• Title/Summary/Keyword: Pediatric trauma

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Temporomandibular Joint Ankylosis Caused by Osteoarthritis: A Case Report Based on Cone Beam Computed Tomography Images

  • Jih, Myeong Kwan;Kim, Jin Soo;Park, Hyun-Jeong
    • Journal of Oral Medicine and Pain
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    • v.47 no.3
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    • pp.156-160
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    • 2022
  • Temporomandibular joint (TMJ) ankylosis is a condition in which condylar movement is restricted because of fibrous or bony union between the mandibular condyle and temporal bone. TMJ ankylosis is most often caused by trauma, followed by systemic or local infection, and secondary to unknown causes. Diagnostic imaging plays a vital role in diagnosing TMJ ankylosis and establishing a treatment plan. Computed tomography (CT) or cone beam computed tomography (CBCT) is currently the imaging technique of choice to accurately demonstrate preoperative ankylosing masses and other surgically important findings, such as the shape of the mandibular condyle and the pathological changes in the joint. The osseous changes in the mandibular condyle are easily identified in the coronal and sagittal sections of CT or CBCT images. This report describes the case of a middle-aged woman who developed TMJ ankylosis of the left TMJ while undergoing repeated treatment for TMJ disease. We report the findings observed on radiographic and CBCT images through continuous observation.

ORTHODONTIC TRACTION OF HORIZONTALLY ERUPTED LOWER LATERAL INCISOR ON THE LINGUAL SIDE (설측으로 수평 맹출한 하악 측절치의 교정적 견인)

  • Mah, Yon-Joo;Sohn, Hyung-Kyu;Choi, Byung-Jai;Lee, Jae-Ho;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.117-123
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    • 2010
  • Tooth eruption is the movement of the tooth from the developing place in the alveolar bone to the functional position in the oral cavity. The permanent incisors originate from the dental lamina on the lingual side of preceding deciduous tooth and erupt to the level of the occlusion through the well developed gubernacular cord. Ectopic eruption is a developmental disturbance in the eruption pattern of the permanent dentition. Most of the ectopically erupted lower incisor has been found in lingual side. The ectopically erupted tooth could be repositioned by orthodontic force in the early mixed dentition, which could help preventing the problems of loss of space and the lingual tilting of the lower anterior teeth. An eight-year-old girl visited the department of pediatric dentistry, Yonsei Dental University Hospital, for the evaluation and the treatment of the lower right lateral incisor, which was horizontally erupted in the lingual side, parallel to the mouth floor. Her tongue was placed on the labial side of that tooth. There was no previous dental history of dental caries or trauma on the pre-occupied primary incisor. Clinical and radiographic examinations including the computed tomography(CT), showed no evidence of dilacerations on root. Therefore, we decided to start active orthodontic traction of the lower right lateral incisor. We designed the fixed type of buccal arch wire and the lip bumper with hook for the traction. Button was attached to the lingual side of the ectopically positioned tooth. Elastic was used between the appliance and the button on that tooth. After the tooth become upright over the tongue level, appliance was change to the removable type and periodic check-up with occlusal guidance was followed to monitor the position of the tooth. In this case using the fixed appliance with modified form of lip bumper and hook embedded in acrylic part instead of extraction was very efficient up-righting the ectopically erupted tooth toward the occlusal plane.

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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IMPACTED TOOTH ASSOCIATED WITH AN ODONTOMA : CASE REPORT (치아종으로 인한 매복치아의 치료 증례)

  • Baik, Seung-Jun;Lee, Kwang-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.3
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    • pp.394-399
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    • 2000
  • Odontoma is defined as a benign odontogenic tumor containing enmel, dentin as well as cementum. It has come to mean a growth in which both the epithelial and the mesenchymal cells exhibit complete differentiation. Most authorities accept the view today that the odontoma represents a hamartomatous malformation rather than a true neoplasm. The etiology of odontomas is uncertain but hypothesized to involve local trauma, infection, inheritance or mutant gene. The odontomas often cause various disturbances in the eruption and position of the teeth. The steps in removal of an odontoma in close relation to an adjacent impacted normal tooth should comprise 1) removal of odontoma and 2) exposure of the impacted tooth. Orthodontic therapy may be applied. Before treatment, the necessary space for the impacted tooth should be evaluated. If there is lack of space in the dental arch, orthodontic treatment should be carried out before operation.

