• 대한소아치과학회지
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• 제8권1호
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• pp.37-46
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• 1981

This study was undertaken to evaluate the pulpal responses to the pulp-capping materials such as glutaraldehyde and formocresol in pulpotomy technique, especially in the primary dentition. Mandibular primary canines and molars of 5 dogs (aged about 8-9 weeks)were selected for this study. The intervals of observation for histologic study of pulpotomized primary teeth with 2% glutaraldehyde, formocresol and calcium hydroxide in the usual manner ranged from 2 hours, 1 week, 2 weeks, 3 weeks and 5 weeks after experiments respectively. Each specimens were fixed with 10% formalin and decalcified in 5% nitric acid. All slides were stained with Hematorylin-Eosin and examined histopathologically. The results were as follows; 1. In calcium hydroxide groups, formation of dentin bridge was initiated in 1 week after experiments and completed in 5 weeks after experiments. 2. Formation of dentin bridge was not seen, whereas necrosis of pulp tissue was noted, in formocresol and glutaraldehyde groups. 3. Duration of tissue reactions and tissue changes were similar, in formocresol and glutaraldehyde groups. 4. In formocresol and glutaraldehyde groups, amputation surfaces of the pulp were covered with blood clots, beneath which coagulation necrois was noted, but inflammatory cells were not prominent, in 2 hours and 1 week after experiments. But coagulation necrosis was proceeded to the apical portion, accompanied by infiltration of inflammatory cells, since 2 weeks after experiments. And suppuration or gangrene of the pulp tissue were noted in 3 weeks and 5 weeks groups. 5. Suppuration or gangrene of pulp seemed to provoke the resorption of dentin wall, and inflammatory changes and resorption of roots were noted in the periodontal membrane near the periapical region. 6. As compared with calcium hydroxide groups, resorption of the root was pronounced in form or cresol and glutaraldehyde groups. Effects of medicaments to the succedaneous tooth germ were not seen.

• Restorative Dentistry and Endodontics
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• 제41권1호
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• pp.44-54
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• 2016

Objectives: The purpose of this study was to evaluate the histopathological effects of an antioxidant therapy on the pulp tissue of rat teeth exposed to a bleaching gel with 35% hydrogen peroxide. Materials and Methods: Forty rats were subjected to oral ingestion by gavage of distilled water (DW) or ascorbic acid (AA) 90 min before the bleaching therapy. For the bleaching treatment, the agent was applied twice for 5 min each to buccal surfaces of the first right mandibular molars. Then, the animals were sacrificed at 6 hr, 24 hr, 3 day, or 7 day post-bleaching, and the teeth were processed for microscopic evaluation of the pulp tissue. Results: At 6 hr, the pulp tissue showed moderate inflammatory reactions in all teeth of both groups. In the DW and AA groups, 100% and 80% of teeth exhibited pulp tissue with significant necrosis and intense tissue disorganization, respectively. At 24 hr, the AA-treated group demonstrated a greater regenerative capability than the DW group, with less intense inflammatory reaction and new odontoblast layer formation in 60% of the teeth. For up to the 7 day period, the areas of pulpal necrosis were replaced by viable connective tissue, and the dentin was underlined by differentiated odontoblast-like cells in most teeth of both groups. Conclusions: A slight reduction in initial pulpal damage during post-bleaching was promoted by AA therapy. However, the pulp tissue of AA-treated animals featured faster regenerative potential over time.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.674-677
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• 2009

Purpose: Typical cross finger flap is still a good method for reconstruction of fingertip injuries. However, it is necessarily followed by great loss and aesthetically unpreferable result of donor finger. Hereby, we introduce a modification of cross finger flap with reduction pulp plasty and full thickness skin graft, with which we could reduce the defect size of injured fingertip and donor site morbidity at the same time, without any need for harvesting additional skin from other part of hand. Method: This method was performed in the patients with fingertip injuries of complete amputation or in case of loss of fingertip due to necrosis after replantation. Firstly, reduction pulp plasty was performed on the injured finger to reduce the size of defect of fingertip. Additional skin flap was obtained from the pulp plasty. Secondly, cross finger flap was elevated from the adjacent finger to cover the defect on the injured finger. At the same time, defect on the donor finger produced by the flap elevation was covered by full thickness skin graft with the skin obtained from the pulp plasty of injured finger. Results: Flap and graft survived without any necrosis after surgical delay and flap detachment. All of them were healed well and did not present any severe adversary symptoms. Conclusion: Cross finger flap with reduction pulp plasty and full thickness skin graft is an effective method that we can easily apply in reconstruction of fingertip injury. We think that it is more helpful than the usual manner, especially in cases of children with less soft tissue on their fingers for preservation and reduction of the morbidity of donor finger.

