• The Journal of the Korean dental association
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• v.54 no.5
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• pp.365-373
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• 2016

Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

• Imaging Science in Dentistry
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• v.54 no.1
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• pp.115-120
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• 2024

Components derived from an infected lesion within the bone can spread through various passages in the mandible, particularly via the mental foramen. Radiologically, the spread of infection is typically nonspecific and challenging to characterize; however, multislice computed tomography (MSCT) can effectively detect pathological changes in soft tissues and the bone marrow space. This report describes the case of a 55-year-old woman who experienced mental nerve paresthesia due to a periapical infection of the right mandibular second premolar. MSCT imaging revealed increased attenuation around the periapical lesion extending into the mandibular canal and loss of the juxta-mental foraminal fat pad. Following endodontic treatment of the tooth suspected to be the source of the infection, the patient's symptoms resolved, and the previous MSCT imaging findings were no longer present. Increased bone marrow attenuation and obliteration of the fat plane in the buccal aspect of the mental foramen may serve as radiologic indicators of inflammation spreading from the bone marrow space.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.515-519
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• 2011

Cemento-osseous dysplasia occurs in the tooth bearing areas of the jaws and is probably the most common fibro-osseous manifestation. They are usually classified into three main groups according to their extent and radiographic appearance: periapical (surrounds the periapical region of teeth and are bilateral), focal (single lesion) and florid (scleroticsymmetrical masses) cemental-osseous dysplasias. Florid cemento-osseous dysplasia clearly appears to be a form of bone and cemental dysplasia that is limited to the jaws. Patients do not have laboratory or radiologic evidence of bone disease in other parts of the skeleton. For asymptomatic patients, the best management consists of regular recall examinations with prophylaxis and the reinforcement of good home hygiene care to control periodontal disease and prevent tooth loss. The treatment of symptomatic patients is more difficult. At this stage, there is an inflammatory component caused by the disease and the process is basically a chronic osteomyelitis involving dysplastic bone and cementum. Antibiotics might be suggested, but are not always effective. Two cases of florid cemento-osseous dysplasia diagnosed in two Korean females are reported with a review of the relevant literature.

• Journal of Oral Medicine and Pain
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• v.38 no.2
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• pp.143-147
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• 2013

Mouth opening limitation is generally caused by masticatory muscle or temporomandibular joint pain, disc dislocation without reduction, adhesion or ankylosis of the temporomandibular joint, and muscle contracture. But otorhinolaryngologic disease, neurologic and vascular disease, tumor, inflammation and infection may cause pain and mouth opening limitation which mimics temporomandibular disorders. Re-evaluation for possibilities of inflammation, infection and tumor should be in cases that do not show symptom improvement or appear with continuous aggravation despite of proper treatment. In this case, we report of medial pterygoid muscle pain and mouth opening limitation caused by periapical abscess of third molar spread to the pterygomandibular space.

• Imaging Science in Dentistry
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• v.37 no.2
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• pp.83-86
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• 2007

Purpose : To evaluate the efficacy of panoramic radiography by comparing the results of clinical examination with radiographic findings. Materials and Methods: We studied 190 patients (20 men and 170 women; mean age, 40 years; range, 22 to 68 years) who visited the health promotion center of Korea Medical Science Institute and were examined both clinically and by panoramic radiography. We compared results from both examinations. Treatment options by clinical examination were described as "no treatment indicated", "treatment of dental caries", "removal of calculus", "treatment of periodontal disease", "prothodontic treatment" and "extraction of the third molar". Findings taken from the panoramic radiography were: dental caries, periapical lesion, alveolar bone loss, calculus deposition, retained root, impaction of the third molar, disease of maxillary sinus, bony change of mandibular condyle, etc. Results: The prevalence of panoramic findings were: 37.9% of dental caries, 17.4% of periapical lesions, 44.7% of alveolar bone losses, 62.6% of calculi deposition, 7.9% of retained roots, 26.8% of third molar impactions, 6.3% of diseases of maxillary sinus, 2.1 % of bony changes of mandibular condlye and 35.8% of miscellaneous lesions. Abnormal conditions revealed by panoramic radiography which had not been discovered on clinical examination were: 24.2% of the patients had dental caries, 17.4% had periapical lesions, 7.4% had calculi deposition, 5.3% had retained roots, 15.3% had third molar impactions. The opposite cases were: 5.2% had dental caries, 12.6% had calculi deposition, and 9.5% had third molar impactions. Conclusion: The use of panoramic radiography as a supplement to the clinical examination might be a valuable screening technique.

