• 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.21 no.1
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• pp.187-201
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• 1996

The purpose of this study was to evaluate the sealing ability of a calcium hydroxide plug treated with a bonding agent. Ninety extracted human anterior teeth and premolars with single canal were used in this study. Crowns were removed. the canal's were instrumented. and the roots were randomly divided into three groups of 30 each. In control group. a single apical seat was prepared with #60 K file 1mm short of the apex and the root canal was obturated with Gutta-percha and Sealapex by the lateral condensation method. In experimental group 1 and group 2. to prepare an apical isthmus of 1mm in length. the first apical seat was prepared with a #45 K file 1mm short of the anatomical apex and with a #60 K file 2mm short for the second apical seat. Dry calcium hydroxide powders were packed in the apical isthmus with a hand plugger and #60 K file and then. the root canal was obturated with Gutta-percha and Seal apex by the lateral condensation method. In experimental group 2. following an application of the bonding agent to the plug. the root canal was obturated in the same way. The teeth of each group were immersed in a 2% methylene blue dye solution. for 1, 2, and 4 weeks. The distance from the tip of the cone to the deepest penetration was measured using the Tool maker's microscope. The results were as follows : 1. The teeth having the calcium hydroxide plug treated with the dentin bonding agent (experimental group 2) showed the lowest leakage with 1.4705mm and the control group without apical plug(no apical isthmus) showed the highest leakage with 3.1735mm. 2. The control group without apical plug showed higher leakage than experimental group 1 having the calcium hydroxide plug treated without the dentin bonding agent(p>0.05). 3. The control group without apical plug and experimental group 1, having the calcium hydroxide plug treated without the dentin bonding agent. showed higher leakage than experimental group 2. having the calcium hydroxide plug treated with the dentin bonding agent(p<0.001). 4. The immersion time had no significant effect on the degree of leakage. In conclusion, the results showed that the calcium hydroxide plug treated with the dentin bonding agent could decrease the microleakage from the root apex effectively.

• Restorative Dentistry and Endodontics
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• v.27 no.5
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• pp.521-529
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• 2002

The purpose of this study was to compare the shaping time of two shaping methods and the leakage of three different obturation techniques. Ninty three canaled human molar teeth were used, which were randomly divided into two groups of forty teeth each and ten control teeth. After working length determination, the one group was prepared crown-down technique using rotary root canal instruments of GT rotary files .12/20, .10/20, .08/20 and .06/20 taper(Maillefer Instrument SA. Switzerland). The other group was instrumented with Gates Glidden burs(#1, #2, and #3) to coronal preparation and GT rotary files .08/20 and .06/30 taper to apical preparation. Shaping time was measured. After root canals were instrumented, they were divided to three subgroups and obturated as follows : Subgroup 1, obturated with single cone method Subgroup 2, obturated with lateral condensation : Subgroup 3, obturated with continuous wave technique. Three subgroups were obturated using non-standardized gutta-percha cone(Diadent, Korea, .06 or .08 taper) and AH-26(Dentsply DeTrey, Germany) as a root canal cement. Ten unobturated teeth served as positive and negative controls. After immersion in 2% methylene blue solution for 1 month, the teeth were washed during 24h. The teeth were demineralized in 10% nitric acid and dehydrated by immersion in 80, 90 and 100% ethyl alcohol. The teeth were finally cleared and stored in 100% methylsalicylate, and apical dye penetration was evaluated under stereomicroscope(Leica M420, LC, U.S.A)at $\times$8.75 magnification. Liner measurement of dye penetration was assessed with the use of digitalized image analysing system (analySIS, GmbH, Germany) The data were analysed statistically using independent T-test and Two-way ANOVA and Tukey test. The result were as follows 1. In canal prepared with GT$^{TM}$ rotary file, shaphing time taked more than the group of using Gates Glidden drill to coronal preparation without statistical significance (p>0.05) 2. The group of single cone obturation using canal preparation of GT$^{TM}$ rotary files showed significantly more apical leakage than those of lateral condensation and continuous wave technique regardless of shaping method (p<0.05). 3 The group of single cone obturation using canal preparation of GT$^{TM}$ rotary files and Gates Glidden drill showed significantly more apical leakage than those of continuous wave technique regardless of shaping method (p<0.05). 4. Regardless of shaping method, The group of continuous wave obturation showed less apical leakage than those of lateral condensation without statistical significance (p>0.05). 5. The group of single cone obturation using canal preparation of GT$^{TM}$ rotary files and Gates Glidden drill showed more apical leakage than the group of lateral condensation using same shaping method with-out statistical significance (p＞0.05).

