• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.2
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• pp.310-316
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• 1999

In the traumatized teeth, the major complications are pulp necrosis, and root resorption. The factors influencing to prognosis are the state of root development, type of injuries, quality of fixation. There are good prognosis in the case of immature teeth, minor luxation injuries. To minimize of occurrence of these complication, it is very important to determine the pulp vitality. This can help us decide whether or not to treat the teeth endodontically. But, it is difficult to determine of pulp vitality in immature teeth or traumatized teeth. In this case, pulp vitality test was done periodically on the traumatized upper central incisors, and the results were different among cold test, electric pulp test, and laser Doppler flowmetry. The conclusions were obtained from this case can be summarized as follows; 1. Pulp vitality of traumatized teeth should be negative early, but with time going, pulp vitality could be recovered. 2. The positive response of pulp vitality test was detected earlier in laser Doppler flowmetry. 3. Between cold test and electric pulp test, cold test was more reliable in determining pulp vitality.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.4
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• pp.683-690
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• 1998

The purpose of this study was to evaluate the reliablity of laser Doppler flowmeter on the permanent maxillary central incisors with open apex. Laser Doppler flowmeter and electric pulp tests were done in 35 elementary students aged between 8 and 9 years and 35 females and males aged between 23 and 24 years. Teeth with open apex were confined to root developmental stage 5 and 6 by Moorrees classification. The threshold of electric pulp tests was decided the time of tingling sensation. More than three different electric pulp tests applied on every teeth with more than 3 minutes interval between each teeth due to the false response. Laser Doppler flowmeter test stablilzation and observation stages took more than 5 minutes each LDF values and electric pulp test thresholds were analyzed with student t-test. The results were as follows: 1. The electric pulp test threshold on teeth with immature and mature roots showed 28.4% and 100% response respectively, and the the LDF values on teeth with immature and mature roots showed 100% response. 2. The EPT thresholds on teeth with immature roots were larger than thresholds on teeth with mature roots(p<0.01). 3. No significant differences were found in the LDF values on teeth with immature and mature roots.

• Restorative Dentistry and Endodontics
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• v.28 no.6
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• pp.475-484
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• 2003

