• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.4
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• pp.524-534
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• 2000

Deciduous teeth can be extracted for two reasons, one due to the physiologic resorption and the other by the inflammation at the apex after traumatic injury. Physiologic resorption may be different from pathologic resorption in timing and mechanism. Therefore we resumed the different features of physiologic and pathologic resorption root surfaces. Many previous studies showed micromorphology of resorbed surface of roots of deciduous teeth. But, few studies compared physiological and pathological root resorption surfaces. In this study, we carefully observed microscopic morphologies of those two different root surfaces by scanning electron microscope and histologic features by light microscope. The resultant differences between physiologic and pathologic resorption surfaces of deciduous teeth were as follows: 1. The morphology of pathologic resorption lacunae due to inflammation varied in size and shape with irregular boundaries compared with the physiologic areas from scanning electron microscope observations. 2. From light microscope observations, several large resorption fossae containing numerous resorption lacunae were found, whereas the resorption lacunae were irregular in shape with pathologic resorption surface. 3. Numerous multinucleated giant cells were closely attached to the physiologic resorption lacunae, whereas several kinds of mesenchymal cells with numerous inflammatory cells were found in the areas adjacent to the pathologic resorption surface. 4. Light microscope findings showed that compensating cementum formation took place along some of the areas of inflammatory dentinal resorption. In conclusion, several morphological differences were present between physiologic and pathologic root resorption surfaces of human deciduous teeth. The future studies should include cytochemistry to clarify the cellular roles in resorption process observations of pulpal surfaces of coronal and radicular dentin to and the changes that occur in each phase of human deciduous tooth resorption.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.3
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• pp.289-297
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• 2017

Local and general factors have been attributed to root resorption occurred by injuries such as trauma and dental caries that affect periodontal ligament or dental pulp tissue. Pathologic root resorption is different from physiologic root resorption in terms of resorption pattern such as micromorphology of resorption fossae and types of observed cells. Microscopic morphologies and histologic features of physiologic and pathologic root resorption surface of maxillary primary central incisors resulting from trauma and periapical inflammation were observed by scanning electron microscope and light microscope. The morphology of physiologic resorption lacunae was small and oval or circular shape with regularities. The morphology of pathologic resorption lacunae was large and polygonal shape with irregularities compared with the physiologic resorption lacunae. Multinucleated giant cells and mononuclear cells were closely attached to the physiologic and pathologic resorption lacunae, whereas several kinds of mesenchymal cells with numerous inflammatory cells were found in the areas adjacent to the pathologic resorption surface. Compensating cementum formation took place along some of the areas of physiologic and pathologic resorption area resulting from trauma, but could not be observed on pathologic resorption area resulting from periapical inflammation.

• Proceedings of the KACD Conference
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• 2003.05a
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• pp.291-291
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• 2003

손상에 의한 치근 흡수는 표면 흡수(surface resorption), 염증성 흡수(inflammatory resorption) 및 대치성 치근 흡수(replacement resorption)가 있는데 치근 흡수의 정도는 탈구와 재식 사이의 시간, 치주 인대의 손상 정도, 탈구된 치아의 보관 조건 및 치아 발육 정도 등에 영향을 받는다.(중략)

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.2
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• pp.192-203
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• 2007

This study histologically assessed the effect of topical alendronate application on periodontal healing in replanted teeth in fifty four SD Rats. Upper first molars in rat were extracted and replanted after dried during 15 minutes or 60 minutes in the air. In Group I, all teeth were replanted after 15 minutes of dry storage without any other treatment. In Group II and III, the pulps were removed and all teeth were replanted after soaking 10 min in Hank's balanced salt solution with/without alendronate, followed by 60 minutes of dry storage. the rats were sacrificed after 7, 15 and 30 days. The histological parameters studied were healed PDL, surface inflammatory and replacement resorption, and inflammatory severity. The following conclusions could be drawn from the present investigation. 1. Group I showed lower inflammatory root resorption and inflammation severity rate, compared to Group II and Group III. In Group I there showed effective for reattachment and regeneration of PDL. 2. In Group II, inflammatory root resorption were more severe and faster than other groups. There were extensive root resorption in the rats sacrificed after 30 days. 3 In Group III, there were localized inflammatory resorption in several areas, but extensive resorption did not occur Group III showed increase in root resorption rate, compared to Group I. However this difference was not statistically significant. 4. There were no difference between sacrificed days in replacement root resorption in all groups.

