• 대한소아치과학회지
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• 제34권2호
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• pp.329-334
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• 2007

유치의 치수감염은 주로 치아우식증이나 외상에 의해 발생한다. 유치의 치수 감염을 적절히 치료하지 않으면, 계승영구치의 법랑질 형성 부전이나 매복, 치배의 위치 변화, 치근 만곡 등의 합병증을 초래한다. 유치의 치근단 병소에 의한 계승영구치는 여러 방향으로 변위가 가능하다. 변위된 계승영구치의 치료법으로는 유치 발거 후 주기적 관찰, 외과적인 노출, 교정적 견인, 치아이식, 영구치의 발거 등이 있다. 본 증례들에서는 초진시 임상적 및 방사선학적 검사 결과, 유전치의 치근단 병소에 의해 변위된 영구치 치배가 관찰되었다. 변위 정도와 치근 발육 정도, 맹출 방향 등을 고려하여 유치 발거 후 변위된 영구치의 자발적 맹출 유도를 기대하였다. 두 증례에서 유치의 발거 후 주기적 관찰만으로 변위된 영구치의 자발적 맹출의 결과를 얻을 수 있었다.

• 대한소아치과학회지
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• 제4권1호
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• pp.35-38
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• 1977

The study was performed to evaluate effects of Conservative treatment between amalgam filling and stainless steel crown. The selected subjects for this study was 350 children who have amalgam filling or stainless steel crown. The obtained results are as followings. 1. In amalgam filling teeth, 120 teeth (60.0%) showed marginal leakage, 57 teeth (28.5%) showed fracture of filling material and 28 teeth (14.0%) teeth showed periapical lesion. 2. In crowned teeth, 6 teeth (3.0%) showed hole on the surface of crown, 29 teeth (14.5%) showed avulsion of crown and 10 teeth (5.0%) showed periapical lesion. 3. After 12 months from examining date, 69 teeth (34.5%) showed sound condition in amalgam filling teeth and 155 teeth (75.2%) showed sound condition in crowned teeth.

• 대한소아치과학회지
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• 제34권2호
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• pp.335-340
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• 2007

적절히 치료받지 못한 유치의 치수 감염은 치근단 주위로 확산되고 그 치근단 병소는 계승 영구치의 조기 맹출, 법랑질의 저형성이나 저석회화, 발육정지 등의 합병증을 야기할 수 있다. 특히 유치의 치근단 감염은 계승치의 변위를 야기할 수 있으며, 계승 영구치배의 위치변화는 선행 유치의 치수변성으로 인한 것이 가장 많다. 본 증례보고는 하악 유구치의 치근단 병소에 의해 계승치가 변위된 경우로서, 증례 1은 하악 우측 유구치 하방의 치근단 낭에 의한 계승치의 변위가 관찰되어 유치 발치 및 조대술을 시행한 후 obturator를 장착하였고, 증례 2는 하악 우측 제2유구치 하방의 치근단 농양에 의한 계승치의 변위가 관찰되어 유치를 발거하고 공간유지장치를 장착하였다. 본 증례를 통하여 하악 유구치 치근단 병소에 의해 계승 영구치가 심한 변위을 나타낸 경우, 적절한 치료를 통해 계승 영구치의 적절한 맹출을 유도할 수 있었기에 보고하는 바이다.

• 대한소아치과학회지
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• 제32권2호
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• pp.224-228
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• 2005

유치의 치수 감염을 적절히 치료하지 않으면 영구 계승치의 저형성이나 저석회화 같은 법랑질 형성부전, 치배의 위치변화, 맹출 부진이나 맹출 정지 같은 많은 합병증을 초래할 수 있다. 이 중에서도 계승 영구치배의 위치변화는 선행 유치의 변성된 치수로 인한 위치변화가 가장 많다. 본 증례는 조선대학교 치과병원 소아치과에 내원한 환아 중 유전치의 치근단 병소로 인해 계승영구전치 치배의 위치변화가 초래된 것으로 사료되어 유치 치료의 중요성을 문헌고찰과 함께 보고하는 바이다.

