Chairside computer-aided design/computer-aided manufacturing (CAD/ CAM)-based restoration of anterior teeth with customized shade and surface characterization: a report of 2 cases

Over the last 30 years, the use of chairside computer-aided design (CAD) and computer-aided manufacturing (CAM) systems has evolved and has become increasingly popular in dentistry. Although CAD/CAM restorations have been used in the anterior dentition, satisfying the esthetic requirements of clinicians and patients, where the restorations are limited to the chairside, remains a challenge. To reproduce multi-shades of CAD/CAM restorations in the clinic, a preliminary experiment to express several shades on A2 lithium disilicate (LS2) blocks using a staining kit was performed. After measurement of the CIE L*a*b* value of specimens, it was compared with that of the commercial shade guide. This report presents two cases with individual customization of shade and surface characterization of the CAD/CAM restorations using predictable methods based on the preliminary experimental data. The anatomical shape of restoration was obtained from ‘copy and paste technique’ and ‘mirror image acquisition technique’. All treatment procedures and fabrication of restorations performed in this report were executed in the clinic itself.

Correlation between clinical clerkship achievement and objective structured clinical examination (OSCE) scores of graduating dental students on conservative dentistry

OBJECTIVES: This study aimed to investigate the effect of clinical clerkship-associated achievements, such as performance of procedures at the student clinic, observation, and attitude towards a clerkship, on the objective structured clinical examination (OSCE) scores of dental students graduating in restorative dentistry. MATERIALS AND METHODS: The OSCEs consisted of two stations designed to assess students' clinical skills regarding cavity preparation for a class II gold inlay and a class IV composite restoration. The clerkship achievements, consisting of the number of student clinical procedures performed, observation-related OSCE, and scores of their attitudes towards a conservative dentistry clerkship, were assessed. Correlation and multiple regression analyses were conducted. RESULTS: The correlation coefficient between the OSCE scores for cavity preparation for a class II gold restoration and clerkship attitude scores was 0.241 (p < 0.05). Regarding a class IV composite restoration, OSCE scores showed statistically significant correlations with the observation (r = 0.344, p < 0.01) and attitude (r = 0.303, p < 0.01) scores. In a multiple regression analysis, attitudes towards a clerkship (p = 0.033) was associated with the cavity preparation for a class II gold inlay OSCE scores, while the number of procedure observations (p = 0.002) was associated with the class IV composite restoration OSCE scores. CONCLUSIONS: The number of clinical procedures performed by students, which is an important requirement for graduation, showed no correlation with either of the OSCEs scores.

Use of temporary filling material for index fabrication in Class IV resin composite restoration

When a patient with a fractured anterior tooth visits the clinic, clinician has to restore the tooth esthetically and quickly. For esthetic resin restoration, clinician can use 'Natural Layering technique' and an index for palatal wall may be needed. In this case report, we introduce pre-restoration index technique on a Class IV defect, in which a temporary filling material is used for easy restoration. Chair-side index fabrication for Class IV restoration is convenient and makes a single-visit treatment possible.

The effect of tumor necrosis factor (TNF)-alpha to induce matrix metalloproteinase (MMPs) from the human dental pulp, gingival, and periodontal ligament cells / 대한치과보존학회지

