• Restorative Dentistry and Endodontics
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• 제24권1호
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• pp.166-179
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• 1999

외과적 근관치료에서 근단부의 폐쇄성은 성공에 필수적이다. 그리고 외과적 근관치료시 근단부 역충전와동은 습기나 혈액에 의해 오염되기 쉬우며 와동을 이상적으로 건조하기가 항상 용이하지는 않다. 본 연구의 목적은 미세 치근단 수술법에서 치근단 역충전와동의 건조 방법이 폐쇄성에 미치는 영향을 연구하고자 함이다. 치근단 폐쇄성은 근단 누출 및 충전물-와벽 적합성으로 평가하였다. 치근단 역충전와동 건조방법에 따른 치근단 누출을 평가하기 위해서는 최근에 발거된 상악 대구치 구개측치근 125개를 와동건조 방법 및 혈액오염에 따라 4개의 군으로 분류하여 실험하였다. 각 시편치아에서 근관을 형성하고 측방가압법으로 충전한 후 각 군에 따라 저속 다이아몬드 절단기를 이용하여 치근단 3 mm를 절제하였으며 초음파 스테인레스 스틸 기구를 이용하여 깊이 3mm의 역충전 와동을 형성하고 IRM, Super EBA 또는 복합레진으로 역충전하였다. 시편을 2% methylene blue 용액에 7일간 침잠시킨 후 35% 질산 용액에서 용해시킨 다음, 원심분리한 상층액을 비색계를 이용하여 누출 색소의 흡광도를 측정하였다. 결과치는 이원변량분석법과 Duncan's Multiple Range Test를 이용하여 분석하였다. 역충전 와동 건조방법에 따른 충전물-와벽 적합성을 평가하기 위해서는 상악 제 1대구치의 구개측 치근 12개를 상기와 같이 4개 군으로 분류하여 근관충전, 역충전와동 형성, 와동 건조 및 역충전을 실험하였으며, 다음과 같은 결과를 얻었다. 1. 압축공기나 paper point로 와동을 건조한 군이, 역충전 와동을 IRM 간이충전재, Super EBA 시멘트 및 복합레진으로 충전한 경우 공히, cottton pellet 만으로 와동을 건조한 군에 비해 적은 치큰단 누출을 나타내었는데 이는 Super EBA 시멘트 충전군에서만 유의한 차이를 나타내었다(p<0.05). 그러나 충전재료에 관계없이 paper point로 와동을 건조한 군과 압축공기로 건조한 군 사이에는 유의한 누출의 차이가 나타나지 않았다. 2. 압축공기로 와동을 건조한 경우에는, 복합레진으로 충전한 군이 IRM이나 Super EBA로 충전한 군에 비해 유의하게 적은 치근단 누출을 나타내었다(p<0.05). 3. 와동을 혈액으로 오염시킨 경우에는, 역충전 와동을 IRM, Super EBA 및 복합레진으로 충전한 군 공히, 압축공기로 와동내부를 건조한 경우에 비해 유의하게 많은 치큰단 누출을 나타내었다(p<0.05). 4. IRM 간이충전재나 Super EBA 시멘트로 역충전와동을 충전한 경우, 와동측벽의 외측 1/2이 내측 1/2에 비해 넓은 충전물-치질 사이 틈을 나타내었다. 5. IRM 간이충전재, Super EBA 시멘트 및 복합레진으로 역충전와동을 충전한 경우 공히, 와동이 혈액에 의해 오염되었거나 와동을 cotton pellet으로만 건조한 경우가 paper point나 압축공기로 와동을 건조한 경우에 비해 와동기저부에 큰 틈을 나타내는 양상을 보였다.

