• Proceedings of the KACD Conference
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• 2003.11a
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• pp.607-607
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• 2003

The purpose of this presentation is to investigate whether the certain therapy resistant bacteria can impair the immune defense system in the pariapical tissue. Recent studies have reported that the facultative or obligatory anaerobic bacteria such as Fusobacterium nucleatum, Enterococcus faecalis and Actinomyces species and Gram positive facultative bacteria Enterococcus faecalis have been shown to dominate in persistent periapical lesion and usually recovered from failed root canal treated cases. Moreover, E. faecalis has been reported to withstand the antimicrobial agent and endure potential starvation and resist the antibacterial effect of calcium hydroxide intracanal medication.(omitted)

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.4
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• pp.455-463
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• 2018

The purpose of this study was to evaluate the effect of the intracanal medicaments on the push-out bond strength of the calcium silicate-based materials. Forty extracted single-root human mandibular premolars were sectioned below cementoenamel junction. Standardized root canal dimension was obtained with a parallel post drill. The specimens were randomly divided into a control group (no medicament), and experimental groups received medicaments with either CH (calcium hydroxide), DAP (double antibiotic paste; a mixture of ciprofloxacin and metronidazole), or TAP (triple antibiotic paste; a mixture of minocycline, ciprofloxacin and metronidazole). Following removal of medicaments with irrigation, roots were cut into sections with 1-mm-thickness. Thereafter, calcium silicate-based materials are applied to the specimens : (i) ProRoot MTA$^{(R)}$ and (ii) Biodentine$^{(R)}$. A push-out bond strength was measured and each specimen was examined to evaluate failure mode. Intracanal medication using CH significantly increased the bond strength to the root dentin. But there are no significant differences on the bond strength of ProRoot MTA$^{(R)}$ or Biodentine$^{(R)}$ among TAP, DAP and control groups. The dislodgement resistance of Biodentine$^{(R)}$ from root dentin was significantly higher than that of ProRoot MTA$^{(R)}$ regardless of the type of intracanal medicaments.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.28.1-28.16
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• 2018

This study investigated the latest findings and notions regarding 'triple antibiotic paste' (TAP) and its applications in dentistry, particularly endodontics. TAP is a combination of 3 antibiotics, ciprofloxacin, metronidazole, and minocycline. Despite the problems and pitfalls research pertaining to this paste has unveiled, it has been vastly used in endodontic treatments. The paste's applications vary, from vital pulp therapy to the recently introduced regeneration and revascularisation protocol. Studies have shown that the paste can eliminate the root canal microorganisms and prepare an appropriate matrix for further treatments. This combination is able to remove diverse groups of obligate and facultative gram-positive and gram-negative bacteria, providing an environment for healing. In regeneration protocol cases, this allows the development, disinfection, and possible sterilization of the root canal system, so that new tissue can infiltrate and grow into the radicular area. Moreover, TAP is capable of creating a discipline in which other wanted and needed treatments can be successfully performed. In conclusion, TAP, as an antibacterial intracanal medication, has diverse uses. Nevertheless, despite its positive effects, the paste has shown drawbacks. Further research concerning the combined paste and other intracanal medications to control microbiota is a must.

• Restorative Dentistry and Endodontics
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• v.12 no.1
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• pp.25-37
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• 1986

This study was undertaken to measure the diffusibility and antimicrobial effectiveness of the medication used in clinical practice. To study the diffusibility of the root canal medicament, loss of formocresol and camphorated phenol from a cotton pellet after insertion into the pulp chamber of 260 molars prepared as routine endodontic treatment was measured. Measurement was done for the one time insertions and for the reinsertions using ultraviolet spectrophotometer. Antibacterial effectiveness against three microoganisms, Staphylococcus aureus, Staphylococcus epidermidis and a-hemolytic streptococcus, on the blood agar plate was observed by measurement of the inhibition zone with. various amount of medicaments. The following results were observed. 1. Nearly all of the medication were lost in the first day after insertion and the residual amount of camphorated phenol was greater than that of formocresol. 2. Residual amounts of medication in the reinsertion group were greater than that of the one time insertion group. 3. Within the pulp chamber diffusibility of formocresol was greater than that of camphorated phenol. 4. The amount of formocresol diffusing out from the tooth was greater than that of camphorated phenol. 5. Antibacterial effectiveness was observed from the residual amount of formocresol in the reinsertion group and in other groups no antibacterial effectiveness was observed.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.18.1-18.12
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• 2018

Objectives: This study compared the retention of BioAggregate (BA; Innovative BioCeramix) and mineral trioxide aggregate (MTA; Angelus) as coronal plugs after applying different intracanal medications (ICMs) used in regenerative endodontic. Materials and Methods: One-hundred human maxillary central incisors were used. The canals were enlarged to a diameter of 1.7 mm. Specimens were divided into 5 groups (n = 20) according to the ICM used: calcium hydroxide (CH), 2% chlorhexidine (CHX), triple-antibiotic paste (TAP), double-antibiotic paste (DAP), and no ICM (control; CON). After 3 weeks of application, ICMs were removed and BA or MTA were placed as the plug material (n = 10). The push-out bond strength and the mode of failure were assessed. The data were analyzed using 2-way analysis of variance, the Tukey's test, and the ${\chi}^2$ test; p values < 0.05 indicated statistical significance. Results: The type of ICM and the type of plug material significantly affected bond strength (p < 0.01). Regardless of the type of ICM, BA showed a lower bond strength than MTA (p < 0.05). For MTA, CH showed a higher bond strength than CON, TAP and DAP; CHX showed a higher bond strength than DAP (p < 0.01). For BA, CH showed a higher bond strength than DAP (p < 0.05). The mode of failure was predominantly cohesive for BA (p < 0.05). Conclusions: MTA may show better retention than BA. The mode of bond failure with BA can be predominantly cohesive. BA retention may be less affected by ICM type than MTA retention.

