Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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A retrospective study of the intentionally replanted mandibular second molars with C-shaped root canal configurations

C-형 근관계를 가진 하악 제2대구치의 의도적 재식술 결과에 대한 후향적 연구

  • Shon, Won-Jun (Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry) ;
  • Kum, Kee-Yeon (Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry) ;
  • Baek, Seung-Ho (Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry) ;
  • Lee, Woo-Cheol (Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry)
  • 손원준 (서울대학교 치의학대학원 치과보존학교실) ;
  • 금기연 (서울대학교 치의학대학원 치과보존학교실) ;
  • 백승호 (서울대학교 치의학대학원 치과보존학교실) ;
  • 이우철 (서울대학교 치의학대학원 치과보존학교실)
  • Received : 2010.10.02
  • Accepted : 2010.11.02
  • Published : 2011.01.31
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Abstract

Objectives: The purpose of this retrospective study was to evaluate the success rate of intentionally replanted mandibular second molar with C-shaped canal configurations and to access the impact of preoperative periapical lesion on the success of intentional replantation procedure. Materials and Methods: This retrospective chart review study evaluated 52 intentionally replanted mandibular second molar teeth treated at Seoul National University Dental Hospital Department of Conservative Dentistry from January 2005 to December 2007. Seventeen teeth were lost for the follow-up, and another 6 teeth did not meet inclusion criteria of C-shaped root canal configurations. Healing outcome such as success, uncertain healing, and failure after follow-up was evaluated by clinical criteria and radiographs. Results: The overall success rate was 72.4% for the 29 intentionally replanted C-shaped mandibular second molars. The success rate of replanted teeth with preoperative periapical lesions was similar to that of replanted teeth which have no periapical lesions. Conclusions: Therefore, root canal treatment failure on C-shaped mandibular second molar can be predictably treated by intentional replantation regardless of the presence of periapical lesion.

연구목적: 인류지질학적으로 동양인에게서 많이 발견되는 C-형 근관계를 가진 하악 제2대구치는 근관치료나 비외과적 재치료에 실패하는 경우 외과적 재치료 방법으로 의도적 재식술을 시행하게 되는데 그 성공률에 대한 보고가 없었다. 따라서 본 연구의 목적은 C-형 근관계를 가진 하악 제2대구치에 의도적 재식술을 시행한 환자의 기록을 후향적으로 조사하여 치료 결과에 따른 성공률을 확인할 뿐 아니라 치료전 존재하던 치근단 병소가 성공률에 영향을 미치는 바에 대하여 알아보는 것이다. 연구 재료 및 방법: 연구를 위해 2005년 1월부터 2007년 12월에 걸쳐 서울대학교치과병원 치과보존과에 내원하여 하악 제2대구치에 의도적 재식술을 받은 52명의 환자 기록을 조사하였으며 7개의 치아는 정기적인 내원검진 기록이 없어서 조사 대상에서 제외하였고 다른 6개의 치아는 C-형 근관계의 조건에 해당되지 않아 연구에서 제외하였다. 정기 내원후 시행한 임상 검사와 방사선 사진 기록을 후향적으로 검토하여 성공이나 불완전한 치유 또는 실패등의 치료 결과에 대하여 판단하였다. 결과: C-형 근관계를 가진 29개의 하악 제2대구치에 시행한 의도적 재식술의 성공률은 72.4%로 관찰되었으며 치료전 치근단 병소가 존재한 경우의 성공률은 치근단 병소가 없었던 경우와 유사한 것으로 확인되었다. 결론: 본 연구결과 C-형 근관계를 가진 하악 제2대구치의 근관치료가 실패한 경우 시행하게 되는 의도적 재식술은 술전 병소의 존재 유무에 상관없이 치근단 수술의 성공률과 유사한 결과를 얻을 수 있는 치료라고 사료된다.

