• Restorative Dentistry and Endodontics
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• 제19권2호
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• pp.568-584
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• 1994

Bacteria have been regarded as major etiolgic factors in root canal infections. Infected root canal flora from thirteen patients who had visited to conservative department of Wonkwang dental hospital were cultured on blood agar plates. Cultued microorganisms were isolated and identified with Gram stain and biochemical tests using Vitek Systems(BioMeriux, MO, USA); Antibiotic susceptibillity was performed with disk diffusion and broth microdilution using Vitek Systems. Gram positive cocci(65 %) were predominant, which were composed of 6 Streptococcus viridans group, 5 Staph. spp., and 4 Enterococcus faecium, in the isolatd 23 strains. Gram negative rods (26 %) were the next common bacteria, which were composed of 5 non - fermentative Gram negative rods, and 1 Enterobacter cloacae. Most strains of S. viridans group and E. faecium were susceptible to antibiotics including penicillin. But strains of Staphylococcus spp. and non - fermentative Gram negative rods showed marked resistance to antibiotics except tetrancyclin and cefotaxime. Most results between disk diffusion and microdilution were all agreed, but the results of non - fermentative Gram negative rods were susceptible to cefotaxime in disk diffusion method but resistant in microdilution.

• Restorative Dentistry and Endodontics
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• 제44권3호
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• pp.29.1-29.7
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• 2019

Endodontic microsurgery is defined as the treatment performed on the root apices of an infected tooth, which was unresolved with conventional root canal therapy. Recently, the advanced technology in 3-dimensional model reconstruction based on computed tomography such as cone beam computed tomography has opened a new avenue in application of personalized, accurate diagnosis and has been increasingly used in the field of dentistry. Nevertheless, direct intra-oral localization of root apex based on the 3-dimensional information is extremely difficult and significant amount of bone removal is inevitable when freehand surgical procedure was employed. Moreover, gingival flap and alveolar bone fenestration are usually required, which leads to prolonged time of surgery, thereby increasing the chance of trauma as well as the risk of infection. The purpose of this case report is to present endodontic microsurgery using the guide template that can accurately target the position of apex for the treatment of an anterior tooth with calcified canal which was untreatable with conventional root canal therapy and unable to track the position of the apex due to the absence of fistula.

• Restorative Dentistry and Endodontics
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• 제22권2호
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• pp.761-768
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• 1997

Microorganisms and their by-products are considered to be the major causes of pulpal and periapical pathosis. The role of microorganisms in endodotic infection has been studied regarding the prevalence of particular organisms found in root canal and periapical lesions. The aim of this study was to investigate the effect of culture supernatants of several oral microorganims isolated from infected root canals on the viability of cultured cell lines using colorimetirc assay. S. simulans, S. sciuri, E. faecium, S. intermedius, S. mitis, S. sanguis and S. uberis were incubated in Todd-Hewitt broth for 16 hours. 20 and 100ul of filtered bacterial cell culture supernatants were added to MK and Hep-2 cells. Cell viability was measured using MIT colorimetric assay. 20ul and 100u1 of S. sanguis supernatant showed significant cytotoxicity compared to control on MK cells. 100ul of S. sanguis supernatant significantly depressed viability of HEp-2 cells. E. faecium and S. intermedius did not affect the viability of MK and HEp-2 cells.

• Restorative Dentistry and Endodontics
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• 제22권1호
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• pp.413-427
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• 1997

