• Restorative Dentistry and Endodontics
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• v.12 no.2
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• pp.101-108
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• 1987

The purpose of this study was to investigate the pulpal responses of dental adhesive resins. A total of 40 cavities of the permanent healthy teeth from 4 dogs were prepared. In the experimental group, the cavities were etched for 1 minute with citric acid and filled with experimental resins (ie. Super-Bond C & B$^{(R)}$). In the control group, the cavities were filled with calcium hydroxide base materials (ie. Dycal$^{(R)}$) without etching. The dogs were sacrificed at one, two, three and four weeks after the time of filling and the specimens were routinely prepared and stained with Hematoxylin-Eosin. The microscopic findings were as follows: Infiltration of inflammatory cells was not observed in both experimental and control groups. Change in the odontoblastic layer was not observed in all control groups but severe swelling was observed in deep dental pulp tissue of the control two and three week cases. Pulp tissue was recovered with plenty of fibrous component in the control four week case and reparative dentin formation was not occurred in all cases. Slight changes of the odontoblastic layer beneath the cavity were observed in the experimental one week case. In experimental two and three week cases, swelling of deep pulp tissue was increased and localized reparative dentin formation was observed. In the experimental four week case, odontoblastic layer was recovered with regular appearance and fibrous component of the pulp was increased, but reparative dentin formation was not evident.

• Restorative Dentistry and Endodontics
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• v.34 no.3
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• pp.169-176
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• 2009

Diabetes Mellitus (DM) is a syndrome accompanied with the abnormal secretion or function of insulin, a hormone that plays a vital role in controlling the blood glucose level (BGL). Type land 2 DM are most common form and the prevalence of the latter is recently increasing, The aim of this article was to assess whet her Type 2 DM could act as a predisposing risk factor on the pulpo-periapical pathogenesis. Previous literature on the pathologic changes of blood vessels in DM was thoroughly reviewed. Furthermore, a histopathologic analysis of artificially-induced periapical specimens obtained from Type 2 diabetic and DM-resistant rats was compared. Histopathologic results demonstrate that the size of periapical bone destruction w as larger and the degree of pulpal inflammation was more severe in diabetic rats, indicating that Type 2 D M itself can be a predisposing risk factor that makes the host more susceptible to pulpal infection. The possible reasons may be that in diabetic state the lumen of pulpal blood vessels are thickened by atheromatous deposits, and microcirculation is hindered, The function of polymorphonuclear leukocyte is also impair ed and the migration of immune cells is blocked, leading to increased chance of pulpal infection. Also, lack of collateral circulation of pulpal blood vessels makes the pulp more susceptible to infection. These decrease the regeneration capacity of pulpal cells or tissues, delaying the healing process, Therefore, when restorative treatment is needed in Type 2 DM patients, dentists should minimize irritation to the pulpal tissue un der control of BGL.

• Journal of the korean academy of Pediatric Dentistry
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• v.8 no.1
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• pp.37-46
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• 1981

This study was undertaken to evaluate the pulpal responses to the pulp-capping materials such as glutaraldehyde and formocresol in pulpotomy technique, especially in the primary dentition. Mandibular primary canines and molars of 5 dogs (aged about 8-9 weeks)were selected for this study. The intervals of observation for histologic study of pulpotomized primary teeth with 2% glutaraldehyde, formocresol and calcium hydroxide in the usual manner ranged from 2 hours, 1 week, 2 weeks, 3 weeks and 5 weeks after experiments respectively. Each specimens were fixed with 10% formalin and decalcified in 5% nitric acid. All slides were stained with Hematorylin-Eosin and examined histopathologically. The results were as follows; 1. In calcium hydroxide groups, formation of dentin bridge was initiated in 1 week after experiments and completed in 5 weeks after experiments. 2. Formation of dentin bridge was not seen, whereas necrosis of pulp tissue was noted, in formocresol and glutaraldehyde groups. 3. Duration of tissue reactions and tissue changes were similar, in formocresol and glutaraldehyde groups. 4. In formocresol and glutaraldehyde groups, amputation surfaces of the pulp were covered with blood clots, beneath which coagulation necrois was noted, but inflammatory cells were not prominent, in 2 hours and 1 week after experiments. But coagulation necrosis was proceeded to the apical portion, accompanied by infiltration of inflammatory cells, since 2 weeks after experiments. And suppuration or gangrene of the pulp tissue were noted in 3 weeks and 5 weeks groups. 5. Suppuration or gangrene of pulp seemed to provoke the resorption of dentin wall, and inflammatory changes and resorption of roots were noted in the periodontal membrane near the periapical region. 6. As compared with calcium hydroxide groups, resorption of the root was pronounced in form or cresol and glutaraldehyde groups. Effects of medicaments to the succedaneous tooth germ were not seen.

