This case report compared the effectiveness of resin infiltration technique (Icon, DMG) with microabrasion (Opalustre, Ultradent Products, Inc.) in management of white spot lesions. It demonstrates that although neither microabrasion nor resin infiltration technique can remove white spot lesions completely, resin infiltration technique seems to be more effective than microabrasion. Therefore resin infiltration technique can be chosen preferentially for management of white spot lesions and caution should be taken for case selection.

The purpose of this study was to evaluate the effect of Er,Cr:YSGG laser irradiation with hypersensitivity mode on microtensile bond strength of composite resin. Twenty extracted permanent molars were randomly assigned to six groups, according to the irradiation of Er,Cr:YSGG laser, adhesive system (Optibond FL or Clearfil SE bond) and application time of etchant (15 sec or 20 sec). Then composite resin was build up on each conditioned surface. The restored teeth were stored in distilled water at room temperature for 24 h and twelve specimens for each group were prepared. All specimens were subjected to microtensile bond strength and the fracture modes were evaluated. Also, the prepared dentin surface and laser irradiated dentin surface were examined under SEM.

The results were as follows:

The microtensile bond strength of laser irradiated group was lower than that of no laser irradiated group.

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.

The purpose of this study was to compare the dye leakage of MTA (mineral trioxide aggregate) apical plug produced by two orthograde placement techniques (hand condensation technique and ultrasonically assisted hand condensation technique).

To simulate straight canal, 60 transparent acrylic blocks with straight canal were fabricated. These transparent acrylic blocks were divided into 2 groups (Group C; hand condensation technique (HC) and Group U; ultrasonically assisted hand condensation technique (UAHC)) of 30 blocks with each MTA application method. Each group was divided into 2 subgroups (n = 15) with different canal size of #70 (subgroup C70 and subgroup U70) and #120 (subgroup C120 and subgroup U120). After apical plug was created, a wet paper point was placed over the MTA plug and specimen was kept in a humid condition at room temperature to allow MTA to set. After 24 hours, remaining canal space was backfilled using Obtura II. All specimens were transferred to floral form socked by 0.2% rhodamine B solution and stored in 100% humidity at room temperature. After 48 hours, resin block specimens were washed and scanned using a scanner. The maximum length of microleakage was measured from the scanned images of four surfaces of each resin block using Photoshop 6.0.

Statistical analysis was performed with Mann-Whitney U test. Group U of UAHC had significantly lower leakage than Group C of HC in #70-size canal (subgroup U70) (p < 0.05).

The purpose of this study was to evaluate the influence of elastic modulus of restorative materials and the number of interfaces of post and core systems on the stress distribution of three differently restored endodontically treated maxillary second premolars using 3D FE analysis. Model 1, 2 was restored with a stainless steel or glass fiber post and direct composite resin. A PFG or a sintered alumina crown was considered. Model 3 was restored by EndoCrown. An oblique 500 N was applied on the buccal (Load A) and palatal (Load B) cusp. The von Mises stresses in the coronal and root structure of each model were analyzed using ANSYS. The elastic modulus of the definitive restorations rather than the type of post and core system was the primary factor that influenced the stress distribution of endodontically treated maxillary premolars. The stress concentration at the coronal structure could be lowered through the use of definitive restoration of high elastic modulus. The stress concentration at the root structure could be lowered through the use of definitive restoration of low elastic modulus.

The purpose of this study was to investigate the effects of four restorative materials under various occlusal loading conditions on the stress distribution at the CEJ of buccal, palatal surface and central groove of occlusal surface of endodontically treated maxillary second premolar, using a 3D finte element analysis.

