• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.348-353
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• 2003

Early detection and prudent management of mesiodens or supernumerary tooth should be considered essential in reducing disturbance in the eruption and position of the adjacent permanent incisor. While it is true that the presence of diastema may be regarded as normal at the early mixed dentition stage, the early detection and removal of the mesiodens is a prerequisite to facilitate spontaneous alignment or subsequent approximation of the permanent central incisors. In many cases, diastema due to mesiodens can be physiologically corrected spontaneously after the extraction of mesiodens. The best choice of treatment of diastema may be observation. Orthodontic intervention is required only spontaneous closing of diastema does not occur within observation period. In orthodontic intervention, careful treatment plan should be established. Clinician gives considerations to angulation of central and lateral incisor, proximity of lateral incisor, developmental stage and position of canine, pattern and extent of anterior crowding. Orthodontic movement should be done slowly with light force. In addition, periodic radiographic observation are needed to monitor the root development and root resorption. Case 1, 2 and 3 showed physiologic closures after the extraction of mesiodens. In these cases, acceptable alignment of central and lateral incisors was obtained. In case 4, orthodontic correction for diastema was performed successfully after the extraction of mesiodens. After the orthodontic closure of the diastema, it was decided that a retainer was not needed, because the dentition was under a dynamic stage in exchanging teeth and also developing arches.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.3
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• pp.597-601
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• 1997

This paper presents improper use of latex-elastic ring in movement of teeth and its consequence. Simple orthodontic movement of teeth including closure of diastema may be achieved by the use of simple method with fixed or removable appliance associated with latex-elastic ring. But, if it is used alone, it acts as a local irritant and then produces localized periodontitis. In case of localized periodontitis resulting from latex-elastic ring, diagnosis is difficult because the patient is usually unaware of the presence of the rings on the roots of the involved teeth and because the ring is not probed and is radiolucent and therefore not discernible radiographically and clinically. Occasionally, surgery is requred for the detection. This case emphasizes the necessity that the use of latex-elastic ring in closing diastema should be accompanied with removable or fixed appliance as well as close professional supervision. Its use without adequate provision for stabilization or retention on the crowns of teeth results in destruction of periodontal support and the teeth may be lost.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.4
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• pp.758-762
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• 1997

There are various types of localized tooth malpositions in the mixed dentition, such as abnormal tooth axis, anterior crossbite of some incisors, impaction, midline diastema, ectopic eruption, and so forth. We, Pediatric Dentists, have usually used removable appliances for these instances. But, removable orthodontic appliances, as is known, have marked limitations in some situations, for example, severe rotation, intrusion and extrusion, root torque, closure of large diastema, traction of impacted tooth, etc. In such cases, Whip spring, combined with fixed or removable appliance, can increase utilities of removable orthodontic appliances. The authors have applied whip springs to some cases showing localized positional and arrangement problems, and have witnessed the results as follows; 1. The refined and elaborate control of direction and magnitude of force by the operator, and accurate compliance of the patients were requisite for the treatment with it. 2. It showed special effectiveness for de rotation of incisors. Although it yields some benefit for root movement, the special consideration for incomplete roots in this age bracket was required. 3. In the localized malalignment cases in mixed dentition, uncurable with traditional removable appliances but practically unrealistic with fixed appliance therapy, the whip spring was thought to be a good alternative.

• The korean journal of orthodontics
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• v.31 no.3 s.86
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• pp.325-333
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• 2001

Optimal orthodontic treatment could be possible when a orthodontist can predict and control tooth movement by applying a planned force system to the dentition. The moment to force(M/F) ratio at the bracket, has been shown to be a primary determinate of the pattern of tooth movement. As various n/F ratios are applied to the bracket on the tooth crown, strain distribution in periodontium can be changed, and the center of rotation in tooth movement can be determined. It is, therefore, so important in clinicalorthodontics to know the strain distribution in a force system of a M/F ratio. The purpose of this study was to analyze the strain distribution in orthodontic force system by strain gauge attached to tooth root, and to evaluate the usage of the method. For this study, an experimental upper anterior arch model was constructed, where upper central incisors, on the root surface of which, 8 strain gauges were attached, were implanted In the photoelastic resin, as in the case of 4mm midline diastema. Three types of closing of upper midline diastema closure were compared : 1. with elastomeric chain(100g force) in no arch wire, 2. elastomeric chain in .016“ round steel wire, 3. elastomeric chain in .016”x.022“ rectangular steel wire. The results were as follows. 1. Strain distributions on labial, lingual, mesial and distal root surface of tooth were able to be evaluated with the strain gauge method, and the patterns of tooth rotation were understood by presuming the location of moment arm. 2. Extrusion and tipping movement of tooth was seen in closing in no arch wire, and intrusion and bodily movement was seen with steel arch wire inserted.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.10 no.1
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• pp.30-45
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• 2001

In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.630-635
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• 2004

The etiology of mesiodens is unknown but the most widely accepted theory is the hyperactivity of the dental lamina. Complications of mesiodens are delayed or prevented eruption of maxillary central incisors, displacement or rotation of permanent teeth, crowding of affected region, abnormal diastema or permanent space closure, dilaceration or abnormal root development of permanent teeth, primordial or follicular cyst formation, root resorption of adjacent teeth, eruption into nasal cavity. If mesiodens rotate the maxillary central incisors, space deficiency is not common and relapse is very common. So overcorrection is needed. To prevent the rotational relapse, early treatment, overcorrection, long retention period, properly formed proximal surface, use of coupled force, and surgical techniques have been suggested. The authors present two cases, whose chief complain were severely rotated maxillary incisors by mesiodens, treated by orthodontic and surgical technique and showed good results.