• Restorative Dentistry and Endodontics
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• v.38 no.3
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• pp.128-133
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• 2013

Objectives: This study was performed to evaluate the effect of blood contamination on the compressive strength (CS) of Root MTA (RMTA) modified with Calcium chloride ($CaCl_2$) and Disodium hydrogen phosphate ($Na_2HPO_4$) as setting accelerators over time. Materials and Methods: A total of 110 cylindrical specimens of RMTA were divided into 6 experimental groups as follows: Group1, RMTA; Group 2, RMTA modified with $CaCl_2$ (RMTA-C); Group 3, RMTA modified with $Na_2HPO_4$ (RMTA-N); Group 4, RMTA contaminated with blood; Group 5, RMTA-C contaminated with blood; Group 6, RMTA-N contaminated with blood. The CS of specimens in all groups was evaluated after 3 hr, 24 hr, and 1 wk. In the modified groups (groups 2, 3, 5, and 6) the CS of five specimens per group was also evaluated after 1 hr. Results: Blood contamination significantly reduced the CS of all materials at all time intervals (p < 0.05). After 3 hr, the CS of specimens in the RMTA groups (with and without blood contamination) was significantly lower than those in the RMTA-C and RMTA-N groups (p < 0.05). The CS values were not significantly different at the other time intervals. In all groups, the CS of specimens significantly increased over time (p < 0.05). Conclusions: Blood contamination decreased the CS of both original and accelerated RMTA.

• Restorative Dentistry and Endodontics
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• v.47 no.1
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• pp.2.1-2.11
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• 2022

Objectives: This study investigated the impact of micro-computed tomography (micro-CT)-based voxel size on the analysis of material/dentin interface voids and thickness of different endodontic cements. Materials and Methods: Following root-end resection and apical preparation, maxillary premolars were filled with mineral trioxide aggregate (MTA), Biodentine, and intermediate restorative material (IRM) (n = 24). The samples were scanned using micro-CT (SkyScan 1272; Bruker) and the cement/dentin interface and thickness of materials were evaluated at voxel sizes of 5, 10, and 20 ㎛. Analysis of variance and the Tukey test were conducted, and the degree of agreement between different voxel sizes was evaluated using the Bland and Altman method (p < 0.05). Results: All materials showed an increase in thickness from 5 to 10 and 20 ㎛ (p < 0.05). When evaluating the interface voids, materials were similar at 5 ㎛ (p > 0.05), while at 10 and 20 ㎛ Biodentine showed the lowest percentage of voids (p < 0.05). A decrease in the interface voids was observed for MTA and IRM at 20 ㎛, while Biodentine showed differences among all voxel sizes (p < 0.05). The Bland-Altman plots for comparisons among voxel sizes showed the largest deviations when comparing images between 5 and 20 ㎛. Conclusions: Voxel size had an impact on the micro-CT evaluation of thickness and interface voids of endodontic materials. All cements exhibited an increase in thickness and a decrease in the void percentage as the voxel size increased, especially when evaluating images at 20 ㎛.

• Restorative Dentistry and Endodontics
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• v.46 no.1
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• pp.1.1-1.13
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• 2021

Objectives: The aim of this study was to evaluate the dystrophic mineralization deposits from 3 calcium silicate-based cements (Micro-Mega mineral trioxide aggregate [MM-MTA], Biodentine [BD], and EndoSequence Root Repair Material [ESRRM] putty) over time after subcutaneous implantation into rats. Materials and Methods: Forty-five silicon tubes containing the tested materials and 15 empty tubes (serving as a control group) were subcutaneously implanted into the backs of 15 Wistar rats. At 1, 4, and 8 weeks after implantation, the animals were euthanized (n = 5 animals/group), and the silicon tubes were removed with the surrounding tissues. Histopathological tissue sections were stained with von Kossa stain to assess mineralization. Scanning electron microscopy and energy-dispersive X-ray spectroscopy (SEM/EDX) were also used to assess the chemical components of the surface precipitates deposited on the implant and the pattern of calcium and phosphorus distribution at the material-tissue interface. The calcium-to-phosphorus ratios were compared using the non-parametric Kruskal-Wallis test at a significance level of 5%. Results: The von Kossa staining showed that both BD and ESRRM putty induced mineralization starting at week 1; this mineralization increased further until the end of the study. In contrast, MM-MTA induced dystrophic calcification later, from 4 weeks onward. SEM/EDX showed no statistically significant differences in the calcium- and phosphorus-rich areas among the 3 materials at any time point (p > 0.05). Conclusions: After subcutaneous implantation, biomineralization of the 3-calcium silicate-based cements started early and increased over time, and all 3 tested cements generated calcium- and phosphorus-containing surface precipitates.

