It has been demonstrated that intracoronal bleaching of pulpless teeth may result in cervical root resorption. Several authors postulated that bleaching agents such as hydrogen peroxide penetrated through the dentinal tubules to damage the surrounding tissues that cause cervical root resorption. The purpose of this study was to suggest on in vitro model for direct determination of hydrogen peroxide penetration through CEJ during nonvital bleaching. In addition, this model permit the quantification of the amount of hydrogen peroxide penetrated during the procedure. Freshly extracted intact premolars, removed for orthodontic reasons were used. Root canal treatment was performed in each tooth. And then the outer surface and crown portion of the teeth was sealed with wax leaving the CEJ. The prepared teeth mounted on the wax laminates were placed in plastic assay tubes containing 1.5ml bidistilled water with their entire root, including the CEJ, submerged in the solution. The teeth were dividied into four groups. Thermo group : thermocatalytic bleaching with superoxol Walk group: walking bleaching with sodium perborate & superoxol Combi group : combination of thermocatalytic & walking bleaching Dw group : walking bleaching with sodium perborate & water The bleaching procedure was performed three times. The bleaching intervals were at 3 days. The hydrogen peroxide present in the assay system was added to ferrous ammonium sulfate resulting in ferric ion release. Upon the addition of potassium thiocyanate a ferrithiocyanate complex results, which absorbs light at the wavelength of 467nm. The radicular penetration of hydrogen peroxide in the four groups was assessed directly using spectrophotometer. The amount of hydrogen peroxide in the samples tested is determined by comparing them with a standard curve generated by known amounts of hydrogen peroxide. The results were obtained as follows : 1. In all experimental groups except the Dw group showed lower penetration amount in day 4 than day 1, there was statistical importance in the difference (P<0.05). 2. After 3rd treatment, Thermo group showed slightly increased value and narrow distribution. Walk group showed much more penetration amount and widely dispersed value. Value of Combi group showed wide distribution without regard to treatment time, but value of Dw group evenly distributed. 3. Thermo group, Walk group and Dw group showed a tendency of increasing penetration amount with increasing treatment times(P<0.01), but Combi group revealed no statistically important differences. 4. Combi group showed the highest degree of penetration. Walk group showed lower penetration than Combi group. Thermo group & Dw group showed lower than Walk group. 5. Cervical root permeability to hydrogen peroxide varied from 0 to 35 %.
Journal of Dental Rehabilitation and Applied Science
/
v.30
no.3
/
pp.215-222
/
2014
Purpose: The aim of this study was to investigate differences between the morphology of the mandibular symphysis and four facial skeletal types. Materials and Methods: 40 cone-beam computed tomographies were selected and classified in to 4 groups according to their vertical and anterior-posterior skeletal patterns. The bone volume ($mm^3$) of the symphysis, the cross sectional area corresponding to the 4 mandibular incisors' axis: the cross sectional area of total bone ($mm^2$), the area of the cancellous bone ($mm^2$) and the thickness (mm) of labial and lingual alveolar bone at 2 mm, 3 mm under the cemento-enamel junction (CEJ) were measured. General linear model (GLM), Kruskal-Wallis test and Tukey honestly significant difference (HSD) test were subsequently used for statistical analysis. Results: The lingual cortical bone thickness of the lateral incisors at 2, 3 mm under CEJ was greater in the Class I low angle group than the other 3 groups (P < 0.05). There were no statistically significant differences in the volume of the mandibular incisor bony support, cross-sectional area of total bone and cancellous bone at the mandibular incisor' axis. Conclusion: Patients in Class I, low angle group have a thicker lingual mandibular symphysis than Class I, high angle patients.
