Accuracy of Root ZX in teeth with simulated root perforation in the presence of gel or liquid type endodontic irrigant

OBJECTIVES: To evaluate the accuracy of the Root ZX in teeth with simulated root perforation in the presence of gel or liquid type endodontic irrigants, such as saline, 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine liquid, 2% chlorhexidine gel, and RC-Prep, and also to determine the electrical conductivities of these endodontic irrigants. MATERIALS AND METHODS: A root perforation was simulated on twenty freshly extracted teeth by means of a small perforation made on the proximal surface of the root at 4 mm from the anatomic apex. Root ZX was used to locate root perforation and measure the electronic working lengths. The results obtained were compared with the actual working length (AWL) and the actual location of perforations (AP), allowing tolerances of 0.5 or 1.0 mm. Measurements within these limits were considered as acceptable. Chi-square test or the Fisher's exact test was used to evaluate significance. Electrical conductivities of each irrigant were also measured with an electrical conductivity tester. RESULTS: The accuracies of the Root ZX in perforated teeth were significantly different between liquid types (saline, NaOCl) and gel types (chlorhexidine gel, RC-Prep). The accuracies of electronic working lengths in perforated teeth were higher in gel types than in liquid types. The accuracy in locating root perforation was higher in liquid types than gel types. 5.25% NaOCl had the highest electrical conductivity, whereas 2% chlorhexidine gel and RC-Prep gel had the lowest electrical conductivities among the five irrigants. CONCLUSIONS: Different canal irrigants with different electrical conductivities may affect the accuracy of the Root ZX in perforated teeth.

Evaluation of the rat tissue reaction to experimental new resin cement and mineral trioxide aggregate cement

OBJECTIVES: New resin cement (NRC) has been developed as a root repairing material and the material is composed of organic resin matrix and inorganic powders. The aim of this study was to compare the rat subcutaneous tissue response to NRC and mineral trioxide aggregate (MTA) cement and to investigate the tissue toxicity of both materials. MATERIALS AND METHODS: Sixty rats received two polyethylene tube-implants in dorsal subcutaneous regions, MTA and NRC specimens. Twenty rats were sacrificed respectively at 1, 4 and 8 wk after implantation and sectioned to 5 microm thickness and stained with Hematoxylin-Eosin (H-E) or von-Kossa staining. The condition of tissue adjacent to the implanted materials and the extent of inflammation to each implant were evaluated by two examiners who were unaware of the type of implanted materials in the tissues. Data were statistically analyzed with paired t-test (p < 0.05). RESULTS: In specimens implanted with both NRC and MTA, severe inflammatory reactions were present at one wk, which decreased with time. At eighth wk, MTA implanted tissue showed mild inflammatory reaction, while there were moderate inflammatory reactions in NRC implanted tissue, respectively. In NRC group, von-Kossa staining showed more calcification materials than MTA group at eighth wk. CONCLUSIONS: It was concluded that the calcium reservoir capability of NRC may contribute to mineralization of the tissues.

Apical microleakage of MTA with 4-META/MMA & TBB resin as a root-end filling material / 대한치과보존학회지

We evaluated in vitro microleakage of Mineral Trioxide Aggregate (MTA) powder with 4-methacryloxyethyl trimellitate anhydride (4-META) / methyl methacrylate (MMA) & tri-n-butylborane (TBB) resin as a retrograde filling material by using methylene blue dye method. Fifty-two single rooted, extracted teeth were instrumented and obturated with gutta percha and AH plus sealer. The apical 3mm of each root was resected and 3mm deep ultrasonic root end preparation was done. External surface of roots was coated with nail varnish. Prepared teeth were randomly divided into five groups; Negative control: completely covered with nail varnish; Positive control: coated with nail varnish except for apical foramen; Group 1 (retrofilled with Portland cement); Group 2 (retrofilled with MTA); Group 3 (retrofilled with MTA powder mixed with 4-META/MMA & TBB resin). Immediately after completion of root-end filling, all specimens were submerged in methylene blue dye for 72 hours in 37degrees C incubator. The roots were longitudinally sectioned and measured for extent of dye penetration by three different examiners under microscope (x10). The results were statistically analyzed using one way ANOVA and Turkey's HSD test. No leakage was evident in negative control and complete leakage in positive control group. Group 3 showed significantly less leakage than group 1 and 2 (p 0.01). It was concluded that MTA powder with 4-META/MMA & TBB resin was excellent in reducing initial apical microleakage.

