• 구강회복응용과학지
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• 제35권2호
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• pp.98-104
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• 2019

의도적 재식술은 흔히 근관 치료가 실패한 경우 사용되는 치료법이나, 중도의 치주 질환에 이환된 치아에서는 대개 추천되지 않는다. 그러나, 일부 연구들은 의도적 재식술을 이용하여 치주 질환에 이환된 치아를 성공적으로 치료한 것을 보고한 바가 있다. 본 연구에서는 중도 치주염에 이환된 치아를 의도적 재식술을 이용하여 치료한 증례를 보고하고자 한다. 해당 치아는 근관-치주 복합 병소로 진단 후 근관치료를 선행하였으나 광범위한 골소실을 나타냈으며, 이에 의도적으로 발치 후 치근 표면의 국소 인자를 완전히 제거한 후 재식하였다. 의도적 재식술을 이용하여 본 증례에서 중도 치주염에 이환된 치아를 발치하지 않고 3년간의 경과 관찰 기간 동안 보존할 수 있었다.

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

• Journal of Periodontal and Implant Science
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• 제37권2호
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• pp.287-295
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• 2007

As a general treatment modality of subgingival tooth defect in aethetic area, implant or crown and bridge therapy after extraction of affected tooth can be used. But as more conservative treatment, crown lengthening can be considered and not to lose periodontal attachment and impair aethetic appearance, surgical extrusion can be considered as a treatment of choice. In this case report, 3 cases of surgical extrusion was represented and appropriate time for initiation of endodontic treatment according to the post-surgical tooth mobility was investigated. In 8 patient who has subgingival tooth defect in aethetic area, intracrevicular incision is performed and flap was reflected with care not to injure interproximal papillae. With forcep or periotome, tooth was luxated and sutured in properely extruded position according to biologic width with or without $180^{\circ}$ rotation. 8 cases show favorable short and long term results. In some cases, surgical extrusion with $180^{\circ}$ rotation can minimized extent of extrusion and semi-rigid fixation without apical bone graft seems to secure good prognosis. In 8 cases, endodontic treatment started about 3 weeks after surgery. This time corresponds with the moment when mobility of extruded tooth became 1 degree and this results concide with other previous reports. If it is done on adequate case selection and surgical technique, surgical extrusion seems to be a good treatment modalilty to replace the implant restoration in aethetic area.

• Restorative Dentistry and Endodontics
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• 제45권2호
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• pp.14.1-14.7
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• 2020

Objective: The aim of this study was to perform a comparative evaluation of the effectiveness of ultrasonic tips versus the Terauchi file retrieval kit (TFRK) for the removal of broken endodontic instruments. Materials and Methods: A total of 80 extracted human first mandibular molars with moderate root canal curvature were selected. Following access cavity preparation canal patency was established with a size 10/15 K-file in the mesiobuccal canals of all teeth. The teeth were divided into 2 groups of 40 teeth each: the P group (ProUltra tips) and the T group (TFRK). Each group was further subdivided into 2 smaller groups of 20 teeth each according to whether ProTaper F1 rotary instruments were fractured in either the coronal third (C constituting the PC and TC groups) or the middle third (M constituting the PM and TM groups). Instrument retrieval was performed using either ProUltra tips or the TFRK. Results: The overall success rate at removing the separated instrument was 90% in group P and 95% in group T (p > 0.05) The mean time for instrument removal was higher with the ultrasonic tips than with the TFRK (p > 0.05). Conclusion: Both systems are acceptable clinical tools for instrument retrieval but the loop device in the TFRK requires slightly more dexterity than is needed for the ProUltra tips.

