• Journal of Periodontal and Implant Science
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• 제38권4호
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• pp.709-716
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• 2008

Purpose: Autogenous transplantation of teeth can be defined as transplantation of teeth from one site to another in the same individual, involving transfer of impacted or erupted teeth into extraction sites or surgically prepared sockets". Successful autogenous transplantation of teeth depends upon a complex variety of factors. Such factors include damage to the periodontal ligament of the donor tooth, residual bone height of the recipient site, extra-oral time of tooth during surgery. Schwartz and Andreasen previously reported that autogenous transplantation of teeth with incomplete root formation demonstrated higher success rate than that of teeth with complete root formation. Gault and Mejare yielded similar rate of successful autogenous transplantation both in teeth with complete root formation and in teeth with incomplete root formation when appropriate cases were selected. This case report was aimed at the clinical and radiographic view in autogenous transplantation of teeth with complete root formation. Materials and Methods: Patients who presented to the department of periodontics, Chonnam National University Hospital underwent autogenous transplantation of teeth. One patient had vertical root fracture in a upper right second molar and upper left third molar was transplanted. And another patient who needed orthodontic treatment had residual root due to caries on upper right first premolar. Upper right premolar was extracted and lower right second premolar was transplanted. Six months later, orthodontic force was applied. Results: 7 months or 11/2 year later, each patient had clinically shallow pocket depth and normal tooth mobility. Root resorption and bone loss were not observed in radiograph and function was maintained successfully. Conclusion: Autogenous transplantation is considered as a predictive procedure when it is performed for the appropriate indication and when maintenance is achieved through regular radiographic taking and follow-up.

• 대한소아치과학회지
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• 제48권3호
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• pp.291-301
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• 2021

이 연구의 목적은 발거 된 매복 상악 과잉치에서 얻은 치수유래 줄기세포의 초기 계대와 후기 계대의 상아질모세포 유전자의 특성을 알아보는 것이다. 전신 의과 병력이 없는 6 - 9세 사이의 남녀아이 12명에게서 서면동의를 얻고 모두 상악에 위치한 과잉치를 발거하여 당일 발거된 과잉치의 치수세포를 채취하였다. 12개의 세포를 각각 3계대와 10계대에서 골형성 유도 분화제를 처리한 군과 처리하지 않은 군을 나누어 실시간 중합효소 연쇄반응을 시행하여 상아질모세포의 특성을 알아보았다. 사용된 유전자는 osteonectin (ONT), alkaline phosphatase (ALP), osteocalcin (OCN), dentin matrix protein 1 (DMP-1), 그리고 dentin sialophosphoprotein (DSPP)였다. 유전자 발현양은, 분화제를 처리하지 않은 군 3계대에서는 ONT, ALP, OCN, DMP-1, DSPP순서로 많이 발현하였다. 분화제를 처리하지 않은 군 10계대에서는 ONT, DMP-1, OCN, ALP, DSPP순으로 ONT, OCN, DSPP의 순서에는 변화가 없지만 ALP, DMP-1의 순서는 서로 바뀌었다. 이상의 결과를 종합해 볼 때, ALP와 DMP-1은 3계대와 10계대 세포의 분화를 위한 중요한 표지자로 사용될 수 있다. 과잉치 치수유래 줄기세포는 상아질모세포의 특성을 가지며, 또한 과잉치가 어린 나이에 발거되고 10계대까지 소요되는 시간이 적게 걸린다는 것을 고려하면, 과잉치는 치아 유래 줄기세포의 공여부로서 훌륭한 활용가능성이 있음을 확인하였다.

• Journal of Periodontal and Implant Science
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• 제39권4호
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• pp.431-435
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• 2009

Purpose: The purpose of this study is to evaluate the long term clinical and radiographic outcome and stability after transplantation of third molar with complete root formation. Methods: The subjects were 31 teeth (male 17, female 14, aged 22-55, average 39.9 yr old) of 31 patients who visited the department of periodontics and passed more than two years after autotransplantation procedure and still under regular check up. Modified success criteria of Chamberlin and Goerig was applied to determine the success of autotransplantation. Results: Three out of 31 teeth failed and resulted 90.3% of success rate. When compared according to sex, 15 out of 17 teeth had succeeded in male, 13 out of 14 succeeded in female. When compared the success rate according to cause of extraction, tooth loss due to caries and root fracture had all succeeded but 3 out of 24 had failed in tooth loss due to periodontal disease. When compared according to donor teeth, 12 out of 14 maxillary third molars and 16 out of 17 mandibular third molars had succeeded. Conclusions: In long term evaluation over two years, if appropriate surgical procedure and proper case selection is made, autotransplantation of the third molar with complete root formation can be the alternative choice that substitutes prosthetic or implant treatment and it is a functionally acceptable procedure.

• Archives of Plastic Surgery
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• 제44권3호
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• pp.188-193
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• 2017

Alveolar cleft is a tornado-shaped bone defect in the maxillary arch. The treatment goals for alveolar cleft are stabilization and provision of bone continuity to the maxillary arch, permitting support for tooth eruption, eliminating oronasal fistulas, providing an improved esthetic result, and improving speech. Treatment protocols vary in terms of the operative time, surgical techniques, and graft materials. Early approaches including boneless bone grafting (gingivoperiosteoplasty) and primary bone graft fell into disfavor because they impaired facial growth, and they remain controversial. Secondary bone graft (SBG) is not the most perfect method, but long-term follow-up has shown that the graft is absorbed to a lesser extent, does not impede facial growth, and supports other teeth. Accordingly, SBG in the mixed dentition phase (6-11 years) has become the preferred method of treatment. The most commonly used graft material is cancellous bone from the iliac crest. Recently, many researchers have investigated the use of allogeneic bone, artificial bone, and recombinant human bone morphogenetic protein, along with growth factors because of their ability to decrease donor-site morbidity. Further investigations of bone substitutes and additives will continue to be needed to increase their effectiveness and to reduce complications.

