• Restorative Dentistry and Endodontics
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• v.46 no.4
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• pp.56.1-56.11
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• 2021

Objectives: This study evaluated 2 nickel-titanium rotary systems and a complementary protocol with an ultrasonic tip and a small-diameter instrument in flattened root canals. Materials and Methods: Thirty-two human maxillary second premolars with flattened canals (buccolingual diameter ≥4 times larger than the mesiodistal diameter) at 9 mm from the radiographic apex were selected. The root canals were prepared by ProDesign Logic (PDL) 30/0.01 and 30/0.05 or Hyflex EDM (HEDM) 10/0.05 and 25/0.08 (n = 16), followed by application of the Flatsonic ultrasonic tip in the cervical and middle thirds and a PDL 25/0.03 file in the apical third (FPDL). The teeth were scanned using micro-computed tomography before and after the procedures. The percentage of volume increase, debris, and uninstrumented surface area were analyzed using the Kruskal-Wallis, Dunn, Wilcoxon, analysis of variance/Tukey, and paired and unpaired t-tests (α = 0.05). Results: No significant difference was found in the volume increase and uninstrumented surface area between PDL and HEDM (p > 0.05). PDL had a higher percentage of debris than HEDM in the middle and apical thirds (p < 0.05). The FPDL protocol resulted in less debris and uninstrumented surface area for PDL and HEDM (p < 0.05). This protocol, with HEDM, reduced debris in the middle and apical thirds and uninstrumented surface area in the apical third (p < 0.05). Conclusions: High percentages of debris and uninstrumented surface area were observed after preparation of flattened root canals. The HEDM, Flatsonic tip, and 25/0.03 instrument protocol enhanced cleaning in flattened root canals.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.464-469
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• 1997

The radiopacity of glass ionomer cements is quite variable. The use of a poorly radiopaque material as a base under other restorative materials can mislead the dentist to a diagnosis of recurrent decay. This study investigates the radiopacity of these materials and proposes a minimal radiopacity under which a material should not be used as a base or liner. It is important to determine the radiopacity of glass ionomer dental materials so that the clinician can appreciate the type of restorative materials used when radiographically evaluation the possibility of recurrent dental caries. In this study, radiopacity of Vitrement and Chemfil was compared with that of Cavalite, Miracle mix and polycarboxylate cement. Tooth model of artificial cavity preparation for diagnosis of recurrent caries was omitted. Radiopacity of each material was measured using relatives between thickness and radiopacity of Aluminium step wedge. The results were as follows : 1. Radiopacity of Vitrement was some higher than enamel. 2. Chemfil, restorative glass ionomer, was less radiopaque than enamel. 3. In order of higher radiopacity than enamel, Miracle mix was highest and was followed by polycarboxylate cement, Cavalite and Vitremer. 4. Vitremer, the Glass Ionomer Cement, is useful to detection of recurrent caries, because it is slightly higher radiopaque than enamel. So, it is suitable for restorative material and luting cement.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.4
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• pp.519-528
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• 2002

It is not a rare occasion that certain dental procedures involving tooth reduction being peformed under inadequate water cooling due to a variety of reasons. This situation could possibly inflict the critical insult to the pulpal tissue of indicated tooth. The purpose of this experiment was to study the pattern of diffusion of external heat produced during routine dental procedures into the pulpal tissue. 30 stone blocks containing three lower second primary molars were used for certain restorative procedures and the temperature of the indicated tooth surface was measured by thermography(Inframetrics 600) and further used as a baseline data for the finite element analysis model fabrication designed in order to evaluate the pattern of thermal diffusion. The ranges of highest surface temperature measured from several dental procedures under water cooling and non-water cooling were $30.8^{\circ}C{\sim}43.6^{\circ}C$ and $51.2^{\circ}C{\sim}103.4^{\circ}C$ respectively. Among procedures studied, crown preparation showed the highest value and amalgam removal showed the lowest. Comparisons between data measured under water cooling and non-water cooling conditions have shown the statistically significant difference(p<0.05). All the non-cooling conditions have shown the relatively larger increment of temperature change at the pulp horn area than the cooling conditions. The results of this study strongly indicate that the water coolant is the essential element in restorative procedures for the maintenance of healthy pulp. Further related studies involving more procedures and conditions are recommended.