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.4
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• pp.213-221
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• 2022

Purpose: The efficacy of the amount of sealer in the root canal and two retreatment NiTi file systems in removing filling materials. Materials and Methods: Extracted premolars with a single root canal were selected for this study. After access opening and root canal preparation up to size #40/.06, the specimens were randomly divided into four groups. Gutta percha (GP) tapers of .06 or .04 were used for each group and filled using a single-cone filling technique with CeraSeal, a calcium silicate-based sealer. Each group was retreated either using the ProTaper Universal Retreatment System (PTUR) or the Hyflex Remover (HR). The time taken to remove the filling material, the amounts of apically extruded debris, and canal cleanliness were measured and compared. Results: The amount of sealer did not affect the efficiency when removing the filling materials. However, the filling material was removed faster in the HR group than in the PTUR group. Two types of NiTi files showed similar retreatment effects in the amounts of apically extruded debris and in the degree of canal cleanliness. Conclusion: The amount of sealer in canal filling had no significant effect on retreatability. Retreatment with HR removed filling materials is faster than PTUR. There was no difference in other removal efficiencies according to the type of retreatment NiTi file.

• The Journal of the Korean dental association
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• v.50 no.9
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• pp.574-585
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• 2012

Purpose : This study was performed to evaluate the healing response around the root perforation restorative material. Materials and Methods : Four beagle dogs were used for experimental study. Endodontic treatment was performed at four maxillary premolars and artificial perforation was formed at furcation area of pulp chamber. Canal was filled with gutta percha cone and the perforation was sealed with MTA at group 1. At group 2, canal was filled and the perforation was sealed with dentin paste. Tooth paste was fabricated using extracted human teeth. Histologic examination of furcation area was performed 2, 4, 8 and 12 weeks after experiment. Results : New trabecular bone formation was observed around the MTA and tooth paste. Lamellar bone was observed as time is over. There were no inflammatory reaction in both groups. Conclusion : There is a possibility which endodontic filling material can be developed using extracted teeth.

• Restorative Dentistry and Endodontics
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• v.43 no.1
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• pp.2.1-2.10
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• 2018

Objectives: To determine the effect of size and insertion depth of irrigation needle on the amount of apical extruded debris and the amount of penetration depth of sealer using a confocal laser scanning microscope (CLSM). Materials and Methods: Twenty maxillary premolars were assigned to 2 groups (n = 10), according to the size of needle tip, 28 G or 30 G. Buccal roots of samples were irrigated with respective needle type inserted 1 mm short of the working length (WL), while palatal roots were irrigated with respective needle type inserted 3 mm short of the WL. Prepared teeth were removed from the pre-weighed Eppendorf tubes. Canals were filled with F3 gutta-percha cone and rhodamine B dye-labeled AH 26 sealer. Teeth were transversally sectioned at 1 and 3 mm levels from the apex and observed under a CLSM. Eppendorf tubes were incubated to evaporate the irrigant and were weighed again. The difference between pre- and post-weights was calculated, and statistical evaluation was performed. Results: Inserting needles closer to the apex and using needles with wider diameters were associated with significantly more debris extrusion (p < 0.05). The position of needles and level of sections had statistically significant effects on sealer penetration depth (p < 0.05 for both). Conclusions: Following preparation, inserting narrower needles compatible with the final apical diameter of the prepared root canal at 3 mm short of WL during final irrigation might prevent debris extrusion and improve sealer penetration in the apical third.

• Restorative Dentistry and Endodontics
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• v.14 no.2
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• pp.49-64
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• 1989

The purpose of this study was to evaluate the effect of several materials on the healing process of apical wound. Sixteen mandibular premolars obtained from 4 healthy dogs were used for this study. Under general anesthesia, the pulpal chamber of each tooth was opened and the pulps were extirpated. The root canals were then instrumented with H-file and irrigated with physiologic saline solution ; the apices were purposely perforated and enlarged with the engine K-reamer. In the experimental groups, apical wounds were filled with one of calcium hydroxide, hydroxylapatite, and tricalcium phosphate materials, mixture of each materials and physiologic saline solution, with a lentulo spiral. In the control group, apical wounds were not filled with any material. All the root canals were filled by the lateral condensation technique with gutta-percha cone and ZOE sealer. The access opening of all the teeth were closed with amalgam. On the 10, 20, 40 and 60th day after experiment, experimental animals were sacrificed. Segments of jaws, each containing one tooth, were fixed in 10% formalin solution and decalcified in Plank-Rychlo solution. The specimens were embedded in paraffin and serially sectioned to an average thickness of $6{\mu}m$. The sections were stained by hematoxylin-eosin and Masson's trichrome stain method and examined under light microscope. The results were as follows : 1. In the experimental groups, the new bone formations were observed in apical wounds. 2. Fourty days later, apical wounds were healed by granulation tissue in the experimental groups, but were not healed by granulation tissue in the control group, and the healing process of experimental groups were more rapid than that of control group. 3. Sixty days later, chronic inflammation disappeared in the experimental groups, and the materials used showed biologic affinity to the periapical tissue. 4. In all the groups, the resorption of cementum appeared on the 10th and 20th day after experiment, and the deposition of cementum appeared on the 40th and 60th day after experiment, especially showing narrowness of apical foramen due to newly formed cementum in calcium hydroxide group. 5. Calcum hydroxide and tricalcium phosphate particles were gradually resolved, but hydroxylapatite particles were not resolved through the experimental period.

