• Journal of the korean academy of Pediatric Dentistry
• /
• v.39 no.4
• /
• pp.397-403
• /
• 2012

The vitality of immature tooth could be lost by dental caries, trauma and fracture of malformed tooth. The vitality loss might lead to halt of the development of the root. The recommended endodontic treatment for a non-vital immature permanent tooth is apexification. Apexification is a method of inducing apical closure through the formation of mineralized tissue in the apical pulp region. Calcium hydroxide is the material of choice for apexification. Long-term exposure to calcium hydroxide may form the apical hard tissue, but weaken the dentin due to its alkaline nature and thus make the roots more susceptible to fracture. It is important to preserve any weakened tooth, so a permanent restoration is needed to reinforce teeth that are prone to fracture. The purpose of this case report was to describe the treatment for reinforcing immature teeth treated with long-term calcium hydroxide. In these cases, the apexes of teeth were sealed with MTA plugs and the root canals were restored with composite resin and fiber post.

• Restorative Dentistry and Endodontics
• /
• v.30 no.2
• /
• pp.102-111
• /
• 2005

The purpose of this study was to assess the incidence of flare-ups among patients who received endodontic treatment and to examine the correlation with pre-operative and operative variables. Analysis was in two aspects (a) overall incidence of flare-ups as expressed by a percentage of all patients visits and (b) percentage of flare-ups that occurred as related to various factors suck as patient demo-graphics, diagnosis, and treatment procedures. 1. From the 840 teeth which were examined in this study, the total number of flare-ups was 13. 2. As to gender of patients, there was no significant difference in flare-ups. 3. As to tooth groups, there was no significant difference in flare-ups. 4. In the teeth with pre-operative symptom, there was a statistically significant higher incidence of flare-ups than the teeth without it. 5. In the teeth with apical periodontitis, there was a statistically significant higher incidence of flare-ups. 6. As to pulp and periapical status. non-vital teeth had a higher incidence as compared with vital teeth, irreversible pulpitis. 7. Multi-visit treatment resulted in the higher incidence of flare-ups than one visit treatment. 8. Re-treatment procedures had a statistically significant higher incidence of flare-ups than root canal treatment. In this study, overall percentages of flare-ups was $1.55\%$. It showed a statistically significant higher incidence related to pre-operative symptom, apical periodontitis, and re-treatment. There was no significant difference in flare-ups related to gender, tooth groups, and fistula.

• Restorative Dentistry and Endodontics
• /
• v.39 no.3
• /
• pp.155-163
• /
• 2014

Objectives: Light-curing of resin-based materials (RBMs) increases the pulp chamber temperature, with detrimental effects on the vital pulp. This in vitro study compared the temperature rise under demineralized human tooth dentin during light-curing and the degrees of conversion (DCs) of three different RBMs using quartz tungsten halogen (QTH) and light-emitting diode (LED) units (LCUs). Materials and Methods: Demineralized and non-demineralized dentin disks were prepared from 120 extracted human mandibular molars. The temperature rise under the dentin disks (n = 12) during the light-curing of three RBMs, i.e. an Ormocer-based composite resin (Ceram. X, Dentsply DeTrey), a low-shrinkage silorane-based composite (Filtek P90, 3M ESPE), and a giomer (Beautifil II, Shofu GmbH), was measured with a K-type thermocouple wire. The DCs of the materials were investigated using Fourier transform infrared spectroscopy. Results: The temperature rise under the demineralized dentin disks was higher than that under the non-demineralized dentin disks during the polymerization of all restorative materials (p < 0.05). Filtek P90 induced higher temperature rise during polymerization than Ceram.X and Beautifil II under demineralized dentin (p < 0.05). The temperature rise under demineralized dentin during Filtek P90 polymerization exceeded the threshold value ($5.5^{\circ}C$), with no significant differences between the DCs of the test materials (p > 0.05). Conclusions: Although there were no significant differences in the DCs, the temperature rise under demineralized dentin disks for the silorane-based composite was higher than that for dimethacrylate-based restorative materials, particularly with QTH LCU.

• The korean journal of orthodontics
• /
• v.21 no.2 s.34
• /
• pp.259-272
• /
• 1991

Orthodontic traction has been suggested as the treatment of choice for intrusive luxation injuries. Prior research has shown orthodontic forces to be ineffective in the presence of ankylosis or in cases with zero mobility following the injury. If orthodontic traction is to be effective, it must be initiated prior to the onset of ankylosis. The purpose of this study was to describe the effects of intrusive luxation at various times following the injury, and to determine the time of the onset of ankylosis, and to examine what effect immediate partial luxation has on the onset of ankylosis. Eight young mongrel dogs were utilized for this study. Intrusive luxation was produced with an axial impact using a gravity hammer and a specially designed holding device on 4 teeth (2 max. and 2 man. first premolars) in each dog. The teeth were intruded approximately 3-4mm in an axial direction. One maxillary and one mandibular premolars were partially luxated with the other two teeth being untouched. Pre and posttrauma tooth position was documented with plaster models and radiographs taken with an individualized X-ray jig. Dogs were sacrificed immediately following the injury and at 1, 2, 4, 7, 10, 14 and 21 days respectively. Tetracycline was administered as a vital bone marker 24 hours before sacrifice. Block sections of the tooth and alveolus were prepared for decalcified and non decalcified histologic sections. The effects of traumatic intrusion were analyzed by means of model casts, radiographs, tetracycline bone marking and histologic preparations. The results obtained were as follows: 1. The animal sacrificed immediately following the injury displayed alveolar fractures, torn periodontal ligaments, and areas of direct tooth-bone contact. 2. The odontoblastic layer of the pulp was disorganized as early as 24 hours after the injury. 3. Bony remodeling was noted at 4 days along with active surface resorption. 4. Ankylosis was first seen 7 days after the injury. 5. Osteogenesis in the dentin (thick tetracycline bands) was observed 7 days after the injury. 6. There was no progressive root resorption and ankylosis where the periodontal ligament has been healed. 7. The Luxated group showed significantly more root resolution and ankylosis than the Nonluxated group with increased observation periods. The results suggest that ankylosis may occur within the first week following the injury, and hence orthodontic traction should be initiated as soon after the injury as possible.

• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.31 no.2
• /
• pp.47-55
• /
• 2022

Food impaction due to proximal space opening after implant restoration is a very common phenomenon in patients who have implant prosthesis. This occurs because the movement mechanism between the implant and the tooth is different, and it occurs about 30-60% over time. Contributing factors include the arch (mandible), region (posterior teeth), adjacent teeth (non-vital teeth), and antagonist teeth (natural teeth or implants), etc. While this phenomenon cannot be prevented, efforts should be made to minimize it. In order to have an ideal proximal contact as much as possible, the concave shape or the prominent lower proximal shape should be modified to create a symmetrical proximal shape. with the buccal dentate in the upper third height should be adjusted. Other conditions should be modified so that the heights of the marginal ridges are similar. Since an irregular occlusal plane is a cause of poor prognosis, food impaction should be minimized by restoring the ideal occlusal plane by correcting the extruded antagonist and reduction of the disto-buccal cusp.

• Restorative Dentistry and Endodontics
• /
• v.24 no.4
• /
• pp.560-569
• /
• 1999

Blood supply rather than nerve supply implies pulp vitality. To evaluate pulp vitality clinically, electric pulp test and thermal test which are based on sensory nerve response have been used in addition to many auxiliary data such as past dental history, visual inspection, radiographic examination, percussion, palpation and transillumination test. However, reactivity of the nerves to the stimulation is not synonymous with normalcy. Therefore measurement of pulpal blood flow using a laser Doppler flowmeter became a new trial to test the pulp vitality. The purpose of the present study was to evaluate normal pulpal blood flow level of maxillary teeth in adult to provide a guideline in determining the vitality of dental pulp. Pulpal blood flow was measured in maxillary central and lateral incisors, canines, first and second premolars and first molars of seventy nine adults of 22 - 30 years old using a laser Doppler flowmeter (PeriFlux 4001, Perimed Co., Stockholm, Sweden, 780 nm infrared laser, 1mW). For directly-made splints, silicone rubber impressions were taken directly from the mouth. For indirectly-made splints, alginate impressions were taken from the mouth and stone cast were made. After making depressions on the buccal surfaces of the cast teeth to indicate the hole positions, second impressions with vinyl polysyloxane putty were taken from the cast. Holes for the laser probes were made at the putty impressions 4mm above the gingival level. Laser probe (PF416 dental probe, 1.5mm) was inserted in the prepared hole and the splint was set in the mouth. After 10 minutes of patient relaxing, pulpal blood flow was recorded for 5 minutes on each tooth. The recorded flow was saved in the computer and calculated with a software 'Perisoft' version 5.1. Pulpal blood flow was also recorded in six teeth of five individuals with no response to electric pulp test and cold test, with periapical radiolucency, or with history of root canal treatment to compare with nonvital teeth. The difference between the mean flow values of each group of teeth were analyzed using one-way ANOVA and Duncan's Multiple Range test. The results were as follows: 1. The average pulpal blood flow values of all the tested teeth of each location were between 9 - 16 Perfusion Unit. Pulpal blood flow value was highest in maxillary lateral incisors, followed by first premolars, second premolars, canines, central incisors, and then first molars (p<0.01). 2. In six anterior teeth, indirectly-made splint group showed higher pulpal blood flow values than directly-made splint group (p<0.01). In posterior teeth, however, there was no significant flow value difference between directly-made splint group and indirectly-made splint one (p>0.05). 3. Teeth with vital pulps showed higher signal values than teeth with nonvital pulps (p<0.01), and the flow photographs showed heartbeat-synchronous fluctuations and vasomotions, while those were absent in non vital tooth.

• Journal of dental hygiene science
• /
• v.16 no.4
• /
• pp.317-322
• /
• 2016

Mineral trioxide aggregate (MTA) is widely used in endodontic therapy as a pulp-capping material, root or furcal perforation repair material, and for apexification and obturation of the root canal system. The purpose of this study was to formally document cases of MTA application in South Korean children and adolescents. Through this research, the practice of using MTA will be introduced and familiarized to the clinical practitioners. This study involved endodontic treatment using MTA for fractured crowns in 11- and 12-year-old. The children were followed up for 12 months until the pulp vitality was confirmed; in young permanent teeth with immature roots, the pulp is integral to the process of apexogenesis. These observational results regarding the use of MTA as an apexification material in non-vital immature permanent incisors appear to provide promising results in the search for new materials to meet existing endodontic needs.