Objectives : This study was to investigate the level of oral health, xerostomia, and oral health related activities of daily living(ADL) and the clinical factors influencing oral health related quality of life(OHIP-14) in elderly for visiting healthcare. Methods : Data were obtained from a cross-sectional survey of 106 elderly people(mean age=$77.5{\pm}4.98$). Participants in the study were recruited when they attended the public health center in Cheonan-si. Data were collected by means of a personal interview from July 19 through to August 20, 2010. Oral health related ADL, OHIP-14 and dry mouth was measured by the total 24-items. The data was analysed with t-test, one-way ANOVA, and multiple regression using the SPSS program. Results : Participants had a mean of 13.6 remaining natural teeth, which was significantly with age and perceived oral health. Xerostomia score achieved a mean of 6.39 out of a maximum 12 points. Powerful predictors of OHIP-14 were natural teeth, masticatory difficulty, oral pain, PHP index, perceived oral health, age and living together for the elderly Conclusions : Based on the findings, OHIP-14 has a significantly impact on oral health related ADL. These results suggest that elder people oral health promotion should be developed assessment index which was measured predictors related oral health in the elderly for visiting healthcare.
The purpose of this study was to observe the effect of ${\beta}GP$ in the remaining dental pulp tissue after pulpotomy in the dogs' teeth. For vital pulpotomy, 72 dogs' teeth were used and class V cavities were prepared and the pulps were amputated. ZOE and Dycal (Caulk Co., USA) were placed over the amputated tissue and cavities were sealed with ZOE cement in the control group. In the experimental group, ${\beta}GP$, ${\beta}GP$-ZOE, ${\beta}GP$-Dycal were placed over the exposed pulp tissues respectively. Dogs were sacrificed after 1, 2 and 4 weeks following the operations and the teeth were decalcified in the nitric acid, sectioned and stained with HE for light microscopic examination. For electron microscopic examination, specimens were made after 2 and 4 weeks following the operation. A comparative microscopic examination revealed as follows. 1. The dentin bridge was formed continuously due to osteodentin in the ${\beta}GP$-Dycal group at the 2nd week, the dentin bridge composed of osteodentin and tubular dentin was observed at the 4th week. 2. Osteodentin formation was vigorously in the ${\beta}GP$-Dycal than in the Dycal group. 3. In the surface of osteodentin the osteodentinoblasts showing vivid synthetic activity were observed and the matrix vesicles were presented during calcification of osteoid dentin matrix. 4. The dentin bridge formation was not observed in ${\beta}GP$ group and ${\beta}GP$-ZOE group.
After a vital pulpotomy in dogs' teeth, the responses of the remaining pulp tissue under calcium hydroxide and formocresol were studied histologically. The class I and V cavities were prepared on the teeth and the pulp was amputated. Calcium hydroxide and formocresol were placed over the amputated tissue and the cavities were sealed with zine oxide eugenol cement and zinc phosphate cement. Animals. were sacrifice after 1, 2, and 3 weeks following the operation. The teeth were decalcfied, sectioned and stained with hematoxylin and eosin. Microscopic examination reveals as follows; 1. Healing of the pulp at the amputation site did not occur in the pulps treated with formocresol. 2. At one week, a thin layer of darker staining tissues just below the necrotic zone was presented in the pulps treated with formocresol. In this stage the tissues beneath the darker staining layer were normal. 3. At two weeks, the cells of the palest staining layer were showed indistinct nucleus which suggested the karyolysis and the karyorrhexis in the pulps treated with formocoresol. As reached to the middle third of the pulp, the odontoblasts were scarcely evident or missed in this stage. 4. At three weeks, the necrotic zone was reached to the middle third of the pulp canal. The cells beneath the zone showed massive infiltration of inflammatory cells in the pulps treated with formocresol. 5. Dentin bridge in the control group was deposited below the necrotic zone from the two. weeks later. 6. Normal tissues were observed ill the apical third of all. the dental pulps in all case of calcium hydroxide and formocresol.
The purpose of this study was to compare the adaptation to the tooth structure of five light cured glass ionomer cements (Fuji II LC. VariGlass VLC, Vitremer, Dyract and Geristore). Human, non-carious fifty extracted permanent premolars stored in normal saline were used. Class V cavity preparations were created on the buccal surfaces. The occlusal margin of each cavity was placed on the enamel and the gingival margin was placed on the cementum/dentin. The teeth were then distributed at random into five groups of 10 teeth each. Group 1: Fuji II LC, Group 2 : VariGlass VLC, Group 3 : Vitremer, Group 4: Dyract, Group 5 : Geristore. The prepared cavities were restored with one of the five light cured glass ionomer cements. The manipulation of each material was handled according to the manufacturer's instructions. All samples were placed in incubator of 100% relative humidity at $37^{\circ}C$ for 24 hours. The roots of the teeth were removed with the tapered fissure bur and the remaining crowns were sectioned buccolingually through the center of restorations. The cut interfaces were gradually hand polished on sandpapers from 300 up to 1200 grit. The adaptation at the tooth/cements interface was assessed by SEM (JSM-840A, JEOL Ltd.). The results of this study were as follows : 1. Group 2 revealed the best adaptation and groups 1, 4 and 5 revealed similar adaptation pattern to the cavity walls. Group 3 revealed the worst adaptation to the cavity walls. 2. Enamel margins showed better adaptation than dentin/cementum margins with each material except group 3. 3. The hybrid layers were observed between the glass ionomer cement and dentin in groups 2, 4 and 5.
