Mucopolysaccharidosis (MPS) is an inherited metabolic disorder caused by a deficiency in enzymes that participate in the degradation of glycosaminoglycans (GAGs) such as heparin sulfate and dermatan sulfate. Left untreated, patients show progressive mental and physical deterioration due to deposition of GAGs in organs. Death often occurs due to cardiac or respiratory failure before patients reach their early twenties. MPS has several oral and dental manifestations. An enlarged head, short neck, and open mouth associated with a large tongue are major characteristics of MPS patients. Dental complications can be severe, including unerupted dentition, dentigerous cyst-like follicles, malocclusions, condylar defects, and gingival hyperplasia. A 21-year-old female patient with MPS was described in this article, with special emphasis on oral manifestations and dental treatment.

X-linked hypophosphatemia (XLH) is a hereditary metabolic disease caused by the loss of phosphate through the renal tubules into the urine, and an associated decrease in serum calcium and potassium phosphate. Its dental features include spontaneous dental abscesses that occur in the absence of trauma or dental caries. The aim of this case report was to describe the dental problems of XLH patients and to evaluate limitations in their treatment. A 14 year old male and a 38 year old female with XLH were referred to the Department of Conservative Dentistry for endodontic treatment. The dental findings were periapical abscesses without obvious trauma or caries. Conservative endodontic treatment was performed in teeth with pulp necrosis and abscess. In case 1, the treated teeth showed improvements in bone healing, without clinical symptoms. However, in case 2, the implants and the treated tooth showed hypermobility, and the final restoration was therefore postponed. Early diagnosis, periodic examinations, and communication with the patient's pediatrician are important in the dental management of patients with XLH.

A recent treatment option for non-vital immature teeth in young patients is revascularization with triple antibiotic paste (TAP). However, tooth discoloration was reported with the use of conventional minocycline-containing TAP. In this case report, amoxicillin-containing TAP was used for revascularization of non-vital immature teeth to prevent tooth discoloration. At the 1 yr follow up, the teeth were asymptomatic on clinical examination and showed slight discoloration of the crown due to mineral trioxide aggregate (MTA) filling rather than amoxicillin-containing TAP. Radiographic examination revealed complete resolution of the periapical radiolucency, and closed apex with obvious periodontal ligament space. However, the root growth was limited, and the treatment outcome was more like apexification rather than revascularization. These results may be due to unstable blood clot formation which could not resist the condensation force of MTA filling, whether or not a collagen matrix was in place. These cases showed that although revascularization was not successful, apexification could be expected, resulting in the resolution of the periapical radiolucency and the closure of the apex. Therefore, it is worthwhile attempting revascularization of non-vital immature teeth in young patients.

Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment.

The autogenous tooth transplantation is an alternative treatment replacing a missing tooth when a suitable donor tooth is available. It is also a successful treatment option to save significant amount of time and cost comparing implants or conventional prosthetics. These cases, which required single tooth extraction due to deep caries and severe periodontal disease, could have good results by transplanting non-functional but sound donor tooth to the extraction site.

The purpose of this study is to compare the antibacterial effect of Listerine® on two microorganisms (P. gingivalis and E. faecalis) with various root canal irrigants (NaOCl, CHX, EDTA) and to identify possibility of using Listerine® as a root canal irrigant. Porphyromonas gingivalis ATCC 3327 and Enterococcus faecalis ATCC 29212 were used in this experiment. For the test irrigants, 0.5%, 1%, 2.5%, 5.25% NaOCl, 0.1%, 0.2%, 1%, 2% CHX, 0.5M EDTA (18.6% EDTA) and Listerine® were prepared. Distiled water was used as control. Two methods-1) Comparison of turbidity in broth and 2) Agar diffusion test-were used to determine the extent of antibacterial effect of Listerine® and to compare it with that of NaOCl, CHX, and EDTA. All solutions tested were effective against two bacterial strains compared with control (p<0.001). Any concentration of NaOCl, CHX, and EDTA showed similarly high effectiveness against all bacterial strains. In all experiment, Listerine® showed significantly low antibacterial effect compared with the other root canal irrigants (p<0.05).

