• Restorative Dentistry and Endodontics
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• 제44권3호
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• pp.27.1-27.12
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• 2019

This case report describes a technique in which endodontic treatment and permanent indirect restoration were completed in the same clinical appointment with the aid of a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Two patients were diagnosed with irreversible pulpitis of the mandibular first molar. After access preparation, root canals were located, irrigation was performed until bleeding ceased, and the coronal tooth structure was prepared for indirect restoration. Then, utilizing an interim 3-mm build-up of the endodontic access cavity, a hemi-arch digital scan was performed with an intraoral scanner. Subsequent to digital scanning, restoration design was performed simultaneously with the endodontic procedure. The root canals were shaped using the Race system under irrigation with 2.5% sodium hypochlorite followed by root canal filling. The pulp chamber was subsequently filled with a 3-mm-thick composite resin restoration mimicking the interim build-up previously utilized to facilitate block milling in the CAD/CAM system. Clinical try-in of the permanent onlay restoration was followed by acid etching, application of a 5th generation adhesive, and cementation of the indirect restoration. Once the restoration was cemented, rubber dam isolation was removed, followed by occlusal adjustment and polishing. After 2 years of follow-up, the restorations were esthetically and functionally satisfactory, without complications.

• Restorative Dentistry and Endodontics
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• 제43권4호
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• pp.42.1-42.7
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• 2018

Objectives: The purpose of this study was to investigate the C-shaped root canal anatomy of mandibular second molars in a Korean population. Materials and Methods: A total of 542 teeth were evaluated using cone-beam computed tomography (CBCT). The canal shapes were classified according to a modified version of Melton's method at the level where the pulp chamber floor became discernible. Results: Of the 542 mandibular second molars, 215 (39.8%) had C-shaped canals, 330 (53%) had 3 canals, 17 (3.3%) had 2 canals, 12 (2.2%) had 4 canals, and 8 (1.7%) had 1 canal. The prevalence of C-shaped canals was 47.8% in females and 28.4% in males. Seventy-seven percent of the C-shaped canals showed a bilateral appearance. The prevalence of C-shaped canals showed no difference according to age or tooth position. Most teeth with a C-shaped canal system presented Melton's type II (45.6%) and type III (32.1%) configurations. Conclusions: There was a high prevalence of C-shaped canals in the mandibular second molars of the Korean population studied. CBCT is expected to be useful for endodontic diagnosis and treatment planning of mandibular second molars.

• Restorative Dentistry and Endodontics
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• 제44권1호
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• pp.10.1-10.11
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• 2019

Objectives: The objective of this study was to assess coronal discoloration induced by the following intracanal medicaments: calcium hydroxide (CH), a mixture of CH paste and chlorhexidine gel (CH/CHX), and triple antibiotic paste (3Mix). Materials and Methods: Seventy extracted single-canal teeth were selected. Access cavities were prepared and each canal was instrumented with a rotary ProTaper system. The specimens were randomly assigned to CH, CH/CHX, and 3Mix paste experimental groups (n = 20 each) or a control group (n = 10). Each experimental group was randomly divided into 2 subgroups (A and B). In subgroup A, medicaments were only applied to the root canals, while in subgroup B, the root canals were completely filled with medicaments and a cotton pellet dipped in medicament was also placed in the pulp chamber. Spectrophotometric readings were obtained from the mid-buccal surface of the tooth crowns immediately after placing the medicaments (T1) and at 1 week (T2), 1 month (T3), and 3 months (T4) after filling. The ${\Delta}E$ was then calculated. Data were analyzed using 2-way analysis of variance (ANOVA), 3-way ANOVA, and the $Scheff{\acute{e}}$ post hoc test. Results: The greatest color change (${\Delta}E$) was observed at 3 months (p < 0.0001) and in 3Mix subgroup B (p = 0.0057). No significant color change occurred in the CH (p = 0.7865) or CH/CHX (p = 0.1367) groups over time, but the 3Mix group showed a significant ${\Delta}E$ (p = 0.0164). Conclusion: Intracanal medicaments may induce tooth discoloration. Use of 3Mix must be short and it must be carefully applied only to the root canals; the access cavity should be thoroughly cleaned afterwards.

