• Journal of Periodontal and Implant Science
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• v.33 no.4
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• pp.705-715
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• 2003

Procedures for treatment of molar furcation invasion defects range from open flap debridement, apically repositioned flap surgery, hemisection, tunneling or extraction, to regenerative therapies using bone grafting or guided tissue regenerative therapy, or a combination of both. Several clinical evaluations using regenerative techniques have reported the potential for osseous repair of treated furcation invasions. Regenerative treatment of maxillary molars are more difficult due to the multiple root anatomy and multiple furcation entrances therefore, purpose of this study was to evaluated histologically compomer and Ketac Silver as a barrier in the treatment of a bi-furcated maxillary premolar. Five adult beagle dogs were used in this experiment. With intrasulcular and crestal incision, mucoperiostcal flap was elevated. Following decortication with 1/2 high speed round bur, furcation defect was made on maxillary premolar. 2 month later one premolar was filled with compomer and the other premolar was filled with Ketac Silver. After 4, 8 weeks, the animals were sacrificed by vascular perfusion. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. Results were as follows. 1. Compomer & Ketac Silver restoration were encapsulated fine connective tissue. 2. In 4 weeks, compomer & Ketac Silver restoration slightly infiltrated inflammatory cells but not disturb the new bone or new cementum formation. 3. In 8 weeks, compomer & Ketac Silver restoration were less infiltrated iflammatory cell and encapsulated fine connective tissue. 4. Therefore, compomer & Ketac Silver filling to the grade III maxillary furcations with multiple root anatomy and multiple furcation entrances is possible clinical method and this technique is useful method for maxillary furcation involvement but it is thought that periodic maintenance should be needed

• Restorative Dentistry and Endodontics
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• v.23 no.1
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• pp.288-295
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• 1998

The microleakage of direct-access Class 2 restorations was evaluated. Cavities were prepared at mesial and distal proximal enamel surfaces of 20 extracted human molars through buccal window. Prepared cavities were filled with Ketac-Fil, Ketac-Silver, and Fuji II LC, following manufacturer's instructions. 4 specimens of each restorations were made through sectioning 1/4 of bucco-lingual length mesio-distally after thermocycling between $5^{\circ}C$ and $60^{\circ}C$ and imerging 0.5% basic-fuchsin dye solution. Leakage at both occlusal and gingival margin of each specimen was scored 0 to 3 with stereomicroscope. The results were as follows: 1. At occlusal margin, leakage in Ketac-Fil group was more than Ketac-Silver and Fuji II LC group (ANOVA p<0.05) and there was no significant difference between Ketac-Silver and Fuji II LC group(p>0.05), and at gingival margin, there was no significant difference amang materials (p>0.05). 2. Occlusal margin leaked more than gingival margin in Ketac-Silver and Fuji II LC group (t-test p<0.05). 3. Leakage was different according to bucco-lingual location in Ketac-Fil and Fuji II LC group, and lingaul specimen exhibited more leakage(ANOVA p<0.05).

• Restorative Dentistry and Endodontics
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• v.25 no.2
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• pp.159-169
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• 2000

The purpose of this study was to examine the tissue response to experimental furcation perforations immediately treated with Super EBA, Ketac Silver, MTA and Emdogain using surgical microscope. Forty experimental furcation perforations were created in the mandibular and maxillary premolars and molars of 4 adult dogs and immediately repaired with experimental materials. The animals were sacrificed after 16 weeks and radiographic and histologic results were evaluated. The results were as follows. 1 All materials tested in this experiment revealed a certain degree of extrusion of the filling materials and infiltration of inflammatory cells into the periodontal space. Except MTA group, epithelial down-growth of the surrounding gingiva was found in all experimental groups. 2. Both Ketac Silver and Emdogain group showed the greatest degree of inflammatory reaction and bone resorption. 3. Super EBA group showed moderate inflammation and newly bone formation under the perforation area. 4. MTA group showed minor inflammation, new bone regeneration toward restorative materials and partially cementum growth onto the surface of the material. This group demonstrated a favorable prognosis.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.305-324
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• 1997

