• Archives of Craniofacial Surgery
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• v.18 no.1
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• pp.5-8
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• 2017

Among the classification of maxillary fracture, the Le Fort classification is the best-known categorization. Le Fort (1901) completed experiments that determined the maxilla areas of structural weakness which he designated as the "lines of weakness". According to these results, there are three basic fracture line patterns (transverse, pyramidal and craniofacial disjunction). A transverse fracture is a Le Fort I fracture that is above the level of the apices of the maxillary teeth section, including the entire alveolar process of the maxilla, vault of the palate and inferior ends of the pterygoid processes in a single block from the upper craniofacial skeleton. Le Fort fractures result in both a cosmetic and a functional deficit if treated inappropriately. In this article, authors review the management of a Le Fort I fracture with a case-based discussion.

• The Journal of the Korean dental association
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• v.54 no.7
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• pp.492-500
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• 2016

Crown fractures are a common type of dental injuries and very frequently occurred on maxillary anterior teeth, area of requiring a rapid aesthetic recovery. Crown fragment reattachment is a simple and conservative method to restore the fractured teeth. The technique promotes esthetic outcomes as utilizing natural contour, shade, surface texture of teeth and gives mechanical similarity in terms of wear-resistance. Also it gives emotional positive responses to patients and requires less of chair time and costs. This case report presents two cases of crown fragment reattachments on maxillrary anterior teeth, including one complicated crown fracture and one uncomplicated crown fracture. If the fragment is available in cases of crown fractures, reattachment of fragment can be regarded as a predictable alternative. However, it is all the time important that a close conversation informing the patients about the limitations and prognoses of this treatment option.

• Restorative Dentistry and Endodontics
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• v.46 no.4
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• pp.49.1-49.8
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• 2021

Objectives: To evaluate the fracture incidence of Reciproc R25 instruments (VDW) used during non-surgical root canal retreatments performed by students in a postgraduate endodontic program. Materials and Methods: From the analysis of clinical record cards and periapical radiographs of root canal retreatments performed by postgraduate students using the Reciproc R25, a total of 1,016 teeth (2,544 root canals) were selected. The instruments were discarded after a single use. The general incidence of instrument fractures and its frequency was analyzed considering the group of teeth and the root thirds where the fractures occurred. Statistical analysis was performed using the χ² test (p < 0.01). Results: Seven instruments were separated during the procedures. The percentage of fracture in relation to the number of instrumented canals was 0.27% and 0.68% in relation to the number of instrumented teeth. Four fractures occurred in maxillary molars, 1 in a mandibular molar, 1 in a mandibular premolar and 1 in a maxillary incisor. A greater number of fractures was observed in molars when compared with the number of fractures observed in the other dental groups (p < 0.01). Considering all of the instrument fractures, 71.43% were located in the apical third and 28.57% in the middle third (p < 0.01). One instrument fragment was removed, one bypassed, while in 5 cases, the instrument fragment remained inside the root canal. Conclusions: The use of Reciproc R25 instruments in root canal retreatments carried out by postgraduate students was associated with a low incidence of fractures.

• Restorative Dentistry and Endodontics
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• v.37 no.3
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• pp.180-184
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• 2012

Traumatic injuries of the face often involve root fractures especially in anterior teeth. The prognosis and the treatment of the root fracture depend on the extent of the fracture line, general health and patient compliance. This case report outlines a new conservative trial treatment modality to stabilize the maxillary central incisors with horizontal root fracture on the cervical to middle third by fabricating canine guidance to remove loading on the traumatized maxillary central incisors during eccentric movements and thus inducing spontaneous healing of the fractured line between the fragments. Radiographs after thirty months showed adequate healing with no signs of pathological changes including root resorption, ankylosis or displacement. Long term follow-up revealed that vitality, stability and aesthetics were maintained and the patient was satisfied with the outcome.

• The Journal of the Korean dental association
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• v.48 no.10
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• pp.754-761
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• 2010

Horizontal root fractures are defined as those that involve cementum, dentin and pulp, comprising from 0.5 to 7% of injuries in permanent dentition on dental trauma. Diagnosis is made through clinical findings and radiographic exams, the latter frequently being limited by the position of the fracture line. Treatment varies according to the displacement of crown portion and vitality of the fragments. Authors describe clinical cases of maxillary right central incisor with horizontal root fractures in dental clinic, Jeju National University Hospital.

• Archives of Craniofacial Surgery
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• v.17 no.1
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• pp.1-4
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• 2016

Absorbable plates are used widely for fixation of facial bone fractures. Compared to conventional titanium plating systems, absorbable plates have many favorable traits. They are not palpable after plate absorption, which obviates the need for plate removal. Absorbable plate-related infections are relatively uncommon at less than 5% of patients undergoing fixation of facial bone fractures. The plates are made from a mixture of poly-L-lactic acid and poly-DL-lactic acid or poly-DL-lactic acid and polyglycolic acid, and the ratio of these biodegradable polymers is used to control the longevity of the plates. Degradation rate of absorbable plate is closely related to the chance of infection. Low degradation is associated with increased accumulation of plate debris, which in turn can increase the chance of infection. Predisposing factors for absorbable plate-related infection include the presence of maxillary sinusitis, plate proximity to incision site, and use of tobacco and significant amount of alcohol. Using short screws in fixating maxillary fracture accompanied maxillary sinusitis will increase the rate of infection. Avoiding fixating plates near the incision site will also minimize infection. Close observation until complete absorption of the plate is crucial, especially those who are smokers or heavy alcoholics. The management of plate infection is varied depending on the clinical situation. Severe infections require plate removal. Wound culture and radiologic exam are essential in treatment planning.

