• 대한치과보존학회:학술대회논문집
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• 대한치과보존학회 2003년도 제120회 추계학술대회 제 5차 한ㆍ일 치과보존학회 공동학술대회
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• pp.586-586
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• 2003

In the infected immature tooth with periapical involvement, the pulp is considered to hardly exist in the canal and periapical area. Such a tooth receives apexification procedure, because revascularization of the pulp chamber is in principle not expected. Apexification is beneficial to induce further development of an apex to close the foramina, but does not promote the thickness of the entire canal wall dentin. It may be possible for the pulp to be only partially necrotic and infected when an extremely large communication from the pulp space to the periapical tissues exists with a very young tooth. If this were the case, vital pulp in the apical part of the canal could proliferate new pulp into the coronal pulp space by the successful removal and disinfection of the necrotic infected coronal pulp.(omitted)

• 대한소아치과학회지
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• 제39권2호
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• pp.192-198
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• 2012

치수 재혈관화 술식은 항생제를 이용하여 근관 내 감염된 조직을 무균 상태로 만들면 치근단에 존재하는 자가 재생 능력과 다분화 능력을 가진 줄기 세포가 미완성 치근을 가진 미성숙 영구치의 치수 재생을 유도한다는 개념이 적용된 것이다. 이 술식은 치근의 길이와 두께가 증가하며 치근단의 폐쇄가 이루어진다. 비정상적으로 근관이 얇거나 만곡이 심해 전통적인 근관 치료시 어려움이 예상되는 경우, 전신 질환 등으로 인해 진정 요법을 시행하기 어려운 경우, 그리고 장애인와 같이 협조를 구하기 어려운 경우에서 치근단 치주염을 가진 미성숙 대구치의 치수 재혈관화 술식을 고려해 볼 수 있다. 본 증례는 우식으로 인해 감염된 미성숙 제1대구치의 근관 내에 ciprofloxacin, metronidazole, minocycline의 3종의 항생제를 적용하여 치수 재혈관화 술식을 시도하여 양호한 결과를 보였기에 이를 보고하고자 한다.

• Journal of Periodontal and Implant Science
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• 제38권3호
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• pp.475-482
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• 2008

Purpose: To evaluate the safety and efficiency of bone regenerative abilities of silk fibroin nanomembrane(Nanoguide-S) Material and Methods: The objects were 38 patients who had large defect at extraction sockets caused by chronic periodontitis and silk fibroin nano matrix were used on experimental group(N=19) and PLA/PLGA matrix were used on control group(N=19). The width, height, and length by crown-apical direction(socket depth) of defects were measured with the occlusal plane as a reference plane, and tooth axis direction, perpendicular to tooth axis direction were measured on radiographs at 3 months pre-operative, 3 months post-operative. Result: Tissue response to silk fibroin nano matrix and Biomesh were clinically satisfactory and complications such as swelling, exudation, ulceration and vesicles were not found except the ordinary discomfort of operated portion. 3 months later, the width, height, and length by crown-apical direction (socket depth) of defects were clinically improved in both groups with no significant difference. 3 months later radiolucency of tooth axis direction and perpendicular to tooth axis direction were all increased in both groups with no significant difference. Conclusion: By these results biodegradadable silk fibroin nano matrix was efficient in GBR on alveolar bone resorption caused by periodontitis compared to Biomesh.

• Restorative Dentistry and Endodontics
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• 제45권3호
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• pp.40.1-40.12
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• 2020

Objectives: The aim of this study was to evaluate the effects of endodontic treatment on levels of substance P (SP) and calcitonin gene-related peptide (CGRP) in the saliva of patients with symptomatic apical periodontitis. Materials and Methods: Twelve patients with mandibular molars with symptomatic apical periodontitis were enrolled in this study. An initial saliva sample was collected just before administration of anesthesia for root canal treatment, which was performed at the first visit. A second saliva sample was collected at a control visit 1 week after treatment. Salivary SP and CGRP levels were evaluated quantitatively using biochemical assays. The data were analyzed using Pearson correlation analysis, the paired samples t-test, and the Mann-Whitney U test (p = 0.05). Results: The postoperative salivary level of SP was significantly lower than the preoperative level (p = 0.005). However, the postoperative salivary level of CGRP was similar to the preoperative level (p = 0.932). Visual analog scale (VAS) scores of patients' subjective pain were found to be positively correlated with salivary levels of SP (r = 0.421; p = 0.040). No statistically significant correlations were observed between salivary levels of CGRP and VAS scores for patients' subjective percussion tenderness (p = 0.533) or VAS scores for patients' subjective pain (p = 0.459). Conclusions: According to the results of the present study, salivary SP levels may be used as an objective indicator in the diagnosis and assessment of the degree of pain in endodontic diseases.

