• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.55-70
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• 1995

Periapical lesions develop as a result of immunopathologic response to irritants from infected root canal systems. Removal of these irritants from the root canal system and sealing the root canal space may induce he31ing of the periapical lesions. 83 periapical lesions diagnosed as periapical abscess, periapical granuloma, chronic nonspecific inflammation, fibrosis and periapical Cyst were evaluated for the distribution of immunoglobulin containing cells. The influence of the state of root canal treatment on the distribution of immunoglobulin containing cells has evaluated. All lesions were divided into a group with no treatment, a group with canal enlargement, a group filled with gutta percha, and a group filled with Vitapex(calcium hydroxide). The distribution of immunoglobulin-containing cells according to the presence of pain and fistula was also evaluated. The following results were obtained. 1. Statistically significant difference in the distribution of immunoglobulin-containing cells among periapical abscess, periapical granuloma, chronic nonspecific inflammation/fibrosis and periapical cyst were found.(Kruskal-Wallis analysis, P<0.05) The number of immunoglobulin-containing cells in fibrosis was remarkably lower than that of periapical abscess, granuloma and cyst. 2. IgM and IgA containing cells were predominantly observed in periapical abscesses and periapical cysts, respectively. 3. All periapical lesions showed a large number of IgG containing cells followed by IgM, IgA and IgE containing cells. 4. There was a decrease in all Ig-containing cells in the group with canal filling compared to groups without treatment or with enlargement. That is, there is a decrease in Ig-containing cells as treatment progresses. 5. No significant correlation existed between the presence of pain and fistula and the distribution of immunoglobulin containing cells in periapical lesions.(t-test) Results appear to support that immune response are actively involved in the development and progress in periapical lesions. The fact that distribution of immunoglobulins differ according to the state of endodontic treatment suggests that root canal treatment may alter the humoral immune response of the periapical lesions.

• The Journal of the Korean dental association
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• v.41 no.9 s.412
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• pp.631-636
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• 2003

Bacteria play a major role in the etiology of apical periodontitis. Traditionally it has been held the microorganisms are present in necrotic tissue in the root canal system and in tubules of the root dentin whereas the periapical tissues are free of bacteria. However, it is reported the presence of bacterial in the periapical lesions. They may form the biofilm and survive in the periapical tissues. Especially high incidence of biofilm is reported in the refractory periapical lesions. treatment was presented in the left maxillary first premolar with a long-standing fistula and apical calculus. Also. the role of biofilm and its treatment were discussed.

• Journal of the korean academy of Pediatric Dentistry
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• v.2 no.1
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• pp.67-75
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• 1975

The conserative treatment of the necrotic and infected primary molars is often necessary in order to avoid extractions which may lead to inability to masticate or loss of space and subsequent problems concerning the development of the occlusion in the permanent dentition. The purpose of this study was to evaluate the clinical significance of the conservative treatment of the infected primary molars with necrotic pulps employing the formocresol pulpotomy technique same as in vital teeth and surgical intervention in the cases with a parulis, fistula or cellulitis. The materials consisted of 25 primary molars of 9 boys and 4 girls ranging in age from 4 to 7 years. This study included clinical and radiographic observation at 3-month intervals postoperatively. The following results were obtained. 1. Clinically, 20 cases of 25 were successful, exhibiting no clinical problems such as fistula, mobility, toothache and tenderness to percussion, etc. 5 cases were regarded as failures. 2. Radiographiclly, 14 cases revealed normal features, in 6 cases slight rarefaction was observed in the periapical and interradicular region, and marked periapical and interradicular rarefaction was observed in 5 cases. 3. Marked bony deposition was observed in the periapical and interradicular regions in all the remainder except for 5 failurese. 4. Pathologic root resorption was observed in 2 cases. 5. No alveolodental ankylosis was observed. 6. Regeneration of the dental sac of the permanent tooth was observed in 1 case of 2 cases which had revealed loss of the dental sac.