A 3D finite element model of human maxillary second premolar was endodontically treated. After endodontic treatment, access cavity was filled with Amalgam, resin, ceramic or gold of different mechanical properties. A static 500N forces were applied at the buccal (Load-1) and palatal cusp (Load-2) and a static 170N forces were applied at the mesial marginal ridge and palatal cusp simultaneously as centric occlusion (Load-3). Under 3-type Loading condition, the value of tensile stress was analyzed after 4-type restoration at the CEJ of buccal and palatal surface and central groove of occlusal surface

Excessive high tensile stresses were observed along the palatal CEJ in Load-1 case and buccal CEJ in Load-2 in all of the restorations. There was no difference in magnitude of stress in relation to the type of restorations. Heavy tensile stress concentrations were observed around the loading point and along the central groove of occlusal surface in all of the restorations. There was slight difference in magnitude of stress between different types of restorations. High tensile stress concentrations around the loading points were observed and there was no difference in magnitude of stress between different types of restorations in Load-3.

The purpose of this study was to compare the stress distributions of NiTi rotary instruments based on their cross-sectional geometries of triangular shape-based cross-sectional design, S-shaped cross-sectional design and modified rectangular shape-based one using 3D FE models.

NiTi rotary files of S-shaped and modified rectangular design of cross-section such as Mtwo or NRT showed larger stress change while file rotation during simulated shaping.

The stress of files with rectangular cross-section design such as Mtwo, NRT was distributed as an intermittent pattern along the long axis of file. On the other hand, the stress of files with triangular cross-section design was distributed continuously.

When the residual stresses which could increase the risk of file fatigue fracture were analyzed after their withdrawal, the NRT and Mtwo model also presented higher residual stresses.

From this result, it can be inferred that S-shaped and modified rectangular shape-based files were more susceptible to file fracture than the files having triangular shape-based one.

The purpose of this study was to investigate the distribution of tensile stress of canal obturated maxillary second premolar with access cavity and notch-shaped class V cavity restored with composite resin using a 3D finite element analysis.

The tested groups were classified as 8 situations by only access cavity or access cavity with notch-shaped class VS cavity (S or N), loading condition (L1 or L2), and with or without glass ionomer cement base (R1 or R2). A static load of 500 N was applied at buccal and palatal cusps. Notch-shaped cavity and access cavity were filled microhybrid composite resin (Z100) with or without GIC base (Fuji II LC). The tensile stresses presented in the buccal cervical area, palatal cervical area and occlusal surface were analyzed using ANSYS.

Tensile stress distributions were similar regardless of base. When the load was applied on the buccal cusp, excessive high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The tensile stress values of the tooth with class V cavity were slightly higher than that of the tooth without class V cavity. When the load was applied the palatal cusp, excessive high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The tensile stress values of the tooth without class V cavity were slightly higher than that of the tooth with class V cavity.

The purpose of this study was to compare the effect of various dentin bonding systems on microtensile bond strength of immediate dentin sealing (IDS) and delayed dentin sealing (DDS). Eighteen extracted permanent molars were used in this study. The teeth for DDS group were restored with a provisional restorations, and immersed in saline solution for 1 week, and divided into 3 subgroups according to various dentin bonding adhesives; SB subgroup (3 step total-etch adhesive), SE subgroup (2 step self-etch adhesive), XE subgroup (1 step self-etch adhesive). In IDS group, the teeth were divided into 3 subgroups, and applied with bonding adhesives as in DDS group. The teeth were restored with provisional restorations, and immersed in saline solution for 1 week. Indirect composite disc was cemented with resin cement, and all specimens were subjected to microtensile bond strength. The data were statistically analyzed with one-way ANOVA and Student t-test.

The results were as follows:

The IDS group showed significantly higher µTBS than DDS group in 3 step total-etch and 2 step self-etch adhesive (p < 0.05).

