• Restorative Dentistry and Endodontics
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• v.47 no.3
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• pp.34.1-34.12
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• 2022

Objectives: This study aimed to evaluate the success rate of endodontic treatments performed by undergraduate students and the factors associated with the outcome. Materials and Methods: A follow-up of 3 to 8 years after root canal filling was carried out in 91 patients. At the follow-up visits, medical and dental history questionnaires were applied along with clinical and radiographic examinations. Data collected in the clinical exam included: the presence of pain, swelling, sinus tract, mobility, tenderness to palpation and percussion, periodontal probing profile, and type/quality of coronal restoration. Postoperative and follow-up radiographs were digitalized and analyzed by 2 trained and calibrated examiners to assess periapical healing. The treatment outcome was based on strict clinical and radiographic criteria and classified as success (absence of any clinical and radiographic sign of apical periodontitis) or failure (other combination). Logistic regression was used to investigate the impact of clinical and radiographic variables on endodontic treatment outcomes at a 5% significance level. Results: The success rate of endodontic treatments was 60.7%. The only risk factor significantly associated with failure was the presence of a periapical lesion on the postoperative radiograph (odds ratio, 3.35; 95% confidence interval, 1.17-9.54). Conclusions: The success rate of endodontic treatments performed by undergraduate students was low and was jeopardized by the presence of a periapical lesion on the postoperative radiograph.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.2
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• pp.174-179
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• 2014

Dens invaginatus is a developmental anomaly resulting from an infolding of the enamel organ into the dental papilla prior to calcification of the dental tissue. Clinical and radiographic presentation of dens invaginatus shows a lot of variation. The classification proposed by Oehlers(1957) is most commonly used among classifications of dens invaginatus. Several treatments have been suggested to treat Type III dens invaginatus where the pulp remains healthy but the invagination is associated with a periodontitis. The top priority objective is to preserve pulp as sound as possible. Thus, if there is no definite evidence of pulpal disease, the conservative access which treat invagination as distinct from the pulp is necessary. But, Endodontic treatment of Type III dens invaginatus has the particular problems associated with achieving adequate chemomechanical debridement of the root canal system and invagination, predictable length control and consistent filling. In this case report, the endodontic treatment limited within invagination was performed for treatment of Type III dens invaginatus, and filling with Mineral Trioxide Aggregate(MTA) resulted in good prognosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.4
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• pp.309-313
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• 2010

The management of teeth in the line of a mandibular fracture is controversial despite the general agreement that most of these teeth can be preserved. Teeth should be retained if bony attachments are adequate for survival, the tooth is sound and important in maintaining fixation of the fractured segment of bone. Teeth should be removed if they are loose and interfere with the reduction of fragments, are devitalized and potentially a source of wound infection, are damaged beyond their usefulness or may become devital and interfere with healing by becoming infected. However, tooth removal will increase the level of trauma, extend the severity of the wound and require expensive prosthetic treatment. Therefore, it is very important to conserve infected teeth in the line of a mandibular fracture through early primary endodontic treatment (pulp extirpation, canal enlargement and canal opening drainage) and splinting. The basic principles underlying the treatment of pulpless teeth are those underlying general surgery. Therefore, debridement of the infected wound (pulp extirpation and canal enlargement), drainage (canal opening) and gentle treatment of the tissues (occlusal reduction and teeth splinting) are the principles of surgery. This is a representative case report of conservative care by the early endodontic drainage of infected teeth in the line of a mandibular fracture.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.4
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• pp.335-343
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• 2014

Regenerative endodontic treatment has the potential to heal a necrotic pulp, which can affect root development in immature teeth. However, several drawbacks and unfavorable outcomes are associated with regenerative endodontic treatment, of which the most significant is coronal discoloration due to the presence of minocycline in triple antibiotic paste and mineral trioxide aggregate (MTA). To prevent tooth discoloration following pulp treatment, the modified triple antibiotics (ciprofloxacin, metronidazole, clindamycin) were used as canal disinfectants and Retro MTA, a $ZrO_2$-containing calcium aluminate cement, was used to seal the canal. Following access cavity acquisition, the canal was copiously irrigated with 2.5% sodium hypochlorite. A modified triple antibiotic paste was then applied to the canal. Once the tooth was asymptomatic (after between 3 and 8 weeks), Retro MTA was carefully placed over the blood clot or a collagen plug. Follow-up radiographs revealed normal periodontal ligament space and root development. In two cases, successful regenerative endodontic treatment of the infected immature tooth, without discoloration, was achieved with disinfection using modified triple antibiotics and Retro MTA sealing.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.4
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• pp.620-625
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• 2001

The pulpectomy or root canal treatment on primary teeth is to be done when there is evidence of chronic in flammation or necrosis in the radicular pulp. Due to the tortuous and ribbon-shaped anatomy of the primary teeth, the instrumentation of endodontic hand files and barbed broaches is not an easy procedure. Recently, many automatic Ni-Ti rotary instruments have been developed and has made endodontic treatment easier and faster. This report describes two cases of root canal treatment on primary molars using Ni-Ti rotary files. The cervical constricture was eliminated by the crown-down method, as smaller file proceeded unhindered into the apical third of the canal. In addition, the crown-down technique enhanced the efficacy of the endodontic irrigant. The use of rotary instrumentation for primary teeth seemed to be a more effective way to debride the uneven walls of primary teeth.

