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Volume 41 (3); August 2016
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Review Article
Criteria for clinical translucency evaluation of direct esthetic restorative materials
Yong-Keun Lee
Restor Dent Endod 2016;41(3):159-166.   Published online June 28, 2016
DOI: https://doi.org/10.5395/rde.2016.41.3.159
AbstractAbstract PDFPubReaderePub

The purpose of this review was to suggest practical criteria for the clinical translucency evaluation of direct esthetic restorative materials, and to review the translucency with these criteria. For the evaluation of reported translucency values, measuring instrument and method, specimen thickness, background color, and illumination should be scrutinized. Translucency parameter (TP) of 15 to 19 could be regarded as the translucency of 1 mm thick human enamel. Visual perceptibility threshold for translucency difference in contrast ratio (ΔCR) of 0.07 could be transformed into ΔTP value of 2. Translucency differences between direct and indirect resin composites were perceivable (ΔTP > 2). Universal and corresponding flowable resin composites did not show perceivable translucency differences in most products. Translucency differed significantly by the product within each shade group, and by the shade group within each product. Translucency of human enamel and perceptibility threshold for translucency difference may be used as criteria for the clinical evaluation of translucency of esthetic restorative materials.

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Research Articles
Cytotoxicity and biocompatibility of Zirconia (Y-TZP) posts with various dental cements
Hyeongsoon Shin, Hyunjung Ko, Miri Kim
Restor Dent Endod 2016;41(3):167-175.   Published online May 30, 2016
DOI: https://doi.org/10.5395/rde.2016.41.3.167
AbstractAbstract PDFPubReaderePub
Objectives

Endodontically treated teeth with insufficient tooth structure are often restored with esthetic restorations. This study evaluated the cytotoxicity and biological effects of yttria partially stabilized zirconia (Y-TZP) blocks in combination with several dental cements.

Materials and Methods

Pairs of zirconia cylinders with medium alone or cemented with three types of dental cement including RelyX U200 (3M ESPE), FujiCEM 2 (GC), and Panavia F 2.0 (Kuraray) were incubated in medium for 14 days. The cytotoxicity of each supernatant was determined using 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays on L929 fibroblasts and MC3T3-E1 osteoblasts. The levels of interleukin-6 (IL-6) mRNA were evaluated by reverse transcription polymerase chain reaction (RT-PCR), and IL-6 protein was evaluated by enzyme-linked immunosorbent assays (ELISA). The data were analyzed using one-way ANOVA and Tukey post-hoc tests. A p < 0.05 was considered statistically significant.

Results

The MTT assays showed that MC3T3-E1 osteoblasts were more susceptible to dental cements than L929 fibroblasts. The resin based dental cements increased IL-6 expression in L929 cells, but reduced IL-6 expression in MC3T3-E1 cells.

Conclusions

Zirconia alone or blocks cemented with dental cement showed acceptable biocompatibilities. The results showed resin-modified glass-ionomer based cement less produced inflammatory cytokines than other self-adhesive resin-based cements. Furthermore, osteoblasts were more susceptible than fibroblasts to the biological effects of dental cement.

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Preference of undergraduate students after first experience on nickel-titanium endodontic instruments
Sang Won Kwak, Gary Shun-Pan Cheung, Jung-Hong Ha, Sung Kyo Kim, Hyojin Lee, Hyeon-Cheol Kim
Restor Dent Endod 2016;41(3):176-181.   Published online June 23, 2016
DOI: https://doi.org/10.5395/rde.2016.41.3.176
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to compare two nickel-titanium systems (rotary vs. reciprocating) for their acceptance by undergraduate students who experienced nickel-titanium (NiTi) instruments for the first time.

