• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권2호
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• pp.176-179
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• 2011

Adenomatoid odontogenic tumors represent 3 to 7 percent of all odontogenic tumors. These tumors are more common in the maxilla than the mandible and usually include the anterior region. Clinically, the most common symptom is painless swelling and the tumor is associated with an unerupted tooth, typically a maxillary or mandibular cuspid. The adenomatoid odontogenic tumor appears radiographically as a unilocular radiolucency around the crown of an impacted tooth, resembling a dentigerous cyst. More often, it contains fine calcifications. Histopathologically, there is a thick wall cystic structure with a prominent intraluminal proliferation of the odontogenic epithelium. The most striking pattern is varying-sized solid nodules of spindle-shaped or cuboidal epithelial cells forming nests or rosette-like structures with minimal stromal connective tissues. Conspicuous within the cellular areas are structures of tubular or duct-like appearance. The duct-like spaces are lined with a single row of cuboidal or low columnar epithelial cells, of which the ovoid nuclei are polarized away from the luminal surface. Small foci of calcification may also be scattered throughout the tumor. These have been interpreted as abortive enamel formations. In some adenomatoid odontogenic tumors, the material has been interpreted as dentoid or cementum.

• 대한소아치과학회지
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• 제31권1호
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• pp.52-58
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• 2004

과잉치는 유치열에서 0.3-0.8%, 영구치열에서 1.0-3.5% 정도로 발생하며, 2:1로 남자에게 호발 9:1로 상악에서 호발한다. 그 중 하악 전치부에서 발생하는 빈도는 전체 과잉치중에서 2-4%의 매우 낮은 빈도를 보인다고 보고되었다. 과잉치가 계속 존재할 경우 나타날 수 있는 합병증으로서 치간이개, 인접한 정상치아의 맹출장애, 치관의 형성이상, 인접치의 치근흡수, 함치성 낭종 등을 들 수 있으며, 치열 발육 중인 어린이의 경우 성장 중임을 감안하여 바람직한 교합유도를 위한 정확한 진단과 함께 적절한 처치가 필요하다. 본 증례는 전북대학교병원 소아치과에 내원한 6세 환아의 하악 전치부에서 발견된 양측성 매복 과잉치로서 그 중 한개는 영구치와 융합된 경우를 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권2호
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• pp.160-166
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• 1991

치성낭종과 법랑아세포종과의 조직학적 기준이 모호한 경우에 과거에는 병리학자들이 진단하는데 어려움이 많았으나 1970년 Robinson & Martinez가 조직학적 기준을 제시하면서 unicystic ameloblastoma라 명명하였다. Unicystic ameloblastoma는 conventional ameloblastoma 보다 젊은 연령인 10대, 20대에서, 하악 제3대구치부에서 호발하며 방사선학적으로 단방성 혹은 다방성의 비교적 경계가 뚜렷한 방사선 투과성 병소를 보인다. 이 병소는 적출술만으로 치료하였을 때 solid or multicystic ameloblastoma보다 현저히 낮은 재발율을 보인다. 임상적, 방사선학적으로 unicystic ameloblastoma가 의심되면 병소를 완전히 적출하여 정확한 병리조직학적 진단을 하여 solid or multicystic ameloblastoma일 때는 2차적으로 광범위한 수술 등을 고려하는 것이 타당할 것으로 사료되어 문헌고찰과 함께 3증례의 치료 경험을 보고하는 바이다.

• 대한소아치과학회지
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• 제32권2호
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• pp.278-283
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• 2005

하악 견치의 매복은 흔하지 않으며, 특히 정중선을 지나서 전위 매복되는 경우는 매우 드물다. 매복 견치의 처치는 장애물의 존재 여부와 매복 위치와 방향, 맹출 가능한 공간의 유무, 치근의 형성 단계에 따라, 맹출 장애요인을 제거한 후의 주기적 관찰 및 외과적 노출과 교정적 견인, 치아 이식, 외과적 발치 등의 방법으로 이루어진다. 본 두 증례 중 치아종과 함치성 낭종을 동반한 매복 견치를 갖는 환아에서 외과적 노출과 교정적 견인을 시행하였고, 함치성 낭종과 과잉치에 의해 매복된 하악 견치를 갖는 환아에서는 견치가 전위 매복된 상태로, 교정적 견인이 어렵다고 판단되어 자가 이식 후 근관 치료와 교정 치료를 시행하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권4호
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• pp.190-193
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• 2015

