• 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.

• 구강회복응용과학지
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• 제35권2호
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• pp.98-104
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• 2019

의도적 재식술은 흔히 근관 치료가 실패한 경우 사용되는 치료법이나, 중도의 치주 질환에 이환된 치아에서는 대개 추천되지 않는다. 그러나, 일부 연구들은 의도적 재식술을 이용하여 치주 질환에 이환된 치아를 성공적으로 치료한 것을 보고한 바가 있다. 본 연구에서는 중도 치주염에 이환된 치아를 의도적 재식술을 이용하여 치료한 증례를 보고하고자 한다. 해당 치아는 근관-치주 복합 병소로 진단 후 근관치료를 선행하였으나 광범위한 골소실을 나타냈으며, 이에 의도적으로 발치 후 치근 표면의 국소 인자를 완전히 제거한 후 재식하였다. 의도적 재식술을 이용하여 본 증례에서 중도 치주염에 이환된 치아를 발치하지 않고 3년간의 경과 관찰 기간 동안 보존할 수 있었다.

• 대한소아치과학회지
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• 제24권3호
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• pp.556-561
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• 1997

Intentional replantation of the posterior teeth has been performed as a last resort except extraction when it is impossible to perform the conventional endodontic or surgical endodontic treatment. Many studies have done with the prognosis, and root resorption, of which the responsibility might have been injury of periodontal ligament and remaining periodontal lesion, proved to be major cause of failure. Intentional replantation, however, can exclude anatomic difficulty, risk of nerve injury, and maxillary sinus trauma that surgical access can raise, especially in posterior teeth, and it is reported that success rate is not less than surgical endodontics, independent of replantation of traumatically avulsed teeth. The success of intentional replantation can be evaluated with, clinically, reduction of pocket depth, pain and mobility(physical mobility), and, radiographically, hard tissue formation, reduction of periapical radiolucency. In this case report, for the maxillary left first bicuspid with dens evaginatus that had periapical lesion, painfulness, mobility and showed no reduction of mobility after even extirpation and a number of irrigation, extraction followed by extraoral root filling with calcium hydroxide and replantation was performed. Based on many studies, it is concluded that hard tissue formation capacity of calcium hydroxide, preceded extirpation before extraction, and careful extraction without injuring periodontal ligament affected successful results of this case.

• Restorative Dentistry and Endodontics
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• 제47권3호
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• pp.34.1-34.12
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• 2022

Objectives: This study aimed to evaluate the success rate of endodontic treatments performed by undergraduate students and the factors associated with the outcome. Materials and Methods: A follow-up of 3 to 8 years after root canal filling was carried out in 91 patients. At the follow-up visits, medical and dental history questionnaires were applied along with clinical and radiographic examinations. Data collected in the clinical exam included: the presence of pain, swelling, sinus tract, mobility, tenderness to palpation and percussion, periodontal probing profile, and type/quality of coronal restoration. Postoperative and follow-up radiographs were digitalized and analyzed by 2 trained and calibrated examiners to assess periapical healing. The treatment outcome was based on strict clinical and radiographic criteria and classified as success (absence of any clinical and radiographic sign of apical periodontitis) or failure (other combination). Logistic regression was used to investigate the impact of clinical and radiographic variables on endodontic treatment outcomes at a 5% significance level. Results: The success rate of endodontic treatments was 60.7%. The only risk factor significantly associated with failure was the presence of a periapical lesion on the postoperative radiograph (odds ratio, 3.35; 95% confidence interval, 1.17-9.54). Conclusions: The success rate of endodontic treatments performed by undergraduate students was low and was jeopardized by the presence of a periapical lesion on the postoperative radiograph.

• Restorative Dentistry and Endodontics
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• 제41권4호
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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.

• 대한치과보존학회:학술대회논문집
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• 대한치과보존학회 2001년도 추계학술대회(제116회) 및 13회 Workshop 제3회 한ㆍ일 치과보존학회 공동학술대회 초록집
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• pp.563.2-563
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• 2001

C-shaped canal configuration is very difficult to treat because that clues about preoperative canal anatomy cannot be ascertained from clinical crown morphology and limited information can be derived from the radiographic examination. This study was done to get more informations about the root and canal configuration of C-shaped root by 3-dimentionally reconstructing for the purpose of enhancing success rate of endodontic treatment. 30 mandibular molars with C-shaped root were selected. Teeth had been extracted from periodontal problems with sound crown and root portion, including teeth with caries lesion limited crown portion only.(omitted)

• 대한치과보존학회:학술대회논문집
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• 대한치과보존학회 2001년도 추계학술대회(제116회) 및 13회 Workshop 제3회 한ㆍ일 치과보존학회 공동학술대회 초록집
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• pp.554-554
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• 2001

C-shaped canal configuration is very difficult to treat because that clues about preoperative canal anatomy cannot be ascertained from clinical crown morphology and limited information can be derived from the radiographic examination. This study was done to get more informations about the root and canal configuration of C-shaped root by 3-dimentionally reconstructing for the purpose of enhancing success rate of endodontic treatment. 30 mandibular molars with C-shaped root were selected. Teeth had been extracted from periodontal problems with sound crown and root portion, including teeth with caries lesion limited crown portion only.(omitted)

• 대한소아치과학회지
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• 제26권2호
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• pp.317-322
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• 1999

