• Title/Summary/Keyword: Endodontic surgery

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Surgical management of idiopathic bone cavity: case series of consecutive 27 patients

  • You, Myoung-Sang;Kim, Dong-Young;Ahn, Kang-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.2
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    • pp.94-99
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    • 2017
  • Objectives: Idiopathic bone cavity (IBC) is an uncommon intra-osseous cavity of unknown etiology. Clinical features of IBC are not well known and treatment modalities of IBC are controversial. The purpose of this study was to investigate the clinical characteristics of 27 IBC patients who underwent surgical exploration. Materials and Methods: A total of 27 consecutive patients who underwent surgery due to a jaw bone cavity from April 2006 to February 2016 were included in this study. Nine male and 18 female patients were enrolled. Patients were examined retrospectively regarding primary site, history of trauma, graft material, radiographic size of the lesion, presence of interdental scalloping, erosion of the inferior border of the mandible, complications, results of bone graft, and recurrence. Results: Female dominance was found. Maxillary lesion was found in one patient, and bilateral posterior mandibular lesions were found in two patients. The other patients showed a single mandibular lesion. The posterior mandible (24 cases) was the most common site of IBC, followed by the anterior mandible (5 cases). Two patients with anterior mandibular lesion reported history of trauma due to car accident, while the others denied any trauma history. Radiographic cystic cavity length over 30 mm was found in 10 patients. Seven patients showed erosion of the mandibular inferior border. The operations performed were surgical exploration, curettage, and bone or collagen graft. One bilateral IBC patient showed recurrence of the lesion during follow-up. Grafted bone was integrated into the native mandibular bone without infection. One patient reported necrosis of the mandibular incisor pulp after operation. Conclusion: Differential diagnosis of IBC is difficult, and IBC is often confused with periapical cyst. Surgical exploration and bone graft are recommended for treating IBC. Endodontic treatment of involved teeth should be evaluated before operation. Bone graft is recommended to reduce the healing period.

A 6-YEAR RETROSPECTIVE STUDY ABOUT CYSTS IN THE ORAL AND MAXILLOFACIAL REGION (구강악안면영역의 낭종에 대한 6년간의 후향적 임상 연구)

  • Choi, Guen-Ho;Jang, Jung-Rok;Park, Young-Jun;Moon, Hyea-Won;Kim, Young-Joon;Yu, Min-Gi;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.401-407
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    • 2009
  • Purpose : This study was designed to evaluate the clinical aspect of cysts which arised in the oral and maxillofacial region. Patients and Methods : We reviewed clinical record, radiograph, histopathologic and operative report of 155 patients who had been diagnosed as cysts and treated at the department of oral and maxillofacial surgery in Chonnam National University Hospital from January 2003 to December 2008. Gender, age, classifiaction, anatomic distribution, clinical sign and symptoms, treatment, complications and recurrence rate were studied. Results : 1. Among 155 patients, the male patients(64.5%) were more than the female(35.5%). 2. The average age ofthe patients was 37.2 years(ranging from 5 to 79 years). 3. In pathologic classification, radicular cyst and dentigerous cyst were most common cysts, irrespective of 73 cases(48.3%) and 35 cases(23.2%). 4. The frequently involved cystic regions were followed as mandibular molars(38.1%), and maxillary incisors(30.2%). 5. The frequent sequence of clinical symptoms was edema(29.9%), no symptom(18.9%), tenderness(13.9%), pain(11.5%) and abscess(9.4%). 6. The most prevalent treatment was the combination operation, such as cyst enucleation with extraction or endodontic treatment of the causative tooth(76.8%) 7. Among 155 cases, 2 cases that were treated using enucleation method were recurred(1.3%).

APPLICATION OF INFRARED THERMOGRAPHY IN DENTISTRY (치과에서의 적외선 체열사진의 응용)

  • Lee, Hoon;Kim, Su-Gwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.4
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    • pp.335-341
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    • 2005
  • This study discusses the effects of infrared thermography in dentistry. Infrared thermography allows the quantification of infrared rays and provides useful data for dental care and research. It has been used for the diagnosis of temporomandibular dysfunction (TMD) and proposed as an objective measure of myofascial pain. It is closely related to temperature and produces beneficial objective data. A study of the heat emissions from facial structures has the potential to benefit dental diagnosis of TMD, postoperative inferior alveolar damage, and endodontic and conservative treatments. In this paper, we assessed infrared thermography in dentistry and consider future developments of infrared thermography.

Misdiagnosis of florid cemento-osseous dysplasia leading to unnecessary root canal treatment: a case report

  • Huh, Jong-Ki;Shin, Su-Jung
    • Restorative Dentistry and Endodontics
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    • v.38 no.3
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    • pp.160-166
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    • 2013
  • This case report demonstrates an unnecessary endodontic treatment of teeth with florid cemento-osseous dysplasia (FCOD) due to a misdiagnosis as periapical pathosis and emphasizes the importance of correct diagnosis to avoid unnecessary treatment. A 30-year-old woman was referred to our institution for apicoectomies of the mandibular left canine and both the lateral incisors. The periapical lesions associated with these teeth had failed to resolve after root canal treatment over a 3-year period. Radiographic examinations revealed multiple lesions on the right canine, the second premolar, and both first molars as well as the anterior region of the mandible. Based on clinical, radiographic and histological evaluations, the patient condition was diagnosed as FCOD. The patient has been monitored for 2 years. To avoid unnecessary invasive treatment, accurate diagnosis is essential before treatment is carried out in managing FCOD.

