(A) clinical and radiographic study of the conservative treatment of the necrotic and infected primary molars

치의학과/석사[한글] 괴사유치의 보존적 처치는 유치의 조기발거로 인한 제문제를 최소한으로 줄이기 위해서도 필요하다고 하겠다. 본 연구의 목적은 이러한 괴사유치를 formocresol을 사용한 치수 절단술로서 보존처치하고 그 예후를 관찰하여 괴사유치의 보존술식으로서의 가치를 평가하고자 함이다. 저자는 연세대학교 치과대학 부속병원 소아치과에 내원한 13명의 소아로부터 25증례의 괴사된 유구치를 대상으로 하여 formocresol을 사용한 치수 절단술과 필요한 경우에 외과적 처치를 겸하여 이들 괴사된 유구치를 보존시키고, 3개월 간격으로 임상 및 방사선학적 으로 관찰하였던 바 다음과 같은 결론을 얻었다. 1. 임상적으로는 25 예중 20 예에서 성공적인 결과를 얻었으나, 5 예에서는 실패하였다. 실패의 원인은 주로 치수강저의 병적 혹은 기계적 천공이었다. 2. 방사선학적으로는 9개월 ∼ 12개월이 지난 후 14 예에서 정상적으로 나타났으며, 6 예에서는 약간의 치근분기부의 희박화상을 관찰할 수 있었고, 5 예에서는 심한 치근분기부 및 치근단부 희박화상을 관찰 할 수 있었다, 3. 실패한 5 예를 제외한 나머지에서는 전면적으로 현저한 골침착이 관찰되었다. 4. 병적인 치근흡수는 2 예에서 관찰되었다. 5. 치조치근유착은 관찰되지 않았다. 6. 영구치 치낭이 손실된 2 예중 1 예에서 치낭이 재생된 것을 관찰할 수 있었다. A Clinical and Radiographic Study of the Conservative Treatment of the Necrotic and Infected Primary Molars Nojeong, Hur. D.D.S. Department of Dental Science Graduate School Yonsei University (Directed by Prof. Joung Kang Yang. D.D.D., M.S.D., M.S., D.M.Sc.) The conservative treatment of the necrotic and infected primary molars is often necessary in order to avoid extractions which may lead to inability to masticate or loss of space and subsequent problems concerning the develipment of the occlusion in the permanent dentition. The purpose of This study was to evaluate the clinical significance of the conservative treatment of the infected primary molars with necrotic pulps employing the formocresol pulpotomy technique same as in vital teeth, and surgical intervention in the cases with a parulis, fistula, or cellulitis. The materials consisted of 25 primary molars of 9 boys and 4 girls ranging in age from 4 to 7 years. This study included clinical and radiographic observations 3, 6, 9, 12 months postoperatively. The following results were obtained. 1. Clinically, 20 cases of 25 were successful, exhibiting no clinical problems such as fistula, mobility, toothache and tenderness to percussion, etc. 5 cases were regarded as failures. 2. Raiographically, 14 cases revealed normal features, in 6 cases slight rarefication was observed in the periapical and interradicular region, and marked periapical and interradicular rarefication was observed in 5 cases. 3. Marked bony deposition was observed in the periapical and interradicular regions in all the remainder except for 5 failures. 4. Pathologic root resorption was observed in 2 cases. 5. No alveolodental ankylosis was observed. 6. Regeneration of the dental sac of the permanent tooth was observed in 1 case of 2 cases which had revealed loss of the dental sac. [영문] The conservative treatment of the necrotic and infected primary molars is often necessary in order to avoid extractions which may lead to inability to masticate or loss of space and subsequent problems concerning the develipment of the occlusion in the permanent dentition. The purpose of This study was to evaluate the clinical significance of the conservative treatment of the infected primary molars with necrotic pulps employing the formocresol pulpotomy technique same as in vital teeth, and surgical intervention in the cases with a parulis, fistula, or cellulitis. The materials consisted of 25 primary molars of 9 boys and 4 girls ranging in age from 4 to 7 years. This study included clinical and radiographic observations 3, 6, 9, 12 months postoperatively. The following results were obtained. 1. Clinically, 20 cases of 25 were successful, exhibiting no clinical problems such as fistula, mobility, toothache and tenderness to percussion, etc. 5 cases were regarded as failures. 2. Raiographically, 14 cases revealed normal features, in 6 cases slight rarefication was observed in the periapical and interradicular region, and marked periapical and interradicular rarefication was observed in 5 cases. 3. Marked bony deposition was observed in the periapical and interradicular regions in all the remainder except for 5 failures. 4. Pathologic root resorption was observed in 2 cases. 5. No alveolodental ankylosis was observed. 6. Regeneration of the dental sac of the permanent tooth was observed in 1 case of 2 cases which had revealed loss of the dental sac.restrictio