In order to obtain the basic data concerning the optimal lasing conditions in using Nd:YAG laser as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum, the author selected 36 human teeth having no cervical abrasion and caries (; 12 anteriors, 12 premolars. 12 molars) extracted due to periodontal diseases, and divided them into 4 groups as Group I, II, III and IV (; each group of 3 anteriors, 3 premolars, 3 molars), and prepared a cementum specimen with thickness of $1.0mm{\pm}0.2mm$ sectioned longitudinally at the middle of mesio-distal thickness (; Group I) or horizontally at 1mm-2mm below the cemento-enamel junction (; Group II, III, IV) from each tooth of each group by low speed diamond wheel saw, and treated them with 0.5 M ethylene diamine tetraacetic acid (; EDTA, pH=7.4) for 2 minutes for elimination of remnants during tooth-sectioning. And the author applied the laser energy from a fiberoptic delivered, free running, pulsed Nd:YAG laser (; wavelength 1064nm. pulse duration $120{\mu}sec$, fiber diameter $320{{\mu}m}$) to cementum surfaces in triplicates of one experiment under the following lasing conditions: 1. stationary mode of fiber in contact to cementum surfaces without air-spray (; Group I )/with air-spray (; Group II), 2. unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec without air-spray (; Group III)/with air-spray (; Group IV), 3. energy per pulse (mJ/pulse) [; energy density ($J/cm^{2}$)] in order of 1.0W/10Hz (100J/pulse); $124J/cm^{2}$, 0.5W/10Hz (50mJ/pulse); $62J/cm^{2}$, 0.4W/10Hz (40mJ/pulse); $50J/cm^{2}$, 0.3W/10Hz (30mJ/pulse); $37J/cm^{2}$, 4. exposure time of 1 second. And the author applied the platinum coating on surfaces of cementum specimens, and evaluated the characteristics of ultrastructural change on surfaces of cementum using the scanning electron microscopy. In general the ultrastructural loss of cervical cementum irradiated under the same lasing condition of laser energy density occurred least in specimens of Group IV. And especially, the ultrastructural loss of cervical cementum irradiated under the laser energy density of $37J/cm^{2}$ almost did not occur in specimens of Group IV. Therefore, it is considered that the pulsed Nd:YAG laser should be applied with the lasing conditions of unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec with air-spray and of laser energy density within $37J/cm^{2}$ as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum.
Periodontal disease is one of the major dental diseases. Currently, various methods are used for healing and successful regeneration of periodontal tissue damaged by periodontal disease. The periodontal ligament and alveolar bone have received considerable interest for use in periodontal tissue regeneration and induction. However, as the functions of the factors required for tooth attachment and key regulatory factors for periodontal tissue regeneration in the cementum have recently been identified, interest in cementum formation and regeneration has increased. Dental cementum forms in the late phase of tooth development because of the reciprocal regulatory interaction between cervical loop epithelial cells and surrounding mesenchymal cells, which is regulated by various gene signaling networks. Many attempts have been made to understand the regulatory factors and cellular and molecular mechanisms associated with new cementum formation. In this paper, we reviewed the study outcomes to date on the regulatory factors that induce cementum formation and regeneration, focusing on understanding the roles and functions of Wnt signaling in the regulation of cementum formation. In addition, we aimed to obtain information on the useful reciprocal regulatory factors that mediate cementum formation and regeneration through a series of molecular mechanisms.
Kim, Yookyung;Lee, Chan-Young;Kim, Euiseong;Roh, Byoung-Duck
Restorative Dentistry and Endodontics
/
v.37
no.4
/
pp.228-231
/
2012
Invasive cervical resorption is a relatively uncommon form of external root resorption. It is characterized by invasion of cervical region of the root by fibrovascular tissue derived from the periodontal ligament. This case presents an invasive cervical resorption occurring in maxillary lateral incisor, following damage in cervical cementum from avulsion and intracoronal bleaching procedure. Flap reflection, debridement and restoration with glass ionomer cement were performed in an attempt to repair the defect. But after 2 mon, more resorption extended apically. Considering root stability and recurrence potential, we decided to extract the tooth. Invasive cervical resorption in advanced stages may present great challenges for clinicians. Therefore, prevention and early detection must be stressed when dealing with patients presenting history of potential predisposing factors.
