• 대한치주과학회:학술대회논문집
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• 2004.11a
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• pp.49-49
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• 2004

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.177-185
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• 2005

The purpose of the study was to investigate the influence of an endodontic infection on presence of furcation involvement in periodontally-involved mandibular molars. All first and second mandibualr molars in 45 patients were selected if at least one was root-filled or had a possible periapical radiolucency. The sample consisted of patients from a referral population at a periodotnal clinic which represented an adult population with a mean age of 47.5 years (range 31 to 63) For mandibular molars with periapical destruction at both roots, frequency of horizontal furcation depth ${\geqq}$ 3 mm was significantly more compared to teeth without periapical destruction. Mean periodontal probing depth was significantly greater at mandibular molars with periapical destruction. It is suggested that a root canal infection in periodontitis-involved molars may potentiate periodontitis progression by spreading of endodontic pathgens through patent accessory canals and dentinal tubules. In conclusion, an endodontic infection in mandibular molars was found to be associated with additional attachment loss in the furcation area, and may thus be considered to be one of several risk factors influencing the prognosis of molars in periodontitis-prone patients.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.4
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• pp.628-633
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• 2005

Deep caries in primary molars without early intervention frequently induce a pulpal disease and consequent furcation lesion with fistulous openings Up to now, majority of the textbooks on pediatric dentistry and literatures have described that extraction of the inflicted teeth is indicated for these cases and in reality these teeth have usually been extracted in the dental clinics. However when we recognize the excellent capacity of bone regeneration in children and the presence of numerous accessory canals at furcation areas, the removal of infection source in pulp by pulpectomy and inflammatory granulation tissues at furcation areas by furcal curettage might open the possibility of rapid healing at the furcation regions. In this report, 10 cases of primary molars in 3 to 6-year-old children with fistulous openings and furcation lesions in moderate size of 2 to 4mm in depth radiolucency at furcation lesion have been chosen. After pulpectomy and furcal curettage, evident bone regeneration was detected radiographically in all cases. Through the cases, we came to realize that all the cases previously described are not the indications of extraction and this approach could make many cases with pulp and furca combined lesions survive and remain healthy in the children's dental arches. However, in order for this approach to acquire objective appropriateness, it is thought that more scrupulous evaluation is desirable on the various factors regarding the indication such as the extent of furcation lesions, absorption status of teeth, amount of covering bone on succeeding teeth and so on.

• Restorative Dentistry and Endodontics
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• v.39 no.2
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• pp.115-119
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• 2014

As long as the prognosis of teeth remains a matter of concern, the endodontic-periodontal relationship will be considered a challenge for the clinician. Many etiologic factors, including bacteria, fungi, and viruses, plus other contributing factors, such as trauma, root resorptions/perforations, and dental malformations, play a role in the co-occurrence of endodontic and periodontal lesions. Whatever the cause, a correct diagnosis on which to base the treatment plan is the key to successful maintenance of the tooth. This article reports the successful endodontic management of a furcation lesion in a mandibular molar that was nonresponsive to a previous periodontal surgical graft. The case had presented a diagnostic challenge for the clinicians, and this article reviews the key points that can lead to a correct diagnosis and treatment planning.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.3
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• pp.482-490
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• 2006

Deep caries in primary molars without early intervention frequently induce a pulpal disease and consequent abscess lesion in surrounding tissue. Especially in many furcation radiolucent lesions of primary molars, accessory canals in furcation areas of primary molars play an important role in theses pathological progress. Although the studies of these communication canals in furcation area of human permanent molar well documented, there has been little research showing their existence in primary molar. For the purpose of understanding the morphological characteristics of accessory canals at furcation areas of primary molars and examining its frequency and patency, 52 specimen teeth were observed under the scanning electro-microscope and tested with dye penetration under vacuum pressure, and obtained the results as follows : 1. In SEM study, the frequency of accessory foramina viewed from the external and internal furcation area was 60% and 35% respectively. Likewise the diameter of the accessory canals was within the range of $11{\sim}107{\mu}m$ and $12{\sim}62{\mu}m$ respectively. 2. The frequency of patent accessory canals evidenced by the dye penetrated under the vacuum suction at furca areas in primary molars was 50% among the 20 specimen teeth tested.

• Journal of Periodontal and Implant Science
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• v.46 no.2
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• pp.107-115
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• 2016

Purpose: The aim of this study was to evaluate and compare tooth surface characteristics in extracted human molars after cervical enamel projections (CEPs) were removed with the use of three rotating instruments. Methods: We classified 60 extracted molars due to periodontal lesion with CEPs into grade I, II, or III, according to the Masters and Hoskins' criteria. Each group contained 20 specimens. Three rotating instruments were used to remove the CEPs: a piezoelectric ultrasonic scaler, a periodontal bur, and a diamond bur. Tooth surface characteristics before and after removal of the projections were then evaluated with scanning electron microscopy (SEM). We analyzed the characteristics of the tooth surfaces with respect to roughness and whether the enamel projections had been completely removed. Results: In SEM images, surfaces treated with the diamond bur were smoothest, but this instrument caused considerable harm to tooth structures near the CEPs. The piezoelectric ultrasonic scaler group produced the roughest surface but caused less harm to the tooth structure near the furcation. In general, the surfaces treated with the periodontal bur were smoother than those treated with the ultrasonic scaler, and the periodontal bur did not invade adjacent tooth structures. Conclusions: For removal of grade II CEPs, the most effective instrument was the diamond bur. However, in removing grade III projections, the diamond bur can destroy both adjacent tooth structures and the periodontal apparatus. In such cases, careful use of the periodontal bur may be an appropriate substitute.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.1
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• pp.99-107
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• 1995

