Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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EVALUATION OF THE INFLUENCE OF APICAL SIZES ON THE APICAL SEALING ABILITY OF THE MODIFIED CONTINUOUS WAVE TECHNIQUE

Modified Continuous Wave Technique을 이용한 근관충전시 형성된 치근단 크기가 치근단 폐쇄에 미치는 영향

  • Ryu, Mu-Hyun (Department of Dentistry, The Graduate School, Yonsei University) ;
  • Jung, Il-Young (Department of Dentistry, The Graduate School, Yonsei University) ;
  • Lee, Seung-Jong (Department of Dentistry, The Graduate School, Yonsei University) ;
  • Shin, Su-Jung (Department of Dentistry, The Graduate School, Yonsei University) ;
  • Kim, Eui-Seong (Department of Dentistry, The Graduate School, Yonsei University)
  • 류무현 (연세대학교 치과대학 보존학교실) ;
  • 정일영 (연세대학교 치과대학 보존학교실) ;
  • 이승종 (연세대학교 치과대학 보존학교실) ;
  • 신수정 (연세대학교 치과대학 보존학교실) ;
  • 김의성 (연세대학교 치과대학 보존학교실)
  • Published : 2008.01.31
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Abstract

This study examined the influence of the apical sizes on the sealing ability of a root canal filling. Thirty-six single rooted teeth with a single canal were divided into 3 groups (n = 12) and instrumented with either the $Profile^{(R)}$ or $LightSpeed^{(R)}$ system to achieve three different apical sizes (master apical file [MAF] of #25, #40, or #60). The teeth were filled with gutta perch a using a modified continuous wave technique. The level of microleakage was determined by immersing ten teeth from each group into India ink for 1 week followed by clearing with nitric acid, ethyl-alcohol, and methylsalicylate. The microleakage was measured using vernier calipers. The data was analyzed statistically using Kruskal-Wallis one-way ANOVA and a Student-Newman-Keuls Method. Two teeth from each group were sectioned horizontally at 1, 2, 3 and 4 mm from the apex in order to observe a cross section. The apical size was significantly (p < .05) influenced the level of microleakage. In the Student-Newman-Deuls Method, MAF sizes of #25 and #40; and MAF sizes of #25 and #60, respectively showed a statistically significant difference. There was no significant difference between #40 and #60. In most cross sections, oval-shaped canals were observed, and the irregularity of the internal surface increased with decreasing apical size. There was also an increase in the area of recess, which is the area where the canal space is not filled with either gutta-percha or sealer. When the root canals are filled using a modified continuous wave technique, canal filling with more consistent and predictable outcome may be expected as the apical preparation size is increased.

본 연구에서는 근관형성의 치근단 크기가 근관 충전의 치근단 폐쇄에 미치는 영향에 대해 알아보고자 하였다. 36개의 단근관, 단근치를 대상으로 3가지 치근단 크기 (Master apical file : #25, #40, #60)에 따라 3가지 실험군으로 나누어 $Profile^{(R)}$과 $LightSpeed^{(R)}$를 이용하여 근관을 확대하고, Modified continuous wave technique으로 근관충전을 시행하였다. 미세누출의 측정을 위해 실험군당 10개의 치아를 1주일간 India ink에 넣어 색소 침투를 일으키고 치아를 투명화시켜 미세누출의 정도를 측정하였다. 미세누출에 치근단 크기가 미치는 영향을 분석하기 위하여 Kruskal-Wallis one-way ANOVA를 시행하였고, 사후 검정을 위하여 Student-Newman-Keuls method를 시행하였다. 또한, 치아 단면의 형태를 관찰하기 위하여 색소 침투까지 실행된 각 실험군당 2개의 치아를 근첨 1 mm에서 4 mm까지 1 mm간격으로 수평 절단하고 사진 촬영하였다. 각 실험군에서 측정된 미세누출양을 Krustal-Wallis one-way ANOVA에서 분석한 결과 치근단 크기는 유의성 있게 (P < 0.05) 미세누출에 영향을 미쳤으며 치근단 크기가 클수록 미세누출의 평균간과 표준편차 값은 감소하는 경향을 보였다. Student-Newman-Keuls method를 통한 사후 검정에서 치근단 크기가 #25 - #40, #25 - #60에서 유의 한 차이를 보였으며 #40 - #60간에는 통계적인 유의차는 없었다. 단면형태에서는 대부분의 치아에서 난원형의 근관 형태를 관찰 할 수 있었고, 치근단의 크기가 작을수록 성형된 근관에 불규칙한 내면이 존재하였고 gutta-percha나 sealer로 충전되지 않는 recess의 면적이 증가함을 알 수 있었으며 이러한 recess는 미세누출의 통로가 됨을 확인 할 수 있었다. 본 연구 결과, Modified continuous wave technique으로 근관충전시 근관 형성된 치근단 크기가 커질수록 보다 일관되고 성공적 인 결과를 예상할 수 있는 근관충전을 시행할 수 있음을 알 수 있었다.

