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Volume 41 (2); May 2016
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Research Articles
Marginal microleakage of cervical composite resin restorations bonded using etch-and-rinse and self-etch adhesives: two dimensional vs. three dimensional methods
Maryam Khoroushi, Ailin Ehteshami
Restor Dent Endod 2016;41(2):83-90.   Published online April 18, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.83
AbstractAbstract PDFPubReaderePub
Objectives

This study was evaluated the marginal microleakage of two different adhesive systems before and after aging with two different dye penetration techniques.

Materials and Methods

Class V cavities were prepared on the buccal and lingual surfaces of 48 human molars. Clearfil SE Bond and Single Bond (self-etching and etch-and-rinse systems, respectively) were applied, each to half of the prepared cavities, which were restored with composite resin. Half of the specimens in each group underwent 10,000 cycles of thermocycling. Microleakage was evaluated using two dimensional (2D) and three dimensional (3D) dye penetration techniques separately for each half of each specimen. Data were analyzed with SPSS 11.5 (SPSS Inc.), using the Kruskal-Wallis and Mann-Whitney U tests (α = 0.05).

Results

The difference between the 2D and 3D microleakage evaluation techniques was significant at the occlusal margins of Single bond groups (p = 0.002). The differences between 2D and 3D microleakage evaluation techniques were significant at both the occlusal and cervical margins of Clearfil SE Bond groups (p = 0.017 and p = 0.002, respectively). The difference between the 2D and 3D techniques was significant at the occlusal margins of non-aged groups (p = 0.003). The difference between these two techniques was significant at the occlusal margins of the aged groups (p = 0.001). The Mann-Whitney test showed significant differences between the two techniques only at the occlusal margins in all specimens.

Conclusions

Under the limitations of the present study, it can be concluded that the 3D technique has the capacity to detect occlusal microleakage more precisely than the 2D technique.

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Antifungal effects of synthetic human β-defensin 3-C15 peptide
Sang-Min Lim, Ki-Bum Ahn, Christine Kim, Jong-Won Kum, Hiran Perinpanayagam, Yu Gu, Yeon-Jee Yoo, Seok Woo Chang, Seung Hyun Han, Won-Jun Shon, Woocheol Lee, Seung-Ho Baek, Qiang Zhu, Kee-Yeon Kum
Restor Dent Endod 2016;41(2):91-97.   Published online March 17, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.91
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this ex vivo study was to compare the antifungal activity of a synthetic peptide consisting of 15 amino acids at the C-terminus of human β-defensin 3 (HBD3-C15) with calcium hydroxide (CH) and Nystatin (Nys) against Candida albicans (C. albicans) biofilm.

Materials and Methods

C. albicans were grown on cover glass bottom dishes or human dentin disks for 48 hr, and then treated with HBD3-C15 (0, 12.5, 25, 50, 100, 150, 200, and 300 µg/mL), CH (100 µg/mL), and Nys (20 µg/mL) for 7 days at 37℃. On cover glass, live and dead cells in the biomass were measured by the FilmTracer Biofilm viability assay, and observed by confocal laser scanning microscopy (CLSM). On dentin, normal, diminished and ruptured cells were observed by field-emission scanning electron microscopy (FE-SEM). The results were subjected to a two-tailed t-test, a one way analysis variance and a post hoc test at a significance level of p = 0.05.

Results

C. albicans survival on dentin was inhibited by HBD3-C15 in a dose-dependent manner. There were fewer aggregations of C. albicans in the groups of Nys and HBD3-C15 (≥ 100 µg/mL). CLSM showed C. albicans survival was reduced by HBD3-C15 in a dose dependent manner. Nys and HBD3-C15 (≥ 100 µg/mL) showed significant fungicidal activity compared to CH group (p < 0.05).

Conclusions

Synthetic HBD3-C15 peptide (≥ 100 µg/mL) and Nys exhibited significantly higher antifungal activity than CH against C. albicans by inhibiting cell survival and biofilm.

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Biocompatibility of two experimental scaffolds for regenerative endodontics
Dephne Jack Xin Leong, Frank C. Setzer, Martin Trope, Bekir Karabucak
Restor Dent Endod 2016;41(2):98-105.   Published online March 28, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.98
AbstractAbstract PDFPubReaderePub
Objectives

The biocompatibility of two experimental scaffolds for potential use in revascularization or pulp regeneration was evaluated.

Materials and Methods

One resilient lyophilized collagen scaffold (COLL), releasing metronidazole and clindamycin, was compared to an experimental injectable poly(lactic-co-glycolic) acid scaffold (PLGA), releasing clindamycin. Human dental pulp stem cells (hDPSCs) were seeded at densities of 1.0 × 104, 2.5 × 104, and 5.0 × 104. The cells were investigated by light microscopy (cell morphology), MTT assay (cell proliferation) and a cytokine (IL-8) ELISA test (biocompatibility).

