Journal of the korean academy of Pediatric Dentistry
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v.39
no.4
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pp.390-396
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2012
Infraocclusion is defined as tooth whose relative occlusal movement was blocked during the period of active eruption due to ankylosis and so on. Then infraoccluded tooth remains under the occlusal plane composed by adjacent structures showing normal eruption patterns. Untreated infraocclusion may cause: prolonged retention of infraoccluded teeth; extrusion of apposed teeth; destruction of periodontal tissues by occlusal force and food packing; increased sensitivity for dental caries; and disturbances on eruption pathway of succedaneous teeth. Therefore, periodic check-ups and proper treatments are required. There are many treatment options on infraoccluded deciduous molars such as periodic observation, conservative method, restoration and space regaining with extraction of the teeth. The choice of treatment may depend on the presence of succedaneous teeth, time of diagnosis and degree of infraocclusion. In this case report, three patients showing displacement of the second premolars due to infraocclusion of upper second primary molars, were treated by means of space regaining with removable orthodontic appliances and extraction of ankylosed primary molars. All malpositioned permanent premolars in the 3 cases showed ordinary eruption pathways after treatment.
The purpose of this study was to evaluate the changes of skeletodental patterns during Class II treatment and its retention period. Forty two patients of Class II malocclusion, which was treated with nonextraction or first premolar-extraction were selected and their lateral cephalograms were examined in this study. Various skeletodental changes in lateral cephalograms of pre-treatment, post-treatment and retention were measured by superimposition in reference to the cranial base for jaws, the palatal plane for maxillary teeth, and mandibular plane for mandibular teeth. The data were analyzed by paired t-test. In this study, occlusal plane showed the significant anterior downward steepening after active treatment, and remained during retention period. In the nonextraction group, maxillary incisors were retracted and extruded during treatment. Maxillary molars were extended, and mandibular molar were uprighted, with no mesial movement. In the extraction group, both maxillary and mandibular incisors were retracted and extruded. Maxillary molars were extruded and moved mesially, and mandibular molars were extruded and moved mesially with no mesial tilting. During retention period in both groups, there were tendencies of labial tipping of maxillary incisor, and mesial tipping of maxillary and mandibular molar. But the changes were not significant and most of teeth showed no change in vortical and horizontal direction.
The purpose of this study was to evaluate the differences of soft tissue profile changes between the growing patients and the adult who had passed the growth peak, in orthodontic treatment with four premolar extractions. The results which was taken by correlating the soft tissue changes with hard tissue changes, lip thickness, molar relationship and arch length discrepancy in both groups was like the followings. 1. Significant hard tissue changes were decrease of VIs, VIi, UlPP, LlMP, HIi and increase of HPog'in adults and decrease of VIs, VIi and increase of VA, VPog'and all the vertical measurements in adolescents. 2. Significant soft tissue changes were decrease of VLs, VLi, and VILS in adults and increase of VSn, VSLS, VLs, VPog' and almost all vertical measurements in adolescents, and ${\Delta}LsE,\;{\Denta}LiE$ in adults and ${\Delta}LsE,\;{\Denta}LiE,\;{\Delta}LiSP\;and\;{\Delta}Mang$ was also significant 3. Correlation coefficient between ${\Delta}VIs\;and\;{\Delta}VLs$ was the greatest in adults and the next was ${\Delta}Ii/{\Delta}Li,\;{\Delta}Ii/{\Delta}ILS,\;{\Delta}ID/{\Delta}Li\;and\;{\Delta}ID/{\Delta}ILS$. In contrast all the vertical and horizontal measurements of hard and soft tissue in adolescents showed statistically significant corerrlation. 4. There were differences in correlation between soft tissue changes and incisor inclination and retraction at both groups, but the lower lip, nasolabial angle and mentolabial angle were commonly less influenced by the hard tissue changes in both groups. 5. The thinner the upper lip was, the more the ${\Delta}LsSP$ was in both groups, and the thinner the lower lip was, the more the ${\Delta}LiE\;and\;{\Denta}LiSP$ was in adolescents. 6. Molar relationship didn't influence the soft tissue profile changes. 7. Arch length discrepancy didn't influence the soft tissue profile changes.