• Restorative Dentistry and Endodontics
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• v.21 no.2
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• pp.628-634
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• 1996

The purpose of this study was to investigate the effect of moisture on apical sealing properties of root canal. Fifty five single rooted human teeth were selected from maxillary and mandibular teeth. After removing crown portion at the cemento-enamel junction, all teeth were routinely prepared with step-back method. And then, the canals were dried with paper point and the teeth were randomly divided into 3 groups of 15 teeth each, and remaining 10 teeth were used as positive and negative control teeth : Group 1 were irrigated with 1ml of 95% alcohol and dried with air and paper point. Group 2 and 3 were intentionally contaminated with 0.05ml of 3.5% NaOCl or saliva, respectively. All the teeth were obturated with sealapex and gutta percha cone by lateral condensation technique, and covered with two coat of nail varnish after 48 hours of obturation. The teeth were immersed in india ink for 1 week and cleaned with methyl salicylate and then the degree of dye penetration were measured with stereomicroscope. The data were analyzed statistically by one-way ANOVA. The results were as follows : 1. All experimental groups showed varying degrees of dye penetration, and the mean degree of dye penetration was 0.1mm to 0.7mm. 2. Saliva contamination group(group 3) showed the highest amount of dye penetration, followed by NaOCl contamination group, then alcohol dried group, but there was no significant difference among three experimental groups. * This results suggest that there was no significant differences of apical leakage after canal obturation between alcohol dried canal and moisture present canals and the use of alcohol instead of paper point is unnecessary to dry the canals prior to canal filling. But other factors such as bacterial contamination and sealer discoloration by moisture must be considered in application of this results to clinical practice.

• Restorative Dentistry and Endodontics
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• v.48 no.1
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• pp.10.1-10.9
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• 2023

Objectives: This study compared the buckling resistance of 3 nickel-titanium (NiTi) retreatment file systems and the torque/force generated during retreatment. Materials and Methods: The buckling resistance was compared among the D-RaCe (DR2), HyFlex Remover, and Mtwo R25/05 retreatment systems. J-shaped canals within resin blocks were prepared with ProTaper NEXT X3 and obturated by the single-cone technique with AH Plus. After 4 weeks, 4 mm of gutta-percha in the coronal aspect was removed with Gates-Glidden drills. Retreatment was then performed using DR1 (size 30, 10% taper) followed by DR2 (size 25, 4% taper), HyFlex Remover (size 30, 7% taper), or Mtrwo R25/05 (size 25, 5% taper) (15 specimens in each group). Further apical preparation was performed with WaveOne Gold Primary. The clockwise torque and upward force generated during retreatment were recorded. After retreatment, resin blocks were examined using stereomicroscopy, and the percentage of residual filling material in the canal area was calculated. Data were analyzed using 1-way analysis of variance with the Tukey test. Results: The HyFlex Remover files exhibited the greatest buckling resistance (p < 0.05), followed by the Mtwo R25/05. The HyFlex Remover and Mtwo R25/05 files generated the highest maximum clockwise torque and upward force, respectively (p < 0.05). The DR1 and DR2 files generated the least upward force and torque (p < 0.05). The percentage of residual filling material after retreatment was not significantly different between file systems (p > 0.05). Conclusions: NiTi retreatment instruments with higher buckling resistance generated greater clockwise torque and upward force.

• Imaging Science in Dentistry
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• v.48 no.1
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• pp.11-19
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• 2018

Purpose: This study compared the diagnostic accuracy of cone-beam computed tomography (CBCT) scans obtained with 2 CBCT systems with high- and low-resolution modes for the detection of root perforations in endodontically treated mandibular molars. Materials and Methods: The root canals of 72 mandibular molars were cleaned and shaped. Perforations measuring 0.2, 0.3, and 0.4 mm in diameter were created at the furcation area of 48 roots, simulating strip perforations, or on the external surfaces of 48 roots, simulating root perforations. Forty-eight roots remained intact(control group). The roots were filled using gutta-percha (Gapadent, Tianjin, China) and AH26 sealer (Dentsply Maillefer, Ballaigues, Switzerland). The CBCT scans were obtained using the NewTom 3G (QR srl, Verona, Italy) and Cranex 3D (Soredex, Helsinki, Finland) CBCT systems in high- and low-resolution modes, and were evaluated by 2 observers. The chi-square test was used to assess the nominal variables. Results: In strip perforations, the accuracies of low- and high-resolution modes were 75% and 83% for NewTom 3G and 67% and 69% for Cranex 3D. In root perforations, the accuracies of low- and high-resolution modes were 79% and 83% for NewTom 3G and was 56% and 73% for Cranex 3D. Conclusion: The accuracy of the 2 CBCT systems was different for the detection of strip and root perforations. The Cranex 3D had non-significantly higher accuracy than the NewTom 3G. In both scanners, the high-resolution mode yielded significantly higher accuracy than the low-resolution mode. The diagnostic accuracy of CBCT scans was not affected by the perforation diameter.