Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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Partial pulp necrosis caused by excessive orthodontic force

과도한 교정력에 의한 부분 치수괴사: 증례보고

  • Kim, Min-Young (Department of Conservative Dentistry, Yonsei University College of Dentistry, Microscope Center) ;
  • Lee, Seung-Jong (Department of Conservative Dentistry, Yonsei University College of Dentistry, Microscope Center) ;
  • Jung, Il-Young (Department of Conservative Dentistry, Yonsei University College of Dentistry, Microscope Center) ;
  • Kim, Eui-Seong (Department of Conservative Dentistry, Yonsei University College of Dentistry, Microscope Center)
  • 김민영 (연세대학교 치과대학 보존학교실, 현미경센터) ;
  • 이승종 (연세대학교 치과대학 보존학교실, 현미경센터) ;
  • 정일영 (연세대학교 치과대학 보존학교실, 현미경센터) ;
  • 김의성 (연세대학교 치과대학 보존학교실, 현미경센터)
  • Received : 2011.01.03
  • Accepted : 2011.01.10
  • Published : 2011.03.31
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Abstract

As the dental pulp is encased with a rigid, noncompliant shell, changes in pulpal blood flow or vascular tissue pressure can have serious implication for the health of pulp. Numerous studies have demonstrated that orthodontic force application may influence both blood flow and cellular metabolism, leading degenerative and/or inflammatory responses in the dental pulp. The aim of this case report is to present a case about tooth with chronic periapical abscess which showed normal vital responses. Excessive orthodontic force is thought to be the prime cause of partial pulp necrosis. Owing to remaining vital tissue, wrong dianosis can be made, and tooth falsely diagnosed as vital may be left untreated, causing the necrotic tissue to destroy the supporting tissuses. Clinician should be able to utilize various diagnostic tools for the precise diagnosis, and be aware of the endodontic-orthodontic inter-relationship.

치수는 견고한 치질에 의해 둘러싸여 있기 때문에 치수 혈류나 혈압의 변화는 치수건강에 심각한 위해를 입힐 수 있다. 여러연구에서 치아에 가해지는 교정력이 치수의 혈류 및 세포대사에 변화를 주어 퇴행성/염증성의 치수반응을 일으킬 수 있음이 밝혀졌다. 이 논문의 목적은 만성 치근단 농양을 가진 치아가 명확한 치수생활력 반응을 나타낸 증례에 대해 보고하는 것이다. 이는 치수가 부분적으로 괴사된 상태였기 때문이며 이것의 주 원인은 과도한 교정력인 것으로 판단된다. 남아있는 생활 치수 조직때문에 잘못된 진단이 이뤄지고, 이러한 경우 적절할 치료가 이뤄지지 않음에 따라 괴사조직이 지속적으로 치아주변조직을 파괴하게 될 수 있다. 임상가는 이러한 경우에 있어 여러 진단도구들을 활용하여 정확한 진단을 해야하며 근관-교정 간의 상호작용에 대해 숙지하고 있어야 할 것이다.

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References

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