• Restorative Dentistry and Endodontics
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• 제27권4호
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• pp.432-440
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• 2002

The purpose of this study is to identificate root canal system including ideal access placement, root curvature, canal configuration, incidence of isthmus in mandibular incisors for success of endodontic treatment. 200 mandibular incisors were selected. The ideal access placement was determimed as follows. The teeth there radiographed from mesiodistal and buccolingual views using intraoral dental film. The image was divided into coronal, middle and apical third using the proximal film. Straight line access was determined by measuring the faciolingual canal width and placing points at midway point between the buccal and lingual wall at the junction of the middle and apical third and at the juntion of coronal and middle third of the root canal. A line was drawn connecting these two points extending through the crown of the tooth. The point at which the line crossed the external crown surface was recorded as facial, incisal, lingual. Degree of root curvature was determined by Schneider Protractor Method. Both section method and clearing method were used in this study. By section method, 100 mandibular incisors were embedded in clear resin and transeverse serial sectioned at 0.5, 1.0, 2.0, 3.0, 4.0, 5.0mm level from root apex. The resected surfaces were stained by methylene blue and examined under $\times$40 magnification with a stereomicroscope. By clearing method, 100 mandibular incisors were cleared in methysalicylate after decalcification with 10% nitric acid and evaluated under $\times$18 magnification with a stereomicroscope. The results were as follows ; 1. 29% had the center of the plotted straight-line access facial to incisal edge, whereas 71% had straight-line access at the incisal edge. When incisal wear classified as extensive, the straight-line access was plotted on the incisal edge 95.5%. When incisal wear classified as slight/none, the straight-line access was plotted on the facial 65.9%. 2. Degree of curvature of main canal was straight or almost straight, and only 10% in buccolingual direction had a degree of curvature greater than 20 degrees and 5.5% in mesiodistal direction had. 3. In section method, canal configuration analysis showed that 51% of the specimen classified as type I, 27% as type II, 12% as type III, 10% as type IV. For theses setions with two canals, the incidence of an isthmus was 36.7%, 64.3%, 79.2%, 96.3%, 97.4%, 97.6% at each level and highest in 3~5mm sections. 4. In clearing method, canal configuration analysis showed that 74% of the specimen classified as type I, 11% as type II, 6% as type III, 9% as type IV. These results suggested that traditional access from lingual should be moved as far toward the incisal as possible to locate and debride the lingual canal and root canal system should be cleaned, shaped completely and obturated three dimensionally for successful endodontic treatment.

• 대한치과보존학회:학술대회논문집
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• 대한치과보존학회 2001년도 추계학술대회(제116회) 및 13회 Workshop 제3회 한ㆍ일 치과보존학회 공동학술대회 초록집
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• pp.563.2-563
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• 2001

C-shaped canal configuration is very difficult to treat because that clues about preoperative canal anatomy cannot be ascertained from clinical crown morphology and limited information can be derived from the radiographic examination. This study was done to get more informations about the root and canal configuration of C-shaped root by 3-dimentionally reconstructing for the purpose of enhancing success rate of endodontic treatment. 30 mandibular molars with C-shaped root were selected. Teeth had been extracted from periodontal problems with sound crown and root portion, including teeth with caries lesion limited crown portion only.(omitted)

• 대한치과보존학회:학술대회논문집
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• 대한치과보존학회 2001년도 추계학술대회(제116회) 및 13회 Workshop 제3회 한ㆍ일 치과보존학회 공동학술대회 초록집
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• pp.554-554
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• 2001

C-shaped canal configuration is very difficult to treat because that clues about preoperative canal anatomy cannot be ascertained from clinical crown morphology and limited information can be derived from the radiographic examination. This study was done to get more informations about the root and canal configuration of C-shaped root by 3-dimentionally reconstructing for the purpose of enhancing success rate of endodontic treatment. 30 mandibular molars with C-shaped root were selected. Teeth had been extracted from periodontal problems with sound crown and root portion, including teeth with caries lesion limited crown portion only.(omitted)

• 대한소아치과학회지
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• 제31권2호
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• pp.256-261
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• 2004

