• Title/Summary/Keyword: Gingival exposure

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Spontaneous bone regeneration after surgical extraction of a horizontally impacted mandibular third molar: a retrospective panoramic radiograph analysis

  • Kim, Eugene;Eo, Mi Young;Nguyen, Truc Thi Hoang;Yang, Hoon Joo;Myoung, Hoon;Kim, Soung Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.4.1-4.10
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    • 2019
  • Background: The mandibular third molar (M3) is typically the last permanent tooth to erupt because of insufficient space and thick soft tissues covering its surface. Problems such as alveolar bone loss, development of a periodontal pocket, exposure of cementum, gingival recession, and dental caries can be found in the adjacent second molars (M2) following M3 extraction. The specific aims of the study were to assess the amount and rate of bone regeneration on the distal surface of M2 and to evaluate the aspects of bone regeneration in terms of varying degree of impaction. Methods: Four series of panoramic radiographic images were obtained from the selected cases, including images from the first visit, immediately after extraction, 6 weeks, and 6 months after extraction. ImageJ software® (NIH, USA) was used to measure linear distance from the region of interest to the distal root of the adjacent M2. Radiographic infrabony defect (RID) values were calculated from the measured radiographic bone height and cementoenamel junction with distortion compensation. Repeated measures of analysis of variance and one-way analysis of variance were conducted to analyze the statistical significant difference between RID and time, and a Spearman correlation test was conducted to assess the relationship between Pederson's difficulty index (DI) and RID. Results: A large RID (> 6 mm) can be reduced gradually and consistently over time. More than half of the samples recovered nearly to their normal healthy condition (RID ≤ 3 mm) by the 6-month follow-up. DI affected the first 6 weeks of post-extraction period and only showed a significant positive correlation with respect to the difference between baseline and final RID. Conclusions: Additional treatments on M2 for a minimum of 6 months after an M3 extraction could be recommended. Although DI may affect bone regeneration during the early healing period, further study is required to elucidate any possible factors associated with the healing process. The DI does not cause any long-term adverse effects on bone regeneration after surgical extraction.

Dental application of glass-ceramic materials for aesthetic restoration (심미수복을 위한 글라스-세라믹 재료의 치과 응용)

  • Bae, Tae Sung
    • The Journal of the Korean dental association
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    • v.58 no.7
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    • pp.435-442
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    • 2020
  • Porcelain is the first ceramic material to be introduced into dentistry. Porcelain jacket crown was introduced by Dr. Charles H Land in 1886, which was an excellent aesthetic dental restoration but has not been widely used due to high firing shrinkage and low tensile strength. Then metal-ceramic system, which combines the esthetic properties of ceramics and the mechanical properties of metals, was introduced and nowadays it is still used in dental clinical field. However, the metal-ceramic system has shown some problems, such as increased lightness by reflection of light at opaque layer, shadow beneath the gingival line due to the block-out of light by metal coping, exposure of metal in margin part, bond failure between metal and porcelain, oxidation of metal coping during firing the porcelain, etc. Recently, along with the advance of fabrication methods of dental ceramics, the all-ceramic restorations with high esthetic and mechanical properties has increased and gradually replaced metal-ceramic restorations. Especially, CAD/CAM technology has opened a new era in fabricating the dental ceramic restorations. This overview will take a look at the past, present and future possibility of the dental ceramic materials.

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Full-mouth rehabilitation with pressed ceramic technique using provisional restorations (Pressed ceramic technique을 이용하여 제작되는 완전 도재관 완전 구강 회복 증례)

  • Roh, Hyun-Sik;Woo, Yi-Hyung;Pae, Ahran
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.1
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    • pp.47-51
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    • 2013
  • With the introduction of dental implants, restoration of missing teeth with conventional fixed or removable partial dentures is being replaced with implants. Especially, with young patients, not only longevity but also esthetic factors need to be considered. Implant restorations provide long-term success functionally but, esthetic complications such as, marginal exposure due to gingival recession, loss of the papilla and dark color of metal abutments may occur. Recently, zirconia restorations with CAD/CAM technology provide functional, biocompatible and esthetic restorations possible. All-ceramic restorations using the pressed ceramic technique show better fracture toughness values than those of the conventional porcelain veneering technique. Pressed ceramic technique creates the veneer design in wax and the lost wax technique is used to create the restoration. The final contour of the restoration may be controlled during wax-up. A 22-year old female patient was restored with dental implants and zirconia restorations using the pressed ceramic technique presenting short-term but optimistic prognosis.

ERUPTION GUIDANCE OF IMPACTED MAXILLARY CENTRAL INCISOR WITH APICALLY POSITIONED FLAP (근단 변위 판막술을 이용한 매복 상악 중절치의 맹출유도)

  • Ryu, Hyun-Seop;Kown, Hoon;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.383-390
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    • 2001
  • It is a relatively common clinical experience to see a impacted maxillary central incisor Most often, the central incisor is impacted labially. The labial impaction has been indicated as the most difficult to manage. The labial impactions have been found to be associated with mucogingival recession, reduced attached gingiva and periodontal pockets. For the successful treatment, clinicians should avoid loss of attached gingiva in surgical exposure. The most common methods of uncovering labially impacted maxillary anterior teeth are gingivectomy, apically positioned flap and closed eruption technique. If gingivectomy will not leave enough attached gingiva, then an apically positioned flap may be the treatment of choice. If the tooth is impacted in the middle of the alveolus or high in the vestibule near the nasal spine, the closed eruption technique may be the treatment of choice. Closed eruption technique was used in one case, apically positioned flap was used in two case. As the result in two cases of impacted maxillary central incisor, apically positioned flap provide the adequate width of attached gingiva. In case of impacted maxillary central incisor, through the clinical and radiologic examination to select correct surgical operation for reduce the complications.

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ORTHODONTIC TREATMENT OF THE PALATALLY IMPACTED MAXILLARY CANINE (구개측 매복된 상악 견치의 교정적 치험례)

  • Kam, Dong-Hoon;Kim, Jung-Wook;Hahn, Se-Hyun
    • 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.

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Sequential traction of a labio-palatal horizontally impacted maxillary canine with a custom three-directional force device in the space of a missing ipsilateral first premolar

  • Yang, Shuliang;Yang, Xiao;Jin, Anting;Ha, Nayong;Dai, Qinggang;Zhou, Siru;Yang, Yiling;Gong, Xinyi;Hong, Yueyang;Ding, Qinfeng;Jiang, Lingyong
    • The korean journal of orthodontics
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    • v.49 no.2
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    • pp.124-136
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    • 2019
  • Orthodontic treatment is more complicated when both soft and hard tissues must be considered because an impacted maxillary canine has important effects on function and esthetics. Compared with extraction of impacted maxillary canines, exposure followed by orthodontic traction can improve esthetics and better protect the patient's teeth and alveolar bone. Therefore, in order to achieve desirable tooth movement with minimal unexpected complications, a precise diagnosis is indispensable to establish an effective and efficient force system. In this report, we describe the case of a 31-year-old patient who had a labio-palatal horizontally impacted maxillary left canine with a severe occlusal alveolar bone defect and a missing maxillary left first premolar. Herein, with the aid of three-dimensional imaging, sequential traction was performed with a three-directional force device that finally achieved acceptable occlusion by bringing the horizontally impacted maxillary left canine into alignment. The maxillary left canine had normal gingival contours and was surrounded by a substantial amount of regenerated alveolar bone. The 1-year follow-up stability assessment demonstrated that the esthetic and functional outcomes were successful.