....


14 1 / 2552

Journal of The Endodontic Society of Thailand

. .
..
.. 23
. 2551
. . .
.

. .. . Resilon
monoblock

. vertical root fracture . postgrad
endo Theme

..
. Flare-up .
.. .
...
..
.. share
..
...



.
2009

:
.
10400
. 08-6512-0999
. 0-2628-9156 0
E mail : thaiendodontics@yahoo.com
www. thaiendodontics.com
 ....
14 1 / 2552

Treatment of Cracked Teeth 3

Reinforcement root canal: is it a realistic goal? 17

:
Flare-ups of root canal treatment: A case report 24

29

ThaiEndo 36

38
 .... 
14 1 / 2552

Treatment of Cracked Teeth

. .
.

2. Seal stabilize :
blood vessels


1. Early detection and diagnosis : seal stabilize adhesive
reversible bonding direct composite restoration
pulpitis indirect resin composite restoration adhesive
Hydrodynamic Theory cement stabilize
(Branstrom 1986) stimulation (full occlusal coverage)
cusp
dentinal fluid dentinal tubule adhesive bonding
free nerve ending pulp

adhesive
( 2)


pulp periodontium
irreversible pulpitis, pulp necrosis, periradicular
periodontitis ( 1)

1. 1. 1.
1 : #37 visit . 6 . distal
 ....
14 1 / 2552

2. 2. 2.
2 -. : #25 mesial distal marginal ridge

(case . )

Opdam 2003
Painful cracked teeth
6 2
Opdam 2008 1. Emergency treatment :
7
(cuspal coverage) reversible pulpitis
6%
(band)
orthodontic band ( 3) copper band
(temporary crown) ( 4)
adhesive

adhesive debonding

(cusp deflection) debonding

pulp periodontium
adhesive
3 : orthodontic band

3. Observation :

4 : temporary crown
 .... 
14 1 / 2552

2. Definitive treatment : (Seal and Stabilization)

pulp periradicular tissue
irreversible pulpitis pulp adhesive
necrosis periradicular tissue

( 5 6)
( 1)

1:

5. 5. 5.

5. 5.
5 : . #26 mesial marginal ridge . fiberoptic
. . .
 ....
14 1 / 2552

6 6

6 : .#45 direct adhesive composite restoration

. 2 (case .)

proximal surface
oral fluid marginal ridge
CEJ
pulp
(extent) stabilize

pulp definitive treatment
oral fluid
(methylene blue) (stainless steel band)
cuspal flexure
(Pane 2002)
(toxin)



3 ( 7 )

7 : #26
 .... 
14 1 / 2552

pulp periradicular tissue
(probing depth)

amalgam onlay, resin composite onlay, metal
onlay full crown ( 8,9,10)
Krell
Setcos (2000 ) Rivera (2007) 127
amalgam onlays with amalgam reversible pulpitis
bond seal Signore 27 (21%)
(2007) bonded indirect 21 irreversible pulpitis
resin composite onlay 4-6 93% 58 6 pulp necrosis 149

8 : #37 : Composite onlay

9 : #47 : Amalgam onlay 10 :#46 : Metal onlay

 ....
14 1 / 2552

2. :

irreversible pulpitis
irreversible pulpitis pulp necrosis pulp necrosis
apical periodontitis
(
)

questionable 3. :
prognosis to unfavorable prognosis


4. :

(Tan 2006 AAE colleagues for excellence,
summer 2008) terminal tooth
1. :
access

5. : para-
(coronal cracks) function habits

seal stabilize
adhesive accidental biting
marginal ridge
marginal ridge
(
marginal ridge marginal ridge
) (unfavorable) 1.
(split tooth)



seal stabilize
2.


3.

 .... 
14 1 / 2552

1/3 (coronal
third) (straight line access) (Webb 1989)
gates glidden bur stabilize
rotary file (Edward JR 2000)

4.

