• Restorative Dentistry and Endodontics
• /
• v.39 no.2
• /
• pp.132-136
• /
• 2014

The presence of radix entomolaris (RE) in a mandibular first molar is a common occurrence in certain ethnic groups, but the presence of RE in a mandibular second molar is a rare occurrence. In the present case, RE was identified from preoperative radiographs and confirmed using cone-beam computed tomography (CBCT). The access cavity was modified to locate the RE. Cleaning and shaping were performed with nickel-titanium rotary instruments. Obturation was completed with gutta-percha cones using AH Plus (Dentsply Detrey GmbH) as sealer. From the CBCT axial images, the RE was determined to have a Type III curvature by the De Moor classification, Type B separate RE by the Carlsen and Alexandersen classification, and radiographically, a Type i image by the Wang classification. The presence of RE in the mandibular second molar makes it essential to anticipate and treat the distolingual root canal. This case report highlights the usefulness of CBCT for assessing RE in the mandibular second molar, which can help the clinician in making a confirmatory diagnosis and assessing the morphology of the root canal.

• Imaging Science in Dentistry
• /
• v.39 no.1
• /
• pp.27-33
• /
• 2009

Purpose: The purpose of this study was to evaluate the clinical usefulness of the recently developed multi-detector computed tomography and cone beam computed tomography in pre-operative implant evaluation, by comparing them with the single detector computed tomography, already confirmed for accuracy in this area. Materials and Methods: Five partially edentulous dry human mandibles, with $1{\times}1mm$ gutta percha cones, placed in 5mm intervals posterior to the mental foramen on each side of the buccal part of the mandible, were used in this study. They were scanned as follows: 1) Single detector computed tomography: slice thickness 1mm, 200mA, 120kV 2) Multi-detector computed tomography: slice thickness 0.75mm, 250mA, 120kV 3) Cone beam computed tomography: 15mAs, 120kV Axial images acquired from three computed tomographies were transferred to personal computer, and then reformatted cross-sectional images were generated using V-Implant $2.0^{(R)}$ (CyberMed Inc., Seoul, Korea) software. Among the cross-sectional images of the gutta perch a cone, placed in the buccal body of the mandible, the most precise cross section was selected as the measuring point and the distance from the most superior border of the mandibular canal to the alveolar crest was measured and analyzed 10 times by a dentist. Results: There were no significant intraobserver differences in the distance from the most superior border of the mandibular canal to the alveolar crest (p>0.05). There were no significant differences among single detector computed tomography, multi-detector computed tomography and cone beam computed tomography in the distance from the most superior border of the mandibular canal to the alveolar crest (p>0.05). Conclusion: Multi-detector computed tomography and cone beam computed tomography are clinically useful in the evaluation of pre-operative site for mandibular dental implants, with consideration for radiation exposure dose and scanning time.

• Restorative Dentistry and Endodontics
• /
• v.32 no.6
• /
• pp.491-497
• /
• 2007

The purpose of this study was to compare apical sealing ability of continuous wave canal filling technique according to various heat source plugging depths. Eighty one extracted human premolars with straight root were cleaned and shaped to size 35 using .06 taper rotary NiTi file. After cleansing and shaping, the teeth were divided into 5 groups following the heat source probing depths from the apex; 3, 4, 5, 6 and 7 mm. All specimens were filled using E&Q plus with #35/.06 tapered gutta-percha cone. The positive control teeth were not filled. All teeth were coated with nail varnish except the apical 1 mm around the apical foramen. Negative control teeth were completely sealed include the apical foramen. All specimens were immersed in 1% methylene blue solution for 72 hours. Then the specimens were sectioned horizontally at 1, 2 and 3 mm from the root apex. Each sectioned surface was photographed using a digital camera attached to the stereomicroscope at $12.5{\times}2.5$ fold magnification. All points at 1, 2 and 3 mm were summed as final score of one specimen. Statistical analysis of the collected data was performed. Under the condition of this study. there was no significant difference between the heat source plugging depths of 3, 4, 5, 6 and 7 mm in apical sealing ability. All of apical heat source plugging depth from 3 to 7 mm including Buchanan's protocol -from 5 to 7 mm- seems to be acceptable in clinical application.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.29 no.4
• /
• pp.418-425
• /
• 2013

This case report describes about recurrent herpetic stomatitis mimicking post-root resection complication. A 49 year-old male patient was diagnosed vertical root fracture of the mesiobuccal root of his left maxillary first molar (#26). The mesiobuccal root was resected following root canal treatment of the same tooth. 19 months later, the patient presented with pain on left hard palate after a barbecue party. Intra oral examination revealed a gum boil-like blister at the hard palate corresponding to the apex of the palatal root of #26. On clinical examination, there was bleeding on probing and the periodontal pocket depth was measured less than 5 mm with no tooth mobility. On a periapical radiograph, periodontal ligament space widening was observed. Tracing the sinus tract with gutta percha cone was attempted, however, it was impossible. Extending the field of vision, small multiple round ulcerations were observed at the palate front which caused pain to the patient. Therefore, the pain was considered a non odontogenic and the patient was referred to the department of oral medicine. The patient was diagnosed recurrent herpetic stomatitis and after 3 days of antiviral medication, the pain and ulceration were subsided.

