• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.670-675
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• 1998

Recently electronic apex locators have been used widely in root canal treatment, but, accuracy of electronic apex locators is controversial. The purpose of this study was to evaluate the accuracy of Apex Finder A.F.A(EIE Analytic Technology, U.S.A.) in vivo compared with Root-Zx and radiograph. The root canal lengths were determined with Root-Zx(32 tooth) in before pulp extirpation and after pulp extirpation. Then the radiographs were taken with a file in the canal. The root canal lengths were determined with Apex Finder A.F.A.(21 tooth) in before pulp extirpation and after pulp extirpation and under NaOCl. Then the radiographs were taken with a file in the canal. The results were as follows: 1. There was no significant statistical difference in Root-Zx between before pulp extirpation and after pulp extirpation(p > 0.05). 2. There was no significant statistical difference in Apex Finder A.F.A. between before pulp extirpation and after pulp extirpation(p > 0.05). But, there was significant statistical difference under NaOCl(p < 0.05). 3. There was no significant statistical difference in accuracy between Root-Zx and Apex Finder A.F.A.

• Restorative Dentistry and Endodontics
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• v.6 no.1
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• pp.71-75
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• 1980

The purpose of this study was to determine the close relation between clinical symptom and histopathologic finding in pulp. 20 samples of pulp tissue were collected from badly decayed teeth with considerable pulp vitality. Hemogram was also made with the first drop of bleedieg after total pulp extirpation (10cases) and vital pulpotomy(10cases). Histologic specimen was made routinely with extirpated pulp and stained by H&E and P.A.S. Stains. The results under microsopic examination were as follows; 1. Hemogram obtained from dental pulp with acute inflammation revealed increase of polymorphonuclear leukocyte in number, more lymphocytes and monocytes. 2. Hemogram from pulp with chronic inflammation shown the number of lymphocyte and monocyte was remarkably increased. 3. Histologi specimen obtained from teeth with severe clinical symptome showed polymorphonuclear leukocyte infiltration and the hemogram also showed polymorphonuclear leukocytes. 4. Specimen from teeth with moderate symptom showed lymphocyte infiltration and vessel dilatation underneath decayed area. Erythrocytes were massively accumulated inside of the vessel wall.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.1
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• pp.25-31
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• 2001

The purpose of this study was to investigate the distribution and fluorescence intensity of vasoactive intestinal polypeptide immunoreactive (VIP-IR) cells in rat trigeminal ganglion following pulp extirpation of rat mandibular molar. The animals were divided into control group(n=6) and experimental group(n=6). The experimental animals were sacrificed at 14 days after pulp extirpation. The trigeminal ganglion was removed and immersed in the 4% paraformaldehyde in 0.1M phosphate buffer. Serial frozen sections about $20{\mu}m$ in thickness were cut with a cryostat. The immunofluorescence staining was performed. The rabbit anti-VIP(1 : 8,000) was used as primary antibody and fluorescene isothiocynate(FITC) conjugated anti-rabbit IgG(1 : 80) as secondary antibody. The slides were observed under confocal laser scanning microscope (CLSM). Unprocessed optical sections were obtained and stored on a optical disk. Color pictures were printed by a video copy processor. The results were as follows; 1. The positive ratio of VIP-IR cells in mandibular part of trigeminal ganglion were 7.40% in control group and 28.42% in experimental group(14 days after pulp extirpation). 2. The relative fluorescence intensity of VIP-IR cells in mandibular part of trigeminal ganglion were 87.78 in control group and 138.65 in experimental group. The relative fluorescence intensity of experimental group was 58% higher than that of control group. 3. In optical serial section analysis of VIP-IR cells of experimental group, most of the 9 sections showed high fluorescence intensity. At high magnification, axons of the experimental group displayed greater VIP-IR than in the control group, and the positive cells were mainly of medium size. The result indicate that number and fluorescence intensity of VIP-IR cells were increased in the mandibular part of trigeminal ganglion following pulp extirpation of mandibular molar, and it suggests that VIP could play a role in processing of nociception.