Porphyromonas endodontalis and Prevotella intermedia are black-pigmented anaerobic gram negative rods which have been isolated from infected root canals and submucous abscesses of endodontic origin. And they are associated with clinical symptoms such as pain, percussion, and foul odor. It has been reported that there are 3 serotypes according to capsule membrane in P. endodontalis and 2 DNA homology groups and 3 serotypes in P. intermedia, but there is no data available regarding genetic diversity for the species P. endodontalis and P. intermedia. The purpose of this study is to investigate genetic diversities between individual strains of P. endodontalis and P. intermedia which are indistinguishable by serotyping and biotyping using bacterial DNA restriction endonuclease analysis. 45 teeth with at least one clinical symptoms, with single canal, and with pulp necrosis were sampled. For sampling bacteria, access cavity was prepared after disinfecting tooth and its surroundings. Then the paper point was inserted to the apex of the canal, leave there for 15 seconds, and finally it was placed into PRAS Ringer's solution and PBS solution. P. endodontalis and P. intermedia were identified by biochemical test and IIF after subculturing black and brown colonies which were produced after 7 days of incubation on BAP in anaerobic chamber. P. endodontalis and P. intermedia strains were grown in BHI broth and whole genomic DNA was extracted by phenol-chloroform extraction technique and digested by restriction endonuclease, Eco RI and Pst I. The resulting DNA fragments were separated by agarose gel electrophoresis, stained with EtBr and photographed under UV light. The results were as follows : 1. In both P. endodontalis and P. intermedia, different serotypes could be found within a root canal of same patient. 2. There were obvious genetic heterogeneity within a patient and within a serotype in both P. endodontalis and P. intermedia. 3. P. endodontalis serotype c, isolated from different patients, exhibited limited genotypic diversity.

• 대한소아치과학회지
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• 제41권4호
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• pp.335-343
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• 2014

재생적 근관치료는 치수 괴사를 보이는 미성숙 영구치 치료에 있어서 괴사된 치수를 치유하고 계속되는 치근의 발달을 유도할 수 있다. 그러나 여기에는 몇 가지 단점과 불리한 결과들이 있다. 이 중 재생적 근관치료에 가장 큰 임상적 부작용은 minocycline과 MTA에 의한 변색이다. 본 증례에서는 재생적 근관치료 후에 나타나는 치관 변색을 방지하기 위해 minocycline을 clindamycin으로 대체한 triple antibiotics와 칼슘 지르코늄 알루민산염 시멘트인 Retro MTA를 사용하였다. 치수 괴사된 미성숙 영구치에서 근관 와동 형성 및 근관 세척 후 수정된 triple antibiotics를 적용하고, 혈병 또는 콜라겐 스펀지를 스캐폴드(scaffold)로 하여 Retro MTA로 근관을 폐쇄하였다. 정기적인 검진 결과 미성숙 영구치의 치근 성장 및 정상적인 치아 주위 조직들이 관찰되었으며, 치관 변색 없이 모두 양호한 치유 결과를 얻었다.

• 대한치과보존학회:학술대회논문집
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• 대한치과보존학회 2003년도 제120회 추계학술대회 제 5차 한ㆍ일 치과보존학회 공동학술대회
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• pp.607-607
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• 2003

The purpose of this presentation is to investigate whether the certain therapy resistant bacteria can impair the immune defense system in the pariapical tissue. Recent studies have reported that the facultative or obligatory anaerobic bacteria such as Fusobacterium nucleatum, Enterococcus faecalis and Actinomyces species and Gram positive facultative bacteria Enterococcus faecalis have been shown to dominate in persistent periapical lesion and usually recovered from failed root canal treated cases. Moreover, E. faecalis has been reported to withstand the antimicrobial agent and endure potential starvation and resist the antibacterial effect of calcium hydroxide intracanal medication.(omitted)

• Restorative Dentistry and Endodontics
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• 제14권1호
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• pp.85-96
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• 1989

