• Title/Summary/Keyword: Periapical lesion

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Apexogenesis and revascularization treatment procedures for two traumatized immature permanent maxillary incisors: a case report

  • Forghani, Maryam;Parisay, Iman;Maghsoudlou, Amir
    • Restorative Dentistry and Endodontics
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    • v.38 no.3
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    • pp.178-181
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    • 2013
  • Traumatic injuries to an immature permanent tooth may result in cessation of dentin deposition and root maturation. Endodontic treatment is often complicated in premature tooth with an uncertain prognosis. This article describes successful treatment of two traumatized maxillary central incisors with complicated crown fracture three months after trauma. The radiographic examination showed immature roots in maxillary central incisors of a 9-year-old boy with a radiolucent lesion adjacent to the right central incisor. Apexogenesis was performed for the left central incisor and revascularization treatment was considered for the right one. In 18-month clinical and radiographic follow-up both teeth were asymptomatic, roots continued to develop, and periapical radiolucency of the right central incisor healed. Considering the root development of these contralateral teeth it can be concluded that revascularization is an appropriate treatment method in immature necrotic teeth.

Delayed diagnosis of a primary intraosseous squamous cell carcinoma: A case report

  • Abdelkarim, Ahmed Z.;Elzayat, Ahmed M.;Syed, Ali Z.;Lozanoff, Scott
    • Imaging Science in Dentistry
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    • v.49 no.1
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    • pp.71-77
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    • 2019
  • Primary intraosseous squamous cell carcinoma is a rare malignant central jaw tumor derived from odontogenic epithelial remnants. Predominantly, it affects mandible, although both jaw bones may be involved. This report describes a 60-year-old man who was initially misdiagnosed with a periapical infection related to the right lower wisdom tooth. After four months, the patient presented to a private dental clinic with a massive swelling at the right side of the mandible. Panoramic radiographs and advanced imaging revealed a lesion with complete erosion of the right ramus, which extended to the orbital floor. A biopsy from the mandibular angle revealed large pleomorphic atypical squamous cells, which is the primary microscopic feature of a poorly differentiated squamous cell carcinoma.

VITAMIN D-RESISTANT RICKETS : A CASE REPORT (비타민 D 저항성 구루병 환아의 치험례)

  • Kim, So-Jung;Park, Jae-Hong;Kim, Kwang-Chul;Choi, Sung-Chul
    • 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.

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MANAGEMENT OF DENS EVAGINATUS IN PREMOLAR (소구치에 발생한 치외치의 치험례)

  • Ra, Eun-Sun;Kim, Jong-Soo;Kwon, Soon-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.1
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    • pp.110-115
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    • 2003
  • Dens evaginatus is an anomalous tooth development arising during morphodifferentiation. It is most often reported in premolar, and familial occurrence has been reported. The primary dental complication of dens evaginatus is fracture or wear of the tubercle which leads to pulp exposure, pulpal necrosis and periapical infection. Pathosis of the pulp can occur before complete root formation with cessation of root development. A rational and conservative approach to the management of dens evaginatus in vital teeth includes early diagnosis and treatment to prevent fracture or attrition of the tubercle. This treatment would include careful sequential grinding, pulp capping, preventive resin restoration. When presented with a case of dens evaginatus in a nonvital tooth with incomplete root development, the treatment of choice has been extraction, apexification. We report two cases of dens evaginatus that appear in two sisters. In the elder, a periapical lesion on radiographs is shown, and it is treated by calcium hydroxide apexification. The other sister is early recognized of dens evaginatus, it is treated using glass ionomer cement reinforcing with sequential grinding.

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DISTRIBUTION OF ORAL PATHOGENS IN INFECTIONS OF ENDODONTIC ORIGIN (근관감염세균의 분포에 관한 연구)

  • Kim, Seung-Yoon;Choi, Ho-Young;Park, Sang-Hyuk;Choi, Gi-Woon
    • 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.

