• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.1
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• pp.125-131
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• 2002

When a tooth is fracture with the pulp exposure, and if a fragment is large enough to save, reattachment of the fragment would be a choice of treatment and reattachment of the fragment provides several advantages over other forms of dental restoration following crown fracture. For the purpose of tooth reattachment, it is important to preserve the sound enamel around fracture area. For young patients, tooth reattachment has more advantages in the sense that they recover faster and that it enables other treatments at the same time. Through the continuous advancement in adhesion technology and the effort for aestheticism, various reattachment methods have been practiced and more efforts are considered necessary. The presented cases are that we had practiced in our department in Kyung Hee Medical center, I may address that fragmentation has been successfully done with aesthetically fine results, and no pathologic changes were found in short term follow-ups.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.1
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• pp.104-112
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• 2022

The purpose of this study is to analyze the fracture resistance of reattached tooth according to the resin materials and tooth preparation type under physiological conditions. Uncomplicated crown fracture in the oblique direction was reproduced on the extracted 64 anterior teeth. Depending on the composite resin material, reattachment was performed using a flowable resin and a packable resin. Depending on retentive forms, reattachment was performed using simple reattachment, 1.0 mm × 1.0 mm labial chamfer bevel, 1.0 mm × 1.0 mm lingual chamfer bevel and 1.0 mm × 1.0 mm circumferential bevel. A load was applied to the palatal surface of the tooth using a universal testing machine at an angle of 125 degree, which is the interincisal angle of normal children. Under the masticatory pressure condition, fracture resistance of lingual chamfer groups was 28.28 ± 7.41 MPa and 27.54 ± 4.45 MPa, which was significantly higher than those of simple reattachment groups, 17.21 ± 5.87 MPa and 20.10 ± 6.00 MPa, in both flowable and packable resin groups. When considering the lingual force similar to masticatory pressure, the fragment retention was significantly improved when the lingual chamfer was formed compared to the simple reattachment. Clinicians may consider the design of the lingual chamfer in order to improve fracture resistance to masticatory pressure during fragment reattachment.

• Restorative Dentistry and Endodontics
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• v.35 no.5
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• pp.395-400
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• 2010

The development of adhesive dentistry has allowed that the crown fragment reattachment can be another option in the treatment of crown fracture. However, additional crown lengthening procedure or extrusion of the tooth may be necessary in the treatment of crown root fracture because subgingival fracture line in close proximity to the alveolar bone leads to challenges for restorative procedure and the violation of the biologic width. This case report presents a modified crown fragment reattachment technique of crown root fracture with pulp exposure, which was done without additional crown lengthening procedures. After the endodontic treatment, the patient was treated using a post insertion and the fragment reattachment technique, which made it possible to preserve the space for the biologic width and maintain a dry surgical field for adequate adhesion through the modification of the fractured coronal fragment. Since a coronal fracture was occurred and reattached afterward, it was observed that the coronal fragment was well maintained without the additional loss of periodontal attachment through 2-year follow up.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.1
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• pp.42-49
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• 2021

This study aimed to evaluate the long-term outcomes of teeth treated with reattachment technique in children and adolescents. Twenty seven permanent anterior teeth from 21 patients treated with fragment reattachment were evaluated. Clinical photos and medical records were used to assess treatment outcomes. Effect of pulp treatment and the ratio of fragment on success rate were statistically analyzed. Detachment of fragment was observed in 17 teeth, and their duration of retention was 21.41 ± 23.39 months. Repeated trauma was found to be the most frequent causes of failure. Pulp treatment before reattachment did not affect the success rate (p > 0.05). The mean ratio of fragment was 0.482 ± 0.147, and the success rate was affected by the ratio of fragment (p = 0.018). The median retention time of the teeth was 72 months if the ratio was under 0.5, and 8 months for that of the others. A significant correlation was found between the ratio of fragment and retention time (p = 0.003). Reattachment can be a predictable treatment option for crown fracture in anterior teeth in children and adolescents when a fracture involves less than 50% of the clinical crown.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.1
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• pp.58-65
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• 2012

The crown-root fracture is defined as a fracture of tooth that contains enamel, dentin and cementum with or without pulp exposure. Generally the fracture lines place obliquely from labial surface, between incisal edge of the crown and marginal gingiva, to palatal surface subgingivally. If the fracture line is located supragingivally, the removal of tooth fragment and supragingival restoration can be performed. In subgingival fracture line, the surgical exposure, orthodontic eruption or surgical eruption can be considered. If the fracture line is too deep to restorate, extraction or decoronation can be selected. In children and adolescents, the extraction should be the last option. Another option to select before extraction is the restoration using fiber-reinforced post and the reattachment of tooth fragment. The fiber-rainforced post enhances the retention and the durability of tooth fragment. The reattachment of crown fragment using resin adhesive system is considered minimal invasive treatment biologically. This case reports the treatment of crown-root fracture using the reattachment of crown fragment and the insertion of fiber-reinforced post.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.288-292
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• 2009

A crown-root fracture is defined as a fracture involving enamel, dentin, and cementum. The fractures may be grouped according to pulpal involvement into uncomplicated and complicated. Generally a vertically crown-root fractured tooth must be extracted. However, it should be mentioned that the cases have been reported where bonding of the coronal fragment has led to consolidation of the intraalveolar part of the fracture. Definitive conservative therapy comprises one of four treatment alternatives; fragment removal only, fragment removal with gingivectomy, orthodontic extrusion of apical fragment, and surgical extrusion of apical fragment. The choice is primarily determined by the exact information on the site and the type of fracture, but the cost and the complexity of treatment can also be decisional factors. On the other hand, intentional replantation of the teeth with vertical root facture reconstructed with resin bonding has emerged as a new promising method in recent years. This case presents an intentional replantation of the crown-root fractured maxillary central incisor reconstructed with resin bonding. However, an obvious increase of radiolucency was observed after 4 months and the tooth was re-fractured after 16 months.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.4
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• pp.274-280
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• 2021

