• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.1
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• pp.31-38
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• 2024

Dens in dente is a developmental anomaly resulting from infolding of the enamel organ into dental papilla prior to calcification of dental tissue. The pulpal tissue of the tooth can be vulnerable for bacterial invasion through direct exposure to the oral cavity or through defective enamel and dentin of the infolding part, thereby increasing the possibility of pulpal necrosis and subsequent apical periodontitis. Treatment planning of teeth with dens invaginatus may be difficult due to the complex root canal morphology. Therefore, thorough knowledge of anatomical variations of dens invaginatus is of great importance for proper treatment planning. The focus of this case report is on Oehler's type II and III dens invaginatus. The infolding of type III dens invaginatus extends beyond the crown and CEJ. Bacterial invasion through the infolding can easily cause inflammation of the pulpal and periradicular tissue. This case report presents endodontic treatment of type II and III dens invaginatus with the aid of CBCT.

• Restorative Dentistry and Endodontics
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• v.29 no.5
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• pp.479-484
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• 2004

Immunoinhibitory protein extracted from sonicated Treponema denticola have been shown to suppress cell cycle progression of human lymphocytes. To study in detail about the effect of this microorganism on the function of lymphocytes. we investigated the levels of Interleukin-2 (IL-2) and Interleukin-4 (IL-4) production by T lymphocytes before and after the addition of $12.5{\;}\mu\textrm{g}/ml$ T. denticola sonicated extracts. In this study. levels of IL-2 and IL-4 produced from T cells pretreated with sonicated extracts were evaluated by using the quantitative sandwich enzyme immunoassay technique. In response to phytohemagglutinin (PHA) stimulation. T cell produced increased levels of IL-2 and IL-4. However. the expressions of both cytokines were significantly inhibited when PHA activated-T cells were pre-exposed to sonicated T. denticola extracts (p < 0.05). These findings suggest that the T. denticola sonicated extracts induced-immunosuppression in Th1 and Th2 cell functions could be a part of the pathogenic mechanism of the endodontic failure associated with this microorganism.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.1
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• pp.37-44
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• 2013

Sodium hypochlorite and ethylene diamine tetra acetic acid are substances usually used during endodontic treatment. Several studies found that the bonding was negated with certain irrigants and some of the used irrigants have demineralizing and chealating effects, so it was advocated to omit the etching step in etch and rinse adhesive systems. The purpose of this in vitro study was to evaluate the influence of NaOCl & EDTA on the bonding strength of ethanol wet bonding. Thirty human molars were selected and mesiodistally sectioned into halves, thus providing sixty specimens. The specimens were randomly assigned to 4 groups(n=15) according to the irrigant regimen used : (1) irrigated with distilled water for 10min (control); (2) irrigated with 5.25% NaOCl(10min), flushed with 5.25% NaOCl(1min) (3) irrigated with 5.25% NaOCl, flushed with 17% EDTA (4) irrigated with 5.25% NaOCl, flushed with 17% EDTA. Each group was acid-etched with 37% phosphoric acid(except group 4) and had their dentin surfaces dehydrated with ethanol solutions : 50%, 70%, 80%, 95%, 3x100%, 30s for each application. After dehydration, a primer( 50% all bond 3 resin + 50% ethanol) was used, followed by the adhesive(ALL-BOND 3 RESIN) application. Resin composite build-ups were then prepared using an incremental technique. Specimens were sectioned into beams and submitted to a tensile load using a Micro Tensile Tester(Bisco Inc.). The data were statistically analyzed using one-way ANOVA and Tukey HSD at p<0.5 level. There was no significant difference on G1(control) and G2(irrigated with NaOCl only ). (p>0.05). G3(flushed with EDTA) showed significantly high tensile bonding strength compared to the G2 (p<0.05). G4( treated with EDTA but no acid-etching) was significantly lower value than G3. (p<0.05) Although there was no significant difference, 5.25% NaOCl seemed to have an adverse effect on the bonding strength of ethanol wet bonding. The flushing with EDTA after NaOCl irrigation prevents the decrease of bonding strength. The use of 17% EDTA as a final flush can enhance the bonding strength but EDTA flushing can't substitute for a acid-etching.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.327-336
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• 2011

Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.

• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.537-549
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• 1998

The purpose of this study was to evaluate the influence of root resection and retrograde cavity preparation methods on the apical leakage in endodontic surgery. To investigate the effect of various root resection and retrograde cavity preparation methods on the apical leakage, 71 roots of extracted human maxillary anterior teeth and 44 mesiobuccal roots of extracted human maxillary first molars were used. Root canals of the all the specimens were prepared with step-back technique and filled with gutta-percha by lateral condensation method. Three millimeters of each root was resected at a 45 degree angle or perpendicular to the long axis of the tooth according to the groups. Retrograde cavities were prepared with ultrasonic instruments or a slow-speed round bur, and occlusal access cavities were filled with zinc oxide eugenol cement. Three coats of clear nail polish were placed on the lateral and coronal surfaces of the specimens except the apical cut one millimeter. All the specimens were immerged in 2% methylene blue solution for 7 days in an incubator at $37^{\circ}C$. The teeth were dissolved in 14 ml of 35% nitric acid solution and the dye present within the root canal system was returned to solution. The leakage of dye was quantitatively measured via spectrophotometric method. The obtained data were analysed statistically using two-way ANOVA and Duncans Multiple Range Test. The results were as follows: 1. No statistically significant difference was observed between ultrasonic retrograde cavity preparation method and slow-speed round bur technique, without apical bevel (p>0.05). 2. Ultrasonic retrograde preparation method showed significantly less apical leakage than slow-speed round bur technique, with bevel (p<0.0001). 3. No statistically significant difference was found between beveled resected root surface and non-beveled resected root surface, with ultrasonic technique (p>0.05). 4. Non-beveled resected root surface showed significantly less apical leakage than beveled resected root surface, with slow-speed round bur technique (p<0.0001). 5. No statistically significant difference in apical leakage was found between the group of retrograde cavity prepared parallel to the long axis of the tooth and the group of one prepared perpendicular to the long axis of the tooth (p>0.05). 6. Regarding isthmus preparation, ultrasonic retrograde preparation method showed significantly less apical leakage than slow-speed round bur technique, in the mesiobuccal root of maxillary molar, without bevel (p<0.0001).

• Journal of Oral Medicine and Pain
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• v.34 no.1
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• pp.1-9
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• 2009

Liver transplantation is definitive treatment for the patients suffering from hepatitis, severe liver cirrhosis and liver cancer. In these patients, systemic infections under immunosuppression may occur easily. Therefore, primary object of dental treatments before liver transplantation is absolute removal of oral infection source. In addition, comprehensive dental management plan is essential for success of liver transplantation. The present study has been performed to investigate decayed, missing and filled permanent teeth index(DMFT index), degree of oral hygiene, past medical history, need of dental treatment, completion of dental treatment need and time interval between dental visit and operation date of liver transplantation in liver transplant candidates. Obtained results were as follows; 1. Decayed teeth of the patients were 2.68, missing teeth were 4.02 and filled teeth were 3.42. DMFT index was 10.12. 2. Twenty percents of patients showed moderate to severe food impactions, 42.2% of patients had moderate to heavy calculus and 37.8% of patients displayed gingival inflammation with swelling. 3. Patients needed periodontal treatments more than any other dental treatments. Periodontal treatments were needed for 88.9% of patients, operative & endodontic treatments were 46.7% of patients and 33.3% of patients needed for oral & maxillofacial surgical treatments. 4. Among 90 patients, time interval between scheduled operation date of liver transplantation and dental visit was within 2 weeks for 32.2% of patients, within 1 week for 20.0% of patients. In conclusion, most liver transplant candidates needed dental treatments for removal of potential infection sources. However because of insufficient interval between dental visit and operation date, they had taken liver transplantation procedures without comprehensive dental management. Development of preventive and comprehensive dental management program is mandatory for these patients. Cooperative interdisciplinary management will play a positive role for successful liver transplantation.

• Journal of Dental Rehabilitation and Applied Science
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• v.16 no.1
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• pp.51-60
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• 2000

The purpose of this study was to compare the microleakage at the interface of cast post and tooth according to the type of cement. Forty anterior teeth with single root were used. The teeth were cut 2 mm coronal from the cementoeamel junction and chamfer finish line was made on 1 mm coronal from the cementoeamel junction. After the routine endodontic treatment, post space was prepared using #5.5 Parapost drill to a depth of 7 mm. After the pick up impression, core building was made to 3 mm of clinical crown with burnout wax, then post and core was cast with nonprecious metal. The teeth were divided into four groups of ten each. In Group I, post and core were cemented with Fleck's(Zinc phosphate cement) In Group II, post and core were cemented with Fuji I(Glass ionomer cement) In Group III, post and core were cemented with Superbond C & B(Composite resin cement) In Group IV, post and core were cemented with Panavia 21(Composite resin cement) All cemented teeth were stored in normal saline at $37^{\circ}C$ for 7 days and thermocycled from $5^{\circ}C$ to $55^{\circ}C$ for 500 cycles with a dwell time of 30 seconds. After thermocycling, teeth were immersed in 1% Basic fuchsin dye for 48 hours. All 40 teeth were then embedded in the epoxy resin and cut buccolingually with a cutting instrument. The degree of penetration of dye at interface was graded on a scale of 0 to 4 using a stereomicroscope at 25 to 40 times magnification. Through the findings of this study, the following conclusion were obtained. 1. All the groups showed the microleakage at the interface of cast post core and tooth. 2. Group I showed the highest microleakage score among the groups with a significant difference(p<0.05). 3. Group II showed higher microleakage score than Group III and Group IV with a significant difference(p<0.05). 4. Group IV showed the lowest microleakage score but there were no significant difference with Group III(p>0.05).

