• 제목/요약/키워드: Endodontic treatment

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A CAD/CAM-based strategy for concurrent endodontic and restorative treatment

  • Escobar, Patricia Maria;Kishen, Anil;Lopes, Fabiane Carneiro;Borges, Caroline Cristina;Kegler, Eugenio Gabriel;Sousa-Neto, Manoel Damiao
    • Restorative Dentistry and Endodontics
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    • 제44권3호
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    • pp.27.1-27.12
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    • 2019
  • This case report describes a technique in which endodontic treatment and permanent indirect restoration were completed in the same clinical appointment with the aid of a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Two patients were diagnosed with irreversible pulpitis of the mandibular first molar. After access preparation, root canals were located, irrigation was performed until bleeding ceased, and the coronal tooth structure was prepared for indirect restoration. Then, utilizing an interim 3-mm build-up of the endodontic access cavity, a hemi-arch digital scan was performed with an intraoral scanner. Subsequent to digital scanning, restoration design was performed simultaneously with the endodontic procedure. The root canals were shaped using the Race system under irrigation with 2.5% sodium hypochlorite followed by root canal filling. The pulp chamber was subsequently filled with a 3-mm-thick composite resin restoration mimicking the interim build-up previously utilized to facilitate block milling in the CAD/CAM system. Clinical try-in of the permanent onlay restoration was followed by acid etching, application of a 5th generation adhesive, and cementation of the indirect restoration. Once the restoration was cemented, rubber dam isolation was removed, followed by occlusal adjustment and polishing. After 2 years of follow-up, the restorations were esthetically and functionally satisfactory, without complications.

근관치료적 이유로 치과대학병원으로 의뢰된 치아들의 특성 (Characteristics of teeth referred to a dental university hospital for endodontic reason)

  • 전수진;황수정;서민석
    • 구강회복응용과학지
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    • 제35권3호
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    • pp.143-152
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    • 2019
  • 목적: 이번 연구의 목적은 치과대학병원 보존과로 근관치료적으로 의뢰된 환자들과 치아들의 특성을 진료기록을 통해 살펴보고 영향을 미치는 요인을 분석하는 것이다. 연구 재료 및 방법: 2017년 1월부터 2018년 12월까지 한 치과대학병원 보존과에 내원한 환자들을 대상으로 환자의 진료기록을 통해 근관치료적으로 의뢰되었던 환자를 취합하였다. 총 1171명의 환자 기록을 분석하였다. 의뢰된 치아의 상태가 근관치료 전인지 근관치료 중인지 또는 근관 충전된 이후인지를 초진 당시의 방사선 사진과 진료기록 내용을 토대로 구분하여 3가지 군으로 정리해서 분석하였다. 결과: 의뢰된 치아들의 69.9%가 상, 하악 제1, 2대구치였다. 이전 기관에서 의뢰된 후 치과대학병원에 내원할 때까지 소요된 일수는 평균 9.03일이었고 의뢰서가 있는 경우가 65.6%였다. 주된 의뢰 이유로는 지속되는 임상 증상(통증, 종창, 누공)이 37.9%로 가장 많았으며 진단의 어려움 16.7%, 근관막힘 13.8%, 높은 해부학적 난이도 11.4% 순이었다. 세부적으로 근관치료 전에 의뢰된 경우에는 진단의 어려움이 많았고 근관치료 중에 의뢰된 경우에는 지속적인 임상 증상과 근관 막힘이 많았다. 근관 충전 후에 의뢰된 경우는 지속되는 임상 증상이 대부분이었다. 결론: 대구치인 경우 지속적인 임상 증상과 근관 막힘이 주된 이유인 비율이 높았고 전치의 경우 치근단 수술과 외상 치료의 비율이 높았다.

YouTube as an information source for instrument separation in root canal treatment

  • Yagiz Ozbay;Neslihan Yilmaz Cirakoglu
    • Restorative Dentistry and Endodontics
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    • 제46권1호
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    • pp.8.1-8.7
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    • 2021
  • Objectives: The reliability and educational quality of videos on YouTube for patients seeking information regarding instrument separation in root canal treatment were evaluated. Materials and Methods: YouTube was searched for videos on instrument separation in root canal treatment. Video content was scored based on reliability in terms of 3 categories (etiology, procedure, and prognosis) and based on video flow, quality, and educational usefulness using the Global Quality Score (GQS). Descriptive statistics were obtained and the data were analyzed using analysis of variance and the Kruskal-Wallis test. Results: The highest mean completeness scores were obtained for videos published by dentists or specialists (1.48 ± 1.06). There was no statistically significant difference among sources of upload in terms of content completeness. The highest mean GQS was found for videos published by dentists or specialists (1.82 ± 0.96), although there was no statistically significant correlation between GQS and the source of upload. Conclusions: Videos on YouTube have incomplete and low-quality content for patients who are concerned about instrument separation during endodontic treatment, or who experience this complication during endodontic treatment.

니켈티타늄 전동파일 파절의 예방 및 처치 (Prevention and Solution of the Fracture of Nickel-Titanium Endodontic Instruments)

  • 김현철
    • 대한치과의사협회지
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    • 제54권8호
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    • pp.640-650
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    • 2016
  • Nickel-Titanium (NiTi) rotary instruments have brought a big step toward "efficient" practice of endodontic procedure. The rotary files help clinicians to reduce their working time and also increase the clinical success rate with minimal procedural errors. However, NiTi instruments still have a few drawbacks including unpredictable fatigue fracture. Clinicians may reduce the potential risk of instruments fracture by following some clinical guidelines for rotary instruments. In some clinical cases of instruments fracture, we may try to remove the instruments' fragments or bypass the fragment to reach the apical canal. In some limited cases, the fractured instruments' fragments would not jeopardize the clinical prognosis of root canal treatment. Nevertheless, it is impossible to be overemphasized that the prevention of file fracture is much easier than the removal of fracture fragment. Clinicians need to understand the fracture mechanisms and, in clinic, need to discard the used instruments timely.

