• Restorative Dentistry and Endodontics
• /
• v.44 no.3
• /
• pp.31.1-31.9
• /
• 2019

Objectives: To compare the formation of dentinal defects using stainless-steel hand K-files (HFs), rotary files, reciprocating files, and Self-Adjusting File (SAF), when used for oval root canals. Materials and Methods: One hundred and forty extracted human mandibular premolar with single root and oval canal were selected for this study. Oval canals were confirmed by exposing to mesio-distal and bucco-lingual radiographs. Teeth with open apices or anatomic irregularities were excluded. All selected teeth were de-coronated perpendicular to the long axis of the tooth, leaving roots segments approximately of 16 mm in length. Twenty teeth were left unprepared (control), and the remaining 120 teeth were divided into 6 groups (n = 20) and instrumented using HF (size 40/0.02), Revo-S (RS; size 40/0.06), ProTaper NEXT (PTN; size 40/0.06), WaveOne (WO; size 40/0.09), RECIPROC (RC; size 40/0.06), and the SAF (2 mm). Roots were then sectioned 3, 6, and 9 mm from the apex, and observed under stereomicroscope, for presence of dentinal defects. "No defect" was defined as root dentin that presented with no visible microcracks or fractures. "Defect" was defined by microcracks or fractures in the root dentin. Results: The control, HF, and SAF did not exhibit any dentinal defects. In roots instrumented by RS, PTN, WO, and RC files exhibited microcracks (incomplete or complete) in 40%, 30%, 55%, and 50%, respectively. Conclusions: The motor-driven root canal instrumentation with rotary and reciprocating files may create microcracks in radicular dentine, whereas the stainless-steel hand file instrumentation, and the SAF produce minimal or less cracks.

• Restorative Dentistry and Endodontics
• /
• v.42 no.3
• /
• pp.232-239
• /
• 2017

Objectives: The evaluation of iatrogenic dentinal defects in extracted teeth may be influenced by extraction forces and prolonged dry times. The purpose of this study was to compare the presence of dentinal defects in freshly extracted, periodontally compromised teeth with those in a group of teeth with uncontrolled extraction forces and storage time. Materials and Methods: The experimental group consisted of eighteen roots obtained from teeth extracted due to periodontal reasons with class II or III mobility. They were kept in saline and sectioned within 1 hour following extraction. The control group consisted of matched root types obtained from an anonymous tooth collection, consistent with previous dentinal defect studies. The slices were obtained at 3, 6, and 9 mm from the apex. The imaging process exposed all specimens to no more than 60 seconds of dry time. The ${\times}12.8$ magnification was used for the 9 mm slices and ${\times}19.2$ magnification for the 3 mm and 6 mm slices under light-emitting diode (LED) transillumination. The root canal spaces and periodontal tissues were masked to minimize extraneous factors that might influence the evaluators. Chi-square test was used for statistical analysis. Results: Dentinal defects were detected in 17% of the experimental group teeth, compared to 61% of control teeth (p = 0.015). Conclusions: LED transillumination assessment of freshly extracted roots with class II or III mobility showed smaller number of dentinal defects than roots with uncontrolled storage time and extraction forces. The use of freshly extracted roots with mobility should be considered for future dental defect assessment studies.

• Journal of Periodontal and Implant Science
• /
• v.52 no.6
• /
• pp.466-478
• /
• 2022

