• Journal of Dental Anesthesia and Pain Medicine
• /
• 제21권2호
• /
• pp.173-178
• /
• 2021

Inferior alveolar nerve (IAN) injury is usually caused by stretching or crushing of the neurovascular structures and postoperative intra-alveolar hematoma or edema after dental procedures. This results in paresthesia in the ipsilateral chin, lip (vermilion border, skin, and mucosa), and labial or buccal alveolar mucosa of the mandibular anterior teeth. However, there are no reports of sensory alterations in the teeth, especially tooth hypersensitivity, after IAN injury. I report a case in which paresthesia of the lower lip and hypersensitivity of the lower anterior teeth occurred simultaneously after the removal of the third molar that was located close to the IAN. In addition, I discuss the reasons for the different sensory changes between the tooth and chin (skin) after nerve injury from a neurophysiological point of view. Since the dental pulp and periodontal apparatus are highly innervated by the inferior alveolar sensory neurons, it seems necessary to pay attention to the changes in tooth sensitivity if IAN injury occurs during dental procedures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제36권5호
• /
• pp.360-365
• /
• 2010

Introduction: Mammalian tooth pulp is densely innervated by sensory nerves that are mostly C fibers and A delta fibers. However, there is evidence suggesting that many unmyelinated axons in the pulp are in fact parent meylinated axons. Immunohistochemical staining for neurofilament protein 200 kDa (NFP200) was performed to identify the demyelinated but parent myelinated axons. Materials and Methods: The pulp was removed from healthy premolars and 3rd molars extracted from juveniles and adults undergoing orthodontic treatment, and immunohistochemical staining were applied with NPF200 antibodies, which specifically dye myelinated axons. The specimens underwent an electron microscopy examination with diaminobenzidine (DAB) immunostaining after observation and analysis by fluorescence and confocal laser scanning microscopy. Results: The NPF200 immuno-positive axons in the radicular pulp areas were observed as bundles of many nerve fibers. Many small bundles were formed with fewer axons when firing to the coronal pulp areas and then reachrd a different direction. In the radicular pulp, unmyelinated axons and myelinated axons were present together. However, in the coronal pulp, unmyelinated axons were most common and NFP200 immuno-positive unmyelinated axons with a larger diameter than those in the radicular pulp were observed more frequently. On the other hand, most of the immuno-positive unmyelinated fibers were similar in size to that of typically well-known unmyelinated fibers. Conclusion: Myelinated fibers innervated to the dental pulp maintain their myelins in the radicular portion, but these fibers lost myelins in the coronal portion. After the loss of myelin, the size of the axoplasm also decreased.

• Journal of Korean Dental Science
• /
• 제9권1호
• /
• pp.9-18
• /
• 2016

Purpose: Wnt signaling plays an essential role in the dental epithelium and mesenchyme during tooth morphogenesis. Deletion of the Wntless (Wls) gene in odontoblasts appears to reduce canonical Wnt activity, leading to inhibition of odontoblast maturation. However, it remains unclear if autonomous Wnt ligands are necessary for differentiation of dental pulp cells into odontoblast-like cells to induce reparative dentinogenesis, one of well-known feature of pulp repair to form tertiary dentin. Materials and Methods: To analyze the autonomous role of Wls for differentiation of dental pulp cells into odontoblast-like cells, we used primary dental pulp cells from unerupted molars of Wls-floxed allele mouse after infection with adenovirus for Cre recombinase expression to knockout the floxed Wls gene or control GFP expression. The differentiation of dental pulp cells into odontoblast-like cells was analyzed by quantitative real-time polymerase chain reaction. Result: Proliferation rate was significantly decreased in dental pulp cells with Cre expression for Wls knockout. The expression levels of Osterix (Osx), runt-related transcription factor 2 (Runx2), and nuclear factor I-C (Nfic) were all significantly decreased by 0.3-fold, 0.2-fold, and 0.3-fold respectively in dental pulp cells with Wls knockout. In addition, the expression levels of Bsp, Col1a1, Opn, and Alpl were significantly decreased by 0.7-fold, 0.3-fold, 0.8-fold, and 0.6-fold respectively in dental pulp cells with Wls knockout. Conclusion: Wnt ligands produced autonomously are necessary for proper proliferation and odontoblastic differentiation of mouse dental pulp cells toward further tertiary dentinogenesis.

