대한소아치과학회지 (Journal of the korean academy of Pediatric Dentistry)
- 제32권4호
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- Pages.628-633
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- 2005
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- 1226-8496(pISSN)
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- 2288-3819(eISSN)
유구치 치근분지부 병소의 치수절제술과 소파술에 의한 골재생
THE INDUCTION OF BONE REGENERATION AT FURCATION LESIONS WITH PULPECTOMY AND FURCATION CURETTAGE IN PRIMARY MOLARS
- 이승현 (부산대학교 치과대학 소아치과학교실) ;
- 우연선 (부산대학교 치과대학 소아치과학교실) ;
- 김재문 (부산대학교 치과대학 소아치과학교실) ;
- 정태성 (부산대학교 치과대학 소아치과학교실) ;
- 김신 (부산대학교 치과대학 소아치과학교실)
- Lee, Seung-Hyun (Department of Pediatric Dentistry, College of Dentistry, Pusan National University) ;
- Woo, Youn-Sun (Department of Pediatric Dentistry, College of Dentistry, Pusan National University) ;
- Kim, Jae-Moon (Department of Pediatric Dentistry, College of Dentistry, Pusan National University) ;
- Jeong, Tae-Sung (Department of Pediatric Dentistry, College of Dentistry, Pusan National University) ;
- Kim, Shin (Department of Pediatric Dentistry, College of Dentistry, Pusan National University)
- 발행 : 2005.11.30
초록
유구치의 깊은 우식은 치수병소을 유발하고 이를 조기에 치료하지 않을 경우에는 치수강저의 수많은 부근관을 통하여 치근분지부 병소로 이어진다. 지금까지 대부분의 교과서나 문헌에서는 이와 같은 경우를 발치의 적응증으로 기술하여 왔고 임상에서도 상례적으로 발치를 흔히 시행하였다. 그러나 유구치의 조기 상실은 수많은 부작용을 낳는 것이 필연적이다. 어린이의 골재생 능력 이 우수하며, 치수강저와 치근분지부를 잇는 많은 부근관이 있음을 생각해 볼 때 유구치 치수 내의 감염원을 치수절제술로 제거하고, 이미 발생한 치근분지부 병소에 대해서는 소파술을 시행한다면 치근분지부 골조직의 신속한 재생이 가능하지 않을까 하는 의문이 제기되었다. 본 증례는
Deep caries in primary molars without early intervention frequently induce a pulpal disease and consequent furcation lesion with fistulous openings Up to now, majority of the textbooks on pediatric dentistry and literatures have described that extraction of the inflicted teeth is indicated for these cases and in reality these teeth have usually been extracted in the dental clinics. However when we recognize the excellent capacity of bone regeneration in children and the presence of numerous accessory canals at furcation areas, the removal of infection source in pulp by pulpectomy and inflammatory granulation tissues at furcation areas by furcal curettage might open the possibility of rapid healing at the furcation regions. In this report, 10 cases of primary molars in 3 to 6-year-old children with fistulous openings and furcation lesions in moderate size of 2 to 4mm in depth radiolucency at furcation lesion have been chosen. After pulpectomy and furcal curettage, evident bone regeneration was detected radiographically in all cases. Through the cases, we came to realize that all the cases previously described are not the indications of extraction and this approach could make many cases with pulp and furca combined lesions survive and remain healthy in the children's dental arches. However, in order for this approach to acquire objective appropriateness, it is thought that more scrupulous evaluation is desirable on the various factors regarding the indication such as the extent of furcation lesions, absorption status of teeth, amount of covering bone on succeeding teeth and so on.
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