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Biomedical subjects

R N Weller

Publications and source records attributed to R N Weller.

At least 19 recordsLinked to original sources

In vitro bacterial penetration of endodontically treated teeth coronally sealed with a dentin bonding agent.

This study evaluated the effectiveness of a dentin bonding agent as a barrier to prevent coronal microleakage and examined the effect of a eugenol-based sealer on the sealing ability of this resin adhesive. Fifty-one extracted human mandibular molars were incorporated in a model system using an oral streptococci as a microbial marker. Group 1 consisted of 15 teeth that were obturated with only gutta-percha and received a coronal barrier of Clearfil Liner Bond 2V. Group 2 was identical to group 1, but included the use of a eugenol-based sealer in the obturation. Group 3 consisted of 15 teeth that were obturated with gutta-percha and sealer, but did not receive a coronal barrier. Six teeth served as controls. Bacterial penetration was monitored for 90 days. Results were analyzed after 30, 60, and 90 days with Fisher's exact test (p < 0.05). All controls behaved as expected. Neither group 1 nor group 2 exhibited any bacterial leakage. Eleven of the 15 specimens in group 3 leaked between 15 and 76 days. The coronal barriers in group 1 and group 2 were significantly better in preventing coronal microleakage at 60 days (p = 0.002) and 90 days (p = 0.00005). The presence of eugenol in the sealer had no significant effect on the sealing ability of Clearfil Liner Bond 2V (p = 1).

Dental Leakage↗

Effects of eugenol on resin bond strengths to root canal dentin.

The purpose of this study was to compare the regional bond strengths of C&B Metabond resin to root canal dentin, with or without treatment using a eugenol-containing endodontic sealer liquid. Eighteen extracted human canines were decoronated at the cementoenamel junction with a slow speed saw. The apical third of the root was removed leaving the cervical and middle dentin. The canal space was then enlarged with files, Gates-Glidden burs, and parapost drills. The teeth were ground on either the mesial or distal sides, permitting direct access to the entire canal. The cervical or middle third dentin was treated with Kerr Root Canal Sealer liquid, alternating between the middle and cervical thirds. Each tooth served as its own control. The adhesive resin was then luted directly to the prepared canal. Specimens, 1 x 1 x 8 mm, were prepared and mounted to a Vitrodyne testing machine enabling microtensile bond strengths to be measured. Data were analyzed using a two-way ANOVA and the least squares means test. The mean microtensile bond strengths for the cervical and middle third dentin treated with eugenol were 13.6 +/- 6.1 MPa (n = 33) and 14.8 +/- 3.9 MPa (n = 29), respectively. Without the eugenol, the mean bond strengths were 18.1 +/- 6.0 MPa (n = 31) and 17.3 +/- 4.6 MPa (n = 31) for the cervical and middle sections. The specimens treated with the eugenol liquid had significantly lower bond strengths than those without eugenol (p < 0.05) only in the cervical third. The region of the tooth tested had no effect on bond strength. That is, bond strength of the cervical third was not significantly different from bond strength on the middle third in either of the two groups (with or without eugenol) tested.

Analysis of Variance↗

Measurement of endodontic file lengths: calibrated versus uncalibrated digital images.

This in vitro study compared the accuracy of file length measurements made on calibrated and uncalibrated direct digital images. Endodontic files of known lengths and ISO sizes were used in 10 single-rooted, relatively straight teeth within cadaver specimens. The crowns of the teeth were ground flat and an orthodontic wire of known length was secured to the coronal surface. This wire was placed mesiodistally and perpendicular to the root and served as the reference point for the file measurement and as a calibration reference length. A #20 file was hand-measured to a length that reached the apical third of each tooth. It was inserted and a radiographic image was secured. The instrument was remeasured three additional times at different lengths on the same tooth and reinserted before each image acquisition. Thus 40 digital images were acquired using a GE X-ray unit and a Schick Computed Dental Radiography (CDR) #2 sensor. These images were placed in random order, and an independent, blinded investigator determined the file lengths using on-screen calibrated and uncalibrated measurement of the CDR image with a straight-line and multiple-line measuring technique. The experimental measurements were compared with each other and with the known clinical measurements. A two-way analysis of variance indicated that there was a statistically significant difference showing that the calibrated measurements were more accurate than the uncalibrated measurements (p = 0.0001), and there was no significant difference between the straight-line and multiple-line measuring techniques (p = 0.14).

