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Volume 34 (5); September 2009
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Original Articles
Fracture resistance of crown-root fractured teeth repaired with dual-cured composite resin and horizontal posts
Seok-Woo Chang, Yong-Keun Lee, Seung-Hyun Kyung, Hyun-Mi Yoo, Tae-Seok Oh, Dong-Sung Park
J Korean Acad Conserv Dent 2009;34(5):383-389.   Published online September 30, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.5.383
AbstractAbstract PDFPubReaderePub

The purpose of this study was to investigate the fracture resistance of crown-root fractured teeth repaired with dual-cured composite resin and horizontal posts. 48 extracted human premolars were assigned to control group and three experimental groups. Complete crown-root fractures were experimentally induced in all control and experimental teeth. In the control group, the teeth (n=12) were bonded with resin cement and endodontically treated. Thereafter, the access cavities were sealed with dual-cured composite resin. In composite resin core - post group (n=12), the teeth were endodontically treated and access cavities were sealed with dual-cured composite resin. In addition, the fractured segments in this group were fixed using horizontal posts. In composite resin core group (n=12), the teeth were endodontically treated and the access cavities were filled with dual-cured composite resin without horizontal posts. In bonded amalgam group (n=12), the teeth were endodontically treated and the access cavities were sealed with bonded amalgam. Experimental complete crown-root fractures were induced again on repaired control and experimental teeth. The ratio of fracture resistance to original fracture resistance was analyzed with Kruskal-Wallis test. The results showed that teeth in control and composite resin core - post group showed significantly higher resistance to re-fracture than those in amalgam core group (p < 0.05). The resistance to refracture was high in the order of composite resin - post group, control group, composite resin group and bonded amalgam group. Within the scope of this study, the use of horizontal post could be beneficial in increasing the fracture resistance of previously fractured teeth.

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EVALUATION OF ENTEROCOCCUS FAECALIS REMOVAL EFFICACY OF THE ENDOVAC® AND ENDOACTIVATOR® INTRACANAL IRRIGATION METHODS
Seung-Gon Song, Kyung-Mo Cho, Jin-Woo Kim
J Korean Acad Conserv Dent 2009;34(5):390-396.   Published online January 14, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.5.390
AbstractAbstract PDFPubReaderePub
Abstract

The aim of this study was to evaluate endodontic irrigation methods with EndoVac® and EndoActivator® in the elimination of Enterococcus faecalis from the root canals. Extracted 70 human single-rooted teeth were used. The canals were instrumented by a crown-down technique with .04 taper ProFile to ISO size 40. After the teeth were autoclaved, the canals were inoculated with E. faecalis and incubated for 48 h. The teeth were randomly divided into three experimental groups of 20 teeth each according to canal irrigation methods and two control groups as follows: group 1 - EndoVac®; group 2 - EndoActivator®; group 3 - Conventional needle irrigation method. After canal irrigation using 2.5% NaOCl, first samples (S1) were taken using sterile paper point. And the canals were filled with sterile brain heart infusion (BHI) broth and incubated for 24 h, then second samples (S2) were taken. The samples were cultured on BHI agar plate to determine the numbers of colony forming units (CFU). In first sampling (S1), only one canal of conventional method among the all experimental groups was positive cultured. In second sampling (S2), EndoVac® group showed the least positive culture numbers of E. faecalis. There was statistically significant difference between the EndoVac® and conventional needle irrigation methods in the mean value of Log CFU. According to the results of this study, EndoVac® showed better efficacy than conventional needle irrigation method in the elimination of E. faecalis from the root canal.

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Effect of an intermediate bonding resin and flowable resin on the compatibility of two-step total etching adhesives with a self-curing composite resin
Sook-Kyung Choi, Ji-Wan Yum, Hyeon-Cheol Kim, Bock Hur, Jeong-Kil Park
J Korean Acad Conserv Dent 2009;34(5):397-405.   Published online September 30, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.5.397
AbstractAbstract PDFPubReaderePub

This study compared the effect of an activator, intermediate bonding resin and low-viscosity flowable resin on the microtensile bond strength of a self-curing composite resin used with two-step total etching adhesives. Twenty extracted permanent molars were used. The teeth were assigned randomly to nine groups (n=10) according to the adhesive system and application of additional methods (activator, intermediate adhesive, flowable resin). The bonding agents and additional applications of each group were applied to the dentin surfaces. Self-curing composite resin buildups were made for each tooth to form a core, 5mm in height. The restored teeth were then stored in distilled water at room temperature for 24h before sectioning. The microtensile bond strength of all specimens was examined. The data was analyzed statistically by one-way ANOVA and a Scheffe's test. The application of an intermediate bonding resin (Optibond FL adhesive) and low-viscosity flowable resin (Tetric N-flow) produced higher bond strength than that with the activator in all groups. Regardless of the method selected, Optibond solo plus produced the lowest µTBS to dentin. The failure modes of the tested dentin bonding agents were mostly adhesive failure but there were some cases showed cohesive failure in the resin.

