• The Journal of the Korean dental association
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• v.54 no.8
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• pp.640-650
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• 2016

Nickel-Titanium (NiTi) rotary instruments have brought a big step toward "efficient" practice of endodontic procedure. The rotary files help clinicians to reduce their working time and also increase the clinical success rate with minimal procedural errors. However, NiTi instruments still have a few drawbacks including unpredictable fatigue fracture. Clinicians may reduce the potential risk of instruments fracture by following some clinical guidelines for rotary instruments. In some clinical cases of instruments fracture, we may try to remove the instruments' fragments or bypass the fragment to reach the apical canal. In some limited cases, the fractured instruments' fragments would not jeopardize the clinical prognosis of root canal treatment. Nevertheless, it is impossible to be overemphasized that the prevention of file fracture is much easier than the removal of fracture fragment. Clinicians need to understand the fracture mechanisms and, in clinic, need to discard the used instruments timely.

• The Journal of the Korean dental association
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• v.52 no.2
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• pp.60-68
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• 2014

Nickel-Titanium(NiTi) rotary instruments have brought a big step toward "efficient" practice of endodontic procedure. The rotary files help clinicians to reduce their working time and also increase the clinical success rate with minimal procedural errors by stainless steel instruments. In spite of these advantages, NiTi instruments still have a few drawbacks including unpredictable fatigue fracture. Clinicians may reduce the potential risk of instruments fracture by following some clinical guidelines for rotary instruments. In some clinical cases of instruments fracture, we may try to remove the instruments' fragments or bypass the fragment to reach the apical canal. In some limited cases, the fractured instruments' fragments would not jeopardize the clinical prognosis of root canal treatment. However, it is impossible to be overemphasized that the fragment removal is more difficult than the prevention of fracture. Clinicians need to understand the fracture mechanisms and, in clinic, need to discard the used instruments timely.

• Proceedings of the KACD Conference
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• 2001.11a
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• pp.574.1-574
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• 2001

Maxillary first molar, the "6-year molar", is the tooth largest in volume and most complex in root and root canal anatomy. Therefore, maxillary first molar is possibly the most treated, least understood. It is the posterior tooth with the highest endodontic failure rate and unquestionably one of the most important teeth. The earliest permanent posterior tooth to erupt, the mandibular first molar seems to be the most frequently in need of endodontic treatment.(omitted)

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.2
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• pp.97-105
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• 2017

Purpose: The purpose of this study was comparing the efficacy of passive irrigation (PI) and passive ultrasonic irrigation (PUI) for ability to remove debriment of canals. Materials and Methods: Mandibular premolars were decoronated and standardized to 16 mm length. After root canal enlargement and half separating longitudinally, standardized groove of 4 mm length, 0.2 mm width and 0.5 mm depth were formed on the dentin wall of one half. Three depressions in the canal wall of the opposite half, 0.3 mm in diameter and 0.5 mm in depth, were formed. After each groove and depression was filled with dentin debris, two sections of each half were reassembled using impression putty material. In group 1 the canals were irrigated with 2.5% NaOCl by PI. In group 2 the canals were irrigated with 2.5% NaOCl by PUI. Before and after root canal irrigation, the root canal wall of the section was taken with a microscope and a digital camera as images. The amount of dentin debris remaining in grooves and depressions was assessed using a scoring system. Results: There was no significant difference between PI and PUI except for the middle 1/3 of the root canal (P = 0.004). Conclusion: At the middle 1/3 of the root canal, PUI removed more dentine debris than PI. But the removal efficiency of dentin debris is not significantly different between the PUI and PI at the apical area of root canal in mandibular premolars.

• Restorative Dentistry and Endodontics
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• v.45 no.1
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• pp.1.1-1.9
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• 2020

Objectives: The purpose of this study was to determine the incidence of radix molaris (RM) (entomolaris and paramolaris) in the mandibular first permanent molars of a sample Saudi Arabian subpopulation using cone-beam computed tomography (CBCT). Materials and Methods: A total of 884 CBCT images of 427 male and 457 female Saudi citizens (age 16 to 70 years) were collected from the radiology department archives of 4 dental centers. A total of 450 CBCT images of 741 mature mandibular first molars that met the inclusion criteria were reviewed. The images were viewed at high resolution by 3 examiners and were analyzed with Planmeca Romexis software (version 5.2). Results: Thirty-three (4.5%) mandibular first permanent molars had RM, mostly on the distal side. The incidence of radix entomolaris (EM) was 4.3%, while that of radix paramolaris was 0.3%. The RM roots had one canal and occurred more unilaterally. No significant difference in root configuration was found between males and females (p > 0.05). Types I and III EM root canal configurations were most common, while type B was the only RP configuration observed. Conclusions: The incidence of RM in the mandibular first molars of this Saudi subpopulation was 4.5%. Identification of the supernumerary root can avoid missing the canal associated with the root during root canal treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.1
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• pp.20-27
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• 2017

This study aimed to assess microleakage of Endoseal MTA when it is used as a root canal sealer and a root canal filling material compared with conventional endodontic treatment materials Forty-two mature human permanent teeth with a single root canal were divided randomly into three experimental groups (n = 10) and two control groups (n = 6). Group A was obturated with AH $plus^{(R)}$ and gutta-percha (GP). Group E1 was obturated with Endoseal MTA and GP. Group E2 was obturated with Endoseal MTA only. The positive control group was obturated with GP only and the negative control group was obturated in the same way as the experimental groups. The samples were kept in saline solution for 24 hours and were immersed in 0.2% rhodamine B dye solution for 24 hours. Then the samples were split longitudinally and the micoleakage was assessed under a stereomicroscope. Complete microleakage was detected in all positive control group samples, whereas no microleakage was detected in the negative control group. There was no statistically significant difference between the experimental groups in the Kruskal-Wallis test. These results suggest that Endoseal MTA has potential use as a root canal sealer and a root canal filling material.

