• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.92-97
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• 2004

Traumatic injuries in the young peranent dentition are common, but root fractures, defined as fractures in volving dentin, cementum and pulp, are relatively uncommon. Case 1 is a 9-year-old boy who had a horizontal root fracture of his maxillary right central incisor in the apical third. Root canal therapy was performed in coronal segment and calcium hydroxide therapy was initiated. Six months after treatment, a periapical radiograph showed calcific tissue formation and normal root development. 1 year and 3 months later, the canal was permanently obturated with gutta-percha. Case 2 is a 7-year-old girl who had a vertical root fracture of her maxillary right central incisor. Fractured tooth was intentionally extracted atraumatically, and then the separated fragments are bonded with resin cement. the restored tooth was replanted into the original socket. Recalls up to 8 months showed normal mobility and no periapical pathosis. In these cases, we performed conservative treatment. Clinical and radiographic examination showed no pathosis or abnormality of the teeth and periodontal tissue.

• Restorative Dentistry and Endodontics
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• v.42 no.2
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• pp.105-110
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• 2017

Objectives: This study investigated the cleaning ability of ultrasonically activated irrigation (UAI) and a novel activation system with reciprocating motion (EC, EasyClean, Easy Equipamentos $Odontol\acute{o}gicos$) when used with a relatively new chelating agent (QMix, Dentsply). In addition, the effect of QMix solution when used for a shorter (1 minute) and a longer application time (3 minutes) was investigated. Materials and Methods: Fifty permanent human teeth were prepared with K3 rotary system and 6% sodium hypochlorite. Samples were randomly assigned to five groups (n = 10) according to the final irrigation protocol: G1, negative control (distilled water); G2, positive control (QMix 1 minute); G3, QMix 1 minute/UAI; G4, QMix 1 minute/EC; G5, QMix 3 minutes. Subsequently the teeth were prepared and three photomicrographs were obtained in each root third of root walls, by scanning electron microscopy. Two blinded and pre-calibrated examiners evaluated the images using a four-category scoring system. Data were statistically analyzed using Kruskal-Wallis and Dunn tests (p < 0.05). Results: There were differences among groups (p < 0.05). UAI showed better cleaning ability than EC (p < 0.05). There were improvements when QMix was used with auxiliary devices in comparison with conventional irrigation (p < 0.05). Conventional irrigation for 3 minutes presented significantly better results than its use for 1 minute (p < 0.05). Conclusions: QMix should be used for 1 minute when it is used with UAI, since this final irrigation protocol showed the best performance and also allowed clinical optimization of this procedure.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.4
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• pp.274-280
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• 2021

Intentional replantation has been used for alternative treatment for conventional root canal therapy. This case report describes that the intentional replantation with application of extrusive orhodontic force for 6 weeks, on which tooth of previous root canal therapy. As preapplicatory orthodontic force, tooth moblity was increased so that extraction of the designated tooth was more easily accomplished and augmented volume of periodontal ligament is expected to acceleated gingival reattachment.

• Journal of the korean academy of Pediatric Dentistry
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• v.21 no.2
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• pp.518-524
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• 1994

A traumatically intruded tooth is one that is forcefully and abruptly dispaced from its position into the surrounding alveolar bone. Although intrusion of permanent teeth is infrequent, the sequelae compromise the longevity of the tooth and often include pulp necrosis, internal and external root resorption, rupture of periodontal ligament and loss of marginal bone. The purpose of this study was to examine three common management techniques for traumatic intrusion, observation for re-eruption, surgical repositioning & fixation and orthodontic extrusion. In the recent, the accepted treatment was to allow the permanent teeth to reerupt spontaneously for 6-8 weeks. If this did not occur, orthodontic traction was applied. The pulpal status of the teeth was monitored and either calcium hydroxide therapy or conventional endodontics was instituted following pulpal necrosis depending on the maturity of the root end. Pulpectomy and a calcium hydroxide filling were also the treatment of choice if there was evidence of internal or external root resorption. This will reduce the chance of root resorption and provide a period of monitoring prior to a definitive root canal filling.

