• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.471-476
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• 2003

The success of autotransplantation depends on the viability of periodontal ligament in the transplanted tooth. Mechanical injury to periodontal tissues frequently results in dental root resorption and ankylosis, which leads to the failure of transplantation. Enamel matrix derivative(EMD) Which contains several enamel matrix protein (amelogenin family) has been reported to be effective in some periodontal therapies has been recently used to induce periodontal regeneration. EMD promotes proliferation of periodontal ligament cells and is suggested to be useful for transplantation. In this case, we report a clinical case of EMD application in the transplantation of an impacted and immature tooth of a 14 year-old girl to enhance the periodontal regeneration.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.2
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• pp.145-148
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• 2010

Maxillofacial injuries are less common in children than in adolescents and adults. This lower incidence is a result of the relatively small size of mandible, the resilient nature of the bones, and a relatively protected environment, which distinguish the treatment principles of pediatric mandibular fractures from those of the adult. The bone of child is malleable, so pediatric fractures tend to be less displaced and rarely comminuted. Moreover, high regeneration potential of the wound allows more conservative treatment modalities for the pediatric mandibular fracture. High risk of damaging unerupted tooth bud renders many clinicians to resort to more conservative treatment modality for the reduction of displaced segments. This case report describes two successful treatment cases using the circummandibular wiring which was applicated to the fracture on parasymphysis of mandible. Circummandibular wiring can protect the tooth buds, and there is no need for intermaxillary fixation so that it prevents the possible complications of intermaxillary fixation such as the temporomandibular joint ankylosis and the facial growth disturbances. The acrylic splint was removed after 3 weeks, which showed clinically good union across the fracture line without complications. They showed complete clinical and radiological bone healing with an optimum occlusion.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.1
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• pp.48-54
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• 2020

In the case of crown-root fracture due to traumatic injury in anterior tooth and the fracture margin is located subgingivally, forced eruption has been proposed for the reconstruction of deficient bone and soft tissue. Forced eruption is one of the easiest orthodontic approaches that can have an acceptable outcome and prognosis, and has a low incidence of relapse. However, using heavy forces or very fast movements can also cause tissue damage or ankylosis. The following case reports present forced eruption as treatment option of crown fracture in maxillary anterior teeth.

• The Journal of the Korean dental association
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• v.55 no.5
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• pp.328-338
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• 2017

Introduction: The aim of the current study was to describe the prevalence and treatment of mandibular first molar eruption disturbances. Methods: A total of 38 mandibular first molars(M1mn) from 36 patients(17 males and 19 females; aged 9 years 2 months?35 years 10 months) were identified from the 13,391 patients that received orthodontic treatment from 1983?2012. The subjects were classified into 3 categories based on panoramic radiographic examination: impaction due to ectopic position of the tooth germ relative to the contra-side same tooth(Group 1), impaction due to obstruction of the eruption path with cyst or calcium mass (Group 2), and primary and secondary retention due to defects in the follicle or periodontal ligament(PDL; Group 3). The treatment outcomes were evaluated into four categories: no treatment(A), orthodontic traction(B), autotransplantation(C), and extraction due to orthodontic traction failure(D). Results: The prevalence rate of M1mn eruption disturbances in this sample was 0.27%. In Groups 1 and 2, most of the impacted M1mn were erupted successfully by orthodontic traction. In Group 3, most of the retained M1mn were failed to erupt and recommended for extraction. Conclusions: Treatment prognosis was favorable on Group 1 & 2 than Group 3. After removing an element of the cause in case of Group 1 & 2, orthodontic traction or periodic observation will be recommended.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.1
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• pp.26-32
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• 2023

Dental trauma is common in active children and adolescents. Among them, in the case of ankylosis due to avulsion, diagnosis through clinical examination is important, and the treatment is important for esthetic prosthetic restoration after adulthood. This case is a case of esthetic prosthetic restoration of maxillary anterior teeth through decoronation and implant. After that, space was maintained for prosthetic restoration using a decoronated crown. After becoming an adult, precise implant placement and esthetic prosthetic restoration were possible using guide surgery. For soft tissue support, the temporary crown were replaced by changing the contours of the temporary crown, and the final esthetic prosthesis was fabricated by digital wax-up.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.1
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• pp.96-102
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• 1999

Tooth avusion implies total displacement of teeth out of its socket. Its frequency range from 0.5 to 16% of traumatic injuries. Replantation procedure is used for the treatment of avulsed tooth. However, its major complications are pulp necrosis, inflammatory root resorption and replacement root resorption. This paper describes 10 years and 2 months old male patient whose both maxillary central incisors were avulsed due to fall-down with slightly underdeveloped root apices. Teeth were replanted 2 hours after accident. Right central incisor's pulp tissues were extirpated and filled with $Vitapex^{(R)}$(calcium hydroxide) at 3-4 weeks after replantation, but left central incisor was filled at 8-9 weeks. Right central incisor showed little inflammatory resorption in apical portion, whereas left central incisor showed severe root resorption. During 18 months' follow-up period, left central incisor showed slightly ankylosis while right central incisor did not. Based upon the above-mentioned results, the following conclusions can be drawn: 1. Inflammatory resorption could be suppressed by endodontic treatment with calcium hydroxide. 2. When apex formation is doubted in replanted tooth due to avulsion, early endodontic treatment with calcium hydroxide seems to act positively for better prognosis.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.13-19
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• 2014

