Effects of dentin bonding agents and silanization on bond strength between 3D printed resin and composite resin.

This study aimed to evaluate the effects of dentin bonding agents and silanization on the bond strength between 3D printed resin and composite resin and compare it with a conventional composite resin. 3D printed resin cylinders (PCB) and composite resin substrates (Z250) were prepared and divided into eight subgroups based on the bonding agents used (n=12). The shear bond strength was measured using a universal testing machine, and the failure modes were evaluated. The bond strength was found to vary significantly among the bonding agents and substrate types. Silane application did not significantly improve the bond strength. Among the bonding agents, the universal adhesives exhibited the highest bond strengths for both substrates. Compared to PCB, Z250 demonstrated stronger bonds and exhibited more cohesive failures. Further research is needed to optimize the surface treatments and resin formulations for enhanced bond strength and durability between 3D printed and composite resins.

Antimicrobial activity and biocompatibility of the mixture of mineral trioxide aggregate and nitric oxide-releasing compound.

BACKGROUND/PURPOSE: Antimicrobial activity and biocompatibility of root canal sealer are related to the success of endodontic treatments. This study investigated the efficacy of mixture of mineral trioxide aggregate (MTA) and a NO-releasing compound for the antimicrobial activity, biocompatibility, and physical properties. MATERIALS AND METHODS: MTA was mixed with diethylenetriamine-NO (MTA-NO), and the extracts from MTA and the MTA-NO mixture before and after setting was obtained were investigated the antimicrobial activity against Enterococcus faecalis and Porphyromonas endodontalis. After setting MTA and MTA-NO, pulp cell was incubated in the presence of MTA and MTA-NO disk using Transwell® cell culture insert, and the proliferation assay and mineralization-stimulated factors of the cells were analyzed by MTT assay and real-time RT-PCR, respectively. The physical properties of MTA and the MTA-NO mixture, such as surface hardness and flowability was also analyzed. RESULTS: The MTA-NO mixture showed stronger antimicrobial activity against E. faecalis and P. endodontalis than that by MTA. Both MTA and MTA-NO mixture increase the ratio of cell proliferation and induced the expression of alkaline phosphatase, collagen type I, osteocalcin, and osteopontin. Moreover, the induction of gene expression by MTA-NO mixture was higher than that by MTA alone. No significant difference was observed for surface hardness and flowability between MTA and MTA-NO mixture. CONCLUSION: The addition of a NO-releasing compound to the endodontic treatment using MTA root canal sealer might reduce the risk of bacterial infection and help to regenerate the dental pulp tissue.

3-D finite element analysis of the effects of post location and loading location on stress distribution in root canals of the mandibular 1st molar.

Objective The purpose of this study was to evaluate, by using finite element analysis, the influence of post location and occlusal loading location on the stress distribution pattern inside the root canals of the mandibular 1st molar. Material and Methods Three different 3-D models of the mandibular 1st molar were established: no post (NP) - a model of endodontic and prosthodontic treatments; mesiobuccal post (MP) - a model of endodontic and prosthodontic treatments with a post in the mesiobuccal canal; and distal post (DP) - a model of endodontic and prosthodontic treatments with a post in the distal canal. A vertical force of 300 N, perpendicular to the occlusal plane, was applied to one of five 1 mm2 areas on the occlusal surface; mesial marginal ridge, distal marginal ridge, mesiobuccal cusp, distobuccal cusp, and central fossa. Finite element analysis was used to calculate the equivalent von Mises stresses on each root canal. Results The DP model showed similar maximum stress values to the NP model, while the MP model showed markedly greater maximum stress values. The post procedure increased stress concentration inside the canals, although this was significantly affected by the site of the force. Conclusions In the mandibular 1st molar, the distal canal is the better place to insert the post than the mesiobuccal canal. However, if insertion into the mesiobuccal canal is unavoidable, there should be consideration on the occlusal contact, making central fossa and distal marginal ridge the main functioning areas.

Comparison of antimicrobial activity of traditional and new developed root sealers against pathogens related root canal.