동통조절을 위해 국소마취제는 치과임상에서 광범위하게 사용되어진다. 가장 널리 쓰이는 국소마취제는 리도카인이고 이는 마취효과의 지속 및 지혈효과 등의 목적으로 혈관수축제를 포함하고 있다. 대표적 혈관수축제인 에피네프린은 임상에서 1:300,000에서부터 1:50,000의 농도로 다양하게 사용되어진다. 수복치료를 위해서는 통상적으로 1:100.000농도의 에피네프린이 사용되고 있고 외과적 근관치료시 지혈효과를 위해서는 1:50,000농도의 에피네프린이 추천되고 있다. 이들 농도의 에피네프린을 포함한 리도카인으로 국소마취시 에피네프린의 농도가 치수의 혈류 및 치은의 혈류에 미치는 영향을 이해할 필요가 있고 그 영향이 전기치수검사에 대한 치수의 반응성에 미치는 영향도 이해할 필요가 있다. 따라서 혈관수축제를 포함한 국소마취제에 의한 치수혈류의 변화와 치수신경의 반응성을 이해하는 것은 중요하다 하겠다. 본 연구의 목적은 두 가지 농도의 에피네프린을 포함한 국소마취제로 마취시 나타나는 치수 및 치은의 혈류 변화를 치수신경의 반응성과 비교, 관찰함으로써 국소마취제가 치수 및 치은에 미치는 영향을 파악하고자 함에 있다. 24세에서 27세까지의 10명의 피검자의 건전한 상악중절치를 시험에 이용하였다. Laser Doppler flowmeter의 probe을 고정하기 위한 splint를 간접법으로 인상용 putty를 이용하여 제작하고 치수 및 치은의 혈류량, 그리고 전기치수검사에 대한 반응성을 측정하기 위한 3개의 구멍을 만들었다. 피검자를 10분간 안정시킨 후 마취 전 10분간 정상 혈류량과 전기검사치를 측정하고 1:50,000 epinephrine과 1:100,00 epinephrine이 각각 함유된 2% 리도카인 용액 0.9 ml를 상악 좌측 중절치 치근단부위 협점막에 침윤마취하였다. 마취 후 70분간 치수 및 치은 혈류량을 laser Doppler flowmeter를 이용해 연속적으로 측정하여 그 수치를 컴퓨터에 저장하였고, 매 5분 간격으로 전기치수검사를 시행하여 그 측정치를 기록하였다. 매 시간 간격의 평균 혈류량을 정상 혈류량에 대한 백분율로 나타내고, 각각의 농도에서 최소 치수 및 치은 혈류량을 Paired t-test, Wilcoxon's signed rank test. Duncan's multiple range test. Fisher's exact test등을 이용. 통계분석 하여 다음과 같은 결과를 얻었다. 에피네프린이 함유되어 있지 않은 리도카인을 협점막에 주사시 혈류변화가 거의 나타나지 않았으나 1:50,000 및 1:100.000 에피네프린이 함유된 2% 리도카인을 협점막에 침윤마취시 치수 및 치은 혈류 공히 현저히 감소하였다(p<0.01). 1:50,000 에피네프린군은 1:100,000 에피네프린군에 비해 치수 혈류량이 현저히 억제되어 나타났으나(p<0.01), 치은 혈류량에서는 유의성 있는 차이를 나타내지 않았다(p>0.05). 두 농도의 에피네프린 군 공히 치은혈류는 치수혈류에 비해 유의하게 많은 감소를 나타내었다(p<0.05). 1:100,000 에피네프린 군에서 마취액 주입 후 치수혈류 최대감소가 가장 먼저 나타났고 이어서 전기검사에 대한 치수의 반응성 소실 및 치은혈류 최대 감소의 순으로 나타났다(p<0.05). 1:50,000 에피네프린군의 경우가 1:100,000 에피네프린군의 경우에 비해 마취지속시간이 길게 나타났으나 유의성은 없었다(p>0.05).

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.371-378
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• 2002

In this study, 40 hypersensitive teeth of 19 patients were investigated. The procedures performed were as follows: Before desensitization, EPT at occlusal third of buccal surface was done for the evaluation of pulp vitality and the EPT value was recorded for the reference value. And mechanical and thermal test was executed for the test of hypersensitivity. If the tooth responded to the above tests, we did EPT at the exposed surface, using toothpaste as a electrolite medium and recorded the EPT value at patient's response. After the tests had been done, desensitization procedures with Gluma(R) Desensitizer were performed according to the manufacturer's instructions. After desensitization, the same tests except EPT at occlusal third were repeated. All the 40 teeth responded positive before desensitization and negative after desensitization procedures. The EPT value at occlusal third ranged from 31 to 65 (48.9${\pm}$7.2). Before desensitization 34 teeth responded at EPT value of 2 and the remaining 6 teeth was in the range of 17 to 25. After desensitization all 40 teeth responded from 12 to 27 (19.6${\pm}$3.5). The 6 teeth responded at greater number than 2 before desensitization was in the range of 18 to 23. Within the limitations of this study we can conclude that: When a tooth with dentinal hypersensitivity responds to mechanical and thermal stimulation, the tooth shows very low resistance to electricity at the exposed surface while when a tooth is desensitized and doesn't show respond to mechanical and thermal stimuli, the tooth shows increased level of resistance to electric stimulation at the exposed surface. EPT can be used for the diagnosis of dentinal hypersensitivity. Furthermore EPT will be useful to evaluate the outcome of desensitization procedures. However, EPT is not a valid tool for measuring dentinal hypersensitivity.

