• 대한소아치과학회지
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• 제28권4호
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• pp.575-582
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• 2001

영구 전치부에 발생한 외상성 치은연하 파절과 자연 맹출을 기대하기 어려운 함입탈구가 발생한 경우에 여러 가지 치료방법이 알려져 있으나, 교정적 치아 정출술이 골수술을 동반한 치관길이 연장술이나 의도적 재식술에 비해 양호한 치료 성과를 나타내는 것으로 보고되고 있다. 본 증례는 외상으로 인해 치은연하로 치관파절을 보이는 환아들에서 근관치료와 함께 고정성 장치를 이용하여 치주수술을 동반한 교정적 치아 정출술을 시행한 후 복합레진 수복술로 치료하였다. 또한 치아함입이 있는 환아에서는 6개월 동안 자연 맹출을 기다린 후 맹출되지 않아 가철성 장치를 이용한 치아 정출술을 시행하여 치아를 원래의 위치로 회복시킬 수 있었는데, 이 환아의 경우 치료도중 실활의 증상을 보여 근첨성형술을 시행하였고 근첨이 형성된 후에는 근관충전을 통하여 비교적 양호한 임상적 결과를 얻을 수 있었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권3호
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• pp.140-145
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• 2024

Objectives: The necessity of retrograde filling after apicoectomy is controversial in cases of non-inflammatory cysts as opposed to bacteria-related periapical abscesses. This study aims to investigate whether the presence or absence of retrograde filling during apicoectomy has differential long-term prognostic implications between inflammatory and non-inflammatory cysts. Materials and Methods: This retrospective study included patients who underwent tooth apicoectomy during jaw cyst enucleation between 2013 and 2022, and who underwent follow-up cone-beam computed tomography for at least 6 months. The prognosis of the tooth was evaluated during the follow-up period according to the cyst type, the presence or absence of retrograde filling, mandible or maxilla, and location. Results: A total of 147 teeth was included in this study. All the operated teeth underwent preoperative root canal treatment by an endodontic specialist. Apicoectomy was performed for 119 inflammatory cysts and 28 non-inflammatory cysts. Retrograde filling was performed on 22 teeth with inflammatory cysts and 3 teeth with non-inflammatory cysts. All teeth survived the 3.5-year follow-up (range, 1.0-9.1 years). However, 1 tooth with an inflammatory cyst developed complications 1 year after surgery that required re-endodontic treatment. Conclusion: The prognosis of a tooth treated by apicoectomy without retrograde filling during cyst enucleation is favorable, regardless of the cyst type.

• Restorative Dentistry and Endodontics
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• 제20권1호
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• pp.71-95
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• 1995

Bacteria have been regarded as a one of major etiologic factors in root canal infections. In endodontic treatment the effective removal of pathogenic microorganisms in the root canal is the key to successful outcome. Bacterial cell wall components may play an important role in the development of pulpal and periapical disease. The purpose of this study was to evaluate the effect of sonic extracts of Streptococcus spp. on cultured L929 cells and to characterize cell wall protein profiles of Streptococcus spp. Streptococcus spp. were isolated from infected root canals and identified with Vitek Systems(Biomeriux, USA). Five streptococci, namely S. sanguis, S. mitis, S uberis, S. mutans (ATCC 10449) and S. faecalis (ATCC 19433) weere enriched in brain heart infusion broth. Cell pellets were sonicated and cell wall extracts were dialyzed and membrane filtered. Prepared cell wall proteins were applied to cultured L929 cell. The cell reaction were evaluated by monitoring DNA synthesis, cell numbers and the change of cell morphology. The total cell wall protein profiles of microorganisms were characterized by sodium dodecyl sulfate polyacrylamide-gel eledruphoresis(SDS-PAGE). DNA synthesis of L929 cells were reduced by the increasing concentration of sonic extracts. DNA synthesis was significantly suppressed in more than $50{\mu}g$/ml of sonic extract conentration in five streptococci. S. nutans (ATCC 10449) showed stronger suppression on DNA synthesis than remaining four streptococci, which had the similar effect on DNA synthesis. Analysis of DNA synthesis measured by [$^3H$]-thymidine uptake was more sensitvie method than cell counting. Sonic extracts affected the microscopic findings of L929 cells. The protein profiles indicated that all five strains shared two major proteins with molecular masses of 70.8 and 57.5 kD respectively. S. uberis and S. mutans shared common minor proteins of which molecular weights were 147.9 and 112.2 kD respectively. However some minor proteins were unique for S. mitis, S. uberis and S. faecalis.

