The aims of the study were to evaluate the effect of epinephrine-containing local anesthetics on pulpal blood flow (PBF) and to investigate its effect on cavity preparation-induced PBF change. PBF was recorded using a laser Doppler flowmeter (Perimed Co., Sweden) from canines of nine cats under general anesthesia before and after injection of local anesthetics and after cavity preparation. 2% lidocaine hydrochloride with 1 : 100,000 epinephrine was administered by local infiltration given apical to the mandibular canine at the vestibular area and the same volume of isotonic saline was injected on the contralateral tooth as a control. A round carbide bur was operated at slow speed with isotonic saline flushing to grind spherical cavities with increasing depth through the enamel and into the dentin on both teeth. The obtained data was analyzed with paired t-test. Cavity preparation caused significant increase of PBF (n = 9, p < 0.05). Local infiltration of lidocaine with epinephrine resulted in decreases of PBF (n = 9, p < 0.05), whereas there was no significant change of PBF with the physiologic saline as a control. Cavity preparation on tooth anesthetized with lidocaine with epinephrine caused significantly less increase of PBF than in control tooth (p < 0.05). Therefore, the result of the present study demonstrates that local infiltration of 2% lidocaine with 1 : 100,000 epinephrine effectively reduces PBF increase caused by cavity preparation.
The purpose of this study was to compare the effects of preparation with GT files and profiles .04 in shaping of root canals and reconstruct the three-dimensional root canal system using micro computed tomography 40 canals of the extracted human mandibular molars were used, and randomly distributed into two experimental groups. In group 1. canals were prepared by GT files. In group 2, Profiles .04. were used. Apical preparation size was #30. For each tooth pre and post operative cross-sectional images were obtained by the micro CT at 50 micron intervals. Pre and post operative cross-sectional images of 1, 2, 3, 5, and 8mm from the apex were compared. For each section. canal area and centering ratio were determined. For each tooth pre- and post-operative root canal volume from the furcation to the apex of the roots was calculated by three-dimensional image software. Following results were obtained: 1. At 8mm from the apex, area of dentin removed by GT rotary file was significantly larger than that by Profile .04. And at the other levels there was not a significant difference. 2. There was a trend for GT rotary file to remain more centered in the canals than Profile .04 at all levels. But at 3mm level. there was a statistically significant difference. 3. In root canal volume increments after instrumentation, there was no significant difference between two groups.
An endodontically treated tooth is likely to be brittle than a vital tooth. Internal structure of the tooth has been weakened due to a significant removal of dentin by coronal access, canal preparation. There are many controversies concerning with various methods of reinforcing an intact anterior tooth that has endodontic treatment. In this experiment, 128 extracted maxillary anterior teeth were endodontically treated, and prepared with 4 methods of restorations; Composite resin filling with zinc phosphate cement, composite resin filling without zinc phosphate cement, composite resin filling with post, and metal crown with post. An Instron testing machine was used to measure the fracture loads of the specimens. The means of the failure loads for the 4 groups were compared by F-test statistically and the failure modes were observed. The results were as follows; 1. There were no statistically significant difference between the failure loads of the four methods of restoration. 2. Teeth without post were fractured in a horizontal or oblique plane through upper or middle third of the root. 3. In the posted teeth, fractures were occurred around the post. 4. In the metal crowned teeth with post, the fracture were occurred around the post or coronal area.
Apical surgery for a mandibular molar is still challenging for many reasons. This report describes the applications of computer-guided cortical 'bone-window technique' using piezoelectric saws that prevented any nerve damage in performing endodontic microsurgery of a mandibular molar. A 49-year-old woman presented with gumboil on tooth #36 (previously endodontically treated tooth) and was diagnosed with chronic apical abscess. Periapical lesions were confirmed using cone-beam computed tomography (CBCT). Endodontic microsurgery for the mesial and distal roots of tooth #36 was planned. Following the transfer of data of the CBCT images and the scanned cast to an implant surgical planning program, data from both devices were merged. A surgical stent was designed, on the superimposed three-dimensional model, to guide the preparation of a cortical window on the buccal side of tooth #36. Endodontic microsurgery was performed with a printed surgical template. Minimal osteotomy was required and preservation of the buccal cortical plate rendered this endodontic surgery less traumatic. No postoperative complications such as mental nerve damage were reported. Window technique guided by a computer-aided design/computer-aided manufacture based surgical template can be considerably useful in endodontic microsurgery in complicated cases.
