• Journal of Periodontal and Implant Science
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• v.41 no.1
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• pp.10-16
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• 2011

Purpose: Avulsed tooth can be completely recovered, if sound periodontal ligament (PDL) of tooth is maintained. Although a lot of storage solutions have been explored for the better storage of avulsed tooth, there is a shortcoming that the preservation time is much short. On the other hand, there has been studies that (-)-epigallocatechin-3-gallate (EGCG), the most abundant polyphenol in green tea, which is related to the anti inflammatory, antioxygenic, and antibacterial effects, allows the successful preservations of tissues and cells. This study evaluated the effect of EGCG on avulsed-teeth preservation of Beagle dogs for a period of time. Methods: The atraumatically extracted teeth of Beagle dogs were washed and preserved with 0/10/$100\;{\mu}M$ of EGCG at the time of immediate, period 1 (4 days in EGCG-contained media and additional 1 day in EGCG-free media), period 2 (8 days in EGCG-contained media and additional 2 days in EGCG-free media) and period 3 (12 days in EGCG-contained media and additional 2 days in EGCG-free media). Then, the cell viabilities of preserved teeth was calculated by dividing optical density (OD) of 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay with OD of eosin assay to eliminate the measurement errors caused by the different tissue volumes. Results: From the results, the immediately analyzed group presented the highest cell viability, and the rate of living cells on teeth surface decreased dependent on the preservation period. However, the $100\;{\mu}M$ of EGCG-treated group showed statistically significant positive cell activity than EGCG-free groups throughout preservation periods. Conclusions: Our findings showed that $100\;{\mu}M$ EGCG could maintain PDL cell viability of extracted tooth. These results suggest that although EGCG could not be a perfect additive for tooth preservation, it is able to postpone the period of tooth storage. However, further in-depth studies are required for more plausible use of EGCG.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.92-97
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• 2004

Traumatic injuries in the young peranent dentition are common, but root fractures, defined as fractures in volving dentin, cementum and pulp, are relatively uncommon. Case 1 is a 9-year-old boy who had a horizontal root fracture of his maxillary right central incisor in the apical third. Root canal therapy was performed in coronal segment and calcium hydroxide therapy was initiated. Six months after treatment, a periapical radiograph showed calcific tissue formation and normal root development. 1 year and 3 months later, the canal was permanently obturated with gutta-percha. Case 2 is a 7-year-old girl who had a vertical root fracture of her maxillary right central incisor. Fractured tooth was intentionally extracted atraumatically, and then the separated fragments are bonded with resin cement. the restored tooth was replanted into the original socket. Recalls up to 8 months showed normal mobility and no periapical pathosis. In these cases, we performed conservative treatment. Clinical and radiographic examination showed no pathosis or abnormality of the teeth and periodontal tissue.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.3
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• pp.254-263
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• 2016

Many studies on the prognosis of avulsed teeth were published but follow-up studies on Korean children and adolescents are insufficient. The aim of this study was to identify clinical factors determining the healing and prognosis of permanent incisors that were replanted after avulsion injury. This study included 184 permanent teeth in 142 patients aged 6-14 years. The clinical and radiographic data of the patients were analyzed from electronic medical records. Immature teeth had a higher probability of pulp revascularization than mature teeth. When extra-alveolar time was longer than 60 minutes, the incidence of inflammatory root resorption (IRR) was higher in immature teeth than mature teeth. However, the incidence of replacement root resorption (RR) was higher in mature teeth than immature teeth under the same condition. The incidence of IRR was increased when pulp was extirpated more than 20 days after replantation. IRR had a more significant influence on the decrease of survival expectation than RR. There was no significant correlation between the root development stage and survival expectation. However, when RR occurred, immature teeth survived shorter than mature teeth. Long term follow-up results from this study are expected to be used as fundamental data for the treatment guidelines and evaluation of the prognosis of replanted teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.607-618
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• 2008

This study three-dimensionally and histologically assessed the effect of Emdogain$^{(R)}$ on periodontal healing in replanted teeth in three beagle dogs which were 1 to 2 years old, weighing from 10 to 13 ㎏. Twelve maxillary and mandibular incisors were intentionally extracted and replanted after 15(Group I), 30(Group II) and 60(Group III) minutes of air dry storage with and without the application of Emdogain$^{(R)}$. The following conclusions could be drawn from the present investigation. 1. Increased incidence of inflammatory healing response in periodontal tissue was proportional to air dry time in Both control and experimental group(P<0.001). 2. Treatment Group showed lower inflammatory root resorption, especially there were statically significant in Group I, III(P<0.001, Group II : P=0.093). 3. Inflammatory root resorption were mainly occurred in apical third(14, 15-16 section)(P<0.05, 0.001), and cervical third(1 section)(P<0.05). 4. In view of horizontal section of long tooth axis, Main root resorption area were 1, 4, 5 line area(bucco-lingual area)(p<0.01).

