• The Journal of the Korean dental association
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• v.20 no.11 s.162
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• pp.929-932
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• 1982

Calcium Hydoxide는 치수복(pulp capping), 생활치수절단술(vital pulpotomy)등에서 bactericidal effect 때문에 많은 사용을 하고 있으며, 최근에는 무수치(pulpless teeth)와 관련된 치근단병소가 있는 경우, 미완성치근단인 경우, 치근흡수, 횡주치근파절(Transverse root fracture)등의 경우에서도 Ca(OH)₂paste를 사용하여 성공적인 근관치료를 할 수 있다. 근관의 instrumentation 과 irrigation후 근과 dressing 은 약 1주일간 행하고 Ca(OH)₂paste를 건조된 근관내에 넣는다. 이때 치근단(root apex)으로부터 약 3~5mm 되게 저속으로 아주 가볍고 부드러운 압력을 가하여 Ca(OH)₂paste를 cotton pellet로 밀어넣고 Sealing(가봉)한다. 이 Temporary sealing은 1개월이상 견딜수 있도록 Cement 또는 Amalgam filling 함이 좋다. Ca(OH)₂paste의 제법은 normal irrigating agents 와 minimal filing으로 시행한다.

• Restorative Dentistry and Endodontics
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• v.3 no.1
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• pp.17-21
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• 1977

After a vital pulpotomy in dogs' teeth, the responses of the remaining pulp tissue under calcium hydroxide and formocresol were studied histologically. The class I and V cavities were prepared on the teeth and the pulp was amputated. Calcium hydroxide and formocresol were placed over the amputated tissue and the cavities were sealed with zine oxide eugenol cement and zinc phosphate cement. Animals. were sacrifice after 1, 2, and 3 weeks following the operation. The teeth were decalcfied, sectioned and stained with hematoxylin and eosin. Microscopic examination reveals as follows; 1. Healing of the pulp at the amputation site did not occur in the pulps treated with formocresol. 2. At one week, a thin layer of darker staining tissues just below the necrotic zone was presented in the pulps treated with formocresol. In this stage the tissues beneath the darker staining layer were normal. 3. At two weeks, the cells of the palest staining layer were showed indistinct nucleus which suggested the karyolysis and the karyorrhexis in the pulps treated with formocoresol. As reached to the middle third of the pulp, the odontoblasts were scarcely evident or missed in this stage. 4. At three weeks, the necrotic zone was reached to the middle third of the pulp canal. The cells beneath the zone showed massive infiltration of inflammatory cells in the pulps treated with formocresol. 5. Dentin bridge in the control group was deposited below the necrotic zone from the two. weeks later. 6. Normal tissues were observed ill the apical third of all. the dental pulps in all case of calcium hydroxide and formocresol.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.192-198
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• 2012

Revascularization of the pulp in a necrotic, infected immature tooth with apical periodontitis was attempting several years. Revascularization of partially necrotic pulp in an immature tooth is based on the concept that vital dental stem cells can survive pulpal necrosis. Revascularization procedure obtains longer and thicker roots in teeth with necrotic pulp diagnosis. Pulp revascularization for immature permanent molars can be possibly applied on cases having difficulty to use conventional root canal treatment due to abnormally thin root canal wall or severe root curvature. Also, when an uncooperative patient does not agree with sedative treatment the revascularization can be useful. And a patient with disability who is barely cooperative can be another indication of this treatment. In this case report, pulp revascularization using triple-antibiotics, metronidazole, ciprofloxacine and minocycline, was applied on the immature first permanent molar infected by caries.

• Restorative Dentistry and Endodontics
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• v.14 no.2
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• pp.77-97
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• 1989

The purpose of this study was to observe the effect of ${\beta}GP$ in the remaining dental pulp tissue after pulpotomy in the dogs' teeth. For vital pulpotomy, 72 dogs' teeth were used and class V cavities were prepared and the pulps were amputated. ZOE and Dycal (Caulk Co., USA) were placed over the amputated tissue and cavities were sealed with ZOE cement in the control group. In the experimental group, ${\beta}GP$, ${\beta}GP$-ZOE, ${\beta}GP$-Dycal were placed over the exposed pulp tissues respectively. Dogs were sacrificed after 1, 2 and 4 weeks following the operations and the teeth were decalcified in the nitric acid, sectioned and stained with HE for light microscopic examination. For electron microscopic examination, specimens were made after 2 and 4 weeks following the operation. A comparative microscopic examination revealed as follows. 1. The dentin bridge was formed continuously due to osteodentin in the ${\beta}GP$-Dycal group at the 2nd week, the dentin bridge composed of osteodentin and tubular dentin was observed at the 4th week. 2. Osteodentin formation was vigorously in the ${\beta}GP$-Dycal than in the Dycal group. 3. In the surface of osteodentin the osteodentinoblasts showing vivid synthetic activity were observed and the matrix vesicles were presented during calcification of osteoid dentin matrix. 4. The dentin bridge formation was not observed in ${\beta}GP$ group and ${\beta}GP$-ZOE group.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.5
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• pp.441-449
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• 2021

