• Journal of Periodontal and Implant Science
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• 제52권2호
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• pp.127-140
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• 2022

Purpose: In dental avulsion, delayed replantation usually has an uncertain prognosis. After tooth replantation, complex inflammatory responses promote a return to periodontal tissue homeostasis. Various types of cytokines are produced in the inflammatory microenvironment, and these cytokines determine the periodontal tissue response. This study aimed to identify the gene expression profiles of replanted teeth and evaluate the functional differences between immediate and delayed replantation. Methods: Maxillary molars from Sprague-Dawley rats were extracted, exposed to a dry environment, and then replanted. The animals were divided into 2 groups according to the extra-oral time: immediate replantation (dry for 5 minutes) and delayed replantation (dry for 60 minutes). Either 3 or 7 days after replantation, the animals were sacrificed. Periodontal soft tissues were harvested for mRNA sequencing. Hallmark gene set enrichment analysis was performed to predict the function of gene-gene interactions. The normalized enrichment score (NES) was calculated to determine functional differences. Results: The hallmark gene sets enriched in delayed replantation at 3 days were oxidative phosphorylation (NES=2.82, Q<0.001) and tumor necrosis factor-alpha (TNF-α) signaling via the nuclear factor kappa light chain enhancer of activated B cells (NF-κB) pathway (NES=1.52, Q=0.034). At 7 days after delayed replantation, TNF-α signaling via the NF-κB pathway (NES=-1.82, Q=0.002), angiogenesis (NES=-1.66, Q=0.01), and the transforming growth factor-beta signaling pathway (NES=-1.46, Q=0.051) were negatively highlighted. Conclusions: Differentially expressed gene profiles were significantly different between immediate and delayed replantation. TNF-α signaling via the NF-κB pathway was marked during the healing process. However, the enrichment score of this pathway changed in a time-dependent manner between immediate and delayed replantation.

• Restorative Dentistry and Endodontics
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• 제38권4호
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• pp.194-203
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• 2013

Objectives: To investigate the effect of enamel matrix derivative (EMD) on periodontal healing of replanted teeth in animal models. Materials and Methods: The authors searched MEDLINE, PubMed, EMBASE, Cochrane Library, Web of Knowledge and Scopus for articles published up to Oct 2012. Animal studies in which EMD was applied in transplanted or replanted teeth with adequate controls and histological data were considered. Normal periodontal healing or root resorption determined by histology after EMD was applied in replanted teeth with adequate controls was used as outcome measures. The following search strategy was used: ('Emdogain' OR 'enamel matrix proteins' OR 'enamel matrix derivative') AND ('avulsion' OR 'transplantion' OR 'autotransplantation' OR 'replantation'). Results: Six animal studies were included in the final review. There was great heterogeneity in study design among included studies. Two studies with similar study designs were identified and analyzed by a meta-analysis. The pooled estimates showed a significantly higher normal healing and surface resorption and significantly less inflammatory and replacement resorption in EMD-treated groups compared with non-EMD-treated groups. Conclusions: With the limitations of this systematic review, the use of EMD led to greater normal periodontal healing and surface root resorption and less inflammatory and replacement root resorption in the presence of periodontal ligaments. However, no definite conclusion could be drawn with regard to the effect of EMD on periodontal healing and root resorption when no periodontal ligaments exist.

• 대한치과의사협회지
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• 제15권2호
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• pp.115-120
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• 1977

Extensive avulsion of the scalp, or stripping of a large area of soft tissue from the skull, is a serious accidnet. The avulsed scalp is often injured otherwise, such as by crushing, tearing, or from multiple laceration. The surrounding skin may be devitalized. Replacement of the scalp is usually followed by necrosis and sloughing within a short time. In such instances, the outer table of the cranium may become sucessively exposed. dry, dead, and affected by osteomyelitis. Hence the securing of early healing to prevent these is of the utmost importance. The successful case of reimplantation of the completely avulsed scalp, which is exposured to air for about 14 hours, is reported, in which there was partial growth of hair afterwards. The avulsed scalp caused by her long hair being caught in a grain belt was contaminated with hairs & dust. Authors treated this 19-year old female patient by split thickness skin graft, intermediate skin graft, full thickness skin graft from her own avulsed scalp.

• Restorative Dentistry and Endodontics
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• 제37권4호
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• pp.228-231
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• 2012

Invasive cervical resorption is a relatively uncommon form of external root resorption. It is characterized by invasion of cervical region of the root by fibrovascular tissue derived from the periodontal ligament. This case presents an invasive cervical resorption occurring in maxillary lateral incisor, following damage in cervical cementum from avulsion and intracoronal bleaching procedure. Flap reflection, debridement and restoration with glass ionomer cement were performed in an attempt to repair the defect. But after 2 mon, more resorption extended apically. Considering root stability and recurrence potential, we decided to extract the tooth. Invasive cervical resorption in advanced stages may present great challenges for clinicians. Therefore, prevention and early detection must be stressed when dealing with patients presenting history of potential predisposing factors.