OBJECTIVES: In the present study, three kinds of tissues cells (pulp, gingiva, and periodontal ligament) were investigated if those cells express MMP and TIMP when they were stimulated with neuropeptides (substance P, CGRP) or proinflammatory cytokine, TNF-alpha. MATERIALS AND METHODS: The cells cultured from human dental pulp (PF), gingiva (GF) and periodontal ligament were (PDLF) stimulated with Mock, SP, TNF-alpha, and CGRP for 24 hrs and 48 hrs. for an RNase protection assay and Enzyme Linked Immunosorbent Assay. Cells (PF, GF and PDLF) seeded in 100 mm culture dish were stimulated with SP (10(-5), 10(-8) M) or only with medium (Mock stimulation) for 4hrs and for 24 hrs for RNase Protection Assay, and they were stimulated with CGRP (10(-5) M) and TNF-alpha (2 ng/mL) for 24 hrs and with various concentraion of TNF-alpha (2, 10, and 100 ng/mL) for Rnase Protection Assay with a human MMP-1 probe set including MMP 1, 2, 8, 7, 8, 9, 12, and TIMP 2, 3. In addition, cells (PF, GF and PDLF) were stimulated with Mock and various concentraion of TNF-alpha(2, 10, and 100 ng/mL) for 24 hrs and with TNF-alpha(10 ng/mL) for 48 hrs, and the supernatents from the cells were collected for Enzyme Linked Immunosorbent Assay (ELISA) for MMP-1 and MMP-13. RESULTS: The expression of MMPs in PF, GF, PDLF after stimulation with SP and CGRP were not changed compared with Mock stimulation for 4 hrs and 24 hrs. The expression of MMP-1, -12, -13 24 hrs after stimulation with TNF-alpha were upregulated, however the expression of TIMP-3 in PF, GF, PDLF after stimulation with TNF-alpha were downregulated. TNF-alpha (2 ng/mL, 10 ng/mL, 100 ng/mL) increased MMP-1 and MMP-12 expression in PF dose dependently for 24 hrs. CONCLUSIONS: TNF-alpha in the area of inflammation may play an important role in regulating the remodeling of dentin, cementum, and alveolar bone.

Optical characteristics of resin composite before and after polymerization / 대한치과보존학회지

OBJECTIVES: The aim of this study was to evaluate the optical characteristics such as color and translucency changes before and after light curing, to quantify the CQ and to measure refractive indices of body and opaque shade of resin composites materials. MATERIALS AND METHODS: Resin composites used in this study were A2 body and A2 opaque shade of Esthet-X, Filtek supreme, Gradia Direct, Clearfil Majesty and Beautifil?? Color and translucency changes before and after light curing were evaluated by colorimeter, the CQ was quantified by GC-MS and refractive index changes were measured by spectroscopic ellipsometer. RESULTS: Translucency parameter (TP) was significantly increased after curing. The CQ content of body shades are higher than that of opaque shades in all resin composites. Refractive index increased after polymerization in all materials and significant difference in Deltarefractive index was found between body and opaque shade (significance level 0.05). CONCLUSIONS: For an accurate shade match, direct shade matching of resin composite should be performed by using the cured material.

The effect of the removal of chondroitin sulfate on bond strength of dentin adhesives and collagen architecture / 대한치과보존학회지

Proteoglycan is highly hydrophilic and negatively charged which enable them attract the water. The objective of study was to investigate the effects of Proteoglycan on microtensile bond strength of dentin adhesives and on architecture of dentin collagen matrix of acid etched dentin by removing the chondroitin sulphate attached on Proteoglycan. A flat dentin surface in mid-coronal portion of tooth was prepared. After acid etching, half of the specimens were immersed in 0.1 U/mL chondroitinase ABC (C-ABC) for 48 h at 37degrees C, while the other half were stored in distilled water. Specimens were bonded with the dentin adhesive using three different bonding techniques (wet, dry and re-wet) followed by microtensile bond strength test. SEM examination was done with debonded specimen, resin-dentin interface and acid-etched dentin surface with/without C-ABC treatment. For the subgroups using wet-bonding or dry-bonding technique, microtensile bond strength showed no significant difference after C-ABC treatment (p > 0.05). Nevertheless, the subgroup using rewetting technique after air dry in the Single Bond 2 group demonstrated a significant decrease of microtensile bond strength after C-ABC treatment. Collagen architecture is loosely packed and some fibrils are aggregated together and relatively collapsed compared with normal acid-etched wet dentin after C-ABC treatment. Further studies are necessary for the contribution to the collagen architecture of noncollagenous protein under the various clinical situations and several dentin conditioners and are also needed about long-term effect on bond strength of dentin adhesive.