• Journal of Periodontal and Implant Science
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• 제54권1호
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• pp.13-24
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• 2024

Purpose: This study investigated the adjunctive effect of light-emitting diodes (LEDs) in the treatment of experimental periodontitis. Methods: Experimental periodontitis was induced by placing ligatures around the mandibular second, third, and fourth premolars of 6 beagles for 3 months. After ligature removal, periodontitis progressed spontaneously for 2 months. The animals' hemimandibles were allocated among the following 3 groups: 1) no treatment (control), 2) scaling and root planing (SRP), and 3) SRP with LED irradiation at 470-nm and 630-nm wavelengths (SRP/LED). The probing pocket depth (PPD) and gingival recession (GR) were measured at baseline, 6 weeks, and 12 weeks. The clinical attachment level (CAL) was calculated. After 12 weeks, histological and histomorphometric assessments were performed. The distances from the gingival margin to the apical extent of the junctional epithelium (E) and to the connective tissue (CT) attachment were measured, as was the total length of soft tissue (ST). Results: PPD and CAL increased at 12 weeks compared with baseline in the control group (6.31±0.43 mm to 6.93±0.50 mm, and 6.46±0.60 mm to 7.61±0.78 mm, respectively). PPD and CAL decreased at 12 weeks compared with baseline in the SRP group (6.01±0.59 to 4.81±0.65 mm, and 6.51±0.98 to 5.39±0.93 mm, respectively). PPD and CAL decreased at 12 weeks compared with baseline in the SRP/LED group (6.03±0.39 to 4.46±0.47 mm, and 6.11±0.47 to 4.78±0.57 mm, respectively). The E/ST and CT/ST ratios significantly differed among the 3 groups (P<0.05). The clinical parameters and histologic findings demonstrated that 470-nm and 630-nm wavelength LED irradiation accompanying SRP could improve treatment results. Conclusions: Within the study limitations, 470 nm and 630 nm wavelength LED irradiation might provide additional benefits for periodontitis treatment.

• Restorative Dentistry and Endodontics
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• 제47권3호
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• pp.26.1-26.10
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• 2022

Wegener's granulomatosis (WG) is a condition with immune-mediated pathogenesis that can present oral manifestations. This report describes the case of a patient diagnosed with WG 14 years previously, who was affected by persistent pain of non-odontogenic origin after successful endodontic treatment. A 39-year-old woman with WG was diagnosed with pulp necrosis and apical periodontitis of teeth #31, #32, and #41, after evaluation through a clinical examination and cone-beam computed tomography (CBCT). At the first appointment, these teeth were subjected to conventional endodontic treatment. At 6- and 12-month follow-up visits, the patient complained of persistent pain associated with the endodontically treated teeth (mainly in tooth #31), despite complete remission of the periapical lesions shown by radiographic and CBCT exams proving the effectiveness of the endodontic treatments, thus indicating a probable diagnostic of persistent pain of non-odontogenic nature. After the surgical procedure was performed to curette the lesion and section 3 mm of the apical third of tooth #31, the histopathological analysis suggested that the painful condition was likely associated with the patient's systemic condition. Based on clinical, radiographic, and histopathological findings, this unusual case report suggests that WG may be related to non-odontogenic persistent pain after successful endodontic treatments.

