• Restorative Dentistry and Endodontics
• /
• v.39 no.2
• /
• pp.120-125
• /
• 2014

Use of an apical plug in management of cases with open apices has gained popularity in recent years. Biodentine, a new calcium silicate-based material has recently been introduced as a dentine substitute, whenever original dentine is damaged. This case report describes single visit apexification in a maxillary central incisor with necrotic pulp and open apex using Biodentine as an apical barrier, and a synthetic collagen material as an internal matrix. Following canal cleaning and shaping, calcium hydroxide was placed as an intracanal medicament for 1 mon. This was followed by placement of small piece of absorbable collagen membrane beyond the root apex to serve as matrix. An apical plug of Biodentine of 5 mm thickness was placed against the matrix using pre-fitted hand pluggers. The remainder of canal was back-filled with thermoplasticized gutta-percha and access cavity was restored with composite resin followed by all-ceramic crown. One year follow-up revealed restored aesthetics and function, absence of clinical signs and symptoms, resolution of periapical rarefaction, and a thin layer of calcific tissue formed apical to the Biodentine barrier. The positive clinical outcome in this case is encouraging for the use of Biodentine as an apical plug in single visit apexification procedures.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.28 no.4
• /
• pp.700-708
• /
• 2001

Traumatic injuries in young patients can result in the interruption of the development of the incompletely formed roots. In teeth with incomplete root-end formation and necrotic pulps, the root canals must be completely debrided. Because of a lack of an apical stop and the presence of thin and fragile walls in these teeth, it is imperative to perform apexification to obtain an adequate apical seal. Calcium hydroxide has become the material of choice for apexification. Despite its popularity for the apexification procedure, calcium hydroxide therapy has some inherent disadvantages that include variablility of treatment time, unpredictability of apical closure, difficulty in patient follow-up, and delayed treatment. An alternative treatment to long-term apexification procedure is the use of an artificial apical barrier that allows immediate obturation of the canal. MTA(Mineral Trioxide Aggregate) is a powder consisting of fine hydrophilic particles of tricalcium silicate, tricalcium aluminate, tricalcium oxide and silicate oxide. MTA has a pH of 12.5 after setting, similar to calcium hydroxide. This may impart some antimicrobial properties. MTA has low solubility and a radiopacity slightly eater than that of dentin. Also, MTA leaked significantly less than other materials and induced hard-tissue formation more than other materials.

• Tuberculosis and Respiratory Diseases
• /
• v.40 no.3
• /
• pp.236-249
• /
• 1993

Background: Among the injurious agents to which the lung airspaces are constantly exposed are reactive species of oxygen. It has been widely believed that reactive oxygen species may be implicated in the etiology of lung injuries. In order to elucidated how this oxidant causes lung cell injury, we investigated the effects of exogenous $H_2O_2$ on alveolar epithelial barrier characteristics. Methods: Rat type II alveolar epithelial cells were plated onto tissue culture-treated polycarbonate membrane filters. The resulting confluent monolayers on days 3 and 4 were mounted in a modified Ussing chamber and bathed on both sides with HEPES-buffered Ringer solution. The changes in short-circuit current (Isc) and monolayer resistance (R) in response to the exogenous hydroperoxide were measured. To determine the degree of cellular catalase participation in protection against $H_2O_2$ injury to the barrier, experiments were repeated in the presence of 20 mM aminotriazole (ATAZ, an inhibitor of catalase) in the same bathing fluid as the hydroperoxide. Results: These monolayers have a high transepithelial resistance (>2000 ohm-$cm^2$) and actively transport $Na^+$ from apical fluid. $H_2O_2$(0-100 mM) was then delivered to either apical or basolateral fluid. Resulting indicated that $H_2O_2$ decreased Isc and R gradually in dose-dependent manner. The effective concentration of apical $H_2O_2$ at which Isc (or R) was decreased by 50% at one hour ($ED_{50}$) was about 4 mM. However, basolateral $H_2O_2$ exposure led to $ED_{50}$ for Isc (and R) of about 0.04 mM. Inhibition of cellular catalase yielded $ED_{50}$ for Isc (and R) of about 0.4 mM when $H_2O_2$ was given apically, while $ED_{50}$ for basolateral exposure to $H_2O_2$ did not change in the presence of ATAZ. The rate of $H_2O_2$ consumption in apical and basolateral bathing fluids was the same, while cellualr catalase activity rose gradually with time in culture. Conclusion: Our data suggest that basolateral $H_2O_2$ may affect directly membrane component (e.g., $Na^+,\;K^+$-ATPase) located on the basolateral cell surface. Apical $H_2O_2$, on the other hand, may be largely degraded by catalase as it passes through the cells before reaching these membrane components. We conclude that alveolar epithelial barrier integrity as measured by Isc and R are compromised by $H_2O_2$ being relatively sensitive to basolateral (and insensitive to apical) $H_2O_2$.

