class I patients (mean age 13.5 ± 1.6 years) who underwent orthodontic treatment (control group). A total of 109 mandibular third molars in the FRD group and 91 in the control group were evaluated. Changes in the retromolar space, angulation of the second (ɣ) and third molars (β), and the angle between these teeth (α) were assessed with panoramic radiographs taken at the beginning and the end of the treatment. Data were statistically analyzed. RESULTS At the end of the treatment, there were significant increases in ɣ and β in the FRD group and ɣ in the control group (p < 0.05). The decrease in α in the FRD group and increase in the control group were not significant (p > 0.05); however, this change led to a small significant change between the groups (p < 0.05). The retromolar space significantly increased in the FRD group compared to the control group (p < 0.05). No significant correlation was found between retromolar space and third molar uprighting in any of the groups (p > 0.05). CONCLUSION Class II correction with FRD led to mesialization of the lower arch which provided an increase in the retromolar space. Little improvement in the uprighting of the third molars occurred.
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Affiliation(s)
- Belma I Aslan
- Department of Orthodontics, Gazi University Dentistry Faculty, Ankara, Turkey.
| | - Zühre Z Akarslan
- Department of Dentomaxillofacial Radiology, Gazi University Dentistry Faculty, Ankara, Turkey
| | - Özge Karadağ
- Faculty of Science, Department of Statistics, Hacettepe University, Ankara, Turkey
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Baik UB, Kang JH, Lee UL, Vaid NR, Kim YJ, Lee DY. Factors associated with spontaneous mesialization of impacted mandibular third molars after second molar protraction. Angle Orthod 2019; 90:181-186. [PMID: 31769700 DOI: 10.2319/050919-322.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To investigate factors associated with spontaneous mesialization of impacted third molars after second molar protraction to close the space caused by a missing mandibular first molar (L-6) or retained deciduous mandibular second molars with a missing succedaneous premolar (L-E). MATERIALS AND METHODS Panoramic radiographs of patients treated with mandibular second molar protraction to close the space due to missing L-6 or L-E (14 males, 36 females, mean age = 18.6 ± 4.4 years) were analyzed before treatment (T1) and after second molar protraction (T2). Factors associated with the amount of third molar mesialization were investigated using regression analyses. RESULTS Mandibular second molars were protracted by 5.1 ± 2.1 mm and 5.8 ± 2.7 mm, measured at the crown and root furcation, respectively. After second molar protraction, third molars showed spontaneous mesialization by 4.3 ± 1.6 mm and 3.8 ± 2.6 mm, measured at the crown and root furcation, respectively. Nolla's stage of the third molar at T1 (B = 0.20, P = .026) and second molar protraction time (B = 0.04, P = .042) were significantly associated with the amount of third molar mesialization. CONCLUSIONS Greater third molar mesialization was observed when Nolla's stage of the third molar was higher before treatment and when the second molar protraction time was longer.
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Baik UB, Choi HB, Kim YJ, Lee DY, Sugawara J, Nanda R. Change in alveolar bone level of mandibular second and third molars after second molar protraction into missing first molar or second premolar space. Eur J Orthod 2019; 41:513-518. [PMID: 30715310 PMCID: PMC6754516 DOI: 10.1093/ejo/cjz001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective To investigate the factors associated with the change in alveolar bone level of mandibular second and third molars after second molar protraction into the space of the missing first molar (L6) or second premolar (LE). Methods Fifty-one patients in whom space of the missing L6 or LE was treated with second molar protraction (13 males, 38 females, mean age 19.6 ± 4.7 years) from 2003 to 2015 were included. The alveolar bone level and position and angulation of the mandibular second and third molars were measured in panoramic radiographs at pre-treatment (T1), and after the alignment of the third molars following second molar protraction (T2). Factors associated with alveolar bone loss on the distal aspect of the mandibular second molars were assessed using linear regression analysis. Results Age at T1 (P < 0.001) and third molar angulation at T1 (P = 0.002) were significant factors for the prediction of alveolar bone level distal to the second molars. Limitation This study used two-dimensional panoramic radiographs, and we could observe only the interproximal bone level. Conclusions After second molar protraction into the missing first molar or second premolar space, mandibular second molars may exhibit alveolar bone resorption in the distal root in older patients and in those with mesially tilted third molars before treatment.
