• 대한치과보철학회지
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• 제32권2호
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• pp.225-233
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• 1994

The restorations of the severely damaged teeth by post core have been increased with the developement of endodontic procedures. But high failure rates of these procedures being reported, various restorative modifications were induced for successful treatments. Cast post-core and prefabricated post with core buildups are choice of treatment. The main causes of failure of the restorations are the fracture of post and core, root fracture, and recurrent caries due to microleakage. Recently, the acid etching technique and the use of dentin bonding agent at tooth surface to reduce the possible microleakage at the tooth-restoration interfaces were introduced. The object of this study was to measure and compare the microleakage by the types and cementation methods of post-core. For this study, forty extracted human anterior teeth were selected for specimen. After cleansing and routine endodontic procedures, anatomic crowns of each specimen were removed at the level of 2mm above the cementoenamel junction. Canals were preparated for post insertion and specimens were divided into four groups randomly. Post-cores were fabricated according to method for each group. Microleakage was measured by length of dye penetration at the tooth-restoration interfaces with measuring microscope at 50 magnification. Oneway ANOVA and t-test were performed for statistical analysis of resulting data. The following results were obtained from this study. 1. There wert significant statistical differences in degree of microleakage between each group (p<0.01). 2. Cast post-core cemented with ZPC (Group I) showed the most severe microleakage pattern$(1.5547{\pm}0.0872mm)$, and cast post-core cemented with adhesive resin cement after tooth surface treatment with dentin bonding agent (Group II) showed the least microleakage $(0.1497{\pm}0.0872mm)$. 3. Group IV revealed less dye penetrations than group III, but no statistical significance was seen between two groups.

• 대한소아치과학회지
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• 제34권2호
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• pp.329-334
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• 2007

유치의 치수감염은 주로 치아우식증이나 외상에 의해 발생한다. 유치의 치수 감염을 적절히 치료하지 않으면, 계승영구치의 법랑질 형성 부전이나 매복, 치배의 위치 변화, 치근 만곡 등의 합병증을 초래한다. 유치의 치근단 병소에 의한 계승영구치는 여러 방향으로 변위가 가능하다. 변위된 계승영구치의 치료법으로는 유치 발거 후 주기적 관찰, 외과적인 노출, 교정적 견인, 치아이식, 영구치의 발거 등이 있다. 본 증례들에서는 초진시 임상적 및 방사선학적 검사 결과, 유전치의 치근단 병소에 의해 변위된 영구치 치배가 관찰되었다. 변위 정도와 치근 발육 정도, 맹출 방향 등을 고려하여 유치 발거 후 변위된 영구치의 자발적 맹출 유도를 기대하였다. 두 증례에서 유치의 발거 후 주기적 관찰만으로 변위된 영구치의 자발적 맹출의 결과를 얻을 수 있었다.

• 대한소아치과학회지
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• 제23권3호
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• pp.688-696
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• 1996

Garre's osteomyelitis is a unique form of osteomyelitis characterized rediographically by localized thickening of the periosteum and deposition of laminated subperiosteal bone. The most common inciting factor is a mandibular infection in permanent first molar with necrotic pulp. This disease occurs primarily in children and to date in all instances it has occured only in mandible. It usually results in hard swelling over the jaws, producing facial asymmetry with little or no pain. The overlying skin is normal but can occasionally be inflammed mostly when pain is present. Palpation reveals a usually smooth, bone-hard lesion which feel like an inherent part of the mandible. Unlike other forms of osteomyelitis, there is no marked increase in fever, white bloods cell count, sedimentation rate or alkaline phosphatase value. The treatment of Garre's osteomyelitis usually consist of elimination of the sourses of infection, i.e., either extration of an offending infected teeth or root canal therapy. This treatment almost always results in resolution of the Garre's osteomyelitis. Resistant cases have involved secondary surgery, i.e., decortication and sequestrectomy. This report presents three cases of Garre's osteomyelitis resolved by endodontic treatment. Cliniqtl examination revealed swelling on the face with no tenderness. Periapical radiograph showed deep caries lesion extending into pulp chamber and periapical radiolucency. Occlusal radiograph showed an enlargement of bone and stretching the periosteum. A clinical diagnosis of the Garre's osteomyelitis was made. Endodontic treatment was accomplished with conventional method and restored facial symmetry. Long-term check-ups are necessary to evaluate the results of endodontic treatment.

