• Restorative Dentistry and Endodontics
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• 제34권3호
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• pp.192-198
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• 2009

이번 연구는 치근 천공의 치료 재료인 white mineral trioxide aggregate (MTA)를 흔히 사용되는 calcium hydroxide liner ($Dycal^{(R)}$), glass ionomer cement (GIC), 그리고 MTA와 유사한 성분을 가진 Portland cement와 세포독성 실험으로 생체 친화성을 평가하는 것이다. 세포독성의 정도는 MG-63 세포를 이용해 주사전자 현미경적 관찰과 수용성 tetrazolium salt를 이용한 흡광도를 측정 (XTT assay)하여 평가하였다. SEM 관찰에서, 1일과 3일째 모두에서 GIC와 MTA, Portland cement 표면에서는 잘 부착된 세포를 보여주었다. 반면에, Dycal 표면의 세포들은 둥글고 부착되지 않은 양상을 보여 주었다. XTT assay에서는 Dycal을 제외한 모든 재료에서 유사하게 높은 세포 활성도를 보여주었으며, 이는 SEM 관찰 소견과 일치하였다. 이번 연구는 MTA가 생체친화적인 재료라는 견해를 뒷받침한다. 또한 Portland cement와 GIC에서도 MTA와 유사한 세포반응을 보여주었다.

• Restorative Dentistry and Endodontics
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• 제34권4호
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• pp.371-376
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• 2009

이 연구에서는 Mineral Trioxide Aggregate (MTA)와 4-methacryloxyethyl trimellitate anhydride (4-META) / methyl methacrylate (MMA) & tri-n-butylborane (TBB) 레진을 혼합하여 치근단 역충전 재료로 사용하였을 때의 미세누출을 MTA, 포틀랜드 시멘트와 비교하였다. 발치된 사람 치아의 근관형성 및 충전 후 치근단 절제와 역충전 와동을 형성하였다. MTA, Portland cement, MTA와 4-META/MMA & TBB레진을 혼합한 각각의 재료로 치근단을 역충전한 후 methylene blue dye에 72시간 동안 침적하여 염료가 침투한 길이를 10배 현미경 하에서 측정하였다. MTA와 4-META/MMA & TBB 레진 혼합 충전 군에서는 포틀랜드 시멘트나 MTA 충전군보다 통계적으로 유의하게 적은 미세 누출을 보였으며, 포틀랜드 시멘트와 MTA 충전군의 미세 누출 정도는 통계적으로 차이가 없었다. 이 실험의 결과로 보아 MTA와 4-META/MMA & TBB레진 혼합 재료는 치근단 역충전시 포틀랜드 시멘트나 MTA에 비해 낮은 초기 미세누출을 보여, 치근단 봉쇄 효과가 우수한 것으로 사료된다.

• 대한소아치과학회지
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• 제44권1호
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• pp.28-37
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• 2017

Mineral trioxide aggreagate는 치수 치료제로서 많이 사용되고 있는 재료중 하나이다. 그 중 가장 널리 쓰이고 있는 Proroot white $MTA^{(R)}$는 치아 변색을 일으킨다는 단점이 있다. 이번 연구에서는 MTA 기반 재료들인 Proroot $wMTA^{(R)}$, $Biodentine^{(R)}$, $Endocem^{(R)}$, $RetroMTA^{(R)}$를 치수강에 각각 채워넣어 시간에 따른 치경부의 변색을 비교하고자 하였다. 교정적인 이유로 발치된 75개의 소구치를 사용하여 무작위로 4개의 실험군(n = 60)과 한 개의 대조군(n = 15)으로 나누었다. 치아는 CEJ 하방 2 mm로 수평절단 하였다. 각각의 재료들을 제조사의 지시에 따라 준비한 후 치수강에 채워넣고 입구를 레진을 이용하여 봉인하였다. 치아 색조 측정은 국제조명위원회(Commission International de I'Eclairage, CIE)의 CIE $L^*a^*b^*$ system을 사용하였다. 색조는 분광 광도계를 사용하여 재료를 넣기 전, 재료를 넣고 1일, 1주, 2주, 4주, 8주, 12주, 16주 후로 총 8번 측정하였다. 이원 변량 분산분석(Two way repeated ANOVA)을 사용하여 시간에 따른 CIE $L^*$, $a^*$, $b^*$와 ${\Delta}E$값을 비교 평가하였고 실험군과 대조군과의 통계적 유의성과 상호관계는 본페로니 검정으로 사후 검정하여 p 값이 0.05이하일 때 통계학적으로 유의하다고 간주하였다. Proroot $wMTA^{(R)}$는 시간에 따라 계속적인 $L^*$값의 감소를 보였고, $Endocem^{(R)}$은 재료를 넣은 직 후 육안으로 인지 불가능한 약간의 회색조 변색을 보였으며, $Biodentine^{(R)}$과 $RetroMTA^{(R)}$는 상대적으로 다른 재료보다 색 안정성을 보였다. 결론적으로, 방사선 불투과성 물질로서 산화 비스무스가 포함된 Proroot $wMTA^{(R)}$와 $Endocem^{(R)}$은 치관 변색을 보인 반면, 방사선 불투과성 물질로서 산화 지르코늄이 포함된 $Biodentine^{(R)}$과 $RetroMTA^{(R)}$는 시간에 따른 유의한 색 변화를 보이지 않았다.

