• Restorative Dentistry and Endodontics
• /
• v.24 no.2
• /
• pp.426-429
• /
• 1999

When the tooth avulsion occur in accidents the drying damage to the periodontal ligament has extremely detrimental effects on healing. Pulp necrosis always occurs after an avulsion injury, but revascularization can only take place in teeth with immature apexes. Therefore complications after avulsion injuries are common, and treatment must be carried out in a timely and correct fashion to prevent or limit these complications. Every effort should be made to replant the tooth within the first 15 to 20 minutes. If doubt exists that the tooth can be replanted adequately, the tooth should quickly be stored in an appropriate medium until the patient can get to the dental office for replantation. A complication of inflammatory root resorption is occurred by bacterial infection of periodontal ligament and dental pulp. Therefore aseptic endodontic treatment must be carried out in a timely and systemic antibiotics given at the time of replantation and before endodontic treatment are effective in preventing bacterial invasion. Further studies are needed to establish the clinical importance of preparation of the socket and root.

• The korean journal of orthodontics
• /
• v.53 no.3
• /
• pp.205-216
• /
• 2023

Objective: To investigate changes in the immature teeth of Sprague-Dawley rats during orthodontic treatment and to explore the changes in the peri-radicular alveolar bone through micro-computed tomography (CT). Methods: Twenty-five 26-day-old male Sprague-Dawley rats were included. The maxillary left first molar was moved mesially under a continuous force of 30 cN, and the right first molar served as the control. After orthodontic treatment for 7, 14, 21, 28, and 42 days, the root length, tooth volume, and alveolar bone mineral density (BMD) around the mesial root were measured through micro-CT. Results: The immature teeth continued to elongate after application of orthodontic force. The root length on the force side was significantly smaller than that on the control side, whereas the differences in the volume change between both sides were not statistically significant. Alveolar bone in the coronal part of the compression and tension sides showed no difference in BMD between the experimental and control groups. The BMD of the experimental group decreased from day 14 to day 42 in the apical part of the compression side and increased from day 7 to day 42 in the apical part of the tension side. The BMD of the experimental group decreased in the root apex part on day 7. Conclusions: The root length and volume of immature teeth showed continued development under orthodontic forces. Alveolar bone resorption was observed on the compression side, and bone formation was observed on the tension side.

• Restorative Dentistry and Endodontics
• /
• v.37 no.2
• /
• pp.119-122
• /
• 2012

Regenerative endodontics has a potential to heal a partially necrotic pulp, which can be beneficial for the continued root development and strengthening of immature teeth. For this purpose, triple antibiotic mixture of ciprofloxacin, metronidazole, and minocycline was recommended as intracanal medicament in an attempt to disinfect the root canal system for revascularization of a tooth with a necrotic pulp. However, discoloration of the tooth was reported after applying this. This case shows the idea for preventing the tooth discoloration using a delivery syringe to avoid the contact between the clinical crown and the antibiotics.

• Restorative Dentistry and Endodontics
• /
• v.45 no.3
• /
• pp.29.1-29.9
• /
• 2020

This study describes the clinical steps taken in the treatment of a patient who had an avulsed right upper central incisor that presented with incomplete root development and chronic apical periodontitis. A 7-year-old boy was referred from a private dentist to a dental office specializing in endodontics. The tooth had remained in a dry environment for 20 minutes, and tooth replantation was performed at an emergency appointment. After clinical and radiographic examinations, root canal decontamination was performed, followed by several changes in intracanal calcium hydroxide medication. Blood clot formation was attempted, but bleeding within the root canal was insufficient; therefore, we opted for an intracanal medication change to stimulate mineralized tissue formation in the apical region. Root obturation was performed 45 days after the last change of intracanal medication, and clinical, radiographic, and tomographic follow-up examinations were performed at 3, 6, 18, and 40 months after the endodontic intervention. The increase in thickness and length of the root structure and the absence of root resorption were verified through follow-up examinations. Therefore, it was concluded that the procedures used were successful for tooth replantation.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.39 no.4
• /
• pp.397-403
• /
• 2012

The vitality of immature tooth could be lost by dental caries, trauma and fracture of malformed tooth. The vitality loss might lead to halt of the development of the root. The recommended endodontic treatment for a non-vital immature permanent tooth is apexification. Apexification is a method of inducing apical closure through the formation of mineralized tissue in the apical pulp region. Calcium hydroxide is the material of choice for apexification. Long-term exposure to calcium hydroxide may form the apical hard tissue, but weaken the dentin due to its alkaline nature and thus make the roots more susceptible to fracture. It is important to preserve any weakened tooth, so a permanent restoration is needed to reinforce teeth that are prone to fracture. The purpose of this case report was to describe the treatment for reinforcing immature teeth treated with long-term calcium hydroxide. In these cases, the apexes of teeth were sealed with MTA plugs and the root canals were restored with composite resin and fiber post.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.44 no.2
• /
• pp.220-227
• /
• 2017

