To investigate the depth of the root concavity and root surface area of the maxillary first premolar, 40 maxillary first premolars were used. All the teeth which extracted because of advanced periodontal disease and orthodontic treatment procedure, were sectioned every 1.5mm from cementoenameljunction to the apex with hard tissue microtome. Each sectioned root was taken photograph with slide film, and projected for measuring with a calibrated digital Curvi-Meter. The root surface area, percentage of the RSA and the linear variation of the RSA were calibrated for each 1.5mm section. Linear variation of the depth of root concavity was measured on mesial and distal root surface for each section using computer-aided digitizer. The results were as follows. 1. The total mean root length of maxillary first premolar was 13.48mm. Mean buccal root length of 2-rooted tooth was 12.59mm, mean palatal root length was 12.73mm, and mean root length of single rooted tooth was 13.78mm. 2. The total mean root surface area of maxillary first premolar was $194.17mm^2$, mean root surface area for 2-rooted tooth was $205.97mm^2$ and mean root surface area for single rooted tooth was $188.49mm^2$. 3. It was 59.93% of the total root surface area that the area from CEJ to coronal 6mm. And, the coronal half of the root length accounted for approximately 71.76% of the total root surface area. 4. Most deepest concavity of the mesial root surface was 0.65mm at apical 3.0mm, 4.5mm level in maxillary first premolar. And, that of the distal root surface was 0.37mm at apical 4.5mm level. 5. All of the maxillary first premolar had mesial root surface concavity. This mesial root surface concavity appeared to be more pronounced in 2-rooted tooth than single rooted tooth.
The thirty six mandibular second molars, which were extracted because of hopeless tooth due to advanced periodontal disease, were measured the length of mesial and distal root and the distance from cementoenamel junction to root separation. The molars were cross-sectioned every 1.5 milimeter from cementoenamel junction to root apex perpendicular to long axis and each section was photographed, projected and measured with a calibrated Digital Curvi-Meter(Com Curvi-8. Japan). The root surface area (RSA), percentage of the RSA and the linear variation of the RSA were calibrated for each 1. 5 mm section. The results were as follows. 1. The mean length of the roots was 12. 98mm for mesial root, 11.84 mm for distal root. The mesial root was longer than distal root.(p<0.01) 2. The mean distance from the cementoenamel junction to the point at which the root separate from the root trunk was 3.82mm for the buccal furcation and 4.75mm for lingual furcation. The buccal root separation was coronal than the lingual root separation.(p<0.01) 3. The total root surface area was $317.78mm^2$. 4. The mean surface area of the root trunk was $150.06mm^2$ and averaged 42.54% of the total root surface area. 5. The mean root surface area was $88.79\;mm^2$ for the mesial root, $78.93mm^2$ for distal root, The mesial root surface area was wider than the distal root surface area.(p<0.05) 6. In comparision, the mean root trunk surface area of the mandibular 2nd molar was wider than that of mandibular 1st molar(p<0.01), but each root of 2nd molar was smaller than that of 1st molar(p<0.01).
A Scanning Electron Microscopic Study of the root surface changes was carried out in advanced periodontal disease. The results obtained were summerized as follow; 1. The root surface of cementoenamel junction of healthy root showed smooth surface, while the root surface of diseased state showed covering of deposits which regareded as a course of calcification. 2. At the mid-portion of the root, the regular cemental projection were observed on the healthy root surface and on the root surface of diseased state, cemental projection showed relatively irregular pattern. 3. On the root surface which consist of wall of periodontal pocket, there were various deposits which could be considered as subgingival calculus, bacterial plaque and epithelial attachment remnant. 4. The bottom area of the pathologic pocket, tearing altered collagen fibers were seen on the root surface. 5. At the apical portion of root surface, calcified fibers ran parallel to the root surface in healthy tooth and the fiber bundles of periodontal ligament were seen in the diseased state.
