• Restorative Dentistry and Endodontics
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• v.33 no.6
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• pp.507-517
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• 2008

There are considerable in vitro and in vivo evidences for remineralization and demineralization occurring simultaneously in incipient enamel caries. In order to "heal" the incipient dental caries, many experiments have been carried out to determine the optimal conditions for remineralization. It was shown that remineralization is affected by different pH, lactic acid concentrations, chemical composition of the enamel, fluoride concentrations, etc. Eighty specimens from sound permanent teeth without demineralization or cracks, 0.15 mm in thickness, were immersed in lactic acid buffered demineralization solutions for 3 days. Dental caries with a surface zone and subsurface lesion were artificially produced. Groups of 10 specimens were immersed for 10 or 12 days in lactic acid buffered remineralization solutions consisting of pH 4.3 or pH 6.0, and 100, 50, 25, or 10 mM lactic acid. After demineralization and remineralization, images were taken by polarizing microscopy (${\times}100$) and micro-computed tomography. The results were obtained by observing images of the specimens and the density of the caries lesions was determined. 1.As the lactic acid concentration of the remineralization solutions with pH 4.3 was higher, the surface zone of the carious enamel increased and an isotropic zone of the subsurface lesion was found. However, the total decalcification depth increased at the same time. 2.In the remineralization solutions with pH 6.0, only the surface zone increased slightly but there was no significant change in the total decalcification depth and subsurface zone. In the lactic acid buffer solutions with the lower pH and higher lactic acid concentration, there were dynamic changes at the deep area of the dental carious lesion.

• Restorative Dentistry and Endodontics
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• v.32 no.2
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• pp.151-161
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• 2007

Dental caries is the most common disease in the oral cavity However, the mechanism and treatment of dental caries is not completely understood since many complex factors are involved. Especially the effect of pH on remineralization of early stage of dental caries is still controversial In this study, dental caries in dentin was induced by using lactic acidulated buffering solutions and the loss or inorganic substance was measured. Also decalcified specimens were remineralized by three groups of solution with different pH (group of pH 4.3, 5.0, and 5.5). Then, the amount and the area of inorganic substance precipitation was quantitatively analyzed with microradiograph. Also a qualitative comparison of the normal phase the demineralized phase, and the remineralized phase of hydroxyapatite crystal was made under SEM. The results were as follows, 1. In microradiograghic analysis, as the pH increased, the amount of remineralization in decalcified dentin tended to increase significantly As the pH decreaced, deeper decalcification, however, occurred along with remineralization. The group of pH 5.5 had a tendency to be remineralized without demineralization (p<0.05). 2. In SEM view, the remineralization in dentine caries occurred from the hydroxyapatite crystal surface surrounding the mesh of organic matrix, and eventually filled up the demineralized area. 3. 5 days after remineralization, hydroxyapatite crystal grew bigger with deposition of inorganic substance in pH 4.3 and 5.0 group, and the crystal in the remineralized area appeared to return to normal. After 10 days, the crystals in group of pH 4.3 and 5.0, which grew bigger after 5 days of remineralization, turned back to their normal size, but in group of pH 5.5, some crystals were found to double their size. In according to the results of this experiment, the decalcifying and remineralizing process of dentine is neither simple nor independent, but a dynamic process in which decalcification and remineralization occur simultaneously. The remineralization process occurred from the hydroxyapatite crystal surface.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.2
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• pp.207-220
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• 2006

