Wan-Hong Lan

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.

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.

Prevalence and distribution of cervical dentin hypersensitivity in a population in Taipei, Taiwan

The prevalence, distribution, and possible causal factors of cervical dentin hypersensitivity were studied in a population attending the Health Examination Center of National Taiwan University Hospital. A total of 780 patients were examined for the presence of cervical dentin hypersensitivity by means of a questionnaire and intraoral tests. There were 253 patients (32%) who claimed to have hypersensitive teeth at present and 90 patients (12%) who reported a history of hypersensitive teeth. The intraoral distribution of hypersensitivity showed that premolars and molars were the most common teeth sensitive to the air and probe stimuli, while the incisors were the least sensitive ones. The presence and history of dentin hypersensitivity were positively correlated with previous tooth-brushing and periodontal disease. Only a few of the patients who claimed to have dentin hypersensitivity had tried treatment with desensitizing tooth-pastes (11%) or sought professional help (5%).

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.

Cytotoxicity of sodium fluoride on human oral mucosal fibroblasts and its mechanisms

Because sodium fluoride (NaF) is widely used for prevention of dental caries, pathobiological effects of NaF were investigated on human oral mucosal fibroblasts. The results showed that NaF was cytotoxic to oral mucosal fibroblasts at concentrations of 4 mmol/L or higher. Exposure of cells to NaF for 2 h also inhibited protein synthesis, cellular ATP level and functional mitochondrial activities in a dose-dependent manner. However, incubation of cells with NaF up to 12 mmol/L for 2 h depleted only 13% of cellular glutathione level. The IC50 of NaF on cellular ATP level was about 5.75 mmol/L. Preincubation of the cells with pyruvate and succinate did not protect cells from NaF-induced ATP depletion. At concentrations of 4 mmol/L, 8 mmol/L and 12 mmol/L, NaF inhibited 31%, 56% and 57% of mitochondrial functions, respectively, after 2 h incubation. No significant inhibition for NaF was found at concentrations lower than 2 mmol/L (40 ppm). These results indicate that NaF can be toxic to oral mucosal fibroblasts in vitro by its inhibition of protein synthesis, mitochondrial function and depletion of cellular ATP. Because of repeated and long-term usage of NaF, more detailed studies should be undertaken to understand its toxic effects in vitro and in vivo.

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.

Bond Strengths of Orthodontic Bracket After Acid-Etched, Er:YAG Laser-Irradiated and Combined Treatment on Enamel Surface

Laser ablation has been proposed as an alternative method to acid etching: however, previous studies have obtained contrasting results. The purpose of this study was to compare the bond strengths after acid etching, laser ablation, acid etching followed by laser ablation, and laser ablation followed by acid etching. Forty specimens were randomly assigned to one of the four groups. Two more specimens in each group did not undergo bond test and were prepared for observation with scanning electron microscope (SEM) after the four kinds of surface treatment. After the bond test, all specimens were inspected under the digital stereomicroscope and SEM to record the bond failure mode. Students t-test results showed that the mean bond strength (13.0 +/- 2.4 N) of the laser group was not significantly different from that of the acid-etched group (11.8 +/- 1.8 N) (P > .05). However, this strength was significantly higher than that of the acid-etched then laser-ablated group (10.4 +/- 1.4 N) or that of the laser-ablated then acid-etched group (9.1 +/- 1.8 N). The failure modes occurred predominantly at the bracket-resin interface. Er:YAG laser ablation consumed less time compared with the acid-etching technique. Therefore, Er:YAG laser ablation can be an alternative tool to conventional acid etching.

Effects of EDTA on the Hydration Mechanism of Mineral Trioxide Aggregate

Ethylenediaminetetraacetic acid (EDTA) is commonly used during the preparation of obstructed root canals that face a high risk of root perforation. Such perforations may be repaired with mineral trioxide aggregate (MTA). Due to EDTA’s ability to chelate calcium ions, we hypothesized that EDTA may disrupt the hydration of MTA. Using scanning electron microscopy and energy-dispersive x-ray spectroscopy, we found that MTA specimens stored in an EDTA solution had no crystalline structure and a Ca/Si molar ratio considerably lower than those obtained for specimens stored in distilled water and normal saline. Poor cell adhesion in EDTA-treated MTA was also noted. X-ray diffraction indicated that the peak corresponding to portlandite, which is normally present in hydrated MTA, was not shown in the EDTA group. The microhardness of EDTA-treated specimens was also significantly reduced (p < 0.0001). These findings suggest that EDTA interferes with the hydration of MTA, resulting in decreased hardness and poor biocompatibility.