• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.4
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• pp.399-406
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• 2011

Traumatic injury on tooth occurs frequently among trauma patients, and mainly occurs on tooth with premature roots which influences pulp tissue, periodontal ligament, alveolar bone, and Hertwig's epithelial root sheath. According to the degree of trauma, a number of kinds of healing process can be observed, such as complete re-vascularization of pulp, root canal obliteration, growth suspension of root apex, and invasion of alveolar bone into root canal, and there can be some complications such as necrotic change of inflammatory root resorption and partial pulp necrosis due to pulp necrosis toward complete necrosis. In this clinical case, 3 patients who had traumatic injury showed root growth suspension and alveolar bone invasion into root canal due to proliferation of periodontal ligament cell and osteocyte at the base of extraction socket into pulp chamber because of the injury on Hertwig's epithelial root sheath. If intrusion of alveolar bone into root canal due to injury on Hertwig's epithelial root sheath after having traumatic injury doesn't show any complication, the pulp may be considered to have normal vitality and doesn't need any further treatment, therefore differential diagnosis is very necessary. However, it may be accompanied with suspension of root growth, therefore, additional trauma during the treatment of injured tooth should not be applied.

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

• The Journal of the Korean dental association
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• v.47 no.6
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• pp.364-372
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• 2009

치주 질환으로 인하여 소실된 치주조직을 재생시키려는 여러 술식이 많이 연구되고있다. 그 중 bioactive factor의 적용은 치주조직의 재생에 있어서 우수한 치료법으로 평가되고 있으며, 이를 수용부에 적절히 적용하기 위한 운반체로 생체친화적인 중합체가 이용되고 있다. 본 연구의 목적은 PLGA를 Inorganic filler에 혼합시킨 재료를 성견의 일벽성 골내낭에 적용하여 이 재료의 생체 친화성과 생체 흡수도를 보고자 하는 것이다. 5마리의 비글견에서 제 3 소구치를 모두 발치한 뒤, 8주간의 치유기간이 지나고 제 2 소구치 원심면과 제 4 소구치 근심면에 5mm 깊이, 4mm폭의 일벽성 골내낭을 형성하였다. 좌측 defect에는 PLGA/inorganic filler matrix를 이식하였고 우측에는 아무것도 이식하지 않은 대조군으로 나누어 술 후 8주에 희생하여 치유 결과를 조직학적으로 비교 관찰하였다. 조직학적 분석 결과, 모든 결손부에서 염증의 소견이 관찰되지 않았으며 치근흡수와 유착은 발견되지 않았다. 백악질과 치조골, 치주인대를 포함한 치주조직의 재생에 있어서 대조군, 실험군 간에 조직학적으로 치유양상에 있어 차이를 많이 보이지 않았으며 PLGA/inorganic filler matrix는 8주 내에 완전히 흡수되어 결합조직이나 신생골내에서 그 흔적을 발견할 수 없었다. 이러한 결과는 PLGA/inorganic filler matrix는 생체친화성 및 생체흡수성이 우수한 재료로서 치주 조직의 재생 치료에 있어서 신체활성인자의 scaffold로 사용될 수 있는 가능성을 보여주었다.

• The korean journal of orthodontics
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• v.25 no.1 s.48
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• pp.101-110
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• 1995

The purpose of this study was to observe the tissue response to the orthodontic force applied immediately after buccal horizontal subapical osteotomy of maxilla. Five mongrel cats weighing about 2.5 Kg were used for this experiment. The left upper canine and premolar of each cat served as a experimental side and the right ones as a control side. On the experimental side, a 100gm orthodontic force was applied between the upper canine and premolar immediately after the osteotomy. On the control side, the same orthodontic force was applied without the osteotomy. After 7days, the experimental animals were sacrificed. The results were as follows: 1. In the pressure zones of the experimental group, significant increase of osteoclasts and direct resolution along the alveolar bone surface was observed as compared with those of the control group. 2. In the pressure 2ones of the experimental group, a less extensive hyalinized zone was observed than those of the control group. 3. In the pressure zones of both group, no root resorption was found. 4. Tn the tension zones of the experimental group, new bone deposition increased along the alveolar bone surface as compared with those of the control group. In conclusion, the results suggest the possibility that early orthodontic treatment after orthognathic surgery may have some benefits if the stability of the repositioned segment at surgery is secured.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.3
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• pp.244-247
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• 2001

We report a case in which a right mandibular incisor was impacted beneath an odontoma in the anterior mandible. An odontoma at the symphyseal region was removed under general anesthesia, and bone was grafted. Tooth #41, which was beneath the lesion, was extracted and transplanted to its original site. It was splinted with resin for 2 weeks and was checked at intervals during that time. After 4 months, it was filled endodontically with calcium hydroxide.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.275-280
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• 2009

