• Restorative Dentistry and Endodontics
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• v.48 no.2
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• pp.17.1-17.8
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• 2023

The present report describes the endodontic treatment of an Oehlers type II dens invaginatus in a maxillary lateral incisor with 5 root canals, an extremely rare condition. Apical periodontitis and related symptoms were noted. Cone-beam computed tomography was used to aid the diagnosis, reveal tooth morphology, and assist in canal location. The pulp chamber was carefully accessed, and the root canals were explored under magnification. All root canals were prepared with an R25 Reciproc Blue system and sodium hypochlorite (NaOCl) irrigation. After initial preparation, a self-adjusting file (SAF) with NaOCl and ethylenediaminetetraacetic acid was used to complement the disinfection. Additionally, calcium hydroxide medication was applied. Vertical compaction was used to fill the canals with a calcium silicate-based endodontic sealer and gutta-percha. After 12 months, the patient exhibited healing of the periapical region, absence of symptoms, and normal dental function. In conclusion, this nonsurgical treatment protocol was successful in promoting the cure of apical periodontitis. Both complementary disinfection with an SAF and use of calcium hydroxide medication should be considered when choosing the best treatment approach for dens invaginatus with very complex anatomy.

• Restorative Dentistry and Endodontics
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• v.48 no.4
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• pp.32.1-32.8
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• 2023

Ingestions and aspirations of foreign bodies are rare, but do occasionally occur during dental treatment. Although reports exist, few include photos demonstrating the extensive surgical intervention that may be necessary to manage such events. Perhaps this lack of visualization, and associated lack of awareness, is one of the reasons some clinicians still provide nonsurgical root canal therapy (NSRCT) without a rubber dam. This case report outlines the medical treatment of a 30-year-old male who initially presented to a general dentist's office (not associated with the authors) for NSRCT of their mandibular right first molar. A rubber dam was not used for this procedure, during which the accidental ingestion of an endodontic K-file occurred. The patient was subsequently hospitalized for evaluation and treatment, consisting of numerous imaging studies, endoscopic evaluation, and surgical removal of the file from his small intestine. The ingestion of foreign bodies, and the associated complications, can be reduced through the routine use of a rubber dam, which is considered the standard of care for NSRCT. This case graphically illustrates the potential consequences associated with deviating from the standard of care and should remind clinicians that a rubber dam is necessary for all cases of NSRCT.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.4
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• pp.267-275
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• 2022

Background: Various instrument kinematics used in single-visit endodontics influence the occurrence of pain after endodontic therapy. This study aimed to evaluate the occurrence of pain after mechanical instrumentation with Hyflex EDM (HEDM) and WaveOne Gold (WOG) during single-visit endodontic therapy. Methods: Sixty patients diagnosed with asymptomatic irreversible pulpitis and normal apical tissues in mandibular premolar teeth were included in the study for single-visit root canal therapy. The patients were divided into two groups (n = 30) according to the rotary instrument used during root canal preparation (group A [HEDM] and group B [WOG]). Pain was evaluated after endodontic therapy at 8, 24, and 48 h intervals using the visual analog scale (VAS). Data obtained were analyzed using the chi-square test, independent t-test, MannWhitney U test, and Wilcoxon matched-pairs test. Results: Statistically significant differences were observed between the two groups (P < 0.001) at 8, 24, and 48 h, with WOG exhibiting less pain than HEDM files. Conclusion: Postoperative pain was lower in the WOG file system than in the HEDM file system after single-visit root canal therapy at 8, 24, and 48 h.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.27 no.1
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• pp.55-71
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• 1997

