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Volume 37 (4); November 2012
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Editorial
A case report as an inductive approach
Byeong-Hoon Cho
Restor Dent Endod 2012;37(4):187-187.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.187
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Review Article
Chemical characteristics of mineral trioxide aggregate and its hydration reaction
Seok-Woo Chang
Restor Dent Endod 2012;37(4):188-193.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.188
AbstractAbstract PDFPubReaderePub

Mineral trioxide aggregate (MTA) was developed in early 1990s and has been successfully used for root perforation repair, root end filling, and one-visit apexification. MTA is composed mainly of tricalcium silicate and dicalcium silicate. When MTA is hydrated, calcium silicate hydrate (CSH) and calcium hydroxide is formed. Formed calcium hydroxide interacts with the phosphate ion in body fluid and form amorphous calcium phosphate (ACP) which finally transforms into calcium deficient hydroxyapatite (CDHA). These mineral precipitate were reported to form the MTA-dentin interfacial layer which enhances the sealing ability of MTA. Clinically, the use of zinc oxide euginol (ZOE) based materials may retard the setting of MTA. Also, the use of acids or contact with excessive blood should be avoided before complete set of MTA, because these conditions could adversely affect the hydration reaction of MTA. Further studies on the chemical nature of MTA hydration reaction are needed.

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Research Articles
Evaluation of the rat tissue reaction to experimental new resin cement and mineral trioxide aggregate cement
Won-Kyung Yang, Hyun-Jung Ko, Mi-Ri Kim
Restor Dent Endod 2012;37(4):194-200.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.194
AbstractAbstract PDFPubReaderePub
Objectives

New resin cement (NRC) has been developed as a root repairing material and the material is composed of organic resin matrix and inorganic powders. The aim of this study was to compare the rat subcutaneous tissue response to NRC and mineral trioxide aggregate (MTA) cement and to investigate the tissue toxicity of both materials.

Materials and Methods

Sixty rats received two polyethylene tube-implants in dorsal subcutaneous regions, MTA and NRC specimens. Twenty rats were sacrificed respectively at 1, 4 and 8 wk after implantation and sectioned to 5 µm thickness and stained with Hematoxylin-Eosin (H-E) or von-Kossa staining. The condition of tissue adjacent to the implanted materials and the extent of inflammation to each implant were evaluated by two examiners who were unaware of the type of implanted materials in the tissues. Data were statistically analyzed with paired t-test (p < 0.05).

Results

In specimens implanted with both NRC and MTA, severe inflammatory reactions were present at one wk, which decreased with time. At eighth wk, MTA implanted tissue showed mild inflammatory reaction, while there were moderate inflammatory reactions in NRC implanted tissue, respectively. In NRC group, von-Kossa staining showed more calcification materials than MTA group at eighth wk.

Conclusions

It was concluded that the calcium reservoir capability of NRC may contribute to mineralization of the tissues.

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A survey of experience-based preference of Nickel-Titanium rotary files and incidence of fracture among general dentists
WooCheol Lee, Minju Song, Euiseong Kim, Hyojin Lee, Hyeon-Cheol Kim
Restor Dent Endod 2012;37(4):201-206.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.201
AbstractAbstract PDFPubReaderePub
Objectives

The purpose was to investigate the preference and usage technique of NiTi rotary instruments and to retrieve data on the frequency of re-use and the estimated incidence of file separation in the clinical practice among general dentists.

Materials and Methods

A survey was disseminated via e-mail and on-site to 673 general dentists. The correlation between the operator's experience or preferred technique and frequency of re-use or incidence of file fracture was assessed.

Results

A total of 348 dentists (51.7%) responded. The most frequently used NiTi instruments was ProFile (39.8%) followed by ProTaper. The most preferred preparation technique was crown-down (44.6%). 54.3% of the respondents re-used NiTi files more than 10 times. There was a significant correlation between experience with NiTi files and the number of reuses (p = 0.0025). 54.6% of the respondents estimated experiencing file separation less than 5 times per year. The frequency of separation was significantly correlated with the instrumentation technique (p = 0.0003).

Conclusions

A large number of general dentists in Korea prefer to re-use NiTi rotary files. As their experience with NiTi files increased, the number of re-uses increased, while the frequency of breakage decreased. Operators who adopt the hybrid technique showed less tendency of separation even with the increased number of re-use.

