• 대한소아치과학회지
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• 제40권2호
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• pp.120-126
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• 2013

심한 우식을 보이는 미성숙 영구치 치료에 있어서 치수생활력을 보존하는 것은 중요하다. 치수절단술을 시행 시 생체적합성이 있는 재료를 이용하여 치료함으로써 남아있는 생활력이 있는 치수를 보호하며 미성숙 영구치의 치근 성장을 도모할 수 있다. 혈소판 농축 섬유소는 환자의 혈액을 직접 채취하여 적용하기 때문에 생체적합성이 뛰어나며 다양한 성장인자를 함유하고 있어 치수생활력을 유지하고 미성숙 영구치의 치근 발육을 촉진시킬 수 있다. 본 증례에서는 심한 치아 우식증을 보이는 미성숙 영구치에서 치수절단술 시행 후 남아 있는 치수 상부에 혈소판 농축 섬유소를 적용하였다. 정기적인 검진 결과 미성숙 영구치의 치근 성장 및 정상적인 치아 주위 조직들이 관찰되었다. 향후 장기간의 임상적 관찰이 필요할 것이며 더 많은 임상 증례를 바탕으로 한 연구가 필요할 것이다.

• 대한치과의사협회지
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• 제56권2호
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• pp.84-93
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• 2018

Purpose: This study evaluated the apical root canal system of maxillary second molars, in which conventional endodontic treatment had failed. Materials and Methods: One hundred eighteen extracted endodontically failed maxillary second molars were examined to investigate the root canal morphology using clinical photographs. High-resolution cross-sectional images at the 3mm level from the root apices were taken to evaluate the anatomic variations and canal cleanliness. The incidence of anatomic variations and canals containing debris were evaluated statistically. Results: One (0.85%) maxillary second molar had four separate roots, while 52 (44.07%) had three separate roots. The remaining 65 (55.08%) showed 6 different types of fusion in their roots. As the number of fused roots increased from none to three, the incidence of isthmuses in the cross-sectional images increased significantly from 43.40% to 76.92% in 2-root fusion and 88.46% in 3-root fusion. In addition, the occurrence of less-cleansed canals increased from 22.64% to 38.46% and 53.85%, respectively (p<0.05). Sixty four teeth (54.24%) had 3 canals while 38(32.2%) had additional canals; most of them were located in the MB roots (81.58%). Seventy six (64.41%) had isthmuses in the apical region and 58 out of 76 were located in MB roots. Condlusions: Logistic analysis indicated that the less division of roots was associated significantly with the occurrence of insufficient cleaning during endodontic treatment (OR=1.765, p<0.05), while the presence of an additional canal showed no association.

• Restorative Dentistry and Endodontics
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• 제19권1호
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• pp.231-254
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• 1994

Fracture of cusp, on posterior teeth, especially those carious or restored, is major cause of tooth loss. Inappropriate treatments, such as unnecessarily wide cavity preparations, increase the potential of further trauma and possible fracture of the remaining tooth structures. Fracture potential may be directly related to the stresses exerted upon the tooth during masticatory function. The purpose of this study is to evaluate the fracture resistance of tooth, restored with composite resin inlay. In this study, MOD inlay cavity prepared on maxillary first premolar and restored with composite resin inlay. Three dimensional finite element models with eight nodes isoparametric solid element, developed by serial grinding-photographing technique. These models have various occlusal isthmus and depth of cavity, 1/2, 1/3 and 1/4 of isthmus width and 0.7, 0.85 and 1.0 of depth of cavity. The magnitude of load was 474 N and 172 N as presented to maximal biting force and normal chewing force. These loads applied onto ridges of buccal and lingual cusp. These models analyzed with three dimensional finite element method. The results of this study were as follows : 1. There is no difference of displacement between width of occlusal isthmus and depth of cavity. 2. The stress concentrated at bucco-mesial comer, bucco-disal comer, pulpal line angle and the interface area between internal slopes of cusp and resin inlay. 3. The vector of stress direct to buccal and lingual side from center of cavity, to tooth surface going on to enamel. The magnitude of vector increase from occlusal surface to cervix. 4. The crack of tooth start interface area, between internal slop of buccal cusp and resin inlay. It progresses through buccopulpal line angle to cervix at buccomesial and buccodistal comer. 5. The influence with depth of cavity to fracture of tooth was more than width of isthmus. 6. It would be favorable to make the isthmus width narrower than a third of the intercuspal distance and depth of cavity is below 1 : 0.7.