This study was performed to evaluate the usability of Er:YAG laser for periodontal therapy. Forty dental root slabs ($5{\times}5{\times}2mm^3$) were prepared from human periodontally diseased extracted teeth and grouped into 4 groups: 1) control (root planing only), 2) root planing and irradiated with laser at 30mJ, 3) root planing and irradiated with laser at 60mJ, and 4) root planing and irradiated with laser at 100mJ. The root slabs were embedded in resin block before laser treatment. Er:YAG laser was irradiated under water irrigation with the tip held perpendicular to the root surface in contact mode. After Er:YAG laser irradiation or planing on the root surface, morphological changes have been observed under SEM, and the micro-hardness and Ca/P ratio were compared. 1. In the Control group, the root surface showed the directional change caused by root planing instrumentation, and the presence of smear layer, and no exposure of dentinal tubule was observed. Laser irradiated group showed surface changes with rough dentin surface of niche and depression and dentinal tubule exposure by the elimination of smear layer. 2. The micro-hardness of root surface in the laser irradiated group was higher than the control group. The higher energy output was applied, the higher micro-hardness on root surface was resulted. 3. The higher energy output was applied, the higher Ca/P ratio was observed. The higher Ca/P ratio in 60mJ group and 100mJ group was statistically significantly compared to the control group and the 30mJ group. These results suggest that Er:YAG laser irradiation on the periodontally diseased root surface could remove smear layer and increase the micro-hardness on root surface and Ca/P ratio which contribute to enhance the acid resistance of periodontally treated root surface.
It is known that growth factors function as potent biologic mediators regulating numerous activities of wound healing via cell proliferation, migration and extracellular matrix formation and they also promote periodontal regeneration. But, method of growth factor application is controversial yet. So purpose of this study is to evaluate the effect of demineralized root surface as one of method of growth factor application. The ginigival fibroblasts were primary cultured and fifth or sixth subpassages were used in these experiments. In first experiment, root surface blocks demineralized with 100mg/ml tetracycline for 5 minutes and pH 1 citric acid for 3 minutes(experimental groups) and nonteminerilized root surface blocks (control groups) were placed in 100ng/ml PDGF-BB for 5 minutes. Then the cells were seeded on each root surface blocks and cultured for 6, 24, 48, 72 hours. In second experiment, root surface blocks deminerilized with tetracycline and citric acid and nondemineralized root surface blocks were placed in 200ng/ml PDGF-BB for 5 minutes and another non-demineralized root surfcae blocks were placed in DMEM without PDGF-BB. At 1, 2, 4, 6, 8 days, the cells were seeded in 24-well plate and using of each eluent, cultured for 72 hours. The results of the four determinants were presented as mean and S.D.. The results were as follows : The attachment and proliferation of human gingival fibroblast on root surface were more increased when PDGF-BB was applicated on root surfrace demineralized with tetracycline or citric acid than non-demineralized root surface. And, in comparision tetracycline with citric acid, there were more attachment and proliferation of human gingival fibroblast on root surface demineralized with tetracycline than citric acid, and proliferation of human gingival fibroblast on demineralized root surface was increased time dependently 1 day to 3 days. In second experiment using eluent, proliferation of human gingival fibroblast was more increased to 6 days when human gingival fibroblast was cultured in eluent that PDGF-BB was applicated on demineralized root surface than two control groups, and degree of proliferation was decreased time dependently 1 day to 6 days. Proliferation of human gingival fibroblast cultured in eluent without PDGF-BB was constant 1 day to 6 days. After 6 days, degree of proliferation of human gingival fibroblast was similar in four groups. This means that release duration of PDGF-BB from demineralized root surface is 6 days. And in comparision tetracycline with citric acid, there was more proliferation of human gingival fibroblast in tetracycline-treated group than citric acid. In conclusion, demineralized root surface as primary site for PDGF-BB application, especially demineralized with tetracycline has important roles in attachment and proliferation of human gingival fibroblast, and may be useful clinical applications in periodontal regenerative procedures.
Adequate root preparation in the treatment of periodontal disease often involves mechanical instrumentation to remove plaque, calculus perhaps contaminated cementum. Although meticulous scaling and root planing may remove some cementum, the use of aggressive root planing to remove cementum does not appear warranted. So ultrasonic device and rotary instrument appear to be replacing hand instrument. But it is not clear those instruments make smooth root surface as hand instrument. The roghness of the root surface were evaluate with SEM following instrumentation with Gracey curette, Perio Clean and piezo ultrasonic device(Setlec) with various tip. 20 extracted teeth were used in vitro experiment, and 9 teeth of a patient destined for extraction for periodontal reasons were utilized in vivo experiment. It was demonstrated that hand curette created the smoothest surface, while diamond tip tended to roughen the root surface. But the hand curette, Perio Clean, and piezo ultasonic device with scaler tip tend to remove cementum completely. Piezo ultrasonic device with curette-like tip made the desirable smooth surface with partial removal of cementum.
