• Restorative Dentistry and Endodontics
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• v.43 no.2
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• pp.17.1-17.7
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• 2018

Iatrogenic perforations negatively impact the outcome of endodontic treatments. Studies on prognostic factors showed that perforations in the coronal third of the root with periodontal pocket formation have an unfavorable prognosis. A 36-year-old female was referred for endodontic evaluation of tooth #13 with a history of an iatrogenic perforation, happened 3 years ago. There was a sinus tract associated with perforation, 10 mm probing on the mesial and mesio-palatal, bleeding on probing, radiolucent lesion adjacent to the perforation and complete resorption of the interdental bone between teeth #13 and #12. After the treatment options were discussed, she chose to save the tooth. The tooth was accessed under rubber dam isolation, the perforation site was cleaned and disinfected using 0.5% sodium hypochlorite and sealed with calcium-enriched mixture cement. Eighteen months after treatment the tooth was functional and asymptomatic. The probing depths were normal without bleeding on probing. Radiographically, the interdental crestal bone formed between teeth #13 and #12. Despite all negative prognostic factors in this case (i.e., perforations in the coronal third, pocket formation, and radiolucent lesion), healing was unexpectedly achieved via non-surgical repair of the perforation. Further research on biological aspects of healing in the periodontium following iatrogenic perforations are recommended.

• The korean journal of orthodontics
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• v.31 no.3 s.86
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• pp.325-333
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• 2001

Optimal orthodontic treatment could be possible when a orthodontist can predict and control tooth movement by applying a planned force system to the dentition. The moment to force(M/F) ratio at the bracket, has been shown to be a primary determinate of the pattern of tooth movement. As various n/F ratios are applied to the bracket on the tooth crown, strain distribution in periodontium can be changed, and the center of rotation in tooth movement can be determined. It is, therefore, so important in clinicalorthodontics to know the strain distribution in a force system of a M/F ratio. The purpose of this study was to analyze the strain distribution in orthodontic force system by strain gauge attached to tooth root, and to evaluate the usage of the method. For this study, an experimental upper anterior arch model was constructed, where upper central incisors, on the root surface of which, 8 strain gauges were attached, were implanted In the photoelastic resin, as in the case of 4mm midline diastema. Three types of closing of upper midline diastema closure were compared : 1. with elastomeric chain(100g force) in no arch wire, 2. elastomeric chain in .016“ round steel wire, 3. elastomeric chain in .016”x.022“ rectangular steel wire. The results were as follows. 1. Strain distributions on labial, lingual, mesial and distal root surface of tooth were able to be evaluated with the strain gauge method, and the patterns of tooth rotation were understood by presuming the location of moment arm. 2. Extrusion and tipping movement of tooth was seen in closing in no arch wire, and intrusion and bodily movement was seen with steel arch wire inserted.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.1
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• pp.167-174
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• 2008

Mandibular first molar and primary molars usually have two roots, on the mesial and distal sides. Occasionally, these molars have an extra root located in the distolingual aspect. Prevalence of the 3-rooted first permanent molar shows ethnic variation, ranging from about 3% in Caucasian to about 20% in Mongoloid group, which includes Chinese, Japanese, Eskimo, American and Canadian Indians. The frequency of the mandibular molar with three roots decreases in the order of the first permanent molar, the second primary molar, and the first primary molar. If the mandibular first or second primary molar has an additional distolingual root, the adjacent molars, including the first permanent molar, posterior to it also may have it. Coronal morphologic change can occur in the mandibular first primary molars with three roots: the crown had more triangular-shape compared to the one with two roots, possibly affected by the presence of additional distolingual root. Clinically, exact diagnosis and treatment should be taken with those teeth for pulp canal treatment, extraction, and SS Cr.

