• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.480-487
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• 2001

In children and adolescents, oral and maxillofacial trauma is one of the most common causes of dental and periodontal damage, which often induces crown fracture of the permanent anterior teeth. Frequently, these traumatized teeth lose their vitality, and require routine endodontic treatment if their root apices are closed. However if their apices are not fully closed, further root formation should be promoted by apexification or apexogenesis. Calcium hydroxide is a biocompatible & bacteriostatic material, and is widely used for apexification. However it has several disadvantages which include the need for multiple visits and patient cooperation, low strength and technical sensitivity in a broad apex. In one-visit apexification using IRM or SuperEBA, patient's visits can be minimized. However, their biocompatibility is questionable. Mineral trioxide aggregate(MTA) is a relatively new material. It is considered biocompatible with periapical hard tissue and has good marginal sealing ability. MTA is also known to help facillitate the growth of the cementum around it. In this case report, apexification with MTA was attempted on traumatized maxillary central incisors with immature root apices, and favorable clinical results were achieved.

• Proceedings of the Korea Contents Association Conference
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• 2016.05a
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• pp.373-374
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• 2016

본 연구는 외상으로 인해 치수괴사가 나타난 미성숙 영구전치에서 한국에서 새롭게 개발된 MTA를 이용한 치근단형성술을 시행한 후 비교적 장기간 그 예후를 살펴본 결과를 보고하고자 한다.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.17-24
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• 2011

The aim of this study was to assess the outcome of MTA apexification in young permanent anterior teeth. Among the patients with the traumatized permanent incisors which were treated with MTA apexification, the dental records and radiographs were examined only for the patient who had follow-up examination at least 3 months after the treatment. Forty nine patients with 64 teeth were included in this study. Demographic information, location and type of teeth and periodontal injury, pre-treatment periapical lesion, clinical symptoms, status of MTA filling, healing of apical lesion and apical barrier formation after treatment were investigated. The outcome based on clinical and radiographic criteria were assessed. The results were as follows 1. Of 64 immature permanent incisors with MTA apexification, the clinical and radiographic success rates were 89.1% and 73.4%, respectively. 2. The maxillary incisors showed significantly higher success rates than the mandibular incisors. 3. There was no statistically significant difference in success rates among the teeth with different types of teeth and periodontal injury. 4. The status of MTA filling did not influence the clinical and radiographic success.

• Journal of dental hygiene science
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• v.16 no.4
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• pp.317-322
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• 2016

Mineral trioxide aggregate (MTA) is widely used in endodontic therapy as a pulp-capping material, root or furcal perforation repair material, and for apexification and obturation of the root canal system. The purpose of this study was to formally document cases of MTA application in South Korean children and adolescents. Through this research, the practice of using MTA will be introduced and familiarized to the clinical practitioners. This study involved endodontic treatment using MTA for fractured crowns in 11- and 12-year-old. The children were followed up for 12 months until the pulp vitality was confirmed; in young permanent teeth with immature roots, the pulp is integral to the process of apexogenesis. These observational results regarding the use of MTA as an apexification material in non-vital immature permanent incisors appear to provide promising results in the search for new materials to meet existing endodontic needs.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.1
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• pp.110-115
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• 2003

Dens evaginatus is an anomalous tooth development arising during morphodifferentiation. It is most often reported in premolar, and familial occurrence has been reported. The primary dental complication of dens evaginatus is fracture or wear of the tubercle which leads to pulp exposure, pulpal necrosis and periapical infection. Pathosis of the pulp can occur before complete root formation with cessation of root development. A rational and conservative approach to the management of dens evaginatus in vital teeth includes early diagnosis and treatment to prevent fracture or attrition of the tubercle. This treatment would include careful sequential grinding, pulp capping, preventive resin restoration. When presented with a case of dens evaginatus in a nonvital tooth with incomplete root development, the treatment of choice has been extraction, apexification. We report two cases of dens evaginatus that appear in two sisters. In the elder, a periapical lesion on radiographs is shown, and it is treated by calcium hydroxide apexification. The other sister is early recognized of dens evaginatus, it is treated using glass ionomer cement reinforcing with sequential grinding.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.4
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• pp.700-708
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• 2001

