• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.17-24
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• 2011

The aim of this study was to assess the outcome of MTA apexification in young permanent anterior teeth. Among the patients with the traumatized permanent incisors which were treated with MTA apexification, the dental records and radiographs were examined only for the patient who had follow-up examination at least 3 months after the treatment. Forty nine patients with 64 teeth were included in this study. Demographic information, location and type of teeth and periodontal injury, pre-treatment periapical lesion, clinical symptoms, status of MTA filling, healing of apical lesion and apical barrier formation after treatment were investigated. The outcome based on clinical and radiographic criteria were assessed. The results were as follows 1. Of 64 immature permanent incisors with MTA apexification, the clinical and radiographic success rates were 89.1% and 73.4%, respectively. 2. The maxillary incisors showed significantly higher success rates than the mandibular incisors. 3. There was no statistically significant difference in success rates among the teeth with different types of teeth and periodontal injury. 4. The status of MTA filling did not influence the clinical and radiographic success.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.3
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• pp.454-460
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• 2007

Traumatic dental injuries in childhood and adolescent occurred more frequently than in adult. The time between the accident and the treatment is one of the most critical factors to prognosis, and because of the limited time available to examine and treat patients with traumatic dental injuries, if not treat appropriately, the result would be critical for the patient. In the previous studies, the prevalence and incidence of traumatic injuries were the most frequent at the age of 8 to 10 years, the majority of dental injuries involve the anterior teeth, especially the maxillary incisors, and males were more prevalent than females in an approximated proportion of 2:1. As the mean age of complete root formation is 10 years old, the maxillary permanent incisor involved in the most affected age group is usually immature, and the possibility of pulpal healing through excellent revascularization exists, more positive prognosis for pulp vitality would be expected. These are treatment cases of the immature maxillary permanent central incisor involved in the traumatic injury, and reports for progress and results of preserving the pulp vitality through the conservative treatment instead of the conventional endodontic root therapy.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.2
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• pp.475-483
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• 1997

Fracture of the crown in a permanent incisor is relatively common. When it occurs with pulp exposure, it presents both restorative and endodontic problems. In the restoration of a fractured incisor, reattachment of the original fragment or restoration with a composite resin is preferred over a temporary crown. If fractured fragment is intact, the tooth can be restored with reattachment of the fragment. An exposed pulp in a young crown-fractured incisor is usually treated with either pulp capping or pulpotomy depending on the size of an exposure and time elapsed since injury. However, in teeth showing vital and/or hyperplastic pulp tissue at the exposure, only superficial layers of the pulp and surrounding dentin should be removed : i.e. partial pulpotomy can be performed in immature as well as mature teeth. This paper reports 2 cases of crown-fractured permanent incisors with pulp exposure that had been treated by reattachment of original fragment followed by partial pulpotomy or partial pulpectomy. The following results are obtained. ; 1. Fragment reattachment is an acceptable semi-permanent restoration of crown fractured young permanent incisor. 2. Partial pulpotomy is recommended as the treatment of choice in crown-fractured permanent teeth with pulp exposure.

• Restorative Dentistry and Endodontics
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• v.40 no.3
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• pp.179-187
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• 2015

Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment.

• Restorative Dentistry and Endodontics
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• v.44 no.4
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• pp.35.1-35.10
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• 2019

Pulp revascularization is an alternative treatment in immature traumatized teeth with necrotic pulp. However, this procedure has not been reported in horizontal root fractures. This is a case report of a 9-year-old patient with multiple horizontal root fractures in 2 upper central incisors that were successfully treated with pulp revascularization. The patient presented for treatment 2 years after the initial trauma, and revascularization was attempted after the initial treatment with calcium hydroxide had failed. Prior to pulp revascularization, cone-beam computed tomography and autoradiograms demonstrated multiple horizontal fractures in the middle and apical thirds of the roots of the 2 affected teeth. Revascularization was performed in both teeth; platelet-rich plasma (PRP) was used in one tooth (#11) and the conventional method (blood clot) was used in the other tooth (#21). Clinical and radiographic follow-up over 4 years demonstrated pulp calcification in the PRP-treated tooth. Neither of the 2 teeth were lost, and the root canal calcification of tooth #11 was greater than that of tooth #21. This case suggests that PRP-based pulp revascularization may be an alternative for horizontal root fractures.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.3
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• pp.506-512
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• 2007

