• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.1
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• pp.46-54
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• 2019

When inflammatory products are found in both periodontal and pulpal tissues simultaneously, a periodontal-endodontic combined lesion is established. The treatment of periodontal-endodontic combined lesions includes root canal therapy and periodontal regenerative procedure for resolution of both the apical and marginal inflammatory lesions. The present study reports the treatment of periodontal-endodontic combined lesions in the mandibular anterior area with root canal therapy, followed by guided tissue regeneration therapy. Teeth with severe bone destruction in each case could be preserved, without extraction, over a 3-year period. Therefore, it appears that treatment of periodontal-endodontic combined lesions in the mandibular anterior area using guided tissue regeneration technique after root canal therapy may provide clinical advantages.

• Restorative Dentistry and Endodontics
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• v.32 no.6
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• pp.483-490
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• 2007

This report describes clinical cases of a palato-gingival groove on a maxillary lateral incisor with associated localized periodontal disease and pulp necrosis. The tooth of the first case was extracted because of severe bone destruction. The palato-gingival groove of the second case was eliminated using a round bur, and the resulting defect was filled with synthetic graft and covered by an absorbable membrane. Both diagnosis and treatment of palato-gingival groove were very difficult and usually extraction of the involved tooth is the treatment of choice. but combined endodontic-peri-odontic treatment allowed the tooth to be saved.

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.2
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• pp.98-104
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• 2019

Although intentional replantation is frequently used as a treatment modality for endodontic problems, severe periodontal involvement has usually been regarded as a contraindication. However, there are some studies suggesting that intentional replantation could be a successful treatment alternative for periodontally involved teeth. This paper reports the treatment of a tooth with severe periodontal involvement using intentional replantation. The tooth, which had had root canal therapy due to endodontic-periodontal combined lesion but showed extensive bone loss, was gently extracted and replanted after thorough debridement of the root surface. By intentional replantation, a tooth with severe periodontal involvement in this case could be preserved, without extraction, over the course of a 3-year follow-up period.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.4
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• pp.575-582
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• 2001

There have been many treatment methods for traumatic subgingival crown fracture and intrusion without spontaneous eruption. The orthodontic forced eruption generally results in favorable clinical findings than crown lengthening with osteotomy and intentional replantation. In first two cases with subgingival crown fracture due to trauma, authors applied orthodontic forced eruption with axed appliance after root canal therapy and then restored them with composite resin. In another case with traumatic intrusive luxation, we observed spontaneous eruption of the corresponding tooth for about 6 months and then returning it to normal position by forced eruption with removable appliance, but root canal filling was conducted after apexification due to devitalization during forced eruption, and so clinically favorable results were obtained.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.1
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• pp.60-69
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• 2016

Complicated crown-root fracture of permanent incisors cause esthetic, functional, and psychological problems to patients. Therefore, treatment is important and multidisciplinary treatment is required. This case report describes the clinical procedures involved in the treatment of trauma-induced complicated crown-root fractures in the maxillary incisor of two young patients. Conventional root canal treatment and apexification were performed in each patient. To expose the fracture margins to the supragingival level and to reestablish the biologic width, orthodontic extrusions with fixed appliances were performed followed by a retention period. During the retention period, fiber-optic posts and cores were built up and provisional crowns were placed. Finally, ceramic crowns manufactured using a computer-aided design/computer-aided manufacturing (CAD/CAM) system were placed. In both patients, the teeth presented satisfactory functional and esthetic outcomes without relapse. The periodontal tissues were healthy.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.4
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• pp.413-420
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• 2011