• Journal of the korean academy of Pediatric Dentistry
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• v.10 no.1
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• pp.35-45
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• 1983

This study was undertaken to evaluate the pulpal responses to the intermediate restorative materials such as Zinc phosphate cement, Polycarboxylate cement, IRM (zinc oxide eugenol cement), Dycal, Life, Cresatin, and Fluoride in caivties which were cut with high speed instrument. 5 dogs were used as experimental animals and devided into 8 groups. The intervals of observaobservation ranged 3 days, 1, 3, 4, 8 weeks after experiment respectively. The specimens were fixed with 10% formalin and decalcified in 5% nitric acid. All slides were stained with hemtoxylin-eosin and examined histopathologically. The results were as follows: 1. In control group, severe vacuolar degeneration and atrophy of odontoblasts were seen in 3 days, hemorrhage and congestion continued until 8 weeks. Necrosis of odontoblastic layer was seen in zinc phosphate cement group and polycarboxylate cement group. 2. In dycal group, vacuolar degeneration and atrophy of odontoblast were not seen. but in Life group, these were seen in 3 days and partially continued until 3 weeks. In 4 weeks, regeneration of odontoblast was occured. 3. In Crcsatin group, there was no pathosis except odontoblastic displacement. In Fluoride group, vacuolar degeneration of odontoblast was seen and soon disappeared. As compared with control group, pathological change of the pulp tissue in experimental group were decreased after amalgam restoration.

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.1
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• pp.46-54
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• 2019

When inflammatory products are found in both periodontal and pulpal tissues simultaneously, a periodontal-endodontic combined lesion is established. The treatment of periodontal-endodontic combined lesions includes root canal therapy and periodontal regenerative procedure for resolution of both the apical and marginal inflammatory lesions. The present study reports the treatment of periodontal-endodontic combined lesions in the mandibular anterior area with root canal therapy, followed by guided tissue regeneration therapy. Teeth with severe bone destruction in each case could be preserved, without extraction, over a 3-year period. Therefore, it appears that treatment of periodontal-endodontic combined lesions in the mandibular anterior area using guided tissue regeneration technique after root canal therapy may provide clinical advantages.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.310-317
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• 2009

Dens evaginatus is a dental anomaly involving an extra cusp or tubercle that protrudes from the occlusal surface of the affected tooth. The prevalence of dens evaginatus is 1 to 4 percent, and dens evaginatus is observed most commonly in premolars. It can be worn or fractured easily, resulting in pulpal exposure, pulpal infection, loss of vitality, facial infection and osteomyelitis. Since the tooth frequently has the immature apex when the tubercle is fractured, there is difficulty in treatment. Although calcium hydroxide is widely used for pulp treatment of an immature permanent tooth, several alternatives have been suggested to reduce patient's appointments. Mineral trioxide aggregate is considered biocom-patible and has excellent marginal sealing ability. In addition, it can minimize patient's visits. In this case report, apexification with MTA was attempted on the immature premolars in patients with cellulitis patient, caused by pulp necrosis due to dens evaginatus. Favorable clinical and radiologic results were achieved. In one case, continued root formation was observed.

• Restorative Dentistry and Endodontics
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• v.13 no.1
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• pp.7-19
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• 1988

The object of this paper was to investigate the histopatological changes on dog's pulp under cavitation by irradiation of the $CO_2$ laser. The subjects were derived from four dogs, and irradiated 113.23 J/$mm^2$, 283.09 J/$mm^2$, 566.08 J/$mm^2$ in Group I, II, and III respectively. The dogs were sacrificed immediately, 24 hour, 72 hour and 1 week after $CO_2$ laser treatment. For light microscopic examination, routine H-E and PAS stains were employed. For electron microscopic observation, the teeth were fixed in 1% paraformaldehyde and 1% glutaraldehyde, decalcified teeth in 10% EDTA were stained by uranyl acetate and lead citrate. The observation was made with a Hitachi H-500 model electron microscope. The following results were obtained in this study: 1. At the early stage of the experimental sub-groups-immediately, 24 hour, 72 hour samples of Group I, II and III-coagulation necrosis and hyperemia were observed in odontoblastic and subodontoblastic pulpal layer. 2. At the 1 week sub-group of Group I, II, regenerative hyperplasia of the odontoblasts without coagulation necrosis were revealed, in addition to thickened predentin. On he other hand coagulation necrosis and atrophic change accompanying with hyperplasia were found at the 1 week sub-group of Group III. 3. Ultrastructurally, the odontoblasts appeared nuclear degeneration, vacuolar change of cytoplasmic organelles and rupture of plasma membrane at the early stage of the experimental period of all groups. 4. Under spectrohelioscopic examination, regenerative odontobalsts were seen at the 1 week specimens of Group I, II and III. 5. The pulpal response occured at 113-566 J/$mm^2$. The pathologic change of pulp tissue occured at the early experimental period but regeneration of odontoblasts could be seen after 1 week.