Numerous materials such as amalgam, IRM, SuperEBA, dessicated ZOE, and Ketac-Silver have been used as a root-end filling material or to repair furcation perforations. But so far no material has been found to satisfy all of the requirements of an ideal restorative material. Recently, mineral trioxide aggregate (MTA) has been suggested for use as a root end filling material and for the repair of furcation perforations. The purpose of this study was to compare the effect of MTA on the proliferation of MC3T3/E1 osteoblastic cell, formation of bone nodule, alkaline phosphatase activity, and finally the tissue reaction of bone with those of amalgam, IRM, SuperEBA, dessicated ZOE, and Ketac-Silver. The following conclusions were drawn within the limits of the experimental results : 1. MTA showed a excellent proliferation of osteoblastic cell and Ketac-Silver showed moderate proliferation of osteoblastic cell. The rest of test materials showed no proliferation of osteoblastic cell. 2. Many of definite bone nodules were found in the MTA group. In contrast, Ketac-Silver group showed no definite bone formation but only showed mild sign of bone formation. 3. Alkaline phosphatase activity of Ketac-Silver and MTA showed similar results. But both of them showed higher activity than that of other materials (p<0.005). 4. The tissue reaction to implanted MTA in the calbarium of mouse was milder than that observed with other materials. The tissue reaction of dessicated ZOE showed the worst results among the test materials.

• Restorative Dentistry and Endodontics
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• v.18 no.1
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• pp.187-196
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• 1993

The purpose of this study was to evaluate the microleakage of retrofilled teeth with various materials [non-zinc Amalgam, IRM, Ketac-silver, CGP(cold-burnished, ultrafil)[and instruments for cavity preparation. Root apex were resected 2mm from apex horizontally and class I cavities were prepared in 2mm denpth, 1.5mm width and were filled with above mentioned materials. Root apex were resected 2mm from apex horizontally and class I cavities were prepared in 2mm depth, 1. 5mm width and were filled with above mentioned materials. 2% methylene blue dye solution was used for 4 days immersion and the linear leakage was measured with calipers and the volumetric leakage was determined with a spectrophotometer. The results were as follows : 1. Amalgam group showed the greatest amount of leakage and Ketac-silver group showed the least value. 2. By linear leakage test, the group retrofilled with Ketac-silver, or CGP showed better seal than the group of Amalgam or IRM. This was shown in both retrograde tip and Conventional method. 3. By volumetric leakage test, the group retrofilled with Ketac-silver showed significantly better seal than the group with IRM in retrograde tip method. 4. By volumetric leakage test, the group retrofilled with Ketac-silver showed significantly better seal than the group with Amalgam in the Conventional method.

• Restorative Dentistry and Endodontics
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• v.18 no.2
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• pp.357-367
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• 1993

The purpose of this study was to evaluate the fracture strength of class II restored premolars with amalgam, posterior composite, amalgam - Ketac silver, resin - Ketac silver restorations at marginal ridge. Fifty extacted maxillary and mandibular premolar teeth that were caries free, fracture free, and restoration free were selected and randomly divided into five groups : Group 1 : 10 intact teeth, Group 2 : 10 teeth with class II cavities and restored with, amalgam, Group 3: 10 teeth with class II cavities and restored with posterior resin, Group 4 : 10 teeth with class II cavities and restored with amalgam - ketac silver, Group 5 : 10 teeth with class II cavities and restored with resin - Ketac silver. All teeth were mounted in base of dental stone within metal rings of 2cm diameter, exposing only the crown portion. Class II mesio - occlusal or disto - occlusal cavities were prepared into specimens of Group 2 through 5 by using a No. 710 fissure bur. The occlusal portion was prepared to a faciolingual width of 1.5mm and a pulpal depth of 1.5mm. The proximal protion was prepared to a faciolingual width of 4mm, a occlusogingival height of 4mm, and a gingival floor of 1.5mm. The teeth in Group 2 and 3 were resotored with silver amalgam apd posterior resin respectively. In Group 4 and 5, proximal portions were first filled with Ketac silver 1.5mm gingivally and remaining cavities were restored with amalgam and posterior resin respectively. All specimens were stored in 100 % relative humidity at $37^{\circ}C$ for 48 hours before testing. All teeth were subjected to a compressive load in a Universal Instron Testing Machine at marginal ridges. The loads required to fracture the restorations were recorded in killograms and the data obtained were subjected to statisticall analysis. The results were all follows : 1. The fracture strength of Group 1 which were unprepared were $100{\pm}10.1\;kg$ and the higher values than Group 2, 3, 4, 5 which were prepared and resotred. 2. In restored groups, Group 2 had the higher fracture strength($81.8{\pm}12.4\;kg$) than other groups and Group 4 had the lowest fracture strength($66.8{\pm}9.2kg$). 3. There were significant differences between fracture strength of between Group 1 and Group 3, 4, 5(P<0.05), but not significant difference between fracture strength of Group 2, 3, 4, 5(P>0.05).

