• Restorative Dentistry and Endodontics
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• v.10 no.1
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• pp.43-53
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• 1984

The purpose of this study was to suggest the use of laser energy in the the field of operative dentistry without considerable pulpal damage and significant effects on the dental hard tissue, additionally to find out the methods which could control the temperature rise. The laser beam (CW $CO_2$ laser, output: 6W, beam diameter: 1.5mm) was focused on the center of the occlusal surface of extracted lower molars. A Ge lens (focal length 200mm) was used to focus the primary laser beam. In order to vary the total amount of the same irradiated energy, experimental subjects were devided into three groups: continuously irradiated group, intermittently irradiated group, and water-cooled group after continuous laser irradiation. Temperature changes in the pulp chamber after laser irradiation were measured and recorded by the digital thermometer and recorder. The following results were obtained: 1. Temperatures in the pulp chamber were raised up in the order of the continuously irradiated group, intermittently irradiated group, water-cooled group after continuous laser irradiation. 2. In the continuously irradiated group, the temperature was raised up $1.7^{\circ}C$, $3.8^{\circ}C$, $7.3^{\circ}C$, $17.2^{\circ}C$ after 2, 4, 8, 16 seconds of the irradiation of laser. In the intermittently irradiated group, the changes were $1.2^{\circ}C$, $3.4^{\circ}C$, $6.3^{\circ}C$, $11.1^{\circ}C$, respectively. In the water-cooled group after continuous laser irradiation, the changes were $0.0^{\circ}C$, $0.8^{\circ}C$, $1.6^{\circ}C$, $6.9^{\circ}C$, respectively. 3. The starting time of temperature rise in the pulp chamber had no connection with laser irradiation time.

• Restorative Dentistry and Endodontics
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• v.28 no.2
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• pp.178-183
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• 2003

The purpose of this study was to investigate the frequency of 7 putative pathogens in endodontic infections. The specimens were collected from infected pulpal tissue of patients who were referred for root canal treatment to the department of conservative dentistry, Chosun University Samples were collected aseptically using a barbed broach and a paper point. The cut barbed broaches and paper points were transferred to an eppendorf tube containing 500 ml of 1 X PBS. DNAs were extracted from the samples by direct DNA extraction method using lysis buffer (0.5% EDTA, 1% Triton X-100). Identification of 7 putative pathogens was performed by PCR based on 16S rDNA. The target species were as follows : Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Bacteroides forsythus, Actinobacillus actinomycetemcomitans, and Treponema denticola. Our data revealed that the prevalence of P. endodontalis was found in 88.6% (39/54), P. ginivalis 52.3% (23/44), P. nigrescens 18.2% (8/44), P intermedia 15.9% (7/44) B. forsythus 18.2% (8/44), A. actinomycetemcomitans 3.3% (1/44), T. denticola 25% (l1/44) of the samples. The high prevalence of P. endodontalis and P. ginivalis suggests that they may play an important role in the etiology of endodontic infections.

• Restorative Dentistry and Endodontics
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• v.38 no.4
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• pp.258-262
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• 2013

The restorative management of deep carious lesions and the preservation of pulp vitality of immature teeth present real challenges for dental practitioners. New tricalcium silicate cements are of interest in the treatment of such cases. This case describes the immediate management and the follow-up of an extensive carious lesion on an immature second right mandibular premolar. Following anesthesia and rubber dam isolation, the carious lesion was removed and a partial pulpotomy was performed. After obtaining hemostasis, the exposed pulp was covered with a tricalcium silicate cement (Biodentine, Septodont) and a glass ionomer cement (Fuji IX extra, GC Corp.) restoration was placed over the tricalcium silicate cement. A review appointment was arranged after seven days, where the tooth was asymptomatic with the patient reporting no pain during the intervening period. At both 3 and 6 mon follow up, it was noted that the tooth was vital, with normal responses to thermal tests. Radiographic examination of the tooth indicated dentin-bridge formation in the pulp chamber and the continuous root formation. This case report demonstrates a fast tissue response both at the pulpal and root dentin level. The use of tricalcium silicate cement should be considered as a conservative intervention in the treatment of symptomatic immature teeth.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.2
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• pp.69-76
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• 2015