• 대한소아치과학회지
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• 제44권1호
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• pp.20-27
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• 2017

본 연구는 포졸란 시멘트를 기반으로 하는 근관전색제인 Endoseal MTA (Maruchi, Wonju, Korea)를 근관전색제와 근관충전제로 사용하였을 때 나타나는 치근단부 미세누출을 기존의 근관전색제인 AH $Plus^{(R)}$ (Dentsply DeTrey, Konstanz, Germany)와 비교하여 평가하고자 하였다. 만곡되지 않은 영구 전치를 3개의 실험군(A군, E1군, E2군)으로 나누고 A군은 AH $Plus^{(R)}$와 gutta-percha (GP), E1군 은 Endoseal MTA와 GP, E2군은 Endoseal MTA 단독으로 충전하였다. 충전이 완료된 치아는 완전한 경화를 위해 24시간동안 멸균 증류수에 보관하였고 염색액 누출을 위해 치근단 부위를 0.2% 로다민 B 염색 용액에 24시간 동안 노출시켰다. 입체 현미경을 이용하여 미세누출 정도를 평가하였으며 3개의 실험군 사이에 유의한 차이가 관찰되지 않았다. 결론적으로 Endoseal MTA는 GP의 사용에 관계 없이 AH $Plus^{(R)}$와 유사한 밀폐력을 보였으며 이러한 결과는 Endoseal MTA의 근관전색제 및 근관 충전제로써 유용한 사용에 대한 가능성을 제시한다.

• Restorative Dentistry and Endodontics
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• 제41권4호
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• pp.310-315
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• 2016

Two case reports describing a new technique of creating a repositionable piezoelectric bony window osteotomy during apicoectomy in order to preserve bone and act as an autologous graft for the surgical site are described. Endodontic microsurgery of anterior teeth with an intact cortical plate and large periapical lesion generally involves removal of a significant amount of healthy bone in order to enucleate the diseased tissue and manage root ends. In the reported cases, apicoectomy was performed on the lateral incisors of two patients. A piezoelectric device was used to create and elevate a bony window at the surgical site, instead of drilling and destroying bone while making an osteotomy with conventional burs. Routine microsurgical procedures - lesion enucleation, root-end resection, and filling - were carried out through this window preparation. The bony window was repositioned to the original site and the soft tissue sutured. The cases were re-evaluated clinically and radiographically after a period of 12 - 24 months. At follow-up, radiographic healing was observed. No additional grafting material was needed despite the extent of the lesions. The indication for this procedure is when teeth present with an intact or near-intact buccal cortical plate and a large apical lesion to preserve the bone and use it as an autologous graft.

• Restorative Dentistry and Endodontics
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• 제25권2호
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• pp.159-169
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• 2000

The purpose of this study was to examine the tissue response to experimental furcation perforations immediately treated with Super EBA, Ketac Silver, MTA and Emdogain using surgical microscope. Forty experimental furcation perforations were created in the mandibular and maxillary premolars and molars of 4 adult dogs and immediately repaired with experimental materials. The animals were sacrificed after 16 weeks and radiographic and histologic results were evaluated. The results were as follows. 1 All materials tested in this experiment revealed a certain degree of extrusion of the filling materials and infiltration of inflammatory cells into the periodontal space. Except MTA group, epithelial down-growth of the surrounding gingiva was found in all experimental groups. 2. Both Ketac Silver and Emdogain group showed the greatest degree of inflammatory reaction and bone resorption. 3. Super EBA group showed moderate inflammation and newly bone formation under the perforation area. 4. MTA group showed minor inflammation, new bone regeneration toward restorative materials and partially cementum growth onto the surface of the material. This group demonstrated a favorable prognosis.

• Restorative Dentistry and Endodontics
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• 제8권1호
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• pp.123-131
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• 1982