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DEVELOPMENT OF ALLOTRANSPLANTED TOOTH GERMS AT VARIOUS DEVELOPMENTAL STAGE INTO THE WHITE RAT'S EXTRACTION SOCKET (흰쥐의 발치와에 이식한 단계별 치아싹의 발육 과정)

  • Jung, Hwi-Hoon;Jung, Han-Sung;Kim, Seoung-Oh;Choi, Hyung-Jun;Lee, Jae-Ho;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.205-215
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    • 2008
  • The purpose of this study is to evaluate at which stage of tooth germ would develop into normal calcification and hence to increase the success rate of transplantation. Therefore, tooth germs on the 15th, 17th embryonic day and the 3rd day of birth were separated for allotransplantation into maxilla of adult rat of 11 weeks. Calcification processes were analyzed radiographically and histopathologically at 4 weeks and 8 weeks after allotransplantation. The results are as follows: 1. Allotransplanted tooth germ at 4 weeks and 8 weeks showed delayed calcification compared to that of normal odontogenesis. 2. At 4 weeks, abnormal calcified tissue, such as odontoma and ankylosis of osteodentin with surrounding alveolar bone were observed. 3. At 8 weeks, allotransplanted tooth germs of the 15th and 17th embryonic day showed calcification and osteodentin surrounded by periodontal ligament. 4. At 8 weeks, allotransplanted tooth germs of the 3rd day of birth showed calcification composed of cementum and osteodentin. In this study, we observed small sized and amorphous calcified tissue from allotropic allotransplantation of tooth germs. Since these calcified tissue were underdeveloped and shaped irregularly, for calcification into normal tooth form, further study needs consideration about the reduction of surgical trauma, developmental stage of transplanted tooth germ, blood supply from recipient site, fixation method in transplanted site and period of transplantation.

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THE SECOND MESIOBUCCAL CANAL OF UPPER PRIMARY MOLAR : CASE REPORT (제 2근심협측근관이 존재하는 상악유구치의 치험례)

  • Kim, Chang-Gi;Hong, Seong-Soo;Ko, Sung-Back;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.2
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    • pp.139-145
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    • 2002
  • In a primary teeth, dental caries is rapidly advanced the pulp disease, because the primary teeth have the thinner and the weaker enamel layer and the wider pulp chamber than relatively the permanent teeth. And the pulps of primary teeth are exposed during caries removal or even they are exposed by unexpected movement of the children or by trauma. For successive pulp treatment in primary teeth, it is necessary to understand completely about multiple canal morphology, variation of root canal anatomy and specific problem related to root formation and resorption of primary teeth. In upper primary molar, canal configuration of mesial root has the most variation same as upper molar. If not canal treatment is completely, most of all endodontic treatment should be failed. In a clinical case report, upper primary molars existed persistent pain or bleeding during treatment were founded the second MB canal and were performed the endodontic treatment of theirs. As a result, the upper primary molars have no symptom and good prognosis. In the examination of extracted upper primary molar, we found that 8 of 35 teeth(22.8%) in the upper primary first molars and 22 of 33 teeth(66.6%) in the upper primary second molar had the second mesiobuccal canal. It has revealed the high prevalence of two canals in mesiobuccal roots of upper primary molars. The frequency of occurrence of the second mesiobuccal canal must be taken into consideration when endodontic treatment is planned and as a possible cause of otherwise un explained failure.

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Determination of Appropriate Exposure Angles for the Reverse Water's View using a Head Phantom (두부 팬텀을 이용한 Reverse Water's View에 관한 적절한 촬영 각도 분석)

  • Lee, Min-Su;Lee, Keun-Ohk;Choi, Jae-Ho;Jung, Jae-Hong
    • Journal of radiological science and technology
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    • v.40 no.2
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    • pp.187-195
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    • 2017
  • Early diagnosis for upper facial trauma is difficult by using the standard Water's view (S-Water's) in general radiograph due to overlapping of anatomical structures, the uncertainty of patient positioning, and specific patients with obese, pediatric, old, or high-risk. The purpose of this study was to analyze appropriate exposure angles through a comparison of two different protocols (S-Water's vs. reverse Water's view (R-Water's)) by using a head phantom. A head phantom and general radiograph with 75 kVp, 400 mA, 45 ms 18 mAs, and SID 100 cm. Images of R-Water's were obtained by different angles in the range of $0^{\circ}$ to $50^{\circ}$, which adjusted an angle at 1 degree interval in supine position. Survey elements were developed and three observers were evaluated with four elements including the maxillary sinus, zygomatic arch, petrous ridge, and image distortion. Statistical significant analysis were used the Krippendorff's alpha and Fleiss' kappa. The intra-class correlation (ICC) coefficient for three observers were high with maxillary, 0.957 (0.903, 0.995); zygomatic arch, 0.939 (0.866, 0.987); petrous ridge, 0.972 (0.897, 1.000); and image distortion, 0.949 (0.830, 1.000). The high-quality image (HI) and perfect agreement (PA) for acquired exposure angles were high in range of the maxillary sinus ($36^{\circ}-44^{\circ}C$), zygomatic arch ($33^{\circ}-40^{\circ}$), petrous ridge ($32^{\circ}-50^{\circ}$), and image distortion ($44^{\circ}-50^{\circ}$). Consequently, an appropriate exposure angles for the R-Water's view in the supine position for patients with facial trauma are in the from $36^{\circ}$ to $40^{\circ}$ in this phantom study. The results of this study will be helpful for the rapid diagnosis of facial fractures by simple radiography.

