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

• Restorative Dentistry and Endodontics
• /
• v.45 no.3
• /
• pp.28.1-28.13
• /
• 2020

Objectives: To evaluate the outcome of in vitro studies comparing the effectiveness of QMix irrigant in removing the smear layer in the root canal system compared with other irrigants. Materials and Methods: The research question was developed by using Population, Intervention, Comparison, Outcome and Study design framework. Literature search was performed using 3 electronic databases PubMed, Scopus, and EBSCOhost until October 2019. Two reviewers were independently involved in the selection of the articles and data extraction process. Risk of bias of the studies was independently appraised using revised Cochrane Risk of Bias tool (RoB 2.0) based on 5 domains. Results: Thirteen studies fulfilled the selection criteria. The overall risk of bias was moderate. QMix was found to have better smear layer removal ability than mixture of tetracycline isonomer, an acid and a detergent (MTAD), sodium hypochlorite (NaOCl), and phytic acid. The efficacy was less effective than 7% maleic acid and 10% citric acid. No conclusive results could be drawn between QMix and 17% ethylenediaminetetraacetic acid due to conflicting results. QMix was more effective when used for 3 minutes than 1 minute. Conclusions: QMix has better smear layer removal ability compared to MTAD, NaOCl, Tubulicid Plus, and Phytic acid. In order to remove the smear layer more effectively with QMix, it is recommended to use it for a longer duration.

• Restorative Dentistry and Endodontics
• /
• v.34 no.2
• /
• pp.103-112
• /
• 2009

The purpose of this study was to compare the effect of curing methods of adhesive resins and resin cements in the root canal. Crown portions of 32 single-rooted mandibular premolars were removed. Routine endodontic treatment was done, and 9 mm deep post spaces were prepared within root canals. No.3 FRC Postec posts (Ivoclar-Vivadent AG, Liechtensteih) were cemented in the post spaces by self-(SC) or light-curing (LC) using two dual-cured adhesives (Adper Scotchbond multi-purpose plus and Exite DSC )and resin cements (RelyX ARC and Variolink II). They were assigned to 4 groups (n=8): R-SC, R-LC, V-SC, V-LC group. After stored in distilled water for 24 hours, each root was transversally sectioned with 1.5 mm thick and made three slices. The specimens were subjected to push-out test in a universal testing machine (EZ Test, Shimadzu Co., Japan) with a crosshead speed of 1 mm/min. The data were analyzed with repeated ANOVA and one-way ANOVA. Also the interface of post-resin cement and resin cement-canal wall of each group was observed under FE-SEM. When fiber posts were cemented into the root canal using total-etch adhesives, the bond strength and adaptation between post and root canal dentin was affected by curing method. Self-cure of adhesives and resin cements showed higher bond strength and closer adaptation than light-cure of them.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.21 no.2
• /
• pp.518-524
• /
• 1994

A traumatically intruded tooth is one that is forcefully and abruptly dispaced from its position into the surrounding alveolar bone. Although intrusion of permanent teeth is infrequent, the sequelae compromise the longevity of the tooth and often include pulp necrosis, internal and external root resorption, rupture of periodontal ligament and loss of marginal bone. The purpose of this study was to examine three common management techniques for traumatic intrusion, observation for re-eruption, surgical repositioning & fixation and orthodontic extrusion. In the recent, the accepted treatment was to allow the permanent teeth to reerupt spontaneously for 6-8 weeks. If this did not occur, orthodontic traction was applied. The pulpal status of the teeth was monitored and either calcium hydroxide therapy or conventional endodontics was instituted following pulpal necrosis depending on the maturity of the root end. Pulpectomy and a calcium hydroxide filling were also the treatment of choice if there was evidence of internal or external root resorption. This will reduce the chance of root resorption and provide a period of monitoring prior to a definitive root canal filling.

• Restorative Dentistry and Endodontics
• /
• v.41 no.1
• /
• pp.63-67
• /
• 2016

During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar.

• Imaging Science in Dentistry
• /
• v.53 no.2
• /
• pp.137-144
• /
• 2023

Purpose: This study aimed to evaluate the anatomic circle around the impacted lower third molar to show, document, and correlate essential findings that should be included in the routine radiographic assessment protocol as clinically meaningful factors in overall case evaluation and treatment planning. Materials and Methods: Cone-beam computed tomographic images of impacted lower third molars were selected according to specific inclusion criteria. Impacted teeth were classified according to their position before assessment. The adjacent second molars were assessed for distal caries, distal bone loss, and root resorption. The fourth finding was the presence of a retromolar canal distal to the impaction. Communication with the dentist responsible for each case was done to determine whether these findings were detected or undetected by them before communication. Results: Statistically significant correlations were found between impaction position, distal bone loss, and detected distal caries associated with the adjacent second molar. The greatest percentage of undetected findings was found in the evaluation of distal bone status, followed by missed detection of the retromolar canal. Conclusion: The radiographic assessment protocol for impacted third molars should consider a step-by-step evaluation for second molars, and clinicians should be aware of the high prevalence of second molar affection in horizontal and mesioangular impactions. They also should search for the retromolar canal due to its associated clinical considerations.

