• Title/Summary/Keyword: Periapical lesion of primary teeth

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MANAGEMENT OF DENS EVAGINATUS IN PREMOLAR (소구치에 발생한 치외치의 치험례)

  • Ra, Eun-Sun;Kim, Jong-Soo;Kwon, Soon-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.1
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    • pp.110-115
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    • 2003
  • Dens evaginatus is an anomalous tooth development arising during morphodifferentiation. It is most often reported in premolar, and familial occurrence has been reported. The primary dental complication of dens evaginatus is fracture or wear of the tubercle which leads to pulp exposure, pulpal necrosis and periapical infection. Pathosis of the pulp can occur before complete root formation with cessation of root development. A rational and conservative approach to the management of dens evaginatus in vital teeth includes early diagnosis and treatment to prevent fracture or attrition of the tubercle. This treatment would include careful sequential grinding, pulp capping, preventive resin restoration. When presented with a case of dens evaginatus in a nonvital tooth with incomplete root development, the treatment of choice has been extraction, apexification. We report two cases of dens evaginatus that appear in two sisters. In the elder, a periapical lesion on radiographs is shown, and it is treated by calcium hydroxide apexification. The other sister is early recognized of dens evaginatus, it is treated using glass ionomer cement reinforcing with sequential grinding.

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ERUPTION DISTURBANCE ASSOCIATED WITH A SMALL ODONTOMA (작은 치아종으로 인한 맹출 장애)

  • Song, Ji-Hyun;Lee, Kwang-Hee;Ra, Ji-Young;Lee, Dong-Jin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.3
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    • pp.490-497
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    • 2007
  • Odontoma is defined as a benign odontogenic tumor containing enamel, dentin as well as cementum and constitued 22% of all odontogenic tumors. Although the lesions are commonly asymptomatic, they may be discovered routine radiographic examination. Odontomas often cause disturbances in the eruption of teeth such as, impaction or delayed eruption, retention of primary teeth, or abnomalities in the position of the teeth such as tipping or displacement of adjacent teeth. Radiologically, odontomas manifest as a dense radiopaque lesion surrounded by a thin radiotransparent halo. However, in some cases, radiopacity was not quite clear and images of the teeth shadowed very tiny odontomas. And at early development stages of odontoma, calcification remains immature and is difficult to diagnose on radiographs. This suggests that when delayed eruption of the teeth is found, periapical radiographs should be taken to clarify whether any small area of radiopaque material exists. This case report shows tiny odontomas involving an impacted tooth and crowding and we remove the tiny odontoma surgically.

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TREATMENT OF RADICULAR CYST USING DECOMPRESSION (감압술을 이용한 치근단 낭의 처치)

  • Kim, Nam-Hyuk;Choi, Byung-Jai;Lee, Jae-Ho;Son, Heung-Kyu;Kim, Seong-Oh;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.2
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    • pp.275-280
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    • 2009
  • Radicular cyst is a true epithelium lined cyst formed when epithelium at the apex of a nonvital tooth is stimulated by inflammation. It is the most common type of cyst in the oral cavity, but its frequency is low in the primary dentition. Treatment of large-sized cyst aims at conservation of adjacent structure and allowance of proper eruption of the successive permanent teeth in the primary dentition. Considering these two aspects, marsupialization or enucleation following decompression is recommended as a treatment means for large-sized radicular cyst. In this case, 8-year old boy visited the pediatric dentistry department. Yonsei University Dental Hospital, with the chief complaint of pain on the lower right area. Clinical and radiographic examinations revealed periapical radiolucent lesion on #84, which had previous pulp treatment and restorated with the stainless steel crown. Dislocation of its successive tooth, #44, was also observed. #84 was extracted and sent for biopsy. Through histologic examination, it was diagnosed as radicular cyst. Following its extraction, removable space maintainer was delivered, which was also used as a decompressor. During periodic check-up for next 22 months, favorable healing of the lesion and eruption of the successive tooth were observed.

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MANAGEMENT OF THE IMPACTED TOOTH ASSOCIATED WITH DENTIGEROUS CYST IN AUTISTIC YOUNG PATIENTS (자폐증 환자에서 함치성 낭종과 연관된 매복치의 처치)

  • Kim, Ki-Rim;Song, Je-Seon;Choi, Byung-Jai;Kim, Seung-Hye;Lee, Jae-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.1
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    • pp.25-28
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    • 2011
  • Autism is a developmental, neuropsychiatric disorder that begins in early childhood. A patient with autism seen in the dental office frequently may have many complications. Therefore, it may be needed to consider modified or alternative therapy for dental care of autistic patients. This is the case of a 16-year old boy who have autism. He came to the department of the pediatric dentistry, Yonsei University Dental Hospital, for evaluation and treatment of dentigerous cyst associated with impacted teeth(#33,34,35). Under daily hospitalization and general anesthesia, the cyst was enucleated with surgical extraction of #34 and autotransplantation of #33,35. And during the periodic dental followup, apexification of #33,35 was performed for periapical lesion and root maturity. At 2 year 6 months follow- up, now, bony healing was completed and there are some complications like external resorption of #33 and space loss of #34 area. Generally, the marsupialization has been widely recommended for treatment of dentigerous cyst. However, in this case, there is a little possibility of spontaneous eruption after marsupialization considering of patient's age, location and angulation of the impacted tooth, root maturity. And there is necessity to choose the treatment that has low recurrence risk and needs short-term follow-up for autism. Above all, poor oral hygiene and lack of cooperation for decompression treatment is a matter of primary consideration. Consequently, enucleation of the cyst was chosen for the final treatment plan in this case. It is important to consider the conditions that affect the eruption of a dentigerous cyst-associated tooth to predict the successful eruption and special health care needs of the patient when the treatment plan is settled.