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.2
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• pp.192-203
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• 2007

This study histologically assessed the effect of topical alendronate application on periodontal healing in replanted teeth in fifty four SD Rats. Upper first molars in rat were extracted and replanted after dried during 15 minutes or 60 minutes in the air. In Group I, all teeth were replanted after 15 minutes of dry storage without any other treatment. In Group II and III, the pulps were removed and all teeth were replanted after soaking 10 min in Hank's balanced salt solution with/without alendronate, followed by 60 minutes of dry storage. the rats were sacrificed after 7, 15 and 30 days. The histological parameters studied were healed PDL, surface inflammatory and replacement resorption, and inflammatory severity. The following conclusions could be drawn from the present investigation. 1. Group I showed lower inflammatory root resorption and inflammation severity rate, compared to Group II and Group III. In Group I there showed effective for reattachment and regeneration of PDL. 2. In Group II, inflammatory root resorption were more severe and faster than other groups. There were extensive root resorption in the rats sacrificed after 30 days. 3 In Group III, there were localized inflammatory resorption in several areas, but extensive resorption did not occur Group III showed increase in root resorption rate, compared to Group I. However this difference was not statistically significant. 4. There were no difference between sacrificed days in replacement root resorption in all groups.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.3
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• pp.303-311
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• 2020

The aim of this study was to assess the awareness of caregivers, emergency medical technicians, and emergency medical doctors by investigating the storage media for avulsed teeth at the trauma site. This study was performed by reviewing medical records of 183 patients with the age under 17 years old, who visited Ajou University Hospital for dental trauma. Based on their medical records, storage media for avulsed permanent teeth were investigated by classifying them as dry, milk, saline, saliva and tap water. The storage media chosen by caregivers at the trauma site were classified as cases by parents and school nurse teachers. Storage media chosen by emergency medical technicians and emergency medical doctors were also investigated using the same classification criteria. The results show that both parents and school nurse teachers used milk the most as a storage medium for avulsed teeth. Dry storage was the second most chosen medium by parents, and saline by nurse teacher. As a storage media emergency medical technicians used saline the most, while emergency medical doctors used only saline when they failed to replant avulsed teeth. There is a need to improve the knowledge of caregivers, emergency medical technicians, and emergency medical doctors regarding the storage media for avulsed teeth.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.208-211
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• 1998

Reflex sympathetic dystrophy is an important clinical entity that is characterized by excessive or prolonged pain, vasomotor and other autonomic disturbances, delayed recovery of function, and trophic changes. This syndrome is among the most frequently encountered problems in clinical medicine, and proper diagnosis and therapy are critical. Accidental or surgical trauma or one of a variety of disease states may become a precipitating factor. Proper recognition and treatment result in rapid elimination of symptoms and complete recovery. A 56-years old male accidented total amputation of the proxomal part of the left index finger in May, 1996. Emergently, complete replantation procedure was successfully performed in the department of reconstructive surgery, medical center, Korea University. Afterward, he began to suffer from uncontrolled, prolonged pain in left index finger, proximally spreading pain to the left upper extremity and limited joint movement of the left shoulder. Although many treatments were used for this syndrom, not all of them were effective. Furthermore, the treatments which proved effective had detrimental side effects. However, thoracoscopic left thoracic sympathectomy was performed in our department. This therapy successfully relieved the pain and improved shoulder joint movement.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.3
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• pp.395-402
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• 2005

