• Title/Summary/Keyword: 치수치료

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Pulp Treatment of Triple Tooth in Primary Dentition: Two Case Reports (유치열에 나타난 삼중치에서 치수 치료 : 증례 보고)

  • Jeong, Hankeul;Lee, Nanyoung;Lee, Sangho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.2
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    • pp.192-199
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    • 2016
  • Triple tooth is rare in primary dentition; it is the abnormal fusion of three teeth. There are a few reports of double teeth, but triple teeth are rare. These multiple teeth create several clinical problems, not only esthetic problems but also a high caries susceptibility, congenital missing permanent tooth germ(s), orthodontic problems, and periodontal problems. They also make it difficult to perform pulp treatment because of the complex tooth structure. A 1-year 7-month-old male underwent a partial pulpotomy with mineral trioxide aggregate (MTA) when pulp exposure caused by deep caries occurred at a maxillary anterior triple tooth in the first case. The second case was a 1-year 9-month-old male presenting with a fracture line at a mandibular anterior triple tooth. After removing the fractured fragment, a pulpectomy was performed at the remaining primary lateral incisors. Specific complications were not observed during 24 and 6 months of follow-up, respectively.

Comparison of Partial Pulpotomy in Permanent Molars Using Different Pulp Capping Agents and Restoration Materials (치수복조재와 최종수복재에 따른 대구치 부분치수절단술의 비교)

  • Lee, Jimi;Lee, Nanyoung;Lee, Sangho;Jih, Myeongkwan
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.2
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    • pp.148-156
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    • 2020
  • The purpose of this study was to compare the success rates of two pulp capping materials, Biodentine™ and RetroMTA®, used for partial pulpotomy in permanent molars after carious exposures and to compare the final restorative outcome of using composite resin to that of using a stainless steel crown. We studied children who were diagnosed with dental caries of permanent molars and underwent partial pulpotomy. The patients were followed up for more than 1 year. Clinical and radiographic evaluation were used to evaluate the success of each treatment. Fisher's exact test was used to compare the outcomes of two groups. For pulp capping agents, the success rate of using RetroMTA® was lower than that of using Biodentine™(p < 0.05). Final restoration with composite resin was less successful than restoration with an stainless steel crown(p < 0.05). In combination of pulp capping agents and final restoration material, RetroMTA®-composite resin shows the lowest success rate(p < 0.05).

The Canal Irrigation in Paediatric Pulpal Treatment (유치 치수 치료의 근관세척)

  • Cho, Yong-Bum
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.4
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    • pp.467-472
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    • 2016
  • Successful root canal treatment can be obtained by the removal of microorganisms from the pulpal space of the root canal system through biomechanical technique with instruments and irrigation. Due to the difference in the dimension of the pulpal structure such as thin wall of the root, large portion of chamber, the primary teeth should be considered in a different way of approach. Traditionally, fluids have been dispensed passively into the root canals for improve the cleansing. The use of sodium hypochlorite as an irrigant in root canal treatment is widespread and common, because it meets requirements for the ideal irrigants.

A Retrospective Study of Critical Success Factors in Regenerative Endodontic Treatment (재생근관치료의 성공에 영향을 미치는 결정 요인에 대한 후향적 연구)

  • Jeong, Hwakyong;Lee, Nanyoung;Lee, Sangho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.1
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    • pp.47-55
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    • 2017
  • This study evaluated critical factors influencing the success of regenerative endodontic treatment for necrotic immature permanent teeth. The study enrolled patients who had regenerative endodontic treatment in a necrotic immature permanent tooth through 1-year follow-up. Possible explanatory variables related to the success rates for 46 teeth were age, gender, dental stage at the initial appointment, etiology, treatment information, and clinical and radiographic outcomes. The dental stage at the time of regenerative endodontic treatment did not influence the success rate. The success rate was significantly related to the etiology of the necrotic immature tooth. The success rate according to etiology decreased in the following order: dens evaginatus, caries, and trauma. There was also a significant difference according to the type of antimicrobial. The success rate was influenced by appropriate disinfection of the root canal system, provision of a scaffold, and coronal sealing. Above all, careful case selection is necessary for treating a necrotic immature permanent tooth, especially in cases of trauma.

