A fiber-reinforced composite (FRC) fixed prosthesis is an innovative alternative to a traditional metal restoration, as it is a conservative treatment method. This case report demonstrates a detailed procedure for restoring a missing anterior tooth with an FRC. A 44-year-old woman visited our department with an avulsed tooth that had fallen out on the previous day and was completely dry. This tooth was replanted, but it failed after one year. A semi-direct technique was used to fabricate a FRC fixed partial prosthesis for its replacement. The FRC framework and the pontic were fabricated using a duplicated cast model and nanofilled composite resin. Later on, interproximal contact, tooth shape, and shade were adjusted at chairside. This technique not only enables the clinician to replace a missing tooth immediately after extraction for minimizing esthetic problems, but it also decreases both tooth reduction and cost.

A common failure in endodontic treatment of the permanent maxillary first molars is likely to be caused by an inability to locate, clean, and obturate the second mesiobuccal (MB) canals. Because of the importance of knowledge on these additional canals, there have been numerous studies which investigated the maxillary first molar MB root canal morphology using in vivo and laboratory methods. In this article, the protocols, advantages and disadvantages of various methodologies for in-depth study of maxillary first molar MB root canal morphology were discussed. Furthermore, newly identified configuration types for the establishment of new classification system were suggested based on two image reformatting techniques of micro-computed tomography, which can be useful as a further 'Gold Standard' method for in-depth morphological study of complex root canal systems.

Crown reattachment is the most conservative treatment which can be used to restore fractured tooth, presumably with sufficient strength, while maintaining original contour, incisal translucency, and reducing chair time and cost.

However, in case of crown fracture with pin-point pulp exposure, we should cautiously minimize the irritation to the pulp and consider pre-treatment pulpal status, choice of pulp capping materials, choice of bonding system and treatment sequence during crown reattachment procedures. This case reports the considerations while crown reattachment with direct pulp capping using calcium hydroxide (Dycal, Dentsply Caulk).

This study aimed to assess the influence of different cross-sectional area on the cyclic fatigue fracture of Ni-Ti rotary files using a fatigue tester incorporating cyclical axial movement. Six brands of Ni-Ti rotary files (ISO 30 size with .04 taper) of 10 each were tested: Alpha system (KOMET), HeroShaper (MicroMega), K3 (SybronEndo), Mtwo (VDW), NRT (Mani), and ProFile (Dentsply). A fatigue-tester (Denbotix) was designed to allow cyclic tension and compressive stress on the tip of the instrument. Each file was mounted on a torque controlled motor (Aseptico) using a 1:20 reduction contra-angle and was rotated at 300 rpm with a continuous, 6 mm axial oscillating motion inside an artificial steel canal. The canal had a 60° angle and a 5 mm radius of curvature. Instrument fracture was visually detected and the time until fracture was recorded by a digital stop watch. The data were analyzed statistically. Fractographic analysis of all fractured surfaces was performed to determine the fracture modes using a scanning electron microscope. Cross-sectional area at 3 mm from the tip of 3 unused Ni-Ti instruments for each group was calculated using Image-Pro Plus (Imagej 1.34n, NIH). Results showed that NRT and ProFile had significantly longer time to fracture compared to the other groups (p < .05). The cross-sectional area was not significantly associated with fatigue resistance. Fractographycally, all fractured surfaces demonstrated a combination of ductile and brittle fracture. In conclusion, there was no significant relationship between fatigue resistance and the cross-sectional area of Ni-Ti instruments under experimental conditions.

The aim of this study was to evaluate the marginal and internal gaps in CEREC3 CAD/CAM inlays of three different preparation designs. CEREC3 Inlays of three different preparation designs (n = 10) were fabricated according to Group I-conventional functional cusp capping/shoulder preparation, Group II-horizontal reduction of cusps and Group III-complete reduction of cusps/shoulder preparation. After cementation of inlays, the bucco-lingual cross section was performed through the center of tooth. Cross section images of 20 magnifications were obtained through the stereomicroscope. The gaps were measured using the Leica application suite software at each reference point. Statistical analysis was performed using one-way ANOVA and Tukey's test (α<0.05).

