• Restorative Dentistry and Endodontics
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• 제40권2호
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• pp.97-103
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• 2015

The first part of this study reviewed the characteristics of calcium hydroxide ($Ca(OH)_2$) and summarized the results of in vitro studies related to its antimicrobial effects. The second part of this review covers in vivo studies including human clinical studies and animal studies. The use of $Ca(OH)_2$ as an intracanal medicament represented better histological results in animal studies. However, human clinical studies showed limited antimicrobial effects that microorganisms were reduced but not eliminated through the treatment, and that some species had resistance to $Ca(OH)_2$. Most of clinical outcome studies supported that there is no improvement in healing of periapical lesions when $Ca(OH)_2$ was applied between appointments. Further studies are required for the antimicrobial effects of $Ca(OH)_2$, and search for the ideal material and technique to completely clean infected root canals should be continued.

• Restorative Dentistry and Endodontics
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• 제47권3호
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• pp.26.1-26.10
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• 2022

Wegener's granulomatosis (WG) is a condition with immune-mediated pathogenesis that can present oral manifestations. This report describes the case of a patient diagnosed with WG 14 years previously, who was affected by persistent pain of non-odontogenic origin after successful endodontic treatment. A 39-year-old woman with WG was diagnosed with pulp necrosis and apical periodontitis of teeth #31, #32, and #41, after evaluation through a clinical examination and cone-beam computed tomography (CBCT). At the first appointment, these teeth were subjected to conventional endodontic treatment. At 6- and 12-month follow-up visits, the patient complained of persistent pain associated with the endodontically treated teeth (mainly in tooth #31), despite complete remission of the periapical lesions shown by radiographic and CBCT exams proving the effectiveness of the endodontic treatments, thus indicating a probable diagnostic of persistent pain of non-odontogenic nature. After the surgical procedure was performed to curette the lesion and section 3 mm of the apical third of tooth #31, the histopathological analysis suggested that the painful condition was likely associated with the patient's systemic condition. Based on clinical, radiographic, and histopathological findings, this unusual case report suggests that WG may be related to non-odontogenic persistent pain after successful endodontic treatments.

• 치과방사선
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• 제20권2호
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• pp.265-276
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• 1990

가격 5마리의 하악에 치근단부위 병소 60례와 해면골내 병소 60례를 다양한 크기의 bur로 형성한 후 관전압을 변화시켜 촬영한 방사선 사진을 육안적으로 판독하고 농도계로 분석하여 다음과 같은 결론을 얻었다. 1 흑화도가 일정한 경우 65-85kVp범위내의 관전압 변화는 크기가 같은 골내병소의 판독에 영향을 미치지 않았다(P>0.05). 2 병소가 2번 bur이하의 작은 크기일 때 1번 bur병소에 대한 2번 bur병소의 판독은 치근단 병소는 80kVp 이상의 관전압에서 판독이 용이하였으며 (P<0.05), 해면골내 병소는 75kVp이하의 관전압에서 판독이 용이하였다.(p<0.05) 3. 해면골내 한정된 병소는 치밀골을 포함한 병소와 육안적 판독의 차이가 있었으나(p<0.05). 해면골과 치밀골간의 경계부를 포함한 병소와는 육안적 판독의 차이가 없었다. (p>0.05). 4. 농도계로 분석한 결과 육안적 판독점수가 같았던 경우에도 농도계 계측치는 차이가 있었으며, 0.15-1.66㎜정도의 aluminum등 가치차이가 있어야 육안적으로 병소판독이 가능하였다.

• Restorative Dentistry and Endodontics
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• 제23권1호
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• pp.328-338
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• 1998

Porphyromonas endodontalis, an anaerobic Gram negative cocobacillus which was known to be associated with the infected root canals and periapical lesions, is very difficult to culture and to detect by the traditional method in that it requires much time to induce the specific black pigmentation, and it is very sensitive to oxygen and the antibiotics added in the culture medium. In this study, the nucleotide sequences of the 'probe h' (0.73kb), one of the specific DNA probes top. endodontalis (ATCC 35406) which had been developed by our department, was determined and then a pair of primers for PCR amplification was fabricated to identify P. endodontalis. The plasmids containing 'probe h' were purified by $Wizard^{TM}$ Midipreps DNA Purification System (Promega Corp.), and the nucleotide sequences of the 'probe h' were determined by the dideoxy chain termination method using TaqTrack Sequencing System (Promega Corp.) and detected by fluorescent labelling method. The sense/antisense PCR primers were designed with computer software (Lasergene, DNASTAR Ind. PCR was done with a programmable GeneAmp PCR System 2400 (Perkin Elmer-Cetus Co.). Each sample containing the whole genomic DNA of P. endodontalis and other black-pigmented Bacteroides was itailly denatured at $94^{\circ}C$ for 5 min and then subjected to 30 cycles, each of them consisting of 60s at $94^{\circ}C$, 60s at $60^{\circ}C$, and 90s. at $72^{\circ}C$. The amplified DNA was resolved electrophoretically in a 1.0 % agarose gel in 1X TAE buffer, stained with EtBr, and photographed on a UV transilluminator. The results were as follows : 1. The nucleotide sequences of 'probe h' (743 base pairs) were obtained by dideoxy chain termination method, and from that results the specific primers to P. endodontalis (ATCC 35406), 'Primer H1/ Primer H2', were designed. 2. It has been found that 'Primer H1/H2' could detect P. endodontalis (ATCC 35406) using PCR. 3. The PCR system with this primers may be a powerful technique to amplify the specific sequences of 'probe h' of P. endodontalis (ATCC 35406) that produce distinct identification of it from other black-pigmented Bacteroides, and this could help us to determine the nature of periapical disease.