The effect of non-resorbable barrier membrane on the change of buccal and lingual alveolar bone in immediate implant placement into periapically infected extraction sockets (치근단 병소를 갖는 발치와에 즉시 임플란트 식립 시 비흡수성 차폐막이 치조골의 흡수에 미치는 영향에 관한 연구)

  • Shin, Seung-Yun;Yang, Seung-Min;Kye, Seung-Beom
    • Journal of Periodontal and Implant Science
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    • v.39 no.1
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    • pp.71-76
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    • 2009
  • Purpose: Many researches showed loss of alveolar bone in fresh extraction socket and even in case of immediate implant placement. The aim of this study was to evaluate the effect of non-resorbable barrier membrane on the change of buccal and lingual alveolar bone in immediate implant placement into periapically infected extraction sockets. Materials and methods: Immediate implants were placed into artificially induced periapical lesion of mandibular premolars after complete debridement using buccal bone defect made by a 6mm trephine bur in 4 mongrel dogs. Before flap repositioning, a non-resorbable barrier membrane was placed on the buccal defect in the experimental group. No membrane was placed in the control group. In 12 weeks after placement, the dogs were sacrificed and undecalcified histologic specimens were prepared. The vertical distance from the smooth-rough surface interface(SRI) to gingiva, 1st bone contact and bone crest were measured in buccal and lingual side. The horizontal thicknesses of gingiva and bone at 0, 1, 2 and 3mm below SRI were measured. Results: The buccal bone was resorbed more than lingual bone in both groups and there was statistical significance(p<0.05). The distances from SRI to 1st bone contact were $2.45{\pm}2.35\;mm$ in experimental group and $4.49{\pm}3.10\;mm$ in control group. In all vertical level, lingual bone was thicker than buccal bone(p<0.05). Conclusion: Buccal bone was reduced more than lingual bone in immediate implant placement into periapically infected extraction sockets. Placement of non-resorbable barrier membrane reduced the buccal bone resorption. However there was no statistical significance.

Deep learning convolutional neural network algorithms for the early detection and diagnosis of dental caries on periapical radiographs: A systematic review

  • Musri, Nabilla;Christie, Brenda;Ichwan, Solachuddin Jauhari Arief;Cahyanto, Arief
    • Imaging Science in Dentistry
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    • v.51 no.3
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    • pp.237-242
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    • 2021
  • Purpose: The aim of this study was to analyse and review deep learning convolutional neural networks for detecting and diagnosing early-stage dental caries on periapical radiographs. Materials and Methods: In order to conduct this review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines were followed. Studies published from 2015 to 2021 under the keywords(deep convolutional neural network) AND (caries), (deep learning caries) AND (convolutional neural network) AND (caries) were systematically reviewed. Results: When dental caries is improperly diagnosed, the lesion may eventually invade the enamel, dentin, and pulp tissue, leading to loss of tooth function. Rapid and precise detection and diagnosis are vital for implementing appropriate prevention and treatment of dental caries. Radiography and intraoral images are considered to play a vital role in detecting dental caries; nevertheless, studies have shown that 20% of suspicious areas are mistakenly diagnosed as dental caries using this technique; hence, diagnosis via radiography alone without an objective assessment is inaccurate. Identifying caries with a deep convolutional neural network-based detector enables the operator to distinguish changes in the location and morphological features of dental caries lesions. Deep learning algorithms have broader and more profound layers and are continually being developed, remarkably enhancing their precision in detecting and segmenting objects. Conclusion: Clinical applications of deep learning convolutional neural networks in the dental field have shown significant accuracy in detecting and diagnosing dental caries, and these models hold promise in supporting dental practitioners to improve patient outcomes.

Dental Management in a Patient with Turner Syndrome with Dental Anomalies : A Case Report (치아형태이상을 가진 터너 증후군 환자의 치과적 관리)

  • Lee, Haney;Shin, Seyoung;Kim, Jaegon;Lee, Daewoo;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.3
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    • pp.386-392
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    • 2018
  • Turner syndrome (TS) is a chromosomal disorder caused by monosomy of the X chromosome, with complete or partial absence of the second sex chromosome. Anomalies of root morphology have been found to occur more often in patients with TS, which make endodontic treatment challenging and requires special handling. The patients with TS may also have systematic problems such as cardiac or renal malformations, so in treating these patients it is important for clinicians not only to be aware of the characteristic intraoral findings, but also to make the patients have regular dental check-ups to prevent oral complications in advance. An 12-year-old girl who had been diagnosed with TS at the age of 10 years was referred due to discomfort in the bilateral mandibular premolar regions. Dens evaginatus and taurodontism were detected in all the mandibular premolars characteristically. The bilateral mandibular first premolars had three roots and the bilateral mandibular second premolars had periapical lesion with two roots. Due to the complexity of the root canal anatomy, root canal treatment were completed with a dental microscope to ensure adequate visualization. After 2 years of regular follow-up examinations, there were no clinical sign or symptom associated with the teeth, and no periapical lesion, was found. This case report describes the characteristic oral features and dental management of TS patients.