The purpose of this study was to observe the responses of the remaining pulp tissue after pulpotomy upon the several kinds of $Ca(OH)_2$ products and the responses of periapical tissue upon some root canal filling materials after extirpation. For pulpotomy, the class V cavities were prepared on the premolars, molars and upper canines, and the pulp was amputated. Each drug was placed over the amputated tissue and cavity was sealed with zinc oxide eugenol cement. The drugs which were used for the study were Dycal (Caulk Co. U.S.A.), Cavitec (Kerr Co. U.S.A.), Calvital, Nobudyne and Neodyne (Neo Dental Chemical Products). For extirpation, the endodontic cavities were prepared on the lingual surfaces of anterior teeth, and the pulp tissues were extirpated as routine method. After enlarging, irrigation, and measuring of root length by taking X-ray, each root canal filling material was filled in the canal with gutta percha cone, and endodontic cavity was sealed with zinc oxide eugenol cement. Zinc oxide eugenol, $Ca(OH)_2$ (Eli Lilly Co. U.S.A.) and Vitapex (Neo Dental Chemical Products) were used as root canal filling materials. Animals were sacrificed after 1, 3 and 6 weeks following the operation. The teeth were decalcified in formic acid, sectioned and stained with hematoxylin eosin. Microscopic examination revealed as follows. 1. Dycal: The dentin bridge formation was observed at the 3rd week after pulpotomy. Inflammatory conditions which were infiltration of inflammatory cells and dilatation of blood vessels were kept in remaining pulp tissue at the 6th week. 2. Calvital: The dentin bridge was observed at the 1st week after pulpotomy. As the time clasped, the pulp tended to be the fibrous degeneration. 3. Cavitec, Nobudyne and Neodyne: In the case of Cavitec and Nobudyne, the incompleted and irregular dentin bridge was observed at the 6th week, and in Neodyne, was observed at the 3rd week. The severe inflammatory changes were seen in the remaining pulp tissue. As the time clasped, the fibrous degeneration tended to spread in the remaining pulp tissue. 4. $Ca(OH)_2$: Osteocementum was formed at the 3rd week, the matrix of cementum and dentin were resorted, and infiltration of lymphocytes was seen in periapical tissue when $Ca(OH)_2$ was used as canal-filling materials. S. ZOE and Vitapex The cementum like substance was seen in periapical portion at the 1st week, when ZOE and Vitapex were used as root canal filling materials. As the time elapsed, the matrix of cementum and dentin tended to be resorted. At the 6th week, the inflammatory condition of periapical tissue was continued in the case of ZOE, but was reduced in the case of Vitapex.

• 대한소아치과학회지
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• 제46권3호
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• pp.255-264
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• 2019

이 연구의 목적은 치수절제술을 시행한 개의 치아에서 서로 다른 수산화칼슘계 근관충전재인 $Vitapex^{(R)}$, $Metapex^{(R)}$, 그리고 $Metapaste^{(R)}$의 적용 기간에 따른 치근단 조직의 조직학적 반응을 비교한 것이다. 12마리의 비글 성견을 연구 대상으로 하였으며 총 132개의 치아를 사용하였다. 각 치아의 근관에 충전될 재료는 $Vitapex^{(R)}$, $Metapex^{(R)}$, 그리고 $Metapaste^{(R)}$ 중 무작위로 배정하여 재료 당 44개의 치아가 선택되었다. 4주 적용 후 섬유화를 제외한 다른 반응 지표는 모두 0점을 기록하였다. 세 재료 모두 치근단 조직의 섬유화가 나타난 시편이 있었으나 통계적으로 유의한 차이는 아니었다. 13주군에서는 4주군에서 보이지 않았던 다형핵백혈구, 림프구, 대식세포, 신생혈관화가 관찰되었고 치근단 조직의 염증세포 침투, 울혈 및 부종이 나타났으나 중등도 이상의 염증 반응을 나타낸 시편은 없었다. 13주군 결과에서 다른 두 재료에 비해 $Metapaste^{(R)}$군의 염증 반응 빈도와 정도가 증가하였으나 통계적으로 유의한 차이는 보이지 않았다. 이번 연구에서는 세 종류의 근관충전재가 근관 적용 후 조직학적으로 유사한 결과를 보였다. 더 장기적인 예후 관찰 및 감염 모델에서의 추가적인 연구가 필요할 것으로 판단된다.

• 치과방사선
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• 제28권2호
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• pp.471-489
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• 1998