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The effect of concentration and application time of hydrogen peroxide on the microtensile bond strength of resin restorations to the dentin at different depths
Jeong-Lyong Son, Gye-Young Lee, Yu-Mi Kang, Young-Taek Oh, Kwang-Won Lee, Tae-Gun Kim
J Korean Acad Conserv Dent 2009;34(5):406-414.   Published online September 30, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.5.406
AbstractAbstract PDFPubReaderePub

The purpose of this study was to examine the effect of hydrogen peroxide at different application time and concentrations on the microtensile bond strength of resin restorations to the deep and the pulp chamber dentin.

A conventional endodontic access cavity was prepared in each tooth, and then the teeth were randomly divided into 1 control group and 4 experimental groups as follows: Group 1, non treated; Group 2, with 20% Hydrogen peroxide(H2O2); Group 3, with 10% H2O2; Group 4, with 5% H2O2; Group 5, with 2.5% H2O2; the teeth of all groups except group 1 were treated for 20, 10, and 5min. The treated teeth were filled using a Superbond C&B (Sun medical Co., Shiga, Japan). Thereafter, the specimens were stored in distilled water at 37℃ for 24-hours and then sectioned into the deep and the chamber dentin. The microtensile bond strength values of each group were analyzed by 3-way ANOVA and Tukey post hoc test(p < 0.05).

In this study, the microtensile bond strength of the deep dentin (D1) was significantly greater than that of the pulp chamber dentin (D2) in the all groups tested. The average of microtensile bond strength was decreased as the concentration and the application time of H2O2 were increased. Analysis showed significant correlation effect not only between the depth of the dentin and the concentration of H2O2 but also between the concentration of H2O2 and the application time(p < 0.05), while no significant difference existed among these three variables(p > 0.05). The higher H2O2 concentration, the more opened dentinal tubules under a scanning electron microscope(SEM) examination.

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A bioactivity study of Portland cement mixed with β-glycerophosphosphate on human pulp cell
Young-Hwan Oh, Young-Joo Jang, Yong-Bum Cho
J Korean Acad Conserv Dent 2009;34(5):415-423.   Published online September 30, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.5.415
AbstractAbstract PDFPubReaderePub

The purpose of this study is to investigate the response of human pulp cell on Portland cement mixed with β-glycerophosphate. To investigate the effect of β-glycerophosphate and/or dexamethasone on human pulp cell, ALP activity on various concentration of β-glycerophosphate and dexamethasone was measured and mineral nodule of human pulp cell was stained with Alizarin red S. MTS assay and ALP activity of human pulp cell on Portland cement mixed with various concentration of β-glycerophosphate (10 mM, 100mM, 1M) was measured and the specimens were examined under SEM.

Addition of β-glycerophosphate or dexamethasone alone had no effect however, the addition of 5 mM β-glycerophosphate and 100 nM dexamethasone had the largest increasement in ALP activity. There was no toxicity in all samples and the data showed that Portland cement mixed with 10 mM β-glycerophosphate had more increase in ALP activity compared with control.

In conclusion, Portland cement mixed with β-glycerophosphate has no toxicity and promotes differentiation and mineralization of pulp cell compared with additive-free Portland cement. This implicated that application of Portland cement mixed with β-glycerophosphate might form more reparative dentin and in turn it would bring direct pulp capping to success.

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Effect of cross-sectional area of 6 nickel-titanium rotary instruments on the fatigue fracture under cyclic flexural stress: A fractographic analysis
Soo-Youn Hwang, So-Ram Oh, Yoon Lee, Sang-Min Lim, Kee-Yeon Kum
J Korean Acad Conserv Dent 2009;34(5):424-429.   Published online September 30, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.5.424
AbstractAbstract PDFPubReaderePub

This study aimed to assess the influence of different cross-sectional area on the cyclic fatigue fracture of Ni-Ti rotary files using a fatigue tester incorporating cyclical axial movement. Six brands of Ni-Ti rotary files (ISO 30 size with .04 taper) of 10 each were tested: Alpha system (KOMET), HeroShaper (MicroMega), K3 (SybronEndo), Mtwo (VDW), NRT (Mani), and ProFile (Dentsply). A fatigue-tester (Denbotix) was designed to allow cyclic tension and compressive stress on the tip of the instrument. Each file was mounted on a torque controlled motor (Aseptico) using a 1:20 reduction contra-angle and was rotated at 300 rpm with a continuous, 6 mm axial oscillating motion inside an artificial steel canal. The canal had a 60° angle and a 5 mm radius of curvature. Instrument fracture was visually detected and the time until fracture was recorded by a digital stop watch. The data were analyzed statistically. Fractographic analysis of all fractured surfaces was performed to determine the fracture modes using a scanning electron microscope. Cross-sectional area at 3 mm from the tip of 3 unused Ni-Ti instruments for each group was calculated using Image-Pro Plus (Imagej 1.34n, NIH). Results showed that NRT and ProFile had significantly longer time to fracture compared to the other groups (p < .05). The cross-sectional area was not significantly associated with fatigue resistance. Fractographycally, all fractured surfaces demonstrated a combination of ductile and brittle fracture. In conclusion, there was no significant relationship between fatigue resistance and the cross-sectional area of Ni-Ti instruments under experimental conditions.