• Journal of Korean Dental Science
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• 제13권2호
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• pp.52-58
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• 2020

Purpose: Using two types of electronic apex locators, this study aimed to investigate the differences in accuracy according to the evaluator and equipment. Materials and Methods: Artificial teeth of the lower first premolars and two mandibular acrylic models (A and B) were used in this study. In the artificial teeth, the pulp chamber was opened and the access cavity was prepared. Using calibrated digital Vernier calipers, the distance from the top of the cavity and the root apex was measured to assess the actual distance between two artificial teeth. The evaluation was conducted by 20 dentists, and each evaluator repeated measurements for each electronic apex locator five times. The difference between the actual distance from the top of the cavity to the root apex and the distance measured using electronic measuring equipment was compared. For statistical analysis, the Friedman test the Mann-Whitney U-test were conducted and the differences between groups were analyzed (α=0.05). Result: As for the accuracy of measurement according to the two types of electronic apex locators, the value of the measurement error was 0.4753 mm in Dentaport ZX and 0.3321 mm in E-Cube Plus. Moreover, electronic apex locators Dentaport ZX and E-Cube Plus showed statistically significant differences (P<0.05). As for the difference in the accuracy of the two types of electronic apex locators according to the evaluator, the resulting values differed depending on the evaluator and showed a statistically significant difference (P<0.001). Conclusion: Electronic apex locator E-Cube Plus showed higher accuracy than did Dentaport ZX. Nevertheless, both types of electronic apex locators showed 100% accuracy in finding the region within root apex ±0.5 mm zone. Furthermore, according to the evaluator, the two electronic apex locators showed different resulting values.

• Restorative Dentistry and Endodontics
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• 제47권1호
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• pp.4.1-4.13
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• 2022

Objectives: This study evaluated the effects of different smear layer preparations on the dentin permeability and microtensile bond strength (µTBS) of 2 self-etching adhesives (Clearfil SE Bond [CSE] and Clearfil Tri-S Bond Universal [CTS]) under dynamic pulpal pressure. Materials and Methods: Human third molars were cut into crown segments. The dentin surfaces were prepared using 4 armamentaria: 600-grit SiC paper, coarse diamond burs, superfine diamond burs, and carbide burs. The pulp chamber of each crown segment was connected to a dynamic intra-pulpal pressure simulation apparatus, and the permeability test was done under a pressure of 15 cmH₂O. The relative permeability (%P) was evaluated on the smear layer-covered and bonded dentin surfaces. The teeth were bonded to either of the adhesives under pulpal pressure simulation, and cut into sticks after 24 hours water storage for the µTBS test. The resin-dentin interface and nanoleakage observations were performed using a scanning electron microscope. Statistical comparisons were done using analysis of variance and post hoc tests. Results: Only the method of surface preparation had a significant effect on permeability (p < 0.05). The smear layers created by the carbide and superfine diamond burs yielded the lowest permeability. CSE demonstrated a higher µTBS, with these values in the superfine diamond and carbide bur groups being the highest. Microscopic evaluation of the resin-dentin interface revealed nanoleakage in the coarse diamond bur and SiC paper groups for both adhesives. Conclusions: Superfine diamond and carbide burs can be recommended for dentin preparation with the use of 2-step CSE.

• Restorative Dentistry and Endodontics
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• 제47권1호
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• pp.7.1-7.14
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• 2022

Objectives: This study evaluated the bleaching efficacy of different in-office protocols associated with violet light emitting diode (V-LED), and measured the pulpal temperature rise caused by V-LED with or without gel application. Materials and Methods: Bovine incisors were distributed in 4 groups (n = 10): VL - V-LED; HP - 35% hydrogen peroxide (control); HYB - hybrid protocol, V-LED applied without gel for 10 irradiation cycles followed by V-LED applied with gel for another 10 irradiation cycles; and HPVL - gel and V-LED applied for 20 irradiation cycles. Three bleaching sessions were performed with 7-day intervals. Bleaching efficacy was evaluated with ΔE_ab^*, ΔE₀₀ and ΔWI_D. Data were recorded at baseline, 7, 14, 21 and 70 days. For pulpal temperature rise, thermocouples were placed inside the pulp chamber of human incisors. To determine intrapulpal temperature, the teeth were irradiated with V-LED with or without application of bleaching gel. Color difference data were analyzed by 2-way repeated measures ANOVA and Tukey's test. Pulpal temperature was analyzed by t-test (α = 5%). Results: VL exhibited lower color (ΔE_ab^* and ΔE₀₀) and whiteness changes (ΔWI_D) than the other groups. HPVL presented higher color change values than HYB. HYB and HPVL showed not different ΔWI_D values; and HP showed the highest whiteness changes at all times. There were significant differences comparing ΔT with gel (8.9℃) and without gel application (7.2℃). Conclusions: HPLV was more efficient than HYB. The 2 protocols with VL showed similar results to control. Gel application combined with VL promoted higher pulpal temperature than to the no gel group.

