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Volume 37 (1); February 2012
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Editorial
A step towards international society
Byeong-Hoon Cho
Restor Dent Endod 2012;37(1):1-1.   Published online March 2, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.1
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Review Article
Effects of matrix metallproteinases on dentin bonding and strategies to increase durability of dentin adhesion
Jung-Hyun Lee, Juhea Chang, Ho-Hyun Son
Restor Dent Endod 2012;37(1):2-8.   Published online March 2, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.2
AbstractAbstract PDFPubReaderePub

The limited durability of resin-dentin bonds severely compromises the longevity of composite resin restorations. Resin-dentin bond degradation might occur via degradation of water-rich and resin sparse collagen matrices by host-derived matrix metalloproteinases (MMPs). This review article provides overview of current knowledge of the role of MMPs in dentin matrix degradation and four experimental strategies for extending the longevity of resin-dentin bonds. They include: (1) the use of broad-spectrum inhibitors of MMPs, (2) the use of cross-linking agents for silencing the activities of MMPs, (3) ethanol wet-bonding with hydrophobic resin, (4) biomimetic remineralization of water-filled collagen matrix. A combination of these strategies will be able to overcome the limitations in resin-dentin adhesion.

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Research Articles
Effect of different chlorhexidine application times on microtensile bond strength to dentin in Class I cavities
Hyun-Jung Kang, Ho-Jin Moon, Dong-Hoon Shin
Restor Dent Endod 2012;37(1):9-15.   Published online March 2, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.9
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated the effect of 2% chlorhexidine digluconate (CHX) with different application times on microtensile bonds strength (MTBS) to dentin in class I cavities and intended to search for ideal application time for a simplified bonding protocol.

Materials and Methods

Flat dentinal surfaces with class I cavities (4 mm × 4 mm × 2 mm) in 40 molar teeth were bonded with etch-and-rinse adhesive system, Adper Single Bond 2 (3M ESPE) after: (1) etching only as a control group; (2) etching + CHX 5 sec + rinsing; (3) etching + CHX 15 sec + rinsing; (4) etching + CHX 30 sec + rinsing; and (5) etching + CHX 60 sec + rinsing. Resin composite was built-up with Z-250 (3M ESPE) using a bulk method and polymerized for 40 sec. For each condition, half of the specimens were immediately submitted to MTBS test and the rest of them were assigned to thermocycling of 10,000 cycles between 5℃ and 55℃ before testing. The data were analyzed using two-way ANOVA, at a significance level of 95%.

Results

There was no significant difference in bond strength between CHX pre-treated group and control group at the immediate testing period. After thermocycling, all groups showed reduced bond strength irrespective of the CHX use. However, groups treated with CHX maintained significantly higher MTBS than control group (p < 0.05). In addition, CHX application time did not have any significant influence on the bond strength among groups treated with CHX.

Conclusion

Application of 2% CHX for a short time period (5 sec) after etching with 37% phosphoric acid may be sufficient to preserve dentin bond strength.

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Effect of fluoride concentration in pH 4.3 and pH 7.0 supersaturated solutions on the crystal growth of hydroxyapatite
Haneol Shin, Sung-Ho Park, Jeong-Won Park, Chan-Young Lee
Restor Dent Endod 2012;37(1):16-23.   Published online March 2, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.16
AbstractAbstract PDFPubReaderePub
Objectives

Present study was undertaken to investigate the crystal growth onto synthetic hydroxyapatite (HA) seeds in pH 4.3 and pH 7.0 supersaturated solutions with different fluoride concentrations.

Materials and Methods

8 groups of pH 4.3 and 7.0 calcium phosphate supersaturated solutions were prepared with different fluoride concentrations (0, 1, 2 and 4 ppm). Calcium phosphate precipitates yield crystal growth onto the HA seed surface while solutions flow. For evaluation of crystallizing process, the changes of Ca2+, PO43-, F- concentrations of the inlet and outlet solutions were determined. The recovered solid samples were weighed to assess the amount of minerals precipitated, and finally determined their composition to deduce characteristics of crystals.

Results

During the seeded crystal growth, there were significantly more consumption of Ca2+, PO43-, F- in pH 4.3 solutions than pH 7.0 (p < 0.05). As fluoride concentration increased in pH 4.3 solution, Ca2+, PO43-, F- consumption in experimental solutions, weight increment of HA seed, and fluoride ratio in crystallized samples were increased. There were significant differences among the groups (p < 0.05). But in pH 7.0 solution, these phenomena were not significant. In pH 7.0 solutions, analyses of crystallized samples showed higher Ca/P ratio in higher fluoride concentration. There were significant differences among the groups (p < 0.05). But in pH 4.3 solution, there were not significant differences in Ca/P ratio.