Purpose: The main purpose of this study was to investigate bone thickness on the buccal and palatal aspects of the maxillary canine and premolars using cone-beam computed tomography (CBCT). The differences between left- and right-side measurements and between males and females were also analyzed. Methods: The sample consisted of 20 subjects (9 males and 11 females; mean age, $21.9{\pm}3.0$) selected from the normal occlusion sample data in the Department of Orthodontics, The Catholic University of Korea. The thickness of the buccal and palatal bone walls, perpendicular to the long axis of the root were evaluated at 3 mm and 5 mm apical to cemento-enamel junction (CEJ) and at root apex. Results: At the canines and first premolars regions, mean buccal bone thickness of at 3 mm and 5 mm apical to CEJ were less than 2 mm. In contrast, at the second premolar region, mean buccal bone thickness at 3 mm and 5 mm apical from CEJ were greater than 2 mm. Frequency of thick bone wall (${\geq}2mm$) increased from the canine to the second premolar. Conclusions: This result should be considered before tooth extraction and planning of rehabilitation in the canine and premolar area of maxilla. Careful preoperative analysis with CBCT may be beneficial to assess local risk factors and to achieve high predictability of success in implant therapy.
Many studies reported that the presence of cervical enamel projection (CEP) in cemento-enamel junction(CEJ) is greatly related to periodontal disease. The aim of this study was to investigate the prevalence of enamel projections in buccal, mesial, distal and lingual(palatal) surface of maxillary and mandibular first and second molars on extracted teeth. Among 660 teeth extracted due to the periodontal disease and dental caries in Seoul National University Dental Hospital was examined, 530 teeth which has distinct CEJ were examined with 8 times x electronic magnifier by one examiner. The prevalence of CEP for maxillary teeth (45.49%) was higher than that of mandible (39.62%). The first molar (45.22%) had more CEP than second (39.89%). Furthermore, buccal surface had highest incidence of CEP than other surfaces. The results of this study imply that the clinicians should take good care of the prevalence of CEP when scaling or root planning, plaque control instruction and periodontal surgery.
Park, Kwan-Soo;Yoon, Kyu-Ho;Cheong, Jeong-Kwon;Shin, Jae-Myung;Hong, Sung-Chul;Jeon, In-Seong
Maxillofacial Plastic and Reconstructive Surgery
/
v.28
no.1
/
pp.58-67
/
2006
In the recent studies, many authors have reported that the success rate of immediate implantation has no difference compared to conventional staged implantation. Although the immediate implantation has many advantages over conventional approach, many clinicians don't seem to practice because they think that most of the extraction sockets will have some bony gab with defects around implant and that this situation makes the result of immediate implantation unpredictable. We clinically analyzed 23 implanted sites of 18 patients treated with immediate implantation in our hospital from September 2003 to January 2004. The $ITI^{(R)}$. dental implant system was used and GBR procedure with $Bio-Oss^{(R)}$. and $Bio-Gide^{(R)}$. was done simultaneously. The pre & post-op. measurements were recorded such as alveolar crest-adjacent tooth CEJ distance, gingival crest-adjacent tooth CEJ distance, existence of periapical lesion, vertical defect around the extraction socket, horizontal defect around the extraction socket, probing depth, radiologic change of alveolar crest height. We report a positive outcome about immediate implantation with review of literatures.
It has been documented that SPA0355 exerts antiinflammatory effects via the inhibition of nuclear factor-kappaB activation. In present study, we investigated the inhibitory effects of SPA0355 on periodontitis in an animal model. Periodontitis was induced by ligation of the cervix of the 1st molar in the left mandible in rats. After ligature, the rats were randomly divided into four groups and topically applied with SPA0355 (0.5, 1, and 2%) or the vehicle alone once daily for 10 days. Body weight and food intake were measured daily throughout the experimental period. At day 10 post-ligature, the infiltration of inflammatory cells and distance of the cementoenamel junction (CEJ) to the alveolar bone crest (ABC) in the distal area of ligatured tooth were estimated histopathologically. No changes in body weight or food intake were found between the control and SPA0355 groups. The degree of inflammation was decreased in all three SPA0355 application groups. A decrease CEJ-ABC distance was observed in the 0.5% and 1% SPA0355 groups. These results indicate that SPA0355 inhibits the infiltration of inflammatory cells and alveolar bone resorption and suggests its potential as a therapeutic agent for periodontitis.