Keywords

References

  1. Jafarzadeh H, Wu Y-N. The C-shaped root canal configuration: a review, J Endod 2007;33:517-523. https://doi.org/10.1016/j.joen.2007.01.005
  2. Fan B, Min Y, Lu G, Yang J, Cheung GSP, Gutmann Jl. Negotiation of C-shaped canal systems in mandibular second molars. J Endod 2009;35:1003-1008. https://doi.org/10.1016/j.joen.2009.04.011
  3. Yang ZP, Yang SF, Lin YC, Shay JC, Chi CY. C-shaped root canals in mandibular second molars in a Chinese population. Endod Dent Traumatol 1988;4:160-163. https://doi.org/10.1111/j.1600-9657.1988.tb00315.x
  4. Seo MS, Park DS. C-shaped root canals of mandibular second molars in a Korean population: clinical observation and in vitro analysis. Int Endod J 2004;37:139-144. https://doi.org/10.1111/j.0143-2885.2004.00772.x
  5. Jin GC, Lee SJ, Roh BD. Anatomical study of C-shaped canals in mandibular second molars by analysis of computed tomography. J Endod 2006;32:10-13. https://doi.org/10.1016/j.joen.2005.10.007
  6. Melton DC, Krell KV, Fuller MW. anatomical and histological features of C-shaped canals in mandibular second molars. J Endod 1991;17:384-388. https://doi.org/10.1016/S0099-2399(06)81990-4
  7. Gao Y, Fan B, Cheung GSP, Gutmann Jl, Fan M. C-shaped canal system in mandibular second molars Part IV-3D morphological analysis and transverse measurement. J Endod 2006;32:1062-1065. https://doi.org/10.1016/j.joen.2006.05.014
  8. Ingle J, Bakland L: Endodontics. 5th ed. Philadelphia: Lea & Febiger; 2002, p558.
  9. Jerome CE. C-shaped root canal systems: diagnosis, treatment, and restoration. Gen Dent 1994;42:424-427.
  10. Peer M. Intentional replantation - a“ last resort”treatment or a conventional treatment procedure: Nine case reports. Dent Traumatol 2004;2:48-55.
  11. Wolcott J, Rossman LE. Intentional replantation of endodontically treated teeth: an update. Compend Contin Educ Dent 2003;24:68-74.
  12. Rud J, Andreasen JO, Jensen JE. Radiographic criteria for the assessment of healing after endodontic surgery. Int J Oral Surg 1972;1:195-214. https://doi.org/10.1016/S0300-9785(72)80013-9
  13. Molven O, Halse A, Grung B. Observer strategy and the radiographic classification of healing after endodontic surgery. Int J Oral Maxillofac Surg 1987;16:432-439. https://doi.org/10.1016/S0901-5027(87)80080-2
  14. Fan B, Cheung GSP, Fan M, Gutmann JL, Bian Z. C-shaped canal system in mandibular second molars: Part I-anatomical features. J Endod 2004;30:899-903. https://doi.org/10.1097/01.don.0000136207.12204.e4
  15. Bender IB, Rossman LE. Intentional replantation of endodontically treated teeth. Oral Surg Oral Med Oral Pathol 1993;76:623-630. https://doi.org/10.1016/0030-4220(93)90073-D
  16. Kingsbury BC Jr, Wiesenbaugh JM Jr. Intentional replantation of mandibular premolars and molars. J Am Dent Assoc 1971;83:1053-1057. https://doi.org/10.14219/jada.archive.1971.0425
  17. Raghoebar GM, Vissink A. Results of intentional replantation of molars. J Oral Maxillofac Surg 1999;57:240-244. https://doi.org/10.1016/S0278-2391(99)90667-5
  18. Cotter MR, Panzarino J. Intentional replantation: a case report. J Endod 2006;32:579-582. https://doi.org/10.1016/j.joen.2005.08.004
  19. Saunders WP. A prospective clinical study of periradicular surgery using mineral trioxide aggregate as a rootend filling. J Endod 2008;34:660-665. https://doi.org/10.1016/j.joen.2008.03.002
  20. Fernandez-Yanez SA, Leco-Berrocal MI, Martinez-Gonzalez JM. Metaanalysis of filler materials in periapical surgery. Med Oral Patol Oral Cir Bucal 2008;13:E180-185.
  21. Torabinejad M, Corr R, Handysides R, Shabahang S. Outcomes of nonsurgical retreatment and endodontic surgery: a systematic review. J Endod 2009;35:930-937. https://doi.org/10.1016/j.joen.2009.04.023
  22. Fan W, Fan B, Gutmann JL, Cheung GSP. Identification of C-shaped canal in mandibular second molars: Part I - radiographic and anatomical features revealed by intraradicular contrast medium. J Endod 2007;33:806-810. https://doi.org/10.1016/j.joen.2007.04.007
  23. Fan B, Cheung GSP, Fan M, Gutmann JL, Fan W. C-shaped canal system in mandibular second molars: Part II - radiographic features. J Endod 2004;30:904-908. https://doi.org/10.1097/01.don.0000136206.73115.93
  24. Calsen O. Root complex and root canal system: a correlation analysis using one-rooted mandibular second molars. Scand J Dent Res 1990;98:273-285.
  25. Fan W, Fan B, Gutmann JL, fan M. Identification of C-shaped canal in mandibular second molars - Part III: Anatomical features revealed by digital subtraction radiography. J Endod 2008;34:1187-1190. https://doi.org/10.1016/j.joen.2008.06.013
  26. Fan B, Gao Y, Fan W, Gutmann JL. Identification of C-shaped canal in mandibular second molars - Part II: the effect of bone image superimposition and intraradicular contrast medium on radiograph interpretation. J Endod 2008;34:160-165. https://doi.org/10.1016/j.joen.2007.10.010
  27. Ricucci D, Pascon EA, Langeland K. Long-term follow-up on C-shaped mandibular molars. J Endod 1996;22:185-187. https://doi.org/10.1016/S0099-2399(96)80098-7
  28. Cheung LHM, Cheung GSP. Evaluation of a rotary instrumentation method for C-shaped canals with micro-computed tomography. J Endod 2008;34:1233-1238. https://doi.org/10.1016/j.joen.2008.07.015
  29. Rodig T, Hulsmann M, Muhge M, Schafer F. Quality of preparation of oval distal root canals in mandibular molars using nickel-titanium instruments. Int Endod J 2002;35:919-928. https://doi.org/10.1046/j.1365-2591.2002.00599.x