• Restorative Dentistry and Endodontics
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• 제25권4호
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• pp.606-618
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• 2000

Dental pulp infection is most commonly caused by extensive dental caries, and some bacterial species invade root canals; bacterial components and products are thought to be associated with the pathogenesis of periapical periodontitis. A principle driving force behind pulpal disease response appears to lie in the host immune system's to bacteria and their products. We examined the production of interleukin $1{\beta}$ (IL-$1{\beta}$) and tumor necrosis factor ${\alpha}$(TNF-${\alpha}$) from human peripheral mononuclear cells, lymphocytes and monocytes stimulated by heat-killed Acitnobacillus actinomycetemcomitans (ATCC 29523), Porphyromonas gingivalis (ATCC 33277) and Prevotella intermedia (ATCC 25611), and also by their sonicated bacterial extracts (SBE), respectively. The effects of three strains of heat-killed bacteria and their SBEs on the morphology of cultured blood cell lines HL-60 (KCLB 10240) and J774A.1 (KCLB 40067) were observed under the inverted microscope. Ultrastructural changes of J774A.1 exposed to heat-killed P. intermedia and its SBE were investigated using transmission electron microscopy. Production of IL-$1{\beta}$ was reduced in human peripheral mononuclear cells after stimulation by sonic bacterial extracts of A. actinomycetemcomitans, P. gingivalis, and P. intermedia. Heat-killed and sonic extract of P. gingivalis inhibited the production of TNF-${\alpha}$ in peripheral mononuclear cells. Production of TNF-${\alpha}$ was inhibited in peripheral monocytes after stimulation by sonic extracts of A. actinomycetemcomitans, P. gingivalis, and P. intermedia. HL-60 and J 774A.1 cells showed granular degeneration after treatment with heat-killed and sonic extracts of A. actinomycetemcomitans, P. gingivalis, and P. intermedia Chromatin margination and shrinkage were observed in 774A.1 treated with heat-killed P. intermedia. Cell wall structure and organelles were destroyed and vacuoles were formed in cytoplasm in J774A.1 treated with P. intermedia sonic extract. These results suggest that A actinomycetemcomitans, P gingivalis and P intermedia may have an important role in the formation and progression of pulpal diseases via both modulation of production of IL-$1{\beta}$ and TNF-${\alpha}$ from blood mononuclear cells and cytopathic effects.

• 대한소아치과학회지
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• 제39권1호
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• pp.84-89
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• 2012

치근낭은 가장 흔한 치성기원 낭으로 치수감염, 치수실활, 외상으로 인한 이차감염 또는 치아 우식에 의해 발생한다. 보통치근낭은 무증상이나 이차 감염이 발생할 경우 통증, 부종, 발적 등을 유발할 수 있으며, 크기가 커질수록 치근낭은 인접한 신경을 압박하여 안면비대칭 또는 마비증세를 일으킬 수 있다. 치료는 보존적 신경치료 또는 외과적 처치를 요하며, 낭의 크기가 크거나 인접 조직의 침범을 야기할 가능성이 있는 경우에는 낭적출술을 시행해야 한다. 대부분의 증례에서 완벽한 치료가 가능하고 재발율이 낮다. 본 증례의 환아들은 하악전치부 낭을 주소로 내원하여 임상검사에서 일부 하악전치가 괴사되었음을 발견하였으므로 근관치료를 시행한 후 전신마취하에 치근단절제술 및 치근낭 적출술을 시행하였다. 이후 컴퓨터단층촬영을 시행하여 이환부의 골생성 및 재발여부를 관찰하였으며 성공적인 결과를 보였기에 이를 보고하는 바이다.

• 대한소아치과학회지
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• 제38권1호
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• pp.82-87
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• 2011

유치의 치수 감염에 대한 적절한 치료가 이루어지지 않거나 치료가 실패한 경우 치근단 병소를 야기할 수 있다. 이는 발육중인 계승 영구치에도 영향을 주어 법랑질 형성 부전, 치배의 위치 및 맹출 경로 변화, 치근 만곡, 치아 매복 등의 합병증을 유발할 수 있다. 계승 영구치의 맹출 방향에 이상을 일으키는 장애 요인으로는 유치의 만기 잔존, 유구치의 불균형적인 치근 흡수, 유치의 치근단 병소 등의 맹출 전 장애 요인과 외상이나 구강 악습관과 같은 맹출 후 장애 요인이 있다. 맹출 경로의 이상을 보이는 계승 영구치의 치료 방법으로는 주기적인 관찰, 외과적 노출, 교정적 견인, 치아 이식, 발치 등이 있으며 치료 방법 선택시 치아의 위치, 상태, 치근 형성 정도 및 만곡 여부, 맹출 방향, 인접 구조물과의 관계 등을 고려하여야 한다. 본 증례들은 유치의 치근단 병소에 의해 비정상적인 맹출 경로를 보이는 소구치를 가진 환자들에서 감염된 유치의 발거와 공간 유지만으로 이환된 소구치의 양호한 자발적 맹출을 보였기에 보고하는 바이다.

