• 대한치과의사협회지
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• 제51권10호
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• pp.556-564
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• 2013

Modern endodontics has essentially changed following the introduction of the dental microscope since 1990's. One of main advantage of using dental microscope in nonsurgical endodontic treatment is enhancing clinician's ability and quality of treatment through illumination and magnification. Scopes of dental microscope in nonsurgical endodontics are finding a missed or additional root canal and a tooth crack, management of procedural errors, and others. These improvements in technology will result in greater confidence in treatment and better success in clinical practice.

• 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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• 제35권6호
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• pp.436-444
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• 2010

연구목적: 이 연구는 근관치료 전문의에 의해 시행된 비외과적 근관치료의 임상적 성공률을 전향적으로 평가하고, 치료 성공율과 관련된 환자요인과 치아요인의 영향력을 평가하는 것을 목적으로 하였다. 연구 재료 및 방법: 비외과적 근관치료가 이루어진 441개 치아 중 175개의 치아를 1-2년 후 임상적 검진과 방사선촬영을 하였다. 결과: 치근단 방사선 병소의 유무로 평가된 비외과적 근관치료의 성공율은 81.1% 였다. 치아요인 중 재근관치료, 괴사된 치수, 치수병변에서 유래된 치은의 부종 또는 sinus tract, 그리고 치료 전 치근단 병변의 존재는 이변수분석에서 치료성공에 부정적 영향을 미치는 것으로 나타났다 (p < 0.05). 환자요인, 치아요인과 근관충전의 길이를 포함한 단계적 로지스틱 회귀분석에서는 치수병변에서 유래된 치은의 문제 (odds ratio [OR]: 4.4; p = 0.005), 치료 전 치근단 병변의 존재 (OR: 3.6; p = 0.011), 그리고 치근단에서부터 1-2 mm 짧은 근관충전 (OR: 9.6; p = 0.012) 이 치료 실패와 관련된 주요한 요인으로 나타났다. 결론: 치료 전 치근단 병변의 존재뿐만 아니라 치수병변에서 유래된 치은의 부종 또는 sinus tract의 존재는 비외과적 근관치료의 실패에 영향을 줄 수 있는 것으로 나타났다.

• Restorative Dentistry and Endodontics
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• 제39권3호
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• pp.210-214
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• 2014

Objectives: To investigate the prevalence of different primary reasons for endodontic referrals and the clinical symptoms of the referred cases. Materials and Methods: Clinical data of total endodontic treatment cases (1,014 teeth) including endodontic referral cases (224 teeth) between January 1, 2010 and December 31, 2012, at Kangdong Sacred Heart Hospital, were investigated retrospectively. The one major reason for referral, the clinical symptoms, and the resulting treatment procedures of referral cases were recorded. The percentages of clinical symptoms of the endodontic referral cases and the total endodontic treatment cases were compared by ${\chi}^2$ test for each symptom. Results: Persistent pain was the most frequent reason for endodontic referral (29.5%), followed by presence of gingival swelling and sinus tract (24.1%), and apical radiolucency (12.9%). Referrals in cases involving endodontic difficulties such as canal calcification, broken instruments, post, perforation, and resorption were less than 5.0%, respectively. The percentages of four major clinical symptoms of pain, apical radiolucency, previous endodontic treatment, and gingival swelling and sinus tract were significantly higher in the endodontic referral cases than those in the total endodontic cases (p = 0.001). Among the included referral cases, 72.8% were treated with nonsurgical endodontic treatment only. Teeth other than the referred teeth were diagnosed as the origin of the problem in 5.8% of the referrals. Conclusions: The high prevalence of pain, apical radiolucency, previous treatment, and gingival swelling and sinus tract in endodontic referral cases suggest that these symptoms may be what general practitioners consider to be difficult and refer to endodontists.

• Restorative Dentistry and Endodontics
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• 제39권2호
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• pp.115-119
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• 2014

As long as the prognosis of teeth remains a matter of concern, the endodontic-periodontal relationship will be considered a challenge for the clinician. Many etiologic factors, including bacteria, fungi, and viruses, plus other contributing factors, such as trauma, root resorptions/perforations, and dental malformations, play a role in the co-occurrence of endodontic and periodontal lesions. Whatever the cause, a correct diagnosis on which to base the treatment plan is the key to successful maintenance of the tooth. This article reports the successful endodontic management of a furcation lesion in a mandibular molar that was nonresponsive to a previous periodontal surgical graft. The case had presented a diagnostic challenge for the clinicians, and this article reviews the key points that can lead to a correct diagnosis and treatment planning.

