• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.2
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• pp.192-199
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• 2016

Triple tooth is rare in primary dentition; it is the abnormal fusion of three teeth. There are a few reports of double teeth, but triple teeth are rare. These multiple teeth create several clinical problems, not only esthetic problems but also a high caries susceptibility, congenital missing permanent tooth germ(s), orthodontic problems, and periodontal problems. They also make it difficult to perform pulp treatment because of the complex tooth structure. A 1-year 7-month-old male underwent a partial pulpotomy with mineral trioxide aggregate (MTA) when pulp exposure caused by deep caries occurred at a maxillary anterior triple tooth in the first case. The second case was a 1-year 9-month-old male presenting with a fracture line at a mandibular anterior triple tooth. After removing the fractured fragment, a pulpectomy was performed at the remaining primary lateral incisors. Specific complications were not observed during 24 and 6 months of follow-up, respectively.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.3
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• pp.216-222
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• 2013

Paradigm shift in management of infected immature permanent teeth has occurred. The new concept of the treatment includes minimal or no intracanal instrumentation, disinfection with triple antibiotic paste and sealing with mineral trioxide aggregate. This regenerative endodontic treatment promotes differentiation of periradicular stem cells that induce regeneration of vital tissue and continuation of root formation. Thorough disinfection and three-dimensional scaffold are important in this new concept of the treatment. Platelet-rich fibrin has been reported as 'new scaffold' instead of blood clot, which had been used in the past. Triple antibiotics can be used to disinfect the tooth but may lead to complications including discoloration. Three cases of infected immature permanent tooth caused by dens evaginatus fracture are presented. After removal of necrotic pulp and thorough intracanal irrigation, only platelet-rich fibrin was applied to the root canal in the first case. In the other cases, topical antibiotics was used for disinfection and platelet-rich fibrin for scaffold. In all the cases, the opening was sealed with mineral trioxide aggregate. All the cases showed proper healing of inrabony lesion and some lengthening of root. According to these cases, regenerating vital tissue of the infected immature permanent tooth can be achieved with disinfection and application of platelet-rich fibrin.

• Restorative Dentistry and Endodontics
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• v.45 no.1
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• pp.3.1-3.10
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• 2020

Objectives: This study investigated the indirect effect of calcium-enriched mixture (CEM) cement and mineral trioxide aggregate (MTA), as 2 calcium silicate-based hydraulic cements, on human dental pulp stem cells (hDPSCs) through different dentin thicknesses. Materials and Methods: Two-chamber setups were designed to simulate indirect pulp capping (IPC). Human molars were sectioned to obtain 0.1-, 0.3-, and 0.5-mm-thick dentin discs, which were placed between the 2 chambers to simulate an IPC procedure. Then, MTA and CEM were applied on one side of the discs, while hDPSCs were cultured on the other side. After 2 weeks of incubation, the cells were removed, and cell proliferation, morphology, and attachment to the discs were evaluated under scanning electron microscopy (SEM). Energy-dispersive X-ray (EDXA) spectroscopy was performed for elemental analysis. Alkaline phosphatase (ALP) activity was assessed quantitatively. The data were analyzed using the Kruskal-Wallis and Mann-Whitney tests. Results: SEM micrographs revealed elongated cells, collagen fibers, and calcified nucleations in all samples. EDXA verified that the calcified nucleations consisted of calcium phosphate. The largest calcifications were seen in the 0.1-mm-thick dentin subgroups. There was no significant difference in ALP activity across the CEM subgroups; however, ALP activity was significantly lower in the 0.1-mm-thick dentin subgroup than in the other MTA subgroups (p < 0.05). Conclusions: The employed capping biomaterials exerted biological activity on hDPSCs, as shown by cell proliferation, morphology, and attachment and calcific precipitations, through 0.1- to 0.5-mm-thick layers of dentin. In IPC, the bioactivity of these endodontic biomaterials is probably beneficial.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.4
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• pp.521-527
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• 2018

In dental trauma, reattachment of the original tooth fragment improves the reproduction of original tooth shape, texture, color, and radiolucency; thus, it provides good aesthetics. A 9-year-old boy was referred due to complicated crown-root fracture of the maxillary right central incisor. Although it had poor prognosis due to severe coronal damage and subcrestal fracture, reattachment of the tooth fragment was chosen due to the patient's age. One-visit apexification with mineral trioxide aggregate (MTA) was performed, followed by osteotomy and reattachment of the tooth fragment with post placement. Regular observation revealed no clinical signs or symptoms and no radiologic complications.

