Effect of pre-curing of two universal adhesives on the shear bond strength of resin cement to zirconia / 대한치과재료학회지

This study aimed to investigate whether pre-curing the universal adhesives affect the resin bonding to zirconia ceramic. Two commercial universal adhesives (All-Bond Universal, ABU; Single Bond Universal Adhesive, SBU) were tested in comparison with a conventional zirconia primer (Z-Prime Plus, ZPP). Air-abraded zirconia specimens were divided into six groups, to which different priming agents were applied with or without photo-polymerization. After resin cylinders were built on the primed zirconia surface using a resin cement (Duo-Link), all bonded specimens were stored in water at 37℃ for 24 hours and half of them (n = 12) were additionally thermocycled 5,000 times. A shear bond strength test was performed at a crosshead speed of 0.5 mm/minute and failure modes were assessed using an optical microscope at 25× magnification. Before thermocycling, the light-cured specimens of ABU and SBU showed higher bond strengths than the uncured ones of the materials (p 0.05). After thermal aging, there were significant decreases in the bond strength for all specimens treated with the universal adhesives (p 0.05) and attained higher bond strength values for both the pre-cured and uncured specimens when compared to the two universal adhesives (p<0.05). Adhesive failures were predominant in all test groups and thermocycling resulted in the higher incidences of adhesive failures for the uncured groups, which was not shown in the pre-cured groups.

Post space preparation timing of root canals sealed with AH Plus sealer

OBJECTIVES: To determine the optimal timing for post space preparation of root canals sealed with epoxy resin-based AH Plus sealer in terms of its polymerization and influence on apical leakage. MATERIALS AND METHODS: The epoxy polymerization of AH Plus (Dentsply DeTrey) as a function of time after mixing (8, 24, and 72 hours, and 1 week) was evaluated using Fourier transform infrared (FTIR) spectroscopy and microhardness measurements. The change in the glass transition temperature (Tg ) of the material with time was also investigated using differential scanning calorimetry (DSC). Fifty extracted human single-rooted premolars were filled with gutta-percha and AH Plus, and randomly separated into five groups (n = 10) based on post space preparation timing (immediately after root canal obturation and 8, 24, and 72 hours, and 1 week after root canal obturation). The extent of apical leakage (mm) of the five groups was compared using a dye leakage test. Each dataset was statistically analyzed by one-way analysis of variance and Tukey's post hoc test (α = 0.05). RESULTS: Continuous epoxy polymerization of the material with time was observed. Although the T(g) values of the material gradually increased with time, the specimens presented no clear T(g) value at 1 week after mixing. When the post space was prepared 1 week after root canal obturation, the leakage was significantly higher than in the other groups (p < 0.05), among which there was no significant difference in leakage. CONCLUSIONS: Poor apical seal was detected when post space preparation was delayed until 1 week after root canal obturation.

Relationship between laboratory bond strengths and clinical performance of dentin adhesives

No abstract available.

Proximity of the mandibular molar root apex from the buccal bone surface: a cone-beam computed tomographic study

OBJECTIVES: The purpose of this study was to evaluate the proximity of the mandibular molar apex to the buccal bone surface in order to provide anatomic information for apical surgery. MATERIALS AND METHODS: Cone-beam computed tomography (CBCT) images of 127 mandibular first molars and 153 mandibular second molars were analyzed from 160 patients' records. The distance was measured from the buccal bone surface to the root apex and the apical 3.0 mm on the cross-sectional view of CBCT. RESULTS: The second molar apex and apical 3 mm were located significantly deeper relative to the buccal bone surface compared with the first molar (p < 0.01). For the mandibular second molars, the distance from the buccal bone surface to the root apex was significantly shorter in patients over 70 years of age (p < 0.05). Furthermore, this distance was significantly shorter when the first molar was missing compared to nonmissing cases (p < 0.05). For the mandibular first molars, the distance to the distal root apex of one distal-rooted tooth was significantly greater than the distance to the disto-buccal root apex (p < 0.01). In mandibular second molar, the distance to the apex of C-shaped roots was significantly greater than the distance to the mesial root apex of non-C-shaped roots (p < 0.01). CONCLUSIONS: For apical surgery in mandibular molars, the distance from the buccal bone surface to the apex and apical 3 mm is significantly affected by the location, patient age, an adjacent missing anterior tooth, and root configuration.

