• Journal of Periodontal and Implant Science
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• 제35권2호
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• pp.311-319
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• 2005

In order to examine the effects of advanced periodontitis on the dental pulps, 38 extracted human teeth were examined histologically. The 38 teeth had a positive or negative state in the electric pulp test(EPT). In addition, almost of the 38 teeth had a deep pocket and severe mobility, and floating state. A medical and dental history was elicited. The extracted teeth fixed in 10% neutral formalin solution. The general tissue processing method was followed. The tissue block including the teeth was prepared for optical microscopy using hematoxillin-eosin staining. Among the 38 periodontally involved teeth, the dental pulps were respectively intact in 12(31%), and a pulp stone(or linear calcifications) was found in 18 teeeth(47%). In addition, 17 teeth(44%) had pulps exhibiting inflammatory reactions with varying intensities, such as hyperemia, pulp abscess, pulp necrosis. Among the 38 periodontally involved teeth, 37 teeth tested a positive to the EPT, and 7 teeth tested negative. The EPT positive 37 teeth had various histological features such as 7 normal pulp(18%), 17 pulp stone(44%), 1 hyperemia (2%), 9 pulpitis(23%), 5 root resorption(13%), 3 pulp abscess(7%), and 3 pulp necrosis(7%), In conclusion, it is suggested that in the EPT positive teeth, advanced periodontally involved teeth can cause inflammation of the dental pulp.

• Restorative Dentistry and Endodontics
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• 제37권1호
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• pp.61-65
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• 2012

Patients with diabetes mellitus show delayed wound healing and increased susceptibility to infection. Therefore, the effects of diabetes on pulpal and periodontal healing should be taken into consideration when treating diabetic dental traumatized patients. This case presents the treatment for dental traumatized 20 yr old female with uncontrolled type II diabetes. The traumatized upper central incisors had showed pulpal healing in early days. However, 7 mon after the trauma, the teeth had been diagnosed with pulp necrosis with apical abscess. Eventually, non surgical root canal treatment on the teeth had been performed.

• 대한치과의사협회지
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• 제54권8호
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• pp.658-665
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• 2016

Treatment of immature permanent teeth with irreversibly damaged pulp has been challenging in dental practice because of the lack of apical constriction, thin dentinal walls, and short roots. This may lead to the extrusion of filling materials, and fracture of the root due to its more fragile feature during shaping of the root canal. Apexification with calcium hydroxide or MTA is one of the treatment options for these cases. Although favorable results of apexification have been reported, these treatment procedures do not guarantee the increase of root length and/or width even after a long term period. Thus, treated teeth are still prone to fractures. Recently, pulp revascularization has been proposed as an alternative treatment for immature teeth with necrotic pulp and periapical pathosis. Pulp revascularization allows the stimulation of the apical development and the root maturation. There have been many treatment protocols using various materials such as antibiotics and calcium hydroxide medicament. In this case report, literature review about pulp revascularization and two related cases are presented.

• 대한치과의사협회지
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• 제25권7호통권218호
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• pp.665-672
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• 1987

In order to study the effects of advanced periodontitis on pulps, 36 human teeth were examined histologically. In addition, a medical and dental history was elicited. The pulps were intact, uninflammed in only 9 teeth (25%) of 36 periodontally involved teeth. 27 teeth (75%) had pulps exhibiting inflammatory lesions of varing intensities. Of 27 teeth with pathological pulp tissue alterations, focal reversible pulpitis was found in 4 teeth, chronic pulpitis in 13 teeth, pulp abscess in 6 teeth, and pulp necrosis in 4 teeth. These observations appeared to indicate that teeth with dvanced periodontitis produce a high incidence of degenertion and inflammation of the pulp. Responses to electric pulp test were not found to be reliable indicators of the state of the pulp in periodontally involved teeth.

• Restorative Dentistry and Endodontics
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• 제44권2호
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• pp.20.1-20.8
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• 2019

Objectives: To achieve pulp-dentin complex regeneration with tissue engineering, treatment efficacies and safeties should be evaluated using in vivo orthotopic transplantation in a sufficient number of animals. Mice have been a species of choice in which to study stem cell biology in mammals. However, most pulp-dentin complex regeneration studies have used large animals because the mouse tooth is too small. The purpose of this study was to demonstrate the utility of the mouse tooth as a transplantation model for pulp-dentin complex regeneration research. Materials and Methods: Experiments were performed using 7-week-old male Institute of Cancer Research (ICR) mice; a total of 35 mice had their pulp exposed, and 5 mice each were sacrificed at 1, 2, 4, 7, 9, 12 and 14 days after pulp exposure. After decalcification in 5% ethylenediaminetetraacetic acid, the samples were embedded and cut with a microtome and then stained with hematoxylin and eosin. Slides were observed under a high-magnification light microscope. Results: Until 1 week postoperatively, the tissue below the pulp chamber orifice appeared normal. The remaining coronal portion of the pulp tissue was inflammatory and necrotic. After 1 week postoperatively, inflammation and necrosis were apparent in the root canals inferior to the orifices. The specimens obtained after experimental day 14 showed necrosis of all tissue in the root canals. Conclusions: This study could provide opportunities for researchers performing in vivo orthotopic transplantation experiments with mice.

