It is often presumed that apical periodontitis follows total pulp necrosis, and consequently root canal treatment is commonly performed. Periapical lesion development is usually caused by bacteria and its byproduct which irritate pulp, develop pulpitis, and result in necrosis through an irreversible process. Afterwards, apical periodontitis occurs. This phenomenon is observed as an apical radiolucency in radiographic view. However, this unusual case presents a spontaneous healing of periapical lesion, which has developed without pulp necrosis in a vital tooth, through conservative treatment.

Patients with diabetes mellitus show delayed wound healing and increased susceptibility to infection. Therefore, the effects of diabetes on pulpal and periodontal healing should be taken into consideration when treating diabetic dental traumatized patients. This case presents the treatment for dental traumatized 20 yr old female with uncontrolled type II diabetes. The traumatized upper central incisors had showed pulpal healing in early days. However, 7 mon after the trauma, the teeth had been diagnosed with pulp necrosis with apical abscess. Eventually, non surgical root canal treatment on the teeth had been performed.

Mineral trioxide aggregate (MTA), which was originally developed for repair of root perforations, is a biocompatible material with numerous clinical applications in endodontics. MTA must be allowed to set in the presence of moisture to optimize the material's physical and chemical properties. In the clinic, occasionally unset MTA has been detected after application of MTA on the tooth, and the reason has been unclear.

This case report presents MTA washed-out for several years after placement at the root apex as an apical plug, and discusses the reason and things to consider in clinics.

As the dental pulp is encased with a rigid, noncompliant shell, changes in pulpal blood flow or vascular tissue pressure can have serious implication for the health of pulp. Numerous studies have demonstrated that orthodontic force application may influence both blood flow and cellular metabolism, leading degenerative and/or inflammatory responses in the dental pulp. The aim of this case report is to present a case about tooth with chronic periapical abscess which showed normal vital responses. Excessive orthodontic force is thought to be the prime cause of partial pulp necrosis. Owing to remaining vital tissue, wrong dianosis can be made, and tooth falsely diagnosed as vital may be left untreated, causing the necrotic tissue to destroy the supporting tissuses. Clinician should be able to utilize various diagnostic tools for the precise diagnosis, and be aware of the endodontic-orthodontic inter-relationship.

The objective of this study was to observe the histology of dental pulp healing after tooth replantation in rats. The maxillary right first molars of 4-week-old rat were extracted, and then the teeth were repositioned in the original socket. At 3 days after replantation, there was localized inflammatory reaction. But, pulp revasculization and healing had already begun in the root area. At 5 days after replantation, odontoblast-like cells were observed. Tertiary dentin deposition was observed beneath the pulp-dentin border from 1 week after replantation. And tertiary dentin was increased at 2 weeks after replantation. The presence of odontoblast-like cells and the formation of tertiary dentin were continued to 4 weeks after replantation. At 4 weeks after replantation, the deposition of bone-like tissues and cementum-like tissues was observed. This results show that there is a possibility of pulp healing after tooth replantation in rats and the mineralization of tooth can progress. The mineralization of tooth after replantation was initially occurred by the deposition of tertiary dentin, but as time passed, the deposition of bone-like tissues and cementum-like tissues was begun and increased.

The purpose of this study was to determine the effect of post types and sizes on fracture resistance in immature tooth model with various restorative techniques. Bovine incisors were sectioned 8 mm above and 12 mm below the cementoenamel junction to simulate immature tooth model. To compare various post-and-core restorations, canals were restored with gutta-percha and resin core, or reinforced dentin wall with dual-cured resin composite, followed by placement of D.T. LIGHT-POST, ParaPost XT, and various sizes of EverStick Post individually. All of specimens were stored in the distilled water for 72 hours and underwent 6,000 thermal cycles. After simulation of periodontal ligament structure with polyether impression material, compressive load was applied at 45 degrees to the long axis of the specimen until fracture was occurred.

