• Restorative Dentistry and Endodontics
• /
• v.39 no.3
• /
• pp.210-214
• /
• 2014

Objectives: To investigate the prevalence of different primary reasons for endodontic referrals and the clinical symptoms of the referred cases. Materials and Methods: Clinical data of total endodontic treatment cases (1,014 teeth) including endodontic referral cases (224 teeth) between January 1, 2010 and December 31, 2012, at Kangdong Sacred Heart Hospital, were investigated retrospectively. The one major reason for referral, the clinical symptoms, and the resulting treatment procedures of referral cases were recorded. The percentages of clinical symptoms of the endodontic referral cases and the total endodontic treatment cases were compared by ${\chi}^2$ test for each symptom. Results: Persistent pain was the most frequent reason for endodontic referral (29.5%), followed by presence of gingival swelling and sinus tract (24.1%), and apical radiolucency (12.9%). Referrals in cases involving endodontic difficulties such as canal calcification, broken instruments, post, perforation, and resorption were less than 5.0%, respectively. The percentages of four major clinical symptoms of pain, apical radiolucency, previous endodontic treatment, and gingival swelling and sinus tract were significantly higher in the endodontic referral cases than those in the total endodontic cases (p = 0.001). Among the included referral cases, 72.8% were treated with nonsurgical endodontic treatment only. Teeth other than the referred teeth were diagnosed as the origin of the problem in 5.8% of the referrals. Conclusions: The high prevalence of pain, apical radiolucency, previous treatment, and gingival swelling and sinus tract in endodontic referral cases suggest that these symptoms may be what general practitioners consider to be difficult and refer to endodontists.

• Restorative Dentistry and Endodontics
• /
• v.40 no.3
• /
• pp.179-187
• /
• 2015

Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment.

• The Journal of the Korean dental association
• /
• v.55 no.8
• /
• pp.542-555
• /
• 2017

1. Diagnosis Diagnosis of Crack, Direct pulp capping 2. Access opening Find the calcified canal orifice Removal of dentin shelf Obtaining the MB2 canal (MB2, MB3, DB2) 3. Perforation repair during endodontic treatment 4. Removal of the separated files 5. Open apex treatment 6. Void removal on CWT procedure 7. Re-endodontic treatment Removal of restorative material filled in pulp chamber Post removal Identification and removal of residual gutta-perch 8. Surgical endodontic treatment In each case will overview how to use a dental microscope.

• The Journal of the Korean dental association
• /
• v.48 no.4
• /
• pp.288-296
• /
• 2010

Although non-surgical endodontic procedures have high success rates, failures do occur, These can be managed by root canal re-treatment or surgical intervention. Intentional replantation is an accepted endodontic treatment procedure in which a tooth is extracted and treated outside the oral cavity and then inserted into its socket to correct an obvious radiographic or clinical endodontic failure. Intentional replantation is indicated when other endodontic treatments performed to maintain the tooth have failed, or when endodontic periradicular surgery is not feasible. Intentional replantation may be particularly useful in these cases because these difficult to access areas can be maximally treated while the tooth is out of the mouth without damaging the periodontal attachment in adjacent teeth. In conclusion, intentional replantation is a reliable and even predictable procedure, and should be considered more often as a treatment modality in our efforts to maintain the natural dentition.

• Journal of Periodontal and Implant Science
• /
• v.43 no.3
• /
• pp.136-140
• /
• 2013

Purpose: The aim of this study was to identify a role for endodontic intervention in enhancing the regenerative potential of the periodontal ligament when combined with periodontal treatment in seriously involved teeth with a secondary endodontic component. Methods: Patients who exhibited radiolucency extending to the periapical region, abnormal electric pulp testing values, and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Intentional root canal treatment was applied to those teeth in which the apical lesions were presumed to communicate with those of the periodontal lesion of the teeth that remained vital. In all three selected cases, regenerative periodontal therapy incorporating either bone graft or guided tissue regeneration was instituted 3 months after the endodontic intervention. Results: Remarkable enhancement in radiographic density was noticeable around the affected teeth as evidenced by changes in radiopacity. There was a significant reduction in the probing pocket depth and gain in the clinical attachment level. Chewing discomfort gradually disappeared from the commencement of the combined treatment. Conclusions: An intentional endodontic intervention may be a worthwhile approach for the sophisticated management of teeth suffering from serious attachment loss and alveolar bone destruction with concomitant secondary endodontic involvement.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.24 no.3
• /
• pp.575-580
• /
• 1997

