• Journal of the korean academy of Pediatric Dentistry
• /
• v.36 no.2
• /
• pp.275-280
• /
• 2009

Radicular cyst is a true epithelium lined cyst formed when epithelium at the apex of a nonvital tooth is stimulated by inflammation. It is the most common type of cyst in the oral cavity, but its frequency is low in the primary dentition. Treatment of large-sized cyst aims at conservation of adjacent structure and allowance of proper eruption of the successive permanent teeth in the primary dentition. Considering these two aspects, marsupialization or enucleation following decompression is recommended as a treatment means for large-sized radicular cyst. In this case, 8-year old boy visited the pediatric dentistry department. Yonsei University Dental Hospital, with the chief complaint of pain on the lower right area. Clinical and radiographic examinations revealed periapical radiolucent lesion on #84, which had previous pulp treatment and restorated with the stainless steel crown. Dislocation of its successive tooth, #44, was also observed. #84 was extracted and sent for biopsy. Through histologic examination, it was diagnosed as radicular cyst. Following its extraction, removable space maintainer was delivered, which was also used as a decompressor. During periodic check-up for next 22 months, favorable healing of the lesion and eruption of the successive tooth were observed.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.38 no.1
• /
• pp.17-24
• /
• 2011

The aim of this study was to assess the outcome of MTA apexification in young permanent anterior teeth. Among the patients with the traumatized permanent incisors which were treated with MTA apexification, the dental records and radiographs were examined only for the patient who had follow-up examination at least 3 months after the treatment. Forty nine patients with 64 teeth were included in this study. Demographic information, location and type of teeth and periodontal injury, pre-treatment periapical lesion, clinical symptoms, status of MTA filling, healing of apical lesion and apical barrier formation after treatment were investigated. The outcome based on clinical and radiographic criteria were assessed. The results were as follows 1. Of 64 immature permanent incisors with MTA apexification, the clinical and radiographic success rates were 89.1% and 73.4%, respectively. 2. The maxillary incisors showed significantly higher success rates than the mandibular incisors. 3. There was no statistically significant difference in success rates among the teeth with different types of teeth and periodontal injury. 4. The status of MTA filling did not influence the clinical and radiographic success.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.34 no.3
• /
• pp.490-497
• /
• 2007

Odontoma is defined as a benign odontogenic tumor containing enamel, dentin as well as cementum and constitued 22% of all odontogenic tumors. Although the lesions are commonly asymptomatic, they may be discovered routine radiographic examination. Odontomas often cause disturbances in the eruption of teeth such as, impaction or delayed eruption, retention of primary teeth, or abnomalities in the position of the teeth such as tipping or displacement of adjacent teeth. Radiologically, odontomas manifest as a dense radiopaque lesion surrounded by a thin radiotransparent halo. However, in some cases, radiopacity was not quite clear and images of the teeth shadowed very tiny odontomas. And at early development stages of odontoma, calcification remains immature and is difficult to diagnose on radiographs. This suggests that when delayed eruption of the teeth is found, periapical radiographs should be taken to clarify whether any small area of radiopaque material exists. This case report shows tiny odontomas involving an impacted tooth and crowding and we remove the tiny odontoma surgically.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.7 no.1
• /
• pp.25-28
• /
• 2011

Autism is a developmental, neuropsychiatric disorder that begins in early childhood. A patient with autism seen in the dental office frequently may have many complications. Therefore, it may be needed to consider modified or alternative therapy for dental care of autistic patients. This is the case of a 16-year old boy who have autism. He came to the department of the pediatric dentistry, Yonsei University Dental Hospital, for evaluation and treatment of dentigerous cyst associated with impacted teeth(#33,34,35). Under daily hospitalization and general anesthesia, the cyst was enucleated with surgical extraction of #34 and autotransplantation of #33,35. And during the periodic dental followup, apexification of #33,35 was performed for periapical lesion and root maturity. At 2 year 6 months follow- up, now, bony healing was completed and there are some complications like external resorption of #33 and space loss of #34 area. Generally, the marsupialization has been widely recommended for treatment of dentigerous cyst. However, in this case, there is a little possibility of spontaneous eruption after marsupialization considering of patient's age, location and angulation of the impacted tooth, root maturity. And there is necessity to choose the treatment that has low recurrence risk and needs short-term follow-up for autism. Above all, poor oral hygiene and lack of cooperation for decompression treatment is a matter of primary consideration. Consequently, enucleation of the cyst was chosen for the final treatment plan in this case. It is important to consider the conditions that affect the eruption of a dentigerous cyst-associated tooth to predict the successful eruption and special health care needs of the patient when the treatment plan is settled.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.40 no.1
• /
• pp.53-59
• /
• 2013

