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Classic Articles > Dentin-Pulp Complex
»ó¾Æ¼¼°üÀÇ ±â´ÉÀûÀÎ ¿ªÇÒ¿¡ ´ëÇØ ÁÖ·Î ¸¹Àº ¹®ÇåÀÌ ÇҾֵǾî ÀÖ½À´Ï´Ù. ÈĹݿ¡ Ä¡¼ö Ç÷·ù¿Í ¸é¿ª¹ÝÀÀ¿¡ ´ëÇÑ ºÎºÐÀÌ ÀÖ½À´Ï´Ù.
| 1. Dentin and pulp |
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1) Garberglio R, Brannstrom M. Scanning electron microscopic investigation of human dentinal tubules. Arch Oral Biol 21:355-362, 1976. |
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*30°³ÀÇ Ä¡¾ÆÀÇ »ó¾Æ¼¼°üÀ» SEMÀ¸·Î ºÐ¼®
#Ä¡¼ö±Ùó : 45,000/mm2 2.5um
#»ó¾ÆÁú Áß°£ : 29,500/mm2 1.2um
#ÁÖº¯ºÎ : 20,000/mm2 0.9um
#Ä¡°üºÎ »ó¾ÆÁú¿¡¼ »ó¾Æ¼¼°üÀÇ Ã¼Àû : 10%
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2) Brannstrom M. Dentin and pulp in restorative dentistry. Wolfe Medical. London, 1982. |
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Chapter 1. The relationship between dentin and pulp and some problems in diagnosis.
*Ä¡¼ö »ó¾ÆÁú º¹ÇÕü¿¡ ´ëÇÑ °íÂû°ú ÀÓ»ó¿¡¼ÀÇ ÇØ¼®.
#Áø´Ü¿¡ ÀÖ¾î ¸ð¼¼°üÇö»ó, ¾ÐÃà°ø±â, ³Ã°¢, ¿¿¡ ÀÇÇÑ ¿µÇâÀ» ½ÇÇè ¸ðµ¨·Î È®ÀÎ
#Ä¡¾ÆÀÇ ¹æ¾î±âÀüÀ» »ó¾ÆÁúµ¿Åë, Ä¡¼ö¿°Áõ, ¼¼°üÀÔ±¸ Ç¥¸é±¤È, °æÈ»ó¾ÆÁú »ý¼º, ºÒ±ÔÄ¢ ÀÌÂ÷»ó¾ÆÁú »ý¼ºÀ¸·Î ³ª´©¾î °íÂû
Chapter 2. Caries
*¹ý¶ûÁú ¿ì½ÄÁõ, »ó¾ÆÁú ¿ì½ÄÁõÀÇ Æ¯Â¡À» È®ÀÎ
Chapter 3. Pulpal reactions to preparation and restorative materials
*¿Ü»ó¼º ¿µÇâ, ¼öº¹¹°ÀÌ Ä¡¼ö¿¡ Ç÷¾× °ø±ÞÀÇ ¹®Á¦, ¹«»ê¼ÒÁõ µîÀ» ÀÏÀ¸ÄÑ Ä¡¼öÀÇ º¯¼º ±«»ç¸¦ ÀÏÀ¸Å³ ¼ö ÀÖÀ½
Chapter 4. The experimental study of pulpal resonse to restorative materials
*¼öº¹Àç¿¡ ´ëÇÑ Ä¡¼ö ¹ÝÀÀÀ» È®ÀÎÇϱâ À§ÇÑ ½ÇÇè °í¾È¿¡ ÀÖ¾î ¿ä°ÇµéÀ» Á¦½Ã
#¿ø¼þÀÌ¿Í Àΰ£Àº »ó¾Æ¼¼°ü ±æÀÌ, ¼ö¿¡ ÀÖ¾î Â÷À̰¡ Àֱ⠶§¹®¿¡ ¼¼±Õµ¶¼º¿¡ ´ëÇÑ ¹ÝÀÀÀÌ ´Ù¸§
#ÃæÀü¹°ÀÌ Ä¡¼ö¿¡ ¹ÌÄ¡´Â ¿µÇâ ¿¬±¸½Ã ÀûÇÕÇÑ ¹æ¹ý ¿¹½Ã
Chapter 5. Pretreatment before the placement of restorations
*¿Íµ¿ Çü¼º ÈÄ »ó¾ÆÁú Ç¥¸é, »ó¾Æ¼¼°ü¿¡ ´ëÇØ ³íÇÔ
#»èÁ¦¸é¿¡ ÀÖ´Â µµ¸»Ãþ, ¼¼°ü¾×, À¯±â¹°¸·¿¡ ÈÇÐÀûÀÎ °áÇÕº¸´Ù´Â µµ¸»Ãþ¿¡ ¹Ì°Ô °áÇÕÀÌ ÀϾ, °á±¹ Ä¡¾Æ¿Í ¼öº¹¹° »çÀÌ 1~20umÀÇ °£°ÝÀÌ »ý±â°í Ÿ¾× ¶Ç´Â ¼¼°ü¾×À¸·Î Â÷°ÔµÊ, µµ¸»Ãþ Á¦°Å¸¦ ±ÇÇÔ.
#Ç¥¸é 󸮸¦ À§ÇÑ ¿©·¯ ¹æ¹ý Á¦½Ã
Chapter 6. The treatment of dentinal and pulpal exposures
*»ó¾ÆÁú, Ä¡¼ö ³ëÃâ¿¡ ´ëÇÑ »óȲº° Ä¡·á ¹æ¹ý Á¦½Ã
#¹Î°¨»ó¾ÆÁú, ¼öº¹ÀÌ ÇÊ¿äÇÑ »ó¾ÆÁú ÆÄÀý, ¿ì½Ä/ÆÄÀý·Î ÀÎÇÑ Ä¡¼ö³ëÃâ Ä¡·á ¹æ¹ý Á¦½Ã
#resin impregnation technique, Cvek tomy ¼³¸í
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3) Pashley DH. Dentin: a dynamic substrate - a review. Scanning Microsc 3(1):161-174, discussion 174-176, 1989. |
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*µµ¸»Ãþ¿¡ ÁßÁ¡À» µÎ¾î »ó¾ÆÁúÀÇ ±¸Á¶¿Í ±× ±â´É »çÀÌÀÇ °ü°è¸¦ ÅäÀÇ
»ó¾ÆÁú Ç¥¸é¿¡¼ ¼¼°üÀÇ ¸éÀû ºñÀ² Pulp(22%), DEJ(1%)
#Dental pain; Poiseuille-Hagen ¹æÁ¤½Ä(¼¼°ü±æÀ̺¸´Ù Á÷°æÀÌ ´õ ¿µÇâ·Â ÀÖÀ½), À¯Ã¼È帧ÀúÇ×¼º(Rp+Ri+Rs=Rt)
#°æÈ»ó¾ÆÁú, caries crystal
#±â´ÉÀûÁ÷°æ=ÇØºÎÇÐÀûÁ÷°æÀÇ 5~10%
#Ä¡°ü»ó¾ÆÁú, Ä¡±Ù»ó¾ÆÁúÀÇ Åõ°ú¼º Â÷ÀÌ
#»ó¾ÆÁúÁ¢Âø¿¡ ÀÖ¾î resin tagÀÇ ¿ªÇÒ |
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4) Pashley DH. Clinical correlations of dentin structure and function. J Prosthet Dent 66(6):777-781, 1991.
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*»ó¾ÆÁú ±¸Á¶, ±â´ÉÀÌ ÀÓ»ó°ú ¾î¶»°Ô °ü·ÃµÇ´ÂÁö¸¦ ¼³¸í
#Ä¡¼ö±Ùó ±â°è¼ö¿ë±â ½Å°æ ¸»´ÜÀÇ ºÐÆ÷ horn(40%), A(ÁÖº¯500°³), C(Áß½É2000°³)
#»ó¾ÆÁúºÐÆ÷ °üÁÖ»ó¾ÆÁú:Pulp(66%)-DEJ(2.8%), °ü°£»ó¾ÆÁú:Pulp(11%)-DEJ(96%)
#4-METAÁ¢ÂøÁ¦ Pulp,DEJ Â÷À̾ø´Â °áÇÕ·Â, µµ¸»ÃþÁ¦°ÅHEMAÁ¢ÂøÁ¦ DEJºÎ ¼±È£
#»ó¾ÆÁú Åõ°ú¼º ±³ÇÕ¸é<Ãà¸é<mesial wall ÃÖ°í
#Ä¡¼öÁ¶Á÷¾Ð, Á¤»ó½Ã 10~11 mmHg |
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5) Pashley DH, Matthews WG, Zhang Y, Johnson M. Fluid shifts across human dentine in vitro in response to hydrodynamic stimuli. Arch Oral Biol 41(11):1065-1072, 1996. |
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*Áø´Ü¹ý°ú °ü·ÃÇÑ ¿©·¯ »óȲÀ» ³ëÃâµÈ Ä¡°üºÎ »ó¾ÆÁú¿¡ ÀÚ±ØÀ» °¡ÇÏ´Â À¯Ã¼ÀûÇÐÀû ½ÇÇè¸ðµ¨·Î ÇØ¼®ÇÏ¿´À½
#PulpÃø ¼¼°ü¾× È帧(¿Â¼ö, Ã˰¢), DEJÃø ¼¼°ü¾× È帧(³Ã¼ö,°ø±â,»ïÅõÀÚ±Ø)
#Àڱؼ¼±â hot > cold > air blast > osmotic > tactile
#¿Âµµ(¼¼°ü±æ¶§Å«¿µÇâ), air/tactile(¼¼°üªÀ»¶§Å«¿µÇâ), osmotic(µµ¸»ÃþÁ¸Àç½ÃÅ«¿µÇâ, reflection coefficient) |
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6) Carvalho RM, Fernandes CA, Villanueva R, Wang L, Pashley DH. Tensile strength of human dentin as a function of tubule orientation and density. J Adhes Dent 3(4):309-314, 2001.
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*»ó¾ÆÁúÀÇ ¼¼°ü ÁÖÇà ¹æÇâ, ¹Ðµµ¿¡ µû¸¥ ±ØÇÑ ÀÎÀå °µµ(UTS) Æò°¡
#¼¼°ü¹æÇâ¿¡ ÆòÇà(57MPa), ¼¼°ü¹æÇâ¿¡ Á÷°¢(80MPa)
#UTS´Â °¡ÇØÁø ÈûÀÇ ¹æÇâ¿¡ ¿µÇâÀ» ¹ÞÀ¸³ª ¼¼°üÀÇ ¹ÐµµÀÇ ¿µÇâÀº Àû´Ù.
