• Title/Summary/Keyword: Vertical root fracture

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SEM STUDY ON THE BACTERIAL ADHESION TO THE DENTIN OF THE ROOT CANAL (미생물의 근관내 상아질 부착에 대한 주사전자현미경적 연구)

  • Jeong, Sang-Kyun;Oh, Tae-Seok;Bae, Kwang-Shik
    • Restorative Dentistry and Endodontics
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    • v.25 no.1
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    • pp.116-122
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    • 2000
  • On the instrumented root canal wall, amorphous, irregular smear layer can be observed with Scanning Electron Microscope(SEM). The purpose of this study was to evaluate the effect of the presence or absence of smear layer on the adhesion of Staphylococcus aureus to the dentin of the root canal. Human incisors, extracted within 7 days, with no caries, no fracture, no calcification of canal, were selected. After cutting crown portion at cemento-enamel junction, root canal preparation was done by modified crown-down technique using Profile and Gates - Glidden Drill. During canal preparation, 10ml physiologic saline solution(group1&3) or 10ml 3.5% NaOCl(group2&4) was used as irrigation solution. And 10ml physiologic saline solution(group1&3) or 10ml 0.5M EDTA(group2&4) was applicated for final flush. After vertical sectioning and ethylene oxide gas sterilization, samples(group1&2) were immersed into BHIYHM broth inoculated with Staphylococcus aureus (ATCC 31153) and incubated for 3hrs at $37^{\circ}C$. All samples were prepared for and observed with SEM(JEOL JSM840S). The data were analyzed by Mann-Whitney rank sum test. The conclusions are as follows ; 1. Smear layer covers entire root canal surface after root canal preparation. 2. Smear layer has been removed away and the entrances of dentinal tubules have opened widely, when applying 0.5M EDTA and 3.5% NaOCl. 3. A significantly higher number of bacteria were adhered to the root canal dentin without smear layer(p<0.0001). 4. Smear layer produced during root canal preparation impedes bacterial adhesion and colonization to dentin matrix, therefore inhibits canal reinfection.

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Effect of object position in the field of view and application of a metal artifact reduction algorithm on the detection of vertical root fractures on cone-beam computed tomography scans: An in vitro study

  • Nikbin, Ava;Kajan, Zahra Dalili;Taramsari, Mehran;Khosravifard, Negar
    • Imaging Science in Dentistry
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    • v.48 no.4
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    • pp.245-254
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    • 2018
  • Purpose: To assess the effects of object position in the field of view (FOV) and application of a metal artifact reduction (MAR) algorithm on the diagnostic accuracy of cone-beam computed tomography (CBCT) for the detection of vertical root fractures(VRFs). Materials and Methods: Sixty human single-canal premolars received root canal treatment. VRFs were induced in 30 endodontically treated teeth. The teeth were then divided into 4 groups, with 2 groups receiving metal posts and the remaining 2 only having an empty post space. The roots from different groups were mounted in a phantom made of cow rib bone, and CBCT scans were obtained for the 4 different groups. Three observers evaluated the images independently. Results: The highest frequency of correct diagnoses of VRFs was obtained with the object positioned centrally in the FOV, using the MAR algorithm. Peripheral positioning of the object without the MAR algorithm yielded the highest sensitivity for the first observer (66.7%). For the second and third observers, a central position improved sensitivity, with or without the MAR algorithm. In the presence of metal posts, central positioning of the object in the FOV significantly increased the diagnostic sensitivity and accuracy compared to peripheral positioning. Conclusion: Diagnostic accuracy was higher with central positioning than with peripheral positioning, irrespective of whether the MAR algorithm was applied. However, the effect of the MAR algorithm was more significant with central positioning than with peripheral positioning of the object in the FOV. The clinical experience and expertise of the observers may serve as a confounder in this respect.

Influence of CBCT metal artifact reduction on vertical radicular fracture detection

