• Restorative Dentistry and Endodontics
• /
• v.28 no.4
• /
• pp.314-325
• /
• 2003

이 연구의 목적은 수종 상아질 접착 시스템과 복합 레진 및 resin-modified glass ionomer를 상아질 표면에 접착하여 재료 및 상아질내 위치에 따른 미세전단결합강도를 측정, 비교하는 것이다. 상아질 접착 시스템으로는, 3-step인 Scotchbond Multi-Purpose Plus, 2-step인 Single Bond와 자가 부식형 시스템인 Clearfil SE Bond를, 1-step인 Prompt L-Pop을 사용하였다. 이와 함께 hybrid type의 복합 레진인 Clearfil AP-X와 2250을 사용하였으며 resin-modified glass ionomer로는 Fuji II LC를 사용하였다. 상악 소구치를 치아의 근원심 중앙부를 절단하여 상아질면을 노출시켰다. 5개 실험군으로 분류하고 상아질면을 위치에 따라 치관부의 occlusal $\frac{1}{3}$, middle $\frac{1}{3}$, cervical $\frac{1}{3}$과 치근부로 구분지어 시편을 부착하였다. 미세전단결합강도측정는 Universal testing machine(EZ-test; Shimadzu, Japan)에서 측정하였다. Occlusal 1/3부위에서는 SE가 가장 높은 값을, SM과 SB간에는 유의차가 없었으며, PL, GI순으로, Middle 1/3부위에서는 $SM{\;}{\geq}{\;}SE{\;}{\geq}{\;}SB{\;}{\geq}{\;}PL{\;}{\geq}{\;}GI$순으로, cervical 1/3부위에서는 SM, SE, SB간에 유의차가 없었다. Root dentin에서는 SM이 가장 높은 값을 보였으며 SE, PL, GI간에 유의차가 없었다. SE만이 치관부 상아질에 비해 치근부에서 유의할만한 결합강도의 감소를 나타냈다(p<0.05). GI는 치관부 상아질에서는 다른 군에 비해 유의성 있게 낮은 결합강도를 보였으나 치근부에서는 SE, PL과 유의차가 없었다.

• Restorative Dentistry and Endodontics
• /
• v.27 no.6
• /
• pp.555-560
• /
• 2002

치근부 민감성 (hypersensitivity)은 부분적으로 치근면에서의 개방된 상아세관이 존재하는 것에 기인한다고 생각되며 이러한 치근부의 개방된 상아세관은 치경부 병소 (cervical lesion)에 주로 존재하는데 이는 칫솔질에 의한 마모(toothbrush abrasion), 화학적 침식 (chemical erosion), 또는 abfraction 등의 결과로 나타난다고 한다. 이미 Nd-YAG 레이저를 이용한 실험에서 레이저를 조사한 상아질 표면의 상아 세관 구경이 감소되고 상아세관의 폐쇄가 많이 증가되는 양상을 관찰한 바 있다. 이 실험의 목적은 고출력레이저인 Nd-YAC 레이저를 이용한 상아질 표면처치의 임상사용가능성을 좀 더 상세히 평가하기 위해 상아질에 레이저를 처리한 후 기계적으로 마모시킨 경우 상아질 표면의 변화를 관찰하는 것이다. 50개의 발치된 치아의 상아질을 노출시켜 표면을 연마한 후 대조군에서는 37% 인산으로 산부식하여 상아 세관을 노출시킨 후 레이저를 조사하였고, 실험군에서는 대조군과 같은 조건으로 산과 레이저로 처리된 상아질 표면을 15, 45, 90 그리고 180분 동안 전동 칫솔로 기계적으로 마모시켜 그 표면을 주사전자현미경으로 관찰한 결과, 대조군, 칫솔질을 15, 45분간 시행한 실험군에서는 상아 세관 입구가 10% 이내에서 노출되었고 50 그리고 180분간 칫솔질을 시행한 실험군에서는 45 그리고 48%의 상아세관 입구의 노출이 관찰되었다. 그러므로 Nd-YAC레이저의 조사는 상아질 표면에서 축적 시간이 45분 이상에서 90분 이하인 기계적 마모에 의한 상아 세관 입구의 노출을 억제할 수 있을 것이라 사료된다.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.40 no.3
• /
• pp.177-184
• /
• 2013

