The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.

Variation in root canal morphology, especially in maxillary first molar presents a constant challenge for a clinician in their detection and management. This case report describes the successful root canal treatment of a three rooted right maxillary first molar presenting with three canals each in the mesiobuccal and distobuccal roots and one canal in the palatal root. The clinical detection of this morphologic aberration was made using a dental operating microscope, and the canal configuration was established after correlating and computing the clinical, radiographic and cone-beam computed tomography (CBCT) scan findings. CBCT images confirmed the configuration of the canals in the mesiobuccal and distobuccal roots to be Al-Qudah and Awawdeh type (3-2) and type (3-2-1), respectively, whereas the palatal root had a Vertucci type I canal pattern. This report reaffirms the importance of careful examination of the floor of the pulp chamber with a dental operating microscope and the use of multiangled preoperative radiographs along with advanced diagnostic aids such as CBCT in identification and successful management of aberrant canal morphologies.

The aim of this vitro-study is to evaluate the effects of fluoride on remineralization of artificial dentine caries. 10 sound permanent premolars, which were extracted for orthodontic reason within 1 week, were used for this study. Artificial dentine caries was created by using a partially saturated buffer solution for 2 days with grounded thin specimens and fractured whole-body specimens. Remineralization solutions with three different fluoride concentration (1 ppm, 2 ppm and 4 ppm) were used on demineralized-specimens for 7 days. Polarizing microscope and scanning electron microscope were used for the evaluation of the mineral distribution profile and morphology of crystallites of hydroxyapatite.

The results were as follows :

When treated with the fluoride solutions, the demineralized dentine specimens showed remineralization of the upper part and demineralization of the lower part of the lesion body simultaneously.

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 purpose of this study is to compare and to evaluate the effect of pH and lactic acid concentration on the progression of artificial root caries lesion using polarizing microscope, and to evaluate the morphological changes of hydroxyapatite crystals of the demineralized area and to investigate the process of demineralization using scanning electron microscope.

Artificial root caries lesion was created by dividing specimens into 3 pH groups (pH 4.3, 5.0, 5.5), and each pH group was divided into 3 lactic acid concentration groups (25 mM, 50 mM, 100 mM). Each group was immersed in acid buffer solution for 5 days and examined. The results were as follows:

1. Under polarized microscope, the depth of lesion was more effected by the lactic acid concentration rather than the pH.

2. Under scanning electron microscope, dissolution of hydroxyapatite crystals were increased as the lactic acid concentration increased and the pH decreased.

3. Demineralized hydroxyapatite crystals showed peripheral dissolution and decreased size and number within cluster of hydroxyapatite crystals and widening of intercluster and intercrystal spaces as the pH decreased and the lactic acid concentration increased.

4. Under scanning electron microscope evaluation of the surface zone, clusters of hydroxyapatite crystals were dissolved, and dissolution and reattachment of crystals on the surface of collagen fibrils were observed as the lactic acid concentration increased.

5. Under scanning electron microscope, demineralization of dentin occurred not only independently but also with remineralization simultaneously.

In conclusion, the study showed that pH and lactic acid concentration influenced the rate of progression of the lesion in artificial root caries. Demineralization process was progressed from the surface of the cluster of hydroxyapatite crystals and the morphology of hydroxyapatite crystals changed from round or elliptical shape into irregular shape as time elapsed.

During root canal preparation procedures, the potential for instrument separation is always present. Files, a lentulo, a Gates-Glidden (GG) bur or any manufactured obstruction can be left behind in the canal. Nickel-titanium (NiTi) rotary files are in common usage in these days. Despite their undeniable advantages, there is a potential risk of separation within the canals. It is very rapid, unpredictable, and creates a great deal of stress for the practitioner.

When an endodontic instrument separates, the best option is to remove it. Ultrasonic instruments and microscopes have improved the success rate for removing separated instruments. But it is difficult and not always possible. Therefore prevention is the key.

In this case report, several management methods of separated file in the canal are presented.

The purposes of this study were to evaluate the effect of adhesive property on microtensile bond strength and to determine the failure mode.

Flat occlusal dentin surfaces were prepared using low-speed diamond saw. The dentin was etched with 37% phosphoric acid. The following adhesives were applied to the etched dentin to manufacturer's directions; Scotchbond Multi-Purpose in group SM, Prime&Bond NT in group NT, Scotchbond Multi-Purpose followed by Tetric-flow in group TR. After adhesive application, a cylinder of resin-based composite was built up on the occlusal surface. Each tooth was sectioned vertically to obtain the 1 × 1mm² "sticks". Microtensile bond strength were determined. Each specimen was observed under stereomicroscope and scanning electron microscope (SEM) to examine the failure mode. Data were analyzed using one way ANOVA.

The results of this study were as follows;

1. The microtensile bond strength value were; group SM (18.98 ± 3.01MPa), group NT (16.01 ± 4.82MPa) and group TR (17.56 ± 3.22MPa). No significant statistical differences were observed among the groups (P>0.05).

2. Most of specimens showed mixed failure. In group TR, there was a higher number of specimens showing areas of cohesive failure in resin.

The purpose of this study was to evaluate the effect of multiple application of all-in-one dentin adhesive system on microtensile bond strength using confocal laser scanning microscope and microtensile bond strength test. Flat occlusal dentin surfaces were prepared using low-speed diamond saw. In group I, Scotchbond Multipurpose (SM) was applied by manufacturer’s recommendation. In group II, after Adper Prompt L-Pop was applied for 15s and light cured for 10s, the second coat was re-applied and light-cured. In group III, after light-curing the second layer, the third coat was re-applied and light-cured. Specimens bonded with a resin-composite were sectioned into resin-dentin stick for measuring the adhesive layer thickness by confocal laser scanning microscope and evaluating micro-tensile bond strength. The adhesive layers of three-step dentin adhesive system, 3 coats of Adper Prompt L-Pop had significantly thicker than SM, 2 coats of Adper Prompt L-Pop (p < 0.05). However, there was no significant differences in bond strengths between SM and 3 coats of Adper Prompt L-Pop (p > 0.05). And SM, 3 coats of Adper Prompt L-Pop had significantly higher than 2 coats of Adper Prompt L-Pop in bond strengths (p < 0.05).

The purpose of this study was to evaluate the correlation between hybrid layer thickness and bond strength using confocal laser scanning microscope and microtensile bond strength test of two adhesive systems.

The dentin surface of human molars, sectioned to remove the enamel from the occlusal surface. Either Scotchbond Multi-Purpose(3M Dental Product, St. Paul, MN, U.S.A) or Clearfil SE Bond(Kuraray, Osaka, Japan) was bonded to the surface, and covered with resin-composite. The resin-bonded teeth were serially sliced perpendicular to the adhesive interface to measure the hybrid layer thickness by confocal laser scanning microscope. The specimen were trimmed to give a bonded cross-sectional surface area of 1mm², then the micro-tensile bone test was performed at a crosshead speed of 1.0 mm/min. All fractured surfaces were also observed by stereomicroscope.

There was no significant differences in bond strengths the materials(p>0.05). However, the hybrid layers of three-step dentin adhesive system, SM, had significantly thicker than self-etching adhesive system, CS(p<0.05). Pearson's correlation coefficient showed no correlation between hybrid layer thickness and bond strengths(p>0.05). Bond strengths of dentin adhesive systems were not dependent on the thickness of hybrid layer.