Laser welding method for removal of instruments debris from root canals.

The purpose of this study was to clarify the viability of a novel method for removing debris from broken instruments from root canals using a laser apparatus. Laser welding was performed on stainless steel or nickel titanium files using an Nd:YAG laser. Retention force between the files and extractors was measured. Increase in temperature on the root surface during laser irradiation was recorded and the irradiated areas evaluated with a scanning electron microscope. Retention force on stainless steel was significantly greater than that on nickel titanium. The maximum temperature increase was 4.1°C. The temperature increase on the root surface was greater in the vicinity of the welded area than that at the apical area. Scanning electron microscopy revealed that the files and extractors were welded together. These results indicate that the laser welding method is effective in removing debris from broken instruments from root canals.

Digital video image processing from dental operating microscope in endodontic treatment.

Recently, optical microscopes have been used in endodontic treatment, as they offer advantages in terms of magnification, illumination, and documentation. Documentation is particularly important in presenting images to patients, and can take the form of both still images and motion video. Although high-quality still images can be obtained using a 35-mm film or CCD camera, the quality of still images produced by a video camera is significantly lower. The purpose of this study was to determine the potential of RegiStax in obtaining high-quality still images from a continuous video stream from an optical microscope. Video was captured continuously and sections with the highest luminosity chosen for frame alignment and stacking using the RegiStax program. The resulting stacked images were subjected to wavelet transformation. The results indicate that high-quality images with a large depth of field could be obtained using this method.

Three-dimensional analysis of mesiobuccal root canal of Japanese maxillary first molar using Micro-CT.

The objective of this study was to three-dimensionally observe the morphological characteristics of mesiobuccal root canals of Japanese maxillary first molars using microcomputed tomography (Micro-CT) and classify root canal variations. This study used 90 maxillary first molars. Three-dimensional reconstruction was performed using data obtained by Micro-CT, and cross-sections of the root canals were observed. Moreover, the root canal morphology was classified by the configuration and root canal diameter, and was evaluated for occurrence using the classification by Weine et al. (1969) as a reference. Overall, single root canals were observed in 44.4%, incomplete separation root canals in 22.3%, and completely separate root canals (upper and lower separation root canals) in 33.3%. Mesiobuccal root canals often had intricate configurations, and accessory root canals (lateral canals and apical ramifications) were observed in most of the mesiobuccal root canals (76.7%), irrespective of whether there were ramifications of the main root canals. While there were no marked differences in the incidence of root canal ramifications between this study and earlier reports, the incidence of accessory root canals was higher in this study. This result may be explained by the far more superior visualization ability of Micro-CT than conventional methods, which allowed the detection of microscopic apical ramifications previously difficult to observe.

Effect of diode laser on proliferation and differentiation of PC12 cells.

This study investigated the effects of diode (GaAlAs) laser irradiation at an effective energy density of 5 or 20 J/cm(2) on cell growth factor-induced differentiation and proliferation in pheochromocytoma cells (PC12 cells), and whether those effects were related to activation of the p38 pathway. Laser irradiation at 20 J/cm(2) significantly decreased the number of PC12 cells, while no difference was seen between the 5 J/cm(2) group and the control group (p<0.05). Western blotting revealed marked expression of neurofilament and ß-tubulin, indicating greater neurite differentiation in the irradiation groups than in the control group at 48 hr. Irradiation also enhanced expression of phospho-p38. The decrease in number of cells after laser irradiation was accelerated by p38 inhibitor, while neurite differentiation was up-regulated by laser irradiation, even when the p38 pathway was blocked. This suggests that laser irradiation up-regulated neurite differentiation in PC12 cells involving p38 and another pathway.

Pregnenolone biosynthesis in the rat salivary gland and its inhibitory effect on secretion.