The marginal gaps ranged from 80.0 to 97.8 µm for Group I, 42.0 to 194.8 µm for Group II, 51.0 to 80.2 µm for Group III. The internal gaps ranged from 90.5 to 304.1 µm for Group I, 80.0 to 274.8 µm for Group II, 79.7 to 296.7 µm for Group III. The gaps of each group were the smallest on the margin and the largest on the horizontal wall. For the CEREC3 CAD/CAM inlays, the simplified designs (groups II and III) did not demonstrate superior results compared to the traditional cusp capping design (group I).

Diabetes Mellitus (DM) is a syndrome accompanied with the abnormal secretion or function of insulin, a hormone that plays a vital role in controlling the blood glucose level (BGL). Type 1and 2 DM are most common form and the prevalence of the latter is recently increasing. The aim of this article was to assess whether Type 2 DM could act as a predisposing risk factor on the pulpo-periapical pathogenesis. Previous literature on the pathologic changes of blood vessels in DM was thoroughly reviewed. Furthermore, a histopathologic analysis of artificially-induced periapical specimens obtained from Type 2 diabetic and DM-resistant rats was compared. Histopathologic results demonstrate that the size of periapical bone destruction was larger and the degree of pulpal inflammation was more severe in diabetic rats, indicating that Type 2 DM itself can be a predisposing risk factor that makes the host more susceptible to pulpal infection. The possible reasons may be that in diabetic state the lumen of pulpal blood vessels are thickened by atheromatous deposits, and microcirculation is hindered. The function of polymorphonuclear leukocyte is also impaired and the migration of immune cells is blocked, leading to increased chance of pulpal infection. Also, lack of collateral circulation of pulpal blood vessels makes the pulp more susceptible to infection. These decrease the regeneration capacity of pulpal cells or tissues, delaying the healing process. Therefore, when restorative treatment is needed in Type 2 DM patients, dentists should minimize irritation to the pulpal tissue un der control of BGL.

The purpose of this study is to observe and compare the dynamic change of artificially demineralized enamel by remineralization solutions of different degrees of saturation at pH 4.3.

In this study, 30 enamel specimens were demineralized artificially by lactic acid buffered solution. Each of 10 specimens was immersed in pH 4.3 remineralization solution of three different degrees of saturation (0.22, 0.30, 0.35) for 10 days. After demineralization and remineralization, images were taken by a polarizing microscope (× 100). The density of lesion were determined from images taken after demineralization and remineralization.

During remineralization process, mineral deposition and mineral loss occurred at the same time. After remineralization, total mineral amount and width of surface lesion increased in all groups. The higher degree of saturation was, the more mineral deposition occurred in surface lesion and the amount of mineral deposition was not much in subsurface lesion. Total demineralized depth increased in all groups.

The purpose of this study is to observe and compare the remineralization tendencies of artificially demineralized enamel by remineralization solutions of different degree of saturations at pH 5.5, using a polarizing microscope and computer programs (Photoshop, Image pro plus, Scion Image, Excel).

For this study, 36 sound permanent teeth with no signs of demineralization, cracks, or dental restorations were used. The specimens were immersed in lactic acid demineralization solution for 3 days in order to produce dental caries artificially that consist of surface and subsurface lesions. Each of 9 or 10 specimens was immersed in pH 5.5 lactic acid buffered remineralization solution of three different degrees of saturation (0.25, 0.30, 0.35) for 12 days. After the demineralization and remineralization, images were taken by a polarizing microscope (× 100). The results were obtained by observing images of the specimens, and using computer programs, the density of caries lesions were determined.

In conclusion, in the group with the lowest degree of saturation, remineralization occurred thoroughly from the surface to the subsurface lesion, whereas in the groups with greater degree of saturation showed no significant change in the subsurface lesion, although there was corresponding increase in the remineralization width on the surface zones.

This study investigated the clinical effectiveness and safety of sealed bleaching compared to conventional in-office bleaching using a randomized clinical trial of split arch design. Ten participants received a chairside bleaching treatment on the upper anterior teeth, and each side was randomly designated as sealed or control side. A mixture of Brite powder (PacDent, Walnut, USA), 3% hydrogen peroxide and carbamide peroxide (KoolWhite, PacDent, Walnut, USA) were used as bleaching agent. The control side was unwrapped and the experimental side was covered with a linear low density polyethylene (LLDPE) wrap for sealed bleaching. The bleaching gel was light activated for 1 hour. The tooth shades were evaluated before treatment, after treatment, and at one week check up by means of a visual shade (VS) assessment using a value oriented shade guide and a computer assisted shade assessment using a spectrophotometer (SP). The data were analyzed by paired t-test.

