Root conditioning has introduced to dissolve the smear layer and to produce surface demineralization, resulting to exposure of dentin collagen fibril and opening of dentinal tubules. The purpose of the present study was to examine the effect of different concentration and application time of tetracycline-HCL on root conditioning. Total 40 root specimen were prepared from 20 periodontitis-prone human single rooted tooth. The specimen were treated with tetracycline-HCL solution(20mg/ml, 50mg/ml, 100mg/ml)for 20 sec, 3 min, 5 min., and saline for 30 sec. The application method was rubbing method with cotton pellet. Under the scanning electron microscopy(20KV), the extent of smear removal and opening of the dentinal tubules were examined at x 3000. The following results were obtained. 1. Treatment of root specimen with saline did not remove the smear layer and open the dentinal tubules. 2. Treatment of root specimen with different concentration of tetracycline-HCL for 20 sec also did not remove the smear layer completely. 3. Treatment of root specimen with different concentration of tetracycline-HCL for 3 min opened the dentinal tubules and removed smear layer. 4. Treatment of root specimen with 50mg/ml of tetracycline-HCL for 3 min showed collagen fibril within the opened dentinal tubules. In conclusion, the effect of root conditioning with tetracycline-HCL is more dependent on the application time than the application concentration. Root conditioning with 50mg/ml tetracycline-HCL for 3 min is enough for obtaining the periodontal regeneration.
Objectives: This study evaluated the penetration depth of 2% chlorhexidine digluconate (CHX) into root dentinal tubules and the influence of passive ultrasonic irrigation (PUI) using a confocal laser scanning microscope (CLSM). Materials and Methods: Twenty freshly extracted anterior teeth were decoronated and instrumented using Mtwo rotary files up to size 40, 4% taper. The samples were randomly divided into two groups (n = 10), that is, conventional syringe irrigation (CSI) and PUI. CHX was mixed with Rhodamine B dye and was used as the final irrigant. The teeth were sectioned at coronal, middle and apical levels and viewed under CLSM to record the penetration depth of CHX. The data were statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests. Results: The mean penetration depths of 2% CHX in coronal, middle and apical thirds were $138{\mu}m$, $80{\mu}m$ and $44{\mu}m$ in CSI group, respectively, whereas the mean penetration depths were $209{\mu}m$, $138{\mu}m$ and $72{\mu}m$ respectively in PUI group. Statistically significant difference was present between CSI group and PUI group at all three levels (p < 0.01 for coronal third and p < 0.001 for middle and apical thirds). On intragroup analysis, both groups showed statistically significant difference among three levels (p < 0.001). Conclusions: Penetration depth of 2% CHX into root dentinal tubules is deeper in coronal third when compared to middle and apical third. PUI aided in deeper penetration of 2% CHX into dentinal tubules when compared to conventional syringe irrigation at all three levels.
Exposure of the root surface due to gingival recession after periodontal surgery, elicit pain response when exposed to mechanical, heat, chemical or osmotic irritation. Especially patients treated with periodontal surgery, show high frequency. There have been reports that the 1 out of 7 patients complains of dentinal hypersensitivity. There have been many studies on the clinical effects of various materials on the treatment of dentinal hypersensitivity. The purposes of this study were to evaluate the effect of sodium chloride and potassium oxalate and to observe the relationship between the dentinal hypersensitivity and surface characteristics such as dentinal tubule size and number. This study included 20 teeth which were scheduled for extraction and had no pulpal disease. These teeth were divided into Root planing group, EDTA group, NaCl group and Oxalate group. Dentinal hypersensitivity is measured by tactile, pressured air and cold water using NRS (Numerical Rating Scales). Teeth were extracted under local anesthesia and each specimen was sectioned to a size about 3 X 5 mm and was examined under the scanning electron microscope (X2,000) The results were as follows, 1. The EDTA group exhibited significantly increased dentinal hypersensitivity comparing with the other groups. 2. The NaCl and Oxalate groups showed significantly reduced dentinal hypersensitivity comparing with the EDTA group. 3. As a method for dentinal hypersensitivity measurement, it was presumed thet tactile sensitivity test was not sensitive method but air blast test and cold water test were adequate method. 4. In a SEM study, the root planing group exhibited amorphous smear layer and showed no dentinal tubule orifice, but the EDTA group showed the large number of dentinal tubules. On the other hand, the NaCl and Oxalate groups did not show exposed dentinal tubules. The NaCl group showed more rough root surface than the EDTA group, and the Oxalate group showed many participates to be presumed as calcium oxalate particle. As the results from this study, root planing couldn't expose the dentinal tubule and NaCl and potassium oxalate occluded exposed dentinal tubule effectively. Dentinal hypersensitivity has close relationship with the exposure of dentinal tubules, especially with it's size and number.