The effect of NaOCl treatment and sterilization procedures on the corrosion of endodontic files / 대한치과보존학회지

A variety files made of stainless steel (S-S) or nickel-titanium (Ni-Ti) are used during endodontic treatment. The purpose of this study was to evaluate the corrosion susceptibility of S-S and Ni-Ti endodontic files. Three brands of files were used for this study: K-flex(R) S-S files (Maillefer, USA), Profile(R) Ni-Ti files (Maillefer, USA), K-3(R) Ni-Ti files (SybronEndo, USA). 120 files of each brands (21mm, ISO size #20) were divided into 12 groups according to 1) sterilization methods using Autoclave or Ethylene Oxide (E-O) gas, 2) Irrigation solutions using 5.25 % NaOCl or Saline, 3) the number of sterilization (1, 5, 10 times). After above procedures, each of the files was inspected by three examiners with a light microscope and camera at X25. Each file was judged and ranked according to the following criteria: 0; no corrosion, 1; mild corrosion, 2; moderate corrosion, and 3; severe corrosion. The files of high score were examined under the Scanning Electron Microscope. Data were statistically analyzed with the Kruskal-Wallis test (p < 0.05). Most of the ten time-autoclaved files had showed mild to moderate corrosion. But, one or five time-autoclaved files did not show corrosive surface. NaOCl treatment and E-O gas sterilization did not influence on corrosion. There was a significant difference in corrosion susceptibility between sterilization methods and the number of autoclaving. However, there was no significant difference between brands and file materials.

MMP and TIMP production in periodontal ligament fibroblasts stimulated by Prevotella nigrescens lipopolysaccharide / 대한치과보존학회지

The purpose of this study was to monitor the secretion of matrix metalloproteinase (MMP) and tissue inhibitor of metalloproteinase (TIMP) by human periodontal ligament (PDL) fibroblasts stimulated with Prevotella nigrescens lipopolysaccharide (LPS), and to examine the effect of calcium hydroxide treatment on P. nigrescens LPS. LPS was extracted and purified from anaerobically cultured P. nigrescens. PDL fibroblasts were stimulated by the LPS (0, 0.1, 1, 10 ug/ml) or LPS (10 ug/ml) pretreated with 12.5 mg/ml of Ca(OH)2 for 3 days, for various periods of time (12, 24, 48 h). Immunoprecipitation were performed for protein level analysis of MMP-1, MMP-2 and TIMP-1. Total RNA was isolated and real-time quantitative polymerase chain reaction (PCR) was performed for quantification of MMP-1 mRNA. According to this study, the results were as follows: 1. The production of MMP-1 by stimulation with P. nigrescens LPS increased in time-dependent manner, and showed maximum value at 48 h in both protein and mRNA level. But there was no dose-dependent increase. 2. MMP-2 production time-dependently increased when stimulated with 1 and 10 ug/ml LPS, but there was no dose-dependent increase. 3. TIMP-1 production increased to 24 h, but decreased at 48 h. It increased when stimulated with 0.1 and 1 ug/ml LPS, but suppressed at 10 ug/ml. 4. P. nigrescens LPS pretreated with Ca(OH)2 markedly downregulated MMP-1 gene expression.

