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Case Reports
Surgical endodontic management of infected lateral canals of maxillary incisors
Ji-Hyun Jang, Jung-Min Lee, Jin-Kyu Yi, Sung-Baik Choi, Sang-Hyuk Park
Restor Dent Endod 2015;40(1):79-84.   Published online October 10, 2014
DOI: https://doi.org/10.5395/rde.2015.40.1.79
AbstractAbstract PDFPubReaderePub

This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment.

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Clinical management of a fused upper premolar with supernumerary tooth: a case report
Kyu-Min Cho, Ji-Hyun Jang, Sang-Hyuk Park
Restor Dent Endod 2014;39(4):319-323.   Published online July 17, 2014
DOI: https://doi.org/10.5395/rde.2014.39.4.319
AbstractAbstract PDFPubReaderePub

In dentistry, the term 'fusion' is used to describe a developmental disorder of dental hard tissues. In the permanent dentition, fusion of a normal tooth and a supernumerary tooth usually involves the incisors or canines. However, a few cases of fusion involving premolars have also been reported to date. We present a rare case in which fusion of the maxillary left second premolar and a supernumerary tooth in a 13-year-old girl was diagnosed using cone beam computed tomography (CBCT, Alphard-3030, Asahi Roentgen Ind. Co., Ltd.). The tooth was bicuspidized after routine nonsurgical root canal treatment, and the separated teeth underwent appropriate restoration procedures. The second premolar and supernumerary tooth remained asymptomatic without any signs of inflammation after a follow-up period of 9 years. Identification of anatomical anomalies is important for treatment in cases involving fusion with supernumerary tooth, and therefore the microscopic examinations and CBCT are essential for the diagnosis. Fused teeth can be effectively managed by the comprehensive treatment which includes both endodontic and periodontal procedures.

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A maxillary canine with two separated root canals: a case report
Dong-Ryul Shin, Jin-Man Kim, Duck-Su Kim, Sun-Young Kim, Paul V Abbott, Sang-Hyuk Park
J Korean Acad Conserv Dent 2011;36(5):431-435.   Published online September 30, 2011
DOI: https://doi.org/10.5395/JKACD.2011.36.5.431
AbstractAbstract PDFPubReaderePub

Maxillary canines have less anatomical diversities than other teeth. They usually have a single root and root canal. This report describes an endodontic treatment of a maxillary canine with two separated root canals which have not been reported through the demonstration of radiography and computerized tomography (CT).

Even though appropriated endodontic treatment has been performed, the severe pain could happen due to lack of consideration of anatomical variations of the teeth. Therefore, the clinicians should be well aware of the possibility of anatomical variations in the root canal system during endodontic treatment even if the number of root canals is obvious such as in this case.

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Basic Research
The effect of tumor necrosis factor (TNF)-α to induce matrix metalloproteinase (MMPs) from the human dental pulp, gingival, and periodontal ligament cells
Eun-Mi Rhim, Sang-Hyuk Park, Duck-Su Kim, Sun-Young Kim, Kyoung-Kyu Choi, Gi-Woon Choi
J Korean Acad Conserv Dent 2011;36(1):26-36.   Published online January 31, 2011
DOI: https://doi.org/10.5395/JKACD.2011.36.1.26
AbstractAbstract PDFPubReaderePub
Objectives

In the present study, three kinds of tissues cells (pulp, gingiva, and periodontal ligament) were investigated if those cells express MMP and TIMP when they were stimulated with neuropeptides (substance P, CGRP) or proinflammatory cytokine, TNF-α.

Materials and Methods

The cells cultured from human dental pulp (PF), gingiva (GF) and periodontal ligament were (PDLF) stimulated with Mock, SP, TNF-α, and CGRP for 24 hrs and 48 hrs. for an RNase protection assay and Enzyme Linked Immunosorbent Assay.

Cells (PF, GF and PDLF) seeded in 100 mm culture dish were stimulated with SP (10-5, 10-8 M) or only with medium (Mock stimulation) for 4hrs and for 24 hrs for RNase Protection Assay, and they were stimulated with CGRP (10-5 M) and TNF-α (2 ng/mL) for 24 hrs and with various concentraion of TNF-α (2, 10, and 100 ng/mL) for Rnase Protection Assay with a human MMP-1 probe set including MMP 1, 2, 8, 7, 8, 9, 12, and TIMP 2, 3.

In addition, cells (PF, GF and PDLF) were stimulated with Mock and various concentraion of TNF-α (2, 10, and 100 ng/mL) for 24 hrs and with TNF-α (10 ng/mL) for 48 hrs, and the supernatents from the cells were collected for Enzyme Linked Immunosorbent Assay (ELISA) for MMP-1 and MMP-13.

Results

The expression of MMPs in PF, GF, PDLF after stimulation with SP and CGRP were not changed compared with Mock stimulation for 4 hrs and 24 hrs. The expression of MMP-1, -12, -13 24 hrs after stimulation with TNF-α were upregulated, however the expression of TIMP-3 in PF, GF, PDLF after stimulation with TNF-α were downregulated. TNF-α (2 ng/mL, 10 ng/mL, 100 ng/mL) increased MMP-1 and MMP-12 expression in PF dose dependently for 24 hrs.

Conclusions

TNF-α in the area of inflammation may play an important role in regulating the remodeling of dentin, cementum, and alveolar bone.

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Clinical Research
Study of endodontic working length of Korean posterior teeth
Jeong-Yeob Kim, Sang-Hoon Lee, Gwang-Hee Lee, Sang-Hyuk Park
J Korean Acad Conserv Dent 2010;35(6):429-435.   Published online November 30, 2010
DOI: https://doi.org/10.5395/JKACD.2010.35.6.429
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to investigate average working lengths of Korean posterior teeth and evaluate validity of endodontic file length.

