치근단 병변이 있는 미성숙 영구치에서 Platelet-rich fibrin(PRF)를 이용한 보존적 근관치료
REGENERATIVE ENDODONTIC TREATMENT OF IMMATURE PERMANENT TEETH BY USING PLATELET-RICH FIBRIN
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
성장 중인 아동에서는 치근의 성장이 계속됨에 따라 치수가 괴사되어 치근의 병변이 있는 미성숙 영구치에서도 치수의 재혈관화가 실제로 일어날 수 있다는 가능성이 제시 되고 있다. 치수의 재혈관화를 위해서는 근관 내의 감염의 조절과 함께 적절한 scaffold가 필요하며, platelet-rich plasma(PRP)가 이상적인 scaffold로 제시되었다. 최근 임상에서는 PRP의 단점을극복한 platelet-rich fibrin(PRF)가 응용되고 있다. 본 증례에서는 치외치의 교두 파절로 인한 치수 감염으로 치근단 병변을 가진 미성숙 영구치의 근관 내에 ciprofloxacin, metronidazole, minocycline의 세 가지 항생제 적용 후 이와 함께 PRF 를 적용하였다. 정기적인 검진 결과 치근단 병변의 치유와 함께 치근 성장이 관찰되었다. 이러한 보존적인 근관 치료는 미성숙 영구치에서 치근단 형성술의 대안적인 치료로서 이용될 수 있을 것이며, 향후 장기간의 임상적 관찰이 필요할 것이다.
Abstract
In case of an immature tooth with necrotic pulp, regeneration of pulp tissue into a canal would be the ideal outcome. It may be capable of promoting the continuation of normal root development. Platelet-rich fibrin has been suggested as a potentially ideal scaffold for regenerative endodontic treatment. Immature permanent teeth of young children were diagnosed with pulp necrosis and apical abscess as the result of clinical and radiographic examination. After removal of necrotic pulp, canal was irrigated with 5.25% NaOCl and dried with paper point. A triple antibiotic mixture was placed in canal space in 3 weeks. After removal of the antibiotic mixture, the platelet-rich fibrin was injected into the canal space with MTA placed directly over the platelet-rich fibrin clot. The coronal region was restored by composite resin. On the basis of short-term results of the present 3 cases,regeneration of vital tissues appears to be possible in a tooth with necrotic pulp and a periapical lesion. Also,platelet-rich fibrin proves to be potentially an ideal scaffold for this procedure. Therefore, long-term clinical observation and examination about this treatment using platelet-rich fibrin in immature permanent teeth of young children are considered to be necessary.
참고문헌 (26)
- Torabinejad M, "Revitalization of tooth with necrotic pulp and open apex by using plateletrich plasma: a case report", J Endod, 37, pp.265~268 (2011)
- Hargreaves K, "Regeneration potential of the young permanent tooth: what does the future hold", J Endod, 34, pp.851~856 (2008)
- Andreasen JO, "Long term calcium hydroxide as a root canal dressing may increase risk of root fracture", Dent Traumatol, 18, pp.134~137 (2002)
- 김소정, "항생제를 이용한 미성숙 영구치의 치험례", 대한소아치과학회지, 38(1), pp.44~50 (2011), 대한소아치과학회
- Rui Yu Ding, "Pulp revascularization of immature teeth with apical periodontitis: A clinical study", J Endod, 35, pp.745~749 (2009)
- Banchs F, "Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol", J Endod, 30, pp.196~200 (2004)
- Hoshino E, "In-vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline", Int Endod J, 29, pp.125~130 (1996)
- Sato T, "In vitro antimicrobial susceptibility to combinations of drugs on bacteria from carious and endodontic lesions of human deciduous teeth", Oral Microbiol Immunol, 8, pp.172~176 (1993)
- Sato I, "Sterilization of infected root-canal dentine by topical application of a ciprofloxacin, metronidazole and minocycline in situ", Int Endod J, 29, pp.118~124 (1996)
- Iwaya SI, "Revascularization of an immature permanent tooth with apical periodontitis and sinus tract", Dent Traumatol, 17, pp.185~187 (2001)
- 박소연, "미성숙영구치의 복합항생제 적용에 의한 변색의 처치: 증례보고", 대한소아치과학회지, 39(1), pp.43~50 (2012), 대한소아치과학회
- Takushige T, "Endodontic treatment of primary teeth using a combination of antibacterial drugs", Int Endod J, 37, pp.132~138 (2004)
- Trope M, "Treatment of immature teeth with nonvital pulps and apical periodontitis", Endodontic Topics, 14, pp.51~59 (2006)
- Kim ST, "The effects of Ledermix paste on discoloration of immature teeth", Int Endod J, 33, pp.233~237 (2000)
- Sa′nchez AR, "Tetracycline and other tetracycline- derivative staining of the teeth and oral cavity", Int J Dermatol, 43, pp.709~715 (2004)
- Thibodeau B, "Pulp revascularization of immature dog teeth with apical periodontitis", J Endod, 33, pp.680~689 (2007)
- Maeda H, "Human periapical granulation tissue contains ostegenic cells", Cell Tissue Res, 315, pp.203~208 (2004)
- Marx RE, "Platelet-rich plasma: evidence to surpport its use", J Oral Maxillofac Surg, 64, pp.498~496 (2004)
- Freymiller EG, "Platelet-rich plasma: ready or not", J Oral Maxillofac Surg, 62, pp.484~488 (2004)
- Anitua E., "Plasma rich in growth factors: preliminary results of use in the preparation of future sites for implants", Int J Oral Maxillofac Implants, 14, pp.529~535 (1999)
- Ito K, "Osteogenic potential of injectable tissue engineered bone: a comparison among autogenous bone, bone substitute (Bio-oss), platelet-rich plasma, and tissue-engineered bone with respect to their mechanical properties and and histological findings", J Biomed Mater Res A, 73, pp.63~72 (2005)
- Kassolis JD, "Alveolar ridge and sinus augmentation utilizing platelet-rich plasma in combination with freeze-dried bone allograft: case series", J Periodontol, 71, pp.1654~1661 (2000)
- Wiltfang J, "Sinus Floor augmentation with beta-tricalciumphosphate (beta-TCP): does platelet-rich plasma promote its osseous integration and degradation", Clin Oral Implants Res, 14, pp.213~218 (2003)
- Demiralp B, "Treatment of periapical inflammatory lesion with the combination of platelet-rich plasma and tricalciumphosphate: a case report", J Endod, 30, pp.796~800 (2004)
- Hiremath H, "Single-step apical barrier placement in immature teeth using mineral trioxide aggregate and management of periapical inflammatory lesion using platelet-rich plasma and hydroxyapatite", J Endod, 34, pp.1020~1024 (2008)