• Journal of Oral Medicine and Pain
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• 제25권2호
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• pp.235-240
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• 2000

This study was carried out among 34 patients who visited Yonsei Dental Hospital from 1996. 1. to 1999. 5 for trigeminal neuralgia. By studying the patient's treatment prior to visiting our hospital, features of trigeminal neuralgia, treatment process of trigeminal neuralgia, prognosis of treatment, consultation with other professions and involvement of surgery, etc., the results are as follows: 1. 67.7% of onset age range from 40s to 60s, and average age is 50.2. 2. Ratio of right to left involvement is 1:2.1, male to female ratio is 1:1.9. 3. Occurrence rate of each branch is V3(44.1%), V2(11.8%), V1+V2+V3(11.8), V1+V2(8.8%). 4. Treatments prior to admission to our hospital are extraction(5.9%), endodontic treatment(5.9%), medication(11.8%), Oriental Medicine treatment(5.9%). 5. Routes of admittance to our hospital are by their preference(55.9%), local clinic referral(32.4%), E.N.T referral(5.9%), Neurology referral(5.9%). 6. 70.6% of patients treated at our hospital who were relieved of symptoms, were referred to Neurology(66.7%) and Pain Clinic(33.3%) for the reason of relapse, side effects of the drug itself, incomplete relief of pain. 7. 2 patients who were referred to medical part showed brain vessels contacting trigeminal nerve root on Brain MRangiography. But pain is being controlled by medication and no specific surgical procedure was carried out. The results show that 17.7% of patients admitted received inappropriate early treatment. In order to relieve tooth loss and patient's psychologic stress due to inappropriate treatment, precise differential diagnosis must be made among local teeth disease and idiopathic facial pain. Medication may show side effects of the drug itself, incomplete relief of pain or relapse of symptoms. Therefore, to treat trigeminal neuralgia appropriately by drug injection, surgery or radiation therapy, consultations among dentists, neurologists and anesthesiologists are required.

• Restorative Dentistry and Endodontics
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• 제44권1호
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• pp.8.1-8.7
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• 2019

Objectives: Irrigants are imperative in endodontic therapy for the elimination of pathogens from the infected root canal. The present study compared the antimicrobial efficacy of octenidine dihydrochloride (OCT) with chlorhexidine (CHX) and sodium hypochlorite (NaOCl) against Staphylococcus epidermidis (S. epidermidis) for root canal disinfection. Materials and Methods: The minimum inhibitory concentration (MIC) was obtained using serial dilution method. The agar diffusion method was then used to determine the zones of inhibition for each irrigant. Lastly, forty 6-mm dentin blocks were prepared from human mandibular premolars and inoculated with S. epidermidis. Samples were randomly divided into 4 groups of 10 blocks and irrigated for 3 minutes with saline (control), 2% CHX, 3% NaOCl, or 0.1% OCT. Dentin samples were then collected immediately for microbial analysis, including an analysis of colony-forming units (CFUs). Results: The MICs of each tested irrigant were 0.05% for CHX, 0.25% for NaOCl, and 0.0125% for OCT. All tested irrigants showed concentration-dependent increase in zones of inhibition, and 3% NaOCl showed the largest zone of inhibition amongst all tested irrigants (p < 0.05). There were no significant differences among the CFU measurements of 2% CHX, 3% NaOCl, and 0.1% OCT showing complete elimination of S. epidermidis in all samples. Conclusions: This study showed that OCT was comparable to or even more effective than CHX and NaOCl, demonstrating antimicrobial activity at low concentrations against S. epidermidis.