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Affiliation(s)
| | | | - Yoon-Ji Kim
- Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University, Seoul, Korea
| | - Dong-Yul Lee
- Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University, Seoul, Korea
| | - Junji Sugawara
- SAS Orthodontic Center, Ichiban-Cho Dental Clinic, Sendai, Japan
| | - Ravindra Nanda
- Division of Orthodontics, School of Dental Medicine, University of Connecticut, Farmington, CT, USA
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Baik UB, Bayome M, Abbas NH, Park JH, Lee UL, Kim YJ. Factors associated with spontaneous angular changes of impacted mandibular third molars as a result of second molar protraction. Am J Orthod Dentofacial Orthop 2019; 156:178-185. [PMID: 31375227 DOI: 10.1016/j.ajodo.2018.08.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 10/26/2022]
Abstract
INTRODUCTION This study aimed to identify significant factors affecting the spontaneous angular changes of impacted mandibular third molars as a result of second molar protraction. Temporary skeletal anchorage devices in the missing mandibular first molar (ML-6) or missing deciduous mandibular second molar (ML-E) with missing succedaneous premolar spaces provided traction. METHODS Forty-one mandibular third molars of 34 patients (10 male and 24 female; mean age 18.3 ± 3.7 years) that erupted after second molar protraction were included in this study. They were classified into upright (U) and tilted (T) groups. Linear and angular measurements were performed at the time of treatment initiation (T1) and of ML-6 or ML-E space closure (T2). Regression analyses were used to identify significant factors related to third molar uprighting. RESULTS Nolla stage (odds ratio [OR] 4.1), sex (OR 0.003 for male), third molar angulation at T1 (OR 1.1), missing tooth space (OR 0.006), rate of third molar eruption (OR 23.3), and rate of second molar protraction (OR 0.2) significantly affected third molar uprighting. Age, third molar angulation at T1, rate of third molar eruption, and rate of second molar protraction were significant factors for predicting third molar angulation at T2. CONCLUSIONS Available space for third molar eruption before and after second molar protraction is not associated with uprighting of erupting third molars. Older patients whose third molars are in greater Nolla stage, are in a more upright position at T1, and have a greater eruption rate have a greater chance for third molar uprighting. Alternatively, an increase in second molar protraction rate results in mesial tipping of the third molars.
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Affiliation(s)
| | - Mohamed Bayome
- Latin American Research Center, Asunción, Paraguay; Department of Orthodontics, Seoul Saint Mary's Hospital, Catholic University of Korea, Seoul, Korea
| | - Noha Hussein Abbas
- Department of Orthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry and Oral Health, A. T. Still University, Mesa, Ariz
| | - Ui-Lyong Lee
- Department of Oral and Maxillofacial Surgery, Chung-Ang University Hospital, Seoul, Korea
| | - Yoon-Ji Kim
- Department of Orthodontics, Korea University Anam Hospital, Seoul, Korea.
