• The korean journal of orthodontics
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• v.38 no.3
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• pp.187-201
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• 2008

Objective: The aim of this study was to determine whether cortical punching stimulates the expression of matrix metalloproteinase-1, -8, and -13 in orthodontic tooth movement in rats. Methods: A total of 32 male sprague-dawley rats at 15 weeks old were divided into two groups of 16 rats each, to form the tooth movement with cortical punching (TMC) group and tooth movement only (TM) group. A total of 20 gm of orthodontic force was applied to rat incisors to cause experimental tooth movement. Cortical punching was performed on the palatal side near the central incisor with a 1.0 mm width microscrew in the TMC group. The duration of tooth movement was 1, 4, 7, and 14 days. Results: Measurements of the mRNA expression were selected as the means to determine the identification of expression of MMP-1, -8, and -13. In the TMC group, the expression of collagen type I was greater than that of the TM group from day 4 to day 14. Expression of TIMP-1 in the TM group was greater than that of the TMC group in the pressure side of PDL and alveolar bone cell at day 4. In the TMC group, TIMP-1 was expressed at the osteoclast, but not at the tooth surface of the TM group at day 14, Maximum induction of the mRNA of MMP-1 was observed on day 4 in the TMC group, but it was observed on day 7 in the TM group. MMP-8 mRNA of the TMC group was twice greater than that of the TM group at f days. In the TMC group, maximum induction of MMP-13 mRNA was observed on day 1. Conclusions: These findings suggested that cortical punching can stimulate remodeling of PDL and alveolar bone connective tissues during experimental orthodontic tooth movement in rats.

• Restorative Dentistry and Endodontics
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• v.36 no.6
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• pp.510-514
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• 2011

Mineral trioxide aggregate (MTA), which was originally developed for repair of root perforations, is a biocompatible material with numerous clinical applications in endodontics. MTA must be allowed to set in the presence of moisture to optimize the material's physical and chemical properties. In the clinic, occasionally unset MTA has been detected after application of MTA on the tooth, and the reason has been unclear. This case report presents MTA washed-out for several years after placement at the root apex as an apical plug, and discusses the reason and things to consider in clinics.

• The Journal of the Korean dental association
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• v.50 no.9
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• pp.574-585
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• 2012

Purpose : This study was performed to evaluate the healing response around the root perforation restorative material. Materials and Methods : Four beagle dogs were used for experimental study. Endodontic treatment was performed at four maxillary premolars and artificial perforation was formed at furcation area of pulp chamber. Canal was filled with gutta percha cone and the perforation was sealed with MTA at group 1. At group 2, canal was filled and the perforation was sealed with dentin paste. Tooth paste was fabricated using extracted human teeth. Histologic examination of furcation area was performed 2, 4, 8 and 12 weeks after experiment. Results : New trabecular bone formation was observed around the MTA and tooth paste. Lamellar bone was observed as time is over. There were no inflammatory reaction in both groups. Conclusion : There is a possibility which endodontic filling material can be developed using extracted teeth.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.177-184
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• 1991

A giant cell granuloma and a cementifying fibroma occurring in the same lesion of right mandibular body in a 10 year old boy is presented with a 12 month follow up without recurrence or any other complications after operation. The relatively small lesion of cementifying fibroma was well delineated from the larger lesion of central giant cell granuloma, and as their origins are different each other(odontogenic or connective tissue origin), we have considered that both lesions had developed independently. Clinically, the evidencesa of aggressiveness of giant cell granuloma were also found, that is, large size, earlier age of 10, root resorption of lower right 1st annd 2nd molars and cortical perforation. With curettage and electric cauterization, we have treated both lesions satisfactorily.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.93-109
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• 1997

Finding a right repair material for furcation perforation is one of the major issues in clinical endodontics. In this experiment, three materials, calcium sulfate, amalgam, and calcium hydroxide were tested for perforated furcation repair. Sixty premolars and molars of five dogs were used. A #4 round bur was used to create the perforation. All experimental teeth were divided into two repair-time groups. One was immediate-repair group, where the perforation was repaired immediately, the other was delayed-repair group, where the perforation was left open for four weeks and then repaired with the same manner as in the immediate-repiar group. All chamber openings were sealed with amalgam and then radiographed. The animals were sacrificed at eighth week following the repair procedure. Radiographic evaluation for furcal bone destruction was done. Histologic evaluation was ranked as 0,1,2,3 according to the inflammation degrees. New bone formation was also recorded. The following conclusions were drawn within the limits of the experimental results: 1. In immediate-repair group, no significant differences existed between the materials. 2. In delayed-repair group, calcium sulfate showed significantly less furcal bone destruction and lower inflammation degree than amalgam.(p<0.05) 3. Overextruded specimens showed more severe inflammation than unextruded specimens. 4. Most of the specimens showed certain degrees of inflammatory reaction and incomplete hard tissue healing. 5. In delayed-repair group, treated group showed less inflammation than untreated control group.

