• Restorative Dentistry and Endodontics
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• v.43 no.2
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• pp.16.1-16.9
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• 2018

Objectives: Understanding the reason for an unsuccessful non-surgical endodontic treatment outcome, as well as the complex anatomy of the root canal system, is very important. This study examined the cross-sectional root canal structure of mandibular first molars confirmed to have failed non-surgical root canal treatment using digital images obtained during intentional replantation surgery, as well as the causative factors of the failed conventional endodontic treatments. Materials and Methods: This study evaluated 115 mandibular first molars. Digital photographic images of the resected surface were taken at the apical 3 mm level and examined. The discolored dentin area around the root canal was investigated by measuring the total surface area, the treated areas as determined by the endodontic filling material, and the discolored dentin area. Results: Forty 2-rooted teeth showed discolored root dentin in both the mesial and distal roots. Compared to the original filled area, significant expansion of root dentin discoloration was observed. Moreover, the mesial roots were significantly more discolored than the distal roots. Of the 115 molars, 92 had 2 roots. Among the mesial roots of the 2-rooted teeth, 95.7% of the roots had 2 canals and 79.4% had partial/complete isthmuses and/or accessory canals. Conclusions: Dentin discoloration that was not visible on periapical radiographs and cone-beam computed tomography was frequently found in mandibular first molars that failed endodontic treatment. The complex anatomy of the mesial roots of the mandibular first molars is another reason for the failure of conventional endodontic treatment.

• Restorative Dentistry and Endodontics
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• v.36 no.1
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• pp.12-18
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• 2011

Objectives: This retrospective study evaluated the therapeutic effects of the intentional replantation (IR) procedure performed on the maxillary and mandibular molars of 35 patients. Materials and Methods: For the subjects, IR was performed due to difficulties in anatomically accessing the lesions and/or close proximity to the thick cortical bone, inferior alveolar nerve, or maxillary sinus, which rendered the ordinary periradicular surgery impossible. The patients'progress was followed for a year and up to 2 years and 4 months. The success of the procedure was evaluated in terms of clinical and radiographic success (%). Results: The results revealed the following: (a) 1 case (3%) of failed tooth extraction during IR; (b) 2 cases (6%) of extraction due to periodontal diseases and inflammatory root resorption; (c) 3 cases (9%) of normally functioning teeth in the oral cavity with minor mobility and apical root resorption, and; (d) 29 cases (82%) of normally functioning teeth without obvious problems. Conclusions: IR was confirmed to be a reliably repeatable, predictable treatment option for those who cannot receive conventional periradicular surgery because of anatomic limitations or patient factors.

• Restorative Dentistry and Endodontics
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• v.36 no.3
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• pp.211-218
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• 2011

Purpose: Intentional replantation (IR) is a suitable treatment option when nonsurgical retreatment and periradicular surgery are unfeasible. For successful IR, fracture-free safe extraction is crucial step. Recently, a new extraction method of atraumatic safe extraction (ASE) for IR has been introduced. Patients and Methods: Ninety-six patients with the following conditions who underwent IR at the Department of Conservative Dentistry, Seoul National University Bundang Hospital, in 2010 were enrolled in this study: failed nonsurgical retreatment and periradicular surgery not recommended because of anatomical limitations or when rejected by the patient. Preoperative orthodontic extrusive force was applied for 2-3 weeks to increase mobility and periodontal ligament volume. A Physics Forceps was used for extraction and the success rate of ASE was assessed. Results: Ninety-six premolars and molars were treated by IR. The complete success rate (no crown and root fracture) was 93% (n = 89); the limited success rates because of partial root tip fracture and partial osteotomy were 2% (n = 2) and 5% (n = 5), respectively. The clinical and overall success rates of ASE were 95% and 100%, respectively; no failure was observed. Conclusions: ASE can be regarded as a reproducible, predictable method of extraction for IR.

• Archives of Reconstructive Microsurgery
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• v.3 no.1
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• pp.81-89
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• 1994

Firstly the wrap-around free flap from the great toe was transferred successfully by Morrison and O'Brien in 1980 for reconstruction in chronic case of amputated thumb distal to the MP joint. Since then, significant bone peg resorption and grafted bone fracture have been reported in most of cases after operation. We have performed thumb reconstructions within 2 weeks after injury in 11 cases which included acute crushing injuries or failed replantation of thumb at Guro Hospital from September, 1983 to October, 1993. The results obtained from this study are as follows: 1. There were 8 males and 3 females and the mean age was 28.8 years old ranged from 3 years old to 50 years old. 2. The most common injury mechanism was machinary injury in 10 of 11 cases. 3. We have performed thumb reconstructions by using wrap-around free flap from the great toe without bone graft in 6 cases and with bone graft in 5 cases within 2 weeks after injury. 4. During 6 years and 1 month mean follow-up period, there were bone resorptions in 3, grafted bone fracture in 1, infections in 2 and soft tissue necrosis in 3 cases. 5. We obtained satisfactable results in respect of function and cosmesis and urged to use this flap for reconstruction in acute thumb injury.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.3
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• pp.303-311
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• 2020

The aim of this study was to assess the awareness of caregivers, emergency medical technicians, and emergency medical doctors by investigating the storage media for avulsed teeth at the trauma site. This study was performed by reviewing medical records of 183 patients with the age under 17 years old, who visited Ajou University Hospital for dental trauma. Based on their medical records, storage media for avulsed permanent teeth were investigated by classifying them as dry, milk, saline, saliva and tap water. The storage media chosen by caregivers at the trauma site were classified as cases by parents and school nurse teachers. Storage media chosen by emergency medical technicians and emergency medical doctors were also investigated using the same classification criteria. The results show that both parents and school nurse teachers used milk the most as a storage medium for avulsed teeth. Dry storage was the second most chosen medium by parents, and saline by nurse teacher. As a storage media emergency medical technicians used saline the most, while emergency medical doctors used only saline when they failed to replant avulsed teeth. There is a need to improve the knowledge of caregivers, emergency medical technicians, and emergency medical doctors regarding the storage media for avulsed teeth.