• Restorative Dentistry and Endodontics
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• 제42권3호
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• pp.157-167
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• 2017

This systematic review aims to summarize the current clinical studies that investigated survival rates against fracture of endodontically treated posterior teeth restored with crowns or resin composite restorations. Literature search were performed using keywords. Publications from 1980 to 2016 were searched in PubMed, ScienceDirect, ISI Web of SCIENCE, MEDLINE, and SCOPUS. Included studies were selected based on inclusion and exclusion criteria. Three clinical studies were included: 1 randomized controlled trial and 1 prospective and 1 retrospective cohort studies. Pooled survival rates ranged from 94%-100% and 91.9%-100% for crowns and resin composite, respectively. The majority of teeth had no more than 3 surface loss of tooth structure. The studies included were heterogeneous, and were not appropriate for further meta-analysis. Current evidence suggested that the survival rates against the fracture of endodontically treated posterior teeth restored with crowns or resin composites were not significantly different in the teeth with minimum to moderate loss of tooth structure.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권3호
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• pp.135-139
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• 2014

This following case report describes the open reduction, internal fixation and the reconstruction of an extensive comminuted mandibular fracture with bilateral condylar fractures in a 19-year-old male patient with an intellectual disability and autistic disorder. He suffered fall trauma, resulting in shattered bony fragments of the alveolus and mandibular body between both mandibular rami, the fracture of both condyles and the avulsion or dislocation of every posterior tooth of the mandible. The patient underwent open reduction and internal fixation between both mandibular rami using a reconstruction plate, open reduction and internal fixation of the shattered fragments using miniplates and screws, and the closed reduction of the bilateral condylar fractures.

• Imaging Science in Dentistry
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• 제34권4호
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• pp.185-190
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• 2004

Purpose: To compare the diagnostic accuracy for the detection of root fractures in CMOS-based digital periapical images with conventional film-based periapical images. Materials and Methods: Sixty extracted single-root human teeth with closed apices were prepared endodontically and divided into two groups; artificially induced vertical root fracture group and control group. All radiographs were obtained using the paralleling technique. The radiographs were examined by 4 observers three times within a 4 week interval. Receiver operating characteristic (ROC) analysis was carried out using data obtained from four observers. Intra- and inter-examiner agreements were computed using kappa analysis. Results: The area under the ROC curve (Az) was used as an indicator of the diagnostic accuracy of the imaging system. Az values were as follows: direct-digital images; 0.93, film-based images; 0.92, and inverted digital images; 0.91. There was no significant difference between imaging modalities (P<0.05). The kappa value of inter-observer agreement was 0.42 (range: 0.28-0.60) and intra-observer agreement was 0.57 (range: 0.44-0.75). Conclusion : There is no statistical difference in diagnostic accuracy for the detection of vertical root fractures between digital periapical images and conventional periapical images. The results indicate that the CMOS sensor is a good image detector for the evaluation of vertical root fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권6호
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• pp.513-519
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• 2007

Typical surgical methods for the treatment of mandibular fractures include intermaxillary-fixation (IMF) for obtaining temporary intraoperative occlusion. Traditionally IMF has been achieved with arch-bars or interdental eyelet wiring. However, these techniques are time-consuming procedures, can produce periodontal damage, and are not well tolerated by the patient even under local anesthesia. Moreover, daily maintenance of oral hygiene is difficult for patients with an arch bar. Recently, intermaxillary fixation using intraoral skeletal anchorage screws (SAS) has been introduced for the treatment of mandibular fractures. This method solves the problems above, but they have the potential for tooth damage, screw fractures and intraoperative occlusal instability. In this study, patients with mandiblular fractures were divided into three groups. Group 1 was treated by IMF using archbars(both maxilla and mandible), Group 2 was treated with SAS(maxilla) and arch-bar (mandible), Group 3 was treated with SAS(both maxilla and mandible). The aim of this study was to evaluate the influence of the different IMF methods on periodontal tissue health and intraoperative occlusal rehabilitation about each groups, and to discuss the most favorable IMF method.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권4호
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• pp.712-717
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• 1996

The term osteomyelitis literally means inflammation of bone marrow. It is described as an inflammatory condition of bone primarily engaging the medullary cavity extending to the periosteum. Following circulatory collapse and ischemia, the involved portions of the bone become necrotic. Cellulitis and osteomyelitis are the most frequent complications of fractures of the mandible and maxilla, because there is an abscessed tooth in the line of fracture. Since most fractures are compound fractures, infection may develop because of contact with oral secretions or outside air. The treatment of chronic osteomyelitis is still under debate. Some authors rely on antibiotics alone, while others advocate combination with surgery. But when infection occurs, establish proper drainage and administer antibiotics. Author treated a case of infected mandibular fracture with mandibular osteotomy, sequestrectomy, iliac bone graft and hyperbaric oxygen therapy, who had suffered suppurative osteomyelitis and mandibular nonunion following the open reduction of the mandibular fracture.

