Hypoesthesia after an inferior alveolar nerve (IAN) block does not commonly occur, but some cases are reported. The causes of hypoesthesia include a needle injury or toxicity of local anesthetic agents, and the incidence itself can cause stress to both dentists and patients. This case presents a hypoesthesia on mental nerve area followed by IAN block anesthesia with 2% lidocaine. Prescription of steroids for a week was performed and periodic follow up was done. After 1 wk, the symptoms got much better and after 4 mon, hypoesthesia completely disappeared. During this healing period, only early steroid medication was prescribed. In most cases, hypoesthesia is resolved within 6 mon, but being aware of etiology and the treatment options of hypoesthesia is important. Because the hypoesthesia caused by IAN block anesthesia is a mild to moderate nerve injury, early detection of symptom and prescription of steroids could be helpful for improvement of the hypoesthesia.
The maintenance of the healthy periodontal ligament cells of the root surface of donor tooth and intimate surface contact between the donor tooth and the recipient bone are the key factors for successful tooth transplantation. In order to achieve these purposes, a duplicated donor tooth model can be utilized to reduce the extra-oral time using the computer-aided rapid prototyping (CARP) technique.
Briefly, a three-dimensional digital imaging and communication in medicine (DICOM) image with the real dimensions of the donor tooth was obtained from a computed tomography (CT), and a life-sized resin tooth model was fabricated. Dimensional errors between real tooth, 3D CT image model and CARP model were calculated. And extra-oral time was recorded during the autotransplantation of the teeth.
The average extra-oral time was 7 min 25 sec with the range of immediate to 25 min in cases which extra-oral root canal treatments were not performed while it was 9 min 15 sec when extra-oral root canal treatments were performed. The average radiographic distance between the root surface and the alveolar bone was 1.17 mm and 1.35 mm at mesial cervix and apex; they were 0.98 mm and 1.26 mm at the distal cervix and apex. When the dimensional errors between real tooth, 3D CT image model and CARP model were measured in cadavers, the average of absolute error was 0.291 mm between real teeth and CARP model.
These data indicate that CARP may be of value in minimizing the extra-oral time and the gap between the donor tooth and the recipient alveolar bone in tooth transplantation.
It is often presumed that apical periodontitis follows total pulp necrosis, and consequently root canal treatment is commonly performed. Periapical lesion development is usually caused by bacteria and its byproduct which irritate pulp, develop pulpitis, and result in necrosis through an irreversible process. Afterwards, apical periodontitis occurs. This phenomenon is observed as an apical radiolucency in radiographic view. However, this unusual case presents a spontaneous healing of periapical lesion, which has developed without pulp necrosis in a vital tooth, through conservative treatment.
Patients with diabetes mellitus show delayed wound healing and increased susceptibility to infection. Therefore, the effects of diabetes on pulpal and periodontal healing should be taken into consideration when treating diabetic dental traumatized patients. This case presents the treatment for dental traumatized 20 yr old female with uncontrolled type II diabetes. The traumatized upper central incisors had showed pulpal healing in early days. However, 7 mon after the trauma, the teeth had been diagnosed with pulp necrosis with apical abscess. Eventually, non surgical root canal treatment on the teeth had been performed.
As the dental pulp is encased with a rigid, noncompliant shell, changes in pulpal blood flow or vascular tissue pressure can have serious implication for the health of pulp. Numerous studies have demonstrated that orthodontic force application may influence both blood flow and cellular metabolism, leading degenerative and/or inflammatory responses in the dental pulp. The aim of this case report is to present a case about tooth with chronic periapical abscess which showed normal vital responses. Excessive orthodontic force is thought to be the prime cause of partial pulp necrosis. Owing to remaining vital tissue, wrong dianosis can be made, and tooth falsely diagnosed as vital may be left untreated, causing the necrotic tissue to destroy the supporting tissuses. Clinician should be able to utilize various diagnostic tools for the precise diagnosis, and be aware of the endodontic-orthodontic inter-relationship.
This study was aimed to examine the patients' perception and satisfaction with the results of endodontic microsurgery which was apicoectomy with retrofilling.