Calcium hydroxide mixture medicaments can nearly be considered to be the ideal primary tooth filling material. However, long-term application of calcium hydroxide combinations as an intra canal medicament softens dentin. The aim of this study was to evaluate the effect of calcium hydroxide on the microhardness of root dentin of primary tooth. For the study, 60 extractedprimary incisors were divided into 3 groups (no medicament, calcium hydroxide/iodorform mixture, and calcium hydroxide/distilled water mixture). After the cleansing and shaping of canals, calcium hydroxide medicaments were applied and stored for different periods of time (1, 7, 30, 90 days). The root was horizontally sectioned into 2 mm thick specimens and the microhardness was measured using Vickers microhardness tester. The results were as follows : Root dentin microhardness of primary teeth decreased with long term exposure to calcium hydroxide medicaments according to the experimental period and showed statistically significance (p < 0.05). Root dentin microhardness of primary tooth filled with calcium hydroxide mixed with distilled water showed more decrease than filled with Vitapex and showed statistically significance (p < 0.05). Root dentin microhardness of a control group without exposure to calcium hydroxide decreased according to the experimental period and showed statistically significance (p < 0.05).

• Journal of dental hygiene science
• /
• v.10 no.5
• /
• pp.395-401
• /
• 2010

Over expression of TGF-${\beta}1$ revealed the same phenotype as NFI-C deficient mouse. It has been reported that NFI-C deficient mice demonstrated abnormal odontoblast differentiation and aberrant dentin formation during root development. In the present study, in order to investigate the histological differences between wild type (WT) mouse and NFI-C deficient mouse, we compared morphological characteristics and smad4 expression between those mice. Hematoxyline-eosin (H-E) staining was used to investigate morphological changes and immunohistochemistry was also performed to observe the Smad4 expression pattern. In H-E staining, incisor of NFI-C deficient mouse showed an open area in the lingual root, irregular odontoblasts and osteodentin. Also, NFI-C deficient mouse showed short root and osteodentin in molar. In addition, Smad4 protein was strongly expressed in NFI-C deficient mouse compared with wild type. These findings suggest that NFI-C deficiency affects odontoblast differentiation and result in the formation of abnormal roots. Therefore, balancing between NFI-C and TGF-${\beta}$ signaling including Smad4 is important for the regulation of normal odontoblast differentiation and dentin formation.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.33 no.2
• /
• pp.181-191
• /
• 2006

NFI-C null mice demonstrated aberrant odontoblast differentiation and thus abnormal dentin formation while other tissues/organs in the body, including ameloblasts, appear to be unaffected and normal. However little is known about the mechanism of NFI-C function in odontoblast differentiation and dentin formation. Odontoblasts are tall, highly polarized cells that are responsible for formation and maintenance of the predentin and dentin. An indication of their polarity is the acquisition of specialized intercellular junctions. As preodontoblasts differentiate into odontoblasts, they are Joined and attached at the apical end by well developed terminal webs of cytoskeletal actins, and associated tight as well as adherent njunctions. In this study, in order to investigate if disruption of the NFI-C gene interferes with formation of a specific or other structural proteins of the intercellular junctions, we examined morphological characteristic of the aberrant odontoblast in NFI-C null mice using light and electron microscope. In addition, we determined the expression of major structural proteins of intercellular junctions, ZO-1 and occludin, during the differentiation of odontoblasts using immunohitochemistry. The results were as follows : 1. In light microscopy, abnormal odontoblasts of incisors of the NFI-C null mice were round in shape, lost their polarity, and trapped in osteodentin-like mineralized tissue. Mutant molars have relatively normal crowns, but short and abnormal differentiating adontoblasts in root formation area. 2. Electron microscopy of abnormal odontoblasts revealed the dissociation of the round osteoblast-like cells, the loss of their cellular polarity, and the absence of an intercellular junctional complex known as the tight junctions. 3. A mutant incisor showed labeling for ZO-1 at the proximal and distal ends of secreting ameloblasts, while staining for ZO-1 was not observed in the abnormal odontoblasts. 4. A normal incisor showed immunoreactivity for occludin in the differentiating odontoblasts. However, staining for occludin was not observed in the abnormal odontoblasts of mutant incisor. These results suggest that NFI-C gene causes dissociation of odontoblast and thus abberant odontoblast differentiation and abnormal dentin formation by interfering with the formation of intercellular junctions.