Materials and Methods

The endodontic working length of the posterior teeth of 670 Korean patients were measured than each mean value and standard deviation were investigated than the frequency deviation and standard deviation per each length were calculated.

Results

Among the canals of premolar, 66.5% of canal length was marked under 20 mm by endodontic working length and 95.4% could be measured under 22 mm and Among the canals of molars, 95.5% of canal length was marked under 20 mm endodontic working length.

Conclusions

With the result of measurement of endodontic working length of premolars of Korean, it suggested that 23 mm endodontic file is more proper than the 21 mm and 25 mm file on the market.

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Basic Research
A comparison of the shaping ability of four rotary nickel-titanium files in simulated root canals
Bo-Hye Kim, Kyoung-Kyu Choi, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2010;35(2):88-95.   Published online March 31, 2010
DOI: https://doi.org/10.5395/JKACD.2010.35.2.088
AbstractAbstract PDFPubReaderePub

The purpose of this study was to compare the root canal shaping ability of 4 rotary NiTi instruments in simulated root canals.

For the preparation of thirty two curved root canals, Mtwo instruments using "single length"technique, and Profile, ProTaper Universal, and K3 using crown-down technique (N = 8) were used. All canal samples were prepared by reaching an apical canal size of #30. Pre- and post-instrumentation digital images were recorded and an assessment of canal shape was determined using a computer image analysis program SigmaScan Pro (Systat Software Inc., San Jose, CA, USA). The changes of the dimension of inner walls of canals, (2) the changes of the dimension of outer walls of canals, and (3) the centering ratio were measured at 7 measuring points, and then data were statistically analyzed using one-way ANOVA and Duncan's test. The results were as below;

The root canal shaping ability of Profile was significantly faster than that of other rotary NiTi instruments (p < 0.05).

The deformation and fracture of all instruments used for this study were not experienced.

In the degree of changes of the dimension of inner walls of canals, Profile demonstrated the lowest changes of the dimension of inner walls of canals except at the measuring points of the 1 and 2 mm (p < 0.05). However, the ProTaper Universal showed the highest changes of the dimension of inner walls of canals at all measuring points (p < 0.05).

In the degree of changes of the dimension of outer walls of canals, Mtwo demonstrated the lowest changse of the dimension of outer walls of canals except at the measuring point of the 1 mm (p < 0.05). However, Profile exhibited the highest changes of the dimension of outer walls of canals at the measuring points of 3 and 4 mm and ProTaper Universal and K3 showed the largest changes of the dimension of outer walls of canals at the measuring points of 1, 2, 6, and 7 mm (p < 0.05).

In degree of centering ratio, Profile demonstrated the least centering ratio comparing with the centering ratio shown by other NiTi instruments at the measuring points of 1, 4, 5, and 6 mm.

Results suggest that in the coronal part of canal preparation, active cutting files such as ProTaper Universal may efficiently flare the canal orifice and form a better taper, and in the apical part of the canal, files which have a better centering ability such as Profile may maintain the original canal curvature and reduce the shaping time.

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Original Articles
Gene expression of human coronary artery endothelial cells in response to Porphyromonas endodontalis invasion
Hee-Joung Kong, Kyoung-Kyu Choi, Sang-Hyuk Park, Jin-Yong Lee, Gi-Woon Choi
J Korean Acad Conserv Dent 2009;34(6):537-550.   Published online November 30, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.6.537
AbstractAbstract PDFPubReaderePub

During the last two decades, there has been an increasing interest in the impact of oral health on atherosclerosis and subsequent cardiovascular disease (CVD). To date, some periodontal pathogens including Porphyromonas gingivalis (P. gingivalis) have been reported to be relevant to CVD. Porphyromonas endodontalis (P. endodontalis), which shares approximately 87% sequence homology with P. gingivalis, is mostly found within infected root canals. However, recent studies reveal that this pathogen also resides in the dental plaque or periodontal pocket in patients with periodontitis. It has been shown that P. endodontalis invades human coronary artery endothelial cells (HCAEC) and coronary artery smooth muscle cells (CASMC). To evaluate whether P. endodontalis can participate in the progression of atherosclerosis and CVD, we examined the changes in transcriptional gene expression profiles of HCAEC responding to invasion by P. endodontalis in this study.

The following results were obtained.

Porphyromonas endodontalis was invasive of HCAEC.

According to the microarray analysis, there were 625 genes upregulated more than two-folds, while there were 154 genes downregulated by half.

Upregulated genes were relevant to inflammatory cytokines, apoptosis, coagulation and immune response. Enhanced expression of MMP-1 was also noticeable.

The transcription profiles of the 10 selected genes examined by real-time PCR agreed well with those observed in the microarray analysis.

Thus, these results show that P. endodontalis presents the potential to trigger and augment atherosclerosis leading to CVD.

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The comparison of gene expression from human dental pulp cells and periodontal ligament cells
Hyoun So, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2009;34(5):430-441.   Published online September 30, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.5.430
AbstractAbstract PDFPubReaderePub

The purpose of this study was to characterize functional distinction between human dental pulp cells(PC) and periodontal ligament cells(PDLC) using cDNA microarray assay and to confirm the results of the microarray assay using RT-PCR. 3 genes out of 51 genes which were found to be more expressed(>2 fold) in PC were selected, and 3 genes out of 19 genes which were found to be more expressed(>2 fold) in PDLC were selected for RT-PCR as well.

