• 대한소아치과학회지
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• 제44권1호
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• pp.47-55
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• 2017

본 연구의 목적은 괴사된 미성숙 영구치의 재생근관치료 시 성공에 영향을 미치는 결정적 인자를 평가하고자 함에 있다. 미성숙 영구치의 치수괴사로 진단된 환자 중 재생근관치료를 시행하고 1년 이상 경과 관찰한 증례로서 46개 치아가 선택되었다. 이를 대상으로 성공률과 관련된 변수로서 나이, 성별, 초진 시 치근발육단계, 치수괴사 원인, 치료과정, 임상 및 방사선학적 결과를 조사하고 관련성을 통계 분석하였다. 분석 결과, 치근발육단계는 재생근관치료의 성공률에 영향을 미치지 않았으나, 치수괴사 원인은 치외치, 우식, 외상 순으로 성공률이 높았으며 유의한 차이가 있었다. 근관내 멸균 시 국소적 항생제를 적용했을 때 높은 성공률을 보이며 통계학적 유의차를 보였으며, double과 triple antibiotic paste간에는 유의차가 없었다. 재생근관치료의 성공률을 높이기 위해 치수 괴사 원인, 특히 외상 증례에 있어 신중한 적응증 판단이 선행되어야 하며, 적절한 항생제 적용이 필요하다.

• Restorative Dentistry and Endodontics
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• 제40권4호
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• pp.306-313
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• 2015

Objectives: Molecular mechanism of the pathogenicity of Enterococcus faecalis (E. faecalis), a suspected endodontic pathogen, has not yet been adequately elucidated due to limited information on its virulence factors. Here we report the identification of in vivo expressed antigens of E. faecalis by using a novel immunoscreening technique called change-mediated antigen technology (CMAT) and an experimental animal model of endodontic infection. Materials and Methods: Among 4,500 E. coli recombinant clones screened, 19 positive clones reacted reproducibly with hyperimmune sera obtained from rabbits immunized with E. faecalis cells isolated from an experimental endodontic infection. DNA sequences from 16 of these in vivo-induced (IVI) genes were determined. Results: Identified protein antigens of E. faecalis included enzymes involved in housekeeping functions, copper resistance protein, putative outer membrane proteins, and proteins of unknown function. Conclusions: In vivo expressed antigens of E. faecalis could be identified by using a novel immune-screening technique CMAT and an experimental animal model of endodontic infection. Detailed analysis of these IVI genes will lead to a better understanding of the molecular mechanisms involved in the endodontic infection of E. faecalis.

• Restorative Dentistry and Endodontics
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• 제37권1호
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• pp.29-33
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• 2012

Objectives: The purpose of this study was to evaluate the microleakage of 4 temporary materials in teeth with Class II-type endodontic access preparations by using a glucose penetration model. Materials and Methods: Glucose reaction test was performed to rule out the presence of any reaction between glucose and temporary material. Class II-type endodontic access preparations were made in extracted human premolars with a single root (n = 10). Each experimental group was restored with Caviton (GC), Spacer (Vericom), IRM (Dentsply-Caulk), or Fuji II(GC). Microleakage of four materials used as temporary restorative materials was evaluated by using a glucose penetration model. Data were analyzed by the one-way analysis of variance followed by a multiplecomparison Tukey test. The interface between materials and tooth were examined under a scanning electron microscope (SEM). Results: There was no significant reaction between glucose and temporary materials used in this study. Microleakage was significantly lower for Caviton and Spacer than for Fuji II and IRM. SEM observation showed more intimate adaptation of tooth-restoration interfaces in Caviton and Spacer than in IRM and Fuji II. Conclusions: Compared to IRM and Fuji II, Caviton and Spacer can be considered better temporary sealing materials in Class II-type endodontic access cavities.

