• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.2
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• pp.255-260
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• 2001

Trauma to the primary incisors may cause developmental or eruptional disturbance of the permanent successors. Two cases illustrate developmental disturbances of arrested root formation, dilaceration, and eruptional disturbances of impaction, ectopic eruption of permanent successors caused by traumatic injury to deciduous incisors. The patient of the first case suffered trauma at the age of 4 years 7 months, causing alveolar bone fracture including the maxillary right primary central and lateral incisors that were immedi-ately extracted. The second patient had trauma episodes at the age of 3 years. Avulsion of the maxillary primary right central and lateral incisors were occurred due to trauma. After such trauma, regular follow-up including radiographs is necessary to detect early any possible interference with normal eruption of permanent successors.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.1
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• pp.162-168
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• 2007

Impaction of the maxillary central incisor may cause social, esthetic, and functional problems in children. There are various means of treatment for the inverted maxillary central incisor, such as extraction, surgical opening followed by orthodontic traction surgical repositioning or intra-alveolar autotransplantation prior to extraction. In this case, we surgically repositioned the inverted maxillary central incisor to normal semi-erupted position in a 5-year-old boy The developmental stage of the inverted tooth was Nolla's 6.5, which indicates formation of less than one third of the root. After surgical reposition, we did follow-up for 21 months, expecting spontaneous growth Unfortunately, poor prognosis was noted further root was not observed. Such failure seems to originate from possible injury on Hertwig's epithelial root sheath by surgical trauma. We performed surgical repositioning to retain the tooth instead of extraction. However, arrest of root development occurred which is one of the critical complications. In order to increase the success rate of the surgical reposition procedure, minimal surgical trauma is required as well as selection of adequate indication and decision of proper time of treatment considering the stage of root development.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.2
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• pp.335-340
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• 2007

Primary teeth and the permanent successor must be understood as interdependent units, where each one of them interacts with and depends upon the other. The spread of pulpal inflammation in primary teeth to the periradicular tissues can lead to early eruption, enamel hypoplasia or hypocalcification, developmental arrest of permanent successor. Also the periapical inflammation cause permanent tooth displacement in various direction. We describe here two clinical cases of displaced permanent successor caused by periapical lesion of mandibular primary molar in children.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.290-295
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• 2011

During tooth formation, tooth development can be affected by physical action or metabolic changes around dental follicle. Especially trauma to primary dentition is the most representative physical factor that can cause development disorders of succedaneous tooth. Enamel hypoplasia and crown discoloration of succedaneous tooth are common complications of trauma. And impaction, ectopic eruption, arrest of root formation and root dilaceration of succedaneous tooth are rare. In this case, a 6-year and 5-month-old female patient visited for dental evaluation after trauma. She was diagnosed with alveolar bone fracture near upper front teeth, extrusion of the upper right and left primary central incisors, intrusion of the upper right primary lateral incisor, and palatal luxation of the upper left primary lateral incisor. Upper right and left primary central incisors with severe mobility were extracted, with gingival suture on the day of the visit. During 24 months check up, root dilacerations were found near the cemento enamel junction in the upper lateral incisors and arrests of root formation were found on the coronal 1/3 of the root in the upper central incisors. Although alveolar bone fracture is rare type of trauma in children, a thorough examination of alveolar bone is essential for prognosis and following treatment in patients with trauma.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.2
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• pp.260-266
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• 2010

