• The Korean Journal of Pain
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• 제10권2호
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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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• 제35권2호
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• pp.80-87
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• 2010

이 실험의 목적은 NaOCl과 CHX의 혼합사용 시, 발생하는 침전물의 형성을 막기 위해 두 용액간의 접촉을 줄일 수 있는 여러 가지 방법을 비교하고, 관찰된 침전물의 원소를 분석하는 것이다. 발거된 50개의 단근치를 사용하였으며 2.5% NaOCl을 이용하여 .04 taper ProFile #40까지 근관형성 하였다. 치아는 다음과 같은 근관세척 방법에 따라 4개의 실험군과 1개의 대조군으로 나누었다; 대조군: 2.5% NaOCl, 1군: 2.5% NaOCl + 2% CHX, 2군: 2.5% NaOCl + paper points + 2% CHX, 3군: 2.5% NaOCl + .04/#45 근관확대 + 2% CHX, 4군: 2.5% NaOCl +95% alcohol+ 2% CHX. 근관세척 후 치아를 양분하고 치관부, 중간부, 치근부 세부위로 나누어 전계 방사형 주사 전자현미경을 통하여 잔사 비율, 개방 상아세관 비율, 상아세관 내 물질의 원소분석을 시행하였다. 실험결과, 실험군 사이에 잔사비율과 개방된 상아세관 비율 비교에서 통계학 적으로 유의할 만한 차이는 나타나지 않았다. 1 군의 한 시편에서 C의 함유량이 높게 나타났으며 N과 Cl도 함께 검출되어 para-chloraniline으로 추정되며, 1 군의 다른 시편과 나머지 실험군에서는 O, P, C, Ca의 순으로 함유량이 높은 것으로 나타나 수산화인회석으로 추정된다. NaOCl 세척 후 바로 CHX 세척을 한 군에서 PCA로 의심되는 물질이 검출된 바, 두 용액의 직접적인 접촉을 피하기 위해 주의가 필요하며, 본 실험에 사용된 여러 근관 세척방법 이용 시 침전물의 형성을 예방할 수 있을 것이다.

• 대한치과의사협회지
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• 제54권3호
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• pp.206-216
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• 2016

Objectives The aim of this study was to evaluate the antibacterial effect of xanthorrhizol (XTZ) on E. faecalis, compared with 2% chlorhexidine (CHX). Materials and Methods Normal physiological state (NS), starvation state (SS), and alkalization state (AS) of E. faecalis were used. A solution containing 1% XTZ in 30% ethanol, 1% dimethyl sulfoxide (DMSO), and 100 mg/ml sodium methyl cocoyl taurate was used and is referred to as Xan in this study. To determine the minimal bactericidal concentration (MBC) of Xan and CHX, $500{\mu}l$ of E. faecalis (NS and two stress states) was added to a microtube containing $500{\mu}l$ of serial 2-fold dilutions of 1% Xan and 2% CHX (1:2-1:128). The MBC of each antimicrobial was determined by the plate count method. Results The antibacterial effect of Xan was more effective on E. faecalis in AS than in the other states (NS, SS) at 0.125% Xan and 0.03325% Xan (P<0.05). In contrast, the antibacterial effect of CHX was more effective against E. faecalis in SS than the other states (NS, AS) at 0.0625% CHX (P<0.05). In SS, the antibacterial effect of CHX was more effective than that of Xan at 0.125% and 0.0625% (P<0.05). However, in AS, the antibacterial effect of Xan was more effective than that of CHX at 0.0625% and 0.03325% (P<0.05). Conclusions In endodontic retreatment cases in which it is important to effectively remove E. faecalis from the infected root canal, Xan may be more suitable when combined with NaOCl than CHX.