The purpose of this study was to compare effects of demineralization of citric acid and tetracycline HCI on periodontally involved root surface. Twelve periodontally involved single rooted teeth were used. After scaling and root planing, root conditioning with citric acid and tetracycline HCI were carried and the teeth were processed scanning electron microscopic observation.The results were as follows: The scaled root surface was covered by much debris and calculus. The effect of demineralization of citric acid and tetracycline HCI was more reduced on scaling group than root planing group, because of hypermineralization of cementum surface and demineralization effect on root surface of tetracycline HCI showed tendency to reduction. The root planed group displayed more smooth root surface than scaling group, the surface was covered by smear layer, thus no exposure of dentinal tubule opening and collagen fiber, especially after root planing, citric acid and tetracycline HCl treated group showed exposure of dentinal tubule and collagen fiber, thus it was thought that new connective tissue attachment could be acquired.
Objectives: To examine the surface topography of intact WaveOne (WO; Dentsply Sirona Endodontics) and WaveOne Gold (WOG; Dentsply Sirona Endodontics) nickel-titanium rotary files and to evaluate the presence of alterations to the surface topography after root canal preparations of severely curved root canals in molar teeth. Materials and Methods: Forty-eight severely curved canals of extracted molar teeth were divided into 2 groups (n = 24/each group). In group 1, the canals were prepared using WO and in group 2, the canals were prepared using WOG files. After the preparation of 3 root canals, instruments were subjected to atomic force microscopy analysis. Average roughness and root mean square values were chosen to investigate the surface features of endodontic files. The data was analyzed using one-way analysis of variance and post hoc Tamhane's tests at 5% significant level. Results: The surface roughness values of WO and WOG files significantly changed after use in root canals (p < 0.05). The used WOG files exhibited higher surface roughness change when compared with the used WO files (p < 0.05). Conclusions: Using WO and WOG Primary files in 3 root canals affected the surface topography of the files. After being used in root canals, the WOG files showed a higher level of surface porosity value than the WO files.
Since pathologic changes of exposed root surface inhibit cell attachment and new attachment of connective tissue have been made, many efforts were apply to change the exposed root surface condition. Scaling and root planing can not remove the endotoxin completely and forms the smear layer which prohibits the new attachment of connective tissue. Therefore, many kinds of chemicals were used for controlling the pathologic change of the root surface. The purposes of this study was to compare and observe the changes of the exposed root surface treated by scaling and root planning, Tetracycline HCl and Argon Laser. After the scaling and root planning of ten extracted premolars, the differences & the root surface among groups were observed under SEM. Control group showed smear layer and irregular amorphous surface. The dentinal tubule was not exposed. The debris and scale like texture were also observed. Tetracycline HCl treated group showed relatively smooth surface and the collagen fiber was observed in the dentinal tubule. Argon Laser treated group showed the most effective results under the conditions of 0.8 to 1.0w irradiation for 0.5 to 1.0 sec with pulse wave. The results of this study showed that the root surface change was associated with the intensity and the duration of Argon Laser irradiation. Further investigation for the surface change with the Argon Laser irradiation is recommended for understanding of clinical effect.
A primary goal of periodontal therapy is the creation of root surfaces that are free of plaque and calculus. It is not yet to be determined whether it is desirable to have a smooth root surface after treatment. It is also not clear what degree of roughness result from different instruments. In the present study various instruments for root surface debridement were evaluated. 20 extracted teeth were utilized, and the teeth were treated with one of the following instrument: Gracey curette, Perio Clean, and piezo ultrasonic device(Setlec, P Max) with general scaler tip, curette-like tip, and diamond tip. 3 dimensional planimetric device(Accura) was used to evaluate the average surface roughness. It was demonstrated hand and power-driven instruments did not have a significant difference in roughness of the root surface following instrumentation. And ultrasonic scaler tip tended to make a most smooth surface than other instruments. The possible reasons of the result were discussed.
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