The study of fractural behavior of repaired composite / 대한치과보존학회지

OBJECTIVES: This study evaluated microtensile bond strength (microTBS) and short-rod fracture toughness to explain fractural behavior of repaired composite restorations according to different surface treatments. MATERIALS AND METHODS: Thirty composite blocks for microTBS test and sixty short-rod specimens for fracture toughness test were fabricated and were allocated to 3 groups according to the combination of surface treatment (none-treated, sand blasting, bur roughening). Each group was repaired immediately and 2 weeks later. Twenty-four hours later from repair, microTBS and fracture toughness test were conducted. Mean values analyzed with two-way ANOVA / Tukey's B test (alpha = 0.05) and correlation analysis was done between microTBS and fracture toughness. FE-SEM was employed on fractured surface to examine the crack propagation. RESULTS: The fresh composite resin showed higher microTBS than the aged composite resin (p < 0.001). Mechanically treated groups showed higher bond strength than non-mechanically treated groups except none-treated fresh group in microTBS (p < 0.05). The fracture toughness value of mechanically treated surface was higher than that of non-mechanically treated surface (p < 0.05). There was no correlation between fracture toughness and microtensile bond strength values. Specimens having high KIC showed toughening mechanism including crack deviation, microcracks and crack bridging in FE-SEM. CONCLUSIONS: Surface treatment by mechanical interlock is more important for effective composite repair, and the fracture toughness test could be used as an appropriate tool to examine the fractural behavior of the repaired composite with microtensile bond strength.

The effect of solvent evaporation of dentin adhesive on bonding efficacy / 대한치과보존학회지

OBJECTIVES: The purpose of this study is to evaluate bonding efficacy by means of measuring the effect of remained solvent on Degree of conversion(DC) and microTBS and FE-SEM examination. MATERIALS AND METHODS: Two 2-step total etching adhesives and two single-step self etching adhesives were used in this study. First, volume weight loss of 4 dentin adhesives were measured using weighting machine in process of time in normal conditions and calculate degree of evaporation (DE). Reaction/reference intensity ratio were measured using micro-Raman spectroscopy and calculate DC according to DE. Then 2 experimental groups were prepared according to air-drying methods (under, over) and control group was prepared to manufacturer's instruction. Total 12 groups were evaluated by means of micro tensile bond strength and FE-SEM examination. RESULTS: Degree of evaporation (DE) was increased as time elapsed but different features were observed according to the kind of solvents. Acetone based adhesive showed higher DE than ethanol and butanol based adhesive. Degree of conversion (DC) was increased according to DE except for S3 bond. In microTBS evaluation, bond strength was increased by additional air-drying. Large gaps and droplets were observed in acetone based adhesives by FE-SEM pictures. CONCLUSIONS: Additional air-drying is recommended for single-step self etching adhesive but careful consideration is required for 2-step total etching adhesive because of oxygen inhibition layer. Evaporation method is carefully chose and applied according to the solvent type.

A comparison of the shaping ability of four rotary nickel-titanium files in simulated root canals / 대한치과보존학회지

The purpose of this study was to compare the root canal shaping ability of 4 rotary NiTi instruments in simulated root canals. For the preparation of thirty two curved root canals, Mtwo instruments using "single length"technique, and Profile, ProTaper Universal, and K3 using crown-down technique (N = 8) were used. All canal samples were prepared by reaching an apical canal size of #30. Pre- and post-instrumentation digital images were recorded and an assessment of canal shape was determined using a computer image analysis program SigmaScan Pro (Systat Software Inc., San Jose, CA, USA). The changes of the dimension of inner walls of canals, (2) the changes of the dimension of outer walls of canals, and (3) the centering ratio were measured at 7 measuring points, and then data were statistically analyzed using one-way ANOVA and Duncan's test. The results were as below; 1. The root canal shaping ability of Profile was significantly faster than that of other rotary NiTi instruments (p < 0.05). 2. The deformation and fracture of all instruments used for this study were not experienced. 3. In the degree of changes of the dimension of inner walls of canals, Profile demonstrated the lowest changes of the dimension of inner walls of canals except at the measuring points of the 1 and 2 mm (p < 0.05). However, the ProTaper Universal showed the highest changes of the dimension of inner walls of canals at all measuring points (p < 0.05). 4. In the degree of changes of the dimension of outer walls of canals, Mtwo demonstrated the lowest changse of the dimension of outer walls of canals except at the measuring point of the 1 mm (p < 0.05). However, Profile exhibited the highest changes of the dimension of outer walls of canals at the measuring points of 3 and 4 mm and ProTaper Universal and K3 showed the largest changes of the dimension of outer walls of canals at the measuring points of 1, 2, 6, and 7 mm (p < 0.05). 5. In degree of centering ratio, Profile demonstrated the least centering ratio comparing with the centering ratio shown by other NiTi instruments at the measuring points of 1, 4, 5, and 6 mm. Results suggest that in the coronal part of canal preparation, active cutting files such as ProTaper Universal may efficiently flare the canal orifice and form a better taper, and in the apical part of the canal, files which have a better centering ability such as Profile may maintain the original canal curvature and reduce the shaping time.

Gene expression of human coronary artery endothelial cells in response to Porphyromonas endodontalis invasion / 대한치과보존학회지

During the last two decades, there has been an increasing interest in the impact of oral health on atherosclerosis and subsequent cardiovascular disease (CVD). To date, some periodontal pathogens including Porphyromonas gingivalis (P. gingivalis) have been reported to be relevant to CVD. Porphyromonas endodontalis (P. endodontalis), which shares approximately 87% sequence homology with P. gingivalis, is mostly found within infected root canals. However, recent studies reveal that this pathogen also resides in the dental plaque or periodontal pocket in patients with periodontitis. It has been shown that P. endodontalis invades human coronary artery endothelial cells (HCAEC) and coronary artery smooth muscle cells (CASMC). To evaluate whether P. endodontalis can participate in the progression of atherosclerosis and CVD, we examined the changes in transcriptional gene expression profiles of HCAEC responding to invasion by P. endodontalis in this study. The following results were obtained. 1. Porphyromonas endodontalis was invasive of HCAEC. 2. According to the microarray analysis, there were 625 genes upregulated more than two-folds, while there were 154 genes downregulated by half. 3. Upregulated genes were relevant to inflammatory cytokines, apoptosis, coagulation and immune response. Enhanced expression of MMP-1 was also noticeable. 4. The transcription profiles of the 10 selected genes examined by real-time PCR agreed well with those observed in the microarray analysis. Thus, these results show that P. endodontalis presents the potential to trigger and augment atherosclerosis leading to CVD.

Effect of chlorhexidine on microtensile bond strength of dentin bonding systems / 대한치과보존학회지

The purpose of this study was to evaluate the effect of chlorhexidine (CHX) on microtensile bond strength (microTBS) of dentin bonding systems. Dentin collagenolytic and gelatinolytic activities can be suppressed by protease inhibitors, indicating that MMPs (Matrix metalloproteinases) inhibition could be beneficial in the preservation of hybrid layers. Chlorhexidine (CHX) is known as an inhibitor of MMPs activity in vitro. The experiment was proceeded as follows: At first, flat occlusal surfaces were prepared on mid-coronal dentin of extracted third molars. GI (Glass Ionomer) group was treated with dentin conditioner, and then, applied with 2% CHX. Both SM (Scotchbond Multipurpose) and SB (Single Bond) group were applied with CHX after acid-etched with 37% phosphoric acid. TS (Clearfil Tri-S) group was applied with CHX, and then, with adhesives. Hybrid composite Z-250 and resin-modified glass ionomer Fuji-II LC was built up on experimental dentin surfaces. Half of them were subjected to 10,000 thermocycle, while the others were tested immediately. With the resulting data, statistically two-way ANOVA was performed to assess the microTBS before and after thermocycling and the effect of CHX. All statistical tests were carried out at the 95% level of confidence. The failure mode of the testing samples was observed under a scanning electron microscopy (SEM). Within limited results, the results of this study were as follows; 1. In all experimental groups applied with 2% chlorhexidine, the microtensile bond strength increased, and thermocycling decreased the microtensile bond strength (P > 0.05). 2. Compared to the thermocycling groups without chlorhexidine, those with both thermocycling and chlorhexidine showed higher microtensile bond strength, and there was significant difference especially in GI and TS groups. 3. SEM analysis of failure mode distribution revealed the adhesive failure at hybrid layer in most of the specimen, and the shift of the failure site from bottom to top of the hybrid layer with chlorhexidine groups. 2% chlorhexidine application after acid-etching proved to preserve the durability of the hybrid layer and microtensile bond strength of dentin bonding systems.

The effect of reinforcing methods on fracture strength of composite inlay bridge / 대한치과보존학회지

The purpose of this study is to evaluate the effects of surface treatment and composition of reinforcement material on fracture strength of fiber reinforced composite inlay bridges. The materials used for this study were I-beam, U-beam TESCERA ATL system and ONE STEP(Bisco, IL, USA). Two kinds of surface treatments were used; the silane and the sandblast. The specimens were divided into 11 groups through the composition of reinforcing materials and the surface treatments. On the dentiform, supposing the missing of Maxillary second pre-molar and indirect composite inlay bridge cavities on adjacent first pre-molar disto-occlusal cavity, first molar mesio-occlusal cavity was prepared with conventional high-speed inlay bur.The reinforcing materials were placed on the proximal box space and build up the composite inlay bridge consequently. After the curing, specimen was set on the testing die with ZPC. Flexural force was applied with universal testing machine (EZ-tester; Shimadzu, Japan). at a cross-head speed of 1 mm/min until initial crack occurred. The data wasanalyzed using one-way ANOVA/Scheffes' post-hoc test at 95% significance level. Groups using I-beam showed the highest fracture strengths (p 0.05). Most of the specimens in groups that used reinforcing material showed delamination. 1. The use of I-beam represented highest fracture strengths (p 0.05). 3. The reinforcing materials affect the fracture strength and pattern of composites inlay bridge. 4. The holes at the U-beam did not increase the fracture strength of composites inlay bridge.

Effect of intermediate resin hydrophilicity on bond strength of single step adhesive / 대한치과보존학회지

The purpose of this study was to evaluate the bond strength of a new Single step system with different curing mode composites, and to evaluate the effect of the intermediate resins which have different hydrophilicity on bonding ability by means of the micro shear bond testing and TEM examination for the adhesive interface. The adhesive used in this study was an experimental single step system (Bisco Inc., Schaumburg, IL). Experimental groups were produced by using six kinds of intermediate resin having different hydrophilicity that was hydrophilic, hydrophobic and most hydrophobic resin and as filled or not after applying adhesive. Each experimental group was further divided into two subgroups whether the adhesive was light cured or not. Dual cured composite (Bis Core, Bisco Ltd., Schaumburg, IL) was placed on the adhesive layer as light cure or self cure mode. The results of bond strength were statistically analyzed using one way ANOVA and multiple comparisons are made using Tukey's test at alpha < 0.05 level. The results of this study were as follows; 1. The application of intermediate resin did not increase the bond strength for light cured composite. 2. The bond strength of an experimental adhesive with self cured composite was significantly increased by the application of intermediate resin layer. 3. The bond strength of adhesive was irrespective of the cure or not of itself before intermediate resin layer applied. 4. As applied hydrophilic resin layer was, the initial bond strength was higher than both hydrophobic and most hydrophobic one used but there was no significance. Using a single step adhesive with dual/self cured composite, the incompatibility between both of them should be solved by the application of intermediate hydrophobic resin to reduce the adhesive permeability. However, Single step adhesive can be used in the light cured composite restoration without any decrease of the initial bond strength.

The bonding durability of resin cements / 대한치과보존학회지

The objectives of this study was to evaluate the durability of 4 resin cements by means of microtensile bond strength test combined with thermocycling method and fractographic FE-SEM analysis. Experimental groups were prepared according to thermocycling (0, 1,000, 5,000) and the kind of resin cements, those were Variolink II, Multilink, Panavia F 2.0, Rely X Unicem. Flat dentin surfaces were created on mid-coronal dentin of extracted third molars. Then fresh dentin surface was grounded with 320-grit silicon carbide abrasive papers to create uniform smear layers. Indirect composite block (Tescera, Bisco Inc., Schaumburg, IL, USA) was fabricated (12 x 12 x 6 mm3). It's surface for bonding to tooth was grounded with silicon carbide abrasive papers from 180- to 600-grit serially, then sandblasted with 20 - 50 microm alumina oxide. According to each manufacturer's instruction, dentin surface was treated and indirect composite block was luted on it using each resin cement. For Rely X Unicem, dentin surface was not treated. The bonded tooth-resin block were stored in distilled water at 37degrees C for 24 hours. After thermocycling, the bonded tooth-resin block was sectioned occluso-gingivally to 1.0 mm thick serial slabs using an Isomet slow-speed saw (Isomet, Buehler Ltd, Lake Bluff, IL, USA). These sectioned slabs were further sectioned to 1.0 x 1.0 mm2 composite-dentin beams. The specimens were tested with universal testing machine (EZ-Test, Shimadzu, Japan) at a crosshead speed of 1.0 mm/min with maximum load of 500 N. The data was analyzed using one-way ANOVA and Duncan's multiple comparison test at p 0.05). 4. Adhesive based-resin cements showed lower bond strength with or without thermocycling than composite based-resin cements. 5. Variolink II & Multilink showed high bond strength and mixed failure, which was occurred with a thin layer of luting resin cement before thermocycling and gradually increased adhesive failure along the dentin surface after thermocycling. The bonding performance of resin cement can be affected by application procedure and chemical composition. Composite based-resin cement showed higher bond strength and durability than adhesive based-resin cement.

The effect of neuropeptides on secretion of Interleukin-8 (IL-8) / 대한치과보존학회지

We investigated the secretion of Interleukin-8 (IL-8) from ginviva and periodontal ligament stimulated with Substance P (SP) and Calcitonin Gene-related Peptide (CGRP). Gingiva (GF), periodontal ligament (PDLF) and pulp (PF) tissues were collected from extracted intact 3rd molars. Cultured cells were stimulated with different concentrations of SP for 4 hrs, and stimulated with SP, CGRP and Tumor Necrosis Factor-alpha (TNF-alpha) for 8 hrs. Then RNase Protection Assay was carried out. ELISA was performed using supernatants of stimulated cells for quantitative analysis of IL-8. Results were assessed using student t-test with significance of P < 0.05. According to this study, the results were as follows: 1. IL-8 mRNA was detected in all type of cells studied (PF, GF and PDLF). 2. IL-8 mRNA expression was not increased after stimulating 4 hrs with SP (10(-5)M) and SP (10(-8)M) compared with Mock stimulation in all type of cells studied. 3. IL-8 mRNA expression was not increased after stimulating 8 hrs with SP (10(-4)M) and CGRP (10(-6)M) compared with Mock stimulation in all type of cells studied. 4. TNF-alpha(2 ng/ml) increased the expression of IL-8 mRNA in all kind of cells studied. 5. The secretion of IL-8 from GF was increased 8 hrs after the stimulation with CGRP (10(-6)M) (p < 0.05). 6. The secretion of IL-8 from PDLF was increased 8 hrs after the stimulation with SP (10(-4)M) (p < 0.05). Calcitonin Gene-related Peptide (CGRP) increased Interleukin-8 (IL-8) which plays an important role in chemotaxis of neutrophil in Calcitonin Gene-related Peptide (CGRP) gingival tissue, whereas Substance P increased the secretion of IL-8 from periodontal ligament.

Replacement of posterior restorations / 대한치과보존학회지

This article complies a survey on the replacement of the posterior restorations and accesses possible factors that influence the replacement of posterior restorations. The data was collected from patients that visited department of conservative dentistry from Dec 1st 2003, to Sep 3rd 2004. Teeth was restricted to posterior permanent teeth. 9 dentists recorded age, gender of patients, tooth location, cavity form and restorative material. They rated marginal adaptation, anatomic form, secondary caries of old restoration by modified Ryge criteria system. The statistical analysis was performed with Chi square test (p < 0.05) for replacement ratio according to patients, tooth factor and One-way ANOVA was performed for comparison of old restoration according to restorative material. The results were as follows; 1. The female (62%) was statistically higher ratio than the male (38%). 2. The distribution of replacement case according to age, the rate of replacement was in descending order, 20's (38.3%), 40's (16.8%), 30's (15.9%), 10's (11.1%), 50's (9.2%), 60's (8.7%). 3. The rate of replacement was 88% for molar and 12% for premolar (p < 0.05). 4. The rate of replacement was 39% for maxillar and 61% for mandible (p < 0.05). 5. The material of restorations was amalgam (69%), gold inlay (17%), composite resin (13%). 6. In rating system by modified Ryge criteria system on margin adaptation, there was statistically significant difference between amalgam and gold inlay. But on anatomic form and caries, there was no statistically significant difference among the material of restorations.

Dynamic Changes of MRI Findings after Seizures / 대한간질학회지

INTRODUCTION: Magnetic resonance imaging has demonstrated reversible peri-ictal MRI changes suggestive of hemodynamic changes or cytotoxic edema. We were to investigate the dynamic peri-ictal MRI changes in patients with seizures. METHODS: We retrospectively reviewed the medical records, electroencephalography, and initial and follow-up MRI of 5 patients with single seizure or status epilepticus. We analyzed the patterns and locations of MRI abnormalities and their relationship with characteristics of seizures. RESULTS: Two patients with complex partial seizures (CPS) and versive or unilateral tonic seizures showed high signal changes in frontal cortex on T2-weighted (T2WI), fluid attenuated inversion recovery (FLAIR) and DWI. Three patients had MRI changes in mesial temporal structures including hippocampus after single generalized tonic-clinic seizure without encephalitic features clinically. One patient had multiple signal abnormalities in the left temporo-parietal, mesial temporal, insular cortices and thalamus on T2WI and FLAIR after frequent CPS. All of the lesions disappeared or resolved partially on the follow-up MRI. CONCLUSION: Our results showed that variable MRI changes in peri-ictal phase are possible at cortical as well as at subcortical areas. The dynamic MRI changes can be associated even in patients with single clinical seizure, suggesting that these changes are not related to the seizure frequency.

The Clinical Characteristics and the Prognosis of Poststroke Seizures after Ischemic Cerebral Infarction / 대한간질학회지

