• Imaging Science in Dentistry
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• v.33 no.2
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• pp.71-77
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• 2003

Purpose : To evaluate and compare the efficacy of digital radiographic images in the detection of bone loss at the bifurcation area of the mandibular first molar with traditional film-based periapical radiographs, Materials and Methods : One dried human mandible with minimal periodontal bone loss around the first molar was selected and an artificial alveolar bone defect at the bifurcation area was serially prepared over 18 steps. Images were taken using a direct CCD-based system and with F-speed periapical films. The images were evaluated by seven interpreters (3 radiologists, 3 periodontologists, and 1 general dentist) using a 5-point confidence rating scale. Results : The readability of both periapical radiographs and digital image increased as the size of the artificial lesion and exposure time increased (p < 0.05). Periapical radiographs offered greater readability of smaller bone defects than digital images, and the coefficient of variation of mean score between periapical radiographs and digital images showed a significant difference. Conclusion : The experimental results indicate that a significant difference in the coefficient of variation of mean score exists between periapical radiographs and digital images, and that traditional film-based periapical images offer greater readability of smaller bone defects than digital images can presently offer.

• Imaging Science in Dentistry
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• v.44 no.1
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• pp.31-35
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• 2014

Purpose: This study was performed to investigate the effect of image enhancement of periapical radiographs according to the diagnostic task. Materials and Methods: Eighty digital intraoral radiographs were obtained from patients and classified into four groups according to the diagnostic tasks of dental caries, periodontal diseases, periapical lesions, and endodontic files. All images were enhanced differently by using five processing techniques. Three radiologists blindly compared the subjective image quality of the original images and the processed images using a 5-point scale. Results: There were significant differences between the image quality of the processed images and that of the original images (P< 0.01) in all the diagnostic task groups. Processing techniques showed significantly different efficacy according to the diagnostic task (P< 0.01). Conclusion: Image enhancement affects the image quality differently depending on the diagnostic task. And the use of optimal parameters is important for each diagnostic task.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.29 no.1
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• pp.261-274
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• 1999

Objectives: The purpose of this study was to evaluate the optimal distance and angle of observers by modulation transfer functions(MTFs) and receiver operating characteristics(ROCs), Material and Methods: Digital periapical radiograms were taken from 43 patients who have dental diseases(19 patients : dental caries. 12 patients : periapical lesions, 12 patients : periodontal diseases). Segmental images(4×4cm) were evaluated by 4 MTFs and ROC analysis. Results: The optimal distance(magnification) using MTF by Mannos & Sakrison was 12.97. and those by Nill. Ngan and Rao were 8.39, 4.78. 5.84 respectively. The optimal distance obtained from 4 radiologists by ROC analysis was 32cm(Az value: 0.89). and it was 40cm(Az value: 0.78) from 4 non-radiologists. There were significant differences of Az values between 4 radiologists and 4 non-radiologists at 24. 32 and 40cm (P<0.05). No significant differences of optimal distances were observed using 4 MTFs among +20, +10, 0, -10, -20 degrees(P>0.05). The optimal angle obtained from 4 radiologists by ROC analysis was +20 degree(Az value: 0.91). and no significant differences of Az values were observed among +20, +10, 0, -10 and -20 degrees(P>0.05). The optimal angle obtained from 4 non-radiologists by ROC analysis was 0 degree(Az value : 0.81). and no significant differences of Az values were observed among +20, +10, 0, -10 and -20 degrees(P>0.05). And there was significant difference of Az value between 4 radiologists and 4 non-radiologists at +20 degree(P<0.05). but no significant differences of Az values were observed among +10, 0, -10 and -20 degrees(P>0.05).

