• Restorative Dentistry and Endodontics
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• v.39 no.1
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• pp.51-55
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• 2014

The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF) and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.1
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• pp.158-163
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• 2005

It is rare that the complete avulsion, intrusive luxation, and extrusive luxation occurred by trauma at the same time. In July, 2003, 10-year and 2 month-old-girl was referred to Department of Pediatric dentistry, Chonnam National University Hospital due to complete avulsion of upper right lateral incisor, intrusive luxation of upper right cental incisor and extrusive luxation of upper left central incisor. Traumatized teeth were surgically repositioned and fixated with resin-wire splint at the same day. Endodontic treatment of avulsed tooth was performed 2 weeks after trauma. A radiograph was taken 3 months after trauma, which demonstrated root resorption of both upper central incisors. External root resorption was arrested by the root canal therapy with calcium hydroxide. It showed good results for 1 year and 4 month but further follow-up is needed to check root resorption and ankylosis.

• Restorative Dentistry and Endodontics
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• v.27 no.4
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• pp.355-362
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• 2002

One fifth dilution of formocresol is usually used for pulpotomy of the primary teeth and emergency pulpotomy of the permanent teeth. However the use of formaldehyde has been subjected to criticism because it may be absorbed into the blood stream and become distributed systemically, it nay also alter the pulp tissue rendering it immunologically active, and have carcinogenic potential. Recently Depulpin$^{\circledR}$(VoCo., Germany) gains popularity as a devitalizing agent during root canal therapy in spite of high concentration of 49 % paraformaldehyde because it facilitate devitalization of pulp and make root canal therapy easier But there have been not enough publications about the reaction of pulp and periapical tissue caused by Depulpin. This study was performed to evaluate the histological changes in pulp and periapical tissue of rats after pulpotomy using formocresol and Depulpin and to elucidate the toxic effects of these agents. Thirty six Sprague-Dawley rats were anesthetized by intraperitoneal injection of ketamine Maxillary first molar teeth were used for pulpotomy with formocresol and Depulpin. Rats were sacrificed after 2 days, 4 days, 1 week, 2 weeks, 3 weeks and 4 weeks respectively. Specimens were histologically observed by light microscope changes in pulp and periapical tissue. The obtained results were as follows. 1. Formocresol group A zone of fixed tissue. in which odontoblasts could clearly be defined, was present directly underneath the pulpotomy dressing in almost all teeth of this group. This was followed by an area of necrotic tissue which resembled dried out fibrous tissue with no cellular detail except some pyknotic nuclei. In the specimens of after 2 days, 4 days, 1 week, 2 weeks in which vital tissue was present, it was separated from the fibrous area by a zone of inflammation. In the specimens of after 3 weeks and after 4 weeks, inflammatory infiltrate was in the periodontal ligament adjacent to the apical foramina of the teeth. 2. Depulpin$^{\circledR}$ group The area of necrotic tissue which had no cells and fibers, was present adjacent to the dressing. This was followed by dried out fibrous tissue with no cellular details except some pyknotic nuclei, A short stump of vital pulp with odontoblasts was present at the end of the canal after 2 days. Inflammatory infiltrate was in the periodontal ligament after 4 days and after 1week. Severe root resolution and necrosis of periapical tissue opposite the root resorption site were defined after 2 weeks and after 3 weeks. Periapical lesion which consist of necrotic tissue surrounded by a fibrous connective wall, was found after 4 weeks. The results indicated that Depulpin can cause more adverse reaction to the dental pulp and periapical tissue than formocresol, and further studies are needed for its clinical use with safety.

• Journal of Veterinary Clinics
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• v.29 no.6
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• pp.474-482
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• 2012

Elongation of cheek teeth roots in pet rabbits is very common, and is associated with malocclusion followed by reduced appetite, salivation, periapical abscess, and epiphora. Conservative methods including medication, drainage, irrigation, tooth trimming, intraoral and extraoral extraction, surgical treatment of periapical abscessation, and diet control have been adapted as the only treatments to resolve elongation of teeth roots. However, remaining challenges include the long-term period of cure and recurrence. This study was performed to investigate the possibility of nonvital pulp therapy on elongation of the mandibular cheek teeth roots in pet rabbits. Thirty-one pet rabbits with dental problems due to root elongation were submitted. Ten pet rabbits among them were treated by nonvital pulp therapy procedures (group A), while the others were treated by conservative methods (group B). Appetite improved within 1-5 days after nonvital pulp therapy and the treatment was discontinued 1 month postoperatively in group A. Abscess occurred in another site not treated with nonvital pulp therapy in only two rabbits. Growth of the mandibular cheek teeth treated with nonvital pulp therapy stopped, resulting in malocclusion, intraoral inflammation from the enamel spur, and abscess of the teeth roots. In the group B rabbits treated with conservative therapy, partial drainage, long term medication, recurrent oral trimming and control of repeated oral inflammation occurred. Consequently, buccotomy or tooth extraction was performed in group B. Owners were satisfied with nonvital pulp therapy preventing dental root abscess and repeated troubles including inflammation and malocclusion and reduction of the treatment period. These results suggest that nonvital pulp therapy can be performed on pet rabbits with elongation of mandibular cheek teeth roots.

