• Archives of Reconstructive Microsurgery
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• v.9 no.1
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• pp.23-26
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• 2000

From Jan. 1998, 28 young children patients with complete amputations at zone I or II were replanted using a microscopic technique. Children's average age was 4.5 years and the amputation levels were zone I in 12 cases and zone II in 16 cases. Overall survival rate was 57%(16 cases). In children, the advantages of the replantation for distal digital amputations are nearly normal length, good soft tissue coverage with nail and cosmetically high patient satisfaction but surgical technical difficulties are much greater than in adults.

• Archives of Plastic Surgery
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• v.36 no.3
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• pp.306-310
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• 2009

Purpose: Owing to improvement of microscope, microsurgery implements, and microsuture, finger replantation has shown much development. With high success rate of microsurgery in children, positive results have been reported ever from distal amputation. Here, we report the patients demographics, methods, and results of the microsurgery performed in children in our hospital for the last 8 years. Methods: From the medical records of 21 patients who had given the treatment in our hospital from January 2000 to December 2007, we analyzed patients' sex, age, operative method, and complication retrospectively. Results: The number of male patients was twice as many as female, where most patients belong to the ages of five to ten years. Operative methods performed in this study included end - to - end anastomosis of artery and vein, vein graft, and epineurial suture. As a result, 19 out of 21 cases were successfully accomplished, and four of them went through the debridement of necrotic tissue due to the partial necrosis of the lesion. A one - year follow - up observation was done after surgery and most of them were almost fully recovered like in their previous state. Conclusion: The success rate of finger replantaion in children is continuously improving despite the difficulty of vessel anastomotic procedure, rehabilitation treatment and management after surgery. We report the satisfactory results of pediatric finger replantation technically and aesthetically.

• Archives of Reconstructive Microsurgery
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• v.8 no.1
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• pp.64-70
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• 1999

Digit that were formerly assessed as non replantable may now be replanted with the help of salvage procedure. In case that, venous repair is either marginal or technically impossible and postoperative venous congestion developed following replantation, are treated with the application of medical leeches. From July 1997 to April 1998, the authors performed arterial anastomosis and venous drainage using medical leeches in 3 children(The age of the patients ranged from 13 months to 6 years.) to have a result of aesthetic and functional success with minimizing the complications. Leech therapy has many advantages, to avoid injuring of finger tip, to decrease focal capillary coagulation, to prevent severe bleeding, and to prevent thromboembolism. The authors conclude that the use of medical leeches shows promise as a safe and effective method of providing temporary venous drainage in replanted digits.

• 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.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.3
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• pp.381-386
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• 2010

As the vertical fracture occurs at the various locations following the long axis of a root, treatment method of crown-root fractured anterior teeth is decided according to the depth. If the fracture line is close to the crown, gingivectomy, orthodontic - forced eruption or surgical extrusion of apical fragment could be done. If the line is over 1/3 length of the root, the prognosis is poor and extraction is usually undertaken. However, extraction of maxillary incisor at growing children causes many complications such as esthetic, phonetic problem and alveolar bone resorption. Therefore, preservation of tooth is the highest priority. Recently, intentional replantation with composite resin could be considered as alternative treatment of crown-root fractured anterior tooth. This report presents a patient in mixed dentition with deep vertical crown-root fracture of the maxillary permanent central incisors by trauma. Intentional replantation of the fractured teeth was performed using composite resin. After 2 years, specific clinical symptom has not been found and the patient was satisfied of esthetic result. This method suggests the new technique to preserve a tooth as an alternative to extraction, although it is technically sensitive and the reports of long-term prognosis is insufficient.

• Korean Journal of Health Education and Promotion
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• v.9 no.1
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• pp.30-38
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• 1992

The purpose of this investigation was to evaluate, by means of a questionaire, the parental awareness of the emergency management of avulsed teeth in children. 297 parents were surveyed during a six week period at Yooseuk elementary school in Seoul. The results indicated that the person who experianced a avulsion of teeth was 16.6%. 35% of parents would attempt replantation of an avulsed tooth but further questioning showed they did not know the correct procedures. 36% of parents were unaware of adequate time for emergency dental services. 62% of parents felt they should seek professional help urgently following an avulsion injury, but their knowledge of transport media for the tooth was poor. Only 8% of parents knew that milk was the medium of choice for both washing and transporting an avulsed tooth. 76% of parents surveyed had never received advice in what to do in the event of an accident where a tooth was avulsed. This study revealed the need for educational campaigns aimed at parents to increase their knowledge of the emergency procedures required when a tooth is avulsed.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.4
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• pp.435-440
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• 2011