Purpose: Coronally advanced split-or full-thickness (CAST or CAFT) flaps in combination with subepithelial connective tissue grafts (SCTGs) are commonly used in root-coverage procedures despite postoperative pain and bleeding from the graft donor site. Therefore, the modified vestibular incision subperiosteal tunnel access procedure (VISTAX) uses a novel collagen matrix (VCMX) instead of autogenous tissue to address the limitations associated with autogenous tissue grafting. This retrospective study compared the clinical outcomes of VISTAX to the results obtained after using a CAST or CAFT flap in combination with SCTG for root coverage. Methods: Patients with single or multiple adjacent recession I/II defects were included, with 10 subjects each in the VISTAX, CAFT, and CAST groups. Defect coverage, keratinized tissue width, esthetic scores, and patients' perceived pain and dentinal hypersensitivity (visual analogue scale [VAS]) were assessed at baseline, 3 months, and 6 months. Results: All surgical techniques significantly reduced gingival recession (P<0.0001). Defect coverage, esthetic appearance, and the reduction in dentinal hypersensitivity were comparable. However, the VAS scores for pain were significantly lower in the VISTAX group than in the CAFT and CAST groups, which had similar scores (P<0.05). Furthermore, the clinical results of VISTAX and CAFT/CAST generally remained stable at 6 months. Conclusions: The clinical outcomes of VISTAX, CAFT, and CAST were comparable. However, patients perceived significantly less pain after VISTAX, indicating a potentially higher patient acceptance of the procedure. A prospective trial with a longer follow-up period and a larger sample size should therefore evaluate VISTAX further.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.23 no.4
• /
• pp.867-886
• /
• 1996

The purpose of this study was to evaluate the shearbond strength and resin-dentin interface of three different dentinal bonding systems in primary and permanent teeth. Thirty extracted human primary molars and premolars, which were non-carious and free of obvious defect, were selected for this study. All specimens were divided into six groups with two groups allocated for each of the three dentinal bonding system(All-bond 2, Scotchbond Multi-Purpose, Gluma bonding system). After completion of bonding composite to dentin using each tested dentin bonding system, bond strength measurement and histological observation were performed. The results are as follows: 1. All-bond 2 and Scotchbond Multi-Purpose, A good quality hybrid layer was identified, the morphology of which could be equated with the zone of H-E and Brown-Brenn staining. In Gluma bonding system, hybrid layer was very thin, and separated from the solid polymer. 2. All-bond 2 had the highest mean shearbond strength, followed by Scotchbond Multi-Purpose and Gluma bonding system in both primary and permanent teeth. There was no statistically significant difference between All-bond 2 and Scotchbond Multi-Purpose. Statistically significant difference could be found between Gluma bonding system and the other two groups(p<0.05). 3. The fracture patterns observed were mainly the mixture of adhesive failure and dentin dettachment pattern in All-bond 2 and Scotchbond Multi-Purpose while adhesive failure prevailed in Gluma bonding system.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.48 no.2
• /
• pp.237-244
• /
• 2021

Dentinogenesis imperfecta (DI) is a hereditary disorder of dentinal defect. It is generally inherited as a single autosomal dominant trait. DI usually affects both the primary and permanent dentition. Affected teeth have various types of discolorations, rapid destruction of the dentin, and severe attrition. In radiologic view, the affected teeth have bulbous crowns, short roots and narrow or closed pulp chambers. The treatment objective is to prevent additional attrition and recover the vertical dimension of occlusion. The aim of this report was to present the long-term prognosis in 15 years in a pair of siblings. Both the patients had DI with tooth attrition and discoloration. Different treatment procedures were used, depending on the difference in the timing of intervention. The first patient saved most of his teeth. The second patient had all of her teeth extracted. This report could be helpful for early diagnosis and overall treatment of DI.

• Journal of Periodontal and Implant Science
• /
• v.32 no.1
• /
• pp.89-112
• /
• 2002

