• The Journal of Korea Assosiation for Disability and Oral Health
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• v.14 no.1
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• pp.31-35
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• 2018

Dentinogenesis imperfecta is a hereditary disorder that causes abnormal dentin formation and tooth morphology. Affected teeth show very thin dentin and large pulp chamber. Immediately after their eruption, the teeth tend to be destroyed rapidly. Early dental intervention is recommended to improve the feeding capacity and quality of life for the child, to maintain vertical dimension, and to promote healthy and functional dentition. This case report describes a treatment for a 4-year-2-month-old girl whose primary and permanent dentition were affected by Dentinogenesis Imperfecta. Shell teeth were observed in the entire primary dentition. The pulp of most teeth was exposed and the patient complained of pain. Most paternal family members were transferred to the Dentinogenesis Imperfecta. She needed an extensive dental treatment, but her compliance could not be expected because she was very young and anxious. So we decided to treat her under general anesthesia. All molar teeth are restored with Stainless Steel crown. Maxillary anterior teeth were extracted and mandibular anterior teeth are restored with composite resin. The patient's pain disappeared and masticatory function was restored.

• The Journal of the Korean dental association
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• v.50 no.9
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• pp.574-585
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• 2012

Purpose : This study was performed to evaluate the healing response around the root perforation restorative material. Materials and Methods : Four beagle dogs were used for experimental study. Endodontic treatment was performed at four maxillary premolars and artificial perforation was formed at furcation area of pulp chamber. Canal was filled with gutta percha cone and the perforation was sealed with MTA at group 1. At group 2, canal was filled and the perforation was sealed with dentin paste. Tooth paste was fabricated using extracted human teeth. Histologic examination of furcation area was performed 2, 4, 8 and 12 weeks after experiment. Results : New trabecular bone formation was observed around the MTA and tooth paste. Lamellar bone was observed as time is over. There were no inflammatory reaction in both groups. Conclusion : There is a possibility which endodontic filling material can be developed using extracted teeth.

• Restorative Dentistry and Endodontics
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• v.29 no.1
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• pp.13-22
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• 2004

본 연구는 치수강 상아질 부위 및 상아질 접착제 종류에 따른 결합 강도를 측정하고 이들 사이의 상관관계를 구명하고자 시행되었다 45개의 대구치를 포매 후, 대조군에서는 교합면 법랑질 제거 후 ＃600 SiC paper까지 순차연마하여 상아질을 노출시켰고, 실험군에서는 치수강 개방 후 1시간동안 NaOCl에 보관 후 axial wall과 pulpal floor를 노출시켰다. 노출된 상아질 면에 상아질 접착제를 적용한 후 Z-100을 충전한 다음 40초간 광중합하였다. 사용된 상아질 접착제는 Scotchbond Multi-Purpose와 Single Bond, Clearfil SE Bond였다. $37^{\circ}C$ 증류수에 24시간 보관 후, 저속 diamond saw를 이용하여 0.7mm 두께로 수직절단하고 고속 diamond point(#104)로 단면적 $1{mm}^2$가 되도록 시편을 제작하고, Universal testing machine에서 미세인장 결합강도를 측정하였다. 1. 모든 상아질 접착제의 미세인장강도는 대조군, axial wall군, pulpal floor군 순으로 감소하는 경향을 보였다. 2. 대조군에서 SM과 BB는 SE에 비해 유의성 있게 높은 결합강도를 나타내었다(p<0.05). 3. SM과 SB는 대조군에 비해 axial wall군과 pulpal floor군에서 유의성있게 낮은 결합강도를 보였으나, SE에서는 pulpal floor군만이 유의성 있게 낮은 결합강도를 보였다(p<0.05). 4. Axial wall군과 pulpal floor군에서는 상아질 접착제의 종류에 따른 유의차를 보이지 않았다. 5. 전자현미경 소견에서는 대조군에 비해 axial wall군과 pulpal floor군이 더 부드러운 접착 계면을 나타내었다. 혼성층의 두께는 결합강도의 감소와는 관련이 없었다.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.147-155
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• 1999