The purpose of this study was to observe the responses of the remaining pulp tissue after pulpotomy upon the several kinds of $Ca(OH)_2$ products and the responses of periapical tissue upon some root canal filling materials after extirpation. For pulpotomy, the class V cavities were prepared on the premolars, molars and upper canines, and the pulp was amputated. Each drug was placed over the amputated tissue and cavity was sealed with zinc oxide eugenol cement. The drugs which were used for the study were Dycal (Caulk Co. U.S.A.), Cavitec (Kerr Co. U.S.A.), Calvital, Nobudyne and Neodyne (Neo Dental Chemical Products). For extirpation, the endodontic cavities were prepared on the lingual surfaces of anterior teeth, and the pulp tissues were extirpated as routine method. After enlarging, irrigation, and measuring of root length by taking X-ray, each root canal filling material was filled in the canal with gutta percha cone, and endodontic cavity was sealed with zinc oxide eugenol cement. Zinc oxide eugenol, $Ca(OH)_2$ (Eli Lilly Co. U.S.A.) and Vitapex (Neo Dental Chemical Products) were used as root canal filling materials. Animals were sacrificed after 1, 3 and 6 weeks following the operation. The teeth were decalcified in formic acid, sectioned and stained with hematoxylin eosin. Microscopic examination revealed as follows. 1. Dycal: The dentin bridge formation was observed at the 3rd week after pulpotomy. Inflammatory conditions which were infiltration of inflammatory cells and dilatation of blood vessels were kept in remaining pulp tissue at the 6th week. 2. Calvital: The dentin bridge was observed at the 1st week after pulpotomy. As the time clasped, the pulp tended to be the fibrous degeneration. 3. Cavitec, Nobudyne and Neodyne: In the case of Cavitec and Nobudyne, the incompleted and irregular dentin bridge was observed at the 6th week, and in Neodyne, was observed at the 3rd week. The severe inflammatory changes were seen in the remaining pulp tissue. As the time clasped, the fibrous degeneration tended to spread in the remaining pulp tissue. 4. $Ca(OH)_2$: Osteocementum was formed at the 3rd week, the matrix of cementum and dentin were resorted, and infiltration of lymphocytes was seen in periapical tissue when $Ca(OH)_2$ was used as canal-filling materials. S. ZOE and Vitapex The cementum like substance was seen in periapical portion at the 1st week, when ZOE and Vitapex were used as root canal filling materials. As the time elapsed, the matrix of cementum and dentin tended to be resorted. At the 6th week, the inflammatory condition of periapical tissue was continued in the case of ZOE, but was reduced in the case of Vitapex.
본 연구는 단면조사로 노인의 구강건강과 치매의 관계를 알아보고자 편의추출된 65세 이상 노인 197명을 대상으로 주관적 건강, 주관적 구강건강 및 관리, 핵심음식 저작능력, OHIP-14, KDSQ를 설문조사하고 구강검사를 실시하여 의치장착여부, 총 잔존치아수, 임플란트와 고정식보철물을 포함한 총 기능치아수를 조사하였다. 그 결과, KDSQ-C가 6점 이상인 치매검사 요구군에서 전신질환 유병률이 높았고, 주관적 건강상태에 부정적 응답 비율이 높았으며, 건강에 대한 염려가 많았고, KDSQ-V와 KDSQ-D도 유의하게 높았다. 정상군과 치매검사 요구군 간의 틀니장착자율, 총 잔존치아수, 총 기능치아수, 1일 칫솔질 횟수, 치아 통증 정도, 치주질환에 대한 주관적 증상정도, 주관적 구강건강상태, 주관적 구강건강염려의 차이는 없었다. 그러나, 치매검사 요구군이 주관적 치과치료 필요도가 높고 구강건강관련 삶의 질 제한정도가 높고 핵심음식 저작능력은 낮았으며 특히 딱딱한 음식군을 저작하기 어렵하고 하였다. KDSQ-C는 OHIP-14와 강한 양의 상관관계를 가지고 핵심음식 저작능력, 총 잔존치아수와는 약한 음의 관계를 가지고 있었다. 다중회귀분석에서는 KDSQ-D, KDSQ-V, OHIP-14 순으로 KDSQ-C에 영향을 미치는 것으로 나타났다. 따라서, 인지능력에 구강건강이 전신건강에 비해 미치는 영향력이 크지는 않지만 구강건강 또한 인지능력과 일부 관계할 수 있으며 인과관계를 분석하기 위해서는 더 정교한 역학연구가 필요할 것으로 제안한다.
