This report describes clinical cases of a palato-gingival groove on a maxillary lateral incisor with associated localized periodontal disease and pulp necrosis. The tooth of the first case was extracted because of severe bone destruction. The palato-gingival groove of the second case was eliminated using a round bur, and the resulting defect was filled with synthetic graft and covered by an absorbable membrane. Both diagnosis and treatment of palato-gingival groove were very difficult and usually extraction of the involved tooth is the treatment of choice, but combined endodontic-periodontic treatment allowed the tooth to be saved.
The purpose of this study was to compare apical sealing ability of continuous wave canal filling technique according to various heat source plugging depths.
Eighty one extracted human premolars with straight root were cleaned and shaped to size 35 using .06 taper rotary NiTi file. After cleansing and shaping, the teeth were divided into 5 groups following the heat source probing depths from the apex; 3, 4, 5, 6 and 7 mm. All specimens were filled using E&Q plus with #35 / .06 tapered gutta-percha cone. The positive control teeth were not filled. All teeth were coated with nail varnish except the apical 1 mm around the apical foramen. Negative control teeth were completely sealed include the apical foramen. All specimens were immersed in 1% methylene blue solution for 72 hours. Then the specimens were sectioned horizontally at 1, 2 and 3 mm from the root apex. Each sectioned surface was photographed using a digital camera attached to the stereomicroscope at 12.5 × 2.5 fold magnification. All points at 1, 2 and 3 mm were summed as final score of one specimen. Statistical analysis of the collected data was performed.
Under the condition of this study, there was no significant difference between the heat source plugging depths of 3, 4, 5, 6 and 7 mm in apical sealing ability. All of apical heat source plugging depth from 3 to 7 mm including Buchanan's protocol -from 5 to 7 mm- seems to be acceptable in clinical application.
Since it was reported that incipient enamel caries can be recovered, previous studies have quantitatively evaluated that enamel artificial caries have been remineralized with fluoride, showing simultaneously the increase of width of surface layer and the decrease of width of the body of legion. There is, however, little report which showed that remineralization could occur without fluoride. In addition, the observations on the change of hydroxyapatite crystals also have been scarcely seen.
In this study, enamel caries in intact premolars or molars was induced by using lactic acidulated buffering solutions over 2 days. Then decalcified specimens were remineralized by seven groups of solutions using different degree of saturation (0.212, 0.239, 0.301, 0.355) and different pH (5.0, 5.5, 6.0) over 10 days. A qualitative comparison to changes of hydroxyapatite crystals after fracturing teeth was made under SEM (scanning electron microscopy) and AFM (atomic force microscopy).
The results were as follows:
1. The size of hydroxyapatite crystals in demineralized area was smaller than the normal ones. While the space among crystals was expanded, it was observed that crystals are arranged irregularly.
2. In remineralized enamel area, the enlarged crystals with various shape were observed when the crystals were fused and new small crystals in intercrystalline spaces were deposited.
3. Group 3 and 4 with higher degree of saturation at same pH showed the formation of large clusters by aggregation of small crystals from the surface layer to the lesion body than group 1 and 2 with relatively low degree of saturation at same pH did. Especially group 4 showed complete remineralization to the body of lesions. Group 5 and 6 with lower pH at similar degree of saturation showed remineralization to the body of lesions while group 7 didn't show it. Unlike in Group 3 and 4, Group 5 and 6 showed that each particle was densely distributed with clear appearance rather than crystals form clusters together.
The purinoreceptor, P2X3 is a ligand-gated cation channel activated by extracellular ATP. It has been reported that ATP can be released during inflammation and tissue damage, which in turn may activate P2X3 receptors to initiate nociceptive signals. However, little is known about the contribution of P2X3 to the dental pain during pulpal inflammation. Therefore, the purpose of this study was to investigate the expression of P2X3 and its colocalization with TRPV1 to understand the mechanism of pain transmission through P2X3 in the human dental pulp with double labeling immunofluorescence method.
In the human dental pulp, intense P2X3 immunoreactivity was observed throughout the coronal and radicular pulp. Of all P2X3-positive fibers examined, 79.4% coexpressed TRPV1.
This result suggests that P2X3 along with TRPV1 may be involved in the transmission of pain and potentiation of noxious stimuli during pulpal inflammation.
The purpose of this study was to compare the apical leakage of the root canal filled with the System B and the EndoTwinn (the combined application of heat and ultrasonic vibration).