BACKGROUND/PURPOSE: Bacterial infection is closely associated with the failure of endodontic treatment, and use of endodontic sealer with antimicrobial activity and biological compatibility is necessary for the success of root canal treatment. The purpose of this study was to investigate and to compare the antibacterial effect of two calcium silicate-based root canal sealers (Endoseal and EndoSequence BC sealer) as recent development sealers and with three conventional root canal sealers (AH Plus, Sealapex, and Tubli-Seal), before or after setting, on Porphyromonas endodontalis, Porphyromonas gingivalis, and Enterococcus faecalis. MATERIALS AND METHODS: The sealers were soaked in phosphate buffered saline to elute its compositions after and before setting, and the elutes were performed the antimicrobial assay. Also, X-ray fluorescence analysis was carried out to compare compositions of two calcium silicate-based sealers. RESULTS: The conventional root canal sealers have strong antibacterial activity against the Gram-negative bacteria, P. endodontalis and P. gingivalis. Endoseal sealer showed antibacterial activity against not only the Gram-negative bacteria, but also against the Gram-positive bacteria, E. faecalis. However, Endosequence BC sealer exhibited a weak antibacterial effect on all bacteria in this study. X-ray fluorescence analysis exhibited that Endoseal contained more types and more amount of the oxide compound known to have strong antimicrobial activity such as Al2O3, Fe2O3, MgO, Na2O, NiO, and SO2 than Endoseqeunce BC. CONCLUSION: Endoseal, which contains various types of oxide compounds, seems to be a suitable sealer for preventing bacterial infection in both treated and untreated root canals.

3-D finite element analysis of the effects of post location and loading location on stress distribution in root canals of the mandibular 1st molar

Abstract Objective The purpose of this study was to evaluate, by using finite element analysis, the influence of post location and occlusal loading location on the stress distribution pattern inside the root canals of the mandibular 1st molar. Material and Methods Three different 3-D models of the mandibular 1st molar were established: no post (NP) - a model of endodontic and prosthodontic treatments; mesiobuccal post (MP) - a model of endodontic and prosthodontic treatments with a post in the mesiobuccal canal; and distal post (DP) - a model of endodontic and prosthodontic treatments with a post in the distal canal. A vertical force of 300 N, perpendicular to the occlusal plane, was applied to one of five 1 mm2 areas on the occlusal surface; mesial marginal ridge, distal marginal ridge, mesiobuccal cusp, distobuccal cusp, and central fossa. Finite element analysis was used to calculate the equivalent von Mises stresses on each root canal. Results The DP model showed similar maximum stress values to the NP model, while the MP model showed markedly greater maximum stress values. The post procedure increased stress concentration inside the canals, although this was significantly affected by the site of the force. Conclusions In the mandibular 1st molar, the distal canal is the better place to insert the post than the mesiobuccal canal. However, if insertion into the mesiobuccal canal is unavoidable, there should be consideration on the occlusal contact, making central fossa and distal marginal ridge the main functioning areas.

Corrigendum to "Biomechanical Evaluation of a Tooth Restored with High Performance Polymer PEKK Post-Core System: A 3D Finite Element Analysis".

[This corrects the article DOI: 10.1155/2017/1373127.].

Effects of desensitizing agents for cervical dentin hypersensitivity: A randomized clinical trial.

PURPOSE: To evaluate the clinical efficacy of five commercially available desensitizing agents with different mechanisms applied to hypersensitive teeth. METHODS: A randomized clinical trial was conducted on subjects suffering dentin hypersensitivity in Korea University Guro Hospital from October 2013 to April 2015. A total of 64 subjects met the selection criteria and were randomly assigned to five commercially available desensitizing agents, and applied according to the manufacturers' instructions. Before and after application of desensitizing agents, subjects were evaluated with the Visual Analogue Scale (VAS) at baseline, 1 week, 1 month and 3 months. The difference between the degree of reduction of hypersensitivity in relation to time were evaluated with the repeated-measures ANOVA (P<0.05). RESULTS: Practitioner and subject-measured VAS values at 1 week, 1 month and 3 months showed a significant difference in all products compared with the first visit. On the other hand, no statistically significant differences between the products was shown. Desensitizing agents used in this clinical trial relieved dentin hypersensitivity up to 3 months. CLINICAL SIGNIFICANCE: The five tested desensitizing agents with different mechanisms were clinically effective in relieving dentin hypersensitivity up to 3 months and showed statistically significant pain reduction when compared to baseline scores.

Pediatric fluoroquinolone prescription in South Korea before and after a regulatory intervention: A nationwide study, 2007-2015.

OBJECTIVE: To investigate the impact of national implementation of age restriction on fluoroquinolone prescription in children and adolescents. METHODS: Data collected from the database of Health Insurance Review and Assessment Service in South Korea, a national health insurance system to analyze fluoroquinolone prescribing practice in children and adolescents younger than 18 years, between 2007 and 2015. The age restriction was implemented in December 2009. The annual prescription rate of FQ per 100,000 person-years was calculated and an autoregressive model was used to predict the prescription pattern if an intervention had not occurred. RESULTS: A total of 505,859 children received systemic fluoroquinolone during the study period-297,054 ciprofloxacin, and 208,805 levofloxacin. After implementation of the drug utilization review program, the annual prescription rate for ciprofloxacin declined by 97.5% (from 840 to 21 per 100,000 person-years, P < 0.001), and for levofloxacin by 96.4% (from 598 to 11 per 100,000 person-years, P < 0.001). The decline was more dramatic in the outpatient setting than in the inpatient setting for both drugs. CONCLUSION: The dramatic and sustained decline in prescription number and change in prescription pattern after the regulatory action suggests that the implementation under drug utilization review program was successful in controlling excessive and inappropriate use of fluoroquinolones in children, possibly guiding towards more judicious and selective prescription behavior.

Biomechanical Evaluation of a Tooth Restored with High Performance Polymer PEKK Post-Core System: A 3D Finite Element Analysis.

The aim of this study was to evaluate the biomechanical behavior and long-term safety of high performance polymer PEKK as an intraradicular dental post-core material through comparative finite element analysis (FEA) with other conventional post-core materials. A 3D FEA model of a maxillary central incisor was constructed. A cyclic loading force of 50 N was applied at an angle of 45° to the longitudinal axis of the tooth at the palatal surface of the crown. For comparison with traditionally used post-core materials, three materials (gold, fiberglass, and PEKK) were simulated to determine their post-core properties. PEKK, with a lower elastic modulus than root dentin, showed comparably high failure resistance and a more favorable stress distribution than conventional post-core material. However, the PEKK post-core system showed a higher probability of debonding and crown failure under long-term cyclic loading than the metal or fiberglass post-core systems.

An in vitro evaluation of the antibacterial properties of three mineral trioxide aggregate (MTA) against five oral bacteria.

OBJECTIVE: The purpose of this study was to evaluate the antibacterial ability of three MTA (MTA-Angelus, Endocem MTA, and ProRoot MTA) against five typical oral bacteria (Streptococcus mutans, Enterococcus faecalis, Lactobacillus rhamnosus, Lactobacillus paracasei, and Porphyromonas gingivalis). DESIGN: For disc diffusion test, each test material was placed into agar plates after inoculation of each bacterial strain. The zones of inhibition of bacterial growth were then measured. Antibacterial broth test was performed by adding the test material into the media. Colony-forming units were counted after incubation with bacteria. The data were analyzed using ANOVA and the Tukey's test. RESULTS: Disc diffusion test showed that the antibacterial activity against S. mutans, L. rhamnosus, L. paracasei, and P. gingivalis ranked in decreasing order of MTA-Angelus>ProRoot MTA>Endocem MTA (p<0.05). An inhibitory effect against E. faecalis was only observed in Endocem MTA. Antibacterial broth test showed that the antibacterial activity against all bacteria was Endocem MTA>MTA-Angelus>ProRoot MTA (p<0.05). CONCLUSION: Discrepant results were obtained from the disc diffusion and antibacterial broth test, with MTA-Angelus and Endocem MTA being most effective, respectively. Both tests revealed that the most resistant bacteria was E. faecalis, which was not susceptible at all, except to Endocem MTA in disc diffusion test.

In vitro microleakage of six different dental materials as intraorifice barriers in endodontically treated teeth.

The aim of this study was to compare the coronal sealing ability of six different dental materials: Three MTA-based cements and three established restorative materials by in vitro dye penetration method. For in vitro infiltration experiments, seventy extracted single-rooted human teeth were used. After crowns of teeth were reduced, root canals were prepared, and filled with gutta-percha cone. Teeth were randomly divided into 6 groups with 10 teeth per group. The orifice of each tooth was prepared to 3 mm depth and filled with the following materials: (I) ProRoot WMTA; (II) EndoCem Zr; (III) Angelus White; (IV) LuxaCore; (V) Fuji II LC; and (VI) Elite. After 5,000 cycles of thermocycling between 5°C and 55°C, dye penetration of each specimen was measured. The order of less dye infiltration of coronal filling materials was: ProRoot WMTA

Effect of mineral trioxide aggregate surface treatments on morphology and bond strength to composite resin.

INTRODUCTION: The aim of this study was to evaluate the micromorphologic changes that accompany different surface treatments on mineral trioxide aggregate (MTA) and their effect on the bond strength to the composite resin with 4 adhesive systems. METHODS: Three types of MTA cement, ProRoot MTA (WMTA) (Dentsply, Tulsa, OK), MTA Angelus (AMTA) (Angelus, Londrina, PR, Brazil), and Endocem MTA (EMTA) (Maruchi, Wonju, Korea), were prepared and stored for a week to encourage setting. Surface treatment was performed using phosphoric acid or self-etch primer, and an untreated MTA surface was prepared as a control. The surface changes were observed using scanning electron microscopy. MTA surfaces were bonded with 4 adhesive systems, including Scotchbond Multipurpose (3M ESPE, St Paul, MN), Single Bond 2 (3M ESPE), Clearfil SE BOND (Kuraray, Osaka, Japan), and AdheSE One F (Ivoclar Vivadent, Schaan, Liechtenstein), to evaluate the adhesive effectiveness of MTA followed by composite resin restoration. The shear bond strength of the polymerized specimens was tested. RESULTS: For WMTA and AMTA, untreated surfaces showed an irregular crystalline plate with clusters of globular aggregate particles. For EMTA, the untreated surface presented a reticular matrix with acicular crystals. After surface treatment, superficial crystalline structures were eroded regardless of the MTA cement and adhesive system used. WMTA bonded significantly more strongly than AMTA and EMTA, regardless of the adhesive system used. In the WMTA and AMTA groups, AdheSE One F showed the highest bond strength to the composite. For EMTA, no significant differences were found across adhesive systems. CONCLUSIONS: Acidic treatment of the MTA surface affected the micromorphology and the bond strength to the composite. Within the limitations of this study, using a 1-step self-etch adhesive system might result in a strong bond to WMTA when the composite resin restoration is required over MTA cement.

Cytotoxicity of a novel mineral trioxide aggregate-based root canal sealer [corrected].

The objective of this study was to assess the cytotoxicity of EndoSeal, a novel mineral trioxide aggregate-based root canal sealer in comparison with two commonly used sealers, AH Plus and Sealapex. For cytotoxicity assay, MG-63 cells and human gingival fibroblasts were incubated in culture medium containing eluates of each sealer at 1, 3, and 7 days. Cell metabolism was evaluated by the WST-1 assay. For cell adhesion assay, disc specimens were fabricated from EndoSeal and AH Plus. MG-63 cells and human gingival fibroblasts were seeded on the discs, and after 1 day and 7 days of incubation, cell morphology and cell adhesion were examined by SEM. The order of cytotoxicity of root canal sealers was as follows: EndoSeal < AH Plus < Sealapex. Both types of cells seeded on the EndoSeal specimens were much larger, flat with rough margins compared to those on the AH Plus specimens. These results suggest that EndoSeal has a satisfactory cytocompatibility.

Management of horizontal root fractures by fabrication of canine protected occlusion using composite resin.

Traumatic injuries of the face often involve root fractures especially in anterior teeth. The prognosis and the treatment of the root fracture depend on the extent of the fracture line, general health and patient compliance. This case report outlines a new conservative trial treatment modality to stabilize the maxillary central incisors with horizontal root fracture on the cervical to middle third by fabricating canine guidance to remove loading on the traumatized maxillary central incisors during eccentric movements and thus inducing spontaneous healing of the fractured line between the fragments. Radiographs after thirty months showed adequate healing with no signs of pathological changes including root resorption, ankylosis or displacement. Long term follow-up revealed that vitality, stability and aesthetics were maintained and the patient was satisfied with the outcome.