• 제목/요약/키워드: Periapical lesions

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임상가를 위한 특집 3 - 임플란트 주위질환의 효과적 진단 (The effective diagnosis of peri-implant diseases)

  • 김용건;이재목
    • 대한치과의사협회지
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    • 제52권7호
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    • pp.408-415
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    • 2014
  • Peri-implant diseases are inflammatory lesions, which include peri-implant mucositis and peri-implantitis. Peri-implant mucositis is described as the presence of inflammation in the mucosa around implants without any bone loss. By contrast, in peri-implantitis, besides the inflammation in the peri-implant mucosa, loss of supporting bone is also seen. Diagnosis of peri-implant diseases require the use of gentle probing(0.2 ~ 0.3N) to identify the presence of bleeding on probing, probing depth and suppuration, both signs of clinical inflammation. Radiographs are required to detect loss of supporting bone. Baseline probing measurements and high quality, long cone periapical radiographs should be obtained once the restoration of the implant is completed to make possible longitudinal monitoring of peri-implant tissue.

Assessment of panoramic radiography as a national oral examination tool: review of the literature

  • Choi, Jin-Woo
    • Imaging Science in Dentistry
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    • 제41권1호
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    • pp.1-6
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    • 2011
  • Purpose : The purpose of this review is to evaluate the possibility of panoramic radiography as a national oral examination tool. Materials and Methods : This report was carried out by review of the literatures. Results : Panoramic radiography has sufficient diagnostic accuracy in dental caries, periodontal diseases, and other lesions. Also, the effective dose of panoramic radiography is lower than traditional full-mouth periapical radiography. Conclusion : Panoramic radiography will improve the efficacy of dental examination in national oral examination. However, more studies are required to evaluate the benefit, financial cost, and operation time and also to make selection criteria and quality management program.

Virulence Genes, Antibiotic Resistance and Capsule Locus Polymorphisms in Enterococcus faecalis isolated from Canals of Root-Filled Teeth with Periapical Lesions

  • Saffari, Fereshteh;Sobhanipoor, Mohammad Hossein;Shahravan, Arash;Ahmadrajabi, Roya
    • Infection and chemotherapy
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    • 제50권4호
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    • pp.340-345
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    • 2018
  • Frequent isolation of Enterococcus faecalis from root canal treated teeth with apical periodontitis, has proposed the role of this organism in endodontic treatment failures. Different factors have been suggested in the pathogenicity of this organism. In this study, 22 E. faecalis isolates from canals of root-filled teeth were identified, and phenotypic and genotypic characteristics were investigated. No resistance to vancomycin and gentamicin was noted, and most isolates (91%) were susceptible to ampicillin. Biofilm formation was detected in 73% of the isolates and may be considered as the most important virulence factor involved in the pathogenesis of these isolates.

An accurate diagnosis of odontogenic cutaneous sinus tract by different computed tomography unit setting

  • Sodnom-Ish, Buyanbileg;Eo, Mi Young;Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제47권1호
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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.

Detection of furcation involvement using periapical radiography and 2 cone-beam computed tomography imaging protocols with and without a metallic post: An animal study

  • Salineiro, Fernanda Cristina Sales;Gialain, Ivan Onone;Kobayashi-Velasco, Solange;Pannuti, Claudio Mendes;Cavalcanti, Marcelo Gusmao Paraiso
    • Imaging Science in Dentistry
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    • 제47권1호
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    • pp.17-24
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    • 2017
  • Purpose: The purpose of this study was to assess the accuracy, sensitivity, and specificity of the diagnosis of incipient furcation involvement with periapical radiography (PR) and 2 cone-beam computed tomography (CBCT) imaging protocols, and to test metal artifact interference. Materials and Methods: Mandibular second molars in 10 macerated pig mandibles were divided into those that showed no furcation involvement and those with lesions in the furcation area. Exams using PR and 2 different CBCT imaging protocols were performed with and without a metallic post. Each image was analyzed twice by 2 observers who rated the absence or presence of furcation involvement according to a 5-point scale. Receiver operating characteristic (ROC) curves were used to evaluate the accuracy, sensitivity, and specificity of the observations. Results: The accuracy of the CBCT imaging protocols ranged from 67.5% to 82.5% in the images obtained with a metallic post and from 72.5% to 80% in those without a metallic post. The accuracy of PR ranged from 37.5% to 55% in the images with a metallic post and from 42.5% to 62.5% in those without a metallic post. The area under the ROC curve values for the CBCT imaging protocols ranged from 0.813 to 0.802, and for PR ranged from 0.503 to 0.448. Conclusion: Both CBCT imaging protocols showed higher accuracy, sensitivity, and specificity than PR in the detection of incipient furcation involvement. Based on these results, CBCT may be considered a reliable tool for detecting incipient furcation involvement following a clinical periodontal exam, even in the presence of a metallic post.

