• The Journal of Korean Academy of Prosthodontics
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• v.50 no.3
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• pp.204-209
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• 2012

Surgical extrusion, immediate extrusion following tooth luxation, is a method to preserve one's natural tooth and achieve esthetic restoration without additional periodontal surgery when subgingival dental caries or crown fracture occurs. A 16-year-old male was referred to the clinic from the department of operative dentistry for the esthetic restoration of maxillary left lateral incisor. Due to the crown to root fracture, the tooth was endodontically treated with a buccal crown length of 4 mm. When the palatal flap was elevated, the mesiopalatal cervical fracture area was situated 3-4 mm subgingivally. Crown lengthening was achieved through surgical extrusion. After 3 months of clinical observation and provisional restoration, the maxillary left central incisor was restored with all ceramic crown and obtained a satisfactory clinical result.

• 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 Dental Society of Anesthesiology
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• v.10 no.1
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• pp.54-57
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• 2010

Foreign body aspiration (FBA) into the tracheobronchial tree could be life threatening requiringprompt intervention. Any objects placed in the oral cavity put patients at a risk of aspirating or swallowing the objects slipped or broken by physical injuries. Here, we report a case of 30 yr old patient with FBA during gold crown replacement was successfully treated with the use of the flexible bronchoscope. Case: A 30 yr old woman was admitted to Seoul National Dental Hospitalfor an amalgam restoration. She was scheduled to gold crown restoration for replacement of the damaged amalgam at #37 site. After performing crown lengthening procedure, the aspiration of gold crown occurred during the cementation of the crown. After aspiration, the patients complained of the subjective distress of respiration. Chest radiograph revealed that gold crown was enlodged to the left bronchus. Flexible fiberoptics was inserted to the bronchus to remove the aspirated crown. Fiberoptic assisted removal of the aspiratedcrown was successfully performed. After removal, there was no radiopaque material in the left bronchus on follow-up chest radiograph. Discussion: When aspiration of dental materials occurs, flexible fiberoptic can be used in the treatment of FBA. It is also very useful to take preventive management such as rubber dam, application of dental floss in dental procedure where there is high likelihood of FBA.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.4
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• pp.262-271
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• 2020

To restore a tooth with a fracture line extending below the marginal bone level, a surgical crown lengthening procedure accompanied by ostectomy could be considered to expose the fracture line and reestablish the biologic width. However, this procedure could lead to esthetic failure, especially in the anterior teeth. Therefore, orthodontic extrusion, which elevates the fracture line from within the alveolar socket without sacrificing the supporting bone and gingiva, is recommended. This technique allows for the proper placement of the crown on a sound tooth structure, with the reestablishment of the biologic width. Alternatively, surgical extrusion is an one-step procedure that is simpler and less time-consuming than orthodontic extrusion; placing and adjusting the orthodontic appliance does not require multiple visits. This study presents successful restoration in 2 cases with a crown-tooth root fracture of the maxillary central incisor treated using a multidisciplinary approach through orthodontic extrusion or surgical extrusion followed by successful restoration.

• The Journal of Advanced Prosthodontics
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• v.3 no.1
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• pp.37-42
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• 2011

Partial edentulism has multiple implications in relation to function, esthetics and future rehabilitative treatment. This case report illustrates the management of a patient with extreme consequences of partial edentulism. The main clinical findings were unopposed remaining teeth, overeruption of the remaining teeth, loss of vertical dimension of occlusion, and significant disfigurement of the occlusal plane. Following the diagnostic procedure, a well-coordinated prosthodontic treatment involving liaison with other dental disciplines was indicated. The management involved an innovative combination of fixed and removable prostheses in conjunction with crown lengthening surgery and strategic implant placement. Series of provisional prostheses were applied to facilitate the transition to the final treatment.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.1
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• pp.67-76
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• 2020

With the evolution of the computer-aided design/computer-aided manufacturing (CAD/CAM) technology, the intraoral scanners are playing an increasingly important role, as they are the first step towards a completely digital workflow. The CAD/CAM double scanning technique has been used to transfer the information from provisional restorations to definitive restorations. In this case, a 67-year-old male with esthetically compromised anterior teeth, generalized severe attrition of teeth, and reduced vertical dimension was treated with full mouth rehabilitation including a re-establishment of the lost vertical dimension of occlusion assisted by the crown lengthening procedure. The provisional restorations were fabricated using an intraoral scanner and the CAD/CAM double scanning technique. After the period of adaption, the definitive monolithic zirconia restorations were delivered. The CAD/CAM double scanning technique successfully transferred the occlusal and morphological characteristics, obtained from the provisional restorations, to the definitive restorations.