According to this study, the results were as follows:

1. From the microarray assay, 51 genes were more expressed (2 fold) from PC than PDLC.

2. RT-PCR confirmed that ITGA4 and TGF β2 were more expressed in PC than in PDLC.

3. From the microarray assay, 19 genes were more expressed (2 fold) from PDLC than PC.

4. RT-PCR confirmed that LUM, WISP1, and MMP1 were more expressed in PDLC than in PC.

From the present study, different expression of the genes between the PC and PDLC were characterized to show the genes which play an important role in dentinogenesis were more expressed from PC than PDLC, while the genes which were related with collagen synthesis were more expressed from PDLC than PC.

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Morphology of the apical root canal system in Korean mandibular first molar
Hyeon Jeong, Sang-jin Park, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2009;34(2):137-144.   Published online March 31, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.2.137
AbstractAbstract PDFPubReaderePub

The aim of this study was to investigate the shapes and diameters of the physiological foramen and anatomy of the root canal at 3mm from apex in mandibular first molars.

Sixty mandibular first molars were randomly selected. The apical anatomy of 60 mandibular first molars was investigated by means of a stereomicroscope (60x magnification).

The results were as follows;

1. There was a high percentage of two physiological foramina in mesial (61.67%) and one foramen in distal(71.66%) roots of mandibular first molars.

2.There was a high frequency of accessory foramina in mesial roots with one foramen (26.07%).

3. The diameters of physiological foramen was as follows:

0.329mm in single mesial foramen

0.266mm in mesiobuccal foramen and 0.246mm in mesiolingual foramen

0.375mm in single distal foramen

0.291mm in distobuccal foramen and 0.237mm in distolingual foramen

4. The most common physiological foramen shape was oval (69.93%).

5. The incidence of isthmus in mesial root at 3mm from apex was 55%. The 3mm-sections contained a complete isthmus 31.66% and a partial isthmus 23.34%.

6. 3mm from the apex, the most common canal shape was oval (50.64%).

Knowledge of the apical anatomy of mandibular first molar would be necessary for success of surgical and nonsurgical endodontic treatment.

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Effect of intermediate resin hydrophilicity on bond strength of single step adhesive
Yong-Sung Kim, Sang-Hyuk Park, Gi-Woon Choi, Kyoung-Kyu Choi
J Korean Acad Conserv Dent 2007;32(5):445-458.   Published online September 30, 2007
DOI: https://doi.org/10.5395/JKACD.2007.32.5.445
AbstractAbstract PDFPubReaderePub

The purpose of this study was to evaluate the bond strength of a new Single step system with different curing mode composites, and to evaluate the effect of the intermediate resins which have different hydrophilicity on bonding ability by means of the micro shear bond testing and TEM examination for the adhesive interface. The adhesive used in this study was an experimental single step system (Bisco Inc., Schaumburg, IL). Experimental groups were produced by using six kinds of intermediate resin having different hydrophilicity that was hydrophilic, hydrophobic and most hydrophobic resin and as filled or not after applying adhesive. Each experimental group was further divided into two subgroups whether the adhesive was light cured or not. Dual cured composite (Bis Core, Bisco Ltd., Schaumburg, IL) was placed on the adhesive layer as light cure or self cure mode. The results of bond strength were statistically analyzed using one way ANOVA and multiple comparisons are made using Tukey's test at α < 0.05 level.

The results of this study were as follows;

1. The application of intermediate resin did not increase the bond strength for light cured composite.

2. The bond strength of an experimental adhesive with self cured composite was significantly increased by the application of intermediate resin layer.

3. The bond strength of adhesive was irrespective of the cure or not of itself before intermediate resin layer applied.

4. As applied hydrophilic resin layer was, the initial bond strength was higher than both hydrophobic and most hydrophobic one used but there was no significance.

Using a single step adhesive with dual/self cured composite, the incompatibility between both of them should be solved by the application of intermediate hydrophobic resin to reduce the adhesive permeability. However, Single step adhesive can be used in the light cured composite restoration without any decrease of the initial bond strength.

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The effect of bonding resin on bond strength of dual-cure resin cements
Duck-Su Kim, Sang-Hyuk Park, Gi-Woon Choi, Kyung-Kyu Choi
J Korean Acad Conserv Dent 2007;32(5):426-436.   Published online September 30, 2007
DOI: https://doi.org/10.5395/JKACD.2007.32.5.426
AbstractAbstract PDFPubReaderePub

The objective of this study is to evaluate the effect of an additional application of bonding resin on the bond strength of resin luting cements in both the light-cure (LC) and self-cure (SC) modes by means of the µTBS tests.

Three combinations of One-Step Plus with Choice, Single Bond with Rely X ARC, and One-Up Bond F with Bistite II were used. D/E resin and Pre-Bond resin were used for the additional application. Twelve experimental groups were made. Three mandibular 3rd molars were used in each group. Indirect composite blocks were cemented on the tooth surface. 1 × 1 mm2 dentin-composite beam for µTBS testing were made and tested.

When total-etching dentin adhesives were used, an additional application of the bonding resin increased the bond strength (P < 0.05). However, this additional application didn't influence the bond strength of self-etching dentin adhesives (P > 0.05).

In conclusion, the results suggest that an additional application of the bonding resin increases bond strength and enhances quality of bonding when using total-etching dentin adhesives.

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The bonding durability of total etching adhesives on dentin
Mi-Ra Jung, Gi-Woon Choi, Sang-Hyuk Park, Sang-Jin Park
J Korean Acad Conserv Dent 2007;32(4):365-376.   Published online July 31, 2007
DOI: https://doi.org/10.5395/JKACD.2007.32.4.365
AbstractAbstract PDFPubReaderePub

The purpose of this study was to evaluate the effect of different etching times on microtensile bond strength (µTBS) to dentin both initial and after thermocycling with 3 different types of total-etching adhesives.

Fifty four teeth were divided into 18 groups by etching times (5, 15, 25 sec), adhesives types (Scotchbond Multipurpose (SM), Single Bond (SB), One-Step (OS)), and number of thermocycling (0, 2,000 cycles).

