• Restorative Dentistry and Endodontics
• /
• 제43권3호
• /
• pp.33.1-33.8
• /
• 2018

Objectives: This study aimed to investigate the prevalence of a separate distolingual root and to measure the thickness of the buccal cortical bone in mandibular first molars in Koreans using cone-beam computed tomography (CBCT) images. Materials and Methods: High-quality CBCT data from 432 patients were analyzed in this study. The prevalence of a separate distolingual root of the mandibular first molar was investigated. The distance from the distobuccal and distolingual root apices to the outer surface of the buccal cortical bone was measured. We also evaluated the thickness of the buccal cortical bone. Results: The prevalence of a separate distolingual root (2 separate distal roots with 1 canal in each root; 2R2C) was 23.26%. In mandibular first molars with 2R2C, the distance from the distobuccal root apex to the outer surface of the buccal cortical bone was 5.51 mm. Furthermore, the distance from the distolingual root apex to the outer surface of the buccal cortical bone was 12.09 mm. In mandibular first molars with 2R2C morphology, the thickness of the buccal cortical bone at the distobuccal root apex of the mandibular first molar was 3.30 mm. The buccal cortical bone at the distobuccal root apex was significantly thicker in the right side (3.38 mm) than the left side (3.09 mm) (p < 0.05). Conclusions: A separate distolingual root is not rare in mandibular first molars in the Korean population. Anatomic and morphologic knowledge of the mandibular first molar can be useful in treatment planning, including surgical endodontic treatment.

• Restorative Dentistry and Endodontics
• /
• 제40권2호
• /
• pp.155-160
• /
• 2015

Objectives: Achieving adequate anesthesia with inferior alveolar nerve blocks (IANB) is of great importance during dental procedures. The aim of the present study was to assess the success rate of two anesthetic agents (bupivacaine and lidocaine) for IANB when treating teeth with irreversible pulpitis. Materials and Methods: Sixty volunteer male and female patients who required root canal treatment of a mandibular molar due to caries participated in the present study. The inclusion criteria included prolonged pain to thermal stimulus but no spontaneous pain. The patients were randomly allocated to receive either 2% lidocaine with 1:80,000 epinephrine or 0.5% bupivacaine with 1:200,000 epinephrine as an IANB injection. The sensitivity of the teeth to a cold test as well as the amount of pain during access cavity preparation and root canal instrumentation were recorded. Results were statistically analyzed with the Chi-Square and Fischer's exact tests. Results: At the final step, fifty-nine patients were included in the study. The success rate for bupivacaine and lidocaine groups were 20.0% and 24.1%, respectively. There was no significant difference between the two groups at any stage of the treatment procedure. Conclusions: There was no difference in success rates of anesthesia when bupivacaine and lidocaine were used for IANB injections to treat mandibular molar teeth with irreversible pulpitis. Neither agent was able to completely anesthetize the teeth effectively. Therefore, practitioners should be prepared to administer supplemental anesthesia to overcome pain during root canal treatment.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권2호
• /
• pp.173-177
• /
• 2010

In 1942, Stafne described 35 "bone cavities" at the angle of the mandible. They appeared as unilocular, well-circumscribed, round or elliptical radiolucencies located below the inferior dental canal and between the angle of the mandible and first molar tooth. Since 1942, these lesions have been frequently described under various terms: aberrant or ectopic salivary gland; static or latent or idiopathic defect, cavity or cyst; mandibular salivary gland inclusion; lingual mandibular cavity; and Stafne's cyst, defect or cavity. Usually they were asymptomatic, with a predilection for men between age 50 and 70 years, and almost unilateral. At surgical exploration, they appeared as concavities on the lingual cortex and contained salivary gland tissue, often in continuity with the submandibular gland. In 1957, Richard and Ziskind were the first to report the appearance of a Stafne's cyst in the premolar region. Contrary to posterior defects, the anterior defects are difficult to diagnose clinically because the mandibular canal is not present, and the unilocular radiolucency can be confused with other cysts (radicular, residual, odontogenic, lateral periodontal,etc). The purpose of the present report is to describe an unusual case of Stafne's cyst in the anterior region of the mandible in 58-years-old woman.

• Imaging Science in Dentistry
• /
• 제44권2호
• /
• 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.