Objective : The purpose of this study was to evaluate the dimensional errors between real tooth, 3D CT image and CARP model. Materials and Methods : Two maxilla and two mandible block bones with intact teeth were taken from two cadavers. Computed tomography was taken either in dry state and in wet state. After then, all teeth were extracted and the dimensions of the real teeth were measured using a digital caliper at mesio-distal and bucco-lingual width both in crown and cervical portion. 3D CT image was generated using the V-works $4.0^{TM}$ (Cybemed Inc., Seoul, Korea) software. Twelve teeth were randomly selected for CARP model fabrication. All the measurements of 3D Ct images and CARP models were made in the same manner of the real tooth group. Dimensional errors between real tooth, 3D CT image model and CARP model was calculated. Results : 1) Average of absolute error was 0.199 mm between real teeth and 3D CT image model, 0.169 mm between 3D CT image model and CARP model and 0.291 mm between real teeth and CARP model, respectively. 2) Average size of 3D CT image was smaller than real teeth by 0.149 mm and that of CARP model was smalier than 3D CT image model by 0.067mm. Conclusion : Within the scope of this study, CARP model with the 0.291 mm average of absolute eror can aid to enhance the success rate cf autogenous tooth transplantation due to the increased accuracy of recipient bone and donor tooth.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.37
no.5
/
pp.375-379
/
2011
Introduction: This study examined the effect of autogenous tooth bone used as a graft material for bone regeneration in an artificial bony defect of minipigs. Materials and Methods: Four healthy minipigs, weighing approximately 35-40 kg, were used. Four standardized artificial two-walled bony defects, 5 mm in length and depth, were made on the bilateral partial edentulous alveolar ridge on the mandible of minipigs, and autogenous tooth bone was augmented in the right side as the experimental group. On the other hand, only alloplastic bone graft material HA was grafted with the same size and manner in the left side as the control group. All minipigs were sacrificed at 4 weeks after a bone graft and evaluated histologically by Haematoxylin-eosin staining. The specimens were also evaluated semi-quantitatively via a histomorphometric study. The percentage of new bone over the total area was evaluated using digital software for an area calculation. Results: All specimens were available but one in the left side (control group) and two in the right side (experimental group) were missing during specimen preparation. The amount of bone formation and remodeling were higher in all experimental groups than the control. The mean percentage area for new bone in the experimental and control groups was $43.74{\pm}11.96%$ and $30.79{\pm}2.93%$, respectively. Conclusion: Autogenous tooth bone is a good alternative to autogenous bone with the possible clinical feasibility of an autogenous tooth bone graft in the reconstruction of bony defects.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.39
no.3
/
pp.120-126
/
2013
Objectives: This study sought to elucidate the effect of autogenous tooth bone material by experimenting on minipig's maxillary sinus and performing histological and histomorphometric analyses. Materials and Methods: Five 18-24 month-old male minipigs were selected, and right maxillary sinuses were grafted with bone graft material made of their respective autogenous teeth extracted eight weeks earlier. The left sides were grafted with synthetic hydroxyapatite as control groups. All minipigs were sacrificed at 12 weeks after bone graft, which was known to be 1 sigma (${\sigma}$) period for pigs. Specimens were evaluated histologically under a light microscope after haematoxylin-eosin staining followed by semi-quantitative study via histomorphometric analysis. The ratio of new bone to total area was evaluated using digital software for calculation of area. Results: All specimens were available, except one on the right side (experimental group), which was missing during specimen preparation. This study demonstrated new bone at the periphery of the existing bone in both groups, showing evidence of bone remodeling, however, encroachment of new bone on the central part of the graft at the 1 ${\sigma}$ period was observed only in the autogenous tooth bone group (experimental group). Histomorphometric analysis showed more new bone formation in the experimental group compared to the control group. Although the difference was not statistically significant (P>0.05), the mean percentage area for new bone for the experimental and control groups were $57.19%{\pm}11.16%$ and $34.07%{\pm}13.09%$, respectively. Conclusion: The novel bone graft material using autogenous tooth is a good alternative to autogenous bone, comparable to autogenous bone, and outperforming synthetic hydroxyapatite bone graft materials in terms of bone regeneration capacity. Augmentation with autogenous tooth bone materials will reduce donor site morbidity without hampering the safety of the autogenous bone graft.