• Journal of Periodontal and Implant Science
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• 제51권2호
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• pp.135-143
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• 2021

Purpose: To investigate factors affecting the antagonistic and adjacent teeth in patients after implant restoration and prosthetic rehabilitation. Methods: In total, 160 patients who visited Kyungpook National University Dental Hospital for implant surgery, prosthesis placement, and supportive periodontal therapy (SPT) were included in this study. The average follow-up period was 88.06 months, and the maximum was 175 months. Patients' history of smoking, diabetes, hypertension, and osteoporosis was investigated, and panoramic radiographs were taken after surgery and prosthetic treatment. During the follow-up period, extraction and prosthetic/endodontic treatments of the antagonistic and adjacent teeth were analyzed. The statistical analyses were performed using descriptive statistics, the chi-square test, the Fisher exact test, and multiple logistic regression analyses. Results: Treatment was performed on 29.4% of the studied antagonistic teeth with extraction performed in 20.0% and prosthetic treatment in 10.0%. Furthermore, 19.4% of the studied adjacent teeth underwent treatment, of which extraction was performed in 12.5% and prosthetic treatment in 7.5%. The treatment rate for adjacent teeth was 25.3% in smokers, which was higher than that of non-smokers (12.3%) (P=0.039). Patients who were non-adherent to SPT showed a significantly higher rate (19.6%) of antagonistic prosthetic treatment than did those who were adherent (5.5%) (P=0.006). Conclusions: Implant restoration can affect the adjacent and antagonistic teeth. Smoking, osteoporosis history, and absence of SPT may be risk factors for the treatment of the adjacent and antagonistic teeth.

• Restorative Dentistry and Endodontics
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• 제47권3호
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• pp.33.1-33.10
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• 2022

Objectives: This study aimed to analyze the proximity of maxillary molar roots to their overlying cortical bone surfaces and the maxillary sinus. Materials and Methods: Cone-beam computed tomographic images of 151 patients with completely erupted upper molars that had 3 separate roots were studied. The following distances were measured: from the root apex to the cortical plate and maxillary sinus floor, and from the apical 3-mm level of the root to the cortical plate. Differences between groups were analyzed with 1-way analysis of variance and the Scheffé post hoc test, the significance of differences between cone-beam computed tomography views with the paired t-test, and the significance of differences among age groups with linear regression analysis. The significance level was set at p < 0.05. Results: The mesiobuccal and distobuccal root apexes of maxillary second molars were more distant from the buccal cortical plate than the maxillary first molars (p < 0.05). The apical 3-mm level of the mesiobuccal root of the first molar was closer to the buccal cortical bone than the second molar (p < 0.05). In the maxillary first molars, the thickness of the buccal cortical bone decreased in all roots with age (p < 0.05). In all root apexes of both molars, the difference in the vertical level between the maxillary sinus floor and the root apex increased with age (p < 0.05). Conclusions: Awareness of the anatomical profile of maxillary molar apices in relation to the cortical bones and maxillary sinus will be beneficial for apical surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권4호
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• pp.679-700
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• 1996

Inferior alveolar nerve dysfunction may be the result of trauma, disease, or iatrogenic injury. Inferior alveolar nerve injury is inherent risk in endodontic therapy, orthognathic surgery of the mandible, and extraction of mandibular teeth, particularly the third molars. The sensory disturbances of inferior alveolar nerve associated with such injury have been well documented clinical problem that is commonly evaluated by several clinical sensory test including Tinels sign, Von Frey test(static light touch detection), directional discrimination, two-point discrimination, pin pressure nociceptive discrimination, and thermal test. These methods used to detect and assess inferior alveolar nerve injury have been subjective in nature, relying on the cooperation of the patients. In addition, many of these techniques are sensitive to differences in the examiners experience and skill with the particular technique. Data obtained at different times or by different examiners are therefore difficult to compare. Prior experimental studies have used electro diagnostic methods(sensory evoked potential) to objectively evaluate inferior alveolar nerve after nerve injury. This study was designed with inferior alveolar nerve of rabbit. Several types of injury including mind, moderate, severe compression and perforation with 19 gauze, 21 gauze needle and 6mm, 10mm traction were applied for taking the sesory evoked ppterntial. Latency and amplitude of injury rabbit inferior alveolar nerve were investigated with sensory evoked potential using unpaired t-test. The results were as follows : 1. Intensity of threshold (T1) was $128{\pm}16{\mu}A$ : latency, $0.87{\pm}0.07$ microsecond : amplitude, $0.4{\pm}0.1{\mu}V$ : conduction velocity, 23.3 m/s in sensory evoked potential of uninjured rabbit inferior alveolar nerve. 2. Rabbit inferior alveolar nerve consists of type II and III sensory nerve fiber. 3. Latency was increased and amplitude was decreased in compression injury. The more injured, the more changed in latency and amplitude. 4. Findings in perforation injury was similar to compression injury. Waveform for sensory evoked potential improved by increasing postinjured time. 5. Increasing latency was prominent in traction injury rabbit inferior alveolar nerve. 6. In microscopic histopathological findings, significant degeneration and disorganization of the internal architecture were seen in nerve facicle of severe compression and 10mm traction group. From the above findings, electrophysiological assessment(sensory evoked potential) of rabbit injured inferior alveolar nerve is reliable technique in diagnosis and prognosis of nerve injury.

