• Journal of Periodontal and Implant Science
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• 제40권2호
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• pp.49-55
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• 2010

Purpose: The purpose of this study was to preliminarily evaluate the influence of diabetes mellitus (DM) on periodontal tissue without establishment of periodontitis. Methods: Seven-week-old db/db mice were used for the diabetic experimental group and systematically healthy mice of the same age were used as controls. After 1 week of acclimatization, the animals were sacrificed for hard and soft tissue evaluation. The pattern of bone destruction was evaluated by stereomicroscope evaluation with alizarin red staining and radiographic evaluation by microscopic computerized tomography images. Histological evaluation was performed with hematoxylin and eosin stain for evaluation of soft tissue changes. Results: In both stereomicroscope evaluation and radiograph image analysis, aggressive form of bone destruction was observed in diabetic animals when compared to the systematically healthy controls. In histological evaluation, apical migration of junctional epithelium with slight inflammatory cell infiltration was observed with disarrangement of connective tissue fibers. Conclusions: Within the limits of this study, diabetic animals presented distortion in periodontal attachment and an aggressive bone loss pattern when compared to the healthy controls, suggesting that DM has an independent effect on periodontal tissue destruction irrespective of the presence or absence of periodontal disease.

• Journal of Periodontal and Implant Science
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• 제31권2호
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• pp.421-436
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• 2001

Transforming growth $factor-{\beta}(TGF-{\beta})$is a polypeptide biologic mediator considered to play a role in promoting bone formation in bony defect area. The purpose of this study was to examine the effect of $TGF-{\beta}$ to the periodontal regeneration of class III furcation defect in dogs. Classs III furcation defects were surgically created on the third and the fourth premolars bilaterally in the mandibles of eight mongrel dogs. Experimental periodontitis were induced by placing small cotton pellets into the created defects for 3 weeks. Experimental sites were divided into 4 groups according to the treatment modalities: Group I-Surgical debridement only; Group II-allogenic demineralized freeze dried bone grafting; Group III-allogenic demineralized freeze dried bone soaked in $TGF-{\beta}(4ng/10{\mu}l)$grafting; Group IV-allogenic demineralized freeze dried bone soaked in $TGF-{\beta}(20ng/10{\mu}l)$ grafting. The animals were sacrificed in the 8th week after periodontal surgery and the decalcified and undecalcified specimens were for histological and histometric examination. Although no significant differences was seen in the length of epitheial growth and connective attachment, group III showed the least apical migration among treatment groups. The amount of bone repair was significantly greater in group III, IV compared to group I and group II. New attachment formation was significantly greater in group III and group IV compared to group I and group II. These results suggest the allogenic demineralized freeze dried bone with $TGF-{\beta}$ in class III furcation defect has the potentiality of promoting alveolar bone formation and periodontal regeneration.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.147-154
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• 2020

Background: Single inferior alveolar nerve block is ineffective in achieving adequate pulpal anesthesia in 30-80% of patients due to anatomical variations, local tissue pH, central sensitization, and several factors. Various supplementary techniques and combination of adjuvants with lignocaine are used to overcome these failures. Magnesium sulfate (MgSO₄), one such adjuvant, acts at the N-methyl-D-aspartate glutamate receptor resulting in effective anesthesia. The aim of this prospective, randomized, double-blind, clinical controlled trial was to evaluate the onset, anesthetic efficacy, duration and post-operative analgesia of 2% lignocaine with and without the addition of MgSO₄ in patients with symptomatic irreversible pulpitis and apical periodontitis. Methods: Fourty-two patients were randomly divided into three groups: 2% lignocaine (group 1) and 2% lignocaine with MgSO₄ (75 mg) and (150 mg) in groups 2 and 3, respectively. Pre-operative vitals and Heft Parker-Visual Analogue Scale (HP-VAS) pain scores were recorded. The onset of anesthesia, anesthetic efficacy, and duration of anesthesia were evaluated post administration of the local anesthetic solution. The post-operative analgesia was examined at intervals of 2, 6, 12, 24, and 48 h. Results: Administration of 150 mg MgSO₄ hastens the onset of anesthesia (1.29 min) and produces better anesthetic efficacy (3.29 HP-VAS) compared to group 2 (2.07 min and 9.14 HP-VAS) and group 1 (3.29 min and 35.79 HP-VAS), respectively. The duration of anesthesia was significantly higher in group 3 (247.07 min) compared to that of groups 2 and 1 (190 min and 110.21 min) with P < 0.05. Conclusion: Combining 75 mg or 150 mg of MgSO₄ with lignocaine is more effective than 2% lignocaine and 75 mg of MgSO₄ is adequate for endodontic procedures.