In an intra-alveolar root fracture (IARF) of a primary tooth with severe mobility and displacement, extraction and periodic-follow-up is the choice of recommended treatments because of the fear of aspiration of the mobile tooth and the possibility of damage in the permanent succeeding tooth. However, repositioning and splinting are presented as a fresh proposal recently. In case of extracting a primary incisor, many problems occur; esthetic problems; functional problems such as pronunciation and mastication; space loss; and psychological and social problems. Therefore, the best treatment is conservation of the primary tooth. The aim of this report was to suggest the conservative treatment of an Intra-alveolar root fracture of the primary central incisors with severe mobility and displacement based on two cases that describe the diagnoses, treatments and follow-ups (mean period: 27-month). All cases have been treated by reduction and immobilization by resin wire splint (RWS) (mean period: 6-week). Both cases were followed up until the successors were erupted. There have been no complications such as pain, pulp necrosis, periapical lesion, displacement of permanent tooth germ, eruption disturbance and etc.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.30 no.4
• /
• pp.637-642
• /
• 2003

Morphology of primary root divergency and curvature determines the pattern of root resorption and periapical lesion, and affects successful root canal treatment. With the purpose of analysing the morphology of primary mandibular second molar roots and canals, the frequency, angle, radius, and start of curvature of the canal were measured. Fifty clinical radiographs were taken from $3{\sim}6$ years old children, followed by digitizing after scanning and analyzing by Scion image Beta 4.02TM(Scion Co. USA). The angle of curvature was determined by Schneider's method and the radius of curvature was determined by Schaefer's method. The results were as follows: 1. The angle of curvatures were $17.3^{\circ}{\pm}5.0$ (mesial), and $27.9^{\circ}{\pm}6.0$ (distal). Distal curvature was significantly larger than mesial.(p<0.05) 2. The radius of curvatures were $8.7mm{\pm}2.5$ (mesial), and $5.8\;mm{\pm}1.5$ (distal). Mesial curvature was significantly larger than distal.(p<0.05) 3. The start of curvatures were $4.1mm{\pm}0.6$ (mesial), and $4.2mm{\pm}0.6$ (distal). There were no difference between two groups. (P<0.05)

• Journal of the korean academy of Pediatric Dentistry
• /
• v.39 no.2
• /
• pp.174-180
• /
• 2012

In case of an immature tooth with necrotic pulp, regeneration of pulp tissue into a canal would be the ideal outcome. It may be capable of promoting the continuation of normal root development. Platelet-rich fibrin has been suggested as a potentially ideal scaffold for regenerative endodontic treatment. Immature permanent teeth of young children were diagnosed with pulp necrosis and apical abscess as the result of clinical and radiographic examination. After removal of necrotic pulp, canal was irrigated with 5.25% NaOCl and dried with paper point. A triple antibiotic mixture was placed in canal space in 3 weeks. After removal of the antibiotic mixture, the platelet-rich fibrin was injected into the canal space with MTA placed directly over the platelet-rich fibrin clot. The coronal region was restored by composite resin. On the basis of short-term results of the present 3 cases, regeneration of vital tissues appears to be possible in a tooth with necrotic pulp and a periapical lesion. Also, platelet-rich fibrin proves to be potentially an ideal scaffold for this procedure. Therefore, long-term clinical observation and examination about this treatment using platelet-rich fibrin in immature permanent teeth of young children are considered to be necessary.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.48 no.4
• /
• pp.449-459
• /
• 2021

This study retrospectively analyzed the effect of clinical factors on the outcomes of REP(regenerative endodontic procedure). Patients who received the REP using triple antibiotic paste due to trauma or fracture of dens evaginatus from February, 2011 to January, 2020 were included in the study. Finally, 57 teeth in 54 patients were selected. Investigated clinical factors were as follows: intentional bleeding, etiology, and root development stage. Treatment outcomes evaluated were as follows: improvement of subjective symptoms, changes in the periapical lesion, and the amounts of root development after REP. To compensate for differences in angulation and position between repeated radiographic examinations, images were aligned by Turboreg plugin. To evaluate the amounts of root development, apical diameter, root area, and root length were measured by ImageJ software. Among the aforementioned factors, intentional bleeding had no significant effect on treatment results. Regarding the etiology, the increase in the root area and the root length was significantly less in trauma cases than in dens evaginatus fracture cases. Considering root development stage, more immature teeth presented more increase in the root area.