#dentinÀÇ cohesive failure´Â resin-dentin Àü´Ü°áÇÕ°µµ º¸´Ù ³ô´Ù. |
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| 2. Dentin physiology |
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1) Reeder OW Jr, Walton RE, Livingston MJ, Pashley DH. Dentin permeability: determinants of hydraulic conductance. J Dent Res 57(2):187-19, 1978. |
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*Ç¥¸éºÎ½Ä¿©ºÎ¿Í µÎ²²,Ç¥¸éÀû¿¡ µû¶ó Á¤¼ö¾ÐÀÇ À¯Ã¼°¡ È帣´Â ´É·ÂÀ» ÃøÁ¤
#Żȸ, ºñŻȸ ½ÃÆíÀº Áõ°¡ÇÏ´Â ¼ö¾Ð¿¡ µû¶ó Åõ°úÀ²ÀÌ ºñ·Ê
#»ó¾ÆÁú µÎ²²°¡ °¨¼Ò½Ã À¯Ã¼Åõ°úÀ²ÀÌ Áö¼öÇÔ¼öÀûÀ¸·Î Áõ°¡ (Á÷¼±ÀûÀÎ Á¤ºñ·Ê ÇüŰ¡ ¾Æ´Ô) ´Ù½Ã¸»ÇØ, »ó¾ÆÁúÀÇ Åõ°ú¼ºÀº Ä¡¼ö°¿¡ Á¢±ÙÇÏ¸é¼ Áö¼öÇÔ¼öÀûÀ¸·Î Áõ°¡ÇÔ |
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2) Pashley DH. Dentin-predentin complex and its permeability: physiologic overview. J Dent Res. 64 Spec No:613-620, 1985. |
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*»ó¾ÆÁú-Àü»ó¾ÆÁú º¹ÇÕü¿Í ±× Åõ°ú¼ºÀ» »ìÆìº» review ³í¹®
#predentin±ÙóÀÇ subodontoblastic plexus¿¡ ÀÖ´Â ¸ð¼¼Ç÷°üµéÀº »ó¾ÆÁúÀ» Åë°úÇÏ¿© Ä¡¼ö·Î È®»êÇÏ´Â ¿ëÁúÀ» Á¦°ÅÇϴµ¥ ¸Å¿ì È¿°úÀûÀÓ. ´Ù½Ã¸»ÇØ, Ä¡¼ö°¡±îÀÌ¿¡¼ °¡ÆÄ¸¥ ³óµµ°æ»ç Çü¼º
#Michelich(1978), »ýü¿¡¼ Ç÷Àå fibrinogenÀÌ ¿Íµ¿Çü¼ºÇÏ¿¡ subodontoblastic capillary·Î ºÎÅÍ ´©ÃâµÇ¾î Á¶»ó¾Æ¼¼Æ÷ ÁÖÀ§·Î È®»êÇϰí Ä¡¼öÂÊ¿¡¼ ¼¼°üÀ¸·Î À̵¿ °¡´É, ÀÏ´Ü ¼¼°ü¿¡ µµ´ÞÇÑ fibrinogenÀº °ÖÈµÇ¾î ¼¼°üÀÇ ±â´ÉÀû ¹Ý°æÀ» ÁÙÀ̰í Åõ°ú¼ºÀ» ¶³¾î¶ß¸². Ç÷Àå´Ü¹éÁúÀÇ À¯¸®´Â Ä¡¼öÀÇ ±â°è¼ö¿ë±â Àڱؿ¡ ÀÇÇÑ µí
#¿Íµ¿Çü¼º ÈÄ dentinal fluid flow, capillary permeability°¡ Áõ°¡ÇÏ¿© Ç÷Àå ´Ü¹éÁúÀÇ ¼¼°ü³» À̵¿ÀÌ Áõ°¡ÇÔ |
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3) Tagami J, Tao L, Pashley DH. Correlation among dentin depth, permeability, and bond strength of adhesive resins. Dent Mater 6(1):45-50, 1990. |
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*¼ÒÀÇ ÀýÄ¡¿¡ ·¹Áø Á¢ÂøÁ¦¸¦ Àû¿ëÇÑ ÈÄ, »ó¾ÆÁú ±íÀÌ¿Í »ó¾ÆÁú Åõ°ú¼º °£ÀÇ °ü°è¸¦ È®ÀÎ
#µµ¸»Ãþ Á¦°Å 󸮸¦ ÇÑ Á¢ÂøÁ¦´Â »ó¾ÆÁú µÎ²² 1/3 °¨¼ÒÈÄ À¯ÀǼº ÀÖ´Â Åõ°ú¼º Áõ°¡
#½ÉºÎ·Î °¥¼ö·Ï »ó¾ÆÁú °áÇÕ°µµ°¡ ¶³¾îÁü
#°áÇÕ°µµ¿Í »ó¾ÆÁú Åõ°ú¼ºÀº Àç·á¿¡ µû¶ó °ü·ÃÀÌ ÀÖÀ»¼öµµ ¾øÀ»¼öµµ ÀÖÀ½ |
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4) Orchardson R, Gangarosa LP Sr, Holland GR, Pashley DH, Trowbridge HO, Ashley FP, Kleinberg I, Zappa U. Dentine hypersensitivity-into the 21st century. Arch Oral Biol 39 Suppl:113S-119S, 1994. |
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*»ó¾ÆÁú °ú¹ÎÁõ symposium¿¡¼ ±â¼ú, ÅäÀÇµÈ 6°¡Áö ÁÖÁ¦¸¦ ¿ä¾à
#Ä¡¼ö»ó¾ÆÁúº¹ÇÕü »ý¹°ÇÐ; »ó¾ÆÁú³» ½Å°æ peptide, neuromodulator ºÐºñ, ½Å°æÁ¾¸» sprouting(¼Õ»ó 18~24½Ã°£ÈÄ), ¸»´Ü ¼Õ»óÈÄ ÁßÃß photo-oncogene c-fos ¹ßÇö µîÀÌ ±â¿©°¡´É
#ÀÓ»ó¾ç»ó; Ä¡ÁÖ¼ö¼úÈÄ 3~4ÁÖ°£ ¹Î°¨¼º °¨¼Ò, Ç¥¸éµµ¸»Ãþ ¿ëÇØµÇ¸ç 10~15% ¹Î°¨¼º Áö¼Ó, 3°³¿ùÈÄ¿¡µµ Áö¼Ó½Ã ¸¸¼ºÀû °ú¹ÎÁõÀ¸·Î Áø´Ü
#»ó¾ÆÁú Ä¡¼ö ¹ÝÀÀ; ±³°¨½Å°æ adrenoreceptor Àڱؽà ¥áÀÚ±Ø, Ç÷°ü¼öÃà, Ä¡¼öÇ÷·ù·®°¨¼Ò. neurogenic inflammationÇü¼º. À¯¼ö±¸½É½Å°æ->axon reflex->vasomotor nerve->Ä¡¼öÇ÷·ùº¯È, ±¸½É¼ ½Å°æÁ¾¸» ¹ÝÀÀ º¯È ¾ß±â °¡´É.
#ÅëÁõ±âÀü°ú ÃøÁ¤; µ¿ÅëÆò°¡¹ý, ¾ð¾îÀûÁöÇ¥, McGill pain ¼³¹®Áö, Á¤½Å³»°úÇÐÀûÆò°¡¹ý, visual analoguq scale
#Áö°¢°ú¹Î¿ÏȱâÀü; Åõ°ú¼ºÀÇ º¯È, ½Å°æÈ°¼ºÀÇ º¯È
#»ó¾ÆÁ÷°ú¹ÎÁõÀÇ ÀÓ»óóġ; Ä¡°ú, °¡Á¤¿¡¼ ÇÏ´Â ´Ù¾çÇÑ ¹æ¹ýÁ¸Àç |
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5) Camps J, Pashley DH. Buffering action of human dentin in vitro. J Adhes Dent 2(1):39-50, 2000. |
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*»ó¾ÆÁúÀÇ ¹Ì³×¶ö, À¯±â¹°ÀÇ ¿ÏÃæ´É ±â¿©µµ È®ÀÎ
#37% Àλê°ÖÀÌ 15sec, 15min, 60min Àû¿ë½Ã ¾à 1%ÀÇ ¼ö¼ÒÀÌ¿ÂÀÌ 0.6mm µÎ²²ÀÇ »ó¾ÆÁú Åë°ú
#¿ì½Ä»ó¾ÆÁú¿¡ 37% 15sec Àλê Àû¿ë½Ã, Åë°ú¼ö¼Ò º¯È ¾øÀ¸³ª Á¤»ó¿¡ ºñÇØ ¿ÏÃæ´É Áõ°¡
#ÃÊÀ½ÆÄ¿Í NaOClÀ» »ç¿ëÇØ ¼¼°ü³» ¹°ÁúÀ» Á¦°ÅÇÑ °æ¿ì ¼ö¼ÒÀÌ¿ÂÈ帧ÀÌ ¾à°£ Áõ°¡ Çϰí, ¿ÏÃæ´ÉÀÌ Å©°Ô Áõ°¡-> ¿ÏÃæÈ¿¿Í°¡ ¾ÆÁÖ ³ô¾Æ ¼ö¼ÒÀÌ¿ÂÀÌ ºó¼¼°üÀ» Åë°úÇÒ ¼ö ¾ø´Ù´Â °ÍÀ» ÀǹÌ
#Żȸ »ó¾ÆÁú °¡·çÀÇ ¿ÏÃæ´É·ÂÀº ±¤ÈµÈ °¡·çÀÇ 1.49%¿¡ ºÒ°ú
#15ÃÊ Àû¿ë ÀλêÀº 0.6mm µÎ²² »ó¾ÆÁú¿¡¼ 88~90%´Â Èí¼ö°¡ ¾ÈµÇ°í ¼ö¼¼·Î ¼Ò¸êÇϸç, 12~14%´Â »ó¾ÆÁú·Î ¿ÏÃæµÇ°í, ¿ÀÁ÷ 1%¸¸ À̵¿ÇÔ
#"diffusion with reaction" - ºÐ»ê¹°(¼ö¼ÒÀÌ¿Â)ÀÌ ´Ù°ø¼º ±âÁú°ú ¹ÝÀÀ½Ã, À̵¿ ¼Óµµ °¨¼Ò |
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6) Pashley DH, Pashley EL, Carvalho RM, Tay FR. The effects of dentin permeability on restorative dentistry. Dent Clin North Am 46(2):211-245, 2002. |
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*»ó¾ÆÁú Åõ°ú¼º¿¡ ´ëÇÑ °íÂû
#3Â÷»ó¾ÆÁúÇü¼º¹ÝÀÀ, È帧¿¡ÀúÇ×ÇÏ´Â3¿ä¼Ò, Àλó/»ó¾ÆÁúÁ¢ÂøÁ¦Àû¿ë½ÃÇ÷°ü¼öÃàÁ¦¿ªÇÒ ¼³¸í
#½ÉºÎ»ó¾ÆÁú¿¡ self etching primer,GIÃßõ
#»ó¾ÆÁúÆó¼â(°æÁ¶Á÷Æó¼â,¿¬Á¶Á÷Æó¼â,FunctionalBarrior)
#½ÇÁ¦ »ó¾ÆÁú³» cohesive failure´Â 50~100MPa(microtensile testÃßõ), ·¹Áø³»ºÎÀÀ·Â 17~20MPa
#intradentin permeability
#dry dentinÀÇ °áÇÕ·ÂÀÌ wet dentin°áÇÕ·ÂÀÇ 2¹è
#nanoleakage(0.02¥ìm), microleakage(20~25¥ìm)
#»êºÎ½Ä »ó¾ÆÁúÀº Á¤»ó »ó¾ÆÁú¿¡ ºñÇØ 8¹è ³ôÀº HEMA uptake, °ÇÁ¶»ó¾ÆÁúÀº ½ÀÀ±»ó¾ÆÁú¿¡ ºñÇØ 10%ÀÇ HEMA uptake
#'dentin matrix'´Â ³»ºÎÀÇ dental hard tissue·Î¸¸ °£ÁÖÇÒ °ÍÀÌ ¾Æ´Ï¶ó ÀûÀýÇÑ »óȲ¿¡ ¿ªÇÐÀ» ±â´Ù¸®´Â bio-active moculeµéÀÌ ÀúÀåµÈ potential tissue, Growth factor À¯¸® |
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| 3. Hard tissue lesions (Carious & Non-carious lesions) |
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1) Bader JD, Levitch LC, Shugars DA, Heymann HO, McClure F. How dentists classified and treated non-carious cervical lesions. J Am Dent Assoc 124(5):46-54, 1993. |
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*Ä¡°úÀÇ»çµéÀÌ ºñ¿ì½Ä¼º Ä¡°æºÎ º´¼Ò¸¦ ¾î¶»°Ô ÀÎÁöÇϰí ÀÖ´ÂÁö¿¡ ´ëÇÑ ¼³¹®Á¶»ç
#ºñ¿ì½Ä¼º Ä¡°æºÎ º´¼Ò¿¡ ´ëÇØ ¸ðµç ÀÀ´äÀÚµéÀº Ä¡·á¸¦ ÇØ¾ßÇÑ´Ù°í ¸ðµÎ µ¿ÀÇÇÏ¿´À¸¸ç, ¿ë¾î/Ä¡·á/¿øÀο¡ ´ëÇØ ´Ù¾çÇÏ°Ô ´ë´äÇÏ¿´À½ |
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2) Mount GJ, Hume WR. A revised classification of carious lesions by site and size. Quintessence Int 28(5):301-303, 1997. |
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*¿ì½Ä º´¼ÒÀÇ À§Ä¡, Å©±â¿¡ µû¶ó »õ·Î¿î ºÐ·ù¸¦ Á¦½Ã
#site1(fit&fissure ÇϾDZ¸Ä¡ÇùÃø¼Ò¿Í,»ó¾Ç±¸Ä¡¼³Ãø±¸,ÀüÄ¡ºÎÀý´Ü¿¬,±¸Ä¡ºÎ±³ÇÕ¸é´Ü¼ø¼Õ»óºÎ½Ä), site2(contact area, ÀüÄ¡±¸Ä¡ÀÇ ÀÎÁ¢¸é º´¼Ò), site3(cervical, Ä¡Àº¿¬¿¡ °¡±õ°Å³ª Ä¡¾ÆÀüü¸¦ µÑ·¯½Ñ ¿ì½Äº´¼Ò)
#size1(minimal, º´¼ÒÀÇ ÁøÇàÀÌ À籤ȸ¦ ¸·Áö³ª¼ »ý±ä°æ¿ì), size2(moderate, ¿ì½ÄÁ¦°ÅÈÄ ¼öº¹¹°À¯ÁöÇüŸ¦ ÁÖÁö ¾Ê¾ÆµµOK), size3(enlarged, ¿Íµ¿À» ´õ³ÐÇô ÆÄÀýÀ» ¹æÁö, ÁÖ±³ÇÕ·ÂÀ» ¼öº¹¹°¿¡¼ ¾òÀ½), size4(extensive, ±¸Ä¡ºÎ±³µÎÁ¤ Æ÷ÇÔ, ÀüÄ¡ºÎ Àý´Ü¿¬ Æ÷ÇÔ)
# 1.1 Àº pit/fissureÀÇ minimal caries¸¦ ÀÇ¹Ì |
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3) Osborne-Smith KL, Burke FJ, Wilson NH. The aetiology of the non-carious cervical lesion. Int Dent J 49(3):139-143, 1999. |
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*ºñ¿ì½Ä¼º Ä¡°æºÎ º´¼ÒÀÇ ¹ß»ý ±âÀü¿¡ ´ëÇØ »ý°¢ÇØ º½
#titratable acidity; Ä¡¾Æ¿¡ erosionÀ» ÀÏÀ¸Å°´Â À¯ÀǼº ÀÖ´Â pH
#abfraction, »ó¾ÆÁú, ¹ý¶ûÁúÀº ³ôÀº ¾ÐÃà°µµ¿¡ ºñÇØ, ÀÎÀå·ÂÀÌ ¾àÇØ ÀÎÀå·ÂÀÌ °¡ÇØÁö´Â °æ¿ì hydroxyapatie°£ °áÇÕÀÌ º¯Çü |
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4) Lussi A, Schaffner M. Progression of and risk factors for dental erosion and wedge-shaped defects over a 6-year period. Caries Res 34(2):182-187, 2000. |
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*dental erosion, wedge-shaped defectsÀÇ À¯¹ß, ÁøÇàÀÎÀÚ¿¡ ´ëÇÑ Á¤º¸¸¦ ¼öÁýÇϰí ÁøÇິÀÎÀ» È®ÀÎ
#ºñ¿ì½Ä¼º º´¼Ò´Â ³ªÀÌ(erosion, wedge), »ê¼·Ãë(erosion), ÀÕ¼ÖÁú(wedge)°ú À¯ÀǼºÀÖ´Â »ó°ü°ü°è¸¦ °®°í ÀÖ¾úÀ½ |
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5) Litonjua LA, Andreana S, Bush PJ, Tobias TS, Cohen RE. Noncarious cervical lesions and abfractions: a re-evaluation. J Am Dent Assoc. 134(7):845-850, 2003. |
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*Ä¡°æºÎ º´¼ÒµéÀ» À¯¹ßÇÏ´Â ±âÀüÀÇ Áõ°Å¿¡ ´ëÇØ Æò°¡
#Grippo ¶óƾ¾î ab(away) + fractio(breaking) »ç¿ë, abraction´Ü¾î Á¦¾È, 'ºÎÇϰ¡ °¡ÇØÁø °÷¿¡¼ ¸Ö¸® ¶³¾îÁø »ó¾ÆÁú, ¹ý¶ûÁúÀÇ ±¼°î ½ÇÆÐ¿¡ »ý¿ªÇÐÀûÀÎ ±â´É·ÂÀÌ Ä¡ÁúÀÇ º´¸®Àû ¼Õ»óÀ» ÀÏÀ¸Å²´Ù.'
