• Imaging Science in Dentistry
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• v.47 no.4
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• pp.233-239
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• 2017

Purpose: This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor(CMOS) intraoral sensor. Materials and Methods: A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. Results: The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and inter-observer agreement was achieved. Conclusion: The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients

• Imaging Science in Dentistry
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• v.45 no.1
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• pp.41-47
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• 2015

Purpose: This study was performed to evaluate the linear distance accuracy and reliability of stitched small field of view (FOV) cone-beam computed tomography (CBCT) reconstructed images for the fabrication of implant surgical guides. Material and Methods: Three gutta percha points were fixed on the inferior border of a cadaveric mandible to serve as control reference points. Ten additional gutta percha points, representing fiduciary markers, were scattered on the buccal and lingual cortices at the level of the proposed complete denture flange. A digital caliper was used to measure the distance between the reference points and fiduciary markers, which represented the anatomic linear dimension. The mandible was scanned using small FOV CBCT, and the images were then reconstructed and stitched using the manufacturer's imaging software. The same measurements were then taken with the CBCT software. Results: The anatomic linear dimension measurements and stitched small FOV CBCT measurements were statistically evaluated for linear accuracy. The mean difference between the anatomic linear dimension measurements and the stitched small FOV CBCT measurements was found to be 0.34 mm with a 95% confidence interval of +0.24 - +0.44 mm and a mean standard deviation of 0.30 mm. The difference between the control and the stitched small FOV CBCT measurements was insignificant within the parameters defined by this study. Conclusion: The proven accuracy of stitched small FOV CBCT data sets may allow image-guided fabrication of implant surgical stents from such data sets.

• Restorative Dentistry and Endodontics
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• v.14 no.1
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• pp.71-84
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• 1989

The purpose of this study was to evaluate the effect of tricalcium phosphate and Vitapex on the dogs' periapical tissues. Twenty mandibular premolars from 5 healthy dogs were used for this study. After the animals were anesthetized intramuscularly, pulp chambers were open and pulp tissue was extirpated with a barbed broach and H-file. Then the working length of the root canal was measured with H-file and pulp tissue was completely removed. Before the actual canal filling, the root canals of twenty teeth have been experimentally infected with opening the pulp chamber for 5 weeks. Periapical radiographs of the experimental teeth were taken to monitor the periapical pathological condition. Each root apex of 20 premolars was perforated with engine reamer and the root canals were enlarged with No. 30-60 H-files. They were divided into treated as follows. Control group: The root canal was filled with gutta-percha. Experimental group 1: The canal was dried with sterile paper points and mixture of tricalcium phosphate and physiological saline was overfilled beyond the root apex with a lentulo spiral. Then the root canal was filled gutta-percha and lateral condensation and the pulp chamber was filled with Caviton. Experimental group 2: The root canals were overfilled with Vitapex and were treated in the same manner as those in experimental group 1 At 1,2,3, and 8 weeks after experiment, the periapical tissues including the alveolar bone were fixed with 10% formalin solution for I week and decalcified with Plank-Rycho solution for 5 weeks. The specimens were embedded in paraffin and serial sections were cut into a thickness of 6 ${\mu}m$ at the plane of the root apex. Hematoxyline-eosin and Masson's trichrome stain were made for the histo-pathological examinations. The results were as follows: 1. Ingrowth of collagen fiber was observed from 1 week in control group and experimental groups. 2. The rate of bone formation of experimental group 1 was accelerated more than that of experimental group 2. 3. Resorption of cementum was seen in control group, but apposition of cementum was seen in experimental groups.

• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.607-617
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• 1998

The purpose of this study was to evaluate the apical sealing ability of lateral condensation method, vertical condensation method, and MicroSeal obturation system. Sixty-four extracted anterior teeth were instrumented to #40 using Profile. Three groups of 20 teeth were obturated by lateral condensation technique, vertical condensation technique, and and MicroSeal obturation system. Control group were not obturated. Teeth were immersed in resorcinol-formaldehyde resin for 5 days at $4^{\circ}C$, and the resin was allowed to polymerize completely for 4 days at room temperature. Teeth were ground horizontally at 1,5mm(level 1), 2.5mm(level 2), and 3.5mm(level 3) from the anatomic apex and examined with a stereomicroscope at X40 magnification. The photographs were taken a at X40 magnification of the filling in each level and scanned. The leakage area, which was filled with the resin, was measured at each of the three levels. Each ratio of leakage was evaluated by calculating the ratio of thearea of the resin to the total area of the canal and was analyzed statistically. The results were as followed: 1. Vertical condensation group had significantly higher percentage of the area which was obturated by gutta percha than other two technique at each level. 2. At the level 1, there was the greatest leakage in the lateral condensation group, but there was no statistically significant(P>0.05) 3. At the level 2, there was the least leakage in the MicroSeal group, and the most leakage in the lateral condensation group. There was statistically significant difference between the MicroSeal group and the lateral condensation group(P<0.05). 4. At the level 3, there was least leakage in the vertical condensation group, and the most leakage in the lateral condensation group. There was statistically significant difference between the vertical condensation group and the lateral condensation group(P<0.05).