• International Journal of Oral Biology
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• v.37 no.2
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• pp.77-83
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• 2012

We investigated the pulpal response to direct pulp capping in rat molar teeth using mineral trioxide aggregate (MTA) and calcium hydroxide (CH). A palatal cavity was prepared in rat maxillary molar teeth. Either MTA or CH was placed on the exposed pulp and all cavities were restored with composite. Rats were sacrificed for histological evaluation after 12 hours and at 2, 7, 14 and 21 days. In both the MTA and CH groups, reparative dentin formation was clearly observed on histology after 14 days. The MTA-capped pulps were found to be mostly free from inflammation, and hard tissue of a tubular consistent barrier was observed. In contrast, in CH-capped teeth, excessive formation of reparative dentin toward residual pulp was evident. The pulpal cell response beneath the reparative dentin layer was examined by immunofluorescence using antibodies against DSP. After 2 days, a few DSP immunopositive cells, most of which showed a cuboidal shape, appeared beneath the predentin layer. At 7 days, DSP-immunopositive cells with columnar odontoblast-like cells were seen beneath the newly formed hard tissues. At 14 and 21 days, DSP was more abundant in the vicinity of the odontoblastic process along the dentinal tubules than in the mineralized reparative dentin. The CH group showed strong expression patterns in terms of DSP immunoreactivity. Our results thus indicate that MTA may be a more effective pulp capping material as it induces the differentiation of odontoblast-like cells and the formation of reparative dentin without the loss of residual pulp functions.

• The Journal of Korean Academy of Prosthodontics
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• v.24 no.1
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• pp.125-138
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• 1986

It is considered that etching solution or material itself of phosphoric ester cement will induce not a little pulpal irritation, if applied directly onto unsealed dentinal tubules. This study was designed to confirm above consideration by comparing two different conditions between $Ca(OH)_2$-based and non-$Ca(OH)_2$-based group. Posterior teeth of 15 male dogs were selected for this experiment. One experimental group was filled with cement after $Ca(OH)_2$-basing and enamel-etching, the other experimental group after enamel etching without $Ca(OH)_2$-basing. And both of two experimental groups were observed at 2 hours, 15 hours, 3 days, 1 week, 2 weeks, 4 weeks, and 6 weeks after filling. The findings reached to the following conclusions histologically. 1. In both groups, the damaged odontoblasts were atrophied and eventually disappeared. 2. In non-based group at early stage, odontoblasts were severely atrophied and defective areas were appeared between odontoblast cell layers. However, in based group, the odontoblasts were arranged slight irregularly. 3. In non-based group, a small number of undifferentiated cells below the odontoblast cell layers started to appear at 1 week after filling. However, in based group, the undifferentiated cells were appeared at 15 hours after filling. 4. In non-based group, formation of reparative dentin was not begun until late stage of experiment. However, in based group, formation of reparative dentin matrix was begun at 2 weeks after filling and very thickened reparative dentin was formed at 6 weeks after filling. 5. In odontoblast cell layers of both groups, dilated capillaries were observed. 6. Argyrophilic fibers were reticularly condensed in zone of Weil, and they were connected to the pulp tissue and dentin.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.4
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• pp.337-344
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• 2021

Background: The primary indication for using long-acting anesthetics in dentistry is extensive dental procedures that require pulpal anesthesia beyond 90 min and management of postoperative pain. Ropivacaine is an amide local anesthetic that is available at various concentrations with inherent vasoconstrictive properties at low concentrations. Ropivacaine has a 75% greater margin of safety than bupivacaine. Ropivacaine can be a good alternative to bupivacaine as a local anesthetic in dental implant surgery as it provides a longer duration of both pulpal and soft tissue anesthesia after mandibular nerve block and lowers CNS and cardiovascular toxicity. This study aimed to evaluate and compare the clinical efficacy of ropivacaine and lignocaine for implant surgery anesthesia. Methods: Fifteen patients with bilateral edentulous sites indicated for implant placement were recruited for this study. Patients aged 20-60 years of both sexes were randomly recruited. Thirty implant placements were performed in the test and control groups using ropivacaine and lignocaine with adrenaline as local anesthetics, respectively. Results: The results were analyzed statistically. The duration of anesthesia was significantly higher in the test group than in the control group. Ropivacaine was found to be superior to lignocaine in terms of the quality of anesthesia. The comparison of mean visual analog scale scores showed ropivacaine to have better anesthetic and analgesic effects than the control group. Conclusion: Ropivacaine 0.75% provides a significantly longer duration of anesthesia than lignocaine 2% with adrenaline. Ropivacaine 0.75% decreased intraoperative and postoperative analgesia compared to lignocaine 2% with adrenaline. Hence, ropivacaine 0.75% can be used as an alternative to lignocaine in implant surgeries and other intraoral surgical procedures that require a longer duration of anesthesia and analgesia.