• Title/Summary/Keyword: Endodontic surgery

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Anatomical analysis of the resected roots of mandibular first molars after failed non-surgical retreatment

  • Yoon, Jiyoung;Cho, Byeong-Hoon;Bae, Jihyun;Choi, Yonghoon
    • Restorative Dentistry and Endodontics
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    • v.43 no.2
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    • pp.16.1-16.9
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    • 2018
  • Objectives: Understanding the reason for an unsuccessful non-surgical endodontic treatment outcome, as well as the complex anatomy of the root canal system, is very important. This study examined the cross-sectional root canal structure of mandibular first molars confirmed to have failed non-surgical root canal treatment using digital images obtained during intentional replantation surgery, as well as the causative factors of the failed conventional endodontic treatments. Materials and Methods: This study evaluated 115 mandibular first molars. Digital photographic images of the resected surface were taken at the apical 3 mm level and examined. The discolored dentin area around the root canal was investigated by measuring the total surface area, the treated areas as determined by the endodontic filling material, and the discolored dentin area. Results: Forty 2-rooted teeth showed discolored root dentin in both the mesial and distal roots. Compared to the original filled area, significant expansion of root dentin discoloration was observed. Moreover, the mesial roots were significantly more discolored than the distal roots. Of the 115 molars, 92 had 2 roots. Among the mesial roots of the 2-rooted teeth, 95.7% of the roots had 2 canals and 79.4% had partial/complete isthmuses and/or accessory canals. Conclusions: Dentin discoloration that was not visible on periapical radiographs and cone-beam computed tomography was frequently found in mandibular first molars that failed endodontic treatment. The complex anatomy of the mesial roots of the mandibular first molars is another reason for the failure of conventional endodontic treatment.

Severe Recurrent Gingival Bleeding and Toothache Control in a Patient with Liver Cirrhosis and Oral Metastatic Hepatoma: Report of a Case (간경화증과 구강전이 간암환자에서 과도한 재발성 치은출혈과 치통조절: 증례보고)

  • Lee, Chun-Ui;Mo, Dong-Yub;Yoo, Jae-Ha;Choi, Byung-Ho;Kim, Jong-Bae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.6
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    • pp.592-596
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    • 2010
  • The common local causes of active gingival bleeding are the vessel engorgement and erosion by severe inflammation and injury to hypervascularity lesion. Abnormal gingival bleeding is also associated with systemic bleeding disorders (liver disease, leukemia etc.). There are many conventional methods for gingival bleeding control, such as, direct pressure, packing, electrocoagulation, tight suture and application of hemostatic agents. If the continuous gingival bleeding is not stopped in spite of the all local application methods, the medical consultation should be obtained for systemic condition care and the major feeding arterial embolization. This is a case report of severe gingival bleeding and periodontitis control in a patient with liver cirrhosis and oral metastatic lesion of hepatocellular carcinoma. The bleeding lesion was placed in left buccal mucosa and gingiva of the left mandibular molars. The control methods were dental crown removal, primary endodontic drainage, gingival sulcus drainage and maxillary arterial embolization with medical consultation.

The experimental study of oral care for early radiation therapy in the head and neck cancer patients (두경부 악성종양 환자에서 조기 방사선치료를 위한 구강관리법에 대한 실험적 연구)

  • Moon, Won-Kyu;Cha, In-Ho;Kim, Hyung-Jun;Jung, Young-Soo;Lee, Chun-Ui;Lee, Jong-Young;Ryu, Mi-Heon;Yoo, Jae-Ha
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.3
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    • pp.169-175
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    • 2011
  • Background: Teeth requiring extraction before radiotherapy in head & neck cancer patients should be removed as long as possible before the initiation of radiation therapy. Conventionally, a minimum 2-week waiting primary healing period is recommended. Although the above 2-week period is ideal, it was not uncommon for the radiotherapist and cancer patient to feel an urgent need to process with radiotherapy despite the need for dental care. Therefore, alternative approaches for early radiotherapy, including conservative endodontic treatment and a 1-week waiting primary healing period after dental extraction at the time of radiotherapy, were considered and applied based on the experimental study Materials and Methods: Eighteen dogs were processed for histopathologic wound healing. The effect of the primary endodontic treatment and extraction before early radiotherapy was examined. Results: No specific complication, such as, post-extraction wound infection, radiation osteitis and osteoradionecrosis, were encountered despite the early radiotherapy. Conclusion: Based on the experimental study, a minimum 1-week waiting primary healing period for oral care before radiotherapy is suitable for the early radiotherapy in head and neck cancer patients.