A questionnaire was given to 109 patients, who were recalled after a minimum of 3 months upon endodontic microsurgery in the Department of Conservative Dentistry, Yonsei University. A contingency table and correlation analysis were used to determine if there were any correlations between age/gender and the patients' responses (
Approximately 60% of respondents answered they had never heard of surgical endodontic procedures. 63.3% of respondents chose the surgical option because they wanted to keep their natural teeth. If the patient required the same procedure on another tooth later, 100 out of 109 respondents answered they would choose microsurgery instead of extraction. Most patients (82.57%) appeared to be satisfied with the surgical procedure.
Endodontic microsurgery consisting of apicoectomy and retrofilling seems to appeal to majority of patients as a satisfactory and valuable treatment choice.
To evaluate the accuracy and consistency of two different apex locators at both the Apex and 0.5 marks.
Twenty-six root canals was scheduled for extraction for periodontal or prosthodontic reasons. Thirteen canals were measured using Root ZX and the rest by i-ROOT. The root canal length was measured both the at 0.5 mark and the Apex mark. The file was then fixed to the tooth, and the distance from the file tip to the major foramen of each canal was measured after removing the root dentin under the microscope so that the major foramen and the file tip were seen.
When the Apex mark was used, 100% of both the Root ZX and i-ROOT groups were within 0.5 mm of the major foramen. When 0.5 mark was used, 100% of the Root ZX group and 77% of the i-ROOT group were within 0.5 mm of the major foramen. In terms of standard deviation and quartile value, the Apex mark was more consistent than 0.5 mark in the Root ZX group, and 0.5 mark was more consistent in the i-ROOT group, but there was no statistically significant difference when compared with The root canal length difference between the Apex mark and 0.5 mark was 0.22 mm and 0.46 mm in the Root ZX and i-ROOT groups, respectively.
In this study, the Apex mark was the more consistent mark. Therefore, it is recommended to subtract 0.5 mm, which is the average length between the apex and apical constriction, from the root canal length at the Apex mark to obtain the working length clinically.
The purpose of this study was to evaluate the viability of periodontal ligament cells of rat teeth after low-temperature preservation under high pressure by means of MTT assay, WST-1 assay. 12 teeth of Sprague-Dawley white female rats of 4 week-old were used for each group.
Both side of the first and second maxillary molars were extracted as atraumatically as possible under tiletamine anesthesia. The experimental groups were group 1 (Immediate extraction), group 2 (Slow freezing under pressure of 3 MPa), group 3 (Slow freezing under pressure of 2 MPa), group 4 (Slow freezing under no additional pressure), group 5 (Rapid freezing in liquid nitrogen under pressure of 2 MPa), group 6 (Rapid freezing in liquid nitrogen under no additional pressure), group 7 (low-temperature preservation at 0℃ under pressure of 2 MPa), group 8 (low-temperature preservation at 0℃ under no additional pressure), group 9 (low-temperature preservation at -5℃ under pressure of 90 MPa). F-medium and 10% DMSO were used as preservation medium and cryo-protectant. For cryo-preservation groups, thawing was performed in 37℃ water bath, then MTT assay, WST-1 assay were processed. One way ANOVA and Tukey HSD method were performed at the 95% level of confidence. The values of optical density obtained by MTT assay and WST-1 were divided by the values of eosin staining for tissue volume standardization.
In both MTT and WST-1 assay, group 7 (0℃/2 MPa) showed higher viability of periodontal ligament cells than other group (2-6, 8) and this was statistically significant (p < 0.05), but showed lower viability than group 1, immediate extraction group (no statistical significance).
By the results of this study, low-temperature preservation at 0℃ under pressure of 2 MPa suggest the possibility for long term preservation of teeth.
The objective of this study was to observe the histology of dental pulp healing after tooth replantation in rats. The maxillary right first molars of 4-week-old rat were extracted, and then the teeth were repositioned in the original socket. At 3 days after replantation, there was localized inflammatory reaction. But, pulp revasculization and healing had already begun in the root area. At 5 days after replantation, odontoblast-like cells were observed. Tertiary dentin deposition was observed beneath the pulp-dentin border from 1 week after replantation. And tertiary dentin was increased at 2 weeks after replantation. The presence of odontoblast-like cells and the formation of tertiary dentin were continued to 4 weeks after replantation. At 4 weeks after replantation, the deposition of bone-like tissues and cementum-like tissues was observed. This results show that there is a possibility of pulp healing after tooth replantation in rats and the mineralization of tooth can progress. The mineralization of tooth after replantation was initially occurred by the deposition of tertiary dentin, but as time passed, the deposition of bone-like tissues and cementum-like tissues was begun and increased.
