Ko, Lim found some differences in the concentrations of bone resorptive cytokines, especially IL-$1{\alpha}$ and IL-$1{\beta}$ in periapical lesions and inflamed pulps. And they suppose that these differences may be due to the type of cells which produce each cytokine. The purpose of this study was to analyze the human odontogenic cysts & cystic fluid for their contents of IL-$1{\alpha}$, IL-$1{\beta}$ and TNF-$1{\alpha}$ and to compare the concentrations of each cytokine according to the cytokine producing cells. The cystic tissues used in this experiment, were obtained from periapical surgery or cyst enucleation surgery. Cystic fluid was obtained from root canal during routine endodontic therapy(n=5). Cystic tissues were subdivided into two groups, inflammatory radicular cyst group(n=15) and developmental odontogenic keratocyst group(n=3). Normal periapical tissues of extracted third molar(n=5) were also obtained to be used as control group. Each specimen was incubated in 0.5ml homogenizing buffer (0.1mol/L potassium chloride, 0.02mol/L TRIS;pH=7.6) for two hours and then homogenized with glass homogenizer. Each specimen was centrifuged in a microcentrifuge for 3 minutes, and supernatants were extracted. The concentrations of cytokines were measured with R&D ELISA kit. The data were analyzed by Mann-Whitney U test for the differences among the diseases and t test for the correlations among each cytokine. Following results were obtained ; 1. For IL-$1{\alpha}$ and IL-$1{\beta}$, all experimental groups showed significantly higher concentrations of each cytokine than the control group (p<0.05). 2. In radicular cysts, the concentrations of IL-$1{\alpha}$ were higher than IL-$1{\beta}$, but not stastically significant (p>0.05). In odontogenic keratocysts, the concentrations of IL-$1{\alpha}$ were significantly higher than IL-$1{\beta}$ (p<0.05). In cystic fluid, the concentration of IL-$1{\beta}$ was significantly higher than IL-$1{\alpha}$ (p<0.05). 3. Between odontogenic keratocysts and radicular cysts, the concentrations of IL-$1{\alpha}$ were significantly higher in odontogenic keratocysts than in radicular cysts (p<0.05). 4. For TNF-${\alpha}$, only cystic fluid group showed significantly higher concentrations than the control group (p<0.05).
This study was designed to examine the specificities of the designed primers for F. nucleatum and F. necrophorum and to compare the PCR results using clinical samples with those of the anaerobic culture method. F. nucleatum and F. necrophorum spp. are frequently isolated in infected root canals, and they are related to periapical diseases. F. nucleatum(VPI 10197) and F. necrophorum(ATCC 25286) were used as references for PCR reaction, and thirty five teeth with one canal and periapical lesion were used. The samples were cultured anaerobically and identified using Rapid ID 32A(BioMerieux Vitek, Inc., France) as biochemical battery. In the GenBank database, species-specific PCR primers(nuc1/nuc2 primers for F. nucleatum and nec1/nec2 primers for F. necrophorum) were designed from the 16S ribosomal DNA(rDNA) sequences of F. nucleatum(accession number M58683) and F. necrophorum(accession number AF044948). PCR procedures of F. nucleatum(VPI 10197) and F. necrophorum (ATCC 25286) were simulated on a computer software. Amplify(v.1.2${\beta}$ for Macintosh). 820 bps and 817 bps of nucleotides were expected, respectively. Using extracted DNAs with QiaAmp tissue kit(Qiagen co., Germany), PCR was done. The results were as follows : 1. The nuc1/nuc2 primers produced an amplicon of 820 bps and the nec1/nec2 primers produced an amplicon of 817 bps. 2. The nuc1/nuc2 primers and the nec1/nec2 primers were specific and did not react with species other than the designated ones(i.e. nuc1/nuc2 primers did not produce amplicons for F. necrophorum, and vice versa.). And the PCR products of Porphyromonas endodontalis(ATCC 35406), Porphyromonas gingivalis(ATCC 33277), Prevotella intermedia(ATCC 25611), and Prevotella nigrescens(ATCC 33563), frequently isolated in infected root canals and periapical lesions, were not amplified by the primers specific for Fusobacterium nucleatum and Fusobacterium necrophorum. 3. This method utilizing PCR could detect F. nucleatum and F. necrophorum in clinical samples, while anaerobic culture method could detect neither.