• 대한소아치과학회지
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• 제50권1호
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• pp.24-34
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• 2023

이 연구의 목적은 유치 치수치료가 치아의 상실에 미친 영향과 관련 요인에 대해 후향적으로 분석하는 것이다. 연구에는 단국대학교 부속 치과병원 소아치과에 내원하여 유치 치수치료를 받은 6개월 - 12세의 환자 97명의 167개 치아가 포함되었고, 치수치료와 치아상실에 관련된 정보가 수집되었다. 연구에 포함된 환자는 남자 56명(57.7%), 여자 41명(42.3%), 치아는 유전치 72개(43.1%), 유구치 95개(56.9%)였다. 평균 관찰기간은 106.1 ± 38.7개월이고, 치료 시 연령은 평균 유전치 34.8 ± 15.4개월, 유구치 69.1 ± 25.1개월이었다. 한 악궁에서 한쪽 치아만 치수치료를 시행한 환자의 좌우측 동명치 탈락 또는 발치 시기를 비교하였을 때 치수절제술된 치아가 유의하게 빨리 상실되었다(p < 0.05). 또, 치료 전에 치근단 염증을 보이는 경우, 치수치료 후에도 염증으로 인해 발치할 확률이 유전치에서 증가했고(p < 0.05, Odds Ratio = 11.04), 유구치에서는 그렇지 않았다(p > 0.05). 치수절제술이 시행된 유치는 유전치에서 평균 7.8개월, 유구치에서 평균 8.5개월 조기 탈락하였다. 유치의 조기 탈락은 공간상실과 계승 영구치의 조기 맹출로 이어질 수 있고, 이는 유치의 치수치료 및 치료계획 수립 시 판단기준으로 활용될 수 있을 것으로 보인다.

• Imaging Science in Dentistry
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• 제47권2호
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• pp.69-74
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• 2017

Purpose: The nasopalatine canal is a well-known, important anatomical structure in the anterior maxilla, but this region contains many accessory canals. The canalis sinuosus (CS) is one of these canals; it contains the anterior superior alveolar nerve, along with veins and arteries. The purpose of this study was to evaluate the CS using cone-beam computed tomography (CBCT) in patients with maxillary impacted canines. Materials and Methods: A total of 111 patients admitted to the Istanbul Medipol University School of Dentistry for the exposure, orthodontic treatment, and/or extraction of an impacted canine were included in this study. CBCT images were obtained for these patients under standard conditions. Axial, coronal, and sagittal sections were evaluated to assess the prevalence of CS, the direction and diameter of the canal, its relation with the impacted canine, and its distance from the alveolar crest. Further, possible correlations with patient gender and age were analyzed. Results: The CS could be detected bilaterally in all the evaluated tomography images. The mean canal diameter was significantly larger in males than in females(P=.001). The CS ran significantly closer to the impacted canine when the canal was located horizontally (P=.03). Variations of the canal, such as accessory canals, were identified in 6 patients. Conclusion: CS is an anatomical entity that may resemble periapical lesions and other anatomical structures. Evaluation with CBCT prior to surgical procedures in the anterior maxilla will help to prevent overlooking such anatomical structures and to decrease possible surgical complications.

