• Restorative Dentistry and Endodontics
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• 제44권3호
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• pp.33.1-33.12
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• 2019

Objectives: To evaluate the influence of the restorative technique on the mechanical response of endodontically-treated upper premolars with mesio-occluso-distal (MOD) cavity. Materials and Methods: Forty-eight premolars received MOD preparation (4 groups, n = 12) with different restorative techniques: glass ionomer cement + composite resin (the GIC group), a metallic post + composite resin (the MP group), a fiberglass post + composite resin (the FGP group), or no endodontic treatment + restoration with composite resin (the CR group). Cusp strain and load-bearing capacity were evaluated. One-way analysis of variance and the Tukey test were used with ${\alpha}=5%$. Finite element analysis (FEA) was used to calculate displacement and tensile stress for the teeth and restorations. Results: MP showed the highest cusp (p = 0.027) deflection ($24.28{\pm}5.09{\mu}m/{\mu}m$), followed by FGP ($20.61{\pm}5.05{\mu}m/{\mu}m$), CR ($17.62{\pm}7.00{\mu}m/{\mu}m$), and GIC ($17.62{\pm}7.00{\mu}m/{\mu}m$). For load-bearing, CR ($38.89{\pm}3.24N$) showed the highest, followed by GIC ($37.51{\pm}6.69N$), FGP ($29.80{\pm}10.03N$), and MP ($18.41{\pm}4.15N$) (p = 0.001) value. FEA showed similar behavior in the restorations in all groups, while MP showed the highest stress concentration in the tooth and post. Conclusions: There is no mechanical advantage in using intraradicular posts for endodontically-treated premolars requiring MOD restoration. Filling the pulp chamber with GIC and restoring the tooth with only CR showed the most promising results for cusp deflection, failure load, and stress distribution.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권6호
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• pp.317-325
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• 2023

Background: Local anesthetic injections may induce pain in children, leading to fear and anxiety during subsequent visits. Among the various approaches recommended to reduce pain, one is the use of a Buzzy Bee^TM device that operates on the concept of gate control theory and distraction. The literature regarding its effectiveness during the deposition of local anesthesia remains limited; hence, the aim of the present study was to determine the efficacy of extraoral cold and vibrating devices in reducing pain perception during the deposition of local anesthesia. Methods: A split-mouth crossover study in which 40 children aged 3-12 years requiring maxillary infiltration or inferior alveolar nerve block for extractions or pulp therapy in the maxillary or mandibular posterior teeth were included. The control intervention involved the application of topical anesthetic gel for one minute (5% lignocaine gel), followed by the administration of local anesthetic (2% lignocaine with 1:80,000 adrenaline) at a rate of 1 ml/ minute. Along with the control protocol, the test intervention involved using the Buzzy Bee^TM device for 2 minutes before and during the deposition of the local anesthetic injection. The heart rate and face, legs, arms, cry, and consolability revised (FLACC-R) scale scores were recorded by the dentist to assess the child's pain perception. Results: The mean age of the participants in Group A and Group B was 7.050 ± 3.12 years and 7.9 ± 2.65 years respectively. A reduction in the mean heart rate and FLACC-R score was observed during the deposition of local anesthetic solution in the tissues when the Buzzy Bee^TM was used in both groups at different visits in the same subjects (P < 0.05) The Buzzy Bee^TM device was effective in reducing the heart rate and FLACC-R scores when used during maxillary infiltration and inferior alveolar nerve block local anesthesia techniques (P < 0.05). Conclusion: The use of extraoral cold and vibrating devices significantly reduces pain perception during local anesthetic deposition in pediatric patients. Considering the results of this study, the device may be incorporated as an adjunct in routine dental practice while administering local anesthesia in children.

