• Restorative Dentistry and Endodontics
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• v.13 no.1
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• pp.161-171
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• 1988

The purpose of this study was to examine the morphological changes of different simulated canals according to the preparation procedures. With the use of clear casting resin, simulated straight and curved canals were created so that canal preparation procedures could be directly visualized and compared. Thirty clear polyester casting resin blocks which contained four simulated canals divided into three groups; Group A($0^{\circ}$), Group B($15^{\circ}$), and Group C($30^{\circ}$). In each block, 3 canals were prepared different preparation techniques, which were conventional method, step-back method, and giromatic filing. But, one canal was not prepared as a control group. The results were as follows: 1. There was no difference on canal shape among three canal preparation methods in straight canals (Group A). 2. When conventional method and Giromatic filing were used in curved canals (Group B, C), elbow, zip and hour-glass shape were formed in apical third. 3. When conventional method and Giromatic filing were used in curved canals (Group B, C), tear-drop appearance developed at the site of the canal exit in curved canals. 4. In curved canals (Group B, C), file tend to straighten within the canal. 5. There was no difference on canal shape according to curved angle in step-back method (p > 0.1). But there was significant difference on canal shape according to curved angle in conventional method and Giromatic filing (p < 0.001). 6. Step-back method was significantly more effective than conventional method and Giromatic preparation in morphologic aspects of apical third of original canals.

• Restorative Dentistry and Endodontics
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• v.12 no.1
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• pp.165-169
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• 1986

A total of 114 extracted human mandibular 2nd molars were used to study the configuration of the floor of the chamber. The specimens were ground and the pulp chamber was examined with a magnifier and explored with sharp explorer. The study showed the shape of the pulp chamber, number of root canals, and the type of canal orifice. The results were as follows, 1. In so far as observing the shape of the pulp chamber of the teeth, 47.4% of the teeth were square, 42.9% were triangle and 9.7% were ovoid shape. 2. 35% of the samples had 2 root canal orifices, 62% had 3 root canal orifices, 3% had 4 root canal orifices. 3. 3% of the specimens showed 'H' shape, 5% showed 'Square' shape, 51% showed 'T' shape, 1% showed 'reverse-T' shape, 35% showed 'I' shape and 5% showed the specific 'C' shape.

• Restorative Dentistry and Endodontics
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• v.20 no.2
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• pp.768-779
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• 1995

This study was performed to investigate the effect of root canal shaping techniques on the change of the shape of prepared root canal. 40 mesiobuccal canals of recently extracted mandibular 1st and 2nd molars were divided into 4 groups and shaped by step-down/balanced force technique, step-down/step-back technique, step-back technique and conventional technique respectively. The change of the shape of root canal was traced by superimposing the radiographs obtained before and after shaping of each root canal. The results were as follows. 1. By the experimented techniques except conventional technique, the root canals were more shaped in convex side of apical area and in concave side of most curved and coronal area than in the other sides(P<0.05). By conventional technique, the root canals were more shaped in convex side than in convave side from apex to orifice(P<0.05). 2. By step-down/balanced force technique, the cancave sides at C and D points of proximal view and C point of clinical view were more shaped than the convex side(P<0.05). Through the entire canal, the concave side was more shaped than the convex side in proximal view(P<0.01). But there was no statistical difference between both sides in clinical view. 3. By step-down/step-back technique, the change of root canal shape was not statistically different in concave and convex sides at each point of both views(P>0.05). And through the entire canal in proximal view, there was no statistical difference in shaping percentage between both sides. But through the entire canal in clinical view, the concave side was more shaped than the convex side(P<0.1). 4. By step-back technique, the convex side at B point of clinical more shaped than the other sides(P<0.05). Through the entire canal in proximal and clinical views, there was no statistical difference in shaping percentage between both sides. 5. Comparing the total shaping percentage among techniques, that in conventional technique was the greatest numerically, and followed by the percentages in step-down/step-back, step-down/balanced force and step-back technique. But, in proximal view, shaping percentages were not statistically different among techniques(P>0.05, ANOVA test). In clinical view, shaping percentages in step-back and conventional techniques were statistically different(P<0.01, ANOVA test). * Proximal view: radiograph taken in mesiodistal direction. * Clincal view: radiograph taken in faciolingual direction. A point : 1mm point from radiographic apex B point : center point between A and C points C point : most curved point of root canal D point : center point between C point and canal oriffice.

