• Title/Summary/Keyword: Dentition, Permanent

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TREATMENT OF HORIZONTAL AND VERTICAL ROOT FRACTURE IN IMMATURE PERMANENT TEETH - A CASE REPORT (미성숙 치근의 수직 파절과 수평 파절의 치험례)

  • Song, Seung-Ho;Park, Ho-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.92-97
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    • 2004
  • Traumatic injuries in the young peranent dentition are common, but root fractures, defined as fractures in volving dentin, cementum and pulp, are relatively uncommon. Case 1 is a 9-year-old boy who had a horizontal root fracture of his maxillary right central incisor in the apical third. Root canal therapy was performed in coronal segment and calcium hydroxide therapy was initiated. Six months after treatment, a periapical radiograph showed calcific tissue formation and normal root development. 1 year and 3 months later, the canal was permanently obturated with gutta-percha. Case 2 is a 7-year-old girl who had a vertical root fracture of her maxillary right central incisor. Fractured tooth was intentionally extracted atraumatically, and then the separated fragments are bonded with resin cement. the restored tooth was replanted into the original socket. Recalls up to 8 months showed normal mobility and no periapical pathosis. In these cases, we performed conservative treatment. Clinical and radiographic examination showed no pathosis or abnormality of the teeth and periodontal tissue.

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TRANSPOSITION OF THE IMPACTED PRIMARY SECOND MOLAR AND THE TOOTH GERM OF SECOND PREMOLAR (매복된 제 2유구치와 제 2소구치 치배의 전위에 관한 증례 보고)

  • Kim, Song-Yi;Choi, Seong-Chul;Kim, Gwang-Chul;Lee, Keung-Ho;Choi, Yeong-Chul;Park, Jae-Hong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.4
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    • pp.722-727
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    • 2006
  • Most of impacted teeth reported are permanent teeth. Impaction of primary tooth caused by primary failure of eruption is rare and the most of impacted primary tooth are second primary molars. The etiology of a primary molar impaction would appear to be a physical barrier, early ankylosis of the tooth, abnormal development of the primary molar germ or malposition of the successor bud. Transposition has been described as an interchange in the position of two teeth within the same quadrant of the dental arch. It is most commonly seen with canine and lateral incisor teeth, but is rarely associated with the primary dentition. The two cases show the transposition of impacted primary molar and the tooth germ of second premolar in their clinical and radiographic examinations. In case 1, lower second primary molar was deeply impacted inferiorly to the tooth germ suspected to be a second premolar. In case 2, impacted all second primary molars were positioned inferiorly to the tooth germs suspected to be the successors. We extracted all second primary molars under general anesthesia and the extracted tooth germs appeared to be second premolars.

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AMELOBLASTIC FIBROMA IN MIXED DENTITION : A REPORT OF 2 CASES (법랑모세포섬유종 환아에 관한 증례보고)

  • Kwon, Joung-Hyun;Lee, Jae-Ho;Choi, Hyung-Jun;Choi, Byung-Jai;Son, Heung-Kyu;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.2
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    • pp.309-314
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    • 2007
  • Ameloblastic fibroma is a rare benign tumor, accounting for only 2.5% of odontogenic tumors. It occurs during the period of tooth formation between the ages of 5 and 20 years with the average age being about 15. There is no gender predilection. In the majority of cases, the lesion arises in the mandible, presenting the swelling of jaw and the failure of tooth eruption. In this report, the main concern of the patient was the failure of eruption of lower permanent and deciduous molars. Radiographic investigation showed a radiolucency surrounding the crown of unerupted teeth. Surgical intervention and histopathologic study revealed the lesion to be ameloblastic fibroma. After the surgery, no evidence of residual tumor or recurrency was found. These patients are scheduled for the long-term continuing evaluation of the eruption of adjacent teeth and successor with radiographic study.

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INTRA-ALVEOLAR TRANSPLANTATION OF COMPLETELY CROWN-ROOT FRACTURED TOOTH WITH DEMINERALIZED FREEZED DRIED BONE GRAFT (치은연 하방으로 파절된 치아의 탈회냉동건조골을 이용한 Intra-alveolar transplantation)

