• Title/Summary/Keyword: Endodontic treatment

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Surgical extrusion of immature permanent tooth with crown-root fractures: a case report with 36-month follow up (외과적 정출술을 이용한 치관-치근 파절된 미성숙 영구치의 치료: 3년 간의 증례보고)

  • Jeon, Su-jin
    • The Journal of the Korean dental association
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    • v.57 no.11
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    • pp.679-688
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    • 2019
  • A 8-year-old patient presented with a crown-root fracture of the maxillary right central incisor with an oblique subgingival fracture line. A multidisciplinary treatment approach including endodontic treatment, surgical extraction and intraalveolar repositioning was used to gain sufficient crown length of the fractured maxillary incisor. The coronally repositioned maxillary right central incisor was stabilized by a resin wire splint. Apexification using MTA was performed. Resin core and direct resin restoration(Cl IV) on fractured teeth was built up. Clinical and radiographic follow-up of the maxillary right central incisor after 36 months showed no signs of root resorption or pathology and acceptable aesthetics and functions were maintained. Surgical extrusion can be considered as a good treatment modality for young patients.

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Cone Beam Computed Tomography in Endodontics (근관치료 영역에서 Cone Beam CT의 활용)

  • Jo, Hyoung-Hoon
    • The Journal of the Korean dental association
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    • v.57 no.7
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    • pp.392-402
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    • 2019
  • The most important part of everyday root canal treatment is diagnosis about the morphology of tooth, root and root canal. Usually this procedure is performed by visual examination and radiographic (panoramic/periapical) examination. However, 2-dimentional radiography has several limitations such as imposition of anatomic structures including buccal/lingual root canals and distortion of images. Recently, owing to the increased interest in dental implant and affordable cost of CBCT equipment, CBCT has been introduced widely in local dental clinics. CBCT is characterized by their lower radiation dose and shorter exposure time than conventional CT scan, and ability of 3-dimentional reconstruction of the dento-alveolar structure. Also in endodontic field, the data from CBCT could be very helpful in diagnosing complex root canal anatomy, apical periodontitis, cause of failure and in determining treatment plan. However, there are some limitations such as radiation dose and artifact. Therefore, clinicians should know about indication, advantages and limitations of CBCT, and properly use it for successful root canal treatment to save the natural teeth.

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Nerve Injury from Overfilled Calcium Hydroxide Root Canal Filling Paste for Maxillary Lateral Incisor Endodontic Treatment (상악 측절치 근관치료 중 수산화칼슘 호제근충제 과충전으로 인하여 발생한 신경손상의 치험례)

  • Na, Kwang Myung;Kim, Jong-Bae;Chin, Byung-Rho;Kim, Jin-Wook;Kim, Chin-Soo;Kwon, Tae-Geon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.4
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    • pp.260-264
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    • 2013
  • Calcium hydroxide root canal filing paste (vitapex) is widely used as canal filling paste for infected canal. However, chemical burn is possible because of the high alkali base of calcium hydroxide. A 57-year old woman was admitted to our clinic for consistent dull pain and paresthesia in the left upper lip, zygoma and buccal cheek area, which developed during an endodontic treatment of the left lateral incisor. Radiographic finding showed radiopaque material, which exits from the left incisor root apex, and was within the left canine and first premolar buccal soft tissue. The overfilled Vitapex extended to the soft tissue was surgically curetted. The result of the surgical curettage was favorable. Though slight hypoesthesia on the upper lip was still remained, paresthesia on zygomatic and buccal cheek area was completely recovered. As far as we know, this is the first case report of infraorbital nerve damage from overfilled Vitapex material.

EFFECT OF TYPE AND CEMENTATION METHOD OF POST-CORE ON MICROLEAKAGE (포스트코어의 종류와 접착방법이 미세누출에 미치는 영향)