Background: There have been few studies on the effect of an elevated concentration of lidocaine hydrochloride in the surgical removal of an impacted lower third molar. This study aimed to examine the efficacy of 4% lidocaine along with 1:100,000 epinephrine compared to 2% lidocaine along with 1:100,000 epinephrine as inferior alveolar nerve block for the removal of an impacted lower third molar. Methods: This single-blind study involved 31 healthy patients (mean age: 23 y; range: 19-33 y) with symmetrically impacted lower third molars as observed on panoramic radiographs. Volunteers required 2 surgical interventions by the same surgeon with a 3-week washout period. The volunteers were assigned either 4% lidocaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine as local anesthetic during each operation. Results: We recorded the time of administration, need for additional anesthetic administration, total volume of anesthetic used. We found that the patient's preference for either of the 2 types of local anesthetic were significantly different (P < 0.05). However, the extent of pulpal anesthesia, surgical duration, and duration of soft tissue anesthesia were not significantly different. Conclusions: Our study suggested that inferior alveolar nerve block using 4% lidocaine HCl with 1:100,000 epinephrine as a local anesthetic was clinically more effective than that using 2% lidocaine HCl with 1:100,000 epinephrine; the surgical duration was not affected, and no clinically adverse effects were encountered.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.3
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• pp.147-154
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• 2020

Background: Single inferior alveolar nerve block is ineffective in achieving adequate pulpal anesthesia in 30-80% of patients due to anatomical variations, local tissue pH, central sensitization, and several factors. Various supplementary techniques and combination of adjuvants with lignocaine are used to overcome these failures. Magnesium sulfate (MgSO₄), one such adjuvant, acts at the N-methyl-D-aspartate glutamate receptor resulting in effective anesthesia. The aim of this prospective, randomized, double-blind, clinical controlled trial was to evaluate the onset, anesthetic efficacy, duration and post-operative analgesia of 2% lignocaine with and without the addition of MgSO₄ in patients with symptomatic irreversible pulpitis and apical periodontitis. Methods: Fourty-two patients were randomly divided into three groups: 2% lignocaine (group 1) and 2% lignocaine with MgSO₄ (75 mg) and (150 mg) in groups 2 and 3, respectively. Pre-operative vitals and Heft Parker-Visual Analogue Scale (HP-VAS) pain scores were recorded. The onset of anesthesia, anesthetic efficacy, and duration of anesthesia were evaluated post administration of the local anesthetic solution. The post-operative analgesia was examined at intervals of 2, 6, 12, 24, and 48 h. Results: Administration of 150 mg MgSO₄ hastens the onset of anesthesia (1.29 min) and produces better anesthetic efficacy (3.29 HP-VAS) compared to group 2 (2.07 min and 9.14 HP-VAS) and group 1 (3.29 min and 35.79 HP-VAS), respectively. The duration of anesthesia was significantly higher in group 3 (247.07 min) compared to that of groups 2 and 1 (190 min and 110.21 min) with P < 0.05. Conclusion: Combining 75 mg or 150 mg of MgSO₄ with lignocaine is more effective than 2% lignocaine and 75 mg of MgSO₄ is adequate for endodontic procedures.

• Restorative Dentistry and Endodontics
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• v.19 no.1
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• pp.64-72
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• 1994