The aim of the present study is to compare the corrosion tendency using two kinds of NiTi files in the various environmental conditions through the visual examination and electrochemical analysis. ProTaper Universal S2, 21 mm (Dentsply Maillefer, Ballaigues, Switzerland) and Hero 642, 0.06 tapers, size 25, 21 mm (Micromega, Besancon, France) rotary instruments were tested. The instruments were randomly divided into eighteen groups (n = 5) by the immersion temperature, the type of solution, the brand of NiTi rotary instrument and the presence of mechanical loading. Each file was examined at various magnifications using Scanning Electron Microscope (JEOL, Akishima, Tokyo, Japan) equipped with energy dispersive X-ray microanalysis (EDX). EDX was used to determine the components of the endodontic file alloy in corroded and noncorroded areas. The corrosion resistance of unused and used NiTi files after repeated uses in the human teeth was evaluated electrochemically by potentiodynamic polarization test using a potentiostat (Applied Corrosion Monitoring, Cark-in-Cartmel, UK).

Solution temperature and chloride ion concentration may affect on passivity of NiTi files. Under the conditions of this in vitro study, the corrosion resistance is slightly increased after clinical use.

Flexibility and fracture properties determine the performance of NiTi rotary instruments. The purpose of this study was to evaluate how geometrical differences between three NiTi instruments affect the deformation and stress distributions under bending and torsional conditions using finite element analysis.

Three NiTi files (ProFile .06 / #30, F3 of ProTaper and ProTaper Universal) were scanned using a Micro-CT. The obtained structural geometries were meshed with linear, eight-noded hexahedral elements. The mechanical behavior (deformation and von Mises equivalent stress) of the three endodontic instruments were analyzed under four bending and rotational conditions using ABAQUS finite element analysis software. The nonlinear mechanical behavior of the NiTi was taken into account.

The U-shaped cross sectional geometry of ProFile showed the highest flexibility of the three file models. The ProTaper, which has a convex triangular cross-section, was the most stiff file model. For the same deflection, the ProTaper required more force to reach the same deflection as the other models, and needed more torque than other models for the same amount of rotation. The highest von Mises stress value was found at the groove area in the cross-section of the ProTaper Universal.

Under torsion, all files showed highest stresses at their groove area. The ProFile showed highest von Mises stress value under the same torsional moment while the ProTaper Universal showed the highest value under same rotational angle.

The purpose of this study was to investigate the influence of various occlusal loading sites and directions on the stress distribution of the cervical composite resin restorations of maxillary second premolar, using 3 dimensional (3D) finite element (FE) analysis. Extracted maxillary second premolar was scanned serially with Micro-CT (SkyScan1072; SkyScan, Aartselaar, Belgium). The 3D images were processed by 3D-DOCTOR (Able Software Co., Lexington, MA, USA). HyperMesh (Altair Engineering, Inc., Troy, USA) and ANSYS (Swanson Analysis Systems, Inc., Houston, USA) was used to mesh and analyze 3D FE model. Notch shaped cavity was filled with hybrid (Z100, 3M Dental Products, St. Paul, MN, USA) or flowable resin (Tetric Flow, Vivadent Ets., FL-9494-Schaan, Liechtenstein) and each restoration was simulated with adhesive layer thickness (40 µm). A static load of 200 N was applied on the three points of the buccal incline of the palatal cusp and oriented in 20° increments, from vertical (long axis of the tooth) to oblique 40° direction towards the buccal. The maximum principal stresses in the occlusal and cervical cavosurface margin and vertical section of buccal surfaces of notch-shaped class V cavity were analyzed using ANSYS. As the angle of loading direction increased, tensile stress increased. Loading site had little effect on it. Under same loading condition, Tetric Flow showed relatively lower stress than Z100 overall, except both point angles. Loading direction and the elastic modulus of restorative material seem to be important factor on the cervical restoration.

This study was to investigate the influence of combining composite resins with different elastic modulus, and occlusal loading condition on the stress distribution of restored notch-shaped non-carious cervical lesion using 3D finite element (FE) analysis.

The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. A notch-shaped cavity was modeled and filled with hybrid, flowable resin or a combination of both. After restoration, a static load of 500N was applied in a point-load condition at buccal cusp and palatal cusp. The stress data were analyzed using analysis of principal stress.

Results showed that combining method such that apex was restored by material with high elastic modulus and the occlusal and cervical cavosurface margin by small amount of material with low elastic modulus was the most profitable method in the view of tensile stress that was considered as the dominant factor jeopardizing the restoration durability and promoting the lesion progression.