Nerve Injury from Overfilled Calcium Hydroxide Root Canal Filling Paste for Maxillary Lateral Incisor Endodontic Treatment (상악 측절치 근관치료 중 수산화칼슘 호제근충제 과충전으로 인하여 발생한 신경손상의 치험례)

  • Na, Kwang Myung;Kim, Jong-Bae;Chin, Byung-Rho;Kim, Jin-Wook;Kim, Chin-Soo;Kwon, Tae-Geon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.4
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    • pp.260-264
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    • 2013
  • Calcium hydroxide root canal filing paste (vitapex) is widely used as canal filling paste for infected canal. However, chemical burn is possible because of the high alkali base of calcium hydroxide. A 57-year old woman was admitted to our clinic for consistent dull pain and paresthesia in the left upper lip, zygoma and buccal cheek area, which developed during an endodontic treatment of the left lateral incisor. Radiographic finding showed radiopaque material, which exits from the left incisor root apex, and was within the left canine and first premolar buccal soft tissue. The overfilled Vitapex extended to the soft tissue was surgically curetted. The result of the surgical curettage was favorable. Though slight hypoesthesia on the upper lip was still remained, paresthesia on zygomatic and buccal cheek area was completely recovered. As far as we know, this is the first case report of infraorbital nerve damage from overfilled Vitapex material.

Development of Root Perforation Filling Material using Demineralized Dentin Paste (치아들을 탈회동결건조처리하여 제작한 치근천공부 충전재 개발 I: 예비실험연구)

  • Choi, Yong-Hun;Bae, Ji-Hyun;Park, Ji-Hoon;Kim, Young-Kyun;Yun, Pil-Young;Hwang, Ji-Yeon;Um, In-Woong;Lee, Chong-Heon
    • The Journal of the Korean dental association
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    • v.50 no.9
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    • pp.574-585
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    • 2012
  • Purpose : This study was performed to evaluate the healing response around the root perforation restorative material. Materials and Methods : Four beagle dogs were used for experimental study. Endodontic treatment was performed at four maxillary premolars and artificial perforation was formed at furcation area of pulp chamber. Canal was filled with gutta percha cone and the perforation was sealed with MTA at group 1. At group 2, canal was filled and the perforation was sealed with dentin paste. Tooth paste was fabricated using extracted human teeth. Histologic examination of furcation area was performed 2, 4, 8 and 12 weeks after experiment. Results : New trabecular bone formation was observed around the MTA and tooth paste. Lamellar bone was observed as time is over. There were no inflammatory reaction in both groups. Conclusion : There is a possibility which endodontic filling material can be developed using extracted teeth.

CYTOTOXICITY OF RETROGRADE FILLING MATERIALS TESTED BY 51Cr RELEASE, MIT AND LD ACTIVITY (51Cr방출과 MTT 및 LD활성도를 이용한 역충전재의 세포독성에 관한 연구)

  • Choi, La-Young;Im, Mi-Kyung
    • Restorative Dentistry and Endodontics
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    • v.19 no.2
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    • pp.409-428
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    • 1994
  • Endodontic surgery is performed when conventional endodontic therapy fails or is contraindicated. In such cases, retrograde filling materials including amalgam, composite resin, and various cements have been used. Biocompatibilty and margin sealing ability of retrograde filling materials are important for the long term success of endodontic surgery. In vitro cell culture is frequently used as the method of measuring the biocompatibilty of dental materials. The purpose of this study was to evaluate the cytotoxicity of six kinds of retrograde filling materials including newly developed light curing glass ionomer cements. Each material was mixed according to. the manufacture's instruction and evaluated as : freshly mixed, 24-hour after mixing, and 168-hour after mixing respectively. The elution solution was extracted after 24-hour contact with materials using media. Cytotoxicity was evaluated by direct contact, or elution contact. Test results of radiochromium($^{51}Cr$) release, cell viability using tetrazolium dye (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl dimethyltetrazolium bromide(MTT) test and lactate dehydrogenase(LD) of damaged L929 cells were analyzed. In the $^{51}Cr$ release of direct contact, all experimental retrograde filling materials except amalgam and glass ionomer cement showed increased cytotoxicity compared to control. In the $^{51}Cr$ release of elution solution, the released $^{51}Cr$ was so minimal that it was impossible. to evlauate the cytotoxicity exactly. The elution solutions of glass ionomer cement and IRM showed marked cytotoxicity in MTT test. LD enzyme activity was highest in tests of direct contact with composite, light curing composite, and light curing glass ionomer cement and IRM. Amalgam revealed least cytotoxicity while IRM showed cytotoxicity using all three methods. Composite, light curing composite and light curing glass iomomer cement were cytotoxic in the tests of $^{51}Cr$ release and LD activity. Glass ionomer cement showed cytotoxic effect only in the MTT method. From these results it is suggested that the standardization and optimization of cytotoxicity testing, especially using elution solutions, should be strongly advised.

