In this article, on page 230, Fig. 2A needs to be corrected.

The flowability of a root canal sealer is clinically important because it improves the penetration of the sealer into the complex root canal system. The purpose of this study was to compare the flowabilities of four root canal sealers, measured using the simple press method (ISO 6876), and their viscosities, measured using a strain-controlled rheometer. A newly developed, calcium phosphate-based root canal sealer (Capseal) and three commercial root canal sealers (AH Plus, Sealapex and Pulp Canal Sealer EWT) were used in this study. The flowabilities of the four root canal sealers were measured using the simple press method (n=5) and their viscosities were measured using a strain-controlled rheometer (n=5). The correlation between these two values was statistically analysed using Spearman's correlation test. The flow diameters and the viscosities of the root canal sealers were strongly negatively correlated (ρ=-0.8618). The viscosity of Pulp Canal Sealer EWT was the lowest and increased in the following order: AH Plus Materials Testing ; Rheology ; Root Canal Filling Materials ; Temperature ; Viscosity

BACKGROUND AND OBJECTIVES: We compared the efficacy and safety of valsartan and rosuvastatin combination therapy with each treatment alone in hypercholesterolemic hypertensive patients. SUBJECTS AND METHODS: Patients who met inclusion criteria were randomized to receive 1 of the following 2-month drug regimens: valsartan 160 mg plus rosuvastatin 20 mg, valsartan 160 mg plus placebo, or rosuvastatin 20 mg plus placebo. The primary efficacy variables were change in sitting diastolic blood pressure (sitDBP) and sitting systolic blood pressure (sitSBP), and percentage change in low-density lipoprotein-cholesterol (LDL-C) in the combination, valsartan, and rosuvastatin groups. Adverse events (AEs) during the study were analyzed. RESULTS: A total of 354 patients were screened and 123 of them were finally randomized. Changes of sitDBP by least squares mean (LSM) were -11.1, -7.2, and -3.6 mm Hg, respectively, and was greater in the combination, as compared to both valsartan (p=0.02) and rosuvastatin (p<0.001). Changes of sitSBP by LSM were -13.2, -10.8, and -4.9 mm Hg, and was greater in the combination, as compared to rosuvastatin (p=0.006) and not valsartan (p=0.42). Percentage changes of LDL-C by LSM were -52, -4, and -47% in each group, and was greater in the combination, as compared to valsartan (p<0.001), similar to rosuvastatin (p=0.16). Most AEs were mild and resolved by the end of the study. CONCLUSION: Combination treatment with valsartan and rosuvastatin exhibited an additive blood pressure-lowering effect with acceptable tolerability, as compared to valsartan monotherapy. Its lipid lowering effect was similar to rosuvatatin monotherapy.
Blood Pressure ; Drug Therapy, Combination ; Humans ; Least-Squares Analysis ; Rosuvastatin Calcium ; Valsartan

BACKGROUND: Diabetes self-management education has an important role in diabetes management. The efficacy of education has been proven in several randomized trials. However, the status of diabetes education programs in real Korean clinical practice has not yet been evaluated in terms of patient compliance with the education prescription. METHODS: We retrospectively analyzed clinical and laboratory data from all patients who were ordered to undergo diabetes education during 2009 at Samsung Medical Center, Seoul, Korea (n=2,291). After excluding ineligible subjects, 588 patients were included in the analysis. RESULTS: Among the 588 patients, 433 received education. The overall compliance rate was 73.6%, which was significantly higher in the subjects with a short duration or living in a rural area compared to those with a long duration (85.0% vs. 65.1%, respectively; P<0.001) or living in an urban area (78.2% vs. 70.4%, respectively; P=0.037). The hemoglobin A1c decreased greater in the compliant group (from 7.84+/-1.54 at baseline to 6.79+/-1.06 at 3 months and 6.97+/-1.20 at 12 months after prescription in the compliant group vs. from 7.74+/-1.25 to 7.14+/-1.02 and 7.24+/-1.24 in the non-compliant group; P=0.001). The decrease in hemoglobin A1c was greater in the subjects with a short duration (P=0.032). CONCLUSION: In our study a large percent of patients refuse to get education despite having a prescription from their physician. This refusal rate was higher in the patients with long-standing diabetes or in urban residence. Furthermore, education was more effective in patients with a short duration of diabetes in clinical practice.
Compliance ; Diabetes Mellitus, Type 2 ; Disulfiram ; Hemoglobins ; Humans ; Korea ; Patient Compliance ; Prescriptions ; Retrospective Studies ; Self Care

