• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.2
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• pp.188-196
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• 2015

Endodontic management of an immature permanent tooth with dens invaginatus poses a challenge to efficient treatment planning for the clinicians. Because it is difficult to shape, disinfect, and seal the canal space effectively, teeth with complex root canal structures often require particularly extensive and thorough treatment approaches. The purpose of this case report was to share clinical insight from the results of short-term follow-ups after regenerative endodontic treatment with a dens invaginatus. Two immature maxillary lateral incisors with Oehlers type I and III dens invaginatus and infected necrotic pulp were treated using regenerative endodontic procedures. For the type III dens invaginatus case, an unusual approach toward redesigning the complex internal structure was taken, in order to have sufficient infection control and sealing. Cone-beam computed tomography (CBCT) and a surgical operating microscope were used to aid visualization and treatment. As a result, regenerative endodontic treatment appears to be effective for managing immature permanent teeth with complex dens invaginatus, and can lead not only to clinical and radiographic resolution, but also increased thickness of the dentinal walls.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.199-205
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• 2012

Although the stainless steel crowns have been recognized as the most effective and durable form of restoration for primary molars, they have been regarded by many dentists as having definite demerits such as invasive nature of procedural complexity and behavioral aspects of children. As an alternative to conventional technique of stainless steel crown restoration, the Hall technique was first introduced in 1988, which is characterized by just pushing the pre-contoured, cement filled crown form onto the abutment molar with no local anesthesia, no caries removal, no tooth preparation. According to several reports, this can slow, arrest, or even reverse the progress of caries. In addition, its atraumatic feature gives less discomfort and stress to children than conventional one, which is thought excellent especially in younger children. Also, It has been reported to be effective and acceptable to dentist, child patients and their parents. In this case study, three children with age of 4 years 5 months, 4 years 10 months, 6 years 4 months were treated with stainless steel crowns using Hall technique on first primary molar respectively. The teeth were free from pulpal, periapical pathology. After follow up of about 3 to 6 months period, the results showed clinically successful outcomes without any marked complication in pulp, tooth or soft tissue till now. But, it should be kept in mind that this technique is not proper to every child, every carious molar, or every dentist. Thorough distinction of indicated cases and continuous follow-up check is highly required. Conclusively, Hall technique might be an effective and realistic minimally invasive alternative for the carious primary molars especially in younger or disabled children, despite potential doubts on its efficacy and some definite limitations.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.27.1-27.8
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• 2018

Purpose: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. Materials and methods: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors' department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery. Results: One patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration. Conclusions: Considering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem.

• Restorative Dentistry and Endodontics
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• v.25 no.1
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• pp.1-16
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• 2000

It is difficult to treat the endodontic apical perforation successfully. In this study, we hypothesized that the application of PDGF-BB and IGF-I into periapical perforation site may accelerate periapical healing and lead to bone deposition. And the specificity of osteonectin in periapical healing was investigated. The experiments were performed on the upper and lower 51 premolar teeth of 4 beagle dogs. The pulp chamber of each tooth was opened and the dental plaque was inserted into the canal for developing the periapical lesion for 5 weeks. Then, the roots were artificially perforated at the apex with the number 4 profile of .06 taper. In each step, standard periapical radiographs were taken to compare the size of lesion each other. The radiographs were scanned and analyzed by image analysis system. The mean and standard deviation of periradicular radiolucency ratios were calculated in each group. ANOVA was used for comparison. 51 premolars were grouped into 3 groups; control group, calcium hydroxide-treated group and calcium hydroxide plus growth factors-treated group. In the control group, the apical perforations were not sealed and obturated with gutta-percha and ZOE sealer by lateral condensation technique. In the experimental groups, the apical perforation were sealed with calcium hydroxide and with/without $4{\mu}g$ of PDGF-BB & IGF-I in cellulose gel and obturated by lateral condensation technique. Fluorescent bone markers were used to measure new bone formation. Following 2, 4, 12 weeks after experiment the dogs were sacrificed and histologic sections were prepared. Each tooth block including periapical lesion was sectioned mesiodistally. One half of the sections were decalcified with 6% nitric acid and processed by standard paraffin embedding technique. The sections were stained by hematoxylin and eosin, and immunostained for osteonectin. Histomorphometrical measurement of neoformed bone was performed using a light microscope. And the other half of the sections were prepared by undecalcified preparation, and confocal laser scanning microscopic investigations were done.

• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.33.1-33.12
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• 2019

Objectives: To evaluate the influence of the restorative technique on the mechanical response of endodontically-treated upper premolars with mesio-occluso-distal (MOD) cavity. Materials and Methods: Forty-eight premolars received MOD preparation (4 groups, n = 12) with different restorative techniques: glass ionomer cement + composite resin (the GIC group), a metallic post + composite resin (the MP group), a fiberglass post + composite resin (the FGP group), or no endodontic treatment + restoration with composite resin (the CR group). Cusp strain and load-bearing capacity were evaluated. One-way analysis of variance and the Tukey test were used with ${\alpha}=5%$. Finite element analysis (FEA) was used to calculate displacement and tensile stress for the teeth and restorations. Results: MP showed the highest cusp (p = 0.027) deflection ($24.28{\pm}5.09{\mu}m/{\mu}m$), followed by FGP ($20.61{\pm}5.05{\mu}m/{\mu}m$), CR ($17.62{\pm}7.00{\mu}m/{\mu}m$), and GIC ($17.62{\pm}7.00{\mu}m/{\mu}m$). For load-bearing, CR ($38.89{\pm}3.24N$) showed the highest, followed by GIC ($37.51{\pm}6.69N$), FGP ($29.80{\pm}10.03N$), and MP ($18.41{\pm}4.15N$) (p = 0.001) value. FEA showed similar behavior in the restorations in all groups, while MP showed the highest stress concentration in the tooth and post. Conclusions: There is no mechanical advantage in using intraradicular posts for endodontically-treated premolars requiring MOD restoration. Filling the pulp chamber with GIC and restoring the tooth with only CR showed the most promising results for cusp deflection, failure load, and stress distribution.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.273-279
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• 2016

