• Title/Summary/Keyword: Pediatric fracture

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Pulp Revascularization of Infected Immature Permanent Teeth Using Platelet-Rich Fibrin and Double Antibiotic Paste : Case Report (감염된 미성숙 영구치에서 platelet-rich fibrin과 double antibiotic paste를 이용한 치수 재혈관화 : 증례 보고)

  • Jeon, Sang-Yun;Lee, Nan-Young;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.3
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    • pp.216-222
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    • 2013
  • Paradigm shift in management of infected immature permanent teeth has occurred. The new concept of the treatment includes minimal or no intracanal instrumentation, disinfection with triple antibiotic paste and sealing with mineral trioxide aggregate. This regenerative endodontic treatment promotes differentiation of periradicular stem cells that induce regeneration of vital tissue and continuation of root formation. Thorough disinfection and three-dimensional scaffold are important in this new concept of the treatment. Platelet-rich fibrin has been reported as 'new scaffold' instead of blood clot, which had been used in the past. Triple antibiotics can be used to disinfect the tooth but may lead to complications including discoloration. Three cases of infected immature permanent tooth caused by dens evaginatus fracture are presented. After removal of necrotic pulp and thorough intracanal irrigation, only platelet-rich fibrin was applied to the root canal in the first case. In the other cases, topical antibiotics was used for disinfection and platelet-rich fibrin for scaffold. In all the cases, the opening was sealed with mineral trioxide aggregate. All the cases showed proper healing of inrabony lesion and some lengthening of root. According to these cases, regenerating vital tissue of the infected immature permanent tooth can be achieved with disinfection and application of platelet-rich fibrin.

FINITE ELEMENT ANALYSIS OF STRESS TRANSMITTED TO THE PULPOTOMIZED PRIMARY MOLARS TREATED BY VARIOUS TEMPORARY FILLING LOADED AT DIFFERENT CONDITION (하악 제2유구치 치수 절단술시 치아 및 충전재에 미치는 응력에 관한 유한 요소법적 분석)

  • Kim, Dong-Su;Kim, Jong-Soo;Kim, Yong-Kee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.4
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    • pp.818-839
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    • 1996
  • The strain gage, holographic and photoelastic analysis etc. have been used for stress analysis of prosthesis, orthodontic or orthopedic appliances and filling materials. But these methods has some limitation in analyzing the internal stress. The Finite Element Analysis has been proved to compensate this defect and widely used in this area. The purpose of this study was to compare the stress distributions of the various temporary filling methods being used in pulpotomy procedure. Three different models were designed according to temporary filling material and method: amalgam filling with ZOE base(Model I), amalgam filling with ZPC sub-base and ZOE(Model II), IRM filling only(Model III). The results of the experiment were as follows: 1. In model I under the load case 6 and 1, the significant stress was shown to be concentrated on the buccal portion of crown. 2. Model II showed the similar pattern of stress distribution to Model I. 3. In model III under load case 2, the stress was mainly distributed on the buccal cusp tip and buccal margin of filling material. In same model under the load case 3, the stress was distributed on the lingual cusp tip. 4. Based on the above data, IRM can be assumed to have advantage over the other tested materials in reducing the incidence of crown fracture by localized the stress within the filling materials.

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DEVELOPMENTAL AND ERUPTIONAL DISTURBANCES OF PERMANENT SUCCESSORS ASSOCIATED WITH TRAUMATIC INJURY TO PRIMARY TEETH (유치열기의 외상으로 인한 계승 영구치의 발육 및 맹출장애)

  • Lim, Hyoung-Soo;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.2
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    • pp.255-260
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    • 2001
  • Trauma to the primary incisors may cause developmental or eruptional disturbance of the permanent successors. Two cases illustrate developmental disturbances of arrested root formation, dilaceration, and eruptional disturbances of impaction, ectopic eruption of permanent successors caused by traumatic injury to deciduous incisors. The patient of the first case suffered trauma at the age of 4 years 7 months, causing alveolar bone fracture including the maxillary right primary central and lateral incisors that were immedi-ately extracted. The second patient had trauma episodes at the age of 3 years. Avulsion of the maxillary primary right central and lateral incisors were occurred due to trauma. After such trauma, regular follow-up including radiographs is necessary to detect early any possible interference with normal eruption of permanent successors.

