• Title/Summary/Keyword: multiple teeth fracture

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TYPE II DENTINOGENESIS IMPERFECTA : CASE REPORT (Type II 상아질형성부전증의 임상 증례)

  • Kim, Chi-Hyun;Lee, Jae-Ho;Choi, Byung-Jai;Lee, Chong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.4
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    • pp.654-660
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    • 2001
  • Dentinogenesis imperfecta is an example of an inheritable dentinal defect originating during the histodifferentiation stage of tooth development, with involvement of the primary and permanent teeth. Shields, Bixler and El-Kafrawy proposed three types of Dentinogenesis imperfecta : Type I, II, III. Witkop reported a prevalence of 1 in 8000 with the trait, and no significant difference between male and female. Affected teeth have red-brown discoloration often with distinctive wearness of occlusal surface of posterior teeth and incisal surface of anterior teeth. Once enamel seperated from underlying defective dentin, the dentin demonstrates significantly acclerated attrision. Radiographically, the teeth have thin roots, bulbous crown, cervical constriction, and obliteration of the root canals and pulp chambers. In primary dentition periapical lesions or multiple root fractures are often observed. In successive generations the phenotypes of discoloration and wearness of teeth occurred, and one of the patient's subships, 10 year-old sister, showed general discoloration of her teeth and mild wearness. In this case, a 4 year-old male reported to the Yonsei University Pedodontics clinic, with a chief complaint of discolored teeth. The teeth showed generally yellowish-brown discoloration and moderate wearness. In radiographic features, obliteration of pulp, bulbous crown, and short roots were observed. It was diagnosed as Dentinogenesis imperfecta. The posterior teeth were restored with Stainless Steel Crown, and defective incisors including left upper primary central incisor which was extracted due to a root fracture with Open-faced Stainless Steel crown.

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Pulp Treatment of Triple Tooth in Primary Dentition: Two Case Reports (유치열에 나타난 삼중치에서 치수 치료 : 증례 보고)

  • Jeong, Hankeul;Lee, Nanyoung;Lee, Sangho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.2
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    • pp.192-199
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    • 2016
  • Triple tooth is rare in primary dentition; it is the abnormal fusion of three teeth. There are a few reports of double teeth, but triple teeth are rare. These multiple teeth create several clinical problems, not only esthetic problems but also a high caries susceptibility, congenital missing permanent tooth germ(s), orthodontic problems, and periodontal problems. They also make it difficult to perform pulp treatment because of the complex tooth structure. A 1-year 7-month-old male underwent a partial pulpotomy with mineral trioxide aggregate (MTA) when pulp exposure caused by deep caries occurred at a maxillary anterior triple tooth in the first case. The second case was a 1-year 9-month-old male presenting with a fracture line at a mandibular anterior triple tooth. After removing the fractured fragment, a pulpectomy was performed at the remaining primary lateral incisors. Specific complications were not observed during 24 and 6 months of follow-up, respectively.

Full mouth rehabilitation of an asthma patient with severe tooth wear and occlusion disharmony (심한 마모 및 교합 부조화를 가진 천식 환자의 전악 수복 증례)

  • Jo, Yu-Jin
    • Journal of Korean society of Dental Hygiene
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    • v.22 no.4
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    • pp.225-230
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    • 2022
  • Objectives: Patients with excessive tooth wear should first be diagnosed for the etiology of the tooth wear. Causes of tooth wear include bruxism, clenching, and taking medications for systemic diseases. After identifying the cause of tooth attrition, the final prosthesis should be restored with an appropriate vertical dimension. Methods: A 79-year-old man with worn out teeth desired a whole dental treatment. He was on medications for high blood pressure and asthma. The treatment proceeded with a consultation with a medical doctor. The medications for asthma evoked multiple teeth wear and a loss of the vertical dimension. After recovery of 3 mm of vertical dimension, 2 months of evaluation was followed by an interim prosthesis. Results: The increased vertical dimension caused no problem in function and esthetics, and the final restoration was performed with a full monolithic zirconia crown. Group function, adequate anterior guidance, and the occlusal plane were determined. Conclusions: After the final restoration, the patient was both esthetically and functionally satisfied, and a night guard splint was delivered to prevent prosthesis fracture. The patient was informed about the potential tooth wear associated with asthma drugs and educated to visit the clinic regularly.

Full mouth rehabilitation of a panfacial fracture patient with bilateral condylar fracture (다발성 안면골절환자의 교합회복 증례)

  • Park, Go-Woon;Cha, Min-Sang;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.2
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    • pp.159-169
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    • 2014
  • Panfacial fractures require complex multidisciplinary approaches for treatment. Functional stability of bilateral condylar-disc complex should be the goal of the treatment. A patient with complex clinical panfacial fractures, including a bilateral condylar fractures visited our clinic. Facial asymmetry, insufficient vertical space and multiple missing teeth of the patient were major problems. Closed reduction and splint treatment were tried for stable condylar position. A functional and esthetic rehabilitation was accomplished by using implants and full mouth rehabilitaion. Potential possibilities of unstable occlusion should be prevented with night guard and periodic occlusal adjustment.

