• The Journal of the Korean dental association
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• v.20 no.12 s.163
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• pp.1011-1013
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• 1982

년령이 증가함에 다라 치아도 신체 다른부위와 같이 노화현상이 나타나는데, 특히 보존영역에서는 상아질 및 치수의 노화에 대한 지식은 매우 중요하다고 생각된다. 일반적으로 상아질 및 치수의 노화는 치수강이나 치근관내 석회화된 조직의 양이 증가하고 세포나 혈관의 수가 감소되는 현상으로 나타나며, 임상에서는 흔히 치수강이나 치근관내 pub stone이나 dystrophic calcification을 발견하게 된다. 이러한 노화현상은 년령이 증가한다는 요소외도 우식, 마모, 교모, 또는 치과시술등이 그 원인이 된다고 알려져 있으며 실제 젊은환자에서도 상아질 및 치수가 노화되어 있는 치아를 볼 수 있다. 그러나 대개 년령적으로는 50세에서 60세사이의 환자에서는 치아의 노화가 있을수있는 가능성이 많다고 알려져 있으므로 임상에서 이점을 고려해야될 것으로 생각되며, 또 한가지는 상아질 및 치수에 이와같은 치유의 능력이 저하된다는 사실이다. 이러한 사실은 우리가 광범위한 충전물을 가진 치아에서 치수복조술을 시행할때는 충전물이 없고 우식이 생긴 치아에서 시술여부를 결정할 때 매우 중요한 점이 되고있는것 처럼 보존시술시 고려되어야 할 중요한 점으로 생각된다. 노인에서 보존치료의 결과는 환자가 신장질환이나 위장병, 폐결핵, 당뇨병등 만성적인 전신 질환을 가지고 있는 경우에는 그 치유가 지연되는 경우가 있기는 하나 시술시에 이러한 사실과 년령증가에 따른 치수 및 상아질의 형태학적 변화나 생리적변화등을 고려해서 치료술식을 약간 달리하면 젊은 환자에서와 똑같은 결과를 가져 올수 있다는 확신 또는 중요하다고 보겠다. 본 난에서는 노인환자의 보존치료시에 임상에서 고려해야할 사항들을 충전시술시와 근관치료시로 나누어서 각 시술 별로 간단히 살펴보조져 한다.

• Restorative Dentistry and Endodontics
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• v.35 no.4
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• pp.238-245
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• 2010

Numerous cases about additional growth of roots or pulp tissue regeneration by using various intracanal medicaments in immature permanent teeth with periapical or pulpal disease have been reported. The underlying mechanism has not been clearly delineated, but it has been widely accepted that undifferentiated mesenchymal cells and stem cells are involved. Moreover, the growth and deposition of osteoid or cementoid tissues have been observed in regenerated pulp and roots. This new and non-invasive treatment has brightened the future of endodontics, and enlarged the vision of regenerative root canal treatment with multi-potent stem cells and various tissue engineering techniques.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.2
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• pp.174-179
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• 2014

Dens invaginatus is a developmental anomaly resulting from an infolding of the enamel organ into the dental papilla prior to calcification of the dental tissue. Clinical and radiographic presentation of dens invaginatus shows a lot of variation. The classification proposed by Oehlers(1957) is most commonly used among classifications of dens invaginatus. Several treatments have been suggested to treat Type III dens invaginatus where the pulp remains healthy but the invagination is associated with a periodontitis. The top priority objective is to preserve pulp as sound as possible. Thus, if there is no definite evidence of pulpal disease, the conservative access which treat invagination as distinct from the pulp is necessary. But, Endodontic treatment of Type III dens invaginatus has the particular problems associated with achieving adequate chemomechanical debridement of the root canal system and invagination, predictable length control and consistent filling. In this case report, the endodontic treatment limited within invagination was performed for treatment of Type III dens invaginatus, and filling with Mineral Trioxide Aggregate(MTA) resulted in good prognosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.4
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• pp.616-622
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• 1999

The primary objective of pulp treatment is to maintain the integrity and health of the oral tissues. The most important and difficult aspect of pulp therapy is determining the health of the pulp, or its stage of inflammation, so that a decision can be made regarding the best form of treatment. Immature permanent teeth are good candidates for many pulp healing procedures, due to their rich blood supply, which is believed to enhance the pulp's ability to react successfully to various insults. Healing was considered to have taken place when the tooth fulfilled the following criteria: 1. Abscence of clinical symtoms 2. Radiographic evidence of dentin bridge formation 3. No intrapulpal or periapical pathosis was evident radiographically 4. Continued root development and closure of the apex in immature teeth 5. Normal dentin apposition in mature teeth 6. Positive response to electrical pulp test This presents a report of cases in which immature permanent teeth, pulp-exposed by caries or trauma, was treated successfully by partial pulpotomy.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.276-283
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• 2011

