• Journal of Periodontal and Implant Science
• /
• 제43권3호
• /
• pp.136-140
• /
• 2013

Purpose: The aim of this study was to identify a role for endodontic intervention in enhancing the regenerative potential of the periodontal ligament when combined with periodontal treatment in seriously involved teeth with a secondary endodontic component. Methods: Patients who exhibited radiolucency extending to the periapical region, abnormal electric pulp testing values, and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Intentional root canal treatment was applied to those teeth in which the apical lesions were presumed to communicate with those of the periodontal lesion of the teeth that remained vital. In all three selected cases, regenerative periodontal therapy incorporating either bone graft or guided tissue regeneration was instituted 3 months after the endodontic intervention. Results: Remarkable enhancement in radiographic density was noticeable around the affected teeth as evidenced by changes in radiopacity. There was a significant reduction in the probing pocket depth and gain in the clinical attachment level. Chewing discomfort gradually disappeared from the commencement of the combined treatment. Conclusions: An intentional endodontic intervention may be a worthwhile approach for the sophisticated management of teeth suffering from serious attachment loss and alveolar bone destruction with concomitant secondary endodontic involvement.

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

• Restorative Dentistry and Endodontics
• /
• 제36권3호
• /
• pp.238-242
• /
• 2011

구개치은발육구는 상악 전치에 나타나는 이상 치근 형태의 하나로 구개측 결절부에서 구개치은발육구를 관찰하였으며, 이 구는 치근단을 향하여 여러 깊이와 길이로 연장될 수 있다. 구개치은발육구는 세정되기 어렵고 청결이 불가능하여, 치태와 치석 등이 축적되어 접합상피의 파괴를 일으키고 빠르게 골연하 결손부가 발생할 수 있다. 또한 이차적으로 치수 조직을 이환시켜 근관-치주 병소가 발생할 수 있다. 본 증례 보고는 구개치은발육구로인해 근관 문제까지 야기된 임상증례를 보고하고 근관치료와 함께 여러가지 재료를 이용한 구개치은발육구의 치료결과를 관찰함으로써 이러한 치료방법의 효용성을 평가하고자 하였다.

• 대한치과의사협회지
• /
• 제47권8호
• /
• pp.479-486
• /
• 2009

Purpose: The aim of this study was to show the clinical results of combination of Nd-YAP (1340nm) laser therapy with conventional endodontic and periodontal treatment. Materials and Methods: Four patients with chronic advanced periodontitis and endodontic infection were treated with conventional treatment and Nd-YAP laser therapy. Occlusal adjustment and splinting were done for stabilization of the teeth with severe horizontal and vertical mobility. The protocol for periodontal treatment was followed as scaling and root planing, pocket irrigation with 3% $H_2O_2$ and exposure of Nd-YAP laser using 320${\mu}m$ optical fiber with 160mJ/pluse, 30Hz. The other protocol for endodontic treatment was followed as access opening, canal preparation by hand and rotary instrument, canal filling, and exposure of Nd-YAP laser using 200${\mu}m$ optical fiber with 200mJ/pluse, 10Hz and 180mJ/pluse, 5Hz which were used respectively for disinfection and canal filling. The assessments of probing depth, mobility, and radiography were made prior to and after treatment. Result: All of these four clinical cases showed good healing of periodontium, which presented decrease of mobility and pocket depth, and increase of bone regeneration and bone density on the radiography. Conclusion: The bactericidal effect of Nd-YAP laser would provide benefits for improving clinical results that are obtained from conventional therapy.

• Restorative Dentistry and Endodontics
• /
• 제39권1호
• /
• pp.51-55
• /
• 2014

The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF) and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material.

• Journal of Periodontal and Implant Science
• /
• 제31권2호
• /
• pp.269-276
• /
• 2001

The purpose of this study was to evaluate the clinical validity of multi-rooted teeth subjected to root-resection treatment. Over a period of 1-7 years, 60 root-resected molars in 59 patients were examined clinically and radiographically. All patients were p0eriodically recalled once or twice a year. Root-resections were due to periodontal, more specifically furcal bone loss or marginal bone loss,in 34 cases and extensive dental carious destruction in 10 cases. In other cases,root-resections resulted from 6 cases of root fracture, 6 cases of periodontal-endodontic combined lesion, and 1 case of endodontic problem. Root-resection was carried out on 26 maxillary molars and 34 mandibular molars. The results are as follows; 1. 14 cases(23.3%) were considered failures. 8 cases(13.3%) of them occurred within the first year(8 cases, 13.3%), 4 cases(6.7%)between 1-3 years, and 2 cases(3.3%) between 4-7 years. 2. 8 cases(13.3%) were considered failures due to periodontal reasons, 3 cases(5%) due to root fracture, 2 cases(3.3%) due to endodontic problem, and 1 case(1.7%) due to prosthetic problem. 3. 37 cases(61.7%) showed up for the recall appointments, and the percentage of failures(13.5%) was lower compared with that of all patients(23.3%). The results of the present study indicate that the prognosis of root-resected teeth is favourable if attention is paid to the selection of proper case and to achieving optimal oral hygiene and periodic check up.

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

• Restorative Dentistry and Endodontics
• /
• 제41권4호
• /
• pp.316-321
• /
• 2016

Although it is challenging, the early diagnosis of a vertical root fracture (VRF) is crucial in order to ensure tooth preservation. The purpose of this clinical case report was to describe reparative surgery performed to treat a tooth affected by an incomplete VRF. A 26 year old male patient was suspected to have a VRF in a maxillary left central incisor, and an exploratory flap was performed in order to confirm the diagnosis. After detecting the fracture, the lesion was surgically treated, the fracture and the infected root-end were removed, and a platelet-rich plasma membrane was used to cover the defect in order to prevent bacterial migration. A 24 month clinical and radiological follow-up examination showed that the tooth was asymptomatic and that the healing process was in progress. The surgical approach described here may be considered an effective treatment for a combined endodontic-periodontal lesion originating from an incomplete VRF and a recurrent periapical lesion.