Yoshifumi Kinomoto

Antibacterial activity and bonding characteristics of an adhesive resin containing antibacterial monomer MDPB.

OBJECTIVES The aims of this study were to investigate the antibacterial activity of an adhesive resin incorporating the antibacterial monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB) as well as its bonding characteristics in terms of bond strength into dentin and curing ability. METHODS An experimental adhesive resin was prepared by incorporation of 2.5% MDPB into proprietary adhesive (LB Bond), and the inhibitory effect of cured specimen against the growth of Streptococcus mutans on its surface was determined. Bond strength to human dentin and degree of conversion of the experimental adhesive in combination with 1, 2, or 5% MDPB-containing primers, which were previously reported to possess bactericidal effect, were evaluated by conventional tensile bond strength test and Fourier transformation infrared spectroscopy. RESULTS The cured experimental adhesive exhibited an inhibitory effect on S. mutans growth, reducing the number of bacteria to approximately 3% of control adhesive without MDPB. Tensile bond strength of experimental adhesive was not significantly different from that of the control (p>0.05), and use in combination with MDPB-containing primer did not show any adverse influence on bond strength. The degree of conversion of the bonding system was not different (p>0.05) between control and experimental adhesive irrespective of addition of MDPB into primer. SIGNIFICANCE These results indicate that an adhesive resin with antibacterial activity after curing could be produced by incorporation of MDPB without influencing bond strength or curing performance, suggesting that the comprehensive bonding system including MDPB-containing primer and adhesive should be highly effective in its antibacterial effect before and after curing.

Incorporation of Antibacterial Monomer MDPB into Dentin Primer

The polymerizable monomer methacryloyloxydodecylpyridinium bromide (MDPB) shows antibacterial activity when immobilized in a resin-based material. In this study, the antibacterial effect of a dentin primer incorporating MDPB was investigated. The influence of incorporation of MDPB on bond strength to dentin and on the curing performance of the adhesive system was also evaluated. Experimental primers were prepared by addition of MDPB into a proprietary primer at 1, 2, or 5%. Antibacterial effects of experimental primers were compared with those of control primer and two other proprietary primers by an agar disc-diffusion method and bactericidal activity test. Experimental primers produced greater inhibition zones against Streptococcus mutans, Actinomyces viscosus, and Lactobacillus casei than any of three proprietary primers, and inhibition increased as the concentration of MDPB was increased. Bactericidal activity of MDPB-containing primers against Streptococcus mutans was greater than those of the other three primers, with incorporation of MDPB at 5% showing complete killing of bacteria after 30 s contact. No decrease in tensile bond strength was observed for materials containing MDPB. On the contrary, the primer incorporating 1 and 2% MDPB showed higher bond strength than all the others, including the control (p < 0.05). When the degree of conversion of the complex of primer and adhesive resin was determined with Fourier Transform Infrared Spectroscopy, there were no significant differences between any of the experimental primers and the control (p > 0.05). These results indicate that incorporation of the antibacterial monomer MDPB enhanced the antibacterial effect of a proprietary dentin primer before curing, and had no adverse influence on bond strength to dentin and curing of the adhesive system.

Comparison of polymerization contraction stresses between self- and light-curing composites

OBJECTIVES The objective of this study was to examine the distributions and the magnitudes of the internal stresses in self- and a light-curing composite restorations resulting from polymerization shrinkage. METHODS Butt-joint box-shaped cavities (5.0 x 2.0 mm2, 2.0 mm in depth) prepared in composite molds were filled with either a self- or light-curing transparent resin composite. The restorations were cross-sectioned perpendicular to the longitudinal axes of the cavities and observed using polarizing microscopes. The principal stresses in the restorations, normal and shear stresses at the cavity wall were evaluated by photoelastic analysis. RESULTS The distributions of the principal stresses and the stresses generated at the cavity wall in both the self- and the light-curing composite restorations were similar. The maximum stress generated at the cavity wall in the light-curing composite restorations was twice as large as that seen in the self-curing restorations. CONCLUSIONS The results of this study indicated that the difference in the magnitude of the internal stresses between self- and light-curing composites was not related to the distribution of the stresses. The velocity of polymerization appeared to be the most important factor contributing to the magnitude of the internal stresses generated in the composite restorations in this study.

