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Volume 42 (1); February 2017
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Research Articles
Effect of adhesive luting on the fracture resistance of zirconia compared to that of composite resin and lithium disilicate glass ceramic
Myung-Jin Lim, Kwang-Won Lee
Restor Dent Endod 2017;42(1):1-8.   Published online October 14, 2016
DOI: https://doi.org/10.5395/rde.2017.42.1.1
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to evaluate the effect of adhesive luting on the fracture resistance of zirconia compared to that of a composite resin and a lithium disilicate glass ceramic.

Materials and Methods

The specimens (dimension: 2 mm × 2 mm × 25 mm) of the composite resin, lithium disilicate glass ceramic, and yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) were prepared. These were then divided into nine groups: three non-luting groups, three non-adhesive luting groups, and three adhesive luting groups, for each restorative material. In the non-luting groups, specimens were placed on the bovine tooth without any luting agents. In the non-adhesive luting groups, only zinc phosphate cement was used for luting the specimen to the bovine tooth. In the adhesive luting groups, specimens were pretreated, and the adhesive luting procedure was performed using a self-adhesive resin cement. For all the groups, a flexural test was performed using universal testing machine, in which the fracture resistance was measured by recording the force at which the specimen was fractured.

Results

The fracture resistance after adhesive luting increased by approximately 29% in the case of the composite resin, 26% in the case of the lithium disilicate glass ceramic, and only 2% in the case of Y-TZP as compared to non-adhesive luting.

Conclusions

The fracture resistance of Y-TZP did not increased significantly after adhesive luting as compared to that of the composite resin and the lithium disilicate glass ceramic.

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Discoloration of various CAD/CAM blocks after immersion in coffee
Sasipin Lauvahutanon, Maho Shiozawa, Hidekazu Takahashi, Naohiko Iwasaki, Meiko Oki, Werner J. Finger, Mansuang Arksornnukit
Restor Dent Endod 2017;42(1):9-18.   Published online December 8, 2016
DOI: https://doi.org/10.5395/rde.2017.42.1.9
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated color differences (ΔEs) and translucency parameter changes (ΔTPs) of various computer-aided design/computer-aided manufacturing (CAD/CAM) blocks after immersion in coffee.

Materials and Methods

Eight CAD/CAM blocks and four restorative composite resins were evaluated. The CIE L*a*b* values of 2.0 mm thick disk-shaped specimens were measured using the spectrophotometer on white and black backgrounds (n = 6). The ΔEs and ΔTPs of one day, one week, and one month immersion in coffee or water were calculated. The values of each material were analyzed by two-way ANOVA and Tukey's multiple comparisons (α = 0.05). The ΔEs after prophylaxis paste polishing of 1 month coffee immersion specimens, water sorption and solubility were also evaluated.

Results

After one month in coffee, ΔEs of CAD/CAM composite resin blocks and restorative composites ranged from 1.6 to 3.7 and from 2.1 to 7.9, respectively, and ΔTPs decreased. The ANOVA of ΔEs and ΔTPs revealed significant differences in two main factors, immersion periods and media, and their interaction except for ΔEs of TEL (Telio CAD, Ivoclar Vivadent). The ΔEs significantly decreased after prophylaxis polishing except GRA (Gradia Block, GC). There was no significant correlation between ΔEs and water sorption or solubility in water.

Conclusions

The ΔEs of CAD/CAM blocks after immersion in coffee varied among products and were comparable to those of restorative composite resins. The discoloration of CAD/CAM composite resin blocks could be effectively removed with prophylaxis paste polishing, while that of some restorative composites could not be removed.

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Retreatability of two endodontic sealers, EndoSequence BC Sealer and AH Plus: a micro-computed tomographic comparison
Enrique Oltra, Timothy C. Cox, Matthew R. LaCourse, James D. Johnson, Avina Paranjpe
Restor Dent Endod 2017;42(1):19-26.   Published online December 8, 2016
DOI: https://doi.org/10.5395/rde.2017.42.1.19
AbstractAbstract PDFPubReaderePub
Objectives

Recently, bioceramic sealers like EndoSequence BC Sealer (BC Sealer) have been introduced and are being used in endodontic practice. However, this sealer has limited research related to its retreatability. Hence, the aim of this study was to evaluate the retreatability of two sealers, BC Sealer as compared with AH Plus using micro-computed tomographic (micro-CT) analysis.

