• 대한소아치과학회지
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• 제44권2호
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• pp.220-227
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• 2017

맹출 전 치관 내 흡수(pre-eruptive intracoronal resorption; PEIR)는 미맹출치 치관의 법랑상아경계하방에 위치한 방사선 투과상의 흔치 않은 병소이다. 맹출 전 치아에서의 PEIR은, 흡수 진행속도에 따라 외과적 노출술 후 수복 혹은 지속적 관찰로 치료가능하다. 하지만 맹출 후에는 우식 병소 발달의 위험이 높아 임상가의 대처가 늦을 경우 근관치료 등을 포함하는 심화된 수복치료를 진행하여야 한다. 본 증례는 어린이에서 PEIR로 인해 감염된 미성숙 영구치의 임상적 특징 및 치료에 관하여 보고하고자 한다.

• The Journal of Advanced Prosthodontics
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• 제9권3호
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• pp.170-175
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• 2017

PURPOSE. The aim of the present study was to evaluate the fracture resistances of zirconia, cast nickel-chromium alloy (Ni-Cr), and fiber-composite post systems under all-ceramic crowns in endodontically treated mandibular first premolars. MATERIALS AND METHODS. A total of 36 extracted human mandibular premolars were selected, subjected to standard endodontic treatment, and divided into three groups (n=12) as follows: cast Ni-Cr post-and-core, one-piece custom-milled zirconia post-and-core, and prefabricated fiber-glass post with composite resin core. Each specimen had an all-ceramic crown with zirconia coping and was then loaded to failure using a universal testing machine at a cross-head speed of 0.5 mm/min, at an angle of 45 degrees to the long axis of the roots. Fracture resistance and modes of failure were analyzed. The significance of the results was assessed using analysis of variance (ANOVA) and Tukey honest significance difference (HSD) tests (${\alpha}=.05$). RESULTS. Fiber-glass posts with composite cores showed the highest fracture resistance values ($915.70{\pm}323N$), and the zirconia post system showed the lowest resistance ($435.34{\pm}220N$). The corresponding mean value for the Ni-Cr casting post and cores was reported as $780.59{\pm}270N$. The differences among the groups were statistically significant (P<.05) for the zirconia group, as tested by ANOVA and Tukey HSD tests. CONCLUSION. The fracture resistance of zirconia post-and-core systems was found to be significantly lower than those of fiber-glass and cast Ni-Cr post systems. Moreover, catastrophic and non-restorable fractures were more prevalent in teeth restored by zirconia posts.

• Imaging Science in Dentistry
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• 제45권2호
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• pp.95-101
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• 2015

Purpose: This study used cone-beam computed tomography (CBCT) to characterize mandibular molar root and canal morphology and its variability in Belgian and Chilean population samples. Materials and Methods: We analyzed the CBCT images of 515 mandibular molars (257 from Belgium and 258 from Chile). Molars meeting the inclusion criteria were analyzed to determine (1) the number of roots; (2) the root canal configuration; (3) the presence of a curved canal in the cross-sectional image of the distal root in the mandibular first molar and (4) the presence of a C-shaped canal in the second mandibular molar. A descriptive analysis was performed. The association between national origin and the presence of a curved or C-shaped canal was evaluated using the chi-squared test. Results: The most common configurations in the mesial root of both molars were type V and type III. In the distal root, type I canal configuration was the most common. Curvature in the cross-sectional image was found in 25% of the distal canals of the mandibular first molars in the Belgian population, compared to 11% in the Chilean population. The prevalence of C-shaped canals was 10% or less in both populations. Conclusion: In cases of unclear or complex root and canal morphology in the mandibular molars, CBCT imaging might assist endodontic specialists in making an accurate diagnosis and in treatment planning.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권6호
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• pp.473-480
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• 2010

Introduction: Tooth requiring extraction before radiotherapy in head and neck cancer patients should be performed 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 is not uncommon for the radiotherapist and cancer patient to feel an urgent need to proceed 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 a literature review Materials and Methods: The clinical study involved 120 head and neck cancer patients who were treated at Wonju Christian Hospital, Wonju College of Medicine, Yonsei University, from January 1995 to December 2004. Results: In the clinical study, there were no specific complications, such as, post-extraction wound infections, radiation osteitis and osteoradionecrosis over the recent 10 years despite the early radiotherapy. Conclusion: Based on the clinical study, a minimum 1-week waiting primary healing period for oral care before radiotherapy is suitable for early radiotherapy in head and neck cancer patients.