The purpose of this study was to investigate the effect of phosphoric acid concentration on the movement of 2-hydroxyethylmethacrylate(HEMA) from bonding resin - resin composite combination through dentin in vitro. Freshly extracted human third molar teeth were divided into four groups each of 10 teeth. A closed chamber with 1 ml distilled water was attached to the CEJ of each tooth. An occlusal cavity of 4mm diameter & remaining dentin thickness of 1.0-1.5mm was prepared in each tooth. Dentin was treated with 10% phosphoric acid gel for 15 seconds. 32% phosphoric acid gel for 15 seconds, or with 35% phosphoric acid gel for 15 seconds. A control group not treated with acid gel was also prepared. The cavities were rinsed, dried and then treated with the HEMA-containing All-Bond 2 primer & bonding resin which was light-cured for 10 seconds. The cavities were then restored with Z100 composite resin(shade:A3.5:3M Dent. Prod. USA) & light cured for 30 seconds. Water samples were retrieved from the chambers over a time course (4.32, 14.4, 43.2, 144 & 432 minutes ; 1, 3 & 10 days) and analyzed by high performance liquid chromatography. The results were as follows. 1. HEMA was detected in the pulp chambers of all teeth from 4.32 minutes after resin placement The highest rate of release was in the first sample period (0-4.32 min) & rate of release declined exponentially thereafter. 2. No significant differences were found for mean release rate for HEMA over a time course among the four groups (p>0.05). 3. The diffusion rate was significantly (p<0.05) less for 10% phosphoric acid gel than 32% phosphoric acid gel at the second sample period(4.32-14.4 min). 4. No significant differences were found for cumulative HEMA diffusion among the four groups at 10 days(p>0.05) and mean total(cumulative) release at 10 days for all groups was in the 9 - 16 nmol range. 5. The cumulative release was significantly (p<0.05) less for 10% phosphoric acid gel than 32% phophoric acid gel at the third(14.4-43.2 min) & fourth(43.2-144 min) sample period.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.1
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• pp.14-18
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• 2017

X-linked dominant hypophosphataemic rickets(XLHR) is a hereditary disease generally transmitted as an X-linked dominant trait. Oral manifestations include poorly mineralized dentin, enlarged pulp chambers and root canals, early tooth loss. Also, spontaneous dental abscesses could occur in the absence of a history of trauma or caries. This report describes the clinical finding and dental treatment of a child, who came to the hospital for treatment caries but was refered to pediatrics because the child showed clinically short of status, bow-leg and radiographically enlarged pulp chamber and canal, there as diagnosed as XLHR. After the diagnosis, 13 years follow-up and treatment were performed.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.5
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• pp.441-449
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• 2021

Background: The efficacy of local anesthesia decreases in patients with symptomatic irreversible pulpitis. Therefore, it was proposed that the use of premedication with an anti-inflammatory drug might increase the success rate of pulpal anesthesia in mandibular posterior teeth with vital inflamed pulp. Methods: One hundred thirty-four patients who were actively experiencing pain willingly participated in this study. The Heft Parker (HP) visual analog scale (VAS) was used to record the initial pain intensity. Patients were randomly allocated to receive a placebo, 10 mg of ketorolac, and 650 mg of paracetamol. The standard inferior alveolar nerve block (IANB) was administered to all patients using 2% lidocaine with 1:200,000 adrenaline after one hour of medication. After 15 min, the patient was instructed to rate the discomfort during each step of the treatment procedure, such as access to remaining dentin, access to the pulp chamber, and during canal instrumentation on the HP VAS. IANB was considered successful if the patient reported no or mild pain during access preparation and instrumentation. Moderate or severe pain was classified as a failure of IANB and another method of anesthesia was used before continuing the treatment. Results: The rate of successful anesthesia in the placebo, paracetamol, and ketorolac groups was 29%, 33%, and 43%, respectively, and no statistically significant difference was found between the groups. Conclusion: Preoperative administration of paracetamol or ketorolac did not significantly affect the success rate of IANB in patients with irreversible pulpitis. No significant difference was observed between the paracetamol and ketorolac groups.

• Restorative Dentistry and Endodontics
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• v.24 no.3
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• pp.453-464
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• 1999

The non-vital bleaching technique has been used widely as a very effective treatment method on discolored non-vital teeth. But periodontal tissue deterioration and cervical external root resorption have been reported because of the high toxicity of hydrogen peroxide in bleaching agents. So in previous studies, placement of base over the root canal obturation prior to bleaching has been suggested in order to prevent microleakage of bleaching agents, however, the effectiveness of base is still controversial. The purpose of this study was to evaluate the effects of base and root canal sealer on prevention of leakage of bleaching agents in non-vital bleaching. Fifty-two extracted sound teeth with single root were used. For root canal obturation, Tubuli seal$^{(R)}$(Kerr Co., USA) was used in 39 teeth and in others, AH-26$^{(R)}$(De Trey Dentsply, Inc., Switzerland) was used as a root canal sealer. 26 teeth among the teeth obturated with Tubuli seal$^{(R)}$ were divided into two groups, and Dentin cement$^{(R)}$(GC corp., Japan) and JRM$^{(R)}$(De Trey Dentsply, Inc. Germany) were used in each group as a intracanal base. In all teeth, non-vital bleaching using bleaching agent mixed with methylene blue dye was performed and all specimens were stored in $37^{\circ}C$ water bath for 72 hours. After sectioning longitudinally, the depth of dye leakage was measured with digital vernier calipers under the stereobinocular microscope using ${\times}40$ magnification. It can be concluded as follows: 1. The microleakage of bleaching agent was observed ill all groups regardless of type of the base and the sealer. 2. The microleakage in the groups using AH-26$^{(R)}$ as a sealer was significantly reduced (p<0.05). 3. In the groups with intracanal base, micro leakage was observed through almost the whole depth of the base and there was no significant difference between Dentin cement$^{(R)}$ and IRM$^{(R)}$ group(p>0.05). In conclusion, all the basing materials and the sealers in this study did not prevent the microleakage of bleaching agent. Therefore further studies and attempts to seal off the pulp chamber will be necessary.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.2
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• pp.144-153
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• 2018