외상 치아에서 일반적으로 발생할 수 있는 합병증으로는 치수 충혈, 내출혈, 근관내 석회화 변성, 외흡수, 치수괴사, 유착 등이 있다. 치아의 근관내 석회화 변성은 치아가 외상을 받았을 경우, 발생할 수 있는 이러한 합병증의 하나이다. 석회화 변성은 여러 요소에 의해 확인될 수 있는데 임상적으로는 치관의 황색 계통의 변색과 방사선학적으로는 치수강을 포함한 근관의 부분적 혹은 전체적인 협착을 특징으로 한다. 이러한 석회화 변성이 발생할 경우, 치수 괴사로 이행되기도 하는데, 모두 치수 괴사로 이행되는 것은 아니며 따라서 근관 치료에 앞서 적절한 검사 및 관찰이 필요하다. 본 증례는 만 9세의 여아가 놀던 중 친구의 머리에 부딪혀 상악 중절치의 외상(subluxation)을 받고 내원한 경우로 지속적인 임상적, 방사선학적 검사를 시행한 결과 근관내 석회화 변성이 관찰되었다 검사 초기에는 임상적으로 경미한 치관의 변색만 보였을 뿐, 전기 치수 검사(EPT)에서는 특이한 소견은 보이지 않았다. 그 후 전기 치수 검사를 이용한 지속적인 검사 결과, 그 반응의 정도가 점차 감소되었으나, 근관 치료는 좀 더 유보하고 관찰하기로 하였다 외상 후 20개월 정도 지나서는 전기 치수검사를 이용한 검사에 거의 반응을 보이지 않았고, 근관의 완전 협착과 치관의 황색 계통의 변색이 관찰되었다. 이에 치수 괴사로 이행되는 것을 막고 치관의 변색술을 시행하기 위하여 근관 치료를 시행하고 그 결과를 보고하는 바이다.

• Restorative Dentistry and Endodontics
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• 제41권1호
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• pp.68-73
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• 2016

This case report describes a unique C-shaped mandibular second premolar with four canals and three apical foramina and its endodontic management with the aid of cone-beam computer tomography (CBCT). C-shaped root canal morphology with four canals was identified under a dental operating microscope. A CBCT scan was taken to evaluate the aberrant root canal anatomy and devise a better instrumentation strategy based on the anatomy. All canals were instrumented to have a 0.05 taper using 1.0 mm step-back filing with appropriate apical sizes determined from the CBCT scan images and filled using a warm vertical compaction technique. A C-shaped mandibular second premolar with multiple canals is an anatomically rare case for clinicians, yet its endodontic treatment may require a careful instrumentation strategy due to the difficulty in disinfecting the canals in the thin root area without compromising the root structure.

• Restorative Dentistry and Endodontics
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• 제48권3호
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• pp.31.1-31.11
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• 2023

Objectives: This retrospective cohort study examined the incidence of interappointment emergencies during multiple-visit molar root canal treatments conducted by undergraduate students. Treatments performed without the use of intracanal medicament were compared to treatments that incorporated calcium hydroxide as an intracanal medicament. Materials and Methods: Interappointment emergencies, defined as instances of pain or swelling that required the patient to make an unscheduled follow-up visit, were recorded for up to 2 months after the intervention. To avoid the influence of obturation on the observed incidence of emergency visits, only unscheduled visits occurring between the start and end of the root canal treatment were included. Results: Of the 719 patients included in this study, 77 (10.7%) were recorded as experiencing interappointment emergencies. Of these emergencies, 62% occurred within 2 weeks following the most recent intervention. In the group of patients who did not receive intracanal medicament, the incidence of interappointment emergencies was 11.9% (46 of 385 patients). In comparison, this rate was 9.3% (31 of 334 patients) among those who received calcium hydroxide as an intracanal medicament (odds ratio, 1.33; 95% confidence interval, 0.82-2.15; p = 0.249). Conclusions: Interappointment emergencies may arise at any point during root canal treatment, but they most commonly occur within the first 2 weeks following intervention. The omission of intracanal medicament in multiple-visit molar root canal treatments, performed by undergraduate students, did not significantly increase the incidence of these emergencies.

• Restorative Dentistry and Endodontics
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• 제41권1호
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• pp.55-62
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• 2016

Objectives: The purpose of this study was to investigate the incidence of root fusion and C-shaped root canals in maxillary molars, and to classify the types of C-shaped canal by analyzing cone-beam computed tomography (CBCT) in a Korean population. Materials and Methods: Digitized CBCT images from 911 subjects were obtained in Chosun University Dental Hospital between February 2010 and July 2012 for orthodontic treatment. Among them, a total of selected 3,553 data of maxillary molars were analyzed retrospectively. Tomography sections in the axial, coronal, and sagittal planes were displayed by PiViewstar and Rapidia MPR software (Infinitt Co.). The incidence and types of root fusion and C-shaped root canals were evaluated and the incidence between the first and the second molar was compared using Chi-square test. Results: Root fusion was present in 3.2% of the first molars and 19.5% of the second molars, and fusion of mesiobuccal and palatal root was dominant. C-shaped root canals were present in 0.8% of the first molars and 2.7% of the second molars. The frequency of root fusion and C-shaped canal was significantly higher in the second molar than the first molar (p < 0.001). Conclusions: In a Korean population, maxillary molars showed total 11.3% of root fusion and 1.8% of C-shaped root canals. Furthermore, root fusion and C-shaped root canals were seen more frequently in the maxillary second molars.