• Imaging Science in Dentistry
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• v.44 no.2
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• pp.115-119
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• 2014

Purpose: The aim of this in vitro study was to determine the sensitivity and specificity of cone-beam computed tomography (CBCT) and digital periapical radiography in the detection of mesial root perforations of mandibular molars. Materials and Methods: In this in vitro study, 48 mandibular molars were divided into 4 groups. First, the mesial canals of all the 48 teeth were endodontically prepared. In 2 groups (24 teeth each), the roots were axially perforated in the mesiolingual canal 1-3 mm below the furcation region, penetrating the root surface ("root perforation"). Then, in one of these 2 groups, the mesial canals were filled with gutta-percha and AH26 sealer. Mesial canals in one of the other 2 groups without perforation (control groups) were filled with the same materials. The CBCT and periapical radiographs with 3 different angulations were evaluated by 2 oral and maxillofacial radiologists. The specificity and sensitivity of the two methods were calculated, and P<0.05 was considered significant. Results: The sensitivity and specificity of CBCT scans in the detection of obturated root canal perforations were 79% and 96%, respectively, and in the case of three-angled periapical radiographs, they were 92% and 100%, respectively. In non-obturated root canals, the sensitivity and specificity of CBCT scans in perforation detection were 92% and 100%, respectively, and for three-angled periapical radiographs, they were 50% and 96%, respectively. Conclusion: For perforation detection in filled-root canals, periapical radiography with three different horizontal angulations would be trustworthy, but it is recommended that CBCT be used for perforation detection before obturating root canals.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.1-12
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• 1999

Bacterial infection of the pulp results in the development of a periapical lesion with the concomitant resorption of periapical bone. The cytokines are believed to play an important role in this matter. The purpose of this study was to find the relationship among the presence of black pigmented bacteria, the levels of cytokines(TNF-${\alpha}$, -${\beta}$, IL-$1{\beta}$, and TGF-${\beta}1$), and the amount of bone resorption in periapical and pulpal diseases. For the purpose, the patients were grouped into chronic apical pathosis, acute apical pathosis, acute pulpitis, and a healthy control group. Root canal samples were taken from periapical tissue exudates during routine endodontic treatment, and the venous blood was taken from each patients. The samples were processed to measure local and systemic levels of the cytokines using enzyme linked immunosorbent assay(ELISA). Bacterial content of Porphyromonas endodontalis, Porphyromonas gingivalis, and Prevotella nigrescens were measured by indirect immunofluorescence method and the size of the periapical lesions were measured from the radiographs. The following results were obtained: 1. The levels of bone resorptive cytokines(TNF-${\alpha}$, TNF-${\beta}$, and IL-$1{\beta}$) in exudates from acute and chronic apical pathoses were significantly higher than those from acute pulpitis and the normal pulps(p<0.05). 2. IL-$1{\beta}$ were the highest among the bone resorptive cytokines in apical pathoses. However, no statistical difference between acute and chronic lesions were found(p>0.05). 3. The levels of TGF-${\beta}1$ in exudates from acute pulpitis and chronic apical pathoses were significantly higher than those from acute apical pathoses and the normal pulps(p<0.05). However, there were no significant correlations among the levels of bone resorptive cytokines. 4. The levels of TNF-${\beta}$ in serum were significantly higher than those from the exudates while serum TGF-${\beta}1$ concentrations were significantly lower(p<0.05). 5. Exudates from the canals in which the P. nigrescens were detected showed significantly higher levels of IL-$1{\beta}$ than those from the canals without the microorganism(p<0.05). 6. There were no significant correlations among the levels of the cytokines, the amount of bone destruction, and the presence of acute and chronic symptoms(p>0.05).

• The Journal of the Korean dental association
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• v.52 no.7
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• pp.408-415
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• 2014

Peri-implant diseases are inflammatory lesions, which include peri-implant mucositis and peri-implantitis. Peri-implant mucositis is described as the presence of inflammation in the mucosa around implants without any bone loss. By contrast, in peri-implantitis, besides the inflammation in the peri-implant mucosa, loss of supporting bone is also seen. Diagnosis of peri-implant diseases require the use of gentle probing(0.2 ~ 0.3N) to identify the presence of bleeding on probing, probing depth and suppuration, both signs of clinical inflammation. Radiographs are required to detect loss of supporting bone. Baseline probing measurements and high quality, long cone periapical radiographs should be obtained once the restoration of the implant is completed to make possible longitudinal monitoring of peri-implant tissue.

