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Volume 40 (4); November 2015
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Research Articles
The effect of different drinks on the color stability of different restorative materials after one month
Neslihan Tekçe, Safa Tuncer, Mustafa Demirci, Merve Efe Serim, Canan Baydemir
Restor Dent Endod 2015;40(4):255-261.   Published online August 7, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.255
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to evaluate the effect of three different drinks on the color parameters of four different restorative materials.

Materials and Methods

Three different composites (Filtek Ultimate Universal Restorative, Filtek Ultimate Flowable, and Filtek Silorane, 3M ESPE) and a polyacid-modified composite resin material (Dyract XP, Dentsply DeTrey GmbH) were evaluated. Eighty-four disc-shaped specimens of 8 mm in diameter and 2 mm in thickness were prepared (n = 21 each). Color coordinates (L*a*b*, ΔL*, Δa*, Δb*, and ΔE*) were measured using a VİTA Easyshade Compact (VİTA Zahnfabrik) after 24 hr of storage (baseline) and after 30 day of storage in three different beverages of black tea, Coca cola, or water (control) (n = 7). In each beverage, the specimens were stored three times a day, one hr each, for 30 day. The color changes (ΔE) were calculated and were analyzed by Kruskal-Wallis and Dunn multiple comparison test.

Results

The color difference (ΔE*) of the resin materials ranged between 1.31 and 15.28 after 30 day of immersion in the staining solutions. Dyract XP in Coca cola (15.28 ± 2.61) and black tea (12.22 ± 2.73) showed the highest mean ΔE* value after 30 day, followed by Filtek Ultimate Universal Restorative (5.99 ± 1.25) and Filtek Ultimate Flowable (4.71 ± 1.40) in black tea (p < 0.05).

Conclusions

The compomers displayed unacceptable color changes at the end of 30 day in all beverages. Among resin composites, the silorane based composite exhibited relatively good color stability than the others. Filtek Ultimate Universal Restorative and Filtek Flowable showed similar color changes in all beverages.

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Comparison of mechanical properties of a new fiber reinforced composite and bulk filling composites
Hazem Abouelleil, Nelly Pradelle, Cyril Villat, Nina Attik, Pierre Colon, Brigitte Grosgogeat
Restor Dent Endod 2015;40(4):262-270.   Published online September 2, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.262
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to evaluate the mechanical and physical properties of a newly developed fiber reinforced dental composite.

Materials and Methods

Fiber reinforced composite EverX Posterior (EXP, GC EUROPE), and other commercially available bulk fill composites, including Filtek Bulk Fill (FB, 3M ESPE), SonicFill (SF, Kerr Corp.), SureFil (SDR, Dentsply), Venus Bulk Fill (VB, HerausKultzer), Tetric evoceram bulk fill (TECB, Ivoclar Vivadent), and Xtra Base (XB, Voco) were characterized. Composite samples light-cured with a LED device were evaluated in terms of flexural strength, flexural modulus (ISO 4049, n = 6), fracture toughness (n = 6), and Vickers hardness (0, 2, and 4 mm in depth at 24 hr, n = 5). The EXP samples and the fracture surface were observed under a scanning electron microscopy. Data were statistically analyzed using one-way ANOVA and unpaired t-test.

Results

EXP, FB, and VB had significantly higher fracture toughness value compared to all the other bulk composite types. SF, EXP, and XB were not statistically different, and had significantly higher flexural strength values compared to other tested composite materials. EXP had the highest flexural modulus, VB had the lowest values. Vickers hardness values revealed SF, EXP, TECB, and XB were not statistically different, and had significantly higher values compared to other tested composite materials. SEM observations show well dispersed fibers working as a reinforcing phase.

Conclusions

The addition of fibers to methacrylate-based matrix results in composites with either comparable or superior mechanical properties compared to the other bulk fill materials tested.