In conclusion, the results reflect remarkably low antibacterial effect of Listerine® as compared with root canal irrigants in general so it is not suitable for the root canal irrigant.

In this study we evaluated the influence of both the thickness of residual enamel and the color of the composite resins applied to lingual surface on the labial surface color.

Background plates were made by randomly (A1, A2, A6D, B1, B2, B3, C1, C2, C6D) selected colors of Filtek Supreme (3M ESPE, St. Paul, U.S.A.) composite resin.

Crown portion of 9 maxillary central incisors were cut off and embedded with acrylic resin except labial surface. Samples of average thickness of 2.2 mm were obtained after cutting it in a thickness of 2.5 mm from the labial surface and sandpaper polish.

The shade of composite resin background was measured using Spectrophotometer (Spectrolino® GretagMacbeth, Regensdorf, Switzerland). And CIE L^*a^*b^* value of 2.2 mm thickness tooth samples were measured on the 9 composite resin backgrounds. And then, the cutting side of tooth samples was ground to the extent of 1.9 mm, 1.6 mm, 1.3 mm, 1.0 mm and placed on composite resin backgrounds and measured L^*a^*b^* values with the same method.

In all samples, L^* value and b^* value seemed to have a tendency of decreasing as thickness of tooth sample becomes thinner regardless of background colors (p < 0.05). But, a^* value didn't show the significant differences depending on the thickness.

The objective of this study was to evaluate the effect of color measuring instrument by measuring the color of dental composite resins.

Nine shade light cured composite resin disks were prepared (diameter : 15 mm, thickness : 4 mm). CIE L^*a^*b^* color scale of each disk was measured with 3 different types of spectrophotometer [MiniScan XE plus (Model 4000S, Hunter Lab, USA), CM-3500d (Minolta, Japan) and Specbos 2100 Miniature VIS Reflection spectrometer (Serial No: 319416, JETI Technishe VIS Instrumentic GmbH, Germany)]. Miniscan XE Plus and CM-3500d using identical measuring geometry with different size of viewing aperture. But Specbos 2100 using different measuring geometry.

Within the limitation of this study, there were color difference (ΔE^*) from 2.4 to 7.8 between Miniscan XE Plus and CM-3500d, but L^*, a^*, b^* values showed the high correlation. However, there were great color difference (ΔE^*) in the extent of about 20 between instruments with the different measuring geometry.

Therefore, color scale measured by color measuring instrument should be used as a relative value rather than an absolute value in the field of dentistry.

This study was carried out in order to determine in vitro biocompatibility of white mineral trioxide aggregate (MTA), and to compare it with that of the commonly used materials, i. e. calcium hydroxide liner (Dycal), glass ionomer cement (GIC), and Portland cement which has a similar composition of MTA. To assess the biocompatibility of each material, cytotoxicity was examined using MG-63 cells. The degree of cytotoxicity was evaluated by scanning electron microscopy (SEM) and a colorimetric method, based on reduction of the tetrazolium salt 2,3 bis {2methoxy 4nitro 5[(sulfenylamino) carbonyl] 2H tetrazolium hydroxide} (XTT) assay.

The results of SEM revealed the cells in contact with GIC, MTA, and Portland cement at 1 and 3 days were apparently healthy. In contrast, cells in the presence of Dycal appeared rounded and detached. In XTT assay, the cellular activities of the cells incubated with all the test materials except Dycal were similar, which corresponded with the SEM observation. The present study supports the view that MTA is a very biocompatible root perforation repair material. It also suggests that cellular response of Portland cement and GIC are very similar to that of MTA.

This study was performed to assess the radiopacity of a variety of root canal sealers according to the specification concerning root canal sealers.

Ten materials including Tubli-Seal™, Kerr Pulp Canal Sealer™, AH 26®, AH plus®, AH plus jet™, Ad sea l™, Sealapex™, NOGENOL™, ZOB seal™, Epiphany™ and dentin were evaluated in this study. In the first part, densitometric reading of an each step of aluminum step wedge on occlusal film was performed at different voltage and exposure time. In the second part, ten specimens were radiographed simultaneously with an aluminum step wedges on the occlusal films under decided condition. The mean radiographic den sity values of the materials were transformed into radiopacity expressed equivalent thickness of aluminum (mm Al).