IDENTIFICATION OF FUSOBACTERIUM NUCLEATUM AND FUSOBACTERIUM NECROPHORUM USING POLYMERASE CHAIN REACTION(PCR) (중합효소연쇄반응(Polymerase Chain Reaction)을 이용한 Fusobacterium nucleatum 및 Fusobacterium necrophorum의 동점에 관한 연구)

  • Kang, Chang-Woo;Park, Dong-Sung;Yoon, Soo-Han
    • Restorative Dentistry and Endodontics
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    • v.24 no.1
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    • pp.40-48
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    • 1999
  • This study was designed to examine the specificities of the designed primers for F. nucleatum and F. necrophorum and to compare the PCR results using clinical samples with those of the anaerobic culture method. F. nucleatum and F. necrophorum spp. are frequently isolated in infected root canals, and they are related to periapical diseases. F. nucleatum(VPI 10197) and F. necrophorum(ATCC 25286) were used as references for PCR reaction, and thirty five teeth with one canal and periapical lesion were used. The samples were cultured anaerobically and identified using Rapid ID 32A(BioMerieux Vitek, Inc., France) as biochemical battery. In the GenBank database, species-specific PCR primers(nuc1/nuc2 primers for F. nucleatum and nec1/nec2 primers for F. necrophorum) were designed from the 16S ribosomal DNA(rDNA) sequences of F. nucleatum(accession number M58683) and F. necrophorum(accession number AF044948). PCR procedures of F. nucleatum(VPI 10197) and F. necrophorum (ATCC 25286) were simulated on a computer software. Amplify(v.1.2${\beta}$ for Macintosh). 820 bps and 817 bps of nucleotides were expected, respectively. Using extracted DNAs with QiaAmp tissue kit(Qiagen co., Germany), PCR was done. The results were as follows : 1. The nuc1/nuc2 primers produced an amplicon of 820 bps and the nec1/nec2 primers produced an amplicon of 817 bps. 2. The nuc1/nuc2 primers and the nec1/nec2 primers were specific and did not react with species other than the designated ones(i.e. nuc1/nuc2 primers did not produce amplicons for F. necrophorum, and vice versa.). And the PCR products of Porphyromonas endodontalis(ATCC 35406), Porphyromonas gingivalis(ATCC 33277), Prevotella intermedia(ATCC 25611), and Prevotella nigrescens(ATCC 33563), frequently isolated in infected root canals and periapical lesions, were not amplified by the primers specific for Fusobacterium nucleatum and Fusobacterium necrophorum. 3. This method utilizing PCR could detect F. nucleatum and F. necrophorum in clinical samples, while anaerobic culture method could detect neither.

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Apical periodontitis of endodontically treated maxillary first molar: Cone-Beam Computed Tomography study (근관치료된 상악 제1대구치의 치근단 병소: CBCT 연구)

  • Hwang, Soo-Jeong;Jeon, Su-Jin;Seo, Min-Seock
    • The Journal of the Korean dental association
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    • v.58 no.10
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    • pp.604-614
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    • 2020
  • Objective: The purpose of this study was to analyze the Cone-beam computed tomograghy(CBCT) scan of endodontically treated maxillary first molars and investigate how second mesiobuccal (MB2) canal is treated, how the prognosis of mesiobuccal (MB) root is different compared to other roots and the prognosis factor on apical periodontitis. Methods: Subjects were endodontically treated maxillary first molars whose were collected from CBCT scans taken from January 2018 until December 2019. A total of 525 maxillary first molars were analyzed by an endodontist to determine the presence of the MB2 canal, the quality of the root canal filling, and the presence of apical periodontitis. The chi square test and Fisher's exact test was used to examine the relationship between each variable. Results: MB2 canals were found in 46.3%, of which 76.5% were not treated. The more main canal of mesiobuccal root (MB1 canal) was well filled, the more significantly MB2 canal was well filled (p<0.001). The apical periodontitis of MB root was not related to the filling quality of MB1 canal (p=0.370) and was related to the filling quality of MB2 canal (p=0.004). The apical periodontitis of MB root was related to the quality of canal filling of MB2 canal and the apical periodontitis of DB and P root. Conclusions: It was found that the majority of MB2 canals were not treated. The apical periodontitis of MB root was analyzed to be related to the quality of canal filling of MB2 canal. The apical lesion of the MB root was not correlated with the treatment of the MB1 canal, but it was significantly related to the quality of filling of MB2 canal.

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