• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.1
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• pp.29-36
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• 2019

Background: An inability to cope with threatening dental stimuli, i.e., sight, sound, and sensation of airotor, manifests as anxiety and behavioral management problems. Behavior modification techniques involving pre-exposure to dental equipment will give children a first-hand experience of their use, sounds, and clinical effects. The aim of this study was to compare the techniques of Tell-Show-Play-doh, a smartphone dentist game, and a conventional Tell-Show-Do method in the behavior modification of anxious children in the dental operatory. Methods: Sixty children in the age group of 4-8 years, with Frankl's behavior rating score of 2 or 3, requiring Class I and II cavity restorations were divided into three groups. The groups were Group 1: Tell-Show-Play-doh; Group 2: smartphone dentist game; and Group 3: Tell-Show-Do technique and each group comprised of 20 children. Pulse rate, Facial Image Scale (FIS), Frankl's behavior rating scale, and FLACC (Face, Leg, Activity, Cry, Consolability) behavior scales were used to quantify anxious behavior. Operator compliance was recorded through a validated questionnaire. Results: The results showed lower mean pulse rates, lower FIS and FLACC scores, higher percentage of children with Frankl's behavior rating score of 4, and better operator compliance in both the Tell-Show-Play-doh and smartphone dentist game groups than in the conventional Tell-Show-Do group. Conclusion: The Tell-Show-Play-doh and smartphone dentist game techniques are effective tools to reduce dental anxiety in pediatric patients.

• Restorative Dentistry and Endodontics
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• v.34 no.6
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• pp.467-476
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• 2009

The aim of this study was to measure the dentinal tubular fluid flow (DFF) during and after amalgam and composite restorations. A newly designed fluid flow measurement instrument was made. A third molar cut at 3 mm apical from the CEJ was connected to the flow measuring device under a hydrostatic pressure of 15 $cmH_2O$. Class I cavity was prepared and restored with either amalgam (Copalite varnish and Bestaloy) or composite (Z-250 with ScotchBond MultiPurpose: MP, Single Bond 2: SB, Clearfil SE Bond: CE and Easy Bond: EB as bonding systems). The DFF was measured from the intact tooth state through restoration procedures to 30 minutes after restoration, and re-measured at 3 and 7days after restoration. Inward fluid flow (IF) during cavity preparation was followed by outward flow (OF) after preparation, In amalgam restoration, the OF changed to IF during amalgam filling and slight OF followed after finishing. In composite restoration, application CE and EB showed a continuous OF and air-dry increased rapidly the OF until light-curing, whereas in MP and SB, rinse and dry caused IF and OF, respectively. Application of hydrophobic bonding resin in MP and CE caused a decrease in flow rate or even slight IF. Light-curing of adhesive and composite showed an abrupt IF. There was no statistically significant difference in the reduction of DFF among the materials at 30 min. 3 and 7 days after restoration (p > 0.05).

• Restorative Dentistry and Endodontics
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• v.13 no.2
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• pp.265-282
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• 1988