Flat dentin surfaces were prepared on mid-coronal dentin of extracted third molars. After exposed fresh dentin surfaces were polished with 600-grit SiC papers, each specimen was acid-etched with 35% phosphoric acid (5, 15, 25 sec) and bonded with 3 different types of total etching adhesives respectively. Then, hybrid composite Z-250 was built up. Half of them were not thermocycled (control group) and the others were subjected to 2,000 thermocycle (experimental group). They were sectioned occluso-gingivally into 1.0 × 1.0 mm2 composite-dentin beams and tested with universal testing machine at a crosshead speed of 1.0 mm/min.

Within limited data of this study, the results were as follows

1. There was no statistically significant difference in µTBS between the thermocycled and non-thermocycled groups, except for both SM and SB etched for 25 sec.

2. In thermocycled SM and SB groups, bond strength decreased by extended etching time.

In total etching systems, adhesive durability for dentin could be affected by type of solvents in adhesive and etching time. Especially, extended etching time may cause deteriorate effects on bond strength when ethanol-based adhesive was used.

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The bonding durability of resin cements
Min-Woo Cho, Sang-Hyuk Park, Jong-Ryul Kim, Kyoung-Kyu Choi
J Korean Acad Conserv Dent 2007;32(4):343-355.   Published online July 31, 2007
DOI: https://doi.org/10.5395/JKACD.2007.32.4.343
AbstractAbstract PDFPubReaderePub

The objectives of this study was to evaluate the durability of 4 resin cements by means of microtensile bond strength test combined with thermocycling method and fractographic FE-SEM analysis.

Experimental groups were prepared according to thermocycling (0, 1,000, 5,000) and the kind of resin cements, those were Variolink II, Multilink, Panavia F 2.0, Rely X Unicem. Flat dentin surfaces were created on mid-coronal dentin of extracted third molars. Then fresh dentin surface was grounded with 320-grit silicon carbide abrasive papers to create uniform smear layers. Indirect composite block (Tescera, Bisco Inc., Schaumburg, IL, USA) was fabricated (12 × 12 × 6 mm3). It's surface for bonding to tooth was grounded with silicon carbide abrasive papers from 180- to 600-grit serially, then sandblasted with 20 - 50 µm alumina oxide. According to each manufacturer's instruction, dentin surface was treated and indirect composite block was luted on it using each resin cement. For Rely X Unicem, dentin surface was not treated. The bonded tooth-resin block were stored in distilled water at 37℃ for 24 hours. After thermocycling, the bonded tooth-resin block was sectioned occluso-gingivally to 1.0 mm thick serial slabs using an Isomet slow-speed saw (Isomet, Buehler Ltd, Lake Bluff, IL, USA). These sectioned slabs were further sectioned to 1.0 × 1.0 mm2 composite-dentin beams. The specimens were tested with universal testing machine (EZ-Test, Shimadzu, Japan) at a crosshead speed of 1.0 mm/min with maximum load of 500 N. The data was analyzed using one-way ANOVA and Duncan's multiple comparison test at p ≤ 0.05 level.

Within the limited results, we conclude as follows;

1. The bond strength of Variolink II was evaluated the highest among experimental groups and was significantly decreased after 1,000 thermocycling (p < 0.05).

2. The bond strength of Multilink was more affected by thermocycling than the other experimental groups and significantly decreased after 1,000 thermocycling (p < 0.05).

3. Panavia F 2.0 and Rely X Unicem showed the gradually decreased tendency of microtensile bond strength according to thermocycling but there was no significant difference (p > 0.05).

4. Adhesive based-resin cements showed lower bond strength with or without thermocycling than composite based-resin cements.

5. Variolink II & Multilink showed high bond strength and mixed failure, which was occurred with a thin layer of luting resin cement before thermocycling and gradually increased adhesive failure along the dentin surface after thermocycling.

The bonding performance of resin cement can be affected by application procedure and chemical composition. Composite based-resin cement showed higher bond strength and durability than adhesive based-resin cement.

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Effect of the additional application of a resin layer on dentin bonding using single-step adhesives
Seung-Mo Choi, Sang-Hyuk Park, Kyung-Kyu Choi, Sang-Jin Park
J Korean Acad Conserv Dent 2007;32(4):313-326.   Published online July 31, 2007
DOI: https://doi.org/10.5395/JKACD.2007.32.4.313
AbstractAbstract PDFPubReaderePub

The purpose of this study was to prove that an intermediate resin layer (IRL) can increase the bond strength to dentin by reducing the permeability of single-step adhesives.

Flat dentin surfaces were created on buccal and lingual side of freshly extracted third molar using a low-speed diamond saw under copious water flow. Approximately 2.0 mm thick axially sectioned dentin slice was abraded with wet #600 SiC paper. Three single-step self-etch adhesives; Adper Prompt L-Pop (3M ESPE, St Paul, MN, USA), One-Up Bond F (Tokuyama Corp, Tokyo, Japan) and Xeno III (Dentsply, Konstanz, Germany) were used in this study. Each adhesive groups were again subdivided into ten groups by; whether IRL was used or not; whether adhesives were cured with light before application of IRL or not; the mode of composite application.

The results of this study were as follows;

1. Bond strength of single-step adhesives increased by an additional coating of intermediate resin layer, and this increasement was statistically signigicant when self-cured composite was used (p < 0.001).

2. When using IRL, there were no difference on bond strengths regardless the curing procedure of single-step adhesives.

3. There were no significant difference on bond strengths between usage of AB2 or SM as an IRL.

4. The thickness of hybrid layer was correlated with the acidity of adhesive used, and the nanoleakage represented by silver deposits and grains was examined within hybrid and adhesive layer in most of single-step adhesives.