• Restorative Dentistry and Endodontics
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• v.17 no.2
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• pp.365-382
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• 1992

The purpose of this study was to evaluate the adaptation of filling material to the dentinal walls of root canals with and without smear layer. Fifty extracted upper and lower anterior teeth were selected, and the root canals were instrumented with K - files 1mm short of the apical foramen by step - back method. The teeth were randomly divided into two groups of 25 each : in the group I, smear layers were not removed, and in the group II, smear layers were removed by 15% EDTA solution. Again the two groups 25 teeth were randomly divided into unfilled contol group and filling groups(lateral, ultrasonic, ULTRAFIL, McSpadden compaction group). Upon completion of root canal filling, the teeth were grooved on the both the labial and lingual surfaces and then split with mallet and chisel. Each specimens were examined with JSM - 840 Scanning Electron Microscope (JEOL., Japan). The results were as follows : 1. In the contol group, dentinal tubules of group I couldn't be distinguished in the canal wall, but those of group II appeared to be open and patent. 2. In the filling groups of group I, the tubular penetration of the sealer or gutta percha couldn't be seen, but in the filling groups of group II, it could be seen except McSpadden compaction group. 3. In the filling groups, ULTRAFIL group showed the best adaptation of filling material to root canal wall among the group I, and lateral and ultrasonic condensation group showed the best adaptation of filling material among the group II. McSpadden compaction group showed the worst adaptation in group I, II. 4. Generally, the group II showed better adapation of filling material to root canal wall than the group I.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.30.1-30.12
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• 2018

Objectives: To evaluate sealing ability of root canals obturated with bioceramic-impregnated gutta percha cone (BCC) or gutta percha (GP), with bioceramic sealer (BCS) or AH Plus (AH; Dentsply-Maillefer), in roundly-prepared canals using matched single-cone technique, based on bacterial leakage test, and to analyze obturation quality using micro-computed tomography (CT) analysis. Materials and Methods: Ninety-two distobuccal roots of maxillary molars were prepared using nickel-titanium files to apical size 40/0.06. The roots were divided into 4 groups (n = 20) that were obturated with a master cone and sealer: GP/AH, BCC/AH, GP/BCS, and BCC/BCS. Bacterial leakage model using Enterococcus faecalis was used to evaluate sealing ability for 60-day period. Obturated samples from each group (n = 4) were analyzed using micro-CT. Results: All groups showed bacterial leakage at 20%-45% of samples with mean leakage times of 42-52 days. There were no significant differences in bacterial leakage among the groups. Micro-CT showed minimal gaps and voids in all groups at less than 1%. Conclusions: In roundly-prepared canals, the single cone obturation with BCC/BCS was comparable to GP/AH for bacterial leakage at 60 days.

• The Journal of Advanced Prosthodontics
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• v.5 no.1
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• pp.16-20
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• 2013

PURPOSE. To assess the retention of glass fiber post cemented with self-adhesive resin cement into optimum and over-prepared root canals following obturation in the presence of either eugenol (EB) or calcium hydroxide (CB)-based sealers. MATERIALS AND METHODS. Roots of extracted premolars were endodontically-treated in 5 groups (n = 10). Roots of Group 1 (control) were left with no obturation and then optimally prepared to receive endodontic dowels. Other root canals were obturated with gutta-percha in the presence of either eugenol-based (Groups 2 and 4) or calcium hydroxide-based (Groups 3 and 5) sealer. Dowel spaces were prepared with optimal diameter in Groups 2 and 3, one size larger in Groups 4 and 5. Standardized fiber posts were luted to the prepared spaces using self-adhesive resin cement and its retention was then tested on an universal testing machine. Both one-way ANOVA and Tukey's HSD comparisons (${\alpha}$=0.05) were used to identify the significance of inter-group retention differences. Scanning electron microscopy (SEM) of both optimally and over-prepared dowel spaces was also considered to figure the nature of their interior out. RESULTS. The post retention was significantly higher to the non-obturated, optimally-prepared dowel spaces of Group 1 compared to the obturated, optimally-prepared ones of Groups 2 and 3. For each dowel space diameter, root canals obturated using CB of Groups 3 and 5 showed significantly higher dowel retention compared to those obturated using EB of Groups 2 and 4. Post retention to the over-prepared dowel spaces of Groups 4 and 5 was significantly higher than that recorded for the optimally-prepared ones of Groups 1-3. SEM images revealed traces of endodontic sealer and gutta-percha on the walls of the optimally-prepared dowel spaces. CONCLUSION. Despite the adverse effect of endodontic sealers on the retention of fiber posts, the over-preparation of dowel spaces helps to improve the retention.

