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Research Articles
Effect of Dental Practicality Index training using an online video on decision-making and confidence level in treatment planning by dental undergraduates
Zhai Wei See, Ming Sern Lee, Abhishek Parolia, Shalini Kanagasingam, Shilpa Gunjal, Shanon Patel
Restor Dent Endod 2024;49(1):e8.   Published online January 24, 2024
DOI: https://doi.org/10.5395/rde.2024.49.e8
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to evaluate the effect of Dental Practicality Index (DPI) training using an online video on the treatment planning decisions and confidence level of dental undergraduates (DUs).

Materials and Methods

Ninety-four DUs were shown 15 clinical case scenarios and asked to decide on treatment plans based on 4 treatment options. The most appropriate treatment plan had been decided by a consensus panel of experienced dentists. DUs then underwent DPI training using an online video. In a post-DPI-training test, DUs were shown the same clinical case scenarios and asked to assign the best treatment option. After 6 weeks, DUs were retested to assess their knowledge retention. In all 3 tests, DUs completed the confidence level scale questionnaire. Data were analyzed using the related-samples Wilcoxon signed rank test and the independent-samples Mann-Whitney U test with the level of significance set at p < 0.05.

Results

DPI training significantly improved the mean scores of the DUs from 7.53 in the pre-DPI-training test to 9.01 in the post-DPI-training test (p < 0.001). After 6 weeks, the mean scores decreased marginally to 8.87 in the retention test (p = 0.563). DPI training increased their confidence level from 5.68 pre-DPI training to 7.09 post-DPI training.

Conclusions

Training DUs using DPI with an online video improved their decision-making and confidence level in treatment planning.

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Radiographic patterns of periosteal bone reactions associated with endodontic lesions
Poorya Jalali, Jessica Riccobono, Robert A. Augsburger, Mehrnaz Tahmasbi-Arashlow
Restor Dent Endod 2023;48(3):e23.   Published online June 8, 2023
DOI: https://doi.org/10.5395/rde.2023.48.e23
AbstractAbstract PDFPubReaderePub
Objectives

The formation of new bone by periosteum due to an insult is called periosteal bone reaction (PBR). This study assessed the cone beam computed tomography (CBCT) patterns of periosteal bone reactions associated with periapical inflammatory lesion (apical periodontitis/periapical rarefying osteitis).

Materials and Methods

Twenty-two small field of view CBCT images of patients with PBR were selected from a database of a private practice limited to endodontics. The volume of the periapical inflammatory lesion, the presence of cortical fenestration, the distance of the root apices to the affected cortex, and the location, pattern, and longest diameter of the periosteal reaction were recorded. Statistical analysis was performed using Wilcoxon Ranksum, Fischer’s exact, Spearman Correlation Coefficient, and paired t-test.

Results

In all cases, periosteal bone reaction manifested as either parallel (90.9%) or irregular (9.1%). No correlation was found between periapical inflammatory lesion volume and the periosteal reaction's longest diameter (p > 0.05). Cortical fenestration was noted in 72.7% of the cases. In addition, the findings showed that periosteal reactions were located mostly on the buccal and were present 53.8% and 100% of the time in the mandible and maxilla, respectively.

Conclusions

The periosteal reactions of endodontic origin had a nonaggressive form (i.e., parallel or irregular), and none of the lesions resulted in a periosteal reaction with an ominous Codman’s triangle or spicule pattern.

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Differential diagnosis of periapical cyst using collagen birefringence pattern of the cyst wall
Hyo Jin Ji, Se-Hee Park, Kyung-Mo Cho, Suk Keun Lee, Jin Woo Kim
Restor Dent Endod 2017;42(2):111-117.   Published online February 9, 2017
DOI: https://doi.org/10.5395/rde.2017.42.2.111
AbstractAbstract PDFPubReaderePub
Objectives

Periapical lesions, including periapical cyst (PC), periapical granuloma (PG), and periapical abscess (PA), are frequently affected by chemical/physical damage during root canal treatment or severe bacterial infection, and thus, the differential diagnosis of periapical lesions may be difficult due to the presence of severe inflammatory reaction. The aim of this study was to make differential diagnosis among PC, PG, and PA under polarizing microscope.

Materials and Methods

The collagen birefringence patterns of 319 cases of PC (n = 122), PG (n = 158), and PA (n = 39) obtained using a polarizing microscope were compared. In addition, 6 cases of periodontal fibroma (PF) were used as positive controls.

Results

Collagen birefringence was condensed with a thick, linear band-like pattern in PC, but was short and irregularly scattered in PG, and scarce or absent in PA. PF showed intense collagen birefringence with a short, palisading pattern but no continuous band-like pattern. The linear band-like birefringence in PC was ascribed to pre-existing expansile tensile stress of the cyst wall.

Conclusions

In this study all PCs (n = 122) were distinguishable from PGs and PAs by their characteristic birefringence, despite the absence of lining epithelium (n = 20). Therefore, the authors suggest that the presence of linear band-like collagen birefringence of the cyst wall aids the diagnostic differentiation of PC from PG and PA.

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Case Reports
Diagnosis and treatment of teeth with primary endodontic lesions mimicking periodontal disease: three cases with long-term follow ups
Jae-Hyung Lim, Ji-Hyun Lee, Su-Jung Shin
Restor Dent Endod 2014;39(1):56-62.   Published online January 20, 2014
DOI: https://doi.org/10.5395/rde.2014.39.1.56
AbstractAbstract PDFPubReaderePub

A tooth with primary endodontic disease that demonstrates a periodontal defect might be extracted because of misdiagnosis as severe periodontal disease or a vertical root fracture. The aim of this case report was to demonstrate the long-term survival of endodontically treated teeth, which had been initially considered unsavable. With meticulous evaluation including the patient's dental history, clinical and radiographic examinations, teeth with primary endodontic lesions could be differentiated and saved after proper root canal treatment. Pain history, vitality test, and radiographic examinations, as well as a general periodontal condition check with periodontal probing on an affected tooth, might be the key methods to differentiate endodontic pathosis from that of periodontal disease.

