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Biomedical subjects

M K Wu

Publications and source records attributed to M K Wu.

At least 37 records · Page 2Linked to original sources

Coronal leakage along apical root fillings after immediate and delayed post space preparation.

The seal provided by a full-length root canal filling may be compromised by post space preparation. Eighty human mandibular premolars each with a single canal were obturated with laterally condensed gutta-percha cones and a sealer. Immediate post space preparation was carried out on half the number of teeth and delayed post space preparation on the remaining 40 teeth. Leakage along the apical root fillings was determined using a fluid transport device under a head space pressure of 30 kPa (0.3 atm). More leakage was found after delayed preparation than after immediate preparation (P = 0.0059).

Bicuspid↗

Microleakage along apical root fillings and cemented posts.

STATEMENT OF PROBLEM: Coronal leakage of endodontically treated teeth has been found to result in a high failure rate. PURPOSE: This study tested leakage along apical root fillings remaining after post space preparation and cemented posts in root canals. MATERIAL AND METHODS: A total of 120 human roots were used in the study and divided into six groups, 20 roots for each group. By using a modified fluid transport model, leakage (in microL/hr) along ParaPost dowels that were cemented in the coronal 7 mm of root canals with Fuji Duet, Ketac Cem, Panavia EX, or zinc phosphate cements was compared with that along the coronal 7 mm of conventional root canal fillings. Leakage along the apical 4 mm of root filling remaining after post space preparation was compared with that along the 11 mm root filling before post space preparation. RESULTS: More leakage was recorded along the apical 4 mm of root filling than along the 11 mm of original root filling (p = 0.0325). ParaPost dowels cemented with any test cement did not produce more leakage than the 7 mm coronal root filling (p = 0.2145). CONCLUSIONS: The apical 4 mm of root canal filling remaining after post space preparation leaks statistically significantly more than the original full-length root canal filling. The leakage created by removal of the coronal part of root canal filling during post space preparation may be compensated by the cemented posts.

Analysis of Variance↗

Long-term seal provided by some root-end filling materials.

A tight and long-lasting seal of root-end fillings is of prime clinical importance. A hundred standard bovine root sections, each 3 mm high and with a central pulp lumen of 2.6 mm in diameter, were filled with five commonly used or potential root-end filling materials. At 24 h, or at 3, 6, or 12 months after filling, leakage along these filling materials was determined under a low headspace pressure of 10 kPa (0.1 atm) using a fluid transport model. During the first 3 months, the percentage of gross leakage (> 20 microliters day-1) increased noticeably for Tytin amalgam (from 20 to 100%) and Super-EBA (from 0 to 55%), whereas it decreased noticeably for mineral trioxide aggregate (MTA; from 55% to 0%). Thereafter, the increased leakage of amalgam and Super-EBA decreased with time, whereas the improved seal of MTA was maintained until the end of the experiment. At 3-, 6-, and 12-month time intervals, both glass ionomer cements (Fuji II and Hi Dense) and MTA showed less leakage than the conventional amalgam and Super-Eba, of which amalgam leaked more.

Aluminum Compounds↗

Decoloration of 1% methylene blue solution in contact with dental filling materials.

OBJECTIVES: Leakage studies have been performed frequently, since a tight seal provided by various dental fillings has been considered clinically important. The dye penetration experiment using a methylene blue solution as a tracer is one of the most common methods applied in these types of studies. The stability of the colour of methylene blue in contact with six dental filling materials was observed. METHODS: Silicon rubber tubes and human tooth roots of 10 mm in length and 1.5 mm inner diameter were filled with amalgam, calcium hydroxide, Cavit, Fuji II, mineral trioxide aggregate, or zinc oxide eugenol, 10 tubes or roots for each material. Groups of five tubes or roots filled with the same material were immersed in 0.8 ml 1% methylene blue dye solution. The optical density of the methylene blue solution before immersion and after 24, 48 and 72 h of immersion was measured in a spectrophotometer at 596 nm. RESULTS: The methylene blue solution was found to be decoloured over time by all the test materials (P < 0.01) except for Fuji II, in both silicone tubes and roots. At 24 h, the optical density value of methylene blue decreased by 73% for the Ca(OH)2/silicone group and 84% for the mineral trioxide aggregate/silicone group. CONCLUSION: Methylene blue is decoloured by some dental filling materials, which may result in unreliable results for these materials in dye leakage studies.

