Seok Woo Chang

Microbial Analysis in Primary and Persistent Endodontic Infections by Using Pyrosequencing

INTRODUCTION The aim of this study was to investigate the bacterial community profile of intracanal microbiota in primary and persistent endodontic infections associated with asymptomatic chronic apical periodontitis by using GS-FLX Titanium pyrosequencing. The null hypothesis was that there is no difference in diversity of overall bacterial community profiles between primary and persistent infections. METHODS Pyrosequencing analysis from 10 untreated and 8 root-filled samples was conducted. RESULTS Analysis from 18 samples yielded total of 124,767 16S rRNA gene sequences (with a mean of 6932 reads per sample) that were taxonomically assigned into 803 operational taxonomic units (3% distinction), 148 genera, and 10 phyla including unclassified. Bacteroidetes was the most abundant phylum in both primary and persistent infections. There were no significant differences in bacterial diversity between the 2 infection groups (P > .05). The bacterial community profile that was based on dendrogram showed that bacterial population in both infections was not significantly different in their structure and composition (P > .05). CONCLUSIONS The present pyrosequencing study demonstrates that persistent infections have as diverse bacterial community as primary infections.

Comparison of Alternative Image Reformatting Techniques in Micro–Computed Tomography and Tooth Clearing for Detailed Canal Morphology

INTRODUCTION Micro-computed tomography (MCT) shows detailed root canal morphology that is not seen with traditional tooth clearing. However, alternative image reformatting techniques in MCT involving 2-dimensional (2D) minimum intensity projection (MinIP) and 3-dimensional (3D) volume-rendering reconstruction have not been directly compared with clearing. The aim was to compare alternative image reformatting techniques in MCT with tooth clearing on the mesiobuccal (MB) root of maxillary first molars. METHODS Eighteen maxillary first molar MB roots were scanned, and 2D MinIP and 3D volume-rendered images were reconstructed. Subsequently, the same MB roots were processed by traditional tooth clearing. Images from 2D, 3D, 2D + 3D, and clearing techniques were assessed by 4 endodontists to classify canal configuration and to identify fine anatomic structures such as accessory canals, intercanal communications, and loops. RESULTS All image reformatting techniques in MCT showed detailed configurations and numerous fine structures, such that none were classified as simple type I or II canals; several were classified as types III and IV according to Weine classification or types IV, V, and VI according to Vertucci; and most were nonclassifiable because of their complexity. The clearing images showed less detail, few fine structures, and numerous type I canals. Classification of canal configuration was in 100% intraobserver agreement for all 18 roots visualized by any of the image reformatting techniques in MCT but for only 4 roots (22.2%) classified according to Weine and 6 (33.3%) classified according to Vertucci, when using the clearing technique. CONCLUSIONS The combination of 2D MinIP and 3D volume-rendered images showed the most detailed canal morphology and fine anatomic structures.

Correlation study between distal caries in the mandibular second molar and the eruption status of the mandibular third molar in the Korean population

OBJECTIVES The purpose of this study was to analyze the correlation parameters between the distal caries of the mandibular second molars (M2Ms) and the eruption status of the mandibular third molars (M3Ms). STUDY DESIGN The records of 786 patients who had their M3Ms extracted from 2002 to 2007 at Samsung Medical Center were reviewed. The distal caries of M2Ms, age, gender, angulations, impaction degree, and distance between M2M and M3M were assessed. RESULTS Among 883 M2Ms, 152 had distal caries (17.2%, caries group). In the caries group, 79.6% of M3Ms exhibited mesial angulation between 40 degrees and 80 degrees and 82.2% of M3Ms exhibited an impaction level in which the most coronal aspect of the M3M was located superior to the occlusal surface of the M2M. The distance between M2M and M3M (between cemontoenamel junctions) was 7-9 mm for 57.2% of the caries group. CONCLUSIONS The M3Ms under eruption status as described here could be considered for preventive extraction.