Trauma to the primary teeth may have an effect on the successive permanent teeth. Thus, the treatment plans should be focused on safety of their permanent teeth. The degree of developmental disturbances in those permanent teeth depends upon many factors including the age of the children, developmental conditions of the affected teeth, types and severities of trauma and time interval from the moment of trauma to the initial treatment the patients received. The complications of the effected permanent teeth vary from the mild enamel hypoplasia to the premature finishing of teeth development. In this study, children whose ages were 33 months, 5 years, and 26 months presented the developmental disturbances to their permanent teeth, which resulted from the trauma to the primary teeth: the intrusion, the avulsion, and the subluxation. There showed a mild complication in the case of subluxation resulting in enamel hypoplasia, but, the more severe complication of the root dilacerations occurred in the case of intrusion. Furthermore, the 5-year-old patient whose primary dentition was near in transition period to the permanent one, the more complicated problem such as stop of root development of the permanent teeth was resulted from the avulsion. Thus, one should assume that the types of trauma and the age of the children at the moment of trauma have different effects on those successive permanent teeth. In conclusion, when the trauma that causes changes in the position of primary teeth happened, it is important to arrange an appropriate treatment procedure considering the types of trauma and the developmental conditions of the permanent teeth.

• 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.28 no.1
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• pp.175-179
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• 2001

Regional odontodysplasia is a relatively rare condition in which both enamel and dentin are hypoplastic and hypocalcified. The result is localized arrest in tooth development. The etiology of regional odontodysplasia is uncertain, but, disturbance in vascular supply, somatic mutation, latent virus infection, trauma, hyperpyrexia, irradiation, nutrition, metabolic disorders and hereditary transmission are supported to be etiologic factors. Females are more often affected than males. (1.4 : 1). The maxillary arch is more often affected than the mandibular arch with the maxillary left quadrant being the most commonly involved. Affected teeth are hypoplastic, typically discolored yellow or yellowish brown, smaller in size and display a variety of surface marking including pitting and grooving. Radiographically, the teeth affected have been described to have a "ghost like" appearance or "fuzzy" appearance. Pulp calcification and denticles may be present within the pulp chambers of the affected teeth. In it's case, a 2 years old male visited for a treatment of uneruption of lower right teeth. Partial eruption of lower right deciduous central incisor and unerupted deciduous lateral incisor, deciduous canine and deciduous first molar showed severly delayed eruption state. On radiographic appearance, "Ghost like appearance", shortened root and opened apexes on lower right region were observed. It was suspected regional odontodysplasia with clinical and radiographic condition.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.1
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• pp.66-72
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• 2012

Autogenous tooth transplantation can be defined as the surgical movement of a tooth from one position in the mouth to another in the same individual. The most common reasons for tooth transplantation include replacement of a missing first molar, transplantation of impacted canines to their normal positions in the arch, and transplantation of premolars in areas of missing teeth, especially in the anterior area of the mouth. The key to successful tooth transplantation is proper selection of graft with adequate root development as well as the design of surgical operation. Root development stage with half to three-quarter-developed roots increase the success rate of autotransplantation. We report the cases of successful autotransplantation which resulted in ideal healing of periodontal ligament, gingiva and alveolar bone. All transplanted teeth presented immature root formation at the moment of the procedure. After surgical procedure, we can observe good healing pattern without endodontic problem.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.96-101
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• 2009

Regional odontodysplasia(ROD) is relatively rare localized developmental anomaly of tooth formation in which hard tissue is affected. The maxilla is typically affected than the mandible, and especially the maxillary left quadrant is the most commonly involved. Females are affected twice as often as males, and there is no association with race. Its etiology remains undetermined, but local circulatory disorders, somatic mutations, virus infections, local trauma, hyperpyrexia, irradiation, metabolic disturbances, and hereditary transmission are considered as possible etiologic factors. The affected teeth are likely to be small, hypoplastic, brown, and grooved. Eruption failure or delay is frequently seen as well as abscess or fistulae formation in absence of caries. Radiographically, there is a lack of contrast between the enamel and dentin, both of which are less radiopaque than unaffected counterparts. Moreover, enamel and dentin layers are thin, giving the teeth a “ghost-like appearance”. The pulp chambers and canals are large, the roots seem like to be short and indistinct. A 2-year-3-month old boy came to the department of pediatric dentistry, Yonsei University, with the chief complaint of delayed eruption and abnormal tooth shape on the lower left quadrant. He was diagnosed as regional odontodysplasia based on the clinical and radiographic findings.

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