• Journal of the korean academy of Pediatric Dentistry
• /
• v.35 no.4
• /
• pp.750-756
• /
• 2008

Supernumerary teeth are frequently found in the anterior portion of the maxilla and develop as a result of abnormal proliferation of the dental lamina during tooth germ formation, caused by genetic or environmental factors. They may result in various complications, such as eruption interference, displacement, rotation of adjacent teeth, diastema, eruption into the nasal cavity, and development of dentigerous cyst. The optimal time for surgical extraction of supernumerary teeth has been a controversial issue. Someone prefer early surgical extraction because supernumerary teeth can cause eruption interference and displacement of adjacent teeth, eventually altering occlusion. Others prefer to delay surgical extraction until $8{\sim}10$ years of age in consideration of root maturation of the adjacent teeth and also patient's behavior. When surgical extraction of supernumerary teeth is postponed, there is possibility that impacted supernumerary teeth in the inverted or horizontal position move toward the nasal cavity, hard palate, or premolar area. When such intraosseous tooth migration is combined with the vertical growth of the maxilla, surgical approach becomes even harder. Therefore, possibility of intraosseous tooth migration should be considered as an important factor when deciding appropriate time for surgical extraction. We are presenting cases of mesiodens which showed intraosseous migration during $6{\sim}7$ years of follow-up period since the first diagnosis had been made at the $2{\sim}3$ years of age.

• The Journal of the Korean dental association
• /
• v.26 no.10 s.233
• /
• pp.898-902
• /
• 1988

완전히 발육된 하악 제3대구치가 매복되어 있거나 또는 부분적으로 맹출된 상태일때는 임상증상을 일으키기 전에 발치하는 것이 치관주위염이나 이로 인한 합병증 및 치주질환 등을 예방할 수 있느느 가장 좋은 방법이며 이미 임상 증상을 유발한 매복 하악 제 3대구치는 대부분 재발방지를 위하여 발거하게 된다. 성공적인 발치의 기준을 1) 치아의 완전한 발치 2) 인접조직에 대한 최소한의 외과적 손상 3) 술후 합병증의 극소화 4) 가능한한 시술 시간의 단축 등이라 할때 매복 하악제 3대구치의 성공적인 발거를 위하여는 발치의 기본 원칙을 숙지하여야 함은 물론이며 더욱 면밀한 술전 평가와 외과적 발치술 시 필요한 기구의 완비 등이 필수적이라 할 것이다.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.34 no.2
• /
• pp.329-334
• /
• 2007

The infection of primary teeth occurs by caries or trauma. But, if it is not treated on time, the complication may occur such as enamel hypoplasia, discoloration, impaction, displacement and dilaceration of permanent successors. The periapical lesion on primary tooth could displace the permanent successors in any direction. Treatment options of displaced tooth are observation after extracting the primary teeth, surgical exposure orthodontic traction, transplantation and extraction. In these cases, displacement of permanent central incisor caused by the periapical lesion of primary teeth was observed. The spontaneous eruption after extraction of primary teeth was expected considering degree of displacement, development of root and direction of eruption. This case report shows spontaneous eruption of displaced permanent tooth germ was achieved with periodic examination after extraction of primary teeth.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.30 no.3
• /
• pp.495-501
• /
• 2003

Impaction is defined as the cessation of the eruption of the tooth caused by a clinically or radiographically detectable physical barrier in the eruption path or by the ectopic position of tooth germ. Besides the third molars and the maxillary canines, the most common impacted tooth is the second premolar. The overall frequency of premolar impaction has been reported to be 0.5%. In some cases, orthodontic traction and surgical repositioning may be indicated. When impacted second premolar is involved with prolonged retained second primary molar, extraction of primary molar and space maintenance lead to eruption of second premolar. In these cases, all patients visited to department of pediatric dentistry of Kyungpook National University Hospital for the chief complaint of unerupted second premolar. Extraction of prolonged retained second primary molar and space management are tried for spontaneous eruption of impacted second premolar tooth. The results were as follows: 1. When impacted second premolar is involved with prolonged retained second primary molar, minimal treatment via elimination of primary molar leads to successful results. 2. Proper space management and periodic radiographic examination are required before eruption of second premolar. 3. Sufficient time must be allowed for confirm of tooth movement before orthodontic traction or surgical repositioning. 4. The result is more successful in incomplete root development.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.1
• /
• pp.34-40
• /
• 2004

Unerupted maxillary anterior teeth is not a common case, However it may present practitioners with management problem. The cause of impaction is considered to be multifactorial, and local cause is the most common. These impacted teeth require surgical intervention, removal, transplantation, or surgical exposure, with or without orthodontic traction to align the malpositioned tooth. The preferred option is surgical exposure and orthodontic correction. Surgical intervention and orthodontic correction should not be delayed to avoid unnecessary difficulties in aligning the tooth in the arch. Surgical exposure should be performed with the intent of providing sufficient attached gingiva rather than simply uncovering the crown, which results in only alveolar mucosal attachment. Attached gingiva is essential to secure the gingival tissues to the adjacent teeth at the dentogingival junction. Thus preventing loss of periodontal tissues as a result of the pull of the surrounding soft tissues and facial muscles. Labially impacted maxillary anterior teeth uncovered with an apically positioned flap technique have more un- esthetic sequelae than those uncovered with a closed-eruption technique. In the case of severly displaced impacted teeth, autotransplantation ensures preservation of the alveolar bone and will facilitate future placement of an osseointegrated implant once growth has ceased or if ankylosis/resorption of the transplant occurs.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.37 no.1
• /
• pp.109-116
• /
• 2010

Impaction is defined as a cessation of the eruption of a tooth caused by a clinically or radiographically detectable physical barrier in the eruption path or by an ectopic position of the tooth. The reasons for impaction of the maxillary central incisor are supernumerary tooth, odontoma, ectopic position of tooth germ, dilacerated tooth and so force. Impacted tooth cause space loss due to proximal movement of adjacent tooth, malocclusion, root resorption of adjacent tooth, cyst formation, so careful observation and early detection is important and exact treatment should be applied to prevent these results. The treatment options of impacted tooth include induction an eruption through extraction of deciduous tooth or surgical exposure, reposition of impacted tooth by surgical method or orthodontic treatment. Orthodontic traction is recommended when an eruption does not happen after removal of barrier or surgical exposure, when eruption path is too transpositioned to be corrected spontaneously so eruption does not expected. In these cases, traction of impacted maxillary central incisor was carried out using orthodontic method with closed eruption technique and it showed good clinical results so we report these cases.