Analysis of Variance↗

Measurement of endodontic file lengths: a density profile plot analysis.

The purpose of this study was to evaluate measurements of endodontic files of known length and diameter using a density profile plot analysis of digital images. Ten single-rooted teeth with relatively straight roots in cadaver specimens were used. The crowns of the teeth were removed and a rectangular orthodontic wire, 5.13 mm in length, was placed horizontally on the occlusal surface to serve as a calibration reference point. The #8, #10, #15, and #20 FlexOFiles were measured to the nearest 0.5 mm and then placed to four working lengths that terminated within the apical third of each root. A GE X-ray unit and a Schick CDR #2 sensor were used to digitally acquire 160 images. The digital images were placed in random order and an independent, blinded investigator determined the file length using a density profile plot analysis. The measurements generated by the histogram analysis (experimental) were compared with the original clinical measurements. The paired t test, intraclass correlation coefficient, and the Bradley-Blackwood test were used to assess reliability. The results revealed that the means of the experimental measurements of all file sizes were within 0.5 mm of the known lengths and were always shorter than the known lengths. Also, the larger the file size the less deviation from the known lengths: #20, -0.16 mm (p = 0.0001); #15, -0.21 mm (p = 0.0001); #10, -0.34 mm (p = 0.0001); and #8, -0.45 mm (p = 0.0001). This study demonstrated that the density profile plot analysis might be a useful adjunct for the measurement of endodontic file lengths on a digital image.

Analysis of Variance↗

Effect of varying the depth of heat application on the adaptability of gutta-percha during warm vertical compaction.

The purpose of this study was to compare the adaptability of gutta-percha after varying the depth of heat application in the obturation of a set of standard root canals. A split-tooth model was constructed using a human maxillary central incisor. The root canal was cleaned and shaped using a step-back preparation to a size #60 FlexOFile at the working length (WL). Five shallow depressions were produced on the root canal wall. Twenty obturations without sealer were performed for each technique (thermoplasticized injectable (TI), lateral condensation, and warm vertical compaction (WVC) with heat applications at 3, 4, 5, and 7 mm from the WL). After each obturation the model was separated and the mesial and distal sides of each obturation were examined and videotaped at x 32 magnification. The quality of the obturation was graded based on the replication to the WL, replication of the artificial depressions, surface adaptation, and homogenicity of the gutta-percha. The Kruskal-Wallis analysis and the Student-Newman-Keuls tests indicated that all the techniques were significantly different from each other (p < 0.05) except for the TI group versus the WVC group with the heat application to within 3 mm from the WL (p > 0.05). The TI technique was ranked best followed by the WVC with heat applications at 3, 4, 5, and 7 mm. The lateral condensation technique received the lowest ranking.

Analysis of Variance↗

Effect of dentin bonding agents on the secretion of inflammatory mediators from macrophages.

Dentin bonding agents (DBAs) have been proposed as substitutes for amalgam as root-end filling materials. The current study tested the hypothesis that certain components of DBAs could alter the secretion of cytokines from macrophages. Such alteration would likely be undesirable for healing of the periapical tissues. Human THP-1 macrophages were exposed to 2-hydroxyethyl methacrylate, 4-methacryloxyethyl trimelliate anhydride, bisphenol-gycidylmethacrylate, and urethane dimethacrylate. The secretion of interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) were measured with or without challenge by lipopolysaccharide (LPS). Results showed that all DBA components completely suppressed LPS-induced IL-1 beta and TNF-alpha secretion at concentrations that suppressed mitochondrial activity by 50%. In addition, 4-methacryloxyethyl trimelliate anhydride induced secretion of IL-1 beta, but not TNF-alpha, without the LPS challenge. These results indicate that DBA components may alter normal macrophage-directed inflammatory responses if the macrophages are exposed to sufficiently high concentrations of these components.