In considering the healing process of injured periodontal tissue, healing rate would be influenced by the cellular activity of periodontal fibroblasts(PDLFs). In addition, the reattachment among PDLFs should be induced for healing process. The purpose of this study was to evaluate the effects of epidermal growth factor(EGF) on the proliferation and attachment of PDLFs and to verify the efficacy of EGF as a storage media or a pre-replantation conditioner of traumatically avulsed tooth. Human recombinant epidermal growth factor(hrEGF) and human periodontal fibroblasts from first premolar were prepared. At first, MTT assay was done to evaluate the toxic effect on human periodontal fibroblast and the maximum cellular growth of EGF. Cellular proliferation rate was then compared between control group and 10ng/ml EGF added group. Also, western blot was done to evaluate the expression of fibronectin in both groups. The results were as follows: 1. From MTT assay, EGF showed no toxic effect on PDL fibroblasts. The highest proliferation was shown at 10ng/ml EGF. 2. In 10ng/ml EGF added group, the degree of proliferation of PDLFs was significantly higher than that in control group. 3. Fibronectin expression of EGF added group was also significantly higher than that of control group. From this study we could conclude that EGF enhanced the regeneration rate of periodontal fibroblast, which could be used as a pretreatment agent or a storage media for traumatically avulsed teeth.

• Restorative Dentistry and Endodontics
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• v.28 no.5
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• pp.385-391
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• 2003

The purpose of this study is to examine the viability of PDL cells in rat molars by using MTT assay and to verify the MTT assay through the histologic observation. Thirty of Sprague-Dawley white female rats of 4-weeks old with a body weight of about 100 grams were used. Groupings are as follows : Immediate Group : Positive control group(n=10)-after extraction immediately. Dried Group : Negative control group(n=10)-after drying for an hour under warm dry. $ViaSpan^{\circledR}$ Group : 1hour $ViaSpan^{\circledR}$ group(n=10)-after storing in $ViaSpan^{\circledR}{\;}at{\;}4^{\circ}C$ for 1hour. Ten teeth of each group were treated as same as above and replanted to the original socket of experimental animals. After two weeks of replantation. all the experimental animals were sacrificed. And after fixation, extracted maxillary jaw was dimineralized. After it was embedded in paraffin. serial section by $5\mu\textrm{m}$ was carried out and for construction of specimen, hematoxylin-eosin dye was used. The mean MTT measurement of immediate group(positive control) is 2.81 and the mean measurement of dried group(negative control) is 0.98 which is significantt differnt(P<0.05), The mean measurement of $ViaSpan^{\circledR}$ group is 2.65 and there is significant difference between dried group and $ViaSpan^{\circledR}$ group(P<0.05), However, there is no difference between immediate group and $ViaSpan^{\circledR}$ group. The average resorption points of immediate group is 3.03 points. In the dried group, average 6.44 points resorption and 2.68 points showed resorption in the $ViaSpan^{\circledR}$ group. Unlike with MTT assay, there was no significant difference between the immediate group and $ViaSpan^{\circledR}$ group. The usage of MTT assay as a viable cell marker may give us a better indication of the maintenance of periodontal ligament cell vitality.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.396-399
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• 2010

Purpose: In hand injury, pedicle is usually damaged by avulsion injury or crushing injury. Because of postoperative pedicle obliteration, it is often hard to save the injured hand and fingers, even after successful replantation. The author introduces three cases of extensive hand injury, and successful results after applicatoin of multiple venous grafts to these patients. Methods: In all cases there was no circulation in any finger. In the first case, some vessels were extracted, so venous graft was applied to two sites of severely damaged venous sites. In the second case, venous grafts were applied to all four digital arteries of all fingers except thumb which got severely crushed, and two sites of dorsal veins. In the third case, venous graft was applied to all four digital arteries of all five fingers, and two sites of dorsal veins and palmar veins each. Results: In all cases, survival of hands and fingers was successful. In the second case, however, amputation in thumb and little finger at DIP joint level was inevitable, because of its severe damage, and the large dorsal defect on index finger was filled with DIEP free flap. Thumb was reconstructed with toe-to-thumb free flap, and additional debulking procedures and contracture release is furtherly needed. In the first case, additional surgery was done, as FDP tendon got re-ruptured, but in long term follow-up, satisfactory range of motion was attained. In the third case, FTSG on dorsal skin region was planned. as flap on dorsal area got partial necrosis. Conclusion: In hand injury, there are many structures to be repaired, but sometimes venous graft is avoided for its long operating time. Even though the length of damaged vessel is enough for anastomosis, the endothelium is often damaged (zone of injury). In extensive hand injury, successful reconstruction would be possible with active venous graft to all vessels suspicious for damage.