Pre-eruptive intracoronal resorption (PEIR) is a rare radiolucent lesion often located within the dentin and adjacent to the dentin-enamel junction, underneath the occlusal aspect of the crowns of unerupted teeth. The treatment approaches for these lesions involved with unerupted teeth have been known as to be relatively simple; depending on the extent of resorption, follow-up or restoration can be performed after surgical exposure. However, once the tooth is exposed to the oral cavity after eruption, it becomes highly vulnerable to the development of carious lesions. Thus, immediate intervention is required in such cases; failure to address it may result in the need for more complex treatments including endodontic therapy. The aim of this case report was to describe the characteristics of PEIR and the clinical management of the impacted immature permanent teeth diagnosed with PEIR.

• The korean journal of orthodontics
• /
• v.48 no.2
• /
• pp.125-130
• /
• 2018

Traumatic dental injury is considered a public dental health problem because of a high childhood incidence, high treatment costs, and prolonged treatment time. Although management guidelines for traumatized teeth have been outlined, tooth loss following trauma is occasionally unavoidable. Here, we describe the successful interdisciplinary management of a traumatized central incisor in an 11-year old boy that was extracted because of a poor prognosis and restored by the autotransplantation of an immature donor tooth into the site. The patient underwent orthodontic treatment in order to close the donor site space and bring the autotransplanted tooth to an ideal position. Postorthodontic treatment radiographs and photographs revealed an esthetic and functional natural tooth replacing the lost tooth. The findings from this case suggest that autotransplantation offers unique advantages as a treatment modality for the restoration of missing teeth, particularly in growing children.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.26 no.4
• /
• pp.616-622
• /
• 1999

The primary objective of pulp treatment is to maintain the integrity and health of the oral tissues. The most important and difficult aspect of pulp therapy is determining the health of the pulp, or its stage of inflammation, so that a decision can be made regarding the best form of treatment. Immature permanent teeth are good candidates for many pulp healing procedures, due to their rich blood supply, which is believed to enhance the pulp's ability to react successfully to various insults. Healing was considered to have taken place when the tooth fulfilled the following criteria: 1. Abscence of clinical symtoms 2. Radiographic evidence of dentin bridge formation 3. No intrapulpal or periapical pathosis was evident radiographically 4. Continued root development and closure of the apex in immature teeth 5. Normal dentin apposition in mature teeth 6. Positive response to electrical pulp test This presents a report of cases in which immature permanent teeth, pulp-exposed by caries or trauma, was treated successfully by partial pulpotomy.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.42 no.2
• /
• pp.188-196
• /
• 2015

Endodontic management of an immature permanent tooth with dens invaginatus poses a challenge to efficient treatment planning for the clinicians. Because it is difficult to shape, disinfect, and seal the canal space effectively, teeth with complex root canal structures often require particularly extensive and thorough treatment approaches. The purpose of this case report was to share clinical insight from the results of short-term follow-ups after regenerative endodontic treatment with a dens invaginatus. Two immature maxillary lateral incisors with Oehlers type I and III dens invaginatus and infected necrotic pulp were treated using regenerative endodontic procedures. For the type III dens invaginatus case, an unusual approach toward redesigning the complex internal structure was taken, in order to have sufficient infection control and sealing. Cone-beam computed tomography (CBCT) and a surgical operating microscope were used to aid visualization and treatment. As a result, regenerative endodontic treatment appears to be effective for managing immature permanent teeth with complex dens invaginatus, and can lead not only to clinical and radiographic resolution, but also increased thickness of the dentinal walls.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.40 no.2
• /
• pp.127-132
• /
• 2013

Traumatic injuries to immature permanent teeth are common and the results can be destructive. Although Hertwig's epithelial root sheath is usually sensitive to trauma, it may resist damage from trauma thereby retaining its vitality and continuing to calcify a root under favorable conditions. This case report describes two cases of trauma to immature permanent incisors. The first case presents an avulsed maxillary central incisor which has been replanted. The other case shows completely avulsed mandibular central incisors which have not been replanted. However, both cases subsequently show continued growing roots separated from the main roots. This report highlights the ability of the immature pulp tissue to continue to form dentin and the robustness of Hertwig's epithelial root sheath to initiate root development despite a traumatic injury.