• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.1
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• pp.90-96
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• 2012

Supernumerary tooth occurs most frequently at premaxilla area. Followed by mandibular premolar area, mandibular fourth molar area, maxillary paramolar area. Mesiodens are mainly impacted in the palatal area and surgical approach is made at palatal side. The time of surgery remains controversial. In case of inverted or horizontal impacted supernumerary tooth, intraosseous tooth movement and vertical growth of premaxilla makes surgical extraction more difficult. And also the more quantity of removed bone is, the higher degree of difficulty is. Inverted mesiodens of these cases were impacted superior to apex level of adjacent permanent incisor. Although CT examination revealed exact location of impacted tooth, surgical procedure including ostectomy may take a long time more than expected. So, before surgical extraction, it's need to be considered several factors such as necessity of CT taking, degree of difficulty, direction of surgical approach, necessity of general anesthesia etc.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.1
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• pp.91-98
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• 2006

Supernumerary teeth are teeth which result from the continued budding of the enamel organ of the preceding tooth or from excessive proliferation of cells. They are most often found in the maxillary anterior region. And they can be responsible for a variey of irregularities in the primary and transitional dentition. There are two morphological types of supernumerary teeth, supplemental and rudimentary. Supplemental teeth have normal shape and size. In contrast, rudimental teeth have abnormal shape and smaller size. Supplemental supernumerary teeth are most common in permanent lateral incisor area. Its extraction must be decided more carefully with differential diagnosis between normal teeth, because it has normal shape and size. We reports 3 cases of the normal incisor shaped teeth in the maxillary anterior region. In all cases, we used the 3D Dental-CT as well as the conventional plain film such as periapical, occlusal, and panoramic radiograph. Consequently, 3B Dental-CT was valualble to figure out the exact position and morphology of supernumerary teeth, to do more conservative surgery and to reduce surgery stress and time.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.3
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• pp.371-375
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• 2002

The calcifying odontogenic cyst(COC) showed diverse terminology or classification, clinicopathologic features as well as in its biologic behavior, although it was recognized as a distinct clinicopathologic entity. The epithelial lining of a COC appears to have the ability to induce the formation of dental tissues in the adjacent connective tissue wall, and that other odontogenic tumors may sometimes be associated with it. This case is a COC associated with a complex odontoma involving an impacted left maxillary lateral incisor in a 5-year-old female child. Radiographic examination revealed a well-demarcated radiolucent lesion partially occupied by a radiopaque mass, involving the left lateral incisor crown. The histologic sections showed a cystic cavity lined with ameloblastic epithelium containing ghost cell masses with admixed with complex odontoma components. The presence of mixed radiolucent-radiopaque lesion in children as observed in this case, the possibility of COC must be considered. In this case, there was no recurrence 1 year after enucleation and the space control is ongoing now.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.1
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• pp.115-122
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• 2018

Noonan syndrome is characterized by distinctive facial features, short stature, and congenital heart disease. It is a congenital genetic disorder with a prevalence of between 1/1,000 and 1/2,500 in both genders. An 11-year-old boy with Noonan syndrome visited the hospital with an ectopically positioned tooth. A pulmonary stenosis was diagnosed and his growth and development were delayed. In many cases of this diseases there is obvious hemostasis, which he was not experiencing. His facial appearance showed characteristic features of Noonan syndrome. The patient showed a dental class II relationship, labioversion of the upper anterior teeth, and a shallow overbite. Radiographic examination revealed that the upper right canine was ectopically positioned, which led to root resorption of the upper right lateral incisor. A lateral cephalometric radiograph revealed a craniofacial pattern that was within normal limits. Surgical opening and button attachment on the impacted upper right canine were performed and traction was applied on the impacted tooth using a removable appliance. This patient was mildly affected by Noonan syndrome and showed some dental problems. However, few studies have reported the oral characteristics of Noonan syndrome despite its high incidence. Thus, this case report describes the oral features and management of Noonan syndrome.

• Journal of Korean Dental Science
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• v.3 no.1
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• pp.17-24
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• 2010

Objective : To investigate the prevalence of dental anomalies and to determine the associations between dental anomalies in permanent teeth Materials and methods : The samples were 1,240 patients (760 females and 480 males, mean age=15.1 years) who visited the Samsung Medical Center. Dental anomalies were diagnosed using pre-treatment dental casts, radiographs, clinical examinations, and medical/dental histories. Prevalence and association were investigated according to gender and sidedness. The Chi-square test was performed for statistical analysis. Results : The most common missing tooth was the lower lateral incisor, followed by the lower and upper second premolars. This particular dental anomaly is characteristic of the East Asian population (prevalence of congenital missing tooth=12.3%). The upper anterior area was the most frequently affected area (prevalence of supernumerary tooth was 1.5%). The presence of a supernumerary tooth was more prevalent in males than in females (p<.05, odds ratio=3.2). The most frequently affected tooth was the upper canine (prevalence of impacted tooth=4.3%). Unilateral impaction of the upper canine occurred significantly more often compared to bilateral impaction (p<.001). The prevalence of peg lateralis was 2.7%. The presence of congenital missing tooth was closely associated with peg lateralis (p<.01). If children aged 7~8 years have peg lateralis, the rest of the teeth should be checked for congenital absences. Conclusion : The early detection of dental anomalies and understanding of their associations help clinicians determine the appropriate treatment timing and methods of dealing with these anomalies.