• Restorative Dentistry and Endodontics
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• v.27 no.1
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• pp.24-33
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• 2002

Leakage studies have been performed frequently, since a fluid-tight seal provided by various dental fill-ing materials has been considered clinically important. The leakage of the various root-end filling materials has been widely investigated mostly dye penetration method. These dye studies cannot offer any information about the quality of the seal of a test material over a long period of time The purpose of this study was to evaluate the microleakage of root end cavities in blood contamination filed amalgam, intermediate restorative material(IRM), light cured glass ionomer cement(GI) and mineral trioxide aggregate(MTA) by means of a modified fluid transport model. Fifty standard human root sections, each 5mm high and with a central pulp lumen of 3mm in diameter, were and filled with our commonly used or potential root end fill ing materials after they were contaminated with blood. At 24h. 72h, 1, 2, 4, 8, and 12 weeks after filling, leakage along these filling materials was determined under a low pressure of 10KPa(0.1atm) using a fluid transport model. The results were as follows : 1 MTA group showed a tendency of decreasing percent of gross leakage (20m1/day) in process of time, whereas the other materials showed a tendency of increasing in the process time. 2. At the all time interval, GI group leaked significantly less than amalgam group and IRM group (p＜0.05). 3. At the 4 weeks, the percentage of gross leakage in MTA group decreased to 0% thereafter, the low per-centage of gross leakage was maintained in MTA group until the end of the experiment, whereas the percentage in IRM group increased to 100% 4. At the 12 weeks, percentage of gross leakage was significantly low in MTA group(0%), comparison with GI group(40%), amalgam group(90%) and IRM group(100%), but there was no significant difference between latter two materials.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.4
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• pp.455-463
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• 2018

The purpose of this study was to evaluate the effect of the intracanal medicaments on the push-out bond strength of the calcium silicate-based materials. Forty extracted single-root human mandibular premolars were sectioned below cementoenamel junction. Standardized root canal dimension was obtained with a parallel post drill. The specimens were randomly divided into a control group (no medicament), and experimental groups received medicaments with either CH (calcium hydroxide), DAP (double antibiotic paste; a mixture of ciprofloxacin and metronidazole), or TAP (triple antibiotic paste; a mixture of minocycline, ciprofloxacin and metronidazole). Following removal of medicaments with irrigation, roots were cut into sections with 1-mm-thickness. Thereafter, calcium silicate-based materials are applied to the specimens : (i) ProRoot MTA$^{(R)}$ and (ii) Biodentine$^{(R)}$. A push-out bond strength was measured and each specimen was examined to evaluate failure mode. Intracanal medication using CH significantly increased the bond strength to the root dentin. But there are no significant differences on the bond strength of ProRoot MTA$^{(R)}$ or Biodentine$^{(R)}$ among TAP, DAP and control groups. The dislodgement resistance of Biodentine$^{(R)}$ from root dentin was significantly higher than that of ProRoot MTA$^{(R)}$ regardless of the type of intracanal medicaments.

• The Journal of the Korean dental association
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• v.54 no.5
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• pp.365-373
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• 2016

Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

• Imaging Science in Dentistry
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• v.50 no.2
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• pp.161-168
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• 2020

Purpose: The aim of this study was to evaluate the influence of voxel size and different post-processing algorithms on the analysis of dental materials using micro-computed tomography (micro-CT). Materials and Methods: Root-end cavities were prepared in extracted maxillary premolars, filled with mineral trioxide aggregate (MTA), Biodentine, and Intermediate Restorative Material (IRM), and scanned using micro-CT. The volume and porosity of materials were evaluated and compared using voxel sizes of 5, 10, and 20 ㎛, as well as different software tools(post-processing algorithms). The CTAn or MeVisLab/Materialise 3-matic software package was used to perform volume and morphological analyses, and the CTAn or MeVisLab/Amira software was used to evaluate porosity. Data were analyzed using 1-way ANOVA and the Tukey test(P<0.05). Results: Using MeVisLab/Materialise 3-matic, a consistent tendency was observed for volume to increase at larger voxel sizes. CTAn showed higher volumes for MTA and IRM at 20 ㎛. Using CTAn, porosity values decreased as voxel size increased, with statistically significant differences for all materials. MeVisLab/Amira showed a difference for MTA and IRM at 5 ㎛, and for Biodentine at 20 ㎛. Significant differences in volume and porosity were observed in all software packages for Biodentine across all voxel sizes. Conclusion: Some differences in volume and porosity were found according to voxel size, image-processing software, and the radiopacity of the material. Consistent protocols are needed for research evaluating dental materials.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.2
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• pp.120-126
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• 2013