Purpose: The purpose of this study was to retrospectively evaluate the survival of periodontally hopeless teeth that were intentionally extracted and replanted after a delay and to compare the radiographic characteristics of the survival group with those of the failure group. Methods: The clinical and radiographic data from patients who underwent delayed intentional replantation between March 2000 and July 2010 were reviewed. Twenty-seven periodontally hopeless teeth were extracted and preserved in medium supplemented with antibiotics for 10-14 days. The teeth were then repositioned in the partially healed extraction socket and followed for 3 to 21 months. The radiographic parameters were analyzed using a paired t test and the cumulative survival rate was analyzed using Kaplan-Meier analysis. Results: Seven replanted teeth failed and the overall cumulative survival rate was 66.4%. In the survival group, the amount of bone loss was reduced from 68.45% to 34.66% three months after replantation. There was radiologic and clinical evidence of ankylosis with 5 teeth. However, no root resorption was found throughout the follow-up period. In the failure group, bone formation occurred from the bottom of the socket. However, a remarkable radiolucent line along the root of a replanted tooth existed. The line lengthened and thickened as time passed. Finally, in each case of failure, the tooth was extracted due to signs of inflammation and increased mobility. Conclusions: Delayed intentional replantation has many advantages compared to immediate intentional replantation and could serve as an alternative treatment for periodontally involved hopeless teeth. However, techniques for maintaining the vitality of periodontal structures on the tooth surface should be developed for improved and predictable results.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.2
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• pp.217-223
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• 2005

The term 'impaction teeth' is used to designate a tooth which remains unerupted in jaw beyond the time at which it should normally be erupted. Most cases of impacted teeth reported in the literature are permanent teeth. The impaction of primary teeth occur rarely whereas impaction of second primary molars is more numerous than all other impactions. Failure of eruption of primary teeth may cause a number of complications, such as interference with development and eruption of successive permanent teeth, malocclusion, cystic change of tooth follicle. The clinican should consider the various treatment option available (a) No treatment and observation, (b) surgical extraction (c) space regainer. Proper treatment plan should be established after thought consideration of impacted tooth and it's relation with successive permanent tooth.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.205-215
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• 2008

The purpose of this study is to evaluate at which stage of tooth germ would develop into normal calcification and hence to increase the success rate of transplantation. Therefore, tooth germs on the 15th, 17th embryonic day and the 3rd day of birth were separated for allotransplantation into maxilla of adult rat of 11 weeks. Calcification processes were analyzed radiographically and histopathologically at 4 weeks and 8 weeks after allotransplantation. The results are as follows: 1. Allotransplanted tooth germ at 4 weeks and 8 weeks showed delayed calcification compared to that of normal odontogenesis. 2. At 4 weeks, abnormal calcified tissue, such as odontoma and ankylosis of osteodentin with surrounding alveolar bone were observed. 3. At 8 weeks, allotransplanted tooth germs of the 15th and 17th embryonic day showed calcification and osteodentin surrounded by periodontal ligament. 4. At 8 weeks, allotransplanted tooth germs of the 3rd day of birth showed calcification composed of cementum and osteodentin. In this study, we observed small sized and amorphous calcified tissue from allotropic allotransplantation of tooth germs. Since these calcified tissue were underdeveloped and shaped irregularly, for calcification into normal tooth form, further study needs consideration about the reduction of surgical trauma, developmental stage of transplanted tooth germ, blood supply from recipient site, fixation method in transplanted site and period of transplantation.

• Journal of Periodontal and Implant Science
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• v.32 no.3
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• pp.501-521
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• 2002

The purpose of this study is to evaluate the influences of the bone morphogenetic protein (BMP) on the healing of periodontal ligament and alveolar bone after replantation of tooth, and to examine the possibility of its clinical application. 45 Sprague Dawley rats weighted about 100 gram were divided into 3 experimental groups by different dose of BMP. All the upper right and left 1st molar were extracted after 5 days feeding of 0.4% ${\beta}$-aminopropionitrile, and right molar were used as experimental group and left molar were used as control group. The root surface of experimental molar were treated with 25,50 and l00ng/ml of human recombinant Bone morphogenetic protein-4 (rh-BMP-4) with micropipet, and 1M Sodium hypochloride were used on control root surface. All the experimental animals were sacrificed as 1, 2, 4, 7 and 14 days after autoreplantation of upper 1st molar into their own position. The maxilla were disected included both side of 1st molar. The collected tissue were processed from demineralization to paraffin embeding as usual procedure, and the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows : 1. There was no significant differences between control and experimental site on 1 and 2 days after replantation of tooth. In the case of 4th days, the evidence of tissue regeneration were observed on experimental site to compare the controls. New osteoid were revealed on high concentration of BMP at 7 days after replantation, and it became more obvious at 14 days, 2. The effect of the rh-BMP-4 coated on root surface was revealed slight influences for the prolifertion of cells of periodontium and tissue regeneration as dose-dependent pattern. 3. Bony ankylosis was observed between alveolar bone and root surface due to the remarkable amount of osteoid formation on the 14 days after replantation of root. In the conclusion, it was suggested that topical application of the rhBMP-4 on the root surface has influence on the periodontal ligament and alveolar bone. The application method of BMP on the root should be designed with calculation of proper concentration.