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Biomedical subjects

B S Chong

Publications and source records attributed to B S Chong.

At least 19 recordsLinked to original sources

Radiopacity of resin-modified glass ionomer liners and bases.

STATEMENT OF PROBLEM: Lining and base materials for restorations have traditionally been autopolymerized and include conventional glass ionomer cements. Light-cured resin-modified glass ionomer cements have recently become available, but a lack of information exists regarding their radiopacity. PURPOSE OF STUDY: In this study the radiopacity of glass ionomer cements was assessed with a standard method that related densitometric measurements to an equivalent thickness of aluminum. MATERIAL AND METHODS: Radiographs were made of specimens with seven materials commonly used as liners and bases: two reinforced zinc oxide-eugenol cements (Kalzinol and Intermediate Restorative Material, De Trey Dentsply), a zinc phosphate cement (SS White, S.S. White Manufacturing), three resin-modified glass ionomer liners (Vitrebond [3M Dental Products], Fuji Lining LC [GC Dental], and Photac-Bond [ESPE Dental Medizin GmbH]), and a conventional glass ionomer liner/base (Ketac-Bond, ESPE Dental-Medizin GmbH), with dentin as a control. The radiopacity of all materials was compared with dentin. RESULTS: Kalzinol had the greatest radiopacity of the materials tested. The glass ionomer cements were substantially less radiopaque than other materials. The conventional glass ionomer cement, Ketac-Bond, was more radiopaque than the three resin-modified glass ionomer cements. Of the three resin-modified glass ionomer materials, Vitrebond was the most radiopaque and Fuji Lining LC was the least radiopaque. CONCLUSION: Future resin-modified glass ionomer materials are recommended to be formulated to increase radiopacity for improved clinical detection.

Absorptiometry, Photon

Short-term tissue response to potential root-end filling materials in infected root canals.

The short-term tissue responses to two potential root-end filling materials, a light-cured glass ionomer cement (Vitrebond) and a reinforced zinc oxide-eugenol cement (Kalzinol), were compared with that to amalgam using a previously devised experimental model. In 24 premolar teeth of beagle dogs (47 roots), a collection of endodontic pathogenic bacteria was first inoculated into the root canals to induce periradicular lesions. On each root, an apicoectomy was performed and root-end cavities prepared to receive fillings of each material. The teeth and surrounding jaw were removed after 2 weeks (23 roots) and 1 week (24 roots); they were then prepared for histological examination. The tissue response to amalgam fillings after 2 weeks and 1 week was marked by moderate or severe inflammation on all roots, and extended to < or = 0.5 mm or > 0.5 mm in 15 out of 16 roots. In contrast, after 2 weeks, the majority of roots filled with Kalzinol showed little or moderate inflammation, while the tissue response to Vitrebond was the best of the three materials, and was also the least extensive. After 1 week, the overall best tissue response was with Vitrebond, followed by Kalzinol. The differences between materials for both time periods with either none or few inflammatory cells when compared with that with either moderate or severe inflammation were not statistically significant (P < 0.02). However, the differences between materials for both time periods with no inflammation or inflammation extending < 0.2 mm when compared with that with inflammation extending > 0.2 mm (< or = 0.5 mm or > 0.5 mm) were statistically significant (P < 0.01). Apart from amalgam, in which healing was marked by the persistence of a localized focus of inflammation adjacent to the root-end filling, even though there were intersample variations, there was little overall difference in the temporal and qualitative healing response to Vitrebond and Kalzinol. Both Vitrebond and Kalzinol have potential as root-end filling materials, as the tissue response was considerably more favourable than that to amalgam even in the short-term.

Animals

Radiological assessment of the effects of potential root-end filling materials on healing after endodontic surgery.

The effects of three root-end filling materials on healing following endodontic surgery were assessed radiologically and correlated with histological findings reported elsewhere. The materials compared were a light-cured glass ionomer cement (Vitrebond), a reinforced zinc oxide-eugenol cement (Kalzinol) and amalgam. The root canals of 27 two-rooted mandibular premolar teeth of six beagle dogs were inoculated with endodontic pathogenic bacteria to induce periradicular lesions. The roots were apicected and root-end cavities filled with the tested filling materials. The teeth and surrounding jaw were removed after 4 weeks (30 roots) or 8 weeks (24 roots). Radiographs were taken of each jaw section and subjected to image analysis. Healing was evaluated based on measurements of the size of the periradicular radiolucent areas. ANOVA disclosed no statistically significant differences in the size of the periradicular areas either between time periods or between materials. These results did not correlate with the tissue responses in the same material as assessed histologically and previously reported. The use of radiographs alone to assess healing after endodontic surgery in the dog mandible is unsatisfactory, and should not be regarded as a substitute for histological examination for the determination of healing.