  • Oliveira, Mariana Rodrigues;Sousa, Thiago Oliveira;Caetano, Aline Ferreira;de Paiva, Rogerio Ribeiro;Valladares-Neto, Jose;Yamamoto-Silva, Fernanda Paula;Silva, Maria Alves Garcia
    • Imaging Science in Dentistry
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    • v.51 no.1
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    • pp.55-62
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    • 2021
  • Purpose: This study evaluated the influence of a metal artifact reduction (MAR) tool in a cone-beam computed tomography (CBCT) device on the diagnosis of vertical root fractures (VRFs) in teeth with different root filling materials. Materials and Methods: Forty-five extracted human premolars were classified into three subgroups; 1) no filling; 2) gutta-percha; and 3) metallic post. CBCT images were acquired using an Orthopantomograph 300 unit with and without a MAR tool. Subsequently, the same teeth were fractured, and new CBCT scans were obtained with and without MAR. Two oral radiologists evaluated the images regarding the presence or absence of VRF. Receiver operating characteristic (ROC) curves and diagnostic tests were performed. Results: The overall area under the curve values were 0.695 for CBCT with MAR and 0.789 for CBCT without MAR. The MAR tool negatively influenced the overall diagnosis of VRFs in all tested subgroups, with lower accuracy (0.45-0.72), sensitivity (0.6-0.67), and specificity (0.23-0.8) than were found for the images without MAR. In the latter group, the accuracy, sensitivity, and specificity values were 0.68-0.77, 0.67-083, and 0.53-087, respectively. However, no significant difference was found between images with and without MAR for the no filling and gutta-percha subgroups (P>0.05). In the metallic post subgroup, CBCT showed a significant difference according to MAR use (P<0.05). Conclusion: The OP 300 MAR tool negatively influenced the detection of VRFs in teeth with no root canal filling, gutta-percha, or metallic posts. Teeth with metallic posts suffered the most from the negative impact of MAR.

Influence of voxel size on cone-beam computed tomography-based detection of vertical root fractures in the presence of intracanal metallic posts

  • Yamamoto-Silva, Fernanda Paula;de Oliveira Siqueira, Claudeir Felipe;Silva, Maria Alves Garcia Santos;Fonseca, Rodrigo Borges;Santos, Ananda Amaral;Estrela, Carlos;de Freitas Silva, Brunno Santos
    • Imaging Science in Dentistry
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    • v.48 no.3
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    • pp.177-184
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    • 2018
  • Purpose: This study was performed to evaluate the influence of voxel size and the accuracy of 2 cone-beam computed tomography (CBCT) systems in the detection of vertical root fracture (VRF) in the presence of intracanal metallic posts. Materials and Methods: Thirty uniradicular extracted human teeth were selected and randomly divided into 2 groups(VRF group, n=15; and control group, n=15). The VRFs were induced by an Instron machine, and metallic posts were placed in both groups. The scans were acquired by CBCT with 4 different voxel sizes: 0.1 mm and 0.16 mm (for the Eagle 3D V-Beam system) and 0.125 mm and 0.2 mm (for the i-CAT system) (protocols 1, 2, 3, and 4, respectively). Interobserver and intraobserver agreement was assessed using the Cohen kappa test. Sensitivity and specificity were evaluated and receiver operating characteristic analysis was performed. Results: The intraobserver coefficients indicated good (0.71) to very good (0.83) agreement, and the interobserver coefficients indicated moderate (0.57) to very good (0.80) agreement. In respect to the relationship between sensitivity and specificity, a statistically significant difference was found between protocols 1 (positive predictive value: 0.710, negative predictive value: 0.724) and 3 (positive predictive value: 0.727, negative predictive value: 0.632) (P<.05). The least interference due to artifact formation was observed using protocol 2. Conclusion: Protocols with a smaller voxel size and field of view seemed to favor the detection of VRF in teeth with intracanal metallic posts.

Autogenous transplantation of tooth with complete root formation (치근단 완성된 치아의 자가이식)

  • Lee, Sul-Hyun;Son, Mee-Kyoung;Park, Ji-Il;Kim, Ok-Su;Chung, Hyun-Ju;Kim, Young-Joon
    • Journal of Periodontal and Implant Science
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    • v.38 no.4
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    • pp.709-716
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    • 2008
  • Purpose: Autogenous transplantation of teeth can be defined as transplantation of teeth from one site to another in the same individual, involving transfer of impacted or erupted teeth into extraction sites or surgically prepared sockets". Successful autogenous transplantation of teeth depends upon a complex variety of factors. Such factors include damage to the periodontal ligament of the donor tooth, residual bone height of the recipient site, extra-oral time of tooth during surgery. Schwartz and Andreasen previously reported that autogenous transplantation of teeth with incomplete root formation demonstrated higher success rate than that of teeth with complete root formation. Gault and Mejare yielded similar rate of successful autogenous transplantation both in teeth with complete root formation and in teeth with incomplete root formation when appropriate cases were selected. This case report was aimed at the clinical and radiographic view in autogenous transplantation of teeth with complete root formation. Materials and Methods: Patients who presented to the department of periodontics, Chonnam National University Hospital underwent autogenous transplantation of teeth. One patient had vertical root fracture in a upper right second molar and upper left third molar was transplanted. And another patient who needed orthodontic treatment had residual root due to caries on upper right first premolar. Upper right premolar was extracted and lower right second premolar was transplanted. Six months later, orthodontic force was applied. Results: 7 months or 11/2 year later, each patient had clinically shallow pocket depth and normal tooth mobility. Root resorption and bone loss were not observed in radiograph and function was maintained successfully. Conclusion: Autogenous transplantation is considered as a predictive procedure when it is performed for the appropriate indication and when maintenance is achieved through regular radiographic taking and follow-up.