5. Neither thickness of hybrid layer nor nanoleakage were related to bond strength.

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Effect of calcium hydroxide on bond strength of dentin bonding systems
No-Hoon Park, Sang-Hyuk Park, Gi-Woon Choi, Sang-Jin Park
J Korean Acad Conserv Dent 2007;32(3):198-207.   Published online May 31, 2007
DOI: https://doi.org/10.5395/JKACD.2007.32.3.198
AbstractAbstract PDFPubReaderePub

The purpose of this study was to investigate the effect of calcium hydroxide on dentin bonding strength of various dentin bonding systems as a function of time in composite resin restoration.

Dentin adhesives used in this study were Scotchbond Multipurpose, Single Bond, SE Bond and Prompt L-Pop. Flat dentin surfaces adjacent to pulp chamber were created, then Ca(OH)2 and saline were mixed and applied on dentin surface of experimental group, then IRM was used to cover the mixture on dentin surface and the specimens were stored at 36.5℃ for experiment period (7 days, 30 days). After removing IRM and Ca(OH)2, each dentin adhesives were treated on dentin surfaces.

Composite resin (Z-250, 3M) was placed with 5 mm height and was light-cured for 20 seconds. After stored in distilled water for 24 hours, each dentin-composite bonded spicemen was embedded in epoxy resin and sectioned into 1.0 × 1.0 mm2 cross section composite-dentin beams. Specimen was mounted on zig of Universal testing machine and µTBS test was performed. SEM analysis was performed to examine the fractured surfaces.

The results suggested that applying calcium hydroxide did not show significant difference in dentin bonding strength.

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The effect of reinforcing methods on fracture strength of composite inlay bridge
Chang-Won Byun, Sang-Hyuk Park, Sang-Jin Park, Kyoung-Kyu Choi
J Korean Acad Conserv Dent 2007;32(2):111-120.   Published online March 31, 2007
DOI: https://doi.org/10.5395/JKACD.2007.32.2.111
AbstractAbstract PDFPubReaderePub

The purpose of this study is to evaluate the effects of surface treatment and composition of reinforcement material on fracture strength of fiber reinforced composite inlay bridges.

The materials used for this study were I-beam, U-beam TESCERA ATL system and ONE STEP(Bisco, IL, USA). Two kinds of surface treatments were used; the silane and the sandblast. The specimens were divided into 11 groups through the composition of reinforcing materials and the surface treatments.

On the dentiform, supposing the missing of Maxillary second pre-molar and indirect composite inlay bridge cavities on adjacent first pre-molar disto-occlusal cavity, first molar mesio-occlusal cavity was prepared with conventional high-speed inlay bur.The reinforcing materials were placed on the proximal box space and build up the composite inlay bridge consequently. After the curing, specimen was set on the testing die with ZPC. Flexural force was applied with universal testing machine (EZ-tester; Shimadzu, Japan). at a cross-head speed of 1 mm/min until initial crack occurred. The data wasanalyzed using one-way ANOVA/Scheffes' post-hoc test at 95% significance level.

Groups using I-beam showed the highest fracture strengths (p < 0.05) and there were no significant differences between each surface treatment (p > 0.05). Most of the specimens in groups that used reinforcing material showed delamination.

The use of I-beam represented highest fracture strengths (p < 0.05).

In groups only using silane as a surface treatment showed highest fracture strength, but there were no significant differences between other surface treatments (p > 0.05).

The reinforcing materials affect the fracture strength and pattern of composites inlay bridge.

The holes at the U-beam did not increase the fracture strength of composites inlay bridge.

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Time-dependent effects of EDTA application on removal of smear layer in the root canal system
Ja-Kyong Lee, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2006;31(3):169-178.   Published online May 31, 2006
DOI: https://doi.org/10.5395/JKACD.2006.31.3.169
AbstractAbstract PDFPubReaderePub

This study was to verify that the combined application of NaOCl and EDTA was more effective in removal of smear layer than the application of NaOCl alone. Furthermore it was aimed to find out the optimal time for the application of EDTA.

Thirty five single rooted teeth were cleaned and shaped. NaOCl solution was used as an irrigant during instrumentation. After instrumentation, root canals of the control group were irrigated with 5 ml of NaOCl for 2 minutes. 30 sec, 1 min, and 2 min group were irrigated with 5 ml of 17% EDTA for 30 sec, 1 min, and 2 min respectively. Then the roots were examined with scanning electron microscopy for evaluating removal of smear layer and erosion of dentinal tubule.

The results were as follows;

The control group:

The smear layer was not removed at all.

The other groups:

1) Middle⅓: All groups showed almost no smear layer. And the erosion occurred more frequently as increasing irrigation time.

2) Apical⅓: The cleaning effect of 2 min group was better than the others.

The results suggest that 2 min application of 17% EDTA should be adequate to remove smear layer on both apical⅓ and middle⅓.

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The effect of neuropeptides on secretion of Interleukin-8 (IL-8)
Kyung-Jun Kim, Sang-Hyuk Park, Kyoung-Kyu Choi, Sang-Jin Park
J Korean Acad Conserv Dent 2006;31(3):153-160.   Published online May 31, 2006
DOI: https://doi.org/10.5395/JKACD.2006.31.3.153
AbstractAbstract PDFPubReaderePub

We investigated the secretion of Interleukin-8 (IL-8) from ginviva and periodontal ligament stimulated with Substance P (SP) and Calcitonin Gene-related Peptide (CGRP). Gingiva (GF), periodontal ligament (PDLF) and pulp (PF) tissues were collected from extracted intact 3rd molars.

Cultured cells were stimulated with different concentrations of SP for 4 hrs, and stimulated with SP, CGRP and Tumor Necrosis Factor-α (TNF-α) for 8 hrs. Then RNase Protection Assay was carried out. ELISA was performed using supernatants of stimulated cells for quantitative analysis of IL-8. Results were assessed using student t-test with significance of P < 0.05.

