• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.603-610
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• 2008

Purpose: The guided bone regeneration (GBR) technique is widely used in periradicular surgery. However, there is still some controversy regarding the effectiveness of GBR in promoting bone healing after periradicular surgery. The purpose of this study was to evaluate the resorbable membrane on the osteointegration of immediate implants in sites with periradicular lesion that had been removed by periradicular surgery. Materials and methods: Six roots of lower second premolars and 15 roots of lower third and fourth premolars of dogs were used as control and experimental teeth, respectively. Periradicular lesions were induced only in the experimental teeth. Twelve weeks later, the control and experimental teeth were extracted and implants were placed immediately. Periradicular lesions were removed with osteotomy, curettage and saline irrigation. Resorbable membranes were used in experimental group 1 but not in experimental group 2. After 12 week of healing period, the implants were clinically not mobile and showed no signs of infection. Data obtained by histomorphometric analysis were analyzed by Kruskal-Wallis test. Results: The control group showed a significantly higher bone to implant contact (BIC) ($74.14{\pm}16.18$) than experimental group 1 ($40.28{\pm}15.96$) and 2 ($48.70{\pm}17.75$)(p<0.05). However, there was no significant difference between experimental group 1 and 2. Conclusion: Although BIC in experimental groups were lower than in control group, immediate implant can be successfully placed at extraction socket with periradicular lesion and osseous defect. However, the use of resorbable membrane in bony defect created during periradicular surgery was questioned.

• Journal of Korean Neurosurgical Society
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• v.44 no.6
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• pp.385-388
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• 2008

We herein describe the case of a focal spontaneous spinal epidural abscess who was initially diagnosed to have a free fragment of a lumbar disc. A 71-year-old woman presented with history of low back and right leg pain. Magnetic resonance imaging suggested a peripherally enhancing free fragment extending down from S1 nerve root axilla. Preoperative laboratory investigation showed elevation of c-reactive protein (CRP), erythrocyte sedimentation rate (ESR) levels. She was taken for surgery and a fluctuating mass at the axilla of S1 nerve was found. When the mass was probed with a dissector, a dark yellow, thick pus drained out. Pus cultures were negative. Patients who present with extreme low back plus leg pain and increased leucocyte count, ESR and CRP levels should raise the suspicion of an infection of a vertebral body or spinal epidural space.

• Restorative Dentistry and Endodontics
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• v.38 no.3
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• pp.119-127
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• 2013

The purpose of a root-end filling is to establish a seal between the root canal space and the periradicular tissues. As root-end filling materials come into contact with periradicular tissues, knowledge of the tissue response is crucial. Almost every available dental restorative material has been suggested as the root-end material of choice at a certain point in the past. This literature review on root-end filling materials will evaluate and comparatively analyse the biocompatibility and tissue response to these products, with primary focus on newly introduced materials.

• Restorative Dentistry and Endodontics
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• v.36 no.1
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• pp.12-18
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• 2011

Objectives: This retrospective study evaluated the therapeutic effects of the intentional replantation (IR) procedure performed on the maxillary and mandibular molars of 35 patients. Materials and Methods: For the subjects, IR was performed due to difficulties in anatomically accessing the lesions and/or close proximity to the thick cortical bone, inferior alveolar nerve, or maxillary sinus, which rendered the ordinary periradicular surgery impossible. The patients'progress was followed for a year and up to 2 years and 4 months. The success of the procedure was evaluated in terms of clinical and radiographic success (%). Results: The results revealed the following: (a) 1 case (3%) of failed tooth extraction during IR; (b) 2 cases (6%) of extraction due to periodontal diseases and inflammatory root resorption; (c) 3 cases (9%) of normally functioning teeth in the oral cavity with minor mobility and apical root resorption, and; (d) 29 cases (82%) of normally functioning teeth without obvious problems. Conclusions: IR was confirmed to be a reliably repeatable, predictable treatment option for those who cannot receive conventional periradicular surgery because of anatomic limitations or patient factors.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.3
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• pp.144-147
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• 2013

Damage to adjacent teeth is one of the various complications that may occur during implant placement and is often the result of improper direction during fixture placement or excessive depth of placement. In general, if detrimental symptoms, such as reaction to percussion in damaged teeth, mobility, and pulp necrosis, are not present, osseointegration should be observed at follow-up. In three cases, the possibility of root damage due to an implant fixture placed too close to each adjacent tooth was perceived on radiographs. However, in all of these cases, there were no clinical symptoms or radiographic changes present in the tooth, and the implants did not exhibit decreased stability or peri-implantitis. Therefore, we can carefully predict that the implant fixture close to the adjacent tooth did not invade the cementum of the root, and therefore did not produce the suspected pulpal damage or periradicular symptoms. In this study, we considered both the implant status as well as the adjacent tooth.

• The Journal of the Korean dental association
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• v.48 no.4
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• pp.288-296
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• 2010

Although non-surgical endodontic procedures have high success rates, failures do occur, These can be managed by root canal re-treatment or surgical intervention. Intentional replantation is an accepted endodontic treatment procedure in which a tooth is extracted and treated outside the oral cavity and then inserted into its socket to correct an obvious radiographic or clinical endodontic failure. Intentional replantation is indicated when other endodontic treatments performed to maintain the tooth have failed, or when endodontic periradicular surgery is not feasible. Intentional replantation may be particularly useful in these cases because these difficult to access areas can be maximally treated while the tooth is out of the mouth without damaging the periodontal attachment in adjacent teeth. In conclusion, intentional replantation is a reliable and even predictable procedure, and should be considered more often as a treatment modality in our efforts to maintain the natural dentition.

• Restorative Dentistry and Endodontics
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• v.36 no.3
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• pp.211-218
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• 2011

Purpose: Intentional replantation (IR) is a suitable treatment option when nonsurgical retreatment and periradicular surgery are unfeasible. For successful IR, fracture-free safe extraction is crucial step. Recently, a new extraction method of atraumatic safe extraction (ASE) for IR has been introduced. Patients and Methods: Ninety-six patients with the following conditions who underwent IR at the Department of Conservative Dentistry, Seoul National University Bundang Hospital, in 2010 were enrolled in this study: failed nonsurgical retreatment and periradicular surgery not recommended because of anatomical limitations or when rejected by the patient. Preoperative orthodontic extrusive force was applied for 2-3 weeks to increase mobility and periodontal ligament volume. A Physics Forceps was used for extraction and the success rate of ASE was assessed. Results: Ninety-six premolars and molars were treated by IR. The complete success rate (no crown and root fracture) was 93% (n = 89); the limited success rates because of partial root tip fracture and partial osteotomy were 2% (n = 2) and 5% (n = 5), respectively. The clinical and overall success rates of ASE were 95% and 100%, respectively; no failure was observed. Conclusions: ASE can be regarded as a reproducible, predictable method of extraction for IR.

• Restorative Dentistry and Endodontics
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• v.38 no.4
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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.