#¿©·¯ ¿¬±¸ ¹æ¹ýµéÀ» °íÂûÇÑ °á°ú, 'abfraction'°¡¼³À» ÁöÁöÇÏ´Â ÀÚ·á´Â ºó¾àÇÏ¸ç ´õ ¸¹Àº ¸íÈ®ÇÑ ÀÚ·á°¡ ÇÊ¿äÇÔ, Ä¡°æºÎ º´¼Ò°¡ abractionÀ¸·Î¸¸ ÀϾٴ Áõ°Å´Â ºÎÁ·ÇÑ »óÅ |
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6) Grippo JO, Simring M, Schreiner S. Attrition, abrasion, corrosion and abfraction revisited: a new perspective on tooth surface lesions. J Am Dent Assoc 135(8):1109-1118, 2004. |
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*Ä¡°æºÎ º´¼Ò¿¡ ´ëÇÑ »õ·Î¿î ¸í¸í¹ý°ú ºÐ·ù¸¦ Á¦¾È
#erosionÀº '°íüǥ¸é°ú À¯Ã¼°£ÀÇ »óÈ£ÀÛ¿ëÀ¸·Î Á¡ÁøÀûÀ¸·Î ¹°Ã¼°¡ ¼ÒÁøµÇ´Â »óÅÂ'¸¦ ÀǹÌÇϹǷΠ±¸°È¯°æ¿¡´Â ÀûÀýÇÏÁö ¾ÊÀ¸¸ç corrosionÀ̶ó´Â ´Ü¾î¸¦ Á¦¾È
#Ä¡¾ÆÇ¥¸éº´¼ÒÀÇ º´¿ªÇÐÀº stress, fraction, corrosionÀÌ ±â¿© |
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4. Pulp Physiology |
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1) Takahashi K, Kishi Y, Kim S. A scanning electron microscope study of the blood vessels of dog pulp using corrosion resin casts. J Endod 8:132-135, 1982. |
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*ÀúÁ¡µµÀÇ ÇÕ¼º·¹ÁøÀ» »ç¿ëÇÏ¿© Ä¡¼öÀÇ Ç÷°ü ÁÖÇüÀ» ¸¸µé°í À̸¦ SEMÀ¸·Î °üÂû
#¼¼Á¤¸ÆÀº Áß¾ÓºÎ, Ä¡±Ù´ÜÀ¸·Î °¥¼ö·Ï ¸ð¿© Á÷°æÀÌ Áõ°¡ÇØ ±Ù´Ü°øÀ» ³ª°¡°í, ¼Òµ¿¸ÆÀº Ä¡±Ù´ÜÀ¸·Î °¥¼ö·Ï Ç÷°ü Á÷°æÀÌ °¨¼ÒÇÔ, ÀϺΠ¼Òµ¿¸ÆÀº U-turn loop¸¦ Çü¼º
#Ä¡¼ö°¡ Á÷°æÀÌ ÀÛÀº ¸î°³ ¶Ç´Â ÇѰ³ÀÇ ¼¼µ¿¸ÆÀ¸·Î Ç÷·ù°ø±ÞÀ» ¹Þ´Â °ÍÀÎÁö Ä¡±ÙÇ¥¸éÀÇ ¼ö¸¹Àº foramen¿¡ °¢ Ç÷°üÀÌ Á¸ÀçÇÏ´ÂÁö´Â ³í¶õ°Å¸®ÀÓ
#¼¼µ¿¸ÆÀº Ä¡¼ö°¢¿¡¼ °¡Áö¸¦ ³»°í ¶Ç´Â Ä¡¼ö°, Ä¡¼öÀú¸¦ ÇâÇÔ
#¸ð¼¼Ç÷°üÀº Ç÷°ü ÁÖÇà·Î¿¡¼ »ó¾Æ¼¼Æ÷ÃþÀ¸·Î ¼öÁ÷À¸·Î ³ª¾Æ°¡ loop of capillary¸¦ Çü¼º, ÀÌ ºÎÀ§´Â Ä¡¼ö°ÀÇ ¿Ü°ûºÎ·Î¼ subodontoblast layer¿¡ capillary plexus°¡ Á¸Àç
#capillary°¡ ¼¼µ¿¸Æ,¼¼Á¤¸Æ°ú ¸¸³ª´Â À§Ä¡¿¡ °ý¾à±ÙÀÌ Á¸ÀçÇÔ
#ÀÌ·¯ÇÑ loop´Â Ä¡¼ö°¢¿¡¼´Â pin-loop¸¦ Çü¼ºÇϳª Ä¡±Ù´Ü¿¡¼´Â flat-cross fenceÀÇ ¾ç»óÀ¸·Î ³ªÅ¸³²
#¸»´Ü¿¡¼ loop of capillary¸¦ Çü¼ºÇÏÁö ¾Ê´õ¶óµµ arteriovenous anastomosis(AVA)µ¿Á¤¸Æ¹®ÇÕÀÌ ¼¼µ¿¸Æ, ¼¼Á¤¸ÆÀ» À̾î Ç÷·ù Á¶Àý¿¡ Áß¿äÇÑ ¿ªÇÒ |
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2) Liu M, Kim S, Park DS, Markowitz K, Bilotto G, Dorscher-Kim J. Comparison of the effects of intra-arterial and locally applied vasoactive agents on pulpal blood flow in dog canine teeth determined by laser doppler velocimetry. Arch Oral Biol 35(5):405-410, 1990. |
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*Ç÷°ü¼öÃàÁ¦¿Í Ç÷°üÈ®ÀåÁ¦¿¡ ´ëÇÑ Ä¡¼öÇ÷·ùÀÇ º¯È¸¦ °Ë»çÇϰí, ƯÈ÷ Ç÷°üÈ®ÀåÁ¦ÀÇ ¹ÝÀÀÀ¸·Î Ä¡¼öÇ÷·ù°¡ °¨¼ÒÇÏ´Â ¿ª¼³ÀûÀÎ »óȲÀ» ¼³¸íÇÔ
#ÀϹÝÀûÀ¸·Î Ç÷°üÈ®ÀåÁ¦¸¦ Åõ¿©Çϸé Ç÷·ù°¡ Áõ°¡, ÇÏÁö¸¸ Ä¡¼ö¿¡¼´Â Ç÷·ù°¡ °¨¼Ò
#stealing of perfusion pressure(Tonder, 1976); Ä¡¼ö¿¡ °¡ÇØÁö´Â ¾Ð·ÂÀº Ç÷°üÈ®ÀåÁ¦¿¡ ´õ¿í ¹ÝÀÀ¼ºÀÌ ÁÁÀº Ä¡Àº, Ä¡ÁÖÀδë, Ä¡Á¶°ñÀÌ °¡·Îè
#low compliance of the pulp(Kim, unpublished); ¼¼µ¿¸ÆÀÇ È®ÀåÀÌ Á¤¸ÆÀ» ¾Ð¹ÚÇÏ¿© Ç÷·ù·® °¨¼Ò
#norepinephrine(±³°¨¥á, Ç÷°ü¼öÃà), 5-hydroxytryptamine(5-HT, serotonin,Ãʱ⿰Áõ½Ã Ç÷¼ÒÆÇ¿¡¼ ¹æÃâ, Ç÷°ü¼öÃà), isopreterenol(±³°¨¥â,Ç÷°üÈ®Àå), bradykinin(Àü±¸Ã¼kininogen,¿°Áõ¹°Áú, C-fiberÀÚ±Ø, Sub P À¯¸®, Ç÷°üÈ®Àå)
#¿Íµ¿¿¡±¹¼ÒÀû¿ë vs Á¤¸ÆÅõ¿© (·¹ÀÌÁ®µµÇ÷¯·Î Ä¡¼öÇ÷·ù·® ÃøÁ¤)
#norepinethrine (µÎ°æ¿ì ¸ðµÎ Ä¡¼öÇ÷·ù°¨¼Ò)
#5-HT (µÎ°æ¿ì ¸ðµÎ Ä¡¼öÇ÷·ù °¨¼Ò, but ¿Íµ¿Àû¿ë½Ã¿¡´Â 5-HT°¡ c-fiber¸¦ ÀÚ±ØÇÏ¿© Åë°èÇÐÀû Â÷ÀÌ ¾øÀ½)
#isopreterenol(¿Íµ¿Àû¿ë½Ã, ÀϽÃÀû Áõ°¡ÀÌÈÄ °¨¼Ò; low compliance, ia Àû¿ë½Ã, Ç÷·ù°¨¼Ò; stealing of perfussion pressure)
#bradykinin(¿Íµ¿Àû¿ë½Ã; ÀϽÃÀû Áõ°¡ÀÌÈÄ °¨¼Ò; low compliance, ia Àû¿ë½Ã, Ç÷·ù°¨¼Òstealing, ÈÄ Áõ°¡ c-fiber °¨ÀÛ) |
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3) Kim S, Dorscher-Kim J. Hemodynamic regulation of the dental pulp in a low compliance environment. J Endod 15:404-408, 1989. |
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*³·Àº ½ÅÀü¼ºÀÇ È¯°æ¿¡¼ Ç÷·ù°¡ ¾î¶»°Ô ÅëÁ¦µÇ´ÂÁö¿Í Ç÷·ùÁ¶Àý°ú Ä¡¼öº´»ý¸®°£ÀÇ °ü°è´Â ¹«¾ùÀÎÁö¿¡ ´ëÇÑ °íÂû
#Type I PBF(pulpal blood flow) response, Ç÷°ü¼öÃàÀ» ÅëÇØ Ç÷·ù°¨¼Ò
; °æºÎ±³°¨½Å°æÀÚ±Ø, norepinephrine ia, 5-HT ia, PGF2 ia, ½ÇÇèÀûÀ¸·Î À¯¹ßµÈ ÀúÇ÷¾ÐÀ¸·Î ÀÎÇÑ ±³°¨½Å°æ°£Á¢ÀÚ±Ø(reflex sympathetic activity)
#Type II PBF response; Ç÷°üÈ®ÀåÁ¦ Åõ¿©ÈÄ phase I¿¡¼ µ¿¸ÆÁ÷°æ Áõ°¡, Ä¡¼öÁ¶Á÷³»¾Ð·Â Áõ°¡=> Ä¡¼ö³» Ç÷·ù Áõ°¡, phase II¿¡¼ µ¿¸ÆÁ÷°æÀº Å©°í, Á¶Á÷¾ÐÀº ¿ª½Ã ³ôÀ¸³ª, Ä¡¼ö Á¶Á÷³» ¾Ð·ÂÀÌ ¼ÒÁ¤¸Æ¾Ðº¸´Ù Ä¿Á® ¼ÒÁ¤¸ÆÀÇ Á÷°æÀÌ °¨¼ÒÇϰí, Ä¡¼ö³» Ç÷·ù°¡ °¨¼Ò, °á±¹¿¡´Â ¼ÒÁ¤¸Æ Á÷°æ°¨¼Ò·Î ºØ±« °¡´É
;isopreterenol, PGE2, Substance P¿¡¼ È®ÀεǸç stealing of perfusion, AVAÇ÷·ùÁõ°¡, low compliance·Î ¼³¸í°¡´É
#Type III PBF response; Àå±â°£¿¡ °ÉÃÄ ¾à°£ °¨¼Ò
;histamine (Ç÷°üÅõ°ú¼ºÀÌ Áõ°¡ -> Ä¡¼öÁ¶Á÷³»¾Ð »ó½Â -> low compliance -> ¾à°£ÀÇ flow °¨¼Ò) |
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4) Meyer MW. Methodologies for studying pulpal hemodynamics. J Endod 6(3):466-472, 1980. |
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*Ä¡¼öÇ÷·ù¿ªÇп¡ ´ëÇÑ ±âº»°ú °³³ä, ´Ù¾çÇÑ ¹æ¹ýÀ» È®ÀÎ, °¡Á¤/Ÿ´ç¼º/ÇѰè, ´Ù¾çÇÑ ¿¬±¸ÀÚ ¿¬±¸¹ý¿¡ µû¸¥ °á°ú Â÷À̸¦ °íÂû
#Ä¡¼ö³» Ç÷·ù´Â Ä¡¼öÀÇ 5~7% Á¤µµ¸¦ Â÷ÁöÇϰí ÀÖÀ½ |
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5) Olgart L. Neural control of pulpal blood flow. Crit Rev Oral Biol Med 7(2):159-171, 1996. |
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* PBF¸¦ Á¶ÀýÇÏ´Â ±âÀü¿¡ ´ëÇÑ °¡¼³À» ¾ö¹ÐÈ÷ Æò°¡ÇØ º½
#ºÎ±³°¨½Å°æ°è, Ç÷·ù Á¶ÀýÀ» À§ÇÑ ¼ö¿ëü, ¸Å°³ÀÚ acetylcholine(Ach), vasoactive intestinal peptide(VIP), ½Å°æ ¸ðµÎ Á¸Àç, ±×·¯³ª Ä¡¼öÇ÷·ù¿¡ ¹ÌÄ¡´Â ¿µÇâ, Á߿伺À» ÀûÀ½
#±³°¨½Å°æ°è, ¥á1(Ç÷°ü¼öÃà, PCF³·Ãã), ¥á2,¥â(¸ðµÎ Ä¡¼ö¿¡ Á¸ÀçÇϳª Ç÷·ùÁ¶Àý¿¡ °ÅÀÇ ¿µÇâ ¾øÀ½)
#½ÅüÀû/Á¤½ÅÀû À§Çè»óÅ¿¡¼ ±³°¨½Å°æ°è°¡ Ä¡¼öÇ÷·ù Á¶Àý