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Effect of immersion into solutions at various pH on the color stability of composite resins with different shades
Ji-Deok Moon, Eun-Mi Seon, Sung-Ae Son, Kyoung-Hwa Jung, Yong-Hoon Kwon, Jeong-Kil Park
Restor Dent Endod 2015;40(4):270-276.   Published online August 28, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.270
AbstractAbstract PDFPubReaderePub
Objectives

This study examined the color changes of a resin composite with different shades upon exposure to water with different pH.

Materials and Methods

Nanohybrid resin composites (Filtek Z350XT, 3M ESPE) with four different shades (A2, A3, B1, and B2) were immersed in water with three different pH (pH 3, 6, and 9) for 14 day. The CIE L*a*b* color coordinates of the specimens were evaluated before and after immersion in the solutions. The color difference (ΔE*) and the translucency parameter (TP) were calculated using the color coordinates.

Results

ΔE* ranged from 0.33 to 1.58, and the values were affected significantly by the pH. The specimens immersed in a pH 6 solution showed the highest ΔE* values (0.87 - 1.58). The specimens with a B1 shade showed the lowest ΔE* change compared to the other shades. TP ranged from 7.01 to 9.46 depending on the pH and resin shade. The TP difference between before and after immersion in the pH solutions was less than 1.0.

Conclusions

The resulting change of color of the tested specimens did not appear to be clinically problematic because the color difference was < 1.6 in the acidic, neutral, and alkaline solutions regardless of the resin shade, i.e., the color change was imperceptible.

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Clinical and radiographical evaluation of mineral trioxide aggregate, biodentine and propolis as pulpotomy medicaments in primary teeth
Bharti Kusum, Kumar Rakesh, Khanna Richa
Restor Dent Endod 2015;40(4):276-285.   Published online September 9, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.276
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to evaluate the efficacy of mineral trioxide aggregate (MTA), Biodentine and Propolis as pulpotomy medicaments in primary dentition, both clinically and radiographically.

Materials and Methods

A total of 75 healthy 3 to 10 yr old children each having at least one carious primary molar tooth were selected. Random assignment of the pulpotomy medicaments was done as follows: Group I, MTA; Group II, Biodentine; Group III, Propolis. All the pulpotomized teeth were evaluated at 3, 6, and 9 mon clinically and radiographically, based on the scoring criteria system.

Results

The clinical success rates were found to be similar among the three groups at 3 and 6 mon where as a significant decrease in success rate was observed in Group III (84%) compared to both Group I (100%) and Group II (100%) at 9 mon. Radiographic success rates over a period of 9 mon in Groups I, II, and III were 92, 80, and 72%, respectively.

Conclusions

Teeth treated with MTA and Biodentine showed more favorable clinical and radiographic success as compared to Propolis at 9 mon follow-up.

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Influence of a glide path on the dentinal crack formation of ProTaper Next system
Sevinç Aktemur Türker, Emel Uzunoğlu
Restor Dent Endod 2015;40(4):286-289.   Published online September 2, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.286
AbstractAbstract PDFPubReaderePub
Objectives

The aim was to evaluate dentinal crack formation after root canal preparation with ProTaper Next system (PTN) with and without a glide path.

Materials and Methods

Forty-five mesial roots of mandibular first molars were selected. Fifteen teeth were left unprepared and served as controls. The experimental groups consist of mesiobuccal and mesiolingual root canals of remaining 30 teeth, which were divided into 2 groups (n = 15): Group PG/PTN, glide path was created with ProGlider (PG) and then canals were shaped with PTN system; Group PTN, glide path was not prepared and canals were shaped with PTN system only. All roots were sectioned perpendicular to the long axis at 1, 2, 3, 4, 6, and 8 mm from the apex, and the sections were observed under a stereomicroscope. The presence/absence of cracks was recorded. Data were analyzed with chi-square tests with Yates correction.

Results

There were no significant differences in crack formation between the PTN with and without glide path preparation. The incidence of cracks observed in PG/PTN and PTN groups was 17.8% and 28.9%, respectively.

