This study was done to present a criterion in selection of the most proper light sources and materials by measuring metamerism index(MI) of the light curing composite resins with spectrocolorimeter. Metamerism is defined when two objects appear to be the same color in one illuminant but different in another. This is due to the fact that they have different spectral curves that fail to match under the second illuminant. In this study, A1 & A3 shade of five light curing composite resins (Esthet-X, Filteck Z250, Filteck A110, Charisma, Vitalescence) were chosen based on Vita shade. Five samples were made for shade of each product with Teflon mold (diameter: 15mm, thickness: 2mm). Metamerism index of each samples on a Barium sulfate plate (L*=96.54, a*=0.19, b*=0.01) prepared for sample fixation were measured with spectrocolorimeter(Miniscan XE plus, Model 4000s, Hunter Lab, USA) by applying standard light source D65, C, Fcw, TL84 and A. Standardization was done with reference standard (X=80.8, Y=85.7, Z=90.8) and light trap. The results were as follows. 1. Different resins with same Vita shade showed recognizable color difference(DeltaE*>2). 2. All composites had MI below accepted value 0.5 between standard illuminant(D65, C, & A) and below 1.5 under fluorescent condition (Fcw & TL84). 3. MI value between D65 and A showed higher value than MI value between other source of light(p<0.01). 4. All resins except Z250 showed MI value that A3 is higher than A1 between D65 and A(p<0.05).
Barium Sulfate ; Composite Resins* ; Fungi ; Polytetrafluoroethylene

OBJECTIVE: The pathophysiology of chronic subdural hematoma (CSH) is not yet clear. Trauma alone is not sufficient to result in CSH in young individuals, while a trivial injury can result in CSH in older adults. Although the causality and apportionment of trauma are important issues in CSH, especially in terms of insurance, it is too obscure to solve all struggles. METHODS: There are three key factors for producing CSH. First, CSH necessitates a potential subdural reservoir. Other important precipitating factors are trauma and coagulopathy. However, these factors are not sufficient to cause CSH development. The trauma apportionment score (TAS) can be used to compare the relative importance of these three factors. Here, we applied the TAS to 239 consecutive cases of CSH. We retrospectively obtained the patients' history and laboratory results from their medical records. RESULTS: The TAS ranged from −5 to 5. The most common score was 0. If we defined the cause of CSH as being combined when the TAS was 0, then the cause was combined in 30 cases (12.6%). If we extended the criteria for a combined cause from 0 to −1 to 1, the cause was combined in 107 cases (44.8%). Regardless of the criteria used, traumatic CSHs were more common than were spontaneous CSHs. Spontaneous CSHs were more common in older than in younger patients (p < 0.01, Fisher's exact test). CONCLUSION: The TAS is a useful tool for differentiating the causality of CSH.
Adult ; Aging ; Craniocerebral Trauma ; Hematoma, Subdural, Chronic* ; Humans ; Insurance ; Intracranial Pressure ; Medical Records ; Precipitating Factors ; Retrospective Studies

The purpose of this study was to evaluate the penetration pattern of dentin adhesives according to the orientation of dentinal tubules with confocal laser scanning microscopy. Specimens having perpendicular, parallel and oblique surface to dentinal tubules were fabricated. The primer of dentin adhesives (ALL BOND(R) 2, CLEARFIL(TM) SE BOND and PQ1) was mixed with fluorescent material, rhodamine B isothiocyanate (Aldrich Chem. CO., Milw., USA). It was applied to the specimens according to the instructions of manufactures. The specimens were covered with composite resin (Estelite, shade A2) and then cut to a thickness of 500 microm with low speed saw (Isomet(TM), Buehler, USA). The adhesive pattern of dentin adhesives were observed by fluorescence image using confocal laser scanning microscopy. The results were as follows. 1. For the groups with tubules perpendicular to bonded surface, funnel shape of resin tag was observed in all specimen. However, resin tags were more prominent in phosphoric acid etching system (ALL BOND(R) 2 and PQ1) than self etching system (CLEARFIL(TM) SE BOND). 2. For the groups with tubules parallel to bonded surface, rhodamine-labeled primer penetrated into peritubular dentin parallel to the orientation of dentinal tubules. But rhodamine-labeled primer of PQ1 diffused more radially into surrounding intertubular dentin than other dentin adhesive systems. 3. For the groups with tubules oblique to bonded surface, resin tags appeared irregular and discontinuous. But they penetrated deeper into dentinal tubules than other groups.
Adhesives* ; Dentin* ; Dentin-Bonding Agents ; Fluorescence ; Microscopy, Confocal* ; Rhodamines