Recurrent Herpetic Stomatitis Mimicking Post-Root Resection Complication (치근 절제술의 합병증으로 오인 가능한 재발성 구내 헤르페스)

  • Hong, Sung-Ok;Lee, Jae-Kwan;Chang, Hoon-Sang
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.4
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    • pp.418-425
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    • 2013
  • This case report describes about recurrent herpetic stomatitis mimicking post-root resection complication. A 49 year-old male patient was diagnosed vertical root fracture of the mesiobuccal root of his left maxillary first molar (#26). The mesiobuccal root was resected following root canal treatment of the same tooth. 19 months later, the patient presented with pain on left hard palate after a barbecue party. Intra oral examination revealed a gum boil-like blister at the hard palate corresponding to the apex of the palatal root of #26. On clinical examination, there was bleeding on probing and the periodontal pocket depth was measured less than 5 mm with no tooth mobility. On a periapical radiograph, periodontal ligament space widening was observed. Tracing the sinus tract with gutta percha cone was attempted, however, it was impossible. Extending the field of vision, small multiple round ulcerations were observed at the palate front which caused pain to the patient. Therefore, the pain was considered a non odontogenic and the patient was referred to the department of oral medicine. The patient was diagnosed recurrent herpetic stomatitis and after 3 days of antiviral medication, the pain and ulceration were subsided.

Investigation of Fatigue Strength and Prediction of Remaining Life in the Butt Welds Containing Penetration Defects (블완전용입 맞대기 용접재의 용입깊이에 따른 피로강도특성 및 잔류수명의 산출)

  • Han, Seung Ho;Han, Jeong Woo;Shin, Byung Chun
    • Journal of Korean Society of Steel Construction
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    • v.10 no.3 s.36
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    • pp.423-435
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    • 1998
  • In this paper fatigue strength reduction of butt weld with penetration defect, which can be seen frequently in the steel bridge, was assessed quantitatively. S-N curves were derived and investigated through the constant amplitude fatigue test of fully or partially penetrated welded specimen made of SWS490 steel. The fracture mechanical method was applied in order to calculate the remaining fatigue life of the partially penetrated butt welds. The fatigue limit of the fully penetrated butt welds was higher than that of category A in AASHTO's fatigue design curves, and the slope of S-N curves with 5.57 was stiffer than that of other result for welded part generally accepted as 3. The fatigue strength of the partially Penetrated butt weld was strongly influenced by the size of lack of penetration, D. It decreased drastically with increasing D from 3.9 to 14.7mm. Fracture behaviour of the partially penetrated butt weld is able to be explained obviously from the beach mark test that a semi-elliptical surface crack with small a/c ratio initiates at a internal weld root and propagates through the weld metal. To estimate the fatigue life of the partially penetrated butt weld with fracture mechanics, stress intensity factors K of 3-dimensional semi-elliptical crack were calculated by appling finite elements method and fracture mechanics parameters such as C and m were derived through the fatigue test of CT-specimen. As a result, the fatigue lives obtained by using the fracture mechanical method agreed well with the experimental results. The results were applied to Sung-Su bridge collapsed due to penetration defects in butt weld of vertical member.

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Investigation of the Thermo-mechanical Crack Initiation of the Gas Turbine Casing Using Finite Element Analysis (유한요소해석을 이용한 가스터빈 케이싱 열피로 균열발생 해석)

  • Kang, M.S.;Yun, W.N.;Kim, J.S.
    • Journal of Power System Engineering
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    • v.13 no.5
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    • pp.52-58
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    • 2009
  • A gas turbine consists of an upstream compressor and a downstream turbine with a combustion chamber, and also the compressor and the turbine are generally coupled using a single shaft. Many casing bolts are used to assemble two horizontally separated casings, the gas turbine casing and the compressor casing, in both of axial and vertical directions. Because drilled holes for casing bolts in vertical direction are often too close to drilled holes for casing bolts in axial direction, one can observe cracks in the area frequently during operations of a gas turbine. In this study of the root cause analysis for the cracking initiating from the drilled holes of the casings of a gas turbine, the finite element analysis(FEA) was applied to evaluate the thermal and mechanical characteristics of the casings. By applying the field operation data recorded from combined cycle power plants for FEA, thermal and thermo-mechanical characteristics of a gas turbine are analyzed. The crack is initiated at the geometrical weak point, but it is found that the maximum stress is relieved when the same type of cracks is introduced on purpose during FEA. So, it is verified that the local fracture could be delayed by machining the same type of defects near the hole for casing flange bolts of the gas turbine, where the crack is initiated.

