• 치과방사선
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• 제17권1호
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• pp.107-120
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• 1987

The purpose of this study was three-fold: to reexamine whether periapical and central lesions can be detected on the radiograph when they are in the cancellous bone, to investigate regianal differences in radiograph visualization of the lesion, and to. compare the interpretation of radiagraphs by densitometric analysis with the visual interpretation af the same radiographs. Forty-nine apical lesions and eighty-two central lesions were made in 8 mandibles and radiographed serially while being enlarged and deepened. All radiagraphs were evaluated by three dental radiologists. Each lesion was scored of 3 to 0, based on the radiographic appearances. Special radiographs of 15 apical and central lesions were analysed by densitometer and the results were compared with the scores which were previously assigned by three examiners. From this study the following conclusians could be drawn; 1. Experimental lesions confined to cancellous bone were detected an the radiagraphs in 41.3% of the cases. 2. Visualization of periapical lesions in cancellous bone was more apparent than that of central lesions in cancellous bone. 3. Visualization of the periapical lesions confined to. cancellous bane was highest in molar teeth, and detection of the central lesions in alveolar portion was easier than those in lower portion of mandibular body area. 4. It was possible to detect the experimental lesions without cortical plate involvement in 78.6% of the all lesions. 5. Densitometric analysis of radiographs could reproducibly distinguish bone changes, especially of central lesions in cancellous bone.

• Restorative Dentistry and Endodontics
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• 제47권3호
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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.

• 대한치과보철학회지
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• 제50권3호
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• pp.191-197
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• 2012

상악 전치부는 심미적 회복이 강조되는 부위다. 발치 후 치유될 때까지 기다린다면 치조골 흡수와 치간 유두 수축을 방지할 수 없다. 일단 흡수된 조직을 재생하기 위해서는 추가적인 외과적 술식이 필요하고 치료 기간도 많이 소요된다. 발치 전 치조골과 치은 조직이 건강하다면 치주 조직을 보존 유지하기 위해 발치와 동시에 즉시 임플란트 식립을 고려할 수 있다. 특히 건전한 발치와에서의 즉시 임플란트 식립은 여러 논문에서 성공적인 결과를 보였다. 치근단 병소가 존재하는 치아의 발치 후 즉시 임플란트 식립에 대해서는 부정적인 반응을 보이는 연구가 많았으나, 최근에는 확실한 발치와의 육아조직제거와 전신적 항생제 투여 시 성공률이 높다는 결과도 보고되고 있다. 본 증례는 73세 여환으로 상악 좌측 중절치의 포스트-코어와 금속도재관이 탈락되었으며 임플란트 치료를 받고 싶다는 주소로 내원하였다. 치근단 병소와 수직적 치근 파절이 존재하였으나 치근단 병소가 있는 치아에서도 즉시 임플란트 식립의 성공사례가 여러 차례 보고되어 발치 및 즉시 임플란트 식립을 계획하였다. 발치 후 발치와 육아조직제거와 클로르헥시딘 용액 소독 및 tetracycline 용액으로 soaking을 시행한 후 임플란트를 식립하였으며 식립 전 후로 전신적 항생제를 투여하였다. 임플란트를 식립하면서 인상채득하여 2일 뒤 임시 보철물을 장착하였다. 약 6개월 뒤 치경부 형태를 재연하여 최종 인상 채득하였으며 최종 보철물을 장착하였다. 보철물 장착 후 2년까지 치은선이 인접치아와 조화를 이루고 변연골 흡수없이 심미적으로 만족할만한 결과를 얻었기에 보고하는 바이다.