Prognosis of Intentional Replantation of Vertically Fractured Roots Reconstructed with Dentin-Bonded Resin

There is no particular treatment established to preserve vertically fractured teeth. We evaluated the long-term prognosis of the intentional replantation of 26 vertically fractured roots after reconstruction with 4-META/MMA-TBB dentin-bonded resin. Replanted teeth were evaluated according to clinical criteria and radiographic examinations for periods ranging from 4 to 76 months. Eighteen cases were functional and retained, with six fully successful; the others needed further observation. Eight cases failed to respond to treatment because of refracture, recurrence of gingival inflammation, or both. Longevity was calculated as 88.5% at 12 months after replantation, 69.2% at 36 months, and 59.3% at 60 months. All failures occurred in premolar and molar teeth. Longitudinal fractures extending more than 2/3 from the cervical portion toward the apex showed significantly shorter longevity compared with fractures within the 2/3 area (log-rank test, p = 0.02). Intentional replantation of vertically fractured roots reconstructed with dentin-bonded resin may be considered for incisors as an alternative to extraction, although the long-term success is not optimal.

Short-term evaluation of intentional replantation of vertically fractured roots reconstructed with dentin-bonded resin.

The purpose of this study was to evaluate intentional replantation of vertically fractured roots reconstructed with dentin-bonded resin. Twenty vertically fractured teeth were extracted intentionally and reconstructed with 4-META/MMA-TBB dentin-bonded resin. After reconstruction, the teeth were replanted into the original sockets. The replanted teeth were evaluated by clinical criteria and radiographic examination. The observation periods ranged between 4 and 45 months. Longevity was calculated by the Kaplan-Meier method, and factors that had significant influence on the longevity were analyzed with the Log rank test at a 95% level of confidence. From this short-term observation, 14 of 20 cases were functioned in the oral environment. Of these 14 cases, 6 could be considered truly successful and 8 cases needed further observation. The other six cases were total failures and were extracted. The longevity was calculated as 83.3% at 12 months and 36.3% at 24 months. Teeth with thin roots or with longitudinal fractures extending over 2/3 of the root from the cervical portion toward the apex showed significantly lower longevity. It was concluded that this method had the potential to preserve vertically fractured teeth.

Internal Root Resorption Associated with Inadequate Caries Removal and Orthodontic Therapy

This case report presents a case of internal root resorption originating from inadequate caries removal and orthodontic therapy in maxillary right lateral incisor in a 13-yr-old female. A preoperative, panoramic radiograph taken at the orthodontic office showed no evidence of resorption, however, the composite restoration in the coronal portion was inadequate. During 4 months of nickel titanium orthodontic wire activation, the patient suffered spontaneous pain. Periapical radiographs revealed internal root resorption in the middle third of the root. Endodontic treatment was accomplished and coronal restorations were completed with composite resin. Periodical radiograph examination as well as orthodontic treatment was continued. The tooth was clinically and radiographically healthy at the 18-month follow-up. The importance of the preoperative radiographic examination as well as radiographs during orthodontic treatment is affirmed.

Optimal Positioning for a Dental Operating Microscope During Nonsurgical Endodontics

The most comfortable positioning for a dental operating microscope (DOM) during nonsurgical endodontics for operators was investigated. Operators were categorized into 3 groups according to height. We recorded the time taken to obtain magnified images, and the angles of binoculars, microscope body, and the mirror to floor surfaces. For the group of shorter operators, observations were also made with an angled optics or a short objective lens (200 mm). It took longer to observe the mandibular molars than maxillary in every group. Although the differences in angles among each group were not remarkable for maxillary observation, we confirmed significant differences for the mandibular. Shorter operators had to adopt a strained position for mandibular observation in a standard setup but were more comfortable using angled optics or a short objective lens. By understanding the proper position, operators could learn to perform microendodontics more efficiently.