• Title/Summary/Keyword: Pulp vitality

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TRAUMATIC ROOT FRACTURES IN UPPER PERMANENT CENTRAL INCISORS - A CASE REPORT (상악 영구 중절치의 외상성 치근파절 : 증례보고)

  • Choi, Hyung-Jun;Kwak, Ji-Youn;Lee, Jong-Gap;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.385-390
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    • 2003
  • Traumatic injuries in the young permanent dentition are common, but root fractures, defined as fractures involving dentin, cementum and pulp, are relatively uncommon. Appropriate management of root fracture involves repositioning the coronal portion of the tooth fragment and firm immobilization with a splint for 2 to 3 month. Root canal treatment should not be initiated until the sign of necrosis or resorption are apparent because in most cases, the apical fragments maintain their vitality. The following case report describes a patient with root fractures injured three times over the period of 7 years. The results, clinically and radiographically, were acceptable, but long term periodic evaluation is required.

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A Literature Review on Cracked Teeth (균열치 증후군에 대한 문헌고찰)

  • Cho, Woong-Rae;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.3
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    • pp.305-316
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    • 2011
  • Cracked teeth are a common problem with incomplete fracture that typically shows pain on biting and temperature stimuli. The most common cause of crack is known to be the masticatory accident. Predisposing factors were aging, old restoration, and iatrogenic stress concentration, etc. Accurate diagnosis is needed for detecting the extent of crack and pulp vitality. There are many diagnostic tools like bite test, direct observation with transillumination, dye penetration, and radiographs. Immediate treatment for pain relief and occlusal adjustment would be needed. Composite resin and bonded amalgam showed favorable prognosis. Moreover, cusp protection is reliable permanent treatment for cracked teeth. The purpose of this article is to review the literature about the prevention, diagnosis, and treatment for cracked teeth.

A CLINICAL STUDY ON THE PROGNOSIS AND SUCCESS IN CONVENTIONAL ENDODONTIC TREATMENT (재래식 근관치료의 예후와 성공에 관한 임상적 연구)

  • Baek, Seung-Ho;Lim, Sung-Sam
    • Restorative Dentistry and Endodontics
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    • v.10 no.1
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    • pp.115-126
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    • 1984
  • The purpose of this study was to determine the incidence and the degree of interappointment pain and post obturation pain associated with the pretreated clinical factors or conditions, and to examine the correlation between the success or failure and the pretreated clinical factors or conditions and postoperative pain. The author experienced the conventional root canal therapy in one hundred fifty-one teeth after recording the following clinical factors or conditions - sex, age, pulp vitality status, presence or absence of periapical rarefaction, single or multirooted teeth, pretreatment pain, and investigated the pain during and after treatment for seven days. After six months all the cases were re-evaluated through the clinical sign, symptom, and the recalled radiograph. The following results were obtained; 1. Of the 151 teeth (73.5%) had no interappointment pain, 31 teeth (20.5%) slight pain; and 9 teeth (6.0%) moderate to severe pain. 2. The presence of the pretreatment pain significantly increased the incidence and degree of interappointment, and there were no significant relationship between interappointment pain and other clinical factors or conditions. 3. Of the 151 teeth, 142 teeth (4.0%) experienced no post obturation pain, 3 teeth (2.0%) slight pain, 6 teeth (4.0%) moderate to severe pain. 4. There were no statistical correlation between postobturation pain and any of the clinical factor or conditions. 5. 141 teeth (3.4%) of 151 teeth were evaluated as success in this study, and success rate was decreased significantly in the cases of periapical rarefaction before treatment and postobturation pain. But there were no significant relationship between success or failure and other clinical factors or conditions.

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The Dentists' View of Dental Hygienist Duties in Korea

  • Han, Yang-Keum;Yu, Ji-Su;Kim, Seung-Hee;Yang, Jin-Young;Bae, Soo-Myoung;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.20 no.1
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    • pp.34-43
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    • 2020
  • Background: The number and curriculum of dental hygienists in Korea have dramatically increased. Controversies have since resulted from insufficient job descriptions of the work performed by a dental hygienist. A dentist's perception was examined to legally reflect the actual work of dental hygienists. Methods: Four hundred and nineteen dentists were surveyed about the duties of a dental hygienist. Their views on the career and availability of each job were examined. The duties of the dental hygienist include 13 items in dental treatment preparation, 14 items of radiography, 21 items of preventive dentistry, 6 items of periodontal treatment, 12 items of oral medicine, 12 items of conservative dentistry, 8 items of prosthetics, 10 items of orthodontics, 7 items of oral and maxillofacial surgery, 6 items of implantation, 6 items of impression taking and model fabrication, 5 items of anesthesia and injection, 11 items of management and administrative, and 3 items of self-development. Results: Most of the duties were doable by a dental hygienist. Many dentists reported that managing implants, oral hygiene of special patients, some duties in oral medicine, teeth brightening, making temporary crowns, making individual trays, selecting shades, ligaturing, and precision impressions need ≥3 years of experience. Duties perceived by dentists not to be performed by dental hygienists were reading radiographs (55.4%), suture and stitch out (48.0%), intramuscular injection (36.0%), root planning (27.2%), cementation and removal of prostheses (23.2%), and examining pulp vitality (22.0%). Conclusion: Current laws are to be revised to include, the care provided by dental hygienists and under a physician's supervision. Flexibility is also needed to cope with rapidly changing dental technology.