The earliest reports of the use of electrical energy to directly stimulate bone healing seem to be in 1853 from England, the techniques involved the introduction of direct current into the non-united fracture site percutaneously via metallic needles, with subsequent healing of the defect. One endpoint of the periodontal therapy is to generate structure lost by periodontal diseases. Several procedural advances may support regeneration of attachment, however, regeneration of alveolar bone does not occur consistently. Therefore, factors which stimulate bone repair are areas for research in periodontal reconstructive therapy. Effects of cytokines or growth factors on bone repair are examples of such areas. Another one is electrical current which occurs in bone naturally, so that such bone may be particularly susceptible to electrical therapy. The purposes of this study were to observe the effects of electrical stimulation on the normal periodontium, to determine whether the electricity is the useful means for periodontal regeneration or not. Forty rats weighted about 100 gram were used and divided into 4 groups, the first group, there was no electrical stimulation with the connection of electrodes only. In the second group, there was stimulated by the 10 mA during 10 minutes per a day, in the third group was stimulated by the 25 mA , and the fourth by the 50 mA. At 3, 5, 10 and 15 days post-appliance , two rats in each group were serially sacrificed. and the maxillae and the mandible processed to paraffin, and the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows : 1. There was the distinct reversal line on the lingual alveolar crest, whereas a little changes in the labial alveolarcrest to the duration and amount of currents. 2. In 50 mA group, the cells were highly concentrated at the apex of anterior teeth, and was observed the necrotic tissue. In posterior root apex, the hypercementosis was appeared, and newly formed cementum layer has been increased continuously with the time. 3. The periodontal ligament fiber and Sharpey's fiber were arranged in order, and the bone trabeculae were increased as the experiment proceeded by, relatively the bone marrows were decreased. 4. In the pulp tissue, the blood vessels were increased with blood congestion in the experimetal specimens remarkably, and the dentinal tubules were obstructed . 5. The osteoblasts in alveolar bone proper had been showed highly activity, and also observed the formation of bone trabeculea. In the conclusion, it was suggested that the electrical stimulation has influence on the periodontium and the pulp tissue. However, there might be the injurious effects.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.33 no.2
• /
• pp.323-328
• /
• 2006

Dentinogenesis imperfecta is an inheritable disease of dentinal defect, generally is inherited as a single autosomal dominant trait. It has a prevalence of 1 in 8000 with the trait, and no significant difference between male and female, with involvement of the primary and permanent teeth. Shields proposed three types of Dentinogenesis imperfecta. Affected teeth have various discoloration, separation of enamel rapid destruction of underlying dentin, and severe attrition. Radiographically, the teeth have cervical constriction, bulbous crown, thin root, obliteration of the root canals and pulp chambers, and periapical lesions in a sound tooth. The objective of treatment is rehabilitation of the esthetics, the masticatory function, and the vertical dimension of occlusion. In these cases, two pediatric patients reported to the Kyungpook University Pediatric clinic, with a chief complaint of discolored teeth and severe attrition. As a result of clinical and radiographic exam, it was diagnosed as Dentinogenesis imperfecta. The posterior teeth were restored with Stainless Steel Crown, and the anterior teeth were restored with composite resin veneering.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.28 no.4
• /
• pp.654-660
• /
• 2001

Dentinogenesis imperfecta is an example of an inheritable dentinal defect originating during the histodifferentiation stage of tooth development, with involvement of the primary and permanent teeth. Shields, Bixler and El-Kafrawy proposed three types of Dentinogenesis imperfecta : Type I, II, III. Witkop reported a prevalence of 1 in 8000 with the trait, and no significant difference between male and female. Affected teeth have red-brown discoloration often with distinctive wearness of occlusal surface of posterior teeth and incisal surface of anterior teeth. Once enamel seperated from underlying defective dentin, the dentin demonstrates significantly acclerated attrision. Radiographically, the teeth have thin roots, bulbous crown, cervical constriction, and obliteration of the root canals and pulp chambers. In primary dentition periapical lesions or multiple root fractures are often observed. In successive generations the phenotypes of discoloration and wearness of teeth occurred, and one of the patient's subships, 10 year-old sister, showed general discoloration of her teeth and mild wearness. In this case, a 4 year-old male reported to the Yonsei University Pedodontics clinic, with a chief complaint of discolored teeth. The teeth showed generally yellowish-brown discoloration and moderate wearness. In radiographic features, obliteration of pulp, bulbous crown, and short roots were observed. It was diagnosed as Dentinogenesis imperfecta. The posterior teeth were restored with Stainless Steel Crown, and defective incisors including left upper primary central incisor which was extracted due to a root fracture with Open-faced Stainless Steel crown.