The purpose of this study was to evaluate the efficiency of the preparation of oval canals using hand and engine-driven instruments with SEM observation. Thirty single-rooted teeth with oval canal were used in this study. The teeth were divided into 3 groups. In group A the teeth were instrumented up to a size 35 K-file using RC-prep and irrigated with 5% NaOCl between each file size. In group B. the teeth were instrumented with Profile according to the manufacture's instructions using RC-Prep and irrigated with 5% NaOCl between each file size. In group C. the teeth were instrumented with GT file according to the manufacture's instructions using RC-prep and irrigated with 5% NaOCl between each file size. Then. in all teeth. a final flush of 5ml of distilled water delivered for 30s. Canals were dried with sterile standardized paper points. After preparing the canals, the teeth were sectioned along their mesial and diatal surfaces by using low-speed diamond disc. chisel and mallet. Each root section was then dehydrated in graded concentration of alcohol (70, 80, 90, 100%). mounted on an aluminum stub. sputter-coated with gold-palladium and observed with scanning electron microscope (HITACHI S-4200) in middle and apical area. The results of this study were as follows: 1. In the middle area. group B and group C showed less smear layer than group A and it was statistically significant (p < 0.05). 2. In the middle area. group B showed greater smear layer than group C. but it was not statistically significant (p > 0.05). 3. In the apical area, group C showed less smear layer than group A. and it was statistically significant (p < 0.05). 4. In the apical area. group A showed greater smear layer than group B. but it was not statistically significant (p > 0.05). 5. In the apical area. group B showed greater smear layer than group C. but it was not statistically significant (p > 0.05). 6. In all groups. the middle area was less smear layer than the apical area. and it was statistically significant (p < 0.05).
1. The author have had a case of class V and class Ⅲ combined carious lesion extended on to root surface of upper right lateral incisor. 2. The patient was 40 years old female. 3. After routine root canal treatment of the tooth, the gingival flap was made by vertical incision on gingival tissue between distal surface of upper right lateral incisor and mesial surface of upper right canine. 4. Cavity preparation and amalgam filling on the carious lesion were performed and the flap was sutured.
Park, Sang-Hee;Kim, Deok-Joong;Song, Yong-Beom;Lee, Hye-Yun;Kim, Hyoung-Sun;Lee, Kwang-Won;Yu, Mi-Kyung
Journal of Dental Rehabilitation and Applied Science
/
v.28
no.4
/
pp.371-383
/
2012
Shaping the root canal system to maintain original canal curvature is essential to clinical success in endodontic treatment. Opposed to most root canals that are curved, endodontic instruments are made from straight metal blanks. They have a tendency of straightening the root canal during preparation and frequently result in procedural errors. A new treatment method to maintain original canal curvature during shaping has been introduced for preventing procedural errors. The aim of this study was to compare the ability of instruments to maintain original canal curvature of continuous rotary system and single file system. Thirty ISO 15, 0.02 taper, Endo Training Blocks(Dentsplay Maillefer) were used. Specimens were assigned to 1 of 3 groups for shaping: specimens in group 1 were shaped with ProFile #20/.06 at the WL. Specimens in group 2 were shaped with Mtwo #35/.04 at the WL. Specimens in group 3 were shaped with WaveOne Primary reciprocating files at the WL after the glide path was achieved with PathFile. Pre- and postinstrumentation digital images were superimposed and processed with Matlab r2010b(The MathWorks Inc, Natick, MA) software to analyze the curvature-radius ratio(CRr), representing canal curvature modification. Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file were analyzed with 1-way ANOVA(P<.05). Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file system were analyzed with independent t-test(P<.05). A statistically significant difference(P<0.05) was noted on each Ni-Ti file. ProFile and WaveOne instrumentations maintained the original canal curvature significantly better(P<0.05) than Mtwo file. There were no significant difference(P>0.05) between continuous rotary system and single file system. Under the conditions of this study, ProFile and WaveOne instruments maintained the original curvature significantly better than Mtwo file and were less modification of the canal curvature compared. There was no significant difference between continuous rotary system and single file system in shaping of simulated canals. As clinical practitioners, it may be advantages to use hybrid approach when root canal shapes depending on the design and usage of Ni-Ti files.