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Diagnostic challenges of nonodontogenic toothache
Hyung-Ok Park, Jung-Hong Ha, Myoung-Uk Jin, Young-Kyung Kim, Sung-Kyo Kim
Restor Dent Endod 2012;37(3):170-174.   Published online August 29, 2012
DOI: https://doi.org/10.5395/rde.2012.37.3.170
AbstractAbstract PDFPubReaderePub

The objective of this article was to present two nonodontogenic conditions that may mimic odontogenic toothache: trigeminal neuralgia and burning mouth syndrome. Two cases are presented in which one is related to the upper left second premolar and the other is related to the upper left first molar. Both showed pain when chewing. These two cases highlight the complexities involved in diagnosing nonodontogenic toothache. This article demonstrates the importance of having a thorough knowledge of both odontogenic and nonodontogenic toothache, as well as the need for careful evaluation of the nature of the pain and history, clinical and radiographic examinations.

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Review Articles
Early caries detection using optical coherence tomography: a review of the literature
Young-Seok Park, Byeong-Hoon Cho, Seung-Pyo Lee, Won-Jun Shon
J Korean Acad Conserv Dent 2011;36(5):367-376.   Published online September 14, 2011
DOI: https://doi.org/10.5395/JKACD.2011.36.5.367
AbstractAbstract PDFPubReaderePub
Abstract

Early detection of carious lesions increases the possibility of treatment without the need for surgical intervention. Optical coherence tomography (OCT) is an emerging three-dimensional imaging technique that has been successfully used in other medical fields, such as ophthalmology for optical biopsy, and is a prospective candidate for early caries detection. The technique is based on low coherence interferometry and is advantageous in that it is non-invasive, does not use ionizing radiation, and can render three-dimensional images. A brief history of the development of this technique and its principles are discussed in this paper. There have been numerous studies on caries detection, which were mostly in vitro or ex vivo experiments. Through these studies, the feasibility of OCT for caries detection was confirmed. However, further research should be performed, including in vivo studies of OCT applications, in order to prove the clinical usefulness of this technique. In addition, some technological problems must be resolved in the near future to allow for the use of OCT in everyday practice.

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Theory of X-ray microcomputed tomography in dental research: application for the caries research
Young-Seok Park, Kwang-Hak Bae, Juhea Chang, Won-Jun Shon
J Korean Acad Conserv Dent 2011;36(2):98-107.   Published online March 31, 2011
DOI: https://doi.org/10.5395/JKACD.2011.36.2.98
AbstractAbstract PDFPubReaderePub

Caries remains prevalent throughout modern society and is the main disease in the field of dentistry. Although studies of this disease have used diverse methodology, recently, X-ray microtomography has gained popularity as a non-destructive, 3-dimensional (3D) analytical technique, and has several advantages over the conventional methods. According to X-ray source, it is classified as monochromatic or polychromatic with the latter being more widely used due to the high cost of the monochromatic source despite some advantages. The determination of mineral density profiles based on changes in X-ray attenuation is the principle of this method and calibration and image processing procedures are needed for the better image and reproducible measurements. Using this tool, 3D reconstruction is also possible and it enables to visualize the internal structures of dental caries. With the advances in the computer technology, more diverse applications are being studied, such automated caries assessment algorithms.

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Case Reports
Partial pulp necrosis caused by excessive orthodontic force
Min-Young Kim, Seung-Jong Lee, Il-Young Jung, Euiseong Kim
J Korean Acad Conserv Dent 2011;36(2):149-153.   Published online March 31, 2011
DOI: https://doi.org/10.5395/JKACD.2011.36.2.149
AbstractAbstract PDFPubReaderePub

As the dental pulp is encased with a rigid, noncompliant shell, changes in pulpal blood flow or vascular tissue pressure can have serious implication for the health of pulp. Numerous studies have demonstrated that orthodontic force application may influence both blood flow and cellular metabolism, leading degenerative and/or inflammatory responses in the dental pulp. The aim of this case report is to present a case about tooth with chronic periapical abscess which showed normal vital responses. Excessive orthodontic force is thought to be the prime cause of partial pulp necrosis. Owing to remaining vital tissue, wrong dianosis can be made, and tooth falsely diagnosed as vital may be left untreated, causing the necrotic tissue to destroy the supporting tissuses. Clinician should be able to utilize various diagnostic tools for the precise diagnosis, and be aware of the endodontic-orthodontic inter-relationship.

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Diagnosis of periapical cemental dysplasia
Soon-Young Lee, Chan-Young Lee, Byoung-Duck Roh
J Korean Acad Conserv Dent 2005;30(1):66-71.   Published online January 31, 2005
DOI: https://doi.org/10.5395/JKACD.2005.30.1.066
AbstractAbstract PDFPubReaderePub

Periapical cemental dysplasia(PCD) is a condition most commonly seen in the mandibular incisor region. Radiographically it passes through the three phases(osteolytic stage, intermediate stage, and mature stage). At osteolytic stage, the lesion is similar to features associated with granuloma or cyst that arise following pulpal necrosis. So, it is important to confirm the vitality of the pulp to diagnosis.

In this case, it is difficult to confirm the vitality of involved tooth because the tooth was covered with PFG bridge. And it is unusual that the PCD lesion at mandibular incisors has occurred at first and the lesion of mandibular canine and mandibular premolar were occurred afterward.

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