The newly developed equipments for the early detection of carious lesion are LFD (laser fluorescence device), Ultrasonic diagnostic system, CLSM(confocal laser scanning microscopy), QLF(quantitative light-induced fluorescence) and DIFOTI (digital imaging fiber-optic trans-illumination) system. In this study, DIFOTI system and LFD were used for the detection of early enamel caries. Twenty five primary teeth extracted from twenty one children at around the dentitional exchanging period were selected as samples. The results obtained from DIFOTI imaging and LFD measurement were compared with those of CLSM and comprehensive evaluations were made for the diagnostic capacity of each device. In vitro test, 40 sample teeth with their buccal & lingual surface formed by a window of $2{\times}3mm$ in diameter were immersed in artificial demineralizing solution for the period of 4, 8, 12 and 16 days. The results obtained from the experimental groups (DIFOTI, LFD) were compared to control group (CLSM) and we have reached to the following conclusions. 1. The sensitivity and specificity of DIFOTI system operated in oral environment was 88.2% and 76.9% respectively. 2. The sensitivity and specificity of LFD measured in oral environment was 76.5% and 69.2% respectively. 3, Regression analysis on the light transparent rate of DIFOTI showed its decrease according to the length of primary enamel decalcification performed in vitro(r=-0.96, p<0.05). 4. No statistically significant difference between LFT measurement and the length of in vitro decalcification was found in regression analysis (p>0.05). 5. The correlation coefficient of DIFOTI image transparent rate and the lesion depth of CLMS was -0.6988 (p<0.05), whereas no statistically significant difference was found for LFD measurement.

• Restorative Dentistry and Endodontics
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• v.27 no.4
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• pp.432-440
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• 2002

The purpose of this study is to identificate root canal system including ideal access placement, root curvature, canal configuration, incidence of isthmus in mandibular incisors for success of endodontic treatment. 200 mandibular incisors were selected. The ideal access placement was determimed as follows. The teeth there radiographed from mesiodistal and buccolingual views using intraoral dental film. The image was divided into coronal, middle and apical third using the proximal film. Straight line access was determined by measuring the faciolingual canal width and placing points at midway point between the buccal and lingual wall at the junction of the middle and apical third and at the juntion of coronal and middle third of the root canal. A line was drawn connecting these two points extending through the crown of the tooth. The point at which the line crossed the external crown surface was recorded as facial, incisal, lingual. Degree of root curvature was determined by Schneider Protractor Method. Both section method and clearing method were used in this study. By section method, 100 mandibular incisors were embedded in clear resin and transeverse serial sectioned at 0.5, 1.0, 2.0, 3.0, 4.0, 5.0mm level from root apex. The resected surfaces were stained by methylene blue and examined under $\times$40 magnification with a stereomicroscope. By clearing method, 100 mandibular incisors were cleared in methysalicylate after decalcification with 10% nitric acid and evaluated under $\times$18 magnification with a stereomicroscope. The results were as follows ; 1. 29% had the center of the plotted straight-line access facial to incisal edge, whereas 71% had straight-line access at the incisal edge. When incisal wear classified as extensive, the straight-line access was plotted on the incisal edge 95.5%. When incisal wear classified as slight/none, the straight-line access was plotted on the facial 65.9%. 2. Degree of curvature of main canal was straight or almost straight, and only 10% in buccolingual direction had a degree of curvature greater than 20 degrees and 5.5% in mesiodistal direction had. 3. In section method, canal configuration analysis showed that 51% of the specimen classified as type I, 27% as type II, 12% as type III, 10% as type IV. For theses setions with two canals, the incidence of an isthmus was 36.7%, 64.3%, 79.2%, 96.3%, 97.4%, 97.6% at each level and highest in 3~5mm sections. 4. In clearing method, canal configuration analysis showed that 74% of the specimen classified as type I, 11% as type II, 6% as type III, 9% as type IV. These results suggested that traditional access from lingual should be moved as far toward the incisal as possible to locate and debride the lingual canal and root canal system should be cleaned, shaped completely and obturated three dimensionally for successful endodontic treatment.

• The korean journal of orthodontics
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• v.35 no.1 s.108
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• pp.51-59
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• 2005

The aim of this study was to compare the species and biotypes of mutans streptococci isolated from dental plaques sampled from the interfaces between the bracket aid tooth surface and smooth tooth surfaces In orthodontic patients. Dental plaque was collected from the interfaces between brackets aid teeth (test group), and from smooth tooth surfaces distant from brackets by more that 2mm (control group). The dental plaque collected by a sterilized curette was transferred into a vial of 1 X PBS. The sample in the vial was vigorously vortexed for 1 min and plated ou mitis-salivarius bacitracin (MSB) agar plate using cotton tips. The agar plates were incubated at $37^[\circ}C$ in a candle jar for 2 days, and again incubated for 1 more day at anambient temperature Individual colonies were cultured in TH broth at $37^[\circ}C\;CO_2$ incubator. The PCR-RFLP based on dextranase gene was performed for the identification of mutans streptococci at the species-level For biotyping of mutans streptococci, biochemical tests were performed There was no significant difference of the species of mutans streptococci isolated from both test and control groups However, the biotypes of the mutans streptococci isolated from test and control groups were different. These results may offer the basic data to verify the relationship between the mutans streptococci biotype and enamel decalcification or dental caries in orthodontic patients with fixed appliances.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.4
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• pp.403-411
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• 2010