This study examined the influence of the storage methods on the viability of oral epithelial cells using conventional cell freezing storage, slow freezing preservation, rapid freezing preservation, and slow freezing preservation with a pressure of 2 Mpa or 3 Mpa. The cell viability was evaluated by cell counting, WST-1 and the clonogenic capacity after 6 days of freezing storage. After 6 days, the frozen cells were thawed rapidly, and the cell counting, WST-1, and clonogenic capacity values were measured and compared.
The results from cell counting demonstrated that conventional cryopreservation, slow freezing under a 2 Mpa pressure and slow freezing under a 3 Mpa pressure showed significantly higher values than slow freezing preservation and rapid freezing preservation (p<0.05). The results from the optical density by WST-1 demonstrated that slow freezing under a 2 Mpa pressure showed significantly higher values than slow freezing preservation and rapid freezing preservation (p<0.05). The clonogenic capacity demonstrated that slow freezing under a 2 Mpa pressure showed significantly higher values than slow freezing preservation and rapid freezing preservation (p<0.05).
The purpose of this study was to evaluate the viability of periodontal ligament cells in rat teeth using slow cryo-preservation method under pressure by means of MTT assay and WST-1 assay. Eighteen teeth of Sprague-Dawley white female rats of 4 week-old were used for each group.
Both sides of the first and second maxillary molars were extracted as atraumatically as possible under Tiletamine anesthesia. The experimental groups were group 1 (Immediate control), group 2 (Cold preservation at 4°C for 1 week), group 3 (Slow freezing), group 4 (Slow freezing under pressure of 3 MPa). F-medium and 10% DMSO were used as preservation medium and cryo-protectant. For cryo-preservation groups, thawing was performed in 37°C water bath, then MTT assay and WST-1 assay were processed. One way ANOVA and Tukey method were performed at the 95% level of confidence. The values of optical density obtained by MTT assay and WST-1 were divided by the values of eosin staining for tissue volume standardization.
In both MTT and WST-1 assay, group 4 showed significantly higher viability of periodontal ligament cells than group 2 and 3 (p < 0.05), but showed lower viability than immediate control group.
By the results of this study, slow cryo-preservation method under pressure suggests the possibility for long term cryo-preservation of the teeth.
The purpose of this study was to evaluate the viability of periodontal ligament cell in rat teeth using slow cryopreservation method with magnetic field through MTT assay and TUNEL test. For each group, 12 teeth of 4 weeks old white female Sprague-Dawley rat were used for MTT assay, and 6 teeth in TUNEL test. The Maxillary left and right, first and second molars were extracted as atraumatically as possible under tiletamine anesthesia. The experimental groups were group1 (immediately extraction), group 2 (cold preservation at 4℃ for 1 week), group 3 (rapid cryopreservation in liquid nitrogen), group 4 (slow cryopreservation with magnetic field of 1 G), and group 5 (slow cryopreservation). F medium was used as preservation medium and 10% DMSO as cryoprotectant. After preservation and thawing, the MTT assay and TUNEL test were processed. One way ANOVA and Scheffe method were performed at the 95% level of confidence. The value of optical density obtained after MTT analysis was divided by the value of eosin staining for tissue volume standardization. In both MTT assay and TUNEL test, it had showed no significant difference among group 3, 4, and 5. And group 3 had showed higher viability of periodontal ligament cell than group 2.
From this study, slow cryopreservation method with magnetic field can be used as one of cryopreservation methods.
The purpose of this study was to evaluate the consistency of two electronic apex locators
Materials consisted of fifty two extracted premolars and two electronic apex locators; Root ZX (J. Morita, Osaka, Japan) and E-Magic Finder Deluxe (S-Denti, Cheonan, Korea). After access preparation, the teeth were embedded in a saline-mixed alginate model. Canal lengths of each tooth were measured at "0.5" and "Apex" mark of the apex locators, respectively so that each tooth had two measurements from 0.5 and Apex points. The file was fixed at final measurement using a glass ionomer cement. The apical 4 mm from the apex was exposed to measure the distance from the file tip to the major apical foramen of each tooth. Average distances and standard deviations were used to evaluate the consistency.
