Biomedical subjects
Publications and source records attributed to H H Messer.
This report describes a series of clinical cases demonstrating the use of the Endo Extractor to remove canal obstructions. Each of the obstructions was removed with the new technique after conventional methods had failed. Preoperative, working, and postoperative radiographs are shown.
The influence of a smear layer on the adhesion of sealer cements to dentin was assessed in recently extracted human anterior teeth. A total of 120 samples was tested, 40 per sealer; 20 each with and without the smear layer. The teeth were split longitudinally, and the internal surfaces were ground flat. One-half of each tooth was left with the smear layer intact, while the other half had the smear removed by washing for 3 min with 17% EDTA followed by 5.25% NaOCl. Evidence of the ability to remove the smear layer was verified by scanning electron microscopy. Using a specially designed jig, the sealer was placed into a 4-mm wide x 4-mm deep well which was then set onto the tooth at a 90-degree angle and allowed to set for 7 days in 100% humidity at 37 degrees C. This set-up was then placed into a mounting jig which was designed for the Instron Universal Testing Machine so that only a tensile load was applied without shearing or applying preloading forces. The set-up was subjected to a tensile load at a crosshead speed of 1 mm per min. The results show significant differences (p less than 0.001) among AH26, Sultan, and Sealapex, with AH26 being the strongest and Sealapex being the weakest. The only significant difference with regard to the presence or absence of the smear layer was found with AH26, which had a stronger bond when the smear layer was removed.
The virucidal efficacy of germicides acting on an irreversible hydrocolloid surface is not known. Tests that are currently performed on germicides do not simulate the conditions under which the germicides are often used. One major concern for the dental profession is the disinfection of dental impressions, particularly irreversible hydrocolloid impressions. This study was designed to test the biocidal action of germicides against an enveloped virus on an irreversible hydrocolloid surface. The disinfection model, which was developed to simulate clinical conditions, specified the use of vesicular stomatitus virus, an animal virus amenable to safe handling. A 0.5% sodium hypochlorite spray inactivated the virus when the spray was allowed to remain on the impression 3 to 10 minutes. The iodophor disinfectant required a 3- to 10-minute immersion for total inactivation. Although 2% glutaraldehyde achieved total viral inactivation in less than 1 minute, the authors conclude that short disinfectant sprays, in general, are not an appropriate disinfection method.
The purpose of this study was to evaluate the effect of instrumenting root canals using an ultrasonic device (Enac) at different power levels on the prepared canal shape and instrumentation time, and to compare these results with those obtained using a standardized hand instrumentation technique. The mesial canals (120) of 60 human mandibular first and second molars were randomly assigned to one of six groups. In groups A through D, the canals were instrumented using the Enac ultrasonic unit at different power settings (1, 2, 3, and 5, respectively). Group E was hand instrumented. Group F served as uninstrumented controls. The roots were then sectioned horizontally and the canal shapes examined, as was the mesiodistal canal diameter as it relates to the external root surface. Instrumentation time for each group was recorded. Ultrasonic instrumentation at the different power settings was significantly faster than hand instrumentation (p less than 0.001). However, the difference between the different power levels was not significant. There were no significant differences between the different groups as to the effect on the prepared canal shape. The only problem arising from using the Enac at a power level more than the recommended (5) was the greater tendency to break size #15 files during instrumentation. Using the Enac at power level 3 provided satisfactory instrumentation capability with minimal risk of file breakage.
A new device for removing silver points was evaluated. The instrument consists of a trepan bur to expose the end of the silver point and a hollow tube which fits over the exposed tip and is bonded to it with cyanoacrylate adhesive. Twenty groups with 10 extractors and silver points in each group were tested for adhesive strength with respect to overlap between extractor and silver point, snugness of fit, and setting time of the adhesive. The adhesive strengths were evaluated using the Instron Universal Testing Machine. Adhesive strengths of 2 to 5 kg were readily achieved, and such adhesion should be adequate under typical clinical conditions for silver point removal. The amount of overlap (in the range of 1 to 3 mm) and snugness of fit were significant in relation to adhesive strengths. A setting time of 5 min was adequate for maximum bonding, except when there was loose fit between the extractor and the silver point. Clinically, the device appears to be an effective method for silver point removal.