• Restorative Dentistry and Endodontics
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• 제7권1호
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• pp.25-31
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• 1981

One of the most important factors for successful endodontic therapy is an accurate length determination of physiological root apex. Some methods suggested for the measurement of root canal length, include digital-tactile sense and roentgenographic technique with measuring wire, scale and grid. But these methods do not derermine an accurate working length to physiological root apex. Recently electronic measuring devices are used to locate the physiological root apex in root canal length determination and these devices are accepted as an effective apparatus. The 89 patients (116 teeth, 144 canals) among the out-patients of Yonsei University Dental Infirmary, who had had an endodontic treatment in the Department of Operative Dentistry, were measured by the Root-Canal Meter$^{(R)}$ as an electronic device, and radiographs to determine the distribution and location of physiological root apex, then the following results were made: (1) Range of ${\pm}$1mm from the radiographic root apex were present in 88.88% (128 canals) of the subjects. (2) Physiological root apex and radiographic root apex were coincided in 31.94% (46 canals) of the subjects. (3) The actual length of the physiological root apex of the teeth were as follow; A : in the maxillary central incisor : 0.46mm B : in the maxillary lateral incisor : 0.44mm C : in the maxillary canine : 0.44mm D : in the maxillary 1st premolar : a) Buccal : 0.59mm b) Lingual : 0.34mm E : in the maxillary 2nd premolar : 0.54mm F : in the maxillary 1st molar : a) Mesio-buccal : 0.50mm b) Disto-buccal : 0.42mm c) Lingual : 0.56mm G : in the mandibular central incisor : 0.62mm H : in the mandibular lateral incisor : 0.45mm in the mandibular canine : 0.54mm J : in the mandibular 1st premolar : 0.47mm K : in the mandibular 2nd premolar : 0.34mm L : in the mandibular 1st molar : a) Mesio-buccal : 0.54mm b) Mesio-lingual : 0.31mm c) Distal : 0.37mm.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권3호
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• pp.140-145
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• 2024

Objectives: The necessity of retrograde filling after apicoectomy is controversial in cases of non-inflammatory cysts as opposed to bacteria-related periapical abscesses. This study aims to investigate whether the presence or absence of retrograde filling during apicoectomy has differential long-term prognostic implications between inflammatory and non-inflammatory cysts. Materials and Methods: This retrospective study included patients who underwent tooth apicoectomy during jaw cyst enucleation between 2013 and 2022, and who underwent follow-up cone-beam computed tomography for at least 6 months. The prognosis of the tooth was evaluated during the follow-up period according to the cyst type, the presence or absence of retrograde filling, mandible or maxilla, and location. Results: A total of 147 teeth was included in this study. All the operated teeth underwent preoperative root canal treatment by an endodontic specialist. Apicoectomy was performed for 119 inflammatory cysts and 28 non-inflammatory cysts. Retrograde filling was performed on 22 teeth with inflammatory cysts and 3 teeth with non-inflammatory cysts. All teeth survived the 3.5-year follow-up (range, 1.0-9.1 years). However, 1 tooth with an inflammatory cyst developed complications 1 year after surgery that required re-endodontic treatment. Conclusion: The prognosis of a tooth treated by apicoectomy without retrograde filling during cyst enucleation is favorable, regardless of the cyst type.

• 대한치과보존학회:학술대회논문집
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• 대한치과보존학회 2001년도 추계학술대회(제116회) 및 13회 Workshop 제3회 한ㆍ일 치과보존학회 공동학술대회 초록집
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• pp.566.1-566
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• 2001

The most desirable healing process for endodontic therapy is apical closure by hard tissue such as dentine or cementum. Then, we estimated hard tissue conductivity of tetracalcium phosphate (4CP)/dicalcium phosphate (2CP) compound using mandibular first molars of SD rats. Residual pulp responses to the calcium phosphate compound were examined at several amputation levels of pulp. 2CP was purchased and passed through a $32-\mu\textrm{m}$ sieve. 4CP was obtained from a stoichiometric mixture of 2CP and calcium carbonate (Mol ratio: Ca/P=2.0) by the dry synthetic method at 1, 400(C for 8 hours.(omitted)

• Restorative Dentistry and Endodontics
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• 제5권1호
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• pp.35-40
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• 1979

The author observed thy actual position of apical foramen and the radiographic appearance of files when the files were filled through canals to the external surface of apical foramen in 280 canals of extracted teeth. All the teeth were radiographed by bisecting technic and once again Walton's projection was employed on mandibular molars. The results were as followings. 1. Sixty five percents of 280 canals were actually classed as having foramina deviant from true apex of root. 2. 160 of 280 canals(Fifty seven percents) appeared to be filled short of apex on the radiograph. 3. When Walton's projection was employed to open up two mesial canals of mandibular molars and compared to straight-on projection, twelve of 120 canals Ten percent appeared to be different in radiographic appearence.