• The Journal of the Korean dental association
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• v.24 no.6 s.205
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• pp.541-547
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• 1986

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.41 no.2
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• pp.61-68
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• 2004

Electric stimulation of teeth has been used for assessing pulp vitality. The principle is based upon the assumption that a subject feels the pain produced by electrical current stimulation of intradental nerve. Because of very high and wide range of impedance of the enamel, it is very difficult to determine stimulation levels regardless of teeth status. Most pulp testers adopt voltage stimulation method and thus, their stimulating threshold levels significantly depend on each individual. Therefore, a constant current stimulator is necessary to minimize the effect of wide variation due to different enamel thickness. And it is also necessary to test teeth vitality with a wide current range regardless of tooth impedance. In this study, we constructed a burst-wave type pulp tester to reduce the pain using a current stabilizing circuit with the maximum current of 150 uA.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.41 no.6
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• pp.43-49
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• 2004

Electric pulp test is a method to examine the vitality of dental pulp using physical and chemical stimulation. During the pulp test, the current stimulates intradental nerve, and it makes patients painful. In this paper, we measured each activating response EMG in anterior belly of digastric muscle, voice, and finger movement during the pulp test by increasing stimulus intensity gradually. We also measured excessive stimulus time from the activating responses (EMG, voice, and finger movement) to the end of the stimulation. We measured and analyzed excessive stimulus time for each stimulus detecting method. As a result, we developed automatic stimulus breaker using the human responses to stimulus during electric pulp test. We reduced the excessive stimulus time by disconnecting the pulp tester stimulus output rapidly in 10 ms after activating human response.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.3
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• pp.562-568
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• 1998

Various diagnostic methods, such as electric pulp test, cold test, test cavity etc., have been used to determine the pulp vitality. At least two or more methods should be used with supplemental information to diagnose each case because using one method doesn't provide sufficient accuracy. These conventional methods have depended on nervous responses, but Laser Doppler Flowmeter determines the pulp vitality by measuring pulpal blood flow. In this case, we tested the vitality of the traumatized teeth with incomplete root apices and autotransplanted teeth with conventional methods and Laser Doppler Flowmeter. Conventional methods, such as electric pulp test and cold test can produce various responses according to the development state of the pulpal nerve and the sensory threshold of the patient. But, Laser Doppler Flowmeter has a lower false response rate than any other pulp vitality test methods and it can determine the vitality somewhat earlier than the other method.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.2
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• pp.256-261
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• 2004

Pulp canal obliteration(PCO) is seen commonly in dental pulp after traumatic tooth injuries and is recognized clinically as early as 3 monthly after injury. Pulp canal obliteration is characterized by deposition of hard tissue within the root canal space and yellow discoloration of the clinical crown. Opinion differs among practitioners as to whether to treat these cases upon early detection of PCO or to observe them until symptoms or radiographic signs of pulpal necrosis are detected. PCO may make root canal treatment necessary because of the development of apical periodotitis or for cosmetic reasons. If carefully executed, root canal treatment in teeth with an PCO is hightly successful and may act as a basis for internal bleaching. During a game, a 12-year-old girl was hit in the face. At that time, she was diagnosis a subluxation of the maxillary right central incisor. At the 24-month recall examination, a root canal of the tooth had been calcified and discolored gradually. We performed endodontic treatment to prevent perfect pulp canal obliteration and internal bleaching.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.1
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• pp.103-107
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• 2000

Traditionally, EPT and thermal tests were used as diagnostic methods for pulp vitality test. The thermal and electrical stimulation tests are the methods to determine the vitality of a tooth based on its neuronal response. These have certain limitations, one of them is the difficulty of approaching the correct result in case of treatment of children. The reason is management problem caused by the unpleasant stimulation. Also, the response from patients are not objective, and false positive or false negative could be happened. Recently, laser doppler flowmetry and pulse oximeter which evaluate vascular integrity are introduced in an effort of overcoming to limitation of traditional methods. The principle of pulse oximeter is to and out level of oxygen saturation by ratio of the two pulses between emitted light and detected light penetrating them to the termination of body, such as ears or fingers. From this point of view, it can be applied to a tooth to determine its vitality. The objective of this study lies mainly on varifying pulse oximeter as a method of determining tooth vitality and providing basic data of its clinical implementation. The result of the research showed that level of oxygen saturation in vital teeth was average of 96.3% and 0.0% in pulpless teeth. As a comprehensive result, pulse oximeter could be an useful diagnostic equipment in determining of tooth vitality.