• Journal of Chest Surgery
• /
• v.43 no.4
• /
• pp.387-393
• /
• 2010

Background: The aims of the present study were to assess and compare mid-term clinical outcomes including recurrences between endovenous laser therapy (EVLT) and stripping. Material and Method: Between January 2007 and February 2010, 318 limbs in 237 patients with saphenous truncal varicosities were treated by laser energy using a 980 nm diode or were treated with conventional stripping. At the initial visit and at 1, 2, 6, 12, 18, 24, and 36 months postoperatively, clinical examination and questioning for Venous Clinical Severity Score (VCSS) as well as duplex ultrasonography were done. In order to compare clinical outcomes between the two treatment groups, EVLT versus stripping, all data were processed and analyzed. Result: There were no significant differences between the two treatment groups in the extent of the reflux and the number of insufficient perforating veins. The in EVLT and the stripping group at 12 months were $90.3{\pm}4.5%$ and $93.9{\pm}4.2%$, respectively (p>0.05). Total recurrence rates were 4.4% in the EVLT group and 1.5% in the stripping group (p>0.05). In both groups, the VCSS scores were significantly reduced at week 1, 1 month, and 2 months after EVLT or stripping (p<0.001). Conclusion: Efficiency in eliminating truncal saphenous vein incompetence and reducing venous clinical severity were equal in the two treatment groups.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.35 no.2
• /
• pp.333-338
• /
• 2008

Supernumerary teeth are characterized by an excess number of teeth, which can be responsible for a variety of irregularities in the primary and transitional dentition. Supernumerary teeth, especially in the maxillary anterior region, may prevent the eruption of adjacent permanent teeth and cause their ectopic eruption, diastema, root resorption, or formation of dentigerous cyst. Therefore, early diagnosis of supernumerary teeth is important for prevention of such complications, and adequate treatment should be given according to their location, number, and morphologic features. In this case, four supernumerary teeth in the maxillary anterior region were disturbing the eruption of adjacent permanent incisors. Two of them were located in proximity to the central incisor tooth germs that their immediate removal may injure the permanent tooth germs. In order to minimize such complications, surgical extraction of the four supernumerary teeth was performed in two stages. At first, only two inverted conical supernumerary teeth were extracted. The other two tuberculous supernumerary teeth, close to the permanent tooth germs, were extracted later after their natural dislocation. In that way, we could minimize affects on the neighboring permanent tooth germs and also the amount of alveolar bone removed during surgery.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.4
• /
• pp.598-604
• /
• 2004

Impaction of mandibular first molar is relatively rare and its overall frequency has been reported to be 0.01%. The etiology of impaction are lack of eruption space, physical obstacles such as supernumerary teeth, odontomas or odontogenic tumors, hereditary factors, functional disturbances of endocrine glands and traumas. Impaction of mandibular first molar can result in a short lower facial height, formation of a follicular cyst, pericoronal inflammation, resorption of the roots of neighboring teeth and malocclusion. The treatment options available for impacted teeth include surgical exposure, orthodontic forced eruption, surgical repositioning and surgical removal of unerupted molar. This report presents two cases of distally tilted and impacted mandibular first molars which were treated by surgical exposure. In these cases, we could observe spontaneous eruption of the impacted mandibular first molars after surgical exposure.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.35 no.2
• /
• pp.268-277
• /
• 2008

Authors evaluated 1171 patients at the department of Pediatric Dentistry in Kyoungpook National University Hospital through clinical records and radiographs. And the following features were studied ; age, sex distribution, number of mesiodens per patients, cause of discovery of mesiodens, location, status of eruption, shape and orientation of crown, complication, dental age of adjacent upper incisor tooth at the time of surgical extraction of mesiodens and the relationship between the resolution rate of complication after extraction of mesiodens and the dental age of adjacent upper incisor tooth, length of diastema, the eruption status of lateral incisor and the crowding status of premaxilla. The followings are the results : 1. The cause of discovery of mesiodens were as follows ; delayed eruption of the permanent incisors in 13.8%, midline diastema in 11.6%, radiographs taken for other reasons in 23.4% and for caries treatment in 15.1%. 2. Complication due to the presence of mesiodens did not occur in 36.8%, delayed eruption of adjacent teeth was observed in 16.1%, midline diastema in 34.4%, rotation in 8.8%, displacement in 2.4%, and crowding in 1.0% of all evaluated patients. 3. As for the dental age of adjacent upper incisor tooth at the time of surgical extraction of mesiodens, below 1/3 of total root length were observed in 3.5%, $1/3{\sim}1/2$ of total root length in 19.9%, $1/2{\sim}2/3$ of total root length in 54.7% and over 2/3 in 21.9% of all evaluated patients. 4. Resolution rate of delayed eruption after the extraction of mesiodens was significant higher in the group with the root length below 1/2. Resolution rate of midline diastema was significant higher in the group with diastema width below 3mm and with non-crowding of adjacent upper incisor teeth.