The effect of estrogen deficiency on rat pulpodentinal complex / 대한치과보존학회지

The purpose of this study was to investigate the effects of estrogen deficiency on pulpodentinal complex of tooth in ovariectomized rats. Thirty female Sprague-Dawley rats, 10 weeks old, were used. Rats were grouped into two groups. One group (n = 15) was subjected to sham surgery (SHAM) and the other group (n = 15) was ovariectomized bilaterally (OVX). Animals were sacrificed 12 weeks later, and their mandibular molars and associated periodontal supporting tissues were dissected out, and fixed in 10% buffered formalin. For comparison of groups, immunostained for osteonectin. Histomorphometrical measurement of change of teeth was performed using an image analysis system and paired t-test was used and the level of significance for overall differences was set at p < 0.05. In immunostaining of osteonectin, they were significantly different from each other. The predentin thickness in OVX rats was wider than in SHAM rats. And in SHAM rats, osteonectin was more specifically stained in predentin areas than in OVX rats. These results indicate that estrogen deficiency increased the unmineralized predentin areas and decreased osteonectin content in pulpal tissues in rats. If our result is applicable to human studies, odotoblast is affected by estrogen deficiency.

MMP-1 and TIMP-1 production in MG-63 cells stimulated with Prevotella nigrescens lipopolysaccharide / 대한치과보존학회지

The purpose of this study is to monitor the secretion of matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) produced by human osteosarcoma cell line (MG63) stimulated with Prevotella nigrescens lipopolysaccharides (LPS), and to compare the level of secretion before and after the treatment of calcium hydroxide on P. nigrescens LPS. LPS was extracted and purified from anaerobically cultured P. nigrescens. MG63 cells were stimulated by the LPS (0, 1, 10 microg/ml) or LPS (10 microg/ml) pretreated with 12.5 mg/ml of Ca(OH)2 for 3 days. Total RNA was isolated from the cell, and real-time quantitative polymerase chain reaction (PCR) was performed for quantification of MMP-1 and TIMP-1. The results were as follows. 1. MMP-1 mRNA expression at 48 hr was highly increased by stimulation with P. nigrescens LPS. The increase was dose-dependent. 2. When stimulated with 1 microg/ml of LPS, TIMP-1 mRNA expression was highly increased at 24 hr and 48 hr. However, TIMP-1 expression was suppressed at higher concentration (10 microg/ml). 3. When P. nigrescens LPS was pretreated with Ca(OH)2, MMP-1 and TIMP-1 gene expression was downregulated. The results of this study suggest that transcriptional regulation of MMP-1 and TIMP-1 by P. nigrescens LPS could be one of the important mechanisms in bone resorption of periapical inflammation. The result of calcium hydroxide on MMP-1 and TIMP-1 gene expression suppression shows that calcium hydroxide detoxified bacterial LPS and thus should be used the medication of choice for intracanal dressings in root canal infected with black-pigmented bacteria.

A Case of Congenital Dyserythropoietic Anemia, Type II

Congenital dyserythropoietic anemia Type II (herditary erythroblatic multinuclearity with positive acidified serum test; HEMPAS) is characterized by binuclearity, multinuclearity, pluripolar mitoses, karyorrhexis of normoblasts, and the presence of abnormal antigens on the red cells. We experienced a case of HEMPAS in a 2 month old girl patient who had an intermittent fever, abdominal distention with palpable liver & spleen, and generalized jaundice. The blood analysis revealed anemia, and thrombocytopenia. Peripheral blood smear showed an averge of 6 mature normoblast per 100 leukocyte count. The red cells showed moderate anisocytosis, poikilocytosis, irregularly crenated, contracted cells and occasional spherocytes. The leukocytes showed relative lymphocytosis, and there were occasional villous lymphocytes. The marrow smear showed abnormality in erythroid series. About ten percent of the erythroblasts showed 2~7 nuclei or lobulated nuclei. The mitotic forms of the erythroid precursors were also increased in frequency. The M:E ratio was 1:3.2. Blood culture on this patient showed a pure growth of Coxiella burnetti. Medical treatment with Doxycycline and Rifampin was performed. After treatment, she became afebrile showing improved general condition with decreased size of liver & spleen. In spite of clinical improvement, she died suddenly 3 weeks after initial treatment.