• Restorative Dentistry and Endodontics
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• v.41 no.4
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• pp.322-331
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• 2016

Variation in the root and canal morphology of the maxillary first molars is quite common. The most common configuration is 3 roots and 3 or 4 canals. Nonetheless, other possibilities still exist. The presence of an additional palatal root is rather uncommon and has been reported to have an incidence of 0.06 - 1.6% in varying populations studied. Whenever two palatal roots exist, one of them is the normal palatal root, the other is a supernumerary structure which can be located either mesiolingually (radix mesiolingualis) or distolingually (radix distolingualis). This case report describes successful endodontic treatment of a maxillary first molar with radix mesiolingualis and radix distolingualis. Identification of this variation was done through clinical examination along with the aid of multiangled radiographs, and an accurate assessment of this morphology was made with the help of a cone-beam computed tomography imaging. In addition to the literature review, this article also discusses the epidemiology, classifications, morphometric features, guidelines for diagnosis, and endodontic management of a maxillary first molar with extra-palatal root.

• Journal of dental hygiene science
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• v.21 no.4
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• pp.243-250
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• 2021

Background: Endodontic sealers or their toxic components may become inflamed and lead to delayed wound healing when in direct contact with periapical tissues over an extended period. Moreover, an overfilled sealer can directly interact with adjacent tissues and may cause immediate necrosis or further resorption. Therefore, the treatment outcome conceivably depends on the endodontic sealer's biocompatibility and osteogenic potential. This study aimed to evaluate the cell viability and osteogenic effects of four different sealers in osteoblastic cells. Methods: AH Plus (resin-based sealer), Pulp Canal Sealer EWT (zinc oxide-eugenol sealer), BioRoot RCS (calcium silicate-based sealer), and Well-Root ST (MTA-based calcium silicate sealer) were mixed strictly according to the manufacturer's instructions, and dilutions of sealer extracts (1/2, 1/5 and 1/10) were determined. Cell viability was measured using the water-soluble tetrazolium-8 (WST-8) assay. Differentiation was assessed by alkaline phosphatase (ALP) activity and mineralized nodule formation by Alizarin Red S staining. Results: The cell viability of the extracts derived from the sealers excluding Well-Root ST was concentration dependent, with sealer extracts having the least viability at a 1/2 dilution. At sealer extract dilution of 1/10, the test groups showed the same survival rate as that control group, with the exception of BioRoot RCS. Among all experimental groups, BioRoot RCS showed the highest cell viability after 48 hours. The ALP activity was significantly higher in a concentration-dependent manner. Furthemore, all four materials promoted ALP activity and mineralized nodule formation compared to the control at 1/10 dilutions. Conclusion: This is the first study to highlight the differences in biological activity of these four materials. These results suggest that the composition of root canal sealers appears to alter the form of biocompatibility and osteoblastic differentiation.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.1
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• pp.32-37
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• 2016

Purpose: To determine the anatomical characteristic of C-shaped canal systems in Korean mandibular 2nd molars by cone beam computed tomography (CBCT). Materials and Methods: The 824 CBCT images were evaluated. These patients were taken CBCT for the diagnosis and treatment of dental implantation on 2013. The 711 mandibular 2nd molars were examined. The configuration of root canal systems were classified according to modified Melton's classifications. Results: Of the 711 mandibular 2nd molars, 21.5% had C-shaped canal systems. This prevalence did not differ with tooth position. Most of the C-shaped canals with bilateral molars were symmetrical. Of the C-shaped canal, the most common configuration Type were Melton's Type I (89%) in the orifice level and Melton's III (83.8%) in the apical level. The prevalence of C-shaped canal was higher in female (25%) than male (13.9%) (P < 0.05). Conclusion: A high prevalence of C-shaped canals were observed in Korean mandibular 2nd molars. For successful C-shaped root canal treatment, the comprehension of root canal systems was important.

• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.30.1-30.6
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• 2019

We report the surgical endodontic treatment of a maxillary first premolar with a lateral lesion that originated from an accessory canal. Although lesions originating from accessory canals frequently heal with simple conventional endodontic therapy, some lesions may need additional and different treatment. In the present case, conventional root canal retreatment led to incomplete healing with the need for further treatment (i.e., surgery). Surgical endodontic management with a fast-setting calcium silicate cement was performed on the accessory canal using a dental operating microscope. At the patient's 9-month recall visit, the lesion was resolved upon radiography.