Chun-Pin Lin

Cyclic Fatigue of Endodontic Nickel Titanium Rotary Instruments: Static and Dynamic Tests

Endodontic instruments upon rotation are subjected to both tensile and compressive stress in curved canals. This stress is localized at the point of curvature. The purpose of this study was to evaluate the cyclic fatigue of 0.04 ProFile nickel titanium rotary instruments operating at different rotational speeds and varied distances of pecking motion in metal blocks that simulated curved canals. A total of 150 ProFile instruments were made to rotate freely in sloped metal blocks at speeds of 200, 300, or 400 rpm by a contra-angle handpiece mounted on an Instron machine. The electric motor and Instron machine were activated until the instruments were broken in two different modes, static and dynamic pecking-motion. The fractured surfaces of separated instruments were examined under a scanning electron microscope. All data obtained were analyzed by a stepwise multiple regression method using a 95% confidence interval. The results demonstrated that the time to failure significantly decreased as the angles of curvature or the rotational speeds increased. However, as pecking distances increased, the time to failure increased. This is because a longer pecking distance gives the instrument a longer time interval before it once again passes through the highest stress area. Microscopic evaluation indicated that ductile fracture was the major cyclic failure mode. To prevent breakage of a NiTi rotary instrument, appropriate rotational speeds and continuous pecking motion in the root canals are recommended.

Structure-Property Relations and Crack Resistance at the Bovine Dentin-Enamel Junction

The present report is a study of the fracture behavior of the dentin-enamel complex, involving enamel, dentin, and the dentin-enamel junction (DEJ), that combines experimental design, computational finite element analysis, and fractography. Seven chevron-notched short-bar bovine DEJ specimens were utilized in this study. The general plane of the DEJ was approximately perpendicular to the fracture plane. All specimens were stored at 37°C and 100% relative humidity for 24 h prior to being tested. A fracture test set-up was designed for application of tensile load on the DEJ specimens to initiate a crack at the vertex of the chevron in the enamel, across the DEJ zone and into the bulk dentin. During fracture testing, a water chamber was used to avoid dehydration of the specimen. The results showed that the lower boundary value of the fracture toughness of the DEJ perpendicular to its own plane was 3.38 ± 0.40 MN/m1.5 and 988.42 ± 231.39 J/m2, in terms of KIC and GIC, respectively. In addition, there was an extensive plastic deformation (83 ± 12%) collateral to the fracture process at the DEJ zone. The fractography revealed that the deviation of the crack path involved an area which was approximately 50-100 μm deep. The parallel-oriented coarse collagen bundles with diameters of 1-5 μm at the DEJ zone may play a significant role in resisting the enamel crack. This reflects the fact, that in the intact tooth, the multiple full thickness cracks commonly found in enamel do not typically cause total failure of the tooth by crack extension into the dentin.

Scanning electron microscopy of type I collagen at the dentin-enamel junction of human teeth.

The dentin-enamel junction constitutes a unique boundary between two highly mineralized tissues with very different matrix composition and physical properties. The nature of the boundary between the ectoderm-derived enamel and mesoderm-derived dentin is not known. This study was undertaken to identify the presence, type, and distribution of collagen at the dentin-enamel junction as an initial step in understanding its structural-functional role in dental occlusion. Sections of human teeth were demineralized with 0.1 M neutral EDTA and examined by high-resolution field-emission scanning electron microscopy at low accelerating voltage. Enamel and dentin were observed to be linked by many parallel 80-120-nm diameter fibrils, which were inserted directly into the enamel mineral and also merged with the interwoven fibrillar network of the dentin matrix. Immunogold labeling for collagen was visualized by secondary electron imaging and backscatter electron imaging at low accelerating voltage. The collagen fibrils at the junctional zone as well as in the dentin matrix were identified as Type I collagen. Collagenase digestion led to loss of the fibrillar structures and prevented immunogold labeling with antibody specific to Type I collagen. Consequently, the dentin-enamel junction can be regarded as a fibril-reinforced bond which is mineralized to a moderate degree.