Traumatic injury of tooth in children is commonly occurred problem. It is classified into tooth, periodontal tissue, supporting bone, soft tissue injury by it's area and extent. Among the periodontal tissue injuries, traumatically intruded teeth are common in anterior maxillary area, though the occurrence rate is rather low, the pulp and supporting tissue injury is possible by vertical impact. The treatment method of traumatically intruded teeth is various. Observation on the spontaneous reeruption for 3-4 weeks is recommended if the traumatized teeth are deciduous teeth or slightly intruded immature permanent anterior teeth. If this did not occur because the extent of intrusion is severe or the traumatized teeth are mature permanent anterior teeth, orthodontic traction is applied by fixed/removable appliances. At this time, light and continuous force is applied for the extrusive movement of the intruded teeth. When above procedures are impossible, surgical repositioning and fixation is recommended. In these cases, we performed conventional endodontic therapy for pulp necrosis and orthodontic traction with fixed appliance. We obtained satisfactory results and will report that.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.2
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• pp.157-165
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• 2014

Skeletal anchorage is recommended as an orthodontic treatment for an impacted immature permanent tooth. Among these methods, C-tube is relatively safe because it is fixed to the cortical bone of interdental and the lower part of the root with several short miniscrews, which causes less damage to the root in patients of early permanent dentition. As it can be easily bent, the traction direction can be adjusted to favorable bone density sites. However, patient cooperation is important and traction based on physiological force in order to gain root and dentoalveolar tissue development in immature permanent teeth is required. Periodic follow-ups should be mandatory.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.2
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• pp.120-126
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• 2013

Preserving the pulp is important in the treatment of carious pulp exposure in young permanent teeth. Pulpotomy is a vital pulp therapy in which a portion of the coronal pulp tissue is surgically removed, and the remaining radicular tissue is covered with suitable material that protects the pulp from further injury and permits and promotes healing. It is important to develop biocompatible treatment directed at maintaining pulp vitality and increasing tooth longevity. Platelet-rich fibrin (PRF) has been referred to as a second-generation platelet concentrate. Two clinical cases in which PRF was applied as a medicament after pulpotomy of an immature permanent tooth are presented. After isolation, caries removal and pulpotomy with PRF was performed. A layer of mineral trioxide aggregate (MTA) was placed over the PRF, and the final restoration was performed. Postoperatively, the patient had no pain or discomfort, and follow-up radiographs revealed normal periodontal ligament space and trabecular bone pattern.

• Restorative Dentistry and Endodontics
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• v.35 no.4
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• pp.257-266
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• 2010

The purpose of this study was to determine the effect of post types and sizes on fracture resistance in immature tooth model with various restorative techniques. Bovine incisors were sectioned 8 mm above and 12 mm below the cementoenamel junction to simulate immature tooth model. To compare various post-and-core restorations, canals were restored with gutta-percha and resin core, or reinforced dentin wall with dual-cured resin composite, followed by placement of D.T. LIGHT-POST, ParaPost XT, and various sizes of EverStick Post individually. All of specimens were stored in the distilled water for 72 hours and underwent 6,000 thermal cycles. After simulation of periodontal ligament structure with polyether impression material, compressive load was applied at 45 degrees to the long axis of the specimen until fracture was occurred. Experimental groups reinforced with post and composite resin were shown significantly higher fracture strength than gutta-percha group without post placement (p < 0.05). Most specimens fractured limited to cervical third of roots. Post types did not influence on fracture resistance and fracture level significantly when cement space was filled with dual-cured resin composite. In addition, no statistically significant differences were seen between customized and standardized glass fiber posts, which cement spaces were filled with resin cement or composite resin individually. Therefore, root reinforcement procedures as above in immature teeth improved fracture resistance regardless of post types and sizes.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.4
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• pp.376-382
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• 2011

In clinical dentistry, it is not difficult to meet the permanent first molars with severe coronal caries lesions in children or adolescents. The circumstances surrounding the first molars of children and adolescents are so immature and imperfect compared with those of adults. So we thought it significant to understand the status of these teeth at the moment of endodontic treatment and immediate cause of it. 106 patients with 135 permanent molars necessitating endodontic treatment in childhood and adolescence were included in this study, and the dental records and radiographs were examined. 1. The mean age was 11.9 year (male 11.5, female 12.5) and the result shows significant difference between gender(p<0.05). The mandibular teeth took more than half percentage than maxillary teeth. 2. Of 135 teeth, 45.2 percent of teeth had history of dental treatment previously and 16.3 percent of teeth showed necessity of re-endodontic treatment. 3. Of 73 teeth, 22 teeth had mesial-wall cavity causing endodontic treatment, 39 had occlusal cavity, and 12 had distal cavity.