• Restorative Dentistry and Endodontics
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• v.34 no.4
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• pp.324-332
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• 2009

The purpose of this study was to investigate the effect of rigidity of post core systems on stress distribution by the theoretical technique, finite element stress-analysis method. Three-dimensional finite element models simulating an endodontically treated maxillary central incisor restored with a zirconia ceramic crown were prepared and 1.5 mm ferrule height was provided. Each model contained cortical bone, trabecular bone, periodontal ligament, 4 mm apical root canal filling, and post-and-core. Six combinations of three parallel type post (zirconia ceramic, glass fiber, and stainless steel) and two core (Paracore and Tetric ceram) materials were evaluated, respectively. A 50 N static occlusal load was applied to the palatal surface of the crown with a $60^{\circ}$angle to the long axis of the tooth. The differences in stress transfer characteristics of the models were analyzed. von Mises stresses were chosen for presentation of results and maximum displacement and hydrostatic pressure were also calculated. An increase of the elastic modulus of the post material increased the stress, but shifted the maximum stress location from the dentin surface to the post material. Buccal side of cervical region (junction of core and crown) of the glass fiber post restored tooth was subjected to the highest stress concentration. Maximum von Mises stress in the remaining radicular tooth structure for low elastic modulus resin core (29.21 MPa) was slightly higher than that for high elastic modulus resin core (29.14 MPa) in case of glass fiber post. Maximum displacement of glass fiber post restored tooth was higher than that of zirconia ceramic or stainless steel post restored tooth.

• Restorative Dentistry and Endodontics
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• v.35 no.6
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• pp.453-460
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• 2010

Objectives: To evaluate the accuracy and consistency of two different apex locators at both the Apex and 0.5 marks. Materials and Methods: Twenty-six root canals was scheduled for extraction for periodontal or prosthodontic reasons. Thirteen canals were measured using Root ZX and the rest by i-ROOT. The root canal length was measured both the at 0.5 mark and the Apex mark. The file was then fixed to the toot, and the distance from the file tip to the major foramen of each canal was measured after removing the root dentin under the microscope so that the major foramen and the file tip were seen. Results: 1. When the Apex mark was used, 100% of both the Root ZX and i-ROOT groups were within 0.5 mm of the major foramen. 2. When 0.5 mark was used, 100% of the Root ZX group and 77% of the i-ROOT group were within 0.5 mm of the major foramen. 3. In terms of standard deviation and quartile value, the Apex mark was more consistent than 0.5 mark in the Root ZX group, and 0.5 mark was more consistent in the i-ROOT group, but there was no statistically significant difference when compared with t-test. 4. The root canal length difference between the Apex mark and 0.5 mark was 0.22 mm and 0.46 mm in the Root ZX and i-ROOT groups, respectively. Conclusions: In this study, the Apex mark was the more consistent mark. Therefore, it is recommended to subtract 0.5 mm, which is the average length between the apex and apical constriction, from the root canal length at the Apex mark to obtain the working length clinically.

• Restorative Dentistry and Endodontics
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• v.35 no.6
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• pp.445-452
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• 2010

Objectives: The aim of this study was to compare apical sealing ability and physical properties of MTA, MTA - AH-plus mixture (AMTA) and experimental Portland cement - Epoxy resin mixture (EPPC) for a development of a novel retro-filling material. Materials and Methods: Forty-nine extracted roots were instrumented and filled with gutta-percha. Apical root was resected at 3 mm and the retro-filling cavity was prepared for 3 mm depth. Roots were randomly divided into 3 groups of 15 roots each. The retro-filling was done using MTA, AMTA, and EPPC as the groups divided. Four roots were used as control groups. After setting in humid condition for 24 hours, the roots were immersed in 1% methylene blue dye solution for 72 hours to test the apical leakage. After immersion, the roots were vertically sectioned and photos were taken to evaluate microleakage. Setting times were measured with Vicat apparatus and digital radiographs were taken to evaluate aluminum equivalent thickness using aluminum step wedge. The results of microleakage and setting time were compared between groups using one-way ANOVA and Scheffe's post-hoc comparison at the significance level of 95%. Results: AMTA and EPPC showed less microleakage than MTA group (p < 0.05). AMTA showed the highest radio-opacity than other groups and the novel EPPC showed 5 mm aluminum thickness radio-opacity. EPPC showed the shortest initial and final setting times than other groups while the MTA showed the longest (p < 0.05). Conclusions: Under the condition of this study, the novel composite using Portland cement-Epoxy resin mixture may useful for retro-filling with the properties of favorable leakage resistance, radio-opacity and short setting time.