• Restorative Dentistry and Endodontics
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• v.44 no.1
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• pp.5.1-5.9
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• 2019

Objectives: The aim of this in vitro study was to evaluate the push-out bond strength of a novel calcium silicate-based root repair material-BIOfactor MTA to root canal dentin in comparison with white MTA-Angelus (Angelus) and Biodentine (Septodont). Materials and Methods: The coronal parts of 12 central incisors were removed and the roots were embedded in acrylic resin blocks. Midroot dentin of each sample was horizontally sectioned into 1.1 mm slices and 3 slices were obtained from each root. Three canal-like standardized holes having 1 mm in diameter were created parallel to the root canal on each dentin slice with a diamond bur. The holes were filled with MTA-Angelus, Biodentine, or BIOfactor MTA. Wet gauze was placed over the specimens and samples were stored in an incubator at $37^{\circ}C$ for 7 days to allow complete setting. Then samples were subjected to the push-out test method using a universal test machine with the loading speed of 1 mm/min. Data was statistically analyzed using Friedman test and post hoc Wilcoxon signed rank test with Bonferroni correction. Results: There were no significant differences among the push-out bond strength values of MTA-Angelus, Biodentine, and BIOfactor MTA (p > 0.017). Most of the specimens exhibited cohesive failure in all groups, with the highest rate found in Biodentine group. Conclusions: Based on the results of this study, MTA-Angelus, Biodentine, and BIOfactor MTA showed similar resistances to the push-out testing.

• Journal of dental hygiene science
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• v.22 no.3
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• pp.191-198
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• 2022

Background: The purpose of this study was to evaluate the composition of the crystal phases of various calcium silicate-based materials (CSMs): ProRoot white MTA^Ⓡ (mineral trioxide aggregate) (WMTA), Ortho MTA^Ⓡ (OM), Endocem MTA^Ⓡ (EM), Retro MTA^Ⓡ (RM), Endocem Zr^Ⓡ (EN-Z), Biodentine^TM (BD), EZ-seal^TM (EZ), and OrthoMTA III (OM3). Methods: In a sample holder, 5 g of the powder sample was placed and the top surface of the material was packed flat using a sterilized glass slide. The prepared slides were mounted on an X-ray diffraction (XRD) instrument (D8 Advance; Bruker AXS GmbH, Germany). The X-ray beam 2θ angle range was set at 10~90° and scanned at 1.2° per minute. The Cu X-ray source set to operate at 40 kV and 40 mA in the continuous mode. The peaks in the diffraction pattern of each sample were analyzed using the software Diffrac (version 2.1). Then, the peaks were compared and matched with those of standard materials in the corresponding Powder Diffraction File (PDF-2, JCPDS International Center for Diffraction Data). A powder samples of the materials were analyzed using XRD and the peaks in diffraction pattern were compared to the Powder Diffraction File data. Results: Eight CSMs showed a similar diffraction pattern because their main component was calcium silicate. Eight CSMs showed similar diffraction peaks because calcium silicate was their main component. Two components were observed to have been added as radiopacifiers: bismuth oxide was detected in WMTA, OM, and EM while zirconium oxide was detected in RM, EN-Z, BD, EZ, and OM3. Unusual patterns were detected for the new material, OM3, which had strong peaks at low angles. Conclusion: It was caused by the presence of Brushite, which is believed to have resulted in crystal growth in a particular direction for a specific purpose.

• Restorative Dentistry and Endodontics
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• v.46 no.3
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• pp.35.1-35.11
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• 2021

Objectives: Endosequence Bioceramic Root Repair Material (BC-RRM) is used in endodontic microsurgery. It is available as a paste and a putty. However, no studies to date have examined the sealing ability of these forms alone or in combination as root-end filling materials. Hence, this study aimed to compare the sealing properties of these 2 forms of BC-RRM. Materials and Methods: Forty-two extracted upper anterior teeth were divided into 3 experimental groups, a positive and negative control. After the root canal treatment, the root ends were resected, retroprepared and retrofilled with either putty, paste + putty or mineral trioxide aggregate (MTA). The teeth were mounted in tubes so the apical 3 mm was submerged in Brain Heart Infusion (BHI) broth. The coronal portions of the canals were inoculated with Enterococcus faecalis and BHI broth and incubated for 30 days. The broth in the tubes was analyzed for colony forming units to check for leakage of bacteria from the canal. The teeth from the groups were sectioned and analyzed using scanning electron microscopy (SEM). The Kruskal-Wallis test and analysis of variance were used to analyze the data with a significance level p < 0.05. Results: The BC-RRM and MTA groups showed similar sealing ability. The positive control showed leakage in all samples. The SEM imaging showed the presence of bacteria in all experimental groups at the material-tooth interface. Conclusions: No significant differences were noted in the experimental groups, providing sufficient evidence that any combination could be effectively used during endodontic microsurgery.

