• 제목/요약/키워드: endodontic

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Endodontic Flare-ups

  • 이승종
    • 대한치과의사협회지
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    • 제25권9호통권220호
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    • pp.831-834
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    • 1987
  • 개업치과의사들에 있어서 근관치료시 발생되는 가장 골치아픈 문제중 하나가 바로 Endodontic Flare-up이다. 미국 근관치료학회에서는 이러한 문제에 대한 일반 개업의들의 이해를 돕고자 미국내에서 개업하고 있는 일반 치과의사 70,000여명에게 다음 내용의 카세트테잎을 보낸바 있다. 역시 우리들에게도 많은 도움이 될 것같아 소개해 본다.

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한국인의 구치부 근관작업장에 관한 연구 (Study of endodontic working length of Korean posterior teeth)

  • 김정엽;이상훈;이광희;박상혁
    • Restorative Dentistry and Endodontics
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    • 제35권6호
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    • pp.429-435
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    • 2010
  • 연구목적: 본 연구의 목적은 한국인의 근관 작업장에 대한 ISO규격의 근관 치료용 기구의 길이가 적절성을 평가하기 위한 것이다. 연구 재료 및 방법: 2006-2008년까지 경희의료원 동서신의학병원 보존과에서 구치부의 근관 치료를 받은 환자를 670명 선발하였다. 모든 근관 치료는 한 명의 술자에 의해 시행되었으며 통법의 와동을 형성하였고 변연 융선부터 0.5 mm의 교합면삭제를 시행하였다. 근관장은 전자 근관장 측정기(Root ZX)를 이용하여 측정하였고 방사선 사진으로 보정하였다. 근관장의 길이는 근관 성형 정도에 따라 달라지기 때문에 이 실험에서는 초기 근관장만을 이용하였다. 심한 우식이 있거나 보철물이 있는 경우, 근관이 석회화 되어서 정상적인 근관 치료를 할 수 없는 경우, 상악 대구치의 근심 설측 근관과 하악의 C-shape 근관을 가진 치아는 실험군에서 제외하였다. 총 487개 소구치 근관과 870개 대구치 근관의 근관장을 측정하였고 각각의 평균 및 표준편차를 측정하였다. 또한 각 길이별 빈도 분포 및 정규 분포를 관찰하였다. 결과: 1. 소구치 근관에서 20 mm 이하의 근관장을 갖는 경우는 전체의 66.5%였으며 22 mm 이하의 근관장을 갖는 경우는 전체의 95.4%였다. 2. 한국인의 소구치 근관장을 측정한 결과, 현재 시판중인 21 mm, 25 mm의 기구보다는 23 mm의 기구가 더 적절하였다. 결론: 한국인의 소구치 근관 치료시 21 mm, 25 mm의 기구보다는 23 mm의 기구가 더 적절하였으며 대구치의 경우 21 mm의 기구의 사용이 적절하다고 사료된다.

Accidental injury of the inferior alveolar nerve due to the extrusion of calcium hydroxide in endodontic treatment: a case report

  • Shin, Yooseok;Roh, Byoung-Duck;Kim, Yemi;Kim, Taehyeon;Kim, Hyungjun
    • 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.

유치의 근관 치료 중 차아염소산나트륨의 치근단 유입으로 인한 합병증 (Accidental Extrusion of Sodium Hypochlorite during Endodontic Treatment in a Primary Tooth)

  • 김민지;김진영;임수민
    • 대한소아치과학회지
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    • 제42권3호
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    • pp.264-269
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    • 2015
  • 차아염소산나트륨은 가장 자주 쓰이는 근관 세척제이지만, 그 독성과 부작용에 대해서는 많이 인식되어 있지 않다. 본 증례는 근관 치료 중 차아염소산나트륨이 치근단 조직으로 압출되어 심각한 합병증이 발생하였기에 이를 보고하는 바이다. 만 5세의 남자 환자에서 근관 치료 중 차아염소산나트륨이 치근단 조직으로 유입되어 갑작스런 통증 및 부종, 주위 조직의 피하출혈 그리고 근관 내의 지속적 출혈을 보였다. 환자는 입원치료를 받았고, 진통제와 항생제를 처방받았다. 근단공이 넓은 미성숙 영구치와 유치, 치근흡수, 천공이 일어난 치아에서는 근관 치료 시 차아염소산나트륨이 압출되지 않도록 더욱 각별한 주의가 필요하다. 합병증이 발생하였을 때에는 적절한 환자의 관리와 약물치료가 필요하다.

근관치료의 근관장 측정에 관한 연구: 근관치료학 전공 교수 설문 (A survey on working length determination of endodontic treatment)

  • 안혜라;서민석
    • 대한치과의사협회지
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    • 제55권1호
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    • pp.42-52
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    • 2017
  • The purpose of this study is to evaluate the preferred method of root canal length determination and the apical limit for canal instrumentation among endodontic teachers of dental school. A questionnaire on the preferred method of root canal length determination and the apical limit for canal instrumentation was designed and distributed to endodontic teachers of various dental schools. The response rate was 90%. The most preferred method of root canal length determination was Electronic apex locator (EAL)(89%). The most favoured apical limit for canal instrumentation was 0.5 to 1.0 mm short of the radiographic apex(78%). The most preferred method of using EAL was that the working length is taken at 'APEX' mark and then distracted 0.5mm from that length.(41%). When there is no agreement between radiographic measurement and EAL measurement, 74% of respondents chose the length of EAL measurement. The majority of endodontic teachers from Korean dental schools preferred EAL to radiograph method in determining root canal length.