Esthetic enhancement of a traumatized anterior tooth with a combination of forced eruption and tooth alignment: a case report

Exposing sound structure of a subgingivally fractured tooth using orthodontic extrusion is considered to be a conservative way to re-establish biologic width without sacrificing esthetics or jeopardizing periodontal support of neighboring teeth. When a misaligned tooth is traumatically involved, a more comprehensive approach combining tooth extrusion and re-alignment may be necessary for a successful restorative outcome. This case report describes a successful esthetic management of a patient with complicated crown-root fracture on the maxillary right central incisor and pre-existing malocclusion in the maxillary anterior region. Forced eruption along with re-alignment of teeth by orthodontic movement seems to allow re-positioning of the fracture line to a favorable position and correction of crowding, providing a better esthetic result.

Educational needs of an integrated health and oral health project for community dental hygienists / 대한구강보건학회지

OBJECTIVES: To determine the educational needs related to an integrated health and oral health project for community dental hygienists. METHODS: In this cross-sectional study, a survey was administered to 1,190 dental hygienists working in community health centers and 627 (about 53%) responded. The dependent variable was educational needs from oral health projects; the independent variables were region, job assignments, job position, and degree of self-development. Data were analyzed using descriptive statistics and chi-square tests, with PASW 20.0 (SPSS Inc., Chicago, IL, USA), and the significance threshold was .05. RESULTS: The educational needs of community dental hygienists were found to be high, at about 58.5 points out of 100. The highest educational needs were for oral health projects linked to public health projects. In this regard, participants reported a high need for "identification of issues and projects suited to the current state of the region," "establishment of strategies for integration of health and oral health projects," and "prioritization." CONCLUSIONS: Professional education for community dental hygienists should be expanded to include integration of health and oral health. It should be based on the assessment of these professionals' educational needs.

Efficacy of various cleaning solutions on saliva-contaminated zirconia for improved resin bonding

PURPOSE: This study aimed to investigate the efficacy of cleaning solutions on saliva-contaminated zirconia in comparison to air-abrasion in terms of resin bonding. MATERIALS AND METHODS: For saliva-contaminated airabraded zirconia, seven cleaning methods)-no contamination (NC), water-spray rinsing (WS), additional airabrasion (AA), and cleaning with four solutions (Ivoclean [IC]; 1.0 wt% sodium dodecyl sulfate [SDS], 1.0 wt% hydrogen peroxide [HP], and 1.0 wt% sodium hypochlorite [SHC])-were tested. The zirconia surfaces for each group were characterized using various analytical techniques. Three bonded resin (Panavia F 2.0) cylinders (bonding area: 4.5 mm2) were made on one zirconia disk specimen using the Ultradent jig method [four disks (12 cylinders)/group; a total of 28 disks]. After 5,000 thermocycling, all specimens were subjected to a shear bond strength test with a crosshead speed of 1.0 mm/minute. The fractured surfaces were observed using an optical and scanning electron microscope (SEM). RESULTS: Contact angle measurements showed that groups NC, AA, IC, and SHC had hydrophilic surfaces. The X-ray photoelectron spectroscopy (XPS) analysis showed similar elemental distributions between group AA and groups IC and SHC. Groups IC and SHC showed statistically similar bond strengths to groups NC and AA (P>.05), but not groups SDS and HP (P<.05). For groups WS, SDS, and HP, blister-like bubble formations were observed on the surfaces under SEM. CONCLUSION: Within the limitations of this in vitro study, some of the cleaning solutions (IC or SHC) were effective in removing saliva contamination and enhancing the resin bond strength.