항생제를 사용한 유치의 치수치료 (PULP TREATMENT OF PRIMARY TEETH USING A COMBINATION OF ANTIBIOTICS)

  • 김대업
    • 대한소아치과학회지
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    • 제32권1호
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    • pp.126-131
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    • 2005
  • 본 연구는 항생제를 복합 투여하여 유치의 근관 및 치근단 주위 감염에 대한 효과를 임상적으로 관찰하고자 하였다. 근관 및 치근단 주위 병소의 멸균을 목적으로 metronidazole, ciprofloxacin 및 minocyclin을 증류수 및 근관시멘트와 혼합하여 적용하였다. 유치의 근관 입구로부터 하방에 $Fissurotomy^{(R)}$ bur(SS White, USA)를 이용하여 약제 공간을 형성하였고 약제는 치수실 바닥까지 채웠다. 본 증례들에서 단회 적용으로 임상 증상이 개선되었다. 치은종창, 동통, 누공 등 모든 증상이 술 후 1주일 내에 소실되었다. 임상적으로 활용하기 위해서는 보다 많은 수의 증례와 장기간의 임상적 평가가 필요하며 아직까지 근관내 항생제 사용에 따른 부작용에 대한 보고가 없지만 항생제에 민감한 환아에 대해서는 사용에 주의가 필요할 것으로 사료된다. 저자는 행동조절이 곤란한 소아에서 생리적 치근흡수가 진행 중인 감염된 유치를 가진 환아들을 대상으로 항생제를 복합 사용한 바 증상의 개선을 관찰하였기에 보고하는 바이다.

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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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    • 제51권3호
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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.

급성 치수염 및 급성 치근단 농양의 치근관으로부터의 세균 분리 및 동정 (ISOLATION AND IDENTIFICATION OF BACTERIA FROM THE ROOT CANAL OF THE TEETH DIAGNOSED AS THE ACUTE PULPITIS AND ACUTE PERIAPICAL ABSCESS)

  • 이연재;김미광;황호길;국중기
    • Restorative Dentistry and Endodontics
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    • 제30권5호
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    • pp.409-422
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    • 2005
  • 치아우식증 및 치주질환에 이환 여부와 치근단 병소의 존재 유무에 따라 급성 치수염 또는 급성 치근단 농양이라고 진단된 17개 치아의 치관부 치수를 제거하고, 치근에 존재하는 괴사된 치수 및 농양부위의 샘플을 채취하여, 혐기성 상태에서 세균을 배양하고, 이들을 16S rDNA 클로닝 및 핵산염기서열결정법으로 종 수준에서 동정하였다. 그 결과 17개의 치근관감염 병소에서 모두 71개의 세균 군락이 자라났으며, 그 중 계대 배양을 통해서 적응하여 자라난 것이 56 균주였다. 치아우식증에 의한 치근관 감염 병소와 치아우식증이 아닌 다른 원인에 의한 치근관 감염 병소에서 검출되는 세균은 서로 다른 양상을 보였다. 즉, 치아우식증에 의한 치아의 치근관 감염 병소에서 연쇄상구균들이 $72.7\%$(8/11)로 가장 많은 빈도로 검출되었다. 반면에 치아우식증이 없는 치아의 치근관 감염 병소에서는 Actinomyces속의 균주들이 $66.7\%$로 가장 높은 빈도로 검출되었다. 치근단 병소가 있는 경우의 치근관 감염 병소에는 대체로 혐기성 세균인 Clostridia 아문, Bacteroides 문, Fusobacteria 문의 균주들이 검출되었지만, 치근단 병소가 없는 치아에서는 검출되지 않았다 반면에 치근단 병소가 없는 치근관 병소에서는 연쇄상구균($60\%$)과 Actinomyces속($50\%$)의 균주들이 높은 빈도로 검출되었다. 본 연구에서는 아직까지 종 수준에서 동정되지 않은 2 균주(ChDC B639 및 ChDC B631)의 Actinomyces속에 속하는 균주가 분리되었다. 이상의 결과를 종합할 때, 세균배양법에 의한 치수 및 치근단 감염 병소에서는 다양한 세균이 검출되었으며, 이는 치근관 감염이 여러 세균에 의해 발병 및 진행된다는 기존의 연구 결과와 동일함을 알 수 있었다. 또한 본 연구 결과 분리 동정된 균주들은 치근관질환과 이와 관련된 세균간의 역학조사에 중요한 자원으로 이용될 수 있을 것으로 생각된다.