• Restorative Dentistry and Endodontics
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• 제43권2호
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• pp.16.1-16.9
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• 2018

Objectives: Understanding the reason for an unsuccessful non-surgical endodontic treatment outcome, as well as the complex anatomy of the root canal system, is very important. This study examined the cross-sectional root canal structure of mandibular first molars confirmed to have failed non-surgical root canal treatment using digital images obtained during intentional replantation surgery, as well as the causative factors of the failed conventional endodontic treatments. Materials and Methods: This study evaluated 115 mandibular first molars. Digital photographic images of the resected surface were taken at the apical 3 mm level and examined. The discolored dentin area around the root canal was investigated by measuring the total surface area, the treated areas as determined by the endodontic filling material, and the discolored dentin area. Results: Forty 2-rooted teeth showed discolored root dentin in both the mesial and distal roots. Compared to the original filled area, significant expansion of root dentin discoloration was observed. Moreover, the mesial roots were significantly more discolored than the distal roots. Of the 115 molars, 92 had 2 roots. Among the mesial roots of the 2-rooted teeth, 95.7% of the roots had 2 canals and 79.4% had partial/complete isthmuses and/or accessory canals. Conclusions: Dentin discoloration that was not visible on periapical radiographs and cone-beam computed tomography was frequently found in mandibular first molars that failed endodontic treatment. The complex anatomy of the mesial roots of the mandibular first molars is another reason for the failure of conventional endodontic treatment.

• 구강회복응용과학지
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• 제35권1호
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• pp.46-54
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• 2019

치수 질환 그리고 치주 질환이 복합적으로 발생하여 치근단 조직과 변연부 치주 조직이 개통되는 것을 치주-근관 복합병소라 일컫는다. 치주-근관 복합 병소의 치료를 위해서는 근관치료 및 치주 재생 처치 둘 다를 필요로 하며, 이는 치근단 및 변연부 조직 모두의 치유를 위함이다. 본 연구에서는 치주-근관 복합 병소를 나타내는 하악 전치부 치아에서 근관치료 이후 조직유도 재생술을 시행하였으며, 각각의 증례에서 심한 치조골 흡수를 보이는 치아들은 3년이 넘는 경과 관찰기간 동안 발치되지 않고 유지될 수 있었다. 따라서 하악 전치부에서 발생한 치주-근관 복합 병소의 근관치료 후 조직유도 재생술을 이용한 치료는 임상적으로 이점이 있는 것으로 고려된다.

• Imaging Science in Dentistry
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• 제52권1호
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• pp.1-9
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• 2022

Purpose: This systematic review aimed to compare assessments of the healing of periapical endodontic surgery using conventional radiography and cone-beam computed tomography (CBCT). Materials and Methods: This review of clinical studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. All articles published from 1990 to March 2020 pertaining to clinical and radiographic healing assessments after endodontic surgery using conventional radiography and CBCT were included. The question was "healing assessment of endodontic surgery using cone-beam computed tomography." The review was conducted by manual searching, as well as undertaking a review of electronic literature databases, including PubMed and Scopus. The studies included compared radiographic and CBCT assessments of periapical healing after periapical endodontic surgery. Results: The initial search retrieved 372 articles. The titles and abstracts of these articles were read, leading to the selection of 73 articles for full-text analysis. After the eligibility criteria were applied, 11 articles were selected for data extraction and qualitative analysis. The majority of studies found that CBCT enabled better assessments of healing than conventional radiography, suggesting higher efficacy of CBCT for correct diagnosis and treatment planning. A risk of bias assessment was done for 10 studies, which fell into the low to moderate risk categories. Conclusion: Three-dimensional radiography provides an overall better assessment of healing, which is imperative for correct diagnosis and treatment planning.