• The korean journal of orthodontics
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• v.29 no.6 s.77
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• pp.689-698
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• 1999

Although the purpose of orthodontic treatment is to increase the function and aesthetics of the jaws as well as to increase stability, there are side effects from the treatment itself such as root resorption and alveolar bone resorption. Such resoiption of the apical root is unpredictable and may even proceed into the dentin layer. Once the process has begun, it is irreversible. By evaluating the effects of different oral habits, especially that ef nail biting, and their correlation with the root and the periodontal tissues, the appropriate biomechanics for orthodontic treatment can be taken into consideration. The possibility of root resorption and alveolar bone loss during orthodontic treatment can also be considered. Also, any legal problems that might occur may be pondered as well. Among the male md female patients of the ages 10~15, 63 were chosen as the test group with known nail biting habits at time of examination and within the same age range those without nail biting habits as the control group. The test group was composed of 30 males and 33 females. The control group had 31 males and 32 females. The result from this study were as follows : 1. Of the 63 patients of both the test and control groups, the male-to-female-ratio was 1:1, and had no statistically significant difference in male and female root resorption. 2. In comparing crown length of the test and control groups, no significant difference existed, but in root length, maxillary and mandibular right and left central incisors and mandibular right lateral incisors had a smaller value. (p<0.001) 3. Average crown-to-root ratio of the test group on the periapical view show a noticeably high value for the maxillary and mandibular right and left central incisors and mandibular right and left lateral incisors. (p<0.01) 4. In comparing and evaluating the alveolar bone loss measured from the cemento-enamel junction to the alveolar bone crest, mesial surfaces of the maxillary and mandibular right and left central incisors and distal surface of maxillary right central incisor of the test group showed greater loss of crestal bone than the control. (p<0.05)

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.47-67
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• 1996

The purpose of this study was to observe the effect of $Biocoral^R$ graft and bioglass 45S5 graft in combination with ePTFE membrane in periodontal osseous defects for new bone formation. Nine healthy dogs were used. Under general anesthesia, 3-wall defects were created on the mesial and distal surfaces of the maxillary right canines, the mesials of the maxillary right second premolars, the distals of the mandibular right canines and the mesials of the mandibular right third premolars. To induce periodontitis, a silicone rubber, $Provil^R$ light body, was injected under pressure into the defects. Ninety days later, $Provil^R$was removed and followed by thorough root planing. The followings were then applied in the mesial and distal defects of the maxillary right canines, the mesials of the maxillary right second premolars, the distals of the mandibular right canines and the mesials of the mandibular right third premolars by random selections : 1) ePTFE membrane only application, 2) $Biocoral^R$ graft, 3) $Biocoral^R$ graft and ePTFE membrane application, 4)Bioglass 45S5 graft, 5) Bioglass 45S5 graft and ePTFE membrane application. The membranes were removed 1 month later. The dogs were sacrified at 1, 2 and 3 months following the graft, and block sections were made, demineralized, embedded, stained and examined by light microscope and transmission electron microscope. On the sections from teeth treated with ePTFE membrane only, the defect demonstrated extensive connnective tissue and alveolar bone regeneration. The $Biocoral^R$ graft group demonstrated extensive bone regeneration compared with ePTFE membrane only group. In the $Biocoral^R$ graft plus ePTFE membrane group, regeneration of new alveolus and crest occurred within the defect. As the experimental period lengthened, bone regeneration was increased and bone bridge was formed among the graft particles. The but bioglass 45S5 graft group demonstrated extensive bone regeneration but the amount of new bone was less than that of the $Biocoral^R$ graft group. For the bioglass 45S5 graft plus ePTFE membrane group, the amount of new bone was also increased. As the experimental period lengthened, bone regeneration was increased. Multinucleated giant cells, fibroblasts and macrophages were observed. As the bone formation was increased, the number of such cells was decreased. In conclusion, the $Biocoral^R$ was found better than the bioglass 45S5 for new bone formation, and the use of ePTFE membrane alone or with $Biocoral^R$/bioglass 45S5 can be supported as potential methods of promoting bone formation.