• 한국전자현미경학회:학술대회논문집
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• 2000.05a
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• pp.23-24
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• 2000

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.4
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• pp.309-313
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• 2010

The management of teeth in the line of a mandibular fracture is controversial despite the general agreement that most of these teeth can be preserved. Teeth should be retained if bony attachments are adequate for survival, the tooth is sound and important in maintaining fixation of the fractured segment of bone. Teeth should be removed if they are loose and interfere with the reduction of fragments, are devitalized and potentially a source of wound infection, are damaged beyond their usefulness or may become devital and interfere with healing by becoming infected. However, tooth removal will increase the level of trauma, extend the severity of the wound and require expensive prosthetic treatment. Therefore, it is very important to conserve infected teeth in the line of a mandibular fracture through early primary endodontic treatment (pulp extirpation, canal enlargement and canal opening drainage) and splinting. The basic principles underlying the treatment of pulpless teeth are those underlying general surgery. Therefore, debridement of the infected wound (pulp extirpation and canal enlargement), drainage (canal opening) and gentle treatment of the tissues (occlusal reduction and teeth splinting) are the principles of surgery. This is a representative case report of conservative care by the early endodontic drainage of infected teeth in the line of a mandibular fracture.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.374-387
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• 1997

The purpose of this study was to examine the distribution of lymphocyte populations in normal, reversibly inflamed and irreversibly inflamed human dental pulp tissues using flow cytometry. Flow cytometry, with specific antibody and fluorochrome reagent allows us to know cellular properties of hematolymphoid cells by measuring fluorescence of stained cells. Before extirpation of pulps in routine endodontic treatment, the clinical diagnosis were performed by symptom. The extirpated pulp tissues were divided into normal pulp group (N=5), reversible pulpit is group(N=10) and irreversible pulpitis group(N=7). The specimen was placed into RPMI 1640 medium, minced into small pieces, and then digested in medium with collagenase. The cell suspension was resuspended in PBS for monoclonal antibody staining of T lymhocytes(CD3+), B lymphocytes (CD19+), T helper cell (CD4+) and T supressor cell (CD8+). The percentages of cells were counted by FACStar(BD) flow cytometer. Following results were obtained; 1. In the most normal and inflamed pulps, the percentages of T lymphocyte, B lymphocytes, T helper cell and T suppressor/cytotoxic cell were less than 1 % in total counted pulpal cells. 2. The higher percentages of T, B, T helper and T suppressor cells were observed in irreversible pulpitis group as compared with the normal pulp and reversible pulpitis group but the differences between groups were not statistically significant (p>0.05). 3. The percentages of T helper cells (CD4 + cells) were greater than that of T suppressor/cytotoxic cells (CD8 + cells) in the inflamed pulps.

• Restorative Dentistry and Endodontics
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• v.8 no.1
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• pp.123-131
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• 1982

The purpose of this study was to observe the responses of the remaining pulp tissue after pulpotomy upon the several kinds of $Ca(OH)_2$ products and the responses of periapical tissue upon some root canal filling materials after extirpation. For pulpotomy, the class V cavities were prepared on the premolars, molars and upper canines, and the pulp was amputated. Each drug was placed over the amputated tissue and cavity was sealed with zinc oxide eugenol cement. The drugs which were used for the study were Dycal (Caulk Co. U.S.A.), Cavitec (Kerr Co. U.S.A.), Calvital, Nobudyne and Neodyne (Neo Dental Chemical Products). For extirpation, the endodontic cavities were prepared on the lingual surfaces of anterior teeth, and the pulp tissues were extirpated as routine method. After enlarging, irrigation, and measuring of root length by taking X-ray, each root canal filling material was filled in the canal with gutta percha cone, and endodontic cavity was sealed with zinc oxide eugenol cement. Zinc oxide eugenol, $Ca(OH)_2$ (Eli Lilly Co. U.S.A.) and Vitapex (Neo Dental Chemical Products) were used as root canal filling materials. Animals were sacrificed after 1, 3 and 6 weeks following the operation. The teeth were decalcified in formic acid, sectioned and stained with hematoxylin eosin. Microscopic examination revealed as follows. 1. Dycal: The dentin bridge formation was observed at the 3rd week after pulpotomy. Inflammatory conditions which were infiltration of inflammatory cells and dilatation of blood vessels were kept in remaining pulp tissue at the 6th week. 2. Calvital: The dentin bridge was observed at the 1st week after pulpotomy. As the time clasped, the pulp tended to be the fibrous degeneration. 3. Cavitec, Nobudyne and Neodyne: In the case of Cavitec and Nobudyne, the incompleted and irregular dentin bridge was observed at the 6th week, and in Neodyne, was observed at the 3rd week. The severe inflammatory changes were seen in the remaining pulp tissue. As the time clasped, the fibrous degeneration tended to spread in the remaining pulp tissue. 4. $Ca(OH)_2$: Osteocementum was formed at the 3rd week, the matrix of cementum and dentin were resorted, and infiltration of lymphocytes was seen in periapical tissue when $Ca(OH)_2$ was used as canal-filling materials. S. ZOE and Vitapex The cementum like substance was seen in periapical portion at the 1st week, when ZOE and Vitapex were used as root canal filling materials. As the time elapsed, the matrix of cementum and dentin tended to be resorted. At the 6th week, the inflammatory condition of periapical tissue was continued in the case of ZOE, but was reduced in the case of Vitapex.

