Gi-Woon Choi

Effects of simvastain and enamel matrix derivative on Portland cement with bismuth oxide-induced growth and odontoblastic differentiation in human dental pulp cells.

INTRODUCTION We previously reported that bismuth oxide containing Portland cement (BPC) showed similar biocompatibility to Portland cement (PC) in periodontal ligament cells. However, the bioactivity of simvastatin and Emdogain (Biora AB, Malmö, Sweden) on BPC was not reported. The aim of this study was to evaluate the effects of simvastatin and Emdogain on BPC compared with mineral trioxide aggregate (MTA) in human dental pulp cells (HDPCs). METHODS Cell growth was determined by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium-bromide (MTT) assay. Differentiation was evaluated by alkaline phosphatase (ALP) activity, alizarin red staining, and reverse-transcriptase polymerase chain reaction. RESULTS The cell growth of HDPCs exposed to Emdogain and simvastatin plus BPC was superior to those administered BPC alone and similar to those that received MTA for 14 days. The simvastatin and Emdogain groups increased the odontogenic potential of the BPC group with respect to ALP activity, mineralization nodules, messenger RNA expression of ALP, osteopontin, osteocalcin, Runx2, and osterix. CONCLUSIONS These results suggest that simvastatin and Emdogain improved cell growth and the differentiation of the BPC group in HDPCs and may be useful ingredients in BPC as pulp-capping material.

Management of complicated crown‐root fractures using intentional replantation: two case reports

The management of complicated crown-root fractures is a challenge. Intentional replantation with 180° rotation may be a useful procedure to overcome this problem. In Case 1, a 23-year-old woman with complicated crown-root fractured teeth #11, #21, and #22 was referred for treatment. All fractured teeth were extracted, rotated 180°, and replanted in a slightly extruded position. After 3 months, root canal treatment was completed and the final restorations fabricated. At the 18-month follow up, the patient was asymptomatic, the tooth was functional, and no root resorption was observed radiographically. At the 90-month follow up, slight cervical root resorption of tooth #11 was noted. In Case 2, a 27-year-old woman with a crown-root fractured tooth #21 was referred for treatment. Despite immediate repositioning of the coronal fragment and a 2-week stabilization with a wire splint, the coronal fragment remained separated from the apical tooth segment. The apical segment was extracted, rotated 180°, and replanted in a slightly extruded position. After 1 and 4 weeks, the root canal treatment was completed and the final restoration fabricated, respectively. At the 24-month follow up, the patient was asymptomatic and apical healing was completed.

MORPHOLOGY OF THE APICAL ROOT CANAL SYSTEM IN KOREAN MANDIBULAR FIRST MOLAR

본 연구는 한국인의 하악 제1 대구치 60개를 대상으로 생리적 근단공의 크기와 형태, 근심 치근의 치근단 3mm에서 isthmus의 발생 빈도와 형태, 그리고 원심 치근의 치근단 3mm의 근관 형태를 입체현미경하에서 60배로 조사한 결과 다음과 같은 결론을 얻었다. 1.근심 치근은 두 개의 근단공을 가지는 비율이 높았으며(51.67%), 원심 치근은 하나의 근단공을 가지는 비율이 높았다(71.66%). 2. 부근단공의 빈도는 근심 치근의 1개의 근단공을 가지는 경우가 가장 높았다(26.07%) 3. 생리적 근단공의 크기는 근심 치근에서 하나의 근단공을 가지는 경우 0.329mm, 근심 협측 근단공은 0.266mm, 근심 설측 근단공은 0.246mm였으며, 원심 치근에서 하나의 근단공을 가지는 경우 0.375mm, 원심 협측 근단공은 0.291mm, 원심 설측 근단공은 0.237mm로 나타났다. 4. 근단공의 형태는 oval 형태 (69.93%)가 가장 많았다. 5.근심 치근의 치근단 3mm에서 isthmus의 발생빈도는 55%였으며, partial isthmus는 31.66%, complete isth-mus는 23.34%로 나타났다. 6.원심 치근의 치근단 3mm의 근관 형태는 oval형태(50.64%)가 가장 많았다. 이상의 연구 결과 하악 제1대구치의 성공적인 근관 치료를 위해서는 생리적 근단공의 실제 크기와 형태 및 isthmus의 존재에 대한사전 지식이 필요할 것이다. 【The aim of this study was to investigate the shapes and diameters of the physiological foramen and anatomy of the root canal at 3mm from apex in mandibular first molars. Sixty mandibular first molars were randomly selected. The apical anatomy of 60 mandibular first molars was investigated by means of a stereo microscope (60x magnification). The results were as follows; 1. There was a high percentage of two physiological foramina in mesial (61.67%) and one foramen in distal(71.66%) roots of mandibular first molars. 2. There was a high frequency of accessory foramina in mesial roots with one foramen (26.07%). 3. The diameters of physiological foramen was as follows: - 0.329mm in single mesial foramen - 0.266mm in mesiobuccal foramen and 0.246mm in mesiolingual foramen - 0.375mm in single distal foramen - 0.291mm in distobuccal foramen and 0.237mm in distolingual foramen 4. The most common physiological foramen shape was oval (69.93%). 5. The incidence of isthmus in mesial root at 3mm from apex was 55%. The 3mm-sections contained a complete isthmus 31.66% and a partial isthmus 23.34%. 6. 3mm from the apex, the most common canal shape was oval (50.64%). Knowledge of the apical anatomy of mandibular first molar would be necessary for success of surgical and nonsurgical endodontic treatment.】