치내치는 석회화가 되기전에 치관의 함입에 의해서 야기되어지는 치아의 형태이상이다. 영구치뿐만 아니라 유치에서 발생될 수 있지만 주로 상악 측절치에서 발생하며 그 발생빈도는 0.04-10%로 다양하게 보고되고 있다. 치내치는 치수와 치근단 조직으로 교통될 수 있어 이로 인해서 치수의 염증, 치근단 농양, 낭종 등을 야기하거나 내흡수를 일으킬 수도 있으며 치관의 형태이상을 보이는 등 심미적인 문제도 초래할 수 있다. 치내치는 그 함입의 정도에 따라서 Oehlers씨에 의해서 3가지 형태로 구분된다. 치내치의 다양한 형태중 Type 3의 치내치는 치내치 함입부가 치수와의 교통없이 치근단공이나 측방 치주조직으로 opening을 형성하는 형태로 치수감염의 여부에 따라 치료전략이 달라지며, 치수감염에 의한 병소가 존재하는 경우에는 함입된 형태와 복잡성을 고려하여 통상적인 근관치료, 외과적 치근단 절제술, 의도적 재식술 및 발치를 시행할 수 있다. 본 증례에서는 근첨이 개방된 측방 치주공을 가진 치내치로 해당치아가 생활력을 보이고 invagination의 형태가 단순하였기에 invagination에 한정된 근관치료와 근첨형성술을 통하여 성공적인 결과를 보였으며 다음과 같은 결과를 얻었다. 1. Type 3 치내치의 경우에서 치아의 생활력이 유지되고 invagination의 형태가 복잡하지 않다면, 그리고 치수와 invagination과의 교통의 증거가 없다면 invagination에 한정된 근관치료로서 병소의 해결과 해당치아의 생활력 유지가 가능했다. 2. 개방된 근첨을 가진 invagination을 보이는 치내치의 경우 근첨형성술로 개방된 근첨의 폐쇄를 유도할 수 있었고 이런 점을 이용 외과적 술식을 피할 수 있었다.

• 대한소아치과학회지
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• 제39권2호
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• pp.181-185
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• 2012

치내치는 치아 조직이 석회화되기 전에 법랑기가 치유두 내로 함입되어 형성된 발육성 기형이다. 가장 널리 통용되는 치내치의 분류법은 방사선 사진 상에서 함입(invagination)이 얼마나 치관에서 치근 쪽으로 연장되어 있는지에 따라 분류하는 Oehler's classification system이다. 그 중 Oehler's classification type III는 함입이 치근까지 연장되어 치주인대와 직접적으로 'pseudo foramen'을 통해 교통하는 경우를 말하며 대체로 치수와는 독립적으로 존재한다. Type III 함입을 통한 감염은 언제나 치주조직의 염증성 반응을 야기할 가능성이 있으며, 이처럼 'pseudo foramen' 주위로 염증성 병변이 발생한 경우 이를 'peri-invagination periodontitis'라 한다. 본 증례는 Oehler's type III 치내치를 갖는 상악 측절치의 'peri-invagination periodontitis'을 주소로 내원한 두 환자에게 각각 다른 치료적 접근을 통하여 양호한 결과를 얻었다. 치내치에 대한 처치 시 조기 진단과 예방적 치료를 통한 치수의 건강 유지가 매우 중요하나, 이미 치수까지 질환에 이환 되었을 경우 환아의 나이, 치근 성숙도, 함입의 종류, 염증의 치수 이환 여부 등을 고려하여 치료계획을 수립해야 한다.

• Journal of Periodontal and Implant Science
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• 제29권3호
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• pp.621-636
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• 1999

When mucoperiosteal flaps are positioned and sutured to desirable position, the wound contains several interface between tissues which differ fundamentally in composition & biological reaction. Thus the C-T surface of the flap will, on one hand, oppose another vascularized surface, and on the other, the avascular dental material for example, when root resoptions, fractured root, endodontic perforation, deep root carious lesions were filled with amalgam, glass ionomer, resin etc. Recently, a number of case report described the successful treatment of a subgingival root lesion with restorative material & free gingival graft, open flap surgery, but more objective research was needed . Most of study on restorative materials were concerned for cytotoxicity not for actual healing event on that materials and its influencing factors such as biocompatibility, surface wettability, surface topography . The aim of this in vitro study was to evaluate the effect of amalgam, resin modified glass ionomer, composite resin per se, and their surface roughness on the growth of human gingival fibroblast. The cells were obtained and placed on culture flask and incubated for 3 days with the prepared test materials. Then count the attached cell number with hemocytometer,(n=12) and 2 samples were examined with SEM about attachment cell morphology . Another 4 samples were evaluated on their surface roughness with Talysurf and average surface roughness value(Ra) were obtained. Statistical difference in attached cell number, roughness value were analyzed using ANOVA. The number of attached cell was as follows, for root dentin specimen 16.7${\pm}$4.41, resin modified glass ionomer 14.0${\pm}$4.15, resin 8.13${\pm}$3.63, amalgam 0.72${\pm}$3.33(${\times}10^3$). Between root dentin and resin-modified glass ionomer, no significant difference was observed, but resin, amalgam showed a significant less cell numbers than for root dentin, resin modified glass ionomer cement. SEM examination expressed many cell surface attachment apparatus in root dentin and resin modified glass ionomer specimens. For resin specimen, cell attachment was observed but exposed less appratus. The average surface roughness value are following results. Dentin specimen 0.6972${\pm}$ 0.104, resin modified glass ionomer 0.0822${\pm}$0.009, resin 0.0875${\pm}$0.005, amalgam 4.2145${\pm}$0.985(${\mu}m$). Between root dentin, resin-modified glass ionomer, and resin, no significant difference was observed, but amalgam showed a significant more rough surface than other groups. When evlauated the interrelationship between cell attachment and surface roughness, therefore, there was weak reverse correlation.(pearson correlation : - 0.593) These results suggest that resin modified glass ionomer have the favorable healing potential when used for subgingival restoration. And for relationship between cell attachment and surface characteristics, further investigations were needed.