Results showed that all measurements of both Root ZX and E-Magic Finder located the major foramen the range of ± 0.5 mm level. Both apex locators showed better consistency at Apex mark than at 0.5 mark. The average distance of file tip-major foramen was - 0.18 mm at 0.5 mark and - 0.07 mm at Apex mark in Root ZX, - 0.25 mm at 0.5 mark and - 0.02 mm at Apex mark in E-Magic Finder. Standard deviation was 0.21 at 0.5 mark and 0.12 at Apex mark in Root ZX, 0.12 at 0.5 mark and 0.09 at Apex mark in E-Magic Finder.
The purpose of this study was to verify the usefulness of MTT analysis as a tool of measurement of the periodontal ligament cell viability from the extracted rat molar.
A total of 80 Sprague-Dawley white female rat of 4 week-old with a body weight of 100 grams were used. The maxillary left and right, first and second molars were extracted under Ketamine anesthesia. Twenty-four teeth of each group (divided as five groups depending upon the time-lapse after extraction such as immediate, 10, 20, 40 and 60 minutes) were immersed in 200 µl of MTT solution (0.5 mg/ml) and processed for optical density measurements . Another 10 teeth of each group were treated as same as above and sectioned at 10 µm for microscopic examination.
All measurements values were divided by the value of hematoxylin-eosin staining which represented the volume of each corresponding samples. Immediate and 10 minute groups showed highest MTT values followed by 20, 40, and 60 minutes consecutively. Statistical significance (p < 0.05) existed between all groups except in immediate versus 10 minute groups and 40 versus 60 minutes. Histological findings also showed similar findings with MTT results in crystal shape and crystal numbers between the experimental groups.
These data indicate that
The purpose of this study was to evaluate the accuracy and the consistency of four different electronic apex locators in an
Fourty extracted premolars were used for the study. Four electronic apex locators (EAL) were Root ZX, SmarPex, Elements Diagnostic Unit (EDU), and E-Magic Finder Deluxe (EMF). After access preparation, the teeth were embedded in an alginate model and the length measurements were carried out at "0.5"and "Apex"mark using four EALs. The file was cemented at the location of the manufacturers'instruction (Root ZX, EDU, EMF: 0.5 mark, SmarPex: Apex mark). The apical 4mm of the apex was exposed and the distance from the file tip to the major foramen was measured by Image ProPlus (× 100). The distance from the file tip to the major foramen was calculated at 0.5 and Apex mark and the consistency of 0.5 and Apex mark was compared by SD and Quartile of Box plots.
In this study, Root ZX and EMF located the apical constriction accurately within ± 0.5 mm in 100%, whereas SmarPex and EDU located in 90% and in 70% respectively. For Root ZX and EMF, there was no significant difference between the consistency of 0.5 and Apex mark. However, for the EDU and SmarPex, Apex mark was more consistent than 0.5 mark.
From the evaluation of the consistency in this study, for Root ZX and EMF, both 0.5 and Apex mark can be used as a standard mark. And for EDU and SmarPex, the Apex mark can be recommended to be used as a standard mark.
The purpose of this study was to examine the viability of PDL cells in rat molars by using
A total of 74 Sprague-Dawley white female rats of 4 week-old with a body weight of 100 grams were used. The maxillary left and right, first and second molars were extracted as atraumatically as possible under ketamine anesthesia.
Ten teeth of each group were divided as six experimental groups depending upon the preservation. Cryopreservation groups were Group 1 (5% DMSO 6% HES in F medium), Group 2 (10% DMSO in F medium), Group 3 (5% DMSO 6% HES in Viaspan®), Group 4 (10% DMSO in Viaspan®) which were cryopreserved for 1 week and cold preservation groups were Group 5 (F medium), Group 6 (Viaspan®) at 4℃ for 1 week. Immediate extraction group was used as a control. After preservation and thawing, the
The value of optical density obtained after
In this study, the groups which were frozen with DMSO as a cryoprotectant and the groups with F medium showed the best results.