• Restorative Dentistry and Endodontics
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• v.36 no.1
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• pp.26-36
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• 2011

Objectives: In the present study, three kinds of tissues cells (pulp, gingiva, and periodontal ligament) were investigated if those cells express MMP and TIMP when they were stimulated with neuropeptides (substance P, CGRP) or proinflammatory cytokine, TNF-$\alpha$. Materials and Methods: The cells cultured from human dental pulp (PF), gingiva (GF) and periodontal ligament were (PDLF) stimulated with Mock, SP, TNF-$\alpha$, and CGRP for 24 hrs and 48 hrs. for an RNase protection assay and Enzyme Linked Immunosorbent Assay. Cells (PF, GF and PDLF) seeded in 100 mm culture dish were stimulated with SP ($10^{-5}$, $10^{-8}\;M$) or only with medium (Mock stimulation) for 4hrs and for 24 hrs for RNase Protection Assay, and they were stimulated with CGRP ($10^{-5}\;M$) and TNF-$\alpha$(2 ng/mL) for 24 hrs and with various concentraion of TNF-$\alpha$(2, 10, and 100 ng/mL) for Rnase Protection Assay with a human MMP-1 probe set including MMP 1, 2, 8, 7, 8, 9, 12, and TIMP 2, 3. In addition, cells (PF, GF and PDLF) were stimulated with Mock and various concentraion of TNF-$\alpha$(2, 10, and 100 ng/mL) for 24 hrs and with TNF-$\alpha$(10 ng/mL) for 48 hrs, and the supernatents from the cells were collected for Enzyme Linked Immunosorbent Assay (ELISA) for MMP-1 and MMP-13. Results: The expression of MMPs in PF, GF, PDLF after stimulation with SP and CGRP were not changed compared with Mock stimulation for 4 hrs and 24 hrs. The expression of MMP-1, -12, -13 24 hrs after stimulation with TNF-$\alpha$ were upregulated, however the expression of TIMP-3 in PF, GF, PDLF after stimulation with TNF-$\alpha$ were downregulated. TNF-$\alpha$(2 ng/mL, 10 ng/mL, 100 ng/mL) increased MMP-1 and MMP-12 expression in PF dose dependently for 24 hrs. Conclusions: TNF-$\alpha$ in the area of inflammation may play an important role in regulating the remodeling of dentin, cementum, and alveolar bone.

• Restorative Dentistry and Endodontics
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• v.36 no.1
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• pp.37-49
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• 2011

Objectives: The aim of this study was to evaluate the surface color of indirect resin restoration according to the layering placement of different shade of incisal composite. Materials and Methods: In this study, CIE $L^*a^*b^*$ value of 16 Body composite of Tescera ATL (Bisco, Schaumburg IL,USA) was measured by spectrophotometer (NF999, Nippon Denshuku, Japan), and compared to CIE $L^*a^*b^*$ value of Vitapan shade guide. Nine shade Incisal composite of Tescera ATL were buildup to 1 mm thickness on Body composites inlay block, and CIE $L^*a^*b^*$ value was measured. Incisal composite was ground to 0.5 mm thickness and CIE $L^*a^*b^*$ value was re-measured. Color difference between Body composite and Incisal composites layered on Body composite was calculated as a function of thickness. Results: Color difference between corresponding shade of Tescera Body composite and Vitapan shade guide was from 6.88 to 12.80. $L^*$ and $b^*$ value was decreased as layering thickness of Incisal composite on Body composite was increased. But, $a^*$ value did not show specific change tendency. Conclusions: Surface color difference between Body composites and Incisal composites layered on Body composite was increased as the layering thickness of Incisal composite increased (p < 0.05).

