• Title/Summary/Keyword: Remaining teeth

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Recruitment and enrollment in a randomized clinical trial of mandibular two-implant overdenture

  • Lee, Jeong-Yol;Kim, Min-Soo;Kim, Ha-Young;Shin, Sang-Wan
    • The Journal of Advanced Prosthodontics
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    • v.5 no.2
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    • pp.204-208
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    • 2013
  • PURPOSE. The purpose of this study was to evaluate the effectiveness of a promotion campaign for subject recruitment and selection, and reasons of withdrawal from a prospective clinical trial of mandibular two-implant supported overdenture. MATERIALS AND METHODS. The subjects of this study were participants in a randomized controlled clinical trial for investigating prognosis of implants and overdentures with attachments. Recruited subjects were classified by gender, age, and participation motives. Withdrawal rate of the participants before and after enrollment were evaluated. RESULTS. 177 patients were recruited and 51 patients were enrolled for the trial. Among them, 40 participants eventually took part in the trial. 116 subjects (65.5%) were recruited by advertisement and 61 (34.5%) were referred by patients of the hospital or local clinics. Regarding recruitment effectiveness, newspaper recruited the largest number of participants. With respect to referral patients, the proportion of our hospital patients was higher (37/61). Subjects in their 70s comprised the largest proportion (22/51). The male to female ratio was similar (25:26). Final withdrawal rate of all subjects were 74.0%. Among the reasons for withdrawal from enrollment (n=126) presence of remaining teeth and lack of motivation were the most common reasons. CONCLUSION. To facilitate recruitment of clinical trial subjects and improve enrollment rate, it is important to obtain a sufficient number of researchers, perform promotion activity with diverse strategies, cooperate with local dentists, increase the research funding, and alleviate subjects' fear against clinical trials by thorough consultation.

VITAL PULP THERAPY USING PLATELET-RICH FIBRIN IN AN IMMATURE PERMANENT TOOTH : CASE REPORTS (미성숙 영구치에서 혈소판 농축 섬유소를 적용한 생활 치수 치료 : 증례보고)

  • Lee, Ka-Young;Lee, Sang-Ho;Lee, Nan-Young
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.2
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    • pp.120-126
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    • 2013
  • Preserving the pulp is important in the treatment of carious pulp exposure in young permanent teeth. Pulpotomy is a vital pulp therapy in which a portion of the coronal pulp tissue is surgically removed, and the remaining radicular tissue is covered with suitable material that protects the pulp from further injury and permits and promotes healing. It is important to develop biocompatible treatment directed at maintaining pulp vitality and increasing tooth longevity. Platelet-rich fibrin (PRF) has been referred to as a second-generation platelet concentrate. Two clinical cases in which PRF was applied as a medicament after pulpotomy of an immature permanent tooth are presented. After isolation, caries removal and pulpotomy with PRF was performed. A layer of mineral trioxide aggregate (MTA) was placed over the PRF, and the final restoration was performed. Postoperatively, the patient had no pain or discomfort, and follow-up radiographs revealed normal periodontal ligament space and trabecular bone pattern.

Prevalence of Various Anatomic Variations in Cross-sectioned Apices of Maxillary Second Molars in Korean and Their Effect on Canal Cleanliness (한국인의 상악 제 2대구치 치근단면 형태에 대한 연구)

  • Park, Jinwoo;Bae, Jihyun;Choi, Yonghoon
    • The Journal of the Korean dental association
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    • v.56 no.2
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    • pp.84-93
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    • 2018
  • Purpose: This study evaluated the apical root canal system of maxillary second molars, in which conventional endodontic treatment had failed. Materials and Methods: One hundred eighteen extracted endodontically failed maxillary second molars were examined to investigate the root canal morphology using clinical photographs. High-resolution cross-sectional images at the 3mm level from the root apices were taken to evaluate the anatomic variations and canal cleanliness. The incidence of anatomic variations and canals containing debris were evaluated statistically. Results: One (0.85%) maxillary second molar had four separate roots, while 52 (44.07%) had three separate roots. The remaining 65 (55.08%) showed 6 different types of fusion in their roots. As the number of fused roots increased from none to three, the incidence of isthmuses in the cross-sectional images increased significantly from 43.40% to 76.92% in 2-root fusion and 88.46% in 3-root fusion. In addition, the occurrence of less-cleansed canals increased from 22.64% to 38.46% and 53.85%, respectively (p<0.05). Sixty four teeth (54.24%) had 3 canals while 38(32.2%) had additional canals; most of them were located in the MB roots (81.58%). Seventy six (64.41%) had isthmuses in the apical region and 58 out of 76 were located in MB roots. Condlusions: Logistic analysis indicated that the less division of roots was associated significantly with the occurrence of insufficient cleaning during endodontic treatment (OR=1.765, p<0.05), while the presence of an additional canal showed no association.