• 대한소아치과학회지
• /
• 제43권4호
• /
• pp.419-426
• /
• 2016

본 연구는 상악 매복 과잉치를 가지고 전신질환 및 의과 병력이 없는 만 5 - 9세 사이의 남녀 20명으로부터 서면동의를 얻고 상악 전치부에 매복된 과잉치를 발치하고 치수세포를 채취하였다. 채취 후 세포의 1차 배양 동안 오염된 3명(남자 2명, 여자 1명)을 제외하고 총 17명(남자 10명, 여자 7명)을 대상으로 하였다. 이번 연구에서 과잉치 치수조직으로부터 유래한 세포의 계대 배양에 소요된 평균 시간은 $2.91{\pm}0.29$일이었다. 최초 치수조직으로부터 세포를 얻은 후 80% confluency를 얻는데 소요되는 시간이 $4.53{\pm}0.94$일로 가장 많이 걸렸고, 이후 계대부터는 $2.73{\pm}0.32$일이 소요되었다. 남자의 비율은 58.82%, 여자의 비율은 41.18%이었다. 여자의 평균 소요시간은 $2.81{\pm}0.27$일 이었으며, 남자는 $2.98{\pm}0.29$이었다. 과잉치가 역위된 비율은 82.35%, 정위 비율은 17.65%였다. 평균 계대 소요 배양 시간은 역위가 $2.94{\pm}0.30$일, 정위는 $2.80{\pm}0.20$일이었다. 원뿔형(Conical type)은 76.47%였고, 그 외 형태는 23.53%였다. 원뿔형의 평균 소요시간은 $2.92{\pm}0.31$이었고, 그 외 형태의 소요 시간은 $2.88{\pm}0.22$이었다. 매복 방향과 형태에 따른 계대 배향 시간은 통계적으로 유의한 차이를 보이지 않았다. 향후 초기 계대와 후기 계대에서 얻어진 세포의 줄기세포로써의 능력을 평가하는 후속 연구들이 필요하며, 3일 이내의 계대 배양 시간이 소요된 점을 고려할 때, 연구의 효율성과 빠른 배양시간 등은 과잉치 유래세포가 치아유래 줄기세포의 연구에 활용가능성이 충분하리라 판단되었다.

• 대한소아치과학회지
• /
• 제26권4호
• /
• pp.616-622
• /
• 1999

치수치료의 주요한 목적은 구강조직의 본래의 건강을 유지하는 것이며, 치수치료 시 가장 중요하고 어려운 점은 치수조직의 건강상태 또는 염증의 정도를 결정함으로써 최선의 치료방법을 결정하는 것이다. 미성숙 영구치는 풍부한 혈류 공급으로 다양한 손상에 성공적으로 반응하게끔 치수의 능력을 향상시킴으로써 많은 치수치료 술식을 위한 좋은 조건을 가지고 있다. 기저재(base) 또는 이장재(liner), 간접 치수복조술, 직접 치수복조술, 그리고 치경부 치수절단술을 포함한 여러 종류의 보존적인 치수치료가 미성숙 영구치를 위해 추천되어 왔다. 근래에는 외상으로 인하여 치수노출된 영구절치를 치료하는데 있어 주로 제시된 부분 치수절단술(partial pulpotomy)이 우식으로 인해 치수노출된 영구대구치를 치료하는 또 다른 술식으로 제안되고 있다. 부분 치수절단술 후 치아가 다음의 criteria를 만족시킬 때 치유가 되었다고 결론지었다. 1. 임상적 무증상 2. dentin bridge 형성의 방사선학적 증거 3. 방사선상에 치수내 또는 치근단 병소가 없다는 증거 4. 지속적인 치근 발육과 미성숙 치아의 치근첨 형성 5. 성숙된 치아에서 정상적인 상아질의 축적 6. 전기치수검사에서 양성 반응 이에 저자는 미성숙 영구치에서 우식 또는 외상으로 인한 치수노출시 부분 치수절단술을 행하여 양호한 결과를 얻었기에 이를 보고하는 바이다.

