근관형성 후 동통에 대한 수산화칼슘의 효과에 관한 연구

남욱,박상혁,최기운 大韓齒科保存學會 2006 Restorative Dentistry & Endodontics Vol.31 No.2

본 연구는 치성 동통을 보이는 치아의 수산화칼숨의 사용 여부에 따른 동통 감소 효과를 판단하고자 시행하였다. 2003년 12월부터 2004년 9월 사이에 경희대학교 치과대학 부속 치과병원 치과보존과에 치성 동통으로 내원한 환자 213명으로부터 근관형성을 시행한 237개의 치아를 대상으로 환자의 성별 및 연령, 치료부위, 재근관 치료의 여부, 치수의 상태, 술전 치아 상태와 술전 동통의 정도를 기록하였다. 수산화칼슘을 적용하지 않은 군 (1군)과 수산화칼슘을 적용한 군 (2군)으로 분류하였다. 환자들에게 설문지를 배분하여 다음 내원시 치료 후 4시간, 2일 및 7일에 술후 동통의 발생 여부와 동통의 정도를 기록하도록 하였다. 수집한 자료들은 Chi-square analysis (p<0.05)를 사용하여 비교, 분석한 결과 근관내 약제로써 수산화칼슘은 술후 동통을 예방하거나 감소시키는 효과를 가지고 있지 않다는 것을 알 수 있었다. The purpose of this clinical study is to assess whether calcium hydroxide as an intracanal medication affects post-treatment pain in teeth especially odontogenic pain which comes from inflammation of the pulp and periradicular tissues when compared with no intracanal medication. From 213 patients who has been treated 237 root canals due to significant pain (moderate-to-severe), we recorded their age, sex, treated tooth, degree of pain, pre-operative states of the tooth. We classified patients into 2 test group: Group 1 (not gain intracanal Ca(OH)_(2)), Group 2 (gain intracanal Ca(OH)_(2)). Through the survey from the patients, we let them write down the occurrence and degree of post-treatment pain in 4hours, 2days, 7days after treatment as none. mild, moderate or severe. The followings were evaluated: the overall incidence of flare-ups, the overall incidence of post-treatment pain in each group at each time period, the incidence of post-treatment pain in each group at each time period as related to pre-operative states of the teeth. These were compared statistically with Chi-square analysis (p < 0.05). Under the condition of this investigation, no difference was observed in the incidence of post-treat-ment pain between the two groups. Therefore, Ca(OH)_(2)as intracanal medication had no effect on preventing or decreasing the post-treatment pain.

Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis

Ibrahim, Ahmed Mohamed,Zakhary, Siza Yacoub,Amin, Suzan Abdul Wanees The Korean Academy of Conservative Dentistry 2020 Restorative Dentistry & Endodontics Vol.45 No.3

Objectives: This study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth. Materials and Methods: Electronic-databases searching for published and grey literature and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing CH to other ICMs in non-vital mature teeth. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The main outcomes were pain and flare-up. Qualitative and quantitative analysis, wherever applicable, was performed. The certainty of evidence (CoE) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Sixteen articles were included in 6 comparisons at different time points for different outcomes. CH reduced pain risk than no ICM within the 1-14-days interval (p < 0.05) and than triple-antibiotic paste within the first day (p < 0.05) and was similar to corticosteroid/antibiotics combination (p > 0.05). Chlorhexidine (CHX) or CH/CHX, however, reduced pain levels than CH alone (p < 0.05). CH showed higher flare-up risk than CHX (p < 0.05). CoE, however, ranged from very low to moderate. Conclusion: Most comparisons for different outcomes are based on very few studies, mostly low-powered, with an overall low CoE. Thus, the available evidence is considered insufficient to either support or refute CH effectiveness or to recommend one ICM over another. Therefore, further well-designed, larger RCTs are required.

Efficacy of various irrigation methods for the removal of calcium hydroxide paste in the root canal

( Ui-jung Lee ),( Ho-keel Hwang ),( Jeong-bum Min ),( Hyoung-hoon Jo ) 조선대학교 구강생물학연구소 2016 Oral Biology Research (Oral Biol Res) Vol.40 No.4

In this study, we compared the efficacy of calcium hydroxide (Ca(OH)₂) paste removal in the apical part of the root canal using various irrigation methods. Ninety extracted single-rooted teeth were prepared and split longitudinally. At the apical third, a standardized groove was made and Ca(OH)₂ paste was inserted. The two split sections were reassembled and Ca(OH)₂paste was removed with 5 ml 2.5% NaOCl using three different irrigation protocols: conventional syringe irrigation (Control), sonic irrigation (Group 1), and ultrasonic irrigation (Group 2). Samples were split again and the remaining Ca(OH)₂ paste was evaluated under a dental operating microscope using a 4-step scale: score 0, empty groove ; score 1, Ca(OH)₂ paste present in less than half of the groove; score 2, Ca(OH)₂ paste covers more than half of the groove; and score 3, Ca(OH)₂ paste completely fills the groove. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney tests at 5% significance level. The groups irrigated with sonic (Group 1, 0.8 ± 0.81) and ultrasonic (Group 2, 1.0 ± 1.02) devices showed significantly better removal of Ca(OH)₂ paste from the grooves, as compared to the group irrigated with conventional syringes (Control, 1.53 ± 0.82) (P < 0.05). However, there was no significant difference between the sonic and ultrasonic irrigation groups. The use of additional (sonic and ultrasonic) irrigation protocols enhanced Ca(OH)₂ paste removal in the root canal as compared with conventional syringe irrigation.