• Journal of Periodontal and Implant Science
• /
• v.19 no.1
• /
• pp.130.1-130.1
• /
• 1989

• Journal of the korean academy of Pediatric Dentistry
• /
• v.28 no.4
• /
• pp.654-660
• /
• 2001

Dentinogenesis imperfecta is an example of an inheritable dentinal defect originating during the histodifferentiation stage of tooth development, with involvement of the primary and permanent teeth. Shields, Bixler and El-Kafrawy proposed three types of Dentinogenesis imperfecta : Type I, II, III. Witkop reported a prevalence of 1 in 8000 with the trait, and no significant difference between male and female. Affected teeth have red-brown discoloration often with distinctive wearness of occlusal surface of posterior teeth and incisal surface of anterior teeth. Once enamel seperated from underlying defective dentin, the dentin demonstrates significantly acclerated attrision. Radiographically, the teeth have thin roots, bulbous crown, cervical constriction, and obliteration of the root canals and pulp chambers. In primary dentition periapical lesions or multiple root fractures are often observed. In successive generations the phenotypes of discoloration and wearness of teeth occurred, and one of the patient's subships, 10 year-old sister, showed general discoloration of her teeth and mild wearness. In this case, a 4 year-old male reported to the Yonsei University Pedodontics clinic, with a chief complaint of discolored teeth. The teeth showed generally yellowish-brown discoloration and moderate wearness. In radiographic features, obliteration of pulp, bulbous crown, and short roots were observed. It was diagnosed as Dentinogenesis imperfecta. The posterior teeth were restored with Stainless Steel Crown, and defective incisors including left upper primary central incisor which was extracted due to a root fracture with Open-faced Stainless Steel crown.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.33 no.2
• /
• pp.323-328
• /
• 2006

Dentinogenesis imperfecta is an inheritable disease of dentinal defect, generally is inherited as a single autosomal dominant trait. It has a prevalence of 1 in 8000 with the trait, and no significant difference between male and female, with involvement of the primary and permanent teeth. Shields proposed three types of Dentinogenesis imperfecta. Affected teeth have various discoloration, separation of enamel rapid destruction of underlying dentin, and severe attrition. Radiographically, the teeth have cervical constriction, bulbous crown, thin root, obliteration of the root canals and pulp chambers, and periapical lesions in a sound tooth. The objective of treatment is rehabilitation of the esthetics, the masticatory function, and the vertical dimension of occlusion. In these cases, two pediatric patients reported to the Kyungpook University Pediatric clinic, with a chief complaint of discolored teeth and severe attrition. As a result of clinical and radiographic exam, it was diagnosed as Dentinogenesis imperfecta. The posterior teeth were restored with Stainless Steel Crown, and the anterior teeth were restored with composite resin veneering.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.36 no.2
• /
• pp.288-292
• /
• 2009

A crown-root fracture is defined as a fracture involving enamel, dentin, and cementum. The fractures may be grouped according to pulpal involvement into uncomplicated and complicated. Generally a vertically crown-root fractured tooth must be extracted. However, it should be mentioned that the cases have been reported where bonding of the coronal fragment has led to consolidation of the intraalveolar part of the fracture. Definitive conservative therapy comprises one of four treatment alternatives; fragment removal only, fragment removal with gingivectomy, orthodontic extrusion of apical fragment, and surgical extrusion of apical fragment. The choice is primarily determined by the exact information on the site and the type of fracture, but the cost and the complexity of treatment can also be decisional factors. On the other hand, intentional replantation of the teeth with vertical root facture reconstructed with resin bonding has emerged as a new promising method in recent years. This case presents an intentional replantation of the crown-root fractured maxillary central incisor reconstructed with resin bonding. However, an obvious increase of radiolucency was observed after 4 months and the tooth was re-fractured after 16 months.

• Restorative Dentistry and Endodontics
• /
• v.26 no.4
• /
• pp.350-359
• /
• 2001

목적 - 근관형성시 근관내 상아질벽에는 항상 도말층(smear layer)이 형성되는데, 이는 상아질, 치수조직 잔사, 조상아세포 돌기, 때로는 미생물 등으로 구성되며, 주사전자현미경상으로는 비규칙적이며, 무정형의 구상(granular)구조물로 관찰된다. 본 연구에서는 도말층의 유무에 따른 혐기성 미생물, Prevotella nigrescens의 근관내 상아질 부착정도를 주사전자현미경으로 평가하고자 한다. 지금까지 사용되었던 실험방법에 비하여 보다 임상적 환경에 가까운 실험방법을 고안, 신빙성 있는 연구결과를 기대할 수 있도록 하였다. 방법 - 치주질환이나 외상 등의 원인으로 발거된 상, 하악 전치 18개를 사용하였다. 각 치아의 치관부를 백악법랑경계부위에서 절단하고, 1군(5개치아)은 10ml의 생리식 염수를, 2군(5개치아)과 3군(5개치아)은 10ml의 3.5% NaOCl을 근관관주용액으로 사용하여 근관형성을 하였다. 근관형성 완료후 1군과 2군은 10ml의 생리식염수로, 3군은 10ml의 0.5M EDTA용액으로 final flush를 시행하여, 3군의 도말층을 제거하였다. 치근수직절단과 ethylene oxide(EO) gas 소독후 1, 2, 3군의 시편(각군10개시편)을 Prevotella nigrescens가 부유된 Brain Heart Infusion with Yeast estract, Hemin and Menadione(BHIYHM) broth내에 37$^{\circ}C$에서 3시간 동안 incubation했다. 4, 5, 6군은 실험과정을 검증하기 위한 대조군으로써, 4군(1개치아)과 5군(1개치아)은 1군, 2군과 같이 각각 생리식염수와 NaOCl만을 이용한 근관형성으로 도말층을 잔존시키고, 6군(1개치아)은 3군과 같이 NaOCl과 EDTA를 적용하여 도말층을 제거한 후, 치근 수직절단과 EO gas 소독을 시행했다. 모든 시편(1, 2, 3, 4, 5, 6군)을 통상의 방법에 따라 처리한 후 주사전자현미경을 통하여 관찰, 근관내면에 부착되어 있는 Prevotella nigrescens의 개수, 모양, 상아세관 및 도말층과의 관계 등을 관찰, 비교, 분석하였다. 결과는 t-test와 one-way ANOVA를 통하여 통계처리 하였다. 결론 - 1. 근관형성 후 근관내 상아질 표면 전체는 도말층으로 덮여 있는 양상을 보였다. 2. 3.5% NaOCl과 0.5M EDTA를 적용하여 근관내 도말층을 효과적으로 제거할 수 있었으며, 상아세관 개구부가 확연히 노출되어 있는 소견을 관찰할 수 있었다. 3. 도말층이 덮인군에서 미생물의 부착이 유의성 있게 높았다(P<0.05). 4. 근관 형성중 형성되어 근관 상아질을 덮고 있는 도말층이 미생물의 부착을 증가시켜, 근관 재감염의 기회를 증가시킴을 알 수 있었다.