The pulp response of posterior composite resins in relation to the thickness of remaining dentin was studied with 120 teeth from 6 dogs, Class V. cavities were prepared on the cervical area of facial surfaces. The thickness of remaining dentin was controlled with Caries Meter$^{(R)}$. The cavities of group A were prepared to show the electrical impedance of 22-26$K{\Omega}$(thickness of remaining dentin:0.4-0.5mm). The cavities of group B, 50-55$K{\Omega}$(thickness of remaining dentin: 0.8-0.9mm). Zinc - Oxide Eugenol cement, Estilux$^{(R)}$ posterior, Heliomolar$^{(R)}$ radiopaque, P-30$^{(R)}$ and Scotchbond$^{(R)}$+P-30$^{(R)}$ were filled in each cavity. After 3days, 1 week, 2 weeks, 4 weeks, 9 weeks and 13 weeks, the teeth and pulp tissue were processed routinely and stained with Hematoxylin and Eosin. Pathological tissue changes were observed with light microscope. The following results were obtained. I. The pulp response of group A cavties was severer than that of group B cavities. 2. In the pulp of group A cavities which were filled with Zinc-Oxide Eugenol Cement, only vascular changes were observed after 3 days and 1 week, severe acute inflammation after 4 weeks, moderate acute inflammation after 9 weeks, and chronic inflammation and formation of granulation tissue after 13 weeks. 3. In the pulp of group A cavities which were filled with Estilux$^{(R)}$ posterior, only vascular changes were observed after 3 days and 1 week. But the inflammatory response has became much severer with the elapsed experimental period. 4. In the pulp of group A cavities which were filled with Heliomolar$^{(R)}$ radiopaque, the inflammatory response with the elapsed experimental period was not severer than that of the pulp of group A cavities which were filled with other materials. 5. In the group B cavities, the difference of pulp response by filling materials was not recognizable. In the group A cavities, the pulp response of Estilux$^{(R)}$ posterior was severest and in order P-30$^{(R)}$, Heliomolar$^{(R)}$ radiopaque was slighter.

• Restorative Dentistry and Endodontics
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• v.39 no.1
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• pp.24-31
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• 2014

Objectives: The purpose of present study was to evaluate the internal adaptation of composite restorations using different adhesive systems. Materials and Methods: Typical class I cavities were prepared in 32 human third molars. The teeth were divided into the following four groups: 3-step etch-and-rinse, 2-step etch-and-rinse, 2-step self-etch and 1-step self-etch system were used. After the dentin adhesives were applied, composite resins were filled and light-cured in two layers. Then, silver nitrate solution was infiltrated, and all of the samples were scanned by micro-CT before and after thermo-mechanical load cycling. For each image, the length to which silver nitrate infiltrated, as a percentage of the whole pulpal floor length, was calculated (%SP). To evaluate the internal adaptation using conventional method, the samples were cut into 3 pieces by two sectioning at an interval of 1 mm in the middle of the cavity and they were dyed with Rhodamine-B. The cross sections of the specimens were examined by stereomicroscope. The lengths of the parts where actual leakage was shown were measured and calculated as a percentage of real leakage (%RP). The values for %SP and %RP were compared. Results: After thermo-mechanical loading, all specimens showed significantly increased %SP compared to before thermo-mechanical loading and 1-step self-etch system had the highest %SP (p < 0.05). There was a tendency for %SP and %RP to show similar microleakage percentage depending on its sectioning. Conclusions: After thermo-mechanical load cycling, there were differences in internal adaptation among the groups using different adhesive systems.

• Restorative Dentistry and Endodontics
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• v.26 no.4
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• pp.263-272
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• 2001

