• Korean Journal of Cleft Lip And Palate
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• v.3 no.1
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• pp.1-9
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• 2000

목적 : 치조파열 환자에 있어서 이차 치조골 이식술을 시행한 후 그 결과를 알아보고자 방사선학적 분석을 통하여 평가하였다. 본 연구의 목적은 수술전 골결손부 인접치아의 치조정 높이와 수술후 골결손부 인접치아의 치조정 높이를 근심측과 원심측에서 각각 측정함으로써 치조정의 높이가 과연 통계적으로 유의성 있게 증가하는지와 치조골 이식술의 성공률이 치조열의 너비와 상관관계가 있는지의 여부를 알아보는 것이다. 환자 및 방법 : 1991년부터 1999년까지 서울대학교병원 구강악안면외과에서 자가장골 채취 후 분쇄피질망사골 형태 또는 block 피질망상골 형태로 이식한 편측성 치조열을 가진 환자 중 최소한 6개월이 경과한 환자 56명을 연구대상으로 하였고 두 술자에 의해 시술되었다. 수술전 골결손부 인접치아의 치조정의 높이와 치조열의 너비 및 수술후 이식한 골의 높이와 절흔의 양은 치과용 파노라마 방사선 사진을 이용하여 측정하였고, 치조열의 너비는 모델이나 환자의 골결손부 근심치아의 근원심 폭경을 이용하여 환산하였다. 그리고 이식한 골의 높이와 절흔의 양을 1995년 Long이 제시한 방법으로 측정하여 술전의 측정치와 비교하였다. 결과 : 치조열의 너비는 평균 6.9mm(1.9mm-12.1mm) 였다. 근심에서의 치아는 골이식 당시 중절치가 52개(92.9%), 측절치가 4개(7.1%)였고, 49명의 환자에서 완전맹출을, 6명의 환자에서 부분맹출(측절치 2개, 중절치 4개)을 보였다. 원심측에서의 치아는 골이식 당시 측절치가 25개(44.6%), 견치가 29개(51.8%), 소구치가 2개(3.6%)였고, 완전 맹출이 32.1%, 부분 맹출이 57.2%, 미맹출이 10.7%로서 완전히 맹출하기 전에 골이식한 경우가 67.9%였다. 모든 환자에 있어서 bony bridge가 나타났고, 절흔이 인접치 아래로 연장되지 않았으며, 치조골 이식술 후 oronasal fistula를 보인 환자는 한 명도 없었으므로 성공률은 100%였다. 술후 근심측에서의 치조정의 높이는 근심측 치아 치근길이의 79%(평균), 원심측에서의 치조정의 높이는 원심측 치아 치근길이의 87%(평균)로서 통계적으로 유의성 있게 증가하였다. 결론: 이차 치조골 이식술을 시행한 후 치조정의 높이는 골결손부 근심측과 원심측에서 모두 유의성있게 증가하였고, 근심측에서보다 원심측에서 통계학적으로 더 유의성 있게 증가하였다. 치조열의 너비와 절흔의 양, 치조정의 높이 및 치조골이식 성공률과는 유의성 있는 관련성이 없었다.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.1
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• pp.26-32
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• 2005

A tooth impaction means a state that a tooth does not erupt out of oral mucosa or alveolar bone for many reasons. The reasons for an impaction of the Maxillary central incisor are an odontoma, supernumerary tooth, space loss, prolonged remaining or early loss of a preceding deciduous tooth, abnormalities of crown or root caused by trauma of a deciduous tooth and an ectopic position of a tooth germ. In the case of the impacted maxillary incisor, a rapid mesial movement of a lateral incisor leads a space loss and a midline deviation can be happened. Furthermore, it can cause a cyst. When we treated a patient with an impacted central incisor early, we could see a better prognosis. It means an early diagnosis and an exact treatment are very important. Generally if the impaction is not severe or it is caused by a keratinized covering tissue, a surgical exposure can induce an eruption easily but an orthodontic force is recommended when an eruption does not happen after a surgical method, when the eruption path is too transpositioned to be corrected spontaneously and when an impacted tooth is located so deeply. In the treatment using an orthodontic force, careful considerations about a root length, pulp, and a periodontal tissue can improve the periodontal and esthetic prognosis for the long follow-up results. This case is using an orthodontic traction following a periodic observation and in no expectation of spontaneous eruption. After treatment of this case, I have got some knowledges, so I report this case.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.1
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• pp.101-108
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• 2005

Children are in mixed dentition during 6 years after 3 years old. this time is very important for sound permanent dentition. There are many factors of influence to tooth eruption stage ; adjacent teeth, tooth resorption, early loss or retention of deciduous tooth, local lesion, lip and tongue, masticatory muscles, ect. These factors should be in balance, if not, relation of adjacent teeth is changed, then severe malocclusion is occurred maybe. These cases revealed influences of resin bonded metal splint on occlusal surface of children's molar to mixed dentition. Splints interfere with falling off of deciduous tooth, tooth eruption, normal occlusion formation, and development of mixed dentition and occlusion. Therefore we removed the metal splint from teeth, follow-up checked occlusion and tooth eruption.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.303-308
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• 2011

