Accidental injury of the inferior alveolar nerve due to the extrusion of calcium hydroxide in endodontic treatment: a case report

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.

Comparison of crown designs of different dental occupational groups, using CAD-CAM / 대한치과보철학회지

PURPOSE: Increasing use of computer aided design-computer aided manufacturing (CAD-CAM) system and number of design software made design of restoration easy and quick. Outcome of restoration has been dependent on dental technician's wax up proficiency, dentists can design restoration for themselves now. This study aims to investigate the outcome of restoration designs, according to handling skill of CAD-CAM design tool. MATERIALS AND METHODS: A patient's mandibular right 1st molar was prepared. After taking impression, stone model was made, scanned the stone model with 3 shape intra-oral scanner, stereolithography (STL) file was extracted. With 3shape dental designer, one dental technician with more than 5 years work experience (designer 0) and three dental technicians with less than 2years work experience (designer 1, 2, 3-group DT) and 4 1st year residents (designer 4, 5, 6, 7-group RT) designed gold crown on the same STL file. Designed crown's MD (mesio-distal) and BL (bucco-lingual) diameter, height of crown, inter-cuspal distance, number of occlusal contact points were compared. Statistical analysis was carried out, test of normality within each group, using independent t-test. Number of contact points were compared, using Wilcoxon signed-rank test. RESULTS: There was no significant difference between group DT and group RT. Number of contact points also resulted in no significant difference. CONCLUSION: The outcome of each designed crowns showed no statistical differences, in values which can be expressed as numbers. Subjective factors were different. With increasing proficiency in handling designing software, fabrication of restorations according to each designer's occlusal concept can be made easy.

Analysis of stress distribution of tooth restored with metal-ceramic crown covering abfraction lesion according to its finish line location under occlusal load / 대한치과보철학회지

PURPOSE: When the full veneer crown was treated in the tooth with abfraction lesion due to various causes, the prognosis of it may be compromised according to the location of the finish line, but there is few study about the location of its buccal finish line. The purpose of this study was to investigate the effect of location of the finish line of the full veneer crown on stress distribution of the tooth with abfraction lesion. MATERIALS AND METHODS: The two dimensional finite element model was developed to express tooth, surrounding tissue and full veneer crown. The stress distribution under eccentric 144 N occlusal load was analyzed using finite element analysis. The location of finish line was set just at the lower border of the lesion (Group 0), 1 mm (Group 1) and 2 mm (Group 2) below the lower border of the lesion. RESULTS: In the Group 0, von Mises stress was concentrated at the finish line and the apex of the lesion. Also, the stress at the bucal finish line propagated to the lingual side. In the Group 1 and Group 2, stress distribution was similar each other. Stress was concentrated at the apex of lesion, but the stress at the buccal finish line did not propagate to the lingual side. That implied decrease of the possibility of horizontal crown fracture. CONCLUSION: Full veneer crown alleviated the stress concentrated at the apex of the abfraction lesion, when the finish line of full veneer crown was set below the lower border of abfraction lesion.