Results

Under microscope, the morphology of cells coincubated for 7 days with the scaffolds appeared healthy with COLL. Cells in contact with PLGA showed signs of degeneration and apoptosis. MTT assay showed that at 5.0 × 104 hDPSCs, COLL demonstrated significantly higher cell proliferation rates than cells in media only (control, p < 0.01) or cells co-incubated with PLGA (p < 0.01). In ELISA test, no significant differences were observed between cells with media only and COLL at 1, 3, and 6 days. Cells incubated with PLGA expressed significantly higher IL-8 than the control at all time points (p < 0.01) and compared to COLL after 1 and 3 days (p < 0.01).

Conclusions

The COLL showed superior biocompatibility and thus may be suitable for endodontic regeneration purposes.

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Orthodontic bracket bonding to glazed full-contour zirconia
Ji-Young Kwak, Hyo-Kyung Jung, Il-Kyung Choi, Tae-Yub Kwon
Restor Dent Endod 2016;41(2):106-113.   Published online April 14, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.106
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated the effects of different surface conditioning methods on the bond strength of orthodontic brackets to glazed full-zirconia surfaces.

Materials and Methods

Glazed zirconia (except for the control, Zirkonzahn Prettau) disc surfaces were pre-treated: PO (control), polishing; BR, bur roughening; PP, cleaning with a prophy cup and pumice; HF, hydrofluoric acid etching; AA, air abrasion with aluminum oxide; CJ, CoJet-Sand. The surfaces were examined using profilometry, scanning electron microscopy, and electron dispersive spectroscopy. A zirconia primer (Z-Prime Plus, Z) or a silane primer (Monobond-S, S) was then applied to the surfaces, yielding 7 groups (PO-Z, BR-Z, PP-S, HF-S, AA-S, AA-Z, and CJ-S). Metal bracket-bonded specimens were stored in water for 24 hr at 37℃, and thermocycled for 1,000 cycles. Their bond strengths were measured using the wire loop method (n = 10).

Results

Except for BR, the surface pre-treatments failed to expose the zirconia substructure. A significant difference in bond strengths was found between AA-Z (4.60 ± 1.08 MPa) and all other groups (13.38 ± 2.57 - 15.78 ± 2.39 MPa, p < 0.05). For AA-Z, most of the adhesive remained on the bracket.

Conclusions

For bracket bonding to glazed zirconia, a simple application of silane to the cleaned surface is recommended. A zirconia primer should be used only when the zirconia substructure is definitely exposed.

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Push-out bond strength and dentinal tubule penetration of different root canal sealers used with coated core materials
Derya Deniz Sungur, Nuhan Purali, Erdal Coşgun, Semra Calt
Restor Dent Endod 2016;41(2):114-120.   Published online May 4, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.114
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to compare the push-out bond strength and dentinal tubule penetration of root canal sealers used with coated core materials and conventional gutta-percha.

Materials and Methods

A total of 72 single-rooted human mandibular incisors were instrumented with NiTi rotary files with irrigation of 2.5% NaOCl. The smear layer was removed with 17% ethylenediaminetetraacetic acid (EDTA). Specimens were assigned into four groups according to the obturation system: Group 1, EndoRez (Ultradent Product Inc.); Group 2, Activ GP (Brasseler); Group 3, SmartSeal (DFRP Ltd. Villa Farm); Group 4, AH 26 (Dentsply de Trey)/gutta-percha (GP). For push-out bond strength measurement, two horizontal slices were obtained from each specimen (n = 20). To compare dentinal tubule penetration, remaining 32 roots assigned to 4 groups as above were obturated with 0.1% Rhodamine B labeled sealers. One horizontal slice was obtained from the middle third of each specimen (n = 8) and scanned under confocal laser scanning electron microscope. Tubule penetration area, depth, and percentage were measured. Kruskall-Wallis test was used for statistical analysis.

Results

EndoRez showed significantly lower push-out bond strength than the others (p < 0.05). No significant difference was found amongst the groups in terms of percentage of sealer penetration. SmartSeal showed the least penetration than the others (p < 0.05).

Conclusions

The bond strength and sealer penetration of resin-and glass ionomer-based sealers used with coated core was not superior to resin-based sealer used with conventional GP. Dentinal tubule penetration has limited effect on bond strength. The use of conventional GP with sealer seems to be sufficient in terms of push-out bond strength.

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The effect of different fluoride application methods on the remineralization of initial carious lesions
Seon Mi Byeon, Min Ho Lee, Tae Sung Bae
Restor Dent Endod 2016;41(2):121-129.   Published online May 10, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.121
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to assess the effect of single and combined applications of fluoride on the amount of fluoride release, and the remineralization and physical properties of enamel.

Materials and Methods

Each of four fluoride varnish and gel products (Fluor Protector, FP, Ivoclar Vivadent; Tooth Mousse Plus, TM, GC; 60 Second Gel, A, Germiphene; CavityShield, CS, 3M ESPE) and two fluoride solutions (2% sodium fluoride, N; 8% tin(ii) fluoride, S) were applied on bovine teeth using single and combined methods (10 per group), and then the amount of fluoride release was measured for 4 wk. The electron probe microanalysis and the Vickers microhardness measurements were conducted to assess the effect of fluoride application on the surface properties of bovine teeth.

