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REINFORCEMENT OF FRACTURE RESISTANCE AFTER APEXIFICATION : CASE REPORT

치근단 형성술 후 약화된 치아의 파절 저항성 보강: 증례보고

  • Lee, Young-Ho (Department of Pediatric Dentistry, Dental College of Dentistry, Gangneung-Wonju National University) ;
  • Park, Ho-Won (Department of Pediatric Dentistry, Dental College of Dentistry, Gangneung-Wonju National University) ;
  • Lee, Ju-Hyun (Department of Pediatric Dentistry, Dental College of Dentistry, Gangneung-Wonju National University) ;
  • Seo, Hyun-Woo (Department of Pediatric Dentistry, Dental College of Dentistry, Gangneung-Wonju National University)
  • 이영호 (강릉원주대학교 치과대학 소아치과학교실) ;
  • 박호원 (강릉원주대학교 치과대학 소아치과학교실) ;
  • 이주현 (강릉원주대학교 치과대학 소아치과학교실) ;
  • 서현우 (강릉원주대학교 치과대학 소아치과학교실)
  • Received : 2012.09.07
  • Accepted : 2012.10.25
  • Published : 2012.11.30

Abstract

The vitality of immature tooth could be lost by dental caries, trauma and fracture of malformed tooth. The vitality loss might lead to halt of the development of the root. The recommended endodontic treatment for a non-vital immature permanent tooth is apexification. Apexification is a method of inducing apical closure through the formation of mineralized tissue in the apical pulp region. Calcium hydroxide is the material of choice for apexification. Long-term exposure to calcium hydroxide may form the apical hard tissue, but weaken the dentin due to its alkaline nature and thus make the roots more susceptible to fracture. It is important to preserve any weakened tooth, so a permanent restoration is needed to reinforce teeth that are prone to fracture. The purpose of this case report was to describe the treatment for reinforcing immature teeth treated with long-term calcium hydroxide. In these cases, the apexes of teeth were sealed with MTA plugs and the root canals were restored with composite resin and fiber post.

미성숙 영구치는 치아우식증, 외상, 비정상적인 치아 형태로 인한 파절 등에 의하여 치수 생활력을 상실할 수 있다. 이때 이용되는 치료법이 치근단 형성술로서 실활치의 치근단 치수 부위에 광화된 조직의 형성을 통하여 치근단 폐쇄를 유도한다. 현재 수산화칼슘 치근단 형성술이 가장 많이 이용되는데 근관 내에 수산화칼슘을 장기간 적용할 경우 치근단 경조직 형성을 유도할 수 있지만, 강한 알칼리성으로 인하여 치근 약화를 야기하여 치아 파절 위험성이 높아진다. 그러므로 근관 충전 시 치아보강을 위한 수복이 고려되어야 한다. 본 증례는 생활력을 상실한 미성숙 영구치에서 장기간의 수산화칼슘 치근단 형성술 후 치아 보강을 위하여 MTA plug, 섬유강화형 포스트 그리고 복합 레진을 이용한 근관 충전을 시도하였기에 보고하는 바이다.

Keywords

References

  1. Schmoldt SJ, Kirkpatrick TC, Rutledge RE, Yaccino JM : Reinforcement of simulated immature roots restored with composite resin, mineral trioxide aggregate, gutta-percha, or a fiber post after thermocycling. J Endod, 37:1390-1393, 2011. https://doi.org/10.1016/j.joen.2011.07.001
  2. Cvek M : Prognosis of luxate non-vital maxillary incisors treated with calcium hydroxide and filled with gutta percha. Endod Dent Traumatol, 8:45-55, 1992. https://doi.org/10.1111/j.1600-9657.1992.tb00228.x
  3. Jeong SY, Ahn BD, Hong SY, et al. : MTA Apexification of traumatized immature permanent incisors: A retrospective study. J Korean Acad Pediatr Dent, 38:17-24, 2011. https://doi.org/10.5933/JKAPD.2011.38.1.017
  4. Jeon HJ, Yang YM, Kim JG, Baik BJ : Pulp revascularization of immature first permanent molars with apical periodontitis: Case report. J Korean Acad Pediatr Dent, 39:192-198, 2012. https://doi.org/10.5933/JKAPD.2012.39.2.192
  5. Andreasen JO, Munksgaard EC, Bakland LK : Comparison of fracture resistance in root canals of immature sheep teeth after filling with calcium hydroxide or MTA. Dent Traumatol, 22:154-156, 2006. https://doi.org/10.1111/j.1600-9657.2006.00419.x
  6. Finucane D, Kinirons MJ : Non-vital immature permanent incisors: factors that may influence treatment outcome. Endod Dent Traumatol, 15:273-277, 1999. https://doi.org/10.1111/j.1600-9657.1999.tb00787.x
  7. Andreasen JO, Farik B, Munksgaard EC : Longterm calcium hydroxide as a root canal dressing may increase risk of root fracture. Dent Traumatol, 18:134-137, 2002. https://doi.org/10.1034/j.1600-9657.2002.00097.x
  8. Desai S, Chandler N : The restoration of permanent immature anterior teeth, root filled using MTA: A review. J Dent, 37:652-657, 2009. https://doi.org/10.1016/j.jdent.2009.05.026
  9. Valois CR, Costa ED, Jr. : Influence of the thickness of mineral trioxide aggregate on sealing ability of root-end fillings in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 97:108-111, 2004. https://doi.org/10.1016/S1079-2104(03)00359-7
  10. Al-omiri MK, Mahmoud AA, Rayyan MR, Abu-Hammad O : Fracture resistance of teeth restored with post-retained restorations: An overview. J Endod, 36:1439-1449, 2010. https://doi.org/10.1016/j.joen.2010.06.005

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  1. Effect of Calcium Hydroxide on the Microhardness of Root Dentin of Primary Tooth vol.40, pp.3, 2013, https://doi.org/10.5933/JKAPD.2013.40.3.177