  • Lim, Hyoung-Soo;Kim, Dong-Phil;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.344-350
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    • 2000
  • Incidence of crown-root fracture due to traumatic injury, have been reported 3% in the permanent dentiton, 2% in the deciduous dentition. There are two treatment methods for crown-root fractured teeth with pulp exposure, when the fracture line was located under the alveolar crest. One way is the extrusion by orthodontic force the other way is intra-alveolar transplantation which occlusally repositioning of apical fragment in the alveolar socket. Since intra-alveolar transplantation has introduced in 1970s, it was practiced as alternative to orthodontic extrusion. As the result, this method may thoughted that had a good prognosis. As a result of trauma, completely crown-root fracture was occured in the maxillary right central incisor in this case. We couldn't reposition the deepest fracture line above the alveolar crest by the conventional surgical extrusion, because apical fragment was too short. Thus, after extraction of apical fragment, we repositioned it to the socket following demineralized freezed dried bone graft, which possible to support the apical fragment. At the 15-month recall examination, the root still showed normal mobility and there was not observed any in flammatory or replacement root resorption in the periapical radiograph.

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A STUDY OF MANDIBULAR ANATOMY FOR ORTHOGNATHIC SURGERY IN KOREANS (악교정 수술을 위한 한국인 하악지의 해부학적 위치에 관한 연구)

  • Woo, Soon-Seop;Cho, Jung-Yeon;Park, Won-Hee;Yoo, Im-Hag;Lee, Young-Soo;Shim, Kwang-Sup
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.2
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    • pp.126-131
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    • 2002
  • Anatomical shape of the mandibular ramus, which includes the area from the rear of the mandibular second molar to the mandibular posterior border and from the mandibular sigmoid notch to the inferior mandibular border, must be carefully considered to perform orthognathic surgery. The locations of the lingula and mandibular foramen in medial side of mandibular ramus are one of the most important factors to decide the location of the horizontal medial osteotomy in sagittal split ramus osteotomy and to select the line of vertical osteotomy in intraoral vertical ramus osteotomy. Sixty-five different Korean human dry mandibles were surveyed. All mandible have permanent dentition including complete eruption of the mandibular second molar. The locations of the lingula and mandibular foramen in medial side of the ramus were identified and following results were obtained. Anterior ramal horizontal distance from lingula was $16.13{\pm}3.53mm(range:8.6{\sim}24.3mm)$, anterior ramal horizontal distance from mandibular foramen was $23.91{\pm}4.79mm(range: 14.1{\sim}39.7mm)$, horizontal width of mandibular foramen was $2.79{\pm}0.95mm(range:1.5{\sim}6.1mm)$, height of lingula was $10.51{\pm}3.84mm(range:3.1{\sim}22.4mm)$, vertical distance from sigmoid notch to lingula was $19.82{\pm}5.11mm(range:9.1{\sim}35.3mm)$. From this study, the result could be used to select the location of osteotomy lines and to decide amount of periosteal elevation to avoid injury of neurovascular bundle, and to accomplish the appropriate split in Korean patients in mandibular orthognathic surgery.

ORAL REHABILITATION IN ECTODERMAL DYSPLASIA WITH OLIGODONTIA

  • Kim, Ryoung;Choi, Yeong-Chul;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.4
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    • pp.636-643
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    • 1999
  • Ectodermal dysplasia is a genetic birth defect in which at least abnormally develop two structures derived from the ectoderm. It is usually inherited in autosomal dominant or autosomal recessive pattern. Oral manifestations are oligodontia, anodontia, dysmorphic teeth(conical shape), decreased occlusal vertical dimension and alveolar bone. Extraoral signs may include decreased or absent sweat glands, sparse and fine hair, saddle nose, hearing loss and decreased production of body fluids including saliva. Most affected children require extensive dental treatment to restore their appearance and help the development of a positive self image. The patient's overclosed profile was due to a decreased vertical dimension. The use of overdenture is to preserve erupted teeth, to accomodate the newly constructed occlusal plane, to improve retention and stability of denture and to maintain the remaining alveolar bone. The restoration of vertical dimension improved the child's speech, swallowing, and eating. Growth continue until the age of approximately 18. As child grows, replacement dentures will have to be fabricated primarily to accomodate increasing vertical dimension and changing dentition. Implants may be indicated later if the alveolar bone is adequate. Periodic recall visits are advised, to monitor the dentures during periods of growth and development, and eruption of the permanent teeth.

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INTENTIONAL REPLANTATION OF THE CROWN-ROOT FRACTURED TOOTH: A CASE REPORT (치관-치근 파절된 치아의 의도적 재식술 치험례)

  • Kim, Soo-Kyoung;Ahn, Seung-Tae;Choi, Sung-Chul;Kim, Kwang-Chul;Park, Jae-Hong
    • 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.