• Journal of Preventive Medicine and Public Health
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• 제28권4호
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• pp.765-771
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• 1995

치과용 핸드피스에서 발산하는 고주파수의 진동에 의한 일시적 진동감각역치 변화를 관찰하고자 치과위생병 28명을 대상으로 34,000rpm의 low-speed handpiece를 진동기구로 사용하였다. 진동에 폭로시키기 전과 후, 치과의사가 스케일링시 취하는 작업자세에 5분간 폭로시킨 후의 진동감각역치를 청력계기의 골전도진동기를 사용하여 250 Hz에서 그들이 주로 사용하는 손의 제2지두수에서 측정한 결과, 각각 $23.5{\pm}3.5dB,\;30.8{\pm}4.2dB,\;23.7{\pm}4.6dB$로 진동에 5분간 폭로시킨 후의 역치가 폭로 전에 비해 7.3dB의 유의한 증가가 있었다(p<0.001). 진동폭로 전후의 차이에 따른 분포를 보면, 10 dB 내외로 증가한 사람이 71.4%로 대부분이었고 16 dB의 증가가 가장 높았다. 진동 폭로 전의 진동감각역치와 신장, 체중, 체질량 지수와의 상관관계는 각각의 상관계수가 0.0360, -0.1657, -0.2641로 통계적 유의성은 없었으며, 흡연에 따른 차이도 흡연군(N=20)과 비흡연군(N=8)의 진동감 각역치가 각각 23.1 dB, 24.6 dB로 그 차이 가 없었다. 본 연구 결과로 볼 때 핸드피스와 같은 고주파-진동기구를 사용하는 치과의사 및 치과위생사에게서 진동감각역치의 변화가 예상되며, 말초신경병증의 원인이 될 수 있는 작업자세에 의한 장기간의 영향 및 아말감 충전시 사용하는 수은의 영향에 대해서도 연구가 필요할 것으로 생각된다.

• Imaging Science in Dentistry
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• 제45권2호
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• pp.95-101
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• 2015

Purpose: This study used cone-beam computed tomography (CBCT) to characterize mandibular molar root and canal morphology and its variability in Belgian and Chilean population samples. Materials and Methods: We analyzed the CBCT images of 515 mandibular molars (257 from Belgium and 258 from Chile). Molars meeting the inclusion criteria were analyzed to determine (1) the number of roots; (2) the root canal configuration; (3) the presence of a curved canal in the cross-sectional image of the distal root in the mandibular first molar and (4) the presence of a C-shaped canal in the second mandibular molar. A descriptive analysis was performed. The association between national origin and the presence of a curved or C-shaped canal was evaluated using the chi-squared test. Results: The most common configurations in the mesial root of both molars were type V and type III. In the distal root, type I canal configuration was the most common. Curvature in the cross-sectional image was found in 25% of the distal canals of the mandibular first molars in the Belgian population, compared to 11% in the Chilean population. The prevalence of C-shaped canals was 10% or less in both populations. Conclusion: In cases of unclear or complex root and canal morphology in the mandibular molars, CBCT imaging might assist endodontic specialists in making an accurate diagnosis and in treatment planning.

• 구강회복응용과학지
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• 제27권3호
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• pp.305-316
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• 2011

균열치는 저작운동과 온도자극에 대한 치아의 통증을 호소하는 환자에서 자주 발견되는 질환으로 균열의 진행정도에 따라 다양하게 분류할 수 있다. 가장 흔한 원인으로는 저작과정 중의 갑작스러운 사고로 알려져 있지만 대부분 증령, 기존 수복물 또는 의원성 응력집중과 같은 기여요인이 있을 때 발생한다. 균열의 진행정도 및 치수침범에 대한 정확한 진단이 필수적이며 저작시 통증을 확인한 후 균열을 가급적 눈으로 확인하는 것이 좋다. 이를 위해 투과광이나 염색과 같은 보조적 방법을 이용할 수 있다. 치료는 즉각적인 통증완화를 위한 교합조정이나 파절편 고정이 필요하며 치수의 상태에 따라 근관치료가 추가적으로 필요할 수도 있다. 궁극적인 치료로는 복합레진이나 접착 아말감으로 균열부위에 가해지는 충격을 완화시킨 후 주조수복물을 이용한 교두보호가 필요하다. 이 논문에서는 균열치에 대한 다양한 원인, 치료, 예후 등에 관한 문헌을 고찰할 것이다.

