• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.2
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• pp.172-179
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• 2015

The developmental mechanism of root formation is a complex process. Hereditary and environmental factors may affect the morphology of the developing root. A total of 12 cases was presented with permanent first molars with abberant root morphology. Clinically, these teeth appeared as a normal crown. However, radiographically, the root was slender, twisted and characterized by irregular lengths. In addition, root trunk length was shorter and pulp chamber was obliterated. In these cases, periapical radiolucency and loss of lamina dura were often observed. In 6 cases, an abnormal root of the primary second molars were also present, as well as root malformation of permanent first molars. In 3 cases, permanent central incisors also had a dysmorphic crown. These cases almost all had medical history, such as premature birth, brain infection or congenital heart disease in infants. The present paper describes cases of permanent first molars with an abnormal root that are rarely reported in literature. This case may intensify the variation in the permanent first molar and is intended to reinforce the clinician's awareness of rare morphology of the roots.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.4
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• pp.644-651
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• 1999

It is a relatively common clinical experience to see an unerupted maxillary central incisor. This phenomenon is apparent at the dental age of almost eight years and over. Among the possible cause for failure of eruption, ectopic development of the tooth germ is mentioned. This is not fully understood but trauma or periapical imflammation of primary predecessors is accepted. The case with no history of trauma may be impacted by the periapical imflammation of primary predecessors. For bringing into the tooth eruption and the continued normal root developement by the Hertwig's epithelial root sheath, there are early considered of surgical invention and orthodontic traction with removable appliance. We reported successful treatment for inverted maxillary central incisor with proper eruption and normal root developement by forced eruption using removable appliance. But further observation will be required to evaluate the final root developement state and amount of keratinized attachment gingiva.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.290-295
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• 2011

During tooth formation, tooth development can be affected by physical action or metabolic changes around dental follicle. Especially trauma to primary dentition is the most representative physical factor that can cause development disorders of succedaneous tooth. Enamel hypoplasia and crown discoloration of succedaneous tooth are common complications of trauma. And impaction, ectopic eruption, arrest of root formation and root dilaceration of succedaneous tooth are rare. In this case, a 6-year and 5-month-old female patient visited for dental evaluation after trauma. She was diagnosed with alveolar bone fracture near upper front teeth, extrusion of the upper right and left primary central incisors, intrusion of the upper right primary lateral incisor, and palatal luxation of the upper left primary lateral incisor. Upper right and left primary central incisors with severe mobility were extracted, with gingival suture on the day of the visit. During 24 months check up, root dilacerations were found near the cemento enamel junction in the upper lateral incisors and arrests of root formation were found on the coronal 1/3 of the root in the upper central incisors. Although alveolar bone fracture is rare type of trauma in children, a thorough examination of alveolar bone is essential for prognosis and following treatment in patients with trauma.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.17-24
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• 2011

The aim of this study was to assess the outcome of MTA apexification in young permanent anterior teeth. Among the patients with the traumatized permanent incisors which were treated with MTA apexification, the dental records and radiographs were examined only for the patient who had follow-up examination at least 3 months after the treatment. Forty nine patients with 64 teeth were included in this study. Demographic information, location and type of teeth and periodontal injury, pre-treatment periapical lesion, clinical symptoms, status of MTA filling, healing of apical lesion and apical barrier formation after treatment were investigated. The outcome based on clinical and radiographic criteria were assessed. The results were as follows 1. Of 64 immature permanent incisors with MTA apexification, the clinical and radiographic success rates were 89.1% and 73.4%, respectively. 2. The maxillary incisors showed significantly higher success rates than the mandibular incisors. 3. There was no statistically significant difference in success rates among the teeth with different types of teeth and periodontal injury. 4. The status of MTA filling did not influence the clinical and radiographic success.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.310-317
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• 2009

Dens evaginatus is a dental anomaly involving an extra cusp or tubercle that protrudes from the occlusal surface of the affected tooth. The prevalence of dens evaginatus is 1 to 4 percent, and dens evaginatus is observed most commonly in premolars. It can be worn or fractured easily, resulting in pulpal exposure, pulpal infection, loss of vitality, facial infection and osteomyelitis. Since the tooth frequently has the immature apex when the tubercle is fractured, there is difficulty in treatment. Although calcium hydroxide is widely used for pulp treatment of an immature permanent tooth, several alternatives have been suggested to reduce patient's appointments. Mineral trioxide aggregate is considered biocom-patible and has excellent marginal sealing ability. In addition, it can minimize patient's visits. In this case report, apexification with MTA was attempted on the immature premolars in patients with cellulitis patient, caused by pulp necrosis due to dens evaginatus. Favorable clinical and radiologic results were achieved. In one case, continued root formation was observed.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.82-87
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• 2011

The pulp infection of primary tooth is often caused by dental caries or trauma. But, if it is not managed properly, it can be produce the periapical lesion. The periapical lesion can cause some complications such as enamel hypoplasia, displacement, root dilaceration and impaction. Treatment options of displaced permanent successor are clinical and radiological follow-up after extraction of primary teeth, surgical opening, orthodontic traction, transplantation and extraction. In these cases, the premolars with abnormal eruption path caused by periapical lesion of the primary tooth have shown successful spontaneous eruption just as a result of extraction of infected primary tooth and space maintenance.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.2
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• pp.262-266
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• 2004