Traumatic injuries in young patients can result in the interruption of the development of the incompletely formed roots. In teeth with incomplete root-end formation and necrotic pulps, the root canals must be completely debrided. Because of a lack of an apical stop and the presence of thin and fragile walls in these teeth, it is imperative to perform apexification to obtain an adequate apical seal. Calcium hydroxide has become the material of choice for apexification. Despite its popularity for the apexification procedure, calcium hydroxide therapy has some inherent disadvantages that include variablility of treatment time, unpredictability of apical closure, difficulty in patient follow-up, and delayed treatment. An alternative treatment to long-term apexification procedure is the use of an artificial apical barrier that allows immediate obturation of the canal. MTA(Mineral Trioxide Aggregate) is a powder consisting of fine hydrophilic particles of tricalcium silicate, tricalcium aluminate, tricalcium oxide and silicate oxide. MTA has a pH of 12.5 after setting, similar to calcium hydroxide. This may impart some antimicrobial properties. MTA has low solubility and a radiopacity slightly eater than that of dentin. Also, MTA leaked significantly less than other materials and induced hard-tissue formation more than other materials.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.4
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• pp.397-403
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• 2012

The vitality of immature tooth could be lost by dental caries, trauma and fracture of malformed tooth. The vitality loss might lead to halt of the development of the root. The recommended endodontic treatment for a non-vital immature permanent tooth is apexification. Apexification is a method of inducing apical closure through the formation of mineralized tissue in the apical pulp region. Calcium hydroxide is the material of choice for apexification. Long-term exposure to calcium hydroxide may form the apical hard tissue, but weaken the dentin due to its alkaline nature and thus make the roots more susceptible to fracture. It is important to preserve any weakened tooth, so a permanent restoration is needed to reinforce teeth that are prone to fracture. The purpose of this case report was to describe the treatment for reinforcing immature teeth treated with long-term calcium hydroxide. In these cases, the apexes of teeth were sealed with MTA plugs and the root canals were restored with composite resin and fiber post.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.310-317
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• 2009

Dens evaginatus is a dental anomaly involving an extra cusp or tubercle that protrudes from the occlusal surface of the affected tooth. The prevalence of dens evaginatus is 1 to 4 percent, and dens evaginatus is observed most commonly in premolars. It can be worn or fractured easily, resulting in pulpal exposure, pulpal infection, loss of vitality, facial infection and osteomyelitis. Since the tooth frequently has the immature apex when the tubercle is fractured, there is difficulty in treatment. Although calcium hydroxide is widely used for pulp treatment of an immature permanent tooth, several alternatives have been suggested to reduce patient's appointments. Mineral trioxide aggregate is considered biocom-patible and has excellent marginal sealing ability. In addition, it can minimize patient's visits. In this case report, apexification with MTA was attempted on the immature premolars in patients with cellulitis patient, caused by pulp necrosis due to dens evaginatus. Favorable clinical and radiologic results were achieved. In one case, continued root formation was observed.

• 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.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.3
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• pp.383-387
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• 2000

Fusion is defined as union of two separate tooth buds at some stage in their development with confluence of dentin and characterized by separate root canal and large single crown, while gemination is defined as an attempt of the single tooth bud to incompletely divide and usually result in a single root with one root canal and two completely or incompletely separated crowns. It is sometimes difficult to decide whether an abnormally large tooth is the result of fusion of a normal and a supernumerary tooth, or of gemination; use of the term 'Double tooth' may make the clinicians avoid this difficulty(Brook & Winter). Commonly there are no symptoms, but the problems associated with these anomalies include esthetics, possible loss of arch length and delayed or ectopic eruption of the permanent teeth, caries along the line of demarcation, and periodontal disease. Commonly, it dose not need to be treated in primary dentition but in case of permanent dentition, it may be requested to be treated due to esthetics and other problems. In our case, a 8 years old girl showed a Double tooth, we attained the favorable results by performing hemisection with apexification.