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The comparison of gene expression from human dental pulp cells and periodontal ligament cells
Hyoun So, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2009;34(5):430-441.   Published online September 30, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.5.430
AbstractAbstract PDFPubReaderePub

The purpose of this study was to characterize functional distinction between human dental pulp cells(PC) and periodontal ligament cells(PDLC) using cDNA microarray assay and to confirm the results of the microarray assay using RT-PCR. 3 genes out of 51 genes which were found to be more expressed(>2 fold) in PC were selected, and 3 genes out of 19 genes which were found to be more expressed(>2 fold) in PDLC were selected for RT-PCR as well.

According to this study, the results were as follows:

1. From the microarray assay, 51 genes were more expressed (2 fold) from PC than PDLC.

2. RT-PCR confirmed that ITGA4 and TGF β2 were more expressed in PC than in PDLC.

3. From the microarray assay, 19 genes were more expressed (2 fold) from PDLC than PC.

4. RT-PCR confirmed that LUM, WISP1, and MMP1 were more expressed in PDLC than in PC.

From the present study, different expression of the genes between the PC and PDLC were characterized to show the genes which play an important role in dentinogenesis were more expressed from PC than PDLC, while the genes which were related with collagen synthesis were more expressed from PDLC than PC.

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The effects of dentin bonding agent thickness on stress distribution of composite-tooth interface : Finite element method
Sang-Il Park, Yemi Kim, Byoung-Duk Roh
J Korean Acad Conserv Dent 2009;34(5):442-449.   Published online September 30, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.5.442
AbstractAbstract PDFPubReaderePub

The aim of this study was to examine that thick dentin bonding agent application or low modulus composite restoration could reduce stresses on dentin bonding agent layer.

A mandibular first premolar with abfraction lesion was modeled by finite element method. The lesion was restored by different composite resins with variable dentin bonding agent thickness (50µm, 100µm, 150µm). 170N of occlusal loading was applied buccally or lingually. Von Mises stress on dentin bonding agent layer were measured.

When thickness of dentin bonding agent was increased von Mises stresses at dentin bonding agent were decreased in both composites. Lower elastic modulus composite restoration showed decreased von Mises stresses. On root dentin margin more stresses were generated than enamel margin.

For occlusal stress relief at dentin boning agent layer to applicate thick dentin bonding agent or to choose low elastic modulus composite is recommended.

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The change of the initial dynamic visco-elastic modulus of composite resins during light polymerization
Min-Ho Kim, In-Bog Lee
J Korean Acad Conserv Dent 2009;34(5):450-459.   Published online September 30, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.5.450
AbstractAbstract PDFPubReaderePub

The aim of this study was to measure the initial dynamic modulus changes of light cured composites using a custom made rheometer. The custom made rheometer consisted of 3 parts: (1) a measurement unit of parallel plates made of glass rods, (2) an oscillating shear strain generator with a DC motor and a crank mechanism, (3) a stress measurement device using an electromagnetic torque sensor. This instrument could measure a maximum torque of 2Ncm, and the switch of the light-curing unit was synchronized with the rheometer.

Six commercial composite resins [Z-100 (Z1), Z-250 (Z2), Z-350 (Z3), DenFil (DF), Tetric Ceram (TC), and Clearfil AP-X (CF)] were investigated. A dynamic oscillating shear test was undertaken with the rheometer. A certain volume (14.2 mm3) of composite was loaded between the parallel plates, which were made of glass rods (3 mm in diameter). An oscillating shear strain with a frequency of 6 Hz and amplitude of 0.00579 rad was applied to the specimen and the resultant stress was measured. Data acquisition started simultaneously with light curing, and the changes in visco-elasticity of composites were recorded for 10 seconds. The measurements were repeated 5 times for each composite at 25±0.5℃. Complex shear modulus G*, storage shear modulus G', loss shear modulus G" were calculated from the measured strain-stress curves. Time to reach the complex modulus G* of 10 MPa was determined. The G* and time to reach the G* of 10 MPa of composites were analyzed with One-way ANOVA and Tukey's test (α= 0.05).

The results were as follows.

1. The custom made rheometer in this study reliably measured the initial visco-elastic modulus changes of composites during 10 seconds of light curing.

2. In all composites, the development of complex shear modulus G* had a latent period for 1~2 seconds immediately after the start of light curing, and then increased rapidly during 10 seconds.

3. In all composites, the storage shear modulus G' increased steeper than the loss shear modulus G" during 10 seconds of light curing.

4. The complex shear modulus of Z1 was the highest, followed by CF, Z2, Z3, TC and DF the lowest.

5. Z1 was the fastest and DF was the slowest in the time to reach the complex shear modulus of 10 MPa.

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