Endodontically treated teeth are thought to be more susceptible to fracture as a result of the loss of tooth vitality and tooth structure. This study was designed to compare the contributions of endodontic and restorative procedures to the loss of strength by using nondestructive occlusal loading on extracted intact, maxillary, second bicuspids. An encapsulated strain gauge was bonded on enamel just above the cementoenamel junction on both the buccal and lingual surfaces, and the teeth were mounted in nylon rings leaving 2 mm of root surface exposed. Under load control, each tooth was loaded at a rate of 37 N per s for 3 s and unloaded at the same rate in a closed loop servo-hydraulic system to measure stiffness. A stress-strain curve was generated from each gauge prior to alteration of the tooth and after each procedure performed on the tooth. Cuspal stiffness, as a measure of tooth strength, was evaluated on one of two series of sequentially performed procedures: 1. (a) unaltered tooth, (b) access preparation, (c) instrumentation, (d) obturation, and (e) MOD cavity preparation; or 2. (a) unaltered tooth, (b) occlusal cavity preparation, (c) two-surface cavity preparation, (d) MOD cavity preparation, (e) access, (f) instrumentation, and (g) obturation. Results on 42 teeth indicate that endodontic procedures have only a small effect on the tooth, reducing the relative stiffness by 5%. This was less than that of an occlusal cavity preparation (20%). The largest losses in stiffness were related to the loss of marginal ridge integrity. MOD cavity preparation resulted in an average of a 63% loss in relative cuspal stiffness.(ABSTRACT TRUNCATED AT 250 WORDS)
The contribution of the stomach and the small intestine to absorption of fluoride from the gastrointestinal tract was examined in rats. Fasted adult male rats weighing approximately 350 g were given 50 micrograms of fluoride in 1 ml of water by stomach intubation, with 14C-labeled polyethylene glycol as a marker of water movement through the gastrointestinal tract. Rats were killed at intervals up to 120 min, and the stomach, duodenum, jejunum, ileum, distal ileum and cecum were rapidly clamped and removed for fluoride analysis and 14C counting. Approximately 90% of the fluoride dose was absorbed in 120 min. Peak plasma fluoride concentration occurred 10 min after intubation and began to decline after 40 min as the rate of fluoride absorption slowed. Absorption from the stomach was derived from rates of gastric emptying and remaining fluoride. Even at 10 min after intubation, when the bulk of the fluoride remained in the stomach, only approximately 25% of fluoride absorption had occurred from the stomach and 75% from the small intestine. After 120 min, 19.8% of total fluoride absorption had occurred from the stomach. Although the stomach is unquestionably a significant site for fluoride absorption, its contribution is much smaller than that of the small intestine.
During endodontic retreatment of a maxillary central incisor, a midroot buccal perforation was created, and sodium hypochlorite was inadvertently forced through the perforation into surrounding tissue. The consequences of this incident included immediate severe pain and swelling, with the subsequent development of a fistula, and in the long term (15 months), paresthesia of the floor and ala of the nose and the infraorbital area.
Endodontically-treated posterior teeth are susceptible to fracture; consequently, full-occlusal-coverage restorations are recommended. We designed this study to examine the potential for alternative restorative techniques for pulpless teeth, using strain gauges mounted on extracted maxillary second premolars to measure strains generated by nondestructive occlusal loading. Cuspal stiffness was evaluated on the following sequentially performed procedures: unaltered tooth, completion of all endodontic procedures, appropriate restorative preparation, and restoration. The restorative procedures evaluated were: (1) amalgam, (2) cast gold onlay, (3) composite restoration with enamel etch, and (4) composite restoration with enamel and dentin etch. Finally, all teeth were loaded to fracture. Cast gold was the strongest restorative material tested (2.11 relative stiffness, compared with that of the unaltered tooth at 1.00), and amalgam was the weakest (0.35 relative stiffness). Composite restoration and enamel plus dentin etch were almost as strong as the unaltered tooth (0.87 relative stiffness), while enamel-etch-only yielded lower stiffness (0.51).
Deposition of fluoride (F) in the skeleton is a major factor in the metabolic regulation of F. The progressive increase in bone F levels with age suggests that F is rather firmly sequestered once it is deposited in bone. We have examined the extent to which F is resorbed and redeposited during bone turnover in growing rats. The skeleton was first preloaded with F by intake of water containing a high level of F (50 mg F/L) and simultaneously labeled with [3H]tetracycline (3H-TC) to provide a measure of subsequent bone turnover. Rats were then changed to a very low F intake, and bone F loss was compared with 3H-TC loss in animals undergoing normal bone turnover or turnover accelerated by a low calcium (Ca) intake. Approximately 60% of F mobilized during bone resorption was redeposited in the skeleton (humerus and vertebrae). The redeposition of F showed a positive correlation with mineral deposition. Thus the retention of F in the skeleton of growing rats results predominantly from redeposition of resorbed F rather than passive retention associated with low bone turnover.
The ability of the adult skeleton to retain fluoride (F) during times of Ca stress was assessed in lactating rats. Rats incorporated F into their skeletons throughout growth by consumption of water containing 50 ppm F from weaning to 11 weeks of age. The rats were then changed to a low-F intake and mated. At delivery, nine dams were killed as a baseline group, and 20 dams were fed a low-F diet plus distilled water during lactation. Half of the rats were subjected to the additional stress of a low-Ca intake to stimulate bone resorption. F loss was determined during lactation. Bone turnover was measured by the loss of previously incorporated tritiated tetracycline (3H-TC), and changes in bone Ca and F contents were compared with changes in 3H-TC content. The extent of bone resorption ranged from 16.5% in the humerus of the adequate-Ca group to 77.1% in the vertebrae of Ca-deficient dams. Loss of bone F was greatest in animals with greatest loss of 3H-TC. Once F was resorbed from bone, only a relatively small portion was redeposited (0-31.4%). The low extent of F redeposition appears to be related to a low Ca deposition in lactating rats.
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Six different lines of diploid cells from human pulp and one commonly used transformed-cell line, L929 (a continuous fibroblast line of mouse lung connective tissue origin), were challenged by sera changes, an agar-overlay toxicity test and transfilter-histochemistry-toxicity test. The normal diploid cells showed greater sensitivity than transformed cells in each test. Although a different parameter of cell toxicity was measured in each test, the data indicate greater toxic response in diploid cells by all measurements. These normal diploid human cells are more appropriate cells for toxicity testing materials for human use.