• Journal of Dental Anesthesia and Pain Medicine
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• 제22권5호
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• pp.377-385
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• 2022

Background: Postoperative endodontic pain is an enigma for the dentist. This study aimed to evaluate the analgesic effect of 300 mg gabapentin or 75 mg pregabalin in reducing postoperative endodontic pain compared with a placebo. Methods: Ninety patients who needed root canal treatment with an initial numerical rating scale (NRS) pain score of > 4 (T0) were randomly divided into three groups (n=30). Patients were then administered either 300 mg gabapentin (group A), 75 mg pregabalin (group B), or a placebo (group C) 30 min prior to the start of endodontic treatment. A single operator performed single-visit endodontics, and pain was evaluated immediately after endodontic treatment (T1) and at 4 h (T2), 8 h (T3), 12 h (T4), 24 h (T5), 48 h (T6), and 72 h (T7) using the NRS. Ibuprofen/paracetamol (400 mg/325 mg) was administered as a rescue dose if needed. Results: Pregabalin performed significantly better when compared with gabapentin at all time points except at 72 h after treatment (P=0.170). The placebo group showed significantly higher pain scores than the other two groups. The percentage of pain relief was maximum for pregabalin (92.1%), followed by gabapentin (87.6%) and placebo (69.1%) at 72 h after treatment completion. Conclusion: This study showed that pretreatment with a single dose of pregabalin and gabapentin both had greater analgesic effects than a placebo. They can be effectively used to reduce postoperative endodontic pain.

• Restorative Dentistry and Endodontics
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• 제41권2호
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• pp.148-153
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• 2016

Tooth transposition is a disorder in which a permanent tooth develops and erupts in the normal position of another permanent tooth. Fusion and gemination are developmental disturbances presenting as the union of teeth. This article reports the nonsurgical retreatment of a very rare case of fused teeth with transposition. A patient was referred for endodontic treatment of her maxillary left first molar in the position of the first premolar, which was adjacent to it on the distobuccal side. Orthopantomography and periapical radiography showed two crowns sharing the same root, with a root canal treatment and an associated periapical lesion. Tooth fusion with transposition of a maxillary molar and a premolar was diagnosed. Nonsurgical endodontic retreatment was performed. At four yr follow-up, the tooth was asymptomatic and the radiolucency around the apical region had decreased, showing the success of our intervention. The diagnosis and treatment of fused teeth require special attention. The canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Thermoplastic techniques were useful in obtaining hermetic obturation. A correct anatomical evaluation improves the set of treatment options under consideration, leading to a higher likelihood of esthetically and functionally successful treatment.

• Restorative Dentistry and Endodontics
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• 제47권3호
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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.

• Journal of Korean Dental Science
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• 제9권1호
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• pp.28-34
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• 2016

Purpose: The purpose of the present retrospective cohort study was to investigate the incidence of sinus perforation during endodontic microsurgery and to assess healing of cases with sinus perforation. Materials and Methods: Clinical and radiographic records were collected from patients who were treated with endodontic microsurgery in the Microscope Center of the Department of Conservative Dentistry at Yonsei University College of Dentistry, Seoul, Korea, between March 2001 and January 2016. To determine the incidence of sinus perforation, all cases involving maxillary premolar and molar teeth were assessed, and cases with perforation of maxillary sinus during the procedure were counted. To assess the outcome of the endodontic microsurgery, cases with sinus perforation were recalled at least 1 year after surgery. Result: Two hundred and forty-nine maxillary premolars and molars were treated with endodontic microsurgery. Among these cases, 16 cases had sinus perforations. Overall incidence of sinus perforation was 6.4%. Thirteen cases with sinus perforation were followed up for 1 year after endodontic microsurgery. Outcome assessment revealed that 2 of 13 cases with sinus perforation had failed. The success rate of endodontic microsurgery with sinus perforation was 84.6%. Conclusion: Endodontic surgery performed using microsurgical techniques decreases the risk of sinus perforation. Predictable outcomes of endodontic microsurgeries and healing of sinus membrane can be expected with adequate treatment steps and careful periodic follow-ups in cases with maxillary sinus perforations.

• Restorative Dentistry and Endodontics
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• 제41권1호
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• pp.63-67
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• 2016

During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar.