Conclusions

Crystal growth in pH 4.3 solutions was superior to that in pH 7.0 solutions. In pH 4.3 solutions, crystal growth increased with showed in higher fluoride concentration up to 4 ppm.

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Effects of canal enlargement and irrigation needle depth on the cleaning of the root canal system at 3 mm from the apex
Ho-Jin Moon, Chan-Ui Hong
Restor Dent Endod 2012;37(1):24-28.   Published online March 2, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.24
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to test the hypothesis, that the effectiveness of irrigation in removing smear layer in the apical third of root canal system is dependent on the depth of placement of the irrigation needle into the root canal and the enlargement size of the canal.

Materials and Methods

Eighty sound human lower incisors were divided into eight groups according to the enlargement size (#25, #30, #35 and #40) and the needle penetration depth (3 mm from working length, WL-3 mm and 9 mm from working length, WL-9 mm). Each canal was enlarged to working length with Profile.06 Rotary Ni-Ti files and irrigated with 5.25% NaOCl. Then, each canal received a final irrigation with 3 mL of 3% EDTA for 4 min, followed by 5 mL of 5.25% NaOCl at different level (WL-3 mm and WL-9 mm) from working length. Each specimen was prepared for the scanning electron microscope (SEM). Photographs of the 3mm area from the apical constriction of each canal with a magnification of ×250, ×500, ×1,000, ×2,500 were taken for the final evaluation.

Results

Removal of smear layer in WL-3 mm group showed a significantly different effect when the canal was enlarged to larger than #30. There was a significant difference in removing apical smear layer between the needle penetration depth of WL-3 mm and WL-9 mm.

Conclusions

Removal of smear layer from the apical portion of root canals was effectively accomplished with apical instrumentation to #35/40 06 taper file and 3 mm needle penetration from the working length.

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Coronal microleakage of four temporary restorative materials in Class II-type endodontic access preparations
Sang-Mi Yun, Lorena Karanxha, Hee-Jin Kim, Sung-Ho Jung, Su-Jung Park, Kyung-San Min
Restor Dent Endod 2012;37(1):29-33.   Published online March 2, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.29
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to evaluate the microleakage of 4 temporary materials in teeth with Class II-type endodontic access preparations by using a glucose penetration model.

Materials and Methods

Glucose reaction test was performed to rule out the presence of any reaction between glucose and temporary material. Class II-type endodontic access preparations were made in extracted human premolars with a single root (n = 10). Each experimental group was restored with Caviton (GC), Spacer (Vericom), IRM (Dentsply-Caulk), or Fuji II(GC). Microleakage of four materials used as temporary restorative materials was evaluated by using a glucose penetration model. Data were analyzed by the one-way analysis of variance followed by a multiple-comparison Tukey test. The interface between materials and tooth were examined under a scanning electron microscope (SEM).

Results

There was no significant reaction between glucose and temporary materials used in this study. Microleakage was significantly lower for Caviton and Spacer than for Fuji II and IRM. SEM observation showed more intimate adaptation of tooth-restoration interfaces in Caviton and Spacer than in IRM and Fuji II.

Conclusions

Compared to IRM and Fuji II, Caviton and Spacer can be considered better temporary sealing materials in Class II-type endodontic access cavities.

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Morphological evaluation during in vitro chondrogenesis of dental pulp stromal cells
Choo-Ryung Chung, Ha-Na Kim, Yeul Park, Min-Jeong Kim, Young-Ju Oh, Su-Jung Shin, Yoon-Jeong Choi, Kyung-Ho Kim
Restor Dent Endod 2012;37(1):34-40.   Published online March 2, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.34
AbstractAbstract PDFPubReaderePub
Objectives

The aim was to confirm the stem cell-like properties of the dental pulp stromal cells and to evaluate the morphologic changes during in vitro chondrogenesis.

Materials and Methods

Stromal cells were outgrown from the dental pulp tissue of the premolars. Surface markers were investigated and cell proliferation rate was compared to other mesenchymal stem cells. Multipotency of the pulp cells was confirmed by inducing osteogenesis, adipogenesis and chondrogenesis. The morphologic changes in the chondrogenic pellet during the 21 day of induction were evaluated under light microscope and transmission electron microscope. TUNEL assay was used to evaluate apoptosis within the chondrogenic pellets.

Results

Pulp cells were CD90, 105 positive and CD31, 34 negative. They showed similar proliferation rate to other stem cells. Pulp cells differentiated to osteogenic, adipogenic and chondrogenic tissues. During chondrogenesis, 3-dimensional pellet was created with multi-layers, hypertrophic chondrocyte-like cells and cartilage-like extracellular matrix. However, cell morphology became irregular and apoptotic cells were increased after 7 day of chondrogenic induction.