• Restorative Dentistry and Endodontics
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• 제37권1호
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• pp.41-49
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• 2012

Objectives: The internal adaptation of composite restorations with or without resin modified glass ionomer cement (RMGIC) was analyzed non-destructively using Microcomputed tomography (micro-CT). Materials and Methods: Thirty intact human teeth were used. The specimens were divided into 3 groups. In the control group, the cavities were etched with 10% phosphoric acid for 15 sec. Composite resin was filled into the cavity without adhesive. In group 1, light cured glass ionomer cement (GIC, Fuji II LC, GC) was applied as a base. The cavities were then etched, bonded, light cured and filled with composites. In group 2, the cavities were then etched, bonded, light cured and filled with composites without base application. They were immersed in a 25% silver nitrate solution. Micro-CT was performed before and after mechanical loading. One-way ANOVA with Duncan analysis was used to compare the internal adaptation between the groups before or after loading. A paired t-test was used to compare internal adaptation before and after mechanical loading. All statistical inferences were made within the 95% confidence interval. Results: The silver nitrate solution successfully penetrated into the dentinal tubules from the pulp spaces, and infiltrated into the gap between restoration and pulpal floor. Group 2 showed a lower adaptation than the control group and group 1 (p < 0.05). There was no significant difference between the control group and group 1. For all groups, there was a significant difference between before and after mechanical loading (p < 0.05). Conclusions: The internal adaptation before and after loading was better when composites were bonded to tooth using adhesive than composites based with RMGIC.

• Restorative Dentistry and Endodontics
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• 제24권2호
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• pp.286-298
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• 1999

The endodontic-periodontic combined lesions have been difficult to get correct diagnosis and predictable treatment. This study was to make the experimental endodontic-periodontic combined defects in dogs for the study of the periodontal regeneration and to evaluate the efficacy of the enamel matrix protein and e-PTFE membrane in the experimental endodontic-periodontic combined defects. 5 mongrel dogs were used. The pulp chambers were opened and the plaque was inserted into the chambers to induce the periapical lesions on the mandibular second, third and fourth premolars of the dogs. 1 month later, the root canal treatments were done with gutta perch a and ZOE sealer. On the day of surgery, the periapical defects were standardized by trephine bur. The buccal dehiscence defects were made by the dental bur and bone chisels. The apicoectomy with retrofilling was done. The prepared roots were randomly selected for test and control groups. In the experimental groups, the enamel matrix derivative and e-PTFE membrane were used. Nothing was placed on the control group. Fluroscent labelling was used to evaluate the bone formation. After 4 and 12 weeks, the dogs were sacrificed and undecalcified sections were prepared and stained with toluidine blue. Those histologic sections were examined by fluorescent microscopy and light microscopy. The results were as follows. 1. In the control group, new bone was formed in the periapical defects and scarcely in the buccal dehiscence defects. New cementum was not detected at 4 and 12 weeks. 2. In the experimental groups, new bone, new cementum and periodontal ligament were found in the periapical and buccal dehiscence defects. The relative amount and the quality of the new bone, new cementum and periodontal ligament tissue that had formed on the experimental groups were superior to those of the control group. 3. The current observation implicated that e-PTFE membrane and enamel matrix protein could be the effective tools for the guided tissue regeneration of the endo-perio combined defects.

• Restorative Dentistry and Endodontics
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• 제46권4호
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• pp.52.1-52.11
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• 2021