#È޽ĻóÅ¿¡¼ °¨°¢½Å°æ ¸»´Ü¿¡¼ À¯¸®µÈ CGRP¿Í substance P°¡ PBF Á¶Àý
#bidirectional interaction between sympathetic n. and sensory n. ±¹¼ÒÀûÀÎ ÀÚ±Ø Á¸Àç½Ã, °¨°¢½Å°æÀº Ç÷°üÀ» È®ÀåÇϰí, ±³°¨½Å°æÀº Ç÷°üÀ» ¼öÃàÇϳª ¿°Áõ ¹ÝÀÀ Á¸Àç½Ã È®ÀåÀÌ ¿ì¼±ÇÑ´Ù. |
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6) Van Hassel HJ. Physiology of the human dental pulp. Oral Surgery 126-134, July 1971. |
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*Ä¡¼ö ¹Ì¼¼¼øÈ¯ »ý¸®¿¡ ´ëÇÑ °íÂû
#'±³»ìÀÌ·Ð' Ä¡¼ö¿°Áò½Ã Ä¡¼ö¾ÐÀÌ ¹Ù·Î ±Ù´ÜºÎ Á¶Á÷¿¡ Àü´ÞµÇ¾î Ç÷·ù¸¦ ¸·¾Æ Ä¡¼ö±«»ç°¡ ÀϾ. ÀÌ ÀÌ·ÐÀº Ä¡¼ö³» ¾Ð·ÂÀÌ À§Ä¡¿¡ µû¶ó µ¿µîÇÔÀ» °¡Á¤À¸·Î ÇÔ
#½ÇÁ¦´Â ¿°ÁõºÎ Ä¡¼ö³» ¾Ð·ÂÀº ÀϽÃÀûÀÎ Áõ°¡¸¦ º¸¿´´Ù°¡ °¨¼ÒÇϸç, ¿°ÁõºÎÀ§¿¡¼ 5mm ¶³¾îÁø ºÎÀ§¿ÍÀÇ ¾Ð·ÂÂ÷°¡ ½Ã°£¿¡ µû¶ó »ç¶óÁü. ±³»ìÀÌ·ÐÀº ÇÕ´çÄ¡ ¸øÇÔ
#Ä¡°üºÎÀÚ±Ø->±¹¼Ò¿°Áõ->±¹¼ÒÀûÄ¡¼ö³»¾ÐÁõ°¡->±¹¼ÒÇãÇ÷->±¹¼Ò±«»ç->¿°Áõ¹°Áú¹æÃâ->ÁÖº¯Ç÷°üÀå¾Ö->Ç÷°üÅõ°¡µµ Áõ°¡->Á¶Á÷³»¾ÐÁõ°¡->ÁÖº¯Á¶Á÷±«»ç ÀÇ ¼ø¼ Á¦½Ã |
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7) Gazelius B, Edwall B, Olgart L, et al. Vasodilatory effects and coexistence of calcitonin gene-related peptide and substance P in sensory nerves of cat dental pulp. Acta Physiol Scand 130:33-40, 1987. |
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*°í¾çÄ¡ Ä¡¼ö¿¡ ½Å°æºÐÁö¸¦ ÇÏ´Â °°Àº »ïÂ÷½Å°æÀý¼¼Æ÷¿¡ CGRP¿Í SP°¡ °øÁ¸ÇÏ´ÂÁö¿Í Ä¡¼ö³» CGRP ¼öÁØÀÌ È®ÀεǾú°í CGRP¿Í SPÀÇ Ç÷°üÈ®Àå´É·ÂÀÌ Æò°¡µÊ
#CGRP´Â SP, ±¸Á¶Àû¿¬°ü¼ºÀÌ ÀÖ´Â tachykinin°ú ÇÔ²² °¨°¢½Å°æÀÚ±ØÀ¸·Î À¯¹ßµÇ´Â Ç÷°üÈ®Àå¿¡ °ü·ÃÇÑ mediatorÀÓ |
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| 5. Pulp protection including base & liner |
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1) Hilton TJ. Cavity sealers, liners, and base: current philosophies and indication for use. Oper Dent 21(4):134, 1996. |
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*´Ù¾çÇÑ º¹Á¶ Àç·áµéÀÌ ¾î¶»°Ô »óÈ£ÀÛ¿ëÇϰí Ä¡¼ö¿¡ ´ëÇÑ º¸È£¸¦ Á¦°øÇÏ´ÂÁö ³íÇÔ
#ÀÜÁ¸ »ó¾ÆÁú µÎ²²°¡ 0.5mmÀ϶§ 75%, 1mm µÎ²²À϶§ 90%±îÁö Àç·áÀÇ µ¶¼ºÀ» ³·Ãã, 2mm µÎ²² À϶§ Ä¡¼ö ¹ÝÀÀÀÌ °ÅÀÇ ¾ø¾úÀ½
#¹Ù´Ï½¬; ¾Æ¸»°¨¼öº¹ÇÏ ¶Ç´Â ÀÎ»ê¾Æ¿¬½Ã¸àÆ®¸¦ »ç¿ëÇÑ °£Á¢¼öº¹¹°ÀÇ Á¢Âø¿¡ ¾Õ¼ »ç¿ë
#ZOE, À¯Áö³îÀº Ä¡¼ö¿¡ Á¢ÃËÇÏ¸é ¼¼Æ÷È£ÈíÀ» ¹æÇØÇÏ¿© ±«»ç¸¦ ÀÏÀ¸Å³ ¼ö ÀÖÀ½, »ý¹°ÇÐÀû´©Ãâ¿¡´Â È¿°úÀûÀÎ ºÀ¼â Á¦°ø
#ZPC, ÁÁÁö ¾ÊÀº ºÀ¼â, ¼¼±ÕħÀÓ
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2) Brannstrom M, Nyborg H. Pulpal reaction to polycarboxylate and zinc phosphate cements used with inlay in deep cavity preparation. J Am Dent Assoc 94:308-310, 1977. |
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*Ä¡¼ö¿¡¼ ¾à 0.4mm °Å¸®ÀÇ ZPC, polycarboxylateÁ¢ÂøÁ¦¿¡ ´ëÇÑ Ä¡¼öÀÇ ¹ÝÀÀÀ» Á¶Á÷ÇÐÀûÀ¸·Î °Ë»ç
#µÎ ½Ã¸àÆ® ¸ðµÎ Ä¡¼ö¿¡ ¿°ÁõÀÌ ¾ø¾úÀ¸¸ç Â÷ÀÌ ¾ø¾úÀ½
#±âÁ¸ ¿¬±¸ÀÇ Ãʱ⿰Áõ, ¿Íµ¿Çü¼ºÈÄ ºÒÃæºÐÇÑ ¼¼Ã´, ¿ÏÀüÇÏÁö ¾ÊÀº cementÀÇ °³Àç |
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3) Brannstrom M, Linden LA, Johnson G. Movement of dentinal and pulpal fluid caused by clinical procedures. J Dent Res 47:679-682, 1968. |
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*Ä¡±Ù´Ü ÂÊ¿¡ À¯Ã¼ tube¸¦ °¡Áø Ä¡¾ÆÀÇ Ä¡°üºÎ Ä¡Áú»èÁ¦, °ø±â°ÇÁ¶ÀÇ °úÁ¤ÀÌ »ó¾ÆÁú ³» À¯Ã¼À̵¿ÀÌ ¹ÌÄ¡´Â ¿µÇâÀ» ¾Ë¾Æº½
#ÁÖ¼ö¾øÀÌ 12Ãʰ£ 8¸¸ prm À» Ä¡Áú »èÁ¦½Ã °¡ÀåÅ« Ä¡±Ù´ÜÂÊÀ¸·ÎÀÇ À¯Ã¼À̵¿
#¿À» °¡Çϸé Ä¡±Ù´ÜÂÊÀ¸·Î À¯Ã¼ À̵¿, °ø±â°ÇÁ¶´Â Ä¡¼öÃøÀ¸·Î À¯Ã¼À̵¿ |
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4) Bergenholtz G, et al. Bacterial leakage around dental restorations; its effect on the dental pulp. J Oral Pathol 11:439-450, 1982. |
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*¿ø¼þÀÌ Ä¡¾Æ 5±Þ¿Íµ¿ÀÇ ¼öº¹ Àç·á ÇϹæÀ¸·Î ħÅõÇÏ´Â ¼¼±Õ°ú Ä¡¼ö °¨¿°°úÀÇ °ü°è¸¦ ¾Ë¾Æº½
#silicate¿¡¼ ´©ÃâÀÌ ¸¹¾Ò°í, Am(ÇϹæ70%), composite(ÇϹæ36%), GP(ÇϹæ33%), ZOE ÇϹ濡´Â ¼¼±Õ ¾øÀ½
#¸ðµç ½ÃÆí¿¡¼ ¼öº¹»ó¾ÆÁúÀÇ Çü¼ºÀº 2~3ÁÖº¸´Ù 8ÁÖ¿¡¼ µÎµå·¯Áü |
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5) Cox CF, Suzuki S. RE-evaluating pulp protection: calcium hydroxide liners vs cohesive hybridization. J Am Dent Assoc 125:823-831, 1994. |
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*±âÁ¸ÀÇ Ä¡¼öº¸È£ ¹æ¹ýµéÀ» Àç°í
#¼ö»êÈ Ä®½·, ³ôÀº pH°¡ ¼¶À¯¸ð¼¼Æ÷¸¦ ÀÚ±Ø, È¿¼Ò½Ã½ºÅÛÀ» Ȱ¼ºÈ but µ¶ÀÚÀûÀ¸·Î »ó¾ÆÁú/°æÈ»ó¾ÆÁú/¼öº¹»ó¾ÆÁú/»ó¾ÆÁú±³ Çü¼º/Ä¡±Ù´ÜÇü¼º¼úÀ» À¯µµÇÏÁö ¾ÊÀ½. À¯Áö³îó·³ Ä¡¼ö ÁøÁ¤ ÀÛ¿ë ¾øÀ½
#Ä£¼ö¼º primer´Â »ó¾ÆÁú±âÁú¿¡ ħÅõÇÏ¿© °ß°íÇÑ È¥¼ºÃþÀ» ¸¸µé°í °ú¹ÎÁõÀ» ¸·°í ´©ÃâÀ» ¸·À½. ÀÌ´Â ÇϺΠÀÜÁ¸ »ó¾ÆÁúÀ» °ÈÇÏ´Â ºü¸£°í È¿°úÀûÀÓ ¹æ¹ýÀÓ |
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6) Going RE. Status report on cement bases, cavity liners, vanishes, primers, and cleaners. J Am Dent Assoc 85:654, 1972. |
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*´Ù¾çÇÑ base,liner,varnish,primer,cleanser¸¦ »ìÆìº¸°í Àû´çÇÑ ÈÇÐÀû ±â´ÉÀû Áý´ÜÀ¸·Î ºÐ·ù, »ç¿ë¹ý, Àå´ÜÁ¡, ¼ºÁúÀ» È®ÀÎ
#base ZOE(pH 7), ZPC(ph 3.5~6.6, °µµ °¡Àå °ÇÔ), Ca(OH)2 (ph 11.5~13.0), PC(ZPC¿Í ºñ½Á°µµ, ZOE¿Í ºñ½ÁÄ¡¼öÀÚ±Ø), ¾Æ¸»°¨ÃæÀü¿¡ ´ëÇÑ ÃÖ¼Ò°µµ 100~170 psi ¸ðµÎ°¡ ÃæÁ·
#liner; ¾èÀº ¿Íµ¿¿¡¼ ¼ö»êÈÄ®½·, ZOE°°Àº È¿°ú¸¦ À§Çؼ, ZPC, silicate ½Ã¸àÆ®ÀÇ À¯¸® »ê Áßȸ¦ À§ÇØ °³¹ß
#varnish; resinÀ» ¿¬È½Ã۰í, ·¹Áø´Ü·®Ã¼°¡ varnish¸¦ ³ìÀ̸ç primerÀÇ wettingÀ» Á¦ÇÑÇÔ, °í·Î ·¹Áø°ú ÇÔ²² ¾²ÀÌÁö ¾ÊÀ½
#primer; methyl methacrylate filling materialÀÇ ¿Íµ¿ÀûÇÐÀ» Áõ°¡
#cleanser; hydrogen peroxide, alcohol, acetone, chloroform ³Î¸®¾²ÀÓ, 50% ÀÌ»óÀÇ etching solutionÀº ¹ý¶ûÁú Ç¥¸é¿¡ Çü¼ºµÇ´Â ionic aggregate°¡ protonÀ» ÅëÇÑ ¼¼Ã´, Żȸȿ°ú¸¦ ¹æÇØÇϹǷΠ»ç¿ë¾ÈÇÔ |