Objectives: A mesiodens appears most commonly as a supernumerary tooth impacted in the anterior maxilla. The purpose of this study is analyze mesiodens clinically. Materials and Methods: Gender, crown form, direction of impaction, relation to permanent incisors, and chief complaints of patients with extracted mesiodens were analyzed. Results: Patients were analyzed for motivation to visit the hospital; 85.4% of the patients were referred from other hospitals. Mesiodens was more common in males than in females (3.7:1), and 70.1% of patients had only one mesiodens, while 29.6% had two mesiodenses. Of the mesiodenses, 61.4% were of the aconical form, and the most common direction was upward (62.4%), followed by the normal position (26.0%) and the horizontal position (11.6%). The mesiodenses caused orthodontic problems with the permanent incisors in 46.3% of cases. Mesiodens associated with dentigerous cyst was rarely observed in our patient group. Conclusion: Mesiodens is more common in males than in females and often affects the permanent incisors. Thus, careful clinical and radiological evaluations of mesiodenses are important.

• Imaging Science in Dentistry
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• 제40권3호
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• pp.109-114
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• 2010

Purpose : This study was performed to analyze the position, pattern of impacted mesiodens, and their relationship to the adjacent teeth using Dental cone-beam CT. Materials and Methods : Sixty-two dental cone-beam CT images with 81 impacted mesiodenses were selected from about 2,298 cone-beam CT images at Chonnam National University Dental Hospital from June 2006 to March 2009. The position, pattern, shape of impacted mesiodenses and their complications were analyzed in cone-beam CT including 3D images. Results : The sex ratio (M : F) was 2.9 : 1. Most of the mesiodenses (87.7%) were located at palatal side to the incisors. 79% of the mesiodenses were conical in shape. 60.5% of the mesiodenses were inverted, 21% normal erupting direction, and 18.5% transverse direction. The complications due to the presence of mesiodenses were none in 43.5%, diastema in 19.4%, tooth displacement in 17.7%, delayed eruption or impaction in 12.9%, tooth rotation in 4.8%, and dentigerous cyst in 1.7%. Conclusions : Dental cone-beam CT images with 3D provided 3-dimensional perception of mesiodens to the neighboring teeth. This results would be helpful for management of the impacted mesiodens.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권1호
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• pp.55-63
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• 2012

The odontogenic keratocyst (OKC) was originally classified as a developmental cyst, and OKCs were histologically divided into orthokeratotic (O-OKCs) and parakeratotic (P-OKCs) types. Clinical features differ between O-OKCs and P-OKCs with P-OKCs having a tendency to recur after surgical treatment. According to the revised histopathological classification of odontogenic tumors by the World Health Organization (2005), the term keratocystic odontogenic tumor (KCOT) has been adopted to describe P-OKCs. In this retrospective study, we examined 186 KCOTs treated at the Maxillofacial Surgery Department of the Tokyo Medical and Dental University Hospital from 1981 through 2005. The patients ranged in age from 7 to 85 years (mean, 32.7) and consisted of 93 males and 93 females. The most frequently treated areas were the mandibular molar region and ramus. The majority of KCOTs in the maxillary region were treated by enucleation and primary closure. The majority of KCOTs in the mandibular region were enucleated, and the wound was left open. Marginal resection was performed in the 4 patients with large lesions arising in the mandible. In patients who were followed for more than a year, recurrences were observed in 19 of 120 lesions (15.8%). The recurrences were found at the margins of the primary lesion in contact with the roots of the teeth or at the upper margins of the mandibular ramus. Clinicians should consider aggressive treatment for KCOTs because the recurrence rate of P-OKCs is higher than that of other cyst types such as O-OKCs, dentigerous cysts, primordial cysts that were non-keratinized, and slightly keratinized stratified squamous epithelium. Although more aggressive treatment is needed for KCOTs as compared to other cystic lesions, it is difficult to make a precise diagnosis preoperatively on the basis of clinical features and X-ray imaging. Therefore, preoperative biopsy is necessary for selecting the appropriate treatment for patients with cystic lesions.