Radicular cyst is a true epithelium lined cyst formed when epithelium at the apex of a nonvital tooth is stimulated by inflammation. It is the most common type of cyst in the oral cavity, but its frequency is low in the primary dentition. Treatment of large-sized cyst aims at conservation of adjacent structure and allowance of proper eruption of the successive permanent teeth in the primary dentition. Considering these two aspects, marsupialization or enucleation following decompression is recommended as a treatment means for large-sized radicular cyst. In this case, 8-year old boy visited the pediatric dentistry department. Yonsei University Dental Hospital, with the chief complaint of pain on the lower right area. Clinical and radiographic examinations revealed periapical radiolucent lesion on #84, which had previous pulp treatment and restorated with the stainless steel crown. Dislocation of its successive tooth, #44, was also observed. #84 was extracted and sent for biopsy. Through histologic examination, it was diagnosed as radicular cyst. Following its extraction, removable space maintainer was delivered, which was also used as a decompressor. During periodic check-up for next 22 months, favorable healing of the lesion and eruption of the successive tooth were observed.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.2
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• pp.317-322
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• 1999

Dens invaginatus is a developmental anomaly resulting from an invagination of the enamel organ. The incidence is highest with maxillary permanent lateral incisors. The reported occurrence ranges from 0.04 to 10%. This anomaly may involve the pulp and periapical tissues and cause pulpal inflammation, loss of vitality, apical and lateral periodontitis, periapical abscesses and cysts and stimulate internal resorption. Oehlers describes dens invaginatus as occurrence in three forms. In treating type 3 invaginatus, treatment strategy can be determined by considering the complexity and accessibility of invagination. In this case, showing simple invagination, it could be treated by simple endodontic treament confining to invagination without loss of vitality of tooth. After treatment of the present case, the results were as follows: 1. In type 3 dens invagiantus, if the tooth is vital and there is no evidence of communicating between invagination and pulp, we can save the vitality of the tooth and resolve the lesion by endodontic treament confining to the invagination. 2. In the invagination with opened apex, the closure of apex can be induced by apexification procedure doing this, we can avoid the neccessity of surgical intervention.

• 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.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.448-452
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• 2004

Trauma from occlusion(TFO) is injury to the periodontal tissue as a result of occlusal forces. Mobility is a common clinical sign of occlusal trauma. In acute occlusal trauma, this may be accomanied by pain, tenderness to percussion, thermal sensitivity, and pathologic tooth migration. Chronic occlusal trauma may be marked by excessive wear and gingival recession. Radiographic finding include a widened periodontal ligament space, radiolucence and condensation of the alveolar bone and root resorption. TFO is related to the pathogenesis of periodontal disease. It can cause increased tooth mobility TFO itself does not initate or aggravate marginal gingivitis or initiate periodontal pockets. Active trauma can accelerate bone loss, pocket formation and gingival recession depending on the presence of local irritants and inflammation. Gingival recession associated with occlusal forces includes traumatic crescent, McCall's festoon and Stillman's cleft. TFO plays a minor role in the pathogenesis of early to moderate periodontitis. A 5-year-old male visited Yonsei University Pedodontics clinic with a chief complaint about gingival recession. Mobility, excessive wear, gingival recession were detected by clinical exam on the both mandibular deciduous ca nine. On the radiographic view, vertical alveolar bone loss was observed on both mandibular deciduous canine.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.2
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• pp.446-452
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• 1999

Ectopic eruption of the first permanent molar means the first permanent molar assumes an atypical path of eruption resulting in premature atypical resorption of the second primary molar. If the reversible eruption does not occur, early loss of the second primary molars results in space loss, mesial tipping of the first permanent molar, impaction of the second premolar, buccal segment crowding and overeruption of opposing tooth. The main objectives of treatment are (1) to prevent loss of the second deciduous molars so it can continue to serve as a space maintainer and (2) to regain lost arch length, allowing the second premolar to erupt into normal position. The optimal treatment approach depends on a number of factors including the clinical eruption status of /6/, the change in position of /6/, the amount of enamel ledge of /E/ entrapping /6/, the mobility of /E/, and the presence of pain or infection. Unilateral appliance to correct the mesial angulation of ectopic permanent first molars, as in the majority of the appliance designs, would produce a resultant force that would further enhance the space loss. A bilateral support similar to the holding arch design is recommended to maximize the anchorage. These case reports present the successful result of preserving space for the second premolar in treatment of ectopic eruption of the first permanent molar using Halterman appliance with bilateral anchorage on patients visiting department of pediatric dentistry in Samsung Medical Center.