The purpose of this study was to evaluate the color stability of resin cements with accelerated test. Four dual curing resin cements: Panavia-F (KURARAY), Duolink (BISCO), Variolink-II (Ivoclar Vivadent), and RelyX Unicem (3M ESPE) and 1 self curing resin cement: Resiment CE (j. l. Blosser) were used in this study. In control group, Gradia Anterior (GC) composite resin and Tescera Dentin (Bisco) indirect composite were used. Ten disk shape specimens were made from each resin cement. The specimens were subjected to an accelerated aging process in a refrigerated bath circulator at 60degrees C for 15 and 30 days. Spectrophotometric analyses were made before and after 15 days and 30 days of accelerated aging time. The color characteristics (L*, a*, b*) and the color difference (DeltaE*) of the specimens before and after immersion were measured and computed. Regardless of type of the resin cements, L* value was decreased and a* value was increased, but there were no significant difference. But b* value was increased significantly (p < 0.05). Tescera inlay showed least color change (p < 0.05), but Gradia showed notable color change after 15 days. After 30 days on accelerated aging, DeltaE* value was increased (Panavia-F < Variolink-II < Resiment CE < Duolink < Unicem) (p < 0.05), but there were no significant difference among Panavia-F, Variolink-II, and Resiment CE groups. After 30 days of accelerated aging, DeltaE* value of all resin cements were greater than 3.0 and could be perceived by the human eye.
Aging ; Baths ; Composite Resins ; Dentin ; Dentin-Bonding Agents ; Eye ; Humans ; Immersion ; Inlays ; Resin Cements

In this study we measured the amount of light energy that was projected through the tooth material and analyzed the degree of polymerization by measuring the surface hardness of composites. For polymerization, Optilux 501 (Demetron, USA) with two types of light guide was used: a 12 mm diameter light guide with 840 mW/cm2 light intensity and a 7 mm diameter turbo light guide with 1100 mW/cm2. Specimens were divided into three groups according to thickness of penetrating tooth (1 mm, 2 mm, 0 mm). Each group was further divided into four subgroups according to type of light guide and curing time (20 seconds, 40 seconds). Vickers'hardness was measured by using a microhardness tester. In 0 mm and 1 mm penetrating tooth group, which were polymerized by a turbo light guide for 40 seconds, showed the highest hardness values. The specimens from 2 mm penetrating tooth group, which were polymerized for 20 seconds, demonstrated the lowest hardness regardless of the types of light guides (p < 0.05). The results of this study suggest that, when projecting tooth material over a specified thickness, the increase of polymerization will be limited even if light intensity or curing time is increased.
Hardness* ; Polymerization ; Polymers ; Tooth*

The purpose of this study was to compare the canal configuration after shaping by ProTaper rotary files and ProTaper hand files in resin simulated canals. Forty resin simulated canals with a curvature of J-shape and S-shape were divided into four groups by 10 blocks each. Simulated root canals in resin block were prepared by ProTaper rotary files and ProTaper hand files using a crown-down pressureless technique. All simulated canals were prepared up to size #25 file at end-point of preparation. Pre- and post-instrumentation images were recorded with color scanner. Assessment of canal shape was completed with an image analysis program. Measurements were made at 0, 1, 2, 3, 4, 5, 6 and 7 mm from the apex. At each level, outer canal width, inner canal width, total canal width, and amount of transportation from original axis were recorded. Instrumentation time was recorded. The data were analyzed statistically using independent t-test. The result was that ProTaper hand files cause significantly less canal transportation from original axis of canal body and maintain original canal configuration better than ProTaper rotary files, however ProTaper hand files take more shaping time.
Axis, Cervical Vertebra ; Dental Pulp Cavity ; Hand* ; Transportation

PURPOSE: This study aimed to investigate the luminal stenosis of the internal carotid artery with calcification detected on panoramic radiographs. MATERIALS AND METHODS: This study used fifty carotid arteries of 36 dental patients whose panoramic radiograph and computed tomography angiography (CTA) revealed the presence of carotid artery calcification. A neuroradiologist interpreted CTA to determine the degree of stenosis of the internal carotid arteries. The degree of stenosis was stratified in four stages; normal (no stenosis), mild stenosis (1-49%), moderate stenosis (50-69%) and severe stenosis (70-99%). RESULTS: Among the fifty carotid arteries with calcification detected on both panoramic radiography and CTA, 20carotid arteries (40%) were normal, 29 carotid arteries (18%) had mild stenosis, 1 carotid artery (2%) had moderate stenosis, and there was none with severe stenosis. CONCLUSION: Sixty percent of the carotid arteries with calcification detected on both panoramic radiography and CTA had internal luminal stenosis, and two percent had moderate stenosis. When carotid atheroma is detected on panoramic radiograph, it is possible that the dental patient has luminal stenosis of the internal carotid artery.
Angiography ; Arteries ; Carotid Arteries ; Carotid Artery, Internal ; Constriction, Pathologic ; Humans ; Phenobarbital ; Plaque, Atherosclerotic ; Radiography, Panoramic