• Restorative Dentistry and Endodontics
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• v.6 no.1
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• pp.7-16
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• 1980

The author observed the periodontal tissue reactions to the root canal sealers after root perforations were made intentionally in dogs. The perforations were made on 74 teeth from 7 dogs. The experiments were performed in two different modes of procedure: In Group I, the perforations were made through the root canal to the alveolar bone. In Group II, the perforations were made from site of alveolar bone to the root canals. The perforated canals in Group I were filled with gutta-percha and root canal cements; Calxyl (Calcium Hydroxide in Ringer's solution), Zinc Oxide -Eugenol cement (Z.O.E.), Kerr sealer (Rickert's paste) and AH 26 (Epoxy Resin preparations). The perforated canals in Group II were sealed with Calxyl, Z.O.E, Kerr sealer and AH26. Histologic examinations of periodontal tissue reactions were observed at various time intervals. The results were as follows; l. Cementum deposition on the perforated root surface in Group II cases showed slightly earlier than that of Group I. Healing tendency of injured alveolar bone in Group II was greater than that of Group I. 2. According to the time increase after experiment, the cementum deposition on the site of perforated dentin in Group II with intact pulp was notably thickened. Secondary dentin deposition on the root canal surface where the dentinal tubles were cut was also found in similar pattern. 3. In the cases of perforated canals sealed with Calxyl both in Group I and Group II, It revealed the earliest cementum-deposition among 4 different root canal cements. In the cases of perforated canals sealed with Kerr sealer and AH26, the cementum-deposition on the root surface was not found. 4. Proliferation of epithelium around the perforated area was first seen at 5-week cases in Group I, and at 3-week cases in Group II. 5. In all cases, dentin resorption on the site of perforated root surface was always occured.

• Restorative Dentistry and Endodontics
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• v.20 no.2
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• pp.610-626
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• 1995

Perforations especially in the furcations during endodontic treatment have notably detrimental effect on prognosis. The purpose of this study was to compare radiographically and histologically the sealing ability and the tissue responses of amalgam, Ketac-Silver, IRM, Vitapex, and mineral trioxide aggregate(MTA) used to repair furcation perforations. Thirty two experimental furcation perforations were created in the mandibular premolars of 6 mongrel dogs and immediately repaired with experimental materials. The animals were sacrificed after 16 weeks and radiographic and histopathologic results were evaluated. The following conclusions were drawn within the limits of the experimental results; 1. All materials tested in this experiment revealed a certain degree of extrusion into the periodontal space. 2. Both amalgam and Ketac-Silver showed the greatest degree of inflammation and bone resorption(p<0.0001). There was no significant difference between the amalgam and Ketac-Silver groups. 3. Both IRM and Vitapex showed a markedly milder degree of inflammatin and less bone resorption than amalgam or ketac-siver(p<0.00005). both IRM and vitapex showed the same respone. 4. MTA showed the least degree of Inflammation and bone resorption(p<0.05). The results of this experiment indicate that among the different materials tested, MTA appeared to be the best material for sealing furcation perforations, although the radiographic and histopathologic differences between the MTA and Vitapex groups were not statistically significant. But further studies with a larger sample are needed to have the exact conclusions.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.27 no.2
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• pp.97-104
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• 2018

Mandibular anterior region has high implant survival rates and better accessibility compared with any other region. Even if there are possibilities for perforation on lingual cortical bone due to improper drilling and bleeding caused by lingual artery damage, mandibular anterior region is a safe region because less amount of major anatomical structures exist compared with other regions. However, because of narrow bucco-lingual width of alveolar ridge, it is challengeable to obtain esthetic implant prosthesis. Although patients are less sensitive subjectively, mandibular anterior region is as difficult as maxillary anterior region in that implant placement location plays a critical role on the prognosis of implant prosthesis. One-piece implant is a very useful option for mandibular anterior region. Considering the narrow roots and thin alveolar bone of mandible, it is clinically difficult for implant diameter to be greater than 3mm In this case, we could approach the esthetic restoration in mandibular anterior region with one-piece implant and immediate loading.

• Journal of Chest Surgery
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• v.38 no.8 s.253
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• pp.529-537
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• 2005

Background: Historically the Fontan operation in patients with single ventricle and heterotaxy syndrome has been associated with high mortality because of systemic or pulmonary anomalous venous drainage, incompetent common atrioventricular valve, right ventricle type univentricular heart, and arrhythmia. Material and Method: A retrospective review of 62 patients $(age:\;54.79\pm33.97\;months)$ with heterotaxy syndrome who underwent a extracadiac Fontan operation between 1996 and 2005 was performed. Twenty one patients had left atrial isomerism, and 41 had right isomerism. The Fontan procedure was staged in all but 2 patients, and a fenestration was less placed in left isomerism. Result: Left isomerism was associated more with interrupted inferior vena cava and pulmonary arteriovenous fistula, and right isomerism was associated more with anomalous pulmonary venous drainage, common atrioventricular valve and morphologic right ventricle. There were 3 hospital deaths$(4.8\%)$ and 3 late deaths $(5.2\%)$ with a follow-up duration of $48.8\pm31.0$ months. Eight-year survivals were $90.5\pm6.4\%$ in left isomerism and $88.6\pm5.4\%$ in right isomerism (p=0.94). At 8 years, freedom from reoperation was $73.9\pm11.3\%$ in left isomerism, and $82.3\pm6.7\%$ in right isomerism (p=0.87). Atrioventricular valve regurgitation progressed after Fontan operation in heterotaxy syndrome, and reoperation for pulmonary arteriovenous fistula and permanent pacemaker implantation for sinus node dysfunction were required more in left isomerism. Conclusion: The extracardiac Fontan operation can now be performed in patients with heterotaxy syndrome with excellent survival. However, morbidity in terms of postoperative atrioventricular valve regurgitation, arrhythmia, and pulmonary arteriovenous fistula remains significant.