• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.10 no.2
• /
• pp.93-96
• /
• 2014

Brain disorder disability is assessed when organic brain lesion such as cerebral palsy, traumatic brain injury, or stroke causes physical impairment which limits daily activites substantially according to its level and range of paralysis or the presence of involuntary movement. According to the disabled person welfare law in Korea, grade I brain disorder is assessed when one is in continuous irreversible state of coma without the ability to prolong one's life without other's help. Self-injurious behavior is defined as the non-suicidal intentional or unintentional injury to one's own body which can occur repetitively temporarily or chronically. People with decreased consciousness often exhibit increased self-injurious behavior which is most commonly associated with tongue or lip biting. This report documents a successful self -injurious lip biting treatment of a brain lesion patient within a short time by applying a removable acrylic resin appliance including posterior bite block.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.13 no.1
• /
• pp.23-27
• /
• 2017

Ectodermal Dysplasia is a genetic disorder caused by the abnormal development of two or more structures derived from the ectodermal layer. As an aspect in dentistry, ectodermal dysplasia is characterized by hypodontia, conical or peg-shaped teeth, reduced salivary secretion and decreased vertical dimension. These unfavorable oral conditions make children to have difficulties with mastication, esthetics, and even in social activities. This case report presents an alternative oral rehabilitation treatment of a 4-year-old boy with ectodermal dysplasia. A removable space maintainer with artificial teeth in maxillary arch was delivered according to the initial treatment plan. However, the child failed to adapt the appliance because of his masticatory habit. Then a fixed-type space maintainer was delivered on the patient's esthetic demand and it restored function, esthetics and self-esteem of the patient. The treatment described here suggests that individually customized considerations are essential for the oral rehabilitation of a patient with ectodermal dysplasia.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.8 no.1
• /
• pp.10-14
• /
• 2012

Self-injurious behavior (SIB) has been defined as the deliberate destruction or alteration of body tissue without conscious suicidal intent. It occurs in conjunction with a variety of psychiatric disorders as well as various developmental disabilities and some syndromes. The behavior is destructive and causes concern and distress to all involved in the care and treatment of the affected individual. A 13-year-old girl with autism, mental retardation and delayed development was reffered from her pediatrician because of severe and painful lower lip biting. An intraoral examination revealed a diffuse swelling of lower lip. It was covered with necrotic slough and the ulcer and scarring of the lower lip was observed. We chose to use an oral removable prosthesis for Conservative treatment. It was decided to use a soft silicone mouthguard in the maxillary arch. Initially, she could not tolerate the appliance inside her mouth but soon adapted with the appliance. After one month, she lost the mouth guard and started lip biting. So we made mouth guard again. There are no standard methods for preventing self-injurious behavior in a patient who is developmentally disabled. Appropriate preventive methods must be developed for each individual patient based on close observation and clinical findings. Behavior modification techniques, pharmacological treatment, extraction of teeth, orthognathic surgery and intra/extra oral appliances can be performed for adjust self-injurious behavior. A suitable oral guard could be tried initially before employing more invasive approaches.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.34 no.4
• /
• pp.685-693
• /
• 2007

Class I malocclusion without skeletal problem results from tooth size/arch-size discrepancies, either evidenced by crowding, or spacing problems. Treatment method can be chosen according to dentition, the amount of arch discrepancy, patient compliance, or patient demands. We report of clear aligner and spring aligner that can be applicated in cases of permanent dentition with minimal arch discrepancy in anterior segment. There are some limits of application, but these are very useful appliances in the selective case. When crowding exists, definitive analysis and diagnosis should be made before starting treatment because certain amount of space must be obtained somewhere in the dentition to resolve the crowding. Therefore, appliance should be applied when lacking space is small. Also, in cases with spacing arch circumference is reduced after alignment so no problem in intermaxilla occlusal relationship must be confirmed. In case with crowding, judicious removal of interproximal enamel is indicated.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.35 no.3
• /
• pp.487-493
• /
• 2008

