• Imaging Science in Dentistry
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• 제52권3호
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• pp.245-258
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• 2022

Purpose: This study compared the root canal anatomy between cone-beam computed tomography (CBCT) and micro-computed tomography (micro-CT) images before and after biomechanical preparation and root canal filling. Materials and Methods: Isthmus-containing mesial roots of mandibular molars(n=14) were scanned by micro-CT and 3 CBCT devices: 3D Accuitomo 170 (ACC), NewTom 5G (N5G) and NewTom VGi evo (NEVO). Two calibrated observers evaluated the images for 2-dimensional quantitative parameters, the presence of debris or root perforation, and filling quality in the root canal and isthmus. The kappa coefficient, analysis of variance, and the Tukey test were used for statistical analyses(α=5%). Results: Substantial intra-observer agreement (κ=0.63) was found between micro-CT and ACC, N5G, and NEVO. Debris detection was difficult using ACC (42.9%), N5G (40.0%), and NEVO (40%), with no agreement between micro-CT and ACC, N5G, and NEVO (0.05<κ<0.12). After biomechanical preparation, 2.4%-4.8% of CBCT images showed root perforation that was absent on micro-CT. The 2D parameters showed satisfactory reproducibility between micro-CT and ACC, N5G, and NEVO (intraclass correlation coefficient: 0.60-0.73). Partially filled isthmuses were observed in 2.9% of the ACC images, 8.8% of the N5G and NEVO images, and 26.5% of the micro-CT images, with no agreement between micro-CT and ACC, and poor agreement between micro-CT and N5G and NEVO. Excellent agreement was found for area, perimeter, and the major and minor diameters, while the roundness measures were satisfactory. Conclusion: CBCT images aided in isthmus detection and classification, but did not allow their classification after biomechanical preparation and root canal filling.

• 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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• 제39권4호
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• pp.258-264
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• 2014

Objectives: This in vitro study aimed to investigate the ability of Candida albicans (C. albicans) and Enterococcus faecalis (E. faecalis) to penetrate dentinal tubules of instrumented and retreated root canal surface of split human teeth. Materials and Methods: Sixty intact extracted human single-rooted teeth were divided into 4 groups, negative control, positive control without canal instrumentation, instrumented, and retreated. Root canals in the instrumented group were enlarged with endodontic instruments, while root canals in the retreated group were enlarged, filled, and then removed the canal filling materials. The teeth were split longitudinally after canal preparation in 3 groups except the negative control group. The teeth were inoculated with both microorganisms separately and in combination. Teeth specimens were examined by scanning electron microscopy (SEM), and the depth of penetration into the dentinal tubules was assessed using the SMILE view software (JEOL Ltd). Results: Penetration of C. albicans and E. faecalis into the dentinal tubules was observed in all 3 groups, although penetration was partially restricted by dentin debris of tubules in the instrumented group and remnants of canal filling materials in the retreated group. In all 3 groups, E. faecalis penetrated deeper into the dentinal tubules by way of cell division than C. albicans which built colonies and penetrated by means of hyphae. Conclusions: Microorganisms can easily penetrate dentinal tubules of root canals with different appearance based on the microorganism size and status of dentinal tubules.

• 구강회복응용과학지
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• 제23권1호
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• pp.85-93
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• 2007

The purpose of this study was to evaluate the microleakage of root-end filling material filled in blood contaminated root-end cavity and self-etching adhesive placed over blood contaminated resected root apices without root-end preparation. Extracted, human maxillary incisors, canines and mandibular premolar were randomly divided into four groups of 15 teeth each. After canal preparation, resection of the apex and root-end preparation, MTA and IRM were filled in the root-end cavity (A and B group). After canal preparation and resection of the apex, Clearfil SE Bond and Prompt L-Pop were applied over the contaminated root-end surfaces (C and D group). The roots were then subjected to 15cm of water pressure to simulate periapical microleakage stress. Data were analyzed using one-way ANOVA. The results were as follows : 1. All groups showed a tendency of decreasing microleakage in process of time after 2weeks later except IRM group. 2. After 2 weeks and 1 month, MTA group showed less microleakage significantly than other groups(p<0.05). After 2 months, Prompt L-Pop group showed less microleakage significantly than other groups(p<0.05). 3. After 9 months, there were no significant differences among four groups(p>0.05). Thus it is considered that apical sealing using adhesives system without root-end preparation is good method in endodontic surgery.

• Restorative Dentistry and Endodontics
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• 제38권2호
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• pp.93-97
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• 2013

During root canal preparation procedures, the potential for instrument breakage is always present. When instrument breakage occurs, it leads to anxiety of the clinician and as well as a metallic obstruction of the canal which hinders further cleaning and shaping. Separated instruments must always be attempted for retrieval and if retrieval is not possible bypass should be tried. With the increased use of nickel-titanium (NiTi) instruments the incidence of separated instruments has increased. A considerable amount of research has been done to understand the various factors related to the fracture of NiTi instruments to minimize its occurrence. This paper presents a review of the literature regarding the fracture of NiTi instruments and also describes a case report showing the use of a modified 18-guage needle and cyanoacrylate glue to retrieve a separated NiTi instrument from the mesiolingual canal of a mandibular first molar.