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.25
no.2
/
pp.521-533
/
1995
This study was performed to develop and evaluate the method to detect Quantitatively the serial changes in the size of artificial lesion in the spongious bone by automatic color image analyzer. 15 intraoral radiograms taken before and after endodontic treatment of 5 cases were used for contour line analysis. 30 intraoral radiograms taken by geometrically standardized apparatus before and after serially the formation of artificial lesions of 0.80, 1.20, 1.75, 2.00mm in diameter at the periapical area and interdental area of spongious bone were used. The analysis of image according to the variance of lesion size by 0.25, 0.35, 0.55, and 0.85mm serially was performed by the histogram and the color enhancement with subtraction. The images inputted by CCDcamera were digitized and analyzed by NEXUS QUBE program with NEC PC-9801 computer. The obtained results were as follows: 1. There was no reliability in the analysis of lesions by contour line 2 .. The mean difference of the grey scale at each pixel was 1 step between reference image and the corrected images. 3. In the analysis by histogram of the artificial lesion in spongeous bone, the change over 0.55mm in the mesiodistal size was detectable by the change of the numbers of pixel showing the change in grey scale. 4. In the analysis by histogram of the artificial lesion in spongeous bone, the change over 0.25mm in the buccolingual size was detectable by the change in grey scale. 5. By color enbancement with- subtraction, each lesion was able to be isolated and the change in it's mesiodistal size was detectable visually , but not in it's buccolingual size.
Purpose : To determine whether subtraction images utilizing contrast media can improve the diagnostic performance of proximal caries diagnosis compared to conventional periapical radiographic images. Materials and Methods: Thirty-six teeth with 57 proximal surfaces were radiographied using a size #2 RVG-ui sensor (Trophy Radiology, Marne-la-Vallee, France). The teeth immersed in water-soluble contrast media and subtraction images were taken. Each tooth was then sectioned for histologic examination. The digital radiographic images and subtraction images were examined and interpreted by three dentists for proximal caries. The results of the proximal caries diagnosis were then verified with the results of the histologic examination. Results: The proximal caries sensitivity using digital subtraction radiography was significantly higher than simply examining a single digital radiograph. The sensitivity of the proximal dentinal carious lesion when analyzed with the subtraction radiograph and the radiograph together was higher than with the subtraction radiograph or the radiograph alone. Conclusion: The use of subtraction radiography with contrast media may be useful for detecting proximal dentinal carious lesions.
Kim, Yong-Kack;Park, Hyung-Kook;Kwon, Hyuk-Jin;Hyun, Jae-Hoon
Maxillofacial Plastic and Reconstructive Surgery
/
v.19
no.2
/
pp.209-214
/
1997
Odontogenic cysts are relatively common pathologic lesions found in the oral and perioral structures, but the case of squamous cell carcinoma arising from those cysts are very uncommon. After first reported of that case in 1889 by Herman, Schwimmer collected 56 cases of previously reported squamous cell carcinoma arising in residual odontogenic cyst during about past one century. More than 60% of cases of carcinoma developing in odontogenic cysts arising in inflammatory periapical or residual cyst, and these tumors are usually well-differentiated with relatively good prognosis, and often are diagnosed as benign lesion in radiographic or clinical examination, therefore definitive diagnosis must be made by histologic examintation. We report a case and review the literatures, in our case, 78-year old woman were clinically and radiographically diagnosed as residual odontogenic cyst. But in histologic examination after enucleation of lesion, mass of squamous cell carinoma were observed, but in other area, typical cyst wall and lining epithelium were observed. And in some area, carcinoma in situ and invading squamous cell carcinoma into the lining epithelium were also observed.