• Journal of Periodontal and Implant Science
• /
• v.36 no.2
• /
• pp.461-471
• /
• 2006

In order to achieve a satisfactory esthetic result of periodontal surgery or implant in maxillary anterior area, periodontists must be aware of normal alveolar bone anatomy. The purpose of this study was to evaluate the relationship of alveolar bone morphology to tooth shape and form. 78(mean age : 25 yrs) periodontally healthy volunteers participated in this study. Two maxillary central incisor and one lateral incisor were selected to study. With minimal local anesthesia, gutta-percha cone inserted to labial gingival sulcus of selected teeth just after bone sounding with periodontal probe. Metal ball (4mm diameter) attached to palatal fossa of central incisor. Then, periapical radiograph was taken according to long cone paralleling technique. After film scan, labial alveolar bone profile reproduced along interproximal bone and apical ends of gutta-percha cones on computer screen. By utilizing computer program, the distance from height of interproximal bone to the labial bone crest in central incisor-central incisor and central incisor-lateral incisor area was measured and converted to real distance by using vertical length of metal ball on film. After measuring crown length & width of central incisor, the 10 individuals ranked lowest GW/L ratio (crown width/length ratio) and the 10 ranked highest were selected as having a long-narrow(group N), or a short-wide(group W) form of the central incisors. Means of the distance from height of interproximal bone to the labial bone crest of group N, W were calculated and compared by means of independent t-test. The results were as follows: 1. Mean distance from the height of the interproximal bone to the labial bone crest was $3.5{\pm}0.7mm$ between two central incisor, and $2.8{\pm}0.6mm$ between central and lateral incisor. 2. Mean GW/L ratio of group N was 0.57, and group W was 0.8. Mean distance from the height of the interproximal bone to the labial bone crest of group N was higher than group W in both measured area(measurements of group N, W were $3.9{\pm0.2mm$ and $3.5{\pm}0.2mm$ between two central incisor, $3.0{\pm}0.2mm$ and $2.8{\pm}0.2mm$ between central and lateral incisor), but there were no statistically significant differences when the groups were compared. Within the limits of the present study, there was a tendency that subjects with long-narrow teeth have more scalloped alveolar bone profile than subjects with short-wide teeth in upper anterior area, but no statistically significant differences were found.

• Imaging Science in Dentistry
• /
• v.44 no.2
• /
• pp.115-119
• /
• 2014

Purpose: The aim of this in vitro study was to determine the sensitivity and specificity of cone-beam computed tomography (CBCT) and digital periapical radiography in the detection of mesial root perforations of mandibular molars. Materials and Methods: In this in vitro study, 48 mandibular molars were divided into 4 groups. First, the mesial canals of all the 48 teeth were endodontically prepared. In 2 groups (24 teeth each), the roots were axially perforated in the mesiolingual canal 1-3 mm below the furcation region, penetrating the root surface ("root perforation"). Then, in one of these 2 groups, the mesial canals were filled with gutta-percha and AH26 sealer. Mesial canals in one of the other 2 groups without perforation (control groups) were filled with the same materials. The CBCT and periapical radiographs with 3 different angulations were evaluated by 2 oral and maxillofacial radiologists. The specificity and sensitivity of the two methods were calculated, and P<0.05 was considered significant. Results: The sensitivity and specificity of CBCT scans in the detection of obturated root canal perforations were 79% and 96%, respectively, and in the case of three-angled periapical radiographs, they were 92% and 100%, respectively. In non-obturated root canals, the sensitivity and specificity of CBCT scans in perforation detection were 92% and 100%, respectively, and for three-angled periapical radiographs, they were 50% and 96%, respectively. Conclusion: For perforation detection in filled-root canals, periapical radiography with three different horizontal angulations would be trustworthy, but it is recommended that CBCT be used for perforation detection before obturating root canals.

• Imaging Science in Dentistry
• /
• v.46 no.2
• /
• pp.133-139
• /
• 2016

Purpose: The aim of this study was to compare the coordinates of anatomical landmarks on cone-beam computed tomographic (CBCT) images in varied head positions before and after reorientation using image analysis software. Materials and Methods: CBCT images were taken in a normal position and four varied head positions using a dry skull marked with 3 points where gutta percha was fixed. In each of the five radiographic images, reference points were set, 20 anatomical landmarks were identified, and each set of coordinates was calculated. Coordinates in the images from the normally positioned head were compared with those in the images obtained from varied head positions using statistical methods. Post-reorientation coordinates calculated using a three-dimensional image analysis program were also compared to the reference coordinates. Results: In the original images, statistically significant differences were found between coordinates in the normal-position and varied-position images. However, post-reorientation, no statistically significant differences were found between coordinates in the normal-position and varied-position images. Conclusion: The changes in head position impacted the coordinates of the anatomical landmarks in three-dimensional images. However, reorientation using image analysis software allowed accurate superimposition onto the reference positions.