• Restorative Dentistry and Endodontics
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• 제8권1호
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• pp.123-131
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• 1982

The purpose of this study was to observe the responses of the remaining pulp tissue after pulpotomy upon the several kinds of $Ca(OH)_2$ products and the responses of periapical tissue upon some root canal filling materials after extirpation. For pulpotomy, the class V cavities were prepared on the premolars, molars and upper canines, and the pulp was amputated. Each drug was placed over the amputated tissue and cavity was sealed with zinc oxide eugenol cement. The drugs which were used for the study were Dycal (Caulk Co. U.S.A.), Cavitec (Kerr Co. U.S.A.), Calvital, Nobudyne and Neodyne (Neo Dental Chemical Products). For extirpation, the endodontic cavities were prepared on the lingual surfaces of anterior teeth, and the pulp tissues were extirpated as routine method. After enlarging, irrigation, and measuring of root length by taking X-ray, each root canal filling material was filled in the canal with gutta percha cone, and endodontic cavity was sealed with zinc oxide eugenol cement. Zinc oxide eugenol, $Ca(OH)_2$ (Eli Lilly Co. U.S.A.) and Vitapex (Neo Dental Chemical Products) were used as root canal filling materials. Animals were sacrificed after 1, 3 and 6 weeks following the operation. The teeth were decalcified in formic acid, sectioned and stained with hematoxylin eosin. Microscopic examination revealed as follows. 1. Dycal: The dentin bridge formation was observed at the 3rd week after pulpotomy. Inflammatory conditions which were infiltration of inflammatory cells and dilatation of blood vessels were kept in remaining pulp tissue at the 6th week. 2. Calvital: The dentin bridge was observed at the 1st week after pulpotomy. As the time clasped, the pulp tended to be the fibrous degeneration. 3. Cavitec, Nobudyne and Neodyne: In the case of Cavitec and Nobudyne, the incompleted and irregular dentin bridge was observed at the 6th week, and in Neodyne, was observed at the 3rd week. The severe inflammatory changes were seen in the remaining pulp tissue. As the time clasped, the fibrous degeneration tended to spread in the remaining pulp tissue. 4. $Ca(OH)_2$: Osteocementum was formed at the 3rd week, the matrix of cementum and dentin were resorted, and infiltration of lymphocytes was seen in periapical tissue when $Ca(OH)_2$ was used as canal-filling materials. S. ZOE and Vitapex The cementum like substance was seen in periapical portion at the 1st week, when ZOE and Vitapex were used as root canal filling materials. As the time elapsed, the matrix of cementum and dentin tended to be resorted. At the 6th week, the inflammatory condition of periapical tissue was continued in the case of ZOE, but was reduced in the case of Vitapex.

• Restorative Dentistry and Endodontics
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• 제33권4호
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• pp.397-404
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• 2008

본 연구의 목적은 최종 근관세척제로서의 MTAD, EDTA 그리고 차아염소산 나트륨 용액이 충전된 근관의 세균 (Enterococcus faecalis) 미세누출에 미치는 영향을 평가하기 위한 것이다. 40개의 발치된 사람의 대구치를 양성대조군 (1군 : n = 5), 음성대조군 (2군 : n = 5), 그리고 실험군 (3, 4, 5군 : n = 10)으로 각각 무작위 배정하였다. 3군에서는 근관형성시 차아염소산 나트륨만 사용하여 근관세척을 시행하였으며, 4군 및 5군에서는 차아염소산 나트륨과 함께 EDTA와 MTAD를 각각 최종 근관세척제로 사용하였다. 실험군 및 대조군의 치아들은 .06 taper를 가지는 40번 profile을 master apical file로 근관형성을 시행하였으며 gutta-percha와 AH-26 근관봉함제로 근관충전하였다. 각 치아의 치관부는 Enterococcus faecalis를 함유한 BHI 배지와 접촉되도록 하였고 치근 끝부분은 멸균된 배양액에 위치되도록 하였다. 각각의 치아는 anaerobic chamber내에 위치되었으며 180일 동안 혼탁도를 관찰하였다. 통계처리는 95% 신뢰수준에서 Fiher's exact test를 사용하였다. 180일의 관찰기간이 경과된 후, 3, 4, 5 군은 각각 7, 4, 5 개의 치아에서 미세누출이 일어났으며 이 차이는 통계적으로 유의성이 없었다.