The parathyroid hormone plays a major role in the metabolism of calcium and phosphorus. In hypoparathyroidism the parathyroid glands are atrophied or absent associated with autoantibodies against parathyroid tissue. Pseudohypoparathyroidism is a metabolic disease caused by the disturbance in peripheral action of parathormone, but parathormone level is normal. In general, patients with pseudohypoparathyroidism have short stature, round face, brachydactylia, obesity, mental retardation, cataracts & ectopic calcifications on soft tissues. Dental manifestations are enamel hypoplasia, delayed eruption, blunting of root apex, hypodontia, pulp calcification, thickened lamina dura, excessive caries & malocclusion. In this case, intraoral examination showed enamel hypoplasia on the erupted permanent teeth & hypermobility on the remaining deciduous teeth. From the radiographic view severe dental anomalies were observed on canines and shortening and blunting of root apex was observed on mandibular incisors. Pathologic root resorption was also observed on deciduous teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.4
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• pp.662-669
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• 2005

Nuclear factor I (NFI) exists in the odontoblast and osteoblast. NFI-C null mice demonstrated aberrant odontoblast differentiation, abnormal dentin formation, and molar lacking roots. The purpose of this study was to examine phenotype of the aberrant odontoblast in NFI-C null mice and to evaluate the expression of DSPP and BSP mRNAs in NFI-C null mice with in-situ hybridization. The results were as follows: 1. In the NFI-C (-/-) mice, the crown dentin of molar showed normally formation, but there was no root dentin. 2. In the NFI-C (-/-) mice, the labial dentin of mandibular incisors showed relatively a lot of dentin formation, but the lingual dentin showed defect. 3. In the NFI-C (-/-) mice, the odontoblast of mandibular incisors revealed abnormal shape and trapped in osteodentin-like mineralized tissue. 4. In the NFI-C (-/-) mice, the odontoblast in the crown dentin of molars showed strong expression of DSPP, the odontoblast in the root dentin of molars was not expression of DSPP. In the NFI-C (-/-) mice the odontoblast in the mandibular incisors showed weekly expression of DSPP 5. In the wild mice, the odontoblasts of mandibular incisors were not expression of BSP, but in the NFI-C (-/ -) mice the odontoblast of mandibular incisors showed strong expression of BSP These results suggest that odontoblast in the NFI-C (-/-) mice changes the phenotype into osteoblast.

• Restorative Dentistry and Endodontics
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• v.26 no.6
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• pp.499-506
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• 2001

불완전하게 충전되거나 충전이 되지않은 isthmus는 다근치에 있어서 근관치료의 높은 실패율을 나타낸다 따라서 본 연구의 목적은 isthmus를 갖는 근관을 골라 근관계의 기구조작을 시행하고 여러 가지 근관충전 방법을 이용하여 근관을 충전한 다음 근단부 형성시 적절한 파일의 크기와 치근단부의 밀폐효과를 각 부위별로 비교평가 해보고자 하는 것이다. Isthmus를 갖는 66개의 발거한 치아를 대상으로 기구조작을 통하여 근관확대를 완성하고 무작위로 각각 20개씩 3군으로 분류한 다음 아래와 같은 방법으로 근관을 충전하였다. : A군 측방가압충전법으로 충전한 군, B군 Continuous wave 충전법으로 충전한 군, C군 MicroSeal$^{TM}$을 이용하여 충전한 군. 나머지 6개의 치아는 3개씩 양성대조군과 음성대조군으로 정하였으며 기구조작 후 근관은 충전하지 않은 채로 두었다. 대조군을 제외한 모든 군은 각각 제조회사의 지시에 따라 근관충전한 후 각 시편의 치근단부 2mm를 제외하고 나머지 부위는 두겹의 nail polish를 발라주었으며 2% methylene blue용액에 침잠시켰다 일주일 후 꺼내어 흐르는 물에 깨끗이 세척한 다음 치근단 부위에서부터 1mm씩 잘라가면서 20배의 배율에서 염색액의 침투정도를 평가하였다. 염색액의 침투정도는 다음과 같이 평가되었다. A군과 B군에서는 많은 수의 시편에서 4mm 이상의 절단면에 염색액의 침투를 보인 반면 C군에서는 단지 3mm절단면에서 총 20개 중 3개의 시편에서 염색액의 침투를 보였을 뿐 그 이상의 절단면에서는 염색액의 침투를 보이지 않았다. 뿐만 아니라 isthmus를 갖는 제2형 근관계의 근단부 형성은 40번 크기보다는 큰 MAF가 요구되는 것으로 나타났다. 이러한 결과를 비추어볼 때 isthmus를 갖는 다근치에서 근관충전시 적어도 40번 이상의 MAF로 근단부 형성을 한 후, 열가소성 Continuous wave 충전법과 MicroSeal$^{TM}$을 이용한 근관충전법이 기존의 측방가압충전법 보다는 효과적인 것으로 나타났다.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.276-283
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• 2011

Recently, undifferentiated stem cells which exist in dental papillae of immature permanent teeth were newly discovered and these stem cells appear to be the origin of ameloblasts associated with the formation of root dentin. When treating immature permanent teeth, the preservation of these stem cells induce the continuous formation of the root. Therefore, it is reported that minimal invasion to periapical region in immature permanent teeth with periapical inflammation resulted in good-healing pattern in clinical and radiographic examination. In this case, a 10 year-old boy(mandibular right premolar) and a 8 year-old girl(maxillary left premolar) who visited the department of pediatric dentistry at Chosun University Dental Hospital were diagnosed with pulp necrosis and periapical abscess in clinical and radiographic examination. Endodontic instrumentation to the periapical region was limited and MTA(Mineral Trioxide Aggregate) was applied into the pulp canal. The periodic checks showed healing of periapical abscess and the development and growth pattern of roots. In permanent teeth with pulp necrosis and periapical abscess, preservation of pulp and dental papillae in the periapical region showed good prognosis during the periodic examinations. Therefore, a lot of clinical examination and long-term evaluation of conservative pulp treatment in immature permanent teeth are expected to be necessary.