Effective application duration of sodium ascorbate antioxidant in reducing microleakage of bonded composite restoration in intracoronally-bleached teeth

OBJECTIVES: The aim of this study was to determine an appropriate application duration of sodium ascorbate (SA) antioxidant gel in reducing microleakage of bonded composite restoration in intracoronally-bleached teeth. MATERIALS AND METHODS: Eighty endodontically-treated human incisors were randomly divided into eight groups: control, no bleaching; IB and DB, immediate and delayed bonding after bleaching, respectively; S10m, S60m, S24h, S3d and S7d, bleaching + SA gel for 10 min, 60 min, 24 hr, 3 day and 7 day, respectively. For bleaching, a mixture of 30% hydrogen peroxide and sodium perborate was applied for 7 day. All access cavities were restored using One-Step adhesive (Bisco Inc.) and then Aelite LS Packable composite (Bisco Inc.). The bonded specimens were subjected to 500 thermal cycles, immersed in 1% methylene blue for 8 hr, and longitudinally sectioned. Microleakage was assessed with a 0 - 4 scoring system and analyzed using nonparametric statistical methods (alpha = 0.05). RESULTS: Group IB showed a significantly higher microleakge than the control group (p = 0.006) and group DB a statistically similar score to the control group (p > 0.999). Although groups S10m, S60m, and S24h exhibited significantly higher scores than group DB (p 0.999). CONCLUSIONS: Application of SA gel for 3 day after nonvital bleaching was effective in reducing microleakage of composite restoration in intracoronally-bleached teeth.

Degree of conversion of two dual-cured resin cements light-irradiated through zirconia ceramic disks

PURPOSE: The aim of this Fourier transform infrared (FTIR) spectroscopic study was to measure the degree of conversion (DC) of dual-cured resin cements light-irradiated through zirconia ceramic disks with different thicknesses using various light-curing methods. MATERIALS AND METHODS: Zirconia ceramic disks (KT12) with three different thicknesses (1.0, 2.0, and 4.0 mm) were prepared. The light transmittance of the disks was measured using ultraviolet visible near-infrared spectroscopy. Four different light-curing protocols were used by combining two curing light modes (Elipar TriLight (standard mode) and bluephase G2 (high power mode)) with light-exposure times of 40 and 120 seconds. The DCs of the two dual-cured resin cements (Duo-Link and Panavia F2.0) light-irradiated through the disks was analyzed at three time intervals (3, 7, and 10 minutes) by FTIR spectroscopy. The data was analyzed using repeated measures ANOVA (alpha=.05).Two-way ANOVA and Tukey post hoc test were used to analyze the 10 minute DC results. RESULTS: The 1.0 mm thick disk exhibited low light transmittance (<25%), and the transmittance decreased considerably with increasing disk thickness. All groups exhibited significantly higher 10 minute DC values than the 3 or 7 minute values (P<.05), but some exceptions were observed in Duo-Link. Two-way ANOVA revealed that the influence of the zirconia disk thickness on the 10 minute DC was dependent on the light-curing methods (P<.001). This finding was still valid even at 4.0 mm thickness, where substantial light attenuation took place. CONCLUSION: The curing of the dual-cured resin cements was affected significantly by the light-curing technique, even though the additional chemical polymerization mechanism worked effectively.

Endodontic treatment of maxillary lateral incisors with anatomical variations

Maxillary lateral incisors usually exhibit a single root with a single canal. However, maxillary lateral incisor teeth with unusual morphology of root canal system are frequently reported. These cases of variable root canal anatomy can be treated well by nonsurgical endodontic methods. A detailed description of root canal morphology is fundamental for successful endodontic treatment. Treatment using an operating microscope, radiographs from different angles, and cone-beam computerized tomography (CBCT) can produce more predictable endodontic outcomes.

Diastema closure using direct bonding restorations combined with orthodontic treatment: a case report

Closure of interdental spaces using proximal build-ups with resin composite is considered to be practical and conservative. However, a comprehensive approach combining two or more treatment modalities may be needed to improve esthetics. This case report describes the management of a patient with multiple diastemas, a peg-shaped lateral incisor and midline deviation in the maxillary anterior area. Direct resin bonding along with orthodontic movement of teeth allows space closure and midline correction, consequently, creating a better esthetic result.