In this in vitro study, confocal laser scanning microscopic morphology of dentin-resin interface and its relationship to shear bond strength were investigated after the exposed dentin surfaces were treated with 3 different kinds of dentin adhesive systems[three-step; Scotchbond Multi-Purpose Plus(SMPP), self-priming bonding resin; Single Bond(SB), self-etching primer; Clearfil Liner Bond 2(LB2)]. 52 extracted human molar teeth without caries and/or restorations. The experimental teeth were randomly divided into three groups of seventeen teeth each. In five teeth of each group, class V cavities(depth: 1.5mm) with 900 cavosurface angles were prepared at the cementoenamel junction on buccal and lingual surfaces. Bonding resins of each dentin adhesive system were mixed with rhodamine B. Primer of SMPP was mixed with fluorescein. In group 1. the exposed dentin was conditioned with etchant, applied with above primer and bonding resin of SMPP. In group 2, with etchant and self-priming bonding agent of SB. In group 3, with self-etching primer and bonding agent of LB2. After treatment with dentin adhesive systems, composite resin were applied and photocured. The experimental teeth were cut longitudinally through the center line of restoration and grounded so that about $90{\mu}m$-thick wafers of buccolingually orientated dentin were obtained. And, $70{\sim}80{\mu}m$-thick wafers sectioned horizontally, thus presenting a dentinal tubules at 900 to the cut surface of a remaining tooth, were obtained. Primer of SMPP mixed with rhodamine B was applied to these wafers. Confocal laser scanning microscopic investigations of these wafers were done within of 24 hours after treatment. To measure shear bond strength, the remaining twelve teeth of each group were grounded horizontally below the dentinoenamel junction, so that no enamel remained. After applying dentin adhesive systems on the dentin surface, composite was applied in the shape of cylinder. The cylinder was 5mm in diameter, and 2mm in thickness. Shear bond strength was measured using Instron with a cross-head speed of 0.5mm/min. It was concluded as follows ; 1. Hybrid layer of SMPP(mean: $4.56{\mu}m$) was thicker than that of any other groups. This value was not statistically significant thicker than that of SB(mean: $3.41{\mu}m$, p>0.05), and significant thicker than that of LB2(mean: $1.56{\mu}m$, p<0.05). There was a statistical difference between SB and LB2(p<0.05). 2. Although there were variations in the length of resin tag even in a sample, and in a group, most samples in SMPP and SB showed resin tags extending above $20{\mu}m$. But samples in LB2 showed resin tags of $10{\mu}m$ at best. 3. Besides primer's infiltration into demineralized peritubular dentin and dentinal tubules, fluorophore of primer was detected in the lateral branches of dentinal tubules. 4. All groups demonstrated statistically significant differences from one another(p<0.05), with shear bond strengths given in descending order as follows: SMPP(18.3MPa), SB(16.0MPa) and LB2(12.4MPa). 5. LB2 having thinnest hybrid layer($1.56{\mu}m$) showed the lowest shear bond strength(12.4MPa).
This study investigated the effects of laser irradiation on the exposed pulp and the possibility of direct pulp capping with the $CO_2$ laser. Results were obtained from the observation of the residual pulpal healing process. Class V cavities on 48 anterior teeth from 8 adult dogs were prepared and pulp chambers were intentionally opened with dental explorer. The control group consisted of 16 teeth. $Dycal^{(R)}$(Caulk Co., U.S.A.) was applied to exposed site once bleeding was stopped. Cavities were sealed with $I.R.M^{(R)}$. In the experimental group 1 (16 teeth), laser(LASERSAT $CO_2^{(R)}$, Satelec Co.) was irradiated on the exposed pulp. The laser procedure followed the manufacturers recommendations for the treatment of human pulp(1.5 Watts, 0.2 seconds, unfocused), and cavities were sealed with $I.R.M^{(R)}$. In the experimental group 2 (16 teeth), laser was irradiated on the exposed pulp in a more powerful dosage(5.0 Watts, 0.2 seconds, unfocused), and cavities were sealed with $I.R.M^{(R)}$. Two dogs were sacrificed immediately after experiment and the others were sacrificed at intervals of one, three, and eight weeks respectively. All teeth were routinely processed and the pulpal tissues and odontoblastic layers were observed by the light microscope. The results were as follows; 1. In the control group, the initial mild inflammation had improved to normal by week eight. An active formation of reparative dentin was observed at week three, and at week eight, a firm dentin bridge was present beneath the $Dycal^{(R)}$ with no inflammatory responses in the remaining pulp. 2. In the experimental group 1, immediately following irradiation, the superficial shape of the exposed pulp was crater-like. And it was lined with the coagulated layer, $60{\sim}70{\mu}m$ in width. Moderate inflammatory pulpal conditions existing at week one were improved to mild at week eight. And from the week three specimens, a reparative dentin formation was observed in the adjacent odontoblastic layer of the exposed site. A dentin bridge at the exposed site, however, did not form during the experimental period. 3. In the experimental group 2, the width of the coagulation layer lining the crater was $70{\sim}130{\mu}m$. Beneath the coagulated layer, severe inflammatory pulpal responses were observed at week one, and conditions did not improve during the experimental period.
