• Restorative Dentistry and Endodontics
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• 제39권1호
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• pp.56-62
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• 2014

A tooth with primary endodontic disease that demonstrates a periodontal defect might be extracted because of misdiagnosis as severe periodontal disease or a vertical root fracture. The aim of this case report was to demonstrate the long-term survival of endodontically treated teeth, which had been initially considered unsavable. With meticulous evaluation including the patient's dental history, clinical and radiographic examinations, teeth with primary endodontic lesions could be differentiated and saved after proper root canal treatment. Pain history, vitality test, and radiographic examinations, as well as a general periodontal condition check with periodontal probing on an affected tooth, might be the key methods to differentiate endodontic pathosis from that of periodontal disease.

• 대한소아치과학회지
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• 제25권3호
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• pp.533-538
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• 1998

[ $Garr{\grave{e}}'s$ ] osteomyelitis is a chronic form of osteomyelitis in which periosteum is thickened with peripheral reactive bone formation. Carl $Garr{\grave{e}}$ first reported localized periosteal thickening as a response to mild stimuli. In dental literatures, Pell et al. first reported $Garr{\grave{e}}'s$ osteomyelitis in jaws. This disease frequent occurs in youngsters and usually in mandible. It usually results in hard swelling over the jaws with little or no pain. Palpation reveals a localized bony swelling lesion. In radiographic findings, it usually reveals laminated periosteal thickening on lesion. The treatment of $Garr{\grave{e}}'s$ osteomyelitis usually consists of elimination of the sources of infection, i.e., either extraction of an infected teeth or root canal therapy. Two children were admitted with the chief complaint of intraoral swelling on lower deciduous molar areas which was diagnosed as $Garr{\grave{e}}'s$ osteomyelitis. The root canal therapy and antibiotic therapy were performed and prognosis was checked. From these case studies, some results were obtained as follows : With the aid of root canal therapy and antibiotic administration, the size of periapical lesions was reduced, the mandible with bony swelling recovered its normal shapes radiographically, and the permanent tooth germs resumed sound development.

• Restorative Dentistry and Endodontics
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• 제45권3호
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• pp.28.1-28.13
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• 2020

Objectives: To evaluate the outcome of in vitro studies comparing the effectiveness of QMix irrigant in removing the smear layer in the root canal system compared with other irrigants. Materials and Methods: The research question was developed by using Population, Intervention, Comparison, Outcome and Study design framework. Literature search was performed using 3 electronic databases PubMed, Scopus, and EBSCOhost until October 2019. Two reviewers were independently involved in the selection of the articles and data extraction process. Risk of bias of the studies was independently appraised using revised Cochrane Risk of Bias tool (RoB 2.0) based on 5 domains. Results: Thirteen studies fulfilled the selection criteria. The overall risk of bias was moderate. QMix was found to have better smear layer removal ability than mixture of tetracycline isonomer, an acid and a detergent (MTAD), sodium hypochlorite (NaOCl), and phytic acid. The efficacy was less effective than 7% maleic acid and 10% citric acid. No conclusive results could be drawn between QMix and 17% ethylenediaminetetraacetic acid due to conflicting results. QMix was more effective when used for 3 minutes than 1 minute. Conclusions: QMix has better smear layer removal ability compared to MTAD, NaOCl, Tubulicid Plus, and Phytic acid. In order to remove the smear layer more effectively with QMix, it is recommended to use it for a longer duration.

• Restorative Dentistry and Endodontics
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• 제34권2호
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• pp.103-112
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• 2009

본 연구에서는 2종의 이원중합 레진시멘트 (RelyX ARC와 Variolink II)를 이용하여 접착제와 레진시멘트의 중합방법 (자가중합과 광중합)이 섬유포스트와 근관 상아질의 결합강도와 접착계면에 미치는 영향을 상호 비교하기 위하여 시행하였다. 단근관을 갖는 발거된 32개의 하악 소구치에 근관을 충전한 후, FRC Postec system의 Reamer로 9 mm 깊이의 포스트 공간을 형성하였다. 레진시멘트의 종류와 중합방법에 따라 4개의 군 (R-SC군, R-LC군, V-SC군, V-LC군)으로 분류하였다. 포스트 공간에 각 군의 접착제를 도포한 후 레진시멘트를 주입하고, No. 3 FRC Postec 포스트를 위치시켜 자가중합 또는 광중합시켰다. 각 군의 치근을 실온의 증류수에 24시간동안 보관한 다음, 저속의 diamond wheel saw를 이용하여 치관부에서 치근단부를 향해 1.5 mm두께로 연속적으로 횡절단하여 1개의 치근에서 3개의 절편을 얻었다. 각 군의 절편 (31개)은 만능시험기에서 push-out 검사를 시행하였고, 각 군의 강도 값은 반복측정 two-way ANOVA와 one-way ANOVA를 이용하여 비교 분석하였다. 각 군의 절편 (3개)은 주사전자현미경하에서 섬유포스트, 레진시멘트 및 치근 상아질 간의 계면을 관찰, 비교하였다. 본 연구의 결과 전 부식 레진시멘트를 이용하여 섬유포스트를 포스트 공간에 합착할 경우, 접착제와 레진시멘트의 중합방법은 근관 상아질의 결합강도에 영향을 주었으며, 광중합보다 자가중합 방법 이 우수한 결합강도와 계면을 나타내었다.