• Restorative Dentistry and Endodontics
• /
• v.25 no.3
• /
• pp.435-445
• /
• 2000

The purpose of this study was to compare the leakage of four different obturation techniques in conjunction with immediate apical barrier of ${\beta}$-tricalcium phosphate(TCP) in teeth with open apex. Eighty single-rooted human premolar teeth were prepared and sectioned horizontally, so maximum diameter in apex was 4mm. Apical defects that were similar to open apex, were created with #1/2 round bur and SF104R bur. The apical foramen were opened to a size 80 file extended 3mm beyond the apex. The teeth were placed into the oasis block soaked saline to simulate periapical tissue often associated with pulpless teeth and received apical barriers consisting of TCP followed by obturation using lateral condensation technique, vertical condensation technique, continuous wave technique and thermoplasticized gutta-percha injection technique. Two unobturated teeth served as positive and negative controls. Teeth were immersed in resorcinol-formaldehyde resin for S days at $4^{\circ}C$, and the resin was allowed to polymerize completely for 4 days at room temperature. Teeth were then sectioned horizontally at 1.5mm(level 1), 2.5mm(level 2) and 3.5mm(level 3) from the apex, and examined under a stereomicroscope at ${\times}40$ magnification. The photographs were taken at ${\times}40$ magnification of the filling in each level and scanned. The leakage length in tooth/resin interface was measured at each of the three levels. Each ratio of leakage was obtained by calculating the ratio of the leakage length of canal wall infiltrated with resin to the total length of the canal and was analyzed statistically(One-way ANOVA and Scheffe test). The result were as follows : 1. At the level 1, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), but there was statistically significant(p<0.05). 2. At the level 2, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), and the most leakage in the continuous wave technique group(group 3). There was statistically significant difference between the thermoplasticized gutta-percha injection technique group and the continuous wave technique group(p<0.05). 3. At the level 3, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), but there were no statistically significant differences between other groups(p>0.05). These results suggest that thermoplasticized gutta-percha injection technique which had 1mm apical gutta-percha matrix after the formation of TCP apical barrier, can demonstrate favorable apical sealing.

• The Journal of the Korean dental association
• /
• v.58 no.6
• /
• pp.336-345
• /
• 2020

Peri-apical implant lesion, also known as 'retrograde peri-implantitis' can occur with multifactorial etiological factors. The purpose of this case report is to demonstrate resolution of periapical implant lesion by removal of causative factors and saving implant by regenerative therapy. A 54-year old male patient with mild dull pain around implant on the right mandibular second premolar area due to persistent peri-apical infection of the adjacent first premolar was treated. Extraction of tooth with symptomatic apical periodontitis and regenerative therapy on the buccal fenestration area of the implant and extraction site were performed. After 6-month reentry, notable regenerated bone tissue around implant was found, and implant placement on the previous extraction site was performed. After 14-month follow-up from the regenerative therapy, neither biological nor mechanical complication could be found around the implant, evidenced by high implant stability, normal clinical probing depth, and absence of discomfort spontaneously and during masticatory function. In conclusion, surgical intervention including regenerative therapy using bone graft and barrier membrane on periapical implant lesion can be suggested as one of the treatment options considering the extent of periapical lesion.

• Proceedings of the PSK Conference
• /
• 2003.10b
• /
• pp.234.3-235
• /
• 2003

The aim of this study is to evaluate the permeability of PEG-conjugated salmon calcitonin (sCT) across monolayers of Caco-2 cells that represent a model of the intestinal barrier. Caco-2 cells were grown to confluency on a permeable polycarbonate membrane to permit transport through it. Permeability experiments were performed with native-sCT and PEG-conjugated sCT (PEG M.W. 2000) at various concentrations (5uM, 10uM, 25uM, 50uM, 100uM) in the apical to basolateral direction. The barrier properties were assessed by detecting transport of markder molecules ($^3$H-mannitol) and by measuring transepithelial electrical resistance (TEER). (omitted)

• Journal of Periodontal and Implant Science
• /
• v.26 no.4
• /
• pp.967-987
• /
• 1996