• 구강회복응용과학지
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• 제23권1호
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• pp.85-93
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• 2007

The purpose of this study was to evaluate the microleakage of root-end filling material filled in blood contaminated root-end cavity and self-etching adhesive placed over blood contaminated resected root apices without root-end preparation. Extracted, human maxillary incisors, canines and mandibular premolar were randomly divided into four groups of 15 teeth each. After canal preparation, resection of the apex and root-end preparation, MTA and IRM were filled in the root-end cavity (A and B group). After canal preparation and resection of the apex, Clearfil SE Bond and Prompt L-Pop were applied over the contaminated root-end surfaces (C and D group). The roots were then subjected to 15cm of water pressure to simulate periapical microleakage stress. Data were analyzed using one-way ANOVA. The results were as follows : 1. All groups showed a tendency of decreasing microleakage in process of time after 2weeks later except IRM group. 2. After 2 weeks and 1 month, MTA group showed less microleakage significantly than other groups(p<0.05). After 2 months, Prompt L-Pop group showed less microleakage significantly than other groups(p<0.05). 3. After 9 months, there were no significant differences among four groups(p>0.05). Thus it is considered that apical sealing using adhesives system without root-end preparation is good method in endodontic surgery.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권2호
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• pp.123-129
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• 2016

Background: The objective of the present study was to examine the status of patients who had received dental treatment under intravenous (IV) sedation at Chungnam Dental Clinic for the Disabled in Korea from its inception to the present time, and to review the analysis results. Methods: Retrospective analysis was performed on 305 cases of patients who had received dental treatments under IV sedation between January 2011 and May 2016. The analysis examined the patient's sex, age, primary reason for IV sedation, duration of anesthesia and dental treatment, type of dental treatment performed, number of clinical departments involved in the dental treatment and level of multidisciplinary cooperation, and annual trends. Results: Most dental treatments using intravenous sedation were performed on medically disabled patients or dentally disabled patients with an extreme gag reflex or dental phobia. The mean duration of IV sedation was 72.5 min, while the mean duration of treatment was 58.0 min. The types of dental treatments included surgical treatment (n = 209), periodontal treatment (n = 28), prosthodontic treatment (n = 28), restorative treatment (n = 23), implant surgery (n = 22), endodontic treatment (n = 9), reduction of temporomandibular joint dislocation (n = 1), and treatment of traumatic injuries (n = 1), with treatments mostly performed on adult patients. Conclusions: With increasing demand for minimally painful treatment, cases using IV sedation are on an upward trend and are expected to continue to increase.

• Journal of Periodontal and Implant Science
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• 제36권4호
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• pp.809-816
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• 2006

Periodontal disease accompany the inflammation around periodontal tissue and generally periodontal destruction is followed, This destruction often makes the molar teeth have furcation defect. And to treat molar furcation involvement, resective surgery such as root resection and ostectomy and regenerative procedure such as guided tissue regeneration were introduced. Also implant can be considered as one of the good treatment methods, Among these treatment alternatives, root resection can be considered as a good procedure in the point of saving one's natural teeth or amount of cost. Therefore the purpose of this article is to evaluate root-resected teeth which were done at least 2 years ago. 70 root-resected teeth in 58 patient who visited Kyungpook National University Hospital were included in this study. They were evaluated by two clinical method. One is subjective evaluation and another is objective evaluation. To evaluate subjective outcome, 58 patients answered to the questionnaire if they experienced tooth extraction, bleeding, swelling, pain, mobility and chewing problem. To evaluate objective outcome, 28 teeth was evaluated according to Langer's criteria. The subjective result showed 82% of success rate and 18% of failure rate. 13 of 70 teeth showed discomfort and were considered as failure, which include chewing problem (39%) and pain (23%). The objective outcome showed that 4 failure (14% failure rate) which were 2 cases of bone loss by periodontal problem, one endodontic problem and one untreatable caries. By these limited results, some of clinical consideration in root resective procedure can be suggested. Periodontal support and less occlusal loading on resected tooth should be evaluated before the procedure, moreover, good oral hygiene is essential. When these factors are considered carefully, the root resection may produce predictive outcomes in the treatment of furcational involvement.