Conclusions

Pulp cells indicated mesenchymal stem cell-like characteristics. During the in vitro chondrogenesis, cellular activity was superior during the earlier phase (within 7 day) of differentiation.

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Evaluation of internal adaptation of dental adhesive restorations using micro-CT
Oh-Hyun Kwon, Sung-Ho Park
Restor Dent Endod 2012;37(1):41-49.   Published online March 2, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.41
AbstractAbstract PDFPubReaderePub
Objectives

The internal adaptation of composite restorations with or without resin modified glass ionomer cement (RMGIC) was analyzed non-destructively using Microcomputed tomography (micro-CT).

Materials and Methods

Thirty intact human teeth were used. The specimens were divided into 3 groups. In the control group, the cavities were etched with 10% phosphoric acid for 15 sec. Composite resin was filled into the cavity without adhesive. In group 1, light cured glass ionomer cement (GIC, Fuji II LC, GC) was applied as a base. The cavities were then etched, bonded, light cured and filled with composites. In group 2, the cavities were then etched, bonded, light cured and filled with composites without base application. They were immersed in a 25% silver nitrate solution. Micro-CT was performed before and after mechanical loading. One-way ANOVA with Duncan analysis was used to compare the internal adaptation between the groups before or after loading. A paired t-test was used to compare internal adaptation before and after mechanical loading. All statistical inferences were made within the 95% confidence interval.

Results

The silver nitrate solution successfully penetrated into the dentinal tubules from the pulp spaces, and infiltrated into the gap between restoration and pulpal floor. Group 2 showed a lower adaptation than the control group and group 1 (p < 0.05). There was no significant difference between the control group and group 1. For all groups, there was a significant difference between before and after mechanical loading (p < 0.05).

Conclusions

The internal adaptation before and after loading was better when composites were bonded to tooth using adhesive than composites based with RMGIC.

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Case Reports
Endodontic management of a maxillary lateral incisor with dens invaginatus and external root irregularity using cone-beam computed tomography
Young-Jun Lim, Sook-Hyun Nam, Sung-Ho Jung, Dong-Ryul Shin, Su-Jung Shin, Kyung-San Min
Restor Dent Endod 2012;37(1):50-53.   Published online March 2, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.50
AbstractAbstract PDFPubReaderePub

Cone-beam computed tomography (CBCT) is a useful diagnostic tool for identification of both internal and external root configurations. This case report describes the endodontic management of a lateral incisor with both dens invaginatus and external root irregularity by using CBCT. Nonsurgical endodontic retreatment was performed on the lateral incisor with dens invaginatus. A perforation through the dens invaginatus and external concavity was repaired using mineral trioxide aggregate. After 18 mon of follow-up, there were no clinical symptoms. Recall radiographs appeared normal and showed healing of the periapical pathosis. The understanding of both internal root canal configuration and external root irregularity using CBCT can ensure predictable and successful results.

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An embouchure aid for saxophone player
Ho-Jin Moon
Restor Dent Endod 2012;37(1):54-60.   Published online March 2, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.54
AbstractAbstract PDFPubReaderePub

This study aims to introduce the method that can relieve vibrating forces to oral environment by making an embouchure aid. Thin plastic crown forms were fabricated to prevent tooth abrasion and irritation to lip mucosa for the saxophone player. After application to the player, the most comfort form was chosen and delivered to 3 professional saxophone players. After 5 mon, the players responded to the survey. This embouchure aid did not disturb playing and gave comfort to lower lip. In general, the players preferred thin soft type and thought it caused little effect on sound. Far too little attention has been paid to the problems encountered by single-reed wind instrumentalist who suffer from tooth abrasion and irritation to lip mucosa. The embouchure aid not only prevent tooth damage but also diminish the discomfort of tight embouchure.

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Pulp necrosis following luxated injury to teeth in a patient with uncontrolled type II diabetes mellitus: a case report
Haneol Shin, Seung-Jong Lee, Il-Young Jung, Chan-Young Lee
Restor Dent Endod 2012;37(1):61-65.   Published online March 2, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.61
AbstractAbstract PDFPubReaderePub

Patients with diabetes mellitus show delayed wound healing and increased susceptibility to infection. Therefore, the effects of diabetes on pulpal and periodontal healing should be taken into consideration when treating diabetic dental traumatized patients. This case presents the treatment for dental traumatized 20 yr old female with uncontrolled type II diabetes. The traumatized upper central incisors had showed pulpal healing in early days. However, 7 mon after the trauma, the teeth had been diagnosed with pulp necrosis with apical abscess. Eventually, non surgical root canal treatment on the teeth had been performed.

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Erratum
Success and failure of endodontic microsurgery
Minju Song, Euiseong Kim
Restor Dent Endod 2012;37(1):66-66.   Published online February 4, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.66
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