• Title/Summary/Keyword: Tooth pulp

Search Result 379, Processing Time 0.026 seconds

Intraosseous anesthesia in symptomatic irreversible pulpitis: Impact of bone thickness on perception and duration of pain

  • Nilius, Manfred;Mueller, Charlotte;Nilius, Minou Helene;Haim, Dominik;Leonhardt, Henry;Lauer, Guenter
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • v.20 no.6
    • /
    • pp.367-375
    • /
    • 2020
  • Background: Intraosseous anesthesia (IO) allows the anesthetic solution to be injected directly into the cancellous bone. The anesthetic solution immediately reaches the periapical region, and thus the axonal area of the nerve, where it can temporarily disable the sodium pump. The effect is felt almost without any time delay, and only a small amount of anesthetic solution is required. Methods: This study aims to investigate the efficacy of IO using the AnestoⓇ device after infiltration anesthesia (IA) and/or inferior alveolar nerve block anesthesia (IANB) failed to work in symptomatic irreversible pulpitis (hot tooth). The 33 patients included in the study were treated additionally with 1.7 ml articaine hydrochloride with 1:100,000 epinephrine hydrochloride (UltracainⓇ D-S, Sanofi-Aventis, Frankfurt, Germany) IO. Results: The electrical pulp test showed that 95.76% of the volunteers reacted positively to the combination of IANB or IA with the IO. In women, the additive IO was effective at 97.22%. In men, the IO led to pain elimination in 94.00% of cases. The duration of the IO was less than a quarter of an hour (13.03 min). The IO worked longer in women than in men (13.61 min vs. 12.33 min). Overall, more than every third tooth that needed trepanation was located in the posterior area of the mandible (36.4%). Treatment of hot teeth in this area was associated with an increased pulse rate and increased residual pain. There was a moderate correlation (Spearman-Rho [IRI] = 0.280) between the Visual Analog Scale (VAS) score and bone density, and a significant correlation (IRI = 0.612) between subjective residual pain and bone width. The IO resulted in a moderate, transient increase in the pulse rate by approximately 20 bpm. This is similar to the temporary increase in heart rate after conventional anesthesia techniques in non-preloaded patients and can be considered clinically irrelevant. Conclusion: IO with the AnestoⓇ device as an extension and deepening of local pain elimination is recommended for the treatment of hot teeth.

Full-mouth rehabilitation of a patient with severe wear using digital facebow transfer and virtual articulator (디지털 안궁이전과 가상교합기를 이용한 광범위한 치아 마모 환자의 완전구강회복 증례)

  • Jinmook Chung;Younghoo Lee;Seoung-Jin Hong;Janghyun Paek;Kwantae Noh;Hyeong-Seob Kim;Kung-Rock Kwon;Ahran Pae
    • The Journal of Korean Academy of Prosthodontics
    • /
    • v.61 no.4
    • /
    • pp.275-283
    • /
    • 2023
  • The progressive wear of teeth is a physiologic process of aging, but excessive wear can lead to occlusal disharmony, tooth sensitivity and pulp exposure, decreased masticatory efficiency, and aesthetic problems. It should be treated by evaluating the cause of tooth wear and establishing a stable centric relation with appropriate vertical dimension of occlusion and occlusal plane. The present case report successfully rehabilitated a full-mouth case of a severely worn dentition with the use of digital facebow transfer and virtual articulator.

A Study on the Expression of Glycosaminoglycans in the Experimental Tooth Movement of Rat and in Cultured Periodontal Ligament Cells (실험적 치아이동시 glycosaminoglycan의 발현에 관한 연구)