• The Journal of Korean Academy of Prosthodontics
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• v.33 no.2
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• pp.177-197
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• 1995

The endodontically treated tooth is generally restored with post & core, owing to the brittleness and the loss of large amount of tooth structure. Although there have been lots of studies about the endodontically treated teeth, the three-dimensional quantitative studies about the strees distribution of them are in rare cases. In this study, it was assumed that the coronal portion of the upper incisou had severely damaged. After the root canal therapy it was post cored, and restored with PFM crown, for this experiment nine types of model were constructed : 1); long, 2); medium, 3); short gold post for the roots supported with a narmal alveolar bone, 4); long, 5); medium, 6); short gold post for the roots supported with an alveolar bone resorbed to its 1/3 of root length, 7); long, 8); medium, 9); short base metal post for the roots supported with an alveolar bone resorbed to its 1/3 of root length. Force was applied from two directions. One was functional maximum bite force(300N) applied to the spot just lingual to the incisal edge with the angle of 45 degrees to the long axis of the tooth, and the other one was horizontal force(300N) applied to the labial surface. The results analyzed with three-dimensional finite element method were as follows : 1. Stress was concentrated on the middle portion of the labial side dentin of the root and the lingual portion of the apical dentin of the root. Stress in the post showed maximum value at 2 mm above the post apex. 2. In case of the long post and base metal post, strees was concentrated on the apex of the root and the post. 3. In case of the longer post, the displacement on the post-cement interface was lessened. The gold post was more displaceable than the base metal post. 4. In case of the alveolar bone resorption, stress concentrated on the root and the post and displacement on the post-cement interface were increased.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.1
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• pp.82-86
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• 2001

Actinomycosis is chronic, granulomatous, suppurative and fibrosing disease caused by Actinomyces. Actinomyces are anaerobic, G(+), non-acid-fast, branched, filamentous bacteria. The most commonly found microorganism is Actinomyces israelii. Common site for isolation of actinomyces are dental plaque, dental caries, calculus, and tonsillar crypt. A breach in the integrity of the mucosa by direct trauma or following a fracture, tooth extraction, root canal therapy or some intraoral surgical procedure is thought to be the most likely portal of entry. This is a case report of 23 years old male with cervicofacial actinomycosis developed after extraction and treated with surgical excision and antibiotics.

• Restorative Dentistry and Endodontics
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• v.47 no.3
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• pp.26.1-26.10
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• 2022

Wegener's granulomatosis (WG) is a condition with immune-mediated pathogenesis that can present oral manifestations. This report describes the case of a patient diagnosed with WG 14 years previously, who was affected by persistent pain of non-odontogenic origin after successful endodontic treatment. A 39-year-old woman with WG was diagnosed with pulp necrosis and apical periodontitis of teeth #31, #32, and #41, after evaluation through a clinical examination and cone-beam computed tomography (CBCT). At the first appointment, these teeth were subjected to conventional endodontic treatment. At 6- and 12-month follow-up visits, the patient complained of persistent pain associated with the endodontically treated teeth (mainly in tooth #31), despite complete remission of the periapical lesions shown by radiographic and CBCT exams proving the effectiveness of the endodontic treatments, thus indicating a probable diagnostic of persistent pain of non-odontogenic nature. After the surgical procedure was performed to curette the lesion and section 3 mm of the apical third of tooth #31, the histopathological analysis suggested that the painful condition was likely associated with the patient's systemic condition. Based on clinical, radiographic, and histopathological findings, this unusual case report suggests that WG may be related to non-odontogenic persistent pain after successful endodontic treatments.