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Wang Y, Min HY, Chen Z, Xie X, Qin C, Zheng Y, Mo S. Study the predisposing factors of root resorption during orthodontic uprighting treatment of impacted mandibular third molars. Int Orthod 2019; 17:249-255. [PMID: 31040074 DOI: 10.1016/j.ortho.2019.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To analyse the amount of root resorption of mesially or horizontally impacted mandibular third molars after orthodontic uprighting treatment. MATERIALS AND METHODS Twenty-four patients with an age range of 20∼26years old who had mesially/horizontally impacted third molars with complete root formation. And those with decayed or missing the mandibular first molar on the same side were selected. The lower third molars were uprighted and the extraction spaces closed. Root resorption was compared with paired t-test. The related risk factors for root resorption were compared with Pearson correlation analysis. RESULT The average uprighting time was 10.00 months (4∼16months). The study showed that all the impacted third molars were uprighted and got satisfactory outcomes after treatment. Shortening in length of mandibular third molar roots was detected at the end of the treatment, but no statistically significant differences were found (P<0.05). Root resorption was correlated with the duration of uprighting and the distance that root moved. CONCLUSION Impacted mandibular third molars were uprighted and the amount of root resorption of third molar after treatment was not increased. The duration of uprighting and the distance that root moved influence the degree of root resorption.
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Affiliation(s)
- Yao Wang
- Guangxi Medical University, College of Stomatology, Department of Orthodontics, Nanning, Guangxi, China
| | - Hsu Yin Min
- Guangxi Medical University, College of Stomatology, Department of Orthodontics, Nanning, Guangxi, China
| | - Zhixing Chen
- Guangxi Medical University, College of Stomatology, Department of Orthodontics, Nanning, Guangxi, China
| | - Xiaolan Xie
- Guangxi Medical University, College of Stomatology, Department of Orthodontics, Nanning, Guangxi, China.
| | - Changtao Qin
- Guangxi Medical University, College of Stomatology, Department of Orthodontics, Nanning, Guangxi, China
| | - Yi Zheng
- Guangxi Medical University, College of Stomatology, Department of Orthodontics, Nanning, Guangxi, China
| | - Shuixue Mo
- Guangxi Medical University, College of Stomatology, Department of Orthodontics, Nanning, Guangxi, China.
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Marchiori DF, Packota GV, Boughner JC. Third-molar mineralization as a function of available retromolar space. Acta Odontol Scand 2016; 74:509-517. [PMID: 27448555 DOI: 10.1080/00016357.2016.1209240] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To test in the maxilla and mandible for an association between stage of third-molar (M3) mineralization and space in the jaws for M3 eruption. Mineralization is hypothesized to be delayed not only for impacted M3s but also for M3s with eruption space less than their mesiodistal crown diameter. MATERIAL AND METHODS Retrospective cone beam computed tomography (CBCT) scans of 37 females and 32 males aged 17-24 years, for a total sample of 197 upper and lower M3s, were used to assess the status of M3 eruption and measure the M3 crown diameter (CD) relative to the length of the retromolar space (RS). Stage of M3 mineralization was then compared between impacted and erupting M3s as well as between two conditions of relative eruption space (RS/CD ≥ 1 versus RS/CD < 1) using Mann-Whitney U tests. RESULTS Impacted M3s were at significantly earlier (delayed) stages of mineralization compared to erupting M3s. Mineralization was also delayed for M3s with eruption space less than their mesiodistal crown diameter (e.g. RS/CD < 1). A moderate positive correlation between stage of M3 mineralization and space was seen in both jaws, and was stronger in the mandible. CONCLUSION Our study shows for the first time that stage of M3 mineralization is associated not only with impaction but also with amount of retromolar space, and that these associations are consistent in upper and lower jaws. Present findings underscore that M3 mineralization stage may be a clinically useful predictor of M3 impaction that thus merits further investigation.