• Restorative Dentistry and Endodontics
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• 제17권1호
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• pp.83-94
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• 1992

This study was executed to measure the biosynthesis of arachidonic acid metabolic products in chronic periapical lesions, to compare the products among periapical granuloma, periapical cyst and chronic periapical abscess, and to understand the pathogensis of chronic periapical lesions. Tissues from 33 chronic periapical lesions of human teeth were enucleated during endodontic surgery. large part of each tissue was contained in liquid nitrogen immediately and the other was examined histologically. In histologically diagnosed 8 cases of periapical granuloma, 9 cases of periapical cyst and 8 cases of chronic periapical abscess. the tissues were homogenatecl and incubated with $_{14}C$-arachidonic acid. Lipid solvent extracts were separated by thin layer chromatography to be analyzed by autoradiography and TLC analyzer. 1. $TXB_2$, 6-keto-$PGF_1{\alpha}$ and $PGE_2$, $LTB_4$, HETEs, and unidentified product which are metabolic products of arachidonic acid were measured in the tissues of chronic peripaical lesions. 2. In all of periapical granuloma, cyst and abscess, the conversion rate of HETEs among all products was the highest(P<0.05), and the percentage of HETEs in total converted products was also the highest(P<0.05). 3. The concentration of each arachidonic acid product was higher in chronic periapical absecss than in periapical granuloma and cyst(P<0.05). The concentration of $TXB_2$ and HETEs in periapical cyst were hight than in periapical granuloma. 4. The relative amounts of total products from lipoxygenase pathway to those from cyclo-oxygenase pathway were about 7 fold in chronic periapical lesions. There was no difference among periapical granuloma, cyst and abscess(P<0.05). The total amount of products from each pathway were higher in chronic periapical abscess than in periapical cyst and granuloma.

• Restorative Dentistry and Endodontics
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• 제25권2호
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• pp.193-201
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• 2000

Prostaglandins (PGs) and Leukotrienes (LTs) have been implicated in the genesis of pulpal and periapical inflammation. In this study, the relationships among $PGE_2$, 6-keto-PG $F_1{\alpha}$ (a stable metabolite of $PGI_2$) and $LTB_4$ concentrations in inflamed pulp and periapical lesions were discussed. Pulp tissue were obtained in routine endodontic treatment and periapical lesions in periapical surgery after clinical diagnoses were made. These specimens were divided into four groups as normal pulp group (Control group), acute pulpitis group, chronic pulpitis group, and periapical lesion group. Pulp tissue and periapical lesions were stored in liquid nitrogen. The concentration of $PGE_2$, $PGI_2$ and $LTB_4$ were measured with ELISA. The data were analyzed by one-way ANOVA. Significantly higher levels of $PGE_2$, 6-keto-PG $F_1{\alpha}$ a and $LTB_4$ were found in acute pulpitis group than chronic pulpitis group and periapical lesion group(p<0.05). Periapical lesion group showed significantly higher mean concentrations of $PGE_2$ and $LTB_4$ than chronic pulpitis group. In control and chronic pulpitis group, significant higher levels of $PGI_2$ than $PGE_2$ and $LTB_4$ were found. These results suggested that the high levels of $PGE_2$ and $LTB_4$ in periapical lesions may be due to rich endothelium., fibroblast and lymphocyte known as the main producers of $PGE_2$ and $LTB_4$. $PGI_2$ may be thought to one of the most abundant PGs in normal pulp tissue.