This study is about the treatment effect of fluoride varnish on white lesion. The changes in microhardness values and lesion sizes were compared and analyzed in relation to application interval, frequency, etc. Resin blocks were fabricated with the crown portion of permanent molars. Samples were classified into group I(1 week), group II(2 weeks) and group III(3 weeks) based on fluoride application intervals, each with 15 samples. Samples were soaked into a decalcifying solution for 15 days, and stored in artificial saliva at $37^{\circ}C$ thermostat. The changes in microhardness values and lesion sizes, before/after decalcification and after fluoride application, were evaluated. The following results were obtained. 1. Microhardness values in group II and III exhibited almost twice the increasing rate than group I. There were significant differences between group I and II, and group I and III (p<0.05), but none between group II and III (p>0.05). 2. Change in lesion sizes showed no significant differences between group I and II, III (p>0.05). In conclusion, fluoride varnish application results in both qualitative and quantitative improvements in white lesions. The satisfactory results can be obtained when varnish is applied at more than 2 weeks interval.

• The korean journal of orthodontics
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• v.39 no.2
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• pp.105-111
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• 2009

Objective: To estimate the effects of bracket material type on enamel decalcification during orthodontic treatment, this study analyzed the adhesion level of mutans streptococci (MS) to orthodontic bracket materials in vivo. Methods: Three different types of orthodontic bracket materials were used: stainless steel, monocrystalline sapphire, and polycrystalline alumina. A balanced complete block design was used to exclude the effect of positional variation of bracket materials in the oral cavity. Three types of plastic individual trays were made and one subject placed the tray in the mouth for 12 hours. Then, the attached bacteria were isolated and incubated on a mitis salivarius media containing bacitracin for 48 hours. Finally, the number of colony forming units of MS was counted. The experiments were independently performed 5 times with each of the 3 trays, resulting in a total of 15 times. Mixed model ANOVA was used to compare the adhesion amount of MS. Results: There was no difference in colony forming units among the bracket materials irrespective of jaw and tooth position. Conclusions: This study suggested that the result of quantitative analysis of MS adhesion to various orthodontic bracket materials in vivo may differ from that of the condition in vitro.

• The Journal of the Korea Contents Association
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• v.10 no.11
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• pp.235-242
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• 2010

The purpose of this study was to evaluate tooth whitening and microhardness after treatments with tooth bleaching agents containing dicalcium phosphate dihydrate (DCPD) and 35% hydrogen peroxide (HP) which were used in-office bleaching. Thirty enamel specimens were obtained from human premolars and randomly divided into 3 groups(n=10). Tooth bleaching agents were prepared with DCPD (0 g for controls, 0.1 g and 1 g for experimental groups) and HP solution (35% HP). All groups were applied to enamel surfaces for 60 min for 1 day. The pH of each tooth bleaching agent was measured. Tooth color, microhardness of enamel surfaces were also measured. The tooth bleaching agents containing DCPD showed a significant increase in pH compared to the ones without DCPD(p<0.05). Paired t-tests showed significant difference in color values of enamel before and after bleaching in all the groups(p<0.05). As a result, changes in color, containing DCPD group does not contain a statistically significant difference between groups was observed.(p>0.05). In all groups, tooth hardness after bleaching showed a significant decrease in microhardness (p<0.05). However, the DCPD concentration increased in the bleaching, microhardness values slightly decreased. Based on the above results, tooth bleaching agents containing DCPD and 35%HP were equally effective. Due to increases in pH and effective reduction of tooth surface decalcification, the surface characteristics are exposed to a reduced degree of negative effects, resulting in fewer constituent enamel alterations. Thus, commercial availability of the constituents of tooth whitening materials can be achieved.