Pregnenolone (PRG), a major neurosteroid, suppressed carbachol-induced salivary secretion in perfused submandibular gland in rats. These effects were enhanced and depressed by agonistic muscimol (MUS) and antagonistic bicuculline to the γ-aminobutyric acid A receptor (GABA(A)-R), respectively. In contrast, PRG-sulfate, a sulfate-conjugated PRG metabolite, antagonized the suppressive effects of MUS, resulting in upregulation of salivary secretion. Quantitative RT-PCR and Western blotting revealed lesser expression of the PRG synthetase CYP11A1 protein and mRNA in the parotid, submandibular, and sublingual gland than in the cerebral cortex or adrenal gland as positive control organs. However, in response to methamphetamine withdrawal-induced stress, CYP11A1 production in each type of the salivary gland was highly upregulated to levels similar to those seen in the cerebral cortex. These results indicate that the salivary gland is capable of producing neurosteroids, as well as the brain. This suggests that steroid biosynthesis occurs in the salivary gland and is involved in the inhibitory regulation of salivary secretion in cooperation with GABA(A)-R. Further studies are needed to determine the pathophysiological significance of the biosynthesis of neurosteroids and their mechanisms of action via nuclear and membrane receptors.

FP core carrier technique: thermoplasticized gutta-percha root canal obturation technique using polypropylene core.

Core carrier techniques are unique among the various root canal filling techniques for delivering and compacting gutta-percha in the prepared root canal system. Thermafil (TF), considered the major core carrier device, is provided as an obturator consisting of a master core coated with thermoplasticized gutta-percha. We have devised a thermoplasticized gutta-percha filling technique using a polypropylene core, FlexPoint® NEO (FP), which was developed as a canal filling material that can be sterilized in an autoclave. Therefore, FP can be coated onto thermoplasticized gutta-percha and inserted into the prepared canal as a core carrier. The FP core carrier technique offers many advantages over the TF system: the core can be tested in the root canal and verified radiographically; the core can be adjusted to fit and surplus material easily removed; furthermore the core can be easily removed for retreatment. The clinical procedure of the FP core carrier technique is simple, and similar that with the TF system. Thermoplasticized gutta-percha in a syringe is heated in an oven and extruded onto the FP core carrier after a trial insertion. The FP core carrier is inserted into the root canal to the working length. Excess FP is then removed with a red-hot plastic instrument at the orifice of the root canal. The FP core carrier technique incorporates the clinical advantages of the existing TF system while minimizing the disadvantages. Hence the FP core carrier technique is very useful in clinical practice. This paper describes the FP core carrier technique as a new core based method.

Dens evaginatus on occlusal surface of maxillary second molar: a case report.

Dens evaginatus is a rare dental anomaly characterized by the development of a tubercle on the occlusal surface of the tooth and can cause pulpitis, pulp necrosis, and periapical periodontitis due to tubercular fracture or attrition. Unlike with caries, pain caused by dens evaginatus may manifest itself in a distant location. Therefore, diagnosing the cause of that pain may prove problematic. Dens evaginatus usually occurs in the mandibular premolars. We report a successfully treated case in which dens evaginatus was difficult to diagnose due to distant radiation of pulpitis-induced pain. This pain occurred as a result of fracture of a tubercle located on the occlusal surface of the maxillary second molar, which is very rare.

Sodium-calcium exchangers in rat ameloblasts.

Although the central role of ameloblasts in synthesis and resorption of enamel matrix proteins during amelogenesis is well documented, the Ca(2+)-transport/extrusion mechanism remains to be fully elucidated. To clarify Ca(2+)-transport in rat ameloblasts, we investigated expression and localization of Na(+)-Ca(2+) exchanger (NCX) isoforms and the functional characteristics of their ion transporting/pharmacological properties. RT-PCR and immunohistochemical analyses revealed expression of NCX1 and NCX3 in ameloblasts, localized in the apical membrane. In patch-clamp recordings, Ca(2+) efflux by Na(+)-Ca(2+) exchange showed dependence on external Na(+). Ca(2+) influx by Na(+)-Ca(2+) exchange, measured by fura-2 fluorescence, showed dependence on extracellular Ca(2+) concentration, and it was blocked by NCX inhibitors KB-R7943, SEA0400, and SN-6. These results showed significant expression of NCX1 and NCX3 in ameloblasts, indicating their involvement in the directional Ca(2+) extrusion pathway from cells to the enamel mineralizing front.