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| 6. Pulpal Responses to Caries and Restorative Treatment |
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1) Bergenholtz G. Pathologenic mechanism in pulpal disease. J Endod 16:98-101, 1990. |
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*Ä¡¼öÁúȯ ±âÀü¿¡ ´ëÇØ °íÂû
#Kakehashi ¿¬±¸¿¡¼ ¼¼±Õ°ú ±× ºÎ»ê¹°ÀÇ Ä¡¼ö¿°ÀÇ ÁÖµÈ ÀÎÀÚ, Cox ¼öº¹¹° »ó¹æºÎ Á¦°ÅÈÄ ZOE Æó¼â¸¦ ÇÑ °æ¿ì 3ÁÖÈÄ °æÁ¶Á÷ Çü¼º, ZOE°¡ ¾ø´Â °æ¿ì ½ÉÇÑ ¿°Áõ ±«»ç
#¼¼±Õ ÀÚü´Â »ó¾ÆÁúÀ» Åë°úÇÏ¿© Ä¡¼ö¿¡ À̸£´Âµ¥ Á¦ÇÑµÈ ´É·ÂÀ» °®°í ÀÖÁö¸¸ »ó¾ÆÁúÀÌ È¿°úÀûÀÎ ¹æ¾î¸·Àº ¾Æ´Ï¸ç ³ëÃâ»ó¾ÆÁú¿¡ ¼¼±ÕÀÇ ÀÚ±ØÀº Ä¡¼ö¿°À» ¹ß»ý°¡´É
#¼öº¹»ó¾ÆÁú Çü¼ºÀü ¿°Áõ¼¼Æ÷°¡ »ç¶óÁü -> ¼öº¹ »ó¾ÆÁúÀÌ ¼¼±ÕÀÚ±ØÀ¸·ÎºÎÅÍ Ä¡¼öȸº¹ ¹ÝÀÀÀ» ÁÖµµÇÏÁö ¾ÊÀ½
#³ëÃâ»ó¾ÆÁúÀº ¸î½Ã°£³»¿¡ ¼¼°ü³» fibrinogen ÃàÀûÀ¸·Î ±â´ÉÀû ¼¼°üÁ÷°æÀÌ °¨¼ÒÇÏ¿© Åõ°ú¼ºÀÌ °¨¼Ò
#antibody-antigen complex¿¡ ÀÇÇØ¼µµ ºÀ¼â°¡ °¡´ÉÇÒ °ÍÀ¸·Î ÃßÃø |
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2) Kim S, Edwall L, Trowbridge H, Chien S. Effects of local anesthetics on pulpal blood flow in dogs. J Dent Res 63:650-652, 1984. |
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*°³¸¦ ħÀ±(»ó¾Ç), Àü´Þ(ÇϾÇ), Á߰ݳ»ÀÚÀÔ(ÇϾÇ) ¸¶Ãë½Ã Ä¡¼ö Ç÷·ù·® ÃøÁ¤
#»ó¾Ç°ßÄ¡ ¸¶Ãë; Ç÷·ù·®°¨¼Ò, ÇϾÇÀü´Þ¸¶Ãë; °ßÄ¡,±¸Ä¡Ç÷·ù·® °¨¼Ò, Á߰ݳ»ÀÚÀÔ ¸¶Ãë´Â °¡ÀåÅ« Ç÷·ù·® °¨¼Ò
#epi+lido;Ç÷·ù°¨¼Ò, only lido;Ç÷·ùÁõ°¡
#Ä¡¼öÇ÷·ù·® °¨¼Ò½Ã, ¼øÈ¯ÀÌ ºÎÁ·ÇÏ¿©, ÀڱؿøÁ¦°Å ´É·ÂÀÌ °¨¼Ò, Àڱؿø ³óÃàÀÇ °á°ú°¡ ³ªÅ¸³¯ ¼ö ÀÖÀ½ |
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3) Kim S. Hypersensitive teeth: Desensitization of pulpal sensory nerves. J Endod 12:482-485, 1986. |
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*°ú¹ÎÁõ óġ¿¡ È¿°úÀûÀÎ ¾àÁ¦¸¦ È®ÀÎ
#strontium Ä¡¾à, »ó¾ÆÁú¿¡ °ÇÏ°Ô ÈíÂøµÇ¾î »ó¾Æ±âÁúÀÇ °¡¼ÓŻȸ·Î ¼¼°üÀ» Æó¼â
#fluoride, ºÒ¼Ò Ä§Âø¹°À» ÅëÇØ ¼¼°ü Æó¼â
#formaldehyde ±âÀü ¸ð¸§
#nitrate compound °áÁ¤È¸¦ ÅëÇØ ¼¼°ü Æó¼â, ±×¸®°í Ä¡¼ö½Å°æ¿¡ È¿°ú
#resin ¼¼°üÀ» Æó¼â
#sodium¿¡ ÀÇÇØ sensory nerve activity(SNA) ÁÙ¾îµéÁö ¾ÊÀ½, Ưº°È÷ Å« È¿°ú´Â ¾ø¾úÀ½
#potassiumÀÌ SNA °¨¼Ò¿¡ È¿°úÀû, Àû´çÇÑ ³óµµ´Â 0.0629 M
#Á¤»ó½Å°æ¿¡¼ K+´Â ½Å°æ¼¶À¯¸·À» Å»ºÐ±Ø ½ÃÄÑ action potential Ãʱâ Áõ°¡ À¯µµ, Å»ºÐ±Ø ½ÃÀÛ, K+¸¦ Àû¿ëÇÔÀ¸·Î½á ÀçºÐ±ØÀ» ¸·¾Æ ½Å°æ action À¯¹ßÀÌ ºÒ°¡´ÉÇØ Áü |
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4) Kim S. Neurovascular Interactions in the Dental Pulp in Health and Inflammation. J Endod 16:48-53, 1990. |
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*Ä¡¼ö¿°Áõ¿¡ ½Å°æÇ÷°ü°èÀÇ ±â¿©¸¦ °íÂû
#Ç÷·ù·® °¨¼Ò; ±³°¨½Å°æ ÀÚ±Ø(¥á-receptor)m Nrepinephrine, 5-HT
#Ç÷·ù·® Á¡ÁøÀû °¨¼Ò; histamine
#ÀϽÃÀûÀÎ »ó½ÂÈÄ ºü¸£°Ô °¨¼Ò; Ç÷°üÈ®ÀåÁ¦, subtance P, isopreterenol, PGE2, bradykinin
#Ç÷·ù·®Àº sensory nerve¿¡ ¿µÇâÀ» ÁÜ (Á÷Á¢ A¥ä, °£Á¢C), Á¶Á÷¾Ð Áõ°¡½Ã sensory nerveÀÇ È°¼º Áõ°¡
%µµÇذ¡ ±¦ÂúÀ½ |
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5) Ohshiman H. Ultrastructural Changes in Ododntoblasts and Pulp Capillaries Following Cavity Preparation in Rat Molars. Arch Histol Cytol 53(4):423-438, 1990. |
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*ÁãÀÇ Ä¡¾Æ¿¡ ¿Íµ¿Çü¼ºÈÄ Ä¡¼öÇ÷°ü°ú »ó¾Æ¸ð¼¼Æ÷ÀÇ ¹Ì¼¼±¸Á¶º¯È¸¦ È®ÀÎÇϰí ÀÏÂ÷/¼öº¹»ó¾ÆÁú°£ÀÇ ÇüÅÂÇÐÀûÀÎ Â÷À̸¦ ³íÇÔ
#ÈÞÁö±â; »ó¾Æ¸ð¼¼Æ÷´Â À§ÁßÃþ¹è¿, nucleus/cytoplasm(N/C) ºñÀ²ÀÌ Å, ¸ð¼¼Ç÷°üÀº 2~4°³ÀÇ endothelial cell·Ñ ±¸¼ºµÇ¾î ÀÖÀ¸¸ç basal lamina¿¡ µÑ·¯½Î¿© ÀÖÀ½, odontoblastic layer¿¡´Â Á¸ÀçÇÏÁö ¾ÊÀ¸¸ç °¡±î¿î subodontoblast layer¿¡ À§Ä¡
#prepÁ÷ÈÄ; »ó¾Æ¸ð¼¼Æ÷°¡ ¼Õ»ó¹Þ°í predetin°ú ºÐ¸®, ±× »çÀÌ¿¡ »ïÃ⼺ º´º¯ÀÌ »ý±è, ¸ð¼¼Ç÷°üÀÌ »ó¾Æ¸ð¼¼Æ÷ ÂÊÀ¸·Î À̵¿
#6½Ã°£ÈÄ; ÅðÃàÁßÀÎ »ó¾Æ¸ð¼¼Æ÷ Á÷ÇϹ濡 ¸ð¼¼Ç÷°ü Á¸Àç
#1ÀÏÈÄ; ÆÄ±«µÈ ¼¼Æ÷Á¶°¢ÀÌ °¨¼Ò, ÅðÃàÁßÀÎ »ó¾Æ¸ð¼¼Æ÷ Á÷ÇÏ¹æ ¸ð¼¼Ç÷°ü Á¸Àç, ¸ð¼¼Ç÷°üÁÖº¯ N/C ³ôÀº ¼¼Æ÷ Á¸Àç
#3ÀÏÈÄ; »ïÃ⼺º´º¯ °ÅÀÇ È¸º¹, »õ·Î ºÐÈµÈ »ó¾Æ¸ð¼¼Æ÷°¡ Á¤»óÀûÀÎ »ó¾Æ¸ð¼¼Æ÷ Ãþ¿¡ ¹è¿, ¸ð¼¼Ç÷°ü ¼ö °¨¼Ò
#5ÀÏÈÄ; »õ·Î¿î »ó¾Æ¸ð¼¼Æ÷ ¼ö Áõ°¡, ¸ð¼¼Ç÷°ü Åõ°úµµ Á¤»ó, ¼öº¹»ó¾ÆÁú Çü¼º½ÃÀÛ, µÎ Á¾·ùÀÇ »ó¾Æ¸ð¼¼Æ÷ dark cell(cytoplasm À߹ߴÞ), light cell(ÀûÀº ¾çÀÇ organelles)
#10ÀÏ ÈÄ; ¼öº¹»ó¾ÆÁúÀÇ ¸¹Àº ¾çÀÌ Çü¼ºµÊ, »ó¾Æ¼¼°üÀÇ ºÒ±ÔÄ¢ ¹è¿
#20~30ÀÏ ÈÄ; »ó¾Æ¸ð¼¼Æ÷ Å©±â Ãà¼Ò, 10ÀÏ º¸´Ù »ó¾Æ¸ð¼¼Æ÷³» organelles ¼ö °¨¼Ò, ÈÞÁö±â¿Í ºñ½ÁÇÏ¸ç ¸ð¼¼Ç÷°üÀº »ó¾Æ¸ð¼¼Æ÷ ÇϹ濡 ¾à°£ÀÇ ±âÀúºÎ¸¦ µÎ°í Á¸Àç |
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6) Wylie SG, Wilson PR. An investigation into the pressure transmitted to the pulp chamber on crown cementation: a laboratory study. J Dent Res 73(1):1684-1689, 1994. |
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*µµ¸»Ãþ Á¸Àç¿©ºÎ¿¡ µû¶ó Á¢Âø½Ã Ä¡¼ö¿¡ °¡ÇØÁö´Â ¾Ð·ÂÀ» È®ÀÎÇÏ°í ±× ¾Ð·Â°ú »ó¾ÆÁú µÎ²², °ü·ù¼Óµµ(perfuse rate)°£ÀÇ »ó°ü°ü°è¸¦ °íÂû
#µµ¸»ÃþÀÌ Á¦°ÅµÈ °æ¿ì ¾Ð·ÂÀÌ ³ô°Ô ³ª¿È, »ó¾ÆÁúµÎ²², ¾Ð·Â°ú °ü·ù¼Óµµ¿Í °ü·Ã ¾øÀ½
#¾Ð·ÂÀº À¯Ã¼¿©°ú¿Í »ó¾ÆÁú º¯ÇüÀÇ °á°ú |
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7) Byers M, Taylor P, et al. Effects of injury and Inflammation on Pulpal and Periapical Nerves. J Endod 16(2):78-, 1990. |
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*Á㸦 ¸¶Ãë ÈÄ ´Ù¾çÇÑ ÇüÅÂÀÇ ¿Íµ¿À» Çü¼ºÇÏ°í ¿°»öÇÏ¿© CGRP½Å°æ ¹ÝÀÀÀ» ºÐ¼®
#¼Õ»ó¹ÞÁö ¾ÊÀ½; Rashkow ½Å°æÃÑ, »ó¾Æ¸ð¼¼Æ÷ ÃþÀ¸·Î ¿¬°á, »ó¾ÆÁú 0.1mm±îÁö ħÀÓ, ¼öº¹»ó¾ÆÁú¿¡´Â ½Å°æÀÌ °ÅÀÇ ¾øÀ½, Ä¡±Ù »ó¾ÆÁú ¼¼°ü¿¡´Â Å©°Ô °¨¼ÒµÈ ½Å°æÀÌ °üÂû
#µµ¸»ÃþÁ¸Àç ¾èÀº ¿Íµ¿; 4ÀÏÈÄ CGRP-IRÀÌ ¹ß¾Æ »ó¾Æ¸ð¼¼Æ÷Ãþ ÇϹ濡 Çü¼º, 6~10ÀÏÈÄ ºÎºÐÀûÀ¸·Î ÁÙ¾î µê, 21ÀÏ ÈÄ ¿ÏÀüÈ÷ ¼Ò¸ê
#37%Àλêó¸® ±íÀº ¿Íµ¿; microabscess Çü¼º°ú Ä¡À¯, ¼öº¹»ó¾ÆÁú Çü¼º, 35ÀÏ ÈÄ ¿Ïº®ÇÑ ¼öº¹»ó¾ÆÁú Çü¼º, microabscess ÁÖº¯ CGRP-IR fibr°¡ ¸¹Àº °¡Áö Çü¼º, »ó¾Æ¸ð¼¼Æ÷¿Í È¥ÇÕµÇ°í ¼öº¹»ó¾ÆÁú Çü¼º, abscess°¡ ¼öº¹»ó¾ÆÁú·Î ´ëüµÉ ¶§ ¹ß¾Æ°¡ °¡¶ó¾ÉÀ½
