Comparison of bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and a universal adhesive

OBJECTIVES: The aim of this study is to compare the shear bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and universal adhesive. MATERIALS AND METHODS: Fifty zirconia blocks (15 × 15 × 10 mm, Zpex, Tosoh Corporation) were polished with 1,000 grit sand paper and air-abraded with 50 µm Al2O3 for 10 seconds (40 psi). They were divided into 5 groups: control (CO), Metal/Zirconia primer (MZ, Ivoclar Vivadent), Z-PRIME Plus (ZP, Bisco), Zirconia Liner (ZL, Sun Medical), and Scotchbond Universal adhesive (SU, 3M ESPE). Transbond XT Primer (used for CO, MZ, ZP, and ZL) and Transbond XT Paste was used for bracket bonding (Gemini clear ceramic brackets, 3M Unitek). After 24 hours at 37°C storage, specimens underwent 2,000 thermocycles, and then, shear bond strengths were measured (1 mm/min). An adhesive remnant index (ARI) score was calculated. The data were analyzed using one-way analysis of variance and the Bonferroni test (p = 0.05). RESULTS: Surface treatment with primers resulted in increased shear bond strength. The SU group showed the highest shear bond strength followed by the ZP, ZL, MZ, and CO groups, in that order. The median ARI scores were as follows: CO = 0, MZ = 0, ZP = 0, ZL = 0, and SU = 3 (p < 0.05). CONCLUSIONS: Within this experiment, zirconia primer can increase the shear bond strength of bracket bonding. The highest shear bond strength is observed in SU group, even when no primer is used.

A study on the compatibility between one-bottle dentin adhesives and composite resins using micro-shear bond strength

OBJECTIVES: This study was performed to determine whether the combined use of one-bottle self-etch adhesives and composite resins from same manufacturers have better bond strengths than combinations of adhesive and resins from different manufacturers. MATERIALS AND METHODS: 25 experimental micro-shear bond test groups were made from combinations of five dentin adhesives and five composite resins with extracted human molars stored in saline for 24 hr. Testing was performed using the wire-loop method and a universal testing machine. Bond strength data was statistically analyzed using two way analysis of variance (ANOVA) and Tukey's post hoc test. RESULTS: Two way ANOVA revealed significant differences for the factors of dentin adhesives and composite resins, and significant interaction effect (p < 0.001). All combinations with Xeno V (Dentsply De Trey) and Clearfil S3 Bond (Kuraray Dental) adhesives showed no significant differences in micro-shear bond strength, but other adhesives showed significant differences depending on the composite resin (p < 0.05). Contrary to the other adhesives, Xeno V and BondForce (Tokuyama Dental) had higher bond strengths with the same manufacturer's composite resin than other manufacturer's composite resin. CONCLUSIONS: Not all combinations of adhesive and composite resin by same manufacturers failed to show significantly higher bond strengths than mixed manufacturer combinations.

Synergistic effect of xylitol and ursolic acid combination on oral biofilms

OBJECTIVES: This study was designed to evaluate the synergistic antibacterial effect of xylitol and ursolic acid (UA) against oral biofilms in vitro. MATERIALS AND METHODS: S. mutans UA 159 (wild type), S. mutans KCOM 1207, KCOM 1128 and S. sobrinus ATCC 33478 were used. The susceptibility of S. mutans to UA and xylitol was evaluated using a broth microdilution method. Based on the results, combined susceptibility was evaluated using optimal inhibitory combinations (OIC), optimal bactericidal combinations (OBC), and fractional inhibitory concentrations (FIC). The anti-biofilm activity of xylitol and UA on Streptococcus spp. was evaluated by growing cells in 24-well polystyrene microtiter plates for the biofilm assay. Significant mean differences among experimental groups were determined by Fisher's Least Significant Difference (p < 0.05). RESULTS: The synergistic interactions between xylitol and UA were observed against all tested strains, showing the FICs < 1. The combined treatment of xylitol and UA inhibited the biofilm formation significantly and also prevented pH decline to critical value of 5.5 effectively. The biofilm disassembly was substantially influenced by different age of biofilm when exposed to the combined treatment of xylitol and UA. Comparing to the single strain, relatively higher concentration of xylitol and UA was needed for inhibiting and disassembling biofilm formed by a mixed culture of S. mutans 159 and S. sobrinus 33478. CONCLUSIONS: This study demonstrated that xylitol and UA, synergistic inhibitors, can be a potential agent for enhancing the antimicrobial and anti-biofilm efficacy against S. mutans and S. sobrinus in the oral environment.