• 대한치과보존학회:학술대회논문집
• /
• 대한치과보존학회 2001년도 춘계학술대회
• /
• pp.247-251
• /
• 2001

;A dental developmental anomaly is defined as an isolated aberration in tooth form, caused by a disturbance or abnormality which occurred during tooth development. There are numerous types of dental anomalies, and a considerable variation in the extent of the defects occurs with each type. Teeth with these anomalies pose unique challenges. Since the defects are not always apparent clinically, they can confuse diagnosticians investigating the etiology of pulpal pathosis. When endodontic treatment is required, the defects often hinder access cavity preparation and canal instrumentation. Treatment planning also becomes more challenging, since the defects can create complicated periodontal problems, and the malformed teeth can be difficult to restore, particularly those weakened by endodontic therapy. Fusion is defined as the joining of two developing tooth germs resulting in a single large tooth structure. The incidence of fusion is < 1% in the Caucasian population, and it is believed that physical force or pressure produces contact of the developing teeth. Clinically and radiographically, a fused tooth usually appears as one large crown with at least partially separated roots and root canals. There may be a vertical groove in the tooth crown delineating the originally separate crowns. Dens invaginatus is a deep surface invagination of the crown or root that is lined by enamel. Teeth in both maxillary and mandibular arches may be affected, but the permanent maxillary lateral incisor is the tooth most commonly involved. Studies have revealed an incidence ranging from 0.25% to as high as 10%. The invagination ranges from a slight pitting to an anomaly occupying most of the crown and root. The invagination frequently communicates with the oral cavity, allowing the entry of irritants and microorganism either directly into pulpal tissues or into an area that is deparated from pulpal tissues by only a thin layer of enamel and dentin. This continuous ingress of irritants and the subsequent inflammation usually lead to necrosis of the adjacent pulp tissue and then to periapical or periodontal abscesses. If the invagination extends from the crown to the periradicular tissue and has no communication with the root canal system, the pulp may remain vital. Recommended treatment of fused tooth and dens invaginatus has been reported in the endodontic literature. This case report describes the endodontic treatment of a maxillary laterl incisors having fused crown and dens invaginatus.natus.

• 대한소아치과학회지
• /
• 제51권2호
• /
• pp.176-184
• /
• 2024

This study aimed to compare color matching between single-shade composite resin-restored teeth with various pulp capping materials and the dentin surrounding the restoration through instrumental analysis and visual evaluation of the color difference. Fifty maxillary right central incisor acrylic resin teeth were prepared with standardized Class III cavities on the proximal surfaces. These teeth were divided into five groups: restored with single-shade composite resin only; Ultra-Blend^TM plus followed by single-shade composite resin; TheraCal PT^TM followed by single-shade composite resin; Endocem^® MTA premixed followed by single-shade composite resin; and Well-root PT^TM followed by single-shade composite resin. The color difference (ΔE_ab^*) between the restored area and the center of the resin teeth was measured using a spectrophotometer. No significant color difference was observed in groups restored with only single-shade composite resin, Ultra-Blend^TM plus, and TheraCal PT^TM. The visual evaluation revealed that Ultra-Blend^TM plus exhibited the best color matching score, whereas the Endocem^® MTA premixed and Well-root PT^TM groups showed significantly lower color matching scores than the single-shade composite resin-only group. When opting for single-shade composite resin usage for anterior tooth restorations with the aim of reducing chair time, pulp capping materials Ultra-Blend^TM plus and TheraCal PT^TM provide esthetically pleasing results.