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Immediate implant placement into extraction sites with periapical lesions in the esthetic zone: a case report (치근단 병소를 가진 치아의 발치 후 즉시 임플란트 식립 및 보철을 통한 심미성 회복)

  • Yi, Jae-Young;Kim, Jee-Hwan;Han, Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.3
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    • pp.191-197
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    • 2012
  • Esthetics is important in restoring maxillary anterior area. Alveolar bone resorption and loss of interdental papilla may be minimized by immediate implantation. Previous studies showed successful results with the immediate implantation in healthy extraction socket, while many of these studies objected the immediate implantation into extraction sites with periapical lesions. Recent studies, however, reported successful results of the immediate implantation into extraction sites with periapical lesions with careful debridement of extraction sockets and general medication of antibiotics prior to implantation. A 73-year-old female visited the department of Prosthodontics in ${\bigcirc}{\bigcirc}$ University Dental Hospital with the chief complaint of fallen post-core and crown on left maxillary incisor. Although the incisor was with vertical root fracture and periapical lesion, the immediate implantation following the extraction of tooth was planned. Thorough socket debridement, irrigation with chlorhexidine, and tetracycline soaking were followed by immediate implantation. The general medication of antibiotics (Moxicle Tab.$^{(R)}$, 375 mg) was prescribed before and after the surgery. Immediate provisional restoration was delivered two days after the surgery, and the definitive metal-ceramic restoration was placed about six months later after reproducing the emergence profile from the provisional restoration. This case presents satisfying result esthetically and functionally upto two years after the placement of prosthesis with the harmonious gingival line and no loss of marginal bone.

Analysis of vertical root fracture in endodontically versus nonendodontically treated teeth on patients with periodontitis (치주질환자에서 근관치료의 유무에 따른 수직 치근 파절의 실태분석)

  • Kim, Myung-Jun;Jang, Hyun-Seon;Kim, Dong-Kie;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.35 no.2
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    • pp.413-426
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    • 2005
  • 수직 치근파절은 특이성을 나타내지 않기 때문에 치과의사가 정확한 진단을 하기 어렵다. 따라서 수직 치근파절의 임상적 특징, 진단적 증상을 파악하여 향후 근관치료된 치아나 치료되지 않은 치아에서 수직 치근파절의 유발인자와의 관련성 및 고찰을 통해 수직 치근파절의 예방 및 치료에 응용할 수 있을 것으로 생각된다. 연구대상은 조선대학교 부속치과병원 치주과에 내원한 환자 중 최근 2년간 144명의 환자에서 근관치료를 받았거나 받지 않았던 치아 중 임상적 및 방사선학적으로 수직 치근파절로 진단된 156개의 증례를 대상으로 하였다. 모든 불확실한 증례에서 수직 지근파절의 최종 진단은 외과적 탐지를 통해 이루어졌고, 금이 간 치아와 관련될 수 있는 치근파절의 증례의 경우는 제외되었다. 근관치료된 치아와 치료되지 않은 치아, 환자의 나이와 성별, 치아종류 및 파절된 치근부위, 자각증상의 유무를 기준으로 각각의 수치와 백분율로 분류하였다. 수직 치근파절의 증상과 증후별로 분류하였으며, 진단방법에 의한 분류, 치료방법에 따른 분류, 근관 치료 후 수직 치근파절이 발생한 기간에 따른 분류를 시행하고 통계분석을 하여 다음과 같은 결과를 얻었다. 1. 근관치료를 받지 않았던 치아의 수직 치근파절의 발생율은 58%였다. 2. 성별에 따른 발생률에 있어서 남성의 호발양상을 나타내었다. 3. 근관치료된 치아에 있어서 치료되지 않은 치아에 비해 호발연령이 낮았다. 4. 전치부의 수직 치근파절은 관찰되지 않았으며 특히, 강한 교합력을 필요로 히는 구치부에서의 높은 발생율을 나타냈다. 5. 수직 치근파절의 가장 주된 증상 및 증후는 깊은 치주낭 깊이였다. 6. 근관 치료 후 수직 치근파절이 발생한 기간은 평균 5.7년이었다. 7. 다수 증례에 있어서 3개 이하의 결손치를 가졌고, 자각증상이 나타났다. 이상의 결괴에서 한국인에 있어서 근관치료를 받지 않은 치아의 수직 치근파절은 드문 현상이 아님을 알 수 있었고 남성과 구치부에 있어서의 높은 발생율을 알 수 있었다. 그 이유로는 강한 교합력, 딱딱한 음식의 저작습관, 치조골 흡수에 따른 낮은 저항성, 골 유연성의 저하 등으로 여겨진다. 그러나, 수직 치근파절은 아직까지 정확한 진단을 내리기는 여전히 어려운 상태이며, 이를 위한 다양한 진단방법 및 더 나은 연구가 필수적이라 하겠다. 그리고, 향후 보다 많은 증례에 대한 분석, 치주질환에 이환되지 않은 경우의 분석, 치료 후 생존 기간에 대한 고찰 등도 필요하리라 사료된다.