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.27-46
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• 1996

The purpose of this study was designed to compare with the effects of 4 different surface active bioceramics on the healing process of alveolar bone defects in dogs. Artificial alveolar bone defects depth 4-6mm, width 3-4mm) were created with # 6 round bur at interproximal areas of maxillary canine, maxillary 2nd premolar, mandibular canine, and mandibular 3rd premolar. porous hydroxyapatite(Interpore $200^R$) , 45S5 bioglass, CJ4/lOC crystalline glass, and JJ crystalline glass were implanted in intrabony defects randomly. Experimental groups were divided into 4 categories according to its implant material. After implantation, all groups were examined postoperatively 4 weeks to 12 weeks. 3 dogs was selected randomly and sacrificed after vascular perfusion with 2.5% glutaraldehyde at every 4 weeks. Tissue blocks with surroundig alveolar bone and soft tissues were removed and immersed in formaldehyde/glutaraldehyde fixative. After 20 weeks decalcification with EDTA and formic acid, sections were made and observed under light microscope and transmission electron microscope. In all experimental groups, the encapsulation of inactive connective tissue was observed around graft particles in 4 weeks. As time elapsed, the thickness of surrounding connective tissue was decreased. Osteoconductive bone growth pattern was seen apparently in all groups. CJ4/lOC crystalline glass showed the most active bone formation until 8 weeks. 45S5 bioglass was, however, the most active in new bone formation at 12 weeks. Though there was difference in resorption rate among grafting materials, the size of graft particles was decreased gradually. 45S5 bioglass was resorbed faster than the others. On the other hand, porous hydroxyapatite was degraded most slowly. Phagocytosed particulate matters was observed in the cytoplasm of multinuclear multinuclear giant cell and macrophage under transmission electron microscope. The results suggested suggested that 45S5 bioglass and CJ4/lOC crystalline glass may have some enhanced reparative potential when compared to porous hydroxapatite in the treatment of periodontal defeds. JJ crystalline glass reguires a further investigation of the safety of its use.

• Journal of the korean academy of Pediatric Dentistry
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• v.11 no.1
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• pp.169-179
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• 1984

The purpose of this study was to observe the effect of dental varnish applied with fluoride to dental pulp by comparing the groups of commercial fluoride product $Duraphat^{(R)}$, $Copalite^{(R)}$ after 1 Mole sodium fluoride application, Cavity $Sealer^{(R)}$ after 1 Mole sodium fluoride application with the control group not applied the dental varnish. After Cl V Cavity form was prepared on the buccal surface of the crowns with the total 75 teeth by using 5 dogs, average weight of 13.2Kg, dental varnish and silver analgram were placed. This study was performed by 3, 7, 21, 28, 56 days each. The dogs were sacrificed to extract the teeth, cut at the apical one fourth, and prepared histologic examination by fixing with 10% buffered formalin perfusion at sacrifice and decalcification in 10% nitric acid. The specimens were embedded in paraffin, stained with Hematoxylin and Eosin, and serially sectioned with 6 ${\mu}$width each. Microscopic evaluation of serial sections at the various time periods among the different groups revealed the following results: 1. In the control group, the marked change of the odontoblastic layer was showed on the 3 days group, and it was decreased gradually. Healing response, such as hyperplasia, was seen on the 28 days group and it was continued to the 56 days group. 2. In the experimental group with Cavity $Sealer,^{(R)}$ a slight hemorrhage was seen in the odontoblastic layer on the 3 days group, and the healing response with the hyperplasia of the odontoblast was showed on the 21, 28 days group. It was completely healed on the 56 days group. 3. In the Duraphat R group, a slight hemorrhage showed on the 3 days group and the disarrangement of the Odontoblastic layer was seen on the 7, 21, 28 days group. Odontoblasts showed hyperplasia on the 28 days group, and healed completely on the 56 days group. 4. In the $Copalite^{(R)}$ group, the 7 days group showed remarkable hemorrhage in the odontoblastic layer and stroma, and also it showed reticular degeneration with the disarrangement of the odontoblastic layer and congestion. Each group showed disarrangement. Healing ability of this group was greater than that of the control group, but less than that of the $Duraphat^{(R)}$ and Cavity $Sealer^{(R)}$ group.