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근관와동 가봉재 종류에 따른 변연누출의 비교 분석 (COMPARATIVE ANALYSIS OF MARGINAL MICROLEAKAGE IN VARIOUS TEMPORARY SEALING MATERIALS)

  • 윤창;홍석진
    • Restorative Dentistry and Endodontics
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    • 제16권1호
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    • pp.151-157
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    • 1991
  • The roles of temporary sealing materials used in endodontics are impotant Especially, its marginal sealing properties affect endodontic success and failure in endodontic treatment The purpose of this in vitro study was to compare and evaluate the marginal sealing properties of various temporary restorative materials used in endodontic access cavity by using electrochemical method. Standard endodontic access cavities were prepared in extracted human molar teeth and filled with Caviton, IRM, zinc oxide - eugenol cement. Each specimen was immersed in 1 % solution of KCl, and applied a potential of 9 V external power supply. Marginal microleakage and water sorption were measured for marginal sealing effect evaluation in comparison with each group. A comparative study of the obtained results have led to the following conclusions. 1. The Caviton group showed lower marginal microleakage value than the zinc oxide - eugenol cement and IRM group the 6 th day after. The IRM group showed lwoer marginal microleakage value than the zinc oxide - eugenol cement group from the 6 th day to the 12 th day. But there was no significant difference between zinc oxide - eugenol cement and IRM group after the 13 th day. 2. As time went by, marginal microleakage value was increased in Caviton, IRM and zine oxide - eugenol cement.

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Does apical root resection in endodontic microsurgery jeopardize the prosthodontic prognosis?

  • Cho, Sin-Yeon;Kim, Euiseong
    • Restorative Dentistry and Endodontics
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    • 제38권2호
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    • pp.59-64
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    • 2013
  • Apical surgery cuts off the apical root and the crown-to-root ratio becomes unfavorable. Crown-to-root ratio has been applied to periodontally compromised teeth. Apical root resection is a different matter from periodontal bone loss. The purpose of this paper is to review the validity of crown-to-root ratio in the apically resected teeth. Most roots have conical shape and the root surface area of coronal part is wider than apical part of the same length. Therefore loss of alveolar bone support from apical resection is much less than its linear length.The maximum stress from mastication concentrates on the cervical area and the minimum stress was found on the apical 1/3 area. Therefore apical root resection is not so harmful as periodontal bone loss. Osteotomy for apical resection reduces longitudinal width of the buccal bone and increases the risk of endo-perio communication which leads to failure. Endodontic microsurgery is able to realize 0 degree or shallow bevel and precise length of root resection, and minimize the longitudinal width of osteotomy. The crown-to-root ratio is not valid in evaluating the prosthodontic prognosis of the apically resected teeth. Accurate execution of endodontic microsurgery to preserve the buccal bone is essential to avoid endo-perio communication.

A preliminary report on histological outcome of pulpotomy with endodontic biomaterials vs calcium hydroxide

  • Nosrat, Ali;Peimani, Ali;Asgary, Saeed
    • Restorative Dentistry and Endodontics
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    • 제38권4호
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    • pp.227-233
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    • 2013
  • Objectives: The purpose of the study was to evaluate human dental pulp response to pulpotomy with calcium hydroxide (CH), mineral trioxide aggregate (MTA), and calcium enriched mixture (CEM) cement. Materials and Methods: A total of nine erupted third molars were randomly assigned to each pulpotomy group. The same clinician performed full pulpotomies and coronal restorations. The patients were followed clinically for six months; the teeth were then extracted and prepared for histological assessments. The samples were blindly assessed by an independent observer for pulp vitality, pulp inflammation, and calcified bridge formation. Results: All patients were free of clinical signs/symptoms of pulpal/periradicular diseases during the follow up period. In CH group, one tooth had necrotic radicular pulp; other two teeth in this group had vital uninflamed pulps with complete dentinal bridge formation. In CEM cement and MTA groups all teeth had vital uninflamed radicular pulps. A complete dentinal bridge was formed beneath CEM cement and MTA in all roots. Odontoblast-like cells were present beneath CEM cement and MTA in all samples. Conclusions: This study revealed that CEM cement and MTA were reliable endodontic biomaterials in full pulpotomy treatment. In contrast, the human dental pulp response to CH might be unpredictable.

Periodontal healing following non-surgical repair of an old perforation with pocket formation and oral communication

  • Asgary, Saeed;Verma, Prashant;Nosrat, Ali
    • Restorative Dentistry and Endodontics
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    • 제43권2호
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    • pp.17.1-17.7
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    • 2018
  • Iatrogenic perforations negatively impact the outcome of endodontic treatments. Studies on prognostic factors showed that perforations in the coronal third of the root with periodontal pocket formation have an unfavorable prognosis. A 36-year-old female was referred for endodontic evaluation of tooth #13 with a history of an iatrogenic perforation, happened 3 years ago. There was a sinus tract associated with perforation, 10 mm probing on the mesial and mesio-palatal, bleeding on probing, radiolucent lesion adjacent to the perforation and complete resorption of the interdental bone between teeth #13 and #12. After the treatment options were discussed, she chose to save the tooth. The tooth was accessed under rubber dam isolation, the perforation site was cleaned and disinfected using 0.5% sodium hypochlorite and sealed with calcium-enriched mixture cement. Eighteen months after treatment the tooth was functional and asymptomatic. The probing depths were normal without bleeding on probing. Radiographically, the interdental crestal bone formed between teeth #13 and #12. Despite all negative prognostic factors in this case (i.e., perforations in the coronal third, pocket formation, and radiolucent lesion), healing was unexpectedly achieved via non-surgical repair of the perforation. Further research on biological aspects of healing in the periodontium following iatrogenic perforations are recommended.