• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.3
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• pp.533-538
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• 1998

[ $Garr{\grave{e}}'s$ ] osteomyelitis is a chronic form of osteomyelitis in which periosteum is thickened with peripheral reactive bone formation. Carl $Garr{\grave{e}}$ first reported localized periosteal thickening as a response to mild stimuli. In dental literatures, Pell et al. first reported $Garr{\grave{e}}'s$ osteomyelitis in jaws. This disease frequent occurs in youngsters and usually in mandible. It usually results in hard swelling over the jaws with little or no pain. Palpation reveals a localized bony swelling lesion. In radiographic findings, it usually reveals laminated periosteal thickening on lesion. The treatment of $Garr{\grave{e}}'s$ osteomyelitis usually consists of elimination of the sources of infection, i.e., either extraction of an infected teeth or root canal therapy. Two children were admitted with the chief complaint of intraoral swelling on lower deciduous molar areas which was diagnosed as $Garr{\grave{e}}'s$ osteomyelitis. The root canal therapy and antibiotic therapy were performed and prognosis was checked. From these case studies, some results were obtained as follows : With the aid of root canal therapy and antibiotic administration, the size of periapical lesions was reduced, the mandible with bony swelling recovered its normal shapes radiographically, and the permanent tooth germs resumed sound development.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.204-211
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• 2018

Background and Objectives : Unilateral maxillary sinus lesions are relatively common but may occur in variety of causes. Therefore, accurate diagnosis and appropriate treatment are needed. The aim of this study is to review patients with unilateral maxillary sinus lesion who underwent surgical treatment and to analyze causes and characteristics of unilateral maxillary sinus lesions with literature review. Materials and Methods : A retrospective chart analysis was completed on 318 patients with unilateral maxillary sinus lesions who underwent surgical treatment from January, 2008 through May, 2018. Clinical history and data such as age, sex, symptoms of initial, radiologic and dental finding, operation type were collected from medical record. Results : Patients mean age was 50.7 years with slight male gender dominance. Most common type was sinusitis (42.7%), followed by odontogenic sinusitis (22.3%) and fungal ball (19.5%). In particular, the most common cause of odontogenic sinusitis was post dental surgery such as implant. Middle meatal antrostomy (90.9%) was accounted for a great part of surgery underwent to patients. Patients complained of post nasal discharge (62.9%), nasal obstruction (40.9%) and odor smell(35.2%) most commonly. Periapical lucency (35.8%) was the most common in CT finding followed by implant perforation (17.3%) and oroantral fistula (12.3%) in odontogenic sinusitis. Conclusions : Unilateral maxillary sinus lesions are relatively common, but they are increasing recently with dental procedures such as implant surgery, and serious adverse effects due to malignant tumors or improper treatment may occur, so accurate diagnosis and treatment are needed.

• Imaging Science in Dentistry
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• v.52 no.4
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• pp.351-357
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• 2022

Purpose: Convolutional neural networks (CNNs) have rapidly emerged as one of the most promising artificial intelligence methods in the field of medical and dental research. CNNs can provide an effective diagnostic methodology allowing for the detection of early-staged diseases. Therefore, this study aimed to evaluate the performance of a deep CNN algorithm for apical lesion segmentation from panoramic radiographs. Materials and Methods: A total of 1000 panoramic images showing apical lesions were separated into training (n=800, 80%), validation (n=100, 10%), and test (n=100, 10%) datasets. The performance of identifying apical lesions was evaluated by calculating the precision, recall, and F1-score. Results: In the test group of 180 apical lesions, 147 lesions were segmented from panoramic radiographs with an intersection over union (IoU) threshold of 0.3. The F1-score values, as a measure of performance, were 0.828, 0.815, and 0.742, respectively, with IoU thresholds of 0.3, 0.4, and 0.5. Conclusion: This study showed the potential utility of a deep learning-guided approach for the segmentation of apical lesions. The deep CNN algorithm using U-Net demonstrated considerably high performance in detecting apical lesions.