• 구강회복응용과학지
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• 제35권1호
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• pp.46-54
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• 2019

치수 질환 그리고 치주 질환이 복합적으로 발생하여 치근단 조직과 변연부 치주 조직이 개통되는 것을 치주-근관 복합병소라 일컫는다. 치주-근관 복합 병소의 치료를 위해서는 근관치료 및 치주 재생 처치 둘 다를 필요로 하며, 이는 치근단 및 변연부 조직 모두의 치유를 위함이다. 본 연구에서는 치주-근관 복합 병소를 나타내는 하악 전치부 치아에서 근관치료 이후 조직유도 재생술을 시행하였으며, 각각의 증례에서 심한 치조골 흡수를 보이는 치아들은 3년이 넘는 경과 관찰기간 동안 발치되지 않고 유지될 수 있었다. 따라서 하악 전치부에서 발생한 치주-근관 복합 병소의 근관치료 후 조직유도 재생술을 이용한 치료는 임상적으로 이점이 있는 것으로 고려된다.

• Restorative Dentistry and Endodontics
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• 제47권3호
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• pp.34.1-34.12
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• 2022

Objectives: This study aimed to evaluate the success rate of endodontic treatments performed by undergraduate students and the factors associated with the outcome. Materials and Methods: A follow-up of 3 to 8 years after root canal filling was carried out in 91 patients. At the follow-up visits, medical and dental history questionnaires were applied along with clinical and radiographic examinations. Data collected in the clinical exam included: the presence of pain, swelling, sinus tract, mobility, tenderness to palpation and percussion, periodontal probing profile, and type/quality of coronal restoration. Postoperative and follow-up radiographs were digitalized and analyzed by 2 trained and calibrated examiners to assess periapical healing. The treatment outcome was based on strict clinical and radiographic criteria and classified as success (absence of any clinical and radiographic sign of apical periodontitis) or failure (other combination). Logistic regression was used to investigate the impact of clinical and radiographic variables on endodontic treatment outcomes at a 5% significance level. Results: The success rate of endodontic treatments was 60.7%. The only risk factor significantly associated with failure was the presence of a periapical lesion on the postoperative radiograph (odds ratio, 3.35; 95% confidence interval, 1.17-9.54). Conclusions: The success rate of endodontic treatments performed by undergraduate students was low and was jeopardized by the presence of a periapical lesion on the postoperative radiograph.

• Restorative Dentistry and Endodontics
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• 제36권6호
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• pp.498-505
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• 2011

연구목적: 본 연구는 원발성 치근단 치주염(primary apical periodontitis)을 갖는 치아에서 임상증상 유무에 따른 미생물 군집의 차이를 GS FLX Titanium pyrosequencing을 이용하여 species level까지 분석하였다. 연구 재료 및 방법: 원발성 치근단 치주염을 갖는 6개의 표본에서 pysequencing을 시행하였다. 중합효소 연쇄반응(PCR)에 의해 얻어진 small-subunit ribosomal RNA의 초가변 영역(hypervariable region)의 amplicon을 이용하여 GS FLX Titanium pyrosequencing 을 시행하였다. 결과: 평균적으로 무증상군 및 증상군에서 각각 10,639 및 45,455개의 16S rRNA sequence을 얻었으며 평균길이는 440bases였다. Ribosomal Database Project Classifier을 이용한 분석결과 142종의 genera 및 13종의 phylum 수준에서의 세균종을 검출하였다. 검출된 13개의 phyla 가운데 Actinobacteria, Bacteroidetes, Firmicutes, Fusobacteria, Proteobacteria, Spirochetes, and Synergistetes 종이 상대적으로 호발하였으며, genus 수준에서는 Pyramidobacter, Streptococcus, Leptotrichia이 무증상의 근관의 50%를 차지하였으며, Neisseria, Propionibacterium, Tessaracoccus 균종은 증상이 있는 근관의 69%를 차지하였다. Operational taxonomic units (3%)로 나눈 결과 증상이 없는 치아에서 450개, 증상이 있는 치아에서 1,997개의 species가 발견되었다. 증상이 있는 치아에서 통계적으로 유의성 있게 많은 수의 세균이 검출되었다(p < 0.05). 결론: GS FLX Titanium Pyrosequencing 기법을 통해 원발성 감염근관에서 이전에 검출하지 못했던 다양한 근관내 분포세균을 검출할 수 있었다.