• 대한치과의사협회지
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• 제54권8호
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• pp.658-665
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• 2016

Treatment of immature permanent teeth with irreversibly damaged pulp has been challenging in dental practice because of the lack of apical constriction, thin dentinal walls, and short roots. This may lead to the extrusion of filling materials, and fracture of the root due to its more fragile feature during shaping of the root canal. Apexification with calcium hydroxide or MTA is one of the treatment options for these cases. Although favorable results of apexification have been reported, these treatment procedures do not guarantee the increase of root length and/or width even after a long term period. Thus, treated teeth are still prone to fractures. Recently, pulp revascularization has been proposed as an alternative treatment for immature teeth with necrotic pulp and periapical pathosis. Pulp revascularization allows the stimulation of the apical development and the root maturation. There have been many treatment protocols using various materials such as antibiotics and calcium hydroxide medicament. In this case report, literature review about pulp revascularization and two related cases are presented.

• 구강생물연구
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• 제42권4호
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• pp.248-253
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• 2018

Cemental tears are uncommon form of root fracture that can lead to rapid localized periodontal attachment loss. Studies have described periodontal breakdown as being associated with the separation of the cementum from the underlying tooth structure. The aim of this case report is to assess the outcome of treatment of cemental tear with several surgical treatment regimens. Three patients with cemental tear were treated with different surgical method. In all three cases, the cemental tear occurred on maxillary right central incisors. In each case, the root fragment were removed, the localized defect was treated using different surgical methods including guided tissue regeneration and bone graft followed by scaling and root planting. In all three cases, symptoms subsided after the treatment and clinical attachment level was improved up to 2 mm at 3 month after surgery. Both conventional and regenerative periodontal surgery could achieve successful outcomes.

• 대한치과보철학회지
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• 제38권3호
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• pp.366-374
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• 2000

FRC/ceromer system provides the clinician with a durable, flexible, and esthetic alternative to conventional porcelain fused to metal crowns. FRC is the matrix which is silica-coated and embedded in a resin matrix. The ceromer material which is a second generation indirect composite resin contains silanized, microhybrid inorganic fillers embedded in a light-curing organic matrix. FRC/ceromer restoration has a several advantages: better shock absorption, less wear of occluding teeth, translucency, color stability, bonding ability to dental hard tissues, and resiliency. It has versatility of use including inlay, onlay, single crown, and esthetic veneers. With adhesive technique, it can be used for single tooth replacement in forms of inlay adhesion bridge. In single tooth missing case, conventional PFM bridge has been used for esthetic restoration. However, this restoration has several disadvantages such as high cost, potential framework distortion during fabrication, and difficulty in repairing fractures. Inlay adhesion bridge with FRC/ceromer would be a good alternative treatment plan. This article describes a cases restored with Targis/Vectris inlay adhesion bridge. Tooth preparation guide, fabrication procedure, and cementation procedure of this system will be dealt. The strength/weakness of this restoration will be mentioned, also. If it has been used appropriately in carefully selected case, it can satisfy not only dentist's demand of sparing dental hard tissue but also patient's desire of seeking a esthetic restorations with a natural appearance.

• 대한소아치과학회지
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• 제30권3호
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• pp.385-390
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• 2003

청소년기에는 두개악안면부위의 외상성 손상이 흔하다. 그러나 상아질, 백악질, 치수를 포함하는 치아파절로 정의되는 치근파절은 비교적 드물다. 치근파절에 대하여 취 할 수 있는 적절한 조치는 파절편의 치관부위를 재위치시키고, $2{\sim}3$달간 레진강선 고정술을 시행하는 것이다. 치수괴사나 치근흡수의 징후가 나타날때까지 근관치료를 보류해야 하는데 대부분의 증례에서 파절편의 치근부위는 그 생활력을 유지하기 때문이다. 본 증례의 10세 4개월된 남아는 상악영구중절치의 치근파절을 주소로 연세대학교 치과병원에 내원하였으며, 그후 7년동안 동일부위에 2번의 반복적인 외상이 있었으나 파절편 치관부의 재위치, 레진 강선 고정술, 근관치료 시행 후 임상적으로 방사선학적으로 비교적 양호한 치료결과를 얻었기에 보고하는 바이다.

• Restorative Dentistry and Endodontics
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• 제41권4호
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• pp.316-321
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• 2016

Although it is challenging, the early diagnosis of a vertical root fracture (VRF) is crucial in order to ensure tooth preservation. The purpose of this clinical case report was to describe reparative surgery performed to treat a tooth affected by an incomplete VRF. A 26 year old male patient was suspected to have a VRF in a maxillary left central incisor, and an exploratory flap was performed in order to confirm the diagnosis. After detecting the fracture, the lesion was surgically treated, the fracture and the infected root-end were removed, and a platelet-rich plasma membrane was used to cover the defect in order to prevent bacterial migration. A 24 month clinical and radiological follow-up examination showed that the tooth was asymptomatic and that the healing process was in progress. The surgical approach described here may be considered an effective treatment for a combined endodontic-periodontal lesion originating from an incomplete VRF and a recurrent periapical lesion.