• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.4
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• pp.512-518
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• 2010

The impaction of the maxillary permanent incisor is a common clinical problem and is mostly found at the "labial to the alveolar process." Surgical exposure and orthodontic treatment with fixed orthodontic appliances can be considered if normal eruption of the labillay impacted tooth is not expected. Surgical exposure of the impacted tooth, that is usually under the attached gingiva or is surrounded by alveolar bone through gingivectomy and removal of alveolar bone, may give a rise to complications such as diminution in the width of the attached gingiva, inflammation of the gingiva, and the loss of marginal alveolar bone. Therefore, closed eruption technique, which includes surgical exposure and orthodontic treatment with fixed orthodontic appliances followed by repositioning of surgical flap, is preferred. However, apically repositioned flap of the impacted tooth, which is beneath the movable submucosal area or is above the alveolar crestal area, can prevent unwanted exposures and facilitate successful tooth eruption. In this report, we described esthetic results of three patients with unerupted maxillary permanent incisor who were performed with an apically positioned flap without the loss of attached gingiva.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.166-173
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• 2012

Dilaceration is a developmental disturbance in shape of teeth. It refers to an angulation, or a sharp bend or curve, in the root or crown of a formed tooth. Dilacerations are estimated to occur in 3% of all permanent dentitions. However, the etiology of dilaceration is not yet fully understood. Traumatic injury to the deciduous predecessors and ectopic development of the tooth germ are the two commonly cited causes of this anomaly. The involved tooth is usually the maxillary central incisor and it also shows high prevalence of impaction. At first, We tried to do surgical exposure with orthodontic traction but to no avail. After then surgical repositioning of the dilacerated tooth was performed. Finally, Satisfactory results were obtained at the end of treatment, with improvement in dental esthetics and functional aspects.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.333-338
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• 2008

Supernumerary teeth are characterized by an excess number of teeth, which can be responsible for a variety of irregularities in the primary and transitional dentition. Supernumerary teeth, especially in the maxillary anterior region, may prevent the eruption of adjacent permanent teeth and cause their ectopic eruption, diastema, root resorption, or formation of dentigerous cyst. Therefore, early diagnosis of supernumerary teeth is important for prevention of such complications, and adequate treatment should be given according to their location, number, and morphologic features. In this case, four supernumerary teeth in the maxillary anterior region were disturbing the eruption of adjacent permanent incisors. Two of them were located in proximity to the central incisor tooth germs that their immediate removal may injure the permanent tooth germs. In order to minimize such complications, surgical extraction of the four supernumerary teeth was performed in two stages. At first, only two inverted conical supernumerary teeth were extracted. The other two tuberculous supernumerary teeth, close to the permanent tooth germs, were extracted later after their natural dislocation. In that way, we could minimize affects on the neighboring permanent tooth germs and also the amount of alveolar bone removed during surgery.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.1
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• pp.12-15
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• 2001

Dilaceration is a tooth abnormaly occuring in the histo-morphodifferention stage resulting from disturbance between the uncalcified and already calcified portion that affects both the crown and root. The involved tooth is usually the maxillary central incisor and it also shows high prevalence of impaction. The cause of dilaceration can be either from the trauma of the primary tooth, ectopic development of the tooth germ or from cysts. And it is also found in some cases of Otodental syndrome, Hurler syndrome, Cleidocranial dysostosis. The purpose of this study is to show that periapical lesions caused by dental caries can be another factor in causing dilaceration.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.290-295
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• 2011

During tooth formation, tooth development can be affected by physical action or metabolic changes around dental follicle. Especially trauma to primary dentition is the most representative physical factor that can cause development disorders of succedaneous tooth. Enamel hypoplasia and crown discoloration of succedaneous tooth are common complications of trauma. And impaction, ectopic eruption, arrest of root formation and root dilaceration of succedaneous tooth are rare. In this case, a 6-year and 5-month-old female patient visited for dental evaluation after trauma. She was diagnosed with alveolar bone fracture near upper front teeth, extrusion of the upper right and left primary central incisors, intrusion of the upper right primary lateral incisor, and palatal luxation of the upper left primary lateral incisor. Upper right and left primary central incisors with severe mobility were extracted, with gingival suture on the day of the visit. During 24 months check up, root dilacerations were found near the cemento enamel junction in the upper lateral incisors and arrests of root formation were found on the coronal 1/3 of the root in the upper central incisors. Although alveolar bone fracture is rare type of trauma in children, a thorough examination of alveolar bone is essential for prognosis and following treatment in patients with trauma.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.1
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• pp.91-98
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• 2006

Supernumerary teeth are teeth which result from the continued budding of the enamel organ of the preceding tooth or from excessive proliferation of cells. They are most often found in the maxillary anterior region. And they can be responsible for a variey of irregularities in the primary and transitional dentition. There are two morphological types of supernumerary teeth, supplemental and rudimentary. Supplemental teeth have normal shape and size. In contrast, rudimental teeth have abnormal shape and smaller size. Supplemental supernumerary teeth are most common in permanent lateral incisor area. Its extraction must be decided more carefully with differential diagnosis between normal teeth, because it has normal shape and size. We reports 3 cases of the normal incisor shaped teeth in the maxillary anterior region. In all cases, we used the 3D Dental-CT as well as the conventional plain film such as periapical, occlusal, and panoramic radiograph. Consequently, 3B Dental-CT was valualble to figure out the exact position and morphology of supernumerary teeth, to do more conservative surgery and to reduce surgery stress and time.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.1
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• pp.90-96
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• 2012

Supernumerary tooth occurs most frequently at premaxilla area. Followed by mandibular premolar area, mandibular fourth molar area, maxillary paramolar area. Mesiodens are mainly impacted in the palatal area and surgical approach is made at palatal side. The time of surgery remains controversial. In case of inverted or horizontal impacted supernumerary tooth, intraosseous tooth movement and vertical growth of premaxilla makes surgical extraction more difficult. And also the more quantity of removed bone is, the higher degree of difficulty is. Inverted mesiodens of these cases were impacted superior to apex level of adjacent permanent incisor. Although CT examination revealed exact location of impacted tooth, surgical procedure including ostectomy may take a long time more than expected. So, before surgical extraction, it's need to be considered several factors such as necessity of CT taking, degree of difficulty, direction of surgical approach, necessity of general anesthesia etc.