Materials and Methods

Fifty-six extracted human maxillary incisors were instrumented and randomly divided into 4 groups of 14 teeth: 1A, gutta-percha, AH Plus retreated with chloroform; 1B, gutta-percha, AH Plus retreated without chloroform; 2A, gutta-percha, EndoSequence BC Sealer retreated with chloroform; 2B, gutta-percha, EndoSequence BC Sealer retreated without chloroform. Micro-CT scans were taken before and after obturation and retreatment and analyzed for the volume of residual material. The specimens were longitudinally sectioned and digitized images were taken with the dental operating microscope. Data was analyzed using an ANOVA and a post-hoc Tukey test. Fisher exact tests were performed to analyze the ability to regain patency.

Results

There was significantly less residual root canal filling material in the AH Plus groups retreated with chloroform as compared to the others. The BC Sealer samples retreated with chloroform had better results than those retreated without chloroform. Furthermore, patency could be re-established in only 14% of teeth in the BC Sealer without chloroform group.

Conclusion

The results of this study demonstrate that the BC Sealer group had significantly more residual filling material than the AH Plus group regardless of whether or not both sealers were retreated with chloroform.

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Post space preparation timing of root canals sealed with AH Plus sealer
Hae-Ri Kim, Young Kyung Kim, Tae-Yub Kwon
Restor Dent Endod 2017;42(1):27-33.   Published online December 19, 2016
DOI: https://doi.org/10.5395/rde.2017.42.1.27
AbstractAbstract PDFPubReaderePub
Objectives

To determine the optimal timing for post space preparation of root canals sealed with epoxy resin-based AH Plus sealer in terms of its polymerization and influence on apical leakage.

Materials and Methods

The epoxy polymerization of AH Plus (Dentsply DeTrey) as a function of time after mixing (8, 24, and 72 hours, and 1 week) was evaluated using Fourier transform infrared (FTIR) spectroscopy and microhardness measurements. The change in the glass transition temperature (Tg) of the material with time was also investigated using differential scanning calorimetry (DSC). Fifty extracted human single-rooted premolars were filled with gutta-percha and AH Plus, and randomly separated into five groups (n = 10) based on post space preparation timing (immediately after root canal obturation and 8, 24, and 72 hours, and 1 week after root canal obturation). The extent of apical leakage (mm) of the five groups was compared using a dye leakage test. Each dataset was statistically analyzed by one-way analysis of variance and Tukey's post hoc test (α = 0.05).

Results

Continuous epoxy polymerization of the material with time was observed. Although the Tg values of the material gradually increased with time, the specimens presented no clear Tg value at 1 week after mixing. When the post space was prepared 1 week after root canal obturation, the leakage was significantly higher than in the other groups (p < 0.05), among which there was no significant difference in leakage.

Conclusions

Poor apical seal was detected when post space preparation was delayed until 1 week after root canal obturation.

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Effect of adaptive motion on cyclic fatigue resistance of a nickel titanium instrument designed for retreatment
Taha Özyürek, Koray Yılmaz, Gülşah Uslu
Restor Dent Endod 2017;42(1):34-38.   Published online December 19, 2016
DOI: https://doi.org/10.5395/rde.2017.42.1.34
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to evaluate the cyclic fatigue resistance of the ProTaper Universal D1 file (Dentsply Maillefer) under continuous and adaptive motion.

Materials and Methods

Forty ProTaper Universal D1 files were included in this study. The cyclic fatigue tests were performed using a dynamic cyclic fatigue testing device, which had an artificial stainless steel canal with a 60° angle of curvature and a 5 mm radius of curvature. The files were randomly divided into two groups (Group 1, Rotary motion; Group 2, Adaptive motion). The time to failure of the files were recorded in seconds. The number of cycles to failure (NCF) was calculated for each group. The data were statistically analyzed using Student's t-test. The statistical significant level was set at p < 0.05.

