• Restorative Dentistry and Endodontics
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• v.40 no.4
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• pp.314-321
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• 2015

Tooth related factors such as palatoradicular groove can be one of the causes for localized periodontal destruction. Such pathological process may result in apicomarginal defect along with inflammation of pulp. This creates challenging situation which clinician must be capable of performing advanced periodontal regenerative procedures for the successful management. This case report discusses clinical management of apicomarginal defect associated with extensive periradicular destruction in a maxillary lateral incisor, along with histopathologic aspect of the lesion.

• The Journal of the Korean dental association
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• v.48 no.4
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• pp.288-296
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• 2010

Although non-surgical endodontic procedures have high success rates, failures do occur, These can be managed by root canal re-treatment or surgical intervention. Intentional replantation is an accepted endodontic treatment procedure in which a tooth is extracted and treated outside the oral cavity and then inserted into its socket to correct an obvious radiographic or clinical endodontic failure. Intentional replantation is indicated when other endodontic treatments performed to maintain the tooth have failed, or when endodontic periradicular surgery is not feasible. Intentional replantation may be particularly useful in these cases because these difficult to access areas can be maximally treated while the tooth is out of the mouth without damaging the periodontal attachment in adjacent teeth. In conclusion, intentional replantation is a reliable and even predictable procedure, and should be considered more often as a treatment modality in our efforts to maintain the natural dentition.

• Proceedings of the KACD Conference
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• 2003.11a
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• pp.553-553
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• 2003

I. Objectives Endodontic disease is caused primarily by bacteria that interact with periradicular host from the root canal system. Chlorhexidine gluconate is known to effective to eliminate Enterococcus faecalis which resists to other intracanal medicaments. The aim of this in vitro study was to develop a slowly releasing root canal disinfectant using using chlorhexidine gluconate and chitoic acid. II. Materials and Methods Three different group were prepared with different drug release mechanism. In group A, paper points as used core material were loaded with 20% chlorhexidine gluconate.(omitted)

• Restorative Dentistry and Endodontics
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• v.36 no.3
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• pp.211-218
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• 2011

Purpose: Intentional replantation (IR) is a suitable treatment option when nonsurgical retreatment and periradicular surgery are unfeasible. For successful IR, fracture-free safe extraction is crucial step. Recently, a new extraction method of atraumatic safe extraction (ASE) for IR has been introduced. Patients and Methods: Ninety-six patients with the following conditions who underwent IR at the Department of Conservative Dentistry, Seoul National University Bundang Hospital, in 2010 were enrolled in this study: failed nonsurgical retreatment and periradicular surgery not recommended because of anatomical limitations or when rejected by the patient. Preoperative orthodontic extrusive force was applied for 2-3 weeks to increase mobility and periodontal ligament volume. A Physics Forceps was used for extraction and the success rate of ASE was assessed. Results: Ninety-six premolars and molars were treated by IR. The complete success rate (no crown and root fracture) was 93% (n = 89); the limited success rates because of partial root tip fracture and partial osteotomy were 2% (n = 2) and 5% (n = 5), respectively. The clinical and overall success rates of ASE were 95% and 100%, respectively; no failure was observed. Conclusions: ASE can be regarded as a reproducible, predictable method of extraction for IR.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.3
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• pp.144-147
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• 2013

Damage to adjacent teeth is one of the various complications that may occur during implant placement and is often the result of improper direction during fixture placement or excessive depth of placement. In general, if detrimental symptoms, such as reaction to percussion in damaged teeth, mobility, and pulp necrosis, are not present, osseointegration should be observed at follow-up. In three cases, the possibility of root damage due to an implant fixture placed too close to each adjacent tooth was perceived on radiographs. However, in all of these cases, there were no clinical symptoms or radiographic changes present in the tooth, and the implants did not exhibit decreased stability or peri-implantitis. Therefore, we can carefully predict that the implant fixture close to the adjacent tooth did not invade the cementum of the root, and therefore did not produce the suspected pulpal damage or periradicular symptoms. In this study, we considered both the implant status as well as the adjacent tooth.