• The korean journal of orthodontics
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• v.20 no.3 s.32
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• pp.447-462
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• 1990

The objective of this experiment is to observe structural differences in the othodontic movement of vital (control group) and devitalized (experimental group) teeth in the mongrel dogs. The 5 utilized dogs in this experiment were approximately 1 year of age and their average weight was about 12 Kg. Endodontic therapy was performed on the 2nd premolars in upper & lower jaws of each animal under the general anesthesia by intravascular injection of 25mg/kg of pentobarbital sodium. The canals of the teeth were obturated by using gutta percha in conjunction with root canal sealer (AH26 Densply). One of the roots in the 2nd premolars was hemisected to make an extraction space for the devitalized teeth to be moved. The edgewise technique was employed for the movement of the teeth. Orthodontic models and intraoral roentgenograms were taken before and after orthodontic tooth movement. The open coil springs (.010 x .040) were used at interbraket space in order to provide equal forces (75gm) between the teeth in each arch wire. After 13 weeks of active orthodontic tooth movement, dogs were sacrified and the experimental results w ere examined through the intraoral radiography, microscopic examination and scanning electromicroscopic examination at the root sulfate. From the results of the study, the following conclusions may be drawn: The root resolution and cemental deposition were observed within the pressure and tension site in both group. 2. The root resorbed lacunae were observed in the cementum and/or into the dentin in both group. 3. The prominent osteoblastic activities were observed on the alveolar margin in the tension site in both group. 4. A few of blood vessels were observed in the pressure site, but also lots of blood vessels were observed in the tension site especially in the periphery of the alveolar bone in both group. 5. In the pressure site, resorbed lacunae were formed with deep and narrow cavity in the control group; the shallow and wide cavity in the experimental group. 6. In the pressure site, the repaired cementum or cementoid tissue was lined on cementum in the experimental group, but not in the control group. 7. There was no significant difference between external root resolution of endodontically and vital teeth when both were subjected to orthodontic forces.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.181-192
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• 1997

The difficulty of endodontic retreatment depends on various factors and it is affected by retention of post. In this experiment, root canal therapy was done in extracted human teeth and cut into 10mm length from the root apex, and then cemented by zinc phosphate cement, Vitremer$^{(R)}$(glass ionomer) luting cement and Panavia 21$^{(R)}$(resin cement). Post preparation was done by #4 Parapost drill at 6mm length and cement was inserted by lentulo spiral. After 24 hours, tensile bond strength, post removal time was measured after the ultrasonic application and the separation site was measured. The following results were obtained. 1. In measuring tensile bond strength, there is no statistical difference between zinc phosphate cement and Panavia 21$^{(R)}$, but Vitremer$^{(R)}$ showed lower value compared with those two cements. (p<0.001) 2. When the post removal time was measured after ultrasonic application, significant different value in order of Panavia 21$^{(R)}$, zinc phosphate cement and Vitremer$^{(R)}$ was shown. (p<0.001) 3. As a result of examining the separating site of each cement, all 16 of zinc phosphate cement group showed the fracture site between cement and post, Vitremer$^{(R)}$ was 13/16, and Panavia 2$^{(R)}$ was 8/16. In case of tooth restoration using Parapost, the use of Panavia 21 showed good retention property than Vitremer$^{(R)}$, but when retreatment is needed the difficulty of post removal will be increased.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.2
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• pp.91-99
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• 2023

Background: Extrusion of debris is a major factor that results in postoperative pain during root canal treatment with various instruments and instrumentation techniques. Therefore, instrumentation techniques that extrude minimal debris into the periapical area while reducing pain are desirable. This study aimed to compare the incidence of postoperative pain and intake of analgesic medication (frequency and quantity) after endodontic treatment of mandibular posterior teeth using two single files and full-sequence continuous rotary systems with different kinematic motions. Methods: Thirty-five of 105 patients were assigned equally to three groups according to the instrumentation system used: ProTaper Next (PN) X2, 25/06 (Dentsply, Maillefer, Ballaigues, Switzerland), One Shape (OS), #0.25/06 (Micro Mega, Besancon, France), and Wave One Gold (WG), Red - #0.25, 0.07 (Dentsply, Maillefer, Ballaigues, Switzerland). Five specialists were included in this study design; each professional prepared 21 teeth, and randomly selected 7 per instrument system. The VAS sheet ranging from 0 to 10 was used to record the initial and postoperative pains at 24, 48, and 72 h, and 7^th day after single visit endodontic treatment in mandibular premolars and molars with a diagnosis of asymptomatic irreversible pulpitis with or without apical periodontitis. Postoperatively, an analgesic, ibuprofen 400 mg was administered for intolerable pain at a dose of 1 tablet for 6 h. The patients were asked over the telephone regarding postoperative pain at intervals of 24, 48, and 72 h, and 7^th day using a visual analogue scale. Result: There were no statistically significant differences among the PN, OS, and WG systems (P > 0.05) with regard to the incidence of postoperative pain at any of the four time points assessed. Conclusion: The intensity of postoperative pain, frequency, and analgesic intake were similar across all three types of instrument systems; however, the reciprocating single file (WG) was associated with less postoperative pain than the full sequence continuous rotary file.