• 대한치과의사협회지
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• 제51권10호
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• pp.542-550
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• 2013

The immature teeth with apical periodontitis present considerable challenges to clinicians. Therefore, new treatment protocols have been suggested to overcome the problems encountered in traditional methods. Regenerative treatment (revascularization) is one of such methods. Many case reports on the revascularization of infected immature teeth have been published, and in most of them, immature teeth with even a periapical abscess continued root formation after the disinfection of the root canal system. We now believe that this continued root formation is not an exceptional incident. As a result, it appeared that apexification has been giving way to a revascularization technique, which is a new option, in treating necrotic immature teeth. These new methods appear to be based on the healing potential of stem cells. The potential of healing or regeneration of stem cells, which are located around teeth, seems to be greater than we thought before. This review summarizes the current techniques for considering regenerative endodontic treatment procedures in treating the immature permanent tooth with pulp necrosis.

• Restorative Dentistry and Endodontics
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• 제24권2호
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• pp.426-429
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• 1999

When the tooth avulsion occur in accidents the drying damage to the periodontal ligament has extremely detrimental effects on healing. Pulp necrosis always occurs after an avulsion injury, but revascularization can only take place in teeth with immature apexes. Therefore complications after avulsion injuries are common, and treatment must be carried out in a timely and correct fashion to prevent or limit these complications. Every effort should be made to replant the tooth within the first 15 to 20 minutes. If doubt exists that the tooth can be replanted adequately, the tooth should quickly be stored in an appropriate medium until the patient can get to the dental office for replantation. A complication of inflammatory root resorption is occurred by bacterial infection of periodontal ligament and dental pulp. Therefore aseptic endodontic treatment must be carried out in a timely and systemic antibiotics given at the time of replantation and before endodontic treatment are effective in preventing bacterial invasion. Further studies are needed to establish the clinical importance of preparation of the socket and root.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2007년도 춘계학술대회 논문집
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• pp.211-212
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• 2007

• 대한치과의사협회지
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• 제47권8호
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• pp.479-486
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• 2009

Purpose: The aim of this study was to show the clinical results of combination of Nd-YAP (1340nm) laser therapy with conventional endodontic and periodontal treatment. Materials and Methods: Four patients with chronic advanced periodontitis and endodontic infection were treated with conventional treatment and Nd-YAP laser therapy. Occlusal adjustment and splinting were done for stabilization of the teeth with severe horizontal and vertical mobility. The protocol for periodontal treatment was followed as scaling and root planing, pocket irrigation with 3% $H_2O_2$ and exposure of Nd-YAP laser using 320${\mu}m$ optical fiber with 160mJ/pluse, 30Hz. The other protocol for endodontic treatment was followed as access opening, canal preparation by hand and rotary instrument, canal filling, and exposure of Nd-YAP laser using 200${\mu}m$ optical fiber with 200mJ/pluse, 10Hz and 180mJ/pluse, 5Hz which were used respectively for disinfection and canal filling. The assessments of probing depth, mobility, and radiography were made prior to and after treatment. Result: All of these four clinical cases showed good healing of periodontium, which presented decrease of mobility and pocket depth, and increase of bone regeneration and bone density on the radiography. Conclusion: The bactericidal effect of Nd-YAP laser would provide benefits for improving clinical results that are obtained from conventional therapy.

• 대한소아치과학회지
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• 제44권1호
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• pp.47-55
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• 2017

본 연구의 목적은 괴사된 미성숙 영구치의 재생근관치료 시 성공에 영향을 미치는 결정적 인자를 평가하고자 함에 있다. 미성숙 영구치의 치수괴사로 진단된 환자 중 재생근관치료를 시행하고 1년 이상 경과 관찰한 증례로서 46개 치아가 선택되었다. 이를 대상으로 성공률과 관련된 변수로서 나이, 성별, 초진 시 치근발육단계, 치수괴사 원인, 치료과정, 임상 및 방사선학적 결과를 조사하고 관련성을 통계 분석하였다. 분석 결과, 치근발육단계는 재생근관치료의 성공률에 영향을 미치지 않았으나, 치수괴사 원인은 치외치, 우식, 외상 순으로 성공률이 높았으며 유의한 차이가 있었다. 근관내 멸균 시 국소적 항생제를 적용했을 때 높은 성공률을 보이며 통계학적 유의차를 보였으며, double과 triple antibiotic paste간에는 유의차가 없었다. 재생근관치료의 성공률을 높이기 위해 치수 괴사 원인, 특히 외상 증례에 있어 신중한 적응증 판단이 선행되어야 하며, 적절한 항생제 적용이 필요하다.