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Effect of chlorhexidine application on the bond strength of resin core to axial dentin in endodontic cavity
Yun-Hee Kim, Dong-Hoon Shin
Restor Dent Endod 2012;37(4):207-214.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.207
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated the influence of chlorhexidine (CHX) on the microtensile bonds strength (µTBS) of resin core with two adhesive systems to dentin in endodontic cavities.

Materials and Methods

Flat dentinal surfaces in 40 molar endodontic cavities were treated with self-etch adhesive system, Contax (DMG) and total-etch adhesive system, Adper Single Bond 2 (3M ESPE) after the following surface treatments: (1) Priming only (Contax), (2) CHX for 15 sec + rinsing + priming (Contax), (3) Etching with priming (Adper Single Bond 2), (4) Etching + CHX for 15 sec + rinsing + priming (Adper Single Bond 2). Resin composite build-ups were made with LuxaCore (DMG) using a bulk method and polymerized for 40 sec. For each condition, half of specimens were submitted to µTBS after 24 hr storage and half of them were submitted to thermocycling of 10,000 cycles between 5℃ and 55℃ before testing. The data were analyzed using ANOVA and independent t-test at a significance level of 95%.

Results

CHX pre-treatment did not affect the bond strength of specimens tested at the immediate testing period, regardless of dentin surface treatments. However, after 10,000 thermocycling, all groups showed reduced bond strength. The amount of reduction was greater in groups without CHX treatments than groups with CHX treatment. These characteristics were the same in both self-etch adhesive system and total-etch adhesive system.

Conclusions

2% CHX application for 15 sec proved to alleviate the decrease of bond strength of dentin bonding systems. No significant difference was shown in µTBS between total-etching system and self-etching system.

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Influence of glide path on the screw-in effect and torque of nickel-titanium rotary files in simulated resin root canals
Jung-Hong Ha, Sang-Shin Park
Restor Dent Endod 2012;37(4):215-219.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.215
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to investigate the screw-in effect and torque generation depending on the size of glide path during root canal preparation.

Materials and Methods

Forty Endo-Training Blocks (REF A 0177, Dentsply Maillefer) were used. They were divided into 4 groups. For groups 1, 2, 3, and 4, the glide path was established with ISO #13 Path File (Dentsply Maillefer), #15 NiTi K-file NITIFLEX (Dentsply Maillefer), modified #16 Path File (equivalent to #18), and #20 NiTi K-file NITIFLEX, respectively. The screw-in force and resultant torque were measured using a custom-made experimental apparatus while canals were instrumented with ProTaper S1 (Dentsply Maillefer) at a constant speed of 300 rpm with an automated pecking motion. A statistical analysis was performed using one-way analysis of variance and the Duncan post hoc comparison test.

Results

Group 4 showed lowest screw-in effect (2.796 ± 0.134) among the groups (p < 0.05). Torque was inversely proportional to the glide path of each group. In #20 glide path group, the screw-in effect and torque decreased at the last 1 mm from the apical terminus. However, in the other groups, the decrease of the screw-in effect and torque did not occur in the last 1 mm from the apical terminus.

Conclusions

The establishment of a larger glide path before NiTi rotary instrumentation appears to be appropriate for safely shaping the canal. It is recommended to establish #20 glide path with NiTi file when using ProTaper NiTi rotary instruments system safely.

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A comparison of the shaping ability of reciprocating NiTi instruments in simulated curved canals
Young-Sil Yoo, Yong-Bum Cho
Restor Dent Endod 2012;37(4):220-227.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.220
AbstractAbstract PDFPubReaderePub
Objectives

The study was to compare the shaping ability of Reciproc (VDW) and WaveOne (Dentsply Maillefer) instruments compared with ProTaper, Profile and hand instrument during the preparation of simulated root canals.

Materials and Methods

Five groups (n = 5) were established. Reciproc, WaveOne, ProTaper, Profile and K file (K-flexo file) were used to prepare the resin simulated canals. A series of preoperative and postoperative images were taken by a microscope and superimposed in 2 different layers. The amount of resin removed from both the inner and the outer sides of the canal was measured to the level of 10 mm from the apical tip, with a 1 mm increment.