(wedging force) root canal spreader 1.
warm (Snyder DE. 1976)
vertical compaction thermoplasticized injection sharp internal line angle ()
lateral compaction (Gutmann & Rakusin 1994) stress (groove)
lateral compaction
spread adhesive (Rosen H. 1982)
2. eccentric contact
spreader (Rosen H. 1982)
finger spreader 3. rigid post indirect restoration
hand spreader (Dang & Walton RE 1989, passive fit fiber post
Lertchirakarn 1999) Nickel Titanium adhesive cement
spreader 4.
stainless steel spreader 5.
(Joyce 1998, Schmidt
2000)
Survival of root filled cracked teeth

adhesive
()

Tan (2006)
Seal and stabilization seal 50 2
85.5 % (survival rate = 85.5%)
prognosis 2

adhesive
rigid post (Mannocci
2005) fiber post
adhesive
(Hydecke 2002) screw pin
stress
10 ....
14 1 / 2552

( 11 . ) irreversible pulpitis with
symptomatic apical periodontitis access

2 ( 11 .)


2
1 ( 11) ( 11 .)
# 37
[ seal & stabilize
(flat occlusal table)
reversible
pulpitis
3

11 . 11 .

11 .
 .... 11
14 1 / 2552

2 ( 12)
# 36 3
OD amalgam filling ( 12.)
periodontal ligament
space ( 12.) symptomatic
irreversible pulpitis symptomatic apical periodontitis seal stabilize
parafunction habits extend

OD amalgam parafunction habits
filling distal gingival wall access
2 mm questionable
CEJ ( 12.)
distal root canal

12 . 12 .

12.
12 ....
14 1 / 2552

3 ( 13)
# 27
O - amalgam filling
mesial (probing occlusal
depth) 4 . mesial splint
EPT 2 2
pulp necrosis with symptomatic apical ( 13)
periodontitis parafunction habit occlusal splint
occlusal splint vertical bone loss
mesial diffused rarified area 2 x 3 .
palatal root ( 13 ) terminal tooth
amalgam filling access habit
1.5 .
CEJ ( 13 ) occlusal table habit

13. 13.

13.
 .... 13
14 1 / 2552

4 ( 14)
# 36 ;
1
stabilize
9

sulcus buccal 1
5 . distal, 5 6 . buccal 7
non-vital pulp necrosis with acute apical
abscess access 2 DB ( 14 )
DL line angles CEJ
3 . (1 4 ) periradicular radiolucency
7 x 10 . distal root seal stabilize
furcation mesial mesial root
( 14 )

14 . 14 .

14 .
14 ....
14 1 / 2552

5 ( 15) 1
# 47 ; bridge 3 units vertical bone loss (15 )
mesial 6
6 . 6- 8 8
access
# 47 # 46
4 - 5 . CEJ pontic #47
() ( 15) 1, 10 .
probing depth 6 . mesial access Ketac silver
buccal vertical bone loss # 47 retained root 10 (15 )
mesial 5x5 . ( 15)

seal
stabilize

unfavorable
prognosis
()


bridge
bridge 4 units (#44, 45, 47 )

15. 15.