• Restorative Dentistry and Endodontics
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• 제44권4호
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• pp.38.1-38.8
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• 2019

Navigation of the main root canal and dealing with a dens invaginatus (DI) is a challenging task in clinical practice. Recently, the guided endodontics technique has become an alternative method for accessing root canals, surgical cavities, and calcified root canals without causing iatrogenic damage to tissue. In this case report, the use of the guided endodontics technique for two maxillary lateral incisors with multiple DIs is described. A 16-year-old female patient was referred with the chief complaint of pain and discoloured upper front teeth. Based on clinical and radiographic findings, a diagnosis of pulp necrosis and chronic periapical abscess associated with double DI (Oehler's type II) was established for the upper left lateral maxillary incisor (tooth #22). Root canal treatment and the sealing of double DI with mineral trioxide aggregate was planned for tooth #22. For tooth #12 (Oehler's type II), preventive sealing of the DI was planned. Minimally invasive access to the double DI and the main root canal of tooth #22, and to the DI of tooth #12, was achieved using the guided endodontics technique. This technique can be a valuable tool because it reduces chair-time and, more importantly, the risk of iatrogenic damage to the tooth structure.

• Restorative Dentistry and Endodontics
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• 제20권1호
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• pp.17-32
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• 1995

The purpose of this study was to examine the response of periradicular tissues to amalgam, IRM, Ketac-silver and MTA(Mineral trioxide aggregate) used as a root end fillings. The lower third and fourth premolars of 5 mongrel dogs were used. Each root was resected, followed by root end fillings with experimental materials. The animals were sacrificed after 16 weeks and radiographic and histologic results were evaluated. The results were as follows : 1. Severe inflammation around apex and disruption of cortical were noted in relation to the amalgam. 2. With IRM, there was severe infiltration of inflammatory cells around filling material, but healing of cortical bone was noted. 3. With Ketac-silver, mild inflammation and thick band of fibrous connetive tissue around filling material were seen, with a cortical bone healing. 4. In case of MTA, complete regeneration of cortical bone was seen, and free MTA was surrounded with newly formed bone tissue.

• Restorative Dentistry and Endodontics
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• 제45권1호
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• pp.10.1-10.8
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• 2020

Objectives: This study aimed to compare the shear bond strength (SBS) of a self-adhering flowable composite (Dyad Flow) and a bulk-fill flowable composite (Smart Dentin Replacement [SDR]) to several pulp-capping materials, including MTA Plus, Dycal, Biodentine, and TheraCal. Materials and Methods: Eighty acrylic blocks with 2-mm-deep central holes that were 4 mm in diameter were prepared and divided into 2 groups (n = 40 each) according to the composite used (Dyad Flow or SDR). They were further divided into 4 sub-groups (n = 10 each) according to the pulp-capping agent used. SBS was tested using a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed using 2-way analysis of variance. A p value of < 0.05 was considered to indicate statistical significance. Results: A statistically significant difference (p = 0.040) was found between Dyad Flow and SDR in terms of bond strength to MTA Plus, Dycal, Biodentine, and TheraCal. Conclusions: Among the 8 sub-groups, the combination of TheraCal and SDR exhibited the highest SBS.