• 대한치과교정학회지
• /
• 제21권3호
• /
• pp.635-656
• /
• 1991

It was the aim of this investigation to evaluate some histologic aspect of rat pulp tissue after it had been compromised by an experimental orthodontic force. Experimental animals of thirty five Spraque-Dawley rats were employed. The first upper molars had been successively mesial moved (initial load 100 gr.) with a closed coil spring during 21 days. The experimental periods were set on immediate, 1 day, 1 week, 2 weeks, 3 weeks, 4 weeks following retention time. On each experimental period, the rats were killed and prepared for the light microscopy. After prepared with H/E stain and Gomori's one-step trichrome stain, the specimens were analyzed with evaluation criteria which were adopted in this study. The result may be summarized as follows; 1. The main pulp changes due to experimental orthodontic force included vacuolization of odontoblastic layer, circulation disturbance, root resorption, reduced pulp collagenous fiber density and mean cell count of pulp fibroblast in the immediate group. 2. The pulp tissue changes were revealed reversible because the relieved pulp tissues from experimental orthodontic force were recovered rapidly in each evaluation criteria during retention periods. 3. Compared with normal control group, pulp collagenous fiber density were decreased in immediated group (p < 0.01), but increased in each retention groups. These seem to suggest that the pulp tissues were aged after experimental orthodontic force conditions. 4. Compared with normal control group, mean cell counts of pulp fibroblasts were decreased in immediate group (p < 0.05), but increased continuous in each retention groups. These seem to indicate that the pulp tissues were highly regenerative after experimental orthodontic force conditions. 5. Compared with normal control group, root resorptions occurred in all immediate specimens (p < 0.01) and they were healed in each retention periods, but often observed in 4 weeks retention group. These seem to indicate that root resorptions were recovered slowly after experimental orthodontic force conditions.

• 대한소아치과학회지
• /
• 제45권2호
• /
• pp.250-256
• /
• 2018

치아의 완전 탈구는 치조골에서 치아가 완전히 이탈된 것으로 정의되며, 결과적으로 신경혈관 공급의 중단을 야기하는 가장 심각한 치과적 손상 중 하나로 알려져 있다. 완전 탈구는 조직 허혈(tissue ischemia)을 야기하며, 이는 치수 괴사를 초래할 수 있다. 치근단형성술(apexification)은 치수 괴사로 진단된 미성숙 영구치에서 치근단 장벽을 유도하는 전통적인 치료 방법이다. 하지만 치근단형성술로는 치근 길이 및 두께의 증가를 포함하는 치근 발육을 얻을 수 없다. 본 증례는 완전 탈구되어 재식된 이후 치수 괴사로 진단된 치아를 가진 5세 환자에서 ciprofloxacin, metronidazole, cefaclor 및 CollaTape과 Biodentine을 이용하여 시행된 치수재생치료(regenerative endodontic treatment)의 임상적 및 방사선학적 결과를 다루고 있다.

• 대한소아치과학회지
• /
• 제41권4호
• /
• pp.335-343
• /
• 2014

재생적 근관치료는 치수 괴사를 보이는 미성숙 영구치 치료에 있어서 괴사된 치수를 치유하고 계속되는 치근의 발달을 유도할 수 있다. 그러나 여기에는 몇 가지 단점과 불리한 결과들이 있다. 이 중 재생적 근관치료에 가장 큰 임상적 부작용은 minocycline과 MTA에 의한 변색이다. 본 증례에서는 재생적 근관치료 후에 나타나는 치관 변색을 방지하기 위해 minocycline을 clindamycin으로 대체한 triple antibiotics와 칼슘 지르코늄 알루민산염 시멘트인 Retro MTA를 사용하였다. 치수 괴사된 미성숙 영구치에서 근관 와동 형성 및 근관 세척 후 수정된 triple antibiotics를 적용하고, 혈병 또는 콜라겐 스펀지를 스캐폴드(scaffold)로 하여 Retro MTA로 근관을 폐쇄하였다. 정기적인 검진 결과 미성숙 영구치의 치근 성장 및 정상적인 치아 주위 조직들이 관찰되었으며, 치관 변색 없이 모두 양호한 치유 결과를 얻었다.