• 치위생과학회지
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• 제15권2호
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• pp.238-245
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• 2015

본 연구는 지각과민처치제에 항균 물질을 첨가하여 항균실험 및 지각과민처치제의 세포독성실험을 실시하여 다음과 같은 결과를 얻었다. 항균실험에서는 Micro Prime은 항균 약물의 농도가 높을수록 항균력도 높게 나타나 각 그룹간의 항균 범위는 통계적인 유의차를 나타내었다(p<0.05). Hurri Seal에서는 gallic acid 항균 약물 농도가 높을수록 항균력이 높게 나타났지만(p<0.05), tetracycline을 함유한 desensitizer에서는 농도가 높을수록 항균효과는 떨어지는 것으로 나타났다(p<0.05). 또한 chlorhexidine과 cetylpyridinium chloride에서는 대조군에서만 차이를 나타내고(p<0.05), 각 실험군에서 차이를 나타내지 않았다. 세포독성도를 평가한 결과 Micro Prime은 미약한 세포독성을 나타냈으며, Hurri Sea은 심한 세포독성을 나타냈다. 이상의 연구결과로 지각과민처치제에 항균물질을 첨가할 경우 우수한 항균력이 나타났기 때문에 지각과민 환자의 동통을 줄여 줄 것으로 사료되며 항균성을 가진 지각과민처치제로 사용이 가능할 것으로 판단된다.

• 대한소아치과학회지
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• 제37권1호
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• pp.136-142
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• 2010

이소맹출은 치아가 비정상적인 위치나 방향으로 맹출하는 것으로 정의되며 구치부에서는 근심측으로 맹출하여 인접치아의 치근 흡수나 조기 탈락을 야기하여 공간 상실을 일으킬 수 있고, 부분 맹출된 경우 치은 하방의 치아우식 위험성이 증가하고 농양을 형성할 수도 있다. 구치부의 이소맹출 가운데 66% 정도는 가역적인 경우로 특별한 치료 없이 자연적으로 정상적인 맹출이 일어나며, 비가역적인 이소맹출의 경우에는 치아의 맹출 상태, 인접치에 의해 매복된 양, 인접치의 동요도, 통증이나 감염 여부 등의 여러 요인을 고려하여 본격적인 치료가 필요하다. 본 논문에서는 비가역적으로 이소맹출된 상악 제1대구치와 하악 제2대구치를 치간이개 고무줄, modified Halterman appliance 그리고 외과적 노출 후 modified Halterman appliance를 이용한 방법 등으로 정상적인 맹출을 유도한 증례를 보고 하는 바이다.

• Restorative Dentistry and Endodontics
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• 제25권2호
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• pp.180-192
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• 2000

One bottle system was recently developed in order to simplify the clinical skills and save chair time after continuous improvements on dentin bonding agents. There has been many studies to measure the bond strength of one bottle systems but no actual work has been done on micromorphologic study of resin-dentin interdiffusion zone after one bottle system application. To evaluate the bonding patterns of various commercially available one bottle systems to dentin, observation of resin-dentin interdiffusion zone under TEM was performed. Caries-free human third molars within one month of extractions were chosen for the experiments. The molars were sectioned 1mm above the cementoenamel junction and got rid of the root portions. Crown portions of the teeth were sectioned parallel to occlusal surface so that dentin discs of 1mm in thickness were remained. 7 one bottle systems and 1 two bottle system were applied according to manufacturer's instructions and followings were the results. 1. In every experimental groups, cross bandings of collagen fiber were distinguishable and tight bon dings between the bonding agents and dentin were observed. 2. Hybrid layer was clearly observed in ONE-STEP$^{(R)}$, Prime & Bond$^{(R)}$ 2.1, Syntac$^{(R)}$ SC, MAC-BOND II groups but it was not clear in Single Bond, D-Liner Dual PLUS, ONE COAT BOND groups. 3. Electron-density of hybrid layer was uniform in pattern in MAC-BOND II, Prime & Bond$^{(R)}$ 2.1 groups but not so uniform in ONE-STEP$^{(R)}$ group. 4. Electron-dense amorphous phase in most superior layer of the resin-dentin interdiffusion zone was characteristically observed in Single Bond, Syntac$^{(R)}$ SC, ONE COAT BOND groups. It can be concluded that bondings between the dentin bonding agents and dentin can be various in pattern according to their chemical compositions and the condition during applications.

• 대한치과마취과학회지
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• 제13권4호
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• pp.209-214
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• 2013

Multiple caries in a pediatric patient often requires dental treatment under general anesthesia, especially when the patient is suffering from a systemic disease. The patient was a 6-year-old boy with Marfan syndrome and needed extensive dental treatment. Marfan syndrome is an inherited disorder resulting from mutations in Fibrillin-1 gene. Patients are known to have mainly cardiovascular, ocular, and musculoskeletal problems. Although clinical symptoms of the syndrome are age-realted, thus hindering early diagnosis of the disease in young children, our patient had been confirmed by a gene study at a younger age. Medical history of the patient revealed moderate to severe mitral regurgitation and aortic root dilatation, which required mitral valve replacement surgery with a mechanical valve. As a result, the patient was taking warfarin post-operatively and changes in medication had to be made before the dental treatment. Also, prophyalctic antibiotics had to be given before the treatment for prevention of (to prevent the) infective endocarditis. With careful control of the medications and bleeding tendency, general anesthesia and the treatment were done successfully without any complications.