Assessment of sterilization effect and the alteration of surface texture and physical properties of gutta-percha cone after short-term chemical disinfection

Pang, Nan-Sim,Jung, Il-Young,Yu, Yoon-Jung,Kum, Kee-Yeon 大韓齒科保存學會 2006 Restorative Dentistry & Endodontics Vol.31 No.2

본 연구의 목적은 첫째 임상에서 진료실에 노출된 가타파차 콘 표면의 오염 균종을 중합효소연쇄반응법(polymerase chain reaction, PCR)을 이용해 동정하고, 둘째 이들 세균으로 오염시킨 가타파차 콘에 대해 3 종의 소독제의 short-term sterilization효과를 비교하였다. 또한 이들 소독제에 5 분간 처리된 가타파차 콘 표면 성상의 변화를 주사전자현미경으로 관찰하였고 물성 변화, 특히 인장 강도와 연신률의 변화를 측정, 비교하고자 하였다. 진료실에 수 개월간 노출된 가타파차 콘 150개를 수거하여 배양지에 넣어 배양 후 universial primer를 사용한 PCR assay를 통해 오염 균종을 동정하였다. 실험실 상에서 이 균종을 다시 배양하여 소독된 가타파차 콘에 접종하고 1 주일간 배양한 후 3 종의 소독제 (5% NaOCl, 2% Chlorhexidine, ChloraPrep)에 1, 5, 10, 30 분간 short-term soaking후 각 소독제의 종류의 적용시간에 따른 멸균 효과를 turbidity test와 subculture를 이용하여 평가하였다. 또한 각 소독제에 5 분간 처리된 가타파차 콘 표면 성상의 변화를 주사전자현미경으로 관찰하였으며, 물성 변화를 평가하기 위해 Instron 5500을 이용하여 연신률 및 tensile strength를 측정한 후 통계학적 유의성 여부를 검증하였다. 중합효소연쇄반응법의 분석결과 19.4%의 가타파차 콘 이 오염된 것으로 나타났고 대부분이 Staphylococcus 계통이었으며, 3 종의 소독제 모두 이들 균종에 대해 1 분내에 멸균 효과를 나타냈다. 주사전자현미경상 NaOCl로 소독된 가타파차 콘 표면에는 cuboidal crystal 의 침전물이 전반적으로 관찰되었다. Tensile strength는 NaOCl군에서 다른 군에 비해 유의성 있는 증가를 보였으며 (p <0.05), elongation rate는 3 종의 소독제 모두 대조군에 비해 유의성 있는 증가를 보였으나 (p < 0.05), 특히 ChloraPrep군에서 가장 큰 증가를 보였다. 본 연구 결과 3 종의 소독제 모두 근관충전 전 가타파차 콘의 rapid sterilization을 위해 유용하게 사용할 수 있음을 시사한다. The purposes of this study were firstly to identify the microbial species on gutta-percha (GP) cones exposed at clinics using polymerase chain reaction, and secondly to evaluate the short-term sterilization effect of three chemical disinfectants. It also evaluated the alteration of surface texture and physical properties of GP cones after 5-min soaking into three chemical disinfectants. 150 GP cones from two endodontic departments were randomly selected for microbial detection using PCR assay with universal primer. After inoculation on the sterilized GP cones with the same microorganism identified by PCR assay, they were soaked in three chemical disinfectants : 5% NaOCl, 2% Chlorhexidine, and ChloraPrep for 1, 5, 10, and 30 minutes. The sterilization effect was evaluated by turbidity and subculture. The change of surface textures using a scanning electron microscope and the tensile strength and elongation rate of the GP cones were measured using an Instron 5500 (Canton). Statistical analysis was performed. Four bacterial species were detected in 29 GP cones (19.4%), and all the species belonged to the genus Staphylococcus. All chemical disinfectants were effective in sterilization with just 1 minute soaking. On the SEM picture of NaOCl-soaked GP cone, a cluster of cuboidal crystals was seenon the cone surface. The tensile strenght of NaOCl-soaked group was significantly higher than the other groups (p< 0.05). Alsi, all disinfectants significantly increased the elongation rate of GP cones compared to the fresh GP cone (p < 0.05). Present data demonstrate that three chemical disinfectants are useful for rapid sterilization of GP cone just before obturation.