• Imaging Science in Dentistry
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• v.32 no.3
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• pp.123-127
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• 2002

Purpose : To determine whether subtraction images utilizing contrast media can improve the diagnostic performance of proximal caries diagnosis compared to conventional periapical radiographic images. Materials and Methods: Thirty-six teeth with 57 proximal surfaces were radiographied using a size #2 RVG-ui sensor (Trophy Radiology, Marne-la-Vallee, France). The teeth immersed in water-soluble contrast media and subtraction images were taken. Each tooth was then sectioned for histologic examination. The digital radiographic images and subtraction images were examined and interpreted by three dentists for proximal caries. The results of the proximal caries diagnosis were then verified with the results of the histologic examination. Results: The proximal caries sensitivity using digital subtraction radiography was significantly higher than simply examining a single digital radiograph. The sensitivity of the proximal dentinal carious lesion when analyzed with the subtraction radiograph and the radiograph together was higher than with the subtraction radiograph or the radiograph alone. Conclusion: The use of subtraction radiography with contrast media may be useful for detecting proximal dentinal carious lesions.

• Journal of Periodontal and Implant Science
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• v.43 no.3
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• pp.136-140
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• 2013

Purpose: The aim of this study was to identify a role for endodontic intervention in enhancing the regenerative potential of the periodontal ligament when combined with periodontal treatment in seriously involved teeth with a secondary endodontic component. Methods: Patients who exhibited radiolucency extending to the periapical region, abnormal electric pulp testing values, and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Intentional root canal treatment was applied to those teeth in which the apical lesions were presumed to communicate with those of the periodontal lesion of the teeth that remained vital. In all three selected cases, regenerative periodontal therapy incorporating either bone graft or guided tissue regeneration was instituted 3 months after the endodontic intervention. Results: Remarkable enhancement in radiographic density was noticeable around the affected teeth as evidenced by changes in radiopacity. There was a significant reduction in the probing pocket depth and gain in the clinical attachment level. Chewing discomfort gradually disappeared from the commencement of the combined treatment. Conclusions: An intentional endodontic intervention may be a worthwhile approach for the sophisticated management of teeth suffering from serious attachment loss and alveolar bone destruction with concomitant secondary endodontic involvement.

• Restorative Dentistry and Endodontics
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• v.15 no.1
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• pp.175-186
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• 1990

The purpose of this study was to determine whether any clinical factors or conditions are associated with an increased incidence or degree of pain occuring during endodontic treatment in patients who begin treatment with no symptoms. The 260 teeth of 256 patients were surveyed and statistical analysis was used to determine whether a significant relationship existed between pain and any recorded clinical factors or conditions. The following conclusions were drawn. 1. No significant relationship between interappointment pain and any of the analyzed clinical factors or conditions except for fistula formation could be determined. 2. The presence of a draining fistula from a periapical lesion significantly decreased the posttreatment pain. 3. The judicious use of canal irrigants and canal medicaments is not associated with an increased incidence or degree of interappointment pain.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.659-664
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• 2004

Dens invaginatus is a developmental variation resulting from invasination of the tooth crown of root before calcification. Teeth most affected are maxillary lateral incisors. The malformation shows a broad spectrum of morphologic variations and frequently results in early pulp necrosis. Root canal therapy may present severe problems because of the complex anatomy of the teeth. So, the early diagnosis of such malformation is crucial and a preventive approach has been recommended. This report describes three cases of dens invaginatus treatment.

• Restorative Dentistry and Endodontics
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• v.47 no.3
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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.

• Restorative Dentistry and Endodontics
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• v.49 no.2
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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.

• Restorative Dentistry and Endodontics
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• v.30 no.5
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• pp.409-422
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• 2005

The aim of this study was to identify the bacteria isolated from acute endodontic lesions by cell culture and 16S rDNA sequencing. The necrotic pulpal tissue was collected from 17 infected root canals, which were diagnosed as being either an acute pulpitis or acute periapical abscess. Samples were collected aseptically from the infected pulpal tissue of the infected root canals using a barbed broach and a paper point. The cut barbed broaches and paper points were transferred to an eppendorf tube containing 500 ul of 1 XPBS. The sample solution was briefly mixed and plated onto a BHI-agar plate containing $5\%$ sheep blood. The agar plates were incubated in a $37^{\circ}C$ anaerobic chamber for 7 days. The bacteria growing on the agar plate were identified by 16S rRNA coding gene (rDNA) cloning and sequencing at the species level. Among the 71 colonies grown on the agar plates, 56 strains survived and were identified. In dental caries involving the root canals, Streptococcus spp. were mainly isolated. Actinomyces, Clostridia, Bacteroides and Fusobacteria were isolated in the periapical lesion without dental caries. Interestingly, two new Actinomyces spp. (ChDC B639 and ChDC B631) were isolated in this study. These results showed that there was diversity among the species in endodontic lesions, This suggests that an endodontic infection is a mixed infection with a polymicrobial etiology. These results may offer the bacterial strains for pathogenesis studies related to an endodontic infection.