• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.1
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• pp.47-55
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• 2017

This study evaluated critical factors influencing the success of regenerative endodontic treatment for necrotic immature permanent teeth. The study enrolled patients who had regenerative endodontic treatment in a necrotic immature permanent tooth through 1-year follow-up. Possible explanatory variables related to the success rates for 46 teeth were age, gender, dental stage at the initial appointment, etiology, treatment information, and clinical and radiographic outcomes. The dental stage at the time of regenerative endodontic treatment did not influence the success rate. The success rate was significantly related to the etiology of the necrotic immature tooth. The success rate according to etiology decreased in the following order: dens evaginatus, caries, and trauma. There was also a significant difference according to the type of antimicrobial. The success rate was influenced by appropriate disinfection of the root canal system, provision of a scaffold, and coronal sealing. Above all, careful case selection is necessary for treating a necrotic immature permanent tooth, especially in cases of trauma.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.6
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• pp.323-341
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• 2019

Background: Local anesthetics alone or in combination with adjuncts, such as oral medications, have routinely been used for pain control during endodontic treatment. The best clinical choice amongst the vast numbers of agents and techniques available for pain control for irreversible pulpitis is unclear. This network meta-analysis combined the available evidence on agents and techniques for pulpal anesthesia in the maxilla and mandible, in order to identify the best amongst these approaches statistically, as a basis for future clinical trials. Methods: Randomized trials in MEDLINE, DARE, and COCHRANE databases were screened based on inclusion criteria and data were extracted. Heterogeneity was assessed and odds ratios were used to estimate effects. Inconsistencies between direct and indirect pooled estimates were evaluated by H-statistics. The Grading of Recommendation, Assessment, Development, and Evaluation working group approach was used to assess evidence quality. Results: Sixty-two studies (nine studies in the maxilla and 53 studies in the mandible) were included in the meta-analysis. Increased mandibular pulpal anesthesia success was observed on premedication with aceclofenac + paracetamol or supplemental 4% articaine buccal infiltration or ibuprofen+paracetamol premedication, all the above mentioned with 2% lignocaine inferior alveolar nerve block (IANB). No significant difference was noted for any of the agents investigated in terms of the success rate of maxillary pulpal anesthesia. Conclusion: Direct and indirect comparisons indicated that some combinations of IANB with premedication and/or supplemental infiltration had a greater chance of producing successful mandibular pulpal anesthesia. No ideal technique for maxillary anesthesia emerged. Randomized clinical trials with increased sample size may be needed to provide more conclusive data. Our findings suggest that further high-quality studies are required in order to provide definitive direction to clinicians regarding the best agents and techniques to use for mandibular and maxillary anesthesia for irreversible pulpitis.

• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.162-165
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• 2014

Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a chronic, progressive, inflammatory disorder characterized by marked fibrosis of the spinal dura mater with unknown etiology. According to the location of the lesion, it might induce neurologic deficits by compression of spinal cord and nerve root. A 58-year old female with a 3-year history of progressive weakness in both lower extremities was referred to our institute. Spinal computed tomography (CT) scan showed an osteolytic lesion involving base of the C6 spinous process with adjacent epidural mass. Magnetic resonance imaging (MRI) revealed an epidural mass involving dorsal aspect of cervical spinal canal from C5 to C7 level, with low signal intensity on T1 and T2 weighted images and non-enhancement on T1 weighted-enhanced images. We decided to undertake surgical exploration. At the operation field, there was yellow colored, thickened fibrous tissue over the dura mater. The lesion was removed totally, and decompression of spinal cord was achieved. Symptoms improved partially after the operation. Histopathologically, fibrotic pachymeninges with scanty inflammatory cells was revealed, which was compatible with diagnosis of idiopathic hypertrophic pachymeningitis. Six months after operation, motor power grade of both lower extremities was normal on physical examination. However, the patient still complained of mild weakness in the right lower extremity. Although the nature of IHSP is generally indolent, decompressive surgery should be considered for the patient with definite or progressive neurologic symptoms in order to prevent further deterioration. In addition, IHSP can present as an osteolytic lesion. Differential diagnosis with neoplastic disease, including giant cell tumor, is important.

• Journal of the Korean Crystal Growth and Crystal Technology
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• v.25 no.3
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• pp.105-110
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• 2015

The fiber-reinforced endodontic posts were prepared using a photocurable resin and a glass fiber. The mechanical property of the posts increased with increasing density of glass fiber and the micro-pores in the post were removed by a vacuum impregnation process. To improve the interfacial adhesion between glass fiber and polymer, silane coupling agent was used. The surface treatment of glass fiber increased the surface wettability of resing on glass fiber and increased the adhesion property with resin, consequently improved the mechanical property of posts.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.11 no.1
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• pp.1-4
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• 2015

Diastema is thought to be a problem related to aesthetics, pronunciation, or malocclusion. Due to its extent and patient conditions, orthodontic treatment, prosthodontic treatment, and conservative direct resin restoration are the treatment options for diastema closure. Additional factors need to be considered when deciding on the most appropriate treatment of diastema, particularly for patients with cerebral palsy. A 13-year-old girl visited the Department of Pediatric Dentistry at Yonsei University Dental Hospital with a chief complaint of the large gap between her upper front teeth. After clinical and radiographic examinations, midline diastema of 4.5 mm, protrusive maxilla incisors, congenital missing teeth, retained primary teeth, etc. were identified. Prosthodontic treatment with intentional root canal treatment was not appropriate because of the patient's age. Dental spaces can be closed effectively via orthodontic appliances. However, additional prosthodontic and restorative intervention is unavoidable, which incurs significant costs and requires more time. Instead of orthodontic and prosthodontic treatment, direct resin restoration can address the chief complaint; these restorations are reversible, less harmful to other oral structure and teeth, relatively easy to apply, less expensive than other treatments, and require shorter office visits. Midline diastema can be treated in several ways. For diastema closure in patients with cerebral palsy, conservative resin restorations are a short, simple, and appropriate treatment compared with orthodontic or prosthodontic treatments.