• 대한치과교정학회지
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• 제39권4호
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• pp.213-224
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• 2009

본 연구에서는 세라믹 브라켓 제거에 Er:YAG 레이저 조사가 도움이 되는지 알아보고, 브라켓 제거에 적합한 레이저 조사 방법을 연구하였으며, 또 이렇게 적용된 레이저가 치수와 법랑질에 손상을 주는지도 알아보았다. 총 190개의 치아, 단결정 세라믹 브라켓(MISO), 다결정 세라믹 브라켓(Transcend series 6000)과 KEY Laser3를 사용하였다. 실험군은 세라믹 브라켓의 종류(단결정, 다결정)와 레이저의 에너지(140, 300, 450, 600 mJ)에 따라 분류하였으며, 레이저를 브라켓당 두 곳에 1펄스씩 조사하고, 전단 강도를 측정하였다. 대조군은 레이저를 조사하지 않는 군으로 하였다. 레이저 조사에 의한 열 효과는 브라켓 하방 법랑질과 치수강에서 측정하였으며, 전단 강도 측정 후 치면에 남아있는 접착제의 양을 접착제 잔류 지수(adhesive remnant index)를 이용하여 평가하였다. 레이저 조사로 인한 접착제의 파괴 양상과 법랑질 표면 변화를 주사전자현미경으로 관찰하였다. 모든 세라믹 브라켓군에서 레이저 에너지가 증가할수록 전단 강도는 유의하게 감소하였다. 또한, 브라켓 하방 법랑질에서 최대 온도 변화는 평균 $3.78^{\circ}C$ 상승에 그쳤으며, 치수강에서 최대 온도 변화는 평균 $0.9^{\circ}C$ 상승에 그쳤다. 주사전자현미경을 이용한 법랑질과 접착제 단면 관찰에서 접착제 표면이 레이저에 의해 붕괴되어 분화구 모양의 구덩이로 관찰되었으며, 일부 시편에서 약 $10\;-\;30{\mu}m$의 법랑질 손상이 발견되었다. Transbond XT로 부착된 단결정 도재 브라켓(MISO)의 디본딩에 Er:YAG 레이저를 이용할 경우, 300 - 450 mJ의 레이저 에너지를, 그리고 다결정 도재 브라켓(Transcend series 6000)의 경우는 450 mJ 정도의 에너지를 사용하는 것이 효과적이고 안전할 것으로 생각된다.

• 대한소아치과학회지
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• 제29권2호
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• pp.139-145
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• 2002

유치에서는 영구치에 비해 법랑질의 두께가 얇고 약하며 상대적으로 큰 치수강으로 인하여 단시간에 치아우식증이 치수까지 이환되며, 외상 또는 치과치료 중 갑작스런 움직임으로 인하여 치수가 노출되는 경우가 빈번하다. 이러한 이유로 어린이에서의 치수처치는 필수적이며, 유치에서 치수치료의 목적은 감염된 치수조직을 제거하여 동통을 완화시키는 것 이외에도 크게는 치열궁을 보존하여 저작기능을 보호하고, 미래의 영구치열이 적절한 교합관계를 이루게 하는데 있다. 유치열에서 성공적인 치수치료를 위해서는 유치 치수의 형태, 유치 근관의 해부학적 형태, 치근형성, 그리고 유치 치근의 흡수와 관련된 특별한 문제점들에 대한 이해를 필요로 한다. 상악 대구치와 마찬가지로 상악 유구치의 근심 치근이 형태에 있어서 가장 큰 변이를 보인다고 알려져 있으며, 이 치근 내에 존재하는 모든 근관을 처치하지 못한다면 결국 치수치료는 실패할 것이다. 본 증례는 근관치료 중이거나 후에 지속적인 동통이나 근관 내 출혈이 지속되는 경우에서 상악 유구치의 근심협측치근의 제 2근심협측근관을 발견하고 처치한 후 임상증상 및 동통이 사라지고, 양호한 예후를 보였다. 또한 발거된 상악 유구치를 대상으로 한 조사 결과 상악 제 1유구치는 35개 증 8개(22.8%), 상악 제 2유구치는 33개 중 22개(66.6%)의 치아에서 제 2근심협측근관이 발견되었으며. 이는 상악 유구치의 근심협측치근 내에 두 개의 근관이 존재할 가능성이 높다는 것을 의미한다.