The purpose of this study was to evaluate the effect of the Nd : YAG laser on the tooth hypersensitivity by the observation of the morphological changes of the dentinal surface irradiated with Nd : YAG laser by use of SEM. In 40 mandibular and maxillary molars without any carious lesion or restoration, severe attrition and abrasion, Enamel was removed with fine grit diamond bur and exposed dentinal surfaces were polished with Soflex discs. In control group (10 teeth), exposed dentinal surfaces were acid-etched with 10 % Maleic acid for 15 seconds. In the experimental group 1 (10 teeth), acid-etched dentinal surfaces with 10% Maleic acid were prepared by Nd : YAG laser (6 watts power, 1 psi water, 18 psi air) for 2 minutes. In the experimental group 2 (10 teeth), exposed dentinal surfaces were irradiated with Nd: YAG laser (10 watts power, 3 psi water, 10 psi air) until the painted black stains on the dentinal surfaces were completely removed. In the experimental group 3 (10 teeth). dentinal surfaces were prepared with Nd : YAG laser (6 watts power, 1 psi water, 18 psi air) until the painted black stanins on them were completely removed and then the irradiated dentinal surfaces were acid-etched with 10 % Maleic acid for 15 seconds. The specimens were routinely processed and observed with scanning electron microscope. The results were as follows : 1. In the irradiated dentinal surfaces, the characteristics of the melting and recrystalization on the dentinal surfaces were observed. Compared with the results in the control group, we could observe that in the irradiated dentinal surfaces, the aperture of the dentinal tubules were reduced and there were more debris obstructing the dentinal tubules. 2. In the irradiated dentinal surfaces, crater structures were commonly present and in the crater bottoms, there were a lot of bead like melted dentin structures, which had the ruptured opening in the center of them. 3. The melted dentins and cracks in the smear layer were less frequently observed in the irradiated dentinal surfaces using copious cooling water than in the irradiated dentinal surfaces using scare cooling water.
To determine the factors which affect the flow of dentinal fluid through cat dentinal tubules in vivo, the flow of fluid was measured by observing the movement of the fat droplets of dilute milk in a glass capillary with a microscope connected to the monitor. After measuring the exposed area of dentin, hydraulic conductances of dentin were calculated. The mean pressure which stoped the outward flow of dentinal fluid was 9.5mmHg. The hydraulic conductance of dentin under the condition of pulp exposed was increased by 21 % from that under the condition of dentin exposed. Under the conditions of pulp cut and pulp removed, the hydraulic conductances of dentin were increased by 22 % and 31 % respectively from that under the condition of dentin exposed. These results show that the direction and rate of dentinal fluid flow in cat dentin is affected mainly by the hydrostatic pressure of interstitial fluid of pulp tissue in the state of low compliance. Both of the osmotic effect produced by the protein constituents of interstitial fluid across the odontoblast tell layer and the change of interstitial fluid pressure produced by the state of the microcirculation of the pulp also affect the direction and rate of dentinal fluid in some degree.
The aim of this study was to evaluate the changes in dentinal permeability after application of dentin desensitizer on exposed dentin immediately after ultrasonic scaling to teeth with non-carious cervical lesions. Thirty caries-free extracted molars were fixed to slide glasses after horizontally being sectioned at 5 mm below the cemento- enamel junction (CEJ). The prepared specimen was connected to a fluid flow measuring device (nano-Flow), and a V-shaped cavity was formed at the CEJ to imitate the non-carious cervical lesion. After no fluid leakage was confirmed in the connected system with specimen, tooth surface was treated ultrasonic cleaning with piezoelectric ultrasonic scalers until dentinal tubules were exposed. And 6 different desensitizers were applied on exposed dentin. Real-time measurements of dentinal fluid flow were performed during ultrasonic scaling and application of dentin desensitizer. To evaluate the occlusion of exposed dentinal tubules, tooth surface was examined by SEM. Following results were observed. After ultrasonic scaling, more dentinal tubules were exposed on the tooth with non-carious cervical lesions compared to tooth without lesions. The rate of fluid flow measured with nano-Flow system had correlation with the degree of dentin occlusion observed with SEM after application of desensitizers on exposed dentin. Desensitizers with glutaraldehyde and HEMA did not decrease the rate of fluid flow and did not show dentin occlusion. Desensitizers with oxalate showed the limited effects on the rate of fluid flow and dentinal tubule occlusion. Desensitizer with resin monomer showed the significant effect on the rate of fluid flow and dentin occlusion.
