• Restorative Dentistry and Endodontics
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• 제25권1호
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• pp.116-122
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• 2000

On the instrumented root canal wall, amorphous, irregular smear layer can be observed with Scanning Electron Microscope(SEM). The purpose of this study was to evaluate the effect of the presence or absence of smear layer on the adhesion of Staphylococcus aureus to the dentin of the root canal. Human incisors, extracted within 7 days, with no caries, no fracture, no calcification of canal, were selected. After cutting crown portion at cemento-enamel junction, root canal preparation was done by modified crown-down technique using Profile and Gates - Glidden Drill. During canal preparation, 10ml physiologic saline solution(group1&3) or 10ml 3.5% NaOCl(group2&4) was used as irrigation solution. And 10ml physiologic saline solution(group1&3) or 10ml 0.5M EDTA(group2&4) was applicated for final flush. After vertical sectioning and ethylene oxide gas sterilization, samples(group1&2) were immersed into BHIYHM broth inoculated with Staphylococcus aureus (ATCC 31153) and incubated for 3hrs at $37^{\circ}C$. All samples were prepared for and observed with SEM(JEOL JSM840S). The data were analyzed by Mann-Whitney rank sum test. The conclusions are as follows ; 1. Smear layer covers entire root canal surface after root canal preparation. 2. Smear layer has been removed away and the entrances of dentinal tubules have opened widely, when applying 0.5M EDTA and 3.5% NaOCl. 3. A significantly higher number of bacteria were adhered to the root canal dentin without smear layer(p<0.0001). 4. Smear layer produced during root canal preparation impedes bacterial adhesion and colonization to dentin matrix, therefore inhibits canal reinfection.

• Restorative Dentistry and Endodontics
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• 제43권2호
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• pp.16.1-16.9
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• 2018

Objectives: Understanding the reason for an unsuccessful non-surgical endodontic treatment outcome, as well as the complex anatomy of the root canal system, is very important. This study examined the cross-sectional root canal structure of mandibular first molars confirmed to have failed non-surgical root canal treatment using digital images obtained during intentional replantation surgery, as well as the causative factors of the failed conventional endodontic treatments. Materials and Methods: This study evaluated 115 mandibular first molars. Digital photographic images of the resected surface were taken at the apical 3 mm level and examined. The discolored dentin area around the root canal was investigated by measuring the total surface area, the treated areas as determined by the endodontic filling material, and the discolored dentin area. Results: Forty 2-rooted teeth showed discolored root dentin in both the mesial and distal roots. Compared to the original filled area, significant expansion of root dentin discoloration was observed. Moreover, the mesial roots were significantly more discolored than the distal roots. Of the 115 molars, 92 had 2 roots. Among the mesial roots of the 2-rooted teeth, 95.7% of the roots had 2 canals and 79.4% had partial/complete isthmuses and/or accessory canals. Conclusions: Dentin discoloration that was not visible on periapical radiographs and cone-beam computed tomography was frequently found in mandibular first molars that failed endodontic treatment. The complex anatomy of the mesial roots of the mandibular first molars is another reason for the failure of conventional endodontic treatment.

• Restorative Dentistry and Endodontics
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• 제24권3호
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• pp.465-472
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• 1999

The aim of this study was to determine the shear bond properties of four dentin bonding systems to internal cervical dentin, and to investigate the effect of the pretreatment for removing smear layer and position of dentin on shear bond strength of dentin bonding agents. The materials tested in this study were consisted of four commercially available dentin bonding systems[Allbond 2(AB), Clearfil Linerbond 2(CL), Optibond FL(OP), Scotchbond Multi-purpose(SB)], a restorative light-cured composite resin[Z100]J and a chelating agent[RC-prep(RC)]. Fifty-six freshly extracted human molars were used in this study. Dentin specimens were prepared by first cutting the root of the tooth 1mm below the cementoenamel junction with a diamond bur in a high speed handpiece under air-water coolant, and then removing occlusal part at pulp horn level by means of a second parallel section, The root canal areas were exposed by means of cutting the dent in specimens perpendicular to the root axis. Dentin specimens were randomly assigned to two groups(pretreated group, not-pretreated group) based on the pretreatment method of dentin surface. In pretreated group, RC was applied to dentin surface for 1minute and then rinsed with NaOCl. In not-pretreated group, dentin surface was rinsed with saline Each groups were subdevided into four groups according to dentin bonding systems. Four dentin bonding systems and a restorative resin were applied according to the directions of manufacturer. The dentin-resin specimens were embedded in a cold cure acrylic resin, and were cut with a low speed diamond saw to the dimension of $1{\times}1mm$. The cut specimens were divided into three groups according to the position of internal cervical dentin. The shear bond properties of dentin-resin specimens were measured with Universal testing machine (Zwick, 020, Germany) with the cross head speed of 0.5mm/min. From this experiment. the following results were obtained : 1. In case of shear bond strength, there was no significant difference among dentin bonding systems in not-pretreated groups, whereas in pretreated groups, the shear bond strengths of AB and of SB were statistically significantly higher than those of CL and of OP. 2. The shear bond strengths of AB and of SB in pretreated groups were significantly higher than those in not-pretreated groups. 3. The shear bond strengths of radicular layer of OP were higher than those of occlusal layer of OP in not-pretreated groups, and of AB in pretreated groups. The shear bond strengths of radicular layer of AB and of CL in not-pretreated groups were higher than those in pretreated group.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.230-243
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• 1996