Background: The efficacy of local anesthesia decreases in patients with symptomatic irreversible pulpitis. Therefore, it was proposed that the use of premedication with an anti-inflammatory drug might increase the success rate of pulpal anesthesia in mandibular posterior teeth with vital inflamed pulp. Methods: One hundred thirty-four patients who were actively experiencing pain willingly participated in this study. The Heft Parker (HP) visual analog scale (VAS) was used to record the initial pain intensity. Patients were randomly allocated to receive a placebo, 10 mg of ketorolac, and 650 mg of paracetamol. The standard inferior alveolar nerve block (IANB) was administered to all patients using 2% lidocaine with 1:200,000 adrenaline after one hour of medication. After 15 min, the patient was instructed to rate the discomfort during each step of the treatment procedure, such as access to remaining dentin, access to the pulp chamber, and during canal instrumentation on the HP VAS. IANB was considered successful if the patient reported no or mild pain during access preparation and instrumentation. Moderate or severe pain was classified as a failure of IANB and another method of anesthesia was used before continuing the treatment. Results: The rate of successful anesthesia in the placebo, paracetamol, and ketorolac groups was 29%, 33%, and 43%, respectively, and no statistically significant difference was found between the groups. Conclusion: Preoperative administration of paracetamol or ketorolac did not significantly affect the success rate of IANB in patients with irreversible pulpitis. No significant difference was observed between the paracetamol and ketorolac groups.

• Journal of dental hygiene science
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• v.16 no.4
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• pp.317-322
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• 2016

Mineral trioxide aggregate (MTA) is widely used in endodontic therapy as a pulp-capping material, root or furcal perforation repair material, and for apexification and obturation of the root canal system. The purpose of this study was to formally document cases of MTA application in South Korean children and adolescents. Through this research, the practice of using MTA will be introduced and familiarized to the clinical practitioners. This study involved endodontic treatment using MTA for fractured crowns in 11- and 12-year-old. The children were followed up for 12 months until the pulp vitality was confirmed; in young permanent teeth with immature roots, the pulp is integral to the process of apexogenesis. These observational results regarding the use of MTA as an apexification material in non-vital immature permanent incisors appear to provide promising results in the search for new materials to meet existing endodontic needs.

• Restorative Dentistry and Endodontics
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• v.40 no.4
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• pp.276-285
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• 2015

Objectives: The purpose of this study was to evaluate the efficacy of mineral trioxide aggregate (MTA), Biodentine and Propolis as pulpotomy medicaments in primary dentition, both clinically and radiographically. Materials and Methods: A total of 75 healthy 3 to 10 yr old children each having at least one carious primary molar tooth were selected. Random assignment of the pulpotomy medicaments was done as follows: Group I, MTA; Group II, Biodentine; Group III, Propolis. All the pulpotomized teeth were evaluated at 3, 6, and 9 mon clinically and radiographically, based on the scoring criteria system. Results: The clinical success rates were found to be similar among the three groups at 3 and 6 mon where as a significant decrease in success rate was observed in Group III (84%) compared to both Group I (100%) and Group II (100%) at 9 mon. Radiographic success rates over a period of 9 mon in Groups I, II, and III were 92, 80, and 72%, respectively. Conclusions: Teeth treated with MTA and Biodentine showed more favorable clinical and radiographic success as compared to Propolis at 9 mon follow-up.

• Restorative Dentistry and Endodontics
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• v.24 no.4
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• pp.560-569
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• 1999

