• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.1
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• pp.158-163
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• 2005

It is rare that the complete avulsion, intrusive luxation, and extrusive luxation occurred by trauma at the same time. In July, 2003, 10-year and 2 month-old-girl was referred to Department of Pediatric dentistry, Chonnam National University Hospital due to complete avulsion of upper right lateral incisor, intrusive luxation of upper right cental incisor and extrusive luxation of upper left central incisor. Traumatized teeth were surgically repositioned and fixated with resin-wire splint at the same day. Endodontic treatment of avulsed tooth was performed 2 weeks after trauma. A radiograph was taken 3 months after trauma, which demonstrated root resorption of both upper central incisors. External root resorption was arrested by the root canal therapy with calcium hydroxide. It showed good results for 1 year and 4 month but further follow-up is needed to check root resorption and ankylosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.2 no.1
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• pp.67-75
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• 1975

The conserative treatment of the necrotic and infected primary molars is often necessary in order to avoid extractions which may lead to inability to masticate or loss of space and subsequent problems concerning the development of the occlusion in the permanent dentition. The purpose of this study was to evaluate the clinical significance of the conservative treatment of the infected primary molars with necrotic pulps employing the formocresol pulpotomy technique same as in vital teeth and surgical intervention in the cases with a parulis, fistula or cellulitis. The materials consisted of 25 primary molars of 9 boys and 4 girls ranging in age from 4 to 7 years. This study included clinical and radiographic observation at 3-month intervals postoperatively. The following results were obtained. 1. Clinically, 20 cases of 25 were successful, exhibiting no clinical problems such as fistula, mobility, toothache and tenderness to percussion, etc. 5 cases were regarded as failures. 2. Radiographiclly, 14 cases revealed normal features, in 6 cases slight rarefaction was observed in the periapical and interradicular region, and marked periapical and interradicular rarefaction was observed in 5 cases. 3. Marked bony deposition was observed in the periapical and interradicular regions in all the remainder except for 5 failurese. 4. Pathologic root resorption was observed in 2 cases. 5. No alveolodental ankylosis was observed. 6. Regeneration of the dental sac of the permanent tooth was observed in 1 case of 2 cases which had revealed loss of the dental sac.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.34-40
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• 2004

Unerupted maxillary anterior teeth is not a common case, However it may present practitioners with management problem. The cause of impaction is considered to be multifactorial, and local cause is the most common. These impacted teeth require surgical intervention, removal, transplantation, or surgical exposure, with or without orthodontic traction to align the malpositioned tooth. The preferred option is surgical exposure and orthodontic correction. Surgical intervention and orthodontic correction should not be delayed to avoid unnecessary difficulties in aligning the tooth in the arch. Surgical exposure should be performed with the intent of providing sufficient attached gingiva rather than simply uncovering the crown, which results in only alveolar mucosal attachment. Attached gingiva is essential to secure the gingival tissues to the adjacent teeth at the dentogingival junction. Thus preventing loss of periodontal tissues as a result of the pull of the surrounding soft tissues and facial muscles. Labially impacted maxillary anterior teeth uncovered with an apically positioned flap technique have more un- esthetic sequelae than those uncovered with a closed-eruption technique. In the case of severly displaced impacted teeth, autotransplantation ensures preservation of the alveolar bone and will facilitate future placement of an osseointegrated implant once growth has ceased or if ankylosis/resorption of the transplant occurs.

• Journal of Periodontal and Implant Science
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• v.46 no.5
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• pp.303-319
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• 2016

Purpose: The purpose of this animal study was to perform a 3-dimensional micro-computed tomography (micro-CT) analysis in order to investigate the influence of root surface distance to the alveolar bone and the periodontal ligament on periodontal wound healing after a guided tissue regeneration (GTR) procedure. Methods: Three adult Sus scrofa domesticus specimens were used. The study sample included 6 teeth, corresponding to 2 third mandibular incisors from each animal. After coronectomy, a circumferential bone defect was created in each tooth by means of calibrated piezoelectric inserts. The experimental defects had depths of 3 mm, 5 mm, 7 mm, 9 mm, and 11 mm, with a constant width of 2 mm. One tooth with no defect was used as a control. The defects were covered with a bioresorbable membrane and protected with a flap. After 6 months, the animals were euthanised and tissue blocks were harvested and preserved for micro-CT analysis. Results: New alveolar bone was consistently present in all experimental defects. Signs of root resorption were observed in all samples, with the extent of resorption directly correlated to the vertical extent of the defect; the medial third of the root was the most commonly affected area. Signs of ankylosis were recorded in the defects that were 3 mm and 7 mm in depth. Density and other indicators of bone quality decreased with increasing defect depth. Conclusions: After a GTR procedure, the periodontal ligament and the alveolar bone appeared to compete in periodontal wound healing. Moreover, the observed decrease in bone quality indicators suggests that intrabony defects beyond a critical size cannot be regenerated. This finding may be relevant for the clinical application of periodontal regeneration, since it implies that GTR has a dimensional limit.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.967-987
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• 1996

