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Review Articles
Calcium silicate-based root canal sealers: a literature review
Miyoung Lim, Chanyong Jung, Dong-Hoon Shin, Yong-bum Cho, Minju Song
Restor Dent Endod 2020;45(3):e35.   Published online June 9, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e35
AbstractAbstract PDFPubReaderePub

Epoxy resin-based sealers are currently widely used, and several studies have considered AH Plus to be the gold-standard sealer. However, it still has limitations, including possible mutagenicity, cytotoxicity, inflammatory response, and hydrophobicity. Drawing upon the advantages of mineral trioxide aggregate, calcium silicate-based sealers were introduced with high levels of biocompatibility and hydrophilicity. Because of the hydrophilic environment in root canals, water resorption and solubility of root canal sealers are important factors contributing to their stability. Sealers displaying lower microleakage and stronger push-out bond strength are also needed to endure the dynamic tooth environment. Although the physical properties of calcium silicate-based sealers meet International Organization for Standardization recommendations, and they have consistently reported to be biocompatible, they have not overcome conventional resin-based sealers in actual practice. Therefore, further studies aiming to improve the physical properties of calcium silicate-based sealers are needed.

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Dental care for patients taking antiresorptive drugs: a literature review
Minju Song
Restor Dent Endod 2019;44(4):e42.   Published online November 1, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e42
AbstractAbstract PDFPubReaderePub

Antiresorptive drugs (ARDs), such as bisphosphonates or denosumab, that prevent bone resorption are widely used in patients with osteoporosis or with cancer that has metastasized to the bones. Although osteonecrosis of the jaw (ONJ) is a well-documented complication of ARD use, the benefits ARDs outweigh the complication. Thus, research has focused on finding ways to prevent or reduce the risk of developing ONJ. Dentists, as part of a multi-professional team, have a critical role in preventing ONJ. However, many dentists tend to hesitate to provide dental care to patients with ONJ, or tend to think that it is a problem to be dealt with by oral surgeons. This review gives an overview of ARD-related ONJ and provides the guidelines for dental care in patients taking ARDs to lower the risk of developing ONJ.

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Research Articles
Effects of the cathepsin K inhibitor with mineral trioxide aggregate cements on osteoclastic activity
Hee-Sun Kim, Soojung Kim, Hyunjung Ko, Minju Song, Miri Kim
Restor Dent Endod 2019;44(2):e17.   Published online April 23, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e17
AbstractAbstract PDFPubReaderePub
Objectives

Root resorption is an unexpected complication after replantation procedures. Combining anti-osteoclastic medicaments with retrograde root filling materials may avert this resorptive activity. The purpose of this study was to assess effects of a cathepsin K inhibitor with calcium silicate-based cements on osteoclastic activity.

Methods

MC3T3-E1 cells were cultured for biocompatibility analyses. RAW 264.7 cells were cultured in the presence of the receptor activator of nuclear factor-kappa B and lipopolysaccharide, followed by treatment with Biodentine (BIOD) or ProRoot MTA with or without medicaments (Odanacatib [ODN], a cathepsin inhibitor and alendronate, a bisphosphonate). After drug treatment, the cell counting kit-8 assay and Alizarin red staining were performed to evaluate biocompatibility in MC3T3-E1 cells. Reverse-transcription polymerase chain reaction, tartrate-resistant acid phosphatase (TRAP) staining and enzyme-linked immunosorbent assays were performed in RAW 264.7 cells to determine the expression levels of inflammatory cytokines, interleukin (IL)-1β, IL-6, tumor necrosis factor-α (TNF-α) and prostaglandin E2 (PGE2). Data were analyzed by one-way analysis of variance and Tukey's post hoc test (p < 0.05).

Results

Biocompatibility results showed that there were no significant differences among any of the groups. RAW 264.7 cells treated with BIOD and ODN showed the lowest levels of TNF-α and PGE2. Treatments with BIOD + ODN were more potent suppressors of inflammatory cytokine expression (p < 0.05).

Conclusion

The cathepsin K inhibitor with calcium silicate-based cement inhibits osteoclastic activity. This may have clinical application in preventing inflammatory root resorption in replanted teeth.

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A study on the compatibility between one-bottle dentin adhesives and composite resins using micro-shear bond strength
Minju Song, Yooseok Shin, Jeong-Won Park, Byoung-Duck Roh
Restor Dent Endod 2015;40(1):30-36.   Published online September 26, 2014
DOI: https://doi.org/10.5395/rde.2015.40.1.30
AbstractAbstract PDFPubReaderePub
Objectives

This study was performed to determine whether the combined use of one-bottle self-etch adhesives and composite resins from same manufacturers have better bond strengths than combinations of adhesive and resins from different manufacturers.