MARGINAL FIDELITY AND FRACTURE STRENGTH OF IPS EMPRESS $2^{(R)}$ CERAMIC CROWNS ACCORDING TO DIFFERENT CEMENT TYPES

  • Cho Hyun-Ok;Kang Dong-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.40 no.6
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    • pp.545-559
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    • 2002
  • There has been increasing use of IPS Empress $2^{(R)}$ owing to easy fabrication method, high esthetics similar to natural teeth, good marginal accuracy, and sufficient fracture strength. However, in clinical application, although a luting agent and the tooth cementation bonding procedure influence the marginal accuracy and fracture strength restoration, there has been a controversy in the selection of proper luting agent. This study was to measure the marginal fidelites and fracture strength of IPS Empress crowns according to three cement types, Protec $cem^{(R)}$, Variolink $II^{(R)}$ and Panavia $21^{(R)}$. After construction of 12 experimental dies for each group, IPS Empress $2^{(R)}$ crowns were fabricated and luted the metal master die prepartion of the maxillary right premolar. Marginal gaps before cementation and after cementation were measured. Buccal incline on the functional cusp of specimens were loaded until the catastrophic failure and fracture strength was measured. The results of this study were as follows: 1. The range of gap was $34.04{\pm}4.84{\mu}m$ before cementation and $37.88{\pm}5.00{\mu}m$ after cementation, which showed significant difference by paired t-test (p<0.05). The difference in the results from marginal accuracy according to measuring point proved to be not statistically significant by two-way ANOVA test (p>0.05). 2. The difference in the results from marginal accuracy according to three cement types Proved that The Variolink $II^{(R)}$ cement group had the least gap, $35.43{\pm}5.03{\mu}m$, and showed superior marginal accuracy while there existed statistic significance in Protec $cem^{(R)}$ cement group, $39.06{\pm}4.41{\mu}m$ or Panavia $21^{(R)}$ cement group, $39.16{\pm}4.39{\mu}m$ by two-way ANOVA test & multiple range test (p<0.05). 3. The difference in the results from fractures strength testing according to three cement type groups proved to be statistically significant (p<0.05). The Variolink $II^{(R)}$ cement group shows highest fracture strength of $1257.33{\pm}226.77N$, Panavia $21^{(R)}$ cement group has $1098.08{\pm}138.45N$, and Protec $cem^{(R)}$ cement group represents the lowest fracture strength of $926.75{\pm}115.75N$. 4. Three different cement groups of different components showed acceptable marginal fidelity and fracture strength. It is concluded that IPS Empress $2^{(R)}$ crowns luted using Variolink $II^{(R)}$ cement group had stronger fracture strength and smaller marginal gap than the other cement groups. Although Variolink $II^{(R)}$ resin cement seemed acceptable to clinical applications in IPS Empress $2^{(R)}$ system, the IPS Empress $2^{(R)}$ system still requires long-term research due to the lack of data in clinical applications.

Postoperative malocclusion after maxillofacial fracture management: a retrospective case study

  • Kim, Sang-Yun;Choi, Yong-Hoon;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.27.1-27.8
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    • 2018
  • Purpose: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. Materials and methods: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors' department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery. Results: One patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration. Conclusions: Considering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem.

SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE (악안면(顎顔面) 외상환자에서 나타난 항이뇨(抗利尿)호르몬 분비장애증후군(分泌障碍症候群))

  • Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo;Choi, Jae-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.1
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    • pp.7-10
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    • 1993
  • The final purpose of oral & maxillofacial trauma is functional & esthetic repair. Nowadays, severe trauma involving with the head & neck trauma is increasing. After these trauma occurs, the patients develop similar signs & symptoms with the postoperative healing period, as like thurst, hypertention, excitability, disorientation, convulsion, et al. Because SIADH which is one of important complications after head trauma, shows similar clinical features after operation, we should pay attention to detect it. SIADH shows characteristic laboratory findings, as like hyponatremia, urine hyperosmolality, increased plasma ADH level, continued renal excretion of sodium, so we can easily distinguish it from postoperative conditions. This paper reports two cases, one was the case of the mandibular fracture and cerebral contusion, which included permanent SIADH. The other was the case of the multiple teeth injury and cerebral contusion, which was transient SIADH. We treated them with water restriction, hypertonic saline, and diuretics.