• Restorative Dentistry and Endodontics
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• v.18 no.1
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• pp.205-213
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• 1993

The purpose of the study was to evaluate the degree of the marginal leakage of esthetic restorative materials on root caries restoration. 120 cavities were prepared to $90^{\circ}$ butt joint on all margins on the crown and root portion, and divided into 4 groups. The four groups of cavity were filled with Amalgam(Dongmuyung Dental Alloy Co., Ltd, KOREA), Silux$^{(R)}$(3M Co., USA)-Scotch Bond 2$^{(R)}$(3M Co., USA), Silux$^{(R)}$-All Bond$^{(R)}$(BISCO USA), and GC Fuji II$^{(R)}$(G-C Co., JAPAN) respectively. The apical margin of the preparation was finished to leave a flash of restorative material. The coronal margin of the preparation was finished not to leave a flash of restorative material. All specimens were sectioned longitudinally with Isomet Low speed saw(Buether Ltd, USA). The degree of dye penetration was evaluated as the parameter of marginal leakage under the stereoscope. The results were as follows. 1. At the enamel and dentin/cementum margins, the margin were finished to leave a flash of material showed less marginal leakage than that were finished not to leave a flash of material (P<0.001). 2. The enamel margins showed less marginal leakage than the dentin/cementum margins(P<0.001). 3. There was no significant difference in the degree of the marginal leakage between Silux$^{(R)}$-Scotch Bond 2$^{(R)}$ group and Silux$^{(R)}$-All Bond$^{(R)}$ group.

• Journal of Periodontal and Implant Science
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• v.52 no.5
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• pp.411-421
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• 2022

Purpose: In this study, we aimed to evaluate the degree of heat generation when a novel drill design with an irrigation slot was used with metal sleeve-free (MF) and metal sleeve-incorporated (MI) surgical guides in an environment similar to that of the actual oral cavity. Methods: A typodont with a missing mandibular right first molar and 21 bovine rib blocks were used. Three-dimensional-printed MF and MI surgical guides, designed for the placement of internal tapered implant fixtures, were used with slot and non-slot drills. The following groups were compared: group 1, MI surgical guide with slot drill; group 2, MI surgical guide with a non-slot drill; and group 3, MF surgical guide with a slot drill. A constant-temperature water bath at 36℃ was used. The drilling was performed in 6 stages, and the initial, highest, and lowest temperatures of the cortical bone were measured at each stage using a non-contact infrared thermometer. Results: There were no temperature increases above the initial temperature in any drilling procedure. The only significant difference between the non-slot and slot groups was observed with the use of the first drill in the MI group, with a higher temperature in the non-slot group (P=0.012). When the heat generation during the first and the second drilling was compared in the non-slot group, the heat generation during the first drilling was significantly higher (P<0.001), and there was no significant difference in heat generation between the drills in the slot group. Conclusions: Within the limitations of this study, implant-site preparation with the surgical guide showed no critical increase in the temperature of the cortical bone, regardless of whether there was a slot in the drill. In particular, the slotted drill had a cooling effect during the initial drilling.

• Journal of Dental Rehabilitation and Applied Science
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• v.17 no.3
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• pp.145-154
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• 2001

In the past, many dentist were interested mainly in the mechanical aspects such as tooth preparation and retainer types for making dental restoration. But, these days, the concept of restorative treatment emphasizes the importarce of gnatic system and masticatory muscles in addition to oral cavity. So, the current considerations for the fixed prosthodontic treatment include the stabilization of temporomandibular joint and neuromuscualr system and the relationship of periodontal ligament and occlusion. To achieve the above objectives, occlusal splint has been used as one of the mouth preparations for restorative treatment. The objectives of occlusal splint are as follows; 1. To use as preliminary application for periodontal-occlusal treatment 2. To provide proper vertical dimension 3. To control abnormal habits and parafunction 4. To treat the temporomandibular disease and myofascial pain 5. To establish the new therapeutic position In some cases, the patients had improper vertical dimension and occlusal interferences caused by prostheses reconstucted using centric relation recorded without considering the health of TMJ and manticatory muscle. And these prosthesis act as primary source that cause pathologic phenomenon in periodontal ligament, muscles and TMJ. Physiologically, in order to make the treatment occlusion guided by proper centric relation method, the method should be guided after the use of occlusal splint for some period. The main objective of prosthetic treatment is to maintain the function and health of stomatognathic system. So, one of the most important things that have to be performed by clinicians is a clinical ability to do the correct diagnosis and treatment planning based on the stomatognatic function and occlusion.

• Restorative Dentistry and Endodontics
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• v.12 no.1
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• pp.51-64
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• 1986

The purpose of this study is to obtain the data of prestep in cavity preparation by observing changed conditions of laser irradiated dental hard tissues. The forty five extracted caries free human molars were divided into three groups and each group into five subgroups. A $CO_2$ laser irradiation was performed each subgroup of group I for one second with output power of 5 W, 10 Wand 20 W. On group II, laser irradiation was done ten times for 0.1 second duration using same power ratings as group I. On group III, laser irradiation was done 0.1 second, 0.2 second and 0.4 second with output power of 50 W. We investigated mineral contents and crater wall of obtained specimens, i.e., laser irradiated teeth, using computer controlled electron probe microanalyzer and scanning electron microscope. The following results were obtained: 1. Both calcium and phosphorus contents in laser irradiated enamel crater wall were increased, and magnesium content was decreased, but these trends were not statistically significant. 2. In laser irradiated dentin, change of mineral content was more significant. 3. In laser irradiated enamel and dentin, there were no significant differences on mineral content change due to irradiation condition and energy density. 4. In scanning electron microscopic study, enamel rods of the crater wall were fused and clefts were observed in parallel with the direction of enamel rod for all groups. 5. In laser irradiated dentin, irregular fusion and clefts were observed. In irradiated teeth with high power and short duration, the locally formed narrow crater wall was observed.