Effect of dentin treatment on proliferation and differentiation of human dental pulp stem cells

Park, Minjeong,Pang, Nan-Sim,Jung, Il-Young The Korean Academy of Conservative Dentistry 2015 Restorative Dentistry & Endodontics Vol.40 No.4

Objectives: Sodium hypochlorite (NaOCl) is an excellent bactericidal agent, but it is detrimental to stem cell survival, whereas intracanal medicaments such as calcium hydroxide ($Ca[OH]_2$) promote the survival and proliferation of stem cells. This study evaluated the effect of sequential NaOCl and $Ca(OH)_2$ application on the attachment and differentiation of dental pulp stem cells (DPSCs). Materials and Methods: DPSCs were obtained from human third molars. All dentin specimens were treated with 5.25% NaOCl for 30 min. DPSCs were seeded on the dentin specimens and processed with additional 1 mg/mL $Ca(OH)_2$, 17% ethylenediaminetetraacetic acid (EDTA) treatment, file instrumentation, or a combination of these methods. After 7 day of culture, we examined DPSC morphology using scanning electron microscopy and determined the cell survival rate with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. We measured cell adhesion gene expression levels after 4 day of culture and odontogenic differentiation gene expression levels after 4 wk using quantitative real-time polymerase chain reaction. Results: DPSCs did not attach to the dentin in the NaOCl-treated group. The gene expression levels of fibronectin-1 and secreted phosphoprotein-1 gene in both the $Ca(OH)_2$- and the EDTA-treated groups were significantly higher than those in the other groups. All $Ca(OH)_2$-treated groups showed higher expression levels of dentin matrix protein-1 than that of the control. The dentin sialophosphoprotein level was significantly higher in the groups treated with both $Ca(OH)_2$ and EDTA. Conclusions: The application of $Ca(OH)_2$ and additional treatment such as EDTA or instrumentation promoted the attachment and differentiation of DPSCs after NaOCl treatment.

Radiographic assessment of clinical root-crown ratios of permanent teeth in a healthy Korean population

Il-Keun Kwon,Nan-Sim Pang,Bock-Young Jung,Jin-Sun Jeong,Hee-Jung Yun 대한치과보철학회 2014 The Journal of Advanced Prosthodontics Vol.6 No.3

PURPOSE The aim of this study was to determine the absolute value of the root/crown ratio (R/C ratio) using panoramic radiographs (PRGs) in a healthy Korean population. MATERIALS AND METHODS In total, 99 patient radiographs (of 50 males and 49 females subjects; aged 16 to 24 years old) were examined, and 2,770 teeth were analyzed. Crown lengths and root lengths were measured with modified Lind's measurements using PACS tools by two examiners in two separate sessions two months apart. All data were analyzed using SPSS. The independent t-test was used to assess for gender differences, and the paired t-test was used to compare both arches with a significance level of P<.05. RESULTS The mean R/C ratios varied from 1.29 to 1.89 (male: 1.28-1.84; females: 1.31-1.94). The highest R/C ratios were recorded for the mandibular canines (1.89), followed by the maxillary canines (1.79). The lowest R/C ratios were recorded for the maxillary second molars (1.31). In comparison with the maxillary teeth (1.29-1.78), the mandibular teeth yielded the higher R/C ratio (1.47-1.89), and this difference was significant in the females (P<.05). The difference between the genders was not statistically significant, except for the maxillary central incisors, mandibular canines and mandibular first premolars. CONCLUSION These data may enhance the understanding of the clinical R/C ratio as a useful guideline for determining the status of teeth and the ethnic difference.

위장관으로 흡인된 치과기구의 처치

방난심,이강희,김영진,정복영,Pang, Nan-Sim,Lee, Kang-Hee,Kim, Young Jin,Jung, Bock-Young 대한치과마취과학회 2013 Journal of Dental Anesthesia and Pain Medicine Vol.13 No.2

Foreign body indigestion during dental procedures is uncommon but sometimes associated with severe and life threatening morbidity. The dentist should decide whether multidisciplinary intervention is necessary and how urgently it has to be done. The active removal of foreign bodies depends on the size, shape, type and duration of impaction, along with the location in the gastrointestinal tract. In this report, we presented how to manage gastric foreign body related swallowing during dental procedure and investigated the predictive risk factors, precaution, and prompt management in foreign body ingestion.