Sealing depth of Nd:YAG laser on human dentinal tubules

Dentin permeability and hypersensitivity are both reduced when the dentinal tubules are occluded. Previous scanning electron microscopic studies showed that Nd:YAG laser could cause melting of dentin and closure of exposed dentinal tubules without dentin surface cracking. Therefore, the aim of the present study was to evaluate the sealing depth of Nd:YAG laser on human dentinal tubules. Thirty-six dentin specimens with exposed dentinal tubule orifices were used in this study. Samples were randomly divided into three groups. Groups A and B were lased by Nd:YAG laser at energy of 30 mJ with 10 pulses/s for a stroke along the dentin surface. Group C was not lased and served as a control. Subsequently, group B was frozen in liquid nitrogen and split by a sharp chisel. Under SEM observation, nonlased specimens showed numerous exposed dentinal tubule orifices, and lased specimens showed melting of dentin and closure of exposed dentinal tubule orifices. The sealing depth of Nd:YAG laser on human dentinal tubules was approximately 4 microns.

Vertical root fracture in endodontically versus nonendodontically treated teethA survey of 315 cases in Chinese patients

OBJECTIVE The purpose of this study was to compare endodontically versus nonendodontically treated teeth with respect to clinical features, including patient age and gender and tooth types of vertical root fractures. STUDY DESIGN A total of 315 consecutive cases of vertical root fracture occurring in 274 Chinese patients during a 1 3-year period were reviewed. Age and gender, as well as tooth type and root distribution of vertical root fractures, were presented and compared in endodontically versus nonendodontically treated teeth. RESULTS Most patients (87%) had 1 fractured tooth; the others had 2 or 3 fractured teeth. Of all vertical root fractures, 40% occurred in nonendodontically treated teeth. In comparison with those in endodontically treated teeth, vertical root fractures in nonendodontically treated teeth tended to occur in patients with a higher mean age (55 years vs. 51 years) and were more frequent in male patients (78% vs. 58%). Vertical root fractures occurred in nonendodontically treated teeth more often in molars (84% vs. 53%), less often in premolars (16% vs. 33%), and seldom in anteriors (1 tooth vs. 27 teeth). CONCLUSIONS Vertical root fractures in nonendodontically treated teeth are not uncommon and comprise a large proportion of such fractures in Chinese patients. Differences between endodontically and nonendodontically treated teeth in patient age and gender, as well as in tooth types of vertical root fractures, were demonstrated.

The combined occluding effect of sodium fluoride varnish and Nd:YAG laser irradiation on human dentinal tubules

Various methods and materials used in the treatment of dentin hypersensitivity are thought to achieve a therapeutic benefit by tubule occlusion. The aim of the present study was to evaluate the combined occluding effect of sodium fluoride varnish and Nd:YAG laser irradiation on human dentinal tubules. Thirty-six dentin specimens with exposed dentinal tubule orifices were used in this study. The samples were randomly divided into four groups. Groups A, B, and C were varnished by sodium fluoride, whereas group D served as a control. Then, group C was lased by 30 mJ of Nd:YAG laser, 10 pulses/s for 2 min by light painting. Three hours later, groups B and C were brushed by an electrical toothbrush for 30 min. Under SEM observation, the control group showed numerous exposed dentinal tubule orifices, and the sodium fluoride varnished specimens showed closure of exposed dentinal tubule orifices. After electrical toothbrushing, most of the sodium fluoride varnish was brushed away, except in the specimens that were irradiated by Nd:YAG laser. Over 90% of the dentinal tubule orifices were occluded by sodium fluoride varnish combined with Nd:YAG laser irradiation.

Repair of Perforating Internal Resorption with Mineral Trioxide Aggregate: A Case Report

A case of internal resorption with buccal perforation was found in a maxillary central incisor. Because of the extensive lesion and continuous exudation, surgical intervention was used. The apical third was obturated with gutta-percha, and the perforated lesion was repaired with mineral trioxide aggregate. The residual canal space was filled by thermoplasticized gutta-percha technique, and the coronal cavity was restored with composite resin. The symptoms and signs ceased, and the results were satisfactory at 1-year follow-up.

Phase, Compositional, and Morphological Changes of Human Dentin after Nd:YAG Laser Treatment

