• Title/Summary/Keyword: root perforation

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Surgical management of a failed internal root resorption treatment: a histological and clinical

  • Asgary, Saeed;Eghbal, Mohammad Jafar;Mehrdad, Leili;Kheirieh, Sanam;Nosrat, Ali
    • Restorative Dentistry and Endodontics
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    • v.39 no.2
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    • pp.137-142
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    • 2014
  • This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.

Development of Root Perforation Filling Material using Demineralized Dentin Paste (치아들을 탈회동결건조처리하여 제작한 치근천공부 충전재 개발 I: 예비실험연구)

  • Choi, Yong-Hun;Bae, Ji-Hyun;Park, Ji-Hoon;Kim, Young-Kyun;Yun, Pil-Young;Hwang, Ji-Yeon;Um, In-Woong;Lee, Chong-Heon
    • The Journal of the Korean dental association
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    • v.50 no.9
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    • pp.574-585
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    • 2012
  • Purpose : This study was performed to evaluate the healing response around the root perforation restorative material. Materials and Methods : Four beagle dogs were used for experimental study. Endodontic treatment was performed at four maxillary premolars and artificial perforation was formed at furcation area of pulp chamber. Canal was filled with gutta percha cone and the perforation was sealed with MTA at group 1. At group 2, canal was filled and the perforation was sealed with dentin paste. Tooth paste was fabricated using extracted human teeth. Histologic examination of furcation area was performed 2, 4, 8 and 12 weeks after experiment. Results : New trabecular bone formation was observed around the MTA and tooth paste. Lamellar bone was observed as time is over. There were no inflammatory reaction in both groups. Conclusion : There is a possibility which endodontic filling material can be developed using extracted teeth.

Periodontal healing following non-surgical repair of an old perforation with pocket formation and oral communication

  • Asgary, Saeed;Verma, Prashant;Nosrat, Ali
    • Restorative Dentistry and Endodontics
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    • v.43 no.2
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    • pp.17.1-17.7
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    • 2018
  • Iatrogenic perforations negatively impact the outcome of endodontic treatments. Studies on prognostic factors showed that perforations in the coronal third of the root with periodontal pocket formation have an unfavorable prognosis. A 36-year-old female was referred for endodontic evaluation of tooth #13 with a history of an iatrogenic perforation, happened 3 years ago. There was a sinus tract associated with perforation, 10 mm probing on the mesial and mesio-palatal, bleeding on probing, radiolucent lesion adjacent to the perforation and complete resorption of the interdental bone between teeth #13 and #12. After the treatment options were discussed, she chose to save the tooth. The tooth was accessed under rubber dam isolation, the perforation site was cleaned and disinfected using 0.5% sodium hypochlorite and sealed with calcium-enriched mixture cement. Eighteen months after treatment the tooth was functional and asymptomatic. The probing depths were normal without bleeding on probing. Radiographically, the interdental crestal bone formed between teeth #13 and #12. Despite all negative prognostic factors in this case (i.e., perforations in the coronal third, pocket formation, and radiolucent lesion), healing was unexpectedly achieved via non-surgical repair of the perforation. Further research on biological aspects of healing in the periodontium following iatrogenic perforations are recommended.

Endodontic management of a maxillary lateral incisor with dens invaginatus and external root irregularity using cone-beam computed tomography

  • Lim, Young-Jun;Nam, Sook-Hyun;Jung, Sung-Ho;Shin, Dong-Ryul;Shin, Su-Jung;Min, Kyung-San
    • Restorative Dentistry and Endodontics
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    • v.37 no.1
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    • pp.50-53
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    • 2012
  • Cone-beam computed tomography (CBCT) is a useful diagnostic tool for identification of both internal and external root configurations. This case report describes the endodontic management of a lateral incisor with both dens invaginatus and external root irregularity by using CBCT. Nonsurgical endodontic retreatment was performed on the lateral incisor with dens invaginatus. A perforation through the dens invaginatus and external concavity was repaired using mineral trioxide aggregate. After 18 mon of follow-up, there were no clinical symptoms. Recall radiographs appeared normal and showed healing of the periapical pathosis. The understanding of both internal root canal configuration and external root irregularity using CBCT can ensure predictable and successful results.