• Restorative Dentistry and Endodontics
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• v.20 no.2
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• pp.610-626
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• 1995

Perforations especially in the furcations during endodontic treatment have notably detrimental effect on prognosis. The purpose of this study was to compare radiographically and histologically the sealing ability and the tissue responses of amalgam, Ketac-Silver, IRM, Vitapex, and mineral trioxide aggregate(MTA) used to repair furcation perforations. Thirty two experimental furcation perforations were created in the mandibular premolars of 6 mongrel dogs and immediately repaired with experimental materials. The animals were sacrificed after 16 weeks and radiographic and histopathologic results were evaluated. The following conclusions were drawn within the limits of the experimental results; 1. All materials tested in this experiment revealed a certain degree of extrusion into the periodontal space. 2. Both amalgam and Ketac-Silver showed the greatest degree of inflammation and bone resorption(p<0.0001). There was no significant difference between the amalgam and Ketac-Silver groups. 3. Both IRM and Vitapex showed a markedly milder degree of inflammatin and less bone resorption than amalgam or ketac-siver(p<0.00005). both IRM and vitapex showed the same respone. 4. MTA showed the least degree of Inflammation and bone resorption(p<0.05). The results of this experiment indicate that among the different materials tested, MTA appeared to be the best material for sealing furcation perforations, although the radiographic and histopathologic differences between the MTA and Vitapex groups were not statistically significant. But further studies with a larger sample are needed to have the exact conclusions.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.746-763
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• 1996