• Restorative Dentistry and Endodontics
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• 제21권1호
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• pp.1-18
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• 1996

There are many advantages when using IIF and DNA probe methods over anaerobic culture method in that they are time-and effort-saving, more precise and more sensitive. Furthermore, in IIF and DNA probe methods, the detection is possible only with small amount of bacteria, the quantitative analysis is possible, and the cell viability is not necessary. The purpose of this study is to observe the incidence of P.endodontalis by carrying out anaerobic culture, IIF and colony lift using DNA probe method respectively, and to compare these 3 methods in terms of effectiveness and sensitivity in order to identify the most effective detection method. 30 teeth with at least one clinical symptoms, with single canal, and with pulp necrosis were sampled. For sampling bacteria, access cavity was prepared after disinfecting tooth and its surroundings. Then the paper point was inserted up to the periapical area, leave there for a while, and finally it was placed into PRAS Ringer's sol. and PBS sol. In anaerobic culture method, P.endodontalis was identified by biochemical tests after subculturing black and brown colonies which were produced after 7 days of incubation on BAP and Brucella BAP in anaerobic chamber. To identify P.endodontalis in IIF method, species-specific polyclonal rabbit-antisera of P.endodontalis(ATCC 35406) was reacted with sampled PBS sol. dispensed onto glass slide, and then P.endodontalis was examined by phase contrast microscopy after incubating with Goat anti-rabbit lgG conjugated to Fluorescein isothiocyanate. For colony lift using DNA probe method, membranes were laid over colonies on the surface of BAP and were hybridized with cloned DNA probe of P.endodontalis. The existence of P.endodontalis was then identified by the methods of chemiluminescent detection and color metric detection. Black colony was found in 11 teeth out of 30 teeth and P.endodontalis was detected in 6 teeth (20 %) by anaerobic culture method, 16 teeth (53 %) by IIF method, and 7 teeth (23 %) by DNA probe method. IIF method is significantly better in detecting P.endodontalis than DNA probe method and anaerobic culture method. There was no significant differences between DNA probe method and anaerobic culture method. There was significant correlation between the formation of black colony and the existence of P.endodontalis. The probability of detecting P.endodontalis when black colony being present is 2.89 times higher than when not being present. There was significant relationship between the foul odor of clinical symptoms and P.endodontalis. The sensitivity of existing P.endodontalis when foul odor being present was 93.75 %, while the specificity of not existing P.endodontalis when foul odor not being present was 28.57 %. These results suggested that the probes of P.endodontalis will be used to decide the method and prognosis in endodontic treatments.

• Restorative Dentistry and Endodontics
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• 제24권1호
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• pp.147-155
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• 1999

The purpose of this study was to investigate the effect of phosphoric acid concentration on the movement of 2-hydroxyethylmethacrylate(HEMA) from bonding resin - resin composite combination through dentin in vitro. Freshly extracted human third molar teeth were divided into four groups each of 10 teeth. A closed chamber with 1 ml distilled water was attached to the CEJ of each tooth. An occlusal cavity of 4mm diameter & remaining dentin thickness of 1.0-1.5mm was prepared in each tooth. Dentin was treated with 10% phosphoric acid gel for 15 seconds. 32% phosphoric acid gel for 15 seconds, or with 35% phosphoric acid gel for 15 seconds. A control group not treated with acid gel was also prepared. The cavities were rinsed, dried and then treated with the HEMA-containing All-Bond 2 primer & bonding resin which was light-cured for 10 seconds. The cavities were then restored with Z100 composite resin(shade:A3.5:3M Dent. Prod. USA) & light cured for 30 seconds. Water samples were retrieved from the chambers over a time course (4.32, 14.4, 43.2, 144 & 432 minutes ; 1, 3 & 10 days) and analyzed by high performance liquid chromatography. The results were as follows. 1. HEMA was detected in the pulp chambers of all teeth from 4.32 minutes after resin placement The highest rate of release was in the first sample period (0-4.32 min) & rate of release declined exponentially thereafter. 2. No significant differences were found for mean release rate for HEMA over a time course among the four groups (p>0.05). 3. The diffusion rate was significantly (p<0.05) less for 10% phosphoric acid gel than 32% phosphoric acid gel at the second sample period(4.32-14.4 min). 4. No significant differences were found for cumulative HEMA diffusion among the four groups at 10 days(p>0.05) and mean total(cumulative) release at 10 days for all groups was in the 9 - 16 nmol range. 5. The cumulative release was significantly (p<0.05) less for 10% phosphoric acid gel than 32% phophoric acid gel at the third(14.4-43.2 min) & fourth(43.2-144 min) sample period.