15. 15.
 .... 15
14 1 / 2552

References

American Association of Endodontists. Crack-
ing the cracked tooth code : Detection and treatment
of various longitudinal tooth fractures . Endodontics :
Colleagues for excellence,summer 2008)
Branstrom M. The hydrodynamic theory of dentinal
occlusal splint pain: sensation in preparations, caries, and the dentinal
mouth guard crack syndrome. J Endod 1986;12(10):453-7.
Dang DA, Walton RE. Vertical root fracture and
(root amputation) root distortion: effect of spreader design. J Endod. 1989;
hemisection 15(7):294-301.
Edward AJR. Managing incomplete tooth fractures.
() J Am Dent Assoc 2000;131:1168-1174.
4-META-MMA-TTB adhesive Gutmann JL, Rakusin H. Endodontic and restorative
management of incompletely fractured molar teeth,
1 ( 26 , 88.5 % 12 , 69.2 % Review. Int Endod J 1994; 27(6):343-8.
36 59.3 % 60 ) (Hayashi 2004) Hayashi M, Kinomoto Y, Takeshige F, Ebisu S.
Prognosis of Intentional Replantation of Vertically Fractured
Roots Reconstructed with Dentin-Bonded Resin J Endod
2005; 30(3):145-148.
Hydecke et al. Fracture strength after dynamic
loading of endododontically treated teeth resored with
different post and core systems. J Prosth Dent 2002;
87:438-445.
questionable unfavorable Joyce AP, Loushine RJ, West LA, Runyan DA,
prognosis Cameron SM. Photoelastic comparison of stress induced
by using stainless-steel versus nickel-titanium spreaders in
vitro. J Endod.1998;24(11):714-5.
Krell KV, Rivera EM. A six year evaluation of
cracked teeth diagnosed with reversible pulpitis: treatment
and prognosis. J Endod 2007;33(12):1405-7.
Lertchirakarn V, Palamara JE, Messer HH. Load
and strain during lateral condensation and vertical root
fracture. J Endod.1999;25(2):99-104.
Mannocci, Francesco et al. (2005) Randomized
clinical comparison of endodontically treated teeth
restored with amalgam or with fiber posts and resin
composite: five-year results. Oper Dent 2005;30:9-15.
16 ....
14 1 / 2552
Opdam NJ, Roeters JM. The effectiveness of
bonded composite restorations in the treatment of painful,
cracked teeth: six-month clinical evaluation. Oper Dent
2003;28(4):327-33.
Opdam NJ, Roeters JJ, Loomans BA, Bronkhorst
EM. Seven-year clinical evaluation of painful cracked
teeth restored with a direct composite restoration.J
Endod. 2008;34(7):808-11.
Pane ES, Palamara JE, Messer HH Stainless steel
bands in endodontics: effects on cuspal flexure and
fracture resistance. Int Endod J 2002;35:467-71.
Rosen H. Cracked tooth syndrome. J Prosth
Dent 1982;47:36-43.
Setcos JC, StninecM, Wilson NH. Bonding of
amalgam restorations:existing knowledge and future
prospects. Oper Dent. 2002;25(2):121-9.
Signore A, Benedicenti S, Covani U, Ravera G. A
4- to 6-year retrospective clinical study of cracked teeth
restored with bonded indirect resin composite onlays.
Int J Prost 2007;20(6):609-16.
Snyder DE. The cracked-tooth syndrome and
fractured posterior cusp. Oral Surg Oral Med Oral Pathol.
1976;41(6):698-704.
Tan L, Chen NN, Poon CY, Wong HB. Survival
of root filled cracked teeth in a tertiary institution. Int
Endod J.2006;39(11):886-9.
Webb EL et al. Tooth crazing associated with
threaded pins. : A three dimensional model. J Prosth
Dent 1989;61 : 642-648.
 .... 17
14 1 / 2552

Reinforcement root canal: Is it a realistic goal?

...

Resilon system ( 1)
reinforcement
Resilon
[1] core polyester
(crown fracture) (vertical root (polycaprolactone) urethane dimethacrylate (UDMA)
fracture) filler bioactive glass, bismuth
reinforcement barium salts sealer
reinforcement core material primer
support dentin sealer dentinal
tubules monoblock
[3-4] 2007 Tay Pashly[5]
100 monoblock 3 primary
(post) monoblock, secondary monoblock tertiary monoblock
core material sealer
[2] secondary monoblock 2

1 Resilon core material standard-

ized tapering primer sealer paste
syringe RealSeal Epiphany
18 ....
14 1 / 2552

2 monoblock primary, secondary tertiary

core material sealer secondary monoblock[5]

penetration sealer dentinal tubules

reinforce root dentin epoxy resin sealer (AH 26 ) penetrate
sealer outer dentin ZnOE-
core material dentin based sealer 71 [6] sealer
dentinal tubules
periapical tissue blanching dentinal tubules ( 3)
tissue fluid working setting time resin-based cement
reinforce root dentin