Sixty extracted premolars with straight root were cleaned and shaped to size 35. Group SB was obturated using System B and Group ET was filled with EndoTwinn. A size 35 of 0.06 tapered gutta-percha and Adseal were used and the plugger which could be introduced to 4 mm short of working length was selected in the obturation procedure. As the positive control, Group PC was not filled. In Group SB, ET and PC, all external surfaces of each tooth were coated with nail varnish leaving only 1 mm area around the apical foramen. In the negative control of Group NSB and Group NET, all of external tooth surface including apical foramen was coated with the nail varnish. The specimens were immersed in methylene blue dye solution for 2 days. Then the specimens were sectioned at each 1 mm from apex to 5 mm level. The final score of one specimen was given by summing up of the points at all levels.
The dye leakage of Group ET was significantly less than that observed in Group SB (p < 0.05). And the frequency of gutta-percha pulling out from root canal when the plugger was removed was more often with the System B than with EndoTwinn but there was no significant difference.
Currently, various Nickel-Titanium rotary files are used in endodontic treatment, but there is no one perfect system that can be applied to any clinical situation. Therefore, the combined uses of various file systems which can emphasize the advantages of each system are introduced as hybrid instrumentation.
The ProTaper system is efficient in body shaping and apical pre-enlargement but is reported to have more possibility of transportation and produce more aberrations and deformation in more or less severe curved canals. Recently, new ProTaper system (ProTaper Universal) with different configuration and cross-sectional design to overcome the week points of ProTaper have been marketed.
The purpose of this study was to compare and evaluate the shaping abilities of ProTaper, ProTaper Universal system, and two hybrid methods using S-series of ProTaper Universal and Hero Shaper or ProFile.
The time lapses for instrumentation were measured and the used files were inspected for distortion. The pre- and post-instrumented root canals were scanned and superimposed to evaluate the aberrations and reduction of root canal curvature and change of radius of canal curvature. The increased canal width and apical centering ratio were calculated at 1, 2, 3, 4 and 5 mm levels from apical foramen.
Under the conditions of this study, the ProTaper Universal seems to have better shaping ability than ProTaper in terms of instrumented width and instrumentation time. It may be suggested that the ProTaper Universal system is efficient as much as hybrid instrumentation using ProTaper and other constant-tapered NiTi file systems in highly experienced operators.
The purpose of this study was to evaluate the difference in the surface roughness after polishing and to evaluate the difference in color stability after immersion in a dye solution among four types of composite resin materials. Four light-polymerized composite resins (Shade A2) with different sized filler content (a nanofilled, a hybrid, a microfilled, a flowble) were used. Average surface roughness (Ra) was measured with a surface roughness tester (Surftest Formtracer) before and after polishing with aluminum oxide abrasive discs (Super-Snap). Color of specimens before and after staining with 2% methylene blue solution were measured using spectrophotometer (CM-3700d) with SCI geometries. The results of Ra and ΔE were analyzed by one-way analysis of variance (ANOVA), a Scheffe multiple comparison test and Student t-test (p = 0.05). After polishing, Ra values were decreased regardless of type of composite resins. In surface roughness after polishing and color stability after staining, nanofilled composite resin was not different with other composite resins except flowable resins.
The purpose of this study was to evaluate the insertion depth of several brands of master gutta percha cones after shaping by various Ni-Ti rotary files in simulated canals.
Fifty resin simulated J-shape canals were instrumented with ProFile, ProTaper and HEROShaper. Simulated canals were prepared with ProFile .04 taper #25 (n = 10), .06 taper #25 (n = 10), ProTaper F2 (n = 10), HEROShaper .04 taper #25 (n = 10) and .06 taper #25 (n = 10). Size #25 gutta percha cones with a .04 & .06 taper from three different brands were used: DiaDent; META; Sure-endo. The gutta percha cones were selected and inserted into the prepared simulated canals. The distance from the apex of the prepared canal to the gutta percha cone tip was measured by image analysis program.
Within limited data of this study, the results were as follows
1. When the simulated root canals were prepared with HEROShaper, gutta-percha cones were closely adapted to the root canal.
2. All brands of gutta percha cones fail to go to the prepared length in canal which was instrumented with ProFile, the cones extend beyond the prepared length in canal which was prepared with ProTaper.
3. In canal which was instrumented with HEROShaper .04 taper #25, Sure-endo .04 taper master gutta percha cone was well fitted (p < 0.05).
4. In canal which was instrumented with HEROShaper .06 taper #25, META .06 taper master gutta percha cone was well fitted (p < 0.05).
As a result, we concluded that the insertion depth of all brands of master gutta percha cone do not match the rotary instrument, even though it was prepared by crown-down technique, as recommended by the manufacturer. Therefore, the master cone should be carefully selected to match the depth of the prepared canal for adequate obturation.