Objectives: This study evaluated the effects of low and moderate concentrations of triple antibiotic paste (TAP) and double antibiotic paste (DAP) loaded into a hydrogel system on crown discoloration and explored whether application of an adhesive bonding agent prevented crown discoloration. Materials and Methods: Intact human molars (n = 160) were horizontally sectioned 1 mm apical to the cementoenamel junction. The crowns were randomized into 8 experimental groups (calcium hydroxide, Ca[OH]₂; 1, 10, and 1,000 mg/mL TAP and DAP; and no medicament. The pulp chambers in half of the samples were coated with an adhesive bonding agent before receiving the intracanal medicament. Color changes (ΔE) were detected by spectrophotometry after 1 day, 1 week, and 4 weeks, and after 5,000 thermal cycles, with ΔE = 3.7 as a perceptible threshold. The 1-sample t-test was used to determine the significance of color changes relative to 3.7. Analysis of variance was used to evaluate the effects of treatment, adhesive, and time on color change, and the level of significance was p < 0.05. Results: Ca(OH)₂ and 1 and 10 mg/mL DAP did not cause clinically perceivable tooth discoloration. Adhesive agent use significantly decreased tooth discoloration in the 1,000 mg/mL TAP group up to 4 weeks. However, adhesive use did not significantly improve coronal discoloration after thermocycling when 1,000 mg/mL TAP was used. Conclusions: Ca(OH)₂ and 1 and 10 mg/mL DAP showed no clinical discoloration. Using an adhesive significantly improved coronal discoloration up to 4 weeks with 1,000 mg/mL TAP.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권6호
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• pp.367-375
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• 2020

Background: Intraosseous anesthesia (IO) allows the anesthetic solution to be injected directly into the cancellous bone. The anesthetic solution immediately reaches the periapical region, and thus the axonal area of the nerve, where it can temporarily disable the sodium pump. The effect is felt almost without any time delay, and only a small amount of anesthetic solution is required. Methods: This study aims to investigate the efficacy of IO using the AnestoⓇ device after infiltration anesthesia (IA) and/or inferior alveolar nerve block anesthesia (IANB) failed to work in symptomatic irreversible pulpitis (hot tooth). The 33 patients included in the study were treated additionally with 1.7 ml articaine hydrochloride with 1:100,000 epinephrine hydrochloride (UltracainⓇ D-S, Sanofi-Aventis, Frankfurt, Germany) IO. Results: The electrical pulp test showed that 95.76% of the volunteers reacted positively to the combination of IANB or IA with the IO. In women, the additive IO was effective at 97.22%. In men, the IO led to pain elimination in 94.00% of cases. The duration of the IO was less than a quarter of an hour (13.03 min). The IO worked longer in women than in men (13.61 min vs. 12.33 min). Overall, more than every third tooth that needed trepanation was located in the posterior area of the mandible (36.4%). Treatment of hot teeth in this area was associated with an increased pulse rate and increased residual pain. There was a moderate correlation (Spearman-Rho [IRI] = 0.280) between the Visual Analog Scale (VAS) score and bone density, and a significant correlation (IRI = 0.612) between subjective residual pain and bone width. The IO resulted in a moderate, transient increase in the pulse rate by approximately 20 bpm. This is similar to the temporary increase in heart rate after conventional anesthesia techniques in non-preloaded patients and can be considered clinically irrelevant. Conclusion: IO with the AnestoⓇ device as an extension and deepening of local pain elimination is recommended for the treatment of hot teeth.

• 대한소아치과학회지
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• 제28권2호
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• pp.228-237
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• 2001

본 연구의 목적은 와동 충전시 충전재와 치질 사이에 개재되는 상아질 결합제가, 수복물에서 유리되는 불소가 와동 벽으로 침투하는 과정에 어떠한 영향을 주는지를 조사함이었고, 부가적으로 레진 강화형-글라스 아이오노머 시멘트의 접착에도 상아질 결합제를 도포 하는것이 치질과의 결합력을 강화시킬 수 있는지에 대해 평가하고자 하였다. Fuji II $LC^{(R)}$와 Dyract $AP^{(R)}$를 선정하여 상아질 결합제의 도포 여부에 따른 불소 유리량 측정과 전단 결합 강도를 비교분석하였으며, 치질 내로의 불소 침투 양상은 교환 시기에 있는 제2유구치에 Fuji II $LC^{(R)}$와 Dyract $AP^{(R)}$를 충전하고 3주내에 발거하여 EPMA로 분석하였다. 상아질 결합제는 불소 유리량을 현저하게 감소시키는 것으로 나타났으며(p<0.05) Fuji II $LC^{(R)}$의 경우 상아질 결합제의 도포가 결합강도를 증가시키지 못하였다. EPMA 분석결과 상아질 결합제는 충전재로부터 유리되어 나오는 불소가 치질 내로 확산되는 것을 방해하는 것으로 확인되었다.