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.41-49
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• 2002

The aim of this study was to compare periodontal conditions around mesially tipped molars by a tipping degree. Patients who had been consecutively treated at the Department of Periodontology, Chonbuk National University Hospital from October 1999 to August 2001 were assessed with radiographs taken at their molar regions. Of all molars investigated, 142 molars of 116 patients tipped mesially more than 10 degrees to the line perpendicular to an occlusal plane were selected for the study. The tipped molars were divided into 2 groups with a reference to a tipping degree, i.e., 66 slightly tipped(group 1 : <$30^{\circ}$) and 76 severely tipped molars (group 2 : ${\geq}30^{\circ}$). Probing depth(PD), plaque retention index(PRI) at mesial surfaces of tipped molars and tooth mobility(TM) were recorded at the clinical examination. Tipping degree(TD) and alveolar bony defect(ABD) at the mesial surface of the molars were measured in a radiograph. The results showed that no statistical differences were found between groups in all measured variables. In Pearson correlation analysis performed in the same group, a positive relationship was shown between PRI and PD in the group 1 and, in the group 2, between PRI and PD as well as PRI and ABD(p < 0.01). However, no statistically significant relationship was found between TD and all other variables in both groups. Within limitations of this study, it may be concluded that tipping degree did not seem to influence periodontal conditions, i.e., PD, ABD and TM of mesially tipped molars per se, but plaque presence/absence seemed to mainly affect the periodontal conditions of the tipped molars.

• The korean journal of orthodontics
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• v.28 no.1 s.66
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• pp.61-74
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• 1998

The Purpose of this study was to investigate the stress distribution and tooth displacement at the initial phase produced by 5 types of molar uprighting springs using finite element method. The three dimensional finite element model of lower dentition, bone and springs was composed of 5083 elements and 2071 nodes. The results were as follows: 1. In case of helical spring and root spring, intrusion of lower canine and first premolar were observed md distal tipping, translation and extrusion of lower second molar were observed. 2. In case of T-loop, modified T-loop and box loop, intrusion and distal translation of lower second premolar were observed, and the largest crown distal tipping and translation of lower second molar were observed in T-loop and the smallest were observed in box loop. 3. In case of T-loop with cinch-bact crown distal tipping and translation of lower second molar were decreased, but extrusion was also decreased. 4. With increase of activation in T-loop, mesial translation and won distal tipping of lower second molar were increased and edentulous space was closing, but distal translation of second premolar was also increased. 5. With increase of tip-back bend in T--loop, distal tipping and translation of lower second molar were increased, but extrusion was also increased more largely.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.27-37
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• 2006

Although the main purpose of periodontal treatment to regenerate is the complete regeneration of periodontal tissue due to periodontal disease, most of the treatment cannot meet such purpose because healing by long epithelial junction. Therefore, diverse materials of resorbable and non-resorbable have been used to regenerate the periodontal tissue. Due to high risk of exposure and necessity of secondary surgical procedure when using non-resorbable membrane, guided tissue regeneration using the resorbable membrane has gain popularity, recently. However, present resorbable membrane has the disadvantage of not having sufficient time to regenerate date to the difference of resorption rate according to surgical site. Meanwhile, other than the structure stability and facile manipulation, acellular dermal matrix has been reported to be a possible scaffold for cellular proliferation due to rapid revascularization and favorable physical properties for cellular attachment and proliferation. The purpose of this study is to estimate the influence of acellular dermal matrix on periodontal ligament, cementum and alveolar bone when acellular dermal matrix is implanted to 1-wall alveolar bone defect. 4 dogs of 12 to 16 month old irrelevant to sex , which below 15Kg of body weight, has been used in this study. ADM has been used for the material of guided tissue regeneration. The 3rd premolar of the lower jaw was extracted bilaterally and awaited for self-healing. subsequently buccal and lingual flap was elevated to form one wall intrabony defect with the depth and width of 4mm on the distal surface of 2nd premolar and the mesial surface of 4th premolar. After the removal of periodontal ligament by root planing. notch was formed on the basal position. Following the root surface treatment, while the control group had the flap sutured without any treatment on surgically induced intrabony defect. Following the root surface treatment, the flap of intrabony defect was sutured with the ADM inserted while the control group sutured without any insertion. The histologic specimen was observed after 4 and 8 weeks of treatment. The control group was partially regenerated by periodontal ligament, new cementum and new alveolar bone. the level of regeneration is not reached on the previous formed notch. but, experimental group was fully regenerated by functionally oriented periodontal ligament fiber. new cementum and new alveolar bone. In conclusion, we think that ADM seems to be used by scaffold for periodontal ligament cells and the matrix is expected to use on guided tissue regeneration.