Assessment of decontamination of gutta-percha cone and the change of surface texture after rapid chemical disinfection

방난심,정일영,유윤정,금기연,Pang, Nan-Sim,Jung, Il-Young,Yu, Yoon-Jung,Kum, Kee-Yeon The Korean Academy of Conservative Dentistry 2006 Restorative Dentistry & Endodontics Vol.31 No.2

본 연구의 목적은 첫째 임상에서 진료실에 노출된 가타파차 콘 표면의 오염 균종을 중합효소연쇄반응법 (polymerase chain reaction, PCR)을 이용해 동정하고, 둘째 이들 세균으로 오염시킨 가타파차 콘에 대해 2종의 소독제의 rapid sterilization 효과를 비교하였다. 또한 이들 소독제에 5분간 처리된 가타파차 콘 표면 성상의 변화를 주사전자현미경으로 관찰하였다. 진료실에 수 개월간 노출된 가타파차 콘 100개를 수거하여 배양지에 넣어 배양 후 universial primer를 사용한 PCR assay 를 통해 오염 균종을 동정하였다. 실험실 상에서 이 균종을 다시 배양하여 소독된 가타파차 콘에 접종하고 1주일간 배양한 후 2종의 소독제(5% NaOCl, 2% Chlorhexidine)에 1, 3, 5, 10 분간 담근 후 각 소독제의 종류와 적용시간에 따른 멸균 효과를 turbidity test 와 subculture 를 이용하여 평가하였다. 또한 각 소독제에 5분간 처리된 가타파차 콘 표면 성상의 변화를 주사전자현미경으로 관찰하였다. 중합효소연쇄반응법의 분석결과 17개의 가타 파차 콘이 오염된 것으로 나타났고 대부분이 Staphylococcus 계통이었으며, 2종의 소독제 모두 이들 균종에 대해 1분내에 멸균 효과를 나타냈다. 주사전자현미경상 NaOCl로 소독된 가타파차 콘 표면에는 cuboidal crystal 의 침전물이 전반적으로 관찰되었다. 본 연구 결과 2종의 소독제 모두 근관충전 전 가타파차 콘의 rapid sterilization 을 위해 유용하였으나 클로헥시딘으로 처리된 가타파차 콘이 크리스탈 침전물이 없는 좀더 깨끗한 표면을 갖는 것으로 나타났다. The purposes of this study were firstly to identify the microbial species on gutta-percha (GP) cones exposed at outpatient clinics using polymerase chain reaction, and secondly to evaluate the rapid sterilization effect of two chemical disinfectants at chair side. It also evaluated the alteration of surface texture of GP cones after 5-min soaking into two chemical disinfectants. A total of 100 GP cones from two endodontic departments were randomly selected for microbial detection using PCR assay with universal primer. After inoculation on the sterilized GP cones with the same microorganism identified by PCR assay, they were soaked in two chemical disinfectants: 5% NaOCl and 2% chlorhexidine for 1, 3, 5, and 10 minutes. The sterilization effect was evaluated by turbidity and subculture. The change of surface textures using a scanning electron microscope was also examined after 5 min-soaking in two chemical disinfectants. Results showed that four bacterial species were detected in 17 GP cones, and all the species belonged to the genus Staphylococcus. Two chemical disinfectants were effective in sterilization with just 1 minute soaking. On the SEM picture of NaOCl-soaked GP cone, a cluster of cuboidal crystals was seen on the cone surface. Present data demonstrate that two chemical disinfectants are useful for rapid sterilization of GP cone just before obturation at chair side, while CHX-soaked GP cone has cleaner surface without crystal precipitation than that of NaOCl-treated cone.

Computer-controlled local anesthetic delivery for painless anesthesia: a literature review

Kwak, Eun-Jung,Pang, Nan-Sim,Cho, Jin-Hyung,Jung, Bock-Young,Kim, Kee-Deog,Park, Wonse The Korean Dental Society of Anesthsiology 2016 Journal of Dental Anesthesia and Pain Medicine Vol.16 No.2

Local anesthesia is administered to reduce pain during dental treatments, but may itself cause pain and contribute to increased dental fear. Computer-controlled local anesthetic delivery (CCLAD) is one the method to reduce patient pain during local anesthesia; it is a device that slowly administers anesthetics by using a computerized device to control the injection speed. This literature review aims to provide an objective assessment of the usefulness of CCLAD for controlling pain by reviewing papers published to date that have used CCLAD.

