• Journal of the korean academy of Pediatric Dentistry
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• v.21 no.2
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• pp.555-560
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• 1994

Among the permanent teeth. the first permanent molars play the greatest role in occlusion and function. So, the congenital missing, abnormal reuption or abnormal formation of the first permanent molars in the course of arch development would inflict normal development of dental arches. Therefore, early detection of abnormal cases related to first permanent molars and understanding of current and predictable clinical problems are essential for proper occlusal guidance in children. With the aim of investigating the clinical patterns of delayed eruption of first permanent molars in children, panoramic tomograms of the childern in mixed and early permanent dentition were observed and analyzed. The results were as follows: 1. Among the delayed eruption of first permanent molars, on tooth or bilateral teeths were affected most frequently. Delayed eruption was more prevalent in maxilla than in mandible. 2. The formation of tardily erupted teeth were also delayed. 3. Delayed eruption was generally limited in first molars or molar segments. 4. Delayed eruption of first permanent molars is accompanied by abnormal position of tooth germs, for example, ectopic eruption, delayed dental age, delayed localized tooth formation and generalized congenital missing. 5. There was a tendency of delayed formation or congenital missing of second molars distal to tardily erupted 1st molars. And that was more marked in maxilla than in mandible. 6. There was reported that affected 1st molars show various size and shapes. Maxillary 1st molars showing delayed eruption showed a tendency of having 3 cusps. But, tardily erupted mandibular 1st molars showed no significant reduction in mesiodistal dimension, as reported. 7. In some cases, the delayed eruption of 1st permanent molars was associated with ectopic eruption, but their formation was not usually retarded. 8. In skeletal class III cases, there showed a tendency of mandibular 1st molars to erupt earlier than maxillary 1st molars with greater interval than in normal occlusion.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.3
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• pp.246-253
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• 2016

The optimal time for the removal of supernumerary teeth can be divided into two groups; early removal and late removal. While each group has its own advantages, the effects on maxillary central incisor can be significant. The purpose of this study was to determine the ideal time for the removal of the supernumerary teeth by evaluating 166 patients for three months after surgical removal of supernumerary teeth. Relatively young patients in early Hellman's dental stage with less developed or unerupted maxillary central incisor had less midline deviation. No statistical significance was found in diastema, rotation of the maxillary incisors and their changes during a follow-up period. Removal of supernumerary teeth should be considered as a preventative measure prior to eruption of the maxillary incisors when the midline deviation is observed in panoramic radiographic examination. This study will be useful in determining the optimal time for the removal of supernumerary teeth depending on the location of the maxillary incisors. This study will be informative on deciding the optimal time to remove the supernumerary teeth depending on the various positions of the maxillary central incisor. (this sentence is better to use)

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.3
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• pp.313-319
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• 2016

Wolf-Hirschhorn syndrome (WHS), associated with the deletion of the short arm of chromosome 4, causes multiple congenital malformations. Patients suffer from various deformities, including mental and growth disorders, epilepsy, hypotonia, congenital heart defects, and atypical craniofacial features. The "Greek warrior helmet appearance" is the most characteristic feature, with a prominent glabella, high arched eyebrow, broad nasal bridge, and hypertelorism. Cleft lip with or without cleft palate is observed in 30% of patients. Dental structure anomalies also exist including multiple tooth agenesis and over-retained primary molars caused by MSX1 gene impairment, and cone-shaped and taurodontic teeth. This case, a 9-year-old girl with WHS, showed intellectual disability, delayed growth development, previous occurrence of seizures, otitis media, and the typical facial features of WHS. Dental findings included multiple congenital missing teeth, over-retained primary teeth, and severe caries on the primary molars. Dental treatments were performed under general anesthesia. This report documents the characteristics of WHS, including general and oral features, and discusses the importance of oral hygiene and preventive dental management.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.766-770
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• 2008

Gingival fibromatosis is a rare condition characterized by varying degrees of gingival hyperplasia. Gingival fibromatosis usually occurs as an isolated disorder or can be associated with a variety of other syndromes. It usually appears at the time of eruption of permanent dentition but, can develop at the time of eruption of the primary dentition and rarely at birth. It may deform palatal contour and subsequently restrict the tongue movement, resulting in interference during speech and mastication. In addition, it incapacitates maintenance of normal lip closure. A 14-month-old girl visited the department of pediatric dentistry, Yonsei University Dental Hospital, for the congenital gingival overgrowth. There was no one in the family, who showed similar pattern of gingival growth. The intraoral clinical examination revealed generalized severe gingival enlargement throughout the maxillary and the mandibular arches. Enlarged gingival tissue was pink and had firm consistency. She was referred for chromosomal analysis, which confirmed absence of any known syndrome. Under local anesthesia, "Punch-biopsy" was performed on the labial area, and the specimen was histologically diagnosed as gingival fibromatosis. For she did not have any medical problem nor familiar history, she was diagnosed as having idiopathic gingival fibromatosis. Regarding her age and behavior, close follow-up was decided.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.4
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• pp.679-684
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• 2007

Odontoma is the most common benign odontogenic tumors, and have been defined as mixed odontogenic tumor composed of epithelial and mesenchymal cells. Odontoma is believed to be hamartomatous rather than neoplastic in nature. The classification by WHO divides odontoma into 2 groups such as complex odontoma and compound odontoma. Compound odontoma comprises dental tissues, resembling the morphology of a tooth and has predilection for the anterior maxilla. In contrast, complex odontoma has unorganized mass, not resembling the normal tooth and has predilection for the posterior mandible. Odontoma is almost asymptomatic, so it is usually found on routine radiographic examination. Common presenting symptom is impacted or unerupted permanent teeth and retained primary teeth, but coexistent odontoma and congenital missing of permanent teeth is a very rare condition. The recommended treatment for an odontoma is conservative surgical excision, with care taken to remove the surrounding soft tissue. This report presents 2 patients with compound odontoma of the mandible who have congenital missing of the permanent teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.4
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• pp.412-417
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• 2012