• Restorative Dentistry and Endodontics
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• v.24 no.2
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• pp.337-345
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• 1999

The purpose of this study was to compare the shape of root canal after instrumentation with some engine driven NiTi files. Thirty narrow and curved canals(15-35 degree) of mesial canals of extracted human mandibular first molars were divided into three groups. Group 1: After radicular access with Gates Glidden drill, apical shaping using step back method with Flexo file Group 2: After radicular access with Gates Glidden drill, apical shaping with Profile .04 Group 3: Canal shaping with GT file and Profile .04. Using modified Bramante technique, the root was sectioned at 2 mm from apical foramen, height of curvature, 2 mm from canal orifice. Canal centering ratio, amount of transport, amount of dentin removed, shape of canal were measured and statistical analysis is done using SPSS Program V 7.5. The results were as follows: 1. Canal centering ratio of group 3 was the lowest at coronal part, but there was no statistical difference. Centering ratio of group 2 was the lowest at curve part, and there was statistical difference between group 1(P<0.05). Centering ratio of group 2 was the lowest at apical part, but there was no statistic difference. 2. Amount of transport of group 3 was the lowest at coronal part, but there was no statistical difference. Amount of transport of group 2 was the lowest at curve part, and there was statistical difference between group 1(P<0.05). Amount of transport of group 3 was the lowest at apical part, and there was statistical difference between group 1 and group 2, group 1 and group 3(P<0.05). 3. Amount of dentin removed of group 3 was the lowest at coronal part, bur there was no statistical difference. Amount of dentin removed of group 2 was the lowest at curve part, but there was no statistical difference. Amount of dentin removed or group 2 was the lowest at apical part, and there was statistical difference between group 1 and group 2, group 1 and group 3(P<0.05). 4. The shape of the canals after instrumentation varied among the groups. The majority of canals at coronal and curve part for group 1 were round in shape(7 in 10), those at apical part were oval(8 in 10). The majority of canals at coronal part for group 2 were round in shape(7 in 10) and there was no difference in the number of shape at other part. There was no difference in the number of shape at every part for group 3. As above results, NiTi rotary instrumentation showed a trend to remain more centered in the canal than SS file instrumentation. At using NiTi file, coronal shaping with Gates Glidden drill was not statistically different from shaping with GT file. But shaping with GT file showed tapered canals, so it may be said that shaping with GT file is a safe and valuable instrumentation method.

• The Journal of the Korean dental association
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• v.56 no.12
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• pp.695-706
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• 2018

Objectives: The purpose of this study was to investigate the ratio of 4 root canals and the incidence of Radix Entomolaris in mandibular first molars and find out anatomical difference according to number of roots by analysis of cone-beam CT images in a Korean population. Materials and Methods: Total 142 images containing mandibular first molars were selected from CBCT images taken from 2013 to 2017 at Gangneung-Wonju National University Dental Hospital. After reconstructing the image with reference to the Cemento-enamel junction, the root canals were detected at the bottom of the pulpal floor and the number of roots and root canals were analyzed. Various lengths and MLO-DLO-DBO angle were measured between each canal orifices and the external contour line of the tooth, and the distolingual canal wall thickness was measured. Student t-test was used for statistical significance. Results: Among the total 142 teeth, 4 canals were 42.2% and Radix Entomolaris was 25.3%. As the results of measuring various lengths and the angle, the distolingual canal orifice in Group 2(with Radix Entomolaris) tends to deviate to the lingual side than the mesiolingual canal orifice and to the mesial side than the distobuccal canal orifice. Besides, thickness of the distolingual canal wall in Group 2(with Radix Entomolaris) was significantly thinner than that of Group 1 at every level except pulpal floor level. Conclusion: It is necessary to consider the difference according to the presence of Radix Entomolaris in endodontic treatment.