Results

The cyclic fatigue resistance of the adaptive motion group was significantly higher than the rotary motion group (p < 0.05).

Conclusion

Within the limitations of the present study, the ‘Adaptive motion’ significantly increased the resistance of the ProTaper Universal D1 file to cyclic facture.

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In vitro study of Streptococcus mutans adhesion on composite resin coated with three surface sealants
Da Hye Kim, Tae-Yub Kwon
Restor Dent Endod 2017;42(1):39-47.   Published online December 30, 2016
DOI: https://doi.org/10.5395/rde.2017.42.1.39
AbstractAbstract PDFPubReaderePub
Objectives

Although the coating of surface sealants to dental composite resin may potentially reduce bacterial adhesion, there seems to be little information regarding this issue. This preliminary in vitro study investigated the adhesion of Streptococcus mutans (S. mutans) on the dental composite resins coated with three commercial surface sealants.

Materials and Methods

Composite resin (Filtek Z250) discs (8 mm in diameter, 1 mm in thickness) were fabricated in a mold covered with a Mylar strip (control). In group PoGo, the surfaces were polished with PoGo. In groups PS, OG, and FP, the surfaces polished with PoGo were coated with the corresponding surface sealants (PermaSeal, PS; OptiGuard, OG; Fortify Plus, FP). The surfaces of the materials and S. mutans cells were characterized by various methods. S. mutans adhesion to the surfaces was quantitatively evaluated using flow cytometry (n = 9).

Results

Group OG achieved the lowest water contact angle among all groups tested (p < 0.001). The cell surface of S. mutans tested showed hydrophobic characteristics. Group PoGo exhibited the greatest bacterial adhesion among all groups tested (p < 0.001). The sealant-coated groups showed statistically similar (groups PS and FP, p > 0.05) or significantly lower (group OG, p < 0.001) bacterial adhesion when compared with the control group.

Conclusions

The application of the surface sealants significantly reduced S. mutans adhesion to the composite resin polished with the PoGo.

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Comparison of two different methods of detecting residual caries
Uzay Koç Vural, Zeynep Bilge Kütük, Esra Ergin, Filiz Yalçın Çakır, Sevil Gürgan
Restor Dent Endod 2017;42(1):48-53.   Published online January 25, 2017
DOI: https://doi.org/10.5395/rde.2017.42.1.48
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to investigate the ability of the fluorescence-aided caries excavation (FACE) device to detect residual caries by comparing conventional methods in vivo.

Materials and Methods

A total of 301 females and 202 males with carious teeth participated in this study. The cavity preparations were done by grade 4 (Group 1, 154 teeth), grade 5 (Group 2, 176 teeth), and postgraduate (Group 3, 173 teeth) students. After caries excavation using a handpiece and hand instruments, the presence of residual caries was evaluated by 2 investigators who were previously calibrated for visual-tactile assessment with and without magnifying glasses and trained in the use of a FACE device. The tooth number, cavity type, and presence or absence of residual caries were recorded. The data were analyzed using the Chi-square test, the Fisher's Exact test, or the McNemar test as appropriate. Kappa statistics was used for calibration. In all tests, the level of significance was set at p = 0.05.

Results

Almost half of the cavities prepared were Class II (Class I, 20.9%; Class II, 48.9%; Class III, 20.1%; Class IV, 3.4%; Class V, 6.8%). Higher numbers of cavities left with caries were observed in Groups 1 and 2 than in Group 3 for all examination methods. Significant differences were found between visual inspection with or without magnifying glasses and inspection with a FACE device for all groups (p < 0.001). More residual caries were detected through inspection with a FACE device (46.5%) than through either visual inspection (31.8%) or inspection with a magnifying glass (37.6%).

Conclusions

Within the limitations of this study, the FACE device may be an effective method for the detection of residual caries.

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Antibacterial effect of urushiol on E. faecalis as a root canal irrigant
Sang-Wan Kim, Dong-Hoon Shin
Restor Dent Endod 2017;42(1):54-59.   Published online January 25, 2017
DOI: https://doi.org/10.5395/rde.2017.42.1.54
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to compare the antibacterial activity of urushiol against Enterococcus faecalis (E. faecalis) to that of NaOCl.