  • Yun Myoung-Jae;Lee Sun-Hyung;Yang Jae-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.32 no.2
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    • pp.225-233
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    • 1994
  • The restorations of the severely damaged teeth by post core have been increased with the developement of endodontic procedures. But high failure rates of these procedures being reported, various restorative modifications were induced for successful treatments. Cast post-core and prefabricated post with core buildups are choice of treatment. The main causes of failure of the restorations are the fracture of post and core, root fracture, and recurrent caries due to microleakage. Recently, the acid etching technique and the use of dentin bonding agent at tooth surface to reduce the possible microleakage at the tooth-restoration interfaces were introduced. The object of this study was to measure and compare the microleakage by the types and cementation methods of post-core. For this study, forty extracted human anterior teeth were selected for specimen. After cleansing and routine endodontic procedures, anatomic crowns of each specimen were removed at the level of 2mm above the cementoenamel junction. Canals were preparated for post insertion and specimens were divided into four groups randomly. Post-cores were fabricated according to method for each group. Microleakage was measured by length of dye penetration at the tooth-restoration interfaces with measuring microscope at 50 magnification. Oneway ANOVA and t-test were performed for statistical analysis of resulting data. The following results were obtained from this study. 1. There wert significant statistical differences in degree of microleakage between each group (p<0.01). 2. Cast post-core cemented with ZPC (Group I) showed the most severe microleakage pattern$(1.5547{\pm}0.0872mm)$, and cast post-core cemented with adhesive resin cement after tooth surface treatment with dentin bonding agent (Group II) showed the least microleakage $(0.1497{\pm}0.0872mm)$. 3. Group IV revealed less dye penetrations than group III, but no statistical significance was seen between two groups.

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PULP TREATMENT OF PRIMARY TEETH USING A COMBINATION OF ANTIBIOTICS (항생제를 사용한 유치의 치수치료)

  • Kim, Dae-Eop
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.126-131
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    • 2005
  • The purpose of this study was to observe the potentiality of a mixture of antibiotics to relieve the endodontic and periapical infections in primary teeth. A mixture of metronidazole, ciprofloxacin, and minocyclin in distilled water or in a root canal sealer were used to disinfect the infected endodontic and periapical lesions. For application of this mixture, medication cavities were prepared at orifices of root canals by using the $Fissurotomy^{(R)}$ burs(S S White, USA). The cavities and bottom of pulp chamber were filled with antibiotics mixture. In this cases, clinical symptoms were improved following a single application of that mixture. Gingival swelling, pain, and fistulae were disappeared within a week. More long term evaluation will be needed. Although there were no reports of side effects, care should be taken if children are sensitive to antibiotics. Within the limitations of this case, the mixture of 3 antibiotics provided an excellent improvement in treatment of infected primary teeth under the physiologic root resorption.

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CONSERVATIVE APPROACH OF IATROGENIC ROOT PERFORATION (IATROGENIC ROOT PERFORATION의 보존적 접근)

  • Baik, Byeoung-Ju;Jeon, So-Hee;Park, Jeong-Yeol;Kwon, Byoung-Woo;Kim, Jae-Gon;Lee, Yong-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.59-65
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    • 2004
  • Root perforations that result in a communication of the root space with the periodontal tissues occasionally occur during endodontic procedures. They may be induced iatrogenically. Successful treatment depends mainly on immediate sealing of the perforation and prevention of infection. Several factors affect the achievement of these goals, most important of which are time of occurrence, size and location of the perforation. Identification of root perforations is possible by direct observation of bleeding, radiography and an apex locator. Perforation defects may be repaired by nonsurgical or surgical techniques. We report two cases of root perforation. One was treated by glass ionomer, other was treated by composite resin with calcium hydroxide.

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IMMUNOHISTOCHEMICAL STUDY ON LYMPHOCYTE DISTRIBUTION IN ENDODONTICALLY TREATED AND UNTREATED PERIAPICAL LESIONS (근관치료전과 후의 치근단 병소에서 임파구의 분포에 관한 면역조직화학적 연구)

  • Oh, Tae-Seok;Lim, Sung-Sam
    • Restorative Dentistry and Endodontics
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    • v.11 no.1
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    • pp.63-75
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    • 1985
  • This study was designed to identify lymphocytes and to compare the lymphocyte distribution in endoodontically treated periapical lesions with that in endodontically untreated periapical lesions by way of immunohistochemical staining. Twenty-one human dental periapical lesions were obtained, frozened, serially sectioned to $4-5{\mu}$, and stained using the three-stage indirect immunoperoxidase technique and monoclonal antibodies for detecting the presence of B,T lymphocyte and T suppressor cell. Following results were obtained; 1. All of the examined periapical lesions had positive staining for B,T lymphocyte and T suppressor cell. 2. The concentration of T lymphocytes in 18 lesions diagnosed as periapical cyst and granuloma in both groups was greater than that of B lymphocytes and 2 periapical lesions identified as abscess in treated lesions had more positive B lymphocytes than positive T lymphocytes. 3. The average numbers of T,B lymphocytes and T suppressor cells in Endodontically treated lesions were lower than those of untreated lesions, but no statistically significant difference was noted. 4. When the distribution ratios of T lymphocytes to B lymphocytes and T suppressor cells to T lymphocytes were compared in Endodontically treated lesions by the histological aspects of the lesions and at the intervals of the duration after Endodontic treatment, a statistically significant change was not found. 5. The mean values of T lymphocytes, B lymphocytes and T suppressor cells in Endodontically treated lesions were markedly decreased in the specimens obtained at 3 month after Endodontic treatment, but no statistically significant difference was found.