Analysis of Variance

Radiopacity of potential root-end filling materials.

OBJECTIVES: In recent years various root-end filling materials have been suggested for clinical use. The purpose of this study was to assess the radiopacity of some potential materials according to ISO specification 6876. STUDY DESIGN: Radiographs were taken of 1-mm thick specimens of eight materials (amalgam, Kalzinol, IRM, Super EBA, Vitrebond, Fuji II LC, Chemfil, gutta-percha); light transmission was assessed densitometrically and related to equivalent thickness of aluminum. RESULTS: Commercial glass ionomer cements (Vitrebond, Fuji II LC, Chemfil) had radiopacities below the international standard for root canal sealers (< 3-mm aluminum); three zinc oxide-eugenol cements (Kalzinol, Super EBA, IRM) had radiopacities equivalent to 5 to 8 mm aluminum; and gutta-percha had a radiopacity equivalent to 6.1-mm aluminum. CONCLUSIONS: We recommend that root-end filling materials should have a radiopacity greater than that for root canal sealers.

Absorptiometry, Photon

Radiopacity of resin-modified glass-ionomer restorative cements.

This in vitro study compared the relative radiopacities of three commercially available resin-modified glass-ionomer cements (Vitremer, Fuji II LC, and Photac-Fil), an experimental resin-modified glass-ionomer (V-66), two conventional glass-ionomers (ChemFil and Fuji Cap II), and amalgam (as the control). Radiopacity was assessed densitometrically and expressed as equivalent thicknesses of aluminum. All the glass-ionomer cements were more radiopaque than enamel and dentin, with the exception of ChemFil and Photac-Fil. Apart from the control material, the experimental resin-modified glass-ionomer material, V-66, had the highest radiopacity of all the materials tested. Of the three resin-modified glass-ionomer materials tested, Fuji II LC was the most radiopaque and Photac-Fil the least. For the radiopacity of restorative glass-ionomer materials to exceed that of enamel, it should be greater than 1.5 mm of equivalent thickness of aluminum.

Absorptiometry, Photon

Endodontic retreatment. 2: Methods.

The best method for retreating a tooth that has already undergone root treatment will depend on the root filling technique and material used; a combination of retreatment techniques may be required. The correct method, combined with the required equipment, skill and experience, are necessary to produce a high standard of retreatment and a successful result. In part 1 of this article, the indications and case selection for root canal retreatment were discussed; this article will now discuss the methods of retreatment available.

Dental Debonding

Endodontic retreatment. 1: Indications and case selection.

Conventional root canal treatment, despite having a reportedly high success rate may not invariably lead to the desired healing response in clinical practice because of shortcomings in the treatment. This is the first of two articles on this subject, and will cover indications and case selection for root canal retreatment. Part 2 will discuss methods of retreatment.

Dental Pulp Diseases

Coronal leakage and treatment failure.

This report presents a case in which undiagnosed coronal leakage resulted in failure in the endodontic management of a tooth. Coronal leakage occurred during root canal treatment as a result of the presence of deficient composite resin fillings and secondary caries. Despite repeated visits of cleaning and dressing, the canal continued to be contaminated and symptoms persisted. On referral, the reason for treatment failure was diagnosed. The tooth was successfully treated by the replacement of the deficient fillings, after the elimination of underlying caries. Symptoms resolved enabling the completion of the root canal treatment.

Adult

Sealing ability of potential retrograde root filling materials.

The sealing ability of two potential retrograde root filling materials, a light-cured glass ionomer cement (Vitrebond) and a reinforced zinc oxide-eugenol cement (Kalzinol) was compared with that of amalgam using three methods of assessment: bacterial leakage, confocal microscopy and Indian ink leakage. the root canals of 80 extracted human single-rooted teeth were prepared. All the teeth were apicected, retrograde cavities were prepared and then divided into four equal groups of 20 teeth. The teeth were sterilised by autoclaving and the retrograde cavities filled with the test materials. In the control group, retrograde cavities in 10 teeth were left unfilled while cavities in another 10 teeth were sealed with cyanoacrylate cement. The teeth were first subjected to a bacterial leakage test using Enterococcus faecalis as a leakage marker. After which, the adaptation of the retrograde root fillings was assessed using a confocal optical microscope. Finally, the teeth were processed for the Indian ink leakage test. Bacterial leakage occurred in more teeth filled with amalgam compared with both Vitrebond and Kalzinol (P<0.001), between which there were no differences. With confocal microscopy, the size of the marginal gap was largest with amalgam and smallest with Vitrebond; all differences were statistically significant (<0.001). Finally, there was more Indian ink penetration with amalgam compared with both Vitrebond and Kalzinol (P<0.001) but there were no differences between Vitrebond and Kalzinol. Although there were individual differences within samples, overall, the three methods of assessment produced similar results. The sealing ability of Vitrebond and Kalzinol was similar and both materials were better than amalgam.

