• The Journal of the Korean dental association
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• v.47 no.11
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• pp.728-735
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• 2009

최근 10여 년 동안 치수치료 분야는 새로운 재료와 약제의 개발 뿐 아니라 새로운 치료개념이 도입되어, 지속적인 발전이 이루어지고 있다. 특히 2007년 11월에는 미국 소아치과학회 (American Academy of Pediatric Dentistry)와 미국 근관치료학회 (American Association of Endodontists)가 공동 심포지움을 열어, 유치와 미성숙 영구치 치수치료분야에서 증거-바탕 임상 (evidence-based practice)의 구현을 위한 획기적인 공동의 노력이 있었다. 또한 치수치료 분야에 조직공학(tissue engineering)의 개념이 적용되어 치수조직의 재생에 대한 연구가 활발히 이루어지고 있다. 이번 원고에서는 유치 및 미성숙 영구치의 치수치료에서 개념에 변화가 있는 분야를 정리해 보고 새로운 술식에 대하여 다루고자 한다.

• 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.

• 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.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.2
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• pp.176-183
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• 2021

This study aimed to analyze the preoperative factors of immature first molars treated with vital pulp therapy and to find out their correlation in pediatric patients. From May 2014 to January 2020, 523 patients and 1,242 immature first molars were investigated. Factors including age, sex, tooth location, Molar-incisor hypomineralization (MIH), caries cavity location, and history of previous restoration were evaluated. As a result of the study, the vital pulp therapy group had 5.56 times more MIH, 3.39 times more mesial cavities, and 8.73 times more distal cavities. In order to avoid vital pulp therapy in immature first molar, early diagnosis and active management of MIH and preventive treatment of mesial and distal caries are necessary after its immediate eruption.

• Journal of the korean academy of Pediatric Dentistry
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• v.50 no.1
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• pp.24-34
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• 2023

The aim of this study was to retrospectively analyze the effects of pulp treatment on exfoliation of primary teeth and its related factors. In this study, 167 teeth of 97 patients aged 6 months to 12 years who were treated with pulp treatment at Dankook Dental Hospital were selected, and information related to pulp treatment and tooth loss was collected. The included subjects were 72 primary anterior teeth (43.1%) and 95 primary posterior teeth (56.9%), of which 56 were males (57.7%) and 41 females (42.3%). The mean follow-up period was 106.1 ± 38.7 months, and the mean age at pulp treatment was 34.8 ± 15.4 months for primary anterior teeth and 69.1 ± 25.1 months for primary posterior teeth. Unilaterally pulpectomized teeth were significantly exfoliated earlier than the same tooth on the opposite side (p < 0.05). Also, in the case of teeth with periapical lesions, despite pulp treatment, the probability of extraction due to infection has been increased on primary anterior teeth (p < 0.05), but not on posterior teeth (p > 0.05). Pulpectomized teeth were lost earlier, an average of 7.8 months for primary anterior teeth and 8.5 months for primary posterior teeth. Early loss of the primary tooth can lead to space loss and premature eruption of the successor, so this can be considered when planning or performing treatment of the primary tooth.

• 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.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.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.324-332
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• 2008

Traumatic crown fracture in mixed dentition or early permanent dentition is relatively common. Crown fracture is classified into simple or complicated crown fracture by the presence of pulp exposure. The condition of pulp must be considered in treatment of crown fractures with pulp exposure. Treatment of immature crown-fractured incisor with pulp exposure is more complex because of its incomplete root formation. Pulp capping, partial pulpotomy, cervical pulpotomy can be used for continuous root development in immature crown-fractured incisor with pulp exposure. The success rate of partial pulpotomy is very high and there are several advantages of partial pulpotomy because the cell-rich coronal pulp tissue is preserved. This paper reports 2 cases of crown-fractured permanent incisors with pulp exposure that had been treated by partial pulpotomy successfully.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.3
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• pp.277-292
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• 2020

The pulp treatment of primary and immature teeth in the children and adolescents is affected by the environment of the patients, clinical careers and dentists performing the techniques, as well as clinical modalities and pulpal diagnosis. The purpose of this study was to investigate the current status of pulp treatment performed in real clinical practice, as well as the reasons behind the choice of treatment methods. The study was conducted on a total of 153 members of the Korean Academy of Pediatric Dentistry, and statistical data from the Health Insurance Review and Assessment Service (HIRA) from 2010 to 2018 were analyzed together. Both the survey results and the statistics from the HIRA showed that 1-visit pulpectomies of primary teeth were most common, and the frequency of the use of the Ni-Ti file was increased in children with primary or mixed-dentition. In the treatment of immature permanent teeth, regenerative endodontic treatment by individual dentists was found to be less frequent than in university hospitals.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.4
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• pp.620-625
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• 2001

The pulpectomy or root canal treatment on primary teeth is to be done when there is evidence of chronic in flammation or necrosis in the radicular pulp. Due to the tortuous and ribbon-shaped anatomy of the primary teeth, the instrumentation of endodontic hand files and barbed broaches is not an easy procedure. Recently, many automatic Ni-Ti rotary instruments have been developed and has made endodontic treatment easier and faster. This report describes two cases of root canal treatment on primary molars using Ni-Ti rotary files. The cervical constricture was eliminated by the crown-down method, as smaller file proceeded unhindered into the apical third of the canal. In addition, the crown-down technique enhanced the efficacy of the endodontic irrigant. The use of rotary instrumentation for primary teeth seemed to be a more effective way to debride the uneven walls of primary teeth.