The aim of this study was to understand the roles of Sonic Hedgehog (SHH) signaling during tooth root and periodontium formation. In this study, we generated the dental mesenchyme-specific Smoothened (Smo) activated/inactivated mice with the activity of Cre recombinase under the control of osteocalcin promoter. In the Smo activated mutant molar sections at the postnatal 28 days, we found extremely thin root dentin and widened pulp chamber. Picrosirius red staining showed loosely arranged fibers in the periodontal space and decreased cellular cementum with some root resorption. Immunohistochemical staining showed less localization of matrix proteins such as Bsp, Dmp1, Pstn, and Ank in the cementum, periodontal ligament, and/or cementoblast. In the Smo inactivated mutant mouse, there was not any remarkable differences in the localization of these matrix proteins compared with the wild type. These findings suggest that adequate suppressing regulation of SHH signaling is required in the development of tooth root and periodontium.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.3
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• pp.555-561
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• 1998

Hypophosphatasia is a rare metabolic disorder which manifests characteristics such as abnormal mineralization of bone and dental tissues, diminished serum and tissue alkaline phosphatase, and increased urinary secretion of PEA. It inherited as an autosomal recessive or dominant trait and occurs in all races. In general, hypophosphatasia can be classified in 4 subtypes which are the perinatal, infantile, childhood, adult type depending upon the age at presentation and severity. In young children with Hypophosphatasia the long bones show irregular defects, and the skull showes poor calcification. In older children with premature closure of the skull sutures there may be multiple lucent area called gyral or convolutional markings, described as resembling beaten copper, presumably resulting from increased intracranial pressure. Examination of the jaws reveals a generalized lucency of the maxilla and mandible. the cortical bone and lamina dura are thin, and the alveolar bone may be deficient. Clinical features of Hypophosphatasia include premature loss of deciduous teeth, especially incisors, hypoplasia or aplasia of root cementum, enamel hypoplasia, irregular calcification of dentin, large pulp chamber, and resorption of marginal alveolar bone and roots. Our report involves a patient with a chief complaint of early loss of both Mx. and Mn. deciduous incisors. After conducting a through clinical and radiographic examination this patient was referred to pediatrics under the suspicion of hypophosphatasia, the diagnosis proved to be correct and successful results were accomplished through a denture made to improve esthetics and function.

• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.701-709
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• 1998

Many dental composites are Bis-GMA based resin which diluted with the more fluid monomer triethylenglycol dimethacrylate(TEGDMA). TEGDMA is often present in exess so that some quantity remains unreacted following photo-initiated polymerization. TEGDMA is a component of some resin composites which contributes to their cytotoxicity. The presence of dentin between resin composite and pulp space reduce the cytotoxicity in vitro. The root system from extrcted human third molar was removed and then a circular occlusal cavity 4mm in diameter was prepared, leaving a remaining dentinal thickness to the roof of the pulpal chamber within the range 1.0-1.5mm. Dentine was treated with 37% phosphoric acid prior to Z 100 placement without using bonding resin(group 1). In group 2, SMP(Scotchbond Multi Purpose) primer, bonding resin prior to Z 100 placement were applied sequently. In group 3, moulds with internal dimensions 4mm diameter by 2mm depth were used to contain the composite alone with an equvalent mass on tooth model, and then they were immersed directly into water. The purpose of this study is to evaluate the release rate and quantity of TEGDMA with or without the application of bonding resin. Both release rate and total cumulative amount of TEGDMA for the three groups were determined using reversed-phase HPLC at times up to 10 days. The results were as follows: 1. All experimental groups showed the highest rate of release was in the first sample period(0-4.32 min) and the rate of release declined exponentially thereafter. 2. The maximum release rate and total cumulative account of TEGDMA in the tooth model of group 1 and group 2 with the use of SMP bonding resin were reduced however ther were no significant differences between these groups(P>0.05). 3. In the first sample period(0-4.32 min), the rate of release of TEGDMA from composite resin in group 3 immersed directly into water was significantly higher than that in group 1 and group 2 of tooth model(P<0.05). Conclusively, TEGDMA diffusion from Z 100 resin was not effectively prevented by the presence of dentin in spite of using the SMP bonding resin.