BACKGROUND: Although stroke is one of the most frequent causes of seizures in adulthood, there has been constant controversy concerning risk factors and prognosis of poststroke seizures. This study was performed to investigate clinical manifestations, risk factors and prognosis in patients with poststroke seizures (PSS). METHODS: A total of 2048 patients with cerebral infarction were recruited for this study. Patients with PSS were reviewed retrospectively regarding stroke subtype, etiology, lesion location, and functional disability of the stroke as well as seizure types, treatment and recurrence rate. Patients with traumatic or hemorrhagic brain lesion or a history of previous seizures were excluded. RESULTS: PSS developed in 4.2% of ischemic stroke patients (85/2048; 46 men and 39 women, mean age 65.4 years). PSS developed within one week of stroke onset in 18.8% (16/85) whereas after one week in 81.2% (69/85). PSS was more common in patients with cortical lesions than subcortical lesions (15.1% and 0.8%; p=0.076). Status epilepticus more frequently manifested in early onset seizures compared to late onset seizures (31.3% and 10.1%; p=0.029). Seizure recurrence was observed in 44.3% of PSS patients, mostly due to poor compliance to treatment or due to inadequate drug treatment. Only 7.1% of PSS patients were drug resistant and all of these patients had late onset seizures. CONCLUSION: Seizures after ischemic infarction developed more commonly after one week of stroke onset, and in patients with cortical lesions. Seizure recurrence occurred in about half of the patients, and the rate of drug resistance was higher in late onset seizures.

The effect of environment on the physical properties of core materials / 대한치과보존학회지

The purpose of this study was to measure the flexural strength and hardness of four core materials in 4 different medias and to evaluate the relationship between the physical properties. For the flexural strength, the specimens were prepared from each of the following materials: Bisfil Core, Core Max, Fuji IX GP, Miracle Mix and randomly divided into four groups and stored at 37 degree C in the following medias: distilled water for 24 hours (DW/1), distilled water for 30 days (DW/30). 2% NaF for 30 days (NF/30), 0.02N lactic acid for 30 days (LA/30). After storage, the specimens were subjected to flexural strength testing and calculated to flexural modulus. For hardness testing, specimens were prepared from four materials and storaged in the uniform way. After storage, the specimens were subjected to Vicker's hardness testing. 1. The flexural strength of Core Max were the highest, and the flexural strength of Miracle Mix were the lowest. 2. The hardness of Bisfil Core were the highest. 3. The hardness of Core Max were the highest. 4. The hardness of Miracle Mix were the lowest. 5. 2% NaF and 0.02N lactic acid negatively affected the flexural strength and hardness of four core materials.

Compatibility of self-etching dentin adhesives with resin luting cements / 대한치과보존학회지

This study was performed to investigate the compatibility between 4 dentin adhesives and 4 resin luting cements. Dentin adhesives used in this study were All-Bond 2 (Bisco Inc., Schaumbrug, IL, USA), Clearfil SE-Bond (Kuraray Medical Inc, Osaka, Japan), Prompt L-Pop (3M Dental Products, St. Paul, MN, USA), One-Up Bond F (Tokuyama corp., Tokyo, Japan). Resin luting cements used in this study were Choice (Bisco Inc., Schaumbrug, IL, USA), Panavia F (Kuraray Medical Inc, Osaka, Japan), RelyX ARC (3M Dental Products, St. Paul, MN, USA), Bistite II DC (Tokuyama corp., Tokyo, Japan). Combination of each dentin adhesive and corresponding resin cement was made to 16 experimental groups. Flat dentin surfaces was created on mid-coronal dentin of extracted mandibular third molars, then dentin surface was polished with 320-grit silicon carbide abrasive papers. Indirect resin composite block (Tescera, Bisco) was fabricated. Its surface for bonding to tooth was polished with silicon carbide abrasive papers. Each dentin adhesive was treated on tooth surface and resin composite overlay were luted with each resin cement. Each bonded specimen was poured in epoxy resin and sectioned occluso-gingivally into 1.0 mm thick slab, then further sectioned into 1.0 x 1.0 mm2 composite-dentin beams. Microtensile bond strength was tested at a crosshead speed of 1.0 mm/min. The data were analysed by one-way ANOVA and Duncan's multiple comparison tests. The results of this study were as follows; 2-step self-etching dentin adhesive which has additional bonding resin is more compatible than 1-step self-etching dentin adhesive.