A number of investigations have shown that the presence of bacteria is prerequisite for developing pulpal and/or periradicular pathosis. Depending on the stage of pulpal pathosis, various species of bacteria can be cultured from infected root canals. Kakehashi et al. showed that exposure of pulpal tissue in germ-free rats was characterized by minimal inflammation and dentinal bridging while exposure of pulpal tissue in conventional rats with normal oral flora was characterized by pulpal necrosis, chronic inflammation, and periapical lesions. Currently used methods of cleaning and shaping, especially rotary instrumentation techniques, produce a smear layer that covers root canal walls and the openings to the dentinal tubules. The smear layer contains inorganic and organic substances that include fragments of odontoblastic processes, microorganisms, their by products and necrotic materials. Because of its potential contamination and adverse effect on the outcome of root canal therapy, it seems reasonable to suggest removal of the smear layer for disinfection of the entire root canal system. Presence of this smear layer prevents penetration of intracanal medications into the irregularities of the root canal system and the dentinal tubules and also prevents complete adaptation of obturation materials to the prepared root canal surfaces. Removal of the smear layer by an intracanal irrigant and placement of an antibacterial agent in direct contact with the content of dentinal tubules should allow disinfection of this complex system and better outcome for the root canal therapy. A new solution, which was a mixture of a tetracycline, an acid, and a detergent(MTAD), was developed in the Department of Endodontics, Dental School. Lorna Linda University, USA. It has been demonstrated that MTAD was an effective solution for the removal of the smear layer and does not significantly change the structure of the dentinal tubules when used as a final irrigant in conjunction with 1 % NaOCl as a root canal irrigant. Studies are in progress to compare the anti- microbial properties of this newly developed solution with those of sodium hypochlorite and EDTA that are currently used to irrigate the root canals and remove the smear layer from the surfaces of instrumented root canals.canals.
If root and resection is done during surgical endodontic treatment, newly exposed dentinal tubules form pathways between the canal and the peripheral tissue. Nd : YAG laser was used to block this phenomenon, and its effect was studied with dye penetration and SEM techniques. 40 intact single rooted teeth were divided into 4 groups(10 each) : control group and test groups, in which retrograde cavity surface, cutting surface, retrograde cavity surface & cutting surface were treated with laser(1 watt 15pps) and finally retrograde filling with IRM was conducted. After that, they were stained with 2 % methylene blue, sectioned and evaluated by the maximum infiltration depth. And to observe surface change, they were prepared for SEM. The results were as follows ; 1. All experimental groups showed microleakage with variation in amount. 2. The 2nd group which treated both the retrograde cavity and cutting surface showed significantly less microleakage than the other groups(p<0.05). There was no significant difference between groups treated on one side only. 3. As a result of SEM observation of dentin surface, obstruction of dentinal tubules with marble shaped granules, which were different from normal dentin could be seen. Cracks could be seen also. 4. In summary of this experiment, it is thought that effort to obstruct the exposed dentinal tubules as well as retrograde cavity after root end resection is needed.
In order to know the effect of dentin bonding agents on the restoration of cervical abrasion, Scotchbond Multipurpose Single Bond and Clearfil Liner Bond 2 were used in 51 teeth with abrasion lesion and normal teeth. The surface structure and dentinal tubules of acid etched dentin and resin replica were examined using scanning electron microscopy. The interfacial morphology between dentin and adhesives was investigated by confocal laser scanning microscopy. Following results were obtained. 1. The hybrid layer and resin tag of the dentin showing cross-sectional surface of dentinal tubules are thicker and longer than those of dentin showing oblique surface of dentinal tubules. 2. The sclerotic cast was frequently observed in dentinal tubule, and the cast looked like cuboidal or rhomboidal-shaped crystals clumped from outer side to inner side. 3. The formation of hybrid layer and resin tag was the most prominent in Scotchbond Multipurpose group, whereas Clearfil Liner Bond 2 group showed very poor formation. The formation of hybrid layer and resin tag in Single Bond group was less than Scotchbond Multipurpose group.
Recently, there have been attempts to obstruct the dentinal tubules and remove the smear layer by way of laser irradiation in the root canal during endodontic treatment. This treatment was designed to make the root canal to be nonporous. Using 33 extracted single rooted teeth, 30 teeth were divided into 3 groups (10 each), and 3 teeth were used as samples for SEM. Using Nd : YAG laser, the control group was not irradiated, experimental group l(1W group) was irradiated with 1W, 15pps, 15sec., 3 times, 6.7mJ and experimental group 2(3W group) was irradiated with 3W, 15pps, 15sec., 3 times 20mJ. Thereafter the roots were immersed in methylene blue for 8 hours, and the dye infiltration pattern was observed under stereomicroscope and canal wall surface change was observed under SEM. The results are as following ; 1. As a result of evaluating the dye infiltration rate of the apical and middle 1/3, there was significant difference between control group and 1W group, control group and 3W group and there was no significant difference between 1 W group and 3W group. 2. In each group, as a result of comparing the dye infiltration rate of the apical and middle 1/3, there was no significant difference in control and 1W group but significant difference in 3W group. 3. In the control group smear layer was scarecely found and many dentinal tubules were found to be open. 4. In the 1W group, the number of dentinal tubules were decreased and gradual changes of the dentin surface could be seen and 3W group, almost no dentinal tubules could be found and the dentin surface was changed a little more and showed signs of partial fusion.
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