Although techniques for repairing root fracture have been proposed, the prognosis is generally poor. If the fusion of a root fracture by laser is possible, it will offer an alternative to extraction. Our group has attempted to use lasers to fuse a low melting-point bioactive glass to fractured dentin. This report is focused on the phase, compositional, and morphological changes observed by means of X-ray diffractometer, Fourier transforming infrared spectroscopy, and scanning electron microscopy-energy dispersive X-ray spectroscopy in human dentin after exposure to Nd:YAG laser. The irradiation energies were from 150 mJ/ pulse-10 pps-4 s to 150 mJ/pulse-30 pps-4 s. After exposure to Nd:YAG laser, dentin showed four peaks on the X-ray diffractometer that corresponding to a-tricalcium phosphate (TCP) and beta-TCP at 20 = 30.78 degrees/34.21 degrees and 32.47 degrees/33.05 degrees, respectively. The peaks of a-TCP and beta-TCP gradually increased in intensity with the elevation of irradiation energy. In Fourier transforming infrared analysis, two absorption bands at 2200 cm(-1) and 2015 cm(-1) could be traced on dentin treated by Nd:YAG laser with the irradiation energies beyond 150 mJ/pulse-10 pps-4 s. The energy dispersive X-ray results showed that the calcium/phosphorus ratios of the irradiated area proportionally increased with the elevation of irradiation energy. The laser energies of 150 mJ/ pulse-30 pps-4 s and 150 mJ/pulse-20 pps-4 s could result in the a-TCP formation and collagen breakdown. However, the formation of glass-like melted substances without a-TCP at the irradiated site was induced by the energy output of 150 mJ/ pulse-10 pps-4 s. Scanning electron micrographs also revealed that the laser energy of 150 mJ/ pulse-10 pps-4 s was sufficient to prompt melting and recrystallization of dentin crystals without cracking. Therefore, we suggest that the irradiation energy of Nd:YAG laser used to fuse a low melting-point bioactive glass to dentin is 150 mJ/ pulse-10 pps-4 s.

Scavenging property of three cresol isomers against H2O2, hypochlorite, superoxide and hydroxyl radicals.

Formocresol has long been used for pulpotomy of primary teeth and as an intracanal medicament. Little is known, however, about the pharmacological effect of tricresols. This study showed that three cresol isomers, o-cresol, m-cresol and p-cresol, are H2O2 scavengers with a 50% inhibitory concentration (IC50) of 502, 6.7 and 10.16 microM, respectively. o-, m- and p-cresol were also shown to be effective scavengers of superoxide radicals generated by xanthine/xanthine oxidase with an IC50 of 282, 153 and > 4000 microM, respectively, as analyzed by luminometer. o-, m- and p-cresol showed protective effects on the DNA breaks generated by H2O2/FeCl2 and FeCl3/ascorbate/H2O2 systems at concentrations ranging from 70 microM to 1.43 mM, o-, m- and p-cresol also showed differential protective effects against DNA breaks induced by 0.17% NaOCl with 100% inhibitory concentration (IC100) of about 10, 1 and 10 mM, respectively. In addition, reaction with 3% H2O2 and 0.17% NaOCl completely prevented NaOCl-induced DNA breaks. The results indicate that the three cresol isomers are effective ROS scavengers and may prevent ROS induced damage when used as pulpotomy agents or as intracanal medicaments. Owing to the difference in the position of the functional hydroxyl group in the three cresol isomers, m-cresol is the most effective ROS scavenger. Concomitant use of H2O2 for root canal irrigation may diminish both the tissue dissolving capacity of NaOCl and NaOCl-induced DNA damage.

Failure mechanisms at the human dentin-resin interface: A fracture mechanics approach

The present study reports on the failure mechanisms at the human dentin-resin interface, with special reference to two specific questions: (1) does failure at the human dentin-resin interface occur by a cohesive or an adhesive mechanism? (2) is the failure mechanism accompanied by a plastic deformation, and if so how important is it? The experimental design, computational analysis, and fractography were applied to two generically different bonding systems: Scotchbond-2 (SB2) and Scotchbond-multipurpose (SBM). The theoretical basis of the study required a three-dimensional finite element analysis for calibration of the new geometric factor coefficient. A minimum geometric factor coefficient (Ym) of 17.3 was then obtained which was vital for the determination of the interfacial fracture toughness. Accordingly, the dentin-resin interfacial fracture toughness (GIC), for the SB2 and for the SBM were 30.22 +/- 5.61 and 49.56 +/- 7.65 J m-2, respectively, which were significantly different (p < 0.01). Both SB2 and SBM interfaces with dentin displayed significant degrees of plasticity (0.15 and 0.19) which were beneficial to crack resistance. Thus, correcting for the plasticity, the GIC for SB2 and for SBM increased to 42.83 +/- 7.75 and 74.97 +/- 10.47 J m-2, respectively. The fractography of the two systems reflected these numeric differences. SB2 showed largely interfacial adhesive failure, while SBM showed adhesive-cohesive failure with occasional dentin adhesions attached to the composite interface and vice versa.