  • Lee, Kyung-Hwan;Lee, Jong-Jin;Kang, Kyung-hwa;Kim, Eun-Cheol;Kim, Sang-Cheol
    • The korean journal of orthodontics
    • /
    • v.31 no.4 s.87
    • /
    • pp.447-458
    • /
    • 2001
  • The purpose of this study was to evaluate 1) in vivo, the expression of chondroitin 4-sulfate (CH-4S), a structural element of glycosaminoglycans(GAGs), in periodontal tissue during the experimental movement of rat incisors, by labelled streptavidine biotin immunohistochemical staining for CH-4S, 2) In vitro, the expression of CH-4S in cultured human periodontal ligament(PDL) cells supplemented with 10ng/ml of $TGF-{\beta}_1$, 20ng/ml of PDGF-BB, 1ng/ml $TNF-\alpha$, or $1{\mu}g/ml$ LPS by western blot analysis. The results of this study were as follows ; 1. The expression of CH-4S was stronger in pulp, PDL, osteoblasts, osteoclasts and osteocytes in experimental group than in control group, but was rare in dentin, and cementum of experimental groups, regardless of the duration of force application, which was not different from that of control group. 2. In experimental group, the expression of CH-4S in pulp began to increase at 1 day after force application and got to the highest degree at 7 days. After 14 days, the expression in CH-4S immunoreactivity was decreased, and became similar to that of control group at 28 days. 3. The expression of CH-4S in PDL was noted in adjacent to alveolar bone. PDL showed higher intensity of immunolabelling after 1 day of orthodontic tooth movement. And the expression was more stronger in the tension side than that of pressure side of PDL at 1 day, but more stronger in the pressure side than that of tension side of PDL at 4 days. After 7 days, a decrease in CH-4S expression was observed. 4. The expression of CH-4S in alveolar bone got to the highest degree at 4 days, and At 7 days, a decrease in CH-4S expression was observed. 5. PDGF-BB notably raised the expression of CH-4S in the PDL cells at 3 days of cultivation 6. The expression of CH-4S of PDL cells was decreased with the application of $TNF-\alpha$ at 1 day. 7. Admixture of $TGF-{\beta}_1$ and PDGF-BB got more expression of CH-4S in PDL as compared to only $TGF-{\beta}1$ or PDGF-BB. A similar decrease of the expression of CH-4S was observed in the case of application of LPS or $TNF-\alpha$.

  • PDF

Halitosis and Related Factors among Rural Residents (농촌지역 주민들의 구취실태와 유발요인)