3 penetrate resin sealer dentinal tubules resin

blanching tubule tubule[6]
 .... 19
14 1 / 2552

Monoblock core bond strength

material sealer modulus of elasticity EndoREZ Resilon [7]
dentin shear bond strength sealer
single unit AH Plus Resilon micro-shear bond strength
bond core material sealer thick film (1.5 mm) thin film (0.1 mm)
bond strength sealer [8] sealer-core
main cone sealer interface interface bond strength
interface sealer dentin failure FE-SEM (Field emission
sealer main cone failure -scanning electron microscope) interface core
interface sealer material sealer
interface interface sealer
dentin sealer dentin
gutta percha resin sealer
AH Plus (Epoxy sealer), EndoREZ (UDMA resin core material failure
sealer) Resilon core material cohesive sealer core material
Resilon sealer ((RealSeal ), mixed UDMA) adhesive sealer
push-out bond strength main cone failure adhesive sealer
sealer 2-8 ( 4) sealer dentinal surface [7]
Epoxy resin sealer (AH Plus ) push-out

4 Diagram interface core material sealer

sealer interface Boxplot push-out bond strength (MPa) [7]
20 ....
14 1 / 2552

infiltration resin sealer dentinal to vertical root fracture micro-punch shear test
tubules fracture properties dentin
( 5, 6 7)
Sudan black AH Plus
intact infiltration sealer
crown down Protaper sound dentin
1% NaOCl 17% EDTA micro-punch
shear strength [9] ( 8)
AH Plus epoxy resin sealer (AH Plus )
Resilon core material RealSeal mixed UDMA (RealSeal )
37oC 100% humidity root dentin infiltration resin
48 complete set sealer sealer dentinal tubules
work of fracture, resistant

5 tooth sample water bath Universal testing machine

work of fracture (J/m2) [10]

6 tooth sample Universal testing machine

resistant to vertical root facture
[10]
 .... 21
14 1 / 2552

7 micro-punch shear apparatus micro-punch shear strength

MPa
[10]

8 sample micro-punch shear strength

penetrate sealer intact dentin
[9]

FE-SEM sealer resin sealer sealer

resin penetrate dentinal resin sealer
tubules filler diameter core material dentin
dentinal tubule interface dentin monoblock
root dentin
filler filler resin sealer compressive strength,
RealSeal plate like particle tensile strength, work of fracture modulus
(10 m) dentin ( 9) of elasticity dentin
bond strength dentin [10]
22 ....
14 1 / 2552

9 FE-SEM filler particle RealSeal plate like dentin

surface resin penetrate dentinal tubules [8]

root dentin bond strength reinforce root dentin [3, 11, 12]
sealer core material
modulus of elasticity dentin gutta percha epoxy
nano-filled resin filler resin [7-17]
resin nano filler
penetrate dentinal tubules
shear bond push-out bond strength
self-etch RealSeal [8]

1 resin sealer dentin [10]