The present study was to evaluate the healing patterns of guided tissue regeneration( GTR) using resorbable $Vicryl^{(R)}$(polyglactin 910) mesh and nonresorbable expanded polytetrafluoroethylene(ePTFE) membrane with or without bone grafting using autogeneous bone and demineralized freeze-dried bone allograft(DFDBA) in the grade II furcation defects. Mucoperiosteal flaps were reflected buccally in the mandibular 2nd, 3rd and 4th premolar areas and furcation defects were created surgically by removing $5{\times}6mm$ alveolar bone in 4 dogs. Root surfaces were thoroughly debrided of periodontal ligament and cementum, and notches were placed on root surface at the most apical bone level. In the right and left mandibular quadrant, each tooth was received $Vicryl^{(R)}$ mesh(ACE Surgical Supply Co., USA) only, $Vicryl^{(R)}$ mesh with DFDBA, $Vicryl^{(R)}$ mesh with autogeneous bone grafts, ePTFE membrane($Core-tex^{(R)}$ membrane, W.L. Gore & Associates Inc., USA) only, ePTFE membrane with DFDBA or ePTFE membrane with autogeneous bone grafts. For the fluorescent microscopic examination, fluorescent agents were injected at 2, 4 and 8 weeks after surgery. Four weeks after surgery, 2 dogs were sacrificed and ePTFE membranes were removed from remaining 2 dogs, which were sacrificed at 12 weeks after surgery. Undecalcified tissues were embedded in methylmethacrylate and $10{\mu}m$ thick sections were cut in a buccolingual direction. These sections were stained with hematoxylin-eosin stain and Masson's trichrome stain, and evaluated by descriptive histology and linear measurements. The results were as follows : 1) $Vicryl^{(R)}$ mesh group showed less connective tissue attachment than ePTFE membrane group. 2) The combination of GTR using $Vicryl^{(R)}$ mesh and osseous grafts resulted in new attachment and new bone formation more than GTR using $Vicryl^{(R)}$ mesh only. 3) GTR using ePTFE membrane, with or without osseous grafts, enhanced periodontal regeneration. 4) Root resorption and dentoalveolar ankylosis were observed in the areas treated with the combination of GTR and DFDBA. It was suggested that the effect of adjunctive bone grafting in GTR procedure depends on the materials and the physical properties of barrier membranes. $Vicryl^{(R)}$ mesh performed a barrier function and the use of adjunctive bone grafting may enhance the periodontal regeneration.

• Journal of Periodontal and Implant Science
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• v.47 no.6
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• pp.352-362
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• 2017

Purpose: Furcation involvement in the molars is difficult to treat, and has been recognized as a risk factor for tooth loss. Although periodontal regenerative therapies, including guided tissue regeneration and various types of bone grafts, have been applied to furcation defects, the effects of these treatments are limited, especially in large class III furcation defects. The purpose of this pilot study was to investigate the effect of reciprocal autologous root transplantation on periodontal wound healing and regeneration in class III furcation defects in dogs. Methods: Furcation defects (7 mm wide and 6 mm high) were surgically created after root separation of the unilateral third and fourth premolars in 4 dogs. Eight furcation defects were randomized to receive either reciprocal autologous root transplantation (test) or no further treatment (control). In the test group, the mesial and distal roots were transplanted into the distal and mesial extraction sockets, respectively. The animals were sacrificed 10 weeks after surgery for histologic evaluation. Results: The healing pattern in the control group was characterized by extensive collapse of the flap and limited periodontal regeneration. New bone formation in the test group ($3.56{\pm}0.57mm$) was significantly greater than in the control group ($0.62{\pm}0.21mm$). Dense collagen fibers inserting into the residual cementum on the transplanted root surfaces were observed in the test group. Slight ankylosis was observed in 2 of the 4 specimens in the test group on the mesiodistal sides where the root-planed surfaces faced the existing bone. Root resorption (RR) was detected in both the control and test groups. Conclusions: Within the limits of this study, it can be concluded that reciprocal autologous root transplantation was effective for bone regeneration in class III furcation defects in dogs. However, further studies are required to standardize the approach in order to prevent unwanted RR prior to clinical application.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.3
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• pp.522-528
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• 2006

When tooth is displaced within the alveolar bone, it could apply pressure and rupture the apical vessels. Pulpal reaction in such case is affected by the stage of root formation, amount of intrusion and pulpal infection. Determining the need of pulp treatment depends on the pulp vitality. Therefore, periodic vitality tests, coronal color changes and radiographic root resorption signs should be observed through periodic post-trauma follow-up. Pulp necrosis, pulp canal obliteration, external root resorption, root ankylosis and marginal bone loss could result from periodontal injuries. Negative sign changes from positive signs of vitality tests suggest pulp necrosis. In this case, pulp treatment should be held before root resorption occurs. By comparing the following two cases, complications of intrusion and factors producing them could be confirmed, thus we propose to report these two cases.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.3
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• pp.444-449
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• 2002

The term 'impaction' is used to designate a tooth which remains unerupted in the jaw beyond the time at which it should normally be erupted. The main causal factors are local (lack of space, ectopic positions of teeth, supernumerary teeth, cyst, the occurrence of infectious process in the eruption path, traumatic facial injury etc.). Systemic and genetic disorders, however, may have primary failure of eruption and retarded eruption as additional symptoms (cleidocranial dysplasia, osteopetrosis etc.). Most cases of impacted teeth reported in the literature are of permanent teeth. The absence of primary teeth occur rarely whereas impaction of second primary molars is more numerous than all other impactions. Impaction due to primary failure of eruption must be distinguished from the secondary infraocclusion. The etiology of impaction of primary teeth is probably related to early ankylosis of primary teeth, but it is not clear. Failure of eruption of primary teeth may cause a number of complications, such as interference with development and eruption of succedaneous teeth, formation of cyst, and damage to adjacent teeth. This study is to report cases of primary failure of eruption in the primary dentition.