• Restorative Dentistry and Endodontics
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• 제39권3호
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• pp.230-234
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• 2014

This study describes the treatment of an immature permanent tooth with periapical lesion which was treated with regenerative approach using platelet rich plasma (PRP). The root canal of immature human permanent tooth with periapical lesion was gently debrided of necrotic tissue and disinfected with 2.5% NaOCl, and then medicated with triple antibiotic paste comprised of ciprofloxacin, metronidazole, and tetracycline. When the tooth was asymptomatic, PRP and mineral trioxide aggregate (MTA) were placed into the root canal. Six months after PRP treatment, radiographical examination revealed resolution of the radiolucency and progressive thickening of the root wall and apical closure. Our findings suggest that PRP can be used for the treatment of immature permanent teeth with periapical lesion, as part of a regenerative endodontic treatment procedure.

• Restorative Dentistry and Endodontics
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• 제37권1호
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• pp.50-53
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• 2012

Cone-beam computed tomography (CBCT) is a useful diagnostic tool for identification of both internal and external root configurations. This case report describes the endodontic management of a lateral incisor with both dens invaginatus and external root irregularity by using CBCT. Nonsurgical endodontic retreatment was performed on the lateral incisor with dens invaginatus. A perforation through the dens invaginatus and external concavity was repaired using mineral trioxide aggregate. After 18 mon of follow-up, there were no clinical symptoms. Recall radiographs appeared normal and showed healing of the periapical pathosis. The understanding of both internal root canal configuration and external root irregularity using CBCT can ensure predictable and successful results.

• Restorative Dentistry and Endodontics
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• 제38권4호
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• pp.227-233
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• 2013

Objectives: The purpose of the study was to evaluate human dental pulp response to pulpotomy with calcium hydroxide (CH), mineral trioxide aggregate (MTA), and calcium enriched mixture (CEM) cement. Materials and Methods: A total of nine erupted third molars were randomly assigned to each pulpotomy group. The same clinician performed full pulpotomies and coronal restorations. The patients were followed clinically for six months; the teeth were then extracted and prepared for histological assessments. The samples were blindly assessed by an independent observer for pulp vitality, pulp inflammation, and calcified bridge formation. Results: All patients were free of clinical signs/symptoms of pulpal/periradicular diseases during the follow up period. In CH group, one tooth had necrotic radicular pulp; other two teeth in this group had vital uninflamed pulps with complete dentinal bridge formation. In CEM cement and MTA groups all teeth had vital uninflamed radicular pulps. A complete dentinal bridge was formed beneath CEM cement and MTA in all roots. Odontoblast-like cells were present beneath CEM cement and MTA in all samples. Conclusions: This study revealed that CEM cement and MTA were reliable endodontic biomaterials in full pulpotomy treatment. In contrast, the human dental pulp response to CH might be unpredictable.

• Restorative Dentistry and Endodontics
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• 제43권3호
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• pp.31.1-31.7
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• 2018

Despite considerable focus on the regenerative endodontic treatment of immature teeth with necrotic infected pulps and apical periodontitis, little data exist with regard to its possible implementation in necrotic permanent teeth with complete apical and radicular development. The present report describes the procedures and outcome of a regenerative endodontic treatment approach in 2 previously-traumatized incisors with closed apex with apical periodontitis. A 2-visit treatment procedure was employed. At initial visit, the root canals were copiously irrigated, followed by placement of a triple antibiotic paste containing ciprofloxacin, metronidazole, and clindamycin into the root canals. After 4 weeks, the antibiotic paste was removed, and apical bleeding was initiated with size 10 hand files beyond the apices. The root canals were coronally sealed with mineral trioxide aggregate, and the access cavities were restored with bonded resin composite. At post-operative 60 months, both teeth were remained asymptomatic, with the recall radiographs showing complete resolution of apical radiolucency and reestablishment of periradicular tissues. In both teeth, the dimensions of root space remained unchanged as verified by image analysis. The revitalization protocol utilizing root canal disinfection and induced apical bleeding in necrotic, closed-apex incisors may offer a clinically acceptable alternative to conventional root canal treatment.