Materials and methods: Sixty extracted premolars were assigned to three groups according to the root canal system (Weine's classification; type I, II and III) of 20 teeth each using radiographic examination. The root tip was cut horizontally 1 mm from the anatomical apex and the apical cross-section was visualized using microscope at x50 magnification and photographed. Minimum and maximum apical root canal diameter of each tooth was measured and classified into three types by canal morphology (round, oval and flattened shape). Statistical analysis was performed to compare the apical root canal diameter and morphology according to the root canal system. Results: In apical root canal morphology at cross-sectional view, the most common shape was round in type I, flat in type II, and oval in type III. In apical root canal diameters at cross-sectional view, there was a significant difference between the minimum and maximum diameter in all types (p<0.05). The maximum diameter was 0.331 mm in type I, 0.519 mm in type II, and 0.310 mm in type III. There was a significant difference among type I, III and type II (p<0.05). Conclusion: The morphology and diameter of apical root canal was different according to the root canal system. Therefore, clinicians should consider the apical file size in view of the apical root canal shape according to the root canal system.
Solomonov, Michael;Kim, Hyeon-Cheol;Hadad, Avi;Levy, Dan Henry;Itzhak, Joe Ben;Levinson, Oleg;Azizi, Hadas
Restorative Dentistry and Endodontics
/
제45권2호
/
pp.21.1-21.12
/
2020
The aim of this article was to review age-dependent clinical recommendations for appropriate root canal instrumentation techniques. A comprehensive narrative review of canal morphology, the structural characteristics of dentin, and endodontic outcomes at different ages was undertaken instead of a systematic review. An electronic literature search was carried out, including the Medline (Ovid), PubMed, and Web of Science databases. The searches used controlled vocabulary and free-text terms, as follows: 'age-related root canal treatment,' 'age-related instrumentation,' 'age-related chemo-mechanical preparation,' 'age-related endodontic clinical recommendations,' 'root canal instrumentation at different ages,' 'geriatric root canal treatment,' and 'pediatric root canal treatment.' Due to the lack of literature with practical age-based clinical recommendations for an appropriate root canal instrumentation technique, a narrative review was conducted to suggest a clinical algorithm for choosing the most appropriate instrumentation technique during root canal treatment. Based on the evidence found through the narrative review, an age-related clinical algorithm for choosing appropriate instrumentation during root canal treatment was proposed. Age affects the morphology of the root canal system and the structural characteristics of dentin. The clinician's awareness of root canal morphology and dentin characteristics can influence the choice of instruments for root canal treatment.
Forty extracted human mandibular second molars with C-shaped canal were chosen to study the anatomy of the root canal. The experimental teeth were injected with china ink, decalcified and cleared with Winter green oil, in vitro, to study the number of root, root canal, canal per root, frequency and location of lateral canal and transverse anastomosis. 1. All teedth had one root. 2. Mesial roots with two canals were 25%, and mesial roots with one canal were 75%. All distal roots had one canal. 3. In the roots with two canals, the common apical foramen appeared in 20% and the separte apical foramen appeared in 80%. 4. The frequence of lateral canal was 33.3% and the most frequent region was middle 1/3. 5. All teeth had the transverse anastomosis in all region of the roots.
The author had selected the roots and root-canal as measurable parts and sought the area ratio by measuring the respective areas of the root. Further, heplotted out a root caual index and studied the correlation with age. The teeth used as reserch material were permanent maxillary central incisors of Korean female. Some 296 teeth of known age were selected on condition that there is no caries or filling material and that they were not malformed in showing normal signs in roentgenograms. The $3" {\times} 4"$ printing paper so as to measure easily. On the ocassion of measureing the area of measured parts with a planimeter (Koizumi, type kp-27, Japan), the cervical lines were joined up into a straight line on a photograph (Figure 1) Root canal index = Area of the root / Area of the root canal The results of the root canal index in Korean female age groups were as follows : 1. The root canal index of maxilary central incisor in women was 4.74 im 20 years of age, 5.44 in 30, 5.90 in 40, 6.32 in 50, 6.63 in 60 in the order. 2. Root canal index and age were in positive correlation ; there was a tendency that the root canal index increase as age advances. 3. The regression equation was as follows : Y = 5.36x + 7.71 (r = 0.54, n= 296 ) (Y = estimated age, x = root canal index)
The purpose of this study was to compare the apical leakage and adaptation to the dentinal wall of a glass ionomer root canal cement(Ketac-Endo) with those of AH-26 and Tubli-Seal. 102 single-rooted teeth were insrumented with step-back technique and randomly divided into four groups according to kinds of root canal cements: Ketac-Endo, AH-26, Tubli-Seal, and no root canal cement. Four experimental groups were as follows; Group 1 : Filling with gutta-percha and Ketac-Endo Group 2 : Filling with gutta-percha and AH-26 Group 3 : Filling with gutta-percha and Tubli-Seal Group 4 : Filling with gutta-percha without root canal cement All the specimens were obturated with lateral condensation technique, and stored in 100% humidity for 4 days. 20 teeth in each group were placed in centrifuge tube filled with India ink, and then centrifuged for 20 minutes at 3,000 rpm. And they were evaluated for linear dye leakage using a stereoscope and analyzed by one-way ANOVA. 22 teeth were split longitudinally and evaluated the adaptation to the dentinal wall using scanning electron microscope(4 teeth in each group) and stereoscope(2 teeth in 1, 2, 3 group). The obtained results were as follows ; 1. In case of not used root canal cement(Group 4), there was showed much degree of dye penetration comparerd with used root canal cements (Group 1, 2, 3)(P<0.01). 2. In the case of used root canal cements(Group 1, 2, 3), there was no significant difference in linear leakage in groups(P>0.01). 3. In the case of used root canal cements(Group 1, 2, 3), there was showed intimate adaptation to the dentinal wall independent on kinds of root canal cements. 4. Fractured surfaces indicated failure of cohesion in Ketac-Endo, and failure of adhesion to dentine in AH-26 and Tubli-Seal. 5. According to similar apical leakage and adaptability to the dentinal wall to another root canal cements, it is possible to be used glass-ionomer cement as root canal cement.
