• 제목/요약/키워드: Dental Pulp

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Apical root canal cleaning after preparation with endodontic instruments: a randomized trial in vivo analysis

  • Fornari, Volmir Joao;Hartmann, Mateus Silveira Martins;Vanni, Jose Roberto;Rodriguez, Rubens;Langaro, Marina Canali;Pelepenko, Lauter Eston;Zaia, Alexandre Augusto
    • Restorative Dentistry and Endodontics
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    • 제45권3호
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    • pp.38.1-38.10
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    • 2020
  • Objectives: This study aimed to evaluate vital pulp tissue removal from different endodontic instrumentation systems from root canal apical third in vivo. Materials and Methods: Thirty mandibular molars were selected and randomly divided into 2 test groups and one control group. Inclusion criteria were a positive response to cold sensibility test, curvature angle between 10 and 20 degrees, and curvature radius lower than 10 mm. Root canals prepared with Hero 642 system (size 45/0.02) (n = 10) and Reciproc R40 (size 40/0.06) (n = 10) and control (n = 10) without instrumentation. Canals were irrigated only with saline solution during root canal preparation. The apical third was evaluated considering the touched/untouched perimeter and area to evaluate the efficacy of root canal wall debridement. Statistical analysis used t-test for comparisons. Results: Untouched root canal at cross-section perimeter, the Hero 642 system showed 41.44% ± 5.62% and Reciproc R40 58.67% ± 12.39% without contact with instruments. Regarding the untouched area, Hero 642 system showed 22.78% ± 6.42% and Reciproc R40 34.35% ± 8.52%. Neither instrument achieved complete cross-sectional root canal debridement. Hero 642 system rotary taper 0.02 instruments achieved significant greater wall contact perimeter and area compared to reciprocate the Reciproc R40 taper 0.06 instrument. Conclusions: Hero 642 achieved higher wall contact perimeter and area but, regardless of instrument size and taper, vital pulp during in vivo instrumentation is not entirely removed.

인간치수세포에 Mineral Trioxide Aggregate와 수산화칼슘 제재 적용 시 유전자 발현 양상 비교 (Comparison of gene expression profiles of human dental pulp cells treated with mineral trioxide aggregate and calcium hydroxide)

  • 김용범;손원준;이우철;금기연;백승호;배광식
    • Restorative Dentistry and Endodontics
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    • 제36권5호
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    • pp.397-408
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    • 2011
  • 연구목적: 이 연구에서는 mineral trioxide aggregate 제재인 white ProRoot MTA (wMTA)와 수산화칼슘 제재인 Dycal을 인간치수세포에 적용한 후 치수세포의 분화와 증식, 석회화, 신생혈관형성(angiogenesis) 그리고 염증에 관여하는 유전자들의 발현 변화를 비교하였다. 연구 재료 및 방법: 실험군은 wMTA와 Dycal을 테플론 튜브(내경 10 mm, 길이 1 mm)에 담아 4시간 경화시킨 후 일차세포배양한 인간치수세포에 적용하였고, 대조군은 빈 튜브만을 적용하였다. 3시간, 6시간, 9시간, 24시간 후 total RNA를 추출하고 oligonucleotide microarray 방법을 통하여 유전자 발현 양상을 분석하였다. 위의 결과를 역전사 중합효소 연쇄반응(reverse transcriptase polymerase chain reaction)으로 재확인하였다. 결과: wMTA를 적용한 실험군에서 24,546개의 유전자 중 43개 유전자의 발현이 2배 이상 증가하였으며(예. BMP2, FOSB, THBS1, EDN1, IL11, COL10A1, TUFT1, HMOX1) 25개 유전자의 발현이 50% 이하로 감소하였다(예. SMAD6, TIMP2, DCN, SOCS2, CEBPD, KIAA1199). Dycal을 적용한 실험군에서 239개 유전자의 발현이 2배 이상 증가하였으며(예. BMP2, BMP6, SMAD6, IL11, FOS, VEGFA, PlGF, HMOX1, SOCS2, CEBPD, KIAA1199) 358개 유전자의 발현이 50% 이하로 감소하였다(예. EDN1, FGF). 결론: wMTA를 적용한 치수세포에서는 분화와 증식 그리고 석회화에 관여하는 유전자들의 변화가 관찰되었다. Dycal을 적용한 치수세포에서는 분화와 증식 그리고 신생혈관형성에 관여하는 유전자들의 변화가 관찰되었다. 또 Dycal이 염증에 관여하는 유전자들을 더 많이 발현시키는 양상을 보였다.