Aluminum Compounds↗

Effect of tubule orientation in the cavity wall on the seal of dental filling materials: an in vitro study.

Dentinal tubules are oriented perpendicularly to the root canal walls but parallel to the lateral walls of class I occlusal preparation. It was hypothesized that the contact surface area of the material may depend on the tubule orientation in the cavity wall to which the material is applied, and that the difference in contact surface may affect the seal provided by the filling material. Standard central lumens, 2.6 mm in diameter and 3 mm high, were machined in human crown or root specimens. After removal of the smear layer with a conditioner, the specimens in each experimental group, consisting of 20 crown and 20 root specimens, were filled with amalgam, Fuji II glass ionomer (with or without varnish), or gutta-percha with Ketac-Endo root canal sealer. A modified fluid transport model was used to test the leakage along the fillings. Selected specimens were then split longitudinally and observed in a scanning electron microscope. The micrographs showed that all the test materials were pressed into the dentinal tubules. The contact surface of the material was calculated to be at least 45% larger in root specimens than in crown specimens, depending on the depth of the tubular penetration of the test material. The leakage results showed that all the test materials leaked less in root specimens than in crown specimens (P = 0.0000 for amalgam, P = 0.0374 for Fuji II with varnish, P = 0.0088 for Fuji II without varnish, P = 0.002 for gutta-percha with sealer). It was concluded that the tubule orientation in the cavity wall may influence the seal provided by certain dental filling materials.

Dental Alloys↗

Leakage of AH26 and Ketac-Endo used with injected warm gutta-percha.

Condensing warm gutta-percha (GP) can greatly reduce the distance between the GP and the root canal walls (RCW). Different sealers with different film thicknesses may seal such close fits differently. With the use of a fluid transport model, leakage of AH26 and Ketac-Endo used with injected warm GP to fill root canals was measured. The distance between the condensed GP and RCW and the film thickness of the two sealers was determined as well. After condensation, the distance between GP and RCW was mostly less than 25 microns. AH26, with a film thickness of 39 microns, leaked more than Ketac-Endo (p < 0.05) of which the film thickness was 22 microns. It seems that film thickness of sealer is an influencing factor on the sealing ability of a root canal filling when condensation of thermoplasticized GP is performed.

Bismuth↗

Effect of sealer thickness on long-term sealing ability: a 2-year follow-up study.

Long-term sealing ability of root-canal sealer is of clinical importance. We compared the performance of five sealers and a dentine bonding agent, at thicknesses of 0.05 mm (thin layer) and 0.3 mm (thick layer), in 212 standard human root specimens, before and after storage in water for 2 years. Thick layers of Roth and Pulp Canal Sealer EWT (PCS-EWT) allowed more leakage than did thin layers (P = 0.0000, 0.0358 for Roth and PCS-EWT, respectively) whereas no significant difference was found between the thin and thick layers for AH26, Ketac-Endo, Sealapex and J&J Bonding Agent. The pooled results of the thin and thick layers, which have clinical relevance, showed that after storing the specimens in water for 2 years, AH26, Sealapex, Ketac-Endo and PCS-EWT leaked more than before storage in water (P = 0.0008, 0.0000, 0.0035, 0.0257 for AH26, Sealapex, Ketac-Endo and PCS-EWT respectively), and that J&J Bonding Agent allowed less leakage and PCS-EWT more leakage than the other four sealers (P = 0.0000).