Diagnostic challenges of nonodontogenic toothache

The objective of this article was to present two nonodontogenic conditions that may mimic odontogenic toothache: trigeminal neuralgia and burning mouth syndrome. Two cases are presented in which one is related to the upper left second premolar and the other is related to the upper left first molar. Both showed pain when chewing. These two cases highlight the complexities involved in diagnosing nonodontogenic toothache. This article demonstrates the importance of having a thorough knowledge of both odontogenic and nonodontogenic toothache, as well as the need for careful evaluation of the nature of the pain and history, clinical and radiographic examinations.

Comparison of screw-in effect for several nickel-titanium rotary instruments in simulated resin root canal / 대한치과보존학회지

Screw-in effect is one of the unintended phenomena that occurs during the root canal preparation with nickel-titanium rotary files. The aim of this study was to compare the screw-in effect among various nickel-titanium rotary file systems. Six different nickel-titanium rotary instruments (ISO 20/.06 taper) were used: K3(TM) (SybronEndo, Glendora, CA, USA), Mtwo (VDW GmbH, Munchen, Germany), NRT with safe-tip and with active tip (Mani Inc., Shioya-gun, Japan), ProFile(R) (Dentsply-Maillefer, Ballaigues, Switzerland) and ProTaper(R) (Dentsply-Maillefer, Ballaigues, Switzerland). For ProTaper(R), S2 was selected because it has size 20. Root canal instrumentations were done in sixty simulated single-curved resin root canals with a rotational speed of 300 rpm and single pecking motion. A special device was designed to measure the force of screw-in effect. A dynamometer of the device recorded the screw-in force during simulated canal preparation and the recorded data was stored in a computer with designed software (LCV-USE-VS, Lorenz Messtechnik GmbH, Alfdorf, Germany). The data were subjected to one-way ANOVA and Tukey's multiple range test for post-hoc test. P value of less than 0.05 was regarded significant. ProTaper(R) produced significantly more screw-in effects than any other instruments in the study (p 0.05), and between NRT with active tip and NRT with safe one neither (p > 0.05). From the result of the present study, it was concluded, therefore, that there seems significant differences of screw-in effect among the tested nickel-titanium rotary instruments. The radial lands and rake angle of nickel-titanium rotary instrument might be the cause of the difference.

Influence of root canal curvature on the screw-in effect of nickel-titanium rotary files in simulated resin root canal / 대한치과보존학회지

OBJECTIVES: Nickel-titanium (Ni-Ti) rotary instruments have some unexpected disadvantages including the tendency to screw-in to the canal. The purpose of this study was to evaluate the influence of root canal curvatures on the screw-in effect of Ni-Ti rotary files. MATERIALS AND METHODS: A total of 80 simulated root canals in clear resin blocks were used in the study. Canals with curvature of 0, 10, 20 and 30 degrees were instrumented with ProTaper instruments SX, S1, S2 and a ProFile of #25/0.06 to 1.0-2.0 mm beyond the initial point of root curvature. The screw-in force was measured with a specially designed device while canal was instrumented with a ProFile of #30/0.06 at a constant speed of 300 rpm. The data were subjected to one-way ANOVA and Scheffe multiple range test for post-hoc test. RESULTS: Larger degree of canal curvature generated significantly lesser screw-in forces in all groups (p < 0.001). CONCLUSIONS: More attention needs to be paid when using rotary instruments in canals with less curvature than canals with more curvatures to prevent or reduce any accidental overinstrumentation.

