• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.1
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• pp.29-36
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• 2019

Background: An inability to cope with threatening dental stimuli, i.e., sight, sound, and sensation of airotor, manifests as anxiety and behavioral management problems. Behavior modification techniques involving pre-exposure to dental equipment will give children a first-hand experience of their use, sounds, and clinical effects. The aim of this study was to compare the techniques of Tell-Show-Play-doh, a smartphone dentist game, and a conventional Tell-Show-Do method in the behavior modification of anxious children in the dental operatory. Methods: Sixty children in the age group of 4-8 years, with Frankl's behavior rating score of 2 or 3, requiring Class I and II cavity restorations were divided into three groups. The groups were Group 1: Tell-Show-Play-doh; Group 2: smartphone dentist game; and Group 3: Tell-Show-Do technique and each group comprised of 20 children. Pulse rate, Facial Image Scale (FIS), Frankl's behavior rating scale, and FLACC (Face, Leg, Activity, Cry, Consolability) behavior scales were used to quantify anxious behavior. Operator compliance was recorded through a validated questionnaire. Results: The results showed lower mean pulse rates, lower FIS and FLACC scores, higher percentage of children with Frankl's behavior rating score of 4, and better operator compliance in both the Tell-Show-Play-doh and smartphone dentist game groups than in the conventional Tell-Show-Do group. Conclusion: The Tell-Show-Play-doh and smartphone dentist game techniques are effective tools to reduce dental anxiety in pediatric patients.

• Restorative Dentistry and Endodontics
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• v.12 no.1
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• pp.119-129
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• 1986

The purpose of this study was to evaluate the marginal leakage of glass ionomer cement with different cavosurface margins. 192 class V cavities were prepared on freshly extracted non-carious teeth and glass ionomer cement were inserted according to the manufacturer's instructions. Cavity preparations for this investigation were performed in four groups. The experimental specimens were made by packing the glass ionomer cement (Fuji Ionomer Type II G-C Co. Japan) into the prepared 192 cavities of four groups with different modes: Group I. - The 48 cavities with $90^{\circ}$ butt-joint cavosurface preparation and restored with glass ionomer cement. Group II. - The 48 cavities with butt-joint preparation modified by $135^{\circ}$ beveling the cavosurface in the dentin and restored with glass ionomer cement. Group III. - The 48 cavities with butt-joint preparation modified by cutting a chamfer in the dentin and restored with glass ionomer cement. Group IV. - The same 48 cavities as group I, and overfilled with glass ionomer cement beyond the cavosurface angle. And four groups above described divided into three subgroups by means of conditioning the cavity walls: Control group. - Glass ionomer cement filled in the prepared 64 cavities after being cleaned with a stream of tap water. Phosphoric acid treatment group. - Glass ionomer cement filled in the prepared 64 cavities after being conditioned with a 50% phosphoric acid. Citric acid treatment group. - Glass ionomer cement filled in the prepared 64 cavities after being conditioned with a 50% citric acid. All 192 specimens were immersed in the 2.0% basic fuchsin solution and subjected to thermal stress at one-minute intervals ($4{\pm}2^{\circ}C$ to $60{\pm}2^{\circ}C$) for 70 minutes before exposure to the dye. The specimens were sectioned ecclesiologically through the center of the restorations for different periods of immersion time, 24 hours, 7 days, 14 days 30 days. The sections were examined under a stereoscopic microscope. The results were as follows: 1. The degree of marginal leakage in group II and III was greater than that in group I and IV. 2. The degree of marginal leakage in phosphoric acid treatment group was similar with that in control group. 3. The degree of marginal leakage in citric acid treatment group was less than that in control group. 4. In all groups, the degree of marginal leakage in phosphoric acid treatment group was greater than that in citric acid treatment group. 5. There is no statistical difference of the degree of marginal leakage according to the immersion time in the dye solution.

