• Restorative Dentistry and Endodontics
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• 제46권3호
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• pp.46.1-46.9
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• 2021

The aim of this review was to evaluate the effects of different access cavity designs on endodontic treatment and tooth prognosis. Two independent reviewers conducted an unrestricted search of the relevant literature contained in the following electronic databases: PubMed, Science Direct, Scopus, Web of Science, and OpenGrey. The electronic search was supplemented by a manual search during the same time period. The reference lists of the articles that advanced to second-round screening were hand-searched to identify additional potential articles. Experts were also contacted in an effort to learn about possible unpublished or ongoing studies. The benefits of minimally invasive access (MIA) cavities are not yet fully supported by research data. There is no evidence that this approach can replace the traditional approach of straight-line access cavities. Guided endodontics is a new method for teeth with pulp canal calcification and apical infection, but there have been no cost-benefit investigations or time studies to verify these personal opinions. Although the purpose of MIA cavities is to reflect clinicians' interest in retaining a greater amount of the dental substance, traditional cavities are the safer method for effective instrument operation and the prevention of iatrogenic complications.

• International Journal of Oral Biology
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• 제31권4호
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• pp.135-140
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• 2006

Temperature signaling can be initiated by members of transient receptor potential (thermo-TRP) channels. Hot and cold substances applied to teeth usually elicit pain sensation. Since odontoblasts constitute a well-defined layer between the pulp and the mineralized dentin, being first to encounter thermal stimulation from oral cavity, they may be involved in sensory transduction process, in addition to their primary function as formation of dentin. We investigated whether thermo-TRP channels are expressed in a odontoblast cell line, MDPC-23. The expressions of thermo-TRP channels were examined using reverse transcription polymerase chain reaction (RT-PCR), immunohistochemistry, fluorometric calcium imaging. Analysis of RT-PCR revealed mRNA expression of TRPV1, TRPV2, TRPV4 and TRPM8, but no TRPV3, TRPA1. Immunohistochemical approach failed to detect TRPV1 expression. Whereas the application of 4-phorbol-12,13-didecanoate($10\;{\mu}M$, a TRPV4 agonist), menthol(1 mM, a TRPM8 agonist) and icilin($10\;{\mu}M$, a TRPM8 agonist) produced the enhancement of intracellular calcium concentration, capsaicin($1\;{\mu}M$, a TRPV1 agonist) did not. Our results suggest that subfamily of thermo-TRP channels expressed in odontoblasts may serve as thermal or mechanical transducer in teeth.

• 대한치과의사협회지
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• 제50권7호
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• pp.384-393
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• 2012

Successful treatment of a badly broken down tooth with pulpal disease depends not only on good endodontic therapy, but also on good prosthetic reconstruction of the tooth after endodontic therapy is completed. The ideal treatment of endodontically treated teeth has been widely and controversially discussed. Endocrown is a restorative option for endodontically treated teeth. Endocrown design incorporates the core and short post into the crown as a single restoration. The preparation of endocrown consists of a circular equigingival butt-joint margin and central retention cavity of the entire pulp chamber instead of employing intraradicular posts. This design significantly increases the surface area of the preparation available for cementation. It is particularly useful in young patient teeth for long-term provisional restoration and in teeth with short clinical crowns. This technique represents a promising and conservative method for the treatment of endodontically treated teeth that require long-term protection and stability. Endocrown can be considered as a feasible alternative to full crowns or composite overlays for the restoration of non vital teeth.

• 대한소아치과학회지
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• 제11권1호
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• pp.169-179
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• 1984