• 대한소아치과학회지
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• 제27권3호
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• pp.383-387
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• 2000

융합(fusion)은 발육하고 있는 두 개의 독립된 치아가 상아질이나 법랑질부위에서의 결합으로 정의되며 보통 분리된 치근관과 단일의 큰 치관을 특징으로 하며 쌍생(gemination)은 단일치배내에서 조직의 함입으로 두 개의 치아로의 불완전한 형성을 이루는 발육상태로 정의되며 일반적으로 단일치근관과 큰 치관의 특징을 보인다. 융합이 정상치열의 두 개 치아사이에서 발생되었다면 치아수가 부족하게 되며 과잉치와 정상치아 사이에서 발생되었다면 정상치아수를 보일 것이며 이것은 방생과의 감별진단을 어렵게 한다. Brook과 Winter는 이러한 혼돈을 피하기 위해 'Double tooth' 라는 단어를 사용하였다. 일반적으로 증세는 없으나 임상적으로는 심미적인 문제와, 우식의 호발 치주적 문제, 치열의 문제를 보일 수 없다. 치료는 유치의 경우 일반적으로 치료가 불필요하며 영구치의 경우 심미적인 문제등으로 환자나 보호자에 의해 치료가 요구되어지기도 한다. 본 증례는 하악 영구측절치의 Double tooth로 내원한 8세된 여아로서 편측절단술(hemisection)과 치근단형성술을 시행후 비교적 양호한 결과를 얻었기에 이에 대해 보고하는 바이다.

• Imaging Science in Dentistry
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• 제48권4호
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• pp.245-254
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• 2018

Purpose: To assess the effects of object position in the field of view (FOV) and application of a metal artifact reduction (MAR) algorithm on the diagnostic accuracy of cone-beam computed tomography (CBCT) for the detection of vertical root fractures(VRFs). Materials and Methods: Sixty human single-canal premolars received root canal treatment. VRFs were induced in 30 endodontically treated teeth. The teeth were then divided into 4 groups, with 2 groups receiving metal posts and the remaining 2 only having an empty post space. The roots from different groups were mounted in a phantom made of cow rib bone, and CBCT scans were obtained for the 4 different groups. Three observers evaluated the images independently. Results: The highest frequency of correct diagnoses of VRFs was obtained with the object positioned centrally in the FOV, using the MAR algorithm. Peripheral positioning of the object without the MAR algorithm yielded the highest sensitivity for the first observer (66.7%). For the second and third observers, a central position improved sensitivity, with or without the MAR algorithm. In the presence of metal posts, central positioning of the object in the FOV significantly increased the diagnostic sensitivity and accuracy compared to peripheral positioning. Conclusion: Diagnostic accuracy was higher with central positioning than with peripheral positioning, irrespective of whether the MAR algorithm was applied. However, the effect of the MAR algorithm was more significant with central positioning than with peripheral positioning of the object in the FOV. The clinical experience and expertise of the observers may serve as a confounder in this respect.

• Restorative Dentistry and Endodontics
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• 제19권2호
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• pp.549-567
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• 1994