• 대한소아치과학회지
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• 제38권1호
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• pp.82-87
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• 2011

유치의 치수 감염에 대한 적절한 치료가 이루어지지 않거나 치료가 실패한 경우 치근단 병소를 야기할 수 있다. 이는 발육중인 계승 영구치에도 영향을 주어 법랑질 형성 부전, 치배의 위치 및 맹출 경로 변화, 치근 만곡, 치아 매복 등의 합병증을 유발할 수 있다. 계승 영구치의 맹출 방향에 이상을 일으키는 장애 요인으로는 유치의 만기 잔존, 유구치의 불균형적인 치근 흡수, 유치의 치근단 병소 등의 맹출 전 장애 요인과 외상이나 구강 악습관과 같은 맹출 후 장애 요인이 있다. 맹출 경로의 이상을 보이는 계승 영구치의 치료 방법으로는 주기적인 관찰, 외과적 노출, 교정적 견인, 치아 이식, 발치 등이 있으며 치료 방법 선택시 치아의 위치, 상태, 치근 형성 정도 및 만곡 여부, 맹출 방향, 인접 구조물과의 관계 등을 고려하여야 한다. 본 증례들은 유치의 치근단 병소에 의해 비정상적인 맹출 경로를 보이는 소구치를 가진 환자들에서 감염된 유치의 발거와 공간 유지만으로 이환된 소구치의 양호한 자발적 맹출을 보였기에 보고하는 바이다.

• Journal of Periodontal and Implant Science
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• 제43권3호
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• pp.136-140
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• 2013

Purpose: The aim of this study was to identify a role for endodontic intervention in enhancing the regenerative potential of the periodontal ligament when combined with periodontal treatment in seriously involved teeth with a secondary endodontic component. Methods: Patients who exhibited radiolucency extending to the periapical region, abnormal electric pulp testing values, and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Intentional root canal treatment was applied to those teeth in which the apical lesions were presumed to communicate with those of the periodontal lesion of the teeth that remained vital. In all three selected cases, regenerative periodontal therapy incorporating either bone graft or guided tissue regeneration was instituted 3 months after the endodontic intervention. Results: Remarkable enhancement in radiographic density was noticeable around the affected teeth as evidenced by changes in radiopacity. There was a significant reduction in the probing pocket depth and gain in the clinical attachment level. Chewing discomfort gradually disappeared from the commencement of the combined treatment. Conclusions: An intentional endodontic intervention may be a worthwhile approach for the sophisticated management of teeth suffering from serious attachment loss and alveolar bone destruction with concomitant secondary endodontic involvement.

• 치위생과학회지
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• 제16권5호
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• pp.349-354
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• 2016

2015년 실시한 국민구강실태조사에 따르면 우리나라 만 12세 아동들의 우식경험영구치지수(DMFT index)는 1.9로 주요 OECD 국가들의 평균인 1.6에 거의 근접한 것으로 조사되었다. 본 연구의 목적은 인접면 우식증의 진단에 있어 새로 개발된 $Qraypen^{TM}$의 효능을 기존의 방법인 시진 및 구내 치근단 방사선 사진과 비교 평가하고, 임상 적용 시의 문제점을 파악하여 차후 $Qraypen^{TM}$에 필요한 개선안을 제시함과 아울러 치아우식증의 예방 및 초기 우식증 재광화 방법에 대한 기초 연구자료를 마련하고자 하였다. 학교 구강검진을 목적으로 내원한 학령기의 혼합치열을 가진 32명의 어린이들을 대상으로 구강검진 2회, 구치부 치근단 방사선 필름 판독 2회 그리고 구치부 인접면 $Qraypen^{TM}$ 이미지 판독 2회를 실시하고 비교한 결과 $Qraypen^{TM}$ 영상은 변연융선이 파괴되지 않은 유구치의 인접면 우식증의 탐지에 효과적이었다. 또한 방사선 촬영 결과와 비교해 보니 차이가 없음을 확인하였다. 그러나 인접면 우식증이 상아질까지 진행되어 병소가 성숙하여야 뚜렷한 붉은색 형광을 관찰할 수 있었기에 우식 병소의 진행 정도와 붉은색 형광 발생의 관련성을 확인하기 위해서는 향후 발치된 치아를 사용하여 조직학적 검사를 병행한 추가적인 연구가 필요할 것으로 생각된다. 본 연구 결과 $Qraypen^{TM}$은 유구치의 육안으로 보이지 않은 인접면 우식증을 탐지하는 데 도움을 줄 수 있는 유용하고 간편한 보조장비가 될 수 있을 것으로 기대된다.