• Restorative Dentistry and Endodontics
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• 제42권3호
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• pp.188-199
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• 2017

Objectives: This in vitro study evaluated the effect of dentin biomodifiers on the immediate and long-term bond strengths of a simplified etch and rinse adhesive to dentin. Materials and Methods: Flat coronal dentin surfaces were prepared in 120 extracted human molars. Teeth were randomly divided into 5 groups (n = 24) according to 5 different surface pre-treatments: No pre-treatment (control); 1M carbodiimide (EDC); 0.1% epigallocatechin-3-gallate (EGCG); 2% minocycline (MI); 10% sodium ascorbate (SA). After surface pre-treatment, adhesive (Adper Single Bond 2 [SB], 3M ESPE) was applied. Composite was applied into transparent plastic tubes (2.5 mm in diameter), which was placed over the bonded dentin surface. From each group, 10 samples were subjected to shear bond strength (SBS) evaluation at 24 hours (immediate) and remaining 10 samples were tested after 6 months (delayed). Additionally, 4 samples per group were subjected to scanning electron microscopic analysis for observation of resin-dentin interface. The data were statistically analysed with Shaperio-Wilk W test, 2-way analysis of variance (ANOVA), and post hoc Tukey's test. Results: At 24 hours, SBS of all surface pre-treatment groups were comparable with the control group, with significant differences found between EDC and SA groups only (p = 0.009). After 6 months storage, EDC, EGCG, and MI pre-treatments preserved the resindentin bond strength with no significant fall. Conclusions: Dentin pre-treatment with all the dentin biomodifiers except SA resulted in significant preservation of resin-dentin bond over 6 months storage period, without negatively affecting the immediate bond strength of the etch and rinse adhesive tested.

• Restorative Dentistry and Endodontics
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• 제38권3호
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• pp.154-159
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• 2013

Objectives: The aim of this study was to compare the cleaning efficacy of different final irrigation regimens in canal and isthmus of mandibular molars, and to evaluate the influence of related variables on cleaning efficacy of the irrigation systems. Materials and Methods: Mesial root canals from 60 mandibular molars were prepared and divided into 4 experimental groups according to the final irrigation technique: Group C, syringe irrigation; Group U, ultrasonics activation; Group SC, VPro StreamClean irrigation; Group EV, EndoVac irrigation. Cross-sections at 1, 3 and 5 mm levels from the apex were examined to calculate remaining debris area in the canal and isthmus spaces. Statistical analysis was completed by using Kruskal-Wallis test and Mann-Whitney U test for comparison among groups, and multivariate linear analysis to identify the significant variables (regular replenishment of irrigant, vapor lock management, and ultrasonic activation of irrigant) affecting the cleaning efficacy of the experimental groups. Results: Group SC and EV showed significantly higher canal cleanliness values than group C and U at 1 mm level (p < 0.05), and higher isthmus cleanliness values than group U at 3 mm and all levels of group C (p < 0.05). Multivariate linear regression analysis demonstrated that all variables had independent positive correlation at 1 mm level of canal and at all levels of isthmus with statistical significances. Conclusions: Both VPro StreamClean and EndoVac system showed favorable result as final irrigation regimens for cleaning debris in the complicated root canal system having curved canal and/or isthmus. The debridement of the isthmi significantly depends on the variables rather than the canals.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권5호
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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.

• 한국융합학회논문지
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• 제10권9호
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• pp.257-264
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• 2019

본 연구는 제 6기 국민건강영양조사 원시자료를 이용하여 우리나라 노인의 하루 평균 흡연량에 따른 흡연상태와 상실치아와의 관련성을 알아보고자 하였다. 연구대상은 만 65세 이상의 4,037명 노인을 대상으로 하였으며, 그 결과, 비흡연군에 비해 과거중증흡연이 2.35배, 현재일반흡연군은 3.01배, 현재중증흡연군에서 3.27배로 상실치아의 교차비가 유의하게 높았다. 결론적으로 하루 평균 흡연량에 따라 상실치아의 위험도에 차이가 있음을 확인하였다. 따라서 잔존치아수를 최대한 증대시키고, 유지하기 위해 치과에서 금연치료의 객관적 자료로 제시되고 동기부여에 기여할 수 있으리라 판단된다.