Restoration of severly damaged teeth after endodontic treatment had been an interest to many dentists, and it is a fact that there have been lots of studies about it. In these days, although we have used Para-Post, pins, threaded steel post, cast gold post and core, and so on, as a method of restoration frequently, it has been in controversy with the influence of them on the teeth and surrounding periodontal tissue. In this study, we assume that the crown of the upper incisor have severly damaged, so, after the root canal therapy, 4 types of restoration had been carried out; 1) coronal-radicular amalgam restoration, 2) after setting up the Para-Post, restore with composite resin core only, 3) after setting up the Para-Post; restore with amalgam core, then cover with the PPM crown 4) after setting up the Para-Post, restore with composite core, then cover with the PPM crown. After restoration, in order to observe the concentration of stress at internal portion of the teeth and the sourrounding periodontal tissue, developing a 2-dimensional finite element model of labiopalatal section, then loading forces from 3 direction - direction of 45 degrees from lingual side near the incisal edge, horizontal direction from labial height of contour, vertical direction at the incisal edge-were applied. The analyzed results were as follows: 1. Stress of the normal central incisor was concentrated on the dentin aroundpulp chamber, labiocervical portion of a tooth and root apex, but with the alveolar bone, in the case of load from the direction of 45 degrees from lingual side near the incisal edge showed remarkable concentration of stress: 2. Coronal-radicular amalgam technique -showed less concentration of stress on the root and surrounding periodontal tissue than the restoration with the Para-Post. 3. The von Mises equivalent stress on the Para-Post showed maximum value at root-core junction rather than both ends and model with PPM restoration with amalgam core showed the least concentration of stress. Only the force from horizontal direction showed large shear stress on internal portion of the root, root apex and alveolar bone. 4. PPM crown with composite core rarely showed the concentration of stress on root and periodontal tissue. 5. As for alveolar bone, remarkable shear stress was concentrated on labial and palatal side by horizontal load.

• Restorative Dentistry and Endodontics
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• 제44권4호
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• pp.35.1-35.10
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• 2019

Pulp revascularization is an alternative treatment in immature traumatized teeth with necrotic pulp. However, this procedure has not been reported in horizontal root fractures. This is a case report of a 9-year-old patient with multiple horizontal root fractures in 2 upper central incisors that were successfully treated with pulp revascularization. The patient presented for treatment 2 years after the initial trauma, and revascularization was attempted after the initial treatment with calcium hydroxide had failed. Prior to pulp revascularization, cone-beam computed tomography and autoradiograms demonstrated multiple horizontal fractures in the middle and apical thirds of the roots of the 2 affected teeth. Revascularization was performed in both teeth; platelet-rich plasma (PRP) was used in one tooth (#11) and the conventional method (blood clot) was used in the other tooth (#21). Clinical and radiographic follow-up over 4 years demonstrated pulp calcification in the PRP-treated tooth. Neither of the 2 teeth were lost, and the root canal calcification of tooth #11 was greater than that of tooth #21. This case suggests that PRP-based pulp revascularization may be an alternative for horizontal root fractures.

• Restorative Dentistry and Endodontics
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• 제41권2호
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• pp.137-142
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• 2016

We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment.

• Restorative Dentistry and Endodontics
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• 제40권3호
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• pp.179-187
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• 2015

Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment.

• 대한소아치과학회지
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• 제39권2호
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• pp.174-180
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• 2012

성장 중인 아동에서는 치근의 성장이 계속됨에 따라 치수가 괴사되어 치근의 병변이 있는 미성숙 영구치에서도 치수의 재혈관화가 실제로 일어날 수 있다는 가능성이 제시 되고 있다. 치수의 재혈관화를 위해서는 근관 내의 감염의 조절과 함께 적절한 scaffold가 필요하며, platelet-rich plasma(PRP)가 이상적인 scaffold로 제시되었다. 최근 임상에서는 PRP의 단점을 극복한 platelet-rich fibrin(PRF)가 응용되고 있다. 본 증례에서는 치외치의 교두 파절로 인한 치수 감염으로 치근단 병변을 가진 미성숙 영구치의 근관 내에 ciprofloxacin, metronidazole, minocycline의 세 가지 항생제 적용 후 이와 함께 PRF를 적용하였다. 정기적인 검진 결과 치근단 병변의 치유와 함께 치근 성장이 관찰되었다. 이러한 보존적인 근관 치료는 미성숙 영구치에서 치근단 형성술의 대안적인 치료로서 이용될 수 있을 것이며, 향후 장기간의 임상적 관찰이 필요할 것이다.