Recently, undifferentiated stem cells which exist in dental papillae of immature permanent teeth were newly discovered and these stem cells appear to be the origin of ameloblasts associated with the formation of root dentin. When treating immature permanent teeth, the preservation of these stem cells induce the continuous formation of the root. Therefore, it is reported that minimal invasion to periapical region in immature permanent teeth with periapical inflammation resulted in good-healing pattern in clinical and radiographic examination. In this case, a 10 year-old boy(mandibular right premolar) and a 8 year-old girl(maxillary left premolar) who visited the department of pediatric dentistry at Chosun University Dental Hospital were diagnosed with pulp necrosis and periapical abscess in clinical and radiographic examination. Endodontic instrumentation to the periapical region was limited and MTA(Mineral Trioxide Aggregate) was applied into the pulp canal. The periodic checks showed healing of periapical abscess and the development and growth pattern of roots. In permanent teeth with pulp necrosis and periapical abscess, preservation of pulp and dental papillae in the periapical region showed good prognosis during the periodic examinations. Therefore, a lot of clinical examination and long-term evaluation of conservative pulp treatment in immature permanent teeth are expected to be necessary.

• Restorative Dentistry and Endodontics
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• v.26 no.5
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• pp.443-446
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• 2001

급격한 치아외상은 치아 경조직에 손상을 주기도 하지만 치수와 치주조직에도 손상을 입힌다. 탈구(luxation)의 경우, 외상에 의해 치근단공 부위에서 신경혈관계의 파괴가 초래되지만 치근파절의 경우에는 파절전 부위에서 이와 유사한 손상이 나타난다. 그러므로 치근파절을 파절선 상부의 치관부에 대한 일종의 탈구로 보기도 한다. 본 증례보고는 외상에 의한 치근파절의 두 가지 치유양상을 비교한 것으로, 한 증례는 특정한 치과적 처치없이 스스로 치유된 경우이고 다른 한 증례는 치아고정 및 근관치료를 포함한 치과치료후에 치유된 경우이다. 수평치근파절의 치유에는 여러 가지 요인이 관여하지만 특히 치아동요도 및 치수생활력이 큰 영향을 미친다. 본 증례에서와 같이 치아의 동요도가 있는 경우에는 고정을 통해서 치유를 촉진하고 치수의 괴사가 초래된 경우에는 근관치료를 포함한 적절한 치과치료를 통해서 치유가 일어날 수 있다. 따라서 치근이 파절된 경우에는 장기간의 관찰을 통해 파절부 치유 및 치수손상 여부를 관찰, 진단하고 그에 따른 적절한 처치를 시행해야 할 것이다.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.174-180
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• 2012

In case of an immature tooth with necrotic pulp, regeneration of pulp tissue into a canal would be the ideal outcome. It may be capable of promoting the continuation of normal root development. Platelet-rich fibrin has been suggested as a potentially ideal scaffold for regenerative endodontic treatment. Immature permanent teeth of young children were diagnosed with pulp necrosis and apical abscess as the result of clinical and radiographic examination. After removal of necrotic pulp, canal was irrigated with 5.25% NaOCl and dried with paper point. A triple antibiotic mixture was placed in canal space in 3 weeks. After removal of the antibiotic mixture, the platelet-rich fibrin was injected into the canal space with MTA placed directly over the platelet-rich fibrin clot. The coronal region was restored by composite resin. On the basis of short-term results of the present 3 cases, regeneration of vital tissues appears to be possible in a tooth with necrotic pulp and a periapical lesion. Also, platelet-rich fibrin proves to be potentially an ideal scaffold for this procedure. Therefore, long-term clinical observation and examination about this treatment using platelet-rich fibrin in immature permanent teeth of young children are considered to be necessary.

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.1
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• pp.111-118
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• 2019

Post-endodontic restorations are both important and challenging for clinical success in endodontically treated posterior teeth. Several options have been proposed to restore endodontically treated molars. In pediatric dentistry, restoration using conventional single crowns, especially for partially erupted molars with insufficient retentive tooth structure, has proven to be difficult. However, the endocrown presents a conservative and esthetic restorative alternative to conventional crowns with post-and-core, as it acquires additional retention within the pulp chamber. The tooth preparation consists of a circular, equigingival, butt-joint margin and a central retention cavity in the pulp chamber that helps to construct both the crown and core as a single unit. This case report describes the esthetic and conservative endocrown restorations of erupting permanent first molars with extensive coronal destruction.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.92-97
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• 2004

Traumatic injuries in the young peranent dentition are common, but root fractures, defined as fractures in volving dentin, cementum and pulp, are relatively uncommon. Case 1 is a 9-year-old boy who had a horizontal root fracture of his maxillary right central incisor in the apical third. Root canal therapy was performed in coronal segment and calcium hydroxide therapy was initiated. Six months after treatment, a periapical radiograph showed calcific tissue formation and normal root development. 1 year and 3 months later, the canal was permanently obturated with gutta-percha. Case 2 is a 7-year-old girl who had a vertical root fracture of her maxillary right central incisor. Fractured tooth was intentionally extracted atraumatically, and then the separated fragments are bonded with resin cement. the restored tooth was replanted into the original socket. Recalls up to 8 months showed normal mobility and no periapical pathosis. In these cases, we performed conservative treatment. Clinical and radiographic examination showed no pathosis or abnormality of the teeth and periodontal tissue.

• 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.