• The Korean Journal of Pain
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• v.26 no.4
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• pp.347-355
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• 2013

Pain and pain control are important to the dental profession because the general perception of the public is that dental treatment and pain go hand in hand. Successful dental treatment requires that the source of pain be detected. If the origin of pain is not found, inappropriate dental care and, ultimately, extraction may result. Pain experienced before, during, or after endodontic therapy is a serious concern to both patients and endodontists, and the variability of discomfort presents a challenge in terms of diagnostic methods, endodontic therapy, and endodontic knowledge. This review will help clinicians understand the basic neurophysiology of pulpal pain and other painful conditions of the dental pulp that are not well understood.

• Restorative Dentistry and Endodontics
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• v.41 no.1
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• pp.68-73
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• 2016

This case report describes a unique C-shaped mandibular second premolar with four canals and three apical foramina and its endodontic management with the aid of cone-beam computer tomography (CBCT). C-shaped root canal morphology with four canals was identified under a dental operating microscope. A CBCT scan was taken to evaluate the aberrant root canal anatomy and devise a better instrumentation strategy based on the anatomy. All canals were instrumented to have a 0.05 taper using 1.0 mm step-back filing with appropriate apical sizes determined from the CBCT scan images and filled using a warm vertical compaction technique. A C-shaped mandibular second premolar with multiple canals is an anatomically rare case for clinicians, yet its endodontic treatment may require a careful instrumentation strategy due to the difficulty in disinfecting the canals in the thin root area without compromising the root structure.

• Restorative Dentistry and Endodontics
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• v.47 no.2
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• pp.17.1-17.8
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• 2022

Endodontic microsurgery is a predictable treatment option when orthograde treatment or retreatment is unsuccessful or unfeasible. However, when there is a gross compromise of periapical bone, achievement of bone regeneration after the surgical procedure may be hampered. In such cases, the application of guided tissue regeneration principles, with adjunctive use of leukocyte platelet-rich fibrin to fill the bone defect as a bone substitute and as a membrane to cover the site, provides a cost-effective solution with the benefits of accelerated physiological healing and reduced post-surgical pain and discomfort. This case report presents 2 cases of endodontic microsurgery of the upper lateral incisors with loss of buccal cortical plate, where platelet-rich fibrin was successfully applied.

• Restorative Dentistry and Endodontics
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• v.43 no.2
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• pp.17.1-17.7
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• 2018

Iatrogenic perforations negatively impact the outcome of endodontic treatments. Studies on prognostic factors showed that perforations in the coronal third of the root with periodontal pocket formation have an unfavorable prognosis. A 36-year-old female was referred for endodontic evaluation of tooth #13 with a history of an iatrogenic perforation, happened 3 years ago. There was a sinus tract associated with perforation, 10 mm probing on the mesial and mesio-palatal, bleeding on probing, radiolucent lesion adjacent to the perforation and complete resorption of the interdental bone between teeth #13 and #12. After the treatment options were discussed, she chose to save the tooth. The tooth was accessed under rubber dam isolation, the perforation site was cleaned and disinfected using 0.5% sodium hypochlorite and sealed with calcium-enriched mixture cement. Eighteen months after treatment the tooth was functional and asymptomatic. The probing depths were normal without bleeding on probing. Radiographically, the interdental crestal bone formed between teeth #13 and #12. Despite all negative prognostic factors in this case (i.e., perforations in the coronal third, pocket formation, and radiolucent lesion), healing was unexpectedly achieved via non-surgical repair of the perforation. Further research on biological aspects of healing in the periodontium following iatrogenic perforations are recommended.

• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.29.1-29.7
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• 2019

Endodontic microsurgery is defined as the treatment performed on the root apices of an infected tooth, which was unresolved with conventional root canal therapy. Recently, the advanced technology in 3-dimensional model reconstruction based on computed tomography such as cone beam computed tomography has opened a new avenue in application of personalized, accurate diagnosis and has been increasingly used in the field of dentistry. Nevertheless, direct intra-oral localization of root apex based on the 3-dimensional information is extremely difficult and significant amount of bone removal is inevitable when freehand surgical procedure was employed. Moreover, gingival flap and alveolar bone fenestration are usually required, which leads to prolonged time of surgery, thereby increasing the chance of trauma as well as the risk of infection. The purpose of this case report is to present endodontic microsurgery using the guide template that can accurately target the position of apex for the treatment of an anterior tooth with calcified canal which was untreatable with conventional root canal therapy and unable to track the position of the apex due to the absence of fistula.