Objective: The purpose of this study was to analyze the Cone-beam computed tomograghy(CBCT) scan of endodontically treated maxillary first molars and investigate how second mesiobuccal (MB2) canal is treated, how the prognosis of mesiobuccal (MB) root is different compared to other roots and the prognosis factor on apical periodontitis. Methods: Subjects were endodontically treated maxillary first molars whose were collected from CBCT scans taken from January 2018 until December 2019. A total of 525 maxillary first molars were analyzed by an endodontist to determine the presence of the MB2 canal, the quality of the root canal filling, and the presence of apical periodontitis. The chi square test and Fisher's exact test was used to examine the relationship between each variable. Results: MB2 canals were found in 46.3%, of which 76.5% were not treated. The more main canal of mesiobuccal root (MB1 canal) was well filled, the more significantly MB2 canal was well filled (p<0.001). The apical periodontitis of MB root was not related to the filling quality of MB1 canal (p=0.370) and was related to the filling quality of MB2 canal (p=0.004). The apical periodontitis of MB root was related to the quality of canal filling of MB2 canal and the apical periodontitis of DB and P root. Conclusions: It was found that the majority of MB2 canals were not treated. The apical periodontitis of MB root was analyzed to be related to the quality of canal filling of MB2 canal. The apical lesion of the MB root was not correlated with the treatment of the MB1 canal, but it was significantly related to the quality of filling of MB2 canal.
This study was to evaluate the cytotoxic effect of three root canal disinfectants (formocresol, camphorated phenol and eugenol) and ten root canal sealers(Cavitec, Hypo-cal, Vitapex, AH26, Canals, Mynol, $N_2$, $N_2$-Medical, Z. O. E. and Calvital) in vitro. The experiments were performed in four differrent modes. In the first and second experiment, the "long-distance" cytotoxicity of three root canal disinfectants were tested on L cells. In the third exeriment, ten root canal sealers were tested for cytotoxicity by means of the tissue culture-agar overlay method immediately, 4 and 24 hours after the experiment. In the fourth experiment, the study with radioactively labeled L cells were employed to determine the relative cytotoxicity of ten root canal sealers. The results were as follows; 1. Every vapors from disinfectants showed more or less cytotoxicity. Of the three disinfectats, formocresol appeared to be the highest cytotoxic effect and camphorated phenol was the lowest. 2. Root canal sealers tested in tbis study showed cytotoxicity at every stage of time intervals. 3. The highest cytotoxic effect was freshly mixed $N_2$ meaical and $N_2$ also revealed the highest cytotoxic effect after 4 or 24 hours among these materials. Vitapex was found the lowest cytotoxic effect at all experimental stage. 4. Root canal sealers except N2 and Mynol showed cytotoxic effect were decreased cytotoxicity according to the time elapsed.