• Restorative Dentistry and Endodontics
• /
• v.45 no.3
• /
• pp.40.1-40.12
• /
• 2020

Objectives: The aim of this study was to evaluate the effects of endodontic treatment on levels of substance P (SP) and calcitonin gene-related peptide (CGRP) in the saliva of patients with symptomatic apical periodontitis. Materials and Methods: Twelve patients with mandibular molars with symptomatic apical periodontitis were enrolled in this study. An initial saliva sample was collected just before administration of anesthesia for root canal treatment, which was performed at the first visit. A second saliva sample was collected at a control visit 1 week after treatment. Salivary SP and CGRP levels were evaluated quantitatively using biochemical assays. The data were analyzed using Pearson correlation analysis, the paired samples t-test, and the Mann-Whitney U test (p = 0.05). Results: The postoperative salivary level of SP was significantly lower than the preoperative level (p = 0.005). However, the postoperative salivary level of CGRP was similar to the preoperative level (p = 0.932). Visual analog scale (VAS) scores of patients' subjective pain were found to be positively correlated with salivary levels of SP (r = 0.421; p = 0.040). No statistically significant correlations were observed between salivary levels of CGRP and VAS scores for patients' subjective percussion tenderness (p = 0.533) or VAS scores for patients' subjective pain (p = 0.459). Conclusions: According to the results of the present study, salivary SP levels may be used as an objective indicator in the diagnosis and assessment of the degree of pain in endodontic diseases.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.22 no.5
• /
• pp.377-385
• /
• 2022

Background: Postoperative endodontic pain is an enigma for the dentist. This study aimed to evaluate the analgesic effect of 300 mg gabapentin or 75 mg pregabalin in reducing postoperative endodontic pain compared with a placebo. Methods: Ninety patients who needed root canal treatment with an initial numerical rating scale (NRS) pain score of > 4 (T0) were randomly divided into three groups (n=30). Patients were then administered either 300 mg gabapentin (group A), 75 mg pregabalin (group B), or a placebo (group C) 30 min prior to the start of endodontic treatment. A single operator performed single-visit endodontics, and pain was evaluated immediately after endodontic treatment (T1) and at 4 h (T2), 8 h (T3), 12 h (T4), 24 h (T5), 48 h (T6), and 72 h (T7) using the NRS. Ibuprofen/paracetamol (400 mg/325 mg) was administered as a rescue dose if needed. Results: Pregabalin performed significantly better when compared with gabapentin at all time points except at 72 h after treatment (P=0.170). The placebo group showed significantly higher pain scores than the other two groups. The percentage of pain relief was maximum for pregabalin (92.1%), followed by gabapentin (87.6%) and placebo (69.1%) at 72 h after treatment completion. Conclusion: This study showed that pretreatment with a single dose of pregabalin and gabapentin both had greater analgesic effects than a placebo. They can be effectively used to reduce postoperative endodontic pain.

• Restorative Dentistry and Endodontics
• /
• v.35 no.1
• /
• pp.1-4
• /
• 2010

The final preparation (MAF) size in infected root canals is still controversial. Nonetheless, recent studies demonstrated that larger apical preparation sizes produces a greater reduction in remaining bacteria and dentinal debris as compared to smaller apical preparation sizes. Therefore, clinicians should be practiced with treatment strategies guided by evidence-based information, especially in infected/failed root canals.

• The Journal of the Korean dental association
• /
• v.55 no.8
• /
• pp.565-573
• /
• 2017

Root canal perforations are defined as the communication between the pulp cavity, the periodontal tissue and alveolar bone. The occurrence of perforations during endodontic treatment is reported to range from 2.3%~12%, which is not a complication rarely happens. Perforations have iatrogenic or pathological etiologies that involve caries or resorption. It leads to inflammation and the destruction of periodontal fibers and alveolar bone, followed by periodontal defects. Mineral trioxide aggregate (MTA) is currently the most indicated material for repair of root perforation, because of its favorable biocompatibility and sealing ability. Using magnification with dental operating microscope enhance the accessibility and visibility to manage the root perforation. It is important to diagnose and repair perforations immediately if possible.