• Restorative Dentistry and Endodontics
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• 제36권1호
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• pp.19-25
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• 2011

연구목적: 인류지질학적으로 동양인에게서 많이 발견되는 C-형 근관계를 가진 하악 제2대구치는 근관치료나 비외과적 재치료에 실패하는 경우 외과적 재치료 방법으로 의도적 재식술을 시행하게 되는데 그 성공률에 대한 보고가 없었다. 따라서 본 연구의 목적은 C-형 근관계를 가진 하악 제2대구치에 의도적 재식술을 시행한 환자의 기록을 후향적으로 조사하여 치료 결과에 따른 성공률을 확인할 뿐 아니라 치료전 존재하던 치근단 병소가 성공률에 영향을 미치는 바에 대하여 알아보는 것이다. 연구 재료 및 방법: 연구를 위해 2005년 1월부터 2007년 12월에 걸쳐 서울대학교치과병원 치과보존과에 내원하여 하악 제2대구치에 의도적 재식술을 받은 52명의 환자 기록을 조사하였으며 7개의 치아는 정기적인 내원검진 기록이 없어서 조사 대상에서 제외하였고 다른 6개의 치아는 C-형 근관계의 조건에 해당되지 않아 연구에서 제외하였다. 정기 내원후 시행한 임상 검사와 방사선 사진 기록을 후향적으로 검토하여 성공이나 불완전한 치유 또는 실패등의 치료 결과에 대하여 판단하였다. 결과: C-형 근관계를 가진 29개의 하악 제2대구치에 시행한 의도적 재식술의 성공률은 72.4%로 관찰되었으며 치료전 치근단 병소가 존재한 경우의 성공률은 치근단 병소가 없었던 경우와 유사한 것으로 확인되었다. 결론: 본 연구결과 C-형 근관계를 가진 하악 제2대구치의 근관치료가 실패한 경우 시행하게 되는 의도적 재식술은 술전 병소의 존재 유무에 상관없이 치근단 수술의 성공률과 유사한 결과를 얻을 수 있는 치료라고 사료된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권2호
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• pp.79-84
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• 2022

Objectives: The purpose of this study was to evaluate risk factors and symptoms in cemento-osseous dysplasia (COD) patients. Materials and Methods: In this study, 62 patients who were diagnosed histologically with COD were investigated from 2010 to 2020 at the author's institution. We compared clinical and radiological characteristics of symptomatic and asymptomatic patients. The factors were sex, age, lesion size, site, radiologic stage of lesion, apical involvement, sign of infection, and history of tooth extraction. Statistical analysis was performed using Fisher's exact test and the chi-square test. Results: COD was more prevalent in female patients. With the exception of three cases, all were focal COD. The majority of patients presented with symptoms when the lesion was smaller than 1.5 cm in size. Symptoms were observed when the apex of the tooth was included in the lesion or there was a local infection around the lesion. The history of tooth extraction and previous endodontic treatment were evaluated, and history was not a significant predictor for the onset of symptoms. Conclusion: In this study, risk factors associated with symptomatic patients were size of lesion, apical involvement, and local infection.

• 대한소아치과학회지
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• 제38권3호
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• pp.276-283
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• 2011

최근 미성숙 영구치의 치근단 유두에서 존재하는 미분화 줄기세포가 새로 발견되었고 이 줄기세포들은 치근 상아질의 형성에 관여하는 법랑모세포의 근원으로 보여진다. 미성숙 영구치를 다룰때 이 줄기세포들의 보존은 치근의 지속적인 형성을 완성시키게 한다. 따라서 치근단 염증을 동반한 미성숙 영구치에서 치근단의 최소한의 침습으로 임상 및 방사선적 치유 양상을 관찰할 수 있었기에 보고하고자 한다. 본 증례는 조선대학교 치과대학병원 소아치과에 내원한 만 10세 남아(하악 우측 소구치), 만 8세 여아(상악 좌측 소구치)에서 임상 및 방사선 검사결과 치수괴사와 치근단 농양으로 진단된 영구치에서 치근단부위의 기구조작을 제한하고 MTA(Mineral Trioxide Aggregate)를 치수강내에 적용하였다. 정기적으로 관찰한 결과 치근단 농양의 치유와 치근 발육 및 성장의 양상이 관찰되었다. 치수괴사와 치근단 농양을 가진 영구치에서 치근단부위의 치수 및 치유두를 보호함으로써 관찰기간동안 양호한 예후를 보였으며, 이는 어린환자의 미성숙영구치에서 보존적 치수치료의 시도에 대한 보다 많은 임상적 검증 및 장기간의 고찰이 필요할 것이다.

