• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.3
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• pp.303-311
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• 2020

The aim of this study was to assess the awareness of caregivers, emergency medical technicians, and emergency medical doctors by investigating the storage media for avulsed teeth at the trauma site. This study was performed by reviewing medical records of 183 patients with the age under 17 years old, who visited Ajou University Hospital for dental trauma. Based on their medical records, storage media for avulsed permanent teeth were investigated by classifying them as dry, milk, saline, saliva and tap water. The storage media chosen by caregivers at the trauma site were classified as cases by parents and school nurse teachers. Storage media chosen by emergency medical technicians and emergency medical doctors were also investigated using the same classification criteria. The results show that both parents and school nurse teachers used milk the most as a storage medium for avulsed teeth. Dry storage was the second most chosen medium by parents, and saline by nurse teacher. As a storage media emergency medical technicians used saline the most, while emergency medical doctors used only saline when they failed to replant avulsed teeth. There is a need to improve the knowledge of caregivers, emergency medical technicians, and emergency medical doctors regarding the storage media for avulsed teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.4
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• pp.555-560
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• 2002

Replantation may be a treatment choice for a completely avulsed tooth caused by a traumatic injury. The outcome of replantation depends on the following factors ; minimal damage to pulp and periodontal membrane, the length of time the avulsed tooth was out of the mouth, how the tooth was stored, the level of root formation, etc. The time from the act of avulsion of the tooth to the actual replantation is especially important. Generally, when replanted within 30 minutes, more than 90% of the cases succeed, but when the time is between 30 to 90minutes, 43%, and greater than 90 minutes, 7%. This is a case of a replanted tooth with relatively good prognosis by ankylosis though there was a great time lapse since the tooth was avulsed. Though such treatment lead to loss of the tooth, in cases of children or adolescents, this treatment is meaningful, because it may earn time until any definitive therapy, functionally stimulate the alveolar bone to retain its height for a better prognosis for future treatment, and act as space maintainer.

• The Journal of the Korean dental association
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• v.36 no.11 s.354
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• pp.766-769
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• 1998

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.3
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• pp.438-446
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• 2007

Viable cells of periodontal ligament would be an important factor for the successful replantation of an avulsed tooth. Therefore, it is critical to choose the storage medium for the preservation of traumatically avulsed teeth. Growth factors and hormones could be considered for the therapeutic application of the maintenance of viable periodontal ligament fibroblasts (PDLFs). Epidermal growth factor (EGF) has been suggested as an important player for the regeneration and wound healing process on other tissues. Therefore, EGF was evaluated for the therapeutic application on avulsed teeth. In addition, the synergic effect of EGF with tri-iodothyronine (T3) and heparin-binding epidermal growth factor-like growth factor (HB-EGF). The cell proliferation of PDLFs was determined by MTT assay and increased dose-dependently up to 10 ng/ml in the presence of EGF. Maximum cellular growth was shown at the concentration of 10 ng/ml EGF. Also, EGF promoted the wound healing of PDLFs examined by in vitro wound healing assay. Combined effects of EGF with T3 or HB-EGF on the proliferation of PDLFs were also studied. Interestingly, EGF showed the synergic effect on the proliferation of PDLFs with T3 and HB-EGF. To find out the mechanism of the synergic effect of EGF and T3, the effect of T3 on the expression of endogenous EGF receptor was determined by RT-PCR. The result was that T3 enhanced the expression of EGF receptor in PDLFs. It suggested that EGF might be a good choice for a therapeutic application, which can be used as combination with T3 and HB-EGF.

• 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.32 no.1
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• pp.158-163
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• 2005

It is rare that the complete avulsion, intrusive luxation, and extrusive luxation occurred by trauma at the same time. In July, 2003, 10-year and 2 month-old-girl was referred to Department of Pediatric dentistry, Chonnam National University Hospital due to complete avulsion of upper right lateral incisor, intrusive luxation of upper right cental incisor and extrusive luxation of upper left central incisor. Traumatized teeth were surgically repositioned and fixated with resin-wire splint at the same day. Endodontic treatment of avulsed tooth was performed 2 weeks after trauma. A radiograph was taken 3 months after trauma, which demonstrated root resorption of both upper central incisors. External root resorption was arrested by the root canal therapy with calcium hydroxide. It showed good results for 1 year and 4 month but further follow-up is needed to check root resorption and ankylosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.2
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• pp.250-256
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• 2018

Dental avulsion, defined as the complete displacement of a tooth from the alveolar bone with consequent loss of the blood and nerve supply, was reported as one of the most severe dental injuries. Avulsion can cause tissue ischemia, which leads to pulp necrosis. Apexification is a conventional treatment method that induces an apical calcified barrier in immature roots with pulp necrosis. However, root development characterized by an increase in the root thickness and length cannot be achieved by apexification. The purpose of this case report was to describe the radiographic and clinical outcomes of regenerative endodontic treatment for the avulsed and necrosed permanent tooth with an immature root after replantation in a 5-year-old girl; the treatment was performed using a mixture of ciprofloxacin, metronidazole and cefaclor, CollaTape and Biodentine.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.729-733
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• 2004

Tooth avulsion usually causes inflammatory root resorption and ankylosis, and ankylosis cause severe functional and esthetic problems, especially in childhood. A 7-year-old female visited the Dept. of Pediatric Dentistry, Yonsei University with the chief complaint of avulsive trauma to the upper right incisor which was left dry for 40 minutes. Tooth was irrigated with saline and replanted immediately and splinted. Anti bacterial agent and anti inflammatory agent were prescribed. After 4 months of replantation slight external root resorption and apical radiolucency was seen at radiographic examination, therfore pulp extirpation and calcium hydroxide($Vitapex^{TM}$) canal filling were carried out. After 16 months, root canal was filled with gutta-percha, and bleaching treatment was done. Treatment results were satisfactory both esthetically and functionally for 8 years and 5 months.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.2
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• pp.127-132
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• 2013

Traumatic injuries to immature permanent teeth are common and the results can be destructive. Although Hertwig's epithelial root sheath is usually sensitive to trauma, it may resist damage from trauma thereby retaining its vitality and continuing to calcify a root under favorable conditions. This case report describes two cases of trauma to immature permanent incisors. The first case presents an avulsed maxillary central incisor which has been replanted. The other case shows completely avulsed mandibular central incisors which have not been replanted. However, both cases subsequently show continued growing roots separated from the main roots. This report highlights the ability of the immature pulp tissue to continue to form dentin and the robustness of Hertwig's epithelial root sheath to initiate root development despite a traumatic injury.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.1
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• pp.1-6
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• 2005

Injury of permanent teeth by trauma usually occurs to $8{\sim}10\;years$ old children, in mixed dentition. Fracture, dislocation, intrusion, extrusion, avulsion are the common types of trauma in teeth. The injuries which teeth are dislocated from the alveolar sockets can be treated by reduction and fixation. In this case report two children visited Wonkwang University Dental Hospital after the emergency treatment of tooth injury by other medical institutes. In these cases the injured teeth were not reducted properly and showed premature contact. So the teeth were dislocated from the alveolar sockets intentionally and fixed again in the proper position. Unproper reduction can cause premature contact, delay of healing, difficulty of mastication, and malocclusion. For this reason emergency rooms or local dental clinics where patients with dental trauma can be examined first, must know well about the treatment procedure of the injured teeth and should be consulted to the profession when necessary.