Root surface exposure due to gingival recession after periodontal surgery, dentin exposure after root planing elicit pain response when exposed to mechanical, heat, chemical or osmotic stimulation. Especially, patients treated with periodontal surgery, show high frequency and there have been reports showing the 1 out of 7 patients have dentin hypersensitivity. There have been many studies on the clinical effects of various materials on the treatment of dentin hypersensitivity. but, none could provide absolute clinical efficacy. In this study, 45 teeth from 30 patients, who had had periodontal surgery and showed dentin hypersensitivity after surgery were chosen for the experimental group and they were illuminated with laser, 15teeth were chosen for the control group and they were not exposed to laser. After this dentin hypersensitivity was elicited by tactile, compressed air, cold water and then, the degree was evaluated using NRS(Numerical Rating Scale). And during LLLT(Low Level Laser Therapy) semiconductor laser using Gallium - Arsenide as a diode was illuminated for 180 seconds at a frequency of 7(500Hz). This therapy was done 10 times, and each time the changes in dentin hypersensitivity was evaluated using NRS. The results were as follows : 1. After treat with LLLT on dentin hypersensitivity due to periodontal surgery, 22.2% showed total loss of dentin hypersensitivity, 60.0% showed loss of tactile dentin hypersensitivity, 48.8% showed loss of compressed air dentin hypersensitivity, 22.2% showed loss of cold water dentin hypersensitivity. 2. As a result of clinical evaluation of dentin hypersensitivity using NRS, there was significant increase in improvement of dentin hypersensitivity in the experimental group compare to the control group(P<0.05). And there was almost no natural loss of dentin hypersensitivity in the control group. 3. In comparison of the stages of evaluation, there was significant difference in between experimental and control group. after the second visit(P<0.05), and the difference increased with each visit.

• Journal of Periodontal and Implant Science
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• 제32권1호
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• pp.13-23
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• 2002

The ultimate goal of periodontal therapy is directed to arresting the progression of the disease, and regenerating the fibrous attachment. In order to achieve such treatment aim, the plaque and calculus must be eliminated and the physiological conditions of the root surface must be changed to facilitate the attachment and migration of the new fibroblasts, The method of changing the proper root surface conditions to promote the healing of periodontal tissue involves mechanical procedures, such as scaling and root planing, and chemical procedures such as tetracycline-HCl. However, the formation of a long junctional epithelium was most frequently observed type of healing. Thus, the aim of this study was to examine in vitro the influence of surface conditioning of dentin by TC-HCl on human gingival epithelial cell attachment. Human gingival epithelial cells were obtained from healthy retromolar pad area(under the age 23 years). Seventy two teeth extracted from severe periodontitis were used as study material. To evaluate the epithelial cell attachment to dentin, the prepared specimen was divided to four groups. For the control group, only scaling and root planing were carried out, and for the test group, 1 to 3, the concentration of the TC-HCl was 50, 125 and 250mg/ml respectively. After cell cultivation time of 1-, 3-. 24 hour, for the indirect quantitative assessment of gingival epithelial cell attached to dentin sample, the absorbance of epithelial cell unattached to dentin was measured. The results were as follows; 1. There was no statistically significant difference between scaling and root planing group and TC-HCl 50mg/ml 125mg/ml and 250mg/ml group about absorbance of unattached epithelial cell to dentin sample(p>0.5). 2. As time passes, the absorbance of unattached gingival epithelial cell to dentin sample was decreased statistically significant(p<0.05). 3. There was no statistically significant difference among the TC-HCl group(p>0.05) We concluded that there was similar effect on gingival epithelial cell attachment between TC-HCl conditioning on root surface and only scaling and root planing treatment

• 대한소아치과학회지
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• 제40권3호
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• pp.177-184
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• 2013