Acrylic Resins↗

Changes in root surface temperatures with in vitro use of the system B HeatSource.

The purpose of this study was to measure root surface temperatures while using the System B HeatSource at various temperature settings. A split-tooth model of a human maxillary central incisor was prepared with 10 thermocouples to record root surface temperatures at 1-mm increments from the root apex. A System B HeatSource model 1005 was used to warm and compact gutta-percha to within 3 mm of the working length using the Buchanan technique. Twenty obturations were recorded at each of the following temperature settings: 250 degrees, 300 degrees, 350 degrees, 400 degrees, 450 degrees, 500 degrees, 550 degrees, and 600 degrees C. Examination of the mean temperatures recorded for each position and at each temperature setting revealed that the thermocouple 5 mm from the apex (T5) detected the highest increases in root surface temperatures. Only this site exceeded the 10 degrees C rise in temperature for one full minute that could cause damage to the supporting structures. The range of instantaneous temperatures at this site was 8.85 to 12.06 degrees C, with a mean of 10.62 +/- 0.93 degrees C. The results of this in vitro study indicate that any temperature setting of the System B HeatSource at or above 250 degrees C has the potential to cause the root surface temperature to rise 10 degrees C. Whether this occurs in vivo or if it does is maintained long enough to cause any tissue damage remains to be determined.

Body Temperature↗

Sex hormone receptor status of the dental pulp and lesions of pulpal origin.

OBJECTIVE: The purpose of this study was to determine whether the dental pulp and lesions of pulpal origin (eg, pulp polyps, periapical granulomas, and periapical cysts) exhibit receptors for the sex steroid hormones estrogen, progesterone, and androgen. STUDY DESIGN: Staining for the receptors of the hormones estrogen, progesterone, and androgen was accomplished through use of available immunohistochemical detection techniques. Pulpal tissues were obtained from freshly extracted human third molars; the other tissues were obtained from the Oral and Maxillofacial Pathology Laboratory archives. Ten samples of each tissue were processed and immunostained for these specific receptors. RESULTS: Staining for estrogen and androgen receptors was essentially negative for all cell populations examined. However, positive progesterone receptor staining of varying degrees was noted in 8 of 10 pulpal specimens. Primarily, pulpal fibroblasts and odontoblasts exhibited positive immunoreactivity. CONCLUSIONS: The results of this study suggest that although the dental pulp may be a potential target tissue for progesterone, evidence is lacking with respect to the other sex steroid hormones.

Composite Resins↗

Anesthetic efficacy of the supplemental intraosseous injection for teeth with irreversible pulpitis.

The purpose of this study was to determine the efficacy of a supplemental intraosseous injection (IOI) of 2% lidocaine with 1:100,000 epinephrine using the Stabident device, after conventional anesthetic methods had failed. Patients who experienced pain during endodontic access and required a supplemental IOI using 0.45 to 0.90 ml of the local anesthetic were identified. All 37 of the patients treated had teeth diagnosed with irreversible pulpitis. Thirty-four of the teeth were mandibular posterior teeth, 2 were maxillary posterior teeth, and 1 was a maxillary anterior tooth. Patients with maxillary teeth had received infiltration anesthesia, and those with mandibular teeth had received an inferior alveolar nerve block in conjunction with long buccal infiltration. A minimum of 3.6 ml of local anesthetic was used with the conventional techniques. Modified visual analogue scales, coupled with operator evaluations, were used to measure success. The Stabident IOI was an effective supplemental anesthetic technique in 89% (+/- 5.1) or 33/37 patients evaluated. The 95% confidence interval was 74 to 97%. The IOI was successful in 91% (+/- 4.9) of the mandibular posterior teeth (31/34), and 67% of the maxillary teeth (2/3).

Adolescent↗

Effects of dentin bonding agents on macrophage mitochondrial activity.