The present study was to evaluate the healing patterns of guided tissue regeneration( GTR) using resorbable $Vicryl^{(R)}$(polyglactin 910) mesh and nonresorbable expanded polytetrafluoroethylene(ePTFE) membrane with or without bone grafting using autogeneous bone and demineralized freeze-dried bone allograft(DFDBA) in the grade II furcation defects. Mucoperiosteal flaps were reflected buccally in the mandibular 2nd, 3rd and 4th premolar areas and furcation defects were created surgically by removing $5{\times}6mm$ alveolar bone in 4 dogs. Root surfaces were thoroughly debrided of periodontal ligament and cementum, and notches were placed on root surface at the most apical bone level. In the right and left mandibular quadrant, each tooth was received $Vicryl^{(R)}$ mesh(ACE Surgical Supply Co., USA) only, $Vicryl^{(R)}$ mesh with DFDBA, $Vicryl^{(R)}$ mesh with autogeneous bone grafts, ePTFE membrane($Core-tex^{(R)}$ membrane, W.L. Gore & Associates Inc., USA) only, ePTFE membrane with DFDBA or ePTFE membrane with autogeneous bone grafts. For the fluorescent microscopic examination, fluorescent agents were injected at 2, 4 and 8 weeks after surgery. Four weeks after surgery, 2 dogs were sacrificed and ePTFE membranes were removed from remaining 2 dogs, which were sacrificed at 12 weeks after surgery. Undecalcified tissues were embedded in methylmethacrylate and $10{\mu}m$ thick sections were cut in a buccolingual direction. These sections were stained with hematoxylin-eosin stain and Masson's trichrome stain, and evaluated by descriptive histology and linear measurements. The results were as follows : 1) $Vicryl^{(R)}$ mesh group showed less connective tissue attachment than ePTFE membrane group. 2) The combination of GTR using $Vicryl^{(R)}$ mesh and osseous grafts resulted in new attachment and new bone formation more than GTR using $Vicryl^{(R)}$ mesh only. 3) GTR using ePTFE membrane, with or without osseous grafts, enhanced periodontal regeneration. 4) Root resorption and dentoalveolar ankylosis were observed in the areas treated with the combination of GTR and DFDBA. It was suggested that the effect of adjunctive bone grafting in GTR procedure depends on the materials and the physical properties of barrier membranes. $Vicryl^{(R)}$ mesh performed a barrier function and the use of adjunctive bone grafting may enhance the periodontal regeneration.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.28 no.2
• /
• pp.201-212
• /
• 2012

There are some similar aspects at histological and morphological characteristics between the peri-implant tissue and periodontal tissue and the direct attachment between the titanium and soft tissue around the implant called as "Functional ankylosis" can prevent the apical infiltration of inflammatory and bone resorption around implant. But, the repeated connection and disconnection of the abutment can destroy the mucosal barrier of soft tissue around the implant and can cause the marginal bone resorption. The amount of marginal bone resorption may reduced if the prosthetic abutment is placed at that time of surgery. Connection of the prosthetic abutment at surgery was limited because the low accuracy of conventional method, but by using of Cone Beam Computed Tomography(CBCT) and guide surgery, the 3-dimensional accuracy of implant placement became much higher than before and it became possible. This is a clinical case of immediate connection of prosthetic abutment and provisional restoration by using of precise CBCT diagnosis and pre-fabricated zirconia customized abutment at surgery and the alternative method is described in this article because of the clinically contentable results.

• Parasites, Hosts and Diseases
• /
• v.28 no.4
• /
• pp.197-206
• /
• 1990

Various conditions of cultures were performed to investigate the role of tight junctions formed between adjacent MDCK cells on the entry of Toxoplasma. When MDCK cells were cocultured with excess number of Toxoplasma at the seeding density of 1×105, 3×105, and 5×105 cells/ml for 4 days, the number of intracellular parasites decreased rapidly as the host cells reached saturation density, i.e., the formation of tight junctions. When the concentration of calcium in the media (1.8 mM in general) was shifted to $5{\mu}M$ that resulted in the elimination of tight junction, the penetration of Toxoplasma increased about 2-fold(p<0.05) in the saturated culture, while that of non-saturated culture decreased by half. Trypsin-EDTA which was treated to conquer the tight junctions of saturated culture favored the entry of Toxoplasma about 2.5-fold(P<0.05) compared to the non-treated, while that of non- saturated culture decreased to about one fifth. It was suggested that the tight junctions of epithelial cells play a role as a barrier for the entry of Toxoplasma and Toxoplasma penetrate into hoot cells through membrane structure-specific, i.e., certain kind of receptors present on the basolateral rather than apical surface of MDCK cells.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.38 no.1
• /
• pp.17-24
• /
• 2011

The aim of this study was to assess the outcome of MTA apexification in young permanent anterior teeth. Among the patients with the traumatized permanent incisors which were treated with MTA apexification, the dental records and radiographs were examined only for the patient who had follow-up examination at least 3 months after the treatment. Forty nine patients with 64 teeth were included in this study. Demographic information, location and type of teeth and periodontal injury, pre-treatment periapical lesion, clinical symptoms, status of MTA filling, healing of apical lesion and apical barrier formation after treatment were investigated. The outcome based on clinical and radiographic criteria were assessed. The results were as follows 1. Of 64 immature permanent incisors with MTA apexification, the clinical and radiographic success rates were 89.1% and 73.4%, respectively. 2. The maxillary incisors showed significantly higher success rates than the mandibular incisors. 3. There was no statistically significant difference in success rates among the teeth with different types of teeth and periodontal injury. 4. The status of MTA filling did not influence the clinical and radiographic success.