A STUDY ON THE TRAUMATIC INJURY OF PATIENTS IN DEPARTMENT OF PEDIATRIC DENTISTRY, KANGNUNG NATIONAL UNIVERSITY DENTAL HOSPITAL (강릉대학교 치과병원 소아치과에 내원한 외상 환자에 대한 분석)

  • Kim, Dong-Won;Lee, Kwang-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.2
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    • pp.247-254
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    • 2001
  • There is a growing tendency for injury and it is essential to know about the epidemiology of the injured teeth for proper and timely treatment. Through empirical data analysis of 120 children who came to pediatric dentistry of Kangnung National University Dental Hospital, this study purposes to give an understanding about the injury and analyzes the frequency by children's sex and age, the number of injured teeth according to the area in the mouth, the types of injury, causes and places of injury, the frequency occurred by month and hour, the position of injured teeth, and the elapse of time. The main findings of this study are summarized as follows: 1. The frequency analysis by sex shows that the rate of boys is more likely to be higher than girls(1.6:1). 2. The frequency analysis by age shows that the ratio of children between aged 2~4 and 8~10 are high. 3. The number of injured teeth is generally one(51.7%). 4. Periodontal tissue injury is the main cause for the primary teeth. In case of permanent teeth, the ratio of hard tissue injury which is much increased than the case of the primary teeth, is similar to that of periodontal tissue injury. 5. The main cause of injury is fall for both dentition; In case of permanent dentition, the ratio of injury by sports is increased. 6. The place of injury for primary teeth is mainly home(38.8%); Street and school for permanent teeth(42.5% and 35%, respectively). 7. The frequency by month shows that the injury is most frequently occurred in July. 8. The frequency analysis by hour shows that injury for primary teeth mostly happens in the morning; in the afternoon for permanent teeth. 9. The position of injured teeth according to the area in the mouth is mainly maxilla anterior in both case of primary and permanent teeth and especially the ratio of central incisors is high, 10. More than half(59.2%) of patients came to the hospital within one day and the seriously injured were likely to come within one day than the slightly injured.

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MILD HEMOPHILIA A DETECTED BY DELAYED BLEEDING: A CASE REPORT (지연된 출혈로 밝혀진 경증 혈우병 A에 대한 증례 보고)

  • Song, Je-Seon;Choi, Byung-Jai;Kim, Seong-Oh;Lee, Jae-Ho;Son, Heung-Gyu;Kim, Hyung-Jun;Choi, Hyung-Jun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.4 no.2
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    • pp.73-76
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    • 2008
  • Hemophilia A is an X-linked disorder resulting from a deficiency in factor VIII. Hemophilia A is classified into severe, moderate, and mild forms. A 12-month old boy visited for uncontrolled bleeding on the upper labial frenum area. Spontaneous bleeding occurred about 13 days ago. We sutured the wound. However, the patient returned after 6 days with large hematoma formation. Consultation to the hematologist and laboratory examination were carried out. Activated PTT was elongated and factor VIII was only 6%. He was diagnosed as mild hemophilia A. Fresh frozen plasma (FFP) was provided and hemostasis was achieved. At 5-day check-up, no more bleeding was observed. For the management of prolonged bleeding in hemophilia A patient, not only local hemostatic measures, but factor VIII replacement therapy, antifibrinolytics, and Desmopressin are also available. Mild hemophilia A often occurs without either familial or medical history. It is often first detected by dental trauma.

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Practical Approach to the Diagnosis of Pediatric Nasal Bone Fractures (소아 환자의 코뼈 골절 진단을 위한 실제적 접근)

  • Lee, Yulkok;Oh, Sungchan;Cho, Sukjin;Kim, Hyejin;Kang, Taekyung;Choi, Seungwoon;Yoo, Hanbin;Ryu, Seokyong
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.95-100
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    • 2014
  • Purpose: Nasal bone fractures are the most common childhood facial bone fractures, with an incidence of about 39%. While taking a nasal bone x-ray is a common modality used in the emergency department, reports have expressed concerns with its low sensitivity and low specificity. Our study was aimed at comparing accuracy of physical and x-ray examination with that of facial bone computed tomography (CT). Methods: Electronic medical records (EMR) were retrospectively reviewed for patients under the age of 15 who visited our emergency department from January 2010 to December 2011with a chief complaint of nasal pain due to trauma and who had also undergone a nasal bone x-ray and facial bone CT. Patients who had not taken facial bone CT, who had been transferred, and who did not have EMR were excluded. We divided the patients into 2 groups, those who had nasal bone fractures and those without a fracture on their facial bone CT. We analyzed other parameters such as age, sex, and type of fracture to find statistical differences between the two groups. Results: A total of 209 patients were included. The patients with nasal bone fractures on their facial bone CT were older, and their traumas were more violent. Ten patients who had apparent nasal bone fractures on their facial bone CT had no definite signs of a fracture on their plain x-ray. Conclusion: Though facial bone CT is an effective modality in detecting nasal bone fractures, in evaluating younger patients suspected of having nasal bone fractures, prudent use of facial bone CT is needed to reduce unnecessary exposure to radiation.