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The experimental study of oral care for early radiation therapy in the head and neck cancer patients (두경부 악성종양 환자에서 조기 방사선치료를 위한 구강관리법에 대한 실험적 연구)

  • Moon, Won-Kyu;Cha, In-Ho;Kim, Hyung-Jun;Jung, Young-Soo;Lee, Chun-Ui;Lee, Jong-Young;Ryu, Mi-Heon;Yoo, Jae-Ha
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.3
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    • pp.169-175
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    • 2011
  • Background: Teeth requiring extraction before radiotherapy in head & neck cancer patients should be removed as long as possible before the initiation of radiation therapy. Conventionally, a minimum 2-week waiting primary healing period is recommended. Although the above 2-week period is ideal, it was not uncommon for the radiotherapist and cancer patient to feel an urgent need to process with radiotherapy despite the need for dental care. Therefore, alternative approaches for early radiotherapy, including conservative endodontic treatment and a 1-week waiting primary healing period after dental extraction at the time of radiotherapy, were considered and applied based on the experimental study Materials and Methods: Eighteen dogs were processed for histopathologic wound healing. The effect of the primary endodontic treatment and extraction before early radiotherapy was examined. Results: No specific complication, such as, post-extraction wound infection, radiation osteitis and osteoradionecrosis, were encountered despite the early radiotherapy. Conclusion: Based on the experimental study, a minimum 1-week waiting primary healing period for oral care before radiotherapy is suitable for the early radiotherapy in head and neck cancer patients.

Microsurgical re-treatment of an endodontically treated tooth with an apically located incomplete vertical root fracture: a clinical case report

  • Taschieri, Silvio;Fabbro, Massimo Del;Kabbaney, Ahmed El;Tsesis, Igor;Rosen, Eyal;Corbella, Stefano
    • Restorative Dentistry and Endodontics
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    • v.41 no.4
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    • pp.316-321
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    • 2016
  • Although it is challenging, the early diagnosis of a vertical root fracture (VRF) is crucial in order to ensure tooth preservation. The purpose of this clinical case report was to describe reparative surgery performed to treat a tooth affected by an incomplete VRF. A 26 year old male patient was suspected to have a VRF in a maxillary left central incisor, and an exploratory flap was performed in order to confirm the diagnosis. After detecting the fracture, the lesion was surgically treated, the fracture and the infected root-end were removed, and a platelet-rich plasma membrane was used to cover the defect in order to prevent bacterial migration. A 24 month clinical and radiological follow-up examination showed that the tooth was asymptomatic and that the healing process was in progress. The surgical approach described here may be considered an effective treatment for a combined endodontic-periodontal lesion originating from an incomplete VRF and a recurrent periapical lesion.

TREATMENT OF FUSED PERMANENT MANDIBULAR LATERAL AND CENTRAL INCISORS: REPORTS OF CASES (유합된 하악 영구 중절치와 측절치의 치료에 관한 증례보고)

  • Han, Jeong-Jae;Kim, Dae-Eop;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.4
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    • pp.795-804
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    • 1997
  • Developmental dental morphological anomalies are fusion, gemination, twinning, concrescence and etc. They may cause many problems in conservative, periodontal and esthetic aspects. Fusion is a condition where two separate tooth buds unite at some stage in their development to form a bifid crown. If tooth contact occurs early, at least before the start of calcification, the two teeth may be completely unites to form a single large tooth. If tooth contact occurs after the time when a portion of the tooth crown has completed its formation, there may be union of the roots only. In fusion the dentin is always confluent. Fusion teeth is more common in the deciduous than in the permanent dentition. Fused teeth are relatively rare, and are mostly mandibular anterior teeth. Fusion of normal and supernumerary teeth or between normal teeth may occurs. The exact etiology factor of fusion is unknown, but genetic and environmental factors seems to be related. A variety of complications and subsequent treatments have been suggested on this teeth. Periodontal conditions may arise due to a groove formed at the line of fusion of the two teeth. Crowding or Protrusion with potential for malocclusion or delayed eruption of adjacent teeth. Fusion teeth appear in the anterior region, they usually cause esthetic problems. Treatments vary depending on the problem, the location, and the extent of fusion. Treatment of fused teeth has been reported from endodontic, orthodontic, periodontic, surgical and multidisciplinary. This report presents the esthetic improvements by separation of two clinical crowns. Bone reduction or endodontic treatments are not required.

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