CONSERVATIVE TREATMENT OF A UPPER CENTRAL INCISOR WITH POOR PROGNOSIS (예후가 불량한 상악 중절치의 유지)

  • Lee, Doo-Young;Kim, Seung-Hye;Choi, Hyung-Jun;Choi, Byung-Jai;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.3
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    • pp.368-373
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    • 2010
  • The incisors function as instruments for biting and cutting food during mastication. They also support the lips and face and maintain vertical dimension. In addition, they contribute to overall normal arch appearance. They play important role during the articulation of speech and assist in guiding jaw closure. Extraction and space maintenance are the most common treatment for a tooth with poor prognosis. However, in the mixed dentition, extraction of the upper permanent incisors results in many complications, such as resorption of alveolar bone, poor esthetics, pronunciation, and mastication. Considering these various roles of incisors in oral cavity, approach for traumatized incisors, even the ones with poor prognosis, should be considered first prior to simple extraction. The dentist must take into account the age of the patient, growth potential, occlusion, oral hygiene status, economic status and motivation towards dental health in addition to patient compliance. In this case, although the prognosis was predicted to be unfavorable due to short root and mobility, we could save the central incisor using conservative treatment, reposition by orthodontic appliance instead of extraction.

Comparison of model analysis measurements among plaster model, laser scan digital model, and cone beam CT image (석고 모형, 레이저 스캔 디지털 모형, 콘 빔 CT 영상 간의 모형 분석 계측치 비교)

  • Lim, Mi-Young;Lim, Sung-Hoon
    • The korean journal of orthodontics
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    • v.39 no.1
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    • pp.6-17
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    • 2009
  • Objective: The purpose of this study was to evaluate the possibility of using a digital model and cone beam computed tomograph(CBCT) image for model analysis. Methods: Model analyses of CBCT images, plaster models, and digital models of 20 orthodontic patients with a permanent dentition with no proximal metal restorations, were compared. Results: The average differences of tooth size measurements were 0.01 to 0.20 mm, and the average difference of arch length discrepancy measurements were 0.41 mm in the maxilla and 0.82 mm in the mandible. The difference in Bolton discrepancy measurements was 0.17 mm for the anterior region and 0.44 mm overall but with no statistically significant difference. When comparing CBCT images with plaster models, the average differences in tooth size measurements were -0.22 to 0.01 mm, and the average differences in arch length discrepancy measurements were 0.43 mm in the maxilla and 0.32 mm in the mandible. Difference in Bolton discrepancy measurements were 0.35 mm in the anterior region and 1.25 mm overall. CBCT images showed significantly smaller overall Bolton discrepancy measurements. Conclusions: Although there were statistically significant differences in some model analysis measurements, the ranges of measurement errors of the digital model and CBCT images were clinically acceptable. Therefore, a digital model and CBCT image can be used for model analysis.

THE DIAGNOSIS OF IMPACTED MAXILLARY MESIODENS USING 3-DIMENSIONAL COMPUTED TOMOGRAPHY : A CASE REPORT (3차원 전산화 단층촬영을 이용한 상악 정중 과잉치의 진단)

  • Hong, Young-Woo;Kim, Seong-Oh;Sohn, Hyung-Kyu;Lee, Jong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.3
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    • pp.549-554
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    • 1998
  • The prevalence of the supernumerary tooth is $1{\sim}4%$. It usually occurs in the permanent dentition. It frequently occurs in the maxillary mid palatal area. The presence of the supernumerary tooth causes the following problems ; (1) interfering the eruption of successional tooth, (2) displacing the neighboring teeth, (3) resulting large diastema, (4) forming cystic change. So the supernumerary tooth should be removed as soon as possible. To extract the supernumerary tooth, the exact position must be noticed first. Radiographic techniques that were used in the past are tube shift technique, right angle technique, sterioradiography, using radiopaque contrast media and conventional tomography. But these methods include the subjective opinion of the operator. So, a technique eliminating the operator's opinion and showing the position 3-dimentionally can be used. 3-dimentional computed tomography equipped with dental softwares can show the position of the impacted supernumerally tooth in 3-dimentional position. It has an advantage to eliminate the subjective opinion of the operator. With a fast computer this techenique is done in a relatively short period of time. The rationale of this methods is relatively simple. After tacking X-ray and reconstructing the data 3-dimentionally, sequential removal of the soft tissue and hard tissue(bone) CT number leaves the teeth alone in 3-dimentional position. The image can be seen from anywhere, so the operator can see the image in front, rear, upper, and lower positions. In both cases 1 and 2, the position of the impacted supernumerary tooth is viewed by the 3-dimensional computed tomography. And it made the operator easy to figureout the exact position.

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