• Restorative Dentistry and Endodontics
• /
• v.26 no.5
• /
• pp.443-446
• /
• 2001

급격한 치아외상은 치아 경조직에 손상을 주기도 하지만 치수와 치주조직에도 손상을 입힌다. 탈구(luxation)의 경우, 외상에 의해 치근단공 부위에서 신경혈관계의 파괴가 초래되지만 치근파절의 경우에는 파절전 부위에서 이와 유사한 손상이 나타난다. 그러므로 치근파절을 파절선 상부의 치관부에 대한 일종의 탈구로 보기도 한다. 본 증례보고는 외상에 의한 치근파절의 두 가지 치유양상을 비교한 것으로, 한 증례는 특정한 치과적 처치없이 스스로 치유된 경우이고 다른 한 증례는 치아고정 및 근관치료를 포함한 치과치료후에 치유된 경우이다. 수평치근파절의 치유에는 여러 가지 요인이 관여하지만 특히 치아동요도 및 치수생활력이 큰 영향을 미친다. 본 증례에서와 같이 치아의 동요도가 있는 경우에는 고정을 통해서 치유를 촉진하고 치수의 괴사가 초래된 경우에는 근관치료를 포함한 적절한 치과치료를 통해서 치유가 일어날 수 있다. 따라서 치근이 파절된 경우에는 장기간의 관찰을 통해 파절부 치유 및 치수손상 여부를 관찰, 진단하고 그에 따른 적절한 처치를 시행해야 할 것이다.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.1
• /
• pp.92-97
• /
• 2004

Traumatic injuries in the young peranent dentition are common, but root fractures, defined as fractures in volving dentin, cementum and pulp, are relatively uncommon. Case 1 is a 9-year-old boy who had a horizontal root fracture of his maxillary right central incisor in the apical third. Root canal therapy was performed in coronal segment and calcium hydroxide therapy was initiated. Six months after treatment, a periapical radiograph showed calcific tissue formation and normal root development. 1 year and 3 months later, the canal was permanently obturated with gutta-percha. Case 2 is a 7-year-old girl who had a vertical root fracture of her maxillary right central incisor. Fractured tooth was intentionally extracted atraumatically, and then the separated fragments are bonded with resin cement. the restored tooth was replanted into the original socket. Recalls up to 8 months showed normal mobility and no periapical pathosis. In these cases, we performed conservative treatment. Clinical and radiographic examination showed no pathosis or abnormality of the teeth and periodontal tissue.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.30 no.3
• /
• pp.465-470
• /
• 2003

Transverse and oblique crown-root fractures constitute a major therapeutic problem, particularly in young dentitions. Because crown-root fracture may involve enamel, dentin, pulp, and periodontal tissues, management of the injuries must be modified accordingly. When the fracture line was located under the alveolar crest. there are several methods for crown-root fractured teeth with pulp exposure, such as extruding the root fragment with orthodontic force and restoring it, or intentionally extracting the tooth and replanting it to a position which it can be restored. This case, the fractured tooth is intentionally extracted atraumatically, and replanted by rotating approximately 180 degree into the original socket and fixing with an orthodontic wire. At the 8-month recall examination, the root still showed normal mobility and there was not observed any inflammatory or replacement root resorption in the periapical radiograph.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.43 no.2
• /
• pp.200-206
• /
• 2016

Root fracture is defined as a fracture involving the dentin, cementum, and pulp. Most fractures occur in the maxillary anterior teeth between the ages of 11 and 20 years old. The treatment for root fracture in permanent teeth involves the reduction and fixation of the displaced coronal segment. When signs of pulp necrosis or inflammatory root resorption are present, root canal therapy should be performed. Since most apical fragments maintain pulp vitality, root canal therapy is typically limited to coronal fragments. However, it's too difficult to achieve a proper apical stop on coronal fragment. Intentional replantation involves performing root apex treatment outside the mouth after intentional extraction of the tooth in a controlled environment and then replanting it. The objective is 'perfect' root canal therapy. Intentional replantation may be used in cases of failed typical root canal therapy, problematic endodontic retreatment due to the existing restoration or a calcified root canal, and when apical surgery is contraindicated because of a lack of reasonable approaches. In this case, intentional replantation was carried out to treat a horizontal root fracture in a maxillary central incisor with a calcified root canal due to previous trauma. We achieved a clinically and functionally satisfactory result.

• Restorative Dentistry and Endodontics
• /
• v.34 no.5
• /
• pp.383-389
• /
• 2009

The purpose of this study was to investigate the fracture resistance of crown-root fractured teeth repaired with dual-cured composite resin and horizontal posts. 48 extracted human premolars were assigned to control group and three experimental groups. Complete crown-root fractures were experimentally induced in all control and experimental teeth. In the control group. the teeth (n=12) were bonded with resin cement and endodontically treated. Thereafter, the access cavities were sealed with dual-cured composite resin. In composite resin core-post group (n=12), the teeth were endodontically treated and access cavities were sealed with dual-cured composite resin. In addition, the fractured segments in this group were fixed using horizontal posts. In composite resin core group (n=12), the teeth were endodontically treated and the access cavities were filled with dual-cured composite resin without horizontal posts. In bonded amalgam group (n = 12), the teeth were endodontically treated and the access cavities were sealed with bonded amalgam. Experimental complete crown-root fractures were induced again on repaired control and experimental teeth. The ratio of fracture resistance to original fracture resistance was analyzed with Kruskal-Wallis test. The results showed that teeth in control and composite resin core-post group showed significantly higher resistance to re-fracture than those in amalgam core group (p < 0.05). The resistance to refracture was high in the order of composite resin - post group, control group, composite resin group and bonded amalgam group. Within the scope of this study, the use of horizontal post could be beneficial in increasing the fracture resistance of previously fractured teeth.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.39 no.4
• /
• pp.267-275
• /
• 2023

To obtain better esthetic results when immediately placing a dental implant, the soft tissue surrounding the implant must be conditioned during healing of the extraction socket. To this end, the emergence profile can be customized through immediate restoration of the provisional prosthesis, and good clinical results can be obtained at the time of definitive restoration in the future, resulting in high patient satisfaction. In this case, horizontal root fracture occurred after trauma to both maxillary central incisors. Immediate implant placement and loading was planned considering aesthetics and alveolar bone condition. By taking an impression using a digital intraoral scanner, a digital diagnostic wax-up was performed to make a more aesthetic prosthesis without applying external force to the traumatized teeth. Based on this, the ideal placement location was determined and immediate implant placement was performed using a 3D printed surgical guide. The provisional prosthesis was restored 5 days after placement, and the definitive zirconia crown was restored through soft tissue conditioning and customization using the shape of the provisional prosthesis for 3 months.