Polymerization of dual cured composites by different thickness / 대한치과보존학회지

The purpose of this study was to evaluate the effect of thickness, filling methods and curing methods on the polymerization of dual cured core materials by means of microhardness test. Two dual cured core materials, MultiCore Flow (Ivoclar Vivadent AG, Schaan, Liechtenstein) and Bis-Core (Bisco Inc., Schaumburg, IL, USA) were used in this study. 2 mm (bulky filled), 4 mm (bulky filled), 6 mm (bulky and incrementally filled) and 8 mm (bulky and incrementally filled)-thickness specimens were prepared with light cure or self cure mode. After storage at 37degrees C for 24 hours, the Knoop hardness values (KHN) of top and bottom surfaces were measured and the microhardness ratio of top and bottom surfaces was calculated. The data were analyzed using one-way ANOVA and Scheffe multiple comparison test, with alpha = 0.05. The effect of thickness on the polymerization of dual cured composites showed material specific results. In 2, 4 and 6 mm groups, the KHN of two materials were not affected by thickness. However, in 8 mm group of MultiCore Flow, the KHN of the bottom surface was lower than those of other groups (p < 0.05). The effect of filling methods on the polymerization of dual cured composites was different by their thickness or materials. In 6 mm thickness, there was no significant difference between bulk and incremental filling groups. In 8 mm thickness, Bis-Core showed no significant difference between groups. However, in MultiCore Flow, the microhardness ratio of bulk filling group was lower than that of incremental filling group (p < 0.05). The effect of curing methods on the polymerization of dual cured composites showed material specific results. In Bis-Core, the KHN of dual cured group were higher than those of self cured group at both surfaces (p < 0.05). However, in MultiCore Flow, the results were not similar at both surfaces. At the top surface, dual cured group showed higher KHN than that of self cured group (p < 0.05). However, in the bottom surface, dual cured group showed lower value than that of self cured group (p < 0.05).

Expression of P2X3 and its colocalization with trpv1 in the human dental pulp / 대한치과보존학회지

The purinoreceptor, P2X3 is a ligand-gated cation channel activated by extracellular ATP. It has been reported that ATP can be released during inflammation and tissue damage, which in turn may activate P2X3 receptors to initiate nociceptive signals. However, little is known about the contribution of P2X3 to the dental pain during pulpal inflammation. Therefore, the purpose of this study was to investigate the expression of P2X3 and its colocalization with TRPV1 to understand the mechanism of pain transmission through P2X3 in the human dental pulp with double labeling immunofluorescence method. In the human dental pulp, intense P2X3 immunoreactivity was observed throughout the coronal and radicular pulp. Of all P2X3-positive fibers examined, 79.4% coexpressed TRPV1. This result suggests that P2X3 along with TRPV1 may be involved in the transmission of pain and potentiation of noxious stimuli during pulpal inflammation.

Change of working length in curved canals by various instrumentation techniques / 대한치과보존학회지

To evaluate the change of working length with various instrumentation techniques in curved canals, working length and canal curvature were determined before and after canal instrumentation in buccal or mesial canals of extracted human molars. Stainless steel K-files (MANI(R), Matsutani Seisakusho Co. Takanezawa, Japan), nickel-titanium K-files (Naviflex NT(TM), Brassler, Savannah, USA), ProFile(R), and ProTaper(TM) (Dentsply-Maillefer, Ballaigues, Switzerland) were used to prepare the canals with crown-down technique. In two hand instrumentation groups, coronal flaring was made with Gates Glidden burs. Apical canals were instrumented until apical diameter had attained a size of 30. Positional relation between the tooth apex and the #10 K-file tip was examined by using AutoCAD 2000 (Autodesk Corp., San Rafael. CA, USA) under a stereomicroscope before and after coronal flaring, and after apical instrumentation. Degree of canal curvature was also measured with Schneider's method in radiographs. Data of working length and canal curvature changes were statistically analyzed with one-way ANOVA and Tukey's studentized range test. Working length and canal curvature were decreased significantly in each step in all instrumentation groups. Coronal flaring using Gates Glidden burs in hand instrument groups and whole canal instrumentation using stainless steel hand K-files caused significantly more working length change than in ProFile instrumentation group (p < 0.05). The result of this study demonstrates that all of the above kinds of instrumentation in curved canals cause reduction of working length and canal curvature at each instrumentation steps, and hand instrumentation causes more working length change than ProFile.

