• 대한소아치과학회지
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• 제24권2호
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• pp.475-483
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• 1997

Fracture of the crown in a permanent incisor is relatively common. When it occurs with pulp exposure, it presents both restorative and endodontic problems. In the restoration of a fractured incisor, reattachment of the original fragment or restoration with a composite resin is preferred over a temporary crown. If fractured fragment is intact, the tooth can be restored with reattachment of the fragment. An exposed pulp in a young crown-fractured incisor is usually treated with either pulp capping or pulpotomy depending on the size of an exposure and time elapsed since injury. However, in teeth showing vital and/or hyperplastic pulp tissue at the exposure, only superficial layers of the pulp and surrounding dentin should be removed : i.e. partial pulpotomy can be performed in immature as well as mature teeth. This paper reports 2 cases of crown-fractured permanent incisors with pulp exposure that had been treated by reattachment of original fragment followed by partial pulpotomy or partial pulpectomy. The following results are obtained. ; 1. Fragment reattachment is an acceptable semi-permanent restoration of crown fractured young permanent incisor. 2. Partial pulpotomy is recommended as the treatment of choice in crown-fractured permanent teeth with pulp exposure.

• Restorative Dentistry and Endodontics
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• 제45권1호
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• pp.10.1-10.8
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• 2020

Objectives: This study aimed to compare the shear bond strength (SBS) of a self-adhering flowable composite (Dyad Flow) and a bulk-fill flowable composite (Smart Dentin Replacement [SDR]) to several pulp-capping materials, including MTA Plus, Dycal, Biodentine, and TheraCal. Materials and Methods: Eighty acrylic blocks with 2-mm-deep central holes that were 4 mm in diameter were prepared and divided into 2 groups (n = 40 each) according to the composite used (Dyad Flow or SDR). They were further divided into 4 sub-groups (n = 10 each) according to the pulp-capping agent used. SBS was tested using a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed using 2-way analysis of variance. A p value of < 0.05 was considered to indicate statistical significance. Results: A statistically significant difference (p = 0.040) was found between Dyad Flow and SDR in terms of bond strength to MTA Plus, Dycal, Biodentine, and TheraCal. Conclusions: Among the 8 sub-groups, the combination of TheraCal and SDR exhibited the highest SBS.

• Restorative Dentistry and Endodontics
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• 제7권1호
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• pp.107-115
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• 1981

The purpose of this investigation was to study histopathological chronology and differences of the proprietary pulpcapping agents. One hundred eighty molars from thrity rats (Srague-Dawley species), weighing about 130gm, were divided into six groups. Cavities were prepared in their maxillary molars under intraperitoneal anesthesia with Secobarbital. The cavities in the right first and second molars were filled with Dycal$^{(R)}$ and the left ones were with Cavitec$^{(R)}$. Each group of rats were sacrificed at the intervals of 1, 3, 5, 7, 14 and 21 days following operation. The rats were decapituated, and the jaws were fixed in 10% neutral buffered formalin. Then the specimens were decalcified, embedded in paraffin or celloid, and sectioned at 6-8 ${\mu}$ in thickness through the cavities included and pulp mesiodistally. They were stained with Hematoxylin-Eosin and examined by lightmicroscope. The results were as follow: 1. The pattern of pulp healing was dependent upon the presence and character of the pulpcapping agents above. 2. Dentin bridge formation as a sign of pulp healing occurred in the 14 days after operation. 3. Dycal$^{(R)}$ reparation appeared to favor pulp bealing rather than Cavitec$^{(R)}$ preparation. 4. In the odontoblastic layer and pulp tissue specific vaculoes were showed at the 3, 5 and 7 days of the Dycal filling.

• 치위생과학회지
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• 제10권4호
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• pp.227-231
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• 2010

The purpose of this study was to examine the MAPK signaling pathways involved in regulation of HO-1 and the odontoblast differentiation markers during the odontoblastic differentiation for HDPCs. We evaluated cell growth by MTT assay and differentiation marker mRNA expression by RT-PCR. When the cells were treated with p38 inhibitor (SB203580, $10{\mu}M$), JNK inhibitor (SP600125, $10{\mu}M$), and ERK inhibitor (PD98059, $20{\mu}M$) for 7 days, cell growth and expression of HO-1 and differentiation makers were significantly decreased in HDPCs. Our results suggest that odontoblastic differentiation is positively regulated by HO-1 induction in HDPCs via ERK, JNK, and p38 signaling pathways. Thus, pharmacological HO-1 induction might represent a potent therapeutic approach for pulp capping and the regeneration of HDPCs.

