• Title/Summary/Keyword: Apical limit

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A survey on working length determination of endodontic treatment (근관치료의 근관장 측정에 관한 연구: 근관치료학 전공 교수 설문)

  • Ahn, Hye-ra;Seo, Min-Seock
    • The Journal of the Korean dental association
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    • v.55 no.1
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    • pp.42-52
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    • 2017
  • The purpose of this study is to evaluate the preferred method of root canal length determination and the apical limit for canal instrumentation among endodontic teachers of dental school. A questionnaire on the preferred method of root canal length determination and the apical limit for canal instrumentation was designed and distributed to endodontic teachers of various dental schools. The response rate was 90%. The most preferred method of root canal length determination was Electronic apex locator (EAL)(89%). The most favoured apical limit for canal instrumentation was 0.5 to 1.0 mm short of the radiographic apex(78%). The most preferred method of using EAL was that the working length is taken at 'APEX' mark and then distracted 0.5mm from that length.(41%). When there is no agreement between radiographic measurement and EAL measurement, 74% of respondents chose the length of EAL measurement. The majority of endodontic teachers from Korean dental schools preferred EAL to radiograph method in determining root canal length.

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Procedural errors detected by cone beam tomography in cases with indication for retreatment: in vivo cross-sectional study

  • Henry Paul Valverde Haro;Carmen Rosa Garcia Rupaya;Flavio R. F. Alves
    • Restorative Dentistry and Endodontics
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    • v.49 no.3
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    • pp.26.1-26.14
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    • 2024
  • Objectives: This study aimed to investigate the frequency and type of endodontic procedural errors in cases indicated for retreatment through cone-beam computed tomography (CBCT) analysis. Materials and Methods: The sample consisted of 96 CBCT scans, encompassing 122 permanent teeth with fully formed roots. Errors included perforation, instrument fracture, canal transportation, missed canals, and inadequate apical limit of filling. Additionally, potential risk factors were analyzed and subjected to statistical modeling. Results: The most frequent procedural error observed was the inadequate apical limit of filling, followed by canal transportation, perforation, missed canal, and instrument fracture. Statistically significant associations were identified between various procedural errors and specific factors. These include canal transportation and root canal wall, with the buccal wall being the most commonly affected; missed canal and tooth type, particularly the palatine and second mesiobuccal canal canals; inadequate apical limit of filling and root curvature, showing a higher deviation to the mesial direction in severely curved canals; inadequate apical limit of filling and the presence of calcifications, with underfilling being the most frequent; canal transportation and periapical lesion, notably with deviation to the buccal direction; and the direction of perforation and periapical lesion, most frequently occurring to buccal direction. Conclusions: CBCT emerges as a valuable tool in identifying procedural errors and associated factors, crucial for their prevention and management.

Treatment of cemental tear associated with periapical lesion using regenerative surgery; A case report (재생술식을 이용한 치근단 병소를 동반한 백악질 열리의 치료)

  • Kang, Hyo-Jin;Jung, Gyu-Un;Pang, Eun-Kyoung
    • The Journal of the Korean dental association
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    • v.54 no.5
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    • pp.365-373
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    • 2016
  • Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

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Bony change of apical lesion healing process using fractal analysis (프랙탈 분석을 이용한 치근단병소 치유과정의 골 변화)