• 대한소아치과학회지
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• 제35권1호
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• pp.136-143
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• 2008

소아의 구강 악안면 부위의 감염은 부비동, 근막간극, 타액선, 악골, 치아 등의 다양한 해부학적 구조물과 연관되어 발생하며 적절히 치료되지 않는다면 짧은 시간 내에 치명적인 상태로 진행될 수 있어 조기 진단 및 치료가 요구된다. 원인은 다양하지만 대부분이 치성 원인으로서, 괴사된 치수로 인한 치근단 병소, 화농성 치주질환, 치관주위 감염 등으로부터 유래된다. 소아의 치성 감염은 치아우식증이 원인인 경우가 대부분이며 병원성 균이 치수를 통해 인접 조직으로 확산되어 치근단 감염 및 농양, 봉와직염, 골수염, Ludwig's angina, toxic shock syndrome 등의 질환을 유발한다고 알려져 있다. 근막간극이란 느슨한 결체조직으로 채워진 근층 사이에 존재하는 잠재적인 공간으로 일반적인 근막간극 농양의 진행과정은 괴사 치수 염증이 치조 농양 형태로 치근 주위로 퍼지고 점차 근막을 침투해 피질골을 통해 잠재적 간극을 이환시킨다. 구강 악안면 부위의 감염이 연조직으로 침투할 경우, 결체조직을 통하여 그리고 근막간극을 따라 가장 조직 저항이 적은 방향으로 확산된다. 이러한 감염은 치아발치, 근관치료, 배농을 포함한 외과적 치료, 항생제 투여 등에 의해 적절히 치료될 수 있다. 본 증례에서는 치성 원인의 견치 간극 농양 및 협부 간극 농양에 이환된 환자들에 대하여 항생제 투여 및 근관치료, 외과적 배농 등을 시행하여 양호한 치료 결과를 얻었기에 보고하는 바이다.

• Restorative Dentistry and Endodontics
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• 제21권1호
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• pp.339-352
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• 1996

Many dentists have been taken an interest in restoration of severly damaged teeth after endodontic treatment and it is a true that there are lots of studies about it. In these days, although we have used Para-Post, pins, threaded steel post, cast gold post and core, and so on, as a method of restoration frequently, it has been in controversy with the effects of them on the teeth and surrounding periodontal tissue. In this study, we assume that the crown of the upper 1st premolar was severly damaged, and after the root canal therapy, two most common types of restoration were carried out ; 1) coronal-radicular amalgam restoration, 2) after setting up the Para-Post, restore with amalgam core and gold crown. After restoration, in order to present the concentration of stress at internal portion of the tooth and the surrounding periodontal tissue, we doveloped a 2-dimensional finite element model of labiopalatal section, then loaded forces from 2 long perpendicular to the lingual incline of buccal ridge an the middle point, parallel to the long direction axis of tooth at the fossa-were applied. The analyzed results were as follows : 1. Stress of the normal first premolar was concentrated on the most weakest anatomical structure, that is, cervical area, and no stress on the bifurcated area of the canal. 2. Crown restoration after root canal therapy causes large stress concentration on the bifurcated area of the canal. This stress concentration has larger value in case of lateral movement of mandible, and there are decrease in the stress concentration compared with natural tooth. 3. Coronal-radicular amalgam restoration method transports more stress to the tooth structure than restoration using Para-Post. 4. There are more stress concentration around Para-Post in the case of lateral movement, and we have more favo rable result when restored with Para-Post. 5. Generally, stress in the lateral movement is larger than stress in the perpendicular load.