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Paresthesia diagnosed using cone-beam computed tomography: a case report

  • Kumar, Umesh;Kaur, Charan Kamal;Vashisht, Ruchi;Rattan, Vidya
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제20권2호
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    • pp.95-99
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    • 2020
  • Various dental procedures, such as injection administration, surgical treatment, and endodontic treatment, can cause injury to the nerves. The most commonly injured nerves are the inferior alveolar and lingual nerves. This can manifest as altered sensation to the area of innervation of the injured nerve, such as the lower lip, chin, teeth, tongue, and mucosa. Altered sensations or loss of sensation are relatively infrequent complications in daily dental practice. Here, we report an uncommon case of altered sensation in the midfacial region caused by an endodontic procedure and discuss the need to consider local dental causes in the differential diagnosis of numbness in the facial region.

Endodontic management of central incisor associated with large periapical lesion and fused supernumerary root: a conservative approach

  • Badole, Gautam P.;Shenoi, Pratima R.;Parlikar, Ameya
    • Restorative Dentistry and Endodontics
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    • 제43권4호
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    • pp.44.1-44.9
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    • 2018
  • Fusion and gemination are developmental anomalies of teeth that may require endodontic treatment. Fusion may cause various clinical problems related to esthetics, tooth spacing, and other periodontal complications. Additional diagnostic tools are required for the diagnosis and the treatment planning of fused tooth. The present case report describes a case of unilateral fusion of a supernumerary root to an upper permanent central incisor with large periapical lesion in which a conservative approach was used without extraction of supernumerary tooth and obturated with mineral trioxide aggregate to reach a favorable outcome.

재식한 치아에서 수산화 칼슘을 사용한 근관치료 (ENDODONTIC TREATMENT WITH CALCIUM HYDROXIDE OF REPLANTED TOOTH : A CASE REPORT)

  • 문상희;김왕근;이창섭;이상호
    • 대한소아치과학회지
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    • 제26권1호
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    • pp.96-102
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    • 1999
  • 외상으로 인해 치근 완성 여부가 불분명 한 완전 탈구된 치아를 재식한 후 18개월 여간 관찰하여 다음과 같은 결과를 얻었다. 1. 재식 초기의 염증성 치근 흡수는 수산화 칼슘을 사용한 근관치료로 억제될 수 있었다. 2. 치근 완성 여부가 불확실한 치아에서 조기 근관치료가 염증성 치근 흡수 및 유착의 방지에 더 큰 임상적 성공을 얻을 수 있었다. 따라서, 재식 당시 치근첨의 개방성 여부가 명확하지 않을 때에는 성인의 치료 지침에 따라 치료하는 것이 보다 효과적이며, 불가피 할 경우에는 환자 및 보호자의 철저한 교육에 뒤따른 정확한 내원 약속이 속발증을 최소화 할 수 있을 것으로 사료된다.

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Root canal treatment of dens invaginatus and fused tooth

  • Park, So-Young;Bae, Kwang-Shik;Lim, Sung-Sam;Baek, Seung-Ho
    • 대한치과보존학회:학술대회논문집
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    • 대한치과보존학회 2001년도 춘계학술대회
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    • pp.247-251
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    • 2001
  • ;A dental developmental anomaly is defined as an isolated aberration in tooth form, caused by a disturbance or abnormality which occurred during tooth development. There are numerous types of dental anomalies, and a considerable variation in the extent of the defects occurs with each type. Teeth with these anomalies pose unique challenges. Since the defects are not always apparent clinically, they can confuse diagnosticians investigating the etiology of pulpal pathosis. When endodontic treatment is required, the defects often hinder access cavity preparation and canal instrumentation. Treatment planning also becomes more challenging, since the defects can create complicated periodontal problems, and the malformed teeth can be difficult to restore, particularly those weakened by endodontic therapy. Fusion is defined as the joining of two developing tooth germs resulting in a single large tooth structure. The incidence of fusion is < 1% in the Caucasian population, and it is believed that physical force or pressure produces contact of the developing teeth. Clinically and radiographically, a fused tooth usually appears as one large crown with at least partially separated roots and root canals. There may be a vertical groove in the tooth crown delineating the originally separate crowns. Dens invaginatus is a deep surface invagination of the crown or root that is lined by enamel. Teeth in both maxillary and mandibular arches may be affected, but the permanent maxillary lateral incisor is the tooth most commonly involved. Studies have revealed an incidence ranging from 0.25% to as high as 10%. The invagination ranges from a slight pitting to an anomaly occupying most of the crown and root. The invagination frequently communicates with the oral cavity, allowing the entry of irritants and microorganism either directly into pulpal tissues or into an area that is deparated from pulpal tissues by only a thin layer of enamel and dentin. This continuous ingress of irritants and the subsequent inflammation usually lead to necrosis of the adjacent pulp tissue and then to periapical or periodontal abscesses. If the invagination extends from the crown to the periradicular tissue and has no communication with the root canal system, the pulp may remain vital. Recommended treatment of fused tooth and dens invaginatus has been reported in the endodontic literature. This case report describes the endodontic treatment of a maxillary laterl incisors having fused crown and dens invaginatus.natus.

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