• Imaging Science in Dentistry
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• v.37 no.2
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• pp.83-86
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• 2007

Purpose : To evaluate the efficacy of panoramic radiography by comparing the results of clinical examination with radiographic findings. Materials and Methods: We studied 190 patients (20 men and 170 women; mean age, 40 years; range, 22 to 68 years) who visited the health promotion center of Korea Medical Science Institute and were examined both clinically and by panoramic radiography. We compared results from both examinations. Treatment options by clinical examination were described as "no treatment indicated", "treatment of dental caries", "removal of calculus", "treatment of periodontal disease", "prothodontic treatment" and "extraction of the third molar". Findings taken from the panoramic radiography were: dental caries, periapical lesion, alveolar bone loss, calculus deposition, retained root, impaction of the third molar, disease of maxillary sinus, bony change of mandibular condyle, etc. Results: The prevalence of panoramic findings were: 37.9% of dental caries, 17.4% of periapical lesions, 44.7% of alveolar bone losses, 62.6% of calculi deposition, 7.9% of retained roots, 26.8% of third molar impactions, 6.3% of diseases of maxillary sinus, 2.1 % of bony changes of mandibular condlye and 35.8% of miscellaneous lesions. Abnormal conditions revealed by panoramic radiography which had not been discovered on clinical examination were: 24.2% of the patients had dental caries, 17.4% had periapical lesions, 7.4% had calculi deposition, 5.3% had retained roots, 15.3% had third molar impactions. The opposite cases were: 5.2% had dental caries, 12.6% had calculi deposition, and 9.5% had third molar impactions. Conclusion: The use of panoramic radiography as a supplement to the clinical examination might be a valuable screening technique.

• 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.

• Restorative Dentistry and Endodontics
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• v.20 no.2
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• pp.549-576
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• 1995

Bacteria are one of the most important causative agents of the pulpal and periapical diseases. Streptococci are one of the most frequently isolated facultative anarerobic bacteria in the infected root canals. Bacterial cell wall components have a direct effect in the pathogenesis of the pulpal and periapical infections. Hyaluronidase produced by bacteria has been implicated in dissemination of the diseases. The purpose of this study was to evaluate the effect of cell wall extract of streptococci on the L929 cells using inverted microscope and the transmission electron microscopy (TEM). Hyaluronidase production of streptococcal strains were investigated to determine the correlation between the severity of cell damage and the activity of enzymes. Bacterial cell wall extracts of S. sanguis, S. mitis and S. uberis isolated from infected root canals and ATCC type strains of S. mutans (ATCC 10449) and E. faecalis (ATCC 19433) were prepared by sonication and confirmed with SDS-PAGE. Silver stain of SDS-PAGE of sonic extract was efficient at $100{\mu}g$/ml concentration of cell wall protein, while Coomasie blue stain was efficient at $100{\mu}g$/ml concentration. Inverted microscope showed that sonic extract-treated L929 cells were round and detached from the substratum while others lost their fibroblastic shapes. Transmission electron microscopic examination revealed that streptococcal extracts induced death of L929 cells. Sonic extracts of streptococci had variable effect on microstructure of L929 cells. significant chromatin condensation was observed in the nucleus of the cells. Disappearance of cell surface microvilli and nuclear fragments with dense chromatin were observed. The cell nucleus had an irregular shape and numerous large vacuoles were seen in the cytoplasm and some breaks of the cell membrane could be seen. Cell organelles were in various stages of destruction and cristae of mitochondria were disoriented or disappeared. Eighteen strains of streptococci did not produce hyaluronidase.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.2
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• pp.150-157
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• 2015

The purpose of this report is to suggest clinical managements of implant periapical lesions by presenting three clinical cases managed by either the infected form or the inactive form with the follow-up period of five to twelve years. One patient with no clinical symptom was regarded as inactive form. Two patients having pain were regarded as infected form and have been under the systemic antibiotic therapy. In one patient, the symptom subsided and the size of radiolucent lesion decreased. However, the other patient showed increased size of lesion causing the implant unstable, which leaded to remove the implant and to replace it. There was neither additional increase of the lesion nor functional problem for all three. It is important to detect implant periapical lesion in early stage before jeopardizing the stable implant and manage properly using systemic antibiotic therapy and surgical approach if needed, depending on infected form and inactive form.