• The Journal of Advanced Prosthodontics
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• 제8권2호
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• pp.101-109
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• 2016

PURPOSE. To investigate the void parameters within the resin cements used for fiber post cementation by micro-CT (${\mu}CT$) and regional push-out bonding strength. MATERIALS AND METHODS. Twenty-one, single and round shaped roots were enlarged with a low-speed drill following by endodontic treatment. The roots were divided into three groups (n=7) and fiber posts were cemented with Maxcem Elite, Multilink N and Superbond C&B resin cements. Specimens were scanned using ${\mu}CT$ scanner at resolution of $13.7{\mu}m$. The number, area, and volume of voids between dentin and post were evaluated. A method of analysis based on the post segmentation was used, and coronal, middle and apical thirds considered separately. After the ${\mu}CT$ analysis, roots were embedded in epoxy resin and sectioned into 2 mm thick slices (63 sections in total). Push-out testing was performed with universal testing device at 0.5 mm/min cross-head speed. Data were analyzed with Kruskal-Wallis and Mann-Whitney U tests (${\alpha}=.05$). RESULTS. Overall, significant differences between the resin cements and the post level were observed in the void number, area, and volume (P<.05). Super-Bond C&B showed the most void formation ($44.86{\pm}22.71$). Multilink N showed the least void surface ($3.51{\pm}2.24mm^2$) and volume ($0.01{\pm}0.01mm^3$). Regional push-out bond strength of the cements was not different (P>.05). CONCLUSION. ${\mu}CT$ proved to be a powerful non-destructive 3D analysis tool for visualizing the void parameters. Multilink N had the lowest void parameters. When efficiency of all cements was evaluated, direct relationship between the post region and push-out bonding strength was not observed.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권6호
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• pp.323-341
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• 2019

Background: Local anesthetics alone or in combination with adjuncts, such as oral medications, have routinely been used for pain control during endodontic treatment. The best clinical choice amongst the vast numbers of agents and techniques available for pain control for irreversible pulpitis is unclear. This network meta-analysis combined the available evidence on agents and techniques for pulpal anesthesia in the maxilla and mandible, in order to identify the best amongst these approaches statistically, as a basis for future clinical trials. Methods: Randomized trials in MEDLINE, DARE, and COCHRANE databases were screened based on inclusion criteria and data were extracted. Heterogeneity was assessed and odds ratios were used to estimate effects. Inconsistencies between direct and indirect pooled estimates were evaluated by H-statistics. The Grading of Recommendation, Assessment, Development, and Evaluation working group approach was used to assess evidence quality. Results: Sixty-two studies (nine studies in the maxilla and 53 studies in the mandible) were included in the meta-analysis. Increased mandibular pulpal anesthesia success was observed on premedication with aceclofenac + paracetamol or supplemental 4% articaine buccal infiltration or ibuprofen+paracetamol premedication, all the above mentioned with 2% lignocaine inferior alveolar nerve block (IANB). No significant difference was noted for any of the agents investigated in terms of the success rate of maxillary pulpal anesthesia. Conclusion: Direct and indirect comparisons indicated that some combinations of IANB with premedication and/or supplemental infiltration had a greater chance of producing successful mandibular pulpal anesthesia. No ideal technique for maxillary anesthesia emerged. Randomized clinical trials with increased sample size may be needed to provide more conclusive data. Our findings suggest that further high-quality studies are required in order to provide definitive direction to clinicians regarding the best agents and techniques to use for mandibular and maxillary anesthesia for irreversible pulpitis.

• Restorative Dentistry and Endodontics
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• 제9권1호
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• pp.15-24
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• 1983

Irradiation is frequently employed as the sole therapy for oral cancer. These irradiated patients presents peculiar and progressive dental problems. But there is only scanty informations concerning specific approaches to endodontic treatment for head and neck cancer patients who have been subjected to tumorcidal doses of radiation therapy. The purpose of the present study was to determine the effects of cobalt-60 radiation on the pulpal healing of dogs after the direct pulp capping. As the experimental animals, 10 dogs (above 7-8 months after birth) were divided into 3 groups (Control, Group I, Group II). The cobalt-60 was irradiated to the Group I and Group II each 1,009 and 1,562.5 rads as single dose. As the capping material Dycal$^{(R)}$(L.D. Caulk company) was selected. After the direct pulp capping the dogs were sacrified 1, 2, 3, 4, week interval and made the original slides cut with a thickness of 8 microns and stained with hematoxylin and eosin. After examination and comparision of all specimen, the results of this study were drawn as follows; 1. The formation of reparative dentin was observed from the 1st week in the Control group, the 2nd week in the Group I & II. The few and irregular tuble structure was appeared in the 4th week in the Control group only, but failed in the Group I & II. 2. The continuity of dentin bridge was appeared in the 3rd week in all group and the degeneration of odontoblast in the 1st week of the Group II. 3. The congestion and hemorrhage in the pulp tissue were observed in all groups until 3rd week. The inflammation was appeared within the 2nd week in the Group I and especially marked in the Group II, but absent in the Control group. 4. In cases Dycal into the pulp tissue deeply, the local necrosis of pulp and decrease of dentin formation was observed.

