• Archives of Craniofacial Surgery
• /
• v.20 no.4
• /
• pp.228-232
• /
• 2019

Background: The epidemiology of nasal fractures varies according to factors such as the era and area of the study, as well as the age of the patient. We compared the characteristics and causes of pediatric nasal fractures. Methods: A total of 2,321 patients with nasal fractures from 2010 to 2017 were examined. The patients were divided into age groups using the Korean school system of age classification. The causes of injury were divided into five groups: violence, fall or slip down, sports, road traffic accidents, and others. Fractures were classified using the Stranc and Robertson standard: vector of force and plane of fracture. Results: Violence was the most common cause of nasal fracture in patients older than 12 years. Violence was a significantly less frequent cause among patients younger than 12 years old than among adolescent and adult patients. Nasal fractures due to violence were not observed in patients younger than 10 years. Plane 2 and lateral force fractures were the most common; however, in patients younger than 12 years, frontal force fractures were significantly more frequent than were lateral force fractures. Conclusion: As children may simply be injured due to a fall or slip down, it is important for the parents and guardians to ensure their safety. As they become older, children should abstain from violence and be monitored. It is therefore very important to ensure that the environment is free of violence in order to prevent such injuries.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.48 no.1
• /
• pp.42-49
• /
• 2021

This study aimed to evaluate the long-term outcomes of teeth treated with reattachment technique in children and adolescents. Twenty seven permanent anterior teeth from 21 patients treated with fragment reattachment were evaluated. Clinical photos and medical records were used to assess treatment outcomes. Effect of pulp treatment and the ratio of fragment on success rate were statistically analyzed. Detachment of fragment was observed in 17 teeth, and their duration of retention was 21.41 ± 23.39 months. Repeated trauma was found to be the most frequent causes of failure. Pulp treatment before reattachment did not affect the success rate (p > 0.05). The mean ratio of fragment was 0.482 ± 0.147, and the success rate was affected by the ratio of fragment (p = 0.018). The median retention time of the teeth was 72 months if the ratio was under 0.5, and 8 months for that of the others. A significant correlation was found between the ratio of fragment and retention time (p = 0.003). Reattachment can be a predictable treatment option for crown fracture in anterior teeth in children and adolescents when a fracture involves less than 50% of the clinical crown.

• 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.43 no.2
• /
• pp.200-206
• /
• 2016

Root fracture is defined as a fracture involving the dentin, cementum, and pulp. Most fractures occur in the maxillary anterior teeth between the ages of 11 and 20 years old. The treatment for root fracture in permanent teeth involves the reduction and fixation of the displaced coronal segment. When signs of pulp necrosis or inflammatory root resorption are present, root canal therapy should be performed. Since most apical fragments maintain pulp vitality, root canal therapy is typically limited to coronal fragments. However, it's too difficult to achieve a proper apical stop on coronal fragment. Intentional replantation involves performing root apex treatment outside the mouth after intentional extraction of the tooth in a controlled environment and then replanting it. The objective is 'perfect' root canal therapy. Intentional replantation may be used in cases of failed typical root canal therapy, problematic endodontic retreatment due to the existing restoration or a calcified root canal, and when apical surgery is contraindicated because of a lack of reasonable approaches. In this case, intentional replantation was carried out to treat a horizontal root fracture in a maxillary central incisor with a calcified root canal due to previous trauma. We achieved a clinically and functionally satisfactory result.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.21 no.6
• /
• pp.547-556
• /
• 2021

Background: This study aimed to determine the efficacy of Physics Forceps in pediatric dental extractions. Methods: This was a double-blind, randomized controlled trial with a parallel-arm design and identical allocation ratio (1:1). Children (n=104) were randomly divided into two groups for extraction of mandibular primary teeth (group I: Physics Forceps; group II: conventional forceps). The outcome variables assessed in the study were the time taken for extraction, pre- and postoperative anxiety (using RMS pictorial scale), incidence of fractured teeth, and postoperative pain on the first and third days (using the Wong-Baker faces pain scale). Results: A significant reduction (P < 0.001) in intraoperative time, anxiety, and incidence of tooth fracture was confined to group I. The pain significantly reduced from the first to the third postoperative day in both groups, but the mean reduction in RMS scores in the physics forceps group was far better than that in the conventional forceps group. Conclusion: Physics Forceps aid in extraction of primary teeth with minimal trauma to supporting structures, as well as reducing anxiety in the pediatric population.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.23 no.4
• /
• pp.968-974
• /
• 1996

Intra-alveolar transverse crown & root fx. provokes many problems in treatment. Conventionally, extraction of the injured tooth and its prosthodontic restoration has been the treatment of choice. Though orthodontic extrusion could be an alternative treatment, there would be a situation it's inadequate to apply. Loss of natural tooth would be a psychological damage to the patient, of course. This report describes a replantation method of tooth in case of intra-alveolar transverse crown & root fracture. The fractured tooth was extracted, rotated, then replanted. Fixation and esthetic restoration was done. And then endodontic treatment was followed. Continuing follow-up of its function and endodontic status is required.