• 대한치과의사협회지
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• 제47권8호
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• pp.479-486
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• 2009

Purpose: The aim of this study was to show the clinical results of combination of Nd-YAP (1340nm) laser therapy with conventional endodontic and periodontal treatment. Materials and Methods: Four patients with chronic advanced periodontitis and endodontic infection were treated with conventional treatment and Nd-YAP laser therapy. Occlusal adjustment and splinting were done for stabilization of the teeth with severe horizontal and vertical mobility. The protocol for periodontal treatment was followed as scaling and root planing, pocket irrigation with 3% $H_2O_2$ and exposure of Nd-YAP laser using 320${\mu}m$ optical fiber with 160mJ/pluse, 30Hz. The other protocol for endodontic treatment was followed as access opening, canal preparation by hand and rotary instrument, canal filling, and exposure of Nd-YAP laser using 200${\mu}m$ optical fiber with 200mJ/pluse, 10Hz and 180mJ/pluse, 5Hz which were used respectively for disinfection and canal filling. The assessments of probing depth, mobility, and radiography were made prior to and after treatment. Result: All of these four clinical cases showed good healing of periodontium, which presented decrease of mobility and pocket depth, and increase of bone regeneration and bone density on the radiography. Conclusion: The bactericidal effect of Nd-YAP laser would provide benefits for improving clinical results that are obtained from conventional therapy.

• Restorative Dentistry and Endodontics
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• 제40권2호
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• pp.123-127
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• 2015

Objectives: Glide path preparation is recommended to reduce torsional failure of nickel-titanium (NiTi) rotary instruments and to prevent root canal transportation. This study evaluated whether the repetitive insertions of G-files to the working length maintain the apical size as well as provide sufficient lumen as a glide path for subsequent instrumentation. Materials and Methods: The G-file system (Micro-Mega) composed of G1 and G2 files for glide path preparation was used with the J-shaped, simulated resin canals. After inserting a G1 file twice, a G2 file was inserted to the working length 1, 4, 7, or 10 times for four each experimental group, respectively (n = 10). Then the canals were cleaned by copious irrigation, and lubricated with a separating gel medium. Canal replicas were made using silicone impression material, and the diameter of the replicas was measured at working length (D0) and 1 mm level (D1) under a scanning electron microscope. Data was analysed by one-way ANOVA and post-hoc tests (p = 0.05). Results: The diameter at D0 level did not show any significant difference between the 1, 2, 4, and 10 times of repetitive pecking insertions of G2 files at working length. However, 10 times of pecking motion with G2 file resulted in significantly larger canal diameter at D1 (p < 0.05). Conclusions: Under the limitations of this study, the repetitive insertion of a G2 file up to 10 times at working length created an adequate lumen for subsequent apical shaping with other rotary files bigger than International Organization for Standardization (ISO) size 20, without apical transportation at D0 level.

• Restorative Dentistry and Endodontics
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• 제48권3호
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• pp.25.1-25.13
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• 2023

Objectives: The purpose of this study was to evaluate the influence of endodontic access cavities design on the removal of calcium hydroxide medication of the apical third of mandibular incisor root canal walls and dentinal tubules with different cleaning protocols: EDDY sonic activation, Er,Cr:YSGG laser-activated irrigation, or conventional irrigation with IrriFlex. Materials and Methods: Seventy-eight extracted human mandibular incisors were assigned to 6 experimental groups (n = 13) according to the endodontic access cavity and cleaning protocol for calcium hydroxide removal: traditional access cavity (TradAC)/EDDY; ultraconservative access cavity performed in the incisal edge (UltraAC.Inc)/EDDY; TradAC/Er,Cr:YSGG; UltraAC. Inc/Er,Cr:YSGG; TradAC/IrriFlex; or UltraAC.Inc/IrriFlex. Confocal laser scanning microscopy images were used to measure the non-penetration percentage, maximum residual calcium hydroxide penetration depth, and penetration area at 2 and 4 mm from the apex. Data were statistically analyzed using Shapiro-Wilk and WRS2 package for 2-way comparison of non-normally distributed parameters (depth of penetration, area of penetration, and percentage of non-penetration) according to cavity and cleaning protocol with the significance level set at 5%. Results: The effect of cavity and cleaning protocol interactions on penetration depth, penetration area and non-penetration percentage was not found statistically significant at 2 and 4 mm levels (p > 0.05). Conclusions: The present study demonstrated that TradAC or UltraAC.Inc preparations with different cleaning protocols in extracted mandibular incisors did not influence the remaining calcium hydroxide at 2 and 4 mm from the apex.