Recently, in proportion to the remarkable development of dentistry and income increases it is growing more and more a concern about changed awareness in appearance. In this study, it had a grasp of the purpose for university hospital visiting, the motive of the commencement for orthodontic treatment and a method of the treatment as well as term. Based on these, the aim of this study is to keep more of the information between parent and doctors for mutual understanding and to grasp the characteristics for the needs of orthodontic treatment. In order to conduct researches, there has made a survey of 150 persons among orthodontic patients' parents who visit CBNU hospital, the pediatric dentistry. The study has found the results like these. 1. There was a question about the reason to visit CBNU hospital in the department of pediatric dentistry for orthodontic treatment. 52.1% of respondents, the survey found, were more likely to receive a good medical service. 25% of them were counselled from a relative or an acquaintance. 16.7% of them were recommended by another dental clinic. 2. There was a question about the expected orthodontic treatment period, when at first hospital visiting. 37.5% of the respondents answered that it was a 'more than 2 years', 12.5% of them said 'from 12 months to 18 months'. 3. There was a question about the reason to receive orthodontic treatment. 58.3% of the respondents, the survey found, answered the reason was parents' concern about the malocclusion of their children, 12.5% of them said a the orthodontic problem pointed out by entourages. 4. There was a question about the method of orthodontic treatment for patients who visit the department in pediatric dentistry. 41.7% of the respondents said that it was used as 'an intra-oral fixed appliance', 29.2% of them said 'an intra-oral removable appliance', 2.1% of them said 'an extra-oral appliance', 5. There was a question about the waiting time for treatment after a dental appointment. 60.4% of the respondents said 'from 5 minutes to 10 minutes', 4.1% of them said 'from 15 minutes to 30 minutes'. There was a question about the extent of an acceptable waiting time. It was answered to 'from 5 minutes to 10 minutes' by 60.4% of them, 2.1% of them said 'from 15 minutes to 30 minutes'.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.7 no.1
• /
• pp.21-24
• /
• 2011

Williams syndrome(WS) is a congenital disorder caused by a deletion of the Elastin gene and other contiguous genes at chromosome 7. Patients with WS are at a high risk of dental caries, and they also have a higher frequency of dental malocclusion compared to normal children. Malocclusion occurs in 85% of individuals with WS, which results from combined causes, such as tongue thrust, hypotonia, and connective tissue abnormality. An 11 year-old girl with WS presented scissor bite on the lower right second premolar and the first molar, and she complained of difficulty in chewing. Active lingual arch was used instead of removable appliance, considering the patient's cooperation ability. Unilateral posterior scissor bite was corrected in 7 months. Although patients with WS are sociable and friendly, dental treatment can be a fearful experience for them. Efforts to build rapport with the patients with WS resulted in improved relationship between the doctor and patient, and desired outcome of dental treatment was achieved with patient's improved cooperation.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.32 no.2
• /
• pp.229-235
• /
• 2005

A problem that affects children's dentitions is the harmful habit which is difficult to treat. Harmful habits for children are such as abnormal swallowing patterns, low/forward tongue rest posture problem, habitual open-lips resting posture, habitual mouth-breathing, excessive digital sucking habit and tongue thrusting. Tongue thrusting habits cause a bit of cranio-facial skeletal changes and a great deal of dental malocclusion such as anterior open bite. Anterior open bite causes masticatory, speech, and esthetic problems in the growing children and difficulties in diagnosis, treatment, and the prediction of its prognosis. The treatments of such abnormal behaviors involve orofacial myofunctional therapy and using of habit breaking appliance. The prognosis is not determined by the presence of severity of oral habit but the skeletal tendency of the patient. Usage of tongue crib resulted in not only the discontinuance of the habit but also improvement in overbite and overbite. This study showed that relatively successful results could be generated by using removable tongue crib and myofunctional therapy in the case of openbite related to tongue thrusting habit.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.37 no.1
• /
• pp.117-123
• /
• 2010