Digora/sup (R)/ an intraoral digital radiography system utilizing image plate (IP) - has a dynamic range of exposure time which allows it to decrease the patient's exposure time and to increase diagnostic ability through image processing, transmission and storage. The purpose of this study was to evaluate the Digora/sup (R)/ system by assessing the effects of various exposure times on the detectability on the tip of the endodontic file. Examining the root canals of 45 extracted sound premolars, K -files No. 10, 15, and 20 were placed at slightly varying distances from the apex. The teeth were glued onto resin-plaster blocks. Five exposure times varying between 0.01 seconds and 0.25 seconds were used. Four observers were asked to measure the distance between the tip of the file and a reduction of crown portion, and obtained mean errors (subtracting true file length from the measured file length), comparing Digora/sup (R)/ monitors with E-plus films, which were both obtained under the same geometrical positions. The results were as follows : 1. Comparing E-plus film with Digora/sup (R)/ at 0.01 seconds, the mean errors in E-plus film showed -4.453 nun, -4.497 nun, and -3.857 nun, while the mean errors in Digora/sup (R)/ showed 0.065 nun, 0.607 nun, and 0.719 mm according to the file groups. Therefore there was a significant difference between E-plus film and Digora/sup (R)/(p<0.05). 2. By comparison of mean errors according to the various exposure times in the Digora/sup (R)/ system, the mean error at 0.01 seconds was significantly lower than that at 0.12 and 0.25 seconds in the No. 10 file group(p<0.05). And the standard deviation was the highest at 0.01 seconds. 3. Comparing E-plus film at 0.25 seconds with the Digora/sup (R)/ system, the mean errors showed a significant difference between E-plus film at 0.25 seconds and the Digora/sup (R)/ system at 0.25 seconds in No. 10 and 20 file groups(p<0.05). 4. Comparing E -plus film at 0.25 seconds with other exposure times, the mean errors showed a significant difference between E-plus film at 0.25 seconds and E-plus film at 0 .. 01 and 0.03 seconds in 10 file group(p<0.05). In the No. 15 and 20 file groups, there was a significant difference between E-plus film at 0.25 seconds and E-plus film at 0.01 seconds(p<0.05). In conclusion, Digora/sup (R)/ was better than E-plus film in detectability on the tip of the file at the exposure time of 0.01 seconds in all file groups. And we concluded that Digora/sup (R)/ can shorten exposure times up to 4％ of 0.25 seconds (0.01 sec), which is adequate exposure time for premolar in E-plus film using No. 15 and 20 files.

• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.316-327
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• 1995

The purpose of this study was to evaluate canal shaping ability and canal angulation change of K-file, straight endosonic K-file and pre curved endosonic K-file. Twenty staight canals and thirty curved canals were selected and divided into five groups according to canals curvature and canal instrumentation method. VI group was prepared by straight endosonic K-file and H1 group by K-file in straigt canals. V2 group was instrumented by straight endosonic K-file, V3 group by pre curved endosonic K-file and H2 group by precurved K-file in curved canals. Radiographs of canals were obtained before and after canal shaping. And postoperative radiographs were compared with preoperative radiographs using superimposition method. The results obtained were as follows ; l. In straight canals, K-file group demonstrated lager percentage of canal enlargement than endosonic K-file group on facial view, but reverse results exhibit on mesial view. 2. In curved canals, precurved K-file group showed largest percentage of canal enlargement, followed by precurved endosonic K-fine group and straight endosonic K-file group was smallest. 3. Percantage of canal enlargement at convex side was greater than at concave side in apical portion of each group. Especially in straight endosonic K-file group, percantage of canal enlargement at convex side and concave side showed sharply difference. 4. In angulation change, the straight endosonic K-file group exhibited the greatest its change, followed by precurved endosonic K-file group and precurved K-file group was the least. Above results suggest that K-file is more effective endodontic instrument than endosonic K-file, and that precurved file is effective for canal shaping in curved canal.

• Restorative Dentistry and Endodontics
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• v.45 no.4
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• pp.51.1-51.10
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• 2020

Objectives: No studies have yet assessed vibration characteristics according to endodontic file length. Accordingly, the objective of the present study was to examine the vibration characteristics according to nickel-titanium file length and to compare these characteristics between different file systems. Materials and Methods: A total of 45 root canal models were divided into 3 experimental groups (n = 15 each) based on the file system used (ProTaper Gold [PTG], ProTaper Next, or WaveOne Gold [WOG]). Each experimental group was further divided into 3 subgroups according to file length (21, 25, or 31 mm). An electric motor (X-SMART PLUS) was used in the experiment. For each file system, vibrations generated when using a size 25 file were measured and used to calculate the average vibration acceleration. The differences in vibrations were analyzed using 1-way analysis of variance and the Scheffé post hoc test with a confidence interval of 95%. Results: In the PTG file system, significantly lower vibration acceleration was observed when using a 21-mm file than when using a 31-mm file. In the WOG file system, significantly stronger vibration acceleration was observed when using a 31-mm file than when using 21- or 25-mm files. Regardless of the file length, the WOG group exhibited significantly stronger vibration acceleration than the other 2 experimental groups. Conclusions: In clinical practice, choosing a file with the shortest length possible could help reduce vibrations. Additionally, consideration should be given to vibrations that could be generated when using WOG files with reciprocating motion.

• 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).