Severe tooth wear may lead to pathological changes of pulp, imbalance in occlusion as well as functional and esthetic problems. In this case, 34-year-old male came to the hospital because of generally worn dentition due to attrition and erosion. After evaluation, a full mouth restoration with elevation of the vertical dimension of occlusion was planned. After occlusion was stabilized by an occlusal stabilization appliance, centric relation position was recorded and subsequent provisional restorations were fabricated. After evaluation, a CAD-CAM (computer aided design-computer aided manufacturing) prosthetic restoration was carried out using monolithic zirconia. After 12 months of follow up observation, the patient was satisfied with function and esthetic appearance.

• Restorative Dentistry and Endodontics
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• v.27 no.6
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• pp.622-631
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• 2002

To understand the recent characteristics of the papers published in the Journal of Korean Academy of Conservative Dentistry(JKACD), All the papers in the JKACD of 1992 to 2001 were analyzed. A total of 513 papers were classified according to its type, fold and subject of the study, school and the number of authors, references, and written language. The results were as follows ; 1 According to the type of the paper, 506(98.6%) were original articles, 3(0.6%) were review articles, and 4(0.8%) were case reports. 2. Anual proportion of papers in the fold of operative dentistry was similar to that of endodontics 3. In the field of operative dentistry, esthetic restorative materials and bonding to tooth constituted major subjects of the studies. In the field of endodotics, pulp biology was prominent and canal shaping, endodontic microbiology and canal obturation were steadily reported. 4. According to author's school, similar number of papers were published in the field of operative den tistry and endodontics in general. However, some schools showed preponderances. 5. Most studies were done by two or more authors. Studies published by two authors were most 6. Fifty(9.7%) papers were done in collaboration with workers of the other field. 7. Average number of references cited in the papers was 41.2, including domestic references of 1.8. 40.7% of the papers was shown to cite no domestic papers at all. 8. Twenty-eight(5.5%) papers were written in English, with increasing ratio.

• Restorative Dentistry and Endodontics
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• v.27 no.6
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• pp.587-599
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• 2002

Extracellular single unit recordings were made from the ventral posteromedial thalamic (VPM) nociceptive neurons to determine mechanoreceptive field (RF) and response properties. A total of 44 VPM thalamic nociceptive neurons were isolated from rats anesthetized with urethane-chloralose. Based on responses to various mechanical stimuli including touch, pressure and pinch applied to the RF, 32 of 44 neurons were classified as nociceptive specific (NS) neuron. The other 12 neurons, classified as wide dynamic range (WDR), showed a graded response to increasingly intense stimuli, with a maximum discharge to noxious pinch. The VPM nociceptive neurons showed various spontaneous activity ranged from 0-6 Hz. They were located throughout the VPM, and had an contralateral RF including mainly intraoral (and perioral) regions. The RF size was relatively small, and very few neurons had a receptive field involving 3 trigeminal divisions. The NS neurons activated only by pressure and pinch stimuli had high mechanical thresholds compared to WDR neurons activated also by touch stimuli. The VPM nociceptive neurons were tested with suprathershold graded mechanical stimuli. Most of 21 NS and 8 WDR neurons showed a progressive increase in number of spikes as mechanical stimulus intensity was increased. In some neurons, the responses reached a peak before the highest intensity was given. Application of 5 mM $CoCl_2{\;}(10{\;}{\mu}\ell)$ solution to the trigeminal subnucleus caudalis did not produce any significant changes in the spontaneous activity, RF size, mechanical threshold, and response to suprathreshold mechanical stimuli of 9 VPM nociceptive neurons tested. 17 of 33 VPM nociceptive neurons responded to noxious heat as well as noxious mechanical stimuli applied to their RF. Application of the mustard oil, a small-fiber excitant and inflammatory irritant, to the right maxillary first molar tooth pulp induced an immediate but short-lasting neuronal discharges upto approximately 4 min in 16 of 42 VPM nociceptive neurons. These results suggest that VPM thalamic nucleus may contribute to the sensory discriminative aspect of orofacial nociception.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.385-390
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• 2003

Traumatic injuries in the young permanent dentition are common, but root fractures, defined as fractures involving dentin, cementum and pulp, are relatively uncommon. Appropriate management of root fracture involves repositioning the coronal portion of the tooth fragment and firm immobilization with a splint for 2 to 3 month. Root canal treatment should not be initiated until the sign of necrosis or resorption are apparent because in most cases, the apical fragments maintain their vitality. The following case report describes a patient with root fractures injured three times over the period of 7 years. The results, clinically and radiographically, were acceptable, but long term periodic evaluation is required.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.3
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• pp.498-505
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• 2007

Management options for impacted maxillary canines can include (1) continued observation, (2) extraction of the primary canine to aid spontaneous eruption, (3) uncovering and bonding of the impacted tooth and its eruption using orthodontic traction, (4) autotransplantation, and (5) extraction followed by prosthetic replacement. Autotransplantation should be considered when the degree of malposition is too severe to correct by orthodontic alignment. The present report describes the management of an ectopic eruption of the left maxillary canine in an 10-year-old girl. The treatment included the extraction of primary maxillary left canine and the autotransplantation using a Rapid Prototyping model. By using RP model to contour the recipient bone and check for fitting in the prepared socket, the extra-oral time can reduce. The autotransplanted canine showed mobility within normal limit, negative response to percussion and positive to electric pulp test after 6 months.