Conclusions

The creation of a glide path with ProGlider before ProTaper Next rotary system did not influence dentinal crack formation in root canals.

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Effect of dentin treatment on proliferation and differentiation of human dental pulp stem cells
Minjeong Park, Nan-Sim Pang, Il-Young Jung
Restor Dent Endod 2015;40(4):290-298.   Published online September 23, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.290
AbstractAbstract PDFPubReaderePub
Objectives

Sodium hypochlorite (NaOCl) is an excellent bactericidal agent, but it is detrimental to stem cell survival, whereas intracanal medicaments such as calcium hydroxide (Ca[OH]2) promote the survival and proliferation of stem cells. This study evaluated the effect of sequential NaOCl and Ca[OH]2 application on the attachment and differentiation of dental pulp stem cells (DPSCs).

Materials and Methods

DPSCs were obtained from human third molars. All dentin specimens were treated with 5.25% NaOCl for 30 min. DPSCs were seeded on the dentin specimens and processed with additional 1 mg/mL Ca[OH]2, 17% ethylenediaminetetraacetic acid (EDTA) treatment, file instrumentation, or a combination of these methods. After 7 day of culture, we examined DPSC morphology using scanning electron microscopy and determined the cell survival rate with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. We measured cell adhesion gene expression levels after 4 day of culture and odontogenic differentiation gene expression levels after 4 wk using quantitative real-time polymerase chain reaction.

Results

DPSCs did not attach to the dentin in the NaOCl-treated group. The gene expression levels of fibronectin-1 and secreted phosphoprotein-1 gene in both the Ca[OH]2- and the EDTA-treated groups were significantly higher than those in the other groups. All Ca[OH]2-treated groups showed higher expression levels of dentin matrix protein-1 than that of the control. The dentin sialophosphoprotein level was significantly higher in the groups treated with both Ca[OH]2 and EDTA.

Conclusions

The application of Ca[OH]2 and additional treatment such as EDTA or instrumentation promoted the attachment and differentiation of DPSCs after NaOCl treatment.

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The effect of saliva decontamination procedures on dentin bond strength after universal adhesive curing
Jayang Kim, Sungok Hong, Yoorina Choi, Sujung Park
Restor Dent Endod 2015;40(4):299-305.   Published online October 2, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.299
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to investigate the effectiveness of multiple decontamination procedures for salivary contamination after curing of a universal adhesive on dentin bond strength according to its etch modes.

Materials and Methods

Forty-two extracted bovine incisors were trimmed by exposing the labial dentin surfaces and embedded in cylindrical molds. A universal adhesive (All-Bond Universal, Bisco) was used. The teeth were randomly divided into groups according to etch mode and decontamination procedure. The adhesive was applied according to the manufacturer's instructions for a given etch mode. With the exception of the control groups, the cured adhesive was contaminated with saliva for 20 sec. In the self-etch group, the teeth were divided into three groups: control, decontamination with rinsing and drying, and decontamination with rinsing, drying, and adhesive. In the etch-and-rinse group, the teeth were divided into four groups: control, decontamination with rinsing and drying, decontamination with rinsing, drying, and adhesive, and decontamination with rinsing, drying, re-etching, and reapplication of adhesive. A composite resin (Filtek Z350XT, 3M ESPE) was used for filling and was cured on the treated surfaces. Shear bond strength was measured, and failure modes were evaluated. The data were subjected to one-way analysis of variation and Tukey's HSD test.

Results

The etch-and-rinse subgroup that was decontaminated by rinse, drying, re-etching, and reapplication of adhesive showed a significantly higher bond strength.

Conclusions

When salivary contamination occurs after curing of the universal adhesive, additional etching improves the bond strength to dentin.