The following results were obtained.

1. Among the various conditions, the appropriate voltage and exposure time that meet the requirement density was 60 kVp at 0.2 s

2. All of the materials had greater radiopacity than 3 mm Al requirement of ANSI/ADA specification No. 57 (2000) and ISO No. 6876 (2001) standards.

3. The radiopacity of materials increased as thickness of materials increased.

4. The mm Al value of each specimen at 1mm in thickness has a significant difference in the statistics.

It suggests that root canal sealers have a sufficient radiopacity that meet the requirement.

This study analyzed the influence of dental adhesive/primer on the bond strength between indirect resin composite and the resin cement.

Seventy disc specimens of indirect resin composite (Tescera Dentin, Bisco) were fabricated. And bonding area of all specimens were sandblasted and silane treated for one minute. The resin cements were used with or without application of adhesive/primer to bonding area of indirect resin restoration: Variolink-II (Ivoclar-Vivadent): Exite DSC, Panavia-F (Kuraray): ED-Primer, RelyX Unicem (3M ESPE): Single-Bond, Duolink (Bisco): One-step, Mulitlink (Ivoclar-Vivadent): Multilinh Primer.

Shear bond strength was measured by Instron universal testing machine.

Adhesive application improved shear bond strength (p < 0.05). But Variolink II and Panavia-F showed no statistically significant difference according to the adhesive application.

With the above results, when resin inlay is luted by resin cement it seems that application of dental adhesive/primer is necessary in order to improve the bond strength.

The purpose of this study was to evaluate the color stability of resin cements with accelerated test. Four dual curing resin cements: Panavia-F (KURARAY), Duolink (BISCO), Variolink-II (Ivoclar Vivadent), and RelyX Unicem (3M ESPE) and 1 self curing resin cement: Resiment CE (j. l. Blosser) were used in this study. In control group, Gradia Anterior (GC) composite resin and Tescera Dentin (Bisco) indirect composite were used. Ten disk shape specimens were made from each resin cement. The specimens were subjected to an accelerated aging process in a refrigerated bath circulator at 60℃ for 15 and 30 days. Spectrophotometric analyses were made before and after 15 days and 30 days of accelerated aging time.

The color characteristics (L^*, a^*, b^*) and the color difference (ΔE^*) of the specimens before and after immersion were measured and computed.

Regardless of type of the resin cements, L^* value was decreased and a^* value was increased, but there were no significant difference. But b^* value was increased significantly (p < 0.05). Tescera inlay showed least color change (p < 0.05), but Gradia showed notable color change after 15 days.

After 30 days on accelerated aging, ΔE^* value was increased (Panavia-F < Variolink-II < Resiment CE < Duolink < Unicem) (p < 0.05), but there were no significant difference among Panavia-F, Variolink-II, and Resiment CE groups. After 30 days of accelerated aging, ΔE^* value of all resin cements were greater than 3.0 and could be perceived by the human eye.

This study was done to evaluate the reliability of the digital color analysis system (ShadeScan, CYNOVAD, Montreal, Canada) for dentistry.

Sixteen tooth models were made by injecting the A2 shade chemical cured resin for temporary crown into the impression acquired from 16 adults. Surfaces of the model teeth were polished with resin polishing cloth. The window of the ShadeScan handpiece was placed on the labial surface of tooth and tooth images were captured, and each tooth shade was analyzed with the ShadeScan software. Captured images were selected in groups, and compared one another.

Two models were selected to evaluate repeatability of ShadeScan, and shade analysis was performed 10 times for each tooth.

And, to ascertain the color difference of same shade code analyzed by ShadeScan, CIE L^*a^*b^*values of shade guide of Gradia Direct (GC, Tokyo, Japan) were measured on the white and black background using the Spectrolino (GretagMacbeth, USA), and Shade map of each shade guide was captured using the ShadeScan.

There were no teeth that were analyzed as A2 shade and unique shade. And shade mapping analyses of the same tooth revealed similar shade and distribution except incisal third.

