OBJECTIVES: The aim of this study was to compare root canal volume change and canal transportation by Vortex Blue (VB; Dentsply Tulsa Dental Specialties), ProTaper Next (PTN; Dentsply Maillefer), and ProTaper Universal (PTU; Dentsply Maillefer) nickel-titanium rotary files in curved root canals. MATERIALS AND METHODS: Thirty canals with 20°–45° of curvature from extracted human molars were used. Root canal instrumentation was performed with VB, PTN, and PTU files up to #30.06, X3, and F3, respectively. Changes in root canal volume before and after the instrumentation, and the amount and direction of canal transportation at 1, 3, and 5 mm from the root apex were measured by using micro-computed tomography. Data of canal volume change were statistically analyzed using one-way analysis of variance and Tukey test, while data of amount and direction of transportation were analyzed using Kruskal-Wallis and Mann-Whitney U test. RESULTS: There were no significant differences among 3 groups in terms of canal volume change (p > 0.05). For the amount of transportation, PTN showed significantly less transportation than PTU at 3 mm level (p = 0.005). VB files showed no significant difference in canal transportation at all 3 levels with either PTN or PTU files. Also, VB files showed unique inward transportation tendency in the apical area. CONCLUSIONS: Other than PTN produced less amount of transportation than PTU at 3 mm level, all 3 file systems showed similar level of canal volume change and transportation, and VB file system could prepare the curved canals without significant shaping errors.
Dental Pulp Cavity ; Humans ; Molar ; Transportation ; X-Ray Microtomography

OBJECTIVES: We analyzed gene-expression profiles after 14 day odontogenic induction of human dental pulp cells (DPCs) using a DNA microarray and sought candidate genes possibly associated with mineralization. MATERIALS AND METHODS: Induced human dental pulp cells were obtained by culturing DPCs in odontogenic induction medium (OM) for 14 day. Cells exposed to normal culture medium were used as controls. Total RNA was extracted from cells and analyzed by microarray analysis and the key results were confirmed selectively by reverse-transcriptase polymerase chain reaction (RT-PCR). We also performed a gene set enrichment analysis (GSEA) of the microarray data. RESULTS: Six hundred and five genes among the 47,320 probes on the BeadChip differed by a factor of more than two-fold in the induced cells. Of these, 217 genes were upregulated, and 388 were down-regulated. GSEA revealed that in the induced cells, genes implicated in Apoptosis and Signaling by wingless MMTV integration (Wnt) were significantly upregulated. CONCLUSIONS: Genes implicated in Apoptosis and Signaling by Wnt are highly connected to the differentiation of dental pulp cells into odontoblast.
Apoptosis ; Dental Pulp ; Gene Expression ; Genes, vif ; Humans ; Microarray Analysis ; Odontoblasts ; Oligonucleotide Array Sequence Analysis ; Polymerase Chain Reaction ; RNA

Corrections to the funding. In this article, the year is missing from the funding information.

Background: Obesity weakens acquired immunity and causes infection. This study aimed to investigate the relationship between the inflammatory markers in the gingival crevicular fluid and serum and periodontal bacteria in saliva through obesity control for 4 weeks. Methods: Forty-six subjects with a body mass index (BMI) of ≥23 kg/m2 stayed in the camp for 4 weeks, followed by exercise and a low salt-low fat diet. Body size measurements, oral examinations, blood, saliva, and gingival crevicular fluid were collected before and after the program. C-reactive protein (CRP) in serum, matrix metalloproteinase (MMP)-8, MMP-9, and interleukin (IL)-1b in the gingival sulcus fluid were measured. After extracting bacterial genomic DNA from saliva, the presence of periodontal bacteria were detected using Taq probe. The relationship of each index before and after the program was analyzed through paired t-test and partial correlation analysis. Results: Campylobacter rectus (Cr) increased after the program, and there was no significant change in other bacteria. Serum CRP and Fusobacterium nucleatum (Fn), Aggregatibacter actinomycetemcomitans, Cr, ratio of Fn, and ratio of Cr had a positive relationship at baseline; however, the relationship was not significant after the program. Ratio of Prevotella intermedia had a positive relationship with MMP-9, MMP-8, IL-1b at baseline. Moreover, the ratio of Treponema denticola and the ratio of Tannerella forsythia showed a positive relationship with MMP-8, MMP-9, and IL-1b. The relationship between the ratio of Porphyromonas gingivalis and IL-1β showed a constant positive relationship at baseline and after the program. Conclusion Obesity control program in subjects with a BMI of ≥23 kg/m2 accompanied by diet and exercise did not affect the changes in periodontal bacteria itself, but changes in the relationship between periodontal bacteria and serum CRP, the relationship between the inflammatory index in the gingival crevicular fluid and periodontal bacteria was observed.