• Journal of Periodontal and Implant Science
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• v.24 no.1
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• pp.39-49
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• 1994

It has been believed that antioxidant enzymes such as CuZn- and Mn-superoxide dismutase and catalase protect the tissue from damage resulting from the oxygen derived free radicals($O_2\;^-$, $H_2O_2$ and OH ). The purpose of this study was to investigate the relationship between activity of antioxidant enzymes including CuZn- and Mn- superoxide dismutase and catalase and inflammatory periodontal disease and periodontal parameters. For this study, the patients were classified into normal, gingivitis, adult periodontitis and rapidly progressive periodontitis, and then their papillary bleeding index(PBI) and probing depth were checked. Gingival tissues were surgically obtained from the patients during periodontal surgery, extraction, and clinical crown lengthening procedure. The activity of CuZn- and Mn- superoxide dismutase and catalase in the gingival tissues was measured by using UV-spectrophotometer by the same methods as Crapo et al. And Aebi did, respectively. The results were as follows : 1. CuZn- and Mn- and total-superoxide dismutase activity were significantly low in rapidly progressive periodontitis group in comparison to normal group (P<0.05). 2. In comparison of the antioxidant enzyme activity according to papillary bleeding index group(PBI), Mn-superoxide dismutase activity only was significantly lower in PBI 2, 3, and 4 groups than PBI 0 group(P<0.05). 3. Superoxide dismutase activity failed to show any significant difference according to probing depth. But significant]y high catalase activity was shown in deep pocket group (${\ge}7mm$)(P<0.05). In conclusion, these results suggest that the activity of Mn-superoxide dismutase among the antioxidant enzymes may reflect the inflammatory status of gingival tissue and that the decreased activity of superoxide dismutase may be one of responsibe factors for progression of rapidly progressive periodontitis.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.87-98
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• 2005

The purpose of present study was to investigate the effects of physiologically active compound (SD62-122) from Phlomidis Radix on the cell cycle progression and its molecular mechanism in human gingival fibroblasts(HGFs). For this purpose, fibroblasts were isolated and cultured from excisioned gingiva during crown lengthening procedure in healthy adult. The following parameter were evaluated that there are cell number counting, MIT assay, cell cycle progression, western blot analysis. The cell number and MIT assay of primary cultured fibroblast was not increased at 2 days but significant increased compare to negative control at 3days(p<0.05). S phase was increased and G1 phase decreased in both $10^{-8}M$ and $10^{-9}M$ of SD62-122 in cell cycle analysis. The cell cycle regulation protein levels of Cyclin $D_1$, Cyclin E, cdk 2, cdk 4 and cdk 6 were increased compare to control in both $10^{-8}M$ and $10^{-9}M$ of SD62-122. The protein levels of p21 and p53 were decreased compare to control, but the level of pRb was not changed compare to control in $10^{-9}M$ of SD2-122. These results suggested that physiologically active compound (SD62-122) isolated from Phlomidis Radix increases the cell proliferation and cell cycle progression in HGFs, which is linked to increased cell cycle regulation protein levels of Cyclin $D_1$, Cyclin E, cdk 2, cdk 4 and cdk 6, and decreased the levels of p21, p53.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.3
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• pp.359-371
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• 2010