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Rapidly growing pediatric trampoline-related injuries in Korea: a 10-year single center retrospective study

  • Cho, Min Jeng;Kim, Jihoon;Kim, Sung Jeep;Kyoung, Kyu Hyouck;Keum, Min Ae;Park, Sung Kyun
    • Clinical and Experimental Pediatrics
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    • v.62 no.3
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    • pp.90-94
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    • 2019
  • Purpose: Several published policy statements have warned against the risks associated with trampoline use and recommended safety guidelines. However, few studies have focused on trampoline-related injuries in Korea. This study aimed to assess the incidence and characteristics of pediatric trampoline-related injuries presented to Ulsan University Hospital. Methods: We retrospectively reviewed the medical records of children aged <16 years with trampoline-related injuries who visited our Emergency Department between 2008 and 2017. Results: Over the 10-year period, 178 trampoline-related injuries were reported, which represented a significant increase (P=0.016). Most (87.6%) of the injuries occurred during the last 5 study years, and a rapid increase in injuries was observed in children aged <6 years. Lower extremity injuries (62.4%) were the most common, followed by injuries of the upper extremities, head and face, and trunk, including injuries to the neck and spine. Sixty-seven children (37.6%) had fractures, and proximal tibia fractures were the most common. Fractures were significantly more common in younger children (<6 years old) than in older children (P=0.026). Conclusion: In Korea, the mechanism of trampoline injury is similar to that of injuries incurred in indoor trampoline parks but is characterized by smaller spaces and multiple users. Trampoline use and the incidence of trampoline-related injuries in children aged <6 years are increasing rapidly. Prohibiting the use of trampolines for children aged <6 years, restricting simultaneous use by multiple children, and ensuring adult supervision should be strictly emphasized. Public awareness and policy guidelines are needed to reduce the incidence of trampoline-related injuries.

The Treatment for Mandibular Condyle Fracture of Children by a Threaded Kirshcner Wire and External Rubber Traction (Threaded Kirschner Wire와 외부 고무줄 견인을 통한 소아 하악골 관절돌기 골절의 치료)

  • Nam, Doo Hyun;Kwon, Ino;Ahn, Hyung Sik;Kim, Jun Hyuk;Lee, Young Man
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.221-224
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    • 2009
  • Purpose: The treatment of children mandibular condyle fracture that is severely displaced is controversial. The conservative treatment of it may lead to complications - mandibular deficiency, asymmetry, malocclusion and temporomandibular joint dysfunction. Moreover, open reduction carries risks for growth retardation, facial nerve injury, scarring and joint stiffness. The aim of this article is to present an alternative technique of the treatment by using a threaded Kirschner wire and external rubber traction. Materials: From November 2005 to May 2008, three patients underwent the management by using a threaded Kirschner wire and external rubber traction. A threaded Kirschner wire was inserted in the condylar segment by using a C-arm. We applied the external rubber traction, and we reducted the segment progressively until complete reduction. The mandibular - maxillary fixations were removed after 3 weeks, and patients went into training for mouth opening. Results: The technique didn't result in complications - joint dysfunction, facial nerve injury, sore, infection and nonunion during follow - up period. Radiologic follow - up examinations revealed correct reduction in all patients. In all cases, we found restoration of preinjury occlusion and temporomandibular joint function. Conclusions: Closed reduction of children mandibular condyle fracture by using a threaded Kirschner wire and external rubber traction did achieve anatomic reduction and restore mandibular height. This alternative technique is simple, effective, inexpensive, easy to apply and minimally invasive.

Arthroscopic Treatment of an Anterior Cruciate Ligament Avulsion Fracture: Physeal-Sparing, All-Inside Suture Bridge Repair (전방십자인대 견열 골절의 관절경적 치료: 성장판을 보존한 All-Inside 교량형 봉합술)

  • Park, Byeong-Mun;Lee, Seung-Hwan;Yang, Bong-Seok;Kim, Ji-Hyeon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.444-449
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    • 2020
  • An anterior cruciate ligament (ACL) avulsion fracture is an uncommon injury that occurs predominantly in the pediatric and adolescent population. Accurate reduction and fixation of an avulsed fragment are necessary to restore and maintain the length of the ACL and normal knee biomechanics. Several techniques are available to repair an ACL avulsion fracture. On the other hand, treatment is controversial in skeletally immature patients due to risk of physeal injury. This paper reports a case of an ACL avulsed fracture in a skeletally immature patient treated with arthroscopic all-inside suture bridge repair, in which an excellent result and firm stability were obtained without physeal injury.

REMOVABLE FLEXIBLE DENTURE FOR CHILDREN WITH OLIGODONTIA : A CASE REPORT (탄성의치를 사용한 부분무치증 환아의 보철적 수복)

  • Kim, Jin-Young;Lee, Kwang-Hee;La, Ji-Young;Lee, Dong-Jin;An, So-Youn;Kim, Yun-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.1
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    • pp.150-156
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    • 2009
  • Objectives : The conventional removable appliance, composed of wires and acrylic resin, had unaesthetic results and poor retention. The flexible denture, as an alternative, presents improved aesthetics with the thin and strong resin retentive area. In addition, it also enhances patients' sensory function as a result of decreased volume of denture base. The flexibility of the flexible denture reduces the possibility of fracture and distributes the masticatory forces transmitted to the abutments and residual bone tissue. This report describes a 10-year-old girl and a 6-year-old boy with oligodontia treated with the flexible dentures as an alternative to conventional removable appliances. Methods : Impression was taken using alginate material and sent to a laboratory with the bite for fabrication of the flexible denture. Prior to try-in, the flexible denture was immersed in water at $90^{\circ}C$ for one minute and cooled. Impinging area of the denture was checked by $Fit-Checker^{(R)}$ and removed and the denture was delivered to the patient. Results : Both patients were satisfied with the flexible dentures, which presented improved retention and aesthetics. Conclusion : For patients with oligodontia, flexible dentures can be considered as a treatment of choice, which may replace the conventional denture.