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A THREE DIMENSIONAL FINITE ELEMENT ANALYSIS WITH CAVITY DESIGN ON FRACTURE OF COMPOSITE RESIN INLAY RESTORED TOOTH (복합레진 인레이 수복시 와동형태에 따른 치아파절에 관한 유한요소법적 연구)

  • Kim, Chull-Soon;Min, Byung-Soon
    • Restorative Dentistry and Endodontics
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    • v.19 no.1
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    • pp.231-254
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    • 1994
  • Fracture of cusp, on posterior teeth, especially those carious or restored, is major cause of tooth loss. Inappropriate treatments, such as unnecessarily wide cavity preparations, increase the potential of further trauma and possible fracture of the remaining tooth structures. Fracture potential may be directly related to the stresses exerted upon the tooth during masticatory function. The purpose of this study is to evaluate the fracture resistance of tooth, restored with composite resin inlay. In this study, MOD inlay cavity prepared on maxillary first premolar and restored with composite resin inlay. Three dimensional finite element models with eight nodes isoparametric solid element, developed by serial grinding-photographing technique. These models have various occlusal isthmus and depth of cavity, 1/2, 1/3 and 1/4 of isthmus width and 0.7, 0.85 and 1.0 of depth of cavity. The magnitude of load was 474 N and 172 N as presented to maximal biting force and normal chewing force. These loads applied onto ridges of buccal and lingual cusp. These models analyzed with three dimensional finite element method. The results of this study were as follows : 1. There is no difference of displacement between width of occlusal isthmus and depth of cavity. 2. The stress concentrated at bucco-mesial comer, bucco-disal comer, pulpal line angle and the interface area between internal slopes of cusp and resin inlay. 3. The vector of stress direct to buccal and lingual side from center of cavity, to tooth surface going on to enamel. The magnitude of vector increase from occlusal surface to cervix. 4. The crack of tooth start interface area, between internal slop of buccal cusp and resin inlay. It progresses through buccopulpal line angle to cervix at buccomesial and buccodistal comer. 5. The influence with depth of cavity to fracture of tooth was more than width of isthmus. 6. It would be favorable to make the isthmus width narrower than a third of the intercuspal distance and depth of cavity is below 1 : 0.7.

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Effect of dentin biomodifiers on the immediate and long-term bond strengths of a simplified etch and rinse adhesive to dentin

  • Singh, Payal;Nagpal, Rajni;Singh, Udai Pratap
    • Restorative Dentistry and Endodontics
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    • v.42 no.3
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    • pp.188-199
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    • 2017
  • Objectives: This in vitro study evaluated the effect of dentin biomodifiers on the immediate and long-term bond strengths of a simplified etch and rinse adhesive to dentin. Materials and Methods: Flat coronal dentin surfaces were prepared in 120 extracted human molars. Teeth were randomly divided into 5 groups (n = 24) according to 5 different surface pre-treatments: No pre-treatment (control); 1M carbodiimide (EDC); 0.1% epigallocatechin-3-gallate (EGCG); 2% minocycline (MI); 10% sodium ascorbate (SA). After surface pre-treatment, adhesive (Adper Single Bond 2 [SB], 3M ESPE) was applied. Composite was applied into transparent plastic tubes (2.5 mm in diameter), which was placed over the bonded dentin surface. From each group, 10 samples were subjected to shear bond strength (SBS) evaluation at 24 hours (immediate) and remaining 10 samples were tested after 6 months (delayed). Additionally, 4 samples per group were subjected to scanning electron microscopic analysis for observation of resin-dentin interface. The data were statistically analysed with Shaperio-Wilk W test, 2-way analysis of variance (ANOVA), and post hoc Tukey's test. Results: At 24 hours, SBS of all surface pre-treatment groups were comparable with the control group, with significant differences found between EDC and SA groups only (p = 0.009). After 6 months storage, EDC, EGCG, and MI pre-treatments preserved the resindentin bond strength with no significant fall. Conclusions: Dentin pre-treatment with all the dentin biomodifiers except SA resulted in significant preservation of resin-dentin bond over 6 months storage period, without negatively affecting the immediate bond strength of the etch and rinse adhesive tested.