Mitov, Gergo;Anastassova-Yoshida, Yana;Nothdurft, Frank Phillip;See, Constantin von;Pospiech, Peter
The Journal of Advanced Prosthodontics
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v.8
no.1
/
pp.30-36
/
2016
PURPOSE. The aim of this study was to evaluate the fracture resistance and fracture behavior of monolithic zirconia crowns in accordance with the preparation design and aging simulation method. MATERIALS AND METHODS. An upper first molar was prepared sequentially with three different preparation designs: shoulderless preparation, 0.4 mm chamfer and 0.8 mm chamfer preparation. For each preparation design, 30 monolithic zirconia crowns were fabricated. After cementation on Cr-Co alloy dies, the following artificial aging procedures were performed: (1) thermal cycling and mechanical loading (TCML): 5000 cycles of thermal cycling $5^{\circ}C-55^{\circ}C$ and chewing simulation (1,200,000 cycles, 50 N); (2) Low Temperature Degradation simulation (LTD): autoclave treatment at $137^{\circ}C$, 2 bar for 3 hours and chewing simulation; and (3) no pre-treatment (control group). After artificial aging, the crowns were loaded until fracture. RESULTS. The mean values of fracture resistance varied between 3414 N (LTD; 0.8 mm chamfer preparation) and 5712 N (control group; shoulderless preparation). Two-way ANOVA analysis showed a significantly higher fracture loads for the shoulderless preparation, whereas no difference was found between the chamfer preparations. In contrast to TCML, after LTD simulation the fracture strength of monolithic zirconia crowns decreased significantly. CONCLUSION. The monolithic crowns tested in this study showed generally high fracture load values. Preparation design and LTD simulation had a significant influence on the fracture strength of monolithic zirconia crowns.
Purpose: Tunneling is a periodontal surgical procedure that creates access for patient cleansing and maintenance within the furcal area of a molar tooth with severe furcation involvement. Up to date, there are few studies about a long term clinical and radiographic stability of tunneling. The purpose of this retrospective study is to evaluate the long term prognosis after tunnel preparation of molars with through and through furcation. Material and Methods: 25 teeth of 23 patients aged 36 to 70 (mean age 51.7) were treated surgically with tunnel preparation. These cases were followed for 2 to 13 years (mean 6.5years) after surgery. Patients were recalled for an evaluation which was based on a questionnaire, a clinical examination, and radiographic analysis. Clinical assessment included plaque index, caries registration, probing pocket depth, bleeding on probing, tooth mobility. Baseline and over 2-year follow-up radiographs were collected and evaluated for this study. Result: 3 teeth(12%) had been extracted and 1 tooth(4%) hemisected. Root caries was detected in 3 teeth(12%). Thus 72% of the teeth were still caries tree and in function. Clinical parameters including PI, PD, BOP, mobility showed somewhat favourable results. Radiographic furcal bone loss showed no statistically significant difference compared to interproximal crestal bone loss ($3.59{\pm}1.69%$ vs $3.42{\pm}2.95%$) when root length was used as reference. There was no correlation between root trunk length and furcal bone loss. Conclusion: Over 2 years after tunneling procedure, teeth showed a clinically and radiographically stable condition, despite of slight root caries and alveolar bone loss within clinically acceptable range. The tunnel procedure may be considered as a viable periodontal treatment option for molar teeth with severe furcation involvement in individuals following a regular maintenance program.
Objectives: To determine the incidence of crack formation and propagation in apical root dentin after retreatment procedures performed using ProTaper Universal Retreatment (PTR), Mtwo-R, ProTaper Next (PTN), and Twisted File Adaptive (TFA) systems. Materials and Methods: The study consisted of 120 extracted mandibular premolars. One millimeter from the apex of each tooth was ground perpendicular to the long axis of the tooth, and the apical surface was polished. Twenty teeth served as the negative control group. One hundred teeth were prepared, obturated, and then divided into 5 retreatment groups. The retreatment procedures were performed using the following files: PTR, Mtwo-R, PTN, TFA, and hand files. After filling material removal, apical enlargement was done using apical size 0.50 mm ProTaper Universal (PTU), Mtwo, PTN, TFA, and hand files. Digital images of the apical root surfaces were recorded before preparation, after preparation, after obturation, after filling removal, and after apical enlargement using a stereomicroscope. The images were then inspected for the presence of new apical cracks and crack propagation. Data were analyzed with ${\chi}^2$ tests using SPSS 21.0 software. Results: New cracks and crack propagation occurred in all the experimental groups during the retreatment process. Nickel-titanium rotary file systems caused significantly more apical crack formation and propagation than the hand files. The PTU system caused significantly more apical cracks than the other groups after the apical enlargement stage. Conclusions: This study showed that retreatment procedures and apical enlargement after the use of retreatment files can cause crack formation and propagation in apical dentin.
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