Materials and Methods

Eighty-one sophomore dental students were first taught on manual root canal preparation with stainless-steel files. After that, they were instructed on the use of ProTaper Universal system (PTU, Dentsply Maillefer), then the WaveOne (WO, Dentsply Maillefer). They practiced with each system on 2 extracted molars, before using those files to shape the buccal or mesial canals of additional first molars. A questionnaire was completed after using each file system, seeking students' perception about 'Ease of use', 'Flexibility', 'Cutting-efficiency', 'Screwing-effect', 'Feeling-safety', and 'Instrumentation-time' of the NiTi files, relative to stainless-steel instrumentation, on a 5-point Likert-type scale. They were also requested to indicate their preference between the two systems. Data was compared between groups using t-test, and with Chi-square test for correlation of each perception value with the preferred choice (p = 0.05).

Results

Among the 81 students, 55 indicated their preferred file system as WO and 22 as PTU. All scores were greater than 4 (better) for both systems, compared with stainless-steel files, except for 'Screwing-effect' for PTU. The scores for WO in the categories of 'Flexibility', 'Screwing-effect', and 'Feeling-safety' were significantly higher scores than those of PTU. A significant association between the 'Screwing-effect' and students' preference for WO was observed.

Conclusions

Novice operators preferred nickel-titanium instruments to stainless-steel, and majority of them opted for reciprocating file instead of continuous rotating system.

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Proximity of the mandibular molar root apex from the buccal bone surface: a cone-beam computed tomographic study
Dokyung Kim, Jung-Hong Ha, Myoung-Uk Jin, Young-Kyung Kim, Sung Kyo Kim
Restor Dent Endod 2016;41(3):182-188.   Published online July 14, 2016
DOI: https://doi.org/10.5395/rde.2016.41.3.182
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to evaluate the proximity of the mandibular molar apex to the buccal bone surface in order to provide anatomic information for apical surgery.

Materials and Methods

Cone-beam computed tomography (CBCT) images of 127 mandibular first molars and 153 mandibular second molars were analyzed from 160 patients' records. The distance was measured from the buccal bone surface to the root apex and the apical 3.0 mm on the cross-sectional view of CBCT.

Results

The second molar apex and apical 3 mm were located significantly deeper relative to the buccal bone surface compared with the first molar (p < 0.01). For the mandibular second molars, the distance from the buccal bone surface to the root apex was significantly shorter in patients over 70 years of age (p < 0.05). Furthermore, this distance was significantly shorter when the first molar was missing compared to nonmissing cases (p < 0.05). For the mandibular first molars, the distance to the distal root apex of one distal-rooted tooth was significantly greater than the distance to the disto-buccal root apex (p < 0.01). In mandibular second molar, the distance to the apex of C-shaped roots was significantly greater than the distance to the mesial root apex of non-C-shaped roots (p < 0.01).

Conclusions

For apical surgery in mandibular molars, the distance from the buccal bone surface to the apex and apical 3 mm is significantly affected by the location, patient age, an adjacent missing anterior tooth, and root configuration.

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In vitro evaluation of a newly produced resin-based endodontic sealer
Yoo-Seok Song, Yoorina Choi, Myung-Jin Lim, Mi-Kyung Yu, Chan-Ui Hong, Kwang-Won Lee, Kyung-San Min
Restor Dent Endod 2016;41(3):189-195.   Published online July 26, 2016
DOI: https://doi.org/10.5395/rde.2016.41.3.189
AbstractAbstract PDFPubReaderePub
Objectives

A variety of root canal sealers were recently launched to the market. This study evaluated physicochemical properties, biocompatibility, and sealing ability of a newly launched resin-based sealer (Dia-Proseal, Diadent) compared to the existing root canal sealers (AHplus, Dentsply DeTrey and ADseal, Metabiomed).

Materials and Methods

The physicochemical properties of the tested sealers including pH, solubility, dimensional change, and radiopacity were evaluated. Biocompatibility was measured using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. For microleakage test, single-rooted teeth were instrumented, and obturated with gutta-percha and one of the sealers (n = 10). After immersion in 1% methylene blue solution for 2 weeks, the specimens were split longitudinally. Then, the maximum length of staining was measured. Statistical analysis was performed by one-way analysis of variance followed by Tukey test (p = 0.05).