Materials and Methods

The canals of thirty two single rooted human teeth were instrumented with Ni-Ti files (ProTaper Next X1, X2, X3, Dentsply). A pure culture of E. faecalis ATCC 19433 was prepared in sterile brain heart infusion (BHI) broth. The teeth were submerged in the suspension of E. faecalis and were incubated at 37℃ for 7 days to allow biofilm formation. The teeth were randomly divided into three experimental groups according to the irrigant used, and a negative control group where no irrigant was used (n = 8). Group 1 used physiologic normal saline, group 2 used 6% NaOCl, and group 3 used 10 wt% urushiol solution. After canal irrigation, each sample was collected by the sequential placement of 2 sterile paper points (ProTaper NEXT paper points, size X3, Dentsply). Ten-fold serial dilutions on each vials, and 100 µL were cultured on a BHI agar plate for 8 hours, and colony forming unit (CFU) analysis was done. The data were statistically analyzed using Kruskal-Wallis and Mann-whitney U tests.

Results

Saline group exhibited no difference in the CFU counts with control group, while NaOCl and urushiol groups showed significantly less CFU counts than saline and control groups (p < 0.05).

Conclusions

The result of this study suggests 10% urushiol and 6% NaOCl solution had powerful antibacterial activity against E. faecalis when they were used as root canal irrigants.

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Case Reports
Maxillary first molar with 7 root canals diagnosed using cone-beam computed tomography
Evaldo Rodrigues, Antônio Henrique Braitt, Bruno Ferraz Galvão, Emmanuel João Nogueira Leal da Silva
Restor Dent Endod 2017;42(1):60-64.   Published online August 29, 2016
DOI: https://doi.org/10.5395/rde.2017.42.1.60
AbstractAbstract PDFPubReaderePub

Root canal anatomy is complex, and the recognition of anatomic variations could be a challenge for clinicians. This case report describes the importance of cone beam computed tomographyic (CBCT) imaging during endodontic treatment. A 23 year old woman was referred by her general dental practitioner with the chief complaint of spontaneous pain in her right posterior maxilla. From the clinical and radiographic findings, a diagnosis of symptomatic irreversible pulpitis was made and endodontic treatment was suggested to the patient. The patient underwent CBCT examination, and CBCT scan slices revealed seven canals: three mesiobuccal (MB1, MB2, and MB3), two distobuccal (DB1 and DB2), and two palatal (P1 and P2). Canals were successfully treated with reciprocating files and filled using single-cone filling technique. Precise knowledge of root canal morphology and its variation is important during root canal treatment. CBCT examination is an excellent tool for identifying and managing these complex root canal systems.

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Retreatment of failed regenerative endodontic of orthodontically treated immature permanent maxillary central incisor: a case report
Musaed Fahad Al-Tammami, Saad A. Al-Nazhan
Restor Dent Endod 2017;42(1):65-71.   Published online October 28, 2016
DOI: https://doi.org/10.5395/rde.2017.42.1.65
AbstractAbstract PDFPubReaderePub

A revascularization procedure was shown to be the best alternative therapy for immature teeth with necrotic pulp and apical infection. A 12 year old female with a history of trauma to her upper central incisor and a sinus tract was referred for endodontic treatment. She was an active orthodontic patient and had undergone regenerative endodontic treatment for the past 2 years. Clinical examination revealed no response to sensibility, percussion, and palpation tests. The preoperative radiograph showed an open apex and apical rarefaction. The case was diagnosed as previously treated tooth with asymptomatic apical periodontitis. Regenerative endodontic retreatment was performed, and the case was followed for 3 years. Clinical, radiographic, and cone-beam computed tomography follow-up examination revealed an asymptomatic tooth, with evidence of periapical healing and root maturation.

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Open Lecture on Statistics
Statistical notes for clinical researchers: Risk difference, risk ratio, and odds ratio
Hae-Young Kim
Restor Dent Endod 2017;42(1):72-76.   Published online January 9, 2017
DOI: https://doi.org/10.5395/rde.2017.42.1.72
PDFPubReaderePub
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