• Restorative Dentistry and Endodontics
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• v.32 no.1
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• pp.1-8
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• 2007

This study compared the microshear bond strength (${\mu}SBS$) of light-cured and dual-cured composites to enamel bonded with three self-etching adhesives. Crown segments of extracted human molars were cut mesiodistally, and 1 mm thickness of specimen was made. They were assigned to three groups by used adhesives: Xeno group (Xeno III), Adper group (Adper Prompt L-Pop), and AQ group (AQ Bond). Each adhesive was applied to cut enamel surface as per manufacturer's instruction. Light-cured (Filtek Z 250) or dual-cured composite (Luxacore) was bonded to enamel of each specimen using Tygon tube. After storage in distilled water for 24 hours, the bonded specimens were subjected to ${\mu}SBS$ testing with a crosshead speed of 1 mm/minute. The mean ${\mu}SBS$ (n = 20 for each group) was statistically compared using two-way ANOVA, Tukey HSD, and t test at the 0.05 probability level, The results of this study were as follows ; 1. The ${\mu}SBS$ of light-cured composite was significantly higher than that of dual-cured composite when same adhesive was applied to enamel. 2. For Z 250, the ${\mu}SBS$ of AQ group ($9.95{\pm}2.51 MPa$) to enamel was significantly higher than that of Adper soup ($6.74{\pm}1.80 MPa$), but not significantly different with Xeno group ($7.73{\pm}2.01 MPa$). 3. For Luxacore, the ${\mu}SBS$ of Xeno group ($5.19{\pm}1.32\;MPa$) to enamel was significantly higher than that of Adper group ($3.41{\pm}1.19\;MPa$), but not significantly different with AQ group ($4.50{\pm}0.96\;MPa$).

• Restorative Dentistry and Endodontics
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• v.32 no.1
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• pp.37-46
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• 2007

The C-shaped canal system is an anatomical variation mostly seen in mandibular second molars, although it can also occur in maxillary and other mandibular molars. The main anatomical feature of C-shaped canals is the presence of fins or web connecting the individual root canals. The complexity of C-shaped canals prevents these canals from being cleaned, shaped, and obturated effectively during root canal therapy, and sometimes it leads to an iatrogenic perforation from the extravagant preparation. The purpose of this study was to provide further knowledge of the anatomical configuration and the minimal thickness of dentinal wall according to the level of the root. Thirty extracted mandibular second molars with fused roots and longitudinal grooves on lingual or buccal surface of the root were collected from a native Korean population. The photo images and radiographs from buccal, lingual, apical direction were taken. After access cavity was prepared, teeth were placed in 5.25% sodium hypochlorite solution for 2 hours to dissolve the organic tissue of the root surface and from the root canal system. After bench dried and all the teeth were embedded in a self-curing resin. Each block was sectioned using a microtome (Accutom-50, Struers, Denmark) at interval of 1 mm. The sectioned surface photograph was taken using a digital camera (Coolpix 995, Nikon, Japan) connected to the microscope. 197 images were evaluated for canal configurations and the minimal thickness of dentinal wall between canal and external wall using 'Root Thickness Gauge Program' designed with Visual Basic. The results were as follows : 1. At the orifice level of all teeth, the most frequent observed configuration was Melton's Type C I (73%), however the patterns were changed to type C II and C III when the sections were observed at the apical third. On the other hand, the type C III was observed at the orifice level of only 2 teeth but this type could be seen at apical region of the rest of the teeth. 2. The C-shaped canal showed continuous and semi-colon shape at the orifice level, but at the apical portion of the canal there was high possibility of having 2 or 3 canals 3. Lingual wall was thinner than buccal wall at coronal, middle, apical thirds of root but there was no statistical differences.