Dentin bonding agents (DBA) have been considered for use as root-end fillings. Previous studies have documented the release of DBA components in vivo and in vitro, but the biological implications are not clear. The macrophage is important in wound healing, and likely to be important in any inflammatory response. Therefore, this study determined the concentrations of the components of DBAs that suppress the mitochondrial activity of human macrophages in vitro. THP-1 macrophages were cultured in the presence of four DBA components (2-hydroxyethyl methacrylate (HEMA), 4-methacryloxyethyl trimellitate anhydride (4-META), bisphenol-glycidylmethacrylate (Bis-GMA), and urethane dimethacrylate (UDMA)) at various concentrations and for varying durations. Residual effects were also measured after the resins were removed. Controls received only the vehicle solution, ethanol or water. THP-1 mitochondrial activity was estimated using the MTT assay, and the 50% toxicity concentrations (TC50) were determined graphically. Resin components suppressed the mitochondrial activity of macrophages at different concentrations (TC50 values for HEMA (10,000 mumol/L), 4-META (3,800 mumol/L), Bis-GMA (130 mumol/L), and UDMA (110 mumol/L) at 24 h, and the effect was time-dependent. Residual effects were observed for all resins.

Acrylic Resins↗

The disintegration of superEBA cement in solutions with adjusted pH and osmolarity.

This study determined the disintegration of fast-set SuperEBA cement using ANSI/ADA Specification No. 30 (Spec #30) as well as modifications in pH, osmolarity, time before immersion, and duration of immersion that mimic the clinical, endodontic application of this material. After immersion intervals of 24 h, 1 wk, 1 m, 3 m, or 6 m, specimens were desiccated and weighed. The preimmersion and postdehydration weights were obtained to the nearest 1.0 mg and the percent weight loss from preimmersion levels was calculated. Adjusting the osmolarity to the physiologic level of 300 mOsm/kg resulted in significantly less weight loss (p < 0.05) than the control group in distilled water (no modification of Spec #30). The pH of the storage solution was found to be a significant factor in weight loss. As the acidity and the time of immersion increased, the weight loss also significantly increased with the greatest weight loss of 19.81% at pH 5.5 after 6 m storage. Immersion within 10 min of mixing was not significantly different (p > 0.05) in weight from the control of 1 h set-time. The 24 h weight loss measurements for the pHs of 5.5 and 6.4 were greater than the 1.5% allowed by Spec #30. All other 24 h measurements were less than the 1.5%.

Analysis of Variance↗

Comparison of various transport media on human periodontal ligament cell viability.

The purpose of this study was to determine the ability of various solutions to maintain human periodontal ligament cell (PDL) viability in vitro. PDL cells were obtained from extracted third molars and premolars of healthy individuals. These cells were placed into 24-well culture plates containing milk, Save-A-Tooth, Save-A-Tooth supplemented with platelet-derived growth factor-BB (PDGF), or Gatorade at a concentration of approximately 80,000/well. Cells left dry served as negative controls, and cells placed in Eagles' Minimal Essential Medium served as positive controls. At 1, 2, 4, 8, and 12 h, cell viability was evaluated using an MTS assay and an ELISA plate reader to determine optical density. ANOVA and Student-Newman-Keuls tests indicated that milk and Save-A-Tooth with PDGF are suitable as transport medium for avulsed teeth and that the addition of PDGF to Save-A-Tooth may enhance its ability to maintain PDL cell viability. They also suggests that Gatorade would be unsuitable as a transport medium.

Animals↗

A comparison of thermoplastic obturation techniques: adaptation to the canal walls.

The purpose of this study was to directly compare the ability of the three types of Thermafil obturators, the Obtura II thermoplasticized injectable technique, and the lateral condensation technique to obturate a standardized root canal. A split-tooth model was constructed and the root canal was obturated 20 times with each technique. The quality of each obturation was graded according to established criteria of adaptation. Statistical analysis of the results indicated that all the techniques were significantly different from each other (p < 0.0001) except for the plastic and titanium Thermafil groups (p > 0.05), which were similar. Based on the evaluated criteria, the Obtura II injectable technique demonstrated the best adaptation to the prepared root canal. This group was followed in order by the plastic and titanium Thermafil obturators, the stainless steel Thermafil obturators, and finally by the lateral condensation technique.

Analysis of Variance↗

An assessment of the ability of various materials to seal furcation canals in molar teeth.