• 대한소아치과학회지
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• 제39권2호
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• pp.120-128
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• 2012

본 연구는 전라북도 지역 초등학교 교사에게 적합한 치아외상 교육내용 및 효과적인 전달 방법이 마련될 수 있도록 치아외상에 대한 지식수준을 파악하고 기존 연구에서 자세히 다루지 않았던 교육현황을 조사하는 데 그 목적이 있다. 전북지역 초등학교 교사 231명에게서 설문지를 통하여 자료를 수집하였으며 설문 문항은 응답자의 일반 사항, 치아외상 교육현황 및 태도, 사례를 통한 지식수준, 치아 보관 매체에 대한 질문으로 구성하였다. 조사 결과 치아외상 대처방법에 교육을 받은 교사는 15.2%에 불과하였고, 교사들을 대상으로 치아외상 대처방법에 대한 교육이 필요한지에 대한 질문에서는 97%가 필요하다고 대답하여 교사 스스로도 치아외상 교육의 필요성에 대해 공감하고 있었으며 교육 방식으로는 전문가에 의한 직접 교육을 선호하였다. 사례를 통한 평가에서는 문항 간에 다소 차이는 있었으나 응급상황시 적절히 대처하기에는 지식수준이 대체로 불충분한 것으로 나타났다. 따라서 향후 전라북도 초등교사들에게 적합한 교육방식과 교육내용을 객관적으로 분석하는 연구 및 교사들에게 알맞은 교육 프로그램의 개발 등이 필요하리라 사료된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.439-447
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• 2011

Introduction: In today's society, the rapid and appropriate care of the dental emergency patients is much more important. So, a retrospective study on the characteristics of emergency dental injuries and diseases will be very meaningful. Materials and Methods: This retrospective clinical study was carried by reviewing the radiographic films and emergency chart of 11,493 patients who had visited the emergency room of Hallym Sacred heart Hospital and were treated in the Department of Oral and Maxillofacial Surgery from January 2006 to December 2010. Results: The male to female ratio was 1.9:1. The highest monthly incidence was observed in May (10.4%) and June (8.9%) and the peak age distribution was the first decade (56.0%), followed by the second decade (16.0%). Trauma was the most common cause in dental emergency patients, followed in order by toothache, odontogenic infection, temporomandibular joint (TMJ) disorder and oral hemorrhage. Soft tissue injury was most prevalent in the trauma group, followed by tooth injury and facial bone fractures. In the tooth injury group, tooth fracture (56.7%) showed the highest incidence followed in order by tooth subluxation (18.2%), tooth concussion (16.9%), tooth avulsion (11.5%) and alveolar bone fractures (3.7%). In the facial bone fracture group, mandibular fractures (81.8%) showed the highest incidence followed in order by maxilla fractures (15.7%), nasal bone fractures (9.0%), zygomaticomaxillary complex fractures (5.4%), orbital bone fractures (2.5%). In mandibular bone fractures, the most common location was the symphysis (70.1%), followed in order by the mandibular angle (33.0%), mandibular condyle (22.8%) and mandibular body (13.6%). In the infection group, a submandibular space abscess (46.2%) was most common followed in order by a buccal space abscess (17.4%), canine space abscess (16.9%) and submental space abscess (12.3%). TMJ dislocation (89.3%) showed the highest incidence in the TMJ disorder group, followed by TMJ derangement (10.7%). In the other group, a range of specific symptoms due to post operation complications, trigeminal neuralgia, chemical burns and foreign body aspiration were reported. Conclusion: For the rapid and appropriate care of the dental emergency patients, well-organized system should be presented in oral and maxillofacial surgery. And it is possible under analysis of pattern and the variation of the dental emergency patients.

• 대한소아치과학회지
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• 제38권3호
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• pp.217-228
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• 2011