• 구강회복응용과학지
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• 제37권4호
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• pp.251-258
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• 2021

치아 외상은 어린이와 비교적 젊은 연령에서 흔히 발생하며 외상 발생 시점, 환자의 나이, 치아의 성숙 상태 등이 치료 방법에 영향을 미친다. 약 파절편이 건전하고 잔존 치아와 밀접한 적합을 보일 경우, 파절편 재부착은 유용한 치료 옵션이 될 수 있다. 이 방법은 치아 본래의 형태와 교합의 회복뿐만 아니라 기능, 표면 광택과 질감을 그대로 재현할 수 있는 여러 가지 이점이 있다. 본 증례보고는 복잡 치관 파절된 치아를 섬유 강화형 포스트를 활용하여 파절편 재부착을 시행한 두 증례에 대해 소개한다.

• Journal of Periodontal and Implant Science
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• 제52권6호
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• pp.509-521
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• 2022

Purpose: Systemic health has a profound effect on dental treatment. The aim of this study was to evaluate peri-implant bone loss and health screening data to discover factors that may influence peri-implant diseases. Methods: This study analyzed the panoramic X-rays of patients undergoing health screenings at the Health Promotion Center at Seoul St. Mary's Hospital in 2018, to investigate the relationship between laboratory test results and dental data. The patients' physical data, such as height, weight, blood pressure, hematological and urine analysis data, smoking habits, number of remaining teeth, alveolar bone level, number of implants, and degree of bone loss around the implant, were analyzed for correlations. Their associations with glycated hemoglobin, glucose, blood urea nitrogen (BUN), creatinine, and severity of periodontitis were evaluated using univariate and multivariate regression analysis. Results: In total, 2,264 patients opted in for dental health examinations, of whom 752 (33.2%) had undergone dental implant treatment. These 752 patients had a total of 2,658 implants, and 129 (17.1%) had 1 or more implants with peri-implant bone loss of 2 mm or more. The number of these implants was 204 (7%). Body mass index and smoking were not correlated with peri-implant bone loss. Stepwise multivariate regression analysis revealed that the severity of periodontal bone loss (moderate bone loss: odds ratio [OR], 3.154; 95% confidence interval [CI], 1.175-8.475 and severe bone loss: OR, 7.751; 95% CI, 3.003-20) and BUN (OR, 1.082; 95% CI, 1.027-1.141) showed statistically significant predictive value. The severity of periodontitis showed greater predictive value than the biochemical parameters of blood glucose, renal function, and liver function. Conclusions: The results of this study showed that periodontal bone loss was a predictor of peri-implant bone loss, suggesting that periodontal disease should be controlled before dental treatment. Diligent maintenance care is recommended for patients with moderate to severe periodontal bone loss.

• Restorative Dentistry and Endodontics
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• 제46권1호
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• pp.13.1-13.9
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• 2021

Objectives: This study aimed to evaluate and compare the efficacy of the S1 reciprocating system and the D-Race retreatment rotary system for filling material removal and the apical extrusion of debris. Materials and Methods: Sixty-four freshly extracted maxillary canines were shaped with size 10 and size 15 K-files, instrumented using ProTaper Gold under irrigation with 2.5% sodium hypochlorite (NaOCl), obturated according to the principle of thermo-mechanical condensation with gutta-percha and zinc oxide eugenol sealer, and allowed to set for 3 weeks at 37℃. Subsequently, the teeth were divided into a control group (n = 4), the D-Race rotary instrument group (n = 30), and the S1 reciprocating instrument group (n = 30). After classical retreatment, the canals were subjected to a complementary approach with the XP-Endo Shaper. Desocclusol was used as a solvent, and irrigation with 2.5% NaOCl was performed. Each group was divided into subgroups according to the timing of radiographic readings. The images were imported into a software program to measure the remaining filling material, the apical extrusion, and the root canal space. The data were statistically analyzed using the Z-test and JASP graphics software. Results: No significant differences were found between the D-Race and S1 groups for primary retreatment; however, using a complementary cleaning method increased the removal of remnant filling (p < 0.05). Conclusions: Classical removal of canal filling material may not be sufficient for root canal disinfection, although a complementary finishing approach improved the results. Nevertheless, all systems left some debris and caused apical extrusion.