• 대한치과보존학회:학술대회논문집
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• 대한치과보존학회 2002년도 추계학술대회
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• pp.720-720
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• 2002

A number of investigations have shown that the presence of bacteria is prerequisite for developing pulpal and/or periradicular pathosis. Depending on the stage of pulpal pathosis, various species of bacteria can be cultured from infected root canals. Kakehashi et al. showed that exposure of pulpal tissue in germ-free rats was characterized by minimal inflammation and dentinal bridging while exposure of pulpal tissue in conventional rats with normal oral flora was characterized by pulpal necrosis, chronic inflammation, and periapical lesions. Currently used methods of cleaning and shaping, especially rotary instrumentation techniques, produce a smear layer that covers root canal walls and the openings to the dentinal tubules. The smear layer contains inorganic and organic substances that include fragments of odontoblastic processes, microorganisms, their by products and necrotic materials. Because of its potential contamination and adverse effect on the outcome of root canal therapy, it seems reasonable to suggest removal of the smear layer for disinfection of the entire root canal system. Presence of this smear layer prevents penetration of intracanal medications into the irregularities of the root canal system and the dentinal tubules and also prevents complete adaptation of obturation materials to the prepared root canal surfaces. Removal of the smear layer by an intracanal irrigant and placement of an antibacterial agent in direct contact with the content of dentinal tubules should allow disinfection of this complex system and better outcome for the root canal therapy. A new solution, which was a mixture of a tetracycline, an acid, and a detergent(MTAD), was developed in the Department of Endodontics, Dental School. Lorna Linda University, USA. It has been demonstrated that MTAD was an effective solution for the removal of the smear layer and does not significantly change the structure of the dentinal tubules when used as a final irrigant in conjunction with 1 % NaOCl as a root canal irrigant. Studies are in progress to compare the anti- microbial properties of this newly developed solution with those of sodium hypochlorite and EDTA that are currently used to irrigate the root canals and remove the smear layer from the surfaces of instrumented root canals.canals.

• Journal of Periodontal and Implant Science
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• 제30권3호
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• pp.527-538
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• 2000

Several extraction cases with advanced bone loss as a result of periodontal disease, root or labial bone fracture, extensive caries, and periapical lesions occur esthetic, functional problems and severe bone loss. Therefore, to treat these cases used several surgical methods and socket preservation among this therapies have been evaluated simple, effective and good prognosis in the implant placement. Socket preservation therapy have been used with barrier membranes or/and graft materials. Deproteinized bovine bone mineral have been evaluated ideal grafting materials. Recently, calcium-phosphate thin film coated bovine bone powders were developed in our country, but the study for these material wasn't reported. When two types of xenograft materials were implanted in extraction sockets of Beagle dogs, the effects of these were analyzed after 4 weeks and 8 weeks histological views. The results of this study were as follows. 1. In control groups, 4 weeks after implantation, the extraction sockets were filled with connective tissue which has dilated vessels and epithelial growth. And after 8 weeks, irregular connective bundles were observed. But new bone formation was not seen. 2. In Bio-Oss groups, epithelial growth was not seen and bone powder was covered with connective tissue fiber. New bone formation was found around the interproximal bone. There was no special change seen after 8 weeks, connective tissue fibers became more regular, and bone growth near bone powder was not made well. 3. In Ca-P BBP groups, epithelial cells didn't grow in the extraction sockets, there was a lot of new bone made around the bone powder after 8 weeks, new bone around bone powder was replaced with mature bone. It is thought that bone powder grafting into the extraction sockets is very useful for conservation of ridge, and Ca-P BBP is more effective in bone formation than Bio-Oss.

• Restorative Dentistry and Endodontics
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• 제16권2호
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• pp.165-173
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• 1991

The purpose of the present study was to measure and compare the arachidonic acid metabolites in diseased periodontal tissue and vital pulp tissue of the tooth, and to investigate the relationship between periodontal and pulp disease. Diseased periodontal tissue of periodontally involved human teeth and vital pulp tissue from the same teeth which were intact with no periapical lesions were obtained. Each periodontal and pulp tissue homogenates from the same tooth were incubated with $^{14}C$ - arachidonic acid. Lipid solvent extracts were separated by thin layer chromatography to be analyzed by autoradiography and TLC analyzer. 1. The conversion into $TXB_2$, 6 - keto - $PGF_{1a}$ and $PGE_2$, and unidentified metabolite in pulp tissue were less than that in diseased periodontal tissue(P<0.05). 2. Biosynthetic levels of $TXB_2$, unidentified metabolite, 6 - keto - $PGF_{1a}$ and HETEs were not satistically significant between diseased periodontal tissue and pulp tissue. $LTB_4$ was measured highly in pulp tissue(P<0.1). 3. The percentage of each metabolite to the total converted metabolites were not statistically significant between diseased periodontal tissue and pulp tissue. But the percentage of $LTB_4$ in pulp tissue was higher than that in diseased periodontal tissue(P<0.05). 4. The relative amounts of the total metabolites formed in lipoxygenase pathway to those formed in cyclo - oxygenase pathway were 6 fold in diseased periodontal tissue and 12 fold in pulp tissue. But there was no statistical significance between diseased periodontal tissue and pulp tissue(P>0.05).

• 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.