The purpose of this study is to compare the shear bond strength of repaired composite resin with different bonding agents and evaluate the effect of bonding agents on composite repair strength. Forty composite specimens (Z-250) were prepared and aged for 1week by thermocycling between 5 and 55℃ with a dwell time of 30s. After air abrasion with 50 µm aluminum oxide, following different bonding agents were applied (n = 10); SB group: Scotchbond multipurpose adhesive (3 step Total-Etch system); SE group: Clearfil SE bond (2 step Self-Etch system); XP group: XP bond (2 step Total-Etch system); XE group: XenoIII (1 step Self-Etch system). After bonding procedure was completed, new composite resin (Z-250) was applied to the mold and cured. For control group, 10 specimens were prepared. Seven days after repair, shear bond strength was measured. Data was statistically analyzed using one-way ANOVA and Tukey's test (p < 0.05). The means and standard deviations of shear bond strength (MPa ± S.D.) per group were as follows: SB group: 17.06; SE group: 19.10; XP group: 14.44; XE group: 13.57; Control Group: 19.40. No significant difference found in each group. Within the limit of this study, it was concluded that the different type of bonding system was not affect on the shear bond strength of repaired composite resin.

This study was to investigate the influence of composite resins with different elastic modulus, cavity modification and occlusal loading condition on the stress distribution of restored notch-shaped noncarious cervical lesion using 3-dimensional (3D) finite element (FE) analysis.

The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. A notch-shaped cavity and a modified cavity with a rounded apex were modeled. Unmodified and modified cavities were filled with hybrid or flowable resin. After restoration, a static load of 500N was applied in a point-load condition at buccal cusp and palatal cusp. The stress data were analyzed using analysis of principal stress.

The results were as follows:

In the unrestored cavity, the stresses were highly concentrated at mesial CEJ and lesion apex and the peak stress was observed at the mesial point angle under both loading conditions.

The purpose of this study was to evaluate the effect of additional etching procedure prior to Maxcem resin cement application in indirect restoration cementation using push-out bonding strength.

One hundred and two extracted human molars were used to make indirect resin restorations of gold inlay and Synfony. These restorations were cemented using Maxcem and Variolink II. Additional etching procedures were done for one group with Maxcem. Three groups have 17 specimens in both restoration types. Push-out bond strength was measured using multi-purpose tester and calculated for bonding strength per sqaure-millimeter area. The mean bonding strength values were compared using SPSS 12.0K program for one-way ANOVA and Scheffe's Test with 95% significance.

Under the condition of this study, the additional etching procedure prior to usage of Maxcem resulted in reduced bond strength for both of restoration types.

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.

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 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.

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.

The aims of this study were to compare the shaping effect and safety between single length technique recommended by manufacturer and crown-down technique using Mtwo rotary file and to present a modified method in use of Mtwo file.

Sixty simulated root canal resin blocks were used. The canals were divided into three groups according to instrument and the manner of using methods. Each group had 20 specimens. Group MT was instrumented with single length technique of Mtwo, group MC was instrumented with crowndown technique of Mtwo and group PT was instrumented with crown-down technique of ProTaper. All of the rotary files used in this study were operated by an electric motor. The scanned canal images of before and after preparation were superimposed. These superimposed images were evaluated at apical 1 to 8 mm levels. Angle changes were calculated. The preparation time, weight loss, instrument failure and binding, canal aberrations, and centering ratio were measured. Statistical analysis of the three experimental groups was performed with ANOVA and Duncan's multiple range tests for post-hoc comparison and Fisher's exact test was done for the frequency comparison.

In total preparation time, group MT and group MC were less than group PT. In the aberrations, group MT had more elbows than those of group MC and group PT. The binding of group MC was least and group MT was less than group PT (P < 0.05).

Under the condition of this study, crown-down technique using Mtwo rotary file is better and safer method than single length technique recommended by the manufacturer.