In vitro evaluation of bacterial leakage resistance of an ultrasonically placed mineral trioxide aggregate orthograde apical plug in teeth with wide open apexes: a preliminary study

OBJECTIVE The purpose of this study was to compare the sealing ability of an ultrasonically placed orthograde mineral trioxide aggregate (MTA) apical plug in open apices. STUDY DESIGN Thirty extracted human maxillary incisors were used. Experimental teeth were instrumented up to #100 file at the apex, and the 5 mm MTA apical barrier was placed with (group A; n = 11) or without (group B; n = 11) ultrasonic activation. Eight teeth served as control group. Bacterial leakage was assessed daily for 180 days using a double-chamber bacterial leakage model with Enterococcus faecalis. The results were analyzed with Fisher exact test. RESULTS After 60 days, the ratio of leaked samples showed significant difference between groups A (2 out of 10) and B (8 out of 11) (P < .05). The mean time elapsed before leakage showed significant difference between groups A (158 days) and B (23 days) (P < .05). CONCLUSIONS Ultrasonically placed orthograde MTA apical plugs were effective at delaying bacterial leakage.

Comparison of mandibular first molar mesial root canal morphology using micro-computed tomography and clearing technique

Abstract Objective. Micro-computed tomography (MCT) with alternative image reformatting techniques shows complex and detailed root canal anatomy. This study compared two-dimensional (2D) and 3D MCT image reformatting with standard tooth clearing for studying mandibular first molar mesial root canal morphology. Materials and methods. Extracted human mandibular first molar mesial roots (n = 31) were scanned by MCT (Skyscan 1172). 2D thin-slab minimum intensity projection (TS-MinIP) and 3D volume rendered images were constructed. The same teeth were then processed by clearing and staining. For each root, images obtained from clearing, 2D, 3D and combined 2D and 3D techniques were examined independently by four endodontists and categorized according to Vertucci’s classification. Fine anatomical structures such as accessory canals, intercanal communications and loops were also identified. Results. Agreement among the four techniques for Vertucci’s classification was 45.2% (14/31). The most frequent were Vertucci’s type IV and then type II, although many had complex configurations that were non-classifiable. Generally, complex canal systems were more clearly visible in MCT images than with standard clearing and staining. Fine anatomical structures such as intercanal communications, accessory canals and loops were mostly detected with a combination of 2D TS-MinIP and 3D volume-rendering MCT images. Conclusions. Canal configurations and fine anatomic structures were more clearly observed in the combined 2D and 3D MCT images than the clearing technique. The frequency of non-classifiable configurations demonstrated the complexity of mandibular first molar mesial root canal anatomy.

Analysis of six heavy metals in Ortho mineral trioxide aggregate and ProRoot mineral trioxide aggregate by inductively coupled plasma-optical emission spectrometry

Ortho mineral trioxide aggregate (MTA) is a mineral aggregate newly developed for perforation repair, root end filling and pulp capping. The aim of this study was to investigate the levels of cadmium (Cd), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni) and zinc (Zn) in Ortho MTA and ProRoot MTA. A total of 0.2 g of each MTA was digested using a mixture of hydrochloric and nitric acids and filtered. Six heavy metals in the resulting filtrates were analyzed by inductively coupled plasma-optical emission spectrometry (n = 5). The results were statistically analyzed using the Mann-Whitney U-test. The concentrations of Cd, Cu, Fe, Mn, Ni and Zn in Ortho MTA were 0.10, 7.73, 49.51, 2.58, 0.82 and 10.09 p.p.m., respectively. The concentrations of Cd, Cu, Fe, Mn, Ni and Zn in ProRoot MTA were 0.16, 9.38, 1438.11, 74.51, 18.98 and 4.05 p.p.m., respectively. In conclusion, Ortho MTA had lower levels of Cd, Cu, Fe, Mn and Ni than ProRoot MTA.

Comparison of the rheological properties of four root canal sealers.

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 Spearmans 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<Sealapex<Capseal (P<0.05). All of the tested root canal sealers showed characteristic time- and temperature-dependent changes in their rheological properties. The viscosities measured using the strain-controlled rheometer were more precise than the flowabilities measured using the simple press method, suggesting that the rheometer can accurately measure the rheological properties of root canal sealers.