Experimental groups reinforced with post and composite resin were shown significantly higher fracture strength than gutta-percha group without post placement (p < 0.05). Most specimens fractured limited to cervical third of roots. Post types did not influence on fracture resistance and fracture level significantly when cement space was filled with dual-cured resin composite. In addition, no statistically significant differences were seen between customized and standardized glass fiber posts, which cement spaces were filled with resin cement or composite resin individually. Therefore, root reinforcement procedures as above in immature teeth improved fracture resistance regardless of post types and sizes.

The purpose of this study was to determine the effect of sodium hypochlorite and steam autoclaving on the cyclic fatigue of nickel-titanium endodontic files.

Two types of files with a .06 taper and #30 were used, K3^® (SybronEndo, Glendora, California, USA) and Hero642^®(Micro-Mega, Besançon, France).

The files were divided into 6 experimental groups containing 10 files each group depending the soaking time in 6% sodium hypochlorite solution and number of cycles of steam autoclave. After sterilization, a cyclic fatigue test was performed on each file, and the fracture time was recorded in seconds. The control group underwent the cyclic fatigue test only. After the test, the surface characteristics of the files were observed using scanning electron microscopy (SEM).

All groups containing the Hero 642^® files showed a similar cyclic fatigue fracture time. However, the cyclic fatigue fracture time with the K3^® files was significantly shorter in groups which were treated with sodium hypochlorite than in the control group (P < 0.05). SEM revealed both Hero642^® and K3^® files to have significant corrosion on the file surface in groups treated with sodium hypochlorite, compared with the sharp and regular blades of the control group. K3^® files showed more corrosion than the Hero642^® files. Bluntness of the blades of the K3^® file was observed in groups treated with steam autoclave. Although there was no obvious destruction on the surface of steam autoclaved Hero642^® files, slight bluntness was observed.

Sterilizing with a steam autoclave is much less destructive to K3^® files than sodium hypochlorite. The longer time exposed to sodium hypochlorite, the more destructive pattern was shown on the blades of the files. Therefore, when using sodium hypochlorite solution, the exposure time should be as short as possible in order to prevent corrosion and increase the cyclic fatigue fracture time.

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.

Dental caries is the most common disease in the oral cavity. However, the mechanism and treatment of dental caries is not completely understood since many complex factors are involved. Especially the effect of pH on remineralization of early stage of dental caries is still controversial.

In this study, dental caries in dentin was induced by using lactic acidulated buffering solutions and the loss of inorganic substance was measured. Also decalcified specimens were remineralized by three groups of solution with different pH (group of pH 4.3, 5.0, and 5.5). Then, the amount and the area of inorganic substance precipitation was quantitatively analyzed with microradiograph. Also a qualitative comparison of the normal phase, the demineralized phase, and the remineralized phase of hydroxyapatite crystal was made under SEM.

The results were as follows;

In microradiograghic analysis, as the pH increased, the amount of remineralization in decalcified dentin tended to increase significantly. As the pH decreaced, deeper decalcification, however, occurred along with remineralization. The group of pH 5.5 had a tendency to be remineralized without demineralization (p < 0.05).

In according to the results of this experiment, the decalcifying and remineralizing process of dentine is neither simple nor independent, but a dynamic process in which decalcification and remineralization occur simultaneously. The remineralization process occurred from the hydroxyapatite crystal surface.

The purposes of this study were firstly to identify the microbial species on gutta-percha (GP) cones exposed at clinics using polymerase chain reaction, and secondly to evaluate the short-term sterilization effect of three chemical disinfectants. It also evaluated the alteration of surface texture and physical properties of GP cones after 5-min soaking into three chemical disinfectants. 150 GP cones from two endodontic departments were randomly selected for microbial detection using PCR assay with universal primer. After inoculation on the sterilized GP cones with the same microorganism identified by PCR assay, they were soaked in three chemical disinfectants: 5% NaOCl, 2% Chlorhexidine, and ChloraPrep for 1, 5, 10, and 30 minutes. The sterilization effect was evaluated by turbidity and subculture. The change of surface textures using a scanning electron microscope and the tensile strength and elongation rate of the GP cones were measured using an Instron 5500 (Canton). Statistical analysis was performed.