• Restorative Dentistry and Endodontics
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• 제21권1호
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• pp.339-352
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• 1996

Many dentists have been taken an interest in restoration of severly damaged teeth after endodontic treatment and it is a true that there are lots of studies about it. In these days, although we have used Para-Post, pins, threaded steel post, cast gold post and core, and so on, as a method of restoration frequently, it has been in controversy with the effects of them on the teeth and surrounding periodontal tissue. In this study, we assume that the crown of the upper 1st premolar was severly damaged, and after the root canal therapy, two most common types of restoration were carried out ; 1) coronal-radicular amalgam restoration, 2) after setting up the Para-Post, restore with amalgam core and gold crown. After restoration, in order to present the concentration of stress at internal portion of the tooth and the surrounding periodontal tissue, we doveloped a 2-dimensional finite element model of labiopalatal section, then loaded forces from 2 long perpendicular to the lingual incline of buccal ridge an the middle point, parallel to the long direction axis of tooth at the fossa-were applied. The analyzed results were as follows : 1. Stress of the normal first premolar was concentrated on the most weakest anatomical structure, that is, cervical area, and no stress on the bifurcated area of the canal. 2. Crown restoration after root canal therapy causes large stress concentration on the bifurcated area of the canal. This stress concentration has larger value in case of lateral movement of mandible, and there are decrease in the stress concentration compared with natural tooth. 3. Coronal-radicular amalgam restoration method transports more stress to the tooth structure than restoration using Para-Post. 4. There are more stress concentration around Para-Post in the case of lateral movement, and we have more favo rable result when restored with Para-Post. 5. Generally, stress in the lateral movement is larger than stress in the perpendicular load.

• Restorative Dentistry and Endodontics
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• 제16권2호
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• pp.33-42
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• 1991

The purpose of this study was to evaluate the sealing properties of the temporary filling materials used in endodontic treatment Access cavities were prepared in 135 extracted human molar teeth. Then, cotton pellets were placed in the pulp chamber until the depth of 5 mm for the temporary filling materials; Caviton, zine oxide-eugenol, double sealing (A) (stopping 15 mm + zinc oxide - eugenol, 3.5mm ) double sealing (B) (stopping 3.0 mm + zinc oxide - eugenol 2.0 mm) and gutta percha stopping. After filling the materials, the teeth were immersed in 1 % methylene blue solutions for 3 days, 1 week and 2 weeks. Then thermal cycling was performed at the temperature of $60^{\circ}C$ and $4^{\circ}C$, followed by longitudinal sections on the center of tooth. Finally, staining on the cotton pellet was evaluated. The following results were obtained. 1. Stopping showed lower marginal sealing quality than Caviton, zinc oxide - eugenol and double sealing. 2. In 1 week group, Caviton showed higher marginal sealing quality than zinc oxide-eugenol, double sealing and stopping. 3. Caviton and double sealing (B) showed a great decrease in marginal sealing quality with the increse of time. 4. Caviton had high marginal sealing quality in 3 day group and 1 week group, but in 2 week group, Caviton showed a great decrease. 5. Double sealing (B) showed fairly high marginal sealing quality in 3 day group, but decreased greatly after 1 week on.

• 대한소아치과학회지
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• 제32권1호
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• pp.158-163
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• 2005

외상으로 인해 완전 탈구와 함입성 및 정출성 탈구가 병합되어 나타나는 경우는 드물다. 2003년 7월에 10세 2개월의 여아가 상악우측 측절치의 완전탈구와 상악우측 중절치의 함입성 탈구, 상악 좌측 중절치의 정출성 탈구로 전남대학교병원 소아치과에 내원하였다. 내원 당일 외상치아를 외과적으로 재위치시켰으며 레진 강선 고정을 시행하였다. 외상 2주 후 완전탈구된 상악우측 측절치는 근관치료를 시행하였다. 외상 3개월 후 방사선사진 상에 상악 좌우측 중절치의 치근 외흡수가 관찰되었으며 수산화칼슘을 이용한 근관치료를 시행한 후 치근 외흡수가 정지되었다. 1년 4개월 동안의 관찰기간 동안 병적인 변화 없이 양호한 결과를 보였으며 추후 장기적인 추적관찰이 필요하리라 사료된다.