• Restorative Dentistry and Endodontics
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• v.32 no.1
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• pp.37-46
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• 2007

The C-shaped canal system is an anatomical variation mostly seen in mandibular second molars, although it can also occur in maxillary and other mandibular molars. The main anatomical feature of C-shaped canals is the presence of fins or web connecting the individual root canals. The complexity of C-shaped canals prevents these canals from being cleaned, shaped, and obturated effectively during root canal therapy, and sometimes it leads to an iatrogenic perforation from the extravagant preparation. The purpose of this study was to provide further knowledge of the anatomical configuration and the minimal thickness of dentinal wall according to the level of the root. Thirty extracted mandibular second molars with fused roots and longitudinal grooves on lingual or buccal surface of the root were collected from a native Korean population. The photo images and radiographs from buccal, lingual, apical direction were taken. After access cavity was prepared, teeth were placed in 5.25% sodium hypochlorite solution for 2 hours to dissolve the organic tissue of the root surface and from the root canal system. After bench dried and all the teeth were embedded in a self-curing resin. Each block was sectioned using a microtome (Accutom-50, Struers, Denmark) at interval of 1 mm. The sectioned surface photograph was taken using a digital camera (Coolpix 995, Nikon, Japan) connected to the microscope. 197 images were evaluated for canal configurations and the minimal thickness of dentinal wall between canal and external wall using 'Root Thickness Gauge Program' designed with Visual Basic. The results were as follows : 1. At the orifice level of all teeth, the most frequent observed configuration was Melton's Type C I (73%), however the patterns were changed to type C II and C III when the sections were observed at the apical third. On the other hand, the type C III was observed at the orifice level of only 2 teeth but this type could be seen at apical region of the rest of the teeth. 2. The C-shaped canal showed continuous and semi-colon shape at the orifice level, but at the apical portion of the canal there was high possibility of having 2 or 3 canals 3. Lingual wall was thinner than buccal wall at coronal, middle, apical thirds of root but there was no statistical differences.

• Restorative Dentistry and Endodontics
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• v.17 no.1
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• pp.141-152
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• 1992

Four endodontic instruments from different manufacturers(K - file, Hedstrom - file, K - flex - file, Cavi - Endo) were used to shape 80 mesial canals of extracted posterior teeth. The instrument's ability to enlarge and shape the canals as the original canal shape was assessed by superimposing radiographs of canals obtained before and after canal shaping. The results were as follows 1. Hedstrom - file enlarged canals greater than K - file, K - flex - file, and Cavi - Endo(P<0.05). There are no differences in canal enlargement among K - flex, K - flex - file, and Cavi - Endo(P<0.05). 2. All the instruments showed no difference in canal enlargement between convex side and concave side of B point in proximal and clinical radiographic views, but at the concave side of C point canals were enlarged greater than at the convex side(proximal view of K - file: P<0.05, the others: P<0.01). 3. There was no difference m canal enlargement between convex side and concave side in proximal view of A and D points of K - file and K - flex - file(P<0.05). But in clinical view, canal enlargement at convex side of A point and concave side of D point was greater than that at concave side of A point and convex side of D point respectively. 4. Hedstrom - files showed greater canal enlargement at convex side of A points and concave side of D points (P<0.05 or P<0.01). Cavi - Endo showed no difference in canal enlargement between convex side and concave side at A and D points in proximal view(P<0.05). Bur canal enlargement was greater at concave side than at convex side of D point in clinical view. 5. K - file and Cavi - Endo showed no differences in canal enlargement between convex and concave side in proximal and clinical view (P<0.05). K - flex - file showed greater canal enlargement at concave side in proximal and clinical view(P<0.0:5). Hedstrom file showed no difference in canal enlargement between convex side and concave side in proximal view, but showed greater canal enlargement at concave side in clinical view(P<0.05).

• Restorative Dentistry and Endodontics
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• v.27 no.4
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• pp.421-431
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• 2002

C-shaped canal configuration is very difficult to treat because that clues about preoperative canal anatomy cannot be ascertained from clinical crown morphology and limited information can be derived from radiographic examination. This study was done to get more informations about the root and canal configuration of C-shape root by 3-dimensionally reconstructing for the purpose of enhancing success rate of endodontic treatment. 30 mandibular molars with C-shaped root were selected. Six photo images from occlusal, apical, mesial, distal, buccal, lingual directions and radiographic view were taken as preoperative ones to compare them with 3-D image. After crown reduction to the level of 1-2mm over pulpal floor was performed, teeth were stored in 5.25% sodium hypochlorite solution for the removal of pulp tissue and debris. They were cleaned under running water, allowed to bench dry and embedded in a self-curing resin. This resin block was serially ground with a microtome (Accutom-50, Struers, Denmark) and the image of each level was recorded by digital camera (FinePix S1-pro, Fuji Co., Japan). The thickness of each section was 0.25mm. Photographs of serial sections through all root canal were digitized using Adobe Photoshop 5.0 and then minimum thickness of open and closed sites were measured (open site is the surface containing occluso-apical groove closed site is oppsite). After dizitization using 3-D Doctor (Able software Corp, USA). 3D reconstruction of the outer surface of tooth and the inner surface of pulp space was made. Canal classsification of C-shaped roots was performed from this 3-D reconstructed image. The results were as follows : 1. Most C-shape rooted teeth showed lingual groove (28/30). 2 According to Vertuccis' calssification, type I, II, III, IV, VII were observed. but also new canal types suck as 2-3-2, 1-2-3-2. 2-3-2-1, 2-3-2-3 were shown. 3 There was little difference in minimum thickness on coronal and apical portions, but open site were thinner than closed site on mid portion. Conclusively, 3D reconstruction method could make the exact configurations of C-shape root possible to be visualized and analyzed from multi-directions. Data from minimum thickness recommend cleaning and shaping be more carefully done on dangerous mid portion.

• The Journal of the Korean dental association
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• v.50 no.4
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• pp.203-210
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• 2012

Objective: The aim of this study was to investigate the incidence of the C-shaped canal of permanent mandibular second molar (PMSM) in Korean sub-population using Cone-Beam CT (CBCT) data and analyze the types of C-shaped canal. Materials & Methods: The protocol for this study was approved by the Institutional Review Board at the Pusan National University Hospital (E-2011039). Among the CBCT images taken of patients who visited the St. Bennedict Dental Hospital (Busan, Korea) from May 2008 to April 2011 for implant surgery and surgical removal of impacted teeth, high-quality CBCTs from 705 patients (361 male and 342 female) were screened and 607 PMSMs of 383 patients were evaluated retrospectively. All PMSMs were anatomically analyzed in detail by using image viewer software (EasyDent; Vatech). PMSMs were evaluated in the axial plane to investigate the shape of root and canals. The C-shaped canals were classified into five types. The total incidence, gender ratio, bilateral and unilateral appearance. and the correlation between right-side and left-side occurrences of C-shaped PMSMs were computed and compared statistically using the chi-square test. Results: Among the 607 PMSMs of 383 CBCTs of 187 females and 196 males, 198 PMSMs(32.6%) had C-shaped root and 158 PMSMs(26.0%) had C-shaped canals. The shape of C-shaped root canals at the furcalion level did not have significant change at the level of mid root (P<0.0001). Female had more prevalence of C-shaped root canals than male (P<0.0001). The prevalence of bilateral occurrence of C-shaped root canals was higher than unilateral occurrence. Conclusions: The occurrence of C-shaped PMSMs among a Korean population was 32.6% and was higher than other countries and ethnicities. Understanding the prevalence of PMSMs with a C-shaped root and/or canal in a Korean population may be useful for successful endodontic treatments.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.4
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• pp.324-328
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• 2014

Aberrant anatomy of mandibular premolars is very rare in Korean, but aberration can contribute the endodontic failure as it makes difficult to remove the irritants during cleaning and shaping procedure. This case report describes the successful root canal treatment of a rare mandibular first premolar with C-shaped root canal as using a cone-beam computed tomography to understand the internal shape of root canal system and a dental operating microscope to improve the magnification and illumination.

• Restorative Dentistry and Endodontics
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• v.34 no.4
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• pp.346-349
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• 2009

Mandibular second molars have many variations in canal configuration. Technical modifications in cleaning, shaping and obturation are required. The purpose of this study was to investigate the root canal anatomy of mandibular second molars. 86 teeth of 85 patients were accessed and evaluated with taking radiographs for working length determination. 27 teeth(31.4%) had C-shaped canals, 43 teeth(50%) had 3 canals, 11 teeth(12.7%) had 4 canals, 5 teeth(5.8%) had 2 canals. Incidence of C-shaped canal was 31.7% in male and 31.1% in female. 30.9% of left mandibular second molar and 31.8% of right mandibular second molar showed C-shaped canals.

• Restorative Dentistry and Endodontics
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• v.32 no.4
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• pp.335-342
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• 2007

C-shaped canals are known to present a complex canal anatomy with numerous fins connecting individual canals, thus requiring supplementary effort to accomplish a successful root canal treatment. This study examined the frequency of the C-shaped mandibular second molars and interrelation between the clinical records and radiographs to recognize them treated in the Department of Conservative Dentistry of the Chosun University Dental Hospital during a six-year period (1998-2004). This study reviewed the clinical records of 227 patients who underwent root canal treatment of the mandibular second molars. After opening the chamber, those cases with C-shaped orifices in the pulpal floor were selected, ana the C-shaped root canal types were classified according to Melton's criteria. Three experienced dentists evaluated the radiographs of the C-shaped mandibular second molar on a viewer using a magnifying glass in order to determine if the root apex was fused or separated, the distal root canal was either centered or mesial shifted in the distal root, and if there was bilateral symmetry in a panorama. In conclusion, there is a high frequency of C-shaped mandibular second molars in Koreans. Simultaneous interpretation of the root shape and distal root canal using the preoperative, working length and post-treatment radiographs is important for diagnosing a C-shaped mandibular second molar.