수산화칼슘 근관충전제는 뛰어난 항균작용과 낮은 세포독성으로 우수한 유치 근관충전제로 평가되고 있다. 하지만 수산화칼슘을 근관 내 장기간 적용할 경우 치근 상아질에 미치는 부정적인 영향이 논의되고 있으며 많은 연구에서 영구치 근관에 수산화칼슘을 적용 후 상아질 경도의 감소가 확인되었다. 본 연구에서는 수산화칼슘 제제의 적용 기간에 따라 유치 치근 상아질의 미세경도를 측정하여, 수산화칼슘의 적용이 유치 치근 상아질의 미세경도에 미치는 영향을 평가하고자 하였다. 생리적 치근 흡수가 1/3이상 진행되지 않은 시기에 발거된 60개의 상악 유전치를 각각 20개 씩 대조군, 수산화칼슘과 요오드포름의 혼합제제(Vitapex, Neodent., Japan), 수산화칼슘과 증류수의 혼합제제를 적용하는 3개의 군으로 분류하였다. 각 치아는 같은 과정의 치수 절제술을 시행한 후 교정용 레진에 매몰하여 군당 5개 치아를 배정하고 24시간, 7일, 30일, 90일 후 치근 중앙부에서 2 mm 두께의 시편을 획득하여 비커스 미세경도 측정기를 통해 미세경도를 측정하였다. 측정된 미세경도 값은 Kruskal-Wallis test로 변수 간의 상호관계를 확인하였으며 사후 검정으로 Mann-Whitney test를 시행하였다. 시간에 따른 미세경도 값의 감소량은 선형 회귀분석을 통해 추이를 분석하였다. 수산화칼슘 근관 충전제가 유치의 치근 상아질의 미세경도에 미치는 영향을 조사한 결과, 다음과 같은 결론을 얻을 수 있었다. 수산화칼슘 근관 충전제를 유치의 근관에 적용 시 기간에 따라 치근상아 질의 미세경도가 감소하였으며, 이는 통계적으로 유의하였다(p < 0.05). 수산화칼슘과 요오드화포름의 혼합제제에 비해 수산화칼슘을 증류수에 혼합하여 적용한 경우 유치 치근상아질의 미세경도가 더 급격하게 감소하였으며, 이는 통계적으로 유의하였다(p < 0.05). 수산화칼슘을 적용하지 않은 대조군에서도 7일, 30일, 90일 후 기간에 따라 치근상아질의 미세경도가 감소하였으며, 이는 통계적으로 유의하였다(p < 0.05).

• Restorative Dentistry and Endodontics
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• 제22권2호
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• pp.670-679
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• 1997

The pH changes in 4 small cavities prepared at the facial inner dentin and lingual outer dentin of the cervical and apical portion of root filled with calcium hydroxide pastes were investigated. Forty extracted permanent teeth with single canal were instrumented with step-back method, and then 4 small cavities were prepared. Two inner dentin cavities were cut a distance of about 1.0mm from the canal wall and two outer dentin cavities were cut to a depth of about 0.5mm from the root surface. Root canals and prepared cavities were flushed with 17% EDTA, and then irrigated with 5% NaOCl to remove smear layer. Teeth were randomly divided into four groups. Control group was not filled and the remaining other groups were filled with mixture of calcium hydroxide and distilled water, Vitapex$^{(R)}$ paste and Pulpdent$^{(R)}$ paste respectively. The pH change of the dentin in each cavity was measured at 0, 1, 3, 7, 14, 21, 28, 60, 90 days with pH microelectrode(WPI Co., USA). The results were as follows : 1. The groups obturated with Pulpdent$^{(R)}$ paste and Aqueous calcium hydroxide produced the increased pH level at 1 day and maintained plateau over next 3weeks and decreased after 3weeks. 2. The group obturated with Vitapex$^{(R)}$ paste observed no significant pH change until 2weeks and slight increased pH at 3weeks and sequential increasing after 3weeks. But, the pH in the group obturated with Vitapex$^{(R)}$ paste remained significantly below the pH measured in the other two experimental groups(P<0.05). 3. All experimental groups showed pH level similar to control group after 28 days. 4. The pH of outer dentin is slightly higher than that of inner dentin. There is no significant difference in pH level between apical and cervical dentin throughout the duration of the experiment, though apical dentin showed slightly higher pH than cervical dentin at 1 day(P<0.05).