• Restorative Dentistry and Endodontics
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• v.46 no.4
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• pp.53.1-53.11
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• 2021

Objectives: This study evaluates the bond strength and marginal adaptation of mineral trioxide aggregate (MTA) Repair HP and Biodentine used as apical plugs; MTA was used as reference material for comparison. Materials and Methods: A total of 30 single-rooted teeth with standardized, artificially created open apices were randomly divided into 3 groups (n = 10 per group), according to the material used to form 6-mm-thick apical plugs: group 1 (MTA Repair HP); group 2 (Biodentine); and group 3 (white MTA). Subsequently, the specimens were transversely sectioned to obtain 2 (cervical and apical) 2.5-mm-thick slices per root. Epoxy resin replicas were observed under a scanning electron microscope to measure the gap size at the material/dentin interface (the largest and smaller gaps were recorded for each replica). The bond strength of the investigated materials to dentin was determined using the push-out test. The variable bond strengths and gap sizes were evaluated independently at the apical and cervical root dentin slices. Data were analyzed using descriptive and analytic statistics. Results: The comparison between the groups regarding the variables' bond strengths and gap sizes showed no statistical difference (p > 0.05) except for a single difference in the smallest gap at the cervical root dentin slice, which was higher in group 3 than in group 1 (p < 0.05). Conclusions: The bond strength and marginal adaptation to root canal walls of MTA HP and Biodentine cement were comparable to white MTA.

• Restorative Dentistry and Endodontics
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• v.46 no.4
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• pp.48.1-48.10
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• 2021

Objectives: This study aimed to evaluate the effects on bone repair of different concentrations of mineral trioxide aggregate (MTA) added to AH Plus. Materials and Methods: Bone tissue reactions were evaluated in 30 rats (Rattus norvegicus) after 7 and 30 days. In the AH + MTA10, AH + MTA20, and AH + MTA30 groups, defects in the tibiae were filled with AH Plus with MTA in proportions of 10%, 20% and 30%, respectively; in the MTA-FILL group, MTA Fillapex was used; and in the control group, no sealer was used. The samples were histologically analyzed to assess bone union and maturation. The Kruskal-Wallis and Mann-Whitney tests were performed for multiple pairwise comparisons (p ≤ 0.05). Results: At the 7-day time point, AH + MTA10 was superior to MTA-FILL with respect to bone union, and AH + MTA20 was superior to MTA-FILL with respect to bone maturity (p < 0.05). At the 30-day time point, both the AH + MTA10 and AH + MTA20 experimental sealers were superior not only to MTA-FILL, but also to AH + MTA30 with respect to both parameters (p < 0.05). The results of the AH + MTA10 and AH + MTA20 groups were superior to those of the control group for both parameters and experimental time points (p < 0.05). Conclusions: The results suggest the potential benefit of using a combination of these materials in situations requiring bone repair.

• Journal of Korean Dental Science
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• v.17 no.1
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• pp.36-44
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• 2024

Purpose: This study investigated the effect of dentin bonding agent acidity on surface microhardness of MTA. Materials and Methods: Forty cylindrical molds (3 mm×5 mm) were prepared, and three dentin bonding agents with different acidities: Adper Single Bond 2 (ASB), Single Bond Universal (SBU), and Clearfil SE bond 2 (CSE) were applied to the inner surface of the molds (n=10). No bonding agent was applied in the control group. MTA was mixed and inserted into the molds and sealed with a wet cotton pellet for 4 days. After setting, the Vickers microhardness (HV) test was done at 200, 400, 600 ㎛ from the inner surface of the mold. One-way ANOVA was conducted for all samples. A P-value of less than .05 was considered significant. Tukey HSD test was performed for post-hoc analysis. Results: The mean HV values and standard deviations were 67.02±11.38 (Con), 48.76±11.33 (ASB), 43.78±11.19 (CSE), 37.84±9.36 (SBU), respectively. The difference between the control group and the experimental groups was statistically significant (P<0.001). The difference between ASB and SBU was statistically significant (P<0.001), while the difference between SBU and CSE was not. There were no statistically significant differences between the various points from the inner surface of the mold within each group (P>0.05). Conclusion: Results of the current study indicate that use of dentin bonding agents with MTA can reduce the surface microhardness of MTA. Moreover, there is a direct relationship between the acidity of dentin bonding agents and the surface microhardness of MTA.