Intentional replantation has been used for alternative treatment for conventional root canal therapy. This case report describes that the intentional replantation with application of extrusive orhodontic force for 6 weeks, on which tooth of previous root canal therapy. As preapplicatory orthodontic force, tooth moblity was increased so that extraction of the designated tooth was more easily accomplished and augmented volume of periodontal ligament is expected to acceleated gingival reattachment.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.1
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• pp.15-25
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• 2012

The relationship between occlusion and periodontal health has been extensively studied. However, reports on the effects of passive eruption using occlusal reduction has not been sufficient. The purpose of the present randomized clinical trial was to assess the influence of passive eruption using occlusal reduction on the clinical periodontal parameters consisting of attachment level, pocket depth, tooth mobility, width of keratinized gingiva and osseous defect. The study was performed on 40 teeth of 16 subjects who have been treated for the moderate periodontitis at the Department of Periodontology, Pusan National University Hospital. At the baseline examination, after hygienic-phase and after 6 month from passive eruption using occlusal reduction, clinical parameters were monitored and radiographs were taken. The 20 teeth in the test group received passive eruption using occlusal reduction while the 20 control teeth did not receive any occlusal reduction. The results were as follows; 1) Degree of inflammation of periodontium was improved by initial therapy 2) Teeth received passive eruption using occlusal reduction demonstrated significantly greater reduction in pocket depth, tooth mobility and amount of bone loss, and increase in the width of keratinized gingiva, but no significant changes in the attachment level compared to the control teeth 3) There was significantly greater reduction in pocket depth, mobility, amount of bone loss and attachment level in the test teeth after initial hygienic phase when compared with baseline data. Taken together, these results suggest that the passive eruption using occlusal reduction would be helpful to improve periodontal health.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.4
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• pp.435-444
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• 2009

Statement of problem: The clinical use of electric and electomagnetic fields for fracture healing applications began in the early 1970s. Since then, several technologies have been developed and shown to promote healing of fractures. Developments of these devices have been aided in recent years by basic research and several well controlled clinical trials not only in the medical field but in dentistry. Purpose: The purpose of this study was to compare alveolar bone reduction following immediate implantation using implants onto which magnets were attached in fresh extracted sockets. Material and methods: Four mongrel dogs were involved. Full buccal and lingual mucoperiosteal flaps were elevated and third and fourth premolars of the mandible were removed. Implants with magnets and implants without magnets were installed in the fresh extracted sockets and after 3 months of healing the animals were sacrificed. The mandibles were dissected and each implant sites were sampled and processed for histological examination. Results: The marginal gaps that were present between the implant and walls of the sockets at the implantation stage disappeared in both groups as a result of bone fill and resorption of the bone crest. The buccal bone crests were located apical of its lingual counterparts. At the 12 week interval the mean of marginal bone resorption in the control group was significantly higher than that of the magnet group. The majority of specimens in magnet group presented early bone formation and less resorption of the buccal marginal bone compared to the control group. Conclusion: Within the limitations of this study, it could be concluded that implants with magnets attached in the early stages of implantation may provide more favorable conditions for early bone formation and reduce resorption and remodeling of marginal bone.

• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.535-563
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• 1993

New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration alre basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, biological mediators. Platelet-derived growth factor (PDGF) is one of polypeptide growth factor. PDGF have been reported as a biological mediator which regulate activities of wound healing progress including cell proliferation, migration, and metabolism. The purposes of this study is to evaluate the possibility of using the PDGF as a regeneration promoting agent for furcation involvement defect. Eight adult mongrel dogs were used in this experiment. The dogs were anesthetized with Pentobarbital Sodium (25-30 mg/kg of body weight, Tokyo chemical Co., Japan) and conventional periodontal prophylaxis were performed with ultrasonic scaler. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree III furcation defect was made on mandibular second(P2) and fourth(P4) premolar. For the basic treatment of root surface, fully saturated citric acid was applied on the exposed root surface for 3 minutes. On the right P4 20ug of human recombinant PDGF-BB dissolved in acetic acid was applied with polypropylene autopipette. On the left P2 and right P2 PDGF-BB was applied after insertion of ${\beta}-Tricalcium$ phosphate(TCP) and collagen (Collatape) respectively. Left mandibular P4 was used as control. Systemic antibiotics (Penicillin-G benzathine and penicillin-G procaine, 1 ml per 10-25 1bs body weight) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operated sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 2, 4, 8, 12 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. At 2 weeks after surgery, therer were rapid osteogenesis phenomenon on the defected area of the PDGF only treated group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. New cementum fromation was observed from 2 weeks after surgery, and the thickness was increased until 8 weeks with typical Sharpey’s fibers reembedded into new bone and cementum. In both PDGF-BB with TCP group and PDGF-BB with Collagen group, regeneration process including new bone and new cementum formation and the group especially in the early weeks. It might be thought that the migration of actively proliferating cells was prohibited by the graft materials. In conclusion, platelet-derived growth factor can promote rapid osteogenesis during early stage of periodontal tissue regeneration.