Esthetic rehabilitation of single anterior edentulous space using fiber-reinforced composite

A fiber-reinforced composite (FRC) fixed prosthesis is an innovative alternative to a traditional metal restoration, as it is a conservative treatment method. This case report demonstrates a detailed procedure for restoring a missing anterior tooth with an FRC. A 44-year-old woman visited our department with an avulsed tooth that had fallen out on the previous day and was completely dry. This tooth was replanted, but it failed after one year. A semi-direct technique was used to fabricate a FRC fixed partial prosthesis for its replacement. The FRC framework and the pontic were fabricated using a duplicated cast model and nanofilled composite resin. Later on, interproximal contact, tooth shape, and shade were adjusted at chairside. This technique not only enables the clinician to replace a missing tooth immediately after extraction for minimizing esthetic problems, but it also decreases both tooth reduction and cost.

Embolization of Inferior Epigastric Artery for Treatment of Rectus Sheath Hematoma Caused by Insulin Injection During Anticoagulation and Antiplatelet Therapy

Rectus sheath hematoma, caused by rupture of epigastric vessel or muscle tear, is most frequently encountered in association with anticoagulation therapy, trauma, operation, and hematologic disorder. It rarely occurs spontaneously. Rectus sheath hematoma related to subcutaneous injection of insulin is very rare. We report a case of percutaneous catheterbased coil embolization for treatment of rectus sheath hematoma caused by subcutaneous injection of insulin on abdomen during anticoagulation and antiplatelet therapy in an 83-year-old thin woman with diabetes.

Inhibition of Streptococcus mutans biofilm formation on composite resins containing ursolic acid

OBJECTIVES: To evaluate the inhibitory effect of ursolic acid (UA)-containing composites on Streptococcus mutans (S. mutans) biofilm. MATERIALS AND METHODS: Composite resins with five different concentrations (0.04, 0.1, 0.2, 0.5, and 1.0 wt%) of UA (U6753, Sigma Aldrich) were prepared, and their flexural strengths were measured according to ISO 4049. To evaluate the effect of carbohydrate source on biofilm formation, either glucose or sucrose was used as a nutrient source, and to investigate the effect of saliva treatment, the specimen were treated with either unstimulated whole saliva or phosphate-buffered saline (PBS). For biofilm assay, composite disks were transferred to S. mutans suspension and incubated for 24 hr. Afterwards, the specimens were rinsed with PBS and sonicated. The colony forming units (CFU) of the disrupted biofilm cultures were enumerated. For growth inhibition test, the composites were placed on a polystyrene well cluster, and S. mutans suspension was inoculated. The optical density at 600 nm (OD600) was recorded by Infinite F200 pro apparatus (TECAN). One-way ANOVA and two-way ANOVA followed by Bonferroni correction were used for the data analyses. RESULTS: The flexural strength values did not show significant difference at any concentration (p > 0.01). In biofilm assay, the CFU score decreased as the concentration of UA increased. The influence of saliva pretreatment was conflicting. The sucrose groups exhibited higher CFU score than glucose group (p < 0.05). In bacterial growth inhibition test, all experimental groups containing UA resulted in complete inhibition. CONCLUSIONS: Within the limitations of the experiments, UA included in the composite showed inhibitory effect on S. mutans biofilm formation and growth.

Effect of moisture and drying time on the bond strength of the one-step self-etching adhesive system

OBJECTIVES: To investigate the effect of dentin moisture degree and air-drying time on dentin-bond strength of two different one-step self-etching adhesive systems. MATERIALS AND METHODS: Twenty-four human third molars were used for microtensile bond strength testing of G-Bond and Clearfil S3 Bond. The dentin surface was either blot-dried or air-dried before applying these adhesive agents. After application of the adhesive agent, three different air drying times were evaluated: 1, 5, and 10 sec. Composite resin was build up to 4 mm thickness and light cured for 40 sec with 2 separate layers. Then the tooth was sectioned and trimmed to measure the microtensile bond strength using a universal testing machine. The measured bond strengths were analyzed with three-way ANOVA and regression analysis was done (p = 0.05). RESULTS: All three factors, materials, dentin wetness and air drying time, showed significant effect on the microtensile bond strength. Clearfil S3 Bond, dry dentin surface and 10 sec air drying time showed higher bond strength. CONCLUSIONS: Within the limitation of this experiment, air drying time after the application of the one-step self-etching adhesive agent was the most significant factor affecting the bond strength, followed by the material difference and dentin moisture before applying the adhesive agent.