Impact of Coronavirus Disease 2019 on Dental Service Utilization of Korean Children and Adolescents (코로나 바이러스 감염증-19가 한국 소아청소년의 치과 이용에 미치는 영향)

  • Joo-Hee, Kim;Hoi-In, Jung;Ik-Hwan, Kim;Jaeho, Lee;Chung-Min, Kang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.2
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    • pp.206-216
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    • 2022
  • This study aimed to investigate the frequency of dental visits after coronavirus disease 2019 (COVID-19) in children and adolescents in comparison to that of adults. The data on the number of dental visits on the basis of different classification and treatment codes for all the age groups were provided by the Health Insurance Review and Assessment Service from January 2017 to December 2020. To reduce the impact of the population change, dental visits per 1000 people was used. After the start of the pandemic, dental visits per 1000 people decreased in all age groups when analyzed for the diseases of pulp and periapical tissues classification code and dental visits per 1000 people decreased over 5 years age groups when analyzed for the pulp treatment code. Regarding the restorative treatment code, visits in the 0 - 19 years age group decreased after the pandemic. Based on the comparison of the number of confirmed COVID-19 cases to that of monthly dental visits by treatment codes, the change rate of pulp and restorative treatments gradually decreased after the waves of the pandemic in February and August 2020 in Korea. Furthermore, dental visits per 1000 people for gingivitis and periodontal disease classification code increased after the pandemic in all age groups. The rate of decrease in dental visits per 1000 people for restorative treatments in children and adolescents was higher than that in adults. The rate of decrease in the number of dental visits for multi-visit pulp treatments showed a rapid decrease as compared to that of 1-visit pulp treatments after the pandemic. This study identified changes in the number of dental visits of children and adolescents after COVID-19 transmission in comparison to that observed in adults.

PULP CANAL OBLITERATION CAUSED BY TRAUMA (외상에 의한 근관내 석회화 변성 치아의 처치)

  • Lee, Sung-Ryong;Lee, Chang-Seop;Lee, Sang-Ho;Lee, Nan-Young
    • 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.

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DENTAL TREATMENT OF SHELL TEETH UNDER GENERAL ANESTHESIA: A CASE REPORT (Shell teeth 환자의 전신마취 하 치과치료 : 증례보고)

  • Jang, Eunjeong;Lee, Hyeongjik;Kim, Jiyeon;Jeong, Taesung
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.14 no.1
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    • pp.31-35
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    • 2018
  • Dentinogenesis imperfecta is a hereditary disorder that causes abnormal dentin formation and tooth morphology. Affected teeth show very thin dentin and large pulp chamber. Immediately after their eruption, the teeth tend to be destroyed rapidly. Early dental intervention is recommended to improve the feeding capacity and quality of life for the child, to maintain vertical dimension, and to promote healthy and functional dentition. This case report describes a treatment for a 4-year-2-month-old girl whose primary and permanent dentition were affected by Dentinogenesis Imperfecta. Shell teeth were observed in the entire primary dentition. The pulp of most teeth was exposed and the patient complained of pain. Most paternal family members were transferred to the Dentinogenesis Imperfecta. She needed an extensive dental treatment, but her compliance could not be expected because she was very young and anxious. So we decided to treat her under general anesthesia. All molar teeth are restored with Stainless Steel crown. Maxillary anterior teeth were extracted and mandibular anterior teeth are restored with composite resin. The patient's pain disappeared and masticatory function was restored.

Regenerative Endodontic Treatment Without Discoloration of Infected Immature Permanent Teeth Using Retro MTA : Two Case Reports (치수 괴사된 미성숙 영구치에서 Retro MTA를 이용한 변색 없는 재생적 근관치료 : 증례 보고)

  • Kim, Yujeong;Kim, Seonmi;Choi, Namki
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.4
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    • pp.335-343
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    • 2014
  • Regenerative endodontic treatment has the potential to heal a necrotic pulp, which can affect root development in immature teeth. However, several drawbacks and unfavorable outcomes are associated with regenerative endodontic treatment, of which the most significant is coronal discoloration due to the presence of minocycline in triple antibiotic paste and mineral trioxide aggregate (MTA). To prevent tooth discoloration following pulp treatment, the modified triple antibiotics (ciprofloxacin, metronidazole, clindamycin) were used as canal disinfectants and Retro MTA, a $ZrO_2$-containing calcium aluminate cement, was used to seal the canal. Following access cavity acquisition, the canal was copiously irrigated with 2.5% sodium hypochlorite. A modified triple antibiotic paste was then applied to the canal. Once the tooth was asymptomatic (after between 3 and 8 weeks), Retro MTA was carefully placed over the blood clot or a collagen plug. Follow-up radiographs revealed normal periodontal ligament space and root development. In two cases, successful regenerative endodontic treatment of the infected immature tooth, without discoloration, was achieved with disinfection using modified triple antibiotics and Retro MTA sealing.

The Influence of Epinephrine Concentration in Local Anesthetics on Pulpal and Gingival Blood Flows (국소마취제에 함유된 에피네프린의 농도가 치수 및 치은 혈류에 미치는 영향)

  • Lee, Jae-Sang;Kim, Sung-Kyo
    • 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).