THE COMPARISON OF GENE EXPRESSION FROM HUMAN DENTAL PULP CELLS AND PERIODONTAL LIGAMENT CELLS

The purpose of this study was to characterize functional distinction between human dental pulp cells(PC) and periodontal ligament cells(PDLC) using cDNA microarray assay and to confirm the results of the microarray assay using RT-PCR. 3 genes out of 51 genes which were found to be more expressed(>2 fold) in PC were selected, and 3 genes out of 19 genes which were found to be more expressed(>2 fold) in PDLC were selected for RT-PCR as well. According to this study, the results were as follows: 1. From the microarray assay, 51 genes were more expressed (2 fold) from PC than PDLC. 2. RT-PCR confirmed that ITGA4 and TGF β 2 were more expressed in PC than in PDLC 3. From the microarray assay, 19 genes were more expressed (2 fold) from PDLC than PC. 4. RT-PCR confirmed that LUM, WISP1, and MMP1 were more expressed in PDLC than in PC. From the present study, different expression of the genes between the PC and PDLC were characterized to show the genes which play an important role in dentinogenesis were more expressed from PC than PDLC, while the genes which were related with collagen synthesis were more expressed from PDLC than PC. [J Kor Acad Cons Dent 34(5):430-441, 2009]

THE EFFECT OF SMEAR LAYER TREATMENT ON THE MICROLEAKAGE

The purpose of this study was to compare the sealing ability of root canal obturation with or without the treatment of smear layer. Eighty extracted human teeth with one canal were selected Instrumentation was performed with crown-down technique. After instrumentation, root canals of the NaOCl group and NaOCl-6 group were irrigated with 3% NaOCl. EDTA group and EDTA-6 group were irrigated with 17% EDTA. Then all teeth were obturated using continuous wane obturation technique NaOCl group and EDTA group were immersed in methylene blue solution for 84hours. NaOCl-6 group and EDTA-6 group were immersed in methylene blue solution for 6months. The teeth were sectioned at 1.5 mn (Level 1), 3.0 mm (Level 2) and 4.5 mm (Level 3) from the root apex. The length of dye-penetrated inter-face and the circumferential length of canal at each level were measured using Sigma-Scan Pro 5.0. 1. The mean leakage ratio was decreased cervically. 2. NaOCl group showed higher mean leakage ratio than EDTA group at each level. But there was significant difference at level 1 only (p

TIME-DEPENDENT EFFECTS OF EDTA APPLICATION ON REMOVAL OF SMEAR LAYER IN THE ROOT CANAL SYSTEM

EDTA의 세정시간에 따른 근관 내 smear layer의 제거효과에 관한 연구 This study was to verify that the combined application of NaOCl and EDTA was more effective in removal of smear layer than the application of NaOCl alone. Furthermore it was aimed to find out the optimal time for the application of EDTA. Thirty five single rooted teeth were cleaned and shaped. NaOCl solution was used as an irrigant during instrumentation. After instrumentation, root canals of the control group were irrigated with 5 ㎖ of NaOCl for 2 minutes. 30 sec, 1 min, and 2 min group were irrigated with 5 ㎖ of 17% EDTA for 30 sec, 1 min, and 2 min respectively. Then the roots were examined with scanning electron microscopy for evaluating removal of smear layer and erosion of dentinal tubule. The results were as follows; 1. The control group: The smear layer was not removed at all. 2. The other groups: 1) Middle⅓: All groups showed almost no smear layer. And the erosion occurred more frequently as increasing irrigation time. 2) Apical⅓: The cleaning effect of 2 min group was better than the others. The results suggest that 2 min application of 17% EDTA should be adequate to remove smear layer on both apical⅓ and middle⅓.