Results

The mean of resin removal from the inner canal wall was not different from the outer canal wall for Reciproc and WaveOne groups at apical third (1 - 3 mm level). There was no difference in the change of working length and maintenance of canal curvature. NiTi instruments are superior to stainless-steel K file in their shaping ability.

Conclusions

Within the limitation of this present study, Reciproc and WaveOne instruments maintained the original canal curvature in curved canals better than ProTaper and Profile, which tend to transport towards the outer canal wall of the curve in the apical part of the canal.

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Case Reports
Invasive cervical resorption: treatment challenges
Yookyung Kim, Chan-Young Lee, Euiseong Kim, Byoung-Duck Roh
Restor Dent Endod 2012;37(4):228-231.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.228
AbstractAbstract PDFPubReaderePub

Invasive cervical resorption is a relatively uncommon form of external root resorption. It is characterized by invasion of cervical region of the root by fibrovascular tissue derived from the periodontal ligament. This case presents an invasive cervical resorption occurring in maxillary lateral incisor, following damage in cervical cementum from avulsion and intracoronal bleaching procedure. Flap reflection, debridement and restoration with glass ionomer cement were performed in an attempt to repair the defect. But after 2 mon, more resorption extended apically. Considering root stability and recurrence potential, we decided to extract the tooth. Invasive cervical resorption in advanced stages may present great challenges for clinicians. Therefore, prevention and early detection must be stressed when dealing with patients presenting history of potential predisposing factors.

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Hypoesthesia after IAN block anesthesia with lidocaine: management of mild to moderate nerve injury
Sungjoo Moon, Seung-Jong Lee, Euiseong Kim, Chan-Young Lee
Restor Dent Endod 2012;37(4):232-235.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.232
AbstractAbstract PDFPubReaderePub

Hypoesthesia after an inferior alveolar nerve (IAN) block does not commonly occur, but some cases are reported. The causes of hypoesthesia include a needle injury or toxicity of local anesthetic agents, and the incidence itself can cause stress to both dentists and patients. This case presents a hypoesthesia on mental nerve area followed by IAN block anesthesia with 2% lidocaine. Prescription of steroids for a week was performed and periodic follow up was done. After 1 wk, the symptoms got much better and after 4 mon, hypoesthesia completely disappeared. During this healing period, only early steroid medication was prescribed. In most cases, hypoesthesia is resolved within 6 mon, but being aware of etiology and the treatment options of hypoesthesia is important. Because the hypoesthesia caused by IAN block anesthesia is a mild to moderate nerve injury, early detection of symptom and prescription of steroids could be helpful for improvement of the hypoesthesia.

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Non-destructive management of white spot lesions by using tooth jewelry
Hee-Jin Kim, Lorena Karanxha, Su-Jung Park
Restor Dent Endod 2012;37(4):236-239.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.236
AbstractAbstract PDFPubReaderePub

Although several methods including composite resin restoration and microabrasion have been used for management of white spot lesion, tooth jewelry can be considered as another noninvasive option. This case report describes the management of white spot lesions by using tooth jewelry. This report also highlights the patients' preference for tooth jewelry as an esthetic concern.

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Considerations during crown reattachment procedure over the pulpal exposure: case report
Bona Kim, Yoon Lee, Min-Ju Song, Su-Jung Shin, Jeong-Won Park
Restor Dent Endod 2012;37(4):240-244.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.240
AbstractAbstract PDFPubReaderePub

Crown reattachment is the most conservative treatment which can be used to restore fractured tooth, presumably with sufficient strength, while maintaining original contour, incisal translucency, and reducing chair time and cost.

However, in case of crown fracture with pin-point pulp exposure, we should cautiously minimize the irritation to the pulp and consider pre-treatment pulpal status, choice of pulp capping materials, choice of bonding system and treatment sequence during crown reattachment procedures. This case reports the considerations while crown reattachment with direct pulp capping using calcium hydroxide (Dycal, Dentsply Caulk).

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Open Lecture on Statistics
Statistical notes for clinical researchers: assessing normal distribution (1)
Hae-Young Kim
Restor Dent Endod 2012;37(4):245-248.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.245
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Reader's Forum
'Wet or Dry tooth surface?' - for self-adhesive resin cement
Jeong-Won Park
Restor Dent Endod 2012;37(4):249-250.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.249
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