Zinc Phosphate Cement hand been used for about more than 100 years in luting of cast gold inlay. But many scientists had been trying to develop the new form of luting agent because the ZPC hand shown the lack of adhesiveness on the tooth structure and the toxicity to the pulp tissue. Recently many researches about the surface treatment of the cast body are being done to increase the adhesion of cement to it. The conventional Class I gold inlays were fabricated in the 20 permanent molars. After the internal surface of the cast body was sandblasted with $Al_2O_3$ particles and was tin-plated, the inlays were cemented with adhesive cement [G I cement and resin cement(Super-Bond & $Panavia_{EX}$)] and the evaluation on the adhesion pattern, adhesive strength and the fracture pattern of the adhesive cast gold inlay was compared to that of the cast gold inlay cemented conventionally with ZPC. The results were as follows : 1. The surface roughness of the cast body was increased significantly after sandblasting with the $Al_2O_3$ particles and the tin oxide layer, which was consisted of round particles, came into being. 2. The bond strength was in the order of Super-Bond, ZPC, Fuji I, $Panavia_{EX}$ group. The group cemented with Super-Bond showed statistically greater strength than the other groups(p<0.05). 3. The group cemented with ZPC was fallen apart by principal adhesion failure and that with Fuji I was by complete adhesion failure. But the group with Super-Bond showed pricncipal cohesive failure pattern and in the group with $Panavia_{EX}$, complete cohesive fracture pattern was shown and small protion of tooth structure was fractured out with cast body and the fractured surface showed the figure just as the enamel prism. 4. Various gaps were shown at the pulpal side regardless of little gap at the side walls of the cavity in all groups. Only the Super-Bond was attached to the tooth structure and the other cements were detached from both the tooth and the cast body.

• Restorative Dentistry and Endodontics
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• v.30 no.5
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• pp.409-422
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• 2005

The aim of this study was to identify the bacteria isolated from acute endodontic lesions by cell culture and 16S rDNA sequencing. The necrotic pulpal tissue was collected from 17 infected root canals, which were diagnosed as being either an acute pulpitis or acute periapical abscess. Samples were collected aseptically from the infected pulpal tissue of the infected root canals using a barbed broach and a paper point. The cut barbed broaches and paper points were transferred to an eppendorf tube containing 500 ul of 1 XPBS. The sample solution was briefly mixed and plated onto a BHI-agar plate containing $5\%$ sheep blood. The agar plates were incubated in a $37^{\circ}C$ anaerobic chamber for 7 days. The bacteria growing on the agar plate were identified by 16S rRNA coding gene (rDNA) cloning and sequencing at the species level. Among the 71 colonies grown on the agar plates, 56 strains survived and were identified. In dental caries involving the root canals, Streptococcus spp. were mainly isolated. Actinomyces, Clostridia, Bacteroides and Fusobacteria were isolated in the periapical lesion without dental caries. Interestingly, two new Actinomyces spp. (ChDC B639 and ChDC B631) were isolated in this study. These results showed that there was diversity among the species in endodontic lesions, This suggests that an endodontic infection is a mixed infection with a polymicrobial etiology. These results may offer the bacterial strains for pathogenesis studies related to an endodontic infection.

• Journal of Periodontal and Implant Science
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• v.47 no.3
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• pp.143-153
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• 2017

Purpose: The aim of the present exploratory study was to evaluate extraction socket healing at sites with a history of periodontal and endodontic pathology. Methods: The mandibular 4th premolar teeth in 5 adult beagle dogs served as experimental units. Periodontal and endodontic lesions were induced in 1 premolar site in each animal using wire ligatures and pulpal exposure over 3 months (diseased sites). The contralateral premolar sites served as healthy controls. The mandibular 4th premolar teeth were then extracted with minimal trauma, followed by careful wound debridement. The animals were sacrificed at days 1, 7, 30, 60, and 90 post-extraction for analysis, and the healing patterns at the healthy and diseased extraction sites were compared using radiography, scanning electron microscopy, histology, and histometry. Results: During the first 7 days of healing, a significant presence of inflammatory granulation tissue was noted at the diseased sites (day 1), along with a slightly accelerated rate of fibrin clot resolution on day 7. On day 30, the diseased extraction sites showed a greater percentage of persistent fibrous connective tissue, and an absence of bone marrow formation. In contrast, healthy sites showed initial signs of bone marrow formation on day 30, and subsequently a significantly greater proportion of mature bone marrow formation on both days 60 and 90. Radiographs exhibited sclerotic changes adjoining apical endodontic lesions, with scanning electron microscopy showing collapsed Volkmann canals protruding from these regions in the diseased sites. Furthermore, periodontal ligament fibers exhibited a parallel orientation to the alveolar walls of the diseased sites, in contrast to a perpendicular arrangement in the healthy sites. Conclusions: Within the limitations of this study, it appears that a history of periodontal and endodontic pathology may critically affect bone formation and maturation, leading to delayed and compromised extraction socket healing.