• Restorative Dentistry and Endodontics
• /
• 제29권4호
• /
• pp.378-385
• /
• 2004

The purpose of this study was to compare the effects of preparation with GT files and profiles .04 in shaping of root canals and reconstruct the three-dimensional root canal system using micro computed tomography 40 canals of the extracted human mandibular molars were used, and randomly distributed into two experimental groups. In group 1. canals were prepared by GT files. In group 2, Profiles .04. were used. Apical preparation size was #30. For each tooth pre and post operative cross-sectional images were obtained by the micro CT at 50 micron intervals. Pre and post operative cross-sectional images of 1, 2, 3, 5, and 8mm from the apex were compared. For each section. canal area and centering ratio were determined. For each tooth pre- and post-operative root canal volume from the furcation to the apex of the roots was calculated by three-dimensional image software. Following results were obtained: 1. At 8mm from the apex, area of dentin removed by GT rotary file was significantly larger than that by Profile .04. And at the other levels there was not a significant difference. 2. There was a trend for GT rotary file to remain more centered in the canals than Profile .04 at all levels. But at 3mm level. there was a statistically significant difference. 3. In root canal volume increments after instrumentation, there was no significant difference between two groups.

• Restorative Dentistry and Endodontics
• /
• 제24권4호
• /
• pp.623-627
• /
• 1999

During canal instrumentation of a curved canal, restoring force of endodontic instrument remove more dentin from the inner wall of the curvature. This effect tends to straighten the canal and thus may significantly shorten the working length. This study was to determine the mean reduction in working length after instrumentation according to the curvature. The curvature of mandibular mesial root was determined before instrumentation. 30 canals were divided into 3 groups each 10 on the basis of degree of curvature. Experimental groups as follows. In group 1, canals having curvature from 15 to 20 degrees: in group 2, canals having curvature from 20 to 30degrees; in group 3, canals having curvature above 30 degrees. Experimental teeth in all groups were accessed, and their actual working length determined by passing a size 15 K-file(IAF) just through the minor apical foramen. The canals were sequentially enlarged to size 35 with ProFile .06 series. The change of working length was calculated by measuring the tip of IAF beyond apical foramen by using stereomicroscope. The change of canal curvature following instrumentation were measured using the Schneider technique. The results were as follows. 1. The greatest changes of curvature and working length were observed in the group 3 canals(P<0.05), next were group 2 canals and group 1 canals(P>0.05). 2. Group 1 canals showed a mean reduction in 1.61 degrees and length of 0.12m respectively(P>0.05). 3. Group 2 canals showed a mean reduction in 3.42 degrees(P<0.05) and length of 0.25mm(P>0.05) respectively. 4. Group 3 canals showed a mean reduction in 7.23 degrees(<0.05) and length of 0.64mm respectively(P<0.05).

• Restorative Dentistry and Endodontics
• /
• 제45권3호
• /
• pp.38.1-38.10
• /
• 2020

Objectives: This study aimed to evaluate vital pulp tissue removal from different endodontic instrumentation systems from root canal apical third in vivo. Materials and Methods: Thirty mandibular molars were selected and randomly divided into 2 test groups and one control group. Inclusion criteria were a positive response to cold sensibility test, curvature angle between 10 and 20 degrees, and curvature radius lower than 10 mm. Root canals prepared with Hero 642 system (size 45/0.02) (n = 10) and Reciproc R40 (size 40/0.06) (n = 10) and control (n = 10) without instrumentation. Canals were irrigated only with saline solution during root canal preparation. The apical third was evaluated considering the touched/untouched perimeter and area to evaluate the efficacy of root canal wall debridement. Statistical analysis used t-test for comparisons. Results: Untouched root canal at cross-section perimeter, the Hero 642 system showed 41.44% ± 5.62% and Reciproc R40 58.67% ± 12.39% without contact with instruments. Regarding the untouched area, Hero 642 system showed 22.78% ± 6.42% and Reciproc R40 34.35% ± 8.52%. Neither instrument achieved complete cross-sectional root canal debridement. Hero 642 system rotary taper 0.02 instruments achieved significant greater wall contact perimeter and area compared to reciprocate the Reciproc R40 taper 0.06 instrument. Conclusions: Hero 642 achieved higher wall contact perimeter and area but, regardless of instrument size and taper, vital pulp during in vivo instrumentation is not entirely removed.

• Restorative Dentistry and Endodontics
• /
• 제46권3호
• /
• pp.33.1-33.12
• /
• 2021