THE PROGNOSIS OF THE TEETH IN THE MANDIBULAR FRACTURE LINES (하악골 골절선상에 위치한 치아의 예후에 관한 연구)

  • Song, Jae-Chul;Chang, Ic-Jun;Chin, Byung-Rho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.5
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    • pp.507-513
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    • 2000
  • Objective : The purpose of this study is to evaluate the vitality of the teeth in and adjacent to the mandibular fracture line according to variable conditions of fracture and to establish the protocol of treatment of fracture line teeth. Materials and Methods : The vitality of 97 teeth in fracture line and 104 teeth adjacent to fracture line of 52 patients were invested preoperatively. Of these, 66 teeth in fracture line and 72 teeth adjacent to fracture line were monitored at least 6 months after operation. An electric pulp tester was used to measure pulpal response. The relationships between the vitality of teeth in variable time(preoperation, immediate post-operation; within 1 week after operation, and 6 months after operation) and variable conditions of fracture(horizontal, vertical gap of fracture line, the number of fracture line)were evaluated statistically. Result : The vitality of fracture line teeth in the 6 months after operation statistically differed by the vertical gap of fracture line and the number of fracture line. The vitality of fracture line adjacent teeth in the immediate post-operation only statistically differed by the vertical gap of fracture line. There were statistically differences between preoperative EPT value and vitality of fracture line teeth on 6 months after operation. There were 5 cases of complications including periapical and periodontal abscess. Of these, only one tooth was extracted and the others were well treated with endodontic treatment and subgingival curettage. Conclusion : It is recommended to retain teeth and to monitor the vitality of teeth in and adjacent to fracture line, unless there is an absolute indication for extraction.

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A CLINICOSTASTICAL STUDY OF ORAL AND MAXILLOFACIAL INFECTED PATIENTS FOR THE LAST 5 YEARS (최근 5년간 구강악안면 감염 환자의 임상통계학적 연구)

  • Jang, So-Jeong;Lee, Yong-Geun;Ahn, Yung;Leem, Dae-Ho;Baek, Jin-A;Shin, Hyo-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.5
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    • pp.401-409
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    • 2006
  • Infections of the oral and maxillofacial region are one of the most common conditions for which a patient presents to a maxillofacial surgeons. Although these infections can arise from a variety of source, dental disease is the most common etiology. So, odontogenic infection are frequently encountered in the practice of oral and maxillofacial surgery. These infections often respond to antimicrobial chemotherapy or surgical intervention, such as extraction of teeth, incision and drainage through clinical features. But, odontogenic infections have the potential to spread via the fascial spaces in the head and neck region, and, they spread to cavernous sinus, deep musculofascial space and other vital structure. We have undertaken clinical studies on infections in the oral and maxillofacial regions by analyzing retrospectively hospitalized patients in the Dept. of Oral and Maxillofacial Surgery, Chonbuk National University Hospital past 5 years from 2000 to 2004. And, the patients' age, sex, medical history, causes of the infection, surgical intervention, and other clinical parameters were reviewed. The obtained results were as follows : 1. The most frequent cause of oral and maxillofacial infection was odontogenic. And in the odontogenic cause, dental caries was the most common cause (47.2%). 2. The most common fascial space involved was the submandibular space (15.7%), followed by the buccal space (14.8%). 3. 60.4% of all patients required surgical drainage of the abscess, endodontic treatment or tooth extraction or periodontal treatment with drainage. 4. The most causative organism isolated from the pus culture were streptococcus viridans (53.9%). 5. Underlying medical problems were found in 136 patients (41.9%), the most common being hypertension (27.9%) and diabetes (14.7%).

A STUDY ON THE DISTRIBUTION OF PARENTAL CONSULTATION ON THE WEBSITE OF KOREAN ACADEMY OF PEDIATRIC DENTISTRY (대한소아치과학회 홈페이지에 오른 진료상담 내용의 분석)