Distribution of oral pathogens in infections of endodontic origin

It has been documented that periodontopathic bacteria are also implicated in endodontic infections. 168 rDNA gene-directed PCR was to examine the prevalence of periodontopathic bacteria including Actinobacillus actinomycetemcomitans (Aa), Prevotella intermedia (Pi), Prevotella nigrescens (Pn), Porphyromonas gingivalis (Pg), Porphyromonas endodontalis (Pe), and Treponema denticola (Td) in the root canals of 36 endodontically infected teeth having apical lesions with or without clinical symptoms like pain, swelling, and fistula. 1. In 36 infected root canals, most frequently detected bacterial species was Pg (61.1%), followed by Td (52.8%) and Pe (38.9%). 2. Of 36 infected root canals, Aa was detected in 6 canals (16.7%) of the teeth, all of which showed clinical symptoms. 3. Of 36 infected root canals, Pi and Pn were found in 4 03.9%) and 5 (33.3%), respectively. Notably, prevalence of Pn in the symptomatic teeth was 50.0%. 4. One of black-pigmented anaerobic bacteria (BPB) including Pi, Pn, Pe, and Pg was detected in all of the teeth that showed pain or especially swelling but not fistula. It was, however, found that prevalence of BPB in the asymptomatic teeth or the teeth with fistula was only 40%. 5. Pe and Pg were detected in the teeth regardless of the presence or absence of symptoms. 6. Td was detected in the teeth regardless of the presence or absence of symptoms. High prevalence of BPB in the symptomatic teeth but low in the asymptomatic teeth suggests that BPB may play an important role in the pathogenesis of periapical lesions.

The canal system of mandibular incisors

The purpose of this study is to identificate root canal system including ideal access placement, root curvature, canal configuration, incidence of isthmus in mandibular incisors for success of endodontic treatment. 200 mandibular incisors were selected. The ideal access placement was determimed as follows. The teeth there radiographed from mesiodistal and buccolingual views using intraoral dental film. The image was divided into coronal, middle and apical third using the proximal film. Straight line access was determined by measuring the faciolingual canal width and placing points at midway point between the buccal and lingual wall at the junction of the middle and apical third and at the juntion of coronal and middle third of the root canal. A line was drawn connecting these two points extending through the crown of the tooth. The point at which the line crossed the external crown surface was recorded as facial, incisal, lingual. Degree of root curvature was determined by Schneider Protractor Method. Both section method and clearing method were used in this study. By section method, 100 mandibular incisors were embedded in clear resin and transeverse serial sectioned at 0.5, 1.0, 2.0, 3.0, 4.0, 5.0mm level from root apex. The resected surfaces were stained by methylene blue and examined under 40 magnification with a stereomicroscope. By clearing method, 100 mandibular incisors were cleared in methysalicylate after decalcification with 10% nitric acid and evaluated under 18 magnification with a stereomicroscope. The results were as follows ; 1. 29% had the center of the plotted straight-line access facial to incisal edge, whereas 71% had straight-line access at the incisal edge. When incisal wear classified as extensive, the straight-line access was plotted on the incisal edge 95.5%. When incisal wear classified as slight/none, the straight-line access was plotted on the facial 65.9%. 2. Degree of curvature of main canal was straight or almost straight, and only 10% in buccolingual direction had a degree of curvature greater than 20 degrees and 5.5% in mesiodistal direction had. 3. In section method, canal configuration analysis showed that 51% of the specimen classified as type I, 27% as type II, 12% as type III, 10% as type IV. For theses setions with two canals, the incidence of an isthmus was 36.7%, 64.3%, 79.2%, 96.3%, 97.4%, 97.6% at each level and highest in 3~5mm sections. 4. In clearing method, canal configuration analysis showed that 74% of the specimen classified as type I, 11% as type II, 6% as type III, 9% as type IV. These results suggested that traditional access from lingual should be moved as far toward the incisal as possible to locate and debride the lingual canal and root canal system should be cleaned, shaped completely and obturated three dimensionally for successful endodontic treatment.