OBJECTIVE: Decompressive craniectomy is an effective therapy to relieve high intracranial pressure after acute brain damage. However, the optimal timing for cranioplasty after decompression is still controversial. Many authors reported that early cranioplasty may contribute to improve the cerebral blood flow and brain metabolism. However, despite all the advantages, there always remains a concern that early cranioplasty may increase the chance of infection. The purpose of this retrospective study is to investigate whether the early cranioplasty increase the infection rate. We also evaluated the risk factors of infection following cranioplasty. METHODS: We retrospectively examined the results of 131 patients who underwent cranioplasty in our institution between January 2008 and June 2015. We divided them into early (≤90 days) and late (>90 days after craniectomy) groups. We examined the risk factors of infection after cranioplasty. We analyzed the infection rate between two groups. RESULTS: There were more male patients (62%) than female (38%). The mean age was 49 years. Infection occurred in 17 patients (13%) after cranioplasty. The infection rate of early cranioplasty was lower than that of late cranioplasty (7% vs. 20%; p=0.02). Early cranioplasty, non-metal allograft materials, re-operation before cranioplasty and younger age were the significant factors in the infection rate after cranioplasty (p<0.05). Especially allograft was a significant risk factor of infection (odds ratio, 12.4; 95% confidence interval, 3.24–47.33; p<0.01). Younger age was also a significant risk factor of infection after cranioplasty by multivariable analysis (odds ratio, 0.96; 95% confidence interval, 0.96–0.99; p=0.02). CONCLUSION: Early cranioplasty did not increase the infection rate in this study. The use of non-metal allograft materials influenced a more important role in infection in cranioplasty. Actually, timing itself was not a significant risk factor in multivariate analysis. So the early cranioplasty may bring better outcomes in cognitive functions or wound without raising the infection rate.
Allografts ; Brain ; Cerebrovascular Circulation ; Cognition ; Decompression ; Decompressive Craniectomy ; Female ; Humans ; Intracranial Pressure ; Male ; Metabolism ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Wounds and Injuries

OBJECTIVE: Preinjection gelfoam embolization during percutaneous vertebroplasty (PVP) has been thought alternative technique to prevent the leakage of bone cement. The goal of this study was to evaluate whether the gelfoam techniques are useful to reduce bone cement leakage. METHODS: Total 100 PVPs of osteoporotic spine compression fractures were performed by 1 spine surgeon who experienced more than 500 PVP cases under prospective control study. Operation was done in T-L junction (T10-L2) fractures with bi-transpedicular approach. Preinjection gelfoam PVP was done in the 50 levels. As control group, PVP without gelfoam was done in the 50 levels. We did not perform preoperative venography. We inserted normal saline-mixed gelfoam to the anterior third of vertebral body via PVP needle, and then 3mL of polymethylmetacrylate (PMMA) was injected. We prospectively evaluated the incidence and leakage pattern of PMMA by postoperative computed tomography. RESULTS: Between gelfoam and control groups, there were 11 leaks (22%) versus 12 leaks (26%). The mean operation time was 7.00 minutes versus 6.30 minutes. In gelfoam group, there were 6 spinal canal leaks, 4 paravertebral venous leaks, and 1 soft tissue leaks. In control group, there were 4 spinal canal leaks, 8 paravertebral venous leaks, and 1 disc space leak. In spite of cement leakage, there was no symptomatic case in both groups. Statistically, gelfoam technique was not related to decrease the incidence of leakage (p=0.64). CONCLUSION: Our prospective study showed that it did not significantly decrease cement leakage when vertebroplasty is performed by experienced spine surgeon.
Fractures, Compression ; Gelatin Sponge, Absorbable* ; Incidence ; Needles ; Osteoporotic Fractures ; Phlebography ; Polymethyl Methacrylate ; Prospective Studies* ; Spinal Canal ; Spine ; Vertebroplasty

OBJECTIVE: To evaluate the efficacy of balloon guiding catheter (BGC) during thrombectomy in anterior circulation ischemic stroke. METHODS: Sixty-two patients with acute anterior circulation ischemic stroke were treated with thrombectomy using a Solitaire stent from 2011 to 2016. Patients were divided into the BGC group (n=24, 39%) and the non-BGC group (n=38, 61%). The number of retrievals, procedure time, thrombolysis in cerebral infarction (TICI) grade, presence of distal emboli, and clinical outcomes at 3 months were evaluated. RESULTS: Successful recanalization was more frequent in BGC than in non-BGC (83% vs. 66%, p=0.13). Distal emboli occurred less in BGC than in non-BGC (23.1% vs. 57.1%, p=0.02). Good clinical outcome was more frequent in BGC than in non-BGC (50% vs. 16%, p=0.03). The multivariate analysis showed that use of BGC was the only independent predictor of good clinical outcome (odds ratio, 5.19: 95% confidence interval, 1.07–25.11). More patients in BGC were successfully recanalized in internal carotid artery (ICA) occlusion with small retrieval numbers (<3) than those in non-BGC (70% vs. 24%, p=0.005). In successfully recanalized ICA occlusion, distal emboli did not occur in BGC, whereas nine patients had distal emboli in non-BGC (0% vs. 75%, p=0.001) and good clinical outcome was superior in BGC than in non-BGC (55.6% vs. 8.3%, p=0.01). CONCLUSION: A BGC significantly reduces the number of retrievals and the occurrence of distal emboli, thereby resulting in better clinical outcomes in patients with anterior circulation ischemic stroke, particularly with ICA occlusion.
Carotid Artery, Internal ; Catheters* ; Cerebral Infarction ; Humans ; Multivariate Analysis ; Stents ; Stroke* ; Thrombectomy*