Considerations during crown reattachment procedure over the pulpal exposure: case report

Crown reattachment is the most conservative treatment which can be used to restore fractured tooth, presumably with sufficient strength, while maintaining original contour, incisal translucency, and reducing chair time and cost. However, in case of crown fracture with pin-point pulp exposure, we should cautiously minimize the irritation to the pulp and consider pre-treatment pulpal status, choice of pulp capping materials, choice of bonding system and treatment sequence during crown reattachment procedures. This case reports the considerations while crown reattachment with direct pulp capping using calcium hydroxide (Dycal, Dentsply Caulk).

'Wet or Dry tooth surface?' - for self-adhesive resin cement

No abstract available.

Effect of fluoride concentration in pH 4.3 and pH 7.0 supersaturated solutions on the crystal growth of hydroxyapatite

OBJECTIVES: Present study was undertaken to investigate the crystal growth onto synthetic hydroxyapatite (HA) seeds in pH 4.3 and pH 7.0 supersaturated solutions with different fluoride concentrations. MATERIALS AND METHODS: 8 groups of pH 4.3 and 7.0 calcium phosphate supersaturated solutions were prepared with different fluoride concentrations (0, 1, 2 and 4 ppm). Calcium phosphate precipitates yield crystal growth onto the HA seed surface while solutions flow. For evaluation of crystallizing process, the changes of Ca2+, PO4(3-), F- concentrations of the inlet and outlet solutions were determined. The recovered solid samples were weighed to assess the amount of minerals precipitated, and finally determined their composition to deduce characteristics of crystals. RESULTS: During the seeded crystal growth, there were significantly more consumption of Ca2+, PO4(3-), F- in pH 4.3 solutions than pH 7.0 (p < 0.05). As fluoride concentration increased in pH 4.3 solution, Ca2+, PO4(3-), F- consumption in experimental solutions, weight increment of HA seed, and fluoride ratio in crystallized samples were increased. There were significant differences among the groups (p < 0.05). But in pH 7.0 solution, these phenomena were not significant. In pH 7.0 solutions, analyses of crystallized samples showed higher Ca/P ratio in higher fluoride concentration. There were significant differences among the groups (p < 0.05). But in pH 4.3 solution, there were not significant differences in Ca/P ratio. CONCLUSIONS: Crystal growth in pH 4.3 solutions was superior to that in pH 7.0 solutions. In pH 4.3 solutions, crystal growth increased with showed in higher fluoride concentration up to 4 ppm.

Proteomic Analysis of Thiol-active Proteins of Helicobacter pylori 26695

Helicobacter pylori are a capnophilic bacterium, which colonize gastric mucosa and are resistant to acidic and oxidative damage. Thiol-active proteins subserve redox functions in tolerating oxidative stress and environmental toxicants, such as hydrogen peroxide and hypochlorous acid. We analyzed disulfide-containing proteins of H. pylori strain 26695. Active disulfide-containing proteins were separated by thiol-affinity chromatography, displayed with two-dimensional electrophoresis (2-DE), and identified by MALDI-TOF-MS. Thirty-five putative disulfide proteins, including AhpC (HP1563), GroEL (HP0011), and FrdB (HP0191), were identified in this study. In addition, 4 disulfide proteins of HypB, FusA, TufB, and AhpC showed enhanced intensities in the periplasmic space when compared with the pellet, suggesting that these proteins might play roles in the first redox system against environmental oxidative stresses. Disulfide-containing proteins identified in this study will provide the standard landscape for constructing the proteome components responsible for redox regulation of H. pylori.