The purpose of this study was to observe the effect of dental varnish applied with fluoride to dental pulp by comparing the groups of commercial fluoride product $Duraphat^{(R)}$, $Copalite^{(R)}$ after 1 Mole sodium fluoride application, Cavity $Sealer^{(R)}$ after 1 Mole sodium fluoride application with the control group not applied the dental varnish. After Cl V Cavity form was prepared on the buccal surface of the crowns with the total 75 teeth by using 5 dogs, average weight of 13.2Kg, dental varnish and silver analgram were placed. This study was performed by 3, 7, 21, 28, 56 days each. The dogs were sacrificed to extract the teeth, cut at the apical one fourth, and prepared histologic examination by fixing with 10% buffered formalin perfusion at sacrifice and decalcification in 10% nitric acid. The specimens were embedded in paraffin, stained with Hematoxylin and Eosin, and serially sectioned with 6 ${\mu}$width each. Microscopic evaluation of serial sections at the various time periods among the different groups revealed the following results: 1. In the control group, the marked change of the odontoblastic layer was showed on the 3 days group, and it was decreased gradually. Healing response, such as hyperplasia, was seen on the 28 days group and it was continued to the 56 days group. 2. In the experimental group with Cavity $Sealer,^{(R)}$ a slight hemorrhage was seen in the odontoblastic layer on the 3 days group, and the healing response with the hyperplasia of the odontoblast was showed on the 21, 28 days group. It was completely healed on the 56 days group. 3. In the Duraphat R group, a slight hemorrhage showed on the 3 days group and the disarrangement of the Odontoblastic layer was seen on the 7, 21, 28 days group. Odontoblasts showed hyperplasia on the 28 days group, and healed completely on the 56 days group. 4. In the $Copalite^{(R)}$ group, the 7 days group showed remarkable hemorrhage in the odontoblastic layer and stroma, and also it showed reticular degeneration with the disarrangement of the odontoblastic layer and congestion. Each group showed disarrangement. Healing ability of this group was greater than that of the control group, but less than that of the $Duraphat^{(R)}$ and Cavity $Sealer^{(R)}$ group.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 추계학술대회
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• pp.380-384
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• 1997

This study was performed to understand the exogenous-water-drop induced thermomechanical effect on the tooth in the free-running Er:YAG laser mode for the proper use of water as a laser energy absorber and coolant in dentistry. The ree-running Er:YAG laser was used in the dental hard tissue ablation study. A Microjet system was employed to dispense precise water drops. Ablation rate, recoil momentum, and temperature rise in the pulp cavity were measured with and without an exogenous water drop on the tooth surface. Exogenous water enhanced ablation rate in the thick tooth in which the ablation rate on the dry surface does not increase linearly but shows plateau. Optimal exogenous water volume was shifted from 2 nl to 4 nl as the laser energy was increased from 48 mJ to 145 mJ. The magnitude of the recoil momentum was increased as the volume of exogenous water increased. The results of this study suggest that we must pay attention to the recoil momentum or recoil pressure study or the optimal and safe usage of water in the dental treatment because these mechanical effects depend on the volume of exogenous water on the tooth surface.

• Imaging Science in Dentistry
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• 제44권2호
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• pp.115-119
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• 2014

Purpose: The aim of this in vitro study was to determine the sensitivity and specificity of cone-beam computed tomography (CBCT) and digital periapical radiography in the detection of mesial root perforations of mandibular molars. Materials and Methods: In this in vitro study, 48 mandibular molars were divided into 4 groups. First, the mesial canals of all the 48 teeth were endodontically prepared. In 2 groups (24 teeth each), the roots were axially perforated in the mesiolingual canal 1-3 mm below the furcation region, penetrating the root surface ("root perforation"). Then, in one of these 2 groups, the mesial canals were filled with gutta-percha and AH26 sealer. Mesial canals in one of the other 2 groups without perforation (control groups) were filled with the same materials. The CBCT and periapical radiographs with 3 different angulations were evaluated by 2 oral and maxillofacial radiologists. The specificity and sensitivity of the two methods were calculated, and P<0.05 was considered significant. Results: The sensitivity and specificity of CBCT scans in the detection of obturated root canal perforations were 79% and 96%, respectively, and in the case of three-angled periapical radiographs, they were 92% and 100%, respectively. In non-obturated root canals, the sensitivity and specificity of CBCT scans in perforation detection were 92% and 100%, respectively, and for three-angled periapical radiographs, they were 50% and 96%, respectively. Conclusion: For perforation detection in filled-root canals, periapical radiography with three different horizontal angulations would be trustworthy, but it is recommended that CBCT be used for perforation detection before obturating root canals.