• Restorative Dentistry and Endodontics
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• v.38 no.4
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• pp.227-233
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• 2013

Objectives: The purpose of the study was to evaluate human dental pulp response to pulpotomy with calcium hydroxide (CH), mineral trioxide aggregate (MTA), and calcium enriched mixture (CEM) cement. Materials and Methods: A total of nine erupted third molars were randomly assigned to each pulpotomy group. The same clinician performed full pulpotomies and coronal restorations. The patients were followed clinically for six months; the teeth were then extracted and prepared for histological assessments. The samples were blindly assessed by an independent observer for pulp vitality, pulp inflammation, and calcified bridge formation. Results: All patients were free of clinical signs/symptoms of pulpal/periradicular diseases during the follow up period. In CH group, one tooth had necrotic radicular pulp; other two teeth in this group had vital uninflamed pulps with complete dentinal bridge formation. In CEM cement and MTA groups all teeth had vital uninflamed radicular pulps. A complete dentinal bridge was formed beneath CEM cement and MTA in all roots. Odontoblast-like cells were present beneath CEM cement and MTA in all samples. Conclusions: This study revealed that CEM cement and MTA were reliable endodontic biomaterials in full pulpotomy treatment. In contrast, the human dental pulp response to CH might be unpredictable.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.31.1-31.7
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• 2018

Despite considerable focus on the regenerative endodontic treatment of immature teeth with necrotic infected pulps and apical periodontitis, little data exist with regard to its possible implementation in necrotic permanent teeth with complete apical and radicular development. The present report describes the procedures and outcome of a regenerative endodontic treatment approach in 2 previously-traumatized incisors with closed apex with apical periodontitis. A 2-visit treatment procedure was employed. At initial visit, the root canals were copiously irrigated, followed by placement of a triple antibiotic paste containing ciprofloxacin, metronidazole, and clindamycin into the root canals. After 4 weeks, the antibiotic paste was removed, and apical bleeding was initiated with size 10 hand files beyond the apices. The root canals were coronally sealed with mineral trioxide aggregate, and the access cavities were restored with bonded resin composite. At post-operative 60 months, both teeth were remained asymptomatic, with the recall radiographs showing complete resolution of apical radiolucency and reestablishment of periradicular tissues. In both teeth, the dimensions of root space remained unchanged as verified by image analysis. The revitalization protocol utilizing root canal disinfection and induced apical bleeding in necrotic, closed-apex incisors may offer a clinically acceptable alternative to conventional root canal treatment.

• Restorative Dentistry and Endodontics
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• v.39 no.4
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• pp.241-252
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• 2014

The goal of endodontic treatment is the prevention and control of pulpal and periradicular infections. Calcium hydroxide ($Ca(OH)_2$) has been widely used in endodontics as an intracanal medicament to eliminate the remaining microorganisms after chemomechanical preparation. The purpose of this article is to review the antimicrobial properties of $Ca(OH)_2$ as an intracanal medicament in root canal treatment. The first part of this review details the characteristics of $Ca(OH)_2$ and summarizes the results of in vitro studies related to its antimicrobial effect. The antimicrobial effect of $Ca(OH)_2$ results from the release of hydroxyl ions when it comes into contact with aqueous fluids. $Ca(OH)_2$ has a wide range of antimicrobial effects against common endodontic pathogens, but is less effective against Enterococcus faecalis and Candida albicans. The addition of vehicles or other agents might contribute to the antimicrobial effect of $Ca(OH)_2$.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.1
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• pp.99-107
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• 2011

The main objective of nonsurgical retreatment is to disinfect the root canal space for periradicular healing. Thus, efficient removal of the filling material from the root canal system is essential to ensure a favorable outcome. Traditionally, the removal of root canal filling material was performed by stainless steel hand instrument and this procedure is time and effort-consuming. Recently, rotary NiTi retreatment instruments are developed to effective removal of root canal filling material. The aim of this study was to evaluate the effectiveness of stainless-steel hand instrument and rotary NiTi retreatment instrument when removing gutta-percha in curved root canals. For the remaining materials, there were no significant differences between groups. But the rotary NiTi system proved to be faster than hand instruments in removing root filling materials.

• Restorative Dentistry and Endodontics
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• v.39 no.2
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• pp.137-142
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• 2014

This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.