• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.2
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• pp.72-76
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• 2016

Traumatic dental injury (TDI) is a common problem in children and adolescent. The prevalence of dental trauma among children with disability as compared to healthy children. The TDI of an immature permanent tooth can lead to the loss of pulp vitality and arrested root development. Traditionally, the treatment of choice for necrotic immature tooth is apexification, which is induction of hard tissue barrier at the apex to produce more favorable conditions for conventional root canal filling. This case report describes the treatment of a necrotic immature permanent central incisor with complicated crown fracture. The patient had multiple disabilities (cerebral palsy, congenital heart disease, developmental delay, and gait disturbance) and suffered from She was suffered from repetitive traumatic injury. Apexification and resin restoration was performed under general anesthesia, and favorable clinical results were achieved.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.4
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• pp.616-622
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• 1999

The primary objective of pulp treatment is to maintain the integrity and health of the oral tissues. The most important and difficult aspect of pulp therapy is determining the health of the pulp, or its stage of inflammation, so that a decision can be made regarding the best form of treatment. Immature permanent teeth are good candidates for many pulp healing procedures, due to their rich blood supply, which is believed to enhance the pulp's ability to react successfully to various insults. Healing was considered to have taken place when the tooth fulfilled the following criteria: 1. Abscence of clinical symtoms 2. Radiographic evidence of dentin bridge formation 3. No intrapulpal or periapical pathosis was evident radiographically 4. Continued root development and closure of the apex in immature teeth 5. Normal dentin apposition in mature teeth 6. Positive response to electrical pulp test This presents a report of cases in which immature permanent teeth, pulp-exposed by caries or trauma, was treated successfully by partial pulpotomy.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.305-309
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• 2009

Dens evaginatus is a dental anomaly most commonly seen in premolar teeth in which a tubercle or protuberance projects from either the center of the occlusal surface or the buccal triangular ridge. These tubercles are easily fractured from mastication as the tooth erupts and frequently leads to pulp necrosis as a common complication. To prevent these sequelae, prophylactic treatment soon after the tooth starts erupting is essential. These preventive treatments include, selective grinding and protection of the tubercle by pit and fissure sealant. When the tooth does shows signs of pulp necrosis and apical periodontitis, endodontic procedures are needed. Apexification and apexogenesis are usually the treatment of choice for the affected teeth which have immature apices. Apexogenesis is a vital pulp therapy procedure performed to encourage continued physiological development and formation of the root end. It involves removal of the inflamed pulp and the placement of calcium hydroxide on the remaining healthy pulp tissue. This case report describes an atypical apexogenesis of a mandibular premolar which showed to be a dens evaginatus. The tooth which was treated with calcium hydroxide shows good results and is planned for permanent root canal filling.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.2
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• pp.267-272
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• 2004

This case report describes an uncommon treatment method for crown-root fractured incisor with immature root. A 7-year-old girl was referred for treatment of crown-root fractured maxillary central incisor. The fracture line extended to 1/2 of the total tooth length with incomplete root formation. The prognosis of crown-root fracture is usually poor and extraction is usually undertaken. But, in the mixed dentition, extraction of maxillary permanent incisor results in many complications, such as resorption of alveolar bone, poor esthetics, pronunciation and mastication. Conservative therapy in the permanent dentition comprises of few treatment modalities; supragingival restoration, gingivectomy, orthodontic extraction of apical fragment, surgical extrusion of apical fragment with or without rotational replantation. However, in this case, these indications are not applicable, so intentional replantation with adhesive resin system is the treatment of choice. The tooth was followed-up for 12 months. Currently, there are no symptoms. Since this modality adopts the respective advantages of both intentional replantation and adhesive treatment, it might be the treatment of choice in cases of vertical crown-root fracture.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.3
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• pp.254-263
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• 2016

Many studies on the prognosis of avulsed teeth were published but follow-up studies on Korean children and adolescents are insufficient. The aim of this study was to identify clinical factors determining the healing and prognosis of permanent incisors that were replanted after avulsion injury. This study included 184 permanent teeth in 142 patients aged 6-14 years. The clinical and radiographic data of the patients were analyzed from electronic medical records. Immature teeth had a higher probability of pulp revascularization than mature teeth. When extra-alveolar time was longer than 60 minutes, the incidence of inflammatory root resorption (IRR) was higher in immature teeth than mature teeth. However, the incidence of replacement root resorption (RR) was higher in mature teeth than immature teeth under the same condition. The incidence of IRR was increased when pulp was extirpated more than 20 days after replantation. IRR had a more significant influence on the decrease of survival expectation than RR. There was no significant correlation between the root development stage and survival expectation. However, when RR occurred, immature teeth survived shorter than mature teeth. Long term follow-up results from this study are expected to be used as fundamental data for the treatment guidelines and evaluation of the prognosis of replanted teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.1
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• pp.125-131
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• 2002