Long-term observation of porous sapphire dental implants.

We used porous sapphire dental implants made of alumina clinically for 4 years 1 month, commencing September, 1984 until September, 1988. Subjects consisted of 18 men and 42 women 20-71 years old (mean age: 35 years). Sixty-five implants were inserted in 60 patients. Of these, 20 were clinical cases of an implant connected with natural teeth and 45 were free-standing cases. We conducted a follow-up study on these patients over a 23-year period. One implant in 1 patient had to be removed because of postoperative infection and 8 implants in 7 patients had to be removed because of fracturing or detachment of the porous-part. This paper reports 3 cases where implants remained in place for 21-23 years. These cases have all shown good long-term clinical progress.

The odontoblast as a sensory receptor cell? The expression of TRPV1 (VR-1) channels.

Previous reports have shown the expression of several mechanosensitive ionic channels on the plasma membrane in odontoblasts, which are the cells responsible for dentin formation. The membrane characteristics of odontoblasts imply that they could play critical roles in the mechano-transduction of fluid displacement within dentinal tubules into the electrical cell signals, to carry dentin sensation to the central nervous system. However, the direct ionic mechanism underlying such a dentin nociceptive function remains unclear. In the present study, we investigated the expression of the transient receptor potential vanilloid subfamily member 1 (TRPV1) channel--which essentially contributes to the detection of pain sensation--in rat odontoblasts by immunohistochemical and nystatin perforated patch-clamp techniques. Immunohistochemical observation showed the localization of TRPV1-immunoreactions on the distal regions of odontoblast membranes. In the patch-clamp experiments, we observed capsaicin-induced inward currents that were inhibited by capsazepine, a TRPV1 channel antagonist. Our results indicate a significant expression of TRPV1 channels in odontoblasts, suggesting that odontoblasts may directly respond to noxious stimuli such as a thermal-heat stimulus, and point to the necessity for a reconsideration of the cellular mechanisms of dentin sensation based on the transmembrane ionic signals in odontoblasts.

Tissue reactions after intraosseous implantation of three retrofilling materials.

Bone tissue reactions to EBA, IRM, and cyanoacrylate cement (Base Liner) were studied in the rat mandible using an intraosseous implant method. Osseous cavities (1.4 mm in diameter) were surgically created in the mandibles, and materials were implanted in 60 male Wistar rats. Each specimen was evaluated histologically after 4 and 8 weeks. The development of fibrous connective tissue in direct apposition to the material was observed in the EBA and IRM groups at 4 weeks. A slight degree of macrophage infiltration was seen in the EBA group. After the 8-week observation period, IRM and EBA were frequently separated from the bone cavity by a fibrous connective tissue layer (p < 0.01). The Base Liner appeared to be in direct apposition to the osseous tissue in several areas (p < 0.01). These findings indicate that Base Liner reacts favorably with osseous tissue, compared with the EBA and IRM materials tested and seems to be a biocompatible material.

Inferior alveolar nerve paresthesia relieved by microscopic endodontic treatment.

We experienced two cases of inferior alveolar nerve paresthesia caused by root canal medicaments, which were successfully relieved by microscopic endodontic treatment. In the first case, the paresthesia might have been attributable to infiltration of calcium hydroxide into the mandibular canal through the root canals of the mandibular left second molar tooth. In the second case, the paresthesia might have been attributable to infiltration of paraformaldehyde through the root canals of the mandibular right second molar tooth. The paresthesia was relieved in both cases by repetitive microscopic endodontic irrigation using physiological saline solution in combination with oral vitamin B12 and adenosine triphosphate.