  • Lee, Young-Ok;Hong, Jung-Pyo;Lee, Tae-Yong
    • Journal of Oral Medicine and Pain
    • /
    • v.32 no.2
    • /
    • pp.157-175
    • /
    • 2007
  • This study was conducted through an interview process in which questionnaires were administered to 293 people. The questionnaires related to the behaviors of oral hygiene care, and disease history related to halitosis, and status of halitosis, halitosis measurement, oral examination, and caries activity tests such as the snyder test, Salivary flow rate test, and Salivary buffering capacity test. Our sample was taken from 293 rural residents within the period from 4th to 21st of January 2006. This was done in order to provide basic data to prepare both policies of halitosis prevention and a device to efficiently measure halitosis status and investigate the factors related therein. The major findings of this study results are as follows: 1. As for frequency of tooth brushing, twice a day occupied the greatest portion at 46.1 % Women exceeded men in frequency of tooth brushing. Tongue brushing everyday produced a 25.6 % result among subjects and The use of auxiliary oral hygiene devices occupied 9.2 %. 2. As for degree of usual self-awareness of halitosis: 62.5 %. This result also demonstrate that the severest time of self-awareness in regards to halitosis is wake up time in the morning. The time period produced the highest portion of 72.7 % in times of self-awareness. In terms of the area in which halitosis was observed, gum resulted in 23.0 %. As for types of halitosis, fetid smell was the most frequent at 37.2 %. 3. As for the result of halitosis measurement, values of OG less than 50 ppm occupied 54.3 % and $50{\sim}100ppm$ occupied 41.6 %. As for $NH_3$ values, $20{\sim}60ppm$ showed the highest value range of 52.6 %. 4. As for OG per disease history related to halitosis, values of OG were significantly high in the ranges of $50{\sim}100ppm$ within family history groups of food impaction by dental caries, diabetes mellitus and halitosis. As for values of $NH_3$, there showed a significant difference in respiratory system disease groups. 5 Value range of OG per ordinary halitosis self-awareness degree: values ranging less than 50 ppm were recorded at 55.9 % from the group realizing not aware of smell. 57.5 % from groups only realizing sometimes, while values range of $50{\sim}100ppm$ were recorded at 52.0 % from groups always aware of smell. 63.6 % from groups always strongly aware of smell. Meanwhile as for the values ranges of $NH_3$, $20{\sim}60ppm$. they occupied high portions for all groups of exams. 6. Values of OG per oral examination: the more pulp-exposed teeth and food impaction and the higher the tongue plaque index, values of OG increased within the range of $50{\sim}100ppm$. As for values of $NH_3$, the more prosthetic teeth and the higher the tongue plaque index, this value increased significantly, and the values increased up to no less than 60 ppm for groups of mandibular partial denture. 7. Within the realm of caries activity test: as for the Snyder test, high activity was highest by 43.0 % wherewith the higher the activity of acidogenic bacteria the higher the OG values. As for the salivary flow rate test, the number of cases below 8.0 ml showed the highest tendency by 62.5 %. The larger the salivary flow rate the more decreased OG values distribution. As for the salivary buffering capacity test, $6{\sim}10$ drops of 0.1N lactic acid showed the overwhelming trend by 58.7 % whereby the higher the salivary buffering capacity the greater distribution occupancy ratio of OG values below 50 ppm which is scentless to on ordinary person. 8. As for the correlation between oral environment and halitosis, OG showed the positive correlation with pulp exposed teeth, filled teeth, present teeth, tongue plaque index, and food impaction, while the negative correlation with salivary flow rate and prosthetic teeth. $NH_3$ showed a positive correlation with prosthetic teeth and frequency of tooth brushing, while decayed teeth was negative correlation. 9. As for the multiple regression analysis result, there have been selected female, pulp exposed teeth, prosthetic teeth, food impaction, salivary flow rate, tongue plaque index and severe activities in the Snyder test as factors affecting OG wherein explanatory power on it was 45.1 %. There have been selected females, pulp exposed teeth, tongue plaque index, and prosthetic teeth as factors affecting on $NH_3$ wherein explanatory power on it was 6.6 %. With the aforementioned results in mind, the status of halitosis among rural residents is considered to bare a close relation with oral environments and other factors related to halitosis such as the Snyder test from caries activity test, and salivary flow rate test. For the prevention of halitosis of residents in rural areas, we have to focus on correct tooth brushing methods and tongue brushing, with using auxiliary oral hygiene devices to remove fur of tongue plaque and food impaction. Also, when the cause and ingredients of halitosis are diverse and complex, in order to analyze exactly the factors of individual halitosis development, we need continuous and systematic study in order to provide rural residents with programs of oral hygiene education and encourage the use of dental hygienists in public health centers.

AN IMMUNOHISTOLOGIC STUDY ON THE ACTIVITY OF MACROPHAGE AND T-CELL IN THE PERIODONTIUM DURING TOOTH MOVEMENT OF DOG (성견의 실험적 치아이동시 치주조직내 대식세포와 T-림파구의 활성에 관한 면역조직화학적 연구)

  • Park, Eui-Woong;Kim, Sang-Cheol;Kook, Yoon-A
    • The korean journal of orthodontics
    • /
    • v.25 no.4
    • /
    • pp.433-445
    • /
    • 1995
  • Tooth movement, the phenomena and mechanisms of which are still controversial, can be considered as part of the result of the inflammatory processes. The purpose of this study was to examine the activity of macrophage and T-cell, playing important roles in the immune reaction, in the periodontal ligament of dog, in which experimental tooth movement was performed. Six one and half year-old dogs, a control and 5 experimentals, were studied. Light force (50-75g) was applied by placing open-coil spring between left mandibular premolars ; heavy force (250-300g), between right mandibular premolars. Experimental dogs were sacrificed at 12 hours, 1, 3, 7 and 14 days since force application, respectively. And the histologic and the immunohistochemical evaluation on the obtained tissue were performed, using $\alpha$-1-antichymotrypsin and CD3 antibodies. The results were as follows : 1. There were more inflammatory cell infiltrations in heavy force group than in light force group until 3 days. But from 7 dsays on, no difference was not observed between groups ; Such an infiltration was more evident at pressure side than at tension side. 2. Osteoclastic activity at pressure side began to be seen in 12 hours, increasing until 7 days. After then it decreased ; Such an activity was more evident in heavy force group than in light force group. 3. Tearing of periodontal ligament and vascular dilatation at tension side began to be seen in 12 hours, increasing until 3 days. After then it decreased ; Such an observation was more evident in heavy force group than in light force group, but there was no difference between groups in 14 days. 4. $\alpha$-1-antichymotrypsin expression in control group was positive, mainly in sulcular epithelium, but negative in periodontal membrane, pulp, bone cells. 5. $\alpha$-1-antichymotrypsin expression in experimental group was more positive in pressure side than in tension side ; The expression was a little more positive in cervical area of tooth until 3 days, but after 7days, it was more positive in apical area. 6. $\alpha$-1-antichymotrypsin expression in light force group began to be observed in 12 hours and reached to the greatest level in 7 days, after which it decreased ; In heavy force group, it was the greatest in 3 days, after which it decreased. 3 Expression in the periodontium was almost negative.