#±«»çÀ¯¹ßÄ¡¼ö³ëÃâ; CGRP fiber´Â Ä¡¼öº´º¯À» µû¶ó ¼ºÀå, Á߽ɺο¡¼ axonÀÇ clustering
#Ä¡±Ù´Ü º´¼Ò; Ä¡¼ö³ëÃâ 5~8ÀÏ ÈÄ Ä¡±Ù´Ü º´º¯ ½ÃÀÛ, CGRP fiber´Â abscess ÁÖº¯¿¡¼ ¹ß¾Æ, CGRP°¡ ÇÏÄ¡Á¶½Å°æ¿¡¼ ´õ ¸¹ÀÌ ¿°»ö
#Á¤»óÀΰ£Ä¡¾Æ; predentin, »ó¾Æ¼¼Æ÷Ãþ, Á¶»ó¾Æ¼¼Æ÷Ãþ ÇϺÎ, Ä¡°üÄ¡°æºÎ »ó¾ÆÁú¿¡¼ CGRP ¹ß°ß
#M.C. Escher(1955) '3°¡Áö ¼¼»ó three world' ½Å°æ(°¨°¢peptide/nonpeptide, ±³°¨/ºÎ±³°¨)+Ä¡¼ö¼¼Æ÷(»ó¾Æ¸ð¼¼Æ÷,¼¶À¯¼¼Æ÷,¸é¿ª¼¼Æ÷)+À¯Ã¼¿ªÇÐ(Ä¡¼ö,¼¼°ü,Ç÷°ü) |
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| 7. Pulpal pathology |
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1) Nair PN. Pathogenesis of apical periodontitis and the causes of endodontic failures. Crit Rev Oral Biol Med 15(6):348-381, 2004. |
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*Ä¡±Ù´Ü Ä¡ÁÖ¿°ÀÇ º´ÀÎÇаú ±Ù°üÄ¡·á ½ÇÆÐÀÇ ¿øÀο¡ ´ëÇÑ Æ÷°ýÀû °íÂû
#±Ù°ü³» ¼¼±Õ »ýÁ¸ ¿ä¼Ò; ¼¼±Õ»óÈ£ÀÛ¿ë, ¼¼±ÕȸÇÇ, LPSµîÁ¶ÀýÀÎÀÚ, È¿¼Ò
#¼÷ÁÖ¹æ¾î ¼¼Æ÷; PMN, Lymphocyte, Macrophage, Osteoclast, Epithelial cell
#¼÷ÁÖ¹æ½Ã Á¶ÀýÀÎÀÚ; IL, IFN, CSF(Á¶Ç÷¼¼Æ÷ºÐÈÁõ½ÄÁ¶Àý), GF(ºñÁ¶Ç÷¼¼Æ÷ºÐÈÁõ½ÄÁ¶Àý), Eicosanoid, Effector molecules, Antibiotics
#Ä¡±Ù´Ü Áø¼º³¶Á¾; ¿µ¾ç°áÇ̼³(»óÇǰ¡´Ú Á߽ɼ¼Æ÷¿¡ ¿µ¾ç°ø±ÞÀÌ ÁßÁöµÇ¸é ±«»ç,¾×Ⱥ¯¼ºÀ» °Þ°í »ê¹°µéÀº ±«»çºÎÀ§·Î ²ø¾îµéÀÓ), ³ó¾ç¼³(³ëÃâµÈ °áÇÕÁ¶Á÷ Ç¥¸éÀ» µ¤À¸·Á´Â »óÇÇÁ¶Á÷ Ư¼ºÀ¸·Î ³ó¾çÀ» µÑ·¯½Ó); Á¶Á÷ÇÐÀû4°¡Áö¿ä¼Ò; ³¶Á¾°, »óÇdz¶Á¾º®, »óÇÇ¿ÜÁ¶Á÷, ±³¿ø¼º ĸ½¶
#Ä¡±Ù´ÜÆ÷ÄÏ ³¶Á¾; Áß¼º±¸µéÀÌ ÃàÀû, Áõ½ÄÇÏ´Â »óÇÇ¿¡ ÀÇÇØ ½ÎÀÌ°í »óÇÇ´Â °¨¿°±Ù°ü°ú ¹Ì¼¼ ³ó¾çÀ» ¹ÐºÀ, ³¶Á¾°³» ÈÇÐÀû ±¸¹è, ´õ¸¹Àº Áß¼º±¸Àû °ú¸³±¸¸¦ ²ø¾îµéÀÓ
#±Ù°üÄ¡·á½ÇÆÐÀÇ ¿øÀÎ; ±Ù°ü³»°¨¿°, ±Ù°ü¼º¼¼±ÕÃÑ, ±Ù°ü¿Ü¹æ¼±±ÕÁõ, ±Ù°ü¿Ü°¨¿°, À̹°¹ÝÀÀ, ¹ÝÈçÁ¶Á÷ÀÇ Ä¡À¯
À̹°¹ÝÀÀÁß ÄÝ·¹½ºÅ×·Ñ °áÁ¤ (º´º¯³» Á¤Ã¼ Ç÷°ü¼Ó¿¡¼ ºÐÇØµÇ´Â ÀûÇ÷±¸, ¸¸¼º±Ù´Üº´º¯ÁÖÀ§¿¡ Á×¾îºÐÇØµÇ´Â ¸²ÇÁ±¸, Ç÷Àå¼¼Æ÷,´ë½Ä¼¼Æ÷, ¼øÈ¯Ç÷ÀåÁöÁú¼ººÐ), ´ë½Ä¼¼Æ÷°¡ Á¦°ÅºÒ°¡´É, Ä¡±Ù´Ü¿°Áõ ¹× °ñÈí¼ö ¸Å°³Ã¼ÀÇ ÁÖ¿ä±Ù¿ø
#±Ù°üÄ¡·áÈÄ ¹æ»ç¼± Åõ°ú¼ºÀÌ Áö¼ÓÀû À¯ÁöµÇ´Â ¿äÀÎ; Ä¡±Ù´Ü ±Ù°ü³» °¨¿°, Ä¡±Ù¿Ü°¨¿°, ³¶¼ºº´º¯, ³»Àμº±â¿ø °áÁ¤Ã¼ ¹°Áú, º´º¯ÀÇ ¹ÝÈçÁ¶Á÷ ȸº¹°úÁ¤ |
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2) Nair PN, Sjogren U, Figdor D, Sundqvist G. Persistent periapical radiolucencies of root-filled human teeth, failed endodontic treatments, and periapical scars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 87(5):617-627, 1999. |
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*ÁïÀÏ ¶Ç´Â ¼ö»êÈÄ®½· ÷¾à ¼ö¹ÝÇÑ ±Ù°üÄ¡·á 5³â ÈÄ¿¡ Áö¼ÓµÇ´Â Ä¡±Ù´Ü Åõ°ú»óÀ» °¡Áø Ä¡¾Æ¸¦ surgeryÈÄ »ý°ËÇÏ¿© TEMÀ¸·Î °üÂû
#°¢ Ä¡¾Æ´Â collagen¼º °áÇÕÁ¶Á÷À¸·Î ÇǸ·ÈµÇ°í ¸²ÇÁ±¸¿Í ÇüÁú¼¼Æ÷·ÎÀÇ ¸¸¼ºÄ§À±ÀÌ º¸ÀÌ´Â ±Ù°ü³»°¨¿°, ³ó¾çÀÌ °üÂûµÇ´Â ±Ù°ü³» °¨¿°, ¹æ¼±±ÕÀÌ °üÂûµÇ°í ³»°°ú »óÇǺ®, ±× ¹ÛÀÇ °áÇÕÁ¶Á÷¿¡ ÄÝ·¹½ºÅ×·Ñ °áÁ¤ÀÌ º¸ÀÌ´Â Ä¡±Ù´Ü³¶, ¿°Áõ¹ÝÀÀ,¼¼±ÕÀÌ ¾ø´Â ¹Ðµµ°¡ ³ô°í Äݶó°ÕÀÇ ºÎµå·¯¿î °áÇÕÁ¶Á÷ÀÌ º¸ÀÌ´Â Ä¡±Ù´Ü ¹ÝÈçÁ¶Á÷ µîÀ¸·Î °üÂû
#Ä¡±Ù´Ü¹ÝÈçÁ¶Á÷Àº ¾Æ¸¶ ºÎµå·¯¿î °áÇÕÁ¶Á÷ÀÇ Àü±¸¼¼Æ÷°¡ Ä¡±Ù´ÜºÎ¿¡ Ä¡ÁÖ±¸Á¶¸¦ Çü¼ºÇÏ´Â ¼¼Æ÷º¸´Ù ¸ÕÀú Áý¶ôÇϱ⠶§¹®¿¡ ¹ß»ýÇÏ´Â °ÍÀ¸·Î ÃßÁï |
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3) Tronstad L. Recent development in endodontic research. Scand J Dent Res 100(1):52-59, 1992. |
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*¹Ì»ý¹°ÀÇ Ä§¹ü¿¡ ÀÇÇÑ Ä¡¼ö/Ä¡ÁÖÀÇ °¨¿°¼º ±âÀü¿¡ ´ëÇÑ ¿¬±¸µéÀÇ ¿ä¾à
#Ä¡¼ö¿°Áõ;Ç÷·ùÀÇ ÀûÀº Áõ°¡, Ç÷°üÅõ°ú¼ºÁõ°¡, neutrophilic leukocyteÃʱ⠿켼 ÀÌÈÄ, lymphocyte, macrophage, plasma cell
#Ä¡¼ö±«»ç½Ã¿¡ ¼¼±ÕÀÌ Á¸ÀçÇÏÁö ¾Ê´Â´Ù¸é °ñÈí¼ö³ª granuloma¸¦ ÀÏÀ¸Å°Áö ¾ÊÀ½
#±Ù°ü°ú ±Ù´ÜºÎ À°¾ÆÁ¾¿¡¼ ¹ß°ßµÇ´Â bacteroid fragilis°°Àº non-oral organismÀº blood-born bacteria ¾Ï½Ã
#±Ù°üÄ¡·áÈÄ ±ÕÇ÷Áõ; ¹ßÄ¡100%, ½ºÄ̸µ70%¿¡ ºñÇØ ±Ù°üÄ¡·á 20% |
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4) Langeland K, Block RM, Grossman LI. A histopathologic and histobacteriologic study of 35 periapical endodontic surgical specimens. J Endod 3(1):8-23, 1977. |
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*¿Ü°úÀû ±Ù°üÄ¡·á Áß »ý°ËÇ¥º»À» ¾ò¾î Ä¡±Ù´Ü º´¼Ò¿¡¼ ±Þ¼º, ¸¸¼º°¨¿°µÈ ¼¼Æ÷¿Í ³¶Á¾ °üÂû, ±Ù°üÄ¡·áµÈ Ä¡¾Æ¿¡¼ Ä¡±Ù´Ü º´¼ÒÀÇ ¹ÚÅ׸®¾Æ À¯¹« È®ÀÎ
#ÀÓ»óÀû Áõ»ó°ú Á¶Á÷º´¸®ÇÐÀû ¹ß°ß »çÀÌ ¾î¶² ¿¬°ü¼ºµµ ¾øÀ½
#±Ù´Ü¿¡ Á¸ÀçÇÏ´Â ¼¼Æ÷µéÀº ³¶Á¾ Çü¼º ¸ÞÄ«´ÏÁòÀ» ¼³¸í; Áß¼º±¸ºØ±«->¼¼Æ÷,°£Áú¹°Áú ºÐÇØÇÒ ¼ö ÀÖ´Â È¿¼Ò->¹Ì¼¼³¶µéÀÇ ÇÕ·ù->»óÇDZÙó³ª »óÇǾȿ¡¼ »ý¼º½Ã ³¶Á¾¹ß»ý
#35°³ ±Ù´Üº´¼ÒÁß 21°³¿¡¼ »óÇǰ¡ °üÂûµÇ¾úÀ¸¸ç ±×Áß ³¶Á¾Àº 9°³ |
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5) Seltzer S, Farber PA. Microbiologic factors in endodontology. Oral Surg Oral Med Oral Pathol 78(5):634-645, 1994. |
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*»õ·Î¿î ¹Ì»ý¹°ÇÐÀû ¹ß°ß°ú ÀÓ»ó Áõ»óÀ» °íÂûÇÏ°í °ü·ÃÁöÀ½
#Ä¡±Ù´Ü°¨¿°; ÀÌÀü ¿¬±¸¿¡¼´Â Å뼺 ¼¼±Õµé¿¡ À¯¸®ÇÑ È£±â¼º ¹è¾çÀ» ÇÏ¿© Çø±â¼ºÀÎ Baterioides (Prevotella¿Í porphyromonas) °°Àº Á¾µé¿¡ ¼ÒÈê
#Àý´ëÇø±â¼º ¼ú½ÄÀÇ ¹ßÀüÀ¸·Î °¨¿°±Ù°üÀÇ ¿ì¼¼ÇÑ ¹Ì»ý¹°ÀÌ Àý´ë Çø±â¼º ±ÕÀ̶ó´Â »ç½ÇÀ» ¾Ë°ÔµÊ (Ç¥º»ÃßÃâÁß »ê¼Ò¸¦ °í·Á)
#¾Ï½Ã¾ß Çö¹Ì°æ°ú À§»óÂ÷ Çö¹Ì°æÀ¸·Î spirochetes¸¦ ¹ß°ß Ä¡ÁÖ³ó¾ç¿¡¼ 30~60%¸¦ Â÷ÁöÇÏÁö¸¸ ±Ù°ü³ó¾ç¿¡¼´Â 10%¹Ì¸¸ ¹ß°ß
#±Ù°ü°¨¿°¿¡ µ¿¹ÝµÇ´Â ÅëÁõ/ºÎÁ¾; bacteroides (porphyromonas/prevotella) eubacterium, fusobacterium °°Àº Çø±â¼º °£±ÕÀÇ Á¸Àç¿Í °ü·Ã, black pigmented bacteroides Á¾Àº ±¸°³» È³ó¼º °¨¿°¿¡¼ ¹ß°ß
#LPS(lipopolysaccharide) ±×¶÷À½¼º±Õ ¼¼Æ÷º®, polysaccharide¿Í phospholipid¸¦ ÇÔÀ¯ÇÑ ¿¿¡ ¾ÈÁ¤ ºÐÀÚ, lipid ¼ººÐÀÌ µ¶¼ºÀ» °áÁ¤, ÀÌ·¯ÇÑ endotoxinÀº ¿°Áõ¼º Ä¡±Ù´Ü º´¼ÒÀÇ ½Å°æÁ¾¸»¿¡¼ Ç÷°üÀۿ뼺 ½Å°æÀü´Þ¹°Áú Áõ°¡¿¡ ±â¿©, µ¿Åë°ú »ó°ü°ü°è°¡ ÀÖ´Ù´Â º¸°í°¡ ÀÖÀ½
#±×¶÷¾ç¼º±Õ ¼¼Æ÷º®; peptidoglycan(¸¸¼º ¿°Áõ Áö¼Ó), LTA(lipoteichoic acid) (°ñÈí¼öÀ¯¹ß)