Orthodontic treatment is more complicated when both soft and hard tissues must be considered because an impacted maxillary canine has important effects on function and esthetics. Compared with extraction of impacted maxillary canines, exposure followed by orthodontic traction can improve esthetics and better protect the patient's teeth and alveolar bone. Therefore, in order to achieve desirable tooth movement with minimal unexpected complications, a precise diagnosis is indispensable to establish an effective and efficient force system. In this report, we describe the case of a 31-year-old patient who had a labio-palatal horizontally impacted maxillary left canine with a severe occlusal alveolar bone defect and a missing maxillary left first premolar. Herein, with the aid of three-dimensional imaging, sequential traction was performed with a three-directional force device that finally achieved acceptable occlusion by bringing the horizontally impacted maxillary left canine into alignment. The maxillary left canine had normal gingival contours and was surrounded by a substantial amount of regenerated alveolar bone. The 1-year follow-up stability assessment demonstrated that the esthetic and functional outcomes were successful.
Journal of Dental Rehabilitation and Applied Science
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v.32
no.1
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pp.47-59
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2016
Purpose: The aim of this study was to investigate the changes in occlusal force after loss of the lower first molar depending on the inclination and extrusion of the adjacent and opposing teeth by using a strain gauge. Materials and Methods: Anatomic teeth were used to reconstruct the normal dental arch with loss of the lower right first molar. A uniformly thick layer of silicone was applied to the root to mimic the periodontal ligament. Four stages of dies with varying degrees of inclination and extrusion of the adjacent and opposing teeth were constructed and attached to master model interchangeably by using a CAD/CAM fabricated customized die system. The strain gauges were attached to teeth and a universal testing machine was used to determine the changes in occlusal force. An independent t-test and one-way ANOVA were performed (${\alpha}=.05$). Results: While simulating chewing food, the upper first, second premolar and lower second molar showed greater occlusal force than before extraction. When the change of adjacent teeth's occlusal force with their progressive movement after molar loss was evaluated, the difference among four die models was significant and was in the decreasing aspect (P < 0.05). Conclusion: When the lower first molar was lost and the adjacent teeth did not move yet, the occlusal force in adjacent teeth was higher than that when the lower first molar still existed. In addition, the occlusal force in the upper premolars and lower second molar decreased significantly with the progressive movement of adjacent teeth.
Kim, Nam-Hyuk;Choi, Byung-Jai;Lee, Jae-Ho;Son, Heung-Kyu;Kim, Seong-Oh;Choi, Hyung-Jun
Journal of the korean academy of Pediatric Dentistry
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v.36
no.2
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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.
Background: Implants are becoming the first choice of rehabilitation for tooth loss. Even though they have a high success rate, failures still occur for many reasons. The objective of this study is to analyze the reasons for recurring failure at the same site and the results of re-implantation. Methods: Thirteen patients (11 males and 2 females, mean age 60 ± 9.9 years) who experienced implant surgery failure at the same site (same tooth extraction area) two or more times in the Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, between 2004 and 2017 were selected. The medical records on a type, sites, diameter, and length of implants; time and estimated cause of failure; and radiographs were reviewed. Data were collected and analyzed retrospectively, and the current statuses were evaluated. Results: A total of 14 implants experienced failure in the same site more than two times. Twelve implants were placed in the maxilla, while 2 implants were placed in the mandible. The maxillary molar area was the most common site of failure (57.1%), followed by the mandibular molar, anterior maxilla, and premolar areas (14.3% each). The first failure occurred most commonly after prosthetic treatment (35.7%) with an average period of failure of 3.8 months after loading. Ten cases were treated as immediate re-implantation, while the other 4 were delayed reimplantation after an average of 3.9 months. The second failure occurred most commonly after prosthetic treatment (42.9%), with an average of 31 months after loading; during the healing period (42.9%); and during the ongoing prosthetic period (14.3%). In 3 cases (21.4%), the treatment plan was altered to an implant bridge, while the other 11 cases underwent another implant placement procedure (78.6%). Finally, a total of 9 implants (64.3%) survived, with an average functioning period of 60 months. Conclusions: Implants can fail repeatedly at the same site due to overloading, infection, and other unspecified reasons. The age and sex of the patient and the location of implant placement seem to be associated with recurring failure. Type of implant, bone augmentation, and bone materials used are less relevant.