Results

Dia-Proseal showed the highest pH value among the tested sealers (p < 0.05). ADseal showed higher dimensional change compared to AHplus and Dia-Proseal (p < 0.05). The solubility values of AHplus and Dia-Proseal were similar, whereas ADseal had the lowest solubility value (p < 0.05). The flow values of sealer in increasing order were AHplus, DiaProseal, and ADseal (p < 0.05). The radiopacity of AHplus was higher than those of ADseal and Dia-Proseal (p < 0.05). The cell viability of the tested materials was statistically similar throughout the experimental period. There were no significant differences in microleakage values among the tested samples.

Conclusions

The present study indicates that Dia-Proseal has acceptable physicochemical properties, biocompatibility, and sealing ability.

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Effect of three nanobiomaterials on microhardness of bleached enamel
Maryam Khoroushi, Farinaz Shirban, Sara Kaveh, Samaneh Doustfateme
Restor Dent Endod 2016;41(3):196-201.   Published online July 14, 2016
DOI: https://doi.org/10.5395/rde.2016.41.3.196
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this in vitro study was to evaluate the effect of incorporating three different nanobiomaterials into bleaching material on microhardness of bleached enamel.

Materials and Methods

The crowns of 24 extracted sound human molars were sectioned. Sixty enamel specimens (2 × 3 × 4 mm) were selected and divided into five groups (n = 12): Group 1 received no bleaching procedure (control); Group 2 underwent bleaching with a 40% hydrogen peroxide (HP) gel; Groups 3, 4, and 5 were bleached with a 40% HP gel modified by incorporation of bioactive glass (BAG), amorphous calcium phosphate (ACP) and hydroxyapatite (HA), respectively. The enamel microhardness was evaluated. The differences in Knoop microhardness data of each group were analyzed by one-way ANOVA, followed by post hoc Tukey tests.

Results

Significant differences were observed between the study groups. The enamel microhardness changes in Groups 1, 3, 4, and 5 were significantly lower than that of Group 2 (p < 0.001).

Conclusions

Within the limitations of this study, it can be concluded that incorporation of each one of the three tested biomaterials as remineralizing agents might be effective in decreasing enamel microhardness changes subsequent to in-office bleaching.

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Involvement of TRPA1 in the cinnamaldehyde-induced pulpal blood flow change in the feline dental pulp
Dokyung Kim, Moon-Hwan Lee, Sung Kyo Kim
Restor Dent Endod 2016;41(3):202-209.   Published online July 29, 2016
DOI: https://doi.org/10.5395/rde.2016.41.3.202
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to investigate the involvement of TRPA1 in the cinnamaldehyde-induced pulpal blood flow (PBF) change in the feline dental pulp.

Materials and Methods

Mandibles of eight cats were immobilized and PBF was monitored with a laser Doppler flowmetry at the mandibular canine tooth. To evaluate the effect of cinnamaldehyde on PBF, cinnamaldehyde was injected into the pulp through the lingual artery at a constant rate for 60 seconds. As a control, a mixture of 70% ethanol and 30% dimethyl sulfoxide (DMSO, vehicle) was used. To evaluate the involvement of transient receptor potential ankyrin 1 (TRPA1) in PBF change, AP18, a specific TRPA1 antagonist, was applied into the pulp through the Class V dentinal cavity followed by cinnamaldehyde-administration 3 minutes later. The paired variables of experimental data were statistically analyzed using paired t-test. A p value of less than 0.05 was considered as statistically significant.

Results

Administration of cinnamaldehyde (0.5 mg/kg, intra-arterial [i.a.]) induced significant increases in PBF (p < 0.05). While administration of a TRPA1 antagonist, AP18 (2.5 - 3.0 mM, into the dentinal cavity [i.c.]) caused insignificant change of PBF (p > 0.05), administration of cinnamaldehyde (0.5 mg/kg, i.a.) following the application of AP18 (2.5 - 3.0 mM, i.c.) resulted in an attenuation of PBF increase from the control level (p < 0.05). As a result, a TRPA1 antagonist, AP18 effectively inhibited the vasodilative effect of cinnamaldehyde (p < 0.05).