Four bacterial species were detected in 29 GP cones (19.4%), and all the species belonged to the genus Staphylococcus. All chemical disinfectants were effective in sterilization with just 1 minute soaking. On the SEM picture of NaOCl-soaked GP cone, a cluster of cuboidal crystals was seen on the cone surface. The tensile strength of NaOCl-soaked group was significantly higher than the other groups (p < 0.05). Also, all disinfectants significantly increased the elongation rate of GP cones compared to the fresh GP cone (p < 0.05). Present data demonstrate that three chemical disinfectants are useful for rapid sterilization of GP cone just before obturation.

The purpose of this study was to observe the effect of canal filling on the bacteria left in the dentinal tubules and to compare the sealing ability between Gutta-percha and Resilon. The bovine dentin block models were prepared. E. faecalis was inoculated to dentin blocks and incubated. The dentin blocks were divided into 5 groups.

Group 1 was the negative control. Group 2 was the positive control. Group 3 was filled with ZOE based sealer and Gutta-percha, Group 4 with resin based sealer and Gutta-percha, and Group 5 with resin based sealer and Resilon. After 24 hour, the blocks were incubated at 37℃ for 1, 2, 3 and 4 weeks on BHI agar plates.

The internal dentin portion of the blocks was removed using ISO 027, 029, 031, 035 round burs and the dentin chips were incubated at 37℃ for 24 hour. Following incubation, the optical density of the medium was measured. The data were statistically analysed using repeated measures ANOVA and one-way ANOVA.

The results were as follows,

1. There was statistically significant reduction in the number of E. faecalis of the group where dentinal tubules were completely sealed with nail varnish in comparison with the groups obturated with gutta-percha or resilon (p < 0.05).

2. In group 5, the number of E. faecalis in the dentinal tubules decreased significantly with time (p < 0.05), whereas in Group 3 and 4, there was no reduction in its number (p > 0.05).

3. Under the conditions of this experiment, E. faecalis survived up to 4 weeks after obturation with gutta-percha or resilon (p > 0.05).

Chewing simulator, which can partly mimic the motion of chewing motion of human, has been successfully developed. The purpose of its development was to make a new machine which can anticipate the clinical results of restoration in the human teeth more accurately in vitro condition It is composed of 4 major parts; chewing part, motor part, water bath, controlling part. The controlling part control the chewing force, frequency, the temperature and running time of water. Additionally, the actual chewing force and remaining time is shown in the monitor of controlling part. At present, the chewing cycle is composed depending on the pre-published data of foreign people. Long term clinical data should be additionally collected for the simulator to mimic the clinical results more accurately.

Dental caries is a chronic disease that causes the destruction of tooth structure by the interaction of plaque bacteria, food debris, and saliva.

There has been attempts to induce remineralization by supersaturating the intra-oral environment around the surface enamel, where there is incipient caries.

In this study, supersaturated remineralized solution "R" was applied to specimens with incipient enamel caries, and the quantitative ananlysis of remineralization was evaluated using microradiography. Thirty subjects volunteered to participate in this study. Removable appliances were constructed for the subjects, and the enamel specimen with incipient caries were embedded in the appliances. The subjects wore the intra-oral appliance for 15 days except while eating and sleeping.

The removable appliance were soaked in supersaturated solution "R", saline, or Senstime® to expose the specimen to those solutions three times a day, 5 minutes each time. After 15 days, microradiography was retaken to compare and evaluate remineralization.

The results were as the following:

1. The ratio of remineralized area to demineralized area was significantly higher in the supersaturated solution "R" and Senstime® than in the saline. (p<0.05)

2. Remineralization in the supersaturated buffer solution "R" occurred in the significantly deeper parts of the tooth, compared to the Senstime® group containing high concentration of fluoride.(p<0.05)

As in the above results, the remineralization effect of remineralized buffer solution "R" on incipient enamel caries has been proven. For clinical utilization, further studies on soft tissue reaction and the effect on dentin and cementum are necessary.

In conclusion compared to commercially available fluoride solution, remineralization solution "R" showed better remineralization effect on early enamel caries lesion, so it is considered as effecient solution for clinical application.