Ninety-seven maxillary and mandibular molar teeth were evaluated for the presence of naturally occurring furcation canals using the fluid filtration method. Only one specimen demonstrated a naturally occurring patent furcation canal. An artificial furcation canal was created with a 0.33-mm drill bit in the 96 teeth lacking naturally occurring furcation canals. Fluid filtration measurements were made before and after the artificial canal was made, and these served as the negative and positive controls for each tooth. The 96 teeth were randomly divided into eight equal groups, and the floor of the pulp chambers was sealed using 3 mm of either Tytin or Dispersalloy amalgams, Vitremer, FluoroCore, gutta-percha with sealer, Tytin with Ali-Bond 2 or Amalgambond, or Dispersalloy with Ali-Bond 2. Analysis of measured microleakage at 3 months indicated that Tytin amalgam used alone had significantly more microleakage than all other materials; however, this difference did not exist when bonding agents were used with Tytin. All materials leaked significantly less than the positive controls.

Dental Leakage↗

Root surface temperatures produced during post space preparation.

In vitro root surface temperatures produced during post space preparation were measured. The preparations were made using a GPX bur with rotational speeds of 6,500, 8,000, 9,500, 11,000, and 15,000 rpm. The overall mean temperature increase ranged from 0.66 degree to 4.81 degrees C and was greatest at 8,000 rpm. When speeds > 8,000 rpm were used, temperature increases also resulted, but they were significantly less than that which occurred at 8,000 rpm. Damage to the supporting structures of teeth should not occur when this bur is used, at any of the speeds evaluated, to create a post space.

Analysis of Variance↗

Push-out strength and SEM evaluation of resin composite bonded to internal cervical dentin.

The bond strength of a resin composite used with a dual-cured dentin bonding system to internal cervical bovine dentin was evaluated using a direct or indirect placement technique. Teeth were sectioned transversely to produce 4 mm-thick specimens. The root canals were enlarged to a standardized taper, treated with a dentin bonding system, and filled with a light-cured resin composite using either direct, incremental composite placement or indirect composite placement of a pre-polymerized composite inlay. The debond stress of indirectly placed restorations using a composite inlay was 8.5 (SD +/- 2.7) MPa which was significantly greater (p < 0.0001) than the value of 5.0 (SD +/- 1.9) MPa for composite placed in a conventional, incremental manner. SEM evaluation revealed the indirect placement technique demonstrated increased resin tag density and length as compared to the direct technique. Enhanced retention of resin composite to endodontically prepared dentin treated with a dentin bonding system was obtained by using a composite inlay technique as opposed to direct, incremental buildup of the material.

Acid Etching, Dental↗

Incidence and position of the canal isthmus. Part 1. Mesiobuccal root of the maxillary first molar.

The mesiobuccal roots of 50 randomly selected maxillary first molars were examined to assess the incidence and position of the canal isthmus. Transverse serial sections of the apical 6 mm of each root were prepared in 1-mm increments. The apical side of each section was stained with methylene blue dye, viewed with a surgical operating microscope, and videotaped. Forty percent of the roots had one canal, whereas 60% had two canals. None of the sections had more than two main canals. The incidence of an isthmus was highest in the apical 3- to 5-mm levels. In teeth that had two canals, the 4-mm sections contained a complete or partial isthmus 100% of the time. The concept of a partial isthmus was presented. Failure to deal with the isthmus may explain why some posterior teeth do not heal completely following endodontic surgery.

Dental Pulp Cavity↗

In vitro radicular temperatures produced by injectable thermoplasticized gutta-percha.

In vitro temperatures produced in the root canal and on the root surface were measured simultaneously as heated gutta-percha was injected into the prepared canal. The canals were obturated with the Obtura II heated gutta-percha system with temperature settings of 160, 185, and 200 degrees C. The mean intracanal temperatures ranged from 40.21 to 57.24 degrees C, whereas the mean root surface temperatures were recorded from 37.22 to 41.90 degrees C for all three temperatures tested. The rise in temperature on the root surface was below the critical level of 10 degrees C and should not cause damage to the periodontal ligament.

Body Temperature↗