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Tomonari H, Yagi T, Kuninori T, Ikemori T, Miyawaki S. Replacement of a first molar and 3 second molars by the mesial inclination of 4 impacted third molars in an adult with a Class II Division 1 malocclusion. Am J Orthod Dentofacial Orthop 2015; 147:755-65. [PMID: 26038080 DOI: 10.1016/j.ajodo.2014.05.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 05/01/2014] [Accepted: 05/01/2014] [Indexed: 11/28/2022]
Abstract
This case report presents the successful replacement of 1 first molar and 3 second molars by the mesial inclination of 4 impacted third molars. A woman, 23 years 6 months old, had a chief complaint of crowding of her anterior teeth and linguoclination of a second molar on the left side. The panoramic radiographic images showed that the maxillary and mandibular third molars on both sides were impacted. Root resorption on the distal surfaces of the maxillary second molars was suspected. The patient was given a diagnosis of Angle Class II Division 1 malocclusion with severe crowding of the anterior teeth and 4 impacted third molars. After we extracted the treated maxillary second premolars and the second molars on both sides, the treated mandibular second premolar and the second molar on the left side, and the root canal-filled mandibular first molar on the right side, the 4 impacted third molars were uprighted and formed part of the posterior functional occlusion. The total active treatment period was 39 months. The maxillary and mandibular third molars on both sides successfully replaced the first and second molars. The replacement of a damaged molar by an impacted third molar is a useful treatment option for using sound teeth.
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Affiliation(s)
- Hiroshi Tomonari
- Assistant professor, Department of Orthodontics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takakazu Yagi
- Assistant professor, Department of Orthodontics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takaharu Kuninori
- Assistant professor, Department of Orthodontics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takahiro Ikemori
- Postgraduate student, Department of Orthodontics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Shouichi Miyawaki
- Professor and department chair, Department of Orthodontics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
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Baik UB, Kook YA, Bayome M, Park JU, Park JH. Vertical eruption patterns of impacted mandibular third molars after the mesialization of second molars using miniscrews. Angle Orthod 2014; 86:565-70. [DOI: 10.2319/061415-399.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
ABSTRACT
Objective:
To investigate (1) whether vertical eruption of impacted third molars improves after mesialization of second molars and (2) what factors affect the vertical eruption of impacted third molars when space caused by missing molars is successfully closed by mesialization of the second molar using miniscrews.
Materials and Methods:
The treatment group (Group 1) included 52 patients who had (1) missing mandibular first molars (ML-6) or missing deciduous mandibular second molars (ML-E), (2) initially impacted mandibular third molars, and (3) successful space closure of the edentulous area with orthodontics. Panoramic radiographs at start of treatment (T1) and at time of space closure (T2) were collected. The control group (Group 2) included 46 nonedentulous patients with impacted mandibular third molars without molar protraction treatment. Panoramic radiographs with similar T1/T2 treatment times were selected. Nine measurements were obtained regarding horizontal available space, vertical eruption, and third molar angulation.
Results:
Third molars erupted vertically an average of 2.54 mm in Group 1 compared with 0.41 mm in Group 2. Age, gender, Nolla stage, and angle of the third molars did not show significant correlations with the vertical change of the impacted third molars, whereas the depth of third molar impaction and available space showed significant correlations.
Conclusions:
Impacted mandibular third molars vertically erupt as a result of uprighting with mesialization of the second molar, and vertical eruption is affected by the initial vertical location of impacted third molars and available space.
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Affiliation(s)
| | - Yoon-Ah Kook
- Professor, Department of Orthodontics, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mohamed Bayome
- Research Assistant Professor, Department of Orthodontics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Visiting Professor, Department of Postgraduate Studies, Universidad Autonóma del Paraguay, Asunción, Paraguay
| | - Je-Uk Park
- Professor, Department of Oral and Maxillofacial Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae Hyun Park
- Professor and Chair, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Ariz
- Adjunct Professor, Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
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How Often Do Asymptomatic, Disease-Free Third Molars Need to Be Removed? J Oral Maxillofac Surg 2012; 70:S41-7. [DOI: 10.1016/j.joms.2012.04.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 04/20/2012] [Indexed: 11/21/2022]
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Gisakis IG, Palamidakis FD, Farmakis ETR, Kamberos G, Kamberos S. Prevalence of impacted teeth in a Greek population. ACTA ACUST UNITED AC 2011; 2:102-9. [DOI: 10.1111/j.2041-1626.2010.00041.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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