Radiographic assessment of clinical root-crown ratios of permanent teeth in a healthy Korean population

Yun, Hee-Jung,Jeong, Jin-Sun,Pang, Nan-Sim,Kwon, Il-Keun,Jung, Bock-Young The Korean Academy of Prosthodonitics 2014 The Journal of Advanced Prosthodontics Vol.6 No.3

PURPOSE. The aim of this study was to determine the absolute value of the root/crown ratio (R/C ratio) using panoramic radiographs (PRGs) in a healthy Korean population. MATERIALS AND METHODS. In total, 99 patient radiographs (of 50 males and 49 females subjects; aged 16 to 24 years old) were examined, and 2,770 teeth were analyzed. Crown lengths and root lengths were measured with modified Lind's measurements using PACS tools by two examiners in two separate sessions two months apart. All data were analyzed using SPSS. The independent t-test was used to assess for gender differences, and the paired t-test was used to compare both arches with a significance level of P<.05. RESULTS. The mean R/C ratios varied from 1.29 to 1.89 (male: 1.28-1.84; females: 1.31-1.94). The highest R/C ratios were recorded for the mandibular canines (1.89), followed by the maxillary canines (1.79). The lowest R/C ratios were recorded for the maxillary second molars (1.31). In comparison with the maxillary teeth (1.29-1.78), the mandibular teeth yielded the higher R/C ratio (1.47-1.89), and this difference was significant in the females (P<.05). The difference between the genders was not statistically significant, except for the maxillary central incisors, mandibular canines and mandibular first premolars. CONCLUSION. These data may enhance the understanding of the clinical R/C ratio as a useful guideline for determining the status of teeth and the ethnic difference.

Management of hyperthyroid patients in dental emergencies: a case report

Lee, Kyung-Jin,Park, Wonse,Pang, Nan-Sim,Cho, Jin-Hyung,Kim, Kee-Deog,Jung, Bock Young,Kwak, Eun-Jung The Korean Dental Society of Anesthsiology 2016 Journal of Dental Anesthesia and Pain Medicine Vol.16 No.2

The prevalence of thyroid disease, particularly hyperthyroidism, has rapidly increased in Korea in the past 10 years. Therefore, it is important to consider the complete medical history including thyroid disease in patients under dental treatment. Both the drugs used for dental treatment and psychological symptoms associated with treatment can induce emergencies in hyperthyroid patients. This case report considers emergency situations during dental treatment for hyperthyroid patients, and discusses risk factors and related concerns.

하악공 전달마취 후 발생한 일시적인 시력 저하

임지영,윤희정,방난심,정복영,김기덕,박원서,Lim, Gee-Young,Yun, Hee-Jung,Pang, Nan-Sim,Jung, Bock-Young,Kim, Kee-Deog,Park, Won-Se 대한치과마취과학회 2012 Journal of Dental Anesthesia and Pain Medicine Vol.12 No.1

One of the most common procedures in dentistry is the inferior alveolar nerve block anesthesia but visual problem can occur during this procedure. Transient visual acuity decrease after inferior alveolar nerve block anesthesia can result from unintended intravascular injection. In this case report, we present ocular complication that has rarely been reported. The understanding of anatomy related to this case is discussed with suggestions for proper management of the patients. The dental management for ocular complications includes a correct diagnosis, management by understanding of patient's anatomic variations. This will prevent intravascular injection.

Protective dental splint for oroendotracheal intubation: experience of 202 cases

Lee, Kang-Hee,You, Tae-Min,Park, Wonse,Lee, Sun Hwa,Jung, Bock-Young,Pang, Nan-Sim,Kim, Kee-Deog The Korean Dental Society of Anesthsiology 2015 Journal of Dental Anesthesia and Pain Medicine Vol.15 No.1

Background: Dental injury as a result of oroendotracheal intubation during general anesthesia is very common. We report our experiences of using mouthguard to prevent dental injury during intubation based on our protocol. Methods: This retrospective study enrolled patients referred for preanesthetic evaluation, those patients with a history of any of the dental treatments to their anterior teeth listed on our fabrication protocol from January 1, 2009 to June 30, 2010. Results: No cases of dental trauma during oroendotracheal intubation were reported among the 202 patients who used a protective device. 66% of the patients had risk factors for hard tissue damage aged 10-40 years. At the ages of 40-70 years, the incidence of risk group for periodontal damage was higher. Conclusions: Preanesthetic consultation was effective for preventing dental injury, so preanesthetic questionnaire and proper dental consultation would be helpful.