근관치료의 시작 - 치수강 개방 (First step of root canal therapy-access cavity preparation)

  • 송민주
    • 대한치과의사협회지
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    • 제56권10호
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    • pp.572-580
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    • 2018
  • Adequate access cavity is the key to achieving endodontic success. The aims of the access cavity can be considered as follows: 1) Creation of a smooth unimpeded pathway for instruments to canal orifices 2) Removal of the entire roof of the pulp chamber in order to inspect the pulp floor, 3) Preservation of natural tooth substance consistent with the above. Recently, contracted endodontic cavities based on minimally invasive endodontics has introduced. This has the benefit of preserving the pericervical dentin more than traditional access cavity with achieving long-term success. However, some studies reported controversial results regarding root canal detection, instrumentation efficacy (noninstrumented canal area, hard tissue debris accumulation, canal transportation, and centering ratio) as well as fracture resistance. Therefore, further studies are required for accepting contracted access cavity, and modified form of traditional and contracted access cavity could be considered.

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Mineral trioxide Aggregate를 이용한 근관치료재생술(Regenerative endodontic procedure) (Regenerative Endodontic Procedure using Mineral Trioxide Aggregate)

  • 이우철
    • 대한치과의사협회지
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    • 제48권11호
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    • pp.803-812
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    • 2010
  • Regenerative endodontic procedure (REP) is a treatment option to replace damaged pulp tissue with the viable tissue which restores the normal function of the pulp-dentin complex. Possible reason for doing REP is not clearly known, however, clinicians perform REP in order to recover the histological structure as well as function of the traumatized and diseased tooth so that this tooth can restore its original root shape and thickness. This REP can be explained by the concept of revascularization or revitalization after induction of blood clot formation in the canal space. For this purpose, several treatment strategies have been suggested. In this regard, the rationale for the application of triantibiotics, calcium hydroxide or mineral trioxide aggregate is discussed in this paper. As a result, we will try to find the best method for REP by reviewing each available technique and their advantages and disadvantages.

치근단절제술 실패의 일례 (A FAILED CASE OF ROOT RESECTION)

  • 이선형
    • 대한치과의사협회지
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    • 제14권5호
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    • pp.457-459
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    • 1976
  • The author experienced a failed ase of root resection which qas performed on the abnormal upper right lateral incisor. The patient was 16year old female. Clinically the effected tooth had neither a carious cavity nor periondontal diseases, ut, a fistula was present on the gum tissue near the root apex. The roentogenogram revealed a pathological area around the apex of the tooth. The results of failed apicoectomy lead to following conclusions. 1. The operated tooth was a case of dense invaginatus which had two pulp cavities and two canals seperated along their entire length. 2. It was the main cause of failure that the second pulp cavity and root canal were not obturated.

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치아탈구 시 처치 (THE TREATMENT OF TOOTH AVULSION)

  • 이세준
    • Restorative Dentistry and Endodontics
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    • 제24권2호
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    • pp.426-429
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    • 1999
  • When the tooth avulsion occur in accidents the drying damage to the periodontal ligament has extremely detrimental effects on healing. Pulp necrosis always occurs after an avulsion injury, but revascularization can only take place in teeth with immature apexes. Therefore complications after avulsion injuries are common, and treatment must be carried out in a timely and correct fashion to prevent or limit these complications. Every effort should be made to replant the tooth within the first 15 to 20 minutes. If doubt exists that the tooth can be replanted adequately, the tooth should quickly be stored in an appropriate medium until the patient can get to the dental office for replantation. A complication of inflammatory root resorption is occurred by bacterial infection of periodontal ligament and dental pulp. Therefore aseptic endodontic treatment must be carried out in a timely and systemic antibiotics given at the time of replantation and before endodontic treatment are effective in preventing bacterial invasion. Further studies are needed to establish the clinical importance of preparation of the socket and root.

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An Insight Into Neurophysiology of Pulpal Pain: Facts and Hypotheses

  • Jain, Niharika;Gupta, Abhishek;Meena, N.
    • The Korean Journal of Pain
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    • 제26권4호
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    • pp.347-355
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    • 2013
  • Pain and pain control are important to the dental profession because the general perception of the public is that dental treatment and pain go hand in hand. Successful dental treatment requires that the source of pain be detected. If the origin of pain is not found, inappropriate dental care and, ultimately, extraction may result. Pain experienced before, during, or after endodontic therapy is a serious concern to both patients and endodontists, and the variability of discomfort presents a challenge in terms of diagnostic methods, endodontic therapy, and endodontic knowledge. This review will help clinicians understand the basic neurophysiology of pulpal pain and other painful conditions of the dental pulp that are not well understood.