An alternative design to conventional class II cavity preparation for proximal carious lesions is the tunnel preparation. It preserves the marginal ridge intact, thus making it possible to maintain the natural contact relationship with the adjacent tooth and minimize tooth reduction. This in vitro study was purposed to evaluate the effect of the materials' elastic constants and shear-bond strength on the marginal ridge fracture resistance of teeth restored by the tunnel technique, and to find the materials of choice for tunnel restorations. $Resinomer^{(R)}$, $Ketac-silver^{(R)}$, $Miracle-Mix^{(R)}$, and Tytin were used as restorative material. The elastic constants of each restorative material were evaluated by ultrasonic pulse measurement. Young's modulus and bulk modulus of the restorative materials were evaluated in three specimens for each material type. The shear-bond strength of the restorative materials to the dentin surface was measured after thermocycling 400 times between 6 and $60^{\circ}C$, using ten specimens for each material type. For measuring marginal ridge strength, 60 sound extracted molar teeth were distributed into six groups by size. Sound molar teeth were used as a Control group and unfilled prepared teeth were grouped as Unrestored. Another four groups were named Resinomer group, Ketac-Silver group, Miracle Mix group, and Tytin group by type of restorative material. Tunnel cavity preparation was done with ' 1/2, 2, and 4 round burs in sequence. Initial access to proximal surface was made through an occlusal access preparation started at least 2mm from the marginal ridge, and the proximal opening was formed about 2.5mm below the marginal ridge. After restoration and thermocycling, marginal ridge strength was measured using a universal testing machine. The results were as follows: 1. The Young's modulus of $Tytin^{(R)}$ was 63.95 GPa, followed by $Ketac-Silver^{(R)}$ 27.60 GPa, $Miracle-mix^{(R)}$ 18.48 GPa, and $Resinomer^{(R)}$ 10.74 GPa showing significant differences between the groups(P<0.05). The bulk modulus of the materials showed the same order as Young's modulus. The value of $Tytin^{(R)}$ showed 59.57 GPa indicating that it will deform less than other materials under the same stress. It was followed by $Ketac-Silver^{(R)}$ 23.57 GPa, Miracle $Mix^{(R)}$ 12.50 GPa, and $Resinomer^{(R)}$ 11.60 GPa. 2. The Resinomer group had a shear-bond strength of 7.41 MPa which was significantly higher than those of the Ketac-Silver group (1.80 MPa) and the Miracle Mix group (2.84 MPa) (P<0.01). All the specimens of Tytin group detatched from the dentin surface during thermocycling. 3. The mean marginal ridge strength of the Unrestored group(46.14 kgf) was significantly lower than that of the Control group (84.24 kgf) (P<0.01). The marginal ridge strength of teeth restored by the tunnel technique was, in order, Ketac-Silver group 74.06 kgf, Miracle Mix group 73.36 kgf, Resinomer group 63.47 kgf, and Tytin group 58.76 kgf. The Ketac-Silver, Miracle Mix, and Resinomer groups showed no significant difference with the Control group (P>0.05), but the Tytin group showed significantly lower strength compared to the Control group(P<0.05). The results showed that the marginal ridge strength of the teeth restored by the tunnel technique was not significantly lower than that of sound teeth. They also demonstrated that the bonding strength of the restorative material to the tooth surface should be high and the modulus of elasticity should not be lower than that of the tooth in order to restore the marginal ridge strength to its natural condition.

• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.17-32
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• 1995

The purpose of this study was to examine the response of periradicular tissues to amalgam, IRM, Ketac-silver and MTA(Mineral trioxide aggregate) used as a root end fillings. The lower third and fourth premolars of 5 mongrel dogs were used. Each root was resected, followed by root end fillings with experimental materials. The animals were sacrificed after 16 weeks and radiographic and histologic results were evaluated. The results were as follows : 1. Severe inflammation around apex and disruption of cortical were noted in relation to the amalgam. 2. With IRM, there was severe infiltration of inflammatory cells around filling material, but healing of cortical bone was noted. 3. With Ketac-silver, mild inflammation and thick band of fibrous connetive tissue around filling material were seen, with a cortical bone healing. 4. In case of MTA, complete regeneration of cortical bone was seen, and free MTA was surrounded with newly formed bone tissue.

• The Journal of Korean Academy of Prosthodontics
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• v.34 no.1
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• pp.125-142
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• 1996

Bond strength of four different cements to dental casting alloys which were treated with #600 emery, tin-plating, and $50{\mu}m$ sandblasting were evaluated. The alloy specimens were Type III Gold alloy(Degulor C), Palladium-Silver alloy(Pors on 4), Nickel-Chromium(Rexillium III) alloy, which were embedded in acrylic resin disc. The specimens were treated with #600 emery and tin plating, #600 emery and sandblasting, then bonded using Fuji I, Ketac Cem(Glass ionomer cements), Poly F, Livcarbo(Polycarboxylate cements). The specimens were immersed in water for 24 hours and shear bond strengths were evaluated by Instron Machine. Tin plated, sandblasted, and debonded alloy surfaces were observed using scanning electron microscope. On the basis of this study, the following conclusions could be drawn. 1. In the tin plated alloy group, increase in bond strength of glass ionomer cements was statistically insignificant. 2. In the tin plated alloy group, increase in bond strength of polycarboxylate cements was statistically significant, except nickel-chromium alloy. 3. Sandblasted alloy group showed higher bond strength than that of tin-plated alloy group.