According to this study, the results were as follows:

IL-8 mRNA was detected in all type of cells studied (PF, GF and PDLF).

IL-8 mRNA expression was not increased after stimulating 4 hrs with SP (10-5M) and SP (10-8M) compared with Mock stimulation in all type of cells studied.

IL-8 mRNA expression was not increased after stimulating 8 hrs with SP (10-4M) and CGRP (10-6M) compared with Mock stimulation in all type of cells studied.

TNF-α(2 ng/ml) increased the expression of IL-8 mRNA in all kind of cells studied.

The secretion of IL-8 from GF was increased 8 hrs after the stimulation with CGRP (10-6M) (p < 0.05).

The secretion of IL-8 from PDLF was increased 8 hrs after the stimulation with SP (10-4M) (p < 0.05).

Calcitonin Gene-related Peptide (CGRP) increased Interleukin-8 (IL-8) which plays an important role in chemotaxis of neutrophil in Calcitonin Gene-related Peptide (CGRP) gingival tissue, whereas Substance P increased the secretion of IL-8 from periodontal ligament.

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The effect of calcium hydroxide on post-treatment pain
Wook Nam, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2006;31(2):86-95.   Published online March 31, 2006
DOI: https://doi.org/10.5395/JKACD.2006.31.2.086
AbstractAbstract PDFPubReaderePub

The purpose of this clinical study is to assess whether calcium hydroxide as an intracanal medication affects post-treatment pain in teeth especially odontogenic pain which comes from inflammation of the pulp and periradicular tissues when compared with no intracanal medication.

From 213 patients who has been treated 237 root canals due to significant pain (moderate-to-severe), we recorded their age, sex, treated tooth, degree of pain, pre-operative states of the tooth. We classified patients into 2 test group; Group 1 (not gain intracanal Ca(OH)2), Group 2 (gain intracanal Ca(OH)2). Through the survey from the patients, we let them write down the occurrence and degree of post-treatment pain in 4hours, 2days, 7days after treatment as none, mild, moderate or severe. The followings were evaluated; the overall incidence of flare-ups, the overall incidence of post-treatment pain in each group at each time period, the incidence of post-treatment pain in each group at each time period as related to pre-operative states of the teeth. These were compared statistically with Chi-square analysis (p < 0.05).

Under the condition of this investigation, no difference was observed in the incidence of post-treatment pain between the two groups. Therefore, Ca(OH)2 as intracanal medication had no effect on preventing or decreasing the post-treatment pain.

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THE EFFECT OF SMEAR LAYER TREATMENT ON THE MICROLEAKAGE
Jung-Min Lee, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2006;31(5):378-389.   Published online January 14, 2006
DOI: https://doi.org/10.5395/JKACD.2006.31.5.378
AbstractAbstract PDFPubReaderePub
Abstract

The purpose of this study was to compare the sealing ability of root canal obturation with or without the treatment of smear layer. Eighty extracted human teeth with one canal were selected. Instrumentation was performed with crown-down technique. After instrumentation, root canals of the NaOCl group and NaOCl-6 group were irrigated with 3% NaOCl. EDTA group and EDTA-6 group were irrigated with 17% EDTA. Then all teeth were obturated using continuous wave obturation technique.

NaOCl group and EDTA group were immersed in methylene blue solution for 84hours. NaOCl-6 group and EDTA-6 group were immersed in methylene blue solution for 6months. The teeth were sectioned at 1.5 mm (Level 1), 3.0 mm (Level 2) and 4.5 mm (Level 3) from the root apex. The length of dye-penetrated interface and the circumferential length of canal at each level were measured using Sigma-Scan Pro 5.0.

The mean leakage ratio was decreased cervically.

NaOCl group showed higher mean leakage ratio than EDTA group at each level. But there was significant difference at level 1 only (p < 0.05).

NaOCl-6 group showed higher mean leakage ratio than EDTA-6 group at each level. But there was significant difference at level 1 only (p < 0.05).

NaOCl-6 group showed higher mean leakage ratio than NaOCl group at each level. But there was significant difference at level 1 only (p < 0.05).

EDTA-6 group showed higher mean leakage ratio than EDTA group at each level. But there was no significant difference.

In NaOCl group and NaOCl-6 group, scanning electron micrographs of tooth sections generally covered with smear layer. In EDTA group and EDTA-6 group, tooth sections showing the penetration of sealers to opened dentinal tubules. The results suggest that removal of smear layer was effective to reduce the apical microleakage of the root canal.

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Interleukin-8 and MCP(Monocyte Chemoattractant Protein)-1 expression by the Human Dental Pulps in cultures stimulated with Substance P
Han-Ju Shin, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2005;30(3):193-203.   Published online May 31, 2005
DOI: https://doi.org/10.5395/JKACD.2005.30.3.193
AbstractAbstract PDFPubReaderePub

The induction of the IL-8 and MCP-1 by the stimulation of Substance P and TNF-α (IL-8 agonist) and the specificity for SP using Spantide (SP antagonist) in the dental pulp tissues was measured quantitatively. In addition, the secretion of the IL-8 in the human dental pulp tissue 36 hrs after the stimulation of SP was observed after the stimulation of SP qualitatively.

According to this study, the results were as follows:

1. There was the significant IL-8 induction at 36 h after SP (10-4M) stimulation of the pulp tissue comparing with the unstimulated dental pulp tissues (p < 0.05). IL-8 immunostaining was weakly detected along the periphery of the pulp tissue after Mock stimulation and IL-8 immunostaining was detected around the fibroblast in the pulp tissue 36h After SP (10-4M) stimulation,

2. The secretion of MCP-1 from the dental pulp tissues comparing with Mock stimulation was induced at 36 hrs after TNF-α (40 ng/ml) stimulation, but no induction with SP(10-4M). TNF-α (40 ng/ml) did not induce the IL-8 secretion from the pulp tissue, weak IL-8 immunostaining was detected along the periphery of the pulp tissue.