• 대한치과재료학회지
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• 제45권4호
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• pp.275-286
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• 2018

본 연구에서는 근관 내의 주사침 말단의 위치, 근관 세척액의 주입 속도, 주사침 말단의 형상이 근관 세척 시 발생하는 치근단 압력에 미치는 영향을 평가하고자 하였다. 5개의 사람 하악 소구치에 근관 와동 형성 후 #35(0.06 taper) 니켈-티타늄 회전식 기구로 근관을 형성하였다. 주사침 말단의 형상에 따라 구분되는 notched, side-vented, flat 3가지 종류의 주사침을 근단 협착부로부터 치관 방향으로 1, 3, 5 mm 거리가 되는 지점(주사침 말단의 위치)에 위치시켰다. 각 군에 대하여 세척액 주입 속도는 0.05, 0.1, 0.2, 0.3 ml/s로 변화시키면서 치근단 압력을 측정하였다. 나머지 조건이 동일한 경우 주사침 말단의 위치가 감소할수록, 세척액 주입 속도가 증가할수록 치근단 압력은 유의하게 증가하였다(p<0.05). 주사침 말단의 위치와 세척액 주입 속도가 동일한 조건 하에서 side-vented 주사침이 가장 낮은 치근단 압력을 보였고, notched, flat 주사침 순서로 치근단 압력이 유의하게 증가하였다(p<0.05). 주사침 말단의 위치가 1 mm인 군 또는 세척액 주입 속도가 0.1 ml/s 이상인 군에서는 나머지 조건에 관계없이 모든 경우에서 중심정맥압(5.88mmHg)보다 높은 치근단 압력을 나타냈다. Flat 주사침은 세척액 주입 속도와 주사침 말단의 위치에 따른 치근단 압력의 급격한 증가로 인해 임상에서 사용이 추천되지 않으며, 안전하고 효율적인 근관 세척을 수행하기 위해서는 근단 협착부로부터 치관 방향으로 3 mm 떨어진 지점에 주사침 말단을 위치시키고 0.05 ml/s 이하의 세척액 주입 속도로 근관 세척액을 적용해야 할 것이다.

• 대한소아치과학회지
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• 제40권3호
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• pp.216-222
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• 2013

감염된 미성숙 영구치의 치수치료에 있어 줄기세포의 분화를 유도하는 생활조직의 재생과 지속적인 치근형성을 도모하는 방향으로 패러다임이 전환되고 있는데, 여기에서는 소독, 스캐폴드(scaffold), 그리고 폐쇄가 중요하다. 소독을 위해 triple antibiotics가 널리 사용되고 있으며, 스캐폴드로써 기존의 혈병대신 platelet-rich fibrin의 사용이 보고되었다. 본 증례보고에서는 치외치 파절에 의해 치수가 감염된 미성숙 영구치에서 platelet-rich fibrin을 스캐폴드로써 이용한 치수 재혈관화를 시행하였다. 발수와 근관세척 후 첫 증례에서 국소적 항생제의 적용 없이 platelet-rich fibrin을 단독 사용하였고 두 번째와 세 번째 증례에서는 국소적 항생제 적용 후 platelet-rich fibrin을 적용하였는데 모두 양호한 치유 결과를 얻었다.