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.
Objective : The purpose of the study was to evaluate if CF herbal acupuncture is more effective than simple acupuncture in the carpal tunnel syndrome. Methods : We classified two groups: CF group(patients treated by CF herbal acupuncture and then treated by acupuncture) and N-CF group(patients treated entirely by acupuncture without other treatment). We evaluated subjective symptoms and Phalen's test of patients after executing, and then analyzed those. Results : 1. Both CF group and N-CF group were statistically significant(p<0.05) in improvement of symptoms and Phalen's test since third times of treatment. 2. It appears that CF group was more effective than N-CF group for treatment of carpal tunnel syndrome. That was statistically significant(p<0.05) since third times of treatment.
Purpose: The authors intended to analyze the operative results of tarsal tunnel syndrome. Materials and Methods: Twenty-one patients with tarsal tunnel syndrome were followed for more than 1 year after operation. The mean age was 44 years, and the mean follow up period was 2 years and 9 months. Clinically preoperative and postoperative AOFAS ankle-hindfoot score and visual analogue scale for pain were analyzed. Radiologically the cause of disease was investigated, and the size of mass was measured, if possible. The duration of symptom, the presence of space occupying lesion (SOL), the effect of epineurolysis were statistically analyzed to see the relation with the operative results. Results: Operative release of tarsal tunnel was done in all cases, and epineurolysis was done in 11 cases. The causes of the disease were 10 soft tissue masses, 7 talocalcaneal coalitions, 1 nonunion of medial talar process fracture, and 1 pes planovalgus, and 3 idiopathic cases. The masses were subdivided into 7 ganglions, 2 neurilemmomas, and 1 lipoma. There was 1 case of combined talocalcaneal coalition and ganglion. Clinically AOFAS ankle-hindfoot score was increased from 62.7 points preoperatively to 84.3 points postoperatively. Visual analogue scale was improved from 6.5 preoperatively to 2.2 postoperatively. Two cases were graded as unsatisfactory. One was severe pes planovalgus, and the other was idiopathic case. The duration of symptom and the epineurolysis were not related with the results. However the presence of space occupying lesion was significantly related with the good results. Conclusion: Early operative release of tarsal tunnel appears to be important for the improvement of symptom. However the prognosis is limited in case that there is no SOL.
Purpose: The purpose of this study is to present our clinical results after surgical treatment in tarsal tunnel syndrome due to space occupying lesions. Material and Methods: We performed surgical decompression for tarsal tunnel syndrome in 20 patients from July 2004 to February 2007. Out of them, thirteen cases were due to space occupying lesions around the tarsal tunnel. The average age at operation was 51.3 years old and the duration from symptom onset to surgery was 16.5 months. The operation included removal of space occupying lesions and tarsal tunnel decompression. The clinical parameters were pain visual analogue scale (VAS), AOFAS scale, and subjective satisfaction. Results: The ganglion cysts were the most frequent causes (ten cases) and synovial chondromatosis in 1 case, neurofibroma in 1 case, talocalcaneal coalition in 1 case. The average follow-up duration was 14.5 months. The AOFAS scale showed significant improvement from 77.8 to 92.7. The average VAS decreased from 6.4 to 2.2. Seven out of thirteen patients were satisfied with the results. The excellent results were shown in six patients, the good results in one patient, the fair result in three patients and the unsatisfactory results in three patients. Conclusion: Favorable results could be obtained in patients with known etiology. But not all cases with surgical decompression of space occupying lesions showed satisfactory results. We assume that the clinical results were related to the multiple factors, not only well performed surgery but also age, size lesions and duration of symptoms, ect.
Purpose: Study was to evaluate the operative results for tarsal coalition with tarsal tunnel syndrome. Materials and Methods: From Jan. 2005 to Mar. 2006, among a number of patients who were diagnosed with tarsal tunnel syndrome caused by tarsal coalition and treated surgically, 5 patients were closely observed for more than 12 months. All cases were talocalcaneal coalition and there were two male and three female patients with a mean age of 36 years (22-50 years). We used the Takakura rating scale as clinical evaluation. Results: All five patients had a burning pain in the sole or extended to toes and showed positive Tinel's sign. Sensory disturbances were observed in the distribution of the medial plantar nerves in four patients and in the area of the medial and lateral plantar nerves in one. Atrophy and weakness of the plantar muscles were seen in two patients. The mean Takakura scale in preoperative and postoperative was 3.4 points (1 to 5 points), 8.6 point (6 to 10 points). The mean follow up was 14.4 months (12 to 16 months). The postoperative results were excellent in two patients, good in two and fair in one. As postoperative complications, there were persistent swelling in one patient and a flexion disturbance of Hallux in one. Conclusion: The coalition resection performed on tarsal tunnel syndrome caused by tarsal coalition could improve a level of pains and neurological symptoms significantly. However, since there were some undesirable complications, a detailed explanation to patients is required prior to surgical treatment and study of such complications may be required.