The Myths and Facts of MTA (MTA의 Myths & Facts)

  • Ko, Hyun-Jung
    • The Journal of the Korean dental association
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    • v.48 no.11
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    • pp.813-818
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    • 2010
  • Since MTA has many beneficial properties such as biocompatibility, great sealing capacity, antibacterial effects, low cytotoxicity, and stimulation of formation of mineralized tissue, it has been widely used as the material of choice in root-end filling, apexification, pulpotomy, perforation repair and so on. However, despite its favorable characteristics, MTA presents working properties which are less than ideal. The resulting cement from the mixing of powder and water is difficult to manipulate, and its setting time has been reported to be 2 h 45 min whereas the working time is <4 minutes. Additional moisture is also required to activate the setting of the cement. Moreover, according to recent studies, the physical properties of MT A may be hampered by acidic environment or blood contamination. Therefore, practitioners may have surprisingly worse results than they expected when they are not fully acquainted with the characteristics and manipulation method of MTA.

Perforation optimization of hydraulic fracturing of oil and gas well

  • Zhu, Hai Yan;Deng, Jin Gen;Chen, Zi Jian;An, Feng Chen;Liu, Shu Jie;Peng, Cheng Yong;Wen, Min;Dong, Guang
    • Geomechanics and Engineering
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    • v.5 no.5
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    • pp.463-483
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    • 2013
  • Considering the influences of fluid penetration, casing, excavation processes of wellbore and perforation tunnels, the seepage-deformation finite element model of oil and gas well coupled with perforating technique is established using the tensile strength failure criterion, in which the user-defined subroutine is developed to investigate the dynamic evolvement of the reservoir porosity and permeability. The results show that the increases of perforation angle and decreases of perforation density lead to a higher fracture initiation pressure, while the changes of the perforation diameter and length have no evident influences on the fracture initiation pressure. As for initiation location for the fracture in wellbore, it is on the wellbore face while considering the presence of the casing. By contrast, the fractures firstly initiate on the root of the tunnels without considering casing. Besides, the initial fracture position is also related with the perforation angle. The fracture initiation position is located in the point far away from the wellbore face, when the perforation angle is around $30^{\circ}$; however, when the perforation angle is increased to $45^{\circ}$, a plane fracture is initiated from the wellbore face in the maximum horizontal stress direction; no fractures was found around perforation tunnels, when the angel is close to $90^{\circ}$. The results have been successfully applied in an oilfield, with the error of only 1.1% comparing the fracture initiation pressure simulated with the one from on-site experiment.

Systematic Studies on Some Korean Woody Plants -Anatomy of Lauraceous Root Wood- (한국산 목본식물에 대한 계통분류학적 연구 -녹나무과 식물뿌리의 목부해부-)

  • Soh, Woong Young
    • Journal of Plant Biology
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    • v.27 no.3
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    • pp.149-162
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    • 1984
  • Anatomical characters of the secondary xylem in roots of Lauraceae, including 6 genera and 13 species grown in Korea, were studied systematically. Lauraceors members studied anatomically possess characters of the secondary xylem that are in the main more specialized than those found in the primitive angiosperm families. The specialized characters are as follows; (1) mostly solitary pores with some radially multiples, (2) mostly simple perforation plates and partially scalariform perforation plates in all species, (3) slightly oblique end wall of vessel element, (4) predominantly alternate intervascular pitting, (5) paratracheal axial parenchyma in all species, (6) heterogeneous II or III vascular rays. It is considered that the series of specialization in this family from the perforation plates and angle of end wall to the vessel axis is as follows; MachiluslongrightarrowNeolitsealongrightarrowLinderalongrightarrowCinammomumlongrightarrowIozostelongrightarrowLitsea.