Antifungal effects of synthetic human β-defensin 3-C15 peptide

Objectives The purpose of this ex vivo study was to compare the antifungal activity of a synthetic peptide consisting of 15 amino acids at the C-terminus of human β-defensin 3 (HBD3-C15) with calcium hydroxide (CH) and Nystatin (Nys) against Candida albicans (C. albicans) biofilm. Materials and Methods C. albicans were grown on cover glass bottom dishes or human dentin disks for 48 hr, and then treated with HBD3-C15 (0, 12.5, 25, 50, 100, 150, 200, and 300 µg/mL), CH (100 µg/mL), and Nys (20 µg/mL) for 7 days at 37℃. On cover glass, live and dead cells in the biomass were measured by the FilmTracer Biofilm viability assay, and observed by confocal laser scanning microscopy (CLSM). On dentin, normal, diminished and ruptured cells were observed by field-emission scanning electron microscopy (FE-SEM). The results were subjected to a two-tailed t-test, a one way analysis variance and a post hoc test at a significance level of p = 0.05. Results C. albicans survival on dentin was inhibited by HBD3-C15 in a dose-dependent manner. There were fewer aggregations of C. albicans in the groups of Nys and HBD3-C15 (≥ 100 µg/mL). CLSM showed C. albicans survival was reduced by HBD3-C15 in a dose dependent manner. Nys and HBD3-C15 (≥ 100 µg/mL) showed significant fungicidal activity compared to CH group (p < 0.05). Conclusions Synthetic HBD3-C15 peptide (≥ 100 µg/mL) and Nys exhibited significantly higher antifungal activity than CH against C. albicans by inhibiting cell survival and biofilm.

Evaluation of pH and calcium ion release in capseal I and II and in two other root canal sealers

OBJECTIVE The aim of this study was to compare the pHs and calcium ion releases of newly developed, calcium phosphate-based root canal sealers (Capseal I and II) with those of Sealapex (SA) and Sankin Apatite Root Sealer III (SARS III). STUDY DESIGN Each material (n = 10) was mixed, inserted into polyvinyl chloride (PVC) tubes, and immersed in a vial containing deionized water. The control group consisted of empty PVC tubes (n = 10). The pHs and calcium ion releases were measured by pH meter and ICP-AES (inductively coupled plasma atomic emission spectrometer) at 24 hours and 96 hours, and at 7, 15, and 28 days. The results were analyzed with the Kruskal-Wallis test. RESULTS Capseal I and II produced pHs and calcium ion releases higher than or equal to those of SA and SARS III (P < .05). CONCLUSIONS Capseal I and II resulted in higher alkalinity and higher calcium ion releases than SA and SARS III.

Bone cement grafting increases implant primary stability in circumferential cortical bone defects

Purpose Implant beds with an insufficient amount of cortical bone or a loss of cortical bone can result in the initial instability of a dental implant. Thus, the objective of this study was to evaluate the effect of bone cement grafting on implant initial stability in areas with insufficient cortical bone. Methods Two different circumferential defect depths (2.5 mm and 5 mm) and a control (no defect) were prepared in six bovine rib bones. Fourteen implants of the same type and size (4 mm×10 mm) were placed in each group. The thickness of the cortical bone was measured for each defect. After the implant stability quotient (ISQ) values were measured three times in four different directions, bone cement was grafted to increase the primary stability of the otherwise unstable implant. After grafting, the ISQ values were measured again. Results As defect depth increased, the ISQ value decreased. In the controls, the ISQ value was 85.45±3.36 (mean±standard deviation). In circumferential 2.5-mm and 5-mm defect groups, the ISQ values were 69.42±7.06 and 57.43±6.87, respectively, before grafting. These three values were significantly different (P<0.001). After grafting the bone cement, the ISQ values significantly increased to 73.72±8.00 and 67.88±10.09 in the 2.5-mm and 5.0-mm defect groups, respectively (P<0.05 and P<0.001). The ISQ value increased to more than double that before grafting in the circumferential 5-mm defect group. The ISQ values did not significantly differ when measured in any of the four directions. Conclusions The use of bone cement remarkably increased the stability of the implant that otherwise had an insufficient level of stability at placement, which was caused by insufficient cortical bone volume. Graphical Abstract