TREATMENT OF AN IMMATURE, TRAUMATIZED PERMANENT TOOTH OF A PATIENT WITH CEREBRAL PALSY : A CASE REPORT (뇌병변 환아에서 외상성 손상을 받은 미성숙 영구치의 치험례)

  • Heo, Seon-Jae;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.2
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    • pp.72-76
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    • 2016
  • Traumatic dental injury (TDI) is a common problem in children and adolescent. The prevalence of dental trauma among children with disability as compared to healthy children. The TDI of an immature permanent tooth can lead to the loss of pulp vitality and arrested root development. Traditionally, the treatment of choice for necrotic immature tooth is apexification, which is induction of hard tissue barrier at the apex to produce more favorable conditions for conventional root canal filling. This case report describes the treatment of a necrotic immature permanent central incisor with complicated crown fracture. The patient had multiple disabilities (cerebral palsy, congenital heart disease, developmental delay, and gait disturbance) and suffered from She was suffered from repetitive traumatic injury. Apexification and resin restoration was performed under general anesthesia, and favorable clinical results were achieved.

CONTINUED ROOT DEVELOPMENT AFTER AVULSION OF IMMATURE TEETH (미성숙 영구치의 탈구성 외상 이후 계속된 치근 성장)

  • Lee, Ju-Eun;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.2
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    • pp.127-132
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    • 2013
  • Traumatic injuries to immature permanent teeth are common and the results can be destructive. Although Hertwig's epithelial root sheath is usually sensitive to trauma, it may resist damage from trauma thereby retaining its vitality and continuing to calcify a root under favorable conditions. This case report describes two cases of trauma to immature permanent incisors. The first case presents an avulsed maxillary central incisor which has been replanted. The other case shows completely avulsed mandibular central incisors which have not been replanted. However, both cases subsequently show continued growing roots separated from the main roots. This report highlights the ability of the immature pulp tissue to continue to form dentin and the robustness of Hertwig's epithelial root sheath to initiate root development despite a traumatic injury.

Complications reported with the use of orthodontic miniscrews: A systematic review

  • Giudice, Antonino Lo;Rustico, Lorenzo;Longo, Miriam;Oteri, Giacomo;Papadopoulos, Moschos A.;Nucera, Riccardo
    • The korean journal of orthodontics
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    • v.51 no.3
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    • pp.199-216
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    • 2021
  • Objective: The aim of this systematic review was to evaluate the complications and side effects associated with the clinical use of orthodontic miniscrews by systematically reviewing the best available evidence. Methods: A survey of articles published up to March 2020 investigating the complications associated with miniscrew insertion, in both the maxilla and mandible, was performed using 7 electronic databases. Clinical studies, case reports, and case series reporting complications associated with the use of orthodontic miniscrew implants were included. Two authors independently performed study selection, data extraction, and risk-of-bias assessment. Results: The database survey yielded 24 articles. The risk-of-bias assessment revealed low methodological quality for the included studies. The most frequent adverse event reported was root injury with an associated periradicular lesion, vitality loss, pink discoloration of the tooth, and transitory loss of pulp sensitivity. Chronic inflammation of the soft tissue surrounding the miniscrew with mucosal overgrowth was also reported. The other adverse events reported were lesion of the buccal mucosa at the insertion site, soft-tissue necrosis, and perforation of the floor of the nasal cavity and maxillary sinus. Adverse events were also reported after miniscrew removal and included secondary bleeding, miniscrew fracture, scars, and exostosis. Conclusions: These findings highlight the need for clinicians to preliminarily assess generic and specific insertion site complications and side effects.