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A multidisciplinary approach to restore crown-root fractured maxillary central incisors: orthodontic extrusion and surgical extrusion (치관-치근 파절이 발생한 상악 중절치를 수복하기 위한 다각적 접근법: 교정적 정출술과 외과적 정출술)

  • Kwon, Eun-Young;Kim, So-Yeun;Jung, Kyoung-Hwa;Choi, Youn-Kyung;Kim, Hyun-Joo;Joo, Ji-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.4
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    • pp.262-271
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    • 2020
  • To restore a tooth with a fracture line extending below the marginal bone level, a surgical crown lengthening procedure accompanied by ostectomy could be considered to expose the fracture line and reestablish the biologic width. However, this procedure could lead to esthetic failure, especially in the anterior teeth. Therefore, orthodontic extrusion, which elevates the fracture line from within the alveolar socket without sacrificing the supporting bone and gingiva, is recommended. This technique allows for the proper placement of the crown on a sound tooth structure, with the reestablishment of the biologic width. Alternatively, surgical extrusion is an one-step procedure that is simpler and less time-consuming than orthodontic extrusion; placing and adjusting the orthodontic appliance does not require multiple visits. This study presents successful restoration in 2 cases with a crown-tooth root fracture of the maxillary central incisor treated using a multidisciplinary approach through orthodontic extrusion or surgical extrusion followed by successful restoration.

ONE-VISIT APEXIFICATION USING MINERAL TRIOXIDE AGGREGATE (MTA를 이용한 미성숙 영구치의 즉일 치근단형성술)

  • Yeom, Soon-Joon;Park, Ki-Tae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.480-487
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    • 2001
  • In children and adolescents, oral and maxillofacial trauma is one of the most common causes of dental and periodontal damage, which often induces crown fracture of the permanent anterior teeth. Frequently, these traumatized teeth lose their vitality, and require routine endodontic treatment if their root apices are closed. However if their apices are not fully closed, further root formation should be promoted by apexification or apexogenesis. Calcium hydroxide is a biocompatible & bacteriostatic material, and is widely used for apexification. However it has several disadvantages which include the need for multiple visits and patient cooperation, low strength and technical sensitivity in a broad apex. In one-visit apexification using IRM or SuperEBA, patient's visits can be minimized. However, their biocompatibility is questionable. Mineral trioxide aggregate(MTA) is a relatively new material. It is considered biocompatible with periapical hard tissue and has good marginal sealing ability. MTA is also known to help facillitate the growth of the cementum around it. In this case report, apexification with MTA was attempted on traumatized maxillary central incisors with immature root apices, and favorable clinical results were achieved.

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A SHEAR BOND STRENGTH OF RESIN CEMENT BONDED TO HUMAN UNCUT ENAMEL, CUT ENAMEL, AND DENTIN IN VITRO

  • Lee Jong-Yeop
    • The Journal of Korean Academy of Prosthodontics
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    • v.41 no.3
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    • pp.319-324
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    • 2003
  • Statement of problem. Adhesives in dentistry playa major role in the success of restorative treatments. In the treatment of all ceramic restoration it is needed to find the adequate bond strength between enamel and dentin. Purpose. The purpose of this study was to evaluate shear bond strength of resin cement bonded to extracted human uncut enamel, cut enamel, and dentin in vitro. Material and methods. Ten freshly extracted anterior teeth without any previous restorative treatments were chosen. The extracted teeth were embedded in PMMA cold acrylic in the shape of a cylinder, 25 mm in diameter by 25 mm in height. The bonding system used was as follow: Uni-Etch (32% phosphoric acid), One-Step adhesive, Duolink resin cement. The specimens were acid etched and rinsed with water. Two layers of One-Step adhesive were coated with a disposable brush on the uncut enamel. VIP curing light at $500mV/cm^2$ was used to cure the adhesive. For cut enamel shear bond test, the specimen used for uncut enamel was further reduced approximately $0.3{\sim}0.5mm$ using a laminate preparation diamond bur (0.3 mm in depth). The specimens were subsequently treated with 320-grit SiC paper followed by 600-grit SiC paper and cleaned with distilled water. The bonding procedure on the cut enamel was same as uncut enamel bonding procedure. For dentin bonding test, the specimen used for cut enamel was further reduced approximately $0.5mm{\sim}1.0mm$ using a laminate preparation diamond bur (0.5 mm in depth of diamond cutting). The amount of reduction was evaluated with the silicone mold. The specimens were subsequently treated with 320-grit SiC paper followed by 600-grit silicon carbon paper and cleaned in distilled water. The bonding procedure on the dentin was same as uncut enamel bonding procedure. All samples were mounted and secured on the Ultradent shear bond test sample holder, and Ultradent restricted shear bond testing device was used with Universal Instron machine until fracture. Analysis of variance (ANOVA) test was performed comparing the result at P<0.05. Multiple comparison (Tukey) was used to compare each groups. Result. The result showed that the mean value in shear bond strength of resin cement bonded to uncut enamel, cut enamel and dentin were 27.04 Mpa, 30.25 Mpa and 26.39 Mpa with respect. Conclusion. Within the limitation of this study, the mean value of the shear bond strength of cut enamel was higher than those of uncut enamel or dentin. However there existed no statistical differences between three different human dentition substrates due to increased adhesive characteristics.