The purpose of this study was to evaluate the sealing properties of the temporary filling materials used in endodontic treatment Access cavities were prepared in 135 extracted human molar teeth. Then, cotton pellets were placed in the pulp chamber until the depth of 5 mm for the temporary filling materials; Caviton, zine oxide-eugenol, double sealing (A) (stopping 15 mm + zinc oxide - eugenol, 3.5mm ) double sealing (B) (stopping 3.0 mm + zinc oxide - eugenol 2.0 mm) and gutta percha stopping. After filling the materials, the teeth were immersed in 1 % methylene blue solutions for 3 days, 1 week and 2 weeks. Then thermal cycling was performed at the temperature of $60^{\circ}C$ and $4^{\circ}C$, followed by longitudinal sections on the center of tooth. Finally, staining on the cotton pellet was evaluated. The following results were obtained. 1. Stopping showed lower marginal sealing quality than Caviton, zinc oxide - eugenol and double sealing. 2. In 1 week group, Caviton showed higher marginal sealing quality than zinc oxide-eugenol, double sealing and stopping. 3. Caviton and double sealing (B) showed a great decrease in marginal sealing quality with the increse of time. 4. Caviton had high marginal sealing quality in 3 day group and 1 week group, but in 2 week group, Caviton showed a great decrease. 5. Double sealing (B) showed fairly high marginal sealing quality in 3 day group, but decreased greatly after 1 week on.
Background : Carpal tunnel syndrome(CTS) is the most common entrapment neuropathy that refers to a group of signs and symptoms resulting from compression of the median nerve at the wrist. The course of CTS in older patients is different from the younger patients. This difference may be the result of different underlying mechanisms. The different nerve conduction studies of CTS may signify different approaches in management. This study was done to assess the differences in nerve conduction study of CTS in younger and older patients. Methods : This study involved 224 patients who visited Gachon Medical School, Gil Medical Center and was diagnosed by nerve conduction study from October 1997 to October 1999. We compared the results of nerve conduction study to age, especially in between those under 60 years and those 60 years or over CTS patients. Nerve conduction study consists of motor studies of both median nerves(terminal latency, compound action potential) and sensory studies(nerve conduction velocity, nerve action potential). And we also evaluated the variables between younger and older patients group. Those variables include sex, symptom period, laterality, abnormal physical findings and radiculopathy. Results : We found that a significant increase of terminal latency(p<0.1), but a decrease in compound motor action potential(p<0.05) in older patient's group. There was no significant differences in sensory nerve conduction velocity and action potential between those under 60 years and those 60 years or even patients. And also there was no significant difference in sex, symptom period, laterality, abnormal physical findings, radiculopathy between older and younger patients. Conclusions : This study showed a significant increase in the terminal latency and a decrease in compound action potential in older patients. The different nerve conduction studies of CTS by age effect may need different approaches in management.
Journal of the korean academy of Pediatric Dentistry
/
v.40
no.3
/
pp.216-222
/
2013
Paradigm shift in management of infected immature permanent teeth has occurred. The new concept of the treatment includes minimal or no intracanal instrumentation, disinfection with triple antibiotic paste and sealing with mineral trioxide aggregate. This regenerative endodontic treatment promotes differentiation of periradicular stem cells that induce regeneration of vital tissue and continuation of root formation. Thorough disinfection and three-dimensional scaffold are important in this new concept of the treatment. Platelet-rich fibrin has been reported as 'new scaffold' instead of blood clot, which had been used in the past. Triple antibiotics can be used to disinfect the tooth but may lead to complications including discoloration. Three cases of infected immature permanent tooth caused by dens evaginatus fracture are presented. After removal of necrotic pulp and thorough intracanal irrigation, only platelet-rich fibrin was applied to the root canal in the first case. In the other cases, topical antibiotics was used for disinfection and platelet-rich fibrin for scaffold. In all the cases, the opening was sealed with mineral trioxide aggregate. All the cases showed proper healing of inrabony lesion and some lengthening of root. According to these cases, regenerating vital tissue of the infected immature permanent tooth can be achieved with disinfection and application of platelet-rich fibrin.
Journal of Dental Rehabilitation and Applied Science
/
v.32
no.2
/
pp.123-129
/
2016
Whereas a somatic pain notifies tissue damage, a neuropathic pain presents disorder of the nerve itself. The causes of neuropathic pains are trauma, infection, chronic irritation by adjacent tissue and so on. The iatrogenic trauma or infection also causes traumatic neuropathy, which may exert a bad influence on doctor-patient relationship. Some of related dental treatments are implantation (directly or indirectly through heating), root canal treatment, teeth extraction, block anesthesia, mandibular surgery. If inappropriate management is performed after nerve trauma, there will be many chances to develop chronic neuropathy for the patient. It is important that the sign of nerve trauma have to be caught by the practitioner as soon as possible and treated properly.
This study was designed to identify lymphocytes and to compare the lymphocyte distribution in endoodontically treated periapical lesions with that in endodontically untreated periapical lesions by way of immunohistochemical staining. Twenty-one human dental periapical lesions were obtained, frozened, serially sectioned to $4-5{\mu}$, and stained using the three-stage indirect immunoperoxidase technique and monoclonal antibodies for detecting the presence of B,T lymphocyte and T suppressor cell. Following results were obtained; 1. All of the examined periapical lesions had positive staining for B,T lymphocyte and T suppressor cell. 2. The concentration of T lymphocytes in 18 lesions diagnosed as periapical cyst and granuloma in both groups was greater than that of B lymphocytes and 2 periapical lesions identified as abscess in treated lesions had more positive B lymphocytes than positive T lymphocytes. 3. The average numbers of T,B lymphocytes and T suppressor cells in Endodontically treated lesions were lower than those of untreated lesions, but no statistically significant difference was noted. 4. When the distribution ratios of T lymphocytes to B lymphocytes and T suppressor cells to T lymphocytes were compared in Endodontically treated lesions by the histological aspects of the lesions and at the intervals of the duration after Endodontic treatment, a statistically significant change was not found. 5. The mean values of T lymphocytes, B lymphocytes and T suppressor cells in Endodontically treated lesions were markedly decreased in the specimens obtained at 3 month after Endodontic treatment, but no statistically significant difference was found.
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