Keywords

References

  1. Schilder H. Filling root canals in three dimensions. Dent Clin North Am 11:723-744, 1967
  2. Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod 16:498-504, 1990 https://doi.org/10.1016/S0099-2399(07)80180-4
  3. Rud J, Andreasen JO. A study of failures after endodontic surgery by radiographic, histologic, and stereomicroscopic methods. Int J Oral Surg 1:311-328, 1972 https://doi.org/10.1016/S0300-9785(72)80052-8
  4. Gutmann JL. Clinical, radiographic, and histologic perspectives on success and failure in endodontics. Dent Clin North Am 36:379-392, 1992
  5. Buckley M, Spa′ngberg L. The prevalence and technical quality of endodontic treatment in an American subpopulation, Oral Surg Oral Med Oral Patho Oral Radiol Endod 79:92-100, 1995 https://doi.org/10.1016/S1079-2104(05)80081-2
  6. Youngson CC, Nattress BR, Manogue M, Speirs AF. In vitro radiographic representation of the extent of voids within obturated root canals. Int Endod J 28:77-81, 1995 https://doi.org/10.1111/j.1365-2591.1995.tb00162.x
  7. Ainley JE. Fluorometric assay of the apical seal of root canal fillings. Oral Surg Oral Med Oral Pathol 29:753- 62, 1970 https://doi.org/10.1016/0030-4220(70)90274-4
  8. Kuttler J. Fundamentos de Endo-metaendodoncia Pr-ctica, 2nd ed, Mexico, Mendez Ostero, 8, 1980
  9. Green D. A stereo-binocular microscopic study of the root apices and surrounding areas of 100 mandibular molars ; preliminary study. Oral Surg Oral Med Oral Pathol 8:1298-304, 1955 https://doi.org/10.1016/0030-4220(55)90434-5
  10. Ponce EH, Vilar Fernandez JA. The cemento-dentinocanal junction, the apical foramen, and the apical constriction : evaluation by optical microscopy. J Endod 29:214-9, 2003 https://doi.org/10.1097/00004770-200303000-00013
  11. Wu MK, Roris A, Barkis D, Wesselink PR. Prevalence and extent of long oval canals in the apical third. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89:739- 743, 2000 https://doi.org/10.1067/moe.2000.106344
  12. Buchanan LS. The standardized-taper root canal preparation : part1. Concepts for variably tapered shaping instruments. Int Endod J 33:516-29, 2000 https://doi.org/10.1046/j.1365-2591.2000.00384.x
  13. Buchanan LS. The standardized-taper root canal preparation : part2. GT file selection and safe handpiece- driven file use. Int Endod J 34:63-71, 2001 https://doi.org/10.1046/j.1365-2591.2001.00385.x
  14. Buchanan LS. The standardized-taper root canal preparation : part3. GT file technique in large root canals with small apical diameters. Int Endod J 34:149-56, 2001 https://doi.org/10.1046/j.1365-2591.2001.00386.x
  15. Buchanan LS. The standardized-taper root canal preparation : part4. GT file technique in large root canals with large apical diameters. Int Endod J 34:149-56, 2001 https://doi.org/10.1046/j.1365-2591.2001.00386.x
  16. Buchanan LS. The standardized-taper root canal preparation : part5. GT file technique in small root canals. Int Endod J 34:244-9, 2001 https://doi.org/10.1046/j.1365-2591.2001.00388.x
  17. Buchanan LS. The standardized-taper root canal preparation : part6. GT file technique in abruptly curved canals. Int Endod J 34:250-9, 2001 https://doi.org/10.1046/j.1365-2591.2001.00389.x
  18. Weine F. Endodontic therapy, St. Louis, C.V. Mosby:209-22, 1972
  19. Wu MK, Barkis D, Roris A, Wesselink PR. Does the first file to bind correspond to the diameter of the canal in the apical region- Int Endod J 35:264-7, 2002 https://doi.org/10.1046/j.1365-2591.2002.00474.x
  20. Strindberg LZ. The dependence of results of pulp therapy on certain factors : an analytic study based on radiographic and clinical follow-up examination. Acta Odontol Scand 14(Suppl):1, 1956 https://doi.org/10.3109/00016355609007499
  21. Hoskinson SE, Ng YL, Hoskinson AE, Moles DR, Gulabivala K. A retrospective comparison of outcome of root canal treatment using two different protocols. Oral Surg Oral Med Oral Pathol Oral Radio Endod 93:705- 15, 2002 https://doi.org/10.1067/moe.2001.122822
  22. Friedman S, Abitbol S, Lawrence HP. Treatment outcome in endodontics : the Toronto Study. Phase 1 : initial treatment. J Endod 29:787-93, 2003 https://doi.org/10.1097/00004770-200312000-00001
  23. Wu MK, Schwartz FB, Van des Sluis LW, Wesselink PR, The quality of root fillings remaining in mandibular incisors after root-end cavity preparation. Int Endod J 34:613-619, 2001 https://doi.org/10.1046/j.1365-2591.2001.00439.x