Dental Leakage↗

Effect of calcium hydroxide dressing on seal of permanent root filling.

Low apical leakage along root fillings following an application of calcium hydroxide was reported in a few methylene blue dye penetration studies. It has been found recently that methylene blue is decolored by calcium hydroxide, indicating that the short penetration of methylene blue may not be due to a tight seal only. Of the 80 roots of human maxillary central incisors used in this study, 40 roots (group 1) received calcium hydroxide root canal dressing whereas another 40 roots (group 2) did not. All the roots were then obturated with gutta-percha and Tubli-Seal sealer. Leakage along 20 filled roots in each group was measured using a modified fluid transport model at 48 h, 2, 4, 8 and 16 weeks after obturation; whereas leakage of another 20 filled roots in each group was measured using dye penetration with 1% methylene blue. Using the fluid transport model, no significant difference was found between the two groups at any time interval (P = 0.4847, 0.3875, 0.9490, 0.4786, 0.9148 respectively after 48 h, 2, 4, 8 and 16 weeks); using the methylene blue penetration method, leakage in group 1 (with root canal dressing) was significantly less than that in group 2 (without root canal dressing) (P = 0.0374). The contradiction in results from the different models indicated that problems existed with the models.

Calcium Hydroxide↗

Efficacy of three techniques in cleaning the apical portion of curved root canals.

Various techniques for root canal instrumentation may have different effects in cleaning curved root canals, especially their apical portions. One hundred thirty-five mesiobuccal canals with an average curvature of 25 degrees from human mandibular molars were treated with step-back, crown-down pressureless, or balanced-force techniques with 2% sodium hypochlorite used as an irrigant. The cleaning efficacy of these techniques was evaluated by counting the remaining surface debris under a stereomicroscope with a calibrated eyepiece micrometer. The results indicated that the apical portion of the canal was less clean than the middle and coronal portions regardless of the technique performed and that the balanced-force technique produced a cleaner apical portion of the canal than did the other techniques studied.

Dental Pulp Cavity↗

Effect of thickness on the sealing ability of some root canal sealers.

A fluid transport model study was used to evaluate the sealing ability of five root canal sealers, AH 26, Sealapex, Ketac Endo, Roth, and Kerr EWT, and a dental bonding agent at thicknesses of 0.05 mm (thin layer) and 0.3 mm (thick layer) with 270 standard human root sections obturated with sealer combined with standard gutta-percha cylinders. AH26 and Sealapex sealed more tightly in thick layers, whereas Ketac Endo, Johnson and Johnson Bonding Agent, Roth, and Kerr EWT sealed more tightly in thin layers. In thin layers J&J Bonding sealed more tightly than any other sealer tested. In thick layers AH 26 and Sealapex sealed more tightly than Ketac Endo and J&J Bonding Agent, and these sealed more tightly than Roth and Kerr EWT. These findings indicate that the thickness of the sealer layer significantly influences the sealing of a root canal filling and that the influence of thickness varies depending on the type of sealer.

Air↗

A 1-year follow-up study on leakage of four root canal sealers at different thicknesses.

Determination of leakage using a fluid transport model allows measurement of leakage in a longitudinal manner. Leakage of four sealers at three different thicknesses in 225 bovine root sections, after storage in water for 1 year, was measured again using the same methodology. The change in seal over time for each sealer was observed. The results after the second measurement showed that every sealer produced the best seal when the sealer layer was the thinnest. AH26, Ketac-Endo and Tubli-Seal showed a reduction in leakage over time and gave significantly less leakage than Sealapex (P<0.005). Sealapex showed significantly more leakage after storing in water for 1 year (P<0.005). Therefore, the long-lasting seal of sealer may, among other influencing factors, depend on the layer thickness and the solubility of the material.

Animals↗

Developmental and regional expression pattern of a novel NMDA receptor-like subunit (NMDAR-L) in the rodent brain.

A novel NMDA receptor-like (NMDAR-L) cDNA was isolated that contained an open reading frame coding for a predicted polypeptide of 1115 amino acids that shares approximately 27% identity with NMDA receptor subunits. In situ hybridization experiments indicated that NMDAR-L mRNA was expressed in the developing rodent CNS. On postnatal day 1 (P1), NMDAR-L mRNA expression was pronounced in the entorhinal cortex, the subiculum and the thalamus, in layer V of the developing neocortex, in the superior and inferior colliculi, and various regions of the hindbrain, excluding the cerebellum. On P5, NMDAR-L mRNA was expressed in layer V of the neocortex, in the entorhinal cortex, in the subiculum, and in the thalamus. On P14, NMDAR-L mRNA was expressed in layers II-VI of the neocortex, in the entorhinal and piriform cortex, in the subiculum and CA1 field, and in the nucleus of the lateral olfactory tract. In the adult brain, NMDAR-L mRNA was detected predominately in the nucleus of the lateral olfactory tract. Injection of NMDAR-L cRNA into Xenopus oocytes did not lead to the expression of homomeric glutamate-activated channels. However, coinjection of the triple combination of NMDAR-L with NMDAR1 and NMDAR2B cRNAs led to a striking decrease in the current magnitude compared to currents obtained after coexpression of the double combination of NMDAR1 with NMDAR2B. While the function of NMDAR-L remains to be established, its developmental and regional expression pattern suggests that NMDAR-L may influence axonal outgrowth and synaptogenesis during brain development.

Aging↗

Fluid transport and dye penetration along root canal fillings.

Dye penetration along root canal fillings may be hindered by the presence of entrapped air. In this study, the sensitivity of a dye penetration method was compared with that of a fluid transport model. Sixty root sections from human maxillary central incisors were prepared and obturated by a modified technique to ensure a slight amount of leakage, and divided into three equal groups. Twenty root sections were first mounted in a fluid transport device and assessed for fluid transport under 10 kPa (0.1 atm.) pressure. Another 20 root sections were mounted in the same device before being subjected to air transport under the same pressure. The remaining 20 root sections were not exposed to fluid or air transport. Then, all the 60 root sections were assessed for penetration of a 2% methylene blue solution. The results showed that fluid transport was a much more sensitive method of detecting voids along root canal fillings than dye penetration. After fluid transport for 3 h under low pressure, to eliminate entrapped air, dye penetrated significantly deeper than without previous fluid transport, which suggested that entrapped air in voids along the root canal filling prevented dye penetration.

Air Pressure↗

Sealing properties of Ketac-Endo glass ionomer cement and AH26 root canal sealers.

Sealing capacity, setting shrinkage and setting time of a recently introduced glass ionomer cement Ketac-Endo were compared with that of a conventional sealer AH26. Sixty half-cylinders, 8 mm long, 4 mm in diameter, made from fresh bovine root dentine, had their smear layer removed before being cemented together while separated by 1-mm spacers. This resulted in a group of 15 cylinders cemented with Ketac-Endo and a similar group with AH26. After coating the lateral surface with nail varnish, one end of each cylinder was connected with a tube filled with water under 120 kPa (1.2 atm) pressure. At the other end the fluid leaking through the cemented interface of the cylinders was measured by displacement of an air bubble in an attached standard glass capillary. In this particular set-up where the sealers were used in bulk between two opposing dentine surfaces, Ketac-Endo leaked significantly more than AH26. After shear loading the cemented specimens, it was found that the area of adhesive failure was 88% for Ketac-Endo, and 15% for AH26. The leakage pathways were most probably at the dentine-sealer interface for Ketac-Endo and through cohesive fractures in the sealer for AH26.

Adhesiveness↗

Leakage of four root canal sealers at different thickness.