• The Journal of Advanced Prosthodontics
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• v.3 no.2
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• pp.90-95
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• 2011

PURPOSE. To compare the fracture resistance and the mode of failure of endodontically treated teeth restored with different post-core systems. MATERIALS AND METHODS. Root canal treatment was performed on 40 maxillary incisors and the samples were divided into four groups of 10 each. For three experimental groups post space preparation was done and teeth were restored with cast post-core (Group B), stainless steel post with composite core (Group C) and glass fiber post with composite core using adhesive resin cement (Group D). Control group (A) samples were selected with intact coronal structure. All the samples were prepared for ideal abutment preparation. All the samples were subjected to a load of 0.5 mm/min at $130^{circ}$.until fracture occurred using the universal testing machine. The fracture resistance was measured and the data were analyzed statistically. The fracture above the embedded resin was considered to be favorable and the fracture below the level was considered as unfavorable. The statistical analysis of fracture resistance between different groups was carried out with t-test. For the mode of failure the statistical analysis was carried out by Kruskal-Wallis test and Chi-Square test. RESULTS. For experimental group Vs control group the fracture resistance values showed significant differences (P<.05). For the mode of failure the chi-square value is 16.1610, which means highly significant (P=.0009) statistically. CONCLUSION. Endodontically treated teeth without post core system showed the least fracture resistance demonstrating the need to reinforce the tooth. Stainless steel post with composite core showed the highest fracture resistance among all the experimental groups. Teeth restored with the Glass fiber post showed the most favorable fractures making them more amenable to the re-treatment.

• The Journal of Advanced Prosthodontics
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• v.3 no.4
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• pp.186-189
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• 2011

PURPOSE. Porcelain fused to metal (PFM) crowns provide the best treatment option for teeth that have a large or defective restoration. More than 20% of teeth with PFM crowns or bridges require non-surgical root canal treatment (NSRCT). This may be due to the effect of restorative procedures and the possible leakage of bacteria and or their by-products, which leads to the demise of the tooth pulp. Thus, this study was planned to compare the ability of the restorative materials to seal perforated PFM specimens. MATERIALS AND METHODS. The study evaluates the ability of amalgam, composite or compomer restorative materials to close perforated PFM specimen's in-vitro. Ninety PFM specimens were constructed using Ni-Cr alloys and feldspathic porcelain, and then they were divided into 3 groups: amalgam (A), composite + Exite adhesive bond (B) and compomer + Syntac adhesive bond (C). All the PFM samples were embedded in an acrylic block to provide complete sealing of the hole from the bottom side. After the aging period, each group was further divided into 3 equal subgroups according to the thermocycling period (one week for 70 cycles, one month for 300 cycles and three months for 900 cycles). Each subgroup was put into containers containing dye (Pelikan INK), one maintained at $5^{\circ}C$ and the other at $55^{\circ}C$, each cycle for 30 sec time. The data obtained was analyzed by SPSS, 2006 using one way ANOVA test and student t-test and significant difference level at (P<.01). RESULTS. The depth of dye penetration was measured at the interfaces of PFM and filling materials using Co-ordinate Vernier Microscope. The lowest levels of the dye penetration for the three groups, as well as subgroups were during the first week. The values of dye leakage had significantly increased by time intervals in subgroups A and C. CONCLUSION. It was seen that amalgam showed higher leakage than composite while compomer showed the lowest level of leakage.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.46-51
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• 2004

Talon cusp is cusp-like structure that develops additionally in crown of anterior tooth. And it is one of dental anomalies. Talon cusp can cause various diagnostic, functional, aesthetic problems depending on the size and configuration of cusp. there is a tendency for caries to occur in the developmental grooves, and advanced attrition, periodontal problems, irritation the tongue and temporomandibular pain, occlusal interference and displacement of affected tooth may result. Therefore, early diagnosis and appropriate treatment of each case is important so that it minimize local problems, such as caries, periodontal diseases, and malocclusion. These cases which are in permanent and primary anterior teeth are about gradual reduction forming reparative dentine and complete reduction of talon cusp and root canal therapy which is an alternative and effective form of treatment when gradual reduction of talon cusp may not be possible.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.495-500
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• 2004

Dens invaginatus is a malformation of tooth resulting from an infolding of the enamel epithelium during tooth development. This malformation shows a broad spectrum of morphologic variations. This invagination frequently allows the entry of irritants and microorganism, which usually lead to necrosis of the adjacent pulp tissue and then to periapical or periodontal abscess. Root canal treatment of such tooth is often difficult because of the un usual form and complicated pulpal space. This article reports 2 cases of dens invaginatus in maxillary lateral incisors. The first case was successfully treated with $Ca(OH)_2$. In the second case, involved tooth was extracted and this extracted tooth was observed using the micro-computed tomography.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.1
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• pp.14-18
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• 2017

X-linked dominant hypophosphataemic rickets(XLHR) is a hereditary disease generally transmitted as an X-linked dominant trait. Oral manifestations include poorly mineralized dentin, enlarged pulp chambers and root canals, early tooth loss. Also, spontaneous dental abscesses could occur in the absence of a history of trauma or caries. This report describes the clinical finding and dental treatment of a child, who came to the hospital for treatment caries but was refered to pediatrics because the child showed clinically short of status, bow-leg and radiographically enlarged pulp chamber and canal, there as diagnosed as XLHR. After the diagnosis, 13 years follow-up and treatment were performed.