• Restorative Dentistry and Endodontics
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• 제32권2호
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• pp.95-101
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• 2007

개의 치수에 MTA, calcium hydroxide 및 calcium sulfate로 치수복조 후 치수 반응을 서로 비교하여 MTA와 calcium sulfate가 임상적으로 치수복조제로서 사용 가능할 것인가를 구명하고자 본 연구를 시행하였다. 8개월 된 2마리 개의 24개의 치아가 본 연구에 사용되었다 전신 마취하에 고속 핸드피스를 사용하여 멸균된 #2 round bur로 치경부에 와동을 형성한 후 치수를 노출시켰다. MTA, calcium hydroxide 및 calcium sulfate를 치수노출부에 도포하였다. 와동 부위는 IRM으로 가봉하고 광중합레진으로 수복하였다. 처리 2개월 후, 전신 마취하에 희생시킨 후 조직학적으로 관찰하였다. MTA처리군에서는 치수 노출부위에 경조직의 상아질교가 형성되었으며 새로 형성된 상아질교 하방에 조상아세포가 새로 형성되었다. 치수충혈과 함께 국소적 인 혈관 증식 이 나타났으며 치수에 염증반응은 나타나지 않았다. Calcium hydroxide로 처리한 군은 상아질교 하방에 조상아세포가 관찰되지 않았으며 만성 염증반응이 다양하게 나타났다. Calcium sulfate로 처리한 군은 경조직의 상아질교가 관찰되었으며, 상아질교 하방에 조상아세포 층이 새로 관찰되었다. 몇몇의 중성구 침윤과 함께 미약한 정도의 만성염증반응이 관찰되었다. 이상의 결과에서 MTA가 calcium hydroxide및 calcium sulfate에 비해 치수에 생체친화적임을 시사하며 기계적 치수노출시 치수복조제로 사용할 수 있음을 시사한다.

• 대한장애인치과학회지
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• 제12권2호
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• pp.45-49
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• 2016

This study investigates the success rate of pulpotomy using electrosurgery operated on a primary molar in caries. The pulpotomy using electrosurgery was done on 253 primary molars of 111 young patients from 2 to 9 years old during the period of the first day of January 2011 to the last day of December 2015. After the amputation of pulp and hemostasis of primary molar were done using electrosurgery, MTA as pulp capping material was applied to the primary molar and the tooth was restored with the stainless steel crown. The follow up period after the treatment ranged from 4-46 months. The clinical and radiographic success rate ranged from 92.1 - 94.3%. Which is comparable to formocresol and ferric sulfate pulpotomy. Due to its non-pharmacological characteristic, electrosurgery can minimize harmful effect on the pulp tissue. Its fast bleeding control makes it easy and safe to use in pediatric and disabled patients in comparatively simple manner. Electrosurgery can be an alternative for pulp therapy considering the side effects of pharmacological ways.

• 대한소아치과학회지
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• 제8권1호
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• pp.37-46
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• 1981

This study was undertaken to evaluate the pulpal responses to the pulp-capping materials such as glutaraldehyde and formocresol in pulpotomy technique, especially in the primary dentition. Mandibular primary canines and molars of 5 dogs (aged about 8-9 weeks)were selected for this study. The intervals of observation for histologic study of pulpotomized primary teeth with 2% glutaraldehyde, formocresol and calcium hydroxide in the usual manner ranged from 2 hours, 1 week, 2 weeks, 3 weeks and 5 weeks after experiments respectively. Each specimens were fixed with 10% formalin and decalcified in 5% nitric acid. All slides were stained with Hematorylin-Eosin and examined histopathologically. The results were as follows; 1. In calcium hydroxide groups, formation of dentin bridge was initiated in 1 week after experiments and completed in 5 weeks after experiments. 2. Formation of dentin bridge was not seen, whereas necrosis of pulp tissue was noted, in formocresol and glutaraldehyde groups. 3. Duration of tissue reactions and tissue changes were similar, in formocresol and glutaraldehyde groups. 4. In formocresol and glutaraldehyde groups, amputation surfaces of the pulp were covered with blood clots, beneath which coagulation necrois was noted, but inflammatory cells were not prominent, in 2 hours and 1 week after experiments. But coagulation necrosis was proceeded to the apical portion, accompanied by infiltration of inflammatory cells, since 2 weeks after experiments. And suppuration or gangrene of the pulp tissue were noted in 3 weeks and 5 weeks groups. 5. Suppuration or gangrene of pulp seemed to provoke the resorption of dentin wall, and inflammatory changes and resorption of roots were noted in the periodontal membrane near the periapical region. 6. As compared with calcium hydroxide groups, resorption of the root was pronounced in form or cresol and glutaraldehyde groups. Effects of medicaments to the succedaneous tooth germ were not seen.