• Restorative Dentistry and Endodontics
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• 제47권4호
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• pp.41.1-41.20
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• 2022

Objectives: This study compared the clinical and radiological outcomes of regenerative endodontic procedures (REPs) using blood clots (BCs), platelet-rich plasma (PRP), and platelet-rich fibrin (PRF) through intraoral periapical radiography (IOPAR) and cone-beam computed tomography (CBCT). Materials and Methods: Forty-five single-rooted necrotic teeth with periapical pathology were randomly allocated to receive BC, PRP, or PRF as an individual scaffold. Outcomes were evaluated in 35 teeth in 23 patients with a follow-up period of 12-24 months through qualitative IOPAR scoring and quantitative CBCT measurements. Healing of periapical lesions and in immature teeth, changes in the apical foramen diameter (AFD), root wall thickness (RWT), and root length (RL) were assessed. A p value less than 0.05 was considered to indicate statistical significance. Results: All teeth were asymptomatic except 1 in the PRP group. Periapical lesion healing was seen in all except 2 teeth in the BC group and 3 in the PRP group. Both IOPAR and CBCT revealed no significant differences in bone healing or changes in AFD, RWT, and RL among the 3 groups. A positive pulp sensibility response to the cold test was seen in 2 teeth in the BC group, but none to the electric pulp test. Intracanal calcification (ICC) was evident in more teeth in the BC group than in the PRP and PRF groups, and was also significantly higher in immature teeth. Conclusions: Our results revealed that BC, PRP, and PRF have similar potential as scaffolds in REPs, and ICC may be a concern for long-term outcomes.

• 한국임상수의학회지
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• 제25권6호
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• pp.533-536
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• 2008

The patient, two-year-old female Maltese dog with recurrent facial cellulitis below the left eye was referred for further investigation to the Veterinary Medical Center, Chungbuk National University. There were no visible dental problems, but extraoral radiographs showed periapical bone lyses on the left maxillary third and fourth premolars. Affected teeth were extracted by closed extraction and communication between some extraction sockets and the facial lesion was confirmed using a periodontal explorer. The facial lesion was treated as open wound. During a followup of 3 weeks, the extraction site and lesion reveal normal healing. In this case, the dog was young and had no clinically significant dental problems, like gingivitis or periodontal pocket. This case suggests that the carnassial abscess occurred secondary to cellulitis.

• 치과방사선
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• 제8권1호
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• pp.5-9
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• 1978

The purpose of this study is to investigate the effect of dental restorations on the periodontal and periapical tissues. The author examined 620 cases of amalgam, 390 cases of gold inlay, 422 cases of crown and 644 cases of bridge through the standard intraoral films being appended in the charts that had been kept at the Dept. of Oral Diagnosis in Seoul National University Hospital. This study obtained the following results; 1. The restorations of amalgam, gold inlay crown and bridge were found more frequently in female than in male. 2. The restorations of amalgam, gold inlay and crown were found more numerously in mandibular teeth than in maxillary teeth in both sexes. But in the case of crown, the fact is quite the reverse especially in anterior teeth. 3. On the contrary, in the case of bridge, the restorations of bridge were much more distributed in the maxillary teeth than in the mandibular teeth. 4. Roentgenographic changes of periodontal tissues whose teeth were treated with any type of four restorations were periodontal space widening, lamina dura discontinuity and periapical lesion in the order described in both sexes. 5. On the occasion of between amalgam and gold inlay or between crown and bridge, the differences of periodontal changes were of no consequence. On the other hand, the differences of periodontal changes were apparant between the group of amalgam & gold inlay and the group of crown & bridge.

• 대한소아치과학회지
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• 제28권1호
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• pp.12-15
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• 2001

치아만곡은 조직-형태분화기에 나타나는 치아형태의 이상으로 석회화된 부위와 미석회화된 부위간의 장애로 인해서 치관 및 치근 모두에서 발생하는 기형이며, 상악 절치에서 호발하며 매복 가능성이 높다고 보고되었다. 만곡의 원인으로는 유치의 외상 치배의 이소성 발육, 낭종이 있으며 그외에 otodental syndrome, Hurler syndrome, 쇄골두개이골증에서 보고되었다. 본 증례는 치아우식증으로 인해서 발생된 치근단병소가 치아만곡을 유발할 수 있는 원인이 될 수 있다고 생각하였기에 이에 보고하는 바이다.