• Restorative Dentistry and Endodontics
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• v.32 no.1
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• pp.69-79
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• 2007

The purpose of this study was to investigate the effects of composite resin restorations on the stress distribution of notch shaped noncarious cervical lesion using three-dimensional (3D) finite element analysis (FEA). Extracted maxillary second premolar was scanned serially with Micro-CT (SkyScan1072 ; SkyScan, Aartselaar, Belgium). The 3D images were processed by 3D-DOCTOR (Able Software Co., Lexington, MA, USA). ANSYS (Swanson Analysis Systems, Inc., Houston, USA) was used to mesh and analyze 3D FE model. Notch shaped cavity was filled with hybrid or flowable resin and each restoration was simulated with adhesive layer thickness ($40{\mu}m$) A static load of 500 N was applied on a point load condition at buccal cusp (loading A) and palatal cusp (loading B). The principal stresses in the lesion apex (internal line angle of cavity) and middle vertical wall were analyzed using ANSYS. The results were as follows 1. Under loading A, compressive stress is created in the unrestored and restored cavity. Under loading B, tensile stress is created. And the peak stress concentration is seen at near mesial corner of the cavity under each load condition. 2. Compared to the unrestored cavity, the principal stresses at the cemeto-enamel junction (CEJ) and internal line angle of the cavity were more reduced in the restored cavity on both load con ditions. 3. In teeth restored with hybrid composite, the principal stresses at the CEJ and internal line angle of the cavity were more reduced than flowable resin.

• Restorative Dentistry and Endodontics
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• v.32 no.1
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• pp.28-36
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• 2007

The purpose of this study was to compare the effect of exponential curing method with conventional curing and soft start curing method on polymerization shrinkage of composite resins. Three brands of composite resins (Synergy Duo Shade, Z250, Filtek Supreme) and three brands of light curing units (Spectrum 800, Elipar Highlight, Elipar Trilight) were used. 40 seconds curing time was given. The shrinkage was measured using linometer for 90 seconds. The effect of time on polymerization shrinkage was analysed by one-way ANOVA and the effect of curing modes and materials on polymerization shrinkage at the time of 90s were analysed by two-way ANOVA. The shrinkage ratios at the time of 20s to 90s were taken and analysed the same way. The results were as follows : 1. All the groups except Supreme shrank almost within 20s Supreme cured by soft start and exponential curing had no further shrinkage after 30s (p < 0.05). 2. Statistical analysis revealed that polymerization shrinkage varied among materials (p = 0.000) and curing modes (p = 0.003). There was no significant interaction between material and curing mode. 3. The groups cured by exponential curing showed the statistically lower polymerization shrinkage at 90s than the groups cured by conventional curing and soft start curing (p < 0.05). 4. The initial shrinkage ratios of soft start and exponential curing were statistically lower than conventional curing (p < 0.05). From this study, the use of low initial light intensities may reduce the polymerization rate and, as a result, reduce the stress of polymerization shrinkage.

• Restorative Dentistry and Endodontics
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• v.32 no.1
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• pp.47-60
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• 2007

The purpose of this study is to compare and to evaluate the effect of pH and lactic acid concentration on the progression of artificial root caries lesion using polarizing microscope, and to evaluate the morphological changes of hydroxyapatite crystals of the demineralized area and to investigate the process of demineralization using scanning electron microscope. Artificial root caries lesion was created by dividing specimens into 3 pH groups (pH 4.3, 5.0, 5.5), and each pH group was divided into 3 lactic acid concentration groups (25 mM, 50 mM, 100 mM). Each group was immersed in acid buffer solution for 5 days and examined. The results were as follows : 1. Under polarized microscope, the depth of lesion was more effected by the lactic acid concentration rather than the pH. 2. Under scanning electron microscope, dissolution of hydroxyapatite crystals were increased as the lactic acid concentration increased and the pH decreased. 3. Demineralized hydroxyapatite crystals showed peripheral dissolution and decreased size and number within cluster of hydroxyapatite crystals and widening of intercluster and intercrystal spaces as the pH decreased and the lactic acid concentration increased. 4. Under scanning electron microscope evaluation of the surface zone, clusters of hydroxyapatite crystals were dissolved, and dissolution and reattachment of crystals on the surface of collagen fibrils were observed as the lactic acid concentration increased. 5. Under scanning electron microscope, demineralizatlon of dentin occurred not only independently but also with remineralization simultaneously. In conclusion, the study showed that pH and lactic acid concentration influenced the rate of progression of the lesion in artificial root caries. Demineralization process was progressed from the surface of the cluster of hydroxyapatite crystals and the morphology of hydroxyapatite crystals changed from round or elliptical shape into irregular shape as time elapsed.