• Restorative Dentistry and Endodontics
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• v.35 no.6
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• pp.436-444
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• 2010

Objectives: This study aimed to assess prospectively the clinical outcome of nonsurgical endodontic treatment and identify patient- and tooth-related factors, rather than treatment-related factors, that were the best predictors of this outcome. Materials and Methods: The inception cohort comprised 441 teeth (320 patients) and 175 teeth (123 patients) were followed up for 1-2 years. Age, gender, presence of medical disease, number of canals, previous endodontic treatment, presence of sensitivity and pain, pulp vitality, swelling or sinus tract of pulpal origin on the gingiva, periapical radiolucency and tendency of unilateral bite on the affected tooth were recorded at treatment start. Results: The outcome was classified on the basis of periapical radiolucency as healed or non healed. The overall healed rate in these cases, including nonsurgical retreatment, was 81.1%. Four tooth-related factors had a negative impact in the bivariate analysis: previous endodontic treatment, necrotic pulp, preoperative gingival swelling or sinus tract of pulpal origin, and preoperative periapical radiolucency. Stepwise logistic regression analysis including patient-, tooth-related factors and level of the root canal filling as a treatment-related factor showed that preoperative gingival lesion (odds ratio [OR]: 4.4; p = 0.005), preoperative periapical radiolucency (OR: 3.6; p = 0.011), and $\leq$ 1-2 mm under root filling length (OR: 9.6; p = 0.012) were significant predictors of failure. Conclusions: A preoperative gingival lesion of pulpal origin can influence the outcome of nonsurgical endodontic treatment in addition to preoperative periapical radiolucency.

• 대한한약
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• s.1
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• pp.76-78
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• 1997

• Journal of Oral Medicine and Pain
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• v.22 no.2
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• pp.219-232
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• 1997

치아는 성별과 연령의 추정은 물론 혈형 검사와 유전자 검사까지 가능하게 하는 중요한 법의치과학적 자료이다 대부분 치아를 이용한 연구는 핵 DNA가 들어있는 치수에서의 연구로 치수내에는 풍부한 혈액 및 세포가 분포해 있어 핵 DNA가 다량 함유되어 있다. 그러나 순수 상아질에는 핵이 없고 따라서 핵 DNA도 없는 것으로 알려졌지만 치수내에 존재하는 핵 DNA가 상아세관을 통하여 상아질내로 침투할 가능성이 있고 실제 근관치료가 되어 있는 무수치를 감정하게 되는 경우도 있다. 본 연구에서는 이러한 치아중에서도 근관치료를 받은 무수치에서 개인식별에 활용되는 유전자가 검출되는지 여부를 확인하고자 하였다. 40개의 근관치료된 치아상아질에서 DNA출 추출하고 중합효소반응을 이용하여 증폭절편다형(Amp-FLPs)을 실시하고 X-Y homologous amelogenin gene과 STR 유전좌위 F13A01, LPL를 검색하여 다음과 같은 결과를 얻었다. 1. 40개의 근관치료된 치아중 19개에서 DNA가 추출되었다. 2. X-Y homologous amelogenin gene 검색으로 40개의 근관치료된 치아에서 21의 남자 치아중 5개, 19개의 여자치아중 7개 등 모두 12개 치아에서 성별검사가 가능하였다. 3. F13A01 유전자는 43개의 근관치료된 치아중 6개의 치아에서 검색되었으며, 4개의 대립유전자 및 5개의 유전자형을 관찰하였다. 4. LPL_유전자는 40개의 근관치료된 치아중 7개의 치아에서 검색되었으며, 3개의 대립유전자 및 3개의 유건자형을 관찰하였다. 이상의 결과를 종합하여 볼 때 근관치료된 치아상아질에서 중합효소반응을 이용한 성별검사 및 STR 유전자위의 검색은 일부 치아에서만 가능하였으나, 근관치료된 치아들도 개인식별을 위한 법의치과학적 자료로서 유용할 것으로 사료된다.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.1
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• pp.131-138
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• 2006

A mixture of metronidazole, ciprofloxacin and minocycline(3Mix) in distilled water or in a root canal sealer were used to disinfect the infected endodontic and periapical lesions. It has been well acknowledged in recent literature that minocycline, a semisynthetic tetracycline derivative, causes discolorations in adult teeth and various other collagenous tissues. In these cases, pulp treatments were finished successfully using a combination of antibiotics but severe discolorations of the teeth were observed. Discolored non-vital posterior tooth was treated using the prosthodontic procedure. And anterior tooth was successfully treated using the walking bleach technique. Bleaching was performed by temporarily placing a mixture of sodium perborate and distilled water into the pulp chamber. There were significant esthetic improvement.