• Restorative Dentistry and Endodontics
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• 제17권2호
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• pp.399-412
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• 1992

The purpose of this study was to evaluate the root canal transportation and remaining dentin / cementum thickness after using hand and ultrasonic instrumentation in the curved mesial root canals of extracted human mandibular molars. Fourty - six clear polyether blocks were made and randomly divided into two groups: hand instrumentation group with K - Flex files and ultrasonic instrumentation group with Suprasson SP unit. All root canals were instrumented to a size corresponding to a # 30 K - Flex file 1mm short from the radiographic apex. The roots were then sectioned perpendicular to the long axis so the apical and middle third could be evaluated with the Zoom stereomicroscope. The results were as follows : 1. In the total amount of removed dentin at middle third level, there was not significant difference between the hand instrumentation and ultrasonic instrumentation (P>0.05). 2. In the total amount of removed dentin at apical third level, there was more removed by the ultrasonic instrumentation than hand instrumentation(P<0.005). 3. In the transportation width, there was not significant difference between the two groups at both sectioned levels(P>0.05). 4. It was suggested that the canal was transported distally at middle third level and mesially at apical third level by booth techniques.

• Journal of Periodontal and Implant Science
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• 제29권3호
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• pp.621-636
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• 1999

When mucoperiosteal flaps are positioned and sutured to desirable position, the wound contains several interface between tissues which differ fundamentally in composition & biological reaction. Thus the C-T surface of the flap will, on one hand, oppose another vascularized surface, and on the other, the avascular dental material for example, when root resoptions, fractured root, endodontic perforation, deep root carious lesions were filled with amalgam, glass ionomer, resin etc. Recently, a number of case report described the successful treatment of a subgingival root lesion with restorative material & free gingival graft, open flap surgery, but more objective research was needed . Most of study on restorative materials were concerned for cytotoxicity not for actual healing event on that materials and its influencing factors such as biocompatibility, surface wettability, surface topography . The aim of this in vitro study was to evaluate the effect of amalgam, resin modified glass ionomer, composite resin per se, and their surface roughness on the growth of human gingival fibroblast. The cells were obtained and placed on culture flask and incubated for 3 days with the prepared test materials. Then count the attached cell number with hemocytometer,(n=12) and 2 samples were examined with SEM about attachment cell morphology . Another 4 samples were evaluated on their surface roughness with Talysurf and average surface roughness value(Ra) were obtained. Statistical difference in attached cell number, roughness value were analyzed using ANOVA. The number of attached cell was as follows, for root dentin specimen 16.7${\pm}$4.41, resin modified glass ionomer 14.0${\pm}$4.15, resin 8.13${\pm}$3.63, amalgam 0.72${\pm}$3.33(${\times}10^3$). Between root dentin and resin-modified glass ionomer, no significant difference was observed, but resin, amalgam showed a significant less cell numbers than for root dentin, resin modified glass ionomer cement. SEM examination expressed many cell surface attachment apparatus in root dentin and resin modified glass ionomer specimens. For resin specimen, cell attachment was observed but exposed less appratus. The average surface roughness value are following results. Dentin specimen 0.6972${\pm}$ 0.104, resin modified glass ionomer 0.0822${\pm}$0.009, resin 0.0875${\pm}$0.005, amalgam 4.2145${\pm}$0.985(${\mu}m$). Between root dentin, resin-modified glass ionomer, and resin, no significant difference was observed, but amalgam showed a significant more rough surface than other groups. When evlauated the interrelationship between cell attachment and surface roughness, therefore, there was weak reverse correlation.(pearson correlation : - 0.593) These results suggest that resin modified glass ionomer have the favorable healing potential when used for subgingival restoration. And for relationship between cell attachment and surface characteristics, further investigations were needed.

• Restorative Dentistry and Endodontics
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• 제47권1호
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• pp.6.1-6.9
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• 2022

Objectives: This study investigated the internal morphology of mesiobuccal (MB) roots of maxillary molars with a second mesiobuccal (MB2) canal. Materials and Methods: Forty-seven maxillary first or second molars from Brazilians were scanned using micro-computed tomography. The following measurements were obtained from the MB roots: root thickness, root width, and dentin thickness of the buccal aspect of the first mesiobuccal (MB1) canal, between the MB1 and MB2 canals, and the palatal aspect of the MB2 and MB1 canals at 3 mm from the root apex and in the furcation region. For statistical analysis, the Student's t-test and analysis of variance with the post-hoc Tukey test were used (α = 0.05). Results: In maxillary molars with an MB2 canal, MB roots were significantly thicker (p = 0.0014) and narrower (p = 0.0016) than in maxillary molars without an MB2 canal. The dentin thickness of the palatal aspect of the MB1 canal was also significantly greater than that of MB roots without an MB2 canal at 3 mm from the root apex (p = 0.0007) and in the furcation region (p < 0.0001). In the furcation region of maxillary molars with an MB2 canal, the dentin thickness between the MB1 and MB2 canals was significantly smaller than that in the buccal and palatal aspects (p < 0.0001). Conclusions: The internal morphology of MB roots of maxillary molars with an MB2 canal revealed differences in dentin thickness, root diameter, and distance between the canals when compared with maxillary molars without an MB2 canal.