Recent reports indicate that shorter etching times than 60 seconds can be adopted without affecting the bond strength and clinical disadvantages. The purpose of this in vitro study was to compare the shear bone strength and to measure depth of etch at different etching time length. One hundred and eight extracted bovine lower central incisors were embedded each in a tooth cup with cold-cure acrylic resin. The facial surfaces of the teeth were ground wet with 600-, 800-, 1000-, and 1200-grit Sic papers, and finally polished with a water slurry of extrafine silicon carbide powder, washed with tap water, and dried with hot air. Nine groups of nine prepared teeth were etched with a commercial($38\%$ phosphoric acid solution) for 0, 5, 10, 15, 20, 30, 60, 90, and 120 seconds, respectively, rinsed with tap water, and dried with hot air. One conditioned teeth from every group was selected randomly for the scanning electron microscopic examination, and the remaining eight teeth of the groups were used for measuring the push shear bond strength after bonding brackets and immensing them in the $36.5^{\circ}C$ water for 24 hours. Another nine groups of three teeth were used for measuring the depth of etch and surface roughness with a surface profilometer. after pieces of adhesive tape of 3mm inner diameter positioned on the ground enamel surfaces, and etched with the above mentioned. The data obtained form the above expeiments were analysed statistically with one way ANOVA and Dunkan's multiple range test with the $95\%$ confidence level. The results and conclusion of the study were as follows; 1. The results of shear bond strength for the given experimental etching times were not statistically different, but showed the tendency of decreasing shear bone strength after over 60 seconds etching times. 2. On the scanning election microscopic examination, it was observed that the morphological patterns of etched enamel surface for 5 to 20 seconds were similar and consitent, and those for 30 to 120 seconds showed increasing over-etched patterns depending on the length of etching times. 3. The depth of etch was increased almost proportionally by the length of etching times, but it was not associated with the shear bond strength. 4. The surface roughness increased depending on the length of etching times, but it was not associated with the shear bond strength. 5. This experiment indicated that proper etching time with $38\%$ phosphoric acid solution is in the range of 5 to 30 seconds.
The purpose of this study was to compare the adaptation to tooth structure of light - cured glass ionomer cement with that of self -cured glass ionomer cement. In this study, class V cavities were prepared on the buccal surfaces of 10 extracted human premolar teeth, and teeth were randomly assigned 2 groups of 5 teeth each. The cavities of self-curing glass ionomer cement group were restored with the Fuji n. and the cavities of lightcuring glass ionomer cement group were restored with the Fuji II LC. The surfaces of glass ionomer cements were applied with All-Bond 2 adhesive, and cured with visible light. The restored teeth were stored in 100% relative humidity at $37^{\circ}C$ for 24 hours. And then. the roots of the teeth were removed with the tapered fissure bur and the remaining crowns were sectioned occlusogingivally through the center of glass ionomer restorations. Adaptation at tooth-restoration interface was assessed occlusally. axially, and gingivally by scanning electron microscope. The results were as follows : 1. On the occlusal margin, the group of self - curing glass ionomer cement showed closer adaptation to both enamel and dentin than the group of light-curing glass ionomer cement showing 5/lm gap between cement and tooth structure. 2. On the axial wall. the group of light-curing glass ionomer cement showing 5-$7{\mu}m$ gap between cement and dentin showed closer adaptation to dentin than the group of self -curing glass ionomer cement showing 10-$15{\mu}m$ gap between cement and dentin. 3. On the gingival margin, the group of light-curing glass ionomer cement showing 2-$5{\mu}m$ gap between cement and dentin(X 1200) showed closer adaptation to dentin than the group of self-curing glass ionomer cement showing 20pm gap between cement and dentin(X 600). 4. The group of self -curing glass ionomer cement showed closer adaptation on the occlusal margin than on the gingival margin, and the group of light-curing glass ionomer cement showed similar adaptation on both occlusal and gingival margins.
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