Carbon

Antibacterial activity of potential retrograde root filling materials.

The antibacterial activity of potential retrograde root filling materials was assessed using the agar diffusion inhibitory test. A light-cured glass ionomer cement (Vitrebond) and three reinforced zinc oxide-eugenol cements (Kalzinol, IRM & ethoxybenzoic acid [EBA] cement) were compared with amalgam, a commonly used retrograde root filling material. Forty standardized pellets of each material were produced. Fresh, and materials aged for 1 week in sterile distilled water, were placed on blood agar plates inoculated with Streptococcus anginosus (milleri) or Enterococcus faecalis. At intervals of 3, 7 and 10 days, the presence and diameter of zones of inhibition were recorded. The diameter of the zones of inhibition increased with time for all materials, both fresh and aged. Vitrebond had the most pronounced antibacterial activity against both bacteria, producing the largest zone of inhibition, followed by Kalzinol. Amalgam had no measurable inhibitory effect whether aged or fresh, regardless of the period of exposure. There was no statistically significant difference in the response of the two bacteria. However, there were statistically significant differences between materials, period of exposure, and between fresh and aged materials (P < 0.001). Kalzinol, IRM and EBA cement were more antibacterial when aged than fresh, whilst Vitrebond was more active when fresh. Vitrebond was the only material for which the diameter of the zones of inhibition was reduced after ageing but it had the most pronounced antibacterial activity compared with the other materials. The antibacterial activity of the materials was ranked in the following order: Vitrebond > Kalzinol > (IRM = EBA cement) > amalgam.

Analysis of Variance

Biological properties of IRM with the addition of hydroxyapatite as a retrograde root filling material.

The effect of adding 10% & 20% hydroxyapatite (HAP) on the antibacterial activity and cytotoxicity of IRM (Intermediate Restorative Material) when used as a retrograde root filling was compared with amalgam, a commonly used material. The antibacterial activity was assessed using the agar diffusion inhibitory test. Forty standardized pellets of each material were produced. Fresh materials, and materials aged for 1 week in sterile distilled water, were placed on blood agar plates inoculated with Streptococcus anginosus (milleri) or Enterococcus faecalis. The presence and diameter of zones of inhibition were recorded at intervals of 3, 7 and 10 days. There was no statistically significant overall difference in the response of the two bacteria tested. However, there were statistically significant overall differences in diameters of the zones of inhibition related to different materials, period of exposure and ageing of materials (P < 0.001). The diameter of the zones of inhibition increased with time for all materials, fresh and aged. IRM and both the HAP-modified forms produced large zones of inhibition. Amalgam produced no measureable zones of inhibition whether aged or fresh, regardless of period of exposure and was different from the other materials (P < 0.001). The cytotoxicity was assessed using the Millipore filter method. Ten standardized pellets of each material were produced and aged by storage in sterile distilled water for 72 h. Ten filters were included as controls. Amalgam produced a consistent cytotoxic score of 1, and the difference between amalgam and the other materials was statistically significant (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

3T3 Cells

Cytotoxicity of potential retrograde root-filling materials.

The cytotoxicity of potential retrograde root-filling materials was assessed using the Millipore filter method. A light-cured glass ionomer cement, Vitrebond (VB), and three reinforced zinc oxide-eugenol cements, Kalzinol, IRM and ethoxybenzoic acid (EBA) cement, were compared with amalgam. Twenty standardized pellets of each material, 10 fresh and 10 aged by storage in sterile distilled water for 72 h were produced. Ten filters were included as controls: five filters with a cell monolayer, but without test specimens, and another five without cells but with test specimens. Fresh IRM exhibited the most pronounced cytotoxic effect and the difference was statistically significant compared with all the other materials. There was no statistically significant difference between fresh VB, Kalzinol, EBA cement and amalgam. When aged, Kalzinol was the most cytotoxic and the difference was statistically significant compared with the other materials. Aged IRM was the second most cytotoxic material and this too was statistically different. The cytotoxicity of VB, EBA, and amalgam did not differ significantly from one another.

3T3 Cells

Apex locators in endodontics: which, when and how?