• Archives of Craniofacial Surgery
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• v.17 no.4
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• pp.206-210
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• 2016

Background: Zygoma is a major buttress of the midfacial skeleton, which is frequently injured because of its prominent location. Zygoma fractures are classified according to Knight and North based on the direction of anatomic displacement and the pattern created by the fracture. In zygomaticomaxillary complex (ZMC) fracture many incisions (lateral eyebrow, lateral upper blepharoplasty, transconjunctival, subciliary, subtarsal, intraoral, direct percutaneous approach) are useful. We reviewed various approaches for the treatment of ZMC fractures and discussed about incisions and fixation methods. Methods: A retrospective review was conducted of patients with ZMC fracture at a single institution from January 2005 to December 2014. Patients with single zygomatic arch fracture were excluded. Results: The identified 694 patients who were admitted for zygomatic fractures from which 192 patients with simple arch fractures were excluded. The remaining 502 patients consisted of 439 males and 63 females, and total 532 zygomatic bone was operated. Orbital fracture was the most common associated fracture. According to the Knight and North classification the most frequent fracture was Group IV. Most fractures were fixated at two points (73%). Conclusion: We reviewed our cases over 10 years according to fracture type and fixation methods. In conclusion, minimal incision, familiar approach and fixation methods of the surgeon are recommended.

• The Journal of the Korean dental association
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• v.40 no.7 s.398
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• pp.542-547
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• 2002

This study was aimed to help diagnose the vertical root fractures in endodontically and in nonendodontically treated teeth. This was a study about mine teeth with a vertical root fractures. Four cases were nonendodontically treated teeth and five cases were endodontically treated teeth. A collection of information including past dental history, periodontal probing, and X-ray was gathered on each case. One of the endodontic cases had no periodontal pocket depth and was in acute pain. It was confusing to find whether causes were because of endodontic failure or vertical root fractures. Most of the vertical root fractures were found in patients aged between 50 and 60. Vertical root fractures were found in the molar and premolar of maxillary and mandibular teeth. The second molars repecially, which had C shaped roots had vertical root fractures with apical propagation type. The apical propagation type means that vertical root fracture initiates in root apex and propagate to coronal root. The teeth with vertical root fractures of the apical propagation type, which was in acute pain, were very difficult in differential diagnosis of periodontal lesion and endodontic failure. Therefore, the dental history was very important to make a differential diagnosis. Past pain history repeated uncomfortable symptoms in bite was a key of differential diagnosis.

• Archives of Craniofacial Surgery
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• v.23 no.6
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• pp.262-268
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• 2022

Background: To compare the sensory change and recovery of infraorbital area associated with zygomaticomaxillary and orbital floor fractures and their recoveries and investigate the factors that affect them. Methods: We retrospectively reviewed 652 patients diagnosed with zygomaticomaxillary (n= 430) or orbital floor (n= 222) fractures in a single center between January 2016 and January 2021. Patient data, including age, sex, medical history, injury mechanism, Knight and North classification (in zygomaticomaxillary fracture cases), injury indication for surgery (in orbital floor cases), combined injury, sensory change, and recovery period, were reviewed. The chi-square test was used for statistical analysis. Results: Orbital floor fractures occurred more frequently in younger patients than zygomaticomaxillary fractures (p< 0.001). High-energy injuries were more likely to be associated with zygomaticomaxillary fractures (p< 0.001), whereas low-energy injuries were more likely to be associated with orbital floor fractures (p< 0.001). The sensory changes associated with orbital floor and zygomaticomaxillary fractures were not significantly different (p= 0.773). Sensory recovery was more rapid and better after orbital floor than after zygomaticomaxillary fractures; however, the difference was not significantly different. Additionally, the low-energy group showed a higher incidence of sensory changes than the high-energy group, but the difference was not statistically significant (p= 0.512). Permanent sensory changes were more frequent in the high-energy group, the difference was statistically significant (p= 0.043). Conclusion: The study found no significant difference in the incidence of sensory changes associated with orbital floor and zygomaticomaxillary fractures. In case of orbital floor fractures and high-energy injuries, the risk of permanent sensory impairment should be considered.

• Proceedings of the KACD Conference
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• 2004.05a
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• pp.304-308
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• 2004

Maxillary anterior crown fractures are a common form of injury that mainly affects children and adolescents. The position of maxillary incisors and their eruptive pattern carries a significant risk for trauma. In the pre-adhesive era, fractured teeth needed to be restored either with pin-retained inlays or cast restorations that sacrificed healthy tooth structure and were a challenge for dentists to match with adjacent teeth. But. recently the development of adhesive dentistry has allowed dentists to use the patient's own fragment to restore the fractured tooth. The purpose of this paper is to present 2 cases of reattachment of fractured teeth which had different fracture mode, and to evaluate prognosis of cases.