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IMMOBILIZATION OF LOWER MANDIBULAR ALVEOLAR BONE FRACTURE USING RESIN-WIRE OPEN CAP SPLINT (하악 유전치부 치조골 골절시 resin-wire open cap splint를 이용한 고정)

  • Kwon, Joung-Hyun;Choi, Byung-Jai;Choi, Hyung-Jun;Kim, Seong-Oh;Son, Heung-Kyu;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.175-180
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    • 2008
  • Traumatic injuries to the primary dentition are commonly encountered problems in dental practice. It is found that 30% of the children had injuries to the primary dentition and 22% to the permanent dentition. The greatest incidence of trauma to the primary dentition occurs at the ages of 2 and 3 as children start to learn motor coordination. Because teeth and alveolar bone are traumatized simultaneously, alveolar bone fractures are likely to occur when multiple teeth are involved in injuries. Dental splints are indicated for the management of maxillofacial fractures. They enable anatomic reduction of fractured segments and help immobilization and maintenance of the fragments after reduction. They also act as a stabilizer during rehabilitation. Various types of dental splints are available. In this case, routine resin-wire splint technique could not be applied because of the child's uncooperative behavior. Oral sedation was not indicated because N.P.O. had not been preceded. Therefore, we decided to use open-cap acrylic splint instead. Stabilization using open cap acrylic splint requires minimum chair time with reduced discomfort to both patient and dentist. It is an effective means of splint for uncooperative children and especially useful when other means of fixation have been failed. Because trauma on the primary dentition can affect the underlying permanent tooth germ, it is important to monitor eruption process of the permanent dentition.

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The Trend of Change in Oral and Maxillofacial Injuries of Pediatric Patients in the COVID-19 Pandemic: a Regional Emergency Medical Center and Dental Hospital Study (COVID-19 팬데믹 상황에서 소아 환자의 구강악안면 외상의 변화 추이: 단일 기관 연구)

  • Suebin Choi;Chankue Park;Jonghyun Shin;Taesung Jeong;Eungyung Lee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.3
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    • pp.318-333
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    • 2023
  • The purpose of this study is to analyze changes in dental trauma in children under the age of 12 during the period of Coronavirus Disease 2019 (COVID-19). March 2020, when COVID-19 was officially declared a pandemic by the World Health Organization, was set as the starting point for COVID-19. From March 2018 to February 2020, subjects in the pre-COVID-19 period were classified as the Pre-COVID-19 group, and from March 2020 to March 2022, subjects in the post-COVID-19 period were classified as the COVID-19 group. Information related to trauma was collected through electronic medical records. The number of trauma patients before and after the outbreak of COVID-19 decreased significantly. During the COVID-19 period, there was no significant difference in the male-female ratio or the distribution order of age groups. In the COVID-19 group of permanent teeth, the ratio of trauma caused by personal mobility was higher than trauma caused by sports. In the COVID-19 group of permanent teeth, the ratio of crown fracture with pulp involvement was significantly higher than the ratio of crown fracture without pulp involvement. Changes in trauma patterns caused by COVID-19 were observed more clearly in school-aged children than in preschool children. In a pandemic situation such as COVID-19, it is expected to be used as a good educational basis for knowing that frequent diagnoses can change due to changes in the environment.

Calcaneal Apophyseal Avulsion Fractures with Achilles Tendon Rupture in a 10-Year-Old Patient: A Case Report (10세 남자 운동선수에서 발생한 아킬레스건 파열을 동반한 종골 골단의 견열 골절: 증례 보고)

  • Lee, Jun Young;Bak, Yi Gyu;Lim, Jae Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.2
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    • pp.74-77
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    • 2018
  • Calcaneal apophysitis is a relatively common disease in young athletes. On the other hand, if not treated properly, it can lead to apophyseal avulsion fracture in rare cases. In the case of apophyseal avulsion fractures, it is often necessary to remove or preserve the bone fragment, which often requires a suture of the Achilles tendon. A 10-year-old badminton athlete visited the outpatients' clinic with pain in both heels from 10 months ago without any trauma history. After conservative therapy, the pain in the left heel was relived but the right heel pain persisted. After 10 months of conservative therapy, the patient visited the outpatients' clinic showing a calcaneal apophyseal avulsion fracture with a total rupture of the Achilles tendon. In the operation room, a bone fragment needed to be removed because of its poor viability and the fragment was too thin for fixation. After removing the bone fragment, the ruptured Achilles tendon was fixed with an anchor system.