• 대한소아치과학회지
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• 제26권1호
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• pp.69-76
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• 1999

The mandibular buccal frenum is defined as a fold of mucous membrane at the posterior labial vestibule and attaches the lips and the cheeks to the alveolar mucosa, gingiva, and underlying periosteum. The buccal frenum becomes a problem when its attachment is too close to the marginal gingiva. It may then pull on healthy gingiva, encourage plaque formation and interfere with tooth brushing. Especially, heavy buccal frenum mucogingivally results in insufficent attached gingiva, inadequate vestibular depth and high frenum attachment and also difficulty in eruption of mandibular premolar. Frenotomy, frenectomy and mucogingival surgery are used in treating heavy buccal frenum. Frenotomy with autogenous free gingival graft has been used popularly because of its stable result. But, it is difficult in younger children because of inadequate donor site, difficulty in making recipient site and behavior management. Frenotomy with apically positioned flap is considered as more efficient way for a very young child with heavy buccal frenum. Additionally, modified deep sedation with $N_2O-O_2$ can be used as an adjunct for the effective treatment outcome. Decrease in muscle pull, adequate width of attached gingiva and increased vestibular depth can be expected from this treatment approach.

• Journal of Periodontal and Implant Science
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• 제28권3호
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• pp.409-418
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• 1998

The socket preservation technique is very effective in preventing alveolar ridge collapse after tooth extraction. Many technigues have been proposed for the primary closure of the flap and we tested a new graft design, "wing graft", which is a modification of free connective tissue graft in this case report. With this technique, primary closure was achieved without shallowing the vestibule. Additionally some vertical ridge augmentation effect could be observed and therefore good esthetic and functional results were obtained from this technique even in the case where severe bone loss and gingival recession was present. Finally we observed good healing appearance in the donor site after 2weeks. The results from this report suggest that this "wing graft" can be used successfully as an adjunctive procedure with socket preservation technique.

• Journal of Periodontal and Implant Science
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• 제37권1호
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• pp.103-113
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• 2007

The purpose of this study was to measure the thickness of masticatory mucosa in the hard palate as a donor site for mucogingival surgery by using computerized tomography(CT), Thickness measurements were performed in 84 adult patients who took CT on maxilla for implant surgery and 24 standard measurement points were defined in the hard palate according to the gingival margin and mid palatal suture. Radiographic measurements were utilized after calibration for standardization. Data were analyzed to determine the differences in mucosal thickness by gender, age, tooth positions and depth of palatal vault. The results of this study were as follows: 1. Mean thickness of palatal masticatory mucosa was $3.93{\pm}0.6mm$ and females had significantly thinner mean masticatory mucosa($3.76{\pm}0.56mm$) than males($4.04{\pm}0.6mm$)(p<0.05). 2. The thickness of palatal masticatory mucosa increased by aging. 3. Depending on position, masticatory mucosa thickness increased from canine to premeolar, but decreased at the first molar, and increased again in the second molar region(p<0.0001). 4. No significant difference in mean thickness of palatal masticatory mucosa were indentified between low palatal vault group and high palatal vault group(p>0.05). The results suggest that canine and premolar area appears to be the most appropriate donor site for soft tissue grafting procedure. The measurement of the thickness of palatal masticatory mucosa by using computerized tomography can offer useful information clinically but further studies in as-sessing the validity and reliability of the method using computerized tomography is needed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권1호
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• pp.7-15
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• 2010

Complex human tissues harbor stem cells and precursor cells, which are responsible for tissue development or repair. Recently, dental tissues such as dental pulp, periodontal ligament (PDL), dental follicle have been identified as easily accessible sources of undifferentiated cells. These tissues contain mesenchymal stem cells that can be differentiate into bone, cartilage, fat or muscle by exposing them to specific growth conditions. In this study, the authors procured the stem cell from pulp, PDL, and dental follicle and differentiate them into osteoblast and examine the bone induction capacity. Dental pulp stem cell (DPSC), periodontal ligament stem cell (PDLSC), and dental follicle precursor cell (DFPC) were obtained from human 3rd molar and cultured. Each cell was analyzed for presence of stem cell by fluorescence activated cell sorter (FACs) against CD44, CD105 and CD34, CD45. Each stem cell was cultured, expanded and grown in an osteogenic culture medium to allow formation of a layer of extracellular bone matrix. Osteogenic pathway was checked by alizarin red staining, alkaline phosphatase (ALP) activity test and RT-PCR for ALP and osteocalcin (OCN) gene expression. According to results from FACs, mesenchymal stem cell existed in pulp, PDL, and dental follicle. As culturing with bone differentiation medium, stem cells were differentiated to osteoblast like cell. Compare with stem cell from pulp, PDL and dental follicle-originated stem cell has more osteogenic effect and it was assumed that the character of donor cell was able to affect on differential potency of stem cell. From this article, we are able to verify the pulp, PDL, and dental follicle from extracted tooth, and these can be a source of osteoblast and stem cell for tissue engineering.