Despite the improvements in bond strengths of dentin adhesives and resin-modified glass ionomers, the marginal seal of cervical restorations remains a concern. Microleakage at poorly sealed margins can result in staining, post-operative sensitivity, pulpal irritation, and recurrent caries. The objective of this study was to evaluate the effect of surface penetrating sealant(SPS) on the microleakage of cervical restorations. 45 extracted human teeth were selected, and Class V preparations were prepared on the both buccal and lingual surface of the teeth to the following dimensions : 1.5mm axially, 3mm mesiodistally, and 3mm incisogingivally. After cervical restoration with composite resin, compomer, glass ionomer each restoration was treated as three methods: No Tx., Scotchbond Multipurpose Adhesive$^{\circledR}$, Fortify$^{\circledR}$. The sections were examined with a stereomicroscope to determine the extent of microleakage at enamel and dentin margins. The results of this study were as follows. 1. All groups showed some microleakage. 2. Gingival cavity wall with cementum margin showed significantly higher leakage value than occlusal cavity wall with enamel margin. 3. The group treated with SPS showed significantly lower leakage value than no treated group(p<0.05). But there is no difference between Fortify$^{\circledR}$ and Scotchbond Multipurpose adhesive$^{\circledR}$. The results of this study suggest that SPS are effective in reducing microleakage of class V restorations. But it is certain that some microleakage still occurred despite the application of SPS.
The purpose of this study was to evaluate the microleakage of compomers. In this in vitro study, class V cavities were prepared on buccal and lingual surfaces of thirty extracted human premolars and molars on cementum cervical margin. The experimental teeth were randomly divided into five groups of six samples (12 surfaces) each, Group 1 : Dyract AP, Group 2 : F2000 compomer(non-etch), Group 3 : F2000 compomer(etch), Group 4 : Elan, Group 5 : Compoglass. The bonding agents and compomer were applied for each group following the manufacturer's instructions. After 500 thermocycling between $5^{\circ}C$ and $55^{\circ}C$, the 30 teeth were placed 1% methylene blue dye for 24 hours then rinsed with tab water. The specimens were embedded in clear resin, then sectioned buccolingually through the center of the restoration with a low speed diamond saw. The dye penetration on each of the specimen was observed with a stereomicroscope. The results of study were statistically analyzed using the Student-Newmann-Kaul' s Test. The results were obtained as follows. 1. All compomer restoration systems did not completely prevent marginal leakage. 2. In enamel margin, F2000 compomer(etch) group showed lower leakage value than other systems. Elan and Compoglass groups showed lower leakage value than Dyract AP and F2000 compomer(non-etch) groups (p<0.05). 3. In cementum margin, F2000 compomer(etch) and F2000 compomer (non-etch) groups showed lower leakage value than other systems. Dyract AP and Elan groups showed lower leakage value than Compoglass group (p<0.05).
Hoda S. Ismail;Ashraf I. Ali;Rabab El. Mehesen;Jelena Juloski;Franklin Garcia-Godoy;Salah H. Mahmoud
Restorative Dentistry and Endodontics
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v.47
no.2
/
pp.15.1-15.18
/
2022
This review aimed to characterize the effect of direct restorative material types and adhesive protocols on marginal adaptation and the bond strength of the interface between the material and the proximal dentin/cementum. An electronic search of 3 databases (the National Library of Medicine [MEDLINE/PubMed], Scopus, and ScienceDirect) was conducted. Studies were included if they evaluated marginal adaptation or bond strength tests for proximal restorations under the cementoenamel junction. Only 16 studies met the inclusion criteria and were included in this review. These studies presented a high degree of heterogeneity in terms of the materials used and the methodologies and evaluation criteria of each test; therefore, only a descriptive analysis could be conducted. The included studies were individually evaluated for the risk of bias following predetermined criteria. To summarize the results of the included studies, the type of restorative material affected the test results, whereas the use of different adhesive protocols had an insignificant effect on the results. It could be concluded that various categories of resin-based composites could be a suitable choice for clinicians to elevate proximal dentin/cementum margins, rather than the open sandwich technique with resin-modified glass ionomers. Despite challenges in bonding to proximal dentin/cementum margins, different adhesive protocols provided comparable outcomes.
The aim of this study was to compare the marginal leakage of class II light curing composite resin restoration according to filling methods. With using acid etching technique and dentin bonding agent, various methods were suggested to eliminate or reduce the marginal leakage. In this study, class II cavities were prepared in 100 extracted human premolars with cementum margin(1mm below the CEJ) and the teeth were randomly assigned to 5 groups of 20 teeth each. The teeth in group 1, 2, 3 and 4 were restored by direct filling methods using P-50 and Clearfil Photoposterior of 10 teeth each, but the method of insertion of the restorative materials varied with each group. And the teeth in group 5 were restored by inlay method using Kulzer Inlay and CR Inlay. Filling methods are as follows : Group 1 : The composite resin was inserted in one layer in the proximal box and one layer in the occlusal portion. Group 2 : Insertion was in two equally thick horizontal layers in the proximal box. Group 3 : Insertion was in two diagonally placed layers in the proximal box. Group 4 : The composite resin was inserted in the same way as in group 3 except that a glass ionomer liner was first placed on the axial wall and gingival floor. Group 5 : The teeth were restored by Inlay technique using dure cure resin cement. All the teeth were thermocycled, stained with 1 % methylene blue solution, sectioned mesiodistally, and scored for marginal leakage. To compare the marginal leakage, ANOVA and T-test were used in analysis. The following results were obtained : 1. In direct filling methods, there was no significant difference in marginal leakage at both occlusal and cervical margins. 2. In all groups, occlusal margin showed significantly less leakage than cervical margin. 3. In group using glass ionomer liner, there was no significant reduction of marginal leakage at the cervical margin. 4. The group restored by inlay method showed significantly less marginal leakage than groups restored by direct filling methods at both occlusal and gingival margins. 5. There was no significant difference in each group according to filling materials.