OBJECTIVES: This study investigated changes in gene expressions concerning of differentiation, proliferation, mineralization and inflammation using Human-8 expression bead arrays when white Mineral Trioxide Aggregate and calcium hydroxide-containing cement were applied in vitro to human dental pulp cells (HDPCs). MATERIALS AND METHODS: wMTA (white ProRoot MTA, Dentsply) and Dycal (Dentsply Caulk) in a Teflon tube (inner diameter 10 mm, height 1 mm) were applied to HDPCs. Empty tube-applied HDPCs were used as negative control. Total RNA was extracted at 3, 6, 9 and 24 hr after wMTA and Dycal application. The results of microarray were confirmed by reverse transcriptase polymerase chain reaction. RESULTS: Out of the 24,546 genes, 43 genes (e.g., BMP2, FOSB, THBS1, EDN1, IL11, COL10A1, TUFT1, HMOX1) were up-regulated greater than two-fold and 25 genes (e.g., SMAD6, TIMP2, DCN, SOCS2, CEBPD, KIAA1199) were down-regulated below 50% by wMTA. Two hundred thirty nine genes (e.g., BMP2, BMP6, SMAD6, IL11, FOS, VEGFA, PlGF, HMOX1, SOCS2, CEBPD, KIAA1199) were up-regulated greater than two-fold and 358 genes (e.g., EDN1, FGF) were down-regulated below 50% by Dycal. CONCLUSIONS: Both wMTA and Dycal induced changes in gene expressions related with differentiation and proliferation of pulp cells. wMTA induced changes in gene expressions related with mineralization, and Dycal induced those related with angiogenesis. The genes related with inflammation were more expressed by Dycal than by wMTA. It was confirmed that both wMTA and Dycal were able to induce gene expression changes concerned with the pulp repair in different ways.
Aluminum Compounds ; Calcium ; Calcium Compounds ; Calcium Hydroxide ; Dental Pulp ; Dental Pulp Capping ; Drug Combinations ; Gene Expression ; Glutamates ; Guanine ; Humans ; Hydroxides ; Inflammation ; Interleukin-11 ; Minerals ; Oxides ; Polytetrafluoroethylene ; Reverse Transcriptase Polymerase Chain Reaction ; RNA ; RNA-Directed DNA Polymerase ; Silicates ; Transcriptome ; Pemetrexed

OBJECTIVES: The aim of this study was to investigate levels of matrix metalloproteinase-8 (MMP-8) and substance P (SP) in root canal exudates during root canal treatment (RCT) of nonvital, painful teeth. MATERIALS AND METHODS: Patients scheduled for nonsurgical RCT were prospectively selected; the study was performed after obtaining informed consent from the patients and was approved by the Institutional Review Board for Clinical Research of Gangnam Severance Hospital, Yonsei University (3-2008-0118). Canal exudates samples were collected using sterilized paper points from teeth scheduled for RCT across three different time periods. MMP-8 and SP levels were measured using enzyme-linked immunosorbent assay (ELISA). Data were analyzed using a mixed model analysis and the Pearson correlation analysis (p < 0.05). RESULTS: MMP-8 and SP levels in GCF were decreased during RCT (p < 0.0001), and they showed a weak positive correlation to each other (p < 0.05). Patients'subjective pain levels and the response from percussion test were significantly related to SP level. CONCLUSIONS: This study demonstrated that periradicular inflammation endodontic origin can elevate SP and MMP-8 levels in root canal exudates. Interestingly, SP level of canal exudates showed a possibility of being used as an indicator of pain due to periapical pathosis.
Dental Pulp Cavity ; Enzyme-Linked Immunosorbent Assay ; Ethics Committees, Research ; Exudates and Transudates ; Humans ; Inflammation ; Informed Consent ; Matrix Metalloproteinase 8 ; Percussion ; Prospective Studies ; Substance P ; Tooth ; Tooth, Nonvital

OBJECTIVES: The purpose of this in vivo study was to investigate the microbial diversity in symptomatic and asymptomatic canals with primary endodontic infections by using GS FLX Titanium pyrosequencing. MATERIALS AND METHODS: Sequencing was performed on 6 teeth (symptomatic, n = 3; asymptomatic, n = 3) with primary endodontic infections. Amplicons from hypervariable region of the small-subunit ribosomal RNA gene were generated by polymerized chain reaction (PCR), and sequenced by means of the GS FLX Titanium pyrosequencing. RESULTS: On average, 10,639 and 45,455 16S rRNA sequences for asymptomatic and symptomatic teeth were obtained, respectively. Based on Ribosomal Database Project Classifier analysis, pyrosequencing identified the 141 bacterial genera in 13 phyla. The vast majority of sequences belonged to one of the seven phyla: Actinobacteria, Bacteroidetes, Firmicutes, Fusobacteria, Proteobacteria, Spirochetes, and Synergistetes. In genus level, Pyramidobacter, Streptococcus, and Leptotrichia constituted about 50% of microbial profile in asymptomatic teeth, whereas Neisseria, Propionibacterium, and Tessaracoccus were frequently found in symptomatic teeth (69%). Grouping the sequences in operational taxonomic units (3%) yielded 450 and 1,997 species level phylotypes in asymptomatic and symptomatic teeth, respectively. The total bacteria counts were significantly higher in symptomatic teeth than that of asymptomatic teeth (p < 0.05). CONCLUSIONS: GS FLX Titanium pyrosequencing could reveal a previously unidentified high bacterial diversity in primary endodontic infections.
Actinobacteria ; Bacteria ; Bacteroidetes ; Fusobacteria ; Genes, rRNA ; Leptotrichia ; Neisseria ; Polymers ; Propionibacterium ; Proteobacteria ; Spirochaetales ; Streptococcus ; Titanium ; Tooth