When a tooth is fracture with the pulp exposure, and if a fragment is large enough to save, reattachment of the fragment would be a choice of treatment and reattachment of the fragment provides several advantages over other forms of dental restoration following crown fracture. For the purpose of tooth reattachment, it is important to preserve the sound enamel around fracture area. For young patients, tooth reattachment has more advantages in the sense that they recover faster and that it enables other treatments at the same time. Through the continuous advancement in adhesion technology and the effort for aestheticism, various reattachment methods have been practiced and more efforts are considered necessary. The presented cases are that we had practiced in our department in Kyung Hee Medical center, I may address that fragmentation has been successfully done with aesthetically fine results, and no pathologic changes were found in short term follow-ups.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.305-312
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• 2008

Crown-root fractures occur throughout both crown and root, and are defined as fractures involving enamel, dentin and cementum. The fractures may be grouped according to pulpal involvement into complicated and uncomplicated one. Crown-root fractures often occur on maxillary anterior teeth and comprise 5% of injuries affecting the permanent dentition and 2% in the primary dentition. To restore crown-root fractured tooth, biologic width must be maintained. For maintaining biologic width, such methods as gingivectomy following osteoplasty or orthodontic extrusion or surgical extrusion are available. Surgical extrusion is a method that extracts the tooth and replants the fractured tooth supragingivally. It is indicated when the length of the crown fragment is less than half the length of the clinical root. In these cases, root canal treatment and crown restoration using light-cured composite resin were performed after surgical extrusion. In following periodic examinations, favorable outcome was observed.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.1
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• pp.66-72
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• 2012

Autogenous tooth transplantation can be defined as the surgical movement of a tooth from one position in the mouth to another in the same individual. The most common reasons for tooth transplantation include replacement of a missing first molar, transplantation of impacted canines to their normal positions in the arch, and transplantation of premolars in areas of missing teeth, especially in the anterior area of the mouth. The key to successful tooth transplantation is proper selection of graft with adequate root development as well as the design of surgical operation. Root development stage with half to three-quarter-developed roots increase the success rate of autotransplantation. We report the cases of successful autotransplantation which resulted in ideal healing of periodontal ligament, gingiva and alveolar bone. All transplanted teeth presented immature root formation at the moment of the procedure. After surgical procedure, we can observe good healing pattern without endodontic problem.

• The korean journal of orthodontics
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• v.28 no.3 s.68
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• pp.419-429
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• 1998

This study was carried out in order to study early histologic changes and repair reaction appling to extrusive force for 3rd premolar of adult dogs. After 1 week of extrusive force with elastic chain, one of dogs was sacrified and after 3 weeks retention period, another dog was sacrified. The paraffin sections of samples were stained with Hematoxylin - Eosin and Masson's Trichrome and were examed by light microscopy . The obtained results as follows 1. In Hematoxylin - Eosin and Masson Trichrome stain of control group , the periodontal ligament width was constant from apical third to cervical third of the root and periodontal fiber arrangement was horizontal or oblique in cervical third. oblique in middle third, oblique in apical third of root. in alveolar bone, smooth appearance was shown 2. In Group 1, all periodontal fiber arrangement was oblique toward tooth, and the periodontal ligament width increased Partially PDL was ruptured in apex. In MT stain, immature bone formation was seen at alveolar crest area. Active bone formation was observed along the one side of alveolus, and apical portion of pulp was involved with blood vessel rupture , vacuolization of pulp tissue and hyperemia 3. In Group 2, most periodontal ligament arrangement and PDL width was repaired and fiber density increased. In MT stain, mineralization of immature bone on the alveolar crest was progressed. In pulp, vacuole and hyperemia was diminished and fibrotic change was diminished 4. After 3 week periodontal ligament has more repair ability than pulp tissue. pulp was involved with vacuolization and fibrosis, so it takes more time for repair.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.2
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• pp.310-316
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• 1999

In the traumatized teeth, the major complications are pulp necrosis, and root resorption. The factors influencing to prognosis are the state of root development, type of injuries, quality of fixation. There are good prognosis in the case of immature teeth, minor luxation injuries. To minimize of occurrence of these complication, it is very important to determine the pulp vitality. This can help us decide whether or not to treat the teeth endodontically. But, it is difficult to determine of pulp vitality in immature teeth or traumatized teeth. In this case, pulp vitality test was done periodically on the traumatized upper central incisors, and the results were different among cold test, electric pulp test, and laser Doppler flowmetry. The conclusions were obtained from this case can be summarized as follows; 1. Pulp vitality of traumatized teeth should be negative early, but with time going, pulp vitality could be recovered. 2. The positive response of pulp vitality test was detected earlier in laser Doppler flowmetry. 3. Between cold test and electric pulp test, cold test was more reliable in determining pulp vitality.