• Restorative Dentistry and Endodontics
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• 제24권2호
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• pp.372-380
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• 1999

The purpose of this study was to investigate the distribution of calcitonin gene-related peptide(CGRP) containing nerve fivers after pulp exposure in rats. The Spague-Dawley rats weighing about 250 - 300g were used. The animals were devided into normal control group and experimental groups. Experimental animals were sacrified on 2, 4, 7, 10 days after pulp exposure. The maxillary teeth and alveolar bone were removed and immersed in the 4% paraformaldehyde plus 0.1M phosphate buffer (pH 7.4). Serial frozen $50{\mu}m$ thick sections were cut with a cryostat. In the immunohistochemical staining procedure, the rabbit CGRP antibody was used as a primary antibody. The sections were incubated for 48 hours at $4^{\circ}C$, and placed into biotinylated anti-rabbit IgG as a secondary antibody and incubated in ABC (avidin-biotin complex), The sections were visualized by 0.05% 3.3 diaminobenzidine tetrahydrochloride. The results of this study were as follows: 1. In control group, CGRP containing nerve fibers ran parallel to the long axis of root and reached the coronal pulp. They were distributed on Raschkow plexus under the odontoblastic layer. 2. In 2 day group after pulp exposure, tissue necrosis and acute inflammation occurred and CGRP containing nerve fibers increased. In 4 day group, the necrotic tissue extended to the pulp and CGRP containing nerve fibers were distributed around the inflammation zone. 3. In 7 day group after pulp exposure, pulp necrosis occurred, and in 10 day group, the abscess under the necrotic pulp extended to the root apex area and CGRP containing nerve fibers were not observed in root canals. 4.The sprouting of CGRP nerve fibers was most remarkable at the pulp chamber under injury in 4 day group, and it was found at inflammation zone under the necrotic tissue in 7 day group and the remaining root pulp tissue in 10 day group. As mentioned above, CGRP nerve fibers had a tendency to increase around the inflammatory zone, especially around the acute inflammation tissue, when compared with control group. It is suggested that CGRP nerve fibers maybe related to the control of inflammatory response of pulp tissue.

• Restorative Dentistry and Endodontics
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• 제41권4호
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• pp.332-337
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• 2016

Paraformaldehyde has been used in the past as a pulpotomy agent. However, it has a severe cytotoxic effect and may cause alveolar bone necrosis. Depulpin, a devitalizing agent containing 49% paraformaldehyde, is no longer used frequently due to its severe side effects. In the two cases described in the present study, Depulpin was used as a devitalizing agent during root canal treatment. It caused a gradual loss of sensibility in adjacent teeth, gingival necrosis, and osteomyelitis. This case report demonstrates the serious side effects of using a paraformaldehyde-containing paste as a devitalizing agent for pulp, particularly mandibular bone necrosis.

• Restorative Dentistry and Endodontics
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• 제48권2호
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• pp.12.1-12.11
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• 2023

Objectives: The present study evaluated the pulp response of human mandibular incisors subjected to in-office dental bleaching using gels with medium or high concentrations of hydrogen peroxide (HP). Materials and Methods: The following groups were compared: 35% HP (HP35; n = 5) or 20% HP (HP20; n = 4). In the control group (CONT; n = 2), no dental bleaching was performed. The color change (CC) was registered at baseline and after 2 days using the Vita Classical shade guide. Tooth sensitivity (TS) was also recorded for 2 days post-bleaching. The teeth were extracted 2 days after the clinical procedure and subjected to histological analysis. The CC and overall scores for histological evaluation were evaluated by the Kruskal-Wallis and Mann-Whitney tests. The percentage of patients with TS was evaluated by the Fisher exact test (α = 0.05). Results: The CC and TS of the HP35 group were significantly higher than those of the CONT group (p < 0.05) and the HP20 group showed an intermediate response, without significant differences from either the HP35 or CONT group (p > 0.05). In both experimental groups, the coronal pulp tissue exhibited partial necrosis associated with tertiary dentin deposition. Overall, the subjacent pulp tissue exhibited a mild inflammatory response. Conclusions: In-office bleaching therapies using bleaching gels with 20% or 35% HP caused similar pulp damage to the mandibular incisors, characterized by partial necrosis, tertiary dentin deposition, and mild inflammation.