• Restorative Dentistry and Endodontics
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• v.24 no.2
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• pp.392-398
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• 1999

The purpose of this study was to assess the effect of catalase used following bleaching for the elimination of hydrogen peroxide residues from human teeth on the microleakage at the tooth-resin composite interface. In this study, class V cavities were prepared on the buccal or lingual surfaces of seventy extracted human molar teeth, and crown of sixty teeth were immersed in 30% hydrogen peroxide at $37^{\circ}C$ for 5 days except for negative control group. Then the teeth were rinsed with water and distributed randomly into seven groups of 10 each and were conditioned as following Negative control group: No bleaching Positive control group : bleaching and no application of catalase (C-40) Experimental group 1 : one cycle of catalase application for 3 min. and water rinse for 2 min. after bleaching Experimental group 2 : two cycles of catalase application for 3 min. and water rinse for 2 min. after bleaching Experimental group 3 : three cycles of catalase application for 3 min. and water rinse for 2 min. after bleaching Experimental group 4 : four cycles of catalase application for 3 min. and water rinse for 2 min. after bleaching Experimental group 5 : five cycles of catalase application for 3 min. and water rinse for 2 min. after bleaching The cavities of each groups were restored with composite resin. The teeth were thermocycled, stained with 2% methylene blue, and sectioned buccolingually. Degree of dye penetration at tooth-restoration interfaces were examined by stereomicroscope(${\times}30$) at occlusal and gingival margin The results were as follows : 1. On the occlusal margin, there was no significant difference in the microleakage between the negative coltrol group and experimental groups (p>0.05). But on the gingival margin, experimental groups showed higher microleakage than the negative coltrol group (p<0.05). 2. On the occlusal margin, positive coltrol group showed higher microleakage than experimental groups (p<0.05) and among the experimental groups, group 1 showed higher microleakage than group 3, 4, 5 (p<0.05). 3. On the gingival margin, there was no significant difference between the positive coltrol group and experimental groups, and between experimental groups (p>0.05). The result indicated that catalase used in bleached cavity for the elimination of hydrogen peroxide residues from human teeth maybe reduced microleakage at the tooth-resin composite interface.

• Restorative Dentistry and Endodontics
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• v.27 no.2
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• pp.142-149
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• 2002

Low-viscosity composite resins may produce better sealed margins than stiffer compositions (KempScholte and Davidson, 1988: Crim, 1989). Plowable composites have been recommended for use in Class V cavities but it is also controversial because of its high rates of shrinkage. On the other hand, in the study comparing elastic moduli and leakage, the microfill had the least leakage (Rundle et at. 1997) Furthermore, in the 1996 survey of the Reality Editorial Team, microfills were the clear choice for abfraction lesions. The purpose of this study was to evaluate the microleakage of 6 compostite resins (2 hybrids, 2 microfills, and 2 flowable composites) with and without load cycling. Notch-shaped Class V cavities were prepared on buccal surface of 180 extracted human upper premolars on cementum margin. The teeth were randomly divided into non-load cycling group (group 1) and load cycling group (group 2) of 90 teeth each. The experimental teeth of each group were randomly divided into 6 subgroups of 15 samples. All preparations were etched, and Single bond was applied. Preparations were restored with the following materials (n=15) : hybrid composite resin [Z250(3M Dental Products Inc. St. Paul, USA), Denfil(Vericom, Ahnyang, Korea)], microfill [Heliomolar RO(Vivadent, Schaan, Liechtenstein), Micronew(Bisco Inc. Schaumburg, IL, USA)], and flowable composite［AeliteFlo(Bisco Inc. Schaumburg, IL, USA), Revolution(Kerr Corp. Orange, CA, USA)]. Teeth of group 2 were subjected to occlusal load (100N for 50,000 cycles) using chewing simulator(MTS 858 Mini Bionix II system, MTS Systems Corp. Minn. USA). All samples were coated with nail polish 1mm short of the restoration, placed in 2％ methylene blue for 24 hours, and sectioned with a diamond wheel. Enamel and dentin/cementum margins were analyzed for microleakage on a sclale of 0 (no leakage) to 3 (3/3 of wall). Results were statistically analyzed by Kruscal-Wallis One way analysis, Mann-Whitney U-test, and Student-Newmann-Keuls method. (p = 0.05) Results : 1. There was significantly less microleage in enamel margins than dentinal margins of all groups (p＜0.05) 2. There was no significant between six composite resin in enamel margin of group 1. 3. In dentin margin of group 1, flowable composite had more microleakage than others but not of significant differences. 4. there was no significant difference between six composite resin in enamel margin of group 2. 5. In dentin margin of group 2, the microleakage were R＞A =H=M＞D＞Z. But there was no significant differences. 6. In enamel margins, load cycling did not affect the marginal microleakage in significant degree. 7. In enamel margins, load cycling did affect the marginal microleakage only in Revolution. (p＜0.05).

