The aim of this study was to evaluate the marginal adaptation of direct class II sandwich restoration with packable composites(P-60), resin modified glass ionomer cement(Fuji-II LC), flowable compomer(Dyract Flow), flowable composites(Filtek Flow) in comparison with total bond restorations. In addition, for sandwich restorations, influence of different sandwich techniques was also evaluated. Large butt-joint box typed class II cavites with cervical margins 1mm below the cemento-enamel junction were cut into 70 extracted human molars. The cavities(7 groups, n=10) were filled using a closed/open sandwich restoration or total bond restoration technique with materials according to the manufacturer's recommandation using the single-component bonding agent for each system. Teeth were thermocycled 500 times between 5degrees C and 55degrees C with 30-second dwell time. The teeth were then coated with nail polish 1mm short of the restoration, placed in a 2% methylene blue for 24 hours, and sectioned with diamond wheel. Sections were examined with a stereoscope to determine the extent of microleakage. Dentine/Cementum margins were analyzed for microleakage on scale of 0(no leakage) to 4(entire axial wall) and interface between materials, on scale of 0(no leakage) to 3(axial wall). Results were evaluated with Kruskal Wallis Test, corrected for ties, to determine whether there were statistically significant differences among the seven groups. Pairs of groups were analyzed using the Student-Newman-Keuls Method and Dunn s Method. The results were as follows: 1. All groups showed some micoleakage in cervical portion. But there were no microleakage in interface between materials. 2. Closed sandwich restorations with Fuji-II LC and Filtek Flow had significantly lower leakage rating than total restorations with only P-60. However, open sandwich restorations with Dyract Flow showed significantly higher (P<0.05). 3. Closed sandwich restorations had significantly lower leakage rating than total restorations. However open sandwich restoration s showed significantly higher (P<0.05). 4. Sandwich restorations with Fuji-II LC were lower leakage than only P-60, Filtek Flow, Dyract Flow. But there were no statistically differences among the materials. From the results above, it could be concluded, closed sandwich restorations was effective in reducing microleakage of class II restorations. The best results showing the least microleakage were for the closed sandwich technique with Fuji-II LC and Filtek Flow.
Acrylic Resins ; Composite Resins ; Diamond ; Glass ; Humans ; Methylene Blue ; Molar ; Nails ; Silicon Dioxide ; Tooth

OBJECTIVES: The aim of this study was to test the hypothesis, that the effectiveness of irrigation in removing smear layer in the apical third of root canal system is dependent on the depth of placement of the irrigation needle into the root canal and the enlargement size of the canal. MATERIALS AND METHODS: Eighty sound human lower incisors were divided into eight groups according to the enlargement size (#25, #30, #35 and #40) and the needle penetration depth (3 mm from working length, WL-3 mm and 9 mm from working length, WL-9 mm). Each canal was enlarged to working length with Profile.06 Rotary Ni-Ti files and irrigated with 5.25% NaOCl. Then, each canal received a final irrigation with 3 mL of 3% EDTA for 4 min, followed by 5 mL of 5.25% NaOCl at different level (WL-3 mm and WL-9 mm) from working length. Each specimen was prepared for the scanning electron microscope (SEM). Photographs of the 3mm area from the apical constriction of each canal with a magnification of x250, x500, x1,000, x2,500 were taken for the final evaluation. RESULTS: Removal of smear layer in WL-3 mm group showed a significantly different effect when the canal was enlarged to larger than #30. There was a significant difference in removing apical smear layer between the needle penetration depth of WL-3 mm and WL-9 mm. CONCLUSIONS: Removal of smear layer from the apical portion of root canals was effectively accomplished with apical instrumentation to #35/40 06 taper file and 3 mm needle penetration from the working length.
Constriction ; Dental Pulp Cavity ; Edetic Acid ; Electrons ; Humans ; Incisor ; Microscopy, Electron, Scanning ; Needles ; Nickel ; Periapical Periodontitis ; Root Canal Therapy ; Smear Layer ; Titanium

The purpose of this study was to compare the effect of exponential curing method with conventional curing and soft start curing method on polymerization shrinkage of composite resins. Three brands of composite resins (Synergy Duo Shade, Z250, Filtek Supreme) and three brands of light curing units (Spectrum 800, Elipar Highlight, Elipar Trilight) were used. 40 seconds curing time was given. The shrinkage was measured using linometer for 90 seconds. The effect of time on polymerization shrinkage was analysed by one-way ANOVA and the effect of curing modes and materials on polymerization shrinkage at the time of 90s were analysed by two-way ANOVA. The shrinkage ratios at the time of 20s to 90s were taken and analysed the same way. The results were as follows: 1. All the groups except Supreme shrank almost within 20s. Supreme cured by soft start and exponential curing had no further shrinkage after 30s (p < 0.05). 2. Statistical analysis revealed that polymerization shrinkage varied among materials (p = 0.000) and curing modes (p = 0.003). There was no significant interaction between material and curing mode. 3. The groups cured by exponential curing showed the statistically lower polymerization shrinkage at 90s than the groups cured by conventional curing and soft start curing (p < 0.05). 4. The initial shrinkage ratios of soft start and exponential curing were statistically lower than conventional curing (p < 0.05). From this study, the use of low initial light intensities may reduce the polymerization rate and, as a result, reduce the stress of polymerization shrinkage.
Composite Resins* ; Polymerization* ; Polymers*

There are increasing usage of Nickel-Titanium rotary files in modern clinical endodontic treatment because it is effective and faster than hand filing due to reduced step. This study was conducted to evaluate the effect of canal preparations using 3 different rotary Nickel-Titanium files that has different cross sectional shape and taper on the maintenance of canal curvature. Simulated resin block were instrumented with Profile(Dentsply, USA), GT rotary files(Dentsply, USA), Hero 642(Micro-Mega, France), and Pro-Taper(Dentsply, USA). The image of Pre-instrumentation and Post-instrumentation were acquired using digital camera and overspreaded in the computer. Then the total differences of canal diameter, deviation at the outer portion of curvature, deviation at the inner portion of curvature, movement of center of the canal and the centering ratio at the pre-determined level from the apex were measured. Results were statistically analyzed by means of ANOVA, followed by Scheffe test at a significance level of 0.05. The results were as follows; 1. Deviation at the outer portion of curvature, deviation at the inner portion of curvature were showed largest in Pro-Taper, so also did in the total differences of canal diameter(p<0.05). 2. All the groups showed movements of center. Profile combined with GT rotary files and Hero 642 has no difference but Pro-Taper showed the most deviation(p<0.05). 3. At the 1, 2, 3mm level from the apex movements of center directed toward the outer portion of curvature, but in 4, 5 mm level directed toward the inner portion of curvature(p<0.05). As a results of this study, it could be concluded that combined use of other Nickel-Titanium rotary files is strongly recommended when use Pro-Taper file because it could be remove too much canal structure and also made more deviation of canal curvature than others.
Hand ; Transportation

The purpose of this study is to evaluate the effect of additional enamel etching with phosphoric acid on the microleakage of the adhesion of self-etching primer system. Class V cavity(4 mmx3 mmx1.5 mm) preparations with all margins in enamel were prepared on buccal surface of 42 extracted human upper central incisor teeth. Prepared teeth were randomly divided into 3 groups. Group 1 : no additional pretreatment with 37% phosphoric acid (NE). Group 2 : additional pretreatment with 37% phosphoric acid for 10 seconds (E10s). Group 3 : additional pretreatment with 37% phosphoric acid for 20 seconds (E20s). The adhesives(Clearfil SE Bond(R), Kuraray, Osaka, Japan) and composite resins(Clearfil AP-X(R), Osaka, Kuraray, Japan) were applied following the manufacturer's instructions. All the specimens were finished with the polishing disc(3M dental product, St Paul, MN, USA), thermocycled for 500 cycles between 5degrees C and 55degrees C and resected apical 3-mm root. 0.028 stainless steel wire was inserted apically into the pulp chamber of each tooth and sealed into position with sticky wax. Surrounding tooth surface was covered with a nail varnish 2 times except areas 1 mm far from all the margins. After drying for one day, soaked the samples in the distilled water. Microleakage was assessed by electrochemical method(System 6514, Electrometer(R), Keithley, USA) in the distilled water. In this study, the microleakage was the lowest in group 1(NE) and the highest in group 3(E20s)(NE Dental Enamel* ; Dental Pulp Cavity ; Humans ; Incisor ; Paint ; Stainless Steel ; Tooth ; Water

The purpose of this study was to evaluate a rotational stability of endodontic electronic motors by comparing the changes of rotational speed, depending on the number of usages and with/without static load. Twelve new endodontic electronic motors were used in this study. Non contact type digital tachometer was used for measuring the rotational speed of handpiece. True RMS Multimeter was used for measuring the voltages and the electric currents. All measurements were recorded every 10 seconds during 10 minutes and repeated 9 times. Five repetition was done per each electronic motor. To statistical analysis, student t-test, repeated measures and Scheffe's post-hoc tests were performed. In the same motor group, there was no significant difference in all measurements. In all groups, there was no significant difference in the amount of rotational speed changes depending on the number of usages and with/without static load. In the limitation of this study, the results showed that all kinds of endodontic electronic motors in this study had an established rotational stability. Therefore they could be safely used in root canal treatment with a reliable maintenance of rotational speed, regardless of the number of usages and with/without load.
Dental Pulp Cavity ; Electronics ; Electrons ; Humans

The aim of this study was to evaluate the radiopacity and cytotoxicity of three resin-based (AH 26, EZ fill and AD Seal), a zinc oxide-eugenol-based (ZOB Seal), and a calcium hydroxide-based (Sealapex) root canal sealers. Specimens, 10 mm in diameter and 1 mm in thickness, were radiographed simultaneously with an aluminum step wedge using occlusal films, according to ISO 6876/2001 standards. Radiographs were digitized, and the radiopacity of sealers was compared to the different thicknesses of the aluminum step wedge, using the Scion image software. Using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, the cytotoxicity of each material was determined in immortalized human periodontal ligament (IPDL) cells. The results demonstrated that EZ fill was the most radiopaque sealer, while Sealapex was the least radiopaque (p < 0.05). AH 26, AD Seal and ZOB Seal presented intermediate radiopacity values. All the materials evaluated, except for Sealapex, presented the minimum radiopacity required by ISO standards. The cell viabilities of resin-based root canal sealers were statistically higher than that of other type of root canal sealers through the all experimental time. Further, EZ fill showed statistically lower cell viability in 24 and 48 hours compared to AD Seal and in 72 hours compared to all other resin-based root canal sealers. However, there was no correlation between the radiopacity and cytotoxicity of three resin-based root canals sealers (p > 0.05). These results indicate that resin-based root canal sealer is more biocompatible and has advantage in terms of radiopacity.
Aluminum ; Calcium ; Cell Survival ; Dental Pulp Cavity* ; Humans ; Periodontal Ligament ; Zinc

OBJECTIVES: A variety of root canal sealers were recently launched to the market. This study evaluated physicochemical properties, biocompatibility, and sealing ability of a newly launched resin-based sealer (Dia-Proseal, Diadent) compared to the existing root canal sealers (AHplus, Dentsply DeTrey and ADseal, Metabiomed). MATERIALS AND METHODS: The physicochemical properties of the tested sealers including pH, solubility, dimensional change, and radiopacity were evaluated. Biocompatibility was measured using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. For microleakage test, single-rooted teeth were instrumented, and obturated with gutta-percha and one of the sealers (n = 10). After immersion in 1% methylene blue solution for 2 weeks, the specimens were split longitudinally. Then, the maximum length of staining was measured. Statistical analysis was performed by one-way analysis of variance followed by Tukey test (p = 0.05). RESULTS: Dia-Proseal showed the highest pH value among the tested sealers (p < 0.05). ADseal showed higher dimensional change compared to AHplus and Dia-Proseal (p < 0.05). The solubility values of AHplus and Dia-Proseal were similar, whereas ADseal had the lowest solubility value (p < 0.05). The flow values of sealer in increasing order were AHplus, DiaProseal, and ADseal (p < 0.05). The radiopacity of AHplus was higher than those of ADseal and Dia-Proseal (p < 0.05). The cell viability of the tested materials was statistically similar throughout the experimental period. There were no significant differences in microleakage values among the tested samples. CONCLUSIONS: The present study indicates that Dia-Proseal has acceptable physicochemical properties, biocompatibility, and sealing ability.
Cell Survival ; Dental Pulp Cavity ; Gutta-Percha ; Hydrogen-Ion Concentration ; Immersion ; In Vitro Techniques* ; Methylene Blue ; Solubility ; Tooth

Background: Type 2 diabetes mellitus (T2DM) is a progressive metabolic disease. Early detection of prediabetes is important to reduce the risk of T2DM. Some cytokines are known to be associated with T2DM. Therefore, we aimed to identify cytokines as novel biomarkers of glucose dysmetabolism. Methods: The first stage of the study included 43 subjects (13 subjects with newly diagnosed T2DM, 13 with prediabetes, and 16 with normoglycemia) for cytokine microarray analysis. Blood samples of the subjects were assessed for 310 cytokines to identify potential indicators of prediabetes. The second stage included 142 subjects (36 subjects with T2DM, 35 with prediabetes, and 71 with normoglycemia) to validate the potential cytokines associated with prediabetes. Results: We identified 41 cytokines that differed by 1.5-fold or more in at least one out of the three comparisons (normoglycemia vs. prediabetes, normoglycemia vs. T2DM, and prediabetes vs. T2DM) among 310 cytokines. Finally, we selected protein Z (PROZ) and validated this finding to determine its association with prediabetes. Plasma PROZ levels were found to be decreased in patients with prediabetes (1,490.32±367.19 pg/mL) and T2DM (1,583.34±465.43 pg/mL) compared to those in subjects with normoglycemia (1,864.07±450.83 pg/mL) (P<0.001). There were significantly negative correlations between PROZ and fasting plasma glucose (P=0.001) and hemoglobin A1c (P=0.010). Conclusion PROZ levels were associated with prediabetes and T2DM. We suggest that PROZ may be a promising biomarker for the early detection of prediabetes. Further large-scale studies are needed to evaluate the relationship and mechanism between PROZ and prediabetes and T2DM.