Blood supply rather than nerve supply implies pulp vitality. To evaluate pulp vitality clinically, electric pulp test and thermal test which are based on sensory nerve response have been used in addition to many auxiliary data such as past dental history, visual inspection, radiographic examination, percussion, palpation and transillumination test. However, reactivity of the nerves to the stimulation is not synonymous with normalcy. Therefore measurement of pulpal blood flow using a laser Doppler flowmeter became a new trial to test the pulp vitality. The purpose of the present study was to evaluate normal pulpal blood flow level of maxillary teeth in adult to provide a guideline in determining the vitality of dental pulp. Pulpal blood flow was measured in maxillary central and lateral incisors, canines, first and second premolars and first molars of seventy nine adults of 22 - 30 years old using a laser Doppler flowmeter (PeriFlux 4001, Perimed Co., Stockholm, Sweden, 780 nm infrared laser, 1mW). For directly-made splints, silicone rubber impressions were taken directly from the mouth. For indirectly-made splints, alginate impressions were taken from the mouth and stone cast were made. After making depressions on the buccal surfaces of the cast teeth to indicate the hole positions, second impressions with vinyl polysyloxane putty were taken from the cast. Holes for the laser probes were made at the putty impressions 4mm above the gingival level. Laser probe (PF416 dental probe, 1.5mm) was inserted in the prepared hole and the splint was set in the mouth. After 10 minutes of patient relaxing, pulpal blood flow was recorded for 5 minutes on each tooth. The recorded flow was saved in the computer and calculated with a software 'Perisoft' version 5.1. Pulpal blood flow was also recorded in six teeth of five individuals with no response to electric pulp test and cold test, with periapical radiolucency, or with history of root canal treatment to compare with nonvital teeth. The difference between the mean flow values of each group of teeth were analyzed using one-way ANOVA and Duncan's Multiple Range test. The results were as follows: 1. The average pulpal blood flow values of all the tested teeth of each location were between 9 - 16 Perfusion Unit. Pulpal blood flow value was highest in maxillary lateral incisors, followed by first premolars, second premolars, canines, central incisors, and then first molars (p<0.01). 2. In six anterior teeth, indirectly-made splint group showed higher pulpal blood flow values than directly-made splint group (p<0.01). In posterior teeth, however, there was no significant flow value difference between directly-made splint group and indirectly-made splint one (p>0.05). 3. Teeth with vital pulps showed higher signal values than teeth with nonvital pulps (p<0.01), and the flow photographs showed heartbeat-synchronous fluctuations and vasomotions, while those were absent in non vital tooth.

• Restorative Dentistry and Endodontics
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• v.39 no.3
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• pp.155-163
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• 2014

Objectives: Light-curing of resin-based materials (RBMs) increases the pulp chamber temperature, with detrimental effects on the vital pulp. This in vitro study compared the temperature rise under demineralized human tooth dentin during light-curing and the degrees of conversion (DCs) of three different RBMs using quartz tungsten halogen (QTH) and light-emitting diode (LED) units (LCUs). Materials and Methods: Demineralized and non-demineralized dentin disks were prepared from 120 extracted human mandibular molars. The temperature rise under the dentin disks (n = 12) during the light-curing of three RBMs, i.e. an Ormocer-based composite resin (Ceram. X, Dentsply DeTrey), a low-shrinkage silorane-based composite (Filtek P90, 3M ESPE), and a giomer (Beautifil II, Shofu GmbH), was measured with a K-type thermocouple wire. The DCs of the materials were investigated using Fourier transform infrared spectroscopy. Results: The temperature rise under the demineralized dentin disks was higher than that under the non-demineralized dentin disks during the polymerization of all restorative materials (p < 0.05). Filtek P90 induced higher temperature rise during polymerization than Ceram.X and Beautifil II under demineralized dentin (p < 0.05). The temperature rise under demineralized dentin during Filtek P90 polymerization exceeded the threshold value ($5.5^{\circ}C$), with no significant differences between the DCs of the test materials (p > 0.05). Conclusions: Although there were no significant differences in the DCs, the temperature rise under demineralized dentin disks for the silorane-based composite was higher than that for dimethacrylate-based restorative materials, particularly with QTH LCU.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.1
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• pp.110-115
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• 2003

Dens evaginatus is an anomalous tooth development arising during morphodifferentiation. It is most often reported in premolar, and familial occurrence has been reported. The primary dental complication of dens evaginatus is fracture or wear of the tubercle which leads to pulp exposure, pulpal necrosis and periapical infection. Pathosis of the pulp can occur before complete root formation with cessation of root development. A rational and conservative approach to the management of dens evaginatus in vital teeth includes early diagnosis and treatment to prevent fracture or attrition of the tubercle. This treatment would include careful sequential grinding, pulp capping, preventive resin restoration. When presented with a case of dens evaginatus in a nonvital tooth with incomplete root development, the treatment of choice has been extraction, apexification. We report two cases of dens evaginatus that appear in two sisters. In the elder, a periapical lesion on radiographs is shown, and it is treated by calcium hydroxide apexification. The other sister is early recognized of dens evaginatus, it is treated using glass ionomer cement reinforcing with sequential grinding.