• Restorative Dentistry and Endodontics
• /
• v.46 no.2
• /
• pp.25.1-25.12
• /
• 2021

Objectives: This study used micro-computed tomography (µCT) to compare voids and interfaces in single-cone obturation among AH Plus, EndoSequence BC, and prototype surface pre-reacted glass ionomer (S-PRG) sealers and to determine the percentage of sealer contact at the dentin and gutta-percha (GP) interfaces. Materials and Methods: Fifteen single-rooted human teeth were shaped using ProTaper NEXT size X5 rotary files using 2.5% NaOCl irrigation. Roots were obturated with a single-cone ProTaper NEXT GP point X5 with AH Plus, EndoSequence BC, or prototype S-PRG sealer (n = 5/group). Results: The volumes of GP, sealer, and voids were measured in the region of 0-2, 2-4, 4-6, and 6-8 mm from the apex, using image analysis of sagittal µCT scans. GP volume percentages were: AH Plus (75.5%), EndoSequence BC (87.3%), and prototype S-PRG (94.4%). Sealer volume percentages were less: AH Plus (14.3%), EndoSequence BC (6.8%), and prototype S-PRG (4.6%). Void percentages were AH Plus (10.1%), EndoSequence BC (5.9%), and prototype S-PRG (1.0%). Dentin-sealer contact ratios of AH Plus, EndoSequence BC, and prototype S-PRG groups were 82.4% ± 6.8%, 71.6% ± 25.3%, and 70.2% ± 9.4%, respectively. GP-sealer contact ratios of AH Plus, EndoSequence BC, and prototype S-PRG groups were 65.6% ± 29.1%, 80.7% ± 25.8%, and 87.0% ± 8.6%, respectively. Conclusions: Prototype S-PRG sealer created a low-void obturation, similar to EndoSequence BC sealer with similar dentin-sealer contact (> 70%) and GP-sealer contact (> 80%). Prototype S-PRG sealer presented comparable filling quality to EndoSequence BC sealer.

• Restorative Dentistry and Endodontics
• /
• v.11 no.1
• /
• pp.27-32
• /
• 1985

The purpose of this study was to examine the influence of canal irrigants and smear layer on the property of apical seal. Fourty-five canals from human teeth were randomly selected and divided into 5 groups according to the irrigants used in conjunction with instrumentation. The irrigants were RC-prep in combination with Naocl, Citric acid, Naocl, Naocl in combination with $H_2O_2$, and normal saline solution. After instrumention and dry the canal with paper point, the canals were obturated by lateral condensation of Zinc-oxide eugenol sealer and gutta percha cone. All the specimens were immersed in 2% methylene blue dye solution for 7 days and the depth of dye penetration into the canals was evaluated by macros cope. The following results were obtained. 1. All the canals experimented showed varying degree of dye penetration. 2. There was no significant difference in depth of dye penetration between the groups known to be effective and ineffective in the removal of the smear layer. 3. The canals irrigated with NaOCl alone showed the highest dye penetration and mean leakage was 7.7 mm. 4. In the canals irrigated with RC-prep in combination with Naocl and citric acid, the mean dye penetration was 5.5 mm and 4.8 mm respectively, and the canals irrigated with NaOCl in combination with $H_2O_2$ and normal saline solution revealed mean dye penetration of 3.9 mm.

• Restorative Dentistry and Endodontics
• /
• v.10 no.1
• /
• pp.127-134
• /
• 1984

This study was conducted to evaluate the sealing ability of McSpadden technique compared with lateral condensation and Engine reamer technique, and according to the degree of canal enlargement and the use and nonuse of sealer. Seventy single-rooted teeth were divided into 14 groups and each tooth was enlarged and obturated according to the purpose of this study. Obturated teeth were infiltrated by Indian ink and decalcified and cleared. The apical sealing ability was evaluated by measuring the degree of ink penetration into the canal. The results were as follows: 1. All the teeth filled by lateral condensation using gutta-percha cone and sealer proved better in canal sealing ability than McSpadden technique and Engine reamer technique, showing less ink penetration. 2. In the McSpadden technique, there was less ink penetration detected in using the sealer than not. 3. In all of the experimental methods, the difference of the degree of ink penetration according the degree of canal enlargement could not be accepted. 4. There was no significant difference in ink penetration degree between Engine reamer technique using sealer and McSpadden technique without sealer.