References
1. Reeh, E.S., Messer, H.H., and Douglas, W.H.,
Reduction in tooth stiffness as a result of endodontic
and restorative procedures. Journal of Endodontics, 1989.
15(11): p. 512-6.
2. Messer, H. and Goodacre, C., Preparation
for Restoration, in Endodontics Principles and Practice,
M. Torabinejad and R.E. Walton, Editors. 2008, Sauders
Elsevier: St. Louis, Missouri. p. 287-297.
3.Teixeira, F.B., Teixeira, E.C., Thompson, J.Y., and
Trope, M., Fracture resistance of roots endodontically
treated with a new resin filling material. Journal of the
American Dental Association, 2004. 135(5): p. 646-52.
4. Shipper, G., rstavik, D., Teixeira, F.B., and Trope,
M., An evaluation of microbial leakage in roots filled
with a thermoplastic synthetic polymer-based root canal
filling material (Resilon). Journal of Endodontics, 2004.
30(5): p. 342-7.
5. Tay, F.R. and Pashley, D.H., Monoblocks in
root canals: a hypothetical or a tangible goal. Journal
of Endodontics, 2007. 33(4): p. 391-8.
6. Mamootil, K. and Messer, H.H., Penetration
of dentinal tubules by endodontic sealer cements in
extracted teeth and in vivo. International Endodontic
Journal, 2007. 40(11): p. 873-881.
7. Jainaen, A., Palamara, J.E., and Messer, H.H.,
Push-out bond strengths of the dentine-sealer interface
with and without a main cone. International Endodontic
Journal, 2007. 40(11): p. 882-90.
8. Rahimi, M., Jainaen, A., Parashos, P., and
Messer, H.H., Bonding of resin-based sealers to root dentin.
Journal of Endodontics, 2009. 35(1): p. 121-4.
9. Jainaen, A., Palamara, J.E., and Messer, H.H.,
The effect of a resin-based sealer cement on micropunch
shear strength of dentin. Journal of Endodontics, 2008.
34(10): p. 1215-8.
.... 23
14 1 / 2552
10. Jainaen, A., Palamara, J.E., and Messer, H.H.,
The effect of resin-based sealers on fracture properties
of dentine. International Endodontic Journal, 2009. 42(2): p.
136-43.
11. Hammad, M., Qualtrough, A., and Silikas, N.,
Effect of new obturating materials on vertical root frac
ture resistance of endodontically treated teeth. Journal
of Endodontics, 2007. 33(6): p. 732-6.
12. Sch fer, E., Zandbiglari, T., and Sch fer, J.,
Influence of resin-based adhesive root canal fillings on
the resistance to fracture of endodontically treated roots:
an in vitro preliminary study. Oral Surgery, Oral Medicine,
Oral Pathology, Oral Radiology, and Endodontology,
2007. 103(2): p. 274-9.
13. Stuart, C.H., Schwartz, S.A., and Beeson, T.J.,
Reinforcement of immature roots with a new resin filling
material. Journal of Endodontics, 2006. 32(4): p. 350-3.
14. Wilkinson, K.L., Beeson, T.J., and Kirkpatrick,
T.C., Fracture resistance of simulated immature teeth
filled with resilon, gutta-percha, or composite. Journal of
Endodontics, 2007. 33(4): p. 480-3.
15. Williams, C., Loushine, R.J., Weller, R.N., Pashley,
D.H., and Tay, F.R., A comparison of cohesive strength
and stiffness of Resilon and gutta-percha. Journal of
Endodontics, 2006. 32(6): p. 553-5.
16. Gesi, A., Raffaelli, O., Goracci, C., Pashley,
D.H., Tay, F.R., and Ferrari, M., Interfacial strength of Resilon
and gutta-percha to intraradicular dentin. Journal of
Endodontics, 2005. 31(11): p. 809-13.
17. Grande, N.M., et al., Influence of different
root canal-filling materials on the mechanical properties
of root canal dentin. Journal of endodontics, 2007. 33(7):
p. 859-63.
24 ....
14 1 / 2552

:
Flare-ups of root canal treatment: A case report

(buccal space)




Altug 2008 (1) (3)
51%
32% 14% 3%

1.4% - 45% 25
,
.

(one-visit
endodontic treatment) (retreatment) (#24) # 24
(2)
Irreversible pulpitis with acute apical
periodontitis

(virulence)
(middle one third)
(localized)

(cellulitis) 2 ( 1)

(canine space) # 24
(infra orbital space ) 10
 .... 25
14 1 / 2552

(Electronic
apex locator)

(lentulo spiral)


2



500
1 500 1 3
2
(24 )
(RC prep)
(palatal
root canal) (buccal root canal) # 24

0.10 (long shank round stainless steel
bur#10)
10 atarax 10 mg
(2) 1
(step back) 48
25 (3 )
2% .
25 clindamycin 600
dexamethazone 4 6

2




1

2
1
26 ....
14 1 / 2552

Becker (4)
Sabala Powell (5)
5.25%



(mucous) (subcutaneous)
Reeh Messer (6)
1


(exudate) 15


3 2
48
2%
(7,8)






( anaphylactic shock) (9-11)
24




(2)
48



3


 .... 27
14 1 / 2552

(12)
(extraradicular)
(13)