The aim of this study was to investigate the influence of four different light curing modes on the marginal leakage of Class V composite resin restoration. Eighty extracted human premolars were used. Wedge-shaped class Y cavities were prepared on the buccal surface of the tooth with high-speed diamond bur without bevel. The cavities were positioned half of the cavity above and half beyond the cemento-enamel junction. The depth, height, and width of the cavity were 2 mm, 3 mm and 2 mm respectively. The specimens were divided into 4 groups of 20 teeth each. All the specimen cavities were treated with Prime & Bond$^{R}$ NT dental adhesive system (Dentsply DeTrey GmbH, Germany) according to the manufacturer's instructions and cured for 10 seconds except group VI which were cured for 3 seconds. All the cavities were restored with resin composite Spectrum$^{TM}$ TPH A2 (Dentsply DeTrey GmbH, Germany) in a bulk. Resin composites were light-cured under 4 different modes. A regular intensity group (600 mW/${cm}^2$, group I) was irradiated for 30 s, a low intensity group (300 mW/${cm}^2$, group II) for 60 s and a ultra-high intensity group (1930 mW/${cm}^2$, group IV) for 3 s. A pulse-delay group (group III) was irradiated with 400 mW/${cm}^2$ for 2 s followed by 800 mW/${cm}^2$ for 10 s after 5 minutes delay. The Spectrum$^{TM}$ 800 (Dentsply DeTrey GmbH, Germany) light-curing units were used for groups I, II and III and Apollo 95E (DMD, U.S.A.) was used for group IV. The composite resin specimens were finished and polished immediately after light curing except group III which were finished and polished during delaying time. Specimens were stored in a physiologic saline solution at 37$^{\circ}C$ for 24 hours. After thermocycling (500$\times$, 5-55$^{\circ}C$), all teeth were covered with nail varnish up to 0.5 mm from the margins of the restorations, immersed in 37$^{\circ}C$, 2% methylene blue solution for 24 hours, and rinsed with tap water for 24 hours. After embedding in clear resin, the specimens were sectioned with a water-cooled diamond saw (Isomet$^{TM}$, Buehler Co., Lake Bluff, IL, U.S.A.) along the longitudinal axis of the tooth so as to pass the center of the restorations. The cut surfaces were examined under a stereomicroscope (SZ-PT Olympus, Japan) at ${\times}$25 magnification, and the images were captured with a CCD camera (GP-KR222, Panasonic, Japan) and stored in a computer with Studio Grabber program. Dye penetration depth at the restoration/dentin and the restoration/enamel interfaces was measured as a rate of the entire depth of the restoration using a software (Scion image, Scion Corp., U.S.A.) The data were analysed statistically using One-way ANOVA and Tukey's method. The results were as follows : 1. Pulse-Delay group did not show any significant difference in dye penetration rate from other groups at enamel and dentin margins (p>0.05) 2. At dentin margin, ultra-high intensity group showed significantly higher dye penetration rate than both regular intensity group and low intensity group (p<0.05). 3. At enamel margin, there were no statistically significant difference among four groups (p>0.05). 4. Dentin margin showed significantly higher dye penetration rate than enamel margin in all groups (p<0.05).

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.166-179
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• 1999

Apical sealing is essential for the success of surgical endodontic treatment. Root-end cavity is apt to be contaminated with moisture or blood, and is not always easy to be dried completely. The purpose of this study was to evaluate the influence of dry methods of retrocavity on the apical seal in endodontic surgery. Apical seal was investigated through the evaluation of apical leakage and adaptation of filling material over the cavity wall. To investigate the influence of various dry methods on the apical leakage, 125 palatal roots of extracted human maxillary molar teeth were used. The clinical crown of each tooth was removed at 10 mm from the root apex using a slow-speed diamond saw and water spray. Root canals of the all the specimens were prepared with step-back technique and filled with gutta-percha by lateral condensation method. After removing of the coronal 2 mm of filling material, the access cavities were closed with Cavit$^{(R)}$. Two coats of nail polish were applied to the external surface of each root. Apical three millimeters of each root was resected perpendicular to the long axis of the root with a diamond saw. Class I retrograde cavities were prepared with ultrasonic instruments. Retrocavities were washed with physiologic saline solution and dried with various methods or contaminated with human blood. Retrocavities were filled either with IRM, Super EBA or composite resin. All the specimens were immersed in 2% methylene blue solution for 7 days in an incubator at $37^{\circ}C$. The teeth were dissolved in 14 ml of 35% nitric acid solution and the dye present within the root canal system was returned to solution. The leakage of dye was quantitatively measured via spectrophotometric method. The obtained data were analysed statistically using one-way ANOVA and Duncan's Multiple Range Test. To evaluate the influence of various dry methods on the adaptation of filling material over the cavity wall, 12 palatal roots of extracted human maxillary molar teeth were used. After all the roots were prepared and filled, and retrograde cavities were made and filled as above, roots were sectioned longitudinally. Filling-dentin interface of cut surfaces were examined by scanning electron microscope. The results were as follows: 1. Cavities dried with paper point or compressed air showed less leakage than those dried with cotton pellet in Super EBA filled cavity (p<0.05). However, there was no difference between paper point- and compressed air-dried cavities. 2. When cavities were dried with compressed air, dentin-bonded composite resin-filled cavities showed less apical leakage than IRM- or Super EBA-filled ones (p<0.05). 3. Regardless of the filling material, cavities contaminated with human blood showed significantly more apical leakage than those dried with compressed air after saline irrigation (p<0.05). 4. Outer half of the cavity showed larger dentin-filling interface gap than inner half did when cavities were filled with IRM or Super EBA. 5. In all the filling material groups, cavities contaminated with blood or dried with cotton pellets only showed larger defects at the base of the cavity than ones dried with paper points or compressed air.