• Restorative Dentistry and Endodontics
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• 제43권2호
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• pp.15.1-15.7
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• 2018

Objectives: The present study aimed to evaluate the shaping ability of 2 thermally treated nickel-titanium reciprocating systems in simulated curved canals. Materials and Methods: Forty simulated canals were prepared to apical size 25 using Reciproc Blue R25 (VDW) and WaveOne Gold Primary (Dentsply Sirona) instruments. Standard pre- and post-preparation images were taken and superimposed. The removal of resin material was measured at 5 standard points: the canal orifice, halfway between the canal orifice and the beginning of the curve, the beginning of the curve, the apex of the curve, and the end-point of the simulated canal. The data were analysed using the independent sample t-test with a 5% significance threshold. Results: The canals in which Reciproc Blue R25 was used showed a significantly greater widening than those in which WaveOne Gold was used at 4 of the 5 measurement points (p < 0.05). The Reciproc Blue R25 instrument removed significantly more resin from the inner aspect of the curve at 2 of the 5 points and similar amounts at the remaining 3 points. At the 2 apical points, there was no significant difference between the Reciproc Blue R25 and WaveOne Gold Primary instruments. Conclusion: Both instruments respected the original canal anatomy; however, WaveOne Gold resulted in a more conservative shape with less transportation.

• Restorative Dentistry and Endodontics
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• 제19권1호
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• pp.85-96
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• 1994

In this study, 24 curved resin blocks were prepared by one of the following four methods: 1) Conventional technique using K-flexo files 2) Step-back technique using K-flexo files 3) Crown-down technique using K-flexo files 4) Canal Master instrumentation using Canal Master Resin blocks were sectioned, photographed, and evaluated the mean centering ratio and the mean area of dentin removed before and after the instrumentation. The results were as follows : I. the mean centering ratio 1. In the level 1 and level 3, there was no significant difference in the mean centering ratio. 2. In the level 2, Step-back technique showed the worst mean centering ratio among the tested groups(p<0.001) and there was no significant difference between the other three groups. 3. In the level 4, Canal Master instrumentation and Step-back technique showed better mean centering ratio than the other two techniques(p<0.001) and there was no significant difference between the two techniques. II. the mean area of dentin removed 1. In the level l and level 3, there was no significant difference in the mean area of dentin removed. 2. In the level 2, Canal Master instrumentation removed less dentin than the other three techniques(P<0.01). 3. In the level 4, Crown-down technique removed less dentin than the other three techniques(P<0.05).

• Restorative Dentistry and Endodontics
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• 제46권1호
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• pp.8.1-8.7
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• 2021

Objectives: The reliability and educational quality of videos on YouTube for patients seeking information regarding instrument separation in root canal treatment were evaluated. Materials and Methods: YouTube was searched for videos on instrument separation in root canal treatment. Video content was scored based on reliability in terms of 3 categories (etiology, procedure, and prognosis) and based on video flow, quality, and educational usefulness using the Global Quality Score (GQS). Descriptive statistics were obtained and the data were analyzed using analysis of variance and the Kruskal-Wallis test. Results: The highest mean completeness scores were obtained for videos published by dentists or specialists (1.48 ± 1.06). There was no statistically significant difference among sources of upload in terms of content completeness. The highest mean GQS was found for videos published by dentists or specialists (1.82 ± 0.96), although there was no statistically significant correlation between GQS and the source of upload. Conclusions: Videos on YouTube have incomplete and low-quality content for patients who are concerned about instrument separation during endodontic treatment, or who experience this complication during endodontic treatment.

• Restorative Dentistry and Endodontics
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• 제46권1호
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• pp.12.1-12.9
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• 2021

Objectives: The present study aims to compare the obturation quality of 2 confluence confirmation techniques in artificial maxillary first premolars showing Vertucci type II root canal configuration. Materials and Methods: Thirty artificial maxillary premolars having Vertucci type II root canal configuration were made. They were divided into 3 groups according to the confluence confirmation technique as follows. Gutta-percha indentation (GPI) group (confluence confirmation using a gutta-percha cone and a K file); electronic apex locator (EAL) group (confluence confirmation using K files and EAL); and no confluence detection (NCD) group. In the GPI group and the EAL group, shaping and obturation were performed with the modified working length (WL). In the NCD group, shaping was performed without WL adjustment and obturation was carried out with an adjusted master cone. Micro-computed tomography was used before preparation and after obturation to calculate the percentage of gutta-percha occupied volume (%GPv) and the volume increase in the apical 4 mm. Data were analyzed using 1-way analysis of variance and post hoc Tukey's test. Results: Statistically significant difference was not found in terms of the %GPv from the apex to apical 4 mm. However, the NCD group showed a statistically significant volume increase compared with the EAL group (p < 0.05). Conclusions: In terms of gutta-percha occupied volume, no significant difference was observed among the 3 groups. Confluence confirmation using an EAL in teeth with Vertucci type II configuration showed less volume increase during canal shaping compared with no confluence confirmation.

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