Mucopolysaccharidosis (MPS) is a disorder which is caused by the defect of the lysosomal enzyme that is essentially needed for resolution of glycosaminoglycans (GAGs). Metabolite of GAGs will accumulate in the lysosome of cells and will result in the dysfunction of cells, tissues, and organs. Eventually, patients will manifest both mental retardation and physical disorders. In worst cases, mucopolysaccharidosis can cause premature death. The current clinical types have been classified as MPS from type I to type IX according to the defect of certain enzyme. The dental complications have been reported as delay of eruption, enamel hypoplasia, microdontia, malocclusion, condylar defects, gingival hyperplasia and dentigerous cystlike follicle. This clinical report presents the case of a boy with MPS type II, Hunter Syndrome which has various dental complications.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.4
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• pp.260-267
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• 2013

The aim of this study was to analyze the three dimensional characteristics of the size, shape and location of mesiodens and their effect on permanent teeth arrangement using Cone-beam computed tomography(CBCT). 191 patients under 15 years old who had visited the hospital between June 2006 and December 2012 and taken CBCT were investigated. Among them, 43 patients with diastema were analyzed to investigate the correlation between the amount of diastema and the mesiodens. The results showed that mesiodens were found in males 3.9 times more than females and found most in 7 years old. The mean length of mesiodens was 13 mm and the width was 6.8 mm. The conical shape comprised of 52.9%. Many mesiodens were located in the palatal side rather than the labial side and located vertically near the crown. 63.0% of mesiodens were reversed and the common complications were delayed eruption followed by diastema, and teeth rotation. And the amount of diastema had correlation with size and mesiodistal position of the mesiodens. The current study used 3D analysis to show the size and position of mesiodens and occurrence distribution of complication. Among these, the amount of diastema had shown the correlation with the size and mesiodistal position of mesiodens.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.3
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• pp.149-158
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• 2013

The purpose of this study was to evaluate the shape and impacted pattern of mesiodens and associated complications using three dimensional images produced by dental CBCT. This study was based on the CBCT (CB Mercury, Hitachi, Tokyo, Japan) radiographic view of 280 pediatric patients who visited the Department of Pediatric Dentistry at the Chosun University Dental Hospital with the chief complain of mesiodens during between 2007 and 2012. Impacted mesiodens occurs more frequently in boys than in girls, the ratio being approximately 3.3:1 and most cases were observed between 6 and 8 years of age. The number of mesiodens per patient was 1.38. Majority of the mesiodens were conical (79.5%) in shape and inverted (48.6%) in direction. The mesio-distal position of mesiodens were the most common in middle sector (81.8%), vertical level were the most common near cervical (60.3%), and labio-palatal position were the most common at palatal side of the dental arch (73.8%). 47.5% of mesiodens had complications and common complications associated with mesiodens were displaced tooth and delayed eruptions. The shape, vertical level, and labio-palatal position of mesiodens had correlations with complications. CBCT appears to be an excellent diagnostic tool, providing three dimensional information and accurate images, for diagnosis of impacted mesiodens.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.3
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• pp.531-536
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• 2005

Infraclusion may be defined as teeth that stop their relative occlusal movement in the dental arches during or after the period of active eruption and then remain under the occlusal plane. Delayed exfoliation, malocclusion, increased susceptibility to dental caries and periodontal disease of both the neighboring teeth and retained molar, and dislocation of the successor are the consequencces of infraclusion of primary molars. Therefore, early diagnosis and appropriate treatments are necessary. The therapeutic approach of the infracluded teeth varied from preservation to extraction. The teeth with simple infraclusion without any signs of interference with occlusal and jaw development may be examined periodically with follow-up check and radiographically. However, if the infracluded tooth interferes with normal eruption of successor or shows any sign of delayed resorption, or the tipping of adjacent teeth or supraeruption of opposing teeth is expected, the teeth inflicted should be extracted and appropriate measures should be provided in order to maintain the normal development of occlusion and dentition. The adjacent teeth which have been collapsed over a infracluded deciduous teeth can disturb the arch length perimeter. In such cases, surgical approach might be necessary, although it would be difficult when teeth are severly leaned. However, an easier surgical access have been obtained by space regaining procedures, in young patients whose arch length has been shortened due to the infracluded teeth.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.2
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• pp.61-72
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• 2021

A beautiful smile is made when it is symmetrical and gums are displayed less than 2 - 3 mm. Excessive gingival display also known as "gummy smile" is often recognized to be unaesthetic. Causes of gummy smile can be caused by delayed eruption, vertical maxillary excess, hypermobile upper lip, or a short upper lip. Meanwhile botulinum toxin which is an exotoxin produced from Clostridium botulinum, works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles. The application site and weakens the muscle tone is drawing attention as a gummy smile treatment caused by hypermobile upper lip. There have been many studies about the method of injecting botulinum toxin into muscles around the lips, but there is still no standardized research method and treatment method, so there is controversy over the therapeutic effect. The aim of this study is to review the previous studies about the predictors of indication and effects of gummy smile treatment using botulinum toxin injection. Especially we tried to propose a protocol for optimal dose and efficient injection point through the anatomical considerations for gummy smile treatment using botulinum toxin.