• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.659-666
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• 1996

The treatment of complete avulsed teeth due to traumatic injuries is replantation procedure. The major complication of replantation are pulp necrosis, ankylosis, and root resorption. It is important to maintain the vitality of periodontal ligament to minimize the complications. The purpose of this case report is to consider the facts that affect the success rate and the prognosis of complete avulsed teeth after replantation. All of these cases had different conditions and transport media. The following results were observed: 1. The successive treatment of complete ayulsed teeth requires the maintainance of vitality of periodontal ligament. 2. The complication of replantation are inflammatory root resorption and ankylosis and in such case, proper endodontic treatment using calcium hydroxide medications and periodic observations are needed. 3. In case of delayed replantation, the use of fluoride and root planning procedure can help to achieve better result. 4. It is more esthetic and functional to maintain the avulsed tooth in mouth.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.2
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• pp.317-322
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• 1999

Dens invaginatus is a developmental anomaly resulting from an invagination of the enamel organ. The incidence is highest with maxillary permanent lateral incisors. The reported occurrence ranges from 0.04 to 10%. This anomaly may involve the pulp and periapical tissues and cause pulpal inflammation, loss of vitality, apical and lateral periodontitis, periapical abscesses and cysts and stimulate internal resorption. Oehlers describes dens invaginatus as occurrence in three forms. In treating type 3 invaginatus, treatment strategy can be determined by considering the complexity and accessibility of invagination. In this case, showing simple invagination, it could be treated by simple endodontic treament confining to invagination without loss of vitality of tooth. After treatment of the present case, the results were as follows: 1. In type 3 dens invagiantus, if the tooth is vital and there is no evidence of communicating between invagination and pulp, we can save the vitality of the tooth and resolve the lesion by endodontic treament confining to the invagination. 2. In the invagination with opened apex, the closure of apex can be induced by apexification procedure doing this, we can avoid the neccessity of surgical intervention.

• Journal of Oral Medicine and Pain
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• v.30 no.4
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• pp.465-473
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• 2005

The purpose of this study was to evaluate the desensitizing effects of a Nd:YAG laser (Sunlase, SUNRISE Technologies, Inc., USA) irradiation on cervically exposed hypersensitive dentine. 45 patients was irradiated with pulsed Nd:YAG laser (1.5 W, 20 Hz, 75 mJ/pulse, 4 minutes) as the experimental group, 27 patients was mock irradiated as the control group. The degree of sensitivity to the thermal and tactile stimuli were determined qualitatively with an evaporative stimulus defined as two times air blast at a distance of 3 mm from each site to be tested and with a mechanical stimulus as a slightly scratching the cervical site with a dental explorer. A qualitative registration of the degree of discomfort was determined according to a numerical pain scale(NPS) in an 11-point scale in which 0= "no pain" and 10="most excruciating pain imaginable". Recordings were assessed before treatment, immediately after, 1 and 2 weeks after treatment. Pain tolerance threshold and pulp vitality were evaluated with electric pulp tester before and immediately after treatment. 1. Desensitizing of hypersensitive dentine with Nd:YAG laser irradiation was more effective than that with mock irradiation. 2. The placebo effect of mock irradiation was recognized for severe sensitive teeth($NPS\;{\geqq}\;6$), but not for moderate sensitive teeth(NPS < 6). 3. Laser irradiation did not affect the pain tolerance threshold and pulp vitality of the hypersensitive teeth. 4. Desensitizing effect of laser irradiation for the hypersensitive teeth had been continuing at least 2 weeks. It was concluded that desensitizing of hypersensitive dentine with a Nd:YAG laser is effective and the maintenance of the positive result was more prolonged than the placebo effect.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.2
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• pp.158-165
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• 2016

The purpose of this study was to analyze photoplethysmographic waveforms from pulse oximeter using raw data of red and infrared light and investigate the reference values of parameters (Height, Width50, Maximum slope, Minimum slope, Area) for evaluating pulpal blood flow in maxillary central incisors with normal pulp vitality in children. The study was performed in 30 pediatric patients, aged 7-16 years old, using pulse oximeter (MEKICS Co., Ltd, Korea) combined with a custom-made sensor. The raw data was obtained and recorded by custom-made software and analyzed by LabChart (v.7.3, ADInstruments, Germany) offline. In this study, we analyzed photoplethysmographic waveforms from pulse oximeter applied to maxillary central incisor for assessment of pulpal blood flow and suggested several reference values of young permanent maxillary central incisor with normal pulp. On average, the waveform of red light was higher, stiffer and wider than that of infrared light. Future studies about reference values for other normal teeth and the teeth with impaired pulp vitality are needed.

• Restorative Dentistry and Endodontics
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• v.44 no.4
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• pp.39.1-39.8
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• 2019

The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.