Use of electric pulp testing elicits painful response in vital teeth. In this study, we examined the excessive time from pain feeling to stimulation disconnection in clinical situation. D626D (Parkell Inc., USA.) scan type electric pulp tester was used in total of 23 young healthy individuals. Each of the right central incisors and first premolars were used as testing teeth. Stimulation disconnection was achieved by EMG in anterior belly of digastric muscle, finger span, and voice and the excessive stimulation time over the sensory threshold was recorded. As a result, we found that the short responses before the stimulation disconnection appeared following order; EMG, finger span, and voice. The EMG disconnection is suggested to be used to reduce the excessive stimulus time in electric pulp testing.
The purpose of this study is to examine the viability of PDL cells in rat molars by using MTT assay and to verify the MTT assay through the histologic observation. Thirty of Sprague-Dawley white female rats of 4-weeks old with a body weight of about 100 grams were used. Groupings are as follows:
Immediate Group : Positive control group(n=10)-after extraction immediately.
Dried Group : Negative control group(n=10)-after drying for an hour under warm dry.
ViaSpan® Group : 1hour ViaSpan® group(n=10)-after storing in ViaSpan® at 4℃ for 1hour.
Ten teeth of each group were treated as same as above and replanted to the original socket of experimental animals. After two weeks of replantation, all the experimental animals were sacrificed. And after fixation, extracted maxillary jaw was dimineralized. After it was embedded in paraffin, serial section by 5µm was carried out and for construction of specimen, hematoxylin-eosin dye was used.
The mean MTT measurement of immediate group(positive control) is 2.81 and the mean measurement of dried group(negative control) is 0.98 which is significant differnt(P<0.05). The mean measurement of ViaSpan® group is 2.65 and there is significant difference between dried group and ViaSpan® group(P<0.05). However, there is no difference between immediate group and ViaSpan® group. The average resorption points of immediate group is 3.03 points. In the dried group, average 6.44 points resorption and 2.68 points showed resorption in the ViaSpan® group. Unlike with MTT assay, there was no significant difference between the immediate group and ViaSpan® group.
The usage of MTT assay as a viable cell marker may give us a better indication of the maintenance of periodontal ligament cell vitality.
The purpose of this study was two-fold. First was to evaluate whether the molecular sieving model was appropriate for ionic dissociation experiment. Second was to compare the dissociation of calcium and hydroxyl ions from five types of calcium hydroxide pastes (Pure calcium hydroxide paste, DT temporary dressing®, Metapaste®, Chidopex®, Metapex®) in three vehicles (aqueous, viscous and oily) and the antibacterial effect.
Each calcium hydroxide pastes was placed into 0.65ml tube with cap and then 15% polyacrylamide gel was placed onto calcium hydroxide pastes. After the gel was hardened, the tubes were filled with tridistilled water (pH 7.14) and closed with cap. The tubes were stored in 37℃, 100% incubator. The pH reading and the concentration of calcium ions were taken at 1, 4, 7, 10, and 14 days. The brain heart infusion agar plates with
The results were as follows.
1. In fresh mixing state, the pH of five types of calcium hydroxide pastes were measured between 12.5 and 12.8.
2. The pH was increased in all five types of calcium hydroxide pastes compared with control group. In 14 days, Pure calcium hydroxide paste (11.45) and DT temporary dressing® (11.33) showed highest pH, followed by Metapaste® (9.49), Chidopex® (8.37) and Metapex® (7.59).
3. Calcium was higher in all five types of calcium hydroxide pastes compared with control group. In 14 days, Pure calcium hydroxide paste (137.29 mg%) and DT temporary dressing® (124.6 mg%) showed highest value, followed by Metapaste® (116.74 mg%), Chidopex® (111.84 mg%) and Metapex® (60.22 mg%).
4. The zones of bacterial inhibition were seen around all five types of calcium hydroxide pastes. Chidopex® and Metapex® groups which include iodoform were observed significantly larger zone of inhibition in A. actinomycetemcomitans compared with the other calcium hydroxide groups (p<0.05). However, Metapex® showed the least antibacterial effect on S. mutans compared with other groups (p<0.05).
The molecular sieving model was found to be acceptable in dissociation experiment of hydroxyl and calcium ions when compared with the previous tooth model study. But this model was not appropriate for the antibacterial test.