Maxillary canine impaction is a common eruption problem in children. Impaction frequently involves further complications such as root resorption of adjacent teeth, cyst formation and migration of the neighboring teeth, etc. Various treatment modalities include extraction of preceding deciduous canine, orthodontic traction, and surgical extraction followed by immediate replantation of the extracted tooth at the proper position(autotransplantation). Autotransplantation is considered as the treatment of choice when surgical exposure and subsequent orthodontic traction are difficult or impossible due to unfavorable impacted position. The prognosis of autotransplantation is affected by the degree of apex formation, surgical procedures performed, timing of root canal treatment, and length of stabilization period. In these two cases presented, the patients with unerupted maxillary canine were treated with autotransplantation. One case was thought that guidance of eruption by orthodontic traction was difficult because of its unfavorable impacted position. In the other case, parents didn't agree to treat by orthodontic traction, therefore autotransplantation was done. In both cases, autotransplantation was carried out following root canal treatment and orthodontic treatment, and both cases have demonstrated to be successful to this day.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.4
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• pp.605-610
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• 2003

Physiologic root resorption occur from the apex of the primary teeth close to the permanent teeth towards the apex. Pathologic root resorption occur on surfaces of root due to causes such as trauma, replantation, orthodontic treatment, delayed or irregular eruption of teeth, or growing cysts or tumors. In children, the most frequently affected teeth from trauma are the maxillary primary central incisors. After such an event, root resorption initiate from the traumatized pulp or periodontium. In this case report, periapical radiographs were used to evaluate the features of pathologic root resorption by studying patients with history of trauma. The following results were noted. 1. Pathologic root resorption was observed in various patterns in all of the 10 traumatized maxillary primary central incisors. 2. Though teeth with pathologic root resorption were treated with pulpectomy, the resorption process continued to progress.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.674-677
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• 2009

Purpose: Typical cross finger flap is still a good method for reconstruction of fingertip injuries. However, it is necessarily followed by great loss and aesthetically unpreferable result of donor finger. Hereby, we introduce a modification of cross finger flap with reduction pulp plasty and full thickness skin graft, with which we could reduce the defect size of injured fingertip and donor site morbidity at the same time, without any need for harvesting additional skin from other part of hand. Method: This method was performed in the patients with fingertip injuries of complete amputation or in case of loss of fingertip due to necrosis after replantation. Firstly, reduction pulp plasty was performed on the injured finger to reduce the size of defect of fingertip. Additional skin flap was obtained from the pulp plasty. Secondly, cross finger flap was elevated from the adjacent finger to cover the defect on the injured finger. At the same time, defect on the donor finger produced by the flap elevation was covered by full thickness skin graft with the skin obtained from the pulp plasty of injured finger. Results: Flap and graft survived without any necrosis after surgical delay and flap detachment. All of them were healed well and did not present any severe adversary symptoms. Conclusion: Cross finger flap with reduction pulp plasty and full thickness skin graft is an effective method that we can easily apply in reconstruction of fingertip injury. We think that it is more helpful than the usual manner, especially in cases of children with less soft tissue on their fingers for preservation and reduction of the morbidity of donor finger.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.1
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• pp.38-46
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• 2017

School nurses can play an important role in improving the prognosis of traumatized teeth of school children when they are informed about the immediate and proper dental first aid steps. The purpose of this study were to assess the awareness of school nurses concerning the management of traumatized teeth and to determine if a lecture on dental trauma management could improve school nurses'knowledge on this topic. School nurses in Gwangju and Jeonnam province completed a questionnaire before and after the lecture on the first-aid knowledge with particular focus on the following three categories. Questionnaires are composed of questions asking general information and about knowledge and proper attitude in case of the specific situation on dental trauma. According to previous studies, school nurses' knowledge tended to be higher compared with the teachers. Improvement of knowledge in school nurse was observed in emergency actions, in visiting time, replantation, carriage method, vaccine prescription related with luxation, and in possibility of fragment reattachment related with subluxation and fracture. In conclusion, it is recommended that periodical education are needed for improvement of school nurses'knowledge on proper management of dental trauma emergency.