In the control and sealed groups, the visual shade scores after bleaching treatment and at check up showed statistically significant difference from the preoperative shade scores (p < .05). The shade scores of the sealed group were significantly lighter than the control immediately after bleaching and at the check-up appointment (p < 0.05). Compared to prebleaching status, the ΔE values at post-bleaching condition were 4.35 ± 1.38 and 5.08 ± 1.34 for the control and sealed groups, respectively. The ΔE values at check up were 3.73 ± 1.95 and 4.38 ± 2.08 for the control and sealed groups. ΔE values were greater for the sealed group both after bleaching (p < .05) and at check up (p < .05).

In conclusion, both ΔE and shade score changes were greater for the sealed bleaching group than the conventional bleaching group, effectively demonstrating the improvement of effectiveness through sealing.

Herpes zoster, an acute viral infection produced by the varicella zoster virus, may affect any of the trigeminal branches. This case report presents a patient with symptoms mimicking odontogenic pain. No obvious cause of the symptoms could be found based on clinical and radiographic examinations. After a dermatologist made a diagnosis of herpes zoster involving the third trigeminal branch, the patient was given antiviral therapy. Two months later, the facial lesions and pain had almost disappeared, and residual pigmented scars were present. During the diagnostic process, clinicians should keep in mind the possibility that orofacial pain might be related to herpes zoster.

This study investigated the effect of intermittent polymerization on the rate of polymerization shrinkage and cuspal deflection in composite resins.

The linear polymerization shrinkage of each composite was measured using the custom-made linometer along with the light shutter specially devised to block the light at the previously determined interval. Samples were divided into 4 groups by light curing method; Group 1) continuous light (60s with light on); Group 2) intermittent light (cycles of 3s with 2s light on & 1s with light off for 90s); Group 3) intermittent light (cycles of 2s with 1s light on & 1s with light off for 120s); Group 4) intermittent light (cycles of 3s with 1s light on & 2s with light off for 180s). The amount of linear polymerization shrinkage was measured and its maximum rate (Rmax) and peak time (PT) in the first 15 seconds were calculated. For the measurement of cuspal deflection of teeth, MOD cavities were prepared in 10 extracted maxillary premolars. Reduction in the intercuspal distance was measured by the custom-made cuspal deflection measuring machine. ANOVA analysis was used for the comparison of the light curing groups and t-test was used to determine significant difference between the composite resins.

Pyramid showed the greater amount of polymerization shrinkage than Heliomolar (p < 0.05). There was no significant difference in the linear polymerization shrinkage among the groups. The Rmax was group 4 < 3, 2 < 1 in Heliomolar and group 3 < 4 < 2, 1 in Pyramid (p < 0.05). Pyramid demonstrated greater cuspal deflection than Heliomolar. The cuspal deflection in Heliomolar was group 4 < 3 < 2, 1 and group 4, 3 < 2, 1 in Pyramid (p < 0.05).

It was concluded that the reduced rate of polymerization shrinkage by intermittent polymerization can help to decrease the cuspal deflection.

The aim of this study was to evaluate the retrievability of Resilon as a root canal filling material. Twenty-seven human single-rooted extracted teeth were instrumented utilizing a crown down technique with Gates-Glidden burs and ProFile system. In group1 (n = 12) canals were obturated with gutta percha and AH-26 plus sealer using a continuous wave technique and backfilled. In group 2 (n = 15) Resilon was used as a filling material. Then teeth were sealed and kept in 37℃ and 100% humidity for 7 days. For retreatment, the samples were re-accessed and filling material was removed using Gates-Glidden burs and ProFiles. Teeth were sectioned longitudinally to compare the general cleanliness and amount of debris (× 75) using SEM. Chi-square test was used (α = 0.05) to analyze the data. The total time required for removal of filling materials was expressed as mean ± SD (min) and analyzed by the Student t-test (α = 0.05). Required time for retreatment was 3.25 ± 0.32 minutes for gutta percha/AH 26 plus sealer and 3.05 ± 0.34 minutes for Resilon. There was no statistically significant difference between the two experimental groups. There was no significant difference between the groups in the cleanliness of the root canal wall. This study showed that Resilon was effectively removed by Gates-Glidden burs and ProFiles.