This study investigated the changes in gene expression when mineral trioxide aggregate (MTA) was applied in vitro to human dental pulp cells (HDPCs). MTA in a teflon tube (diameter 10 mm, height 2 mm) was applied to HDPCs. Empty tube-applied HDPCs were used as negative control. For microarray analysis, total RNA was extracted at 6, 24, and 72 hrs after MTA application. The results were confirmed selectively by performing reverse transcriptase polymerase chain reaction for genes that showed changes of more than two-fold or less than half. Of the 24,546 genes, 109 genes were up-regulated greater than two-fold (e.g., FOSB, THBS1, BHLHB2, EDN1, IL11, FN1, COL10A1, and TUFT1) and 69 genes were down-regulated below 50% (e.g., SMAD6 and DCN). These results suggest that MTA, rather than being a bio-inert material, may have potential to affect the proliferation and differentiation of pulp cells in various ways.
Aluminum Compounds ; Calcium Compounds ; Dental Pulp ; Dental Pulp Capping ; Drug Combinations ; Gene Expression ; Gene Expression Profiling ; Glutamates ; Guanine ; Humans ; Interleukin-11 ; Microarray Analysis ; Oxides ; Polytetrafluoroethylene ; Reverse Transcriptase Polymerase Chain Reaction ; RNA ; Silicates ; Pemetrexed

The purpose of this study was to find out the relationship of radiographic lesion size, gender, age of patients and radiographic character to the diagnosis of periapical cyst and granuloma. The data was collected from 187 periapical lesions of 167 patients who undergone apical surgery at Department of Conservative Dentistry, Seoul National University Dental Hospital from 2003 to 2005. The lesion were surgically removed and send for biopsy to the Oral Pathology Laboratory. From the initial radiograph, lesion size was calculated using PiViewSTAR(R) (INFINITT, Korea) program. The obtained data were statistically evaluated using SPSS (p < 0.05). The result were as followings: 1. From 187 biopsy samples, the incidence of periapical cyst was 28.34% and granuloma was 65.24%. 2. There was a significant correlation between periapical cyst and the size of radiographic lesion (p < 0.01). 3. There were no significant correlations between age, gender, location of lesion and the final diagnosis (p > 0.05). 4. There was a significant correlation between the non-demarcation of the lesion and the incidence of periapical granuloma (p < 0.01).
Biopsy ; Dentistry ; Granuloma ; Humans ; Incidence ; Pathology, Oral ; Periapical Granuloma ; Radicular Cyst

The aim of this in vitro study was to evaluate the cleaning efficacy of various irrigation methods in the mandibular mesial roots. The forty five mesial root canals were shaped by Profile .06 instruments to apical size #30 and irrigated with 5 ml of 3.5% NaOCl. The teeth were divided into 3 groups and irrigated finally for 1 minute; Group 1: syringe irrigation, Group 2: ultrasonic irrigation, Group 3: RinsEndo irrigation. After histological processing, the cross sections of apical 1, 3, and 5 mm level were examined with an optical microscope. The cleanliness values of canals and isthmuses were calculated and analyzed by Mann-Whitney U test. 1. There were no significant differences in both canal and isthmus cleanliness between syringe irrigation and ultrasonic irrigation except 5 mm level of isthmus. 2. RinsEndo irrigation had significantly higher canal cleanliness values than syringe irrigation at 1 mm and 3 mm levels (p < 0.05). Also, RinsEndo irrigation had significantly higher isthmus cleanliness values than syringe irrigation at all levels evaluated (p < 0.05). 3. There were no statistical differences in both canal and isthmus cleanliness between ultrasonic irrigation and RinsEndo irrigation except 3 mm level of canal. From this study, RinsEndo irrigation can be useful as an additional irrigation procedure.
Dental Pulp Cavity ; Molar ; Syringes ; Tooth ; Ultrasonics