• Restorative Dentistry and Endodontics
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• v.40 no.2
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• pp.155-160
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• 2015

Objectives: Achieving adequate anesthesia with inferior alveolar nerve blocks (IANB) is of great importance during dental procedures. The aim of the present study was to assess the success rate of two anesthetic agents (bupivacaine and lidocaine) for IANB when treating teeth with irreversible pulpitis. Materials and Methods: Sixty volunteer male and female patients who required root canal treatment of a mandibular molar due to caries participated in the present study. The inclusion criteria included prolonged pain to thermal stimulus but no spontaneous pain. The patients were randomly allocated to receive either 2% lidocaine with 1:80,000 epinephrine or 0.5% bupivacaine with 1:200,000 epinephrine as an IANB injection. The sensitivity of the teeth to a cold test as well as the amount of pain during access cavity preparation and root canal instrumentation were recorded. Results were statistically analyzed with the Chi-Square and Fischer's exact tests. Results: At the final step, fifty-nine patients were included in the study. The success rate for bupivacaine and lidocaine groups were 20.0% and 24.1%, respectively. There was no significant difference between the two groups at any stage of the treatment procedure. Conclusions: There was no difference in success rates of anesthesia when bupivacaine and lidocaine were used for IANB injections to treat mandibular molar teeth with irreversible pulpitis. Neither agent was able to completely anesthetize the teeth effectively. Therefore, practitioners should be prepared to administer supplemental anesthesia to overcome pain during root canal treatment.

• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.27.1-27.12
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• 2019

This case report describes a technique in which endodontic treatment and permanent indirect restoration were completed in the same clinical appointment with the aid of a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Two patients were diagnosed with irreversible pulpitis of the mandibular first molar. After access preparation, root canals were located, irrigation was performed until bleeding ceased, and the coronal tooth structure was prepared for indirect restoration. Then, utilizing an interim 3-mm build-up of the endodontic access cavity, a hemi-arch digital scan was performed with an intraoral scanner. Subsequent to digital scanning, restoration design was performed simultaneously with the endodontic procedure. The root canals were shaped using the Race system under irrigation with 2.5% sodium hypochlorite followed by root canal filling. The pulp chamber was subsequently filled with a 3-mm-thick composite resin restoration mimicking the interim build-up previously utilized to facilitate block milling in the CAD/CAM system. Clinical try-in of the permanent onlay restoration was followed by acid etching, application of a 5th generation adhesive, and cementation of the indirect restoration. Once the restoration was cemented, rubber dam isolation was removed, followed by occlusal adjustment and polishing. After 2 years of follow-up, the restorations were esthetically and functionally satisfactory, without complications.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.5
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• pp.341-350
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• 2024

Background: Achieving successful pain control and adequate anesthesia through an inferior alveolar nerve block for endodontic treatment in cases with symptomatic irreversible pulpitis (SIP) is difficult, especially in mandibular molars. This study was designed to compare the effect of oral medication with ibuprofen and soft laser therapy on inferior alveolar nerve block during endodontic treatment. Methods: The trial comprised 180 patients (45 each group) with SIP. Four groups of patients were created: group 1 received 400 mg of ibuprofen; group 2 received soft laser irradiation; group 3 received a combination of soft laser and ibuprofen 400 mg; and group 4 received a placebo 1 h prior to local anesthesia. Patients recorded their pain scores on the Heft-Parker visual analog scale (VAS) before the start of intervention, 15 min after anesthesia, during access cavity preparation, and ultimately during root canal instrumentation. Each patient also rated their level of discomfort on a VAS. Every stage with no or minimal discomfort was deemed successful. The chi-square, Kruskal-Wallis, and one-way analysis of variance tests were used to evaluate the data. Results: The best success rate was achieved for soft laser ibuprofen combination, ibuprofen and soft laser groups reported similar success results, and control group recorded the least pain scores. The mean pain scores were lowest for group 3 and highest for group 4 (P < 0.001). Ibuprofen and soft laser combination was significantly better than control group (P < 0.001). There was no significant difference between ibuprofen and laser groups (P = 0.24). Conclusions: For teeth with irreversible pulpitis, preoperative ibuprofen treatment combined with soft laser irradiation greatly improved the success rates of inferior alveolar nerve block anesthesia.