16S rDNA sequence에 대한 종특이성 primer를 이용한 중합효소연쇄반응증폭에 의한 Porphyromonas endodontalis의 동정에 관한 연구 (A STUDY ON THE IDENTIFICATION OF Porphyromonas endodontalis BY PCR USING SPECIES SPECIFIC PRIMERS FOR THE 16S rDNA)

  • 엄승희;임성삼;배광식
    • Restorative Dentistry and Endodontics
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    • 제24권1호
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    • pp.13-25
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    • 1999
  • P. endodontalis which was known to be associated with the infected root canals and periapical lesions is very difficult to detect by culture methods or traditional methods. Detection of bacteria using polymerase chain reaction(PCR) for 16S ribosomal DNA(rDNA) is fast, simple, and accurate with relatively small amount of target cells. 16S rDNA consist of conserved regions those are same to all species, and variable regions which represent species specificity. The 16S rDNA sequences of P. endodontalis and P. gingivalis were aligned and two highly variable regions were selected as a pair of species specific oligonucleotide primers for P. endodontalis. And then the pair of primers for PCR amplification was synthesized to identify P. endodontalis. The sequences of the species specific primers for the 16S rDNA of P. endodontalis were as follows ; sense primer[endo1]: 5'-CTATATTCTTCTTTCTCCGCATGGAGGAGG-3' antisense primer[endo2]: 5'-GCATACCTTCGGTCTCCTCTAGCATAT-3' In this study, for the identification of P. endodontalis without culture from the mixed clinical samples, PCR was done with species specific primers for the 16S rDNA sequences of P. endodontalis. The results were as follows : 1. The species specificity of the primers for the 16S rDNA of P. endodntalis was determined by the PCR methods. About 490bp amplicon which was specific only for P. endodntalis was produced with P. endodontalis. No amplicon was produced by PCR with other strains similar to P. endodontalis. 2. The synthesized species specific primers reacted with conventionally identified P. endodontalis which we have in conservative dentistry laboratory. 3. The identification of P. endodontalis using PCR technique with samples collected from infected root canals or periapical lesions was more sensitive than that of culture methods. 4. Seven samples revealed including P. endodontalis by PCR technique. Five of them were related with pains, two of them with sinus tract, three of them with foul odor, and three of them with purulent drainage. P. endodontalis was shown to have great relation with pains.

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Volumetric analysis of mucous retention cysts in the maxillary sinus: A retrospective study using cone-beam computed tomography

  • Hung, Kuofeng;Hui, Liuling;Yeung, Andy Wai Kan;Wu, Yiqun;Hsung, Richard Tai-Chiu;Bornstein, Michael M.
    • Imaging Science in Dentistry
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    • 제51권2호
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    • pp.117-127
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    • 2021
  • Purpose: The aim of this study was to evaluate the volumetric characteristics of mucous retention cysts(MRCs) in the maxillary sinus and to analyze potential associations of MRCs with dentoalveolar pathologies. Materials and Methods: Cone-beam computed tomography (CBCT) scans exhibiting bilateral maxillary sinuses that were acquired from January 2016 to February 2019 were initially screened. A total of 227 scans(454 sinuses) that fulfilled the inclusion criteria were included. The presence, location, and volumetric characteristics of the diagnosed MRCs were evaluated on CBCT images using the 3D-Slicer software platform. The presence of MRCs was correlated with potential influencing factors including age, sex, and dentoalveolar pathology. For MRCs located on the sinus floor, factors with a potential impact on the volume, surface, and diameter were analyzed. Results: An MRC was present in 130 (28.6%) of the 454 sinuses. Most MRCs were located on the sinus walls and floor. The mean MRC volume, surface, and diameter were 551.21±1368.04 mm3, 228.09±437.56 mm2, and 9.63±5.40 mm, respectively. Significantly more sinuses with associated endodontically treated teeth/periapical lesions were diagnosed with an MRC located on the sinus floor. For MRCs located on the sinus floor, endodontic status exhibited a significant association with increased volume, surface, and diameter. Conclusion: Periapical lesions might be a contributing factor associated with the presence and volume of MRCs located on the sinus floor. The 3D-Slicer software platform was found to be a useful tool for clinicians to analyze the size of MRCs before surgical interventions such as sinus floor elevation procedures.