Influence of plugger penetration depth on the area of the canal space occupied by gutta-percha / 대한치과보존학회지

To evaluate the ratio of gutta-percha area in the canal after canal obturation with Continuous Wave of Condensation Technique (CWCT) with varying depths of plugger penetration, forty root canals of extracted human teeth were prepared up to size 40 of 0.06 taper with ProFile(R). Canals of three groups were filled with CWCT with System B(TM) (Analytic Tech., USA) and different plugger penetration depths of 3, 5, or 7 mm from the apex. Canals of one group were filled with lateral condensation technique as a control. The filled teeth were cross-sectioned at 1, 2, and 3 mm levels from the apical foramen. The ratio of gutta-percha area in the canal was analyzed using Auto(R)Cad 2000. Data were analyzed with one-way ANOVA and Duncan's multiple range test. At all levels, higher gutta-percha area ratio was found with deeper plugger penetration depth in CWCT, and cold lateral condensation group showed higher ratio than group of plugger penetration to apical 7 mm in CWCT. At apical 1 mm and 2 mm levels, group of plugger penetration to apical 3 mm showed significantly higher gutta-percha area ratio than those of apical 7 mm and lateral condensation (p < 0.05). It is concluded therefore that, under the conditions of the present study, deeper plugger penetration depth results in more favorable and efficient obturation in CWCT.

The Ultrastructure of TRPV1-positive Nerve Terminals in the Human Tooth Pulp / 대한해부학회지

The vanilloid receptor TRPV1 has been suggested to play an important role in thermal nociception and inflammatory hyperalgesia. In our previous study, we examined the expression of TRPV1 and colocalization of TRPV1 with substance P (SP) and calcitonin gene related peptide (CGRP) through fluorescence immunocytochemistry. Here, we investigated ultrastructural characteristics of TRPV1 immunoreactive fibers in the human tooth pulp through preembedding immunocytochemistry. TRPV1 immunoreactivity was present in the unmyelinated nerve fibers in the tooth pulp. There were two types of TRPV1 IR nerve fibers identified in the human tooth pulp: one containing clear round vesicles and many dense-cored vesicles, the other containing clear round vesicles and few dense-cored vesicles. TRPV1 immunoreactive fibers were constant in diameter without swellings along the length. Boutons en passant and boutons terminaux usually observed in the CNS were not observed in the TRPV1 immunoreactive fibers. Many vesicles were accumulated in the TRPV1 immunoreactive fibers, however synaptic structure was not found. It is known that dense-cored vesicles contain neuropeptides such as SP and CGRP and clear round vesicles contain neurotransmitter such as glutamate. Taken together, our results suggest that TRPV1 immunoreactive fibers showing distinct ultrastructructural features may be involved in inflammatory hyperalgesia and thermal nociception in the tooth pulp.

Influence of additional etching on shear bond strength of self-etching adhesive system to enamel / 대한치과보존학회지

Recently, self-etching adhesive system has been introduced to simplify the clinical bonding procedures. It is less acidic compared to the phosphoric acid, thus there is doubt whether this system has enough bond strength to enamel. The purpose of this study was to investigate the influence of additional etching on the adhesion of resin composite to enamel. Ninety extracted bovine permanent anterior teeth were used. The labial surfaces of the crown were ground with 600-grit abrasive paper under wet condition. The teeth were randomly divided into six groups of 15 teeth each. Clearfil SE Bond(R), Adper(TM) Prompt L-Pop and Tyrian SPE(TM) were used as self-etching primers. Each self-etching primers were applied in both enamel specimens with and without additional etching. For additional etching groups, enamel surface was pretreated with 32% phosphoric acid (UNI-ETCH, Bisco, Inc., Schaumburg, IL, USA). Hybrid resin composite Clearfil AP-X, (Kuraray Co., Ltd., Osaka, Japan) was packed into the mold and light-cured for 40 seconds. Twenty-four hours after storage, the specimens were tested in shear bond strength. The data for each group were subjected to independent t - test at p 0.01). In conclusion, self-etching adhesive system with weak acid seems to have higher bond strength to enamel with additional etching, while self-etching adhesive system with strong acid seems not.