Various alloplastic materials have been used on the periodontally diseased ossous defects. Hydroxyapatite, which is used the most common alloplastic material is a non-resorbable form of calcium phosphate and natural coral which is a biodegradable by carbonic anhydrase in osteoclast was introduced recently. The purpose of the present study was to evaluate the clinical effects of porous hydoxyapatite and natural coral on the human periodontal defects. Four males and three females who had adult periodontitis were selected for this study. The teeth that had similar bone loss radiographically and periodontal pocket deeper than 5mm were selected. Gingival recession, pocket depth, plaque index(Silness & Loe), sulcus bleeding index and tooth mobility (measured by Periotest$^{(r)}$) were examined before graft. Before insertion of alloplastic materials, the depth from CEJ to bone crest and from CEJ to base of the osseous defect was recorded. Porous particulate hydroxyapatite(Interpore 200$^{(r)}$, A group) was place on the defect and natural coral(Biocoral$^{(r)}$, B group) was placed on the defect of the opposing tooth. Six months post-surgically the same parameters were recorded by reentry procedures. A and B group showed 0.6mm of mean recession. Mean reduction of pocket depth were 5mm for A group and 4.9mm of B group. Reduced SBI and tooth mobility were recorded. Osseous defect fills of the original defects were 2.9mm for A and 3mm for B group. Percentage defect fills were 71% for A and 59% for B group. The difference of defect fill between pre- and post-insertion was statstically significant(p<0.05). But the difference between the two groups was not significant statistically(p<0.05). The clinical impression at 6 month re-entry and the numerical date indicate that natural coral as well as porous particulate hydoxyapatite has a definite potential as an alloplastic implant in the treatment of periodontal osseous defects.
Purpose: The aim of this study was to investigate and identify the main causes of periodontal tissue change associated with labial gingival recession by examining the anterior region of patients who underwent orthodontic treatment. Methods: In total, 45 patients who had undergone orthodontic treatment from January 2010 to December 2015 were included. Before and after the orthodontic treatment, sectioned images from 3-dimensional digital model scanning and cone-beam computed tomography images in the same region were superimposed to measure periodontal parameters. The initial labial gingival thickness (IGT) and the initial labial alveolar bone thickness (IBT) were measured at 4 mm below the cementoenamel junction (CEJ), and the change of the labial gingival margin was defined as the change of the distance from the CEJ to the gingival margin. Additionally, the jaw, tooth position, tooth inclination, tooth rotation, and history of orthognathic surgery were investigated to determine the various factors that could have affected anterior periodontal tissue changes. Results: The mean IGT and IBT were 0.77±0.29 mm and 0.77±0.32 mm, respectively. The mean gingival recession was 0.14±0.57 mm. Tooth inclination had a significant association with gingival recession, and as tooth inclination increased labially, gingival recession increased by approximately 0.2 mm per 1°. Conclusions: In conclusion, the IGT, IBT, tooth position, tooth rotation, and history of orthognathic surgery did not affect labial gingival recession. However, tooth inclination showed a significant association with labial gingival recession of the anterior teeth after orthodontic treatment.
Purpose: This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. Materials and Methods: The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. Results: The periapical radiographs of 564 teeth showed that the average root resorption was $1.39{\pm}1.27$ ($8.24{\pm}7.22$%) and $1.69{\pm}1.14$ mm ($10.16{\pm}6.78%$) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (p<0.001). Allergic condition was a significant factor at p<0.01. Age at the start of treatment, large overjet, and history of facial trauma were also factors significantly associated with root resorption (p<0.05). There was no statistically significant difference in root resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. Conclusion: These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration.
Purpose: Passive eruption is characterized by the apical shift of the dentogingival junction. As this occurs, the length of the clinical crown increases as the epithelial attachment migrates apically. Altered passive eruption occurs when the margin of gingiva is malpositioned incisally on the anatomic crown in adulthood and results in excessive gingiva. The purpose of this article is to evaluate esthetic results of crown lengthening procedure in altered passive eruption.s. Materials and Methods: Three patients who complained "My front teeth look too short" were included. Bone sounding with periodontal probe revealed that alveolar bone crest was close to CEJ. Based on the diagnostic information, a diagnosis of altered passive eruption was made. They were performed apically positioned flap procedure with osseous resection. Results: Six months later, all patients achieved favorable esthetic results and gingival margins were healthy and stable. Conclusion: When the diagnostic procedures reveal alveolar bone crest levels approximating the CEJ, apically positioned flap procedure with osseous resection is indicated.
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