• 대한치과의사협회지
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• 제55권8호
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• pp.556-564
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• 2017

Endodontic surgery is a procedure to treat apical periodontitis or abscess in cases that did not heal after nonsurgical treatment or retreatment. This might include situations with persistent intracanal infection after root canal treatment. Other reasons might be found in extraradicular infection, such as bacterial biofilm on the apical root surface or bacteria within the lesion. For many years, the treatment standard was the traditional approach with surgical burs and amalgam for root-end filling. Endodontic microsurgery is the most recent step in the evolution of endodontic surgery, applying not only ultrasonic tip and biocompatible filling materials but also incorporating high-power magnification and illumination. Although many studies have been published that advocate the use of modern technique, the traditional techniques are still widely used in the surgery community. The purpose of this study was to demonstrate the endodontic microsurgery procedure including the root-end preparation and filling with the use of a surgical operating microscope.

• Restorative Dentistry and Endodontics
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• 제38권4호
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• pp.253-257
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• 2013

Maxillary lateral incisors usually exhibit a single root with a single canal. However, maxillary lateral incisor teeth with unusual morphology of root canal system are frequently reported. These cases of variable root canal anatomy can be treated well by nonsurgical endodontic methods. A detailed description of root canal morphology is fundamental for successful endodontic treatment. Treatment using an operating microscope, radiographs from different angles, and cone-beam computerized tomography (CBCT) can produce more predictable endodontic outcomes.

• Restorative Dentistry and Endodontics
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• 제48권2호
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• pp.17.1-17.8
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• 2023

The present report describes the endodontic treatment of an Oehlers type II dens invaginatus in a maxillary lateral incisor with 5 root canals, an extremely rare condition. Apical periodontitis and related symptoms were noted. Cone-beam computed tomography was used to aid the diagnosis, reveal tooth morphology, and assist in canal location. The pulp chamber was carefully accessed, and the root canals were explored under magnification. All root canals were prepared with an R25 Reciproc Blue system and sodium hypochlorite (NaOCl) irrigation. After initial preparation, a self-adjusting file (SAF) with NaOCl and ethylenediaminetetraacetic acid was used to complement the disinfection. Additionally, calcium hydroxide medication was applied. Vertical compaction was used to fill the canals with a calcium silicate-based endodontic sealer and gutta-percha. After 12 months, the patient exhibited healing of the periapical region, absence of symptoms, and normal dental function. In conclusion, this nonsurgical treatment protocol was successful in promoting the cure of apical periodontitis. Both complementary disinfection with an SAF and use of calcium hydroxide medication should be considered when choosing the best treatment approach for dens invaginatus with very complex anatomy.

• 대한치과교정학회지
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• 제47권6호
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• pp.384-393
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• 2017

Fusion of teeth is a developmental anomaly. It occurs at the stage of tooth formation, which determines the shape and size of the tooth crown, when one or more teeth fuse at the dentin level during the morphodifferentiation of the dental germs. Such teeth show macrodontia and may cause crowding, as well as esthetic and endodontic problems. In this article, we report a rare case of a maxillary central incisor fused to a supernumerary tooth showing labial and palatal talon cusps, which was orthodontically moved across the midpalatal suture. A 13-year-old Caucasian boy sought treatment for the unesthetic appearance of his maxillary central incisor and anterior crowding. He was rehabilitated successfully via a multidisciplinary approach involving orthodontic, nonsurgical endodontic, periodontal, and prosthodontic treatments. After a 26-month treatment period, the patient's macroesthetics and microesthetics were improved. The overall improvement of this macrodontic tooth and its surrounding tissues through multidisciplinary treatment was documented using cone-beam computed tomography.

• Restorative Dentistry and Endodontics
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• 제49권2호
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• pp.13.1-13.7
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• 2024

Chronic osteomyelitis with proliferative periostitis, known as Garre's osteomyelitis, is a type of osteomyelitis characterized by a distinctive gross thickening of the periosteum of bones. Peripheral reactive bone formation can be caused by mild irritation or infection. Garre's osteomyelitis is usually diagnosed in children and young adults, and the mandible is more affected than the maxilla. The following is a case report of a 12-year-old female patient with Garre's osteomyelitis of the mandible due to an infection of a root canal-treated tooth. Without surgical intervention, the patient's symptoms were relieved through nonsurgical root canal re-treatment with long-term calcium hydroxide placement. A cone-beam computed tomography image obtained 6 months after treatment completion displayed complete healing of the periapical lesion and resolution of the peripheral reactive buccal bone. Due to the clinical features of Garre's osteomyelitis, which is characterized by thickening of the periosteum, it can be mistaken for other diseases such as fibrous dysplasia. It is important to correctly diagnose Garre's osteomyelitis based on its distinctive clinical features to avoid unnecessary surgical intervention, and it can lead to minimally invasive treatment options.