It has been reported that the operative treatment for the preservation of tooth having periapical lesion has shown over ninety percent of success whereas in the case where calcified canal is severe, canal is perforated, ledge is formed, tooth restored by post and core and cases where symptoms still exist after treatment, endodontic treatment may not all be the solution in attaining a successful treatment. Thus Apicoectomy would generally be used to prevent the loss of tooth having periapical lesion where treatment prognosis is poorly evaluated by endodontic treatment. In case 1 and 2, endodontic treatment was applied due to unilocular radiolucent lesion in periapical area but the symptoms somehow did not show improvement and therefore operated apicoectomy, and as in case 1, favorable results were attained but as in case 2, yet more observation has to be done. The followings are the results we have concluded : 1. In the process of endodontic treatment, absolute canal obturation has great effect on attaining successful treatment. 2. In cases where endodontic treatment is not highly recommended, for example, tooth having dental pulp and periapical lesion, favorable results can be attained by applying apicoectomy.

• The Journal of the Korean dental association
• /
• v.54 no.11
• /
• pp.874-879
• /
• 2016

Damage to the inferior alveolar nerve(IAN) is a relatively infrequent complication in endodontic treatment. However, endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve resulting in sensory disturbances such as pain, dysesthesia, paresthesia or anesthesia. Two mechanism(chemical neurotoxicity and mechanical compression) are responsible for the IAN injury. When absorbent materials overfilled, it can be treated as a non-surgical procedure. But early surgical intervention required when mechanical, chemical nerve damage expected. We report surgical removal of overfilled gutta-percha and IAN decompression through sagittal split osteotomy in case of dysesthesia after overfilling of endodontic material into the mandibular canal. Dysesthesia recovered 3 months after surgical treatment.

• Proceedings of the KACD Conference
• /
• 2001.05a
• /
• pp.257-257
• /
• 2001

Failures occur in dentistry as a result of manny factors some of which can be controlled by the operator whilst others are unavoidable. The long-term success rate of endodontic treatment has often been thought to be very high although studies reported in the literature do not support this perception. The number of failure can be reduced by adhereing to accepted treatment procedures and by avoiding 'short cut'. Endodontic disaters are usually related to operator errors and they mat have detrimental effects on the outcome of treatment in the long term, eventually becoming catastrophes. Endodontic disasters will require special techniques to salvage them whereas catastrophes usually result in loss of the tooth and every effort should be made to prevent such problems from occurring. This presentation will cover common errors in endodontic procedures especially access opening, canal negotiation, canal irrigation, canal preparation, canal filling, post preparation.ration.

• Restorative Dentistry and Endodontics
• /
• v.39 no.2
• /
• pp.115-119
• /
• 2014

As long as the prognosis of teeth remains a matter of concern, the endodontic-periodontal relationship will be considered a challenge for the clinician. Many etiologic factors, including bacteria, fungi, and viruses, plus other contributing factors, such as trauma, root resorptions/perforations, and dental malformations, play a role in the co-occurrence of endodontic and periodontal lesions. Whatever the cause, a correct diagnosis on which to base the treatment plan is the key to successful maintenance of the tooth. This article reports the successful endodontic management of a furcation lesion in a mandibular molar that was nonresponsive to a previous periodontal surgical graft. The case had presented a diagnostic challenge for the clinicians, and this article reviews the key points that can lead to a correct diagnosis and treatment planning.

• Restorative Dentistry and Endodontics
• /
• v.40 no.1
• /
• pp.79-84
• /
• 2015

This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment.