• Restorative Dentistry and Endodontics
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• v.20 no.2
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• pp.627-643
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• 1995

The resistance to fracture of the restored tooth may be influenced by many factors, among these are the cavity dimension and the physical properties of the restorative material. The placement of direct composite resin restorations has generally been found to have a strengthening effect on the prepared teeth. It is the purpose of this investigation to study the relationship between the cavity isthmus and the fracture resistance of a tooth in composite resin restorations. In this study, MO cavity was prepared on the maxillary left first molar and then filled with composite resin. Three dimentional model with 3049 nodes and 2450 8-node blick elements was made by the serial photographic method and isthmus (1/4, 1/3, 1/2 and 2/3 of intercusplal distance between mesiobuccal cusp tip and mesiolingual cusp tip) was varied. Two types of model(B and R model) were developed. B model was assumed perfect bonding between the restoration and cavity wall and R model was left unfilled. A load of 1500N was applied vertically on the node from the lingual slope of the mesiobuccal cusp. The results were as follows : 1. There was a significant decrease of stress resulting in increase of fracture resistance in B model when compared with R model. 2. When it comes to stress distribution, the stress was concentrated in the facio-gingival line angle and the buccal side of the distal margin of the cavity in both Band R model. 3. With the increase of the isthmus width, the stress decreased in the area of the facio-gingival line angle, and increased in the area of facio-gingival line angle as well as the buccal side of the distal margin of the cavity in B model. In R model, the stress increased both in the area of facio-gingival line angle and the buccal side of the distal margin of the cavity, therefore the possibility of crack increased. 4. As the width of cavity increased, in B model, the direction of crack moved from horizontal to vertical on the facio-gingival line angle and the facio-pulpal line angle. In R model, the direction of the crack was horizontal on the facio-gingival line angle and moved from horizontal to the $45^{\circ}$ direction on the facio-pulpal line angle.

• Restorative Dentistry and Endodontics
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• v.21 no.2
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• pp.619-627
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• 1996

There are increasing use of composite resin in the posterior teeth and the new indirect inlay technique was introduced for compensating much troubles faced in direct technique. Many researchers insisted that overall properties of restorative materials were enhanced by an additional curing but this technique still has a problems about using cement material. Resin inlay obtains retention force from friction and another adhesion to tooth structure. A shape of cavity preparation was noted but studies about cement thickness and bond strength with cavity divergency are rare. The purpose of this study is to assess the effect of cavity divergency on cement thickness and bond strength of resin inlay. Cavities, which divergency was $6^{\circ}$, $16^{\circ}$, and $26^{\circ}$ in each group, were prepared and their divergency was verified by Adobe Photoshop program through the image capture with stereo microscope and FlexCam. Inlays were fixed into the cavities with a resin cement, Superbond and were handled under chemical (in 75% ethanol for 24 hrs.) and thermal stress (500 cycles from $5^{\circ}$ to $55^{\circ}C$). MXT 70 (x400) was used for measuring the cement thickness and bond strength was evaluated with a universal testing machine. Following results were obtained : 1. The cement thickness in Mean (S.D.) were; 35.58 (10.31)${\mu}m$ in $6^{\circ}$ group, 35.97 (10.49)${\mu}m$ in $16^{\circ}$ group, and 41.43 (9.33)${\mu}m$ in $26^{\circ}$ group. But there was no significant difference between groups. 2. The bond strength in Mean (S.D.) were ; 33.18 (5.53)kg in $6^{\circ}$ group, 23.47 (13.40)kg in $16^{\circ}$ group, and 19.75 (10.48)kg in $26^{\circ}$ group. $6^{\circ}$ group showed significantly higher value compared to $16^{\circ}$ and $26^{\circ}$ groups (p<0.05). Although the results of this study indicate $6^{\circ}$ divergency will be good for resin inlay, cavity preparation with this type will have lots of difficulties in manufacturing, try-in, and cementation procedures, such as deformation. So it is concluded that $16^{\circ}$ divergent cavity preparation is recommended in resin inlay technique.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.3
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• pp.169-175
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• 2016

Purpose: Direct splinting material should have high flexural strength to withstand force during mastication and low modulus of elasticity to provide some movement while force applied for relief of stress. The purpose of this study was to compare flexural strength and modulus of elasticity of several resinous splinting materials. Materials and Methods: Four materials; Super-Bond C&B, G-FIX, G-aenial Universal Flo, FiltekTM Z350 XT; were used in this study. Fifteen rectangular bar specimens of each material were prepared. Three-point bending test were performed to determine physical properties. Maximum load at fracture was recorded and flexural strength and modulus of elasticity were calculated. One-way analysis of variance (ANOVA) and Scheffe's tests at a 0.05 level of significance were conducted on all test results. Results: Statistical analysis reveals that Super-Bond C&B had significant low mean value for flexible strength and the other three materials showed no significant difference. For modulus of elasticity, Super-Bond C&B exhibited statistically lower modulus of elasticity. G-FIX presented intermediate result, showing statistically higher modulus of elasticity than Super-Bond C&B but lower than G-aenial Universal Flo and FiltekTM Z350 XT. There was no significant difference on modulus of elasticity between G-aenial Universal Flo and FiltekTM Z350 XT. Conclusion: Using a G-FIX, the newly commercially available splinting material, which shows higher fracture resistance properties comparable to flowable and restorative composite resin and a relatively flexible nature might be a beneficial for stabilizing teeth mobility.

• Restorative Dentistry and Endodontics
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• v.34 no.4
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• pp.371-376
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• 2009

We evaluated in vitro microleakage of Mineral Trioxide Aggregate (MTA) powder with 4-methacryloxyethyl trimellitate anhydride (4-META) / methyl methacrylate (MMA) & tri-n-butylborane (TBB) resin as a retrograde filling material by using methylene blue dye method. Fifty-two single rooted, extracted teeth were instrumented and obturated with gutta percha and AH plus sealer. The apical 3mm of each root was resected and 3mm deep ultrasonic root end preparation was done. External surface of roots was coated with nail varnish. Prepared teeth were randomly divided into five groups; Negative control: completely covered with nail varnish; Positive control: coated with nail varnish except for apical foramen; Group 1 (retrofilled with Portland cement); Group 2 (retrofilled with MTA); Group 3 (retrofilled with MTA powder mixed with 4-META/MMA & TBB resin). Immediately after completion of root-end filling, all specimens were submerged in methylene blue dye for 72 hours in $37^{\circ}C$incubator. The roots were longitudinally sectioned and measured for extent of dye penetration by three different examiners under microscope (${\times}$10). The results were statistically analyzed using one way ANOVA and Turkey's HSD test. No leakage was evident in negative control and complete leakage in positive control group. Group 3 showed significantly less leakage than group 1 and 2 (p < 0.01). There was no significant difference between group 1 and 2 (p > 0.01). It was concluded that MTA powder with 4-META/MMA & TBB resin was excellent in reducing initial apical microleakage.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.3
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• pp.257-265
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• 2009

Statement of problem & Purpose: To study the effect of different fluoridation methods after in-office bleaching on the color of teeth during severe staining with coffee. Material and methods: 44 specimens were randomly divided into four groups. Group 1 (no bleaching, no fluoride, coffee) was served as control for the influence of coffee on the color of untreated teeth. Group 2, 3 and 4 were undergone bleaching with 35% $H_2O_2$ for 30 minutes a day on 3 consecutive days. Group 2 was remained without fluoridation. Group 3 and 4 were fluoridated for 1 hour with either Cavity shield$^{(R)}$ or pH 7 Gel$^{(R)}$. All of groups were immersed in coffee solution for 7 days. Color determination was accomplished using the spectrophotometer (VITA Easyshade$^{(R)}$). Results: ${\Delta}L$ and ${\Delta}h$ increased, whereas ${\Delta}C$ decreased in the bleached groups. Pairwise comparisons with Tukey's HSD showed that there were statistically significant differences for ${\Delta}L$ and ${\Delta}h$ between the bleached groups and the non-bleached group (P < .05). ${\Delta}L$ and ${\Delta}h$ decreased continuously, while ${\Delta}C$ showed an increase after a decrease in all of groups during immersion in coffee solution. After immersion in coffee solution for 7 days there were no statistically significant differences for ${\Delta}L$, ${\Delta}C$ and ${\Delta}h$ between the groups (P > .05). Also there were no statistically significant differences for ${\Delta}L$, ${\Delta}C$ and ${\Delta}h$ between the group 3 treated with Cavity shield. and the group 4 treated with pH 7 Gel. (P > .05). Conclusion: It was concluded that fluoridation was not beneficial to the prevention of extrinsic stains after bleaching.

• Restorative Dentistry and Endodontics
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• v.38 no.1
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• pp.11-20
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• 2013

Objectives: In most retrospective studies, the clinical performance of restorations had not been considered in survival analysis. This study investigated the effect of including the clinically unacceptable cases according to modified United States Public Health Service (USPHS) criteria into the failed data on the survival analysis of direct restorations as to the longevity and prognostic variables. Materials and Methods: Nine hundred and sixty-seven direct restorations were evaluated. The data of 204 retreated restorations were collected from the records, and clinical performance of 763 restorations in function was evaluated according to modified USPHS criteria by two observers. The longevity and prognostic variables of the restorations were compared with a factor of involving clinically unacceptable cases into the failures using Kaplan-Meier survival analysis and Cox proportional hazard model. Results: The median survival times of amalgam, composite resin and glass ionomer were 11.8, 11.0 and 6.8 years, respectively. Glass ionomer showed significantly lower longevity than composite resin and amalgam. When clinically unacceptable restorations were included into the failure, the median survival times of them decreased to 8.9, 9.7 and 6.4 years, respectively. Conclusions: After considering the clinical performance, composite resin was the only material that showed a difference in the longevity (p < 0.05) and the significantly higher relative risk of student group than professor group disappeared in operator groups. Even in the design of retrospective study, clinical evaluation needs to be included.

• Restorative Dentistry and Endodontics
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• v.39 no.2
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• pp.137-142
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• 2014

This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.

• Restorative Dentistry and Endodontics
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• v.44 no.4
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• pp.39.1-39.8
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• 2019

The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.

• The Journal of the Korean dental association
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• v.58 no.11
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• pp.683-689
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• 2020

Dentin surface of non-carious lesion is usually attached with oral biofilm. The biofilm should be removed before application of restorative material, because it may reduce the bond strength of adhesive system. The aim of this study was to evaluate the microtensile bond strength, when the biofilm was removed with brush or bur. Twenty extracted human third molars were sectioned horizontally to obtain dentin surface. Specimen were divided randomly into four group. Biofilm formation was performed in three group, except for Group 1 (negative control). Biofilm was removed as follows: Group 3, using ICB brush; Group 4, using lowspeed round bur #2. Group 2 (positive control) was not removed Biofilm. And in all four groups, the adhesive system (Optibond FL, Kerr) was applied to etched dentin surface, and resin composite was built up in three 1mm increments. After 24 hour storage in distilled water, the teeth were perpendicularly sectioned to obtain beams (1 × 1 mm2). Microtensile bond strength was measured and the data were statistically analyzed using one-way ANOVA and Tukey's post hoc test (p<0.05). Group 4 showed the highest microtensile bond strength (p<0.05), Group 3 showed no significant improvements when compared to Group 1. Group 2 showed lowest microtensile bond strength (p<0.05). When restoring a non-carious cervical lesion, it is essential to remove the biofilm present on the dentin surface. In addition, in the method of removing the biofilm, both the brush removal method and the bur removal method were effective.

• Restorative Dentistry and Endodontics
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• v.42 no.4
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• pp.332-341
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• 2017

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.