• Restorative Dentistry and Endodontics
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• v.26 no.3
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• pp.191-199
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• 2001

목적 - 기질금속단백분해효소(matrix metalloproteinase)는 조직의 염증 및 치유과정에서 숙주세포에서 생성, 분비되어 세포외기질(extracellular matrix)의 분해에 작용한다. 다양한 염증반응에 기질금속단백분해효소가 중요한 역할을 하는것으로 보고되고 있으나 치수 및 치근단 질환에서의 그 역할은 거의 알려져 있지 않은 상태이다. 본 연구에서는 염증이 있는 사람의 치수 및 치근단 조직을 채취하여 Enzymeimmunoassay 및 면역조직화학적 검색을 통해 제1형, 2형, 3형 기질금속단백분해효소의 수준 및 그 분포를 측정하여 치수 및 치근단 병소에서 이 효소의 작용을 알아보는 것을 목적으로 한다. 방법 - 연구재료는 근관치료를 위해 서울대학교 병원 치과 진료부 보존과에 내원한 환자를 대상으로 34개의 치아에서 통상의 근관치료 중 발수한 치수조직과 치근단 수술중 얻은 치근단 병소(n=10)를 이용하였다. 치수는 발수 전에 임상진단을 통해 급성 치수염(n=12), 만성 치수염(n=12), 정상 치수(n=10)로 구분하고 정상치수로 진단된 것을 대조군으로 설정하였다. 채취된 표본은 둘로 나누어 절반은 30분 이내에 5$\mu\textrm{m}$ 두께로 동결절단을 시행하여 조직표본을 제작하였고 deep freezer에 보관하였다가 헤마톡실린-에오신 염색 및 면역조직화학적 검색을 시행하였다. 나머지 조직은 ELISA를 위해 액체 질소에 보관하였다. ELISA를 시행하기전 표본의 단백질 정량을 시행하여 모든 표본의 단백질 양을 50mg/$\mu\textrm{l}$로 일치시키고 Amersham사의 ELISA kit를 사용하여 제1형, 2형, 3형의 기질금속단백분해효소의 양을 측정하였으며 그 결과를 Mann-Whitney U test를 사용하여 각 군간의 통계학적 유의성을 검증하였다. 결과 1. ELISA의 결과 제1형 기질금속단백분해효소의 농도는 모든 실험군에서 대조군보다 유의성있게 높게 나타났다.(p<.05). 또한 급성치수염군의 제1형 기질금속단백분해효소의 농도가 다른 실험군보다 유의성있게 높았다(p<.05). 2. 제2형 기질금속단백분해효소의 경우 급성치수염군과 대조군에서만 유의성있는 차이를 보였다(p<.05). 3. 제3형 기질금속단백분해효소의 경우 급성치수염군에서 대조군이나 만성치수염군보다 유의성 있는 높은 수치를 보였다(p<.05). 4. 면역조직화학검색 결과 염증성 치수에 존재하는 급성 및 만성염증세포 주위로 기질금속단백분해효소에 대한 면역 반응이 존재하였으며 주로 제1형과 제3형 기질금속단백분해효소의 경우 대식세포 및 림파구 주위로 강한 발색제의 침윤양상이 관찰되었다. 5. 치근단병소의 면역조직화학적 검색 결과 만성염증 세포 주변으로 미약한 발색제의 침윤양상이 관찰되었다.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.659-664
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• 2004

Dens invaginatus is a developmental variation resulting from invasination of the tooth crown of root before calcification. Teeth most affected are maxillary lateral incisors. The malformation shows a broad spectrum of morphologic variations and frequently results in early pulp necrosis. Root canal therapy may present severe problems because of the complex anatomy of the teeth. So, the early diagnosis of such malformation is crucial and a preventive approach has been recommended. This report describes three cases of dens invaginatus treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.1
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• pp.97-101
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• 2010