• 대한소아치과학회지
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• 제21권2호
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• pp.518-524
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• 1994

A traumatically intruded tooth is one that is forcefully and abruptly dispaced from its position into the surrounding alveolar bone. Although intrusion of permanent teeth is infrequent, the sequelae compromise the longevity of the tooth and often include pulp necrosis, internal and external root resorption, rupture of periodontal ligament and loss of marginal bone. The purpose of this study was to examine three common management techniques for traumatic intrusion, observation for re-eruption, surgical repositioning & fixation and orthodontic extrusion. In the recent, the accepted treatment was to allow the permanent teeth to reerupt spontaneously for 6-8 weeks. If this did not occur, orthodontic traction was applied. The pulpal status of the teeth was monitored and either calcium hydroxide therapy or conventional endodontics was instituted following pulpal necrosis depending on the maturity of the root end. Pulpectomy and a calcium hydroxide filling were also the treatment of choice if there was evidence of internal or external root resorption. This will reduce the chance of root resorption and provide a period of monitoring prior to a definitive root canal filling.

• Restorative Dentistry and Endodontics
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• 제41권1호
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• pp.63-67
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• 2016

During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar.

• Imaging Science in Dentistry
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• 제53권2호
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• pp.137-144
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• 2023

Purpose: This study aimed to evaluate the anatomic circle around the impacted lower third molar to show, document, and correlate essential findings that should be included in the routine radiographic assessment protocol as clinically meaningful factors in overall case evaluation and treatment planning. Materials and Methods: Cone-beam computed tomographic images of impacted lower third molars were selected according to specific inclusion criteria. Impacted teeth were classified according to their position before assessment. The adjacent second molars were assessed for distal caries, distal bone loss, and root resorption. The fourth finding was the presence of a retromolar canal distal to the impaction. Communication with the dentist responsible for each case was done to determine whether these findings were detected or undetected by them before communication. Results: Statistically significant correlations were found between impaction position, distal bone loss, and detected distal caries associated with the adjacent second molar. The greatest percentage of undetected findings was found in the evaluation of distal bone status, followed by missed detection of the retromolar canal. Conclusion: The radiographic assessment protocol for impacted third molars should consider a step-by-step evaluation for second molars, and clinicians should be aware of the high prevalence of second molar affection in horizontal and mesioangular impactions. They also should search for the retromolar canal due to its associated clinical considerations.

• Restorative Dentistry and Endodontics
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• 제45권3호
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• pp.40.1-40.12
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• 2020

Objectives: The aim of this study was to evaluate the effects of endodontic treatment on levels of substance P (SP) and calcitonin gene-related peptide (CGRP) in the saliva of patients with symptomatic apical periodontitis. Materials and Methods: Twelve patients with mandibular molars with symptomatic apical periodontitis were enrolled in this study. An initial saliva sample was collected just before administration of anesthesia for root canal treatment, which was performed at the first visit. A second saliva sample was collected at a control visit 1 week after treatment. Salivary SP and CGRP levels were evaluated quantitatively using biochemical assays. The data were analyzed using Pearson correlation analysis, the paired samples t-test, and the Mann-Whitney U test (p = 0.05). Results: The postoperative salivary level of SP was significantly lower than the preoperative level (p = 0.005). However, the postoperative salivary level of CGRP was similar to the preoperative level (p = 0.932). Visual analog scale (VAS) scores of patients' subjective pain were found to be positively correlated with salivary levels of SP (r = 0.421; p = 0.040). No statistically significant correlations were observed between salivary levels of CGRP and VAS scores for patients' subjective percussion tenderness (p = 0.533) or VAS scores for patients' subjective pain (p = 0.459). Conclusions: According to the results of the present study, salivary SP levels may be used as an objective indicator in the diagnosis and assessment of the degree of pain in endodontic diseases.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권5호
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• pp.377-385
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• 2022

Background: Postoperative endodontic pain is an enigma for the dentist. This study aimed to evaluate the analgesic effect of 300 mg gabapentin or 75 mg pregabalin in reducing postoperative endodontic pain compared with a placebo. Methods: Ninety patients who needed root canal treatment with an initial numerical rating scale (NRS) pain score of > 4 (T0) were randomly divided into three groups (n=30). Patients were then administered either 300 mg gabapentin (group A), 75 mg pregabalin (group B), or a placebo (group C) 30 min prior to the start of endodontic treatment. A single operator performed single-visit endodontics, and pain was evaluated immediately after endodontic treatment (T1) and at 4 h (T2), 8 h (T3), 12 h (T4), 24 h (T5), 48 h (T6), and 72 h (T7) using the NRS. Ibuprofen/paracetamol (400 mg/325 mg) was administered as a rescue dose if needed. Results: Pregabalin performed significantly better when compared with gabapentin at all time points except at 72 h after treatment (P=0.170). The placebo group showed significantly higher pain scores than the other two groups. The percentage of pain relief was maximum for pregabalin (92.1%), followed by gabapentin (87.6%) and placebo (69.1%) at 72 h after treatment completion. Conclusion: This study showed that pretreatment with a single dose of pregabalin and gabapentin both had greater analgesic effects than a placebo. They can be effectively used to reduce postoperative endodontic pain.

• Restorative Dentistry and Endodontics
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• 제35권1호
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• pp.1-4
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• 2010

감염근관에서의 주치근단 파일의 크기는 학자들마다 많은 논란이 되고 있지만 최근 여러 연구 결과들은 감염근관의 효과적인 세정을 위해서는 근단부 확대 크기가 증가해야 함을 보여주고 있다. 따라서 임상가는 감염근관의 치료 시 새로운 개념에 맞는 치료 전략을 가지고 근관치료에 임해야 한다.