Multivariate analysis of the cleaning efficacy of different final irrigation techniques in the canal and isthmus of mandibular posterior teeth

  • Yoo, Yeon-Jee;Lee, WooCheol;Kim, Hyeon-Cheol;Shon, Won-Jun;Baek, Seung-Ho
    • Restorative Dentistry and Endodontics
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    • v.38 no.3
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    • pp.154-159
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    • 2013
  • Objectives: The aim of this study was to compare the cleaning efficacy of different final irrigation regimens in canal and isthmus of mandibular molars, and to evaluate the influence of related variables on cleaning efficacy of the irrigation systems. Materials and Methods: Mesial root canals from 60 mandibular molars were prepared and divided into 4 experimental groups according to the final irrigation technique: Group C, syringe irrigation; Group U, ultrasonics activation; Group SC, VPro StreamClean irrigation; Group EV, EndoVac irrigation. Cross-sections at 1, 3 and 5 mm levels from the apex were examined to calculate remaining debris area in the canal and isthmus spaces. Statistical analysis was completed by using Kruskal-Wallis test and Mann-Whitney U test for comparison among groups, and multivariate linear analysis to identify the significant variables (regular replenishment of irrigant, vapor lock management, and ultrasonic activation of irrigant) affecting the cleaning efficacy of the experimental groups. Results: Group SC and EV showed significantly higher canal cleanliness values than group C and U at 1 mm level (p < 0.05), and higher isthmus cleanliness values than group U at 3 mm and all levels of group C (p < 0.05). Multivariate linear regression analysis demonstrated that all variables had independent positive correlation at 1 mm level of canal and at all levels of isthmus with statistical significances. Conclusions: Both VPro StreamClean and EndoVac system showed favorable result as final irrigation regimens for cleaning debris in the complicated root canal system having curved canal and/or isthmus. The debridement of the isthmi significantly depends on the variables rather than the canals.

Effect of pre-operative medication with paracetamol and ketorolac on the success of inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a double-blind randomized clinical trial

  • Kumar, Umesh;Rajput, Akhil;Rani, Nidhi;Parmar, Pragnesh;Kaur, Amandeep;Aggarwal, Vivek
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.5
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    • pp.441-449
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    • 2021
  • Background: The efficacy of local anesthesia decreases in patients with symptomatic irreversible pulpitis. Therefore, it was proposed that the use of premedication with an anti-inflammatory drug might increase the success rate of pulpal anesthesia in mandibular posterior teeth with vital inflamed pulp. Methods: One hundred thirty-four patients who were actively experiencing pain willingly participated in this study. The Heft Parker (HP) visual analog scale (VAS) was used to record the initial pain intensity. Patients were randomly allocated to receive a placebo, 10 mg of ketorolac, and 650 mg of paracetamol. The standard inferior alveolar nerve block (IANB) was administered to all patients using 2% lidocaine with 1:200,000 adrenaline after one hour of medication. After 15 min, the patient was instructed to rate the discomfort during each step of the treatment procedure, such as access to remaining dentin, access to the pulp chamber, and during canal instrumentation on the HP VAS. IANB was considered successful if the patient reported no or mild pain during access preparation and instrumentation. Moderate or severe pain was classified as a failure of IANB and another method of anesthesia was used before continuing the treatment. Results: The rate of successful anesthesia in the placebo, paracetamol, and ketorolac groups was 29%, 33%, and 43%, respectively, and no statistically significant difference was found between the groups. Conclusion: Preoperative administration of paracetamol or ketorolac did not significantly affect the success rate of IANB in patients with irreversible pulpitis. No significant difference was observed between the paracetamol and ketorolac groups.