  • Lee Ji-Min;Park Hyok;Jeong Ho-Gul;Kim Kee-Deog;Park Chang-Seo
    • Imaging Science in Dentistry
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    • v.35 no.2
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    • pp.91-96
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    • 2005
  • Purpose : To investigate the change of bone healing process after endodontic treatment of the tooth with an apical lesion by fractal analysis. Materials and Methods Radiographic images of 35 teeth from 33 patients taken on first diagnosis, 6 months, and 1 year after endodontic treatment were selected. Radiographic images were taken by JUPITER Computerized Dental X-ray $System^{(R)}$. Fractal dimensions were calculated three times at each area by Scion Image $PC^{(R)}$ program. Rectangular region of interest $(30\times30)$ were selected at apical lesion and normal apex of each image. Results : The fractal dimension at apical lesion of first diagnosis $(L_0)$ is $0.940{\pm}0.361$ and that of normal area $(N_0)$ is $1.186{\pm}0.727(p<0.05)$. Fractal dimension at apical lesion of 6 months after endodontic treatment $(L_1)$ is $1.076{\pm}0.069$ and that of normal area $ (N_1)$ is $1.192{\pm}0.055(p<0.05)$. Fractal dimension at apical lesion of 1 year after endodontic treatment $(L_2)$ is $1.163{\pm}0.074$ and that of normal area $(N_2)$ is $1.225{\pm}0.079(p<0.05)$. After endodontic treatment, the fractal dimensions at each apical lesions depending on time showed statistically significant difference. And there are statistically significant different between normal area and apical lesion on first diagnosis, 6 months after, 1 year after. But the differences were grow smaller as time flows. Conclusion : The evaluation of the prognosis after the endodontic treatment of the apical lesion was estimated by bone regeneration in apical region. Fractal analysis was attempted to overcome the limit of subjective reading, and as a result the change of the bone during the healing process was able to be detected objectively and quantitatively.

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Finite element analysis of cortical bone strain induced by self-drilling placement of orthodontic microimplant (Self-drilling 방식의 마이크로임플란트 식립에 의해 발생하는 피질골 스트레인의 유한요소해석)

  • Park, Jin-Seo;Yu, Won-Jae;Kyung, Hee-Moon;Kwon, Oh-Won
    • The korean journal of orthodontics
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    • v.39 no.4
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    • pp.203-212
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    • 2009
  • Objective: The aim of this study was to evaluate the strain induced in the cortical bone surrounding an orthodontic microimplant during insertion in a self-drilling manner. Methods: A 3D finite element method was used to simulate the insertion of a microimplant (AbsoAnchor SH1312-7, Dentos Co., Daegu, Korea) into 1 mm thick cortical bone. The shape and dimension of thread groove in the center of the cortical bone produced by the cutting flute at the apical of the microimplant was obtained from animal test using rabbit tibias. A total of 3,600 analysis steps was used to calculate the 10 turns and 5 mm advancement of the microimplant. A series of remesh in the cortical bone was allowed to accommodate the change in the geometry accompanied by the implant insertion. Results: Bone strains of well higher than 4,000 microstrain, the reported upper limit for normal bone remodeling, were observed in the peri-implant bone along the whole length of the microimplant. Level of strains in the vicinity of either the screw tip or the valley part were similar. Conclusions: Bone strains from a microimplant insertion in a self-drilling manner might have a negative impact on the physiological remodeling of cortical bone.

Extended Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy -Report of a case- (비후형 심근증 환아에서 시행한 광범위 중격절제술 - 1예 보고 -)

  • Lee Jae-Hang;Kwak Jae-Gun;Jung Eui-Suk;Oh Se-Jin;Chang Myoung-Woo;Kim Woong-Han
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.775-778
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    • 2006
  • Hypertrophic cardiomyopathy is characterized by inappropriate hypertrophy of the myocardium and is associated with various clinical presentations ranging from complete absence of symptoms to sudden, unexpected death. These are caused by dynamic obstruction of the left ventricular outflow tract and surgical approaches were initiated. But, the complete resection of hypertrophied midventricular septum is impossible by standard, transaortic approach, because of narrow vision and limited approach. And it leads to inadequate excision, will leave residual left ventricular out-flow tract obstruction or systolic anterior motion of mitral leaflet, and limit symptomatic improvement and patient's survival. We report a case of extended septal myectomy for hypertrophic cardiomyopathy of mid-septum in a child. The extended septal myectomy was performed by aortotomy and left ventricular apical incision, and made possible the complete resection of mid-ventricular septum, abnormal papillary muscles and chordae. The patient's symptom was improved and the postoperative course was uneventful.