  • Oh, Young-Jun;Min, Yun-Kyung;Jung, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.3
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    • pp.439-443
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    • 2002
  • The purpose of this study was to analyze the parental consultation. Also, it was to investigate the tendency divided into different subjects. The subjects were 2142 questions on korean academy of pediatric dentistry homepage. The questions were categorized into 7 subjects, 37 subdivided subjects and children age. The results were as follows: 1. Age group was divided into $0{\sim}6months$, $7{\sim}12months$, $13{\sim}24months$, $25{\sim}36months$, $3{\sim}6years$, $7{\sim}12years$ 12years and over 13 years. $13{\sim}24months$ and $3{\sim}6years$ age group had the largest number of questions. 2. The subject were growth & development, development disturbance & oral disease, behavior management, operative & endodontic treatment, dentition & occlusal guidance, traumatic injury & surgery and etc. Development disturbance & oral disease had the largest number of questions. 3. In subdivided subjects, operative & endodontic treatment showed the most, followed by development & eruption of teeth, traumatic injury, cross-bite, tooth brushing methods in sequence. 4. In age group within subdivided subjects, the most frequent question was neonatal & natal tooth in $0{\sim}6months$, development & eruption of teeth in $7{\sim}12months$, $13{\sim}24months$, operative & endodontic treatment in $25{\sim}36months$, $3{\sim}6years$, time & method of orthodontics in $7{\sim}12years$ and operative & endodontic treatment in over 13years. 5. The questions about cross-bite, traumatic injury and soft tissue disease were distributed evenly in age group.

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Multislice computed tomography demonstrating mental nerve paresthesia caused by periapical infection: A case report

  • Yong-Min Kim;Ho-Keun Choi;Jo-Eun Kim;Jeong-Joon Han;Kyung-Hoe Huh
    • Imaging Science in Dentistry
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    • v.54 no.1
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    • pp.115-120
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    • 2024
  • Components derived from an infected lesion within the bone can spread through various passages in the mandible, particularly via the mental foramen. Radiologically, the spread of infection is typically nonspecific and challenging to characterize; however, multislice computed tomography (MSCT) can effectively detect pathological changes in soft tissues and the bone marrow space. This report describes the case of a 55-year-old woman who experienced mental nerve paresthesia due to a periapical infection of the right mandibular second premolar. MSCT imaging revealed increased attenuation around the periapical lesion extending into the mandibular canal and loss of the juxta-mental foraminal fat pad. Following endodontic treatment of the tooth suspected to be the source of the infection, the patient's symptoms resolved, and the previous MSCT imaging findings were no longer present. Increased bone marrow attenuation and obliteration of the fat plane in the buccal aspect of the mental foramen may serve as radiologic indicators of inflammation spreading from the bone marrow space.

STRESS REDUCTION PROTOCOL FOR PROPER EXTRACTION OF ADVANCED INFECTED TEETH IN MEDICALLY COMPROMISED PATIENTS : REVIEW OF LITERATURE & REPORT OF CASES (전신질환자에서 과도한 감염치아 발치시 스트레스 감소법 : 문헌적 고찰 및 증례보고)

  • Yoo, Jae-Ha;Choi, Byung-Ho;Hong, Soon-Jae;Nam, Woong;Kim, Jong-Bae;Yoon, Jung-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.1
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    • pp.85-92
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    • 2000
  • Common dental procedures(dental extraction & minor operation) are potentially stress-inducing in many patients, especially medically compromised patients. 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 to the medical risk patient, the stress reduction protocol 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 higher medical risk patient later on the same day that treatment was given Though the stress reduction protocol above was applied to the dental extraction in medically compromised patients with the advanced infected teeth, the final responsibility for the complications(syncope, bleeding & infection, etc.) in a patient rests with the dentist who ultimately treats him. For the prevention of postextraction complications & poor prognosis, the authors treated the advanced infected teeth with the pulp extirpation, opening drainage through the canal and complete occlusal reduction. The final extraction and wound closure were then done after $1{\sim}2$ weeks. The final prognosis was comfortable without common complications.

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Early complications and performance of 327 heat-pressed lithium disilicate crowns up to five years

  • Huettig, Fabian;Gehrke, Ulf Peter
    • The Journal of Advanced Prosthodontics
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    • v.8 no.3
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    • pp.194-200
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    • 2016
  • PURPOSE. The prospective follow-up aimed to assess the performance of lithium disilicate crowns and clinical reasons of adverse events compromising survival and quality. MATERIALS AND METHODS. 58 patients were treated with 375 heat-pressed monolithic crowns, which were bonded with resin cement. Annual recalls up to five years included a complete dental examination as well as quality assessment using CDA-criteria. Any need for clinical intervention led to higher complication rate and any failure compromised the survival rate. Kaplan-Meier-method was applied to all crowns and a dataset containing one randomly selected crown from each patient. RESULTS. Due to drop-outs, 45 patients (31 females, 14 males) with the average age of 43 years (range = 17-73) who had 327 crowns (176 anterior, 151 posterior; 203 upper jaw, 124 lower jaw) were observed and evaluated for between 4 and 51 months (median = 28). Observation revealed 4 chippings, 3 losses of retention, 3 fractures, 3 secondary caries, 1 endodontic problem, and 1 tooth fracture. Four crowns had to be removed. Survival and complication rate was estimated 98.2% and 5.4% at 24 months, and 96.8% and 7.1% at 48 months. The complication rate was significantly higher for root canal treated teeth (12%, P<.01) at 24 months. At the last observation, over 90% of all crowns showed excellent ratings (CDA-rating Alfa) for color, marginal fit, and caries. CONCLUSION. Heat pressed lithium disilicate crowns showed an excellent performance. Besides a careful luting, dentists should be aware of patients' biological prerequisites (grade of caries, oral hygiene) to reach full success with these crowns.