OBJECTIVES: This study aimed to evaluate the healing rate of non-surgical endodontic treatment between C-shaped and non-C-shaped mandibular second molars. MATERIALS AND METHODS: Clinical records and radiological images of patients who had undergone endodontic treatment on mandibular second molars between 2007 and 2014 were screened. The periapical index scoring system was applied to compare healing outcomes. Information about preoperative and postoperative factors as well as the demographic data of the patients was acquired and evaluated using chi-square and multinomial logistic regression tests. RESULTS: The total healing rate was 68.4%. Healing rates for the mandibular second molar were 70.9% in C-shaped canals (n = 79) and 66.6% in non-C-shaped ones (n = 117). The difference was not statistically significant. CONCLUSIONS: The presence of a C-shaped canal in the mandibular second molar did not have a significantly negative effect on healing after treatment. Instead, proper pulpal diagnosis and final restoration were indicated as having significantly greater influence on the healing outcomes of C-shaped and non-C-shaped canals, respectively.
Dental Pulp Cavity* ; Diagnosis ; Humans ; Logistic Models ; Molar* ; Retrospective Studies*

PURPOSE: This study evaluated the prevalence of distolingual roots in mandibular molars among Koreans, the root canal system associated with distolingual roots, and the concurrent appearance of a distolingual root in the mandibular first molar and a C-shaped canal in the mandibular second molar. MATERIALS AND METHODS: Cone-beam computed tomographic images of 264 patients were screened and examined. Axial sections of 1056 mandibular molars were evaluated to determine the number of roots. The interorifice distances from the distolingual canal to the distobuccal canal were also estimated. Using an image analysis program, the root canal curvature was calculated. Pearson's chi-square test, the paired t-test, one-way analysis of variance, and post-hoc analysis were performed. RESULTS: Distolingual roots were observed in 26.1% of the subjects. In cases where a distolingual root was observed in the mandibular molar, a significant difference was observed in the root canal curvature between the buccolingual and mesiodistal orientations. The maximum root canal curvature was most commonly observed in the mesiodistal orientation in the coronal portion, but in the apical portion, maximum root canal curvature was most often observed in the buccolingual orientation. CONCLUSION: The canal curvature of distolingual roots was found to be very complex, with a different direction in each portion. No correlation was found between the presence of a distolingual root in the mandibular first molar and the presence of a C-shaped canal in the mandibular second molar.
Cone-Beam Computed Tomography* ; Dental Pulp Cavity ; Humans ; Mandible ; Molar* ; Prevalence*

OBJECTIVES: The aims of this study were to quantify tug-back by measuring the pulling force and investigate the correlation of clinical tug-back pulling force with in vitro gutta-percha (GP) cone adaptation score using micro-computed tomography (µCT). MATERIALS AND METHODS: Twenty-eight roots from human single-rooted teeth were divided into 2 groups. In the ProTaper Next (PTN) group, root canals were prepared with PTN, and in the ProFile (PF) group, root canals were prepared using PF (n = 14). The degree of tug-back was scored after selecting taper-matched GP cones. A novel method using a spring balance was designed to quantify the tug-back by measuring the pulling force. The correlation between tug-back scores, pulling force, and percentage of the gutta-percha occupied area (pGPOA) within apical 3 mm was investigated using µCT. The data were analyzed using Pearson's correlation analysis, one-way analysis of variance (ANOVA) and Tukey's test. RESULTS: Specimens with a strong tug-back had a mean pulling force of 1.24 N (range, 0.15–1.70 N). This study showed a positive correlation between tug-back score, pulling force, and pGPOA. However, there was no significant difference in these factors between the PTN and PF groups. Regardless of the groups, pGPOA and pulling force were significantly higher in the specimens with a higher tug-back score (p < 0.05). CONCLUSIONS: The degree of subjective tug-back was a definitive determinant for master cone adaptation in the root canal. The use of the tug-back scoring system and pulling force allows the interpretation of subjective tug-back in a more objective and quantitative manner.
Dental Pulp Cavity ; Gutta-Percha ; Humans ; In Vitro Techniques ; Methods ; Root Canal Obturation ; Tooth ; X-Ray Microtomography