• 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.35 no.4
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• pp.607-618
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• 2008

This study three-dimensionally and histologically assessed the effect of Emdogain$^{(R)}$ on periodontal healing in replanted teeth in three beagle dogs which were 1 to 2 years old, weighing from 10 to 13 ㎏. Twelve maxillary and mandibular incisors were intentionally extracted and replanted after 15(Group I), 30(Group II) and 60(Group III) minutes of air dry storage with and without the application of Emdogain$^{(R)}$. The following conclusions could be drawn from the present investigation. 1. Increased incidence of inflammatory healing response in periodontal tissue was proportional to air dry time in Both control and experimental group(P<0.001). 2. Treatment Group showed lower inflammatory root resorption, especially there were statically significant in Group I, III(P<0.001, Group II : P=0.093). 3. Inflammatory root resorption were mainly occurred in apical third(14, 15-16 section)(P<0.05, 0.001), and cervical third(1 section)(P<0.05). 4. In view of horizontal section of long tooth axis, Main root resorption area were 1, 4, 5 line area(bucco-lingual area)(p<0.01).

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.1
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• pp.96-102
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• 1999

Tooth avusion implies total displacement of teeth out of its socket. Its frequency range from 0.5 to 16% of traumatic injuries. Replantation procedure is used for the treatment of avulsed tooth. However, its major complications are pulp necrosis, inflammatory root resorption and replacement root resorption. This paper describes 10 years and 2 months old male patient whose both maxillary central incisors were avulsed due to fall-down with slightly underdeveloped root apices. Teeth were replanted 2 hours after accident. Right central incisor's pulp tissues were extirpated and filled with $Vitapex^{(R)}$(calcium hydroxide) at 3-4 weeks after replantation, but left central incisor was filled at 8-9 weeks. Right central incisor showed little inflammatory resorption in apical portion, whereas left central incisor showed severe root resorption. During 18 months' follow-up period, left central incisor showed slightly ankylosis while right central incisor did not. Based upon the above-mentioned results, the following conclusions can be drawn: 1. Inflammatory resorption could be suppressed by endodontic treatment with calcium hydroxide. 2. When apex formation is doubted in replanted tooth due to avulsion, early endodontic treatment with calcium hydroxide seems to act positively for better prognosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.4
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• pp.640-646
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• 2009

In case of luxation injuries, loss of tooth vitality is common. And in case of trauma in the immature permanent teeth, precise diagnosis of pulp necrosis is very difficult. That is because limitation in distinguishing between normal dental papilla in immature permanent teeth, transient apical breakdown(TAB), which is part of normal healing process, and apical radiolucency in pulp necrosis. Especially in non-vital immature permanent tooth, the treatment is complex and requires long time. This clinical case report shows that severely infected immature teeth with periradicular periodontitis can undergo healing and apexogenesis or maturogenesis with no definative treatment or after conservative treatment. In the cases reported, we emphasize the considerable power of regeneration of the tooth, probably due to its large number of undifferentiated mesenchymal cells in the dental papilla, pulp tissue, periodontal ligament tissues. Thus, when endodontic treatment in immature permanent teeth, over instrumentation is not recommend for preserve the apical vital stem cells.

• Restorative Dentistry and Endodontics
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• v.36 no.1
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• pp.12-18
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• 2011

Objectives: This retrospective study evaluated the therapeutic effects of the intentional replantation (IR) procedure performed on the maxillary and mandibular molars of 35 patients. Materials and Methods: For the subjects, IR was performed due to difficulties in anatomically accessing the lesions and/or close proximity to the thick cortical bone, inferior alveolar nerve, or maxillary sinus, which rendered the ordinary periradicular surgery impossible. The patients'progress was followed for a year and up to 2 years and 4 months. The success of the procedure was evaluated in terms of clinical and radiographic success (%). Results: The results revealed the following: (a) 1 case (3%) of failed tooth extraction during IR; (b) 2 cases (6%) of extraction due to periodontal diseases and inflammatory root resorption; (c) 3 cases (9%) of normally functioning teeth in the oral cavity with minor mobility and apical root resorption, and; (d) 29 cases (82%) of normally functioning teeth without obvious problems. Conclusions: IR was confirmed to be a reliably repeatable, predictable treatment option for those who cannot receive conventional periradicular surgery because of anatomic limitations or patient factors.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.344-350
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• 2000

Incidence of crown-root fracture due to traumatic injury, have been reported 3% in the permanent dentiton, 2% in the deciduous dentition. There are two treatment methods for crown-root fractured teeth with pulp exposure, when the fracture line was located under the alveolar crest. One way is the extrusion by orthodontic force the other way is intra-alveolar transplantation which occlusally repositioning of apical fragment in the alveolar socket. Since intra-alveolar transplantation has introduced in 1970s, it was practiced as alternative to orthodontic extrusion. As the result, this method may thoughted that had a good prognosis. As a result of trauma, completely crown-root fracture was occured in the maxillary right central incisor in this case. We couldn't reposition the deepest fracture line above the alveolar crest by the conventional surgical extrusion, because apical fragment was too short. Thus, after extraction of apical fragment, we repositioned it to the socket following demineralized freezed dried bone graft, which possible to support the apical fragment. At the 15-month recall examination, the root still showed normal mobility and there was not observed any in flammatory or replacement root resorption in the periapical radiograph.