학교에서 학생들의 치아외상은 흔한 일이다. 따라서 이 연구의 목적은 광주광역시의 초중고 교사들의 치아외상 처치 방안과 지식을 설문지를 사용하여 평가하는 것이다. 광주광역시의 초중고 중에서 무작위로 선정된 초등학교 교사 325명, 중학교교사 101명, 고등학교 교사 232명으로 총 658명(남성362명, 여성296)에게 설문지를 배분하여 조사하였다. 설문지 1에는 성별, 나이, 교직경험, 치과적인 외상에 관한 교육여부 등이 포함되었다. 설문지 2는 특정 치아외상이 일어난 상황에서 적절한 태도에 대한 질문을 포함하고 있다. 설문지 3은 가능한 응급 서비스와 손상된 치아의 상태에 관한 지식을 물어보는 질문으로 구성되었다. 치아파절시 대처 태도에서 남녀 교사 사이에는 유의한 차이가 있었다. 치아 완전탈구시 대처 태도에서 초중고교사 사이에는 유의한 차이가 있었다. 문항별로 차이는 있었으나, 치아 외상 처치에 있어서 광주광역시 교사들의 전반적인 지식과 인지상태가 불충분함을 보여주었다. 따라서 향후 치아외상시 즉각적 처치에 대한 초중고 교사들의 지식을 향상시키기 위한 교육적 프로그램이 필요하다.

• 대한소아치과학회지
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• 제50권3호
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• pp.347-359
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• 2023

본 연구는 탈구된 치아의 저장 매체로서 polydeoxyribonucleotide (PDRN)의 적합성을 평가하고자 하였다. HBSS와 10, 25, 50, 100 ㎍/mL 농도의 PDRN 용액과 수돗물에 저장된 인간 치주인대 세포의 생존율을 측정하기 위해 Cell Counting Kit-8 assay와 Live/Dead assay를 시행하였다. 또한, PDRN의 항염증 효과를 평가하기 위한 NO 검출 및 qRT-PCR 실험을 진행하였다. 100 ㎍/mL 농도의 PDRN 용액에 저장된 치주인대 세포의 생존율이 다른 용액보다 유의하게 높았다(p < 0.01). 또한, 100 ㎍/mL 농도의 PDRN 용액은 유의하게 NO의 생산을 줄였다(p < 0.0001). 그리고, HBSS 용액에 비하여 50 및 100 ㎍/mL 농도의 PDRN 용액에서 유의하게 tumor necrosis factor α, interleukin (IL)-4, IL-6, 그리고 IL-10의 발현이 낮았다(p < 0.01). 이 연구를 통해 PDRN은 치주인대 세포에 세포 보존 및 항염증 효과를 가진 것으로 밝혀졌다. 이 연구는 효과적인 탈구치 저장매체의 개발을 위한 향후 추가적인 실험의 기반이 될 수 있을 것이라 생각한다.

• Restorative Dentistry and Endodontics
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• 제39권2호
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• pp.126-131
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• 2014

Among dental traumas, horizontal root fractures are relatively uncommon injuries. Proper initial management and periodical evaluation is essential for the successful treatment of a root-fractured tooth. If pulpal necrosis develops, endodontic treatment is indicated, exclusively for the coronal fragment. Fragment diastases exert a great influence on healing at the fracture line and on pulpal necrosis. An adequately treated root-fractured tooth has a good prognosis. This case report describes the treatment and 2-yr follow up of 3 maxillary central incisors, first with horizontal root fracture, second with horizontal root fracture and avulsion, and third with horizontal root fracture and lateral luxation. All three cases were treated with mineral trioxide aggregate (ProRoot, Dentsply). During 2 yr of follow-up evaluation, the root-fractured teeth of the present patients were well retained in the arch, showing periodontal healing, even after endodontic treatment.

• 대한소아치과학회지
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• 제47권3호
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• pp.303-311
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• 2020

이 연구의 목적은 치아의 완전탈구를 주소로 내원한 소아 청소년을 대상으로 보호자 및 구급대원과 응급의학과 의사가 보인 탈구치의 보관 방법을 조사하여 인식을 평가하고자 하였다. 최근 18년간 아주대학교 치과병원에서 영구치의 완전탈구로 진단받고 응급처치를 시행받은 만 17세 이하의 환자 183명을 대상으로 후향적 조사를 시행하였다. 조사 결과 치아의 보관매체로 부모와 보건교사 모두 우유를 가장 많이 이용하였다. 다음으로 부모는 건조 상태로, 보건교사는 생리식염수에 치아를 보관하는 비율이 높았다. 치아의 보관매체로 구급대원은 생리식염수를 가장 이용하였고 응급의학과 의사의 경우 재식 실패 시 생리식염수만을 이용하였다. 이상의 결과들을 통해 적합한 치아의 보관매체에 대한 교육이 필요할 것으로 사료되었다. 외상 현장에서 즉시 재식이 불가능할 경우, 치아의 보관매체로 우유가 권장되며 우유가 식염수보다 우수한 보관매체임에 관한 교육 역시 필요해 보였다. 보호자 및 응급처치를 행하는 구급대원과 응급의학과 의사들을 대상으로 완전탈구된 치아의 보관 방법에 대한 인식을 향상시킬 수 있는 체계적인 교육이 필요할 것으로 사료되었다.