The aim of this study was to evaluate pulp and periodontal changes following rapid tooth retraction by periodontal distraction after bone undermining surgery in young adult dogs. Methods: Alter extraction of second premolars, the interseptal bone mesial to the upper 3rd premolar was undermined. After activating the distraction appliance at 0.5 mm/day for six days, the dogs were sacrificed at 0, 1, 3, 5, 7, and 9 weeks during the consolidation period. Tissue changes of periodontium and pulp were evaluated radiologically, histologically, and immunohistochemically. Results: Digital subtraction radiography showed active bone formation in the stretched periodontal ligament from 0 - 4 weeks. Resorption of the alveolar bone, appearance of osteoclasts, and infiltration of inflammatory cells were observed just after the activation period at the pressure side, and distinctive bone formation was seen in the tension side of the periodontal ligament from 1 week. New bone formation was active at 1 - 3 weeks. The expression of calcitonin gene-related peptide in the experimental group was increased at the alveolar bone and pulp, and periodontal ligament at the pressure side from 0 - 1 week, and it decreased after 5 weeks to become similar to that of the control group. Conclusions: The results showed that rapid tooth movement using periodontal distraction can be new form of orthodontic tooth movement for accelerating normal bone formation.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.44
no.5
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pp.225-231
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2018
Objectives: The purpose of this study was to investigate the demographic and clinical characteristics of patients with medication-related osteonecrosis of the jaw (MRONJ) and to elucidate factors affecting recurrence in surgical treatment. Materials and Methods: A total of 51 patients who were diagnosed with MRONJ were analyzed according to demographic and clinical features and treatment results through a retrospective chart review from 2013 to 2017 in the Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul in Korea. Results: Alendronate composed the majority of medication doses (55.6%), followed by ibandronate (20.0%), risedronate (15.6%), and zoledronate (6.7%). Forty patients (88.9%) were given oral medication, and five patients (11.1%) were intravenously treated, and the mean duration of medication use was $61.1{\pm}42.9$ months. A total of 10 patients (22.2%) had a drug holiday before MRONJ-induced dental treatment lasting an average of $6.8{\pm}7.0$ months. MRONJ occurred 2.7 times more in the mandible, with 41 cases (73.2%) occurring in the mandible and 15 cases (26.8%) occurring in the maxilla, and the prevalence of affected posterior parts (premolar-molar) was six times greater than that of the anterior parts (incisor-canine) (48 cases vs 8 cases, 85.7% vs 14.3%). The most common dental cause of MRONJ was tooth extraction (69.6%). Regarding recurrence, there was no statistical difference in recurrence rate according to either site or stage. However, recurrence occurred in 4 out of 34 cases (11.8%) in the primary closure group and 9 out of 20 cases (45.0%) in the secondary healing group, and there was a statistical difference with respect to closure technique. Conclusion: The identified risk factors in patients taking bone resorption inhibitors can aid dental clinicians in ensuring prevention and proper treatment of MRONJ.
Kim, Hyun-Jung;Kim, Min-Jeong;Noh, Hong-Seok;Kim, Shin;Jeong, Tae-Sung
The Journal of Korea Assosiation for Disability and Oral Health
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v.7
no.1
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pp.33-37
/
2011
The ectopic eruption is defined as abnormal eruption which gives to displacement of the teeth and abnormal root resorption of adjacent teeth. The prevalence of ectopic eruption is reported to vary 2~6%, most of them are in the maxilla. Etiologic factors include narrow maxilla, large maxillary teeth, inclined eruption path of the first molar, retruded position of the maxilla and hereditary factor. Irreversible ectopic eruption where the second primary molar is lost often causes mesial tipping and rotation of the permanent molar, unfavorable occlusion and space deficiency for the second premolar. Ectopically erupted teeth should be treated early to maintain normal development of the dentition, harmony of facial growth and occlusal support. The method of the treatment are classified as follows : appliances that is positioned at the contact point for unlocking and the distal movement, fixed appliance that is connected to more than one tooth, and occlusion guiding method after disking or extraction of the second deciduous molar. A case report of a patient with bilaterally ectopic eruption of maxilla and mandible first permanent molar was present. Also, the patient who had experienced the chronic myelogenous leukemia, show various dental developmental complications. The ectopic eruption was treated with a Halterman appliance that was a effective way of correcting of ectopic eruption of the permanent first molar.
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