• The Journal of the Korean dental association
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• v.25 no.4 s.215
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• pp.359-363
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• 1987

72559 children, who visited the Dept. of Pedodontics, SNU Hospital from 1982 to 1985 were surveyed on the yearly tendency of dental treatment. The data were compared with those of previous reports, and the results were as follows, 1. The number out-patients were decreasing year by year. 2. Compared with those of 1982, in 1985, total number of visiting patient decreased to 14%, amalgam filling, 73.8% vital pulpotomy ; 69.55%, gold inlays ; 42.57%, Space maintainer ; 69.55%, tooth extraction ; 63.99% on the other hand, some items increased such as pulp extirpation ; 192%, canal filling ; 290%, 3. There revealed overall increasing tendency in almost all treatment items except Gold Inlay7s in from 1982 to 1985, compared with those from 1976 to 1979.

• Restorative Dentistry and Endodontics
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• v.48 no.1
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• pp.9.1-9.11
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• 2023

Objectives: This study evaluated the effect of adjacent gingival blood flow on detection of pulpal blood flow (PBF) using ultrasound Doppler flowmetry (UDF) through animal study. Materials and Methods: The study included 36 right and left maxillary the third incisors and canines in 9 experimental dogs. The study included 2 main steps: In the first step, the pulse sound level (PSL) was recorded on the cervical part of each tooth without flap elevation (Group 1), with flap elevation (Group 2), and after it was repositioned in place (Group 3). In the second step, the PSL was recorded on the cervical part of each tooth (Group 4), after pulpotomy (Group 5), after partial pulp extirpation (Group 6), after complete extirpation (Group 7), and after canal filling (Group 8). In Groups 5-8, the study was performed with and without flap elevation in the left and right teeth, respectively. The PSL was graded as follows: 0, inaudible; 1, heard faintly; and 2, heard well. The difference between each group was analyzed using Friedman's test with Wilcoxon signed-rank tests (α = 0.05). Results: In step 1, the PSL results were Group 1 > 2 and 3. In step 2, there was no significant difference between the groups when the flap was not elevated, while PSL results were Group 4 > 5 ≥ 6 and 7 ≥ 8 when the flap was elevated. Conclusions: PBF is affected by gingival blood flow when measured with UDF. UDF measurements require isolation of gingiva from the tooth.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.1
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• pp.104-111
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• 1994

Necrotizing fascitis is a severe soft tissue infection characterized by extensive necrosis of superficial fascia, suppurative fascitis, vascular thrombosis, widespread undermining of surrounding tissues. Associated systemic problems are widespread undermining of surrounding tissues, Associated systemic problems are common, with chronic alcoholism and diabetes being most prominent. Most commonly this disease presents in the extremities, trunk, and perineum. Necrotizing fascitis of dental origing is rare and its fulminating clinical course is not well documented in the dental literature. The present report is a case of necrotizing fascitis following vital extirpation of the pulp in a patient with uncontrolled diabetes mellitus and liver cirrhosis. Originally throught to be caused by hemolytic streptococcus organism or stphylococcus aureus, advances in anaerobic culturing have shown it to be a synergistic bacterial infection involving aerobic and ovligate anaerobes. it is relatively rare in relatively rare in haea and neck regions. If it was not diagnosed and treated in early stages, necrotizing fascitis can be potentially fetal, with a mortality rate approaching 40%. It's treatment requires early recognition, prompt and aggressive surgical debriment and proper supportive cares, such as, antibiotic therapy, fluid resuscitation and correction of metabolic and electrolyte disorder, resolving of the underlying systemic disease. Recently, we experienced two cases of necrotizing fascitis in cervicofacial region, One patient was 60 years old male with uncontrolled Diabetes Mellitus and other patient was 48 years old with steroid therapy during 30 years. Local surgical wound healing was successful but, patients were died after admission, because of lung abscess, gastrointestinal bleeding, septic shock and respiration hold.