• 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 the Korean Arthroscopy Society
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• v.12 no.1
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• pp.53-57
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• 2008

Purpose: We analyzed the clinical results after arthroscopic treatment in acute pyogenic arthritis of the knee. Materials and Methods: From July 2000 to January 2005, we reviewed 16 cases(15 patients) of acute pyogenic arthritis of the knee on which arthroscopic treatment was done. The mean age was 61.9 years and the mean follow-up period was 30.5 months. There were 8 cases with diabetes or degenerative osteoarthritis and 14 cases with acupuncture or intraarticular injection history. Results: Causative organisms were identified in 7 cases. The average postoperative antibiotics were used intravenously for 25.5 days and per orally for 22.5 days. There were 11 complications; 5 cases of partial ankylosis, 2 cases of secondary arthritis, 1 case of chronic osteomyelitis and 3 cases of death. Patients with over 3 week immobilization had higher rate of stiffness of knee joint(p=0.032) but there was no significant difference between the symptom to treatment duration and the incidence rate of complications(p=0.293). The cases of which the causative organism was detected had higher incidences of complications(p=0.034). Conclusion: The incidence of joint stiffness was higher in the patients of longer immobilization. More complications were detected in the cases of which the causative organism is detected.

• 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.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.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.25 no.2
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• pp.279-289
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• 1995

The most important object of periodontal treatment is the perfect regeneration of destructed periodontal tissue. The healing of periodontal lesion is affected by several cells & factors, which result in formation of long juntional epithelium, root resorption, bony ankylosis or connective tissue attachment. And ideal healing is enhanced by epithilial exclusion or periodontal ligament cell activation. In this investigation, I studied the effect of Zizyphus Fructus extract which enhances biologic activity& collagen synthesis, on the chemotaxis & cell nature. The cells were obtained from interdental area & middle third area of the freshly extracted teeth for the orthodontic purpose. And they were fully incubated in${\alpha}-MEM$ solution containing $100{\mu]g/ml$ penicillin & $100{\mu]g/ml$ streptomycin followed by 6 generation incubation. The test cells were collected by trypsin-EDTA & centrifuge in the fully incubated cells, counted by Hernacyotmeter, incbated $5{\times}10^5/ml$ cells for 24 hours, re-incubated 24 hours in media containing natural extract and photographed. The cells were incubated for 4 hours in 48 well microchemotaxis chamber bisecting upper & lower chamber by 8ug/m pore polycarbonate membrane coating 5mg/ml gelatin solution. The migrated cells in microscope were counted, which meaned cell chemotaxis activity. The study had shown that the morphology of cell was spindle-shaped as the control group, and the subextract test groups were not significantly different. In gingival fibroblasts, the chemotaxis effect of PDGF was statistically significant compared to control group. The Zizyphus Fructus extract was more or less enhanced chemotaxis effect and in $1{\mu}g/ml$ concentration the chemotaxis effect was slightly elevated compared with $10{\mu}g/ml$ concentration. But, among the subextracts, it was not significantly defferent. In PDL cells, the chemotaxis effect of PDGF in statistically significant, and the zizyphus Fructus extract had shown the enhanced effect. The effect was slightly higher in $1{\mu}g/ml$ concentration than 10g/ml concentration,and no significance among the subextracts.

• Journal of Periodontal and Implant Science
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• v.25 no.3
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• pp.557-567
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• 1995

The purpose of this study was to investigated the effect of root planing and decalcified freeze dried allografts on the resorption of transplanted roots and the healing of preveously diseased recipient extraction sockets. The experimental chronic periodontitis was induced by elastic ligatures on the 2nd and 3rd mandibular premolars of 4 adult dogs, and after 8 weeks, crowns were removed and the teeth extracted. The extracted roots were split in half along the long-axis, and the extednt of plaque exposure was morked on the root surfaces with burs. The roots were either root-planed(Test group), or left uninstrumented(Control group), and transplanted in the extraction sockets with decalcified freeze-dried allografts filling the void. The flaps were sutured to cover the sockets completely. The animals were sacrificed after 12 weeks of healing, and the specimens were examined histologically. The results were as follows : 1. No signs of inflammation or disease activity were observed in either groups. 2. Replacement root resorption was observed in both groups. 3. More connective tissue attachments and less ankylosis were observed in the test groups compared to the control. 4. The unresorbed remains of DFDB particles were observed in both groups. 5. DFDB particles in the apical portion of the alveolar sockets were encased in newly-formed bone, while those in the coronal areas were seen encapsulated with connective tissue. 6. No significant difference was found between root-planed and uninstrumented roots relative to the healing and the bone fromation in the recipient extraction sockdets. From the present study, there seemed to be no significant benefits in root planing the transplanted roots or grafting the sockets with DFDB in order to curve the replacement resorption, although the root-planed roots showed more connective tissue attachments. There was also no significant benefits in root transplantation and DFDB for and enhanced healing and bone formation in alveolar extraction sockets.

• 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 the korean academy of Pediatric Dentistry
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• v.33 no.4
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• pp.722-727
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• 2006

Most of impacted teeth reported are permanent teeth. Impaction of primary tooth caused by primary failure of eruption is rare and the most of impacted primary tooth are second primary molars. The etiology of a primary molar impaction would appear to be a physical barrier, early ankylosis of the tooth, abnormal development of the primary molar germ or malposition of the successor bud. Transposition has been described as an interchange in the position of two teeth within the same quadrant of the dental arch. It is most commonly seen with canine and lateral incisor teeth, but is rarely associated with the primary dentition. The two cases show the transposition of impacted primary molar and the tooth germ of second premolar in their clinical and radiographic examinations. In case 1, lower second primary molar was deeply impacted inferiorly to the tooth germ suspected to be a second premolar. In case 2, impacted all second primary molars were positioned inferiorly to the tooth germs suspected to be the successors. We extracted all second primary molars under general anesthesia and the extracted tooth germs appeared to be second premolars.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.303-308
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• 2011

Tooth impaction refers to situations in which the eruption is inhibited by some physical barriers in eruptive path and the tooth remains unerupted beyond the normal time of eruption. The etiology of impacted tooth is controversial, but ankylosis has been suggested probably as a leading role. Impacted primary molars may cause several problems such as space loss, tipping of adjacent teeth, supra-eruption of the antagonists, dislocation of succeeding premolar, cystic change and infection. As one of conventional treatments of impacted primary molars, early tooth extraction or surgical extraction following space regaining when there is space loss has been suggested. However, when they are in normal formation and not ankylosed, orthodontic traction following surgical exposure can be the choice of treatment. In this case, a 3-year-old boy was referred to the department of pediatric dentistry for the unerupted mandibular right second primary molar. After surgical removal of gingiva on the occlusal surface, orthodontic traction was performed. After treatment, we could get normal alignment of primary teeth and the opportunity for normal development of permanent teeth.