• Korean Journal of Digital Imaging in Medicine
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• v.13 no.2
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• pp.91-97
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• 2011

This study was conducted to know usefulness of panoramic radiography by comparing clinical evaluation and dental panoramic radiography in case of oral examination. Following results were concluded by analyzing difference between the result of Clinical evaluation and dental panoramic radiography. According to comparison the result of clinical evaluation and panoramic radiography, In Shin's research, dental caries was higher by 23.1%, periodontal disease was 31.9%, in An's research, dental caries was 24.2%. From new point of view from panoramic radiography, impacted tooth was 33.6%, Sinus abnormalities was 11.6%, periapical lesion was 5.4% in Shin's research and periapical lesion was 17.4%, 3rd molar impaction was 15.3% and retained root was 5.3% in An's research. Any kind of caries were not found in oral examination in the 66.7% of patients among patients with dental root caries in An's research. There were misdiagnose in oral examination(even side(59.5%),proximal side(59.5%), seconds caries(44.0%).

• Imaging Science in Dentistry
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• v.46 no.4
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• pp.229-237
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• 2016

Purpose: The aim of this article is to review a group of lesions associated with periodontal ligament (PDL) widening. Materials and Methods: An electronic search was performed using specialized databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus to find relevant studies by using keywords such as "periodontium", "periodontal ligament", "periodontal ligament space", "widened periodontal ligament", and "periodontal ligament widening". Results: Out of nearly 200 articles, about 60 were broadly relevant to the topic. Ultimately, 47 articles closely related to the topic of interest were reviewed. When the relevant data were compiled, the following 10 entities were identified: occlusal/orthodontic trauma, periodontal disease/periodontitis, pulpo-periapical lesions, osteosarcoma, chondrosarcoma, non-Hodgkin lymphoma, progressive systemic sclerosis, radiation-induced bone defect, bisphosphonate-related osteonecrosis, and osteomyelitis. Conclusion: Although PDL widening may be encountered by many dentists during their routine daily procedures, the clinician should consider some serious related conditions as well.

• Restorative Dentistry and Endodontics
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• v.35 no.6
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• pp.436-444
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• 2010

Objectives: This study aimed to assess prospectively the clinical outcome of nonsurgical endodontic treatment and identify patient- and tooth-related factors, rather than treatment-related factors, that were the best predictors of this outcome. Materials and Methods: The inception cohort comprised 441 teeth (320 patients) and 175 teeth (123 patients) were followed up for 1-2 years. Age, gender, presence of medical disease, number of canals, previous endodontic treatment, presence of sensitivity and pain, pulp vitality, swelling or sinus tract of pulpal origin on the gingiva, periapical radiolucency and tendency of unilateral bite on the affected tooth were recorded at treatment start. Results: The outcome was classified on the basis of periapical radiolucency as healed or non healed. The overall healed rate in these cases, including nonsurgical retreatment, was 81.1%. Four tooth-related factors had a negative impact in the bivariate analysis: previous endodontic treatment, necrotic pulp, preoperative gingival swelling or sinus tract of pulpal origin, and preoperative periapical radiolucency. Stepwise logistic regression analysis including patient-, tooth-related factors and level of the root canal filling as a treatment-related factor showed that preoperative gingival lesion (odds ratio [OR]: 4.4; p = 0.005), preoperative periapical radiolucency (OR: 3.6; p = 0.011), and $\leq$ 1-2 mm under root filling length (OR: 9.6; p = 0.012) were significant predictors of failure. Conclusions: A preoperative gingival lesion of pulpal origin can influence the outcome of nonsurgical endodontic treatment in addition to preoperative periapical radiolucency.

• Restorative Dentistry and Endodontics
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• v.35 no.4
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• pp.238-245
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• 2010

Numerous cases about additional growth of roots or pulp tissue regeneration by using various intracanal medicaments in immature permanent teeth with periapical or pulpal disease have been reported. The underlying mechanism has not been clearly delineated, but it has been widely accepted that undifferentiated mesenchymal cells and stem cells are involved. Moreover, the growth and deposition of osteoid or cementoid tissues have been observed in regenerated pulp and roots. This new and non-invasive treatment has brightened the future of endodontics, and enlarged the vision of regenerative root canal treatment with multi-potent stem cells and various tissue engineering techniques.

• The Journal of the Korean dental association
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• v.52 no.6
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• pp.363-369
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• 2014

The cutaneous sinus tract is an uncommon disease. It is difficult to diagnose exactly of odontogenic cutaneous sinus tract for dentists or dermatologists except experienced clinicians or previously known clinicians. Many patients may be treated with repeated surgical excisions, biopsies, and antibiotic medications, but most of them could be frustrated with the recurrence of disease. There are several methods for diagnosis of odontogenic cutaneous sinus tract - such as GP cone tracing, conventional computed tomography(CT), periapical x-ray imaging, and cone beam computed tomography(CBCT). This case report describes the diagnosis and treatment of odontogenic cutaneous sinus tract that referred from medical doctors.