3. Spantide (10-5M) inhibited IL-8 induction from the pulp tissues 36 h after SP (10-4M) stimulation.

These results suggest that SP significantly induces IL-8 recruiting neutrophils in localized human dental pulp tissue. MCP-1 appears to be less involved in the early establishment of pulpal inflammation in response to irritation such as mechanical insult of dentin. SP may have positive relation with the inflammation of the human dental pulp tissues.

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Endodontic flare-ups incidence and related factors
Hye-Young Jung, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2005;30(2):102-111.   Published online March 31, 2005
DOI: https://doi.org/10.5395/JKACD.2005.30.2.102
AbstractAbstract PDFPubReaderePub

The purpose of this study was to assess the incidence of flare-ups among patients who received endodontic treatment and to examine the correlation with pre-operative and operative variables.

Analysis was in two aspects (a) overall incidence of flare-ups as expressed by a percentage of all patients visits and (b) percentage of flare-ups that occurred as related to various factors such as patient demographics, diagnosis, and treatment procedures.

1. From the 840 teeth which were examined in this study, the total number of flare-ups was 13.

2. As to gender of patients, there was no significant difference in flare-ups.

3. As to tooth groups, there was no significant difference in flare-ups.

4. In the teeth with pre-operative symptom, there was a statistically significant higher incidence of flare-ups than the teeth without it.

5. In the teeth with apical periodontitis, there was a statistically significant higher incidence of flare-ups.

6. As to pulp and periapical status, non-vital teeth had a higher incidence as compared with vital teeth, irreversible pulpitis.

7. Multi-visit treatment resulted in the higher incidence of flare-ups than one visit treatment.

8. Re-treatment procedures had a statistically significant higher incidence of flare-ups than root canal treatment.

In this study, overall percentages of flare-ups was 1.55%. It showed a statistically significant higher incidence related to pre-operative symptom, apical periodontitis, and re-treatment. There was no significant difference in flare-ups related to gender, tooth groups, and fistula.

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COMPARISON OF APICAL SEAL WITH OR WITHOUT THE USE OF DENTIN ADHESIVE SYSTEM
Min-Jo Lee, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2005;30(1):7-15.   Published online January 14, 2005
DOI: https://doi.org/10.5395/JKACD.2005.30.1.7
AbstractAbstract PDFPubReaderePub
ABSTRACT

The purpose of this study was to compare the sealing ability of root canal obturation with or without the use of dentin adhesive system. Forty extracted human teeth with one canal were selected and decoronated. The teeth were divided into two Groups. The obturation procedure of Group 1 was the same as that of Group 2 with the exception of dentin adhesive system. Group 2 were obturated with dentin adhesive system, AH-26, and gutta-percha.

After obturation, the teeth were immersed in methylene blue solution for 84 hours. The teeth were sectioned horizontally at 1.5 mm (Level 1), 2.0 mm (Level 2), 2.5 mm (Level 3) from the root apex using a low speed microtome. Distance of dye-penetrated surface and total dentinal surface were measured using SigmaScan Pro 5.0, and the ratio of dye-penetrated distance to the total dentinal distance was analyzed statistically by Mann-Whitney U-test.

In both groups, the mean leakage ratio was decreased cervically.

At level 1, there was no significant difference between group 1 and grpup 2 (p > 0.05).

At level 2 and 3, group 1 showed significantly higher mean leakage ratio than group 2 (p < 0.05). The results suggest that using dentin adhesive system in root canal obturation procedure reduces the apical microleakage.

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Tissue engineering of dental pulp on type I collagen
Gwang-Hee Lee, Sung-Yoon Huh, Sang-Hyuk Park
J Korean Acad Conserv Dent 2004;29(4):370-377.   Published online July 31, 2004
DOI: https://doi.org/10.5395/JKACD.2004.29.4.370
AbstractAbstract PDFPubReaderePub

The purpose of this study was to regenerate human dental pulp tissues similar to native pulp tissues. Using the mixture of type I collagen solution, primary cells collected from the different tissues (pulp, gingiva, and skin) and NIH 3T3 (1 × 105 cells/ml/well) were cultured at 12-well plate at 37℃ for 14 days. Standardized photographs were taken with digital camera during 14 days and the diameter of the contracted collagen gel matrix was measured and statistically analyzed with student t-test. As one of the pulp tissue engineering, normal human dental pulp tissue and collagen gel matrix cultured with dental pulp cells for 14 days were fixed and stained with Hematoxyline & Eosin.

According to this study, the results were as follows:

1. The contraction of collagen gel matrix cultured with pulp cells for 14 days was significantly higher than other fibroblasts (gingiva, skin) (p < 0.05).

2. The diameter of collagen gel matrix cultured with pulp cells was reduced to 70.4% after 7 days, and 57.1% after 14 days.

3. The collagen gel without any cells did not contract, whereas the collagen gel cultured with gingiva and skin showed mild contraction after 14 days (88.1% and 87.6% respectively).

4. The contraction of the collagen gel cultured with NIH 3T3 cells after 14 days was higher than those cultured with gingival and skin fibroblasts, but it was not statistically significant (72.1%, p > 0.05).

5. The collagen gel matrix cultured with pulp cells for 14 days showed similar shape with native pulp tissue without blood vessels.

This approach may provide a means of engineering a variety of other oral tissue as well and these cell behaviors may provide information needed to establish pulp tissue engineering protocols.