• Restorative Dentistry and Endodontics
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• v.26 no.4
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• pp.263-272
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• 2001

The aim of this study was to investigate the influence of four different light curing modes on the marginal leakage of Class V composite resin restoration. Eighty extracted human premolars were used. Wedge-shaped class Y cavities were prepared on the buccal surface of the tooth with high-speed diamond bur without bevel. The cavities were positioned half of the cavity above and half beyond the cemento-enamel junction. The depth, height, and width of the cavity were 2 mm, 3 mm and 2 mm respectively. The specimens were divided into 4 groups of 20 teeth each. All the specimen cavities were treated with Prime & Bond$^{R}$ NT dental adhesive system (Dentsply DeTrey GmbH, Germany) according to the manufacturer's instructions and cured for 10 seconds except group VI which were cured for 3 seconds. All the cavities were restored with resin composite Spectrum$^{TM}$ TPH A2 (Dentsply DeTrey GmbH, Germany) in a bulk. Resin composites were light-cured under 4 different modes. A regular intensity group (600 mW/${cm}^2$, group I) was irradiated for 30 s, a low intensity group (300 mW/${cm}^2$, group II) for 60 s and a ultra-high intensity group (1930 mW/${cm}^2$, group IV) for 3 s. A pulse-delay group (group III) was irradiated with 400 mW/${cm}^2$ for 2 s followed by 800 mW/${cm}^2$ for 10 s after 5 minutes delay. The Spectrum$^{TM}$ 800 (Dentsply DeTrey GmbH, Germany) light-curing units were used for groups I, II and III and Apollo 95E (DMD, U.S.A.) was used for group IV. The composite resin specimens were finished and polished immediately after light curing except group III which were finished and polished during delaying time. Specimens were stored in a physiologic saline solution at 37$^{\circ}C$ for 24 hours. After thermocycling (500$\times$, 5-55$^{\circ}C$), all teeth were covered with nail varnish up to 0.5 mm from the margins of the restorations, immersed in 37$^{\circ}C$, 2% methylene blue solution for 24 hours, and rinsed with tap water for 24 hours. After embedding in clear resin, the specimens were sectioned with a water-cooled diamond saw (Isomet$^{TM}$, Buehler Co., Lake Bluff, IL, U.S.A.) along the longitudinal axis of the tooth so as to pass the center of the restorations. The cut surfaces were examined under a stereomicroscope (SZ-PT Olympus, Japan) at ${\times}$25 magnification, and the images were captured with a CCD camera (GP-KR222, Panasonic, Japan) and stored in a computer with Studio Grabber program. Dye penetration depth at the restoration/dentin and the restoration/enamel interfaces was measured as a rate of the entire depth of the restoration using a software (Scion image, Scion Corp., U.S.A.) The data were analysed statistically using One-way ANOVA and Tukey's method. The results were as follows : 1. Pulse-Delay group did not show any significant difference in dye penetration rate from other groups at enamel and dentin margins (p>0.05) 2. At dentin margin, ultra-high intensity group showed significantly higher dye penetration rate than both regular intensity group and low intensity group (p<0.05). 3. At enamel margin, there were no statistically significant difference among four groups (p>0.05). 4. Dentin margin showed significantly higher dye penetration rate than enamel margin in all groups (p<0.05).

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.3
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• pp.483-495
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• 1998