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| 8. Periapical Pathosis |
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1) Takahashi K. Microbiological, pathological, inflammatory, immunological and molecular biological aspects of periradicular disease. Int Endo J 31:311-325, 1998. |
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*Áö³ 30³â°£ Ä¡±ÙÁÖÀ§ º´¼Ò¿¡ ´ëÇÑ ¿¬±¸¼º°ú¸¦ ¿ä¾àÇϰí, Ä¡±ÙÁÖÀ§ º´¼ÒÀÇ º´¸®ÇÐÀû ±âÀüÀ» °íÂû
#APC(antigen-presenting cell, Ç׿øÀ» °øÁ¤ÇÏ¿© peptideÇüÅ·ΠTcell¿¡ Á¦½Ã); ´ë½Ä¼¼Æ÷(Ç׿øÁ¦°Å,opsonin;Ç׿øÀ»Àâ¾ÆTh cell¿¡ Á¦½Ã), Langerhans cell/dendritic cell(Ç׿øÁ¦°ÅºÒ°¡, opsonin¸¸)
#Th cell; IFN-¥ãºÐºñÇÏ¿© B cell, ´ë½Ä¼¼Æ÷¿¡ ¿µÇâ, subtype Th1, Th2·Î ºÐ·ù
#Th cell¿¡ ¿µÇâ¹ÞÀº B cell; IgG, IgA, IgM, IgE »ý¼º
#Immunoglobulin-producing cell; B cellÀÌ º¯ÈÇÏ¿© ÇüÁú¼¼Æ÷°¡ µÇ¸ç ÀÌ´Â LPS°¡ Áõ½ÄÀ» À¯µµÇÔ, IgG ÇüŰ¡ Á¦ÀÏ ¸¹À½
#Cytokine; PG(Ä¡±Ù´Üº´¼Ò°ñÈí¼öÀ¯¹ß), MMP(matrix metalloproteinase, Ä¡±Ù´Ü Ä¡ÁÖ¿°¿¡¼ Äݶó°Õ¼¶À¯ÆÄ±«¿Í °ñÈí¼öÀ¯¹ß, gelatinase, stromelysin,collagenase°¡ ÀÖÀ¸¸ç, PMN, fibroblast, macrophage, keratocyte¿¡¼ ºÐºñ) |
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2) Torabinejad M, et al. Identification and relative concentration of B and T lymphocytes in human chronic periapical lesion. J Endod 11:122-125, 1985. |
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*Àΰ£ÀÇ13°³ ¸¸¼ºÄ¡±Ù´Ü º´¼Ò¿¡¼ T cellÀÇ Á¸À縦 È®ÀÎÇϰí B cell¿¡ ´ëÇÑ T cellÀÇ ºñÀ²À» °áÁ¤
#T cell(À̹°Áú °ÅºÎ¹ÝÀÀ, virus Á¦°Å, delayed hypersensitivity), B cell(ÇüÁú¼¼Æ÷ÀÇ Àü±¸¼¼Æ÷,antibody forming cell)
#9°³º´¼Ò granuloma(lymphocyte¿Í plasma cellÀÌ Ä§Åõ±«¾î ÀÖ´Â °áÇÕÁ¶Á÷)
#4°³º´¼Ò cyst(° ³»ºÎ¿¡ lymphocyte¿Í plasma cellÀÌ Á¸Àç)
#T cell°ú B cellÀÇ ³óµµ; granuloma¿Í cyst°£¿¡ Â÷ÀÌ ¾øÀ½, T cell>B cell, T helper=T suppress |
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3) Akamine A, Hashiguchi I, et al. Immunohistochemical examination on the localization of macrophages and plasma cells in induced rat periapical lesions. Endo Dent Traumatol 10:121-128, 1994. |
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*ÁãÀÇ Ä¡¼öÁ¦°ÅÈÄ ½Ã°£º° ´ë½Ä¼¼Æ÷¿Í Ig¸¦ °üÂûÇÔÀ¸·Î½á Ä¡±Ù´Ü º´¼Ò ÁøÇà¿¡¼ plasma cell°ú macrophageÀÇ ¿ªÇÒÀ» Á¶»ç
#control; ¿°Áõ¼¼Æ÷,°ñÈí¼ö ¾øÀ½
#4ÀÏÈÄ; ¿°Áõ¹ÝÀÀ, ÀûÀº¼öÀÇ ÆÄ°ñ¼¼Æ÷
#10ÀÏÈÄ; ¿°Áõ¼¼Æ÷°¡ Áõ°¡ÇÏ°í ÆÄ°ñ¼¼Æ÷ Áõ°¡
#20ÀÏÈÄ; PDL space È®Àå, °ñ/»ó¾ÆÁú/¹é¾ÇÁú Èí¼ö
#30~60ÀÏÈÄ; À°¾ÆÁ¶Á÷³» macrophage, plasma cell, lymphocyte Á¸Àç
#90ÀÏÈÄ; ¿°Áõ¼¼Æ÷°¨¼Ò, ¼¶À¯Á¶Á÷/collagen bundle°üÂû, ÆÄ°ñ¼¼Æ÷/Á¶°ñ¼¼Æ÷ °üÂû, º´¼ÒÅ©±â ¾à°£°¨¼Ò
#º´¼ÒÀÇ ¼ºÀåÀº 10~60ÀÏ »çÀÌ¿¡ ÀϾ
#°ñÆÄ±«°¡ ÀϾ´Â 10~60ÀÏ »çÀÌ¿¡ macrophage°¡ Ȱ¼ºÈ µÇ°í, 60~120ÀÏ»çÀÌ¿¡ Ig¸¦ °®´Â ÇüÁú¼¼Æ÷°¡ Áõ°¡Çϴµ¥, 90~120ÀÏ »çÀÌ¿¡ Ä¡±Ù´Ü Á¶Á÷ÀÇ È¸º¹ÀÌ ÀϾ |
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4) Stashenko P, Yu SM. T helper and T suppressor cell reversal during development of induced rat periapical lesions. J Dent Res 68:830-, 1989. |
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*ÁãÀÇ Ä¡¼ö¸¦ ³ëÃâ ÈÄ »ý¼ºµÇ´Â Ä¡±Ù´Ü º´¼Ò ÁøÇà¿¡ µû¸¥ Th¿Í Ts ¼¼Æ÷¼öÀÇ °è»ê
#Th/Ts; Ãʱ⠰ñÆÄ±«, º´¼ÒÈ®ÀåÀÌ ÀϾ´Â 15ÀÏ µ¿¾È Th°¡ ¿ì¼¼ÇÏ°Ô Á¸ÀçÇϳª ±×ÈÄ Áõ»óÀÌ °¨¼ÒÇϴµ¥ 20¿©ÀÏÀÌ Áö³ÈÄ ºñÀ²ÀÇ ¹ÝÀüÀÌ ÀϾ(Ts°¡ ¸¹¾ÆÁü)
#Th; Ä¡±Ù´Ü º´¼Ò È®Àå¿¡ °ü·ÃÇÏ¸ç ´ë½Ä¼¼Æ÷(°ñÈí¼ö monokineÀÓ ±×¸®°í IL-1¥â, IL-1¥á, TNFÇü¼º)¿Í B cellÀ» Ȱ¼ºÈÇÔ
#Ts; º´¼Ò ¾ÈÁ¤È¿¡ °ü·Ã, ¸¸¼º ºñÁøÇ༺ ¿°Áõ º´¼Ò(±¹¼ÒÀûÀÎ ¸é¿ª¾ïÁ¦ ȯ°æ Çü¼º) |
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5) Wang CY, et al. Characterization of bone resorbing activity in human periapical lesions. J Endod 19:107-, 1993. |
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*Ä¡±Ù´Ü °ñÈí¼ö°¡ IL-1¥â, TNF-¥â¿¡ ÀÇÇØ ¸Å°³µÊÀ» º¸ÀÓ
#Ä¡±Ù´Üº´º¯¿¡ LPS¸¦ ¾ïÁ¦ÇÏ´Â ¾à¹°À» ÁÖ»ç(°ñÈí¼ö¾ïÁ¦µÇÁö ¾ÊÀ½), ´Ü¹éÁú ºÐÇØ ¾à¹°ÁÖ»ç(°ñÈí¼ö¾ïÁ¦)
#°ñÈí¼ö´Â LPS °°Àº ¼¼±Õ ±¸¼º ¼ººÐ º¸´Ù´Â °ñÈí¼ö´Ü¹éÁú°ú °ü·ÃÀÌ ÀÖÀ» °Í
#anti-IL-1¥â, anti-TNF-¥â, indomethacin ÁÖ»ç ->°ñÈí¼ö¾ïÁ¦
#macrophage¹æÃâ IL-1¥â, lymphocyte¿¡¼ ¹æÃâµÇ´Â TNF-¥â´Â °ñÈí¼ö¸¦ Áõ°¡½Ã۸ç, PG´Â °ñÈí¼ö, °ñ¼ºÀå¿¡ ¸ðµÎ °ü¿© |
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6) Matsuo T, Ebisu S, et al. IL-1¥á and IL-1¥â in periapical exudates of infected root canals: correlations with the clinical findings of the involved teeth. J Endod 20:432-, 1994. |
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*Ä¡±Ù´Ü »ïÃâ¹°¿¡¼ IL-1¥á¿Í IL-1¥â¸¦ ÃøÁ¤Çϰí ÃËÁø½ÃÅëÁõ, ŸÁø, ÀÚ¹ßÅë, pus, ±Ù°üº´¼ÒÅ©±â °°Àº ÀÓ»óÁõ»ó°úÀÇ °ü°è¸¦ Á¶»ç
#IL-1¥á´Â pus°¡ Á¸ÀçÇÒ¶§ º´¼ÒÀÇ Å©±â°¡ 1cmÀÌ»óÀ϶§ ¸¹ÀÌ Á¸ÀçÇÏ¿´À¸¸ç ³ª¸ÓÁö ÀÎÀÚ¿Í´Â Â÷ÀÌ ¾ø¾úÀ½
#IL-1¥â´Â ³ª¸ÓÁö ÀÎÀÚ¿Í Â÷ÀÌ ¾ø¾úÀ½
#IL-1¥á´Â ¿°Áõ¼¼Æ÷¿¡ ºÙ¾î Àֱ⠶§¹®¿¡ pus°¡ Çü¼ºµÇ´Â ¼¼Æ÷¿¡ ¸¹À½
#Ãѳ󵵴 IL-1¥â > IL-1¥á
#±Ù°üÄ¡·á °úÁ¤ Áß IL-1¥á°¡ Áõ°¡Çϰí, IL-1¥â°¡ °¨¼ÒÇÏ´Â ÀÌÀ¯´Â ºÒÈ®½ÇÇÔ |
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| 9. Pulp and dentin regeneration |
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1) Murray PE. Analysis of pulpal reactons to restorative procedures materials, pulp capping and future therapy. Crit Rev Oral Biol Med 13(6):509-520, 2002. |
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*´Ù¾çÇÑ Àç·á¿¡ ´ëÇÑ Ä¡¼ö¼Õ»ó°ú Ä¡À¯ ¹ÝÀÀÀ» »ìÆì º½
#Growth factor, ƯÈ÷ TGF-¥â´Â »ó¾Æ¸ð¼¼Æ÷ ºÐÈ, »ó¾ÆÁú ±âÁú ºÐºñ ÃËÁøÀ» À§ÇÑ ¼¼Æ÷½ÅÈ£¸¦ º¸³»´Âµ¥ Áß¿ä, »ó¾Æ¸ð¼¼Æ÷¿¡ ÀÇÇØ ºÐºñ, »ó¾ÆÁú ±âÁú Ä§Âø
#¼ö»êÈ Ä®½·¿¡ ÀÇÇÑ Ä¡·áÈ¿°ú´Â »ó¾ÆÁú ±âÁú¿¡¼ ¼ºÀåÀÎÀÚ°¡ À¯¸®µÇ¾ú±â ¶§¹®ÀÌ¶ó ¿©°ÜÁü