To ensure that root canal treatment is successful the clinician must accurately determine the working length of the root canal. Traditionally this has been determined using radiography, but electronic apex locators are increasingly being used. This article describes the locators available, the principles behind their use and gives guidelines on how and where to use them.

Dental Pulp Cavity

Light-cured glass ionomer cement as a retrograde root seal.

A light-cured ionomer cement was investigated as a retrograde root seal, without a retrograde cavity. This was compared with the material used in a retrograde cavity, and with a conventional glass ionomer cement, as a seal. The adaptation and sealing ability of the test materials were assessed using a confocal optical microscope with a fluorescent dye. The root canals of 40 extracted human single-rooted teeth were prepared and filled with gutta-percha and sealer. All the teeth were subsequently apicected, then divided into four equal groups. In one group, a retrograde cavity was prepared, and the light-cured glass ionomer cement was placed as a retrograde root filling. No retrograde cavities were prepared in the three remaining groups. The light-cured glass ionomer cement was applied directly onto the apicected root face. Two different thicknesses of light-cured glass ionomer cement were tested, a thin layer (approximately 1 mm) in one group, and a thicker layer (> 1 mm) in another group. A conventional glass ionomer cement was used in the last group, and applied directly onto the root face in a single thickness (approximately 1 mm). In the group where the light-cured glass ionomer cement was used in a retrograde cavity, the material was often well adapted to one cavity wall, but gaps were found on the opposite wall. The light-cured and conventional glass ionomer cement retrograde root seals were well adapted to the root face, regardless of the thickness of material used. The thinly applied (approximately 1 mm) light-cured glass ionomer cement retrograde root seals permitted the least leakage.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance

The role of intracanal medication in root canal treatment.

The role of intracanal medication as a root canal dressing is re-examined. In pulpectomy and some root canal treatments, where the root canal contains vital pulp tissue, it is doubtful whether a routine intracanal medicament is needed. In infected root canals, intracanal medication has been advocated for many purposes. An intracanal medicament is used to: (i) eliminate any remaining bacteria after canal instrumentation; (ii) reduce inflammation of periapical tissues and pulp remnants; (iii) render canal contents inert and neutralize tissue debris; (iv) act as a barrier against leakage from the temporary filling; (v) help to dry persistently wet canals. However, most of the indications for intracanal medicaments are questionable. Intracanal medicaments should only be used for root canal disinfection as part of controlled asepsis in infected root canals, and their role is secondary to cleaning and shaping of the root canal. Thorough canal debridement and adequate canal preparation are more pertinent, and their importance is emphasized. Bacteriological sampling may be necessary if a tooth does not respond to treatment, to help in the choice of intracanal medicament.

Adrenal Cortex Hormones

The adaptation and sealing ability of light-cured glass ionomer retrograde root fillings.

The adaptation and sealing ability of a light-cured glass ionomer cement when used as a retrograde root filling was assessed using a confocal optical microscope with and without a fluorescent dye. This material was compared with a conventional glass ionomer cement and amalgam. The root canals of 60 extracted human single-rooted teeth were prepared and filled with gutta-percha and sealer. All the teeth were apicected, retrograde cavities were prepared, and then divided into three groups of 20 teeth each and filled with the test materials. The light-cured glass ionomer cement was well adapted to the retrograde cavity and apicected root surface. Within the retrograde cavity the cement was often well adapted to one wall, but gaps were found on the opposite cavity wall. This was probably caused by the polymerization contraction of the material. In contrast, the amalgam retrograde root fillings were poorly adapted to the cavities, with gaps between the cavity walls and amalgam. This group exhibited the poorest sealing ability as measured by the extent of dye penetration. The conventional glass ionomer cement was often found smeared over the root face, and there were unfilled voids at the base of some retrograde cavities. The results of the dye leakage study were analysed statistically. The sealing ability of the light-cured glass ionomer cement was significantly better than that of amalgam (P less than 0.001). The dye penetration around the light-cured glass ionomer cement and the conventional glass ionomer cement was not significantly different (P greater than 0.05). However, the sealing ability of the conventional glass ionomer cement was significantly better than that of amalgam (P less than 0.05).

Analysis of Variance

Bilateral cracked teeth: a case report.

This report presents a case of undiagnosed, cracked, bilateral, maxillary molars. Both teeth were non-carious and unrestored. Failure to diagnose the initial cracks resulted in further splitting, and finally complete vertical fractures. The problem of diagnosis is highlighted and the treatment of the cracked tooth to prevent its fracture is discussed.

Cracked Tooth Syndrome