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Identification of Enterococcus faecalis antigens specifically expressed in vivo
Seok-Woo Lee, Uttom K. Shet, Sang-Won Park, Hyun-Pil Lim, Kwi-Dug Yun, Seong Soo Kang, Se Eun Kim
Restor Dent Endod 2015;40(4):306-311.   Published online October 5, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.306
AbstractAbstract PDFPubReaderePub
Objectives

Molecular mechanism of the pathogenicity of Enterococcus faecalis (E. faecalis), a suspected endodontic pathogen, has not yet been adequately elucidated due to limited information on its virulence factors. Here we report the identification of in vivo expressed antigens of E. faecalis by using a novel immunoscreening technique called change-mediated antigen technology (CMAT) and an experimental animal model of endodontic infection.

Materials and Methods

Among 4,500 E. coli recombinant clones screened, 19 positive clones reacted reproducibly with hyperimmune sera obtained from rabbits immunized with E. faecalis cells isolated from an experimental endodontic infection. DNA sequences from 16 of these in vivo-induced (IVI) genes were determined.

Results

Identified protein antigens of E. faecalis included enzymes involved in housekeeping functions, copper resistance protein, putative outer membrane proteins, and proteins of unknown function.

Conclusions

In vivo expressed antigens of E. faecalis could be identified by using a novel immune-screening technique CMAT and an experimental animal model of endodontic infection. Detailed analysis of these IVI genes will lead to a better understanding of the molecular mechanisms involved in the endodontic infection of E. faecalis.

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Case Reports
Management of apicomarginal defect in esthetic region associated with a tooth with anomalies
Vinayak Venkoosa Meharwade, Dipali Yogesh Shah, Pradyna Prabhakar Mali, Vidya Vinayak Meharwade
Restor Dent Endod 2015;40(4):314-321.   Published online June 24, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.314
AbstractAbstract PDFPubReaderePub

Tooth related factors such as palatoradicular groove can be one of the causes for localized periodontal destruction. Such pathological process may result in apicomarginal defect along with inflammation of pulp. This creates challenging situation which clinician must be capable of performing advanced periodontal regenerative procedures for the successful management. This case report discusses clinical management of apicomarginal defect associated with extensive periradicular destruction in a maxillary lateral incisor, along with histopathologic aspect of the lesion.

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Treatment of non-vital immature teeth with amoxicillin-containing triple antibiotic paste resulting in apexification
Hyon-Beom Park, Bin-Na Lee, Yun-Chan Hwang, In-Nam Hwang, Won-Mann Oh, Hoon-Sang Chang
Restor Dent Endod 2015;40(4):322-327.   Published online August 28, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.322
AbstractAbstract PDFPubReaderePub

A recent treatment option for non-vital immature teeth in young patients is revascularization with triple antibiotic paste (TAP). However, tooth discoloration was reported with the use of conventional minocycline-containing TAP. In this case report, amoxicillin-containing TAP was used for revascularization of non-vital immature teeth to prevent tooth discoloration. At the 1 yr follow up, the teeth were asymptomatic on clinical examination and showed slight discoloration of the crown due to mineral trioxide aggregate (MTA) filling rather than amoxicillin-containing TAP. Radiographic examination revealed complete resolution of the periapical radiolucency, and closed apex with obvious periodontal ligament space. However, the root growth was limited, and the treatment outcome was more like apexification rather than revascularization. These results may be due to unstable blood clot formation which could not resist the condensation force of MTA filling, whether or not a collagen matrix was in place. These cases showed that although revascularization was not successful, apexification could be expected, resulting in the resolution of the periapical radiolucency and the closure of the apex. Therefore, it is worthwhile attempting revascularization of non-vital immature teeth in young patients.

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Open Lecture on Statistics
Statistical notes for clinical researchers: effect size
Hae-Young Kim
Restor Dent Endod 2015;40(4):328-331.   Published online October 2, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.328
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Readers' Forum
Simple methods to enhance bond strength of self-adhesive resin cements
Sung-Ae Son
Restor Dent Endod 2015;40(4):332-333.   Published online October 2, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.332
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Letter to Editor
Working width, a deserted aspect of Endodontics
Denzil Albuquerque, Jojo Kottoor
Restor Dent Endod 2015;40(4):334-335.   Published online September 23, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.334
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