• The korean journal of orthodontics
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• v.46 no.6
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• pp.395-408
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• 2016

We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.5
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• pp.429-434
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• 2009

Basal cell nevus syndrome is a rare inherited disorder characterized by mulitple cutaneous basal cell carcinoma, pits of the palms and soles, cysts of the jaws, skeletal abnormalities and ectopic calcifications. Currently there are new lines of investigation based on biomolecular studies, which aim at identifying the molecules responsible for these cysts and thus early allowing an early diagnosis of these patients. We report a case of a 9-year-old boy with the various manifestation of basal cell nevus syndrome, which are multiple odontogenic keratocysts, pits of the soles, bifid ribs, ectopic calcification, macrocephaly, and hypertelorism, etc. Total five odontogenic keratocysts were found. For the reduction of the size of the odon-togenic keratocysts, following preoperative marsupialization, there were surgically enucleated. And the impacted upper right lateral incisor and canine are tracted orthodontically.

• The korean journal of orthodontics
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• v.31 no.1 s.84
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• pp.51-61
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• 2001

Cleft lip and/or palate (CLP) is one of the most common congenital craniofacial anomalies and occurs more frequently in Asian people. Dental abnormalities in number, size, shape, and eruption of teeth are frequently associated with CLP. The purposes of this study were to investigate the effects of CLP on number, size, shape and eruption of teeth and to provide basic clinical data for diagnosis and treatment of the CLP patients. With the orthodontic and cleft charts, diagnostic models, orthopantomograms and intraoral x-ray films from 241 CLP patients who visited Dept. of Orthodontics, Seoul National University Dental Hospital, we evaluated the frequency of congenital missing teeth, supernumerary teeth, Impacted teeth, and microdontia. The results were as fellows ; 1. Frequency of congenital missing was relatively high up to $56.8\%$. Congenital missing occurred frequently in the maxillary lateral incisor and the maxillary second premolar. Among the CLP types, frequencies of congenital missing in cleft lip and Palate group and cleft lip and alveolus group were higher than those of cleft lip group and cleft palate group. And bilateral cleft showed higher frequencies than unilateral ones. 2. Supernumerary tooth was shown in $11.2\%$ of CLP patients. It occurred frequently in the area between the maxillary lateral Incisors and the maxillary canine. Among the CLP types, cleft lip group showed relatively most highest frequency. 3. Impaction was shown in $18.3\%$ of CLP patients. It occurred most frequently In the maxillary lateral incisor and the maxillary canine than other teeth. Among the CLP types, cleft lip group and cleft lip and palate group showed most highest frequencies. 4. Microdontia was shown in $15.8\%$ of CLP patients. It occurred the most frequently In the maxillary lateral incisors and maxillary canines. Among the CLP types, cleft lip and alveolus group and cleft lip and palate group showed relatively higher frequencies. There was no microdontia in cleft palate group.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.298-304
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• 2009

XLH (X-linked hypophosphatemic rickets) is a form of rickets which is resistant to the usual dose of vitamin D and inherited in a X-linked dominant manner. It is also known as vitamin D-resistant rickets or familial hypophosphatemic rickets. Here we report a 6-year-and-6-month-old female patient of XLH who is diagnosed with in SNUB. She was referred from local clinic for impaction of maxillary left permanent incisor and its treatment. She presents bowing deformities of the legs, short stature, enlargement of wrist and ankles and spontaneous dental abscesses of clinically sound teeth delayed eruption, taurodontism, delayed apical closure, enlarged pulp chambers, and absent or poorly defined lamina dura. The purpose of this case is to review the literatures of XLH and report the dental and medical characteristics of this patient.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.593-600
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• 1996

This case report is a treatment of patient with hemophilia A and autism. The patient's chief complaint was treatment of dental caries on entire dentition and he has an impacted mesiodens located on the apex of the upper right primary central incisor. The patient was consulted with pediatrician and anesthetist about the detailed discussion of the complexities of hemorrhagic disorder. Because he had some problems of behavior management and bleeding, the treatment was done under the gerneral anesthesia. The following results were obtained. 1. Consult with the patient's physician and hematologist about the replacement therapy and bleeding tendency. 2. For the severe hemophiliac child who requires extensive or surgical treatment, general anesthesia may be indicated for the comprehensive care. 3. For the hemophiliac child who has a behavior management problem due to autism and other defects, general anesthesia may be considerable. 4. Care must be taken during dental procedures not to causing a bleeding. 5. Local hemostatic methods must be acquired for the emergency state. 6. Neve prescribe aspirin or non-steroidal anti-inflammatory drugs such as ibuprofen, indomethacin, and phenylbutazone. These drugs affect platelet aggregation and exaggerate the bleeding defect. 7. Do not be afraid of hemophiliac patient, and never compromise quality of dental care.