• Journal of Periodontal and Implant Science
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• 제35권1호
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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.

• Imaging Science in Dentistry
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• 제54권1호
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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 Periodontal and Implant Science
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• 제32권4호
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• pp.745-752
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• 2002

Osteomyelitis is an exhaustive disease whose main feature is an inflammation of inner part of bone, bone marrow. In oral and maxillofacial area, we have maxillary and mandibular osteomyelitis and the latter is dominant because of its impaired blood supply. The main cause of osteomyelitis is a bacterial infection and the ways of infections are by periapical odontogenic infection, fracture, post-operative complication, and periodontal disease. The predominant etiologic factor is periapical odontogenic infection mostly caused by advanced dental caries. It is generally believed that periodontal disease could be a cause of osteomyelitis. But periodontal disease is usually confined to the alveolar bone area and not extends to the underlying bone marrow. Accordingly periodontal infection per se rarely cause produce oseomyelitis. Even though osteomyeltis could be occurred by periodontal disease, its virulence of infection is milder than periapical odontogenic infection. So it usually provokes sclerosing or hyperplastic osteomyelitis rather than suppurative type. We had a case of suppurative osteomyelitis caused by periodontal disease and treated it with periodontal and oral and maxillofacial surgical method.

• Restorative Dentistry and Endodontics
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• 제38권2호
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• pp.90-92
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• 2013

Although periapical inflammatory lesions are usually resulted by infection in the root canal system, this rare case showed that a periapical lesion related to an infected tooth may cause pulpal necrosis in adjacent intact tooth, with no history or clinical signs of caries, disease, trauma or developmental anomaly. This case also suggests that the periapical lesion can be treated conservatively, without surgical intervention. Furthermore, this case highlights the importance of prompt treatment of apical periodontitis before the lesion becomes extensive as well as follows up of large lesions.

• Restorative Dentistry and Endodontics
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• 제42권2호
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• pp.111-117
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• 2017

Objectives: Periapical lesions, including periapical cyst (PC), periapical granuloma (PG), and periapical abscess (PA), are frequently affected by chemical/physical damage during root canal treatment or severe bacterial infection, and thus, the differential diagnosis of periapical lesions may be difficult due to the presence of severe inflammatory reaction. The aim of this study was to make differential diagnosis among PC, PG, and PA under polarizing microscope. Materials and Methods: The collagen birefringence patterns of 319 cases of PC (n = 122), PG (n = 158), and PA (n = 39) obtained using a polarizing microscope were compared. In addition, 6 cases of periodontal fibroma (PF) were used as positive controls. Results: Collagen birefringence was condensed with a thick, linear band-like pattern in PC, but was short and irregularly scattered in PG, and scarce or absent in PA. PF showed intense collagen birefringence with a short, palisading pattern but no continuous band-like pattern. The linear band-like birefringence in PC was ascribed to pre-existing expansile tensile stress of the cyst wall. Conclusions: In this study all PCs (n = 122) were distinguishable from PGs and PAs by their characteristic birefringence, despite the absence of lining epithelium (n = 20). Therefore, the authors suggest that the presence of linear band-like collagen birefringence of the cyst wall aids the diagnostic differentiation of PC from PG and PA.

• 대한소아치과학회지
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• 제32권2호
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• pp.224-228
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• 2005

유치의 치수 감염을 적절히 치료하지 않으면 영구 계승치의 저형성이나 저석회화 같은 법랑질 형성부전, 치배의 위치변화, 맹출 부진이나 맹출 정지 같은 많은 합병증을 초래할 수 있다. 이 중에서도 계승 영구치배의 위치변화는 선행 유치의 변성된 치수로 인한 위치변화가 가장 많다. 본 증례는 조선대학교 치과병원 소아치과에 내원한 환아 중 유전치의 치근단 병소로 인해 계승영구전치 치배의 위치변화가 초래된 것으로 사료되어 유치 치료의 중요성을 문헌고찰과 함께 보고하는 바이다.

• 대한치과의사협회지
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• 제58권6호
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• pp.336-345
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• 2020

Peri-apical implant lesion, also known as 'retrograde peri-implantitis' can occur with multifactorial etiological factors. The purpose of this case report is to demonstrate resolution of periapical implant lesion by removal of causative factors and saving implant by regenerative therapy. A 54-year old male patient with mild dull pain around implant on the right mandibular second premolar area due to persistent peri-apical infection of the adjacent first premolar was treated. Extraction of tooth with symptomatic apical periodontitis and regenerative therapy on the buccal fenestration area of the implant and extraction site were performed. After 6-month reentry, notable regenerated bone tissue around implant was found, and implant placement on the previous extraction site was performed. After 14-month follow-up from the regenerative therapy, neither biological nor mechanical complication could be found around the implant, evidenced by high implant stability, normal clinical probing depth, and absence of discomfort spontaneously and during masticatory function. In conclusion, surgical intervention including regenerative therapy using bone graft and barrier membrane on periapical implant lesion can be suggested as one of the treatment options considering the extent of periapical lesion.

• Journal of Oral Medicine and Pain
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• 제38권2호
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• pp.143-147
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• 2013

측두하악장애 중 개구제한은 일반적으로 저작근, 측두하악관절의 통증, 비정복성 관절원판변위, 측두하악관절의 유착이나 강직, 저작근의 근경축 등에 의해 발생한다. 하지만 이비인후과적인 질환, 신경 및 혈관질환, 종양, 염증, 감염 등에 의해 측두하악장애와 유사한 통증 및 개구제한이 유발 될 수 있다. 따라서 병력 조사 및 임상 검사 시 이러한 이차적 질환에 대한 고려가 필요하다. 특히 초진 시 전형적인 측두하악장애의 소견을 보인다고 할지라도 적절한 치료 및 환자의 자기 관리에도 불구하고 증상의 호전이 없거나 지속적인 악화 소견을 보이는 경우에는 염증, 감염, 종양 등의 가능성에 관한 포괄적인 재평가가 필수적이다. 본 증례에서는 제 3 대구치의 치근단 농양이 익돌하악간극(pterygomandibular space)으로 확산되어 발생한 내익돌근(medial pterygoid muscle)의 통증 및 개구제한에 관하여 경험하였기에 이를 보고하고자 한다.

• 한국미생물·생명공학회지
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• 제32권2호
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• pp.195-198
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• 2004

Molec-ular analysis was performed on the microflora found In the necrotic pulpal tissue collected from 5 infected root canals that were diagnosed as a periapical abscess. 16S rRNA coding gene (rDNA) library construction and sequencing were performed in order to identify the microflora, The 16S rDNA sequences from 278 clones were identified by a comparison with the database sequence in GenBank. Three phylum and 31 species, which were related to the oral microflora, were identified from the 3 samples (No. 87, 105, and 115). Dialister invisus (5.6％), Peptostreptococcus micron (18.3％), and Veillonella sp. (3.3％) were the organism present in all tee samples. Lac-tobacillusfementum (2.8％),Eubacterumsp./E. infirmum (6.7％), Shuttleworthiasatelles (3.9％), Psudorarnihacfer alactoiyticus (13.3％), Bulleidia moorei (2.8％), and Prevotella denticola (1.1％) were found in two samples. Two phylum and low species of environmental microflora were identified from 2 samples (No.95 and 101). The reason for this might be contamination of the samples with dental water. These results showed that molecular analysis could reveal more diverse microflora that are associated with endodontic infections than that revealed by conventional cultural methods. In addition, these results may of for the basic data to epidemiological studies related with endodontic infection.

• 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.