Conclusions

The result of the present study provided a functional evidence that TRPA1 is involved in the mechanism of cinnamaldehyde-induced vasodilation in the feline dental pulp.

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Case Reports
Esthetic enhancement of a traumatized anterior tooth with a combination of forced eruption and tooth alignment: a case report
So-Hee Kang, Jung-Hong Ha, Myoung-Uk Jin, Sung-Kyo Kim, Young-Kyung Kim
Restor Dent Endod 2016;41(3):210-217.   Published online June 1, 2016
DOI: https://doi.org/10.5395/rde.2016.41.3.210
AbstractAbstract PDFPubReaderePub

Exposing sound structure of a subgingivally fractured tooth using orthodontic extrusion is considered to be a conservative way to re-establish biologic width without sacrificing esthetics or jeopardizing periodontal support of neighboring teeth. When a misaligned tooth is traumatically involved, a more comprehensive approach combining tooth extrusion and re-alignment may be necessary for a successful restorative outcome. This case report describes a successful esthetic management of a patient with complicated crown-root fracture on the maxillary right central incisor and pre-existing malocclusion in the maxillary anterior region. Forced eruption along with re-alignment of teeth by orthodontic movement seems to allow re-positioning of the fracture line to a favorable position and correction of crowding, providing a better esthetic result.

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A combined approach to non-carious cervical lesions associated with gingival recession
SungEun Yang, HyeJin Lee, Sung-Ho Jin
Restor Dent Endod 2016;41(3):218-224.   Published online May 2, 2016
DOI: https://doi.org/10.5395/rde.2016.41.3.218
AbstractAbstract PDFPubReaderePub

Non-carious cervical lesions (NCCLs) with gingival recession require specific consideration on both aspects of hard and soft tissue lesion. In the restorative aspect, careful finishing and polishing of the restorations prior to mucogingival surgery is the critical factor contributing to success. Regarding surgery, assessment of the configuration of the lesion and the choice of surgical technique are important factors. The precise diagnosis and the choice of the proper treatment procedure should be made on the basis of both restorative and surgical considerations to ensure the successful treatment of NCCLs.

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Application of quantitative light-induced fluorescence to determine the depth of demineralization of dental fluorosis in enamel microabrasion: a case report
Tae-Young Park, Han-Sol Choi, Hee-Won Ku, Hyun-Su Kim, Yoo-Jin Lee, Jeong-Bum Min
Restor Dent Endod 2016;41(3):225-230.   Published online June 20, 2016
DOI: https://doi.org/10.5395/rde.2016.41.3.225
AbstractAbstract PDFPubReaderePub

Enamel microabrasion has become accepted as a conservative, nonrestorative method of removing intrinsic and superficial dysmineralization defects from dental fluorosis, restoring esthetics with minimal loss of enamel. However, it can be difficult to determine if restoration is necessary in dental fluorosis, because the lesion depth is often not easily recognized. This case report presents a method for analysis of enamel hypoplasia that uses quantitative light-induced fluorescence (QLF) followed by a combination of enamel microabrasion with carbamide peroxide home bleaching. We describe the utility of QLF when selecting a conservative treatment plan and confirming treatment efficacy. In this case, the treatment plan was based on QLF analysis, and the selected combination treatment of microabrasion and bleaching had good results.

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Open Lecture on Statistics
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Reader's Forum
Introducing the GentleWave System
Won-Jun Shon
Restor Dent Endod 2016;41(3):235-235.   Published online July 26, 2016
DOI: https://doi.org/10.5395/rde.2016.41.3.235
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Letter to Editor
Nano-computed tomography: current and future perspectives
Hany Mohamed Aly Ahmed
Restor Dent Endod 2016;41(3):236-238.   Published online July 26, 2016
DOI: https://doi.org/10.5395/rde.2016.41.3.236
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Restor Dent Endod : Restorative Dentistry & Endodontics
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