• Restorative Dentistry and Endodontics
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• v.33 no.2
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• pp.115-124
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• 2008

The purpose of this study was to measure the polymerization shrinkage and hygroscopic expansion of resin-based temporary filling materials and to evaluate microleakage at the interface between the materials and cavity wall. Five resin-based temporary filing materials were investigated: Fermit (Vivadent), Quicks (Dentkist), Provifil (Promedica), Spacer (Vericom), Clip (Voco). Caviton (GC) was also included for comparison. Polymerization shrinkage of five resin-based temporary filling materials was measured using the bonded disc method. For the measurement of hygroscopic expansion, the discs of six cured temporary filling materials were immersed in saline and a LVDT displacement sensor was used to measure the expansion for 7 days. For estimating of microleakage, Class I cavities were prepared on 120 extracted human molars and randomly assigned to 6 groups of 20 each. The cavities in each group were filled with six temporary filling materials. All specimens were submitted to 1000 thermocycles, with temperature varying from $5^{\circ}C/55^{\circ}C$. Microleakage was determined using a dye penetration test. The results were as follows: 1. Fermit had significantly less polymerization shrinkage than the other resin-based temporary fill ing materials. Fermit (0.22%) < Spacer (0.38%) < Quicks (0.64%), Provifil (0.67%), Clip (0.67%) 2. Resin-based temporary filling materials showed 0.43-1.1% expansion in 7 days. 3. Fermit showed the greatest leakage, while Quicks exhibited the least leakage. 4. There are no correlation between polymerization shrinkage or hygroscopic expansion and microleakage of resin-based temporary filling materials.

• Restorative Dentistry and Endodontics
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• v.28 no.1
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• pp.23-33
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• 2003

The purpose of this study was to compare in vitro interfacial relationship of restorations bonded with three self-etching primer adhesives and one self-etching adhesive. Class I cavity preparations were prepared on twenty extracted human molars. Prepared teeth were divided into four groups and restored with four adhesives and composites Clearfil SE $Bond/Clearfil^{TM}$ AP-X (SE), UniFil $Bond/UniFil^{\circledR}$ F (UF), FL $Bond/Filtek^{TM}$ Z 250 (FL) and Prompt $L-Pop/Filtek^{TM}$ Z 250 (LP) After storing in distilled water of room temperature for 24 hours, the specimens were vertically sectioned and decalcified. Morphological patterns between the enamel/dentin and adhesives were observed under SEM. The results of this study were as follows : 1. They showed close adaptation between enamel and SE, UF and FL except for LP. 2. The hybrid layer in dentin was $2{\;}\mu\textrm{m}$ thick in SE, $1.5{\;}\mu\textrm{m}$ thick in UF, and $0.4{\;}\mu\textrm{m}$ in both FL and LP. So, the hybrid layers of SE and UF were slightly thicker than that of FL and LP. 3. The lengths and diameters of resin tags in UF and FL were similar, but those of LP were slightly shorter and slenderer than those of SE. 4. The resin tags were long rod shape in SE, and funnel shape in other groups Within the limitations of this study, it was concluded that self-etching primer adhesives showed close adaptation on enamel. In addition, the thickness of hybrid layer ranged from $0.4-1.5{\;}\mu\textrm{m}$ between adhesives and dentin. The resin tags were long rod or funnel shape, and dimension of them was similar or different among adhesives.