• Restorative Dentistry and Endodontics
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• 제41권1호
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• pp.44-54
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• 2016

Objectives: The purpose of this study was to evaluate the histopathological effects of an antioxidant therapy on the pulp tissue of rat teeth exposed to a bleaching gel with 35% hydrogen peroxide. Materials and Methods: Forty rats were subjected to oral ingestion by gavage of distilled water (DW) or ascorbic acid (AA) 90 min before the bleaching therapy. For the bleaching treatment, the agent was applied twice for 5 min each to buccal surfaces of the first right mandibular molars. Then, the animals were sacrificed at 6 hr, 24 hr, 3 day, or 7 day post-bleaching, and the teeth were processed for microscopic evaluation of the pulp tissue. Results: At 6 hr, the pulp tissue showed moderate inflammatory reactions in all teeth of both groups. In the DW and AA groups, 100% and 80% of teeth exhibited pulp tissue with significant necrosis and intense tissue disorganization, respectively. At 24 hr, the AA-treated group demonstrated a greater regenerative capability than the DW group, with less intense inflammatory reaction and new odontoblast layer formation in 60% of the teeth. For up to the 7 day period, the areas of pulpal necrosis were replaced by viable connective tissue, and the dentin was underlined by differentiated odontoblast-like cells in most teeth of both groups. Conclusions: A slight reduction in initial pulpal damage during post-bleaching was promoted by AA therapy. However, the pulp tissue of AA-treated animals featured faster regenerative potential over time.

• Restorative Dentistry and Endodontics
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• 제36권2호
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• pp.149-153
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• 2011

치수는 견고한 치질에 의해 둘러싸여 있기 때문에 치수 혈류나 혈압의 변화는 치수건강에 심각한 위해를 입힐 수 있다. 여러연구에서 치아에 가해지는 교정력이 치수의 혈류 및 세포대사에 변화를 주어 퇴행성/염증성의 치수반응을 일으킬 수 있음이 밝혀졌다. 이 논문의 목적은 만성 치근단 농양을 가진 치아가 명확한 치수생활력 반응을 나타낸 증례에 대해 보고하는 것이다. 이는 치수가 부분적으로 괴사된 상태였기 때문이며 이것의 주 원인은 과도한 교정력인 것으로 판단된다. 남아있는 생활 치수 조직때문에 잘못된 진단이 이뤄지고, 이러한 경우 적절할 치료가 이뤄지지 않음에 따라 괴사조직이 지속적으로 치아주변조직을 파괴하게 될 수 있다. 임상가는 이러한 경우에 있어 여러 진단도구들을 활용하여 정확한 진단을 해야하며 근관-교정 간의 상호작용에 대해 숙지하고 있어야 할 것이다.

• Restorative Dentistry and Endodontics
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• 제48권2호
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• pp.12.1-12.11
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• 2023

Objectives: The present study evaluated the pulp response of human mandibular incisors subjected to in-office dental bleaching using gels with medium or high concentrations of hydrogen peroxide (HP). Materials and Methods: The following groups were compared: 35% HP (HP35; n = 5) or 20% HP (HP20; n = 4). In the control group (CONT; n = 2), no dental bleaching was performed. The color change (CC) was registered at baseline and after 2 days using the Vita Classical shade guide. Tooth sensitivity (TS) was also recorded for 2 days post-bleaching. The teeth were extracted 2 days after the clinical procedure and subjected to histological analysis. The CC and overall scores for histological evaluation were evaluated by the Kruskal-Wallis and Mann-Whitney tests. The percentage of patients with TS was evaluated by the Fisher exact test (α = 0.05). Results: The CC and TS of the HP35 group were significantly higher than those of the CONT group (p < 0.05) and the HP20 group showed an intermediate response, without significant differences from either the HP35 or CONT group (p > 0.05). In both experimental groups, the coronal pulp tissue exhibited partial necrosis associated with tertiary dentin deposition. Overall, the subjacent pulp tissue exhibited a mild inflammatory response. Conclusions: In-office bleaching therapies using bleaching gels with 20% or 35% HP caused similar pulp damage to the mandibular incisors, characterized by partial necrosis, tertiary dentin deposition, and mild inflammation.

• Imaging Science in Dentistry
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• 제35권1호
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• pp.9-14
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• 2005

Purpose : To observe the histopathological changes in the pulp tissues of mandibular molars in streptozotocin-induced diabetic rats after irradiation. Materials and Methods : The male Sprague-Dawley rats weighing approximately 250 gm were divided into four groups: control, diabetes, irradiation, and diabetes-irradiation groups. Diabetes mellitus was induced in the rats by injecting streptozotocin. Rats in control and irradiation groups were injected with citrate buffer only. After 5 days, the head and neck region of the rats in irradiation and diabetes-irradiation groups were irradiated with a single absorbed dose of 10 Gy. All the rats were sacrificed at 3, 7, 14, 21, and 28 days after irradiation. The specimen including the mandibular molars were sectioned and observed using a histopathological method. Results : In the diabetes group, capillary dilatation was observed. However, there was no obvious morphologic alteration of the odontoblasts. In the irradiation group, generalized necrosis of the dental pulp tissues was observed. Vacuolation of the odontoblasts and dilatation of the capillaries were noted in the early experimental phases. In the diabetes-irradiation group, generalized degeneration of the dental pulp tissues was observed. Vacuolation of the dental pulp cells and the odontoblasts was noted in the late experimental phases. Conclusion : This experiment suggests that dilatation of the capillaries in the dental pulp tissues is induced by diabetic state, and generalized degeneration of the dental pulp tissues is induced by irradiation of the diabetic group.

• Restorative Dentistry and Endodontics
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• 제38권2호
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• pp.90-92
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• 2013

Although periapical inflammatory lesions are usually resulted by infection in the root canal system, this rare case showed that a periapical lesion related to an infected tooth may cause pulpal necrosis in adjacent intact tooth, with no history or clinical signs of caries, disease, trauma or developmental anomaly. This case also suggests that the periapical lesion can be treated conservatively, without surgical intervention. Furthermore, this case highlights the importance of prompt treatment of apical periodontitis before the lesion becomes extensive as well as follows up of large lesions.