Surgical management with intentional replantation on a tooth with palato-radicular groove

Forero-Lopez, Jorge,Gamboa-Martinez, Luis,Pico-Porras, Laura,Nino-Barrera, Javier Laureano The Korean Academy of Conservative Dentistry 2015 Restorative Dentistry & Endodontics Vol.40 No.2

A palato-radicular groove (PRG) is a developmental anomaly primarily found in the maxillary lateral incisors. It is a potential communication path between the root canal and the periodontium that decreases the survival prognosis of the affected tooth, therefore compromising the stability of the dental structure in the oral cavity. The aim of this case report is to present an original technique where a PRG was treated by means of intracanal disinfection, PRG sealing with glass ionomer, replantation with intentional horizontal 180 degree rotation of the tooth, and an aesthetic veneer placed to provide adequate tooth morphology. The clinical and biological benefits of this novel technique are presented and discussed.

Surgical management with intentional replantation on a tooth with palato-radicular groove

Jorge Forero-López,Luis Gamboa-Martínez,Laura Pico-Porras,Javier Laureano Niño-Barrera 대한치과보존학회 2015 Restorative Dentistry & Endodontics Vol.40 No.2

A palato-radicular groove (PRG) is a developmental anomaly primarily found in the maxillary lateral incisors. It is a potential communication path between the root canal and the periodontium that decreases the survival prognosis of the affected tooth, therefore compromising the stability of the dental structure in the oral cavity. The aim of this case report is to present an original technique where a PRG was treated by means of intracanal disinfection, PRG sealing with glass ionomer, replantation with intentional horizontal 180 degree rotation of the tooth, and an aesthetic veneer placed to provide adequate tooth morphology. The clinical and biological benefits of this novel technique are presented and discussed.

항생제를 이용한 미성숙 영구치의 치험례

김소정,조해성,정윤주,최성철,박재홍 大韓小兒齒科學會 2011 大韓小兒齒科學會誌 Vol.38 No.1

미성숙 영구치의 치수가 괴사되면, 치근 형성이 더 이상 이루어지지 않아 치근벽이 매우 얇고, 치근단공이 열려 있어 근관 치료를 시행하기가 매우 어렵다. 치수가 괴사되고, 치근단 병소가 있는 치아의 근관치료를 시행할 때 가장 중요한 것은 감염 된 근관계를 소독하는 것이다. 이러한 소독은 근관 내 기계적인 기구 조작, 근관 세척, 근관 내 약제를 통해서 이루어질 수 있 는데, 최근 ciprofloxacin, metronidazole, minocycline의 세 가지 항생제 조합을 이용하여 근관 내 병원균을 제거하고, 치 수의 재혈관화를 도모하여, 치근의 지속적인 성장을 유도한 연구와 증례가 많이 보고되고 있다. 이러한 재생적인 근관 치료는 미성숙 영구치를 치료함에 있어서 통법적인 치근단형성술보다 보존적인 치료법으로서 널리 이용될 것이라 사료된다. 본 증례는 치외치의 교두파절로 인하여 치수가 괴사되고, 치근단 병소가 생긴 미성숙 영구치를 주소로 내원한 두 환아에 대 하여 세 가지 항생제 조합을 근관 내 약제로 이용하여 치료한 바, 성공적인 치료결과를 보여 이를 보고하는 바이다. An immature tooth with infected pulp has numerous potential complications. Conventional apexification with calcium hydroxide has several disadvantages, including susceptibility to tooth fracture. This method does not promote continual root development. Pulp revascularization of a necrotic, immature permanent tooth will allow further development of the root and dentinal structure. Disinfection of the root canal system is a prerequisite for pulp revascularization and tissue regeneration. A combination of antibiotic drugs (ciprofloxacin, metronidazole, and minocycline) is effective for disinfection of necrotic pulp, and has been used successfully in regenerative endodontic treatment. These case reports involve the treatment of 3 immature permanent teeth with necrotic pulp using a 3-Mix paste and mineral trioxide aggregate. All cases showed the notable apical maturation with closure of the apex and increased thickness of dentinal walls. This approach suggests a paradigm shift in treating endodontically involved immature permanent teeth from the traditional apexification with calcium hydroxide to the conservative approach by providing a favorable environment for tissue regeneration.

수산화칼슘 근관약제와 산화아연-유지놀의 반응에 관한 화학적 분석

김성교,박준철,박숙형 大韓齒科保存學會 2000 Restorative Dentistry & Endodontics Vol.25 No.2