• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.4
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• pp.555-560
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• 2002

Replantation may be a treatment choice for a completely avulsed tooth caused by a traumatic injury. The outcome of replantation depends on the following factors ; minimal damage to pulp and periodontal membrane, the length of time the avulsed tooth was out of the mouth, how the tooth was stored, the level of root formation, etc. The time from the act of avulsion of the tooth to the actual replantation is especially important. Generally, when replanted within 30 minutes, more than 90% of the cases succeed, but when the time is between 30 to 90minutes, 43%, and greater than 90 minutes, 7%. This is a case of a replanted tooth with relatively good prognosis by ankylosis though there was a great time lapse since the tooth was avulsed. Though such treatment lead to loss of the tooth, in cases of children or adolescents, this treatment is meaningful, because it may earn time until any definitive therapy, functionally stimulate the alveolar bone to retain its height for a better prognosis for future treatment, and act as space maintainer.

• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.29.1-29.9
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• 2020

This study describes the clinical steps taken in the treatment of a patient who had an avulsed right upper central incisor that presented with incomplete root development and chronic apical periodontitis. A 7-year-old boy was referred from a private dentist to a dental office specializing in endodontics. The tooth had remained in a dry environment for 20 minutes, and tooth replantation was performed at an emergency appointment. After clinical and radiographic examinations, root canal decontamination was performed, followed by several changes in intracanal calcium hydroxide medication. Blood clot formation was attempted, but bleeding within the root canal was insufficient; therefore, we opted for an intracanal medication change to stimulate mineralized tissue formation in the apical region. Root obturation was performed 45 days after the last change of intracanal medication, and clinical, radiographic, and tomographic follow-up examinations were performed at 3, 6, 18, and 40 months after the endodontic intervention. The increase in thickness and length of the root structure and the absence of root resorption were verified through follow-up examinations. Therefore, it was concluded that the procedures used were successful for tooth replantation.

• Journal of Periodontal and Implant Science
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• v.52 no.2
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• pp.127-140
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• 2022

Purpose: In dental avulsion, delayed replantation usually has an uncertain prognosis. After tooth replantation, complex inflammatory responses promote a return to periodontal tissue homeostasis. Various types of cytokines are produced in the inflammatory microenvironment, and these cytokines determine the periodontal tissue response. This study aimed to identify the gene expression profiles of replanted teeth and evaluate the functional differences between immediate and delayed replantation. Methods: Maxillary molars from Sprague-Dawley rats were extracted, exposed to a dry environment, and then replanted. The animals were divided into 2 groups according to the extra-oral time: immediate replantation (dry for 5 minutes) and delayed replantation (dry for 60 minutes). Either 3 or 7 days after replantation, the animals were sacrificed. Periodontal soft tissues were harvested for mRNA sequencing. Hallmark gene set enrichment analysis was performed to predict the function of gene-gene interactions. The normalized enrichment score (NES) was calculated to determine functional differences. Results: The hallmark gene sets enriched in delayed replantation at 3 days were oxidative phosphorylation (NES=2.82, Q<0.001) and tumor necrosis factor-alpha (TNF-α) signaling via the nuclear factor kappa light chain enhancer of activated B cells (NF-κB) pathway (NES=1.52, Q=0.034). At 7 days after delayed replantation, TNF-α signaling via the NF-κB pathway (NES=-1.82, Q=0.002), angiogenesis (NES=-1.66, Q=0.01), and the transforming growth factor-beta signaling pathway (NES=-1.46, Q=0.051) were negatively highlighted. Conclusions: Differentially expressed gene profiles were significantly different between immediate and delayed replantation. TNF-α signaling via the NF-κB pathway was marked during the healing process. However, the enrichment score of this pathway changed in a time-dependent manner between immediate and delayed replantation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.6
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• pp.339-346
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• 2023

Objectives: This analysis details the characteristics of dental trauma in South Korea during the coronavirus disease 2019 (COVID-19) (DC) pandemic and compares them in patients before and after COVID-19 (BC and AC, respectively). Materials and Methods: Data were collected from medical records of patients who visited Seoul National University Bundang Hospital's Emergency Dental Care Center during three 12-month periods: BC, DC, and AC (BC from March 1, 2019 to February 29, 2020; DC from March 1, 2020 to February 28, 2021; AC from March 1, 2022 to February 28, 2023). A retrospective review was conducted to investigate patient age, sex, time of visit, cause, and diagnosis. The study included 1,544 patients: 660 BC, 374 DC, and 510 AC. Results: Significant difference in age and sex was not observed among the three periods; 1-9 years of age was the largest group (38.3% in BC, 29.6% in DC, and 27.8% in AC), and the percentage of male patients was greater than of female patients (male proportion as 63.5% in BC, 67.4% in DC, and 64.9% in AC). The number of patients generally peaked at a Saturday night in spring (for BC: May, Saturday, 18:00-19:59; for DC: March, Saturday, 18:00-19:59; for AC: April as the second most (October as the most peaked), Saturday, 20:00-21:59). The primary etiology of the dental trauma was identical in the three periods: falls, followed by sports. The most frequent diagnosis was laceration, followed by tooth avulsion and jaw fracture. Conclusion: Significant differences were not found between the characteristics and patterns of dental trauma in the BC, DC, and AC periods. However, due to the pandemic and social distancing, activities decreased and associated dental trauma-related incidents declined.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.4
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• pp.280-285
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• 2012

From the standpoint of general guidelines of a dentist, the following conditions should be considered before replanting a permanent tooth. The avulsed tooth should be without advanced periodontal disease. The alveolar socket should be reasonably intact in order to provide a seat for the avulsed tooth. The extra-alveolar period should be considered, i.e. periods exceeding. 2 hours are usually associated with marked root resorption. But, the above mentioned regulations are often difficult to keep in the actual situation of the medical emergency room, owing it to the delay of primary medical care in multiple trauma patients. The successful cases have been reported with minimal root resorption in the long-term periods, in spite of extra-alveolar periods of several hours and combined alveolar bone fracture. This is a case report regarding the effect of endodontic drainage in delayed replantation after a prolonged extra-alveolar period of the avulsed teeth with alveolar bone fracture.

• Proceedings of the KACD Conference
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• 2001.05a
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• pp.241-242
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• 2001

Tooth resorption os perplexing problem for all dental practitioners. The etiology factors and diagnosis are vague, chosen treatment dose not prevent the rapid disappearance of the calcified dental tissues. Since the etiologic factors, diagnosis, treatment and prognosis differ for these various types of resorptive defects, it is important to diagnose resorption radiographically or clinicall and distinguish internal from external resorption. Following these cases are internal root resorption, external root resorption of serious complication subsequent to avulsion and traumatic injury.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.6
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• pp.422-427
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• 2020

Management of maxillofacial trauma includes primary care, in which diagnosis and management of dentoalveolar injury play a vital role. Due to the impact sustained during a maxillofacial injury (whether direct or indirect), dentoalveolar injuries can occur, leading to fracture and displacement of teeth and associated alveolar bone into the surrounding soft tissues and associated structures, such as the maxillary sinus, nasal cavity, upper respiratory tract, tracheobronchial tree, or gastrointestinal tract. Undiagnosed displaced teeth may cause complications such as airway obstruction. This paper reports a case of displaced teeth in the nasal cavity and gastrointestinal tract and highlights the management protocol for displaced teeth secondary to maxillofacial trauma.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.1
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• pp.1-6
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• 2005

Injury of permanent teeth by trauma usually occurs to $8{\sim}10\;years$ old children, in mixed dentition. Fracture, dislocation, intrusion, extrusion, avulsion are the common types of trauma in teeth. The injuries which teeth are dislocated from the alveolar sockets can be treated by reduction and fixation. In this case report two children visited Wonkwang University Dental Hospital after the emergency treatment of tooth injury by other medical institutes. In these cases the injured teeth were not reducted properly and showed premature contact. So the teeth were dislocated from the alveolar sockets intentionally and fixed again in the proper position. Unproper reduction can cause premature contact, delay of healing, difficulty of mastication, and malocclusion. For this reason emergency rooms or local dental clinics where patients with dental trauma can be examined first, must know well about the treatment procedure of the injured teeth and should be consulted to the profession when necessary.

• 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.

• Restorative Dentistry and Endodontics
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• v.39 no.2
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• pp.126-131
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• 2014

Among dental traumas, horizontal root fractures are relatively uncommon injuries. Proper initial management and periodical evaluation is essential for the successful treatment of a root-fractured tooth. If pulpal necrosis develops, endodontic treatment is indicated, exclusively for the coronal fragment. Fragment diastases exert a great influence on healing at the fracture line and on pulpal necrosis. An adequately treated root-fractured tooth has a good prognosis. This case report describes the treatment and 2-yr follow up of 3 maxillary central incisors, first with horizontal root fracture, second with horizontal root fracture and avulsion, and third with horizontal root fracture and lateral luxation. All three cases were treated with mineral trioxide aggregate (ProRoot, Dentsply). During 2 yr of follow-up evaluation, the root-fractured teeth of the present patients were well retained in the arch, showing periodontal healing, even after endodontic treatment.