• Archives of Craniofacial Surgery
• /
• v.18 no.2
• /
• pp.128-131
• /
• 2017

With advances in diagnostic technology, radiologic diagnostic methods have been used more frequently, and physical examination may be neglected. The authors report a case of pediatric medial orbital trapdoor fracture in which the surgery was delayed because computed tomography (CT) findings did not indicate bone displacement, incarceration of rectus muscle, or soft tissue herniation. A healthy 6-year-old boy was admitted to the emergency room for right eyebrow laceration. We could not check eyeball movement or diplopia, because the patient was irritable. Thus, we performed facial CT under sedation, but there was normal CT finding. Seven days later, the patient visited our hospital due to persistent nausea and dizziness. We were able to perform a physical examination this time. Lateral gaze of right eye was limited. CT still did not show any findings suggestive of fracture, but we decided to perform exploratory surgery. We performed exploration, and found no bone displacement, but discovered entrapped soft tissue. We returned the soft tissue to its original position. The patient fully recovered six weeks later. To enable early detection and treatment, thorough physical examination and CT reading are especially needed when the patient shows poor compliance, and frequent follow-up observations are also necessary.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.25 no.1
• /
• pp.234-248
• /
• 1998

The purpose of this study was to compare the fracture and shear bonding strength of resin-modified glass ionomer cements with composite resin and conventional glass ionomer cement Three kinds of restorative materials including a composite resin (Z 100), a conventional glass ionomer cement(Fuji II), and resin- modified glass ionomer cements(Fuji II LC, Vitremer, Dyract and Compoglass) were investigated in this study. For measurement of fracture and shear bonding strength, disk samples of the materials were prepared and cylindrical samples of the materials were bonded the flat enamel and dentin surfaces according to manufactuer's instructions. All specimen were determinated by using an Instron testing machine with a crosshead speed of 1 mm/min. Then, each treated enamel and dentin surface was observed by SEM. The following results were obtained. 1. The bi-axial flexural strength of Z 100 was highest, and Fuji n LC, Vitremer, Dyract and Compoglass were significantly higher than Fuji n (P<0.05). 2. The shear bonding strength of Z 100 on the enamel and dentin surface was higher than other experimental groups except Fuji II LC(P<0.05). Fuji II LC was significantly higher than Fuji II (P<0.05), but in the case of Vitremer, Dyract and Compoglass were similar to Fuji II (P>0.05). 3. The shear bonding strength of Z 100 and Fuji II LC on the enamel surface were highly increased as compared with dentin surface (P<0.05), but in the case of Fuji II, Vitremer, Dyract and Compoglass were not different between enamel and dentin(P>0.05). 4. In the Z 100 and Fuji II LC, obvious etched enamel surface and exposed dentinal tubules according to remove of smear layer and smear plug were observed.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.45 no.3
• /
• pp.378-385
• /
• 2018

Mandibular fractures occur with high incidence among various fractures in maxillofacial region in children. Jaw fractures in children should be approached differently than in adults because bone growth continues throughout childhood. As far as displacement of the fragment is not severe, or if it is condyle that is fractured, closed reduction and additional intermaxillary fixation can be considered. Functional exercise is also required to prevent ankylosis of temporomandibular joint. Several complications, particularly malocclusion and facial asymmetry due to growth disturbances, can occur after condylar fractures. If growth disturbances take place after mandibular fractures, catch-up growth may occur in some patients, thus, periodic observation is necessary. In case of persistent growth disturbances, functional devices may be used to prevent severe facial asymmetry. This case report describes the long-term follow-up of two patients with facial asymmetry after mandibular fracture.

• Journal of Korean Biological Nursing Science
• /
• v.22 no.1
• /
• pp.45-52
• /
• 2020

Purpose: The purpose of this study was to investigate the risk factors of intracranial hemorrhage in children with skull fractures from head trauma. Methods: The retrospective study included 205 patients diagnosed with a skull fracture in a pediatric emergency room. Data were analyzed using 𝓍²-test, Fisher's exact test, t-test, and logistic regression analysis with the SPSS/WIN24.0 program. Results: Intracranial hemorrhage was diagnosed in 71 patients. There were statistically significant differences between the hemorrhagic group and non-hemorrhagic group in age group, places of accident, type of accident, location of the fracture, and symptoms. Intracranial hemorrhage by age group was higher in school-age and adolescence than in infancy. The places of accidents of hemorrhage were higher in street and school than in the home. The types of an accident of bleeding were higher in the case of knock and traffic accident than in fall. Symptoms of nausea, headache, and loss of consciousness were associated with higher intracranial hemorrhage. Multivariable logistic regression analysis showed that knock (OR= 3.29, 95% CI= 1.50-7.22), traffic accident (OR= 4.78, 95% CI= 1.31-17.43), nausea (OR= 4.18, 95% CI= 1.42-12.31), and loss of consciousness (OR= 3.29, 95% CI= 1.41-9.50) were risk factors for intracranial hemorrhage. Conclusion: In this study, the risk factors of intracranial hemorrhage were identified in pediatric patients with skull fractures caused by head trauma. It is recommended that the results of this study be used to manage and educate patients, caregivers, and medical staff after head trauma hemorrhage.