Tooth impaction refers to situations in which the eruption is inhibited by some physical barriers in eruptive path and the tooth remains unerupted beyond the normal time of eruption. The etiology of impacted tooth is controversial, but ankylosis has been suggested probably as a leading role. Impacted primary molars may cause several problems such as space loss, tipping of adjacent teeth, supra-eruption of the antagonists, dislocation of succeeding premolar, cystic change and infection. As one of conventional treatments of impacted primary molars, early tooth extraction or surgical extraction following space regaining when there is space loss has been suggested. However, when they are in normal formation and not ankylosed, orthodontic traction following surgical exposure can be the choice of treatment. In this case, a 3-year-old boy was referred to the department of pediatric dentistry for the unerupted mandibular right second primary molar. After surgical removal of gingiva on the occlusal surface, orthodontic traction was performed. After treatment, we could get normal alignment of primary teeth and the opportunity for normal development of permanent teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.262-269
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• 2011

Ameloblastic fibroma is rare true benign mixed odontogenic tumor. Most of these tumors occur in the posterior region of the mandible under 20 years of age. It develops generally associated with unerupted tooth and grows slowly on the surface of alveolar bone, therefore interferes normal tooth eruption. These lesions rarely showing a little bony expansion, are usually asymptomatic and are discovered incidentally on routine dental exam. It is similar to amleoblastic fibroodontoma and ameloblastic fibrodentinoma clinically and roentgenographically but represents no dental hard tissue formation histologically. Enucleation and curettage of surrounding bone are generally recommended options for treatment. Even though there are some reports of recurrence and malignant transformation and more aggressive treatment options like block resection are suggested sometimes, but in most cases, recurrence is unusual because it is well encapsulated and easily separated from adjucent bony socket. In these cases, we did conservative treatment such as enucleation and curettage to the patients who were visited for ameloblastic fibroma associated with delayed eruption of lower first molar. After regular check-ups, we found relatively natural eruption process of combined teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.3
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• pp.456-463
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• 2009

Cleidocranial dysplasia(CCD) is a congenital disorder of skeletal and dental abnormality, which is a mesodermal dysfunction influencing many tisssues and organs. Skeletal abnormalities in CCD are delayed closure of cranial suture and fontanelle, presence of wormian bone and clavicle aplasia. CCD also has an effect on long bones, phalanges, spine, pelvis, muscles, and central nervous system. Dental manifestations include retention of deciduous teeth, multiple supernumerary teeth, delayed eruption or impaction of permanent teeth and formation of cysts around nonerupted teeth. However, due to lack of any substansive medical or physical disability, diagnosis is often late, thereby causing masticatory and psychological problems caused by delayed eruption of permanent teeth after exfoliation of deciduous teeth. For this reason, CCD requires early diagnosis, and the patient's appearance must be improved. Also, provision for a functional masticatiory mechanism by treatment of surgical removal of supernumerary teeth followed by orthodontic eruption of the natural permanent teeth at an adequate time is necessary.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.383-390
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• 2001

It is a relatively common clinical experience to see a impacted maxillary central incisor Most often, the central incisor is impacted labially. The labial impaction has been indicated as the most difficult to manage. The labial impactions have been found to be associated with mucogingival recession, reduced attached gingiva and periodontal pockets. For the successful treatment, clinicians should avoid loss of attached gingiva in surgical exposure. The most common methods of uncovering labially impacted maxillary anterior teeth are gingivectomy, apically positioned flap and closed eruption technique. If gingivectomy will not leave enough attached gingiva, then an apically positioned flap may be the treatment of choice. If the tooth is impacted in the middle of the alveolus or high in the vestibule near the nasal spine, the closed eruption technique may be the treatment of choice. Closed eruption technique was used in one case, apically positioned flap was used in two case. As the result in two cases of impacted maxillary central incisor, apically positioned flap provide the adequate width of attached gingiva. In case of impacted maxillary central incisor, through the clinical and radiologic examination to select correct surgical operation for reduce the complications.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.4
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• pp.390-396
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• 2012

Infraocclusion is defined as tooth whose relative occlusal movement was blocked during the period of active eruption due to ankylosis and so on. Then infraoccluded tooth remains under the occlusal plane composed by adjacent structures showing normal eruption patterns. Untreated infraocclusion may cause: prolonged retention of infraoccluded teeth; extrusion of apposed teeth; destruction of periodontal tissues by occlusal force and food packing; increased sensitivity for dental caries; and disturbances on eruption pathway of succedaneous teeth. Therefore, periodic check-ups and proper treatments are required. There are many treatment options on infraoccluded deciduous molars such as periodic observation, conservative method, restoration and space regaining with extraction of the teeth. The choice of treatment may depend on the presence of succedaneous teeth, time of diagnosis and degree of infraocclusion. In this case report, three patients showing displacement of the second premolars due to infraocclusion of upper second primary molars, were treated by means of space regaining with removable orthodontic appliances and extraction of ankylosed primary molars. All malpositioned permanent premolars in the 3 cases showed ordinary eruption pathways after treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.3
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• pp.550-556
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• 2005

Tooth impaction is defined as a cessation of the eruption of a tooth at the level of the oral mucosa or alveolar bone by any causes. Any tooth in the dental arch can be impacted, but the teeth frequently involved in a descending order are the mandibular and maxillary third molars, the maxillary canines, the mandibular and maxillary second premolars, and the maxillary central incisors. In these teeth, impaction of maxillary incisor occurs in about 0.1-0.5% and major causes are trauma, supernumerary teeth and periapical inflammation of primary maxillary incisor. Delayed eruption of a maxillary central incisor results in midline shift, the space's being occupied by an adjacent tooth and different levels of alveolar height. Treatment options are observation, surgical intervention, surgical exposure and orthodontic traction, transplantation and extraction. These cases were about the patients with delayed eruption of maxillary central incisor. We surgically exposed impacted tooth and guided it into normal position by the orthodontic traction. At the completion of traction, the maxillary central incisor was positoned fairly within the arch and complications such as root resorption were not observed.

• 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.