  • PDF

FRACTURE RESISTANCE OF THE THREE TYPES OF UNDERMINED CAVITY FILLED WITH COMPOSITE RESIN (복합 레진으로 수복된 세 가지 첨와형태 와동의 파절 저항성에 관한 연구)

  • Choi, Hoon-Soo;Shin, Dong-Hoon
    • Proceedings of the KACD Conference
    • /
    • 2008.05a
    • /
    • pp.177-183
    • /
    • 2008
  • It was reported that esthetic composite resin restoration reinforces the strength of remaining tooth structure with preserving the natural tooth structure. However, it is unknown how much the strength would be recovered. The purpose of this study was to compare the fracture resistance of three types of undermined cavity filled with composite resin with that of non-cavitated natural tooth. Forty sound upper molars were allocated randomly into four groups of 10 teeth. After flattening occlusal enamel. undermined cavities were prepared in thirty teeth to make three types of specimens with various thickness of occlusal structure (Group $1{\sim}3$). All the cavity have the 5 mm width mesio-distally and 7 mm depth bucco-lingually. Another natural 10 teeth (Group 4) were used as a control group. Teeth in group 1 have remaining occlusal structure about 1 mm thickness, which was composed of mainly enamel and small amount of dentin. In Group 2, remained thickness was about 1.5 mm, including 0.5 mm thickness dentin. In Group 3, thickness was about 2.0 mm, including 1 mm thickness dentin. Every effort was made to keep the remaining dentin thickness about 0.5 mm from the pulp space in cavitated groups. All the thickness was evaluated with radiographic Length Analyzer program. After acid etching with 37% phosphoric acid, one-bottle adhesive (Single $Bond^{TM}$, 3M/ESPE, USA) was applied following the manufacturer's recommendation and cavities were incrementally filled with hybrid composite resin (Filtek $Z-250^{TM}$, 3M/ESPE, USA). Teeth were stored in distilled water for one day at room temperature, after then, they were finished and polished with Sof-Lex system. All specimens were embedded in acrylic resin and static load was applied to the specimens with a 3 mm diameter stainless steel rod in an Universal testing machine and cross-head speed was 1 mm/min. Maximum load in case of fracture was recorded for each specimen. The data were statistically analyzed using one-way analysis of variance (ANOVA) and a Tukey test at the 95% confidence level. The results were as follows: 1. Fracture resistance of the undermined cavity filled with composite resin was about 75% of the natural tooth. 2. No significant difference on fracture loads of composite resin restoration was found among the three types of cavitated groups. Within the limits of this study, it can be concluded the fracture resistance of the undermined cavity filled with composite resin was lower than that of natural teeth, however remaining tooth structure may be supported and saved by the reinforcement with adhesive restoration, even of that portion consists of mainly enamel and a little dentin structure.