The aim of this study was to evaluate clinician's detectability in the diagnosis of bone loss in the bifurcation of mandibular molars on periapical radiographs and Digital images. Periapical radiographs were obtained of the first molars in 2 dry mandibles after preparation of bony defects corresponding to degree I, degree II and degree III buccal furcation involvements. The radiographs were randomly presented to 39 clinicians(1 oral radiologist, 4 periodontist, 34 general dentists) who were asked to determine the presence or absence of bone loss. Periapical films were digitized with a TV camera. Digital images were assessed by 15 clinicians(1 oral radiologist, 4 periodontist, 10 general dentists). I. the overall diagnostic accuracy of Digital images for detection of bone loss in the bifurcation of mandibular molars was higher than that of the periapical radiographs. 2. the largest increase in diagnostic accuracy was found between lesion grade II and III on both radiographs and Digital images(P<0.05). 3. there was no significant difference between the standard state and the controlled contrast state on Digital images. 4. the overall diagnostic accuracy of I radiologist and 4 periodontists was better than that of the general dentists for detecting bifurcation involvements.

• Imaging Science in Dentistry
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• v.33 no.2
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• pp.71-77
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• 2003

Purpose : To evaluate and compare the efficacy of digital radiographic images in the detection of bone loss at the bifurcation area of the mandibular first molar with traditional film-based periapical radiographs, Materials and Methods : One dried human mandible with minimal periodontal bone loss around the first molar was selected and an artificial alveolar bone defect at the bifurcation area was serially prepared over 18 steps. Images were taken using a direct CCD-based system and with F-speed periapical films. The images were evaluated by seven interpreters (3 radiologists, 3 periodontologists, and 1 general dentist) using a 5-point confidence rating scale. Results : The readability of both periapical radiographs and digital image increased as the size of the artificial lesion and exposure time increased (p < 0.05). Periapical radiographs offered greater readability of smaller bone defects than digital images, and the coefficient of variation of mean score between periapical radiographs and digital images showed a significant difference. Conclusion : The experimental results indicate that a significant difference in the coefficient of variation of mean score exists between periapical radiographs and digital images, and that traditional film-based periapical images offer greater readability of smaller bone defects than digital images can presently offer.

• Proceedings of the KACD Conference
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• 2002.11a
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• pp.721-721
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• 2002

For about half a century. dental implants made of titanium have developed as a method of restoration for the tooth loss. In these days. the titanium implants seem to be considered as the alternative for the conventional prosthodontics. But its hard to say that the titanium implants are superior to the treatments that preserve the natural tooth. As this is a general opinion among dentists. the implant will not be able to be the alternative for all the prosthetic treatments. Clinically, there are many causes for extracting tooth. The severe destruction of the tooth structure or periodontal diseases leads to inevitable tooth extraction. When the complete cure is doubtful because of narrow intraoral visibility and improper accessibility in approaching to the tooth and periodontal lesion, we. clinicians often inevitably extract tooth. Passive treatments like conventional restoration, curettage or surgical flap cant be the perfect treatments for the tooth that has subgingival root caries or severe periodontal diseases involved furcation. Many clinicians might have been forced to pull out the relatively healthy tooth by the difficulties of approaching to the lesions and poor prognosis. Though the intentional tooth replantation is performed sometimes. as it doesnt have enough scientific foundation. it has not been considered as a popular treatment method yet. I have been felt keenly the necessity of positive tooth preservation, so I have been attempting the treatment that has new concept. calling Natural Tooth Implantation (NTI) clinically. NTI differs from the tooth replantation in the goal for the treatment and biological healing process. Now. I confirm that NT! is a very positive and valid method of tooth preservation. Like you can get from the name. NTI is the dental implant procedure using natural teeth and similar to the healing process of the titanium implants in many aspects. I have been using biocompatible composite resin. DRM. with NTI and got affirmative clinical results from that. So I would like to introduce.roduce.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.269-276
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• 2001

The purpose of this study was to evaluate the clinical validity of multi-rooted teeth subjected to root-resection treatment. Over a period of 1-7 years, 60 root-resected molars in 59 patients were examined clinically and radiographically. All patients were p0eriodically recalled once or twice a year. Root-resections were due to periodontal, more specifically furcal bone loss or marginal bone loss,in 34 cases and extensive dental carious destruction in 10 cases. In other cases,root-resections resulted from 6 cases of root fracture, 6 cases of periodontal-endodontic combined lesion, and 1 case of endodontic problem. Root-resection was carried out on 26 maxillary molars and 34 mandibular molars. The results are as follows; 1. 14 cases(23.3%) were considered failures. 8 cases(13.3%) of them occurred within the first year(8 cases, 13.3%), 4 cases(6.7%)between 1-3 years, and 2 cases(3.3%) between 4-7 years. 2. 8 cases(13.3%) were considered failures due to periodontal reasons, 3 cases(5%) due to root fracture, 2 cases(3.3%) due to endodontic problem, and 1 case(1.7%) due to prosthetic problem. 3. 37 cases(61.7%) showed up for the recall appointments, and the percentage of failures(13.5%) was lower compared with that of all patients(23.3%). The results of the present study indicate that the prognosis of root-resected teeth is favourable if attention is paid to the selection of proper case and to achieving optimal oral hygiene and periodic check up.