• Restorative Dentistry and Endodontics
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• v.32 no.2
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• pp.95-101
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• 2007

This study was performed to verify the possibility of MTA and calcium sulfate as a pulp capping agent through comparing the dental pulp response in dogs after capping with MTA, calcium sulfate, and calcium hydroxide. 24 teeth of 2 dogs, 8 month old, were used in this study. Under general anesthesia, cervical cavities were prepared and pulp was exposed with sterilized #2 round bur in a high speed handpiece. MTA calcium hydroxide, and calcium sulfate were applied on the exposed pulp. Then the coronal openin,fs were sealed with IRM and light-cured composite. Two months after treatment, the animals were sacrificed. The extracted teeth were fixed in 10% neutral-buffered formalin solution and were decalcified in formic acid-sodium citrate. They were prepared for histological examination in the usual manner. The sections were stained with haematoxylin and eosin. In MTA group, a hard tissue bridges formation and newly formed odontoblasts layer was observed. There was no sign of pulp inflammatory reaction in pulp tissue. In calcium hydroxide group, there was no odontoblast layer below the dentin bridge. In pulpal tissue, chronic inflammatory reaction with variable intensity and extension occurred in all samples. In calcium sulfate group, newly formed odontoblast layer was observed below the bridge. Mild chronic inflammation with a few neutrophil infiltrations was observed on pulp tissue. These results suggest that MTA is more biocompatible on pulp tissue than calcium hydroxide or calcium sulfate.

• Journal of Oral Medicine and Pain
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• v.30 no.3
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• pp.375-381
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• 2005

Er:YAG laser has been considered a promising alternative to dental drill and many researches indicate that adjustment to variable parameters, including water flow rate, pulse energy and pulse repetition rate, can be made to improve ablation ability and efficiency of the laser. Of these parameters, addition of water spray during irradiation has been thought to ablate dental hard tissue more rapidly and safely. The purpose of this study was to investigate tooth ablation amount by Er:YAG laser irradiation as related to varied water flow rates added and, ultimately to find the most effective water flow rate for ablation. In addition, the temperature change of pulp chamber during irradiation was also monitored on the irradiated and opposite pulpal walls, respectively. An Er:YAG laser with contact mode was employed. Extracted human molars were split into two pieces for ablation experiment. Pulse energies of 200 and 300 mJ with a pulse repetition rate of 20 Hz and 5 water flow rates (1.6, 3.0, 5.0, 7.0, and 10.0 ml/min) were applied. Each irradiation was performed for 3 seconds. According to these parameters, experimental groups were divided into 10 subgroups which consisted of 5 specimens. For temperature experiment, another 5 tooth-specimens were prepared in the manner that pulp chamber was open through access cavity preparation and two temperature-measuring probes were placed respectively on the irradiated and the opposite walls of pulp chamber. From the experiment on ablation amount related to different water flow rates, it was shown that the least water flow rate of 1.6 ml/min ablated more than any other water flow rates (p<0.000). When the irradiation for 3 seconds, combined with the pulse repetition time of 20Hz and the water flow rate of 1.6 ml/min was done to tooth specimen, the temperature rise was not noticeable both on the irradiated and the opposite pulpal walls (less than 3$^{\circ}C$) and there was no significant difference in temperature rise between the two pulse energies, 200 and 300 mJ. From the results of this study, it is suggested that tooth ablation with Er:YAG laser can be done effectively and safely at a energy between 200 and 300 mJ/pulse and a pulse repetition rate of 20 Hz when the lasing is conjugated with the water flow rate of 1.6ml/min.