• Journal of Oral Medicine and Pain
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• 제30권4호
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• pp.457-464
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• 2005

본 연구의 목적은 법랑질과 상아질에서 와동을 형성하는 동안 치수벽에서 발생하는 온도변화를 관찰하여 치수 손상 가능성을 평가하고자 하였고 조사반복율의 차이에 따른 영향도 함께 조사하고자 하였다. 발거된 건전 대구치에 access cavity를 형성하고 레진 block에 식립한 다음, 온도측정센서를 레이저가 조사될 치수벽에 위치시켰다. 레이저를 조사하는 동안 분사되는 물이 온도변화에 영향을 주지 않도록 하기 위해 레진을 이용하여 occlusal cap을 만들고 가운데 작은 구멍을 내어 온도측정센서가 들어갈 수 있도록 하였으며 치아의 내부는 생리식염수로 채웠다. 치아표본은 법랑질실험군과 상아질 실험군으로 나누고 각 군당 치아표본수는 5개로 하였다. 상아질군에서는 모든 표본의 상아질 두께를 일정하게 하기 위하여, 고속핸드피스를 이용하여 상아질 두께가 2 mm가 되도록 삭제하여 사용하였다. $3\;mm{\times}2\;mm$의 일정한 면적을 치면에 표시한 다음 와동을 형성하였는데, 법랑질군에서는 상아질 이 노출되는 순간까지, 상아질군에서는 상아질벽이 천공되는 순간까지 온도변화를 조사하였다. 조사방식은 접촉식(contact mode)으로 하였으며 레이저가 한번 조사되는 시간을 3초 이하로 유지하면서 와동을 형성하였다. 300 mJ의 펄스 에너지, 10, 15, 20 Hz의 조사반복율, 1.6 ml/min의 물분사량이 가해지는 조건에서 레이저 조사측의 온도변화를 측정하였다. 본 연구의 결과에 따르면, Er:YAG 레이저 조사시 적절한 양의 물분사가 이루어질 때, 즉 1.6 ml/min의 물분사량과 300 mJ의 펄스에너지의 조건에서 법랑질에서 와동형성시 10, 15, 20 Hz 의 조사반복율 모두에서 온도상승이 미미하여 치수손상을 야기할 만한 온도상승이 이루어 지지 않았고 세 군 간의 유의한 차이도 존재하지 않았다(p=0.358). 상아질에서의 와동형성시에는 조사반복율이 증가할수록 온도상승이 컸지만(p=0.001), 실제 온도상승은 여전히 치수손상을 야기 하지 않는 안전한 범위에 있었다. 결론적으로 적절한 양의 물이 레이저 조사면에 적절하게 분사되기만 하면 법랑질이나 상아질에 서의 와동형성은 안전하게 시행할 수 있을 것으로 생각된다.

• 대한치과보철학회지
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• 제14권1호
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• pp.47-54
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• 1976

Pulpal temperature is changed in response for various conditions which were mechanical, thermal, chemical and biological stimuli. This study was performed to determine the pulpal temperature changes which were using air turbine with air-water coolant, water coolant, and conventional dental engine with water coolant and no coolant on 28 canine of dogs. In order to record pulpal temperature, pulp chamber was opened on the labiocervical area of canine. Thermocouple was inserted into pulp chamber and was fixed with filling material(dycal). Changes of pulpal temperature were recorded on the physiograph, which had been standardized temperature degree, through thermocouple to thermistor bridge and carrier preamplifier. The amount of experimental temperature change to that of control was interpreted in the pulpal cavity. The obtained results were as followings: 1. The mean normal temperature was 33.07 centigrade. 2. The temperature was decreased than normal pulpal temperature. It was 12.04 centigrade in reduction by air turbine with air-water coolant, 7.17 centigrade in reduction by air turbine with air coolant, 5.54 centigrade in reduction by conventional engine with water coolant, and 1.26 centigrade in reduction by conventional engine with no coolant. 3. The time for maximal temperature change was 53.3 seconds in reduction by air turbine with air-water coolant, 73.4 seconds in reduction by air turbine with air coolant, 50.9 seconds in reduction by conventional engine with water coolant, and 27.1 seconds in reduction by conventional engine with no coolant. 4.. After reduction was ceased, the recovery time to normal pulp temperature was 287.1 seconds in air turbine with air-water coolant, 189.0 seconds in air turbine with air coolant, 86.9 seconds in conventional engine with water coolant, and 52.9 seconds in conventional engine with no coolant respectively.