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Comparative analysis of physicochemical properties of root perforation sealer materials

  • Orcati Dorileo, Maura Cristiane Goncales;Pedro, Fabio Luis Miranda;Bandeca, Matheus Coelho;Guedes, Orlando Aguirre;Villa, Ricardo Dalla;Borges, Alvaro Henrique
    • Restorative Dentistry and Endodontics
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    • v.39 no.3
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    • pp.201-209
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    • 2014
  • Objectives: This study evaluated the solubility, dimensional alteration, pH, electrical conductivity, and radiopacity of root perforation sealer materials. Materials and Methods: For the pH test, the samples were immersed in distilled water for different periods of time. Then, the samples were retained in plastic recipients, and the electrical conductivity of the solution was measured. The solubility, dimensional alteration, and radiopacity properties were evaluated according to Specification No. 57 of the American National Standards Institute/American Dental Association (ANSI/ADA). Statistical analyses were carried out using analysis of variance (ANOVA) and Tukey's test at a significance level of 5%. When the sample distribution was not normal, a nonparametric ANOVA was performed with a Kruskal-Wallis test (${\alpha}$ = 0.05). Results: The results showed that white structural Portland cement (PC) had the highest solubility, while mineral trioxide aggregate (MTA)-based cements, ProRoot MTA (Dentsply-Tulsa Dental) and MTA BIO ($\hat{A}$ngelus Ind. Prod.), had the lowest values. MTA BIO showed the lowest dimensional alteration values and white PC presented the highest values. No differences among the tested materials were observed in the the pH and electrical conductivity analyses. Only the MTA-based cements met the ANSI/ADA recommendations regarding radiopacity, overcoming the three steps of the aluminum step wedge. Conclusions: On the basis of these results, we concluded that the values of solubility and dimensional alteration of the materials were in accordance with the ANSI/ADA specifications. PCs did not fulfill the ANSI/ADA requirements regarding radiopacity. No differences were observed among the materials with respect to the pH and electrical conductivity analyses.

Statistical evaluation of ameloblastoma on the relationship between radiological and clinical characteristics (법랑모세포종의 방사선학적 소견에 따른 임상 통계학적 평가)

  • Park, Ji-Hoon;Kim, Jin-Wook;Kwon, Tae-Geon;Kim, Chin-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.3
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    • pp.176-183
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    • 2011
  • Introduction: Very high aggressiveness and recurrence are important clinical characteristics of ameloblastoma compared to the other benign tumors. Therefore, an accurate diagnosis and treatment plan is important. This study examined the association of the clinical findings and recurrence based on the radiological findings of ameloblastoma. In recurrent cases, these results are expected to help in the diagnosis and treatment of ameloblastoma to examine the relevance with the clinical characteristics and radiological features. Materials and Methods: For a clinical (gender, age) and radiological (location, internal pattern, size, perforation, border pattern, impacted tooth, root resorption) evaluation, this study examined 156 cases of 147 patients diagnosed with ameloblastoma, who had been treated and in most cases regularly checked at the department of oral and maxillofacial surgery, Kyungpook National University Hospital, between January 1993 and December 2009. For a recurrent rate evaluation, a more than 3 years follow-up period is needed. Accordingly, 116 patients diagnosed with ameloblastoma between January 1994 and December 2007 were investigated. Results: The recurrence rate in all cases was 6.1% but was 7.8% in cases with follow-up periods more than 3 years. The male-to-female ratio was 3:2, showing a slight male predilection. Ameloblastoma had a peak occurrence in the second decade of life followed by the fourth decade of life. The mandibular angle area is the most frequent site of ameloblastoma (50.8%) in the jaws. Six cases of unilocular (7.8%) and 3 cases of multilocular (7.7%) ameloblastomas recurred. Seven cases of smooth (10%) and 2 cases of irregular (4.3%) ameloblastomas recurred. No cases of ameloblastomas without perforation of the cortical bone (0%) and 9 cases with a perforation of cortical bone (11.1%) recurred. Four cases of the ameloblastomas with impacted teeth (11.4%) and 5 cases of ameloblastomas without impacted tooth (6.2%) recurred. Seven cases of ameloblastomas with root resorption (10.9%) and 2 cases of ameloblastomas without root resorption (3.8%) recurred. Conclusion: A multiple smooth margin, unilocular ameloblastoma with an impacted tooth, root resorption tends to recur more easily. Therefore, they need to be treated more carefully and require a a longer follow-up.