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Culturing the Human Dental pulp cells in the Collagen Matrix and on the ground tooth surface
Sang-Hyuk Park
J Korean Acad Conserv Dent 2003;28(5):419-424.   Published online September 30, 2003
DOI: https://doi.org/10.5395/JKACD.2003.28.5.419
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Micro-shear bond strength of resin-modified glass ionomer and resin-based adhesives to dentin
Hyun-Kyung Hong, Kyoung-Kyu Choi, Sang-Hyuk Park, Sang-Jin Park
J Korean Acad Conserv Dent 2003;28(4):314-325.   Published online July 31, 2003
DOI: https://doi.org/10.5395/JKACD.2003.28.4.314
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Distribution of oral pathogens in infections of endodontic origin
Seung-Yoon Kim, Ho-Young Choi, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2003;28(4):303-313.   Published online July 31, 2003
DOI: https://doi.org/10.5395/JKACD.2003.28.4.303
AbstractAbstract PDFPubReaderePub

It has been documented that periodontopathic bacteria are also implicated in endodontic infections. 16S rDNA gene-directed PCR was to examine the prevalence of periodontopathic bacteria including Actinobacillus actinomycetemcomitans (Aa), Prevotella intermedia (Pi), Prevotella nigrescens (Pn), Porphyromonas gingivalis (Pg), Porphyromonas endodontalis (Pe), and Treponema denticola (Td) in the root canals of 36 endodontically infected teeth having apical lesions with or without clinical symptoms like pain, swelling, and fistula.

In 36 infected root canals, most frequently detected bacterial species was Pg (61.1%), followed by Td (52.8%) and Pe (38.9%).

Of 36 infected root canals, Aa was detected in 6 canals (16.7%) of the teeth, all of which showed clinical symptoms.

Of 36 infected root canals, Pi and Pn were found in 4 (13.9%) and 5 (33.3%), respectively. Notably, prevalence of Pn in the symptomatic teeth was 50.0%.

One of black-pigmented anaerobic bacteria (BPB) including Pi, Pn, Pe, and Pg was detected in all of the teeth that showed pain or especially swelling but not fistula. It was, however, found that prevalence of BPB in the asymptomatic teeth or the teeth with fistula was only 40%.

Pe and Pg were detected in the teeth regardless of the presence or absence of symptoms.

Td was detected in the teeth regardless of the presence or absence of symptoms.

High prevalence of BPB in the symptomatic teeth but low in the asymptomatic teeth suggests that BPB may play an important role in the pathogenesis of periapical lesions.

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The canal system in the mesiobuccal root of the maxillary first molar
Dong-Hyun Cho, Ho-Young Choi, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2003;28(3):232-240.   Published online May 31, 2003
DOI: https://doi.org/10.5395/JKACD.2003.28.3.232
AbstractAbstract PDFPubReaderePub

This study is to investigate the canal system in the mesiobuccal root of the maxillry first molar.

61 maxillary first molars were randomly selected. Serial transverse sections were made perpendicular to the long axis of the mesiobuccal root. Each section was placed in 3% sodium hypochlorite for 24 hours and rinsed in water and dried. The resected surface was stained with 2% methylene blue dye and examined with stereomicroscope.

Canal configuration analysis showed that 36.1% of the specimen classified as type I, 16.4% as type II, 37.7% as type III and 9.8% as type IV.

Type II canal was merged in one canal within 1 to 4mm of the apex. 40% of type II canal converged at 2mm of the apex.

Type IV canal was divided into two canal within 2 to 4mm of the apex. 66.6% of type IV canal branched off at 2mm of the apex.

None of the sections had more than two main root canal.

48.4% of the sections in 3mm with two canals contained an isthmusand more than 70% with two canals has isthmus at 4 to 5mm sections.

63.9% of the mesiobuccal root of maxillary first molar had two canaland 76.5% of sections with two canals in 5 MM had an isthmus. Because of this complexity the clinician should always search for extra canal carefullyand root canal system, including an isthmus, should be cleaned and shaped completelyand obturated three dimensionally for successful endodontic treatment.

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Self-adhesion of low-viscosity composites to dentin surface
Tae-Hee Cho, Kyoung-Kyu Choi, Sang-Hyuk Park, Sang-Jin Park
J Korean Acad Conserv Dent 2003;28(3):209-221.   Published online May 31, 2003
DOI: https://doi.org/10.5395/JKACD.2003.28.3.209
AbstractAbstract PDFPubReaderePub

The objectiveness of this study was to evaluate whether low-viscosity composite can bond effectively to dentin surface without bonding resin. The low-viscosity composites being 50wt% filler content were made by the inclusion of bonding resin of two self-etching systems(Clearfil SE Bond, Unifil Bond) varied with contents as 0, 10, 20, 30, 40, 50wt%.

Exposed dentin surfaces of extracted 3rd molars are used. Dentin bond strengths were measured. The tests were carried out with a micro-shear device placed testing machine at a CHS of 1mm/min after a low-viscosity composite was filled into an iris cut from micro tygon tubing with internal diameter approximately 0.8mm and height of 1.0mm.

Flexural strength and modulus was increased with the addition of bonding resin.

Micro-shear bond strength to dentin was improved according to content of bonding resin irrespective of applying or not bonding resin in bonding procedure, and that of Clearfil SE Bond groups was higher than Unifil Bond.

There were no significant difference whether use of each bonding resin in bonding procedure for S-40, S-50, U-50(p>0.05).

In SEM examination, resin was well infiltrated into dentin after primed with self-etching primer only for S-50 and U-50 in spite of the formation of thinner hybrid layer.

Low viscosity composite including some functional monomer may be used as dentin bonding resin without an intermediary bonding agent. It makes a simplified bonding procedure and foresees the possibility of self-adhesive restorative material.

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