24


clindamycin 600 dexamethazone
4 6

48


1. Altug HA., Erdogan O., Sahin S.,Sencimen
M., Okcu KM. Diagnosis and management of oro-facial
infection : a retrospective study . Abst In J.of Cranio-
Maxillofacial Surgery 2008 suppl.1 :S212
2. Cohen AS, Brown DC. Oro facial dental pain
1,000 emergencies : Endodontic diagnosis and management.
500 8 6 -10 In: Cohen S,Burn RC, editors. Pathway of the pulp.8th
ed.,St. Louis : Mosby Inc ; 2002. p. 31-75.
(anaerobe) 3. Baumgartner JC., Hutter JW.Endodontic mi-
(gram-positive facultative bacteria) crobiology and treatment of infections. In: Cohen S,
(gram-positive cocci) Burn RC, editors. Pathway of the pulp.8th ed.,St. Louis
24 : Mosby Inc ; 2002. p.501-519.
clindamycin 300 4. Becker GL, Cohen S, Borer R. The sequelae
150-300 6 of accidentally injecting sodium hypochlorite beyond
6-10 (2) the root apex Oral Surg Med. Oral Pathol. 1974; 38: 633 7
5. Sabala CL, Powell SE. Sodium hypochlorite
clindamycin injection into periapical tissue. J. Endod 1989 ; 15 : 490 2
600 6. Reeh ES, Messer HH. Long term paresthesia
clindamycin following inadvertent forcing of sodium hypochlorite
through perforation in maxillary incisor. Endod Dent
(2,14) Traumatol. 1989 ; 5 : 200-3
7. Orstavik D. Intracanal medication. In: Pitt
Ford TR. editors. Endodontics in clinical practice 5 th
ed. , London : Wright; 2004 p. 95 112
(15) 48
28 ....
14 1 / 2552

8. Basrani B, Santos JM, Tjaderhane L, et al. 13. .

Substantive antimicrobial activity in chlorhexidine- treated . 2550.;12:20-25
human root dentin. Oral Surg Oral Med Oral Pathol 14. Hargreaves KM.,Baumgartner JC.Endodontic
Oral Radiol Endod 2002,94(2): 240-5 Therapeutics. In: Walton RE and Torabinejad M editors..
9. Beaudouin E, Kanny G, Morisset M et al. Principlesand practice of endodontics. 3 th ed.
Immediate hypersensitivity to chlorhexidine : literature Philadelphia: W.B. Sauders ; 2002 p.533-544
review. Abst. In Allerg Immunol ( Paris) . 2004; 36: 123 6 15. . Antibiotics in Endodontics.
10. Snell man E, Rantanen T. Severe anaphylaxis 2546. ; 2:5-10
after a chlorhexidine bath. Abst. In J am Acad.
Dermatol. 1999 ; 40 : 771 2
11. Okano M, Nomara M, Hata S. et al. Anaphylactic
symptoms due to chlorhexidine gluconate. Abst. In ..
Arch Dermatol. 1989 ; 125 : 50-2 .
12. Cohen S, Goerig AC. Endodontics Emergencies.
In: Cohen S,Burn RC, editors. Pathway of the pulp.5th
ed.,St. Louis : Mosby Inc ; 1991. p. 2547.
 .... 29
14 1 / 2552

.
.

40%)(2)

(vertical root fracture)
3.6 55 (2)

(longitudinal tooth fractures)(1) ( 1) (3)
/
1.4 51 (2)
(spilt root)





Testori (4)


(58%

Fractured cusp Cracked tooth Split tooth Vertical root fracture

1 classification of longitudinal tooth fracture

( www.aae.org)
30 ....
14 1 / 2552

(post)

(Incomplete root fracture) (stress)




Peeso reamer





threaded screw posts





 .... 31
14 1 / 2552

(special designed bite
sticks) Tooth slooth ( 3)
cusp


(periodontal pocket)
( 1-2 )

(sinus-like probing)
3 Tooth slooth

enamel spurs
developmental groove

(dual sinus tract) (methylene blue)
()
70% isopropyl alcohol
( 2)

(Transillumination )



(fiber optic illumination)
2 dual sinus tract
32 ....
14 1 / 2552

( 4)


1.
( 6)

4 transillumination 6

2. Halo-like lesion


halo-like radiolucent lesion
( 5) ( 7)


mucoperiosteal flap
granulation tissue

7 Halo-like radiolucency

5
 .... 33
14 1 / 2552

3.
( 8)