Heliosit복합레진이 치수조직에 미치는 영향에 관한 실험적 연구 (An Experimental Study on the Effect of the "Heliosit" Composite Resin to Pulp Tissue)

  • 맹형열;권혁춘
    • Restorative Dentistry and Endodontics
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    • 제10권1호
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    • pp.93-101
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    • 1984
  • The experimental study was made to investigate the effect of the "Heliosit" composite resin on the dental pulp. The 36 class V cavities were prepared on the healthy permanent teeth of 3 days, and were divided into 5 groups and filled with the experimental filling materials. Control group: Zinc Oxide-Eugenol cement filling Experimental groups: Group 1: Dentin Adhesit application & Heliosit filling with or without dycal base Group 2: Heliosit filling with or without dycal base Group 3: Durafill filling with dycal base Group 4: Hipol filling with dycal base Animals were sacrificed after 1 weeks, 2 weeks, and 4 weeks following operation. The teeth were decalcified, sectioned and stained with hematoxylin and eosin. The results obtained form this study were as follows: 1. All experimental group showed slight pulp response. 2. Dentin Adhesit group showed minimal pulp response in both dycal bases and no base cases. 3. In group 2, mild pulp response was found in early stage and repairing process was found as the time elapsed. In no base cases, healing process was delayed slightly. 4. There was little difference in the result among Heliosit group, Durafill group and Hipol group.

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Dental Age Estimation in Adults: A Review of the Commonly Used Radiological Methods

  • Jeon, Hye-Mi;Jang, Seok-Min;Kim, Kyung-Hee;Heo, Jun-Young;Ok, Soo-Min;Jeong, Sung-Hee;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • 제39권4호
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    • pp.119-126
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    • 2014
  • This review provides an overview of the most commonly used dental age estimation techniques which focus on radiological methods in Korean adults. The literature from 1995 through July 31, 2014, was searched, using PubMed, for publications in English language. In PubMed, the keywords 'tooth' OR 'dental' AND 'pulp' AND 'age estimation' were searched. Inclusion criteria was comprised of the following: the subjects were living adults and dental radiography (excluded computed tomography [CT] and cone-beam CT) was used to measure the pulpal size. Twenty articles that met the criteria were selected. The method of age estimation using dental radiographs for measuring pulp and tooth size was represented in all studies. The methods were assorted into three categories generally; Kvaal's, Ikeda's and Cameriere's methods. Those methods had certain limitations such as large error range and low correlation coefficient depending on populations, type of employed teeth and particular method. Various techniques and many studies have been published for age estimation from human teeth using dental radiographs, but those techniques showed various predictability and reliability. Therefore, future studies on larger samples with well-distributed age group using not only existing techniques but new techniques are necessary for deriving convincing results.

Triple antibiotic paste: momentous roles and applications in endodontics: a review

  • Parhizkar, Ardavan;Nojehdehian, Hanieh;Asgary, Saeed
    • Restorative Dentistry and Endodontics
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    • 제43권3호
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    • pp.28.1-28.16
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    • 2018
  • This study investigated the latest findings and notions regarding 'triple antibiotic paste' (TAP) and its applications in dentistry, particularly endodontics. TAP is a combination of 3 antibiotics, ciprofloxacin, metronidazole, and minocycline. Despite the problems and pitfalls research pertaining to this paste has unveiled, it has been vastly used in endodontic treatments. The paste's applications vary, from vital pulp therapy to the recently introduced regeneration and revascularisation protocol. Studies have shown that the paste can eliminate the root canal microorganisms and prepare an appropriate matrix for further treatments. This combination is able to remove diverse groups of obligate and facultative gram-positive and gram-negative bacteria, providing an environment for healing. In regeneration protocol cases, this allows the development, disinfection, and possible sterilization of the root canal system, so that new tissue can infiltrate and grow into the radicular area. Moreover, TAP is capable of creating a discipline in which other wanted and needed treatments can be successfully performed. In conclusion, TAP, as an antibacterial intracanal medication, has diverse uses. Nevertheless, despite its positive effects, the paste has shown drawbacks. Further research concerning the combined paste and other intracanal medications to control microbiota is a must.