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.4
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• pp.371-383
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• 2012

Shaping the root canal system to maintain original canal curvature is essential to clinical success in endodontic treatment. Opposed to most root canals that are curved, endodontic instruments are made from straight metal blanks. They have a tendency of straightening the root canal during preparation and frequently result in procedural errors. A new treatment method to maintain original canal curvature during shaping has been introduced for preventing procedural errors. The aim of this study was to compare the ability of instruments to maintain original canal curvature of continuous rotary system and single file system. Thirty ISO 15, 0.02 taper, Endo Training Blocks(Dentsplay Maillefer) were used. Specimens were assigned to 1 of 3 groups for shaping: specimens in group 1 were shaped with ProFile #20/.06 at the WL. Specimens in group 2 were shaped with Mtwo #35/.04 at the WL. Specimens in group 3 were shaped with WaveOne Primary reciprocating files at the WL after the glide path was achieved with PathFile. Pre- and postinstrumentation digital images were superimposed and processed with Matlab r2010b(The MathWorks Inc, Natick, MA) software to analyze the curvature-radius ratio(CRr), representing canal curvature modification. Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file were analyzed with 1-way ANOVA(P<.05). Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file system were analyzed with independent t-test(P<.05). A statistically significant difference(P<0.05) was noted on each Ni-Ti file. ProFile and WaveOne instrumentations maintained the original canal curvature significantly better(P<0.05) than Mtwo file. There were no significant difference(P>0.05) between continuous rotary system and single file system. Under the conditions of this study, ProFile and WaveOne instruments maintained the original curvature significantly better than Mtwo file and were less modification of the canal curvature compared. There was no significant difference between continuous rotary system and single file system in shaping of simulated canals. As clinical practitioners, it may be advantages to use hybrid approach when root canal shapes depending on the design and usage of Ni-Ti files.

• Restorative Dentistry and Endodontics
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• v.46 no.3
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• pp.31.1-31.13
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• 2021

Objectives: To evaluate postoperative pain after endodontic treatment of necrotic teeth using large intentional foraminal enlargement (LIFE). Materials and Methods: The sample included 60 asymptomatic necrotic teeth (with or without chronic apical periodontitis), and a periodontal probing depth of 3 mm, previously accessed and referred to perform endodontic treatment. After previous procedures, the position and approximate size of the apical foramen (AF) were determined by using an apex locator and K flexo-files, respectively. The chemomechanical preparation was performed with Profile 04 files 2 mm beyond the AF to achieve the LIFE, using 2.5 mL of 2.5% NaOCl at each file change. The filling was performed by Tagger's hybrid technique and EndoFill sealer. Phone calls were made to all the patients at 24, 48 and 72 hours after treatment, to classify postoperative pain. Statistical analysis was performed by different tests with a significance level of 5%. Results: Age, gender, periradicular status and tooth type did not influence postoperative pain (p > 0.05). Only 1 patient (1.66%) reported severe pain after 72 hours. Moderate pain was reported by 7, 4 and 3 patients after 24, 48 and 72 hours, respectively (p = 0.0001). However, paired analyses showed a statistically significant difference only between 24 and 72 hours (p = 0.04). Sealer extrusion did not influence the postoperative pain (p > 0.05). Conclusions: Acute or moderate postoperative pain was uncommon after endodontic treatment of necrotic teeth with LIFE.

• Restorative Dentistry and Endodontics
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• v.45 no.2
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• pp.14.1-14.7
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• 2020

Objective: The aim of this study was to perform a comparative evaluation of the effectiveness of ultrasonic tips versus the Terauchi file retrieval kit (TFRK) for the removal of broken endodontic instruments. Materials and Methods: A total of 80 extracted human first mandibular molars with moderate root canal curvature were selected. Following access cavity preparation canal patency was established with a size 10/15 K-file in the mesiobuccal canals of all teeth. The teeth were divided into 2 groups of 40 teeth each: the P group (ProUltra tips) and the T group (TFRK). Each group was further subdivided into 2 smaller groups of 20 teeth each according to whether ProTaper F1 rotary instruments were fractured in either the coronal third (C constituting the PC and TC groups) or the middle third (M constituting the PM and TM groups). Instrument retrieval was performed using either ProUltra tips or the TFRK. Results: The overall success rate at removing the separated instrument was 90% in group P and 95% in group T (p > 0.05) The mean time for instrument removal was higher with the ultrasonic tips than with the TFRK (p > 0.05). Conclusion: Both systems are acceptable clinical tools for instrument retrieval but the loop device in the TFRK requires slightly more dexterity than is needed for the ProUltra tips.