• Restorative Dentistry and Endodontics
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• v.41 no.2
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• pp.114-120
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• 2016

Objectives: The aim of this study was to compare the push-out bond strength and dentinal tubule penetration of root canal sealers used with coated core materials and conventional gutta-percha. Materials and Methods: A total of 72 single-rooted human mandibular incisors were instrumented with NiTi rotary files with irrigation of 2.5% NaOCl. The smear layer was removed with 17% ethylenediaminetetraacetic acid (EDTA). Specimens were assigned into four groups according to the obturation system: Group 1, EndoRez (Ultradent Product Inc.); Group 2, Activ GP (Brasseler); Group 3, SmartSeal (DFRP Ltd. Villa Farm); Group 4, AH 26 (Dentsply de Trey)/gutta-percha (GP). For push-out bond strength measurement, two horizontal slices were obtained from each specimen (n = 20). To compare dentinal tubule penetration, remaining 32 roots assigned to 4 groups as above were obturated with 0.1% Rhodamine B labeled sealers. One horizontal slice was obtained from the middle third of each specimen (n = 8) and scanned under confocal laser scanning electron microscope. Tubule penetration area, depth, and percentage were measured. Kruskall-Wallis test was used for statistical analysis. Results: EndoRez showed significantly lower push-out bond strength than the others (p < 0.05). No significant difference was found amongst the groups in terms of percentage of sealer penetration. SmartSeal showed the least penetration than the others (p < 0.05). Conclusions: The bond strength and sealer penetration of resin-and glass ionomer-based sealers used with coated core was not superior to resin-based sealer used with conventional GP. Dentinal tubule penetration has limited effect on bond strength. The use of conventional GP with sealer seems to be sufficient in terms of push-out bond strength.

• Restorative Dentistry and Endodontics
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• v.23 no.1
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• pp.515-524
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• 1998

The purposes of this study were to observe the cavity wall morphology and to evaluate the degree of cavity cleanliness when root-end retrograde cavity preparation was done with ultrasonic diamond instruments. To observe the morphology of retrocavity and to evaluate the degree of cavity cleanliness. root-end resections were done on 20 palatal roots of extracted maxillary first molars after canal filling with gutta-percha. Retrocavities were prepared using either ultrasonic diamond instruments or stainless steel ones of medium power setting of level 6 ($Miniendo^{TM}$, EIE, CA, U.S.A.). Morphology of the cavity. degrees of the remaining canal debris and smear layer were evaluated under the scanning electron microscope. The results were as follows: Cavities prepared with ultrasonic diamond instruments showed scratched appearance of wall, while ultrasonic stainless steel preparation showed hatcheted appearance. Ultrasonic diamond instruments induced more smear layer than stainless steel ones did (p<0.01) in the cavity. However, there was no significant difference in canal debris (p>0.05).

• Restorative Dentistry and Endodontics
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• v.25 no.2
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• pp.202-211
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• 2000

The aim of this study was to compare the apical sealing ability of a new thermoplasticized gutta-percha filling technique, the Easy Filling and the Quick Obturation system with lateral condensation technique and Thermafil system to evaluate their clinical acceptabilities. Fifty-two extracted single-rooted teeth were instrumented to #35 using the .04 taper ProFile system. Four groups of 12 teeth were obturated by lateral condensation technique. Thermafil system and two new thermoplasticized gutta-percha techniques, the Easy Filling system and Quick Obturation system (Meta Dental co. Ltd. Korea), respectively. Four teeth served as controls. After the teeth were immersed in 2% methylene blue dye for 48 hours, they were resected horizontally at 1mm to 5mm level from the anatomical apex using a low-speed microtome. Each section was examined under a stereomicroscope at ${\times40}$ magnification and photographed. After each image was scanned, the leakage area was measured at each level using Brain 3 (Nosdia Tech., Korea) software. Leakage ratio was calculated for each group and was analyzed statistically to come up with the following results: 1. At 1mm level, the Quick Obturation system had the largest amount of apical leakage and it was statistically significant when compared with the lateral condensation group and the Thermafil group (p<0.05). 2. At 2mm and 3mm level, there were no significant difference of apical leakage among all four groups (p>0.05), and from 4mm level, no apical dye penetration was observed in all the groups. In conclusion, the apical seal produced by Easy Filling system and the Quick Obturation system was comparable to lateral condensation technique and Thermafil system except for the 1mm level. More improvement of the apical seal can be expected as the operator becomes skillful with the new techniques.