The purpose of this study was to evaluate the human pulpal response to Dentin Bonding Desensitizer. Class V cavities were prepared on the buccal surfaces of the first premolars and Dentin Bonding Desensitizer(ALL-BOND Desensitizer, Bisco, Inc. U.S.A.) was applicated in ten experimental teeth, or ZOE(PROPAC, GC Co. TOKYO, JAPAN) cement in eight control teeth and cavities were filled with light curing glass ionomer(Fuji II LC, GC Co., TOKYO, JAPAN). At 3-day and 25-day postoperative interval. pulpal response was observed and evaluated histologically with light microscope. The results were as follows. ; 1. At 3-day postoperative interval, the control teeth were grade 1 inflammatory cell response and grade 1 connective tissue response. 2. At 25-day postoperative interval, all control teeth were grade 1 inflammatory cell response and in three control teeth grade 1 connective tissue response were observed, and one teeth showed grade 2 connective tissue response. 3. At 3-day postoperative interval, the experimental teeth were grade 1 inflammatory cell response and grade 1 connective tissue response. Below the cavity, a few inflammatory cell(PMNs) in odontoblastic layer, increased blood vessels and pulpal cells were seen and this pulpal response was similar to control teeth. 4. At 25-day postoperative interval, in four experimental teeth grade 1 inflammatory cell response and grade 1 connective tissue response were observed, and one experimental teeth showed mild inflammatory response. 5. At 3-day and 25-day postoperative interval, no reparative dentin deposition was seen. 6. Both experimental and control group, pulpal response showed difference between 3 and 25-day of postoperative interval. In control teeth, increased predentin and pulpal cells were seen and in experimental teeth, congestion of blood vessels and increased pulpal cells were seen. In conclusion, the pulpal irritation due to this Dentin Bonding Desensitizer was not severe, and it was considered that the agent was not harmful to the human pulp.

• Restorative Dentistry and Endodontics
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• v.21 no.1
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• pp.321-338
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• 1996

The purpose of this study was to evaluate the effect of moistening and air-drying of acid conditioned dentin and enamel on the marginal microleakage. In this study, Class V cavity were prepared on both buccal and lingual surface of sixty extracted human premolars with cementum margin. These specimens were randomly devided into three groups and three dentin adhesives(Scotchbond Multi-Purpose, All bond 2, Prisma Universal Bond 3) were applied to each group. The specimens in each group were subdevided into four groups (Wet/primed, Dry/primed, Wet/not primed, Dry/not primed) and the etched dentin and enamel surface were treated these four surface treatments prior to the placement of a bonding agent or adhesive. Wet/primed group was simply blot-dried with a damp facial tissue before primer placement ; Dry/primed group was air dried for 30 seconds before the placement of a primer ; Wet/not primed group and Dry/not primed group were not primed after blot dried and air dried for 30 seconds each group. The bonding agent and composite resin were applied for each group. All specimens were exposed to 500 cycle of thermal stress. Specimens were placed in a silver nitrate solution and then sectioned buccolingually through the center of the restoration. The dye penetrations of the specimens were observed with a stereo microscope. The statistical test were applied to the results using a one way analysis variance (ANOVA) and Duncan's multiple range test. The aspects of silver ion penetration into the resin/dentin interface were examined under scanning electron microscopy. The results were as follows. 1. In all groups, the enamel margin showed significantly lower leakage value than the cementum margin (p<0.05). 2. Regardless of various surface treatment and dentin adhesives, there was no significant difference at the enamel margins (p>0.05). 3. At the dentin margins, the leakage values of Dry/not primed group showed significantly higher than that of the other groups (p<0.05). The leakage values of Wet/primed group showed significantly lower than that of the other groups, but, there was no significant difference between Wet group and Dry group. 4. There was no significantly difference between the dentin adhesives regarding the surface treatments in all groups(p>0.05). 5. On the backscatterd scanning electron microscopy observation, the penetration of the silver ion occured at the bonding resin/dentin interface. In the Wet/primed group, resindentin hybrid zone and resin penetration into the dentin was observed. The resin tags were compactively formed to a thickness of $3\sim4{\mu}m$ at the upper part of dentinal tubules. In the Dry/primed group, the thickness of the hybrid zone and the diameter, depth of the resin tags diminished. In the Non-primed groups, the hybrid zone was not identified and few resin tag was observed. There was the gap formation in the resin/dentin interface.

• Restorative Dentistry and Endodontics
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• v.27 no.5
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• pp.493-501
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• 2002