Color difference (ΔE^*) among the Shade map which analyzed as same shade by ShadeScan were above 3.

Within the limits of this study, digital color analysis instrument for dentistry has relatively high repeatability, but has controversial in accuracy.

This study was performed to assess the radiopacity of a variety of canal filling and retrograde root-end filling materials according to the specification concerning root canal obturation materials.

Ten materials including Gutta-percha pellets, amalgam, Fuji II LC, Dyract® AP, Super EBA®, IRM®, AH 26®, Sealapex™, Tubli-Seal™ and dentin were evaluated in this study. In the first part, densitometric reading of an each step of aluminum step wedge on occlusal film were performed at 60 kVp (0.2, 0.3, 0.4 s), 70 kVp (0.2, 0.3, 0.33 s) to decide appropriate voltage and exposure time. In the second part, ten specimens which are 5 mm in diameter and 0.5, 1.0, 1.5, 2.0, 2.5, 3.0 mm in thickness, were fabricated from each material studied. The specimens were radiographed simultaneously with an aluminum step wedge under decided condition (60 kVp, 0.2 s). The mean radiographic density values of the materials were transformed into radiopacity expressed equivalent thickness of aluminum (mm Al).

The following results were obtained.

Among the various conditions including 0.2 s, 0.3 s, 0.4 s at 60 kVp and 0.2 s, 0.3 s, 0.33 s at 70 kVp, the appropriate voltage and exposure time that meet the requirement of density from 0.5 to 2.0 was 0.2 s at 60 kVp.

It suggests that all experimental canal filling and retrograde root-end filling materials have a sufficient radiopacity that meet the requirement concerning root canal obturation materials except for Fuji II LC and Dyract.

The purpose of this study was to evaluate whether intracanal irrigation method could affect the adhesion between intracanal dentin and root canal filling materials (Gutta-percha/AH 26 sealer and Resilon/Epiphany sealer).

Thirty extracted human incisor teeth were prepared. Canals were irrigated with three different irrigation methods as a final rinse and obturated with two different canal filling materials (G groups : Gutta-percha/AH 26 sealer, R groups : Resilon/Epiphany sealer) respectively.

Group G1, R1 - irrigated with 5.25% NaOCl

Thirty obturated roots were horizontally sliced and push-out bond strength test was performed in the universal testing machine. After test, the failure patterns of the specimens were observed using Image-analyzing microscope.

The results were as follows.

Gutta-percha/AH 26 sealer groups had significantly higher push-out bond strength compared with the Resilon/Epiphany sealer groups (p < 0.05).

The purpose of this study was to evaluate the insertion depth of several brands of master gutta percha cones after shaping by various Ni-Ti rotary files in simulated canals.

Fifty resin simulated J-shape canals were instrumented with ProFile, ProTaper and HEROShaper. Simulated canals were prepared with ProFile .04 taper #25 (n = 10), .06 taper #25 (n = 10), ProTaper F2 (n = 10), HEROShaper .04 taper #25 (n = 10) and .06 taper #25 (n = 10). Size #25 gutta percha cones with a .04 & .06 taper from three different brands were used: DiaDent; META; Sure-endo. The gutta percha cones were selected and inserted into the prepared simulated canals. The distance from the apex of the prepared canal to the gutta percha cone tip was measured by image analysis program.

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

1. When the simulated root canals were prepared with HEROShaper, gutta-percha cones were closely adapted to the root canal.

2. All brands of gutta percha cones fail to go to the prepared length in canal which was instrumented with ProFile, the cones extend beyond the prepared length in canal which was prepared with ProTaper.

3. In canal which was instrumented with HEROShaper .04 taper #25, Sure-endo .04 taper master gutta percha cone was well fitted (p < 0.05).

4. In canal which was instrumented with HEROShaper .06 taper #25, META .06 taper master gutta percha cone was well fitted (p < 0.05).

As a result, we concluded that the insertion depth of all brands of master gutta percha cone do not match the rotary instrument, even though it was prepared by crown-down technique, as recommended by the manufacturer. Therefore, the master cone should be carefully selected to match the depth of the prepared canal for adequate obturation.