BACKGROUND: Smoking exerts an adverse effect on the periodontal tissue by reorganizing the ecosystem of oral microorganisms and is considered to be an important factor in the development of periodontal disease. Although cross-sectional studies on smokers and non-smokers have been attempted to investigate the microbial differences in periodontal oral cavity, only few studies have been conducted to investigate the changes in oral microorganisms during smoking cessation. The purpose of this study was to investigate the changes of bacteria in saliva and gingival crevicular fluid (GCF) over a period of one year among 11 smokers trying to quit smoking.METHODS: Eleven smokers trying to quit smoking visited the clinic at baseline, two weeks, two months, four months, six months, and 12 months to give saliva and GCF samples. The amounts of 16S rRNA, Porphyromonas gingivalis, Treponema denticola, Prevotella intermedia, Fusobacterium nucleatum subsp. nucleatum, Streptococcus mutans, and Streptococcus sobrinus in saliva and GCF were quantified using real-time polymerase chain reaction TaqMan probe assay. The results were analyzed by nonparametric statistical analysis using Friedman test and Spearman correlation coefficient.RESULTS: After cessation of smoking, the amounts of 16S rRNA corresponding to P. gingivalis, F. nucleatum, P. intermedia, and T. denticola in saliva decreased and then again increased significantly. The amount of F. nucleatum 16S rRNA in GCF decreased significantly after smoking cessation. Positive correlations were observed between 16S rRNA and F. nucleatum and between F. nucleatum and T. denticola in saliva and GCF.CONCLUSION: Even if the number of subjects in this study was small, we suggest that smoking cessation may reduce the total bacterial amount and F. nucleatum in GCF. However, the results regarding changes in the microbial ecosystem due to smoking or smoking cessation were inconsistent. Therefore, further in-depth studies need to be carried out.
Bacteria ; Bacterial Load ; Cross-Sectional Studies ; Ecosystem ; Fusobacterium nucleatum ; Gingival Crevicular Fluid ; Mouth ; Periodontal Diseases ; Porphyromonas gingivalis ; Prevotella intermedia ; Real-Time Polymerase Chain Reaction ; Saliva ; Smoke ; Smoking Cessation ; Smoking ; Streptococcus mutans ; Streptococcus sobrinus ; Treponema denticola

PURPOSE: The aim of this study is to investigate the characteristics of patients and teeth referred to a university dental hospital for endodontic problem. MATERIALS AND METHODS: From January, 2017 to December, 2018, patients who were referred to a university dental hospital for endodontic problem were collected from clinical records. A total of 1171 patient records were analyzed. The status of the referred teeth was divided into three groups according to whether they were treated endodontically based on radiographs and clinical records at the time of referred visit. RESULTS: 69.9% of the referred teeth were maxillary and mandibular first and second molars. The average time from referral to actual visit is 9.03 days and 65.6% of the case referred with referring letter. The most primary reasons of referral were persistent clinical symptom (pain, swelling, and sinus tract) (37.9%), diagnosis difficulty (16.7%), blockage of canal space (13.8%) and difficult tooth anatomy (11.4%). In the case of referral before endodontic treatment, the most primary reason of referral was failure to make a proper diagnosis. If the teeth were referred in the middle of endodontic treatment, the most primary reason of referral was persistent clinical symptom and blockage of canal space. In the case of referral after root canal filling, the most primary reason of referral was persistent clinical symptom. CONCLUSION: In the case of molars, the rate of persistent clinical symptom and blockage of canal space were the most primary reason of referral, and the rate of apical surgery and management of trauma was high in the case of anterior teeth.
Dental Pulp Cavity ; Diagnosis ; Humans ; Molar ; Referral and Consultation ; Tooth

OBJECTIVES: The purpose of this study was to determine the optimal master apical file size with minimal transportation and optimal efficiency in removing infected dentin. We evaluated the transportation of the canal center and the change in untouched areas after sequential preparation with a #25 to #40 file using 3 different instruments: stainless steel K-type (SS K-file) hand file, ProFile and LightSpeed using microcomputed tomography (MCT). MATERIALS AND METHODS: Thirty extracted human mandibular molars with separated orifices and apical foramens on mesial canals were used. Teeth were randomly divided into three groups: SS K-file, Profile, LightSpeed and the root canals were instrumented using corresponding instruments from #20 to #40. All teeth were scanned with MCT before and after instrumentation. Cross section images were used to evaluate canal transportation and untouched area at 1- , 2- , 3- , and 5- mm level from the apex. Data were statistically analyzed according to' repeated nested design'and Mann-Whitney test (p = 0.05). RESULTS: In SS K-file group, canal transportation was significantly increased over #30 instrument. In the ProFile group, canal transportation was significantly increased after preparation with the #40 instrument at the 1- and 2- mm levels. LightSpeed group showed better centering ability than ProFile group after preparation with the #40 instrument at the 1 and 2 mm levels. CONCLUSIONS: SS K-file, Profile, and LightSpeed showed differences in the degree of apical transportation depending on the size of the master apical file.
Dental Pulp Cavity ; Dentin ; Hand ; Humans ; Molar ; Nickel ; Stainless Steel ; Titanium ; Tooth ; Tooth Apex ; Transportation ; X-Ray Microtomography