Tooth eruption is the movement of the tooth from the developing place in the alveolar bone to the functional position in the oral cavity. The permanent incisors originate from the dental lamina on the lingual side of preceding deciduous tooth and erupt to the level of the occlusion through the well developed gubernacular cord. Ectopic eruption is a developmental disturbance in the eruption pattern of the permanent dentition. Most of the ectopically erupted lower incisor has been found in lingual side. The ectopically erupted tooth could be repositioned by orthodontic force in the early mixed dentition, which could help preventing the problems of loss of space and the lingual tilting of the lower anterior teeth. An eight-year-old girl visited the department of pediatric dentistry, Yonsei Dental University Hospital, for the evaluation and the treatment of the lower right lateral incisor, which was horizontally erupted in the lingual side, parallel to the mouth floor. Her tongue was placed on the labial side of that tooth. There was no previous dental history of dental caries or trauma on the pre-occupied primary incisor. Clinical and radiographic examinations including the computed tomography(CT), showed no evidence of dilacerations on root. Therefore, we decided to start active orthodontic traction of the lower right lateral incisor. We designed the fixed type of buccal arch wire and the lip bumper with hook for the traction. Button was attached to the lingual side of the ectopically positioned tooth. Elastic was used between the appliance and the button on that tooth. After the tooth become upright over the tongue level, appliance was change to the removable type and periodic check-up with occlusal guidance was followed to monitor the position of the tooth. In this case using the fixed appliance with modified form of lip bumper and hook embedded in acrylic part instead of extraction was very efficient up-righting the ectopically erupted tooth toward the occlusal plane.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.45 no.1
• /
• pp.115-122
• /
• 2018

Noonan syndrome is characterized by distinctive facial features, short stature, and congenital heart disease. It is a congenital genetic disorder with a prevalence of between 1/1,000 and 1/2,500 in both genders. An 11-year-old boy with Noonan syndrome visited the hospital with an ectopically positioned tooth. A pulmonary stenosis was diagnosed and his growth and development were delayed. In many cases of this diseases there is obvious hemostasis, which he was not experiencing. His facial appearance showed characteristic features of Noonan syndrome. The patient showed a dental class II relationship, labioversion of the upper anterior teeth, and a shallow overbite. Radiographic examination revealed that the upper right canine was ectopically positioned, which led to root resorption of the upper right lateral incisor. A lateral cephalometric radiograph revealed a craniofacial pattern that was within normal limits. Surgical opening and button attachment on the impacted upper right canine were performed and traction was applied on the impacted tooth using a removable appliance. This patient was mildly affected by Noonan syndrome and showed some dental problems. However, few studies have reported the oral characteristics of Noonan syndrome despite its high incidence. Thus, this case report describes the oral features and management of Noonan syndrome.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.37 no.4
• /
• pp.519-525
• /
• 2010

Ectopic eruption means the eruption of the tooth in an abnormal position due to multiple factors, which found most frequently in maxillary fist permanent molars, mandibular lateral incisors and maxillary permanent canines. Ectopic eruption of the maxillary first permanent molar occurs when the molar erupts with a more mesial angulation than normal, and locks itself in an atypical resorption on the distobuccal root of the second primary molar. The maxillary first permanent molar plays important roles for mastication and occlusion, so ectopically erupted maxillary first permanent molars should be relocated into proper position. Treatment options are separation by insertion of the brass wire or elastic rings, preparation of distal aspect of the maxillary second primary molar, using fixed or removable appliance with finger spring, and placement of space maintainer or space regainer after extraction of the maxillary second primary molar. We report three cases treated of ectopically erupted maxillary first permanent molar by re-setting of stainless steel crowns, placement of brass wire and using active plate. We could find out distal movement of maxillary first permanent molars into proper position and normal occlusion.