Sealers play a key role in sealing the root canal system. Fluid transport under a headspace pressure of 50 kPa (0.5 atm) through four sealers, AH26, Ketac-Endo, Sealapex and Tubli-Seal at a thickness of 0.05, 0.25 or 3 mm, was determined using 240 standard bovine root sections which were obturated with either sealer only or sealer combined with standard gutta-percha cylinders. AH26 and Sealapex sealed more tightly than Ketac-Endo or Tubli-Seal when used without gutta-percha; AH26, Ketac-Endo, and Sealapex sealed more tightly than Tubli-Seal when the sealer layer was 0.25 mm thick, while Ketac-Endo sealed more tightly than the other three sealers when the sealer layer was 0.05 mm thick. These findings indicate that the thickness of the sealer layer influences the sealing ability of a root canal filling.

Animals↗

Endodontic leakage studies reconsidered. Part I. Methodology, application and relevance.

An increasing number of endodontic leakage studies have been published. In the 1990 volumes of Journal of Endodontics and International Endodontic Journal, there was one leakage study to every 4.3 scientific articles. The most popular method was linear measurement of tracer (dye or radioisotope) penetration along a root filling. Comparing some data on linear measurement of dye penetration following the cold lateral condensation of gutta-percha that were published between 1980 and 1990, a high level of variation has been found, although the experimental methods used in these studies were quite similar. In almost all studies evaluating various techniques, the cold lateral condensation technique has been used as a standard control for comparison. The reliability of these results is questionable. The problems with such studies are discussed. It seems that more research should be done on leakage study methodology, instead of continuing to evaluate the sealing ability of different materials and techniques by methods that may give little relevant information.

Coloring Agents↗

Endodontic leakage studies reconsidered. Part II. Statistical aspects.

The aim of many endodontic studies is to compare two or more treatment methods, techniques or materials, for example, to detect differences in mean leakage scores. As it is not feasible to study large populations, samples are taken. The important question then arises as to how large the sample sizes have to be in order to establish the 'true' (= populations') mean scores. First, it must be determined which magnitude of the difference (= v) between the mean scores is of endodontic interest. Based upon v and a few related statistical parameters, one may calculate how large the samples must be in order that a statistical test yields a significant result for a difference that is of endodontic importance. In other words, the 'power' of a test, depending on the sample size among other factors, must be large enough to detect the 'true' a priori determined difference between the populations. The use of small sample sizes may imply that a rather large difference between two mean leakage scores is not found to be significant, thereby leading to incorrect conclusions. This article describes the power and the statistical related factors that determine the adequate size of samples. Examples of power calculation are presented. Next, the power of publicized endodontic leakage studies was evaluated. Almost two-thirds of the sample sizes were 10 or less, and about 90% were 20 or less. Less than one-half of the tests had an adequate power (conventionally > or = 0.80). It is necessary to be cautious when extrapolating the results of such studies, because of the limited power of the statistical tests. The power may be increased by using larger sample sizes or, alternatively, by enlarging the 'effect size', by either taking an interest in a larger difference between the mean scores, or by minimizing the variability of the data.

Analysis of Variance↗

Periapical status and prevalence of endodontic treatment in an adult Dutch population.

This study examined the prevalence of endodontic treatment in a group of 184 Dutch adults, and determined the periapical status of all teeth using panoramic radiographs. The results indicate that in this group, 2.3% of the teeth were root-filled, and that 5.2% of all non-endodontically treated teeth showed signs of periapical pathology. Around the apices of 39.2% of the endodontically treated teeth in this survey, radiographic signs of periapical pathology were observed. Using the level of the root canal filling as a criterion for evaluating the quality of the root canal treatment, 50.6% of the endodontic treatments were qualified as inadequate. There was a significant correlation between the presence of periapical pathology and underfilling of the root canal(s). 44.6% of the patient sample had at least one tooth with radiographic signs of periapical pathology, indicating a substantial future need for endodontic treatment.

Adult↗