• Restorative Dentistry and Endodontics
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• 제46권3호
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• pp.31.1-31.13
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• 2021

Objectives: To evaluate postoperative pain after endodontic treatment of necrotic teeth using large intentional foraminal enlargement (LIFE). Materials and Methods: The sample included 60 asymptomatic necrotic teeth (with or without chronic apical periodontitis), and a periodontal probing depth of 3 mm, previously accessed and referred to perform endodontic treatment. After previous procedures, the position and approximate size of the apical foramen (AF) were determined by using an apex locator and K flexo-files, respectively. The chemomechanical preparation was performed with Profile 04 files 2 mm beyond the AF to achieve the LIFE, using 2.5 mL of 2.5% NaOCl at each file change. The filling was performed by Tagger's hybrid technique and EndoFill sealer. Phone calls were made to all the patients at 24, 48 and 72 hours after treatment, to classify postoperative pain. Statistical analysis was performed by different tests with a significance level of 5%. Results: Age, gender, periradicular status and tooth type did not influence postoperative pain (p > 0.05). Only 1 patient (1.66%) reported severe pain after 72 hours. Moderate pain was reported by 7, 4 and 3 patients after 24, 48 and 72 hours, respectively (p = 0.0001). However, paired analyses showed a statistically significant difference only between 24 and 72 hours (p = 0.04). Sealer extrusion did not influence the postoperative pain (p > 0.05). Conclusions: Acute or moderate postoperative pain was uncommon after endodontic treatment of necrotic teeth with LIFE.

• Restorative Dentistry and Endodontics
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• 제47권3호
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• pp.34.1-34.12
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• 2022

Objectives: This study aimed to evaluate the success rate of endodontic treatments performed by undergraduate students and the factors associated with the outcome. Materials and Methods: A follow-up of 3 to 8 years after root canal filling was carried out in 91 patients. At the follow-up visits, medical and dental history questionnaires were applied along with clinical and radiographic examinations. Data collected in the clinical exam included: the presence of pain, swelling, sinus tract, mobility, tenderness to palpation and percussion, periodontal probing profile, and type/quality of coronal restoration. Postoperative and follow-up radiographs were digitalized and analyzed by 2 trained and calibrated examiners to assess periapical healing. The treatment outcome was based on strict clinical and radiographic criteria and classified as success (absence of any clinical and radiographic sign of apical periodontitis) or failure (other combination). Logistic regression was used to investigate the impact of clinical and radiographic variables on endodontic treatment outcomes at a 5% significance level. Results: The success rate of endodontic treatments was 60.7%. The only risk factor significantly associated with failure was the presence of a periapical lesion on the postoperative radiograph (odds ratio, 3.35; 95% confidence interval, 1.17-9.54). Conclusions: The success rate of endodontic treatments performed by undergraduate students was low and was jeopardized by the presence of a periapical lesion on the postoperative radiograph.

• 대한치과의사협회지
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• 제56권10호
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• pp.556-566
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• 2018

Whether you use a hand file or an engine-driven file, you cannot remove bacteria completely from the root canal by mechanical work alone. If the root canal is well cleaned, endodontic irrigants will well penetrate into these areas that will not be mechanically accessible. It will decompose and remove the biofilm and also remove the smear layer to reach the dentinal tubule. Clinicians who are not yet using NaOCl as their primary irrigant, should be aware that there are no other irrigants that offer all the benefits of NaOCl and are inexpensive. Clinicians may be reluctant to use it because of concern about NaOCl accident, but this possibility is extremely low if used with caution.

• 한국임상수의학회지
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• 제17권1호
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• pp.298-298
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• 2000

Seven years old male lion in Everland Zoo has three fractured canine tooth. To avoid the risk of a possible fracture with pulp exposure after restroration of largest abration defects, endodontic therapy was performed. The pulp chamber was filled with calcium hydroxide, zinc oxide cement and gutta percha. We also installed the Crown prosthesis was installed in fractured canine tooth to protect the tooth and to improve the cosmetics and function of the tooth. The lion could eat in one day and there were no any signs of dental problem. It is the obvious prophylactic procedure for wild animal is the inclusion of an oral examination at every opportunity to handle the animal. It is considered that crown prosthesis after endodontic therapy was useful for maintaining normal physiological function and for provention of additional fracture or complication.