Authors have made a study on the prevalence of the dental caries of distal surface of the lower 2nd molar adjacent to the lower wisdom tooth turned anteriorly. The total number examined was 893 including 542 cases of male and 351 cases of female from the 10s to the 60s. This was taken from the diagnostic charts and intraoral standard films in the infirmary of the college of dentistry, Seoul National University from Jan. 1974 to Aug. 1976. The results are as follows: 1. The caries incidence rate in male was higher than that of female (p<0.01), but the difference between right side and left side was not significant statistically(p>0.1). 3. The Incidence rate of the periapical lesions considered by dental caries of the distal surface of the lower 2nd molar was 3.9%.
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.
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.10
no.1
/
pp.15-28
/
1980
The author studied age and sex distribution, etiology, affected site and several radiographic features of osteomyelitis of the jaw. And radiologic classification of osteomyelitis was also done. The material consisted of 118 males and 96 females examined and/or treated under the diagnosis of osteomyelitis during past 11 years (1970-1980.6) in SNUDH. The obtained results were as followings. 1. The incidence is the highest in teenages(22.9%) and the lowest in seventies. (2.8%). 2. 199 cases were found in lower jaw, and 15 cases in upper jaw. 30.8% of all cases were located at the posterior portion of mandibular body comprising alveolar region. 3. Radiographic examination of osteolytic lesion revealed that 21. 5% of all patients had periapical and alveolar bone rarefaction combined with osteoporotic changes and that in most of patients two or more of the above described changes were present at the same time. 4. Sclerotic lesions were seen in 62.2 % of all patients and 21.5% of sclerotic lesion were diffuse or homogenuous type. 5. Based on the radiologic study, classification of the osteomyelitis of the jaw was made. Loclized osteolytic type was the highest in incidence (38.8%) and localized sclerotic type was the lowest (7.0%)
Two case reports describing a new technique of creating a repositionable piezoelectric bony window osteotomy during apicoectomy in order to preserve bone and act as an autologous graft for the surgical site are described. Endodontic microsurgery of anterior teeth with an intact cortical plate and large periapical lesion generally involves removal of a significant amount of healthy bone in order to enucleate the diseased tissue and manage root ends. In the reported cases, apicoectomy was performed on the lateral incisors of two patients. A piezoelectric device was used to create and elevate a bony window at the surgical site, instead of drilling and destroying bone while making an osteotomy with conventional burs. Routine microsurgical procedures - lesion enucleation, root-end resection, and filling - were carried out through this window preparation. The bony window was repositioned to the original site and the soft tissue sutured. The cases were re-evaluated clinically and radiographically after a period of 12 - 24 months. At follow-up, radiographic healing was observed. No additional grafting material was needed despite the extent of the lesions. The indication for this procedure is when teeth present with an intact or near-intact buccal cortical plate and a large apical lesion to preserve the bone and use it as an autologous graft.
Apical surgery for a mandibular molar is still challenging for many reasons. This report describes the applications of computer-guided cortical 'bone-window technique' using piezoelectric saws that prevented any nerve damage in performing endodontic microsurgery of a mandibular molar. A 49-year-old woman presented with gumboil on tooth #36 (previously endodontically treated tooth) and was diagnosed with chronic apical abscess. Periapical lesions were confirmed using cone-beam computed tomography (CBCT). Endodontic microsurgery for the mesial and distal roots of tooth #36 was planned. Following the transfer of data of the CBCT images and the scanned cast to an implant surgical planning program, data from both devices were merged. A surgical stent was designed, on the superimposed three-dimensional model, to guide the preparation of a cortical window on the buccal side of tooth #36. Endodontic microsurgery was performed with a printed surgical template. Minimal osteotomy was required and preservation of the buccal cortical plate rendered this endodontic surgery less traumatic. No postoperative complications such as mental nerve damage were reported. Window technique guided by a computer-aided design/computer-aided manufacture based surgical template can be considerably useful in endodontic microsurgery in complicated cases.
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