• 대한소아치과학회지
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• 제38권4호
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• pp.399-406
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• 2011

영구치의 외상성 손상은 전체 외상 환자 중 높은 빈도로 발생하며 사고의 대부분은 치근이 미완성되어 있는 시기에 발생하여 치수, 치주인대, 치조골, Hertwig 상피 근초(HERS)에 다양한 영향을 주게 된다. 손상 정도에 따라 치수의 완전한 재혈관화, 근관 석회화, 근관내 치조골 함입 등의 다양한 치유 양상을 나타내며, 치근단의 성장 정지 및 치수 괴사로 인한 염증성 치근 흡수 등의 합병증을 나타낼 수 있다. 본 증례에서는 미성숙 영구치 치근단을 가진 세 환아에서 외상에 의한 Hertwig 상피 근초의 손상으로 발치와 기저부에 존재하는 치근막 세포와 골세포의 치수강내로의 증식으로 인해 치근 발육 정지 및 근관내로의 치조골 함입을 나타내어 보고하고자 한다. 외상 후 Hertwig 상피 근초의 손상에 의한 근관내로의 치조골 함입 치유 양상은 치수는 정상적인 기능을 하는 것으로 생각되며, 유착 등의 합병증이 동반되지 않는 경우 특별한 치료를 필요로 하지 않으므로 감별 진단이 요구되며, 외상 받은 치아의 치료시 Hertwig 상피 근초에 대한 부가적인 외상을 가하지 않도록 주의해야 한다.

• Restorative Dentistry and Endodontics
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• 제13권1호
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• pp.7-19
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• 1988

The object of this paper was to investigate the histopatological changes on dog's pulp under cavitation by irradiation of the $CO_2$ laser. The subjects were derived from four dogs, and irradiated 113.23 J/$mm^2$, 283.09 J/$mm^2$, 566.08 J/$mm^2$ in Group I, II, and III respectively. The dogs were sacrificed immediately, 24 hour, 72 hour and 1 week after $CO_2$ laser treatment. For light microscopic examination, routine H-E and PAS stains were employed. For electron microscopic observation, the teeth were fixed in 1% paraformaldehyde and 1% glutaraldehyde, decalcified teeth in 10% EDTA were stained by uranyl acetate and lead citrate. The observation was made with a Hitachi H-500 model electron microscope. The following results were obtained in this study: 1. At the early stage of the experimental sub-groups-immediately, 24 hour, 72 hour samples of Group I, II and III-coagulation necrosis and hyperemia were observed in odontoblastic and subodontoblastic pulpal layer. 2. At the 1 week sub-group of Group I, II, regenerative hyperplasia of the odontoblasts without coagulation necrosis were revealed, in addition to thickened predentin. On he other hand coagulation necrosis and atrophic change accompanying with hyperplasia were found at the 1 week sub-group of Group III. 3. Ultrastructurally, the odontoblasts appeared nuclear degeneration, vacuolar change of cytoplasmic organelles and rupture of plasma membrane at the early stage of the experimental period of all groups. 4. Under spectrohelioscopic examination, regenerative odontobalsts were seen at the 1 week specimens of Group I, II and III. 5. The pulpal response occured at 113-566 J/$mm^2$. The pathologic change of pulp tissue occured at the early experimental period but regeneration of odontoblasts could be seen after 1 week.

• Journal of Trauma and Injury
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• 제32권3호
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• pp.181-186
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• 2019

Finger reconstruction involves paramount significance of both functional and aesthetic aspects, due to its great impact on quality of life. The options range from primary closure, skin grafts, local flaps, pedicled flaps, and free flaps. The optimal method should consider various circumstances of the patient and surgeon. We would like to report a case of a young woman who initially presented with cellulitis and necrosis of the left second finger-tip who underwent reconstruction with bilateral toe pulp free flap. The patient could successfully return to her job that involves keyboard typing and playing the piano, with acceptable donor site morbidity.

• Restorative Dentistry and Endodontics
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• 제38권2호
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• pp.90-92
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• 2013

Although periapical inflammatory lesions are usually resulted by infection in the root canal system, this rare case showed that a periapical lesion related to an infected tooth may cause pulpal necrosis in adjacent intact tooth, with no history or clinical signs of caries, disease, trauma or developmental anomaly. This case also suggests that the periapical lesion can be treated conservatively, without surgical intervention. Furthermore, this case highlights the importance of prompt treatment of apical periodontitis before the lesion becomes extensive as well as follows up of large lesions.