10 Step-like in shape
8
6. (Radiopaque sign)
4. (Radiolucent fracture lines)


faciolingual

( 11)
( 9) mesiodistal

5.

crestal bone
(Step-
like in shape) ( 10)

10-15
11
(mesial distal shift)

34 ....
14 1 / 2552

7. (external root Tamse (5)

resorption)

Halo
( 12)
(periodontal radiolucency)
(57.2%)
(defined, not corticated)
(diffuse) 32.6%

Optical coherence tomography (OCT)

OCT

OCT
(atherosclerotic
plaque) Shemesh (7)


( 14)
12 external root resorption

( www.exodontia.info)
8.
retention apical cavity
preparation

( 13)

14
OCT system
( Shemesh (6))

13
 .... 35
14 1 / 2552

dehiscence
( 15 a b) medium fine finger spreader
hand spreader,
D11T(8)
( 15c) fenestration buccal

1. Torabinejad M and Walton RE. Principles and

practice of endodontics, 4th ed. W.B. Saunders Company,
2008. p108-28.
2. Chan CP, Lin CP, Tseng SC, Jeng JH. Vertical
root fracture in endodontically versus nonendodontically
treated teeth. Oral Surg Oral Med Oral Pathol Oral Radiol
Endod 1999;87:504-7
3. Yang SF, Rivera EM, Walton RE. Vertical root
fracture in nonendodontically treated teeth. J Endod
1995;21:337-9
a b c 4. Testori T, Badino M, Castagnola M. Vertical
15 root fractures in endodontically treated teeth:a clinical
survey of 36 cases. J Endod 1993:19:87-91
Lustig (7)
5. Tamse A,Fuss Z, Lustig J, Ganor Y, Kaffe I.

Radiographic features of vertically fractured, endodontically

dehiscence
treated maxillary premolars. Oral Surg Oral Med
91 Triangular V-shape
Oral Pathol Oral Radiol Endod 1999;88:348-52
wide type narrow type fenestration
6. Shemesh H, Soest GV, Wu MK, Wesselink PR.
9 oval shape
Diagnosis of Vertical Root Fractures with Optical Coherence

Tomography. J Endod 2008;34:739-42

7. Lustig JP, Tamse A, Fuss Z. Pattern of bone

resorption in vertically fractured,endodontically treated

teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod

2000;90:224-7

8. Lertchirakarn V, Palamara JEA, Messer HH.

1. root amputation
Load and Strain during Lateral Condensation and Vertical
hemisection
Root Fracture. J Endod 1999;25:99-104

2.
36 ....
14 1 / 2552

ThaiEndo

. .
. . .
.
.


. 51


300 400

... ..
.. . .
. ..
..

. . .
. . .
. . .
. case


(
)
 .... 37
14 1 / 2552

. () Science (DMSc) and Certificate in Endodontics

Harvard School of Dental Medicine, Harvard University
.

24

..
PhD. (Dental
Science) University of Melbourne

. 3 4

rubber dam
leak
. ( )
4
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4. (references)
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Vancouver


1. 6
1 1 6 3 et al.
(diskette CD) 14
(double spacing) Torabinejad M, Hong CU, Pittford TR, Kettering JD.
A4 2.5 Antibacterial effects of some root end fil ing materials. J Endod
1995; 21 : 403-6.
, .
. . 2544; 21:35-39.
2.
International Standard ISO 6876 for dental root
canal sealing materials. Reference NO.ISO 6876-1986(E),
FDI two digit International Organization for standardization, 1986.
system #13 ()
1.
Grossman LI. Root canal therapy. Philadelphia, Lea &
1. (text) Febiger; 1940. p.189.
1.1 2.
Dorn SO, Gartner AH. Case selection and treatment
1.2 planning. In: Cohen S, Burns RC, editors. Pathway of the pulp. 7th
ed., St Louis: Mosby Inc; 1998. p. 60-79.
1.3
Varella CH, Nosrat CA, Holland GR. Pain from pulpitis
2. (table) correlated with pulpal neuropeptides and inflammatory
(title) (footnote) mediators. Abst. In J Endod 2002; 28:236.

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