Materials and Methods

25 experimental micro-shear bond test groups were made from combinations of five dentin adhesives and five composite resins with extracted human molars stored in saline for 24 hr. Testing was performed using the wire-loop method and a universal testing machine. Bond strength data was statistically analyzed using two way analysis of variance (ANOVA) and Tukey's post hoc test.

Results

Two way ANOVA revealed significant differences for the factors of dentin adhesives and composite resins, and significant interaction effect (p < 0.001). All combinations with Xeno V (Dentsply De Trey) and Clearfil S3 Bond (Kuraray Dental) adhesives showed no significant differences in micro-shear bond strength, but other adhesives showed significant differences depending on the composite resin (p < 0.05). Contrary to the other adhesives, Xeno V and BondForce (Tokuyama Dental) had higher bond strengths with the same manufacturer's composite resin than other manufacturer's composite resin.

Conclusions

Not all combinations of adhesive and composite resin by same manufacturers failed to show significantly higher bond strengths than mixed manufacturer combinations.

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Cytotoxicity of newly developed pozzolan cement and other root-end filling materials on human periodontal ligament cell
Minju Song, Tae-Sun Yoon, Sue-Youn Kim, Euiseong Kim
Restor Dent Endod 2014;39(1):39-44.   Published online January 20, 2014
DOI: https://doi.org/10.5395/rde.2014.39.1.39
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to evaluate in vitro cytotoxicity of the pozzolan cement and other root-end filling materials using human periodontal ligament cell.

Materials and Methods

Endocem (Maruchi), white ProRoot MTA (Dentsply), white Angelus MTA (Angelus), and Super EBA (Bosworth Co.) were tested after set completely in an incubator at 37℃ for 7 days, Endocem was tested in two ways: 1) immediately after mixing (fresh specimens) and 2) after setting completely like other experimental materials. The methods for assessment included light microscopic examination, cell counting and WST-1 assay on human periodontal ligament cell.

Results

In the results of microscopic examination and cell counting, Super EBA showed significantly lower viable cell than any other groups (p < 0.05). As the results of WST-1 assay, compared with untreated control group, there was no significant cell viability of the Endocem group. However, the fresh mixed Endocem group had significantly less cell viability. The cells exposed to ProRoot MTA and Angelus MTA showed the highest viability, whereas the cells exposed to Super EBA displayed the lowest viability (p < 0.05).

Conclusions

The cytotoxicity of the pozzolan cement (Endocem) was comparable with ProRoot MTA and Angelus MTA. Considering the difficult manipulation and long setting time of ProRoot MTA and Angelus MTA, Endocem can be used as the alternative of retrofilling material.

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Inhibition of Streptococcus mutans biofilm formation on composite resins containing ursolic acid
Soohyeon Kim, Minju Song, Byoung-Duck Roh, Sung-Ho Park, Jeong-Won Park
Restor Dent Endod 2013;38(2):65-72.   Published online May 28, 2013
DOI: https://doi.org/10.5395/rde.2013.38.2.65
AbstractAbstract PDFPubReaderePub
Objectives

To evaluate the inhibitory effect of ursolic acid (UA)-containing composites on Streptococcus mutans (S. mutans) biofilm.

Materials and Methods

Composite resins with five different concentrations (0.04, 0.1, 0.2, 0.5, and 1.0 wt%) of UA (U6753, Sigma Aldrich) were prepared, and their flexural strengths were measured according to ISO 4049. To evaluate the effect of carbohydrate source on biofilm formation, either glucose or sucrose was used as a nutrient source, and to investigate the effect of saliva treatment, the specimen were treated with either unstimulated whole saliva or phosphate-buffered saline (PBS). For biofilm assay, composite disks were transferred to S. mutans suspension and incubated for 24 hr. Afterwards, the specimens were rinsed with PBS and sonicated. The colony forming units (CFU) of the disrupted biofilm cultures were enumerated. For growth inhibition test, the composites were placed on a polystyrene well cluster, and S. mutans suspension was inoculated. The optical density at 600 nm (OD600) was recorded by Infinite F200 pro apparatus (TECAN). One-way ANOVA and two-way ANOVA followed by Bonferroni correction were used for the data analyses.

Results

The flexural strength values did not show significant difference at any concentration (p > 0.01). In biofilm assay, the CFU score decreased as the concentration of UA increased. The influence of saliva pretreatment was conflicting. The sucrose groups exhibited higher CFU score than glucose group (p < 0.05). In bacterial growth inhibition test, all experimental groups containing UA resulted in complete inhibition.

Conclusions

Within the limitations of the experiments, UA included in the composite showed inhibitory effect on S. mutans biofilm formation and growth.