For the successful endodontic treatment, root canal should be cleaned thoroughly by accurate mechanical and chemical canal preparation and sealed completely with canal filling material without damaging the periapical tissues. The accuracy of the root canal length measurement is a prerequisite for the success of the endodontic treatment, and the root canal length is often determined by the standard periapical radiographs and digital tactile sense. In this study, the accuracy and the clinical usefulness of Digora/sup (R)/, an intraoral digital imaging processor and the conventional standard radiographs were compared by measuring the length from the top of the file to the root apex. 30 single rooted premolars were invested in a uniformly sized blocks and No.25 K-file was inserted into and fixed in each canal. Each block was placed in equal distance and position to satisfy the principle of the bisecting angle and paralleling techniques and Digora/sup (R)/ system's image and standard periapical radiographs were taken. Each radiograph was examined by 3 different observers by measuring the length from top of the file to the root apex and each data was compared and analyzed. The results were as follows; 1. In the bisecting angle technique, the average difference between the Digora/sup (R)/ system and standard periapical radiograph was 0.002 mm and the standard deviation was 0.341 mm which showed no statistically significant difference between the two systems(p>0.05). Also, in the paralleling technique, the average difference between these two system was 0.007 mm and the standard deviation was 0.323 mm which showed no statistically significant difference between the two systems(p>0.05). 2. In Digora/sup (R)/ system, the average difference between the bisecting angle and paralleling technique was -0.336 mm and the standard deviation was 0.472 mm which showed a statistically significant difference between the two techniques(p<0.05). Also, in the standard periapical radiographs, the average difference between the bisecting angle and paralleling technique was 0.328 mm and the standard deviation was 0.517 mm which showed a statistically significant difference between these two techniques(p<0.05). 3. In Digora/sup (R)/ system and the standard periapical radiographs. there was a statistically significant difference between the measurement using the bisecting angle technique and the actual length(p<0.05), But there was no statistically significant difference between the measurement using the paralleling technique and the actuallength(p>0.05). In conclusion. the determination of the root canal length by using the Digora/sup (R)/ system can give us as good an image as the standard periapical radiograph and using the paralleling technique instead of the bisecting angle technique can give a measurement closer to the actual canal length. thereby contributing to a successful result. Also. considering the advantages of the digital imaging processor such as decreasing the amount of exposure to the patient. immediate use of the image. magnification of image size. control of the contrast and brightness and the ability of storing the image can give us good reason to replace the standard periapical radiographs.

• Restorative Dentistry and Endodontics
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• 제44권4호
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• pp.39.1-39.8
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• 2019

The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.

• 한국임상수의학회지
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• 제30권5호
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• pp.380-383
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• 2013

치아 골절을 가진 고양이에서 근관 치료 이후 복합레진과 포스트를 이용한 재건술의 증례이다. 내원한 고양이 3례 모두 구강검사와 치과 방사선 검사를 통해 치수가 노출된 치아 골절로 진단 되었다. 근관치료가 완료된 후, 일부 충전 물질을 제거하고 포스트를 설치하고 에칭과 본딩 전처치 후 복합 레진으로 광중합을 시행하였다. 치료된 치아들은 치과용 바와 디스크를 이용하여 성형하였으며, 6개월 동안 추시한 결과 치료된 치아들은 특별한 부작용을 발견할 수 없었다. 따라서 고양이에서 치수가 노출된 치아골절의 경우, 먼저 근관치료를 시행한 다음, 결과를 확인하고 복합 레진과 포스트를 이용한 재건술은 실시한다면 임상에 있어서 매우 좋은 효과를 거둘 수 있을 것으로 생각된다.

• Restorative Dentistry and Endodontics
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• 제15권2호
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• pp.1-16
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• 1990

This study was to evaluate the cytotoxic effect in vitro and the tissue response within the rat peritoneal cavity to high copper amalgam and glass ionomer-silver cement, suggested for use as a retrograde endodontic filling material. In the cytotoxicity experiment, the radioactively ($^{51}Cr$) labeled L929 mouse fibroblasts were employed to determine the relative cytotoxicity of two experimental materials. Those materials were evaluated immediately after set and after one and seven days setting. In the tissue response experiment, two experimental materials were to evaluate mean peritoneal cellular count, differential cell count and the content of silver and copper in pooled packed cells and eluate samples taken by peritoneal lavage technique, and compared with surgical control after one day. two, four and six weeks of implantation. The results were as following: 1. High copper amalgam exhibited significant cytotoxicity immediately after set but showed no sign of toxicity after one day and seven days setting materials. 2. Glass ionomer-silver cement showed no sign of toxicity immediately after set and after one day and seven days setting. 3. High copper amalgam and glass ionomer-silver cement groups produce no significant difference in the mean peritoneal cell count when compared with the surgical control group after one day, two and four weeks of implantation. Surgical control group exhibited significantly a greater cell count when compared with the High copper amalgam group after six weeks. 4. High copper amalgam group increased significantly in the percentage macrophages after four and six weeks of implantation when compared with surgical control group. 5. The trace metal analysis involved an increased silver content in the elutes and an increased copper content in the packed cells of high copper amalgam group, and an increased silver content in the packed cells and elutes of glass ionomer-silver cement group.