• Restorative Dentistry and Endodontics
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• v.45 no.2
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• pp.14.1-14.7
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• 2020

Objective: The aim of this study was to perform a comparative evaluation of the effectiveness of ultrasonic tips versus the Terauchi file retrieval kit (TFRK) for the removal of broken endodontic instruments. Materials and Methods: A total of 80 extracted human first mandibular molars with moderate root canal curvature were selected. Following access cavity preparation canal patency was established with a size 10/15 K-file in the mesiobuccal canals of all teeth. The teeth were divided into 2 groups of 40 teeth each: the P group (ProUltra tips) and the T group (TFRK). Each group was further subdivided into 2 smaller groups of 20 teeth each according to whether ProTaper F1 rotary instruments were fractured in either the coronal third (C constituting the PC and TC groups) or the middle third (M constituting the PM and TM groups). Instrument retrieval was performed using either ProUltra tips or the TFRK. Results: The overall success rate at removing the separated instrument was 90% in group P and 95% in group T (p > 0.05) The mean time for instrument removal was higher with the ultrasonic tips than with the TFRK (p > 0.05). Conclusion: Both systems are acceptable clinical tools for instrument retrieval but the loop device in the TFRK requires slightly more dexterity than is needed for the ProUltra tips.

• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.1
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• pp.31-38
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• 2024

Dens in dente is a developmental anomaly resulting from infolding of the enamel organ into dental papilla prior to calcification of dental tissue. The pulpal tissue of the tooth can be vulnerable for bacterial invasion through direct exposure to the oral cavity or through defective enamel and dentin of the infolding part, thereby increasing the possibility of pulpal necrosis and subsequent apical periodontitis. Treatment planning of teeth with dens invaginatus may be difficult due to the complex root canal morphology. Therefore, thorough knowledge of anatomical variations of dens invaginatus is of great importance for proper treatment planning. The focus of this case report is on Oehler's type II and III dens invaginatus. The infolding of type III dens invaginatus extends beyond the crown and CEJ. Bacterial invasion through the infolding can easily cause inflammation of the pulpal and periradicular tissue. This case report presents endodontic treatment of type II and III dens invaginatus with the aid of CBCT.

• Proceedings of the KACD Conference
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• 2001.05a
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• pp.247-251
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• 2001

;A dental developmental anomaly is defined as an isolated aberration in tooth form, caused by a disturbance or abnormality which occurred during tooth development. There are numerous types of dental anomalies, and a considerable variation in the extent of the defects occurs with each type. Teeth with these anomalies pose unique challenges. Since the defects are not always apparent clinically, they can confuse diagnosticians investigating the etiology of pulpal pathosis. When endodontic treatment is required, the defects often hinder access cavity preparation and canal instrumentation. Treatment planning also becomes more challenging, since the defects can create complicated periodontal problems, and the malformed teeth can be difficult to restore, particularly those weakened by endodontic therapy. Fusion is defined as the joining of two developing tooth germs resulting in a single large tooth structure. The incidence of fusion is < 1% in the Caucasian population, and it is believed that physical force or pressure produces contact of the developing teeth. Clinically and radiographically, a fused tooth usually appears as one large crown with at least partially separated roots and root canals. There may be a vertical groove in the tooth crown delineating the originally separate crowns. Dens invaginatus is a deep surface invagination of the crown or root that is lined by enamel. Teeth in both maxillary and mandibular arches may be affected, but the permanent maxillary lateral incisor is the tooth most commonly involved. Studies have revealed an incidence ranging from 0.25% to as high as 10%. The invagination ranges from a slight pitting to an anomaly occupying most of the crown and root. The invagination frequently communicates with the oral cavity, allowing the entry of irritants and microorganism either directly into pulpal tissues or into an area that is deparated from pulpal tissues by only a thin layer of enamel and dentin. This continuous ingress of irritants and the subsequent inflammation usually lead to necrosis of the adjacent pulp tissue and then to periapical or periodontal abscesses. If the invagination extends from the crown to the periradicular tissue and has no communication with the root canal system, the pulp may remain vital. Recommended treatment of fused tooth and dens invaginatus has been reported in the endodontic literature. This case report describes the endodontic treatment of a maxillary laterl incisors having fused crown and dens invaginatus.natus.