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EFFECT OF DRAINAGE AS A STRESS REDUCTION METHOD BEFORE EXTRACTION OF ADVANCED INFECTED TEETH IN DISABLED PATIENTS : REVIEW OF LITERATURE & REPORT OF CASES (장애환자에서 과도한 감염치아 발치전 스트레스 감소법으로서 배농술의 효과 : 문헌적 고찰 및 증례보고)

  • Yoo, Jae-Ha;Choi, Byung-Ho;Lee, Chun-Ui;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.2
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    • pp.107-114
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    • 2011
  • Dental extraction is potentially stress-inducing in many disabled patient. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress, the stress reduction method was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk, (2) Complete medical consultation before dental therapy, (3) Schedule the patient's appointment in the morning, (4) Monitor and record preoperative and postoperative vital signs, (5) Use psychosedation during therapy, (6) Use adequate pain control during therapy, (7) Short length of appointment : do not exceed the patient's limits of tolerance, (8) Follow up with postoperative pain/anxiety control, (9) Telephone the risk patient later on the same day that treatment was given. Though the stress reduction method above was applied to the dental extraction in disabled patients with the advanced infected teeth, the complications(syncope, shock, bleeding & infection, etc.) may be occurred. For prevention of complications associated with the extraction, the authors treated the advanced infected teeth with endodontic drainage and incision & drainage before extraction. The final extraction and wound closure were then done after about 3 weeks.

Treatment of Invasive Candida Osteomyelitis of the Mandible: A Case Report

  • Hae-In, Choi;Ji-Su, Oh;Jae-Seak, You;Seong-Yong, Moon;Ji-Yun, Choi;Hyun-Jeong, Park
    • Journal of Oral Medicine and Pain
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    • v.47 no.4
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    • pp.212-216
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    • 2022
  • Osteomyelitis in the oral and maxillofacial area is a relatively uncommon inflammatory disease that occurs due to odontogenic causes such as endodontic infection, facial trauma, insufficient blood supply caused by some medical conditions, and iatrogenic postoperative infections. Among them, the incidence rate of candida osteomyelitis in this area is minimal; therefore, no consensus on the diagnosis, treatment, and prognosis has not been established yet. With the increasing number of immunocompromised elderly patients, candida osteomyelitis of the jaw is expected to become more prevalent. In this case report, we present an 81-year-old male patient with candida osteomyelitis of the jaw, including the maxillary and ethmoid sinuses.

Paresthesia diagnosed using cone-beam computed tomography: a case report

  • Kumar, Umesh;Kaur, Charan Kamal;Vashisht, Ruchi;Rattan, Vidya
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.2
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    • pp.95-99
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    • 2020
  • Various dental procedures, such as injection administration, surgical treatment, and endodontic treatment, can cause injury to the nerves. The most commonly injured nerves are the inferior alveolar and lingual nerves. This can manifest as altered sensation to the area of innervation of the injured nerve, such as the lower lip, chin, teeth, tongue, and mucosa. Altered sensations or loss of sensation are relatively infrequent complications in daily dental practice. Here, we report an uncommon case of altered sensation in the midfacial region caused by an endodontic procedure and discuss the need to consider local dental causes in the differential diagnosis of numbness in the facial region.