• Journal of Periodontal and Implant Science
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• 제40권1호
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• pp.3-10
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• 2010

Purpose: Periodontal regenerative therapies for defects created by severe periodontitis are mainly focused on bone regeneration. Although cementum regeneration needs to be better understood, it is believed to play an important role in periodontal regeneration. The first step toward a full understanding of cementum regeneration is to compare repaired cementum to pristine cementum. This study, which used histological techniques, was designed to focus on cementum regeneration and to compare pristine cementum to repaired cementum after surgical procedures with 8 and 24 week healing periods in a canine model. Methods: Buccal and lingual mucoperiosteal flaps of 10 beagle dogs were surgically reflected to create critical-sized defects. Intrabony one-wall defects, of which dimension is 4 mm width and 5 mm depth, were made at the distal aspect of mandibular second premolars and the mesial aspect of mandibular fourth premolars in the right and left jaw quadrants. Animals were sacrificed after 8 and 24 weeks post-surgery for histological specimen preparation and histometric analysis. Results: The repaired cementum was composed mostly of acellular cementum and cellular mixed fiber cementum and was thicker in the apical area than in the coronal area. The acellular cementum of the supracrestal area appeared to be amorphous. The newly formed cellular cementum was partially detached from the underlying circumpulpal dentin, which implied a weak attachment between new cementum and dentin, and this split was observed to a lesser extent in the 24 week group than in the 8 week group. The vertical height of the repaired cementum was greater in the 24 week group than in the 8 week group. Conclusions: Within the limitations of this study, we can conclude that repaired cementum after root planing was mainly acellular cementum and cementum tissue that matured to a shape similar to pristine cementum as the healing progressed from 8 to 24 weeks.

• 대한소아치과학회지
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• 제26권2호
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• pp.317-322
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• 1999

치내치는 석회화가 되기전에 치관의 함입에 의해서 야기되어지는 치아의 형태이상이다. 영구치뿐만 아니라 유치에서 발생될 수 있지만 주로 상악 측절치에서 발생하며 그 발생빈도는 0.04-10%로 다양하게 보고되고 있다. 치내치는 치수와 치근단 조직으로 교통될 수 있어 이로 인해서 치수의 염증, 치근단 농양, 낭종 등을 야기하거나 내흡수를 일으킬 수도 있으며 치관의 형태이상을 보이는 등 심미적인 문제도 초래할 수 있다. 치내치는 그 함입의 정도에 따라서 Oehlers씨에 의해서 3가지 형태로 구분된다. 치내치의 다양한 형태중 Type 3의 치내치는 치내치 함입부가 치수와의 교통없이 치근단공이나 측방 치주조직으로 opening을 형성하는 형태로 치수감염의 여부에 따라 치료전략이 달라지며, 치수감염에 의한 병소가 존재하는 경우에는 함입된 형태와 복잡성을 고려하여 통상적인 근관치료, 외과적 치근단 절제술, 의도적 재식술 및 발치를 시행할 수 있다. 본 증례에서는 근첨이 개방된 측방 치주공을 가진 치내치로 해당치아가 생활력을 보이고 invagination의 형태가 단순하였기에 invagination에 한정된 근관치료와 근첨형성술을 통하여 성공적인 결과를 보였으며 다음과 같은 결과를 얻었다. 1. Type 3 치내치의 경우에서 치아의 생활력이 유지되고 invagination의 형태가 복잡하지 않다면, 그리고 치수와 invagination과의 교통의 증거가 없다면 invagination에 한정된 근관치료로서 병소의 해결과 해당치아의 생활력 유지가 가능했다. 2. 개방된 근첨을 가진 invagination을 보이는 치내치의 경우 근첨형성술로 개방된 근첨의 폐쇄를 유도할 수 있었고 이런 점을 이용 외과적 술식을 피할 수 있었다.