• 대한소아치과학회지
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• 제24권1호
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• pp.27-40
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• 1997

This study investigated the effects of laser irradiation on the exposed pulp and the possibility of direct pulp capping with the $CO_2$ laser. Results were obtained from the observation of the residual pulpal healing process. Class V cavities on 48 anterior teeth from 8 adult dogs were prepared and pulp chambers were intentionally opened with dental explorer. The control group consisted of 16 teeth. $Dycal^{(R)}$(Caulk Co., U.S.A.) was applied to exposed site once bleeding was stopped. Cavities were sealed with $I.R.M^{(R)}$. In the experimental group 1 (16 teeth), laser(LASERSAT $CO_2^{(R)}$, Satelec Co.) was irradiated on the exposed pulp. The laser procedure followed the manufacturers recommendations for the treatment of human pulp(1.5 Watts, 0.2 seconds, unfocused), and cavities were sealed with $I.R.M^{(R)}$. In the experimental group 2 (16 teeth), laser was irradiated on the exposed pulp in a more powerful dosage(5.0 Watts, 0.2 seconds, unfocused), and cavities were sealed with $I.R.M^{(R)}$. Two dogs were sacrificed immediately after experiment and the others were sacrificed at intervals of one, three, and eight weeks respectively. All teeth were routinely processed and the pulpal tissues and odontoblastic layers were observed by the light microscope. The results were as follows; 1. In the control group, the initial mild inflammation had improved to normal by week eight. An active formation of reparative dentin was observed at week three, and at week eight, a firm dentin bridge was present beneath the $Dycal^{(R)}$ with no inflammatory responses in the remaining pulp. 2. In the experimental group 1, immediately following irradiation, the superficial shape of the exposed pulp was crater-like. And it was lined with the coagulated layer, $60{\sim}70{\mu}m$ in width. Moderate inflammatory pulpal conditions existing at week one were improved to mild at week eight. And from the week three specimens, a reparative dentin formation was observed in the adjacent odontoblastic layer of the exposed site. A dentin bridge at the exposed site, however, did not form during the experimental period. 3. In the experimental group 2, the width of the coagulation layer lining the crater was $70{\sim}130{\mu}m$. Beneath the coagulated layer, severe inflammatory pulpal responses were observed at week one, and conditions did not improve during the experimental period.

• 대한소아치과학회지
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• 제35권2호
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• pp.324-332
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• 2008

혼합 치열기 및 초기 영구치열기의 소아, 청소년에서 외상에 의한 치관 파절은 빈번하게 발생한다. 치관파절은 치수의 노출 유무에 따라 단순 치관파절, 복잡 치관파절로 분류된다. 치수가 노출된 복잡 치관파절의 경우 치수에 대한 고려 및 처치가 필수적인데, 초기 영구치열기에는 전치부 치근의 발육이 완전히 이루어지지 않았기 때문에 완성된 치근을 가지는 치아보다 치료가 복잡하다. 치료의 목적은 적절한 치수 치료를 통해 치근의 완성을 도모하는 것으로 이를 위해 직접 치수복조술, 부분 치수절단술, 치경부 치수절단술의 방법을 이용한다. 이 중 부분 치수절단술은 성공률도 높으며 치경부 치수를 보존하기 때문에 여러 장점을 지니는 치료방법이다. 복잡 치관파절을 주소로 내원한 환자에서 부분 치수절단술을 시행하여 양호한 결과를 나타내어 이를 보고하는 바이다.

• Restorative Dentistry and Endodontics
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• 제34권5호
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• pp.415-423
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• 2009

$\beta$-glycerophosphate는 치수의 상아모세포 분화를 촉진하는 물질이다. Portland cement는 수중에서 장기간에 걸쳐 용해되기 때문에 $\beta$-glycerophosphate을 혼합한 Portland cement는 수산화칼슘과 함께 $\beta$-glycerophosphate를 장기간 용출하게 된다. 본 실험에서는 $\beta$-glycerophosphate을 혼합한 Portland cament에 대한 인간치수세포의 반응을 알아보았다. 인간 치수 세포에 대한 $\beta$-glycerophosphate의 효과를 알아보기 위해 다양한 농도의 $\beta$-glycerophosphate와 dexamethasone에 대한 인간 치수 세포의 ALP activity을 측정하였고 alizarin red S로 염색하여 관찰하였다. $\beta$-glycerophosphate가 다양한 농도(10 mM, 100 mM, 1 M)로 혼합된 Portland cement에 대한 인간 치수 세포의 MTS assay, ALP activity를 측정하고 SEM으로 관찰하였다. 치수세포의 석회화 정도를 관찰한 연구에서 $\beta$-glycerophosphate와 dexamethasone 단독으로 적용하였을 때 거의 효과가 없었으나 5 mM $\beta$-glycerophosphate와 100 nM dexamethasone을 혼합 적용하였을 때 가장 높은 ALP acticity를 보였다. 분화제를 첨가하거나 첨가하지 않은 모든 실험군에서 치수세포에 대한 독성은 관찰되지 않았으며 Portland cement에 10 mM $\beta$-glycerophosphate을 혼합한 시편의 ALP activity가 대조군에 비교하여 가장 많이 증가하였다. 결론적으로 $\beta$-glycerophosphate이 혼합된 Portland cement는 세포 독성이 없으며 첨가물이 없는 Portland cement에 비해 치수 분화 및 석회화를 더 많이 일으키므로 임상적으로 $\beta$-glycerophosphate을 혼합한 Portland cement 적용은 재료 하방에 더 많은 상아질을 형성시킬 것으로 추측된다.