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A survey of experience-based preference of Nickel-Titanium rotary files and incidence of fracture among general dentists
WooCheol Lee, Minju Song, Euiseong Kim, Hyojin Lee, Hyeon-Cheol Kim
Restor Dent Endod 2012;37(4):201-206.   Published online November 21, 2012
DOI: https://doi.org/10.5395/rde.2012.37.4.201
AbstractAbstract PDFPubReaderePub
Objectives

The purpose was to investigate the preference and usage technique of NiTi rotary instruments and to retrieve data on the frequency of re-use and the estimated incidence of file separation in the clinical practice among general dentists.

Materials and Methods

A survey was disseminated via e-mail and on-site to 673 general dentists. The correlation between the operator's experience or preferred technique and frequency of re-use or incidence of file fracture was assessed.

Results

A total of 348 dentists (51.7%) responded. The most frequently used NiTi instruments was ProFile (39.8%) followed by ProTaper. The most preferred preparation technique was crown-down (44.6%). 54.3% of the respondents re-used NiTi files more than 10 times. There was a significant correlation between experience with NiTi files and the number of reuses (p = 0.0025). 54.6% of the respondents estimated experiencing file separation less than 5 times per year. The frequency of separation was significantly correlated with the instrumentation technique (p = 0.0003).

Conclusions

A large number of general dentists in Korea prefer to re-use NiTi rotary files. As their experience with NiTi files increased, the number of re-uses increased, while the frequency of breakage decreased. Operators who adopt the hybrid technique showed less tendency of separation even with the increased number of re-use.

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Erratum
Success and failure of endodontic microsurgery
Minju Song, Euiseong Kim
Restor Dent Endod 2012;37(1):66-66.   Published online February 4, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.66
PDFPubReaderePub
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Review Article
Success and failure of endodontic microsurgery
Minju Song, Euiseong Kim
J Korean Acad Conserv Dent 2011;36(6):465-476.   Published online November 30, 2011
DOI: https://doi.org/10.5395/JKACD.2011.36.6.465
AbstractAbstract PDFPubReaderePub

In current endodontic practice, introduction of operating microscope, ultrasonic instruments, and microinstruments has induced a big change in the field of surgical retreatment. In this study, we aimed to offer key steps of endodontic microsurgery procedure compared with traditional root-end surgery, and to evaluate factors influencing success and failure based on published articles.

Endodontic microsurgery is a surgical procedure performed with the aid of a microscope, ultrasonic instruments and modern microsurgical instruments. The microscope provides magnification and illumination - essential for identifying minute details of the apical anatomy. Ultrasonic instruments facilitate the precise root-end preparation that is within the anatomical space of the canal. Modern endodontics can therefore be performed with precision and predictability, thus eliminating the disadvantages inherent in traditional periapical surgery such as large osteotomy, beveled apicoectomy, inaccurate root-end preparation and the inability to observe isthmus.

Factors influencing the outcomes of endodontic microsurgery may be diverse, but standardization of procedures can minimize its range. Among patient and tooth-related factors, periodontal status and tooth position are known to be prognostic, but there are only few articles concerning this matter. High-evidence randomized clinical trials or prospective cohort studies are needed to confirm these findings.

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Basic Research
Evaluation of canal preparation for apical sealing with various Ni-Ti rotary instruments
Yooseok Shin, Su-Jung Shin, Minju Song, Euiseong Kim
J Korean Acad Conserv Dent 2011;36(4):300-305.   Published online July 31, 2011
DOI: https://doi.org/10.5395/JKACD.2011.36.4.300
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to evaluate the various NiTi rotary instruments regarding their ability to provide a circular apical preparation.

Materials and Methods

50 single canal roots were selected, cut at the cementodentinal junction and the coronal 1/3 of the canals was flared using Gates Glidden burs. Samples were randomly divided into 5 experimental groups of 10 each. In group I, GT files, Profile 04 and Quantec #9 and #10 files were used. In Group II Lightspeed was used instead of Quantec. In Group III, Orifice shaper, Profile .06 series and Lightspeed were used. In Group IV, Quantec #9 and #10 files were used instead of Lightspeed. In Group V, the GT file and the Profile .04 series were used to prepare the entire canal length. All tooth samples were cut at 1 mm, 3 mm and 5 mm from the apex and were examined under the microscope.

Results

Groups II and III (Lightspeed) showed a more circular preparation in the apical 1mm samples than the groups that used Quantec (Group I & IV) or GT files and Profile .04 series.(Group V)(p < 0.05) There was no significant difference statistically among the apical 3, 5 mm samples. In 5 mm samples, most of the samples showed complete circularity and none of them showed irregular shape.

Conclusions

Lightspeed showed circular preparation at apical 1 mm more frequently than other instruments used in this study. However only 35% of samples showed circularity even in the Lightspeed Group which were enlarged 3 ISO size from the initial apical binding file (IAF) size. So it must be considered that enlarging 3 ISO size isn't enough to make round preparation.

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