• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.2
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• pp.95-98
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• 2017

Due to hypodontia, poor oral hygiene, and significantly more prevalent periodontal disease, patients with Down syndrome show higher incidence of edentulism. Oral rehabilitation of such patients is imperative but challenging as high rates of prosthesis failure are reported due to malocclusion, high masticatory force, and parafunctional habits. As CAD/CAM(Computer-Aided Design and Computer Aided Manufacturing) is the recent trend in prosthodontics, this report discusses the application of CAD/CAM in a Down syndrome patient. A 25-year-old patient with Down syndrome was presented to the Department of Pediatric Dentistry, Yonsei University Dental Hospital for oral examination. 5 maxillary teeth were missing, 3 were fully impacted, and 4 had grade III mobility. The patient underwent general anesthesia for extraction of impacted and mobile teeth, implant surgery, and final impression for prosthesis. Afterwards, CAD/CAM was used to design and manufacture a 10-unit zirconia bridge. However the bridge was fractured after 18 months due to the patient's bruxism and high masticatory force. Final impression taking, bite registration, cast fabrication, cast scanning, and prosthesis designing were not needed as CAD/CAM data remained. Previous CAD/CAM design was used to remanufacture the zirconia bridge. Down syndrome patients have malocclusion, high masticatory force, and parafunctional habits which increase the possibility of prosthesis fracture. CAD/CAM is beneficial for Down syndrome patients as previous digital records can be utilized for prosthesis repair or remake. In detail, application of CAD/CAM in remanufacturing decreases patient's discomfort of impression taking, shortens and simplifies dental laboratory procedures, and reduces clinician's effort of taking detailed final impressions or accurate bite registration. In conclusion, oral rehabilitation using CAD/CAM provides not only satisfactory levels of comfort, stability, and esthetics, but also easier repair or remake compared to conventional prostheses.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.480-487
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• 2001

In children and adolescents, oral and maxillofacial trauma is one of the most common causes of dental and periodontal damage, which often induces crown fracture of the permanent anterior teeth. Frequently, these traumatized teeth lose their vitality, and require routine endodontic treatment if their root apices are closed. However if their apices are not fully closed, further root formation should be promoted by apexification or apexogenesis. Calcium hydroxide is a biocompatible & bacteriostatic material, and is widely used for apexification. However it has several disadvantages which include the need for multiple visits and patient cooperation, low strength and technical sensitivity in a broad apex. In one-visit apexification using IRM or SuperEBA, patient's visits can be minimized. However, their biocompatibility is questionable. Mineral trioxide aggregate(MTA) is a relatively new material. It is considered biocompatible with periapical hard tissue and has good marginal sealing ability. MTA is also known to help facillitate the growth of the cementum around it. In this case report, apexification with MTA was attempted on traumatized maxillary central incisors with immature root apices, and favorable clinical results were achieved.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.4
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• pp.314-321
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• 2014

This study investigated the pattern and treatment of traumatic dental injury (TDI), with respect to the time elapsed prior to the initial visit to the Department of Pediatric Dentistry, Chonnam National University Dental Hospital for TDI, from January 2009 to December 2013. The dental trauma records of a total of 378 patients (940 traumatic teeth) were analyzed. The prevalence rate of dental trauma was twofold higher in males versus females. The principal cause of injury, among all participants, was falling (36.5%). The most commonly affected teeth were the maxillary central incisors (66.9%). Subluxation (43.9%) represented the most common trauma for primary teeth, and uncomplicated crown fracture in permanent teeth (30.9%). Only 10% of patients visited the dental clinic within 1 hour of sustaining trauma. The principal treatment provided for primary teeth, during the initial clinical visit, was follow-up (53.2%); for permanent teeth it was root canal treatment (27.3%). The prevalence of root canal treatment for permanent teeth increased commensurate with the time elapsed since injury. These data suggest that delayed checkup following trauma may increase the risk of loss of pulp vitality.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.3
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• pp.199-206
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• 2014

The number of reported traumatic injuries has been increasing in recent years, particularly that of dental trauma in children and adolescents. While the risks associated with dental trauma in this population have been increasingly realized, domestic reports on this issue seem to be insufficient. The purpose of this study was to investigate the prevalence of dental trauma and to evaluate the relevant risk factors and the level of self-recognition. 1,371 adolescents attending middle schools at Yangsan were surveyed via clinical examination and questionnaire; the results were as follows: According to the clinical examination, the overall prevalence of dental trauma was 16.8% with preponderance of males (19.2%) compared to females (13.7%) (p < 0.05). The average number of injured teeth per adolescent with a history of trauma was 1.34. Comparing the prevalence, maxillary central incisors and enamel fracture occupied the highest ranks by tooth type and mode of trauma, respectively. Class II division 1 malocclusion and overjet exceeding 8.0 mm were identified as significant risk factors (p < 0.05). The degree of self-recognition of dental trauma showed a low coincidence rate compared with results of the clinical examination. Males expressed a higher level of satisfaction toward the results of treatment for dental trauma than females (p < 0.05).

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.4
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• pp.418-425
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• 2013

This case report describes about recurrent herpetic stomatitis mimicking post-root resection complication. A 49 year-old male patient was diagnosed vertical root fracture of the mesiobuccal root of his left maxillary first molar (#26). The mesiobuccal root was resected following root canal treatment of the same tooth. 19 months later, the patient presented with pain on left hard palate after a barbecue party. Intra oral examination revealed a gum boil-like blister at the hard palate corresponding to the apex of the palatal root of #26. On clinical examination, there was bleeding on probing and the periodontal pocket depth was measured less than 5 mm with no tooth mobility. On a periapical radiograph, periodontal ligament space widening was observed. Tracing the sinus tract with gutta percha cone was attempted, however, it was impossible. Extending the field of vision, small multiple round ulcerations were observed at the palate front which caused pain to the patient. Therefore, the pain was considered a non odontogenic and the patient was referred to the department of oral medicine. The patient was diagnosed recurrent herpetic stomatitis and after 3 days of antiviral medication, the pain and ulceration were subsided.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.3
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• pp.227-233
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• 2023

Tardive dyskinesia is an involuntary neurological movement disorder caused by long-term use of dopamine receptor-blocking drugs leading to dental implications like uncontrolled gnashing and grinding of teeth which in turn imperil the oral rehabilitation procedures as the excessive load increases the risk of prosthesis fracture. A 40-year male with a medical history of tardive dyskinesia visited the hospital to receive oral rehabilitation for missing maxillary anterior teeth. After the oral examination, tooth preparation was done on teeth 13, 15, and 23. After that silicon impression was made and the gypsum cast was digitalized using a desktop scanner and an interim prosthesis was fabricated by milling a resin block. During the try-in, the occlusal one-third of the interim prosthesis was trimmed, and an auto-polymerizing acrylic resin was applied on the occlusal surfaces and inserted in the patient's mouth. Then, the functionally generated path (FGP) of occluding surfaces of opposing arches was traced on the resin surface. When the resin was hardened, the modified interim prosthesis was removed and digitized using an intraoral scanner. The scan image was used in designing the occlusal morphology of definitive prosthesis by modifying the design of the interim prosthesis using the dual scan method. Lastly, a monolithic zirconia prosthesis was fabricated by milling a zirconia block. The definitive prosthesis was delivered reflecting the patient's occlusal scheme. This case report shows that the FGP technique with the dual scan method can help in fabricating fixed prosthesis with harmonious occlusion in a tardive dyskinesia patient.