#¾àÇÑÄ¡¾Æ¼Õ»ó/ÀÛÀº¼öº¹/Ä¡¼ö³ëÃâ¾øÀ½; »ó¾ÆÁú¿¡¼ TGF-¥â¿Í bioactiveºÐÀںкñ, Á¶»ó¾Æ¼¼Æ÷ ºÐºñȰ¼ºÁõ°¡, ÀÏÂ÷Á¶»ó¾Æ¼¼Æ÷¿¡ ÀÇÇÑ reactionary dentin Ä§Âø
#½É°¢ÇÑÄ¡¼ö¼Õ»ó/Å«¼öº¹/Ä¡¼ö³ëÃâ; »ó¾ÆÁú¿¡¼ TGF-¥â¿Í bioactiveºÐÀںкñ, odontoblastoid precusor cell Áõ½Ä/ÀÌÁÖ/ºÐÈ, odontoblastoid cell¿¡¼ ¼Õ»óºÎÀ§·Î chemotactant gradient, »õ·Î ºÐÈ odontoblastoid cell¿¡ ÀÇÇÑ »ïÂ÷»ó¾ÆÁú ±âÁú Ä§Âø
#Ä¡¼ö¼Õ»ó°ü·Ã ¿©·¯ º¯¼öÁß °¡Àå Áß¿äÇÑ °ÍÀº ÀÜÁ¸»ó¾ÆÁú µÎ²²¿Í ¼öº¹Àç Á¾·ù
#RMGI, ZOE´Â ·¹Áø¿¡ ºñÇØ ¼¼±Õ´©Ãâ/Ä¡¼ö¿°Áõ ÀûÀ½
#Á¶Á÷¼Õ»ó Ä¡·á¸¦ À§ÇÑ Á¶Á÷ °øÇÐÀû¿ë; ±¸°¼¼±ÕDNAº¯È¿ì½ÄÁ¤Áö, ¼ºÀåÀÎÀÚÀû¿ë, progenitor cellÀ» ½Ä¸³ÇÏ¿© Á¶Á÷ Àç»ý, ¿©·¯ÀÎÀÚ¸¦ÅëÇØÀΰøÄ¡¾Æ¸¦3Â÷¿øÀû¹è¾ç |
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2) Mitsiadis TA, Rahiotis C. Parallels between tooth development and repairs conserved molecular mechanisms following carious and dental injury. J Dent Res 83(12):896-902, 2004. |
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*¼öº¹»ó¾ÆÁú Çü¼ºµ¿¾È ¹ß»ýÇÏ´Â ºÐÀÚÀû Ȱµ¿¿¡ ´ëÇÑ °íÂû
#gap-junction; (Ä¡¼ö¼¼Æ÷°£ÀÇ ¿¬°á;¼Õ»óºÎÀ§¿¡¼ Áõ½Ä, À̵¿, ºÐÈ È°µ¿ Á¶Àý. ƯÈ÷ Cx43 gap juntionÀº ¼Õ»óºÎÀ§ ÁÖº¯ Á¶»ó¾Æ¼¼Æ÷¿¡¼ Ȱ¼ºÈ, »ó¾ÆÁúÀç»ýµ¿¾È Á¶»ó¾Æ¼¼Æ÷ À§Ä¡¿Í ±Ø¼ºÀ» À¯ÁöÇϴµ¥ Áß¿ä, N-cadherin; ÀÌ Á¢ÂøºÐÀÚÀÇ Ç¥ÇöÀº ȸº¹°úÁ¤ Áß »ó¾Æ¸ð¼¼Æ÷¿¡¼ Ȱ¼ºÈ)
#Cx43°ú N-cadherinÀº Ä¡¼ö¼Õ»óÈÄ À籸¼ºÀ» ÁøÇàÇÏ´Â ±â´ÉÀ» °®À½
#TGF¥â-1Àº ¼Õ»óºÎÀ§¿¡ subodontoblastic cell°ú pulp fibroblastÀÇ Áõ½Ä, ÀÌÁÖ À¯µµ, Á¶»ó¾Æ¼¼Æ÷ºÐÈ, ¼öº¹»ó¾ÆÁú Çü¼º ÀÚ±Ø
#¼öº¹»ó¾ÆÁú Çü¼ººÎ; AP-1, cx43, nestin, N-cadherin, sub-odontoblast cell; Notch ¹ßÇö
#¼Õ»ó->TGF¥â, FGFs <-> AP-1(activator protein-1) -> Notch -> N-cadherin, Cx-43 -> nestin
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3) Tziafas D. The future role of a molecular approach to pulp dentin regeneration. Caries res 38:314-320, 2004. |
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*»ýȰġ¼öÄ¡·á ¹æ¹ýÀ¸·Î »ý¹°ÇÐÀûÀ¸·Î Ȱ¼ºÀ» °®´Â ºÐÀÚÀÇ ÀáÀçÀûÀÎ Ä¡·á´É·Â
#Ä¡¼ö³ëÃâÈÄÀϾ´Â°úÁ¤; Ãʱ⿡´Â º¹Á¶ Àç·á ÇϹæÀÇ Ä¡¼ö ¼¼Æ÷µéÀº Áõ½Ä, À̵¿, Ä¡·á Ä¡¼öºÎÀÇ ´Ü´ÜÇÑ ±«»çÁö¿ª°ú Á¢ÃËµÈ »õ·Î¿î collagenÀ» »ý¼º, ±×ÈÄ mineral salt°¡ ±«»çÁö¿ª¿¡ Ä§ÂøÇÏ°í °ü·ÃµÈ »õ·Î¿î collagen matrix¾È¿¡ Ä§Âø, Ç¥¸éÀÇ ¼®È¸È¿Í °ü·ÃµÇ¾î ÇÑÃþÀÇ odontoblast-like cellÀÌ Çü¼º, tubular mineralized matrix°¡ ±Ø¼ºÀÇ predentin-like patternÀ¸·Î ºÐºñ
#EDTA¿¡ ÀÇÇØ ¿ëÇØµÇ´Â »ó¾ÆÁú ±¸¼º¹°Áú, Àΰ£TGF¥â1À» Æ÷ÇÔÇÏ´Â milliporeÇÊÅÍ Ä¡¼öÀÌ½Ä -> ƯÁ¤ »ó¾ÆÁú Çü¼º°úÁ¤ À¯µµ |
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4) Smith AJ. Vitality of the dentin pulp complex in health and disease; growth factors as key mediators. J Dent Edu 67(6):678-689, 2003. |
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*¿©·¯ ¼ºÀåÀÎÀÚ°¡ Ä¡¼ö»ó¾ÆÁú º¹ÇÕü Áúȯ¿¡ ±â¿©ÇÏ´Â ºÎºÐ¿¡ ´ëÇÑ °íÂû
#(reparative dentinogenesis, ¼öº¹»ó¾ÆÁú, ¹«¼¼°ü) stem/progenitor cell -> recruitment;proliferation, migration -> differentiation -> (reactionary dentinogenesis, ¹ÝÀÀ¼º»ó¾ÆÁú, ¼¼°ü) up-regulation -> matrix secretion
#TGF¥â : bell stage ¸»±â, ³»Ãø»óÇÇ¿Í Ä¡À¯µÎÀÇ ÀÎÁ¢¼¼Æ÷µéÀÌ ±âÀú¸·¿¡ ½ÅÈ£¸¦ º¸³», odontoblast·Î ºÐÈÇϴµ¥ °ü¿©
#¿ëÇØµÈ »ó¾ÆÁú ±âÁú ¼ººÐ(Ä¡¾ÆÀÇ ¿ì½Ä, »êºÎ½ÄÁ¦ÀÇ Àû¿ë, ¼ö»êÈÄ®½· Àû¿ë); matrix bound growth factor À¯¸®
#TGF¥â¿Í BMPs¸¦ ³ëÃâµÈ Ä¡¼ö¿¡ Àû¿ë½Ã dentinogenesis°¡ ÀϾ
#TGF-1°ú BMP-7À» »ó¾Æ¼¼°üÀ» ÅëÇØ ¶Ç´Â odontoblast¿¡ Á÷Á¢ µµÆ÷ÇÔÀ¸·Î½á dentinogenesis¸¦ À¯µµ |
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5) Slavkin YC, and HC. Prospect for tooth regeneration in the 21st century; A perspective. Microscopy Res & Tech 60:469-479, 2003. |
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*±×°£ ¿¬±¸µÈ »ý¹°ÇÐÀûÀÎ ¹ÙÅÁÀ¸·Î »ý¹°ÇÐÀû ±âÀüÀ» ÀçÇöÇØ ÇâÈÄ ¿¬±¸ °¡´É¼ºÀÖ´Â ºÎºÐÀ» Á¦½Ã
#Initial of tooth development
#craniofacial development ¹× Çü¼ºÀº frontonasal prominence¿Í first brachial arch¿¡¼ ¹ßÀ°½ÃÀÛ
#cranial neural crest(CNC) ectomesenchymal cellÀÇ ÀÌÁÖ´Â brachial arch°¡ ¹ßÀ°Çϴµ¥ ÁÖµÈ ¿ªÇÒÀ» ÇÔ
#ù¹øÂ° brachial arch¿¡¼ »ó¾Ç°ú ÇÏ¾Ç µ¹±âµéÀÌ Çü¼º
#Ä¡¾ÆÇü¼ºÀÇ °³½Ã´Â ectomesenchymal Á¶Á÷¿¡ ÀÎÁ¢ÇÏ°Ô »óÇǼº Á¶Á÷ÀÇ ¼º°øÀûÀÎ invagination¿¡ ´Þ·ÁÀÖÀ½
#Ä¡¾Æ Çü¼ºÀ» ¿Ï¼ºÇϱâ À§Çؼ´Â ¼øÂ÷ÀûÀÎ epithelial-mesenchymal »óÈ£ÀÛ¿ëÀÌ ÇÊ¿ä
#Tooth regeneration using adult stem cell
#epithelial stem cellÀ» palate¿¡¼ ¾òÀ½
#mesenchymal stem cellÀ» °ñ¼ö³ª 3´ë±¸Ä¡ÀÇ Ä¡¼ö¿¡¼ ¾òÀ½
#epithelial stem cell°ú mesenchymal stem cellÀ» ºÐ¸®ÇÏ¿© ¹èÁö¿¡¼ Áõ½Ä
#Á¤È®ÇÑ spatial and temporal organizationÀ¸·Î ºÐÆ÷µÈ ÀûÀýÇÑ signaling molculeÀÇ support·Î, epithelial°ú mesenchymal stem cellÀÇ combination ÈÄ tooth organÀÌ ¹ß»ýÇϱ⠽ÃÀÛÇÔ
#ÈĹݱâÀÇ cap or bell stage¿¡ tooth germÀÌ missing tooth ºÎÀ§¿¡ À̽ĵÊ
#Ä¡¾Æ°¡ °è¼Ó ¹ß»ýÇÏ¿© ¸ÍÃâ |
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6) Krebsbach PH, Robey PG. Dental & Skeletal stem cells: potential cellular therapeutics for craniofacial regeneration. J Dent Edu 66(6);766-773, 2002. |
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*embryonic and adult stem cell¿¡ ´ëÇØ ³íÇϰí, ÀÌ·± ¼¼Æ÷µéÀÌ µÎ°³¾È¸é Àç»ý¿¡ »ç¿ëµÉ ÀáÀ缺¿¡ ´ëÇØ ³íÇÔ
#embryonic stem cell; ¹ßÀ°ÇÏ´Â ¹è¾Æ¿¡¼ ½ÅüÀÇ ¸ðµç Á¾·ùÀÇ ¼¼Æ÷·Î ºÐÈÇÒ ¼ö ÀÖ´Â ´É·Â °¡Áü -> nerve, muscle, bone, liver
#adult stem cell; adult tissue¿¡¼ ºÐ¸®µÈ hematopoietic stem cellÀº Ç÷¾× ¼¼Æ÷µéÀ» °ÅÀÇ ¸ðµÎ ¹ß»ý½ÃÅ´, °ñ¼ö¿¡ ÀÖ´Â stem cellÀº bone fracture¸¦ repairÇÔ
#adult stem cellÀº ¿ø·¡ ´Ù¼Ò Á¦ÇÑµÈ Àç»ý´É·ÂÀ» °¡Áø´Ù°í »ý°¢‰çÀ¸³ª ÃÖ±ÙÀÇ ¿¬±¸µéÀº ÀÌ·± °³³äÀ» º¯È½ÃÅ´
#transplanted skeletal ro dental stem cellÀº ¾Ç¾È¸éºÎÀ§ÀÇ Ä¡À¯³ª Ä¡¾ÆÀÇ Àç»ý ȤÀº Ä¡À¯¿¡ »ç¿ë °¡´É |
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