• 대한소아치과학회지
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• 제35권2호
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• pp.333-338
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• 2008

과잉치란 정상에 비해 많은 수의 치아를 일컫는 것으로 유치열기와 혼합치열기에 발생하며, 여러 가지 임상적 문제를 일으킬 수 있다. 특히 상악 전치부의 과잉치는 상악 전치의 맹출 장애 및 전위, 정중부의 치간 이개, 치근 흡수, 함치성낭종 형성 등의 문제를 유발할 수 있으므로 조기에 진단하고, 과잉치의 위치 및 수, 형태에 따라 적절한 치료를 시행하는 것이 중요하다. 이 증례는 상악 전치부에 네 개의 과잉치가 영구치의 맹출을 방해하고 있는 경우로, 발거 시 합병증을 최소화하기 위하여 두 단계로 나누어 발거하였다. 컴퓨터 단층 촬영에서 네 개의 과잉치가 주위의 영구치 맹출을 방해하고 있었고, 그 중 두 개의 과잉치는 절치 치배에 매우 근접해 있었다. 네 개의 과잉치를 동시에 제거할 경우 영구 치배에 손상을 줄 위험이 있으므로 두 개의 역위 매복된 원추형의 과잉치만 먼저 발거하였다. 남은 두 개의 과잉치는 위치가 변화되기를 기다린 후 두 번째 발거 수술을 시행하여, 주위 절치 치배에 손상을 가하지 않고 치조골 삭제를 적게 하여 합병증 발생을 줄일 수 있었다.

• 대한소아치과학회지
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• 제32권4호
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• pp.644-648
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• 2005

과잉치는 정상치판(dental lamina)의 과도한 증식의 결과로 발생되어 가족적 성향을 보이며, 쇄골두개이형성(Cleidocranial dysplasia), Gardner 증후군 등의 여러 질환과 관련되어 나타나기도 한다. 그 빈도는 유치열에서 $0.3{\sim}0.8%$, 영구치열에서 $1.0{\sim}3.5%$이고, 남성에서 호발되며(2 : 1), 상악에서 더 많이 발생한다(9 : 1). 상악에서는 mesiodens라고 불리는 중절치 사이의 위치가 가장 흔한 부위이고, 그 다음은 fourth molar와 측절치 부위이다. 하악에서는 소구치 부위가 가장 흔한 부위이고 전치부위에서는 약 2%로 매우 드물게 발생한다. 과잉치의 만기 잔존은 치간 이개, 인접한 치아의 맹출 장애, 치근 흡수 등을 야기하고 과잉치와 관련되어 함치성 낭종이 발생될 수 있으므로 조기진단과 적절한 치료가 중요하다. 본 두 증례는 비교적 드물게 나타나는 하악에 발생한 과잉치로, 하악 전치부와 소구치부에 발생한 과잉치를 발거하고 교정치료를 시행하여 양호한 결과를 얻었기에 보고하는 바이다.

• 대한소아치과학회지
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• 제25권1호
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• pp.127-133
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• 1998

An impacted tooth is defined pathologically as a tooth that remains under the mucosa of inside bone without eruption of the crown after a specific period of eruption. Clinically, the term includes those teeth, even before eruption period, that are not expected to erupt due to shape, position and alignment of tooth and lack of space. Canine is prone to impaction more than other teeth because it has the longest time to develop and a complex route from the place of formation to the site of eruption. The impaction incidence of maxillary canine is repoted 0.92$\sim$3.3% (Ferguson, 1990). In 1995 Orton reported that the incidence was 0.92$\sim$2.2% and palatal impaction was more frequent than labial impaction(85%:15%). In 1969 Johnston presented it was more common to woman than to man(3:1). The etiology includes systemic disease such as endocrine disorder, cleidocranial dysostosis, irradiation, Crouzon syndrome, ricketts, facial hemihypertrophy and hereditary and local problems such as ectopic position of the tooth, distance of tooth from its place of eruption, malformation of the tooth, presence of supernumerary teeth, trauma of tooth germ, infection of tooth germ, displacement of tooth germ or tooth by a neoplasm, ankylosis, overretention of deciduous predecessor, lack of space for the tooth in the dental arch and mucosal barrier due to gingival fibrosis. The maxillary canine is especially important as it has the longest root, provides guidance for lateral movement of the mandible and masticatory function and assumes an important role esthetically as it is located at mouth angle. If left untreated, it may cause migration and external, internal resorption of adjacent teeth, loss of arch length, formation of dentigerous cyst or tumors, infection and referred pain as well as malposition of the tooth. Therefore, periodic examination of the development and eruption of the maxillary canine is especially important in a growing child. This case study presents the results of treatment of palatally impacted maxillary canine utilizing surgical exposure and orthodontic tooth movement on patients visiting SNUDH dept. of pediatric dentistry.