In the Infected root canals, the majority of the isolated bacteria are either strict anaerobes or microaerophilic organisms. Among thease, Black-pigmented Bacteroides species are the most important and have relation with clinical symptoms. The purpose of this study were to investigate on the 7 different types of bacteria which include Black-pigmented Bacteroides - Black--pigmented Bacteroides, Actinobacillus actinomycetemcomitans, Streptococcus, Capnocytophaga, Eiknella corrodens, Fusobacterium, Actinomyces - and the interrelationship between these 7 bacterical species, and to compare Black-pigmented Bacteroides with the clinical symptoms in infected root canals. The canal contents of 15 necrotized teeth with 8 clinical symptoms were sampled and cultured aerobically and anaerobically for growth in 7 selective agar plates for 7 bacterial species. Black-pigmented Bacteroides and Streptococcus subspecies were identified by biochemical tests. The results were as follows; 1. 70.51% of the bacteria isolated were anaerobes and 29.49% were aerobes. 2. B. loescheii, B. intermedius, B. denticola were isolated in 8 cases, Streptococcus was isolated in 8 cases, Fusobacterium was isolated in 6 cases, Actinomyces was isolated in 5 cases and Eiknella corrodens, Actinobacillus actinomycetemcomitans, Capnocytophaga were not isolated. 3. There were mutual inhibition of growth between Black-pigmented Bacteroides and Streptococcus. (P<0.01) But Actinomyces and Fusobacterium showed mutual aids for growth. (P<0.05) 4. Black-Pigmented Bacteroides was found to be related both to sinus tract formation and to apical sensitivity to palpation.(P < 0.05).

• Restorative Dentistry and Endodontics
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• 제28권4호
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• pp.303-313
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• 2003

It has been documented that periodontopathic bacteria are also implicated in endodontic infections. 168 rDNA gene-directed PCR was to examine the prevalence of periodontopathic bacteria including Actinobacillus actinomycetemcomitans (Aa), Prevotella intermedia (Pi), Prevotella nigrescens (Pn), Porphyromonas gingivalis (Pg), Porphyromonas endodontalis (Pe), and Treponema denticola (Td) in the root canals of 36 endodontically infected teeth having apical lesions with or without clinical symptoms like pain, swelling, and fistula. 1. In 36 infected root canals, most frequently detected bacterial species was Pg (61.1%), followed by Td (52.8%) and Pe (38.9%). 2. Of 36 infected root canals, Aa was detected in 6 canals (16.7%) of the teeth, all of which showed clinical symptoms. 3. Of 36 infected root canals, Pi and Pn were found in 4 03.9%) and 5 (33.3%), respectively. Notably, prevalence of Pn in the symptomatic teeth was 50.0%. 4. One of black-pigmented anaerobic bacteria (BPB) including Pi, Pn, Pe, and Pg was detected in all of the teeth that showed pain or especially swelling but not fistula. It was, however, found that prevalence of BPB in the asymptomatic teeth or the teeth with fistula was only 40%. 5. Pe and Pg were detected in the teeth regardless of the presence or absence of symptoms. 6. Td was detected in the teeth regardless of the presence or absence of symptoms. High prevalence of BPB in the symptomatic teeth but low in the asymptomatic teeth suggests that BPB may play an important role in the pathogenesis of periapical lesions.

• Restorative Dentistry and Endodontics
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• 제18권2호
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• pp.377-386
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• 1993

The purpose of this study was to evaluate the disinfection efficacy of root canal irrigation method and irrigation solution in infected root canals. Access cavity were prepared in single-rooted extracted human teeth and each canals were prepared with step-back method and sterilized with ethylene oxide gas. Prepared teeth were experimentally inoculated in the canals for 30 minutes with four aerobes(Streptococcus mutans, Stapylococcus aures, Streptococcus sanguis, and E. coli) and two anaerobes(Streptoccus intermedius, and Clostrium perfringens). Normal saline, 3% $H_2O_2$, and 3% NaOCl were used as irrgation solutions. And root canals were irrigated with each irrigation solutions manually with disposible syringe or ultrasonic instument. (Apoza Uitrasonc, Taiwan). The irrigation effect on the eradication of S. aures and S. intermedius with normal saline was not similar between manual method and ultrasonic method. No significant differences were observed in the eradication of E. coli and C. perfringens among the irrigation solution and irrespective of the irrigation methods. In S. aurues and S. mutans, there was somewhat different eradication effect according to irrigation solutions, but there was no significant difference between manual method and ultrasonic methods. These results suggest that ultrasonic irrigation method with saline is more effective in some strains than manual irrigation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권4호
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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.