• Restorative Dentistry and Endodontics
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• v.42 no.3
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• pp.232-239
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• 2017

Objectives: The evaluation of iatrogenic dentinal defects in extracted teeth may be influenced by extraction forces and prolonged dry times. The purpose of this study was to compare the presence of dentinal defects in freshly extracted, periodontally compromised teeth with those in a group of teeth with uncontrolled extraction forces and storage time. Materials and Methods: The experimental group consisted of eighteen roots obtained from teeth extracted due to periodontal reasons with class II or III mobility. They were kept in saline and sectioned within 1 hour following extraction. The control group consisted of matched root types obtained from an anonymous tooth collection, consistent with previous dentinal defect studies. The slices were obtained at 3, 6, and 9 mm from the apex. The imaging process exposed all specimens to no more than 60 seconds of dry time. The ${\times}12.8$ magnification was used for the 9 mm slices and ${\times}19.2$ magnification for the 3 mm and 6 mm slices under light-emitting diode (LED) transillumination. The root canal spaces and periodontal tissues were masked to minimize extraneous factors that might influence the evaluators. Chi-square test was used for statistical analysis. Results: Dentinal defects were detected in 17% of the experimental group teeth, compared to 61% of control teeth (p = 0.015). Conclusions: LED transillumination assessment of freshly extracted roots with class II or III mobility showed smaller number of dentinal defects than roots with uncontrolled storage time and extraction forces. The use of freshly extracted roots with mobility should be considered for future dental defect assessment studies.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.270-273
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• 1997

Caudal epiduroscopy has been introduced as an alternative technique for direct injection of epidural steroid and lysis of adhesion. Futher, it gives a better understanding of the role of epidural adhesion in recurrence of sciatica and low back disorder after surgery. We experienced a clinical application of flexible fiberoptic epiduroscope inserted through the sacral canal. A 37-year-old woman was suffering from right lumbar radiculopathy after an operation for a herniated disc. A series of volumetric caudal steroid injections and physical therapy had little effect on her symptoms. Patient was thought to be a good candidate for epiduroscopy. Flexible flberoptic epiduroscopy was as follows: 60 ml of normal saline irrigation and epidurogram, 40 mg of triamcinolone in 10m1 of normal saline was directed around right L5 nerve root. The following morning, patient reported reduced pain in her leg.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.244-253
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• 1997

During preparation of narrow curved canals, procedural accidents such as, ledge, zipping, and transportation are frequently encountered and may lead to failure of endodontic therapy. To reduce these procedural errors and efficiently manage curved canals, various modifications in instrumentation technique and the design and flexibility of instruments have been advocated. This study compared the maintenance of the original canal curvature, cross sectional canal shape, and preparation time during instrumentation with stainless steel hand (K-Flexo) file, and nickel-titanium rotary files (Profile and Lightspeed). Thirty resin blocks with simulated curved canals of 20~25 degrees were used and divided into three groups of 10 each. In group 1, canals were instrumented using a quarter turn/pull technique with K-Flexofiles. Group 2 canals were prepared with rotary NiTi Profiles. Group 3 was prepared with rotary NiTi Lightspeed instrument. Before and after instrumentation, all canals were scanned using stereo microcope, FlexCam camera, and Photoshop 3.0 computer program. The results were as follows : 1. All groups showed some loss of canal curvature after instrumentation. Average loss of canal curvature was 8.6 degrees for K-Flexofile, 7.7 degrees for Profile, and 5.8 degrees for Lightspeed. Lightspeed exhibited significantly less curvature loss than K-Flexofile (p<0.05). 2. At the apical 1-mm level, Profile produced significantly rounder canals than Lightspeed (p<0.05). At the 3-mm level, Profile and Lightspeed exhibited significantly rounder canals than K-Flexofile (p<0.05). 3. Preparation with Lightspeed was significantly faster than Profile and K-Flexofile, and Profile was faster than K-Flexofile (p<0.05). 4. There was no significant difference in incidence of zipping between the hand K-Flexofile and rotary NiTi (Profile and Lightspeed) instruments. Most of apical canals were slightly widened near the apical foramen. As a results of this study, rotary NiTi instruments are superior to the K-Flexofile in regard to the maintenance of original canal curvature, cross-sectional shape and preparation time. But more investigations and studies should be needed to evaluate the ideal canal instrumentation.