This study evaluated the microleakage performance of four self-etcing primer adhesives(Clearfil SE Bond, Clearfil Liner Bond 2, UniFil Bond, and FL Bond) and one self-etching adhesive(Prompt L-Pop). Class V cavity preparations with occlusal margins in enamel and gingival margins in dentin were prepared on both buccal and lingual surfaces of 50 extracted human molar teeth. Prepared teeth were randomly divided into five groups and restored using one of five adhesives and composite resins: Prompt L-Pop/Filtek Z 250(Group 1), Clearfil SE Bond/Clearfil AP-X(Group 2), Clearfil Liner Bond 2/Clearfil AP-X(Group 3), UniFil Bond/UniFil F(Group 4), and FL Bond/Filtek Z 250(Group 5). Following one day storage in room temperature water, the restored teeth were thermocycled for 500 cycles between 5$^{\circ}C$ and 55$^{\circ}C$. Marginal microleakage was assessed by dye penetration using 2% methylene blue dye. After 24 hours, the teeth were sectioned longitudinally and evaluated for microleakage under steromicroscope The data were statistically analysed by Kruskal-Wallis Test, Mann-Whitney and Wilcoxon signed ranked tests. The results of this study were as follows ; 1. The microleakges at both enamel and dentinal mal$.$gins were the lowest in group 4. increasing among groups in the following order: group 2, follwed by group 5, follwed by group 1, and the highest in group 3. 2. At the enamel margins, the microleakage of group 3 was significantly higher than those of groups 2. 4 and 5(p<0.05), and also the microleakage of group 1 was statistically higher than those of groups 2 and 5(p<0.05). 3. At the dentinal margins, microleakage of group 3 was signincantly higher than microleakages of groups 1, 2, 4 and 5(p<0.05). 4. Compared with microleakages between the enamel and dentinal margins of each group, groups 1, 4 and 5 at enamel margin and group 2 and group 3 at dentinal margin were higher microleakage. But there was no significant difference between enamel and dentinal microleakages of each group(p>0.05).

• Restorative Dentistry and Endodontics
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• v.28 no.1
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• pp.11-22
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• 2003

This study compared the dentin adhesion to composite resin according to air-dry, blot dry, application of rewetting agent on air-dry or blot dry dentin surface by microleakag test and SEM observation. For microleakage test, class V cavity preparations with dentinal margins were prepared on both buccal and lingual surfaces of 40 extracted human molars. For SEM observation, occlusal dentin of 20 extracted human molars were exposed. After etched the dentin, prepared teeth were randomly divided into four groups; D group: air dry for 10-15 sec., B group: blot dry with moist cotton pellet, D-R group: air dry and rewet with Aqua-Prep F for 20 sec., B-R group: blot dry and rewet with Aqua-Prep F for 20 sec. Treated cavities and surfaces were filled or constructed using One-Step adhesives and Aelitefil composite resins. Specimens were stored in distilled water for 24 hours. For microleakage test, the specimens were thermocycled and soaked into 2% methylene blue. The specimens were sectioned longitudinally and evaluated for microleakage under steromicroscope. The data were statistically analysed by Kuskal-Wallis Test, Mann-Whitney and Wilcoxon signed ranked tests. For SEM observation, the specimens were bisectioned mesiodiatally. After decalcified and deproteinized, specimens were observed under SEM. The results of this study were as follows; 1. The microleakges on dentinal margin were the highest in D group compared with B group, D-R group, and B-R group(p<0.05). But there was no significant difference between B group, D-R group and B-R group. 2. D group showed gap and a few resin tags between dentin and composite resin. 3 B group, D-R group, and B-R groups showed close adaptation between dentin and composite resin. It showed that resin rags in B group were numerous and long, in D-R group were few and short, in B-R group were numerous and short or long. 4. Adhesive layer showed in D-R group ($10{\;}\mu\textrm{m}$) and B-R group ($3{\;}\mu\textrm{m}$) In conclusion, use of rewetting agent to dry dentin was efficient to dentin adhesion, also it did not provide reverse effect on blot dry dentin.

• Proceedings of the KACD Conference
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• 2008.05a
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• pp.184-197
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• 2008

This study was to investigate the influence of combining composite resins with different elastic modulus, and occlusal loading condition on the stress distribution of restored notch-shaped non-carious cervical lesion using 3D finite element (FE) analysis. The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. A notch-shaped cavity was modeled and filled with hybrid, flowable resin or a combination of both. After restoration, a static load of 500N was applied in a point-load condition at buccal cusp and palatal cusp. The stress data were analyzed using analysis of principal stress. Results showed that combining method such that apex was restored by material with high elastic modulus and the occlusal and cervical cavosurface margin by small amount of material with low elastic modulus was the most profitable method in the view of tensile stress that was considered as the dominant factor jeopardizing the restoration durability and promoting the lesion progression.