• Restorative Dentistry and Endodontics
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• v.47 no.1
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• pp.11.1-11.11
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• 2022

This study aimed to describe the outcomes of the GentleWave system (GW) (Sonendo) on root canal treatment. Published articles were collected from scientific databases (MEDLINE/PubMed platform, Web of Science, Scopus, Science Direct and Embase). A total of 24 studies were collected from August/2014 to July/2021, 20 in vitro and 4 clinical. GW System was not associated with extrusion of the irrigant, promoted faster organic dissolution than conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI) continuous ultrasonic irrigation (CUI) and EndoVac, reduced more bacterial DNA and biofilm than PUI and CUI, promoted higher penetration of sodium hypochlorite into dentinal tubules than PUI and CUI in vitro, and removed more intracanal medication than CSI and PUI. GW was able to remove pulp tissue and calcifications. Moreover, its ability to remove hard-tissue debris and smear layer was better than that of CSI, and its ability to remove root canal obturation residues was lower or similar to that of PUI, and similar to that of CSI and EndoVac. Regarding root canal obturation of minimally instrumented molar canals, GW was associated with high-quality obturation. Clinically, the success rate of endodontic treatment using GW was 97.3%, and the short-term postoperative pain in the GW group was not different from CSI. Further research, mainly clinical, is needed to establish whether GW has any advantages over other available irrigation methods.

• Restorative Dentistry and Endodontics
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• v.25 no.2
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• pp.272-288
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• 2000

Calcium hydroxide is used as a root canal medicament with its several pharmacological effects. However, it has been known that the usage of calcium hydroxide in the root canal system before canal filling with gutta-percha and zinc oxide eugenol-based cement induced change in the properties of root canal cement which might adversely affect sealing ability of the canal filling. The purpose of this study was to identify the reactivity of calcium hydroxide-eugenol compound made from chemical interaction of between calcium hydroxide and zinc oxide eugenol. Chemical properties of calcium hydroxide, eugenol, zinc oxide eugenol, calcium hydroxide-eugenol and calcium hydroxide-zinc oxide eugenol compound were analyzed using XRD. FT-IR Spectrophotometer and FT-NMR Spectrometer. The results were as follows: 1. The compound made from interaction between calcium hydroxide and zinc oxide eugenol was as follows : 2. Calcium hydroxide was shown to make chemical bond (ionic bond) with eugenol. 3. Since bonding between $Ca^{2+}$ and eugenol is simple ionic nature, under water existence, calcium hydroxide-eugenol compound may be ionized easily and its physical property be deteriorated.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.44-50
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• 2011

An immature tooth with infected pulp has numerous potential complications. Conventional apexification with calcium hydroxide has several disadvantages, including susceptibility to tooth fracture. This method does not promote continual root development. Pulp revascularization of a necrotic, immature permanent tooth will allow further development of the root and dentinal structure. Disinfection of the root canal system is a prerequisite for pulp revascularization and tissue regeneration. A combination of antibiotic drugs (ciprofloxacin, metronidazole, and minocycline) is effective for disinfection of necrotic pulp, and has been used successfully in regenerative endodontic treatment. These case reports involve the treatment of 3 immature permanent teeth with necrotic pulp using a 3-Mix paste and mineral trioxide aggregate. All cases showed the notable apical maturation with closure of the apex and increased thickness of dentinal walls. This approach suggests a paradigm shift in treating endodontically involved immature permanent teeth from the traditional apexification with calcium hydroxide to the conservative approach by providing a favorable environment for tissue regeneration.

• Restorative Dentistry and Endodontics
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• v.29 no.5
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• pp.470-478
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• 2004

The purpose of this study is to monitor the secretion of matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) produced by human osteosarcoma cell line (MG63) stimulated with Prevotella nigrescens lipopolysaccharides (LPS). and to compare the level of secretion before and after the treatment of calcium hydroxide on P. nigrescens LPS. LPS was extracted and purified from anaerobically cultured P. nigrescens. MG63 cells were stimulated by the LPS (0, 1, $10{\;}\mu\textrm{g}/ml$) or LPS($10{\;}\mu\textrm{g}/ml$) pretreated with 12.5 mg/ml of $Ca(OH)_2$ for 3 days. Total RNA was isolated from the cell. and real-time quantitative polymerase chain reaction (PCR) was performed for quantification of MMP-1 and TIMP-1. The results were as follows. 1. MMP-1 mRNA expression at 48 hr was highly increased by stimulation with P. nigrescens LPS. The increase was dose-dependent. 2. When stimulated with ($1{\;}\mu\textrm{g}/ml$ of LPS. TIMP-1 mRNA expression was highly increased at 24 hr and 48 hr. However. TIMP-1 expression was suppressed at higher concentration ($10{\;}\mu\textrm{g}/ml$). 3. When P. nigrescens LPS was pretreated with $Ca(OH)_2$. MMP-1 and TIMP-1 gene expression was downregulated. The results of this study suggest that transcriptional regulation of MMP-1 and TIMP-1 by P. nigrescens LPS could be one of the important mechanisms in bone resorption of periapical inflammation. The result of calcium hydroxide on MMP-1 and TIMP-1 gene expression suppression shows that calcium hydroxide detoxified bacterial LPS and thus should be used the medication of choice for intracanal dressings in root canal infected with black-pigmented bacteria.