The effect of tumor necrosis factor (TNF)-α to induce matrix metalloproteinase (MMPs) from the human dental pulp, gingival, and periodontal ligament cells

Objectives: In the present study, three kinds of tissues cells (pulp, gingiva, and periodontal ligament) were investigated if those cells express MMP and TIMP when they were stimulated with neuropeptides (sub- stance P, CGRP) or proinflammatory cytokine, TNF-α . Materials and Methods: The cells cultured from human dental pulp (PF), gingiva (GF) and periodontal liga- ment were (PDLF) stimulated with Mock, SP, TNF-α , and CGRP for 24 hrs and 48 hrs. for an RNase pro- tection assay and Enzyme Linked Immunosorbent Assay. Cells (PF, GF and PDLF) seeded in 100 mm culture dish were stimulated with SP (10 -5 , 10 -8 M) or only with medium (Mock stimulation) for 4hrs and for 24 hrs for RNase Protection Assay, and they were stim- ulated with CGRP (10-5 M) and TNF-α(2 ng/mL) for 24 hrs and with various concentraion of TNF-α(2, 10, and 100 ng/mL) for Rnase Protection Assay with a human MMP-1 probe set including MMP 1, 2, 8, 7, 8, 9, 12, and TIMP 2, 3. In addition, cells (PF, GF and PDLF) were stimulated with Mock and various concentraion of TNF-α(2, 10, and 100 ng/mL) for 24 hrs and with TNF-α(10 ng/mL) for 48 hrs, and the supernatents from the cells were collected for Enzyme Linked Immunosorbent Assay (ELISA) for MMP-1 and MMP-13. Results: The expression of MMPs in PF, GF, PDLF after stimulation with SP and CGRP were not changed compared with Mock stimulation for 4 hrs and 24 hrs. The expression of MMP-1, -12, -13 24 hrs after stimulation with TNF-αwere upregulated, however the expression of TIMP-3 in PF, GF, PDLF after stim- ulation with TNF-αwere downregulated. TNF-α(2 ng/mL, 10 ng/mL, 100 ng/mL) increased MMP-1 and MMP-12 expression in PF dose dependently for 24 hrs. Conclusions: TNF-αin the area of inflammation may play an important role in regulating the remodeling of dentin, cementum, and alveolar bone. ABSTRACT

A COMPARISON OF THE SHAPING ABILITY OF FOUR ROTARY NICKEL-TITANIUM FILES IN SIMULATED ROOT CANALS

The purpose of this study was to compare the root canal shaping ability of 4 rotary NiTi instruments in sim-ulated root canals. For the preparation of thirty two curved root canals, Mtwo inst ruments using “single length”technique, andProfile, ProTaper Universal, and K3 using crown-down technique (N = 8) were used. All canal samples were pre-pared by reaching an apical canal size of #30. Pre- and post-in strumentation digital images were recorded and anassessment of canal shape was determined using a computer image analysis program SigmaScan Pro (SystatSoftware Inc., San Jose, CA, USA). The changes of the dimension of inner walls of canals, (2) the changes of thedimension of outer walls of canals, and (3) the centering ratio were measured at 7 measuring points, and thendata were statistically analyzed using one-way ANOVA and Duncan’s test. The results were as below; 1. The root canal shaping ability of Profile was significantly faster than that of other rotary NiTi instru-ments (p < 0.05).2. The deformation and fracture of all instruments used for this study were not experienced. 3. In the degree of changes of the dimension of inner walls of canals, Profile demonstrated the lowestchanges of the dimension of inner walls of canals except at the measuring points of the 1 and 2 mm (p <0.05). However, the ProTaper Universal showed the highest changes of the dimension of inner walls ofcanals at all measuring points (p < 0.05). 4. In the degree of changes of the dimension of outer walls of canals, Mtwo demonstrated the lowest changseof the dimension of outer walls of canals except at the measuri ng point of the 1 mm (p < 0.05). However,Profile exhibited the highest changes of the dimension of outer walls of canals at the measuring points of3 and 4 mm and ProTaper Universal and K3 showed the largest cha nges of the dimension of outer wallsof canals at the measuring points of 1, 2, 6, and 7 mm (p < 0.05). 5. In degree of centering ratio, Profile demonstrated the least centering ratio comparing with the centeringratio shown by other NiTi instruments at the measuring points of 1, 4, 5, and 6 mm.Results suggest that in the coronal part of canal preparation, active cutting files such as ProTaper Universalmay efficiently flare the canal orifice and form a better taper , and in the apical part of the canal, files whichhave a better centering ability such as Profile maymaintain the original canal curvature and reduce theshaping time.