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.2
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• pp.139-155
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• 2009

Objective : To assess the biological stability of immediate transmucosal placement of tapered implants into tooth extraction sockets. Material and methods : Following tooth extraction, tapered implants were immediately placed into the sockets. Teeth with evidence of acute periapical pathology were excluded. After implant placement, sutured allowing a non-submerged, transmucosal healing. Standardized radiographs were obtained every visiting from baseline to 32 weeks after implant placment. Changes in depth of the distance from the implant shoulder (IS) and from the alveolar crest (AC) to the bottom of the defect (BD) were assessed. Results : Thirteen patients (10 males and 3 females) were enrolled and followed. They contributed with 15 tapered implants. extraction iste displayed sufficient residual bone volume to allow primary stability of all implants. The mean surgery time was $41{\pm}10.0$ mins. All implants healed uneventfully yielding a survival rate of 100%. Mean ISQ values were relatively stable. Interproximal crestal bone decreased $1.69{\pm}1.2mm$ (mesial), $1.65{\pm}1.2mm$ (distal) from baseline to 32-week follow-up. No statistically significant changes with respect to FMPS, FMBS, PPD and width of KG were observed. Conclusions: Immediate transmucosal implant placement represented a predictable treatment option for the replacement of teeth lost due to reasons including fractures, endodontic failures and caries.

• Restorative Dentistry and Endodontics
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• v.32 no.6
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• pp.530-541
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• 2007

Currently, various Nickel-Titanium rotary files are used in endodontic treatment, but there is no one perfect system that can be applied to any clinical situation. Therefore, the combined uses of various file systems which can emphasize the advantages of each system are introduced as hybrid instrumentation. The ProTaper system is efficient in body shaping and apical pre-enlargement but is reported to have more possibility of transportation and produce more aberrations and deformation in more or less severe curved canals. Recently, new ProTaper system(ProTaper Universal) with different configuration and cross-sectional design to overcome the week points of ProTaper have been marketed. The purpose of this study was to compare and evaluate the shaping abilities of ProTaper, ProTaper Universal system, and two hybrid methods using S-series of ProTaper Universal and Hero Shaper or ProFile. The time lapses for instrumentation were measured and the used files were inspected for distortion. The pre- and post-instrumented root canals were scanned and superimposed to evaluate the aberrations and reduction of root canal curvature and change of radius of canal curvature. The increased canal width and apical centering ratio were calculated at 1, 2, 3, 4 and 5 mm levels from apical foramen. Under the conditions of this study, the ProTaper Universal seems to have better shaping ability than ProTaper in terms of instrumented width and instrumentation time. It may be suggested that the ProTaper Universal system is efficient as much as hybrid instrumentation using ProTaper and other constant-tapered NiTi file systems in highly experienced operators.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.2
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• pp.207-218
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• 2001

The purpose of this study was to investigate the direct inhibitory effect of calcium hydroxide materials on differentiation and activation of osteoclast. we used the osteoclast progenitor cells isolated from bone marrow cell of chick embryo tibia and four experimental materials [$Ca(OH)_2$ powder, Metapaste$^{(R)}$, Vitapex$^{(R)}$, Pulpdent$^{(R)}$] diluted at 0.1, 0.01, $0.05{\mu}g/ml$. There were measured both the number of differentiated osteoclast and the area of resorption lacunae. Also, we conducted MTT assay on U2OS osteoblast to examine of cytotoxic effect and obtained following result. 1. Considering the result of the inhibitory effects upon osteoclast differentiation, There were shown a significant difference increased in the following order: Metapaste$^{(R)}$, $Ca(OH)_2$ powder, Vitapex$^{(R)}$. But no significant difference was found in pulpdent group that the number of differentiated osteoclast was increased at all concentrations(p<0.05). 2. Among the three experimental groups, that is, $Ca(OH)_2$ powder, Metapaste$^{(R)}$, Vitapex$^{(R)}$ at $0.1{\mu}g/ml$ dilution that were statistically significant in reduction of the number of differentiated osteoclast. Vitapex group showed significant cytotoxic effect compared to control and another two groups exhibited no significant difference. Also, 0.2% DMSO group was shown statistically siginificant cytotoxicity (p<0.05). 3. Examining pattern and measured area of resorption lacunae in the control and the three experimental groups ,that is, $Ca(OH)_2$ powder, Metapaste$^{(R)}$, Vitapex$^{(R)}$ at $0.1{\mu}g/ml$ dilution, except $Ca(OH)_2$ powder group, statistically significant differences were found between experimental groups and control group. Also, DMSO group showed statistically significant decrease (p<0.05). From these results, we think that calcium hydroxide is responsible for suppression of hard tissue resorption by a direct inhibition of dfferentiation and activation of osteoclast.