The practice pattern of pediatric dentistry in the university dental hospital has been changing for the last several decades, due to socioeconomic changes, developments in dental materials and increasing number of private pediatric dental clinics. The purpose of this study is to survey the changing patterns of pediatric dental treatment in the university dental hospital and to present the future direction for pediatric dentistry. Patient distribution and practice trends were reviewed based on the OCS (order communication system) records of the department of pediatric dentistry, Seoul National University Dental Hospital from 2001 to 2008. Results were as follows; 1. The number of patients increased up to 2005 and decreased in 2006, and has remained constant up to 2008. 2. The proportion of preventive and orthodontic treatment increased and the proportion of restorative and pulpal treatment decreased. 3. In restorative treatment, amalgam restoration decreased and resin restoration increased. 4. Frequency of sedation decreased in 2006, 2007 and increased in 2008. 5. Frequency of general anesthesia increased up to 2008.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.4
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• pp.488-496
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• 2010

Dens evaginatus is a tooth with cylindrical enamel projection which forms a nodule on occlusal surface. It could be explained as outward overgrowth of inner enamel epithelium or localized hyperplasia of pulpal mesenchymal tissue during tooth development. A problem is that it is likely to be worn out or fractured by mastication ensuing pulpal inflammation. It is occasionally found on the lingual surface of upper anterior teeth as well, called talon cusp. Dens invaginatus is a tooth with deep lingual pit made by invagination of lingual enamel epithelium during tooth development while it is considered normal in terms of size and shape. Radiographically, a part of cervical enamel shows inward growth forming cavity and it is reasonable to say that the base is possibly open to pulpal cavity since they are very close. Talon cusp and dens invaginatus are relatively common abnormality of shape. However it becomes the opposite if the two exist in the same tooth. Once the talon cusp is broken by occlusal force or fissure between cusps is decayed, the complicated structure of canals makes the pulpal treatment difficult. Preventive treatments such as occlusal equilibrium and sealant, and regular oral examination should be preceded and thorough understanding of canal shape, using radiography, is required when pulpal treatment is necessary. This report is about a 9- year-old boy(lower left central incisor), a 8-year-old girl(upper right central incisor), and a 7-year-old boy(upper right central incisor), who have dens invaginatus and talon cusp in the same teeth. The first and the second patients are under pulpal treatments, and the last one is being observed showing no pathologic impressions.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.276-283
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• 2011

Recently, undifferentiated stem cells which exist in dental papillae of immature permanent teeth were newly discovered and these stem cells appear to be the origin of ameloblasts associated with the formation of root dentin. When treating immature permanent teeth, the preservation of these stem cells induce the continuous formation of the root. Therefore, it is reported that minimal invasion to periapical region in immature permanent teeth with periapical inflammation resulted in good-healing pattern in clinical and radiographic examination. In this case, a 10 year-old boy(mandibular right premolar) and a 8 year-old girl(maxillary left premolar) who visited the department of pediatric dentistry at Chosun University Dental Hospital were diagnosed with pulp necrosis and periapical abscess in clinical and radiographic examination. Endodontic instrumentation to the periapical region was limited and MTA(Mineral Trioxide Aggregate) was applied into the pulp canal. The periodic checks showed healing of periapical abscess and the development and growth pattern of roots. In permanent teeth with pulp necrosis and periapical abscess, preservation of pulp and dental papillae in the periapical region showed good prognosis during the periodic examinations. Therefore, a lot of clinical examination and long-term evaluation of conservative pulp treatment in immature permanent teeth are expected to be necessary.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.2
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• pp.139-145
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• 2002

In a primary teeth, dental caries is rapidly advanced the pulp disease, because the primary teeth have the thinner and the weaker enamel layer and the wider pulp chamber than relatively the permanent teeth. And the pulps of primary teeth are exposed during caries removal or even they are exposed by unexpected movement of the children or by trauma. For successive pulp treatment in primary teeth, it is necessary to understand completely about multiple canal morphology, variation of root canal anatomy and specific problem related to root formation and resorption of primary teeth. In upper primary molar, canal configuration of mesial root has the most variation same as upper molar. If not canal treatment is completely, most of all endodontic treatment should be failed. In a clinical case report, upper primary molars existed persistent pain or bleeding during treatment were founded the second MB canal and were performed the endodontic treatment of theirs. As a result, the upper primary molars have no symptom and good prognosis. In the examination of extracted upper primary molar, we found that 8 of 35 teeth(22.8%) in the upper primary first molars and 22 of 33 teeth(66.6%) in the upper primary second molar had the second mesiobuccal canal. It has revealed the high prevalence of two canals in mesiobuccal roots of upper primary molars. The frequency of occurrence of the second mesiobuccal canal must be taken into consideration when endodontic treatment is planned and as a possible cause of otherwise un explained failure.