Prevention of tooth discoloration associated with triple antibiotics

Regenerative endodontics has a potential to heal a partially necrotic pulp, which can be beneficial for the continued root development and strengthening of immature teeth. For this purpose, triple antibiotic mixture of ciprofloxacin, metronidazole, and minocycline was recommended as intracanal medicament in an attempt to disinfect the root canal system for revascularization of a tooth with a necrotic pulp. However, discoloration of the tooth was reported after applying this. This case shows the idea for preventing the tooth discoloration using a delivery syringe (SW-O-01, Shinwoo dental) to avoid the contact between the clinical crown and the antibiotics.

Patients' perception and satisfaction with apicoectomy / 대한치과보존학회지

OBJECTIVES: This study was aimed to examine the patients' perception and satisfaction with the results of endodontic microsurgery which was apicoectomy with retrofilling. MATERIALS AND METHODS: A questionnaire was given to 109 patients, who were recalled after a minimum of 3 months upon endodontic microsurgery in the Department of Conservative Dentistry, Yonsei University. A contingency table and correlation analysis were used to determine if there were any correlations between age/gender and the patients' responses (p = 0.05). RESULTS: Approximately 60% of respondents answered they had never heard of surgical endodontic procedures. 63.3% of respondents chose the surgical option because they wanted to keep their natural teeth. If the patient required the same procedure on another tooth later, 100 out of 109 respondents answered they would choose microsurgery instead of extraction. Most patients (82.57%) appeared to be satisfied with the surgical procedure. CONCLUSIONS: Endodontic microsurgery consisting of apicoectomy and retrofilling seems to appeal to majority of patients as a satisfactory and valuable treatment choice.

The evaluation of surface roughness and polishing time between polishing systems / 대한치과보존학회지

OBJECTIVES: The purpose of this experiment was to evaluate four different polishing systems of their polishability and polishing time. MATERIALS AND METHODS: 4 mm diameter and 2 mm thickness Teflon mold was made. Z-250 (3M ESPE) hybrid composite resin was slightly overfilled and pressed with slide glass and cured with Optilux 501 for 40 sec each side. Then the surface roughness (glass pressed: control group) was measured with profilometer. One surface of the specimen was roughened by #320 grit sand paper and polished with one of the following polishing systems; Sof-Lex (3M ESPE), Jiffy (Ultradent), Enhance (Dentsply/Caulk), or Pogo (Dentsply/Caulk). The surface roughness and the total polishing time were measured. The results were analyzed with one-way ANOVA and Duncan's multiple range test. RESULTS: The surface roughness was lowest in Pogo, and highest in Sof-Lex. Polishing times were shortest with Pogo, and followed by the Sof-Lex, Enhance and Jiffy. CONCLUSIONS: One-step polishing system (Pogo) is very effective to get the smooth surface in a short time, therefore it can be recommended for final polishing system of the restoration.

Understanding of the color in composite resin / 대한치과보존학회지

In clinic, esthetic restoration of a defective natural tooth with composite resin is challenging procedure and needs complete understanding of the color of tooth itself and materials used. The optical characteristics of the composites are different because the chemical compositions and microstructures are not same. This review provided basic knowledge of the color and the color measurement devices, and analyze the color of the natural tooth. Further, the accuracy of the shade tab, color of the composite resins before and after curing, effect of the water, food and bleaching agent, and translucency, opalescence, and fluorescence effects were evaluated.

Proteomic Analysis of Differentially Expressed Proteins in Bovine Endometrium with Endometritis

Endometritis is one of the primary reasons for reproductive failure. In order to investigate endometritis-associated marker proteins, proteomic analysis was performed on bovine endometrium with endometritis. In bovine endometritis, desmin, alpha-actin-2, heat-shock protein (HSP) 27, peroxiredoxin-6, luteinizing hormone receptor isoform 1, collectin-43 precursor, deoxyribonuclease-I (DNase-I), and MHC class I heavy chain (MHC-Ih) were up-regulated. In contrast, transferrin, interleukin-2 precursor, hemoglobin beta subunit, and potassium channel tetramerisation domain-containing 11 (KCTD11) were down-regulated in comparison to normal endometrium. The proteomic results were validated by semiquantitative-PCR and immunoblot analysis. The mRNA levels of desmin, transferrin, alpha-actin-2, HSP27, KCTD11, and MHC-Ih were up-regulated by over 1.5-fold, and showed a pattern similar to their proteomic profiles. Desmin and alpha-actin-2 protein showed positive correlations between proteomic analysis and immunoblot analysis. These results suggest that desmin and alpha-actin-2 may play important roles in endometritis-related function, and could be useful markers for the diagnosis of bovine endometritis.