• The Journal of Advanced Prosthodontics
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• v.7 no.1
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• pp.21-26
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• 2015

PURPOSE. To evaluate the cytotoxicity of temporary luting cements on bovine dental pulp-derived cells (bDPCs). MATERIALS AND METHODS. Four different temporary cements were tested: Rely X Temp E (3M ESPE), Ultratemp (Ultradent), GC Fuji Temp (GC), and Rely X Temp NE (3M ESPE). The materials were prepared as discs and incubated in Dulbecco's modified eagle's culture medium (DMEM) for 72 hours according to ISO 10993-5. A real-time cell analyzer was used to determine cell vitality. After seeding $200{\mu}L$ of the cell suspensions into the wells of a 96-well plate, the bDPCs were cured with bioactive components released by the test materials and observed every 15 minutes for 98 hours. One-way ANOVA and Tukey-Kramer tests were used to analyze the results of the proliferation experiments. RESULTS. All tested temporary cements showed significant decreases in the bDPCs index. Rely X Temp E, GC Fuji Temp, and Rely X Temp NE were severely toxic at both time points (24 and 72 hours) (P<.001). When the cells were exposed to media by Ultratemp, the cell viability was similar to that of the control at 24 hours (P>.05); however, the cell viability was significantly reduced at 72 hours (P<.001). Light and scanning electron microscopy examination confirmed these results. CONCLUSION. The cytotoxic effects of temporary cements on pulpal tissue should be evaluated when choosing cement for luting provisional restorations.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.4
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• pp.640-646
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• 2009

In case of luxation injuries, loss of tooth vitality is common. And in case of trauma in the immature permanent teeth, precise diagnosis of pulp necrosis is very difficult. That is because limitation in distinguishing between normal dental papilla in immature permanent teeth, transient apical breakdown(TAB), which is part of normal healing process, and apical radiolucency in pulp necrosis. Especially in non-vital immature permanent tooth, the treatment is complex and requires long time. This clinical case report shows that severely infected immature teeth with periradicular periodontitis can undergo healing and apexogenesis or maturogenesis with no definative treatment or after conservative treatment. In the cases reported, we emphasize the considerable power of regeneration of the tooth, probably due to its large number of undifferentiated mesenchymal cells in the dental papilla, pulp tissue, periodontal ligament tissues. Thus, when endodontic treatment in immature permanent teeth, over instrumentation is not recommend for preserve the apical vital stem cells.

• Restorative Dentistry and Endodontics
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• v.38 no.4
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• pp.258-262
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• 2013

The restorative management of deep carious lesions and the preservation of pulp vitality of immature teeth present real challenges for dental practitioners. New tricalcium silicate cements are of interest in the treatment of such cases. This case describes the immediate management and the follow-up of an extensive carious lesion on an immature second right mandibular premolar. Following anesthesia and rubber dam isolation, the carious lesion was removed and a partial pulpotomy was performed. After obtaining hemostasis, the exposed pulp was covered with a tricalcium silicate cement (Biodentine, Septodont) and a glass ionomer cement (Fuji IX extra, GC Corp.) restoration was placed over the tricalcium silicate cement. A review appointment was arranged after seven days, where the tooth was asymptomatic with the patient reporting no pain during the intervening period. At both 3 and 6 mon follow up, it was noted that the tooth was vital, with normal responses to thermal tests. Radiographic examination of the tooth indicated dentin-bridge formation in the pulp chamber and the continuous root formation. This case report demonstrates a fast tissue response both at the pulpal and root dentin level. The use of tricalcium silicate cement should be considered as a conservative intervention in the treatment of symptomatic immature teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.4
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• pp.399-406
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• 2011

Traumatic injury on tooth occurs frequently among trauma patients, and mainly occurs on tooth with premature roots which influences pulp tissue, periodontal ligament, alveolar bone, and Hertwig's epithelial root sheath. According to the degree of trauma, a number of kinds of healing process can be observed, such as complete re-vascularization of pulp, root canal obliteration, growth suspension of root apex, and invasion of alveolar bone into root canal, and there can be some complications such as necrotic change of inflammatory root resorption and partial pulp necrosis due to pulp necrosis toward complete necrosis. In this clinical case, 3 patients who had traumatic injury showed root growth suspension and alveolar bone invasion into root canal due to proliferation of periodontal ligament cell and osteocyte at the base of extraction socket into pulp chamber because of the injury on Hertwig's epithelial root sheath. If intrusion of alveolar bone into root canal due to injury on Hertwig's epithelial root sheath after having traumatic injury doesn't show any complication, the pulp may be considered to have normal vitality and doesn't need any further treatment, therefore differential diagnosis is very necessary. However, it may be accompanied with suspension of root growth, therefore, additional trauma during the treatment of injured tooth should not be applied.

• The Journal of the Korean dental association
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• v.48 no.10
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• pp.754-761
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• 2010

Horizontal root fractures are defined as those that involve cementum, dentin and pulp, comprising from 0.5 to 7% of injuries in permanent dentition on dental trauma. Diagnosis is made through clinical findings and radiographic exams, the latter frequently being limited by the position of the fracture line. Treatment varies according to the displacement of crown portion and vitality of the fragments. Authors describe clinical cases of maxillary right central incisor with horizontal root fractures in dental clinic, Jeju National University Hospital.