Facial asymmetry has been found with a higher frequency (70~84%) in skeletal class III malocclusion patients. Anticipating the poor prognosis of prosthesis due to malocclusion, occlusal stability must be obtained by orthodontic treatment. Moreover, orthodontic surgery would be needed in some severe cases for better functional and esthetic results. The orthognathic surgery is performed on one jaw or two jaw depending on the results of facial diagnosis. Genioplasty may change the vertical, horizontal, sagittal position of chin by osteotomy or augmentation using implants, also. This case is about a 24 year-old male patient who visited our clinic to solve the facial asymmetry and mandibular prognathism. Skeletal class III malocclusion, maxillary canting and menton deviation to left by 13 mm were detected. Multiple ill-fitting prostheses, unesthetic maxillary anterior prostheses, and several dental caries were found. After pre-operative orthodontic treatment, Le-Fort I osteotomy, sagittal split ramus osteotomy, genioplasty, right mandibular angle augmentation were done for the correction of jaw relation and asymmetry. By diagnostic wax-up after post-operative orthodontic treatment, maxillary full mouth rehabilitation and mandibular posterior restorations were planned out. For better result, clinical crown lengthening procedure was done on #11, 12 and implant was placed on left mandibular first molar area. The patient was satisfied with the final prostheses. Because of his high caries risk, long-term prognosis will depend on the consistent maintenance of oral hygiene and periodic follow-up.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.989-1002
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• 1996

The purpose of this study was to determine the effect of a pulsed Nd:YAG laser irradiation on human gingival tissues. The patients, who were planned to be treated by clinical crown lengthening procedure and gingivectomy, were selected. All the patients received oral hygiene instruction, scaling and root planing at preoperation. The crest of gingival tissue on upper and lower anterior teeth was irradiated by a pulsed Nd:YAG laser(El. EN. EN060, Italy) with a fiber optic of 300 m in contact mode for 20 seconds. Gingival tissues were divided into 4 groups according to the laser power of 1.0W(10Hz, 100mJ), 2.0W(20Hz, 100mJ), 3.0W(30Hz, 100mJ) and 4.0W(40Hz, 100mJ). Immediately after the laser irradiation, the specimens were excised, fixed 10% neutral formalin, sectioned $4-6{\mu}m$ thick, stained by Hematoxylin-Eosin and Periodic Acid Schiff stain and observed under light microscope. The removed tissue depth and the coagulated layer depth due to a laser irradiation by a laser irradiation were measured on the microphotographs. The difference of measurements according to the different laser power was statistical1y analyzed by Kruskal Wallis Test with SAS program. The results were as follows : 1. In histologic findings of irradiated gingival tissues; a. In the irradiated gingival specimen with 1.0W laser power, some vesicles were observed in limited superficial layer of gingival epithelium. b. In the irradiated gingival specimen with 2.0W and 3.0W laser power, the epithelium was almost removed except for the traces of viable basal cell remnants at ret peg, and coagulation necrosis related with the thermal effect of laser was noted. c. In the irradiated gingival specimen with 4.0W laser power, complete removal of epithelium, partial removal of underlying connective tissue, and the coagulation necrosis of subjacent gingival tissue were shown. 2. The removed tissue depth was deeper in the irradiated specimens with higher power. There was a statistical significance in the difference of removed tissue depth between 1.0W group ($44.54{\pm}6.99um$) and 3.0W group ($99.75{\pm}6.64{\mu}m$), and between 1.0W group($44.54{\pm}6.99{\mu}m$) and 4.0W group($111.36{\pm}4.50{\mu}m$), and between 2.0W group($98.01{\pm}4.53{\mu}m$) and 4.0W group($111.36{\pm}4.50{\mu}m$)(P<0.05). 3. The coagulated layer depth was deeper in the irradiated specimens with higher power. There was a statistical significance in the difference of coagulated layer depth between 1.0W group($31.82{\pm}8.99{\mu}m$) and 3.0W group($55.99{\pm}20.94{\mu}m$), and between 1.0W group($31.82{\pm}8.99{\mu}m$) and 4.0W group($83.68{\pm}10.34{\mu}m$)(P<0.05). From this study, the results demonstrated that the effects of a pulsed Nd:YAG laser irradiation on gingival tissues seemed to depend on the laser power and that the irradiation with high power could be harmful to adjacent healthy tissue.