• Restorative Dentistry and Endodontics
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• 제38권1호
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• pp.2-10
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• 2013

A common failure in endodontic treatment of the permanent maxillary first molars is likely to be caused by an inability to locate, clean, and obturate the second mesiobuccal (MB) canals. Because of the importance of knowledge on these additional canals, there have been numerous studies which investigated the maxillary first molar MB root canal morphology using in vivo and laboratory methods. In this article, the protocols, advantages and disadvantages of various methodologies for in-depth study of maxillary first molar MB root canal morphology were discussed. Furthermore, newly identified configuration types for the establishment of new classification system were suggested based on two image reformatting techniques of micro-computed tomography, which can be useful as a further 'Gold Standard' method for in-depth morphological study of complex root canal systems.

• Restorative Dentistry and Endodontics
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• 제6권1호
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• pp.51-62
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• 1980

A Scanning Electron Microscope study was conducted to compare the effectiveness of mechanical preparation of the root canal in conjunction with a few number of canal irrigants that have been widely used for canal treatment. The irrigants used in this study were 5% sodium hypochlorite, 3% hydrogen peroxide, 15% EDTA, and 30% hydrochloric acid. The root canals of 84 freshly extracted teeth with single or multi root were conventionally prepared with Hedstroem files. 78 canals were irrigated with normal saline solution following each instrument number and 6 canals were prepared without irrigation. After instrumentation 72 canals were flushed with various irrigants for predetermined length of time as shown on the Table 1. Additional 20 teeth were kept uninstrumented and five of them were immersed in 15% EDTA for 5 minutes, five in 5% sodium hypochlorite for 5 minutes, five in 3% hydrogen peroxide for 20 minutes, and the last five were only rinsed with saline solution. The SEM examination revealed as follows: 1. The canal wall cannot be thoroughly prepared by means of files. 2. No typical structural changes occured on instrumented dentin surface by saline solution, 3% $H_2O_2$, 5% NaOCl, within 5 minutes. 3. 5% NaOCl Solution showed excellent solvent effect to organic substances in uninstrumented canal within 5 minutes and 15% EDTA and 3% $H_2O_2$ showed unsignificant changes. 4. 15% EDTA and 30% HCl dissolved calcified debris and dentin chips that obturated the dentinal tubules and showed patent orifices. 5. 15% EDTA affected on peritubular dentin more readily and showed concavity around dentinal tubules.

• Restorative Dentistry and Endodontics
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• 제43권1호
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• pp.11.1-11.10
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• 2018

Objectives: This study aimed to introduce the use of laser-induced breakdown spectroscopy (LIBS) for evaluation of the mineral content of root canal dentin, and to assess whether a correlation exists between LIBS and scanning electron microscopy/energy dispersive spectroscopy (SEM/EDS) methods by comparing the effects of irrigation solutions on the mineral content change of root canal dentin. Materials and Methods: Forty teeth with a single root canal were decoronated and longitudinally sectioned to expose the canals. The root halves were divided into 4 groups (n = 10) according to the solution applied: group NaOCl, 5.25% sodium hypochlorite (NaOCl) for 1 hour; group EDTA, 17% ethylenediaminetetraacetic acid (EDTA) for 2 minutes; group NaOCl+EDTA, 5.25% NaOCl for 1 hour and 17% EDTA for 2 minutes; a control group. Each root half belonging to the same root was evaluated for mineral content with either LIBS or SEM/EDS methods. The data were analyzed statistically. Results: In groups NaOCl and NaOCl+EDTA, the calcium (Ca)/phosphorus (P) ratio decreased while the sodium (Na) level increased compared with the other groups (p < 0.05). The magnesium (Mg) level changes were not significant among the groups. A significant positive correlation was found between the results of LIBS and SEM/EDS analyses (r = 0.84, p < 0.001). Conclusions: Treatment with NaOCl for 1 hour altered the mineral content of dentin, while EDTA application for 2 minutes had no effect on the elemental composition. The LIBS method proved to be reliable while providing data for the elemental composition of root canal dentin.