• Restorative Dentistry and Endodontics
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• v.28 no.4
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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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• v.15 no.1
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• pp.175-186
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• 1990

The purpose of this study was to determine whether any clinical factors or conditions are associated with an increased incidence or degree of pain occuring during endodontic treatment in patients who begin treatment with no symptoms. The 260 teeth of 256 patients were surveyed and statistical analysis was used to determine whether a significant relationship existed between pain and any recorded clinical factors or conditions. The following conclusions were drawn. 1. No significant relationship between interappointment pain and any of the analyzed clinical factors or conditions except for fistula formation could be determined. 2. The presence of a draining fistula from a periapical lesion significantly decreased the posttreatment pain. 3. The judicious use of canal irrigants and canal medicaments is not associated with an increased incidence or degree of interappointment pain.

• Archives of Craniofacial Surgery
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• v.19 no.4
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• pp.291-295
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• 2018

Dental origins are a common cause of facial cutaneous sinus tracts. However, it can be easily overlooked or misdiagnosed if not suspected by a surgeon who is not familiar with dental origins. Cutaneous odontogenic sinuses are typically nodulocystic lesions with discharge and are most frequently located on the chin or jaw. This article presents two cases of unusual cutaneous odontogenic sinus presentations, as deep dimpling at the middle of the cheek. The patients were undergone surgical excision of sinus tract and dimpling immediate before and after treatment of causal teeth and the lesions resolved without recurrence. Surgeons should consider dental origins of facial dimpling lesions with discharge and provide appropriate treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.1
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• pp.51-56
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• 2021

Due to their rarity and the lack of associated dental symptoms, odontogenic cutaneous sinus tracts (OCSTs) are often misdiagnosed and confused with cutaneous lesions or non-odontogenic infections. It has been estimated that 50% of individuals affected by OCSTs are subjected to inappropriate treatments before the correct diagnosis is established. We describe the diagnosis and treatment of two cases of OCSTs. By using a computed tomography (CT) with soft tissue window setting, the extent of cortical bone destruction and the path of the sinus tract in the soft tissue was easily identified. Thus, we recommend the use of imaging techniques such as CT, which can confirm the odontogenic origin and the exact location of the OCST.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.6 no.1
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• pp.10-14
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• 2010

Vitamin D-resistant rickets(VDRR) is hereditary disease manifesting marked hypophosphatemia caused by renal tubular loss of phosphate into urine and an associated decrease in the calcium and phosphorous ion product. VDRR is identified by clinical symptoms, such as in the limbs, gait disturbance, dwarfism, familial occurrence, bowlegs, and knock-knees, as well as by laboratory findings. Dental findings are enlarged chambers and extension of the pulp horns into the cusp tips in both the primary and the permanent dentition in contrast to the vitamin D-deficient rickets. The major oral manifestations are multiple spontaneous abscesses in a caries-free dentition. We reported the clinical features and treatment of a 6-year-old boy with vitamin D-resistant rickets referred to the department of pediatric dentistry in Kyung Hee University for multiple spontaneous periapical abscesses and gingival fistula without severe dental caries.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.1
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• pp.108-112
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• 2000

Hypophosphatemic rickets is lack of reponse to physiologic doses of vitamin D, different from the vitamin D-dependent rickets. It is inherited in an X-linked dominant fashion. The prime features of this disorder are lowered serum phosphate levels, elevated serum alkaline phosphatase and normal serum calcium levels. The dental manifestation often include apical radiolucencies, abscess and fistulas of clinically sound teeth. Dental radiographs show ricketic bone trabeculations, abscent or abnormal lamina dura and abnormal cementum. This case which was diagnosed to hypophosphatemic rickets, showed multiple spontaneous periapical abscess and gingival fistula enlarged pulp chambers, extension of the pulp horns into the cusp tips and delayed eruption.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.298-304
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• 2009

XLH (X-linked hypophosphatemic rickets) is a form of rickets which is resistant to the usual dose of vitamin D and inherited in a X-linked dominant manner. It is also known as vitamin D-resistant rickets or familial hypophosphatemic rickets. Here we report a 6-year-and-6-month-old female patient of XLH who is diagnosed with in SNUB. She was referred from local clinic for impaction of maxillary left permanent incisor and its treatment. She presents bowing deformities of the legs, short stature, enlargement of wrist and ankles and spontaneous dental abscesses of clinically sound teeth delayed eruption, taurodontism, delayed apical closure, enlarged pulp chambers, and absent or poorly defined lamina dura. The purpose of this case is to review the literatures of XLH and report the dental and medical characteristics of this patient.