• Imaging Science in Dentistry
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• 제47권1호
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• pp.25-31
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• 2017

Purpose: The aim of this study was to compare the diagnostic accuracy of previously trained endodontists in the detection of artificially created periapical lesions using cone-beam computed tomography (CBCT) and digital periapical radiography (DPR). Materials and Methods: An ex vivo model using dry skulls was used, in which simulated apical lesions were created and then progressively enlarged using #1/2, #2, #4, and #6 round burs. A total of 11 teeth were included in the study, and 110 images were obtained with CBCT and with an intraoral digital periapical radiographic sensor (Instrumentarium dental, Tuusula, Finland) initially and after each bur was used. Specificity and sensitivity were calculated. All images were evaluated by 10 previously trained, certified endodontists. Agreement was calculated using the kappa coefficient. The accuracy of each method in detecting apical lesions was calculated using the chisquare test. Results: The kappa coefficient between examiners showed low agreement (range, 0.17-0.64). No statistical difference was found between CBCT and DPR in teeth without apical lesions (P=.15). The accuracy for CBCT was significantly higher than for DPR in all corresponding simulated lesions(P<.001). The correct diagnostic rate for CBCT ranged between 56.9% and 73.6%. The greatest difference between CBCT and DPR was seen in the maxillary teeth (CBCT, 71.4%; DPR, 28.6%; P<.01) and multi-rooted teeth (CBCT, 83.3%; DPR, 33.3%; P<.01). Conclusion: CBCT allowed higher accuracy than DPR in detecting simulated lesions for all simulated lesions tested. Endodontists need to be properly trained in interpreting CBCT scans to achieve higher diagnostic accuracy.

• 대한소아치과학회지
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• 제36권4호
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• pp.640-646
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• 2009

치아에 외상을 받은 경우 치수 생활력의 상실은 흔한 일이다. 치수 생활력을 검사하는 방법으로는 임상적, 방사선학적으로 여러 가지가 있지만, 미성숙 외상치의 경우 일시적 현상과 가성 반응이 나타날 수 있으므로 치수 괴사에 대한 정확한 진단은 매우 어렵다. 생활력을 상실한 치아는 염증성 치근흡수, 치근단 낭종 등의 발생을 방지하기 위하여 치수 치료를 시행한다. 그러나 미성숙 영구치의 경우, 치수 치료를 시행 후 치근 성장이 정지될 수 있어 결과적으로 얇고 짧은 치근이 형성되어 장기적인 예후는 좋지 않다. 본 임상 증례에서는 외상으로 인하여 실활된 초기 영구치에서 치근단부의 최소한의 침습적 치근단 형성술로 계속된 치근 형성을 보여 이에 보고하는 바이다.

• 대한치과의사협회지
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• 제51권10호
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• pp.542-550
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• 2013

The immature teeth with apical periodontitis present considerable challenges to clinicians. Therefore, new treatment protocols have been suggested to overcome the problems encountered in traditional methods. Regenerative treatment (revascularization) is one of such methods. Many case reports on the revascularization of infected immature teeth have been published, and in most of them, immature teeth with even a periapical abscess continued root formation after the disinfection of the root canal system. We now believe that this continued root formation is not an exceptional incident. As a result, it appeared that apexification has been giving way to a revascularization technique, which is a new option, in treating necrotic immature teeth. These new methods appear to be based on the healing potential of stem cells. The potential of healing or regeneration of stem cells, which are located around teeth, seems to be greater than we thought before. This review summarizes the current techniques for considering regenerative endodontic treatment procedures in treating the immature permanent tooth with pulp necrosis.

• 대한치과보존학회:학술대회논문집
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• 대한치과보존학회 2003년도 제120회 추계학술대회 제 5차 한ㆍ일 치과보존학회 공동학술대회
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• pp.591-591
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• 2003

Apical periodontitis is inflammation of the periodontium caused by infection of the pulp canal system. Moreover, a dental periradicular lesion occurs as a periradicular tissue reaction to bacterial infection and consists of periradicular inflammation with alveolar bone destruction and root resorption, a consequence of the interaction between oral flora and the existing host defenses. Many investigations dealing with the pathogenesis and history of periradicular lesions have described histologically, immunologically, biochemically the development of the periradicular lesion；but none of these studies have shown any correlation between this lesion and several factors, the whole body disease in the worldwide.(omitted)