  24. Wu MK, Wesselink PR. Efficacy of three techniques in cleaning the apical portion of the curved root canals. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 79:492-6, 1995 https://doi.org/10.1016/S1079-2104(05)80134-9
  25. Siqueira JE, Araujo MC, Garcia PF, Fraga RC, Dantas CJ. Histological evaluation of the effectiveness of five instrumentation techniques for cleaning the apical third of root canals. J Endod 23:499-502, 1997 https://doi.org/10.1016/S0099-2399(97)80309-3
  26. Rollison S, Barnett F, Stevens RM. Efficacy of bacterial removal from instrumented root canals in vitro related to instrumentation technique and size. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94:366- 71, 2002 https://doi.org/10.1067/moe.2002.126164
  27. Card SJ. Sigurdsson A, Orstavik D, Trope M. The effectiveness of increased apical enlargement in reducing intracanal bacteria. J Endod 28:779-83, 2002 https://doi.org/10.1097/00004770-200211000-00008
  28. Tan BT, Messer HH. The quality of apical canal preparation using hand and rotary instruments with specific criteria for enlargement based on initial apical file size. J Endod 28:658-64, 2002 https://doi.org/10.1097/00004770-200209000-00008
  29. Shuping GB. Orstavik D, Sigurdsson A, Trope M. Reduction of intracanal bacteria using nickel-titanium rotary instrumentation and various medications. J Endod 26:751-5, 2000 https://doi.org/10.1097/00004770-200012000-00022
  30. Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod 16:498-504, 1990 https://doi.org/10.1016/S0099-2399(07)80180-4
  31. Nair PN, Sjogren U, Krey G, Kahnberg KE, Sundqvist E. Intraradicular bacteria and fungi in root-filled, asymptomatic human teeth with therapy-resistant periapical lesions : a long-term light and electron microscopic follow-up study. J Endod 16:580-8, 1990 https://doi.org/10.1016/S0099-2399(07)80201-9
  32. Kerekes K, Tronstad L. Morphometric observations on root canals of human anterior teeth. J Endod 3:24-29, 1977 https://doi.org/10.1016/S0099-2399(77)80218-5
  33. Alani AH, Toh CG. Detection of microleakage aroud dental restorations : a review. Oper Dent 22:173-85, 1997
  34. Michailesco PM, Valcarcel J, Grieve AR, Levallois B, Lerner D. Bacterial leakage in endodontics. J Endod 22:535-9, 1996 https://doi.org/10.1016/S0099-2399(96)80013-6
  35. Chaisrisookumporn S, Rabinowitz JL. Evaluation of ionic leakage of lateral condensation and McSpadden methods by autoradiopraphy. J Endod 8:493-6, 1982 https://doi.org/10.1016/S0099-2399(82)80074-5
  36. Czonstkowsky M, Michanowicz A, Vazquez JA Evaluation of an injection of thermoplasticized lowtemperature gutta-percha using radioactive isotopes. J Endod 11:71-4, 1985 https://doi.org/10.1016/S0099-2399(85)80122-9
  37. Ravanshad S, Torabinejad M. Coronal dye penetration of the apical filling materials after post space preparation. Oral Surg Oral Med Oral Pathol 74:644-647, 1992 https://doi.org/10.1016/0030-4220(92)90359-X
  38. Kos WL, Aulozzi DP, Gerstein H. A comparative bacterial microleakage study of retrofilling materials. J Endod 8:355-8, 1982 https://doi.org/10.1016/S0099-2399(82)80193-3
  39. Kersten HW, Moorer WR. Particles and molecules in endodontic leakage. Int Endod J 22:118-24, 1989 https://doi.org/10.1111/j.1365-2591.1989.tb00909.x
  40. Usman N, Baumgartner JC, Marshall JG. Influence of instrument size on root canal debridement. J Endod 30:110-2, 2004 https://doi.org/10.1097/00004770-200402000-00012
  41. Coldero LG, McHugh S, MacKenzie D, Saunders WP. Reduction in intracanal bacteria during root canal preparation with and without apical enlargement. Int Endod J 35:437-46, 2002 https://doi.org/10.1046/j.1365-2591.2002.00496.x
  42. Green D. Stereomicroscopic study of 700 root apices of maxillary and mandibular posterior teeth. Oral Surg Oral Med Oral Pathol 13:728-33, 1960 https://doi.org/10.1016/0030-4220(60)90373-X
  43. West JD. The relation between the three-dimensional endodontic seal and endodontic failure, master's thesis, Boston, Boston University, 1975
  44. Barbakow F. The lightspeed system, Dent Clin North Am 48:113-135, 2004 https://doi.org/10.1016/j.cden.2003.10.003
  45. Sedgley CM, Messer HH. Are endodontically treated teeth more brittle- J Endod. 18:332-335, 1992 https://doi.org/10.1016/S0099-2399(06)80483-8
  46. Stern N, Hirshfeld Z. Principles of preparing endodontically treated teeth for dowel and core restorations. J Prosthet Dent 30:162-5, 1973 https://doi.org/10.1016/0022-3913(73)90051-6
  47. Tilk MA, Lommel TJ, Gerstein H. A study of mandibular and maxillary root widths to determine dowel size. J Endod 5:79-82, 1979 https://doi.org/10.1016/S0099-2399(79)80153-3