• 대한소아치과학회지
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• 제36권2호
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• pp.305-309
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• 2009

치외치(Dens Evaginatus)란 교합면에 법랑질이 원추형으로 돌출되어 결절을 형성한 치아로 치아발육중 법랑기의 내측법랑상피가 외부로 과증식되거나 치수 간엽조직이 국소적으로 과증식되어 나타난다. 결절은 교합력이나 저작에 의해 파절 또는 마모되기 쉬우며 따라서 이로 인하여 치수노출에 의한 감염이 야기될 수 있다. 치외치는 예방목적으로 결절을 주기적으로 조금씩 갈아주어 2차 상아질을 유도하거나 전색제등으로 결절주위를 보강하여 자연마모를 유도할 수 있다. 반면 이미 증상을 보인 치아에 대해서는 근관치료를 시행하거나, 미완성치근인 경우 치근단유도술(Apexogenesis)이나 치근단형성술(Apexification)을 시행한다. 치근단유도술이란 생활력을 가진 미성숙 영구치의 손상, 또는 치아우식에 의한 치수노출 시 치수절단술을 시행하여 치수의 생활력을 유지시켜 정상적인 치근으로 발육하도록 유도하는 술식을 말한다. 주로 수산화칼슘을 이용한 통상의 치수절단술이 이용되고 이후 계속적인 치근형성 확인을 위해 주기적 방사선검사가 요구된다. 본 증례는 하악 좌측 제2소구치 부위의 동통을 주소로 내원한 한자에 대한 것으로, 임상검사결과 양측 소구치 부위에 치외치를 확인하게 되었다. 이에 수산화칼슘을 통한 치근단유도술을 시도하였고, 3년간 주기적 내원을 통해 치료한 결과 치근의 근심면의 비정형적 발달을 보였다. 현재 이 치아는 임상증상과 방사선 사진을 통해 확인한 결과 특이한 염증소견 없는 예후를 보이고 있기에 보고하는 바이다.

• Journal of Periodontal and Implant Science
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• 제25권3호
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• pp.557-567
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• 1995

The purpose of this study was to investigated the effect of root planing and decalcified freeze dried allografts on the resorption of transplanted roots and the healing of preveously diseased recipient extraction sockets. The experimental chronic periodontitis was induced by elastic ligatures on the 2nd and 3rd mandibular premolars of 4 adult dogs, and after 8 weeks, crowns were removed and the teeth extracted. The extracted roots were split in half along the long-axis, and the extednt of plaque exposure was morked on the root surfaces with burs. The roots were either root-planed(Test group), or left uninstrumented(Control group), and transplanted in the extraction sockets with decalcified freeze-dried allografts filling the void. The flaps were sutured to cover the sockets completely. The animals were sacrificed after 12 weeks of healing, and the specimens were examined histologically. The results were as follows : 1. No signs of inflammation or disease activity were observed in either groups. 2. Replacement root resorption was observed in both groups. 3. More connective tissue attachments and less ankylosis were observed in the test groups compared to the control. 4. The unresorbed remains of DFDB particles were observed in both groups. 5. DFDB particles in the apical portion of the alveolar sockets were encased in newly-formed bone, while those in the coronal areas were seen encapsulated with connective tissue. 6. No significant difference was found between root-planed and uninstrumented roots relative to the healing and the bone fromation in the recipient extraction sockdets. From the present study, there seemed to be no significant benefits in root planing the transplanted roots or grafting the sockets with DFDB in order to curve the replacement resorption, although the root-planed roots showed more connective tissue attachments. There was also no significant benefits in root transplantation and DFDB for and enhanced healing and bone formation in alveolar extraction sockets.