• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.2
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• pp.176-179
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• 2011

Adenomatoid odontogenic tumors represent 3 to 7 percent of all odontogenic tumors. These tumors are more common in the maxilla than the mandible and usually include the anterior region. Clinically, the most common symptom is painless swelling and the tumor is associated with an unerupted tooth, typically a maxillary or mandibular cuspid. The adenomatoid odontogenic tumor appears radiographically as a unilocular radiolucency around the crown of an impacted tooth, resembling a dentigerous cyst. More often, it contains fine calcifications. Histopathologically, there is a thick wall cystic structure with a prominent intraluminal proliferation of the odontogenic epithelium. The most striking pattern is varying-sized solid nodules of spindle-shaped or cuboidal epithelial cells forming nests or rosette-like structures with minimal stromal connective tissues. Conspicuous within the cellular areas are structures of tubular or duct-like appearance. The duct-like spaces are lined with a single row of cuboidal or low columnar epithelial cells, of which the ovoid nuclei are polarized away from the luminal surface. Small foci of calcification may also be scattered throughout the tumor. These have been interpreted as abortive enamel formations. In some adenomatoid odontogenic tumors, the material has been interpreted as dentoid or cementum.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.52-58
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• 2004

Supernumerary tooth describes an excess of tooth number, which are found in primary dentition with 0.3-0.8%, permanent dentition with 1.0-3.5% prevalence. Their frequency is about 2:1 (male vs female) and 9:1 (maxilla vs mandible). However, occurrence is very rare in the incisor region of the mandible. We need a early diagnosis and appropriate treatment plan because of possibility of diastema, eruption failure, displacement, rotation of the associated permanent teeth, root resorption, dentigerous cyst with presence of the supernumerary teeth. This is a case report about two impacted supernumerary teeth found in madibular anterior region of 6 years old girl. One was extracted and another was retained because of fusion with permanent central incisor on the labial surface.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.160-166
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• 1991

In 1977, Robinson & Martinez described a distinct varient of ameloblastomas in which the response to curettage was found to be favorable, with a recurrence rate of 25%. They referred to this varient as unicystic ameloblastoma. Unicystic ameloblastoma occur most commonly in the second and third decades of life, which is considerablly younger than the average age of discovery for the classical ameloblastoma. For the accurate histopathological diagnosis of the unicystic ameloblastoma, the specimen obtained the excisional biopsy, complete enucleation or incisional biopsy from the multiple site of the lesion. The purpose of this report is to review of the literature and to present three cases in which an unicystic ameloblastoma appear to be arising in the wall of a dentigerous cyst.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.2
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• pp.278-283
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• 2005

Impaction of mandibular canine is not common, and transmigration of mandibular canine is rare. Treatment of impacted canine can be removal of physical obstacle and periodic observation, surgical exposure of impacted tooth and orthodontic traction, autotransplantation, surgical extraction. Management of impacted canine depends on existence of physical obstacle, position and direction of impacted tooth, space available for canine eruption, stage of root development. Of the two case in this report, one case involved impaction of lower canine with odontoma and dentigerous cyst that is treated by surgical exposure and orthodontic traction. The other case involved transmigration of lower canine with supernumerary teeth. It was thought difficult to treat only by orthodontic treatment, so the impacted canine was transplanted to its normal position and orthodontic treatment was conducted.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.4
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• pp.190-193
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• 2015

Objectives: A mesiodens appears most commonly as a supernumerary tooth impacted in the anterior maxilla. The purpose of this study is analyze mesiodens clinically. Materials and Methods: Gender, crown form, direction of impaction, relation to permanent incisors, and chief complaints of patients with extracted mesiodens were analyzed. Results: Patients were analyzed for motivation to visit the hospital; 85.4% of the patients were referred from other hospitals. Mesiodens was more common in males than in females (3.7:1), and 70.1% of patients had only one mesiodens, while 29.6% had two mesiodenses. Of the mesiodenses, 61.4% were of the aconical form, and the most common direction was upward (62.4%), followed by the normal position (26.0%) and the horizontal position (11.6%). The mesiodenses caused orthodontic problems with the permanent incisors in 46.3% of cases. Mesiodens associated with dentigerous cyst was rarely observed in our patient group. Conclusion: Mesiodens is more common in males than in females and often affects the permanent incisors. Thus, careful clinical and radiological evaluations of mesiodenses are important.

• Imaging Science in Dentistry
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• v.40 no.3
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• pp.109-114
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• 2010

Purpose : This study was performed to analyze the position, pattern of impacted mesiodens, and their relationship to the adjacent teeth using Dental cone-beam CT. Materials and Methods : Sixty-two dental cone-beam CT images with 81 impacted mesiodenses were selected from about 2,298 cone-beam CT images at Chonnam National University Dental Hospital from June 2006 to March 2009. The position, pattern, shape of impacted mesiodenses and their complications were analyzed in cone-beam CT including 3D images. Results : The sex ratio (M : F) was 2.9 : 1. Most of the mesiodenses (87.7%) were located at palatal side to the incisors. 79% of the mesiodenses were conical in shape. 60.5% of the mesiodenses were inverted, 21% normal erupting direction, and 18.5% transverse direction. The complications due to the presence of mesiodenses were none in 43.5%, diastema in 19.4%, tooth displacement in 17.7%, delayed eruption or impaction in 12.9%, tooth rotation in 4.8%, and dentigerous cyst in 1.7%. Conclusions : Dental cone-beam CT images with 3D provided 3-dimensional perception of mesiodens to the neighboring teeth. This results would be helpful for management of the impacted mesiodens.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.1
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• pp.55-63
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• 2012