;A new root canal instrument and instrumentation technique: a preliminary report. Cleaning and shaping the root canal system has been and continues to be a challenge for even the most experienced endodontist. Curved. narrow canals. in particular. cause difficulties for the beginner as well as the specialist. A new instrument designed to incorporate new concepts was developed to ameliorate the problems in cleaning and shaping root canal systems. This new instrument has been given the name of SW (Senia and Wildey). The new SW instrument uses controlled right and left rotational forces. This motion was used to clean and shape simulated root canals in plastic blocks and root canals in extracted teeth. Instrumentation appeared to be easier. faster. and more precise than with conventional instruments. especially in curved canals where there was remarkable reduction of canal transportation. A mechanical version of the SW instrument was also developed. It was used to flare the coronal portion of the root canal system. Wildey WL. Senia ES., Oral Surg Oral Med Oral Pathol1989 Feb:67(2):198-207 Another look at root canal instrumentation. Several aspects of root canal instrumentation need additional research. Various factors must be considered in an analysis of instrumentation of the root canal system: the dentin that is cut: the technique used to cut it: the design of the instruments: the material and manufacturing process used to make the instruments: the irrigant used during the procedure: and the anatomic configuration of the root canal system. An analysis of these factors clearly indicates that existing root canal instruments and techniques are less than ideal and. in fact. do not accomplish what is expected of them. Root canals must be properly. but. at the same time. destructive and unnecessary removal of dentin should be kept to a minimum. The Flex-R and Canal Master instruments were developed to address some of the shortcomings of existing instruments and techniques. More scientifically based research is needed to fully evaluate these new instruments and techniques and to develop future instruments. Wildey WL; Senia ES. Montgomery S., Oral Surg Oral Med Oral Pathol1992 Oct:74(4):499-50799-507
Recently the development of rotary instrument makes it possible that in root canal treatment operator saves much more time, maintans original curved canal shape and easily prepares continuous tapered root canal. The purpose of this experiment was to examine the smoothness of the internal surface of prepared root canal and the effectiveness of debridement in prepared root canal by SEM for the comparison of hand and Ni-Ti rotary instrument. 25 extracted human teeth were access opened and # 10 K-type file was introduced into canal until it was appeared at the apical foramen. The working length was established by subtracting 0.5mm from this measurement. Group 1. The root canal preparation was done to # 30 with working length and then step-back until # 45 with K-Flexofile (Maillefer, Swiss). Group 2. Root canal preparation was done by Naviflex Ni-Ti file (Brasseler, USA) as the same technique with group 1. Group 3. Canal was prepared by Profile .04 (Maillefer, Swiss) taper until #30. Group 4. With use of Quantec (Tycom, USA) root canal was prepared from file number 1 to 8. In group 1 and 2, the root canal irrigant was NaOCl and the other groups, NaOCl and RC-prep (Premine Dental Products, USA) was used. The prepared teeth were notched with high-speed bur as bucco-lingual direction and fractured with chisel and mallet, then examined with SEM. Group 1 showed smooth internal surface. There were scratches mainly to the axial direction. Group 2 showed similar characteristics to those in group 1. Group 3 showed more smoother and linear cutting surface with bised scratches. Group 4 has the almost same characteristics group 3 and there was no difference in the file design. Ni-Ti rotary root canal instrument prepare the dentinal wall more smoother than hand instrument. The effectiveness of debridement was not fully affected by file design. The isthmus area and accessory canals of the root canal system were not prepared in any group. According to the result, hand and rotary type instrumentation techniques were effective in removal of major amount of tissue from root canal but it was not complete. In the direction of cutting movement there was difference between them.
Root canal preparation process is of utmost importance in successful treatment of root canal. Also, one of the most important purpose of the root canal preparation is to enlarge the root canal three dimensionally without changing the curvature of the root canal However as the curvature of the root canal increases, there are many difficulties involved in formation of optimum root canal. Therefore in order to solve the above mentioned problems, new developments in methods of root canal preparation and equipments for such purposes were made. Recently, vigorous studies about newly introduced engine-driven nickel-ti-tanium rotary file are conducted. As shown in research results to dates, it is well established that the use of nickel-titanium file is better suited for curved root canal than stainless steel file in maintaining the curvature or root canal and reducing the deformation of root canal. However it is also acknowledged that there are a few discrepancies in research results according to protocol, due to failure to remove variables in experiments. In addition, although it is recommended by the manufacturer that the GT rotary file should maintain a low rotational speed of 150~350rpm and 'light pressure' as light as not to break the lead of a pencil, academic studies about the vertical force which is not yet standardized are not sufficiently explored. Therefore, this research devised and utilized a special research equipment to standardize the appropriate range of vertical force for GT rotary file through experiments by breaking of the lead of a pencil as expressed by the manufacturer and to accurately measure factors involved through repeating and recreating the environment of root canal preparation. Forming nine experimental groups by varying the vertical forces (150g. 220g, 300g) and rpm (150rpm, 250rpm, 350rpm), the effects of changing vertical forces and rpm on working efficiency were measured in terms of time expended in root canal preparation by crown-down method using a transparent resin block with 35 degree curvature and GT rotary file (z-test). The following research using this special research equipment that involved nine experimental groups and varying the vertical force for root canal preparation from 300g which is within the normal vertical force range to 700g and 1000g which fall outside the normal rpm range. The results were as follows : 1. Analysis of the experiment results revealed that the time spent in root canal preparation decreased as the vertical forces and rpm increased (p<0.05). Also, the effects of rpm were greater than those of the vertical forces within the normal vertical force range ($\beta$-weight test). 2. Observation of the deformation of GT rotary file revealed that deformation increases in a direct correlation with the vertical force increase and in a reverse correlation with the rpm decrease. In the case of the vertical forces close to the normal range, the probability of GT rotary file deformation were quite different depending on the rpm changes. In the case of greater vertical forces, the occurrences of deformation of the file were more frequent regardless of the rpm changes. 3. Deformation and breakage of file were also commonly observed in the expended time measurement experiments and GT rotary file deformation experiments in which low speed rpm (150rpm) was used and at the curved portion of the resin block.
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