Development of anticariogenic composite resin / 대한치과보존학회지

Due to the improvement of the composite resin and esthetic desire of the patient, amalgam restoration has been replaced by composite resin. However, still there are many unsolved problems, for example, technique sensitivity, polymerization shrinkage stress and limited mechanical properties. These factors results in fracture of the restoration and secondary caries of the tooth. Also the use of the dental bonding system should be used for the retention of the restoration. In this paper, I want to talk about the present and the future of the remineralizing component released from dental composite resin to overcome the secondary caries and there possibility in the clinical use.

The remineralization aspect of enamel according to change of the degree of saturation of the organic acid buffering solution in pH 5.5 / 대한치과보존학회지

The purpose of this study is to observe and compare the remineralization tendencies of artificial enamel caries lesion by remineralization solutions of different degree of saturations at pH 5.5, using a polarizing microscope and computer programs (Photoshop, Image pro plus, Scion Image, Excel). For this study, 48 sound permanent teeth with no signs of demineralization, cracks, or dental restorations were used. The specimens were immersed in lactic acid demineralization solution for 2 days in order to produce artificial dental caries that consist of surface and subsurface lesions. Each of 9 or 10 specimens was immersed in pH 5.5 lactic acid buffering remineralization solution of four different degrees of saturation (0.507, 0.394, 0.301, and 0.251) for 12 days. After the demineralization and remineralization, images were taken by a polarizing microscope (x100). The results were obtained by observing images of the specimens, and using computer programs, the density of caries lesions were estimated. While the group with the lowest degree of saturation (0.251) showed total remineralization feature from the surface to the subsurface of the lesion, the group with the highest degree of saturation (0.507) showed demineralization mainly on the surface of the lesion at the constant organic acid concentration 0.01 M and pH 5.5.

Influence of post types and sizes on fracture resistance in the immature tooth model / 대한치과보존학회지

The purpose of this study was to determine the effect of post types and sizes on fracture resistance in immature tooth model with various restorative techniques. Bovine incisors were sectioned 8 mm above and 12 mm below the cementoenamel junction to simulate immature tooth model. To compare various post-and-core restorations, canals were restored with gutta-percha and resin core, or reinforced dentin wall with dual-cured resin composite, followed by placement of D.T. LIGHT-POST, ParaPost XT, and various sizes of EverStick Post individually. All of specimens were stored in the distilled water for 72 hours and underwent 6,000 thermal cycles. After simulation of periodontal ligament structure with polyether impression material, compressive load was applied at 45 degrees to the long axis of the specimen until fracture was occurred. Experimental groups reinforced with post and composite resin were shown significantly higher fracture strength than gutta-percha group without post placement (p < 0.05). Most specimens fractured limited to cervical third of roots. Post types did not influence on fracture resistance and fracture level significantly when cement space was filled with dual-cured resin composite. In addition, no statistically significant differences were seen between customized and standardized glass fiber posts, which cement spaces were filled with resin cement or composite resin individually. Therefore, root reinforcement procedures as above in immature teeth improved fracture resistance regardless of post types and sizes.

Treatment of crown-root fracture with a modified crown fragment reattachment technique / 대한치과보존학회지

The development of adhesive dentistry has allowed that the crown fragment reattachment can be another option in the treatment of crown fracture. However, additional crown lengthening procedure or extrusion of the tooth may be necessary in the treatment of crown root fracture because subgingival fracture line in close proximity to the alveolar bone leads to challenges for restorative procedure and the violation of the biologic width. This case report presents a modified crown fragment reattachment technique of crown root fracture with pulp exposure, which was done without additional crown lengthening procedures. After the endodontic treatment, the patient was treated using a post insertion and the fragment reattachment technique, which made it possible to preserve the space for the biologic width and maintain a dry surgical field for adequate adhesion through the modification of the fractured coronal fragment. Since a coronal fracture was occurred and reattached afterward, it was observed that the coronal fragment was well maintained without the additional loss of periodontal attachment through 2-year follow up.