Results

The amount of fluoride release was higher in combined applications than in single application (p < 0.05). Microhardness values were higher after combined applications of N with FP, TM, and CS than single application of them, and these values were also higher after combined applications of S than single application of A (p < 0.05). Ca and P values were higher in combined applications of N with TM and CS than single application of them (p < 0.05). They were also increased after combined applications of the S with A than after single application (p < 0.05).

Conclusions

Combined applications of fluoride could be used as a basis to design more effective methods of fluoride application to provide enhanced remineralization.

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The effect of red and white wine on color changes of nanofilled and nanohybrid resin composites
Saijai Tanthanuch, Boonlert Kukiattrakoon, Thanwalee Peerasukprasert, Nilobon Chanmanee, Parnchanok Chaisomboonphun, Apisara Rodklai
Restor Dent Endod 2016;41(2):130-136.   Published online May 3, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.130
AbstractAbstract PDFPubReaderePub
Objectives

This study investigated the effect of red and white wine on color changes of nanofilled and nanohybrid resin composite.

Materials and Methods

Sixty specimens of each resin composite were prepared. Baseline data color values were recorded using a spectrophotometer. Three groups of discs (n = 20) were then alternately immersed in red, white wine, and deionized water (as a control) for twenty five minutes and artificial saliva for five minutes for four cycles. Specimens were then stored in artificial saliva for twenty two hours. This process was repeated for five days following immersion in artificial saliva for two days. Subsequently, the process was repeated again. Data were analyzed by two-way repeated ANOVA, one-way ANOVA, and Tukey's HSD.

Results

Red wine caused significantly higher color change (ΔE* > 3.3) than did white wine and deionized water (p < 0.05). Nanohybrid resin composites had significantly more color changes than nanofilled resin composite (p < 0.05).

Conclusions

The effect of red and white wine on the color changes of resin composite restorative materials depended upon the physical and chemical composition of the restorative materials and the types of wine.

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Case Reports
Progression of periapical cystic lesion after incomplete endodontic treatment
Jong-Ki Huh, Dong-Kyu Yang, Kug-Jin Jeon, Su-Jung Shin
Restor Dent Endod 2016;41(2):137-142.   Published online February 22, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.137
AbstractAbstract PDFPubReaderePub

We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment.

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Fibre reinforcement in a structurally compromised endodontically treated molar: a case report
Renita Soares, Ida de Noronha de Ataide, Marina Fernandes, Rajan Lambor
Restor Dent Endod 2016;41(2):143-147.   Published online February 22, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.143
AbstractAbstract PDFPubReaderePub

The reconstruction of structurally compromised posterior teeth is a rather challenging procedure. The tendency of endodontically treated teeth (ETT) to fracture is considerably higher than vital teeth. Although posts and core build-ups followed by conventional crowns have been generally employed for the purpose of reconstruction, this procedure entails sacrificing a considerable amount of residual sound enamel and dentin. This has drawn the attention of researchers to fibre reinforcement. Fibre-reinforced composite (FRC), designed to replace dentin, enables the biomimetic restoration of teeth. Besides improving the strength of the restoration, the incorporation of glass fibres into composite resins leads to favorable fracture patterns because the fibre layer acts as a stress breaker and stops crack propagation. The following case report presents a technique for reinforcing a badly broken-down ETT with biomimetic materials and FRC. The proper utilization of FRC in structurally compromised teeth can be considered to be an economical and practical measure that may obviate the use of extensive prosthetic treatment.

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Nonsurgical endodontic retreatment of fused teeth with transposition: a case report
Miguel Agostinho Beco Pinto Cardoso, Rita Brandão Noites, Miguel André Duarte Martins, Manuel Pedro da Fonseca Paulo
Restor Dent Endod 2016;41(2):148-153.   Published online February 22, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.148
AbstractAbstract PDFPubReaderePub

Tooth transposition is a disorder in which a permanent tooth develops and erupts in the normal position of another permanent tooth. Fusion and gemination are developmental disturbances presenting as the union of teeth. This article reports the nonsurgical retreatment of a very rare case of fused teeth with transposition. A patient was referred for endodontic treatment of her maxillary left first molar in the position of the first premolar, which was adjacent to it on the distobuccal side. Orthopantomography and periapical radiography showed two crowns sharing the same root, with a root canal treatment and an associated periapical lesion. Tooth fusion with transposition of a maxillary molar and a premolar was diagnosed. Nonsurgical endodontic retreatment was performed. At four yr follow-up, the tooth was asymptomatic and the radiolucency around the apical region had decreased, showing the success of our intervention. The diagnosis and treatment of fused teeth require special attention. The canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Thermoplastic techniques were useful in obtaining hermetic obturation. A correct anatomical evaluation improves the set of treatment options under consideration, leading to a higher likelihood of esthetically and functionally successful treatment.

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Open Lecture on Statistics
Statistical notes for clinical researchers: Sample size calculation 2. Comparison of two independent proportions
Hae-Young Kim
Restor Dent Endod 2016;41(2):154-156.   Published online April 5, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.154
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Readers' Forum
Phosphoric acid etching for multi-mode universal adhesive
Kyung-Mo Cho
Restor Dent Endod 2016;41(2):157-158.   Published online April 5, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.157
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