The C-shaped canal system is an anatomical variation mostly seen in mandibular second molars, although it can also occur in maxillary and other mandibular molars. The main anatomical feature of C-shaped canals is the presence of fins or web connecting the individual root canals. The complexity of C-shaped canals prevents these canals from being cleaned, shaped, and obturated effectively during root canal therapy, and sometimes it leads to an iatrogenic perforation from the extravagant preparation. The purpose of this study was to provide further knowledge of the anatomical configuration and the minimal thickness of dentinal wall according to the level of the root. Thirty extracted mandibular second molars with fused roots and longitudinal grooves on lingual or buccal surface of the root were collected from a native Korean population. The photo images and radiographs from buccal, lingual, apical direction were taken. After access cavity was prepared, teeth were placed in 5.25% sodium hypochlorite solution for 2 hours to dissolve the organic tissue of the root surface and from the root canal system. After bench dried and all the teeth were embedded in a self-curing resin. Each block was sectioned using a microtome (Accutom-50, Struers, Denmark) at interval of 1 mm. The sectioned surface photograph was taken using a digital camera (Coolpix 995, Nikon, Japan) connected to the microscope. 197 images were evaluated for canal configurations and the minimal thickness of dentinal wall between canal and external wall using 'Root Thickness Gauge Program' designed with Visual Basic. The results were as follows : 1. At the orifice level of all teeth, the most frequent observed configuration was Melton's Type C I (73%), however the patterns were changed to type C II and C III when the sections were observed at the apical third. On the other hand, the type C III was observed at the orifice level of only 2 teeth but this type could be seen at apical region of the rest of the teeth. 2. The C-shaped canal showed continuous and semi-colon shape at the orifice level, but at the apical portion of the canal there was high possibility of having 2 or 3 canals 3. Lingual wall was thinner than buccal wall at coronal, middle, apical thirds of root but there was no statistical differences.
Kim, Cheol-Woo;Park, Jin-Woo;Suh, Jo-Young;Lee, Jae-Mok
Journal of Periodontal and Implant Science
/
v.39
no.1
/
pp.53-58
/
2009
Purpose: The resective treatment in mandibular Degree III furcation areas includes root resection and tunnel preparation. The purpose of this retrospective study is to evaluate which treatment procedure(root resection vs tunnel preparation) has more favorable prognosis in mandibular Degree III furcation involvement. Materials and methods: The subjects of this study were patients who were treated their mandibular posteriors with either root resection(22 teeth on 22 patients) or tunnel preparation(24 teeth on 22 patients) and have participated in periodic recall check program for at least 2 years. Failure rate, plaque index, bleeding on probing and probing pocket depth were measured and the results were compared and statistically analysed. Results: Failure rates of root resection and tunnel praparation were 13.6% and 16.7%, respectively, and showed no significant difference between two procedures. No significant differences were observed between two procedures with respect to plaque index, bleeding on probing and probing pocket depth. Conclusion: root resection and tunnel preparation are both effective procedures to treat mandibular posterior furcation involvement, if adequate treatment of choice is made and patient's cooperation is accompanied. However, tunnel preparation is more preservative procedure in mandibular posterior furcation involvement since root canal treatment and prosthetic restoration are needed additionally, in case of root resection.
Endodontic surgery is a procedure to treat apical periodontitis or abscess in cases that did not heal after nonsurgical treatment or retreatment. This might include situations with persistent intracanal infection after root canal treatment. Other reasons might be found in extraradicular infection, such as bacterial biofilm on the apical root surface or bacteria within the lesion. For many years, the treatment standard was the traditional approach with surgical burs and amalgam for root-end filling. Endodontic microsurgery is the most recent step in the evolution of endodontic surgery, applying not only ultrasonic tip and biocompatible filling materials but also incorporating high-power magnification and illumination. Although many studies have been published that advocate the use of modern technique, the traditional techniques are still widely used in the surgery community. The purpose of this study was to demonstrate the endodontic microsurgery procedure including the root-end preparation and filling with the use of a surgical operating microscope.
During cleaning and shaping of narrow and curved canals, it is very difficult or nearly impossible to maintain the original canal shape. Procedural accidents such as, ledge, zipping, perforation, and instrument breakage are frequently occurred and even may lead to failure of endodontic therapy. To prevent these kinds of accidents, various instrumentation techniques and materials have been introduced. Recently some nickel titanium (NiTi) files are introduced and it is reported that These NiTi files created rounder preparations with less transportation than conventional instruments in curved canals. This study compared the change of the canal curvature and procedural accidents after instrumentation produced by stainless steel K-flexo file, and NiTi rotary files (Profile 29 and Quantec 2000). Thirty narrow and curved canals (25-45 degree) of extracted human molars were randomly divided into three groups. In group 1, canals were instrumented using a step-back and watch-winding/pull motion with K-flexo files. In group 2, canals were prepared with Profile 29. Group 3, canals were prepared with Quantec 2000 files. Before and after preparation of canals, periapical radiographs were taken and scanned. The change of canal curvature were measured using Photoshop 4.0 program and the incidence of procedural accidents were also evaluated. The results were as follows: 1. All group showed some loss of canal curvature after instrumentation. 2. Average loss of canal curvature was $6.70{\pm}5.31$ degree for group 1, $3.80{\pm}2.57$ degree for group 2, and $5.40{\pm}4.83$ degree for group 3. All group There was significant change in curvature between before and after instrumentation (p<0.05). But there was no statistical difference amoung 3 groups. 3. In group I, there were no procedural accidents, such as ledging, perforation, or instrument fracture. In group 2, two cases of ledge and one case of instrument fracture were produced Goup 3, each one case of ledge, perforation and instrument fracture were occurred. Whthin the limits of above results, It seems that NiTi rotary instrumentation is not All Mighty and if we use uncarefully, it is more dangerous to produce some procedural accidents than conventional hand files. But more studies should be taken to evaluate the exact effects of NiTi rotary instrumentations.