Objectives: This study aimed to investigate the efficacy of ionic and non-ionic-based contrast media (in vitro study) and the combinatorial effect of chitosan-based endo-radiopaque solution (CERS) (in vivo study) for visualization of the root canal anatomy. Materials and Methods: In vitro study (120 teeth): The root canal of maxillary premolars and molars (in vitro group 1 and 2 respectively, n = 60 each) were analyzed using 4 different contrast media (subgroups: Omnipaque 350, Iopamidol, Xenetix 350, and Urografin 76; n = 15 each) in combination with 5.25% sodium hypochlorite (NaOCl). Based on the results of the in vitro study, in vivo study (80 teeth) was done to compare Xenetix 350 + 5.25% NaOCl with CERS (in vivo group 1 and 2 respectively, n = 40 each) on maxillary and mandibular premolars and molars. Two endodontists used radiovisiography to assess the depth of ingress and identify the aberrant root anatomy after access cavity preparation, and after initial cleaning and shaping of canals. Kruskal-Wallis test was used for in vitro comparison (p < 0.05), and Wilcoxon signed-rank test and Mann-Whitney U test for in vivo analysis (p < 0.01). Results: In vitro study, Xenetix 350 + 5.25% NaOCl facilitated a significant higher visualization (p < 0.05). For in vivo study, CERS had a statistically significant depth of ingress (p < 0.01), and was efficient in identifying the aberrant root canal anatomy of premolars and molars. Conclusions: CERS facilitates better visualization of the root canal anatomy of human premolars and molars.

• Restorative Dentistry and Endodontics
• /
• 제46권2호
• /
• pp.16.1-16.11
• /
• 2021

Objectives: The aim of this study was to evaluate the shaping ability of the TruShape and Reciproc Blue systems and the apical extrusion of debris after root canal instrumentation. The ProTaper Universal system was used as a reference for comparison. Materials and Methods: Thirty-three mandibular premolars with a single canal were scanned using micro-computed tomography and were matched into 3 groups (n = 11) according to the instrumentation system: TruShape, Reciproc Blue and ProTaper Universal. The teeth were accessed and mounted in an apparatus with agarose gel, which simulated apical resistance provided by the periapical tissue and enabled the collection of apically extruded debris. During root canal preparation, 2.5% sodium hypochlorite was used as an irrigant. The samples were scanned again after instrumentation. The percentage of unprepared area, removed dentin, and volume of apically extruded debris were analyzed. The data were analyzed using 1-way analysis of variance and the Tukey test for multiple comparisons at a 5% significance level. Results: No significant differences in the percentage of unprepared area were observed among the systems (p > 0.05). ProTaper Universal presented a higher percentage of dentin removal than the TruShape and Reciproc Blue systems (p < 0.05). The systems produced similar volumes of apically extruded debris (p > 0.05). Conclusions: All systems caused apically extruded debris, without any significant differences among them. TruShape, Reciproc Blue, and ProTaper Universal presented similar percentages of unprepared area after root canal instrumentation; however, ProTaper Universal was associated with higher dentin removal than the other systems.

• Restorative Dentistry and Endodontics
• /
• 제20권2호
• /
• pp.768-779
• /
• 1995

This study was performed to investigate the effect of root canal shaping techniques on the change of the shape of prepared root canal. 40 mesiobuccal canals of recently extracted mandibular 1st and 2nd molars were divided into 4 groups and shaped by step-down/balanced force technique, step-down/step-back technique, step-back technique and conventional technique respectively. The change of the shape of root canal was traced by superimposing the radiographs obtained before and after shaping of each root canal. The results were as follows. 1. By the experimented techniques except conventional technique, the root canals were more shaped in convex side of apical area and in concave side of most curved and coronal area than in the other sides(P<0.05). By conventional technique, the root canals were more shaped in convex side than in convave side from apex to orifice(P<0.05). 2. By step-down/balanced force technique, the cancave sides at C and D points of proximal view and C point of clinical view were more shaped than the convex side(P<0.05). Through the entire canal, the concave side was more shaped than the convex side in proximal view(P<0.01). But there was no statistical difference between both sides in clinical view. 3. By step-down/step-back technique, the change of root canal shape was not statistically different in concave and convex sides at each point of both views(P>0.05). And through the entire canal in proximal view, there was no statistical difference in shaping percentage between both sides. But through the entire canal in clinical view, the concave side was more shaped than the convex side(P<0.1). 4. By step-back technique, the convex side at B point of clinical more shaped than the other sides(P<0.05). Through the entire canal in proximal and clinical views, there was no statistical difference in shaping percentage between both sides. 5. Comparing the total shaping percentage among techniques, that in conventional technique was the greatest numerically, and followed by the percentages in step-down/step-back, step-down/balanced force and step-back technique. But, in proximal view, shaping percentages were not statistically different among techniques(P>0.05, ANOVA test). In clinical view, shaping percentages in step-back and conventional techniques were statistically different(P<0.01, ANOVA test). * Proximal view: radiograph taken in mesiodistal direction. * Clincal view: radiograph taken in faciolingual direction. A point : 1mm point from radiographic apex B point : center point between A and C points C point : most curved point of root canal D point : center point between C point and canal oriffice.