Garre's osteomyelitis is associated with bacterial infection and bone necrosis resulting from obstruction of blood supply. The most common cause for Garre's osteomyelitis is odontogenic infection that originates from periodontal tissue or dental pulp. Subperiosteal abscess may also cause Garre's osteomyelitis in the progress of the infection. Mandible is more often affected than maxilla, most commonly in the permanent first molar region of mandible. Clinically, it results in a hard swelling over the jaw, producing facial asymmetry. Meanwhile, radiograph shows a characteristic feature of irregular pulpal cavity, showing new periosteal proliferation located in successive layers to the condensed cortical bone on stimulated site. The treatment method for Garre's osteomyelitis are removal of the infection source, root canal treatment, antibiotic medication, and incision and drainage. This report presents a case of Garre's osteomyelitis under 15 years old. The patient was successfully treated by antibiotic medication accompanied with root canal treatment. Since the symptom of pediatric patients is less severe than adult, careful diagnosis with history taking and clinical examination is necessary. Furthermore long-term follow-up examination is needed to prevent recurrence even after the symptom disapears.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.119-125
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• 2009

Fusion and gemination are irregularities in tooth development. It is often difficult to differentiate between gemination and fusion and it is common to refer to these anomalies as 'double teeth'. The deciduous teeth are most commonly involved, but in 0.1% of cases permanent teeth are affected, in which case aesthetic, funtional and periodontal problems can result. Double teeth present great difficulties in management and required a multidisciplinary approach. The central groove on the labial and palatal surfaces of a double tooth is extremely prone to caries, therefore early 'fissure sealing' is essential. In permanent dentition, surgical separation of fused teeth may be possible with subsequent orthodontic alignment and restorative treatment as needed to reshape the crown. Reshaping or reduction of a double tooth with a single canal may be attempted by modifying the appearance of the labial groove and the use of composite tints but is often impossible and extraction may be the only alternative. Orthodontic treatment and prosthetic replacement is then required. Implants may be an option for adolescents. The present study describes three clinical cases of double teeth in the position of the maxillary permanent incisors. The first case demonstrates an example of multidisciplinary care including surgical intraoral hemisection, root canal therapy, restorative and orthodontic treatment. The second and third cases describe the external and internal morphology of the two fused teeth by means of three dimensional dental computer tomography.

• The Journal of the Korean dental association
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• v.47 no.8
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• pp.479-486
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• 2009

Purpose: The aim of this study was to show the clinical results of combination of Nd-YAP (1340nm) laser therapy with conventional endodontic and periodontal treatment. Materials and Methods: Four patients with chronic advanced periodontitis and endodontic infection were treated with conventional treatment and Nd-YAP laser therapy. Occlusal adjustment and splinting were done for stabilization of the teeth with severe horizontal and vertical mobility. The protocol for periodontal treatment was followed as scaling and root planing, pocket irrigation with 3% $H_2O_2$ and exposure of Nd-YAP laser using 320${\mu}m$ optical fiber with 160mJ/pluse, 30Hz. The other protocol for endodontic treatment was followed as access opening, canal preparation by hand and rotary instrument, canal filling, and exposure of Nd-YAP laser using 200${\mu}m$ optical fiber with 200mJ/pluse, 10Hz and 180mJ/pluse, 5Hz which were used respectively for disinfection and canal filling. The assessments of probing depth, mobility, and radiography were made prior to and after treatment. Result: All of these four clinical cases showed good healing of periodontium, which presented decrease of mobility and pocket depth, and increase of bone regeneration and bone density on the radiography. Conclusion: The bactericidal effect of Nd-YAP laser would provide benefits for improving clinical results that are obtained from conventional therapy.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.1
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• pp.60-65
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• 2013

The term 'triple tooth' is used to describe a rare dental abnormality in which three teeth appear to be joined. The literature contains many reports of joined primary teeth; most cases have involved, however, the joining of two teeth, and only rarely three teeth. Triple tooth has clinical problems such as dental caries, esthetic problems, malocclusions, and periodontal problems. Therefore, it may require multi-disciplinary approach. The present study describes rare case of triple tooth between maxillary primary central and lateral incisors and a supernumerary tooth. An one-year, eleven-month old girl was seen for evaluation of swelling in the labial gingiva above a right maxillary triple tooth. She experienced traumatic dental injury in that area three weeks ago. Intraoral examination revealed an abscess and fistula in the region of the triple tooth. A radiographic examination showed that right lateral incisor was missing. Endodontic treatment and composite resin restoration was performed on the triple tooth. After follow-ups of 7 months period, there were no marked complications.