The odontogenic keratocyst (OKC) was originally classified as a developmental cyst, and OKCs were histologically divided into orthokeratotic (O-OKCs) and parakeratotic (P-OKCs) types. Clinical features differ between O-OKCs and P-OKCs with P-OKCs having a tendency to recur after surgical treatment. According to the revised histopathological classification of odontogenic tumors by the World Health Organization (2005), the term keratocystic odontogenic tumor (KCOT) has been adopted to describe P-OKCs. In this retrospective study, we examined 186 KCOTs treated at the Maxillofacial Surgery Department of the Tokyo Medical and Dental University Hospital from 1981 through 2005. The patients ranged in age from 7 to 85 years (mean, 32.7) and consisted of 93 males and 93 females. The most frequently treated areas were the mandibular molar region and ramus. The majority of KCOTs in the maxillary region were treated by enucleation and primary closure. The majority of KCOTs in the mandibular region were enucleated, and the wound was left open. Marginal resection was performed in the 4 patients with large lesions arising in the mandible. In patients who were followed for more than a year, recurrences were observed in 19 of 120 lesions (15.8%). The recurrences were found at the margins of the primary lesion in contact with the roots of the teeth or at the upper margins of the mandibular ramus. Clinicians should consider aggressive treatment for KCOTs because the recurrence rate of P-OKCs is higher than that of other cyst types such as O-OKCs, dentigerous cysts, primordial cysts that were non-keratinized, and slightly keratinized stratified squamous epithelium. Although more aggressive treatment is needed for KCOTs as compared to other cystic lesions, it is difficult to make a precise diagnosis preoperatively on the basis of clinical features and X-ray imaging. Therefore, preoperative biopsy is necessary for selecting the appropriate treatment for patients with cystic lesions.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.333-338
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• 2008

Supernumerary teeth are characterized by an excess number of teeth, which can be responsible for a variety of irregularities in the primary and transitional dentition. Supernumerary teeth, especially in the maxillary anterior region, may prevent the eruption of adjacent permanent teeth and cause their ectopic eruption, diastema, root resorption, or formation of dentigerous cyst. Therefore, early diagnosis of supernumerary teeth is important for prevention of such complications, and adequate treatment should be given according to their location, number, and morphologic features. In this case, four supernumerary teeth in the maxillary anterior region were disturbing the eruption of adjacent permanent incisors. Two of them were located in proximity to the central incisor tooth germs that their immediate removal may injure the permanent tooth germs. In order to minimize such complications, surgical extraction of the four supernumerary teeth was performed in two stages. At first, only two inverted conical supernumerary teeth were extracted. The other two tuberculous supernumerary teeth, close to the permanent tooth germs, were extracted later after their natural dislocation. In that way, we could minimize affects on the neighboring permanent tooth germs and also the amount of alveolar bone removed during surgery.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.4
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• pp.644-648
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• 2005

Supernumerary tooth was resulted from excessive proliferation of dental lamina and associated with familial tendency and a congenital syndrome such as Cleidocranial dysostosis or Gardner's syndrome. Incidence reports identify a range of $0.3{\sim}0.8%$ in primary dentition, $1.0{\sim}3.5%$ in permanent dentition with males being affected twice as frequently as females, maxilla nine times as frequently as mandible. The most common supernumerary tooth is the mesiodens, which located between the maxillary central incisors, and the next common site is the fourth molar and lateral incisors. Supernumerary teeth are uncommon in the mandible, but premolars are the most common supernumerary teeth and occurrence is very rare in the incisor region of the mandible and the incidence is 2%. We need a early diagnosis and appropriate treatment plan because of possiblilty of diastema and eruption failure displacement, rotation of the associated permanent teeth, root resorption and dentigerous cyst with presence of the supernumerary teeth. In this two case, one supernumerary tooth located in the mandibular incisor region, the other supernumerary tooth located in premolar region. We could get normal alignment of mandibular dentition by extraction and orthodontic treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.1
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• pp.127-133
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• 1998

An impacted tooth is defined pathologically as a tooth that remains under the mucosa of inside bone without eruption of the crown after a specific period of eruption. Clinically, the term includes those teeth, even before eruption period, that are not expected to erupt due to shape, position and alignment of tooth and lack of space. Canine is prone to impaction more than other teeth because it has the longest time to develop and a complex route from the place of formation to the site of eruption. The impaction incidence of maxillary canine is repoted 0.92$\sim$3.3% (Ferguson, 1990). In 1995 Orton reported that the incidence was 0.92$\sim$2.2% and palatal impaction was more frequent than labial impaction(85%:15%). In 1969 Johnston presented it was more common to woman than to man(3:1). The etiology includes systemic disease such as endocrine disorder, cleidocranial dysostosis, irradiation, Crouzon syndrome, ricketts, facial hemihypertrophy and hereditary and local problems such as ectopic position of the tooth, distance of tooth from its place of eruption, malformation of the tooth, presence of supernumerary teeth, trauma of tooth germ, infection of tooth germ, displacement of tooth germ or tooth by a neoplasm, ankylosis, overretention of deciduous predecessor, lack of space for the tooth in the dental arch and mucosal barrier due to gingival fibrosis. The maxillary canine is especially important as it has the longest root, provides guidance for lateral movement of the mandible and masticatory function and assumes an important role esthetically as it is located at mouth angle. If left untreated, it may cause migration and external, internal resorption of adjacent teeth, loss of arch length, formation of dentigerous cyst or tumors, infection and referred pain as well as malposition of the tooth. Therefore, periodic examination of the development and eruption of the maxillary canine is especially important in a growing child. This case study presents the results of treatment of palatally impacted maxillary canine utilizing surgical exposure and orthodontic tooth movement on patients visiting SNUDH dept. of pediatric dentistry.