The Journal of Korea Assosiation for Disability and Oral Health
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v.7
no.2
/
pp.99-102
/
2011
A-12year-old boy visited the clinic with chief complaint of anterior maxillary trauma. He was diagnosed with first degree mental retardation and cerebral disorders. By clinical and radiographic examination, intrusion of maxillary central incisors were found. The intrusion was not severe, teeth were luxated with a slight force and the prognosis was followed. After the first year, external root resorption was seen radiographically. Due to difficult behavior management, one visit root canal filling with OrthoMTA(BioMTA, Korea) which is known to generate of cementum and periodontal ligament was planned along with general anesthesia. OrthoMTA was filled from the apex to 1-2mm below cervical area and composite resin used for crown restoration. 6 months after, further resorption, discoloration and mobility was not found. This case is currently checked yearly and further research is needed for inflammatory root resorption and ankylosis.
The purpose of this study was to evaluate the effect of two dentin desensitizers and Er,Cr:YSGG laser for dentinal tubule occlusion. Twenty recently extracted single-rooted human teeth were used to obtain root dentinal fragments. The crowns were cut approximately 1mm below the cementum enamel junction(CEJ). A second cut was used to remove the apex of the root. Subsequently, a longitudinal cut was made in order to obtain 2 fragments from each root sample. The cementum from the cervical portion was removed using a high-speed diamond-coated bur in order to expose the dentin. To open dentinal tubules, forty samples were treated with 50% citric acid for 2 min and then rinsed under distilled water for 1 min. These were divided into four groups of ten samples each. The first group served as a control group. In group 2, the samples were irradiated with the Er,Cr:YSGG laser(Waterlase MD, Biolase, USA). In group 3, the samples were treated with Bisblock and ONE-STEP PLUS(Bisco, USA). In group 4, the samples were treated with Gluma comfort bond & Desensitizer(Heraeus Kulzer, Germany). All the samples were examined using Scanning electron microscopy(Hitachi, S-4700, Japan) with two different magnifications(X2000, X5000). These images were assessed by one examiner who was blind to the experimental procedure, using the index of smear layer removal. The distribution of smear layer removal grades was tested using Fisher's exact test. On the order hand, in order to evaluate the occluding effect of two dentin desensitizers and Er,Cr:YSGG laser, the number of exposed dentinal tubules was counted in each group. These were evaluated using the Kruskal-Wallis test with significance predetermined $\alpha$=0.05. There were statistically significant differences between the three groups(Er,Cr:YSGG laser, Bisblock+ONE-STEP PLUS, Gluma comfort bond & Desensitizer) and control group.
Kim, Jae-Hyuk;Kim, Chong-Yeo;Lim, Sung-Bin;Chung, Chin-Hyung
Journal of Periodontal and Implant Science
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v.29
no.2
/
pp.387-400
/
1999
One of the fundamental causes of periodontal disease is accumulation of bacterial plaque and calculus and most effective method of removing these plaque and calculus are scaling and root planning using hand curet and ultrasonic scaler. Many studies concerning residual degenerated mineral content after periodontal therapies have been carried out, but some problems about these studies were also known. This research studies mineral concents and distribution of residual root surfaces after perfoming hand curet and ultrasonic scaler on root surfaces of single rooted teeth which were extracted for periodontal reasons. EPMA were used to avoid errors from chemical quantative analysis and in addition SEM observation was also performed. The results were as follows. 1. No differences were found between curet group andultrasonic scaler group in Ca, P, Mg and Na level. 2. Concentration level was decreased in the sequence of Ca, P, Mg and Na. 3. Ca and P level were decreased as going to apical portion at curet group and ultrasonic scaler group. 4. More cementum was removed at cervical portion compared to other portion at curet group and ultrasonic scaler group. 5. Ca, P, Mg level was higher in dentin compared to cememtum. There was no difference in mineral level for Ca, P, Mg and Na between root surfaces treated with hand curet and ultrasonic scaler.
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