• Restorative Dentistry and Endodontics
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• 제27권4호
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• pp.355-362
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• 2002

One fifth dilution of formocresol is usually used for pulpotomy of the primary teeth and emergency pulpotomy of the permanent teeth. However the use of formaldehyde has been subjected to criticism because it may be absorbed into the blood stream and become distributed systemically, it nay also alter the pulp tissue rendering it immunologically active, and have carcinogenic potential. Recently Depulpin$^{\circledR}$(VoCo., Germany) gains popularity as a devitalizing agent during root canal therapy in spite of high concentration of 49 % paraformaldehyde because it facilitate devitalization of pulp and make root canal therapy easier But there have been not enough publications about the reaction of pulp and periapical tissue caused by Depulpin. This study was performed to evaluate the histological changes in pulp and periapical tissue of rats after pulpotomy using formocresol and Depulpin and to elucidate the toxic effects of these agents. Thirty six Sprague-Dawley rats were anesthetized by intraperitoneal injection of ketamine Maxillary first molar teeth were used for pulpotomy with formocresol and Depulpin. Rats were sacrificed after 2 days, 4 days, 1 week, 2 weeks, 3 weeks and 4 weeks respectively. Specimens were histologically observed by light microscope changes in pulp and periapical tissue. The obtained results were as follows. 1. Formocresol group A zone of fixed tissue. in which odontoblasts could clearly be defined, was present directly underneath the pulpotomy dressing in almost all teeth of this group. This was followed by an area of necrotic tissue which resembled dried out fibrous tissue with no cellular detail except some pyknotic nuclei. In the specimens of after 2 days, 4 days, 1 week, 2 weeks in which vital tissue was present, it was separated from the fibrous area by a zone of inflammation. In the specimens of after 3 weeks and after 4 weeks, inflammatory infiltrate was in the periodontal ligament adjacent to the apical foramina of the teeth. 2. Depulpin$^{\circledR}$ group The area of necrotic tissue which had no cells and fibers, was present adjacent to the dressing. This was followed by dried out fibrous tissue with no cellular details except some pyknotic nuclei, A short stump of vital pulp with odontoblasts was present at the end of the canal after 2 days. Inflammatory infiltrate was in the periodontal ligament after 4 days and after 1week. Severe root resolution and necrosis of periapical tissue opposite the root resorption site were defined after 2 weeks and after 3 weeks. Periapical lesion which consist of necrotic tissue surrounded by a fibrous connective wall, was found after 4 weeks. The results indicated that Depulpin can cause more adverse reaction to the dental pulp and periapical tissue than formocresol, and further studies are needed for its clinical use with safety.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권2호
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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.

• 대한소아치과학회지
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• 제23권2호
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• pp.389-400
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• 1996

In Class II amalgam restoration in deciduous molar, failure rate and incidence of recurrent caries are high as children become older. In order to preserve deciduous molars till the physiologic exfoliation time, stainless steel crown is a choice of the treatment. As a result of a careless treatment, such as overhanging margin, poor marginal adaptation, poor proximal contour and inadequate mesiodistal width give rise to interfering eruption of the adjacent teeth, recurrent caries and chronic gingival irritation and insufficient arch length respectively. In this study, 252 s.s. crowned teeth extracted due to physiologic exfoliation or periapical lesion. The purpose of this study is to analyze the marginal adaptation of stainless steel crown to the deciduous molar in order to obtain better clinical result. The results were as follows : 1. Between the length of s.s. crown and the marginal gap of crown, positive correlations were shown. 2. Largest amount of marginal gap was shown at buccal side in upper deciduous molars and lower first deciduous molar, lingual side in lower second deciduous molar. But no significant diffrence were found statistically compared to second most largest one. 3. Incidence of exposed restoration and recurrent caries were higher in proximal surface than buccal/lingual surface. And extension of restoration below the margin of s.s. crown gives rise to higher rate of recurrent caries. 4. Defect of contour was found in 34%, frequently found in lower 1st deciduous molar and upper 1st deciduous molar. 5. Marginal polishing defects were found in 23%. 6. Ledge was formed in 10% especially in lower 1st deciduous molar and lower 2nd deciduous molar. 7. 16% of the teeth had wear facet due to traumatic occlusion, 7% of them had occlusal perforation.