A Study on the Convergence of the Average Daily Smoking and Tooth Loss of the Elderly in Korea (우리나라 노인의 하루 평균 흡연량과 상실치아의 융합적 관련성)

  • Kang, Eun-Jung;Lee, Ji-yeoun;Cho, Min-jin
    • Journal of the Korea Convergence Society
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    • v.10 no.9
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    • pp.257-264
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    • 2019
  • This study was to investigate the relationship between the smoking status and the number of tooth loss according to the daily average smoking amount of the elderly in Korea using the raw data of the 6th National Health and Nutrition Survey. The study subjects were 4,037 elderly people aged 65 or older. As a result, it was found that 2.35 times more severe heavy smoking in the past, 3.01 times in the current light smoker, 3.27 times in the current heavy smoker, Respectively. This study confirmed that there is a difference in the risk of tooth loss according to the average daily smoking amount. Therefore, in order to increase and maintain the residual teeth as much as possible, it can be suggested as an objective data of smoking cessation treatment at the dental clinic and contribute to motivation.

Management of complicated crown fracture by tooth fragment reattachment with fiber post: a case report (섬유 강화형 포스트를 이용한 치관 파절된 치아의 재부착: 증례보고)

  • Kim, Yu-Ri;Jung, Kyoung-Hwa;Son, Sung-Ae;Park, Jeong-Kil
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.4
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    • pp.251-258
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    • 2021
  • Dental trauma is very common in children and relatively young people, with the line of treatment depending on the time elapsed, age of the child, and tooth maturity. If the fractured segment is available and there is close approximation of the segment to the remaining tooth, reattachment of the fractured segment is a feasible option. This treatment offers several advantages, including the reestablishment of function, aesthetics, shape, shine and surface texture, in addition to the original contour and alignment of the teeth. The following cases present two different complex crown fracture cases that were treated using tooth fragment reattachment with fiber-reinforced composite post.

Evaluation of health screening data for factors associated with peri-implant bone loss

  • Hyunjong Yoo;Jun-Beom Park;Youngkyung Ko
    • Journal of Periodontal and Implant Science
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    • v.52 no.6
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    • pp.509-521
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    • 2022
  • Purpose: Systemic health has a profound effect on dental treatment. The aim of this study was to evaluate peri-implant bone loss and health screening data to discover factors that may influence peri-implant diseases. Methods: This study analyzed the panoramic X-rays of patients undergoing health screenings at the Health Promotion Center at Seoul St. Mary's Hospital in 2018, to investigate the relationship between laboratory test results and dental data. The patients' physical data, such as height, weight, blood pressure, hematological and urine analysis data, smoking habits, number of remaining teeth, alveolar bone level, number of implants, and degree of bone loss around the implant, were analyzed for correlations. Their associations with glycated hemoglobin, glucose, blood urea nitrogen (BUN), creatinine, and severity of periodontitis were evaluated using univariate and multivariate regression analysis. Results: In total, 2,264 patients opted in for dental health examinations, of whom 752 (33.2%) had undergone dental implant treatment. These 752 patients had a total of 2,658 implants, and 129 (17.1%) had 1 or more implants with peri-implant bone loss of 2 mm or more. The number of these implants was 204 (7%). Body mass index and smoking were not correlated with peri-implant bone loss. Stepwise multivariate regression analysis revealed that the severity of periodontal bone loss (moderate bone loss: odds ratio [OR], 3.154; 95% confidence interval [CI], 1.175-8.475 and severe bone loss: OR, 7.751; 95% CI, 3.003-20) and BUN (OR, 1.082; 95% CI, 1.027-1.141) showed statistically significant predictive value. The severity of periodontitis showed greater predictive value than the biochemical parameters of blood glucose, renal function, and liver function. Conclusions: The results of this study showed that periodontal bone loss was a predictor of peri-implant bone loss, suggesting that periodontal disease should be controlled before dental treatment. Diligent maintenance care is recommended for patients with moderate to severe periodontal bone loss.