Evaluation of dental status using a questionnaire before administration of general anesthesia for the prevention of dental injuries

  • Kyungjin Lee;Seo-Yul Kim;Kyeong-Mee Park;Sujin Yang;Kee-Deog Kim;Wonse Park
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.1
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    • pp.9-17
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    • 2023
  • Background: Dental evaluation and protection are important for preventing traumatic dental injuries when patients are under general anesthesia. The objective of the present study was to develop a questionnaire based on dentition-related risk factors that could serve as a valuable tool for dental evaluation and documentation. Methods: We developed a questionnaire for dental evaluation before administration of general anesthesia, investigated the association between patient-and-dentist responses and mouthguard fabrication, and assessed response agreement between 100 patients. Results: Protective mouthguards were fabricated for 27 patients who were identified as having a high risk of dental injury. There was a strong association between dentists' responses and mouthguard fabrication, depending on the general oral health status, use of ceramic prosthesis, presence of masticatory pain related to periodontal diseases, gingival edema, and implants (P < 0.05). Response agreement between patients and dentists for items related to dental pain, loss of dental pulp vitality, root canal therapy, dental trauma, aesthetic prosthesis, tooth mobility, and implant prosthesis was high (Cohen's kappa coefficient κ ≥ 0.6). Conclusions: A high agreement was observed between patient-dentist responses and a strong association with mouthguard fabrication for items pertaining to ceramic prosthesis, masticatory pain, and dental implants. Patients with a "yes" response to these items are recommended to undergo a dental evaluation and use a dental protective device while under general anesthesia.

Impact of Periodontal Treatment and Demographic and Socioeconomic Factors on Tooth Loss in Persons with Disabilities: An Analysis of Korean National Health Insurance Claims Data

  • Bo-Ra Kim
    • Journal of dental hygiene science
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    • v.23 no.3
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    • pp.225-235
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    • 2023
  • Background: This study aimed to analyze the effects of periodontal treatment and individual- and tooth-related factors on tooth extraction in people with disabilities. Methods: The Korea National Health Insurance claims data of individuals with disabilities aged 40~64 years with chronic periodontitis in 2008 were obtained. Of these, data on the disabled who underwent scaling/root plaining, subgingival curettage/periodontal surgery, or non-periodontal treatments, and data on their teeth were selected. The extraction of 716,688 teeth from 39,097 patients was tracked until 2018, and the patient- and tooth-level factors related to tooth loss were identified using a mixed-effect logistic regression analysis. Results: Data from approximately 17% of the teeth were extracted during a follow-up period of approximately 11 years. Among the tooth-level variables, scaling/root planing treatment at baseline and periodontal treatment during the follow-up period were associated with a lower risk of tooth loss (odds ratio=0.692 and 0.769, respectively, p<0.001). Non-vital teeth increased the risk of tooth loss by 3.159 times (p<0.001). Among the patient-level variables, females were less likely to have lost their teeth than males, and those with orthopedic impairment or brain lesions/mental disabilities, a higher age group, lower income level, or residents in medium/small cities or rural areas were more likely to have lost their teeth (p<0.001). Conclusion: Through approximately 11 years of follow-up, scaling or root planing, experience with periodontal treatment at least once, female sex, older age, lower income, smaller residential areas, type of disability, and pulp vitality were found to be associated with tooth loss in individuals with disabilities aged 40~64 years with chronic periodontitis. To prevent tooth loss in individuals with disabilities, it is necessary to establish a dental treatment plan that considers the timing of periodontal treatment and the characteristics of the patient and teeth.

Evaluation of Electric Pulp Test (EPT) as a Tool for Measurement of Dentinal Hypersensitivity (상아질 지각과민 측정 도구로서의 전기치수검사에 대한 평가)

  • Kim, Young-Sung
    • Journal of Periodontal and Implant Science
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    • v.32 no.2
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    • pp.371-378
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    • 2002
  • In this study, 40 hypersensitive teeth of 19 patients were investigated. The procedures performed were as follows: Before desensitization, EPT at occlusal third of buccal surface was done for the evaluation of pulp vitality and the EPT value was recorded for the reference value. And mechanical and thermal test was executed for the test of hypersensitivity. If the tooth responded to the above tests, we did EPT at the exposed surface, using toothpaste as a electrolite medium and recorded the EPT value at patient's response. After the tests had been done, desensitization procedures with Gluma(R) Desensitizer were performed according to the manufacturer's instructions. After desensitization, the same tests except EPT at occlusal third were repeated. All the 40 teeth responded positive before desensitization and negative after desensitization procedures. The EPT value at occlusal third ranged from 31 to 65 (48.9${\pm}$7.2). Before desensitization 34 teeth responded at EPT value of 2 and the remaining 6 teeth was in the range of 17 to 25. After desensitization all 40 teeth responded from 12 to 27 (19.6${\pm}$3.5). The 6 teeth responded at greater number than 2 before desensitization was in the range of 18 to 23. Within the limitations of this study we can conclude that: When a tooth with dentinal hypersensitivity responds to mechanical and thermal stimulation, the tooth shows very low resistance to electricity at the exposed surface while when a tooth is desensitized and doesn't show respond to mechanical and thermal stimuli, the tooth shows increased level of resistance to electric stimulation at the exposed surface. EPT can be used for the diagnosis of dentinal hypersensitivity. Furthermore EPT will be useful to evaluate the outcome of desensitization procedures. However, EPT is not a valid tool for measuring dentinal hypersensitivity.