• 대한치과보철학회지
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• 제45권5호
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• pp.579-588
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• 2007

Statement of problem: A tenderness of the dentin after tapering of teeth for dental prosthesis is a common phenomenon. In practice, the alternative desensitizer may be used for minor pain after tapering of teeth. Purpose: In this study, the desensitizers were used to investigate the affect decreasing of shear bond strength according to the use of various cement, such as resin, Glass Ionomer, and phosphate cement. Material and method: Three different desensitizers were used on this study Compositions of two dentin desensitizers were HEMA(hydroxyethylmethacrylate) and glutaraldehyde. The other one is oxalic acid. Three dentin desensitizers applied on 12 degrees taper teeth. Then, Ni-Cr crowns were bonded with Resin cement, Zinc Phosphate (ZPC) cement and Glass Ionomer (GIC) cement. 120 human premolar teeth were used for specimens. The specimens were divided into four group as the reference and the empirical each with thirty specimens, then further divided into 12 group according to type of desensitizers and cement types. The shear bond strength were measured by Instron multi task instrument. Results: According to the result, the measured shear bond strength in order from the weakest to the strongest in general was ZPC, Resin, and GIC. And it is found that the application of desensitizers on dentin surface does not affect the shear bond strength. Conclusion: Dentin desensitizers that alleviate or prevent a dentin tenderness, usually contains HEMA and glutaraldehyde compounds. Such desensitizers are widely used in clinical studies. By applying the dentin desensitizer on the exposed dentin surface, the dentin capillary are blocked and periodontal membrane and cementum can not be drawn in pulp cavity. Since HEMA and glutaraldehyde may cause harm to the pulp cavity, an alternative desensitizer was developed.

• Restorative Dentistry and Endodontics
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• 제8권1호
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• pp.123-131
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• 1982

The purpose of this study was to observe the responses of the remaining pulp tissue after pulpotomy upon the several kinds of $Ca(OH)_2$ products and the responses of periapical tissue upon some root canal filling materials after extirpation. For pulpotomy, the class V cavities were prepared on the premolars, molars and upper canines, and the pulp was amputated. Each drug was placed over the amputated tissue and cavity was sealed with zinc oxide eugenol cement. The drugs which were used for the study were Dycal (Caulk Co. U.S.A.), Cavitec (Kerr Co. U.S.A.), Calvital, Nobudyne and Neodyne (Neo Dental Chemical Products). For extirpation, the endodontic cavities were prepared on the lingual surfaces of anterior teeth, and the pulp tissues were extirpated as routine method. After enlarging, irrigation, and measuring of root length by taking X-ray, each root canal filling material was filled in the canal with gutta percha cone, and endodontic cavity was sealed with zinc oxide eugenol cement. Zinc oxide eugenol, $Ca(OH)_2$ (Eli Lilly Co. U.S.A.) and Vitapex (Neo Dental Chemical Products) were used as root canal filling materials. Animals were sacrificed after 1, 3 and 6 weeks following the operation. The teeth were decalcified in formic acid, sectioned and stained with hematoxylin eosin. Microscopic examination revealed as follows. 1. Dycal: The dentin bridge formation was observed at the 3rd week after pulpotomy. Inflammatory conditions which were infiltration of inflammatory cells and dilatation of blood vessels were kept in remaining pulp tissue at the 6th week. 2. Calvital: The dentin bridge was observed at the 1st week after pulpotomy. As the time clasped, the pulp tended to be the fibrous degeneration. 3. Cavitec, Nobudyne and Neodyne: In the case of Cavitec and Nobudyne, the incompleted and irregular dentin bridge was observed at the 6th week, and in Neodyne, was observed at the 3rd week. The severe inflammatory changes were seen in the remaining pulp tissue. As the time clasped, the fibrous degeneration tended to spread in the remaining pulp tissue. 4. $Ca(OH)_2$: Osteocementum was formed at the 3rd week, the matrix of cementum and dentin were resorted, and infiltration of lymphocytes was seen in periapical tissue when $Ca(OH)_2$ was used as canal-filling materials. S. ZOE and Vitapex The cementum like substance was seen in periapical portion at the 1st week, when ZOE and Vitapex were used as root canal filling materials. As the time elapsed, the matrix of cementum and dentin tended to be resorted. At the 6th week, the inflammatory condition of periapical tissue was continued in the case of ZOE, but was reduced in the case of Vitapex.