Jae-Yun, Hyun;Kyung-Mo, Cho;Se-Hee, Park;Yoon, Lee;Yoon-Joo, Lee;Jin-Woo, Kim
Journal of Dental Rehabilitation and Applied Science
/
v.38
no.4
/
pp.213-221
/
2022
Purpose: The efficacy of the amount of sealer in the root canal and two retreatment NiTi file systems in removing filling materials. Materials and Methods: Extracted premolars with a single root canal were selected for this study. After access opening and root canal preparation up to size #40/.06, the specimens were randomly divided into four groups. Gutta percha (GP) tapers of .06 or .04 were used for each group and filled using a single-cone filling technique with CeraSeal, a calcium silicate-based sealer. Each group was retreated either using the ProTaper Universal Retreatment System (PTUR) or the Hyflex Remover (HR). The time taken to remove the filling material, the amounts of apically extruded debris, and canal cleanliness were measured and compared. Results: The amount of sealer did not affect the efficiency when removing the filling materials. However, the filling material was removed faster in the HR group than in the PTUR group. Two types of NiTi files showed similar retreatment effects in the amounts of apically extruded debris and in the degree of canal cleanliness. Conclusion: The amount of sealer in canal filling had no significant effect on retreatability. Retreatment with HR removed filling materials is faster than PTUR. There was no difference in other removal efficiencies according to the type of retreatment NiTi file.
The purposes of this study were to evaluate the degree of cavity cleanliness and to observe cavity wall morphology when root-end retrograde cavity preparation was done with ultrasonics. Root resections were done on 20 extracted human maxillary central incisors after canal filling with gutta-percha, and retrocavities were prepared using a slow-speed round bur as a control, and stainless steel ultrasonic tips of power settings of 2 and 6 ($Miniendo^{TM}$, EIE, SA, USA) as experimentals. The degree of the remaining cavity debris and smear layer, and wall morphology were evaluated under the scanning electron microscope. The results were as follows : Cavity prepared with ultrasonics of either power setting showed significantly less smear layer than did slow-speed preparations (p<0.01). However, there was no significant difference in canal debris (p<0.05). Cavity prepared with ultrasonics showed hatcheted appearance of wall, while slow-speed preparation showed relatively plain one.
Meireles, Daniely Amorin;Bastos, Mariana Mena Barreto;Marques, Andre Augusto Franco;Garcia, Lucas Da Fonseca Roberti;Sponchiado, Emilio Carlos Junior
Restorative Dentistry and Endodontics
/
v.38
no.3
/
pp.167-171
/
2013
Biomechanical preparation of root canals with accentuated curvature is challenging. New rotatory systems, such as Reciproc, require a shorter period of time to prepare curved canals, and became a viable alternative for endodontic treatment of teeth with root dilaceration. Thus, this study aimed to report a clinical case of endodontic therapy of root with accentuated dilaceration using Reciproc single-file system. Mandibular right second molar was diagnosed as asymptomatic irreversible pulpitis. Pulp chamber access was performed, and glide path was created with #10 K-file (Dentsply Maillefer) and PathFile #13, #16 and #19 (Dentsply Maillefer) up to the temporary working length. The working length measured corresponded to 20 mm in the mesio-buccal and mesio-lingual canals, and 22 mm in the distal canal. The R25 file (VDW GmbH) was used in all the canals for instrumentation and final preparation, followed by filling with Reciproc gutta-percha cones (VDW GmbH) and AH Plus sealer (Dentsply Maillefer), using thermal compaction technique. The case has been receiving follow-up for 6 mon and no painful symptomatology or periapical lesions have been found. Despite the difficulties, the treatment could be performed in a shorter period of time than the conventional methods.
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