  • PDF

FRACTURE RESISTANCE OF THE THREE TYPES OF UNDERMINED CAVITY FILLED WITH COMPOSITE RESIN (복합 레진으로 수복된 세 가지 첨와형태 와동의 파절 저항성에 관한 연구)

  • Choi, Hoon-Soo;Shin, Dong-Hoon
    • Restorative Dentistry and Endodontics
    • /
    • v.33 no.3
    • /
    • pp.177-183
    • /
    • 2008
  • It was reported that esthetic composite resin restoration reinforces the strength of remaining tooth structure with preserving the natural tooth structure. However, it is unknown how much the strength would be recovered. The purpose of this study was to compare the fracture resistance of three types of undermined cavity filled with composite resin with that of non-cavitated natural tooth. Forty sound upper molars were allocated randomly into four groups of 10 teeth. After flattening occlusal enamel, undermined cavities were prepared in thirty teeth to make three types of specimens with various thickness of occlusal structure (Group $1{\sim}3$). All the cavity have the 5 mm width mesiodistally and 7 mm depth bucco-lingually. Another natural 10 teeth (Group 4) were used as a control group. Teeth in group 1 have remaining occlusal structure about 1 mm thickness, which was composed of mainly enamel and small amount of dentin. In Group 2, remained thickness was about 1.5 mm, including 0.5 mm thickness dentin. In Group 3, thickness was about 2.0 mm, including 1 mm thickness dentin. Every effort was made to keep the remaining dentin thickness about 0.5 mm from the pulp space in cavitated groups. All the thickness was evaluated with radiographic Length Analyzer program. After acid etching with 37% phosphoric acid, one-bottle adhesive (Single $Bond^{TM}$, 3M/ESPE, USA) was applied following the manufacturer's recommendation and cavities were incrementally filled with hybrid composite resin (Filtek $Z-250^{TM}$, 3M/ESPE, USA). Teeth were stored in distilled water for one day at room temperature, after then, they were finished and polished with Sof-Lex system. All specimens were embedded in acrylic resin and static load was applied to the specimens with a 3 mm diameter stainless steel rod in an Universal testing machine and cross-head speed was 1 mm/min. Maximum load in case of fracture was recorded for each specimen. The data were statistically analyzed using one-way analysis of variance (ANOVA) and a Tukey test at the 95% confidence level. The results were as follows: 1. Fracture resistance of the undermined cavity filled with composite resin was about 75% of the natural tooth. 2. No significant difference in fracture loads of composite resin restoration was found among the three types of cavitated groups. Within the limits of this study, it can be concluded the fracture resistance of the undermined cavity filled with composite resin was lower than that of natural teeth, however remaining tooth structure may be supported and saved by the reinforcement with adhesive restoration, even if that portion consists of mainly enamel and a little dentin structure.

MORPHOLOGIC ANALYSIS OF C-SHAPED ROOT USING 3-D RECONSTRUCTION (3차원 재구성법에 의한 C-shaped root의 형태분석)

  • Jung, Eun-Hee;Shin, Dong-Hoon
    • Restorative Dentistry and Endodontics
    • /
    • v.27 no.4
    • /
    • pp.421-431
    • /
    • 2002
  • C-shaped canal configuration is very difficult to treat because that clues about preoperative canal anatomy cannot be ascertained from clinical crown morphology and limited information can be derived from radiographic examination. This study was done to get more informations about the root and canal configuration of C-shape root by 3-dimensionally reconstructing for the purpose of enhancing success rate of endodontic treatment. 30 mandibular molars with C-shaped root were selected. Six photo images from occlusal, apical, mesial, distal, buccal, lingual directions and radiographic view were taken as preoperative ones to compare them with 3-D image. After crown reduction to the level of 1-2mm over pulpal floor was performed, teeth were stored in 5.25% sodium hypochlorite solution for the removal of pulp tissue and debris. They were cleaned under running water, allowed to bench dry and embedded in a self-curing resin. This resin block was serially ground with a microtome (Accutom-50, Struers, Denmark) and the image of each level was recorded by digital camera (FinePix S1-pro, Fuji Co., Japan). The thickness of each section was 0.25mm. Photographs of serial sections through all root canal were digitized using Adobe Photoshop 5.0 and then minimum thickness of open and closed sites were measured (open site is the surface containing occluso-apical groove closed site is oppsite). After dizitization using 3-D Doctor (Able software Corp, USA). 3D reconstruction of the outer surface of tooth and the inner surface of pulp space was made. Canal classsification of C-shaped roots was performed from this 3-D reconstructed image. The results were as follows : 1. Most C-shape rooted teeth showed lingual groove (28/30). 2 According to Vertuccis' calssification, type I, II, III, IV, VII were observed. but also new canal types suck as 2-3-2, 1-2-3-2. 2-3-2-1, 2-3-2-3 were shown. 3 There was little difference in minimum thickness on coronal and apical portions, but open site were thinner than closed site on mid portion. Conclusively, 3D reconstruction method could make the exact configurations of C-shape root possible to be visualized and analyzed from multi-directions. Data from minimum thickness recommend cleaning and shaping be more carefully done on dangerous mid portion.

