• Restorative Dentistry and Endodontics
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• v.30 no.1
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• pp.31-37
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• 2005

The aim of this study was to evaluate the effectiveness of sealer placement in simulated root canal extensions. Forty resin blocks were attained from the Endo-training Bloc. In each block. The simulated root canal was made with $\#20$, 80taper GT file. After each block was longitudinally split into two halves, a standardized groove was prepared on one canal wall of two halves to simulate the canal extensions with various irregularities. The two halves of each block were assembled and all simulated root canals were obturated by single cone method with AH26 sealer. Four different methods of sealer placement were used: group A, $\#20$ K-file; group B, ultrasonic file; group C, lentulo spiral; group D, EZ-Fill bi-directional spiral. All obturated blocks were stored in $100\%$ humidity at $37^{\circ}C$ for 1 week, Using a low speed saw, each block was sectioned horizontally. Images of the sections were taken using a stereomicroscope at $\times$ 30 magnification and a digital camera. The amount of the sealer in the groove was evaluated using a scoring system, a higher score indicated better sealing effectiveness. The data was statistically analysed by Fisher's Exact Test. The sealing score was the lowest, specially at the middle area of canal extensions in group A, and that was statistically significant difference from other groups. In conclusion, the ultrasonic file, lentulo spiral and EZ-Fill bi-directional spiral were effective methods of sealer placement in simulated canal extensions. The K file was the least effective method, specially at the middle area of canal extensions.

• Restorative Dentistry and Endodontics
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• v.35 no.6
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• pp.479-485
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• 2010

Objectives: The aim of this study was to compare the push-out bond strengths of resin cement/fiber post systems to post space dentin using different application methods of resin cement. Materials and Methods: Thirty extracted human premolars were selected and randomly divided into 3 groups according to the technique used to place the cement into root canal: using lentulo-spiral instrument (group Lentulo), applying the cement onto the post surface (group Direct), and injecting the material using a specific elongation tip (group Elongation tip). After shaping and filling of the root canal, post space was drilled using Rely-X post drill. Rely-X fiber post was seated using Rely-X Unicem and resin cement was light polymerized. The root specimens were embedded in an acrylic resin and the specimens were sectioned perpendicularly to the long axis using a low-speed saw. Three slices per each root containing cross-sections of coronal, middle and apical part of the bonded fiber posts were obtained by sectioning. The push-out bond strength was measured using Universal Testing Machine. Specimens after bond failure were examined using operating microscope to evaluate the failure modes. Results: Push-out bond strengths were statistically influenced by the root regions. Group using the elongation tip showed significantly higher bond strength than other ways. Most failures occurred at the cement/dentin interface or in a mixed mode. Conclusions: The use of an elongation tip seems to reduce the number of imperfections within the selfadhesive cement interface compared to the techniques such as direct applying with the post and lentulospiral technique.

• The Journal of the Korean dental association
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• v.48 no.9
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• pp.680-687
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• 2010

The purpose of this study was to compare post cementation efficacy according to the different adhesive systems and cement delivery methods. A total of 40 extracted human single-rooted premolar teeth were randomly divided in four groups according to the two luting agents of Unicem applicap (3M ESPE, St. Paul, MN, USA) or Variolink II (Ivoclar Vivadent, Liechtenstein) and cement delivery methods of direct cement application or lentulo spiral application. After restoration using glass?fiber posts, the samples were embedded in acrylic resin. Three sections of 2 mm thickness were prepared from each specimen, and the post in each section was subjected to a push-out test. The data were analysed statistically at significant level of 95%. The Unicem had significantly higher push-out bond strength than Variolink and the lentulo spiral application made higher bond strength (p<0.05). Adhesive failure between cement and dentin was predominant in all groups. The Unicem of self-etch system and cement delivery using lentulo spiral showed clinically acceptable and comparable bonding strength for the fiber post.

• Proceedings of the KACD Conference
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• 2003.11a
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• pp.579-579
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• 2003

I. Objectives The aim of this study was to evaluate and compare the effectiveness of sealer placement in simulated root canal extensions using the K file, ultrasonic file, lentulo spiral and EZ-Fill. II. Materials and Methods Forty resin blocks were attained from cutting Endo-training Bloc with diamond saw. In each parallelepiped block, the simulated root canal was made with ＃20, 08taper GT file. After each block was longitudinally split into two halves using mallet and chisel, a standardized groove of 4mm in length, located 2mmapart from the root apex, was prepared on one wall of two halves using the custom-made knife to simulate the canal extensions with various irregularities.(omitted)

• Restorative Dentistry and Endodontics
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• v.31 no.3
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• pp.161-168
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• 2006

During root canal preparation procedures, the potential for instrument separation is always present. Files, a lentulo, a Gates-Glidden (GG) bur or any manufactured obstruction can be left behind in the canal Nickel-titanium (NiTi) rotary files are in common usage in these days. Despite their undeniable advantages, there is a potential risk of separation within the canals. It is very rapid, unpredictable, and creates a great deal of stress for the practitioner. When an endodontic instrument separates, the best option is to remove it. Ultrasonic instruments and microscopes have improved the success rate for removing separated instruments. But It is difficult and not always possible. Therefore prevention is the key. In this case report, several management methods of separated file in the canal are presented.

• Restorative Dentistry and Endodontics
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• v.41 no.1
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• pp.63-67
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• 2016

During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar.

• 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.22 no.1
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• pp.181-192
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• 1997

The difficulty of endodontic retreatment depends on various factors and it is affected by retention of post. In this experiment, root canal therapy was done in extracted human teeth and cut into 10mm length from the root apex, and then cemented by zinc phosphate cement, Vitremer$^{(R)}$(glass ionomer) luting cement and Panavia 21$^{(R)}$(resin cement). Post preparation was done by #4 Parapost drill at 6mm length and cement was inserted by lentulo spiral. After 24 hours, tensile bond strength, post removal time was measured after the ultrasonic application and the separation site was measured. The following results were obtained. 1. In measuring tensile bond strength, there is no statistical difference between zinc phosphate cement and Panavia 21$^{(R)}$, but Vitremer$^{(R)}$ showed lower value compared with those two cements. (p<0.001) 2. When the post removal time was measured after ultrasonic application, significant different value in order of Panavia 21$^{(R)}$, zinc phosphate cement and Vitremer$^{(R)}$ was shown. (p<0.001) 3. As a result of examining the separating site of each cement, all 16 of zinc phosphate cement group showed the fracture site between cement and post, Vitremer$^{(R)}$ was 13/16, and Panavia 2$^{(R)}$ was 8/16. In case of tooth restoration using Parapost, the use of Panavia 21 showed good retention property than Vitremer$^{(R)}$, but when retreatment is needed the difficulty of post removal will be increased.

• 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.