Preserving the pulp is important in the treatment of carious pulp exposure in young permanent teeth. Pulpotomy is a vital pulp therapy in which a portion of the coronal pulp tissue is surgically removed, and the remaining radicular tissue is covered with suitable material that protects the pulp from further injury and permits and promotes healing. It is important to develop biocompatible treatment directed at maintaining pulp vitality and increasing tooth longevity. Platelet-rich fibrin (PRF) has been referred to as a second-generation platelet concentrate. Two clinical cases in which PRF was applied as a medicament after pulpotomy of an immature permanent tooth are presented. After isolation, caries removal and pulpotomy with PRF was performed. A layer of mineral trioxide aggregate (MTA) was placed over the PRF, and the final restoration was performed. Postoperatively, the patient had no pain or discomfort, and follow-up radiographs revealed normal periodontal ligament space and trabecular bone pattern.

• Restorative Dentistry and Endodontics
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• v.43 no.4
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• pp.36.1-36.12
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• 2018

Objectives: Direct pulp capping is a treatment for mechanically exposed pulp in which a biocompatible capping material is used to preserve pulpal vitality. Biocompatibility tests in animal studies have used a variety of experimental protocols, particularly with regard to the exposure site. In this study, pulp exposure on the occlusal and mesial surfaces of molar teeth was investigated in a rat model. Materials and Methods: A total of 58 maxillary first molars of Wistar rats were used. Forty molars were mechanically exposed and randomly assigned according to 3 factors: 1) the exposure site (occlusal or mesial), 2) the pulp-capping material (ProRoot White MTA or Bio-MA), and 3) 2 follow-up periods (1 day or 7 days) (n = 5 each). The pulp of 6 intact molars served as negative controls. The pulp of 12 molars was exposed without a capping material (n = 3 per exposure site for each period) and served as positive controls. Inflammatory cell infiltration and reparative dentin formation were histologically evaluated at 1 and 7 days using grading scores. Results: At 1 day, localized mild inflammation was detected in most teeth in all experimental groups. At 7 days, continuous/discontinuous calcified bridges were formed at exposure sites with no or few inflammatory cells. No significant differences in pulpal response according to the exposure site or calcium-silicate cement were observed. Conclusions: The location of the exposure site had no effect on rat pulpal healing. However, mesial exposures could be performed easily, with more consistent results. The pulpal responses were not significantly different between the 2 capping materials.

• Restorative Dentistry and Endodontics
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• v.44 no.2
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• pp.17.1-17.10
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• 2019

Objectives: Root resorption is an unexpected complication after replantation procedures. Combining anti-osteoclastic medicaments with retrograde root filling materials may avert this resorptive activity. The purpose of this study was to assess effects of a cathepsin K inhibitor with calcium silicate-based cements on osteoclastic activity. Methods: MC3T3-E1 cells were cultured for biocompatibility analyses. RAW 264.7 cells were cultured in the presence of the receptor activator of nuclear factor-kappa B and lipopolysaccharide, followed by treatment with Biodentine (BIOD) or ProRoot MTA with or without medicaments (Odanacatib [ODN], a cathepsin inhibitor and alendronate, a bisphosphonate). After drug treatment, the cell counting kit-8 assay and Alizarin red staining were performed to evaluate biocompatibility in MC3T3-E1 cells. Reverse-transcription polymerase chain reaction, tartrate-resistant acid phosphatase (TRAP) staining and enzyme-linked immunosorbent assays were performed in RAW 264.7 cells to determine the expression levels of inflammatory cytokines, interleukin $(IL)-1{\beta}$, IL-6, tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) and prostaglandin E2 (PGE2). Data were analyzed by one-way analysis of variance and Tukey's post hoc test (p < 0.05). Results: Biocompatibility results showed that there were no significant differences among any of the groups. RAW 264.7 cells treated with BIOD and ODN showed the lowest levels of $TNF-{\alpha}$ and PGE2. Treatments with BIOD + ODN were more potent suppressors of inflammatory cytokine expression (p < 0.05). Conclusion: The cathepsin K inhibitor with calcium silicate-based cement inhibits osteoclastic activity. This may have clinical application in preventing inflammatory root resorption in replanted teeth.