A CLINICAL STUDY ON THE CARE OF ODONTOGENIC INFECTIONS IN THE ADMISSION PATIENTS WITH AGE-RELELATED GERIATRIC DISEASES (노인성 전신질환 입원환자에서 치성감염 관리에 관한 임상적 연구)

  • Yoo, Jae-Ha;Choi, Byung-Ho;Han, Sang-Kwon;Chung, Won-Gyun;Noh, Hie-Jin;Jang, Sun-Ok;Kim, Jong-Bae;Nam, Ki-Young;Chung, Jae-Hyung;Kim, Byung-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.30 no.5
    • /
    • pp.414-421
    • /
    • 2004
  • This is a reprospective study on the care of odontogenic infections in admission patients with geriatric diseases. The study was based on a series of 480 patients at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, From Jan. 1, 2000, to Dec. 31, 2002. The Obtained results were as follows: 1. The systemic malignant tumor was the most frequent cause of the geriatric diseases with odontogenic infectious diseases, and refractory lung disease, systemic heart disease, type II diabetes mellitus, cerebrovascular disease, bone & joint disease, senile psychologic disease were next in order of frequency. 2. Male prediction(57.5%) was existed in the odontogenic infectious patients with geriatric diseases. But, there were female prediction in senile psychologic disease, systemic heart disease and cerebrovascular disease. 3. The most common age group of the odontogenic infectious patient with geriatric disease was the sixty decade(47.9%), followed by the seventy & eighty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with geriatric disease, peak incidence was occurred as toothache(52.7%), followed by extraction wish, tooth mobility, oral bleeding, oral ulcer, fracture of restoration, gingival swelling in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis & periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(34.2%) was showed in primary endodontic treatment (pulp extirpation, occlusal reduction and canal opening drainage) and followed by scaling, incision & drainage, only drugs, pulp capping, restoration in order.

REGIONAL ODONTODYSPLASIA : CASE REPORT (국소적 치아 이형성증(Regional odontodysplasia)에 대한 증례)

  • Lee, Jae-Ho;Cho, Jae-Hyun;Kim, Ki-Dug;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.28 no.1
    • /
    • pp.175-179
    • /
    • 2001
  • Regional odontodysplasia is a relatively rare condition in which both enamel and dentin are hypoplastic and hypocalcified. The result is localized arrest in tooth development. The etiology of regional odontodysplasia is uncertain, but, disturbance in vascular supply, somatic mutation, latent virus infection, trauma, hyperpyrexia, irradiation, nutrition, metabolic disorders and hereditary transmission are supported to be etiologic factors. Females are more often affected than males. (1.4 : 1). The maxillary arch is more often affected than the mandibular arch with the maxillary left quadrant being the most commonly involved. Affected teeth are hypoplastic, typically discolored yellow or yellowish brown, smaller in size and display a variety of surface marking including pitting and grooving. Radiographically, the teeth affected have been described to have a "ghost like" appearance or "fuzzy" appearance. Pulp calcification and denticles may be present within the pulp chambers of the affected teeth. In it's case, a 2 years old male visited for a treatment of uneruption of lower right teeth. Partial eruption of lower right deciduous central incisor and unerupted deciduous lateral incisor, deciduous canine and deciduous first molar showed severly delayed eruption state. On radiographic appearance, "Ghost like appearance", shortened root and opened apexes on lower right region were observed. It was suspected regional odontodysplasia with clinical and radiographic condition.

  • PDF