• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.291-304
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• 1997

The purposes of this study were to evaluate the changes in root canal configuration with canal instrumentation using different file types and techniques and to investigate most appropriate instrumentation technique in maintaining the original canal configuration with different file types. Fifty curved mesiobuccal or distobuccal canals of extracted human maxillary molar teeth were instrumented using a step-back technique with stainless steel K-files or nickel-titanium K-files, a crown-down pressureless technique with stainless steel K-files or nickel-titanium K-files and nickel-titanium engine-driven files. Radiographs were taken before and after instrumentation using a specially designed device that allowed for the pre-and postinstrumentation canals to be taken with the same X-ray angulation. Magnified X-ray images on a magnifier screen were traced and post instrumentation canal images were compared with the preinstrumentation ones. Changes in canal curvature and the incidence of procedural accidents were analyzed. The results were as follows : Crown-down pressureless technique with nickel-titanium K-files and nickel-titanium engine-driven filing produced no significant changes in canal curvature (p>0.05), while the step-back technique with stainless steel K-files or nickel-titanium K-files (p<0.01) and the crown-down pressureless technique with stainless steel K-files (p<0.05) produced significant changes. With nickel-titanium K-file, crown-down pressureless technique produced significantly less changes in canal curvature than step-back technique (p<0.05), while there was no significant difference between techniques with stainless steel K-files (p>0.05). File types exerted no significant influences in the changes of canal curvature both in the step-back technique and crown-down pressureless technique (0>0.05). Regardless of the file types used, step-back technique produced more procedural accidents such as ledge or elbow formation, apical zipping and apical transportation than the crowndown pressureless technique and nickel-titanium engine-driven filing. Both with stainless steel K-files and with nickel-titanium K-files, the incidence of apical extrusion of canal debris was higher in step-back technique than in crown-down pressureless technique.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.347-357
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• 1997

An accurate working length is an essential factor in the success of endodontic treatment. There are several methods for determining working length; electronic apex locator, tactile sense by clinician, and radiography. Among these methods, the most commonly used method is radiography. But this method requires excessive radiation, long developing time, and many equipments. In additon, it could give an image distortion and two dimensional image. To improve these disadvantages, an intraoral digital radiographic system (Digora$^{(R)}$) which use an imaging plate instead of a film, was developed. The purpose of this investigation was to compare Digora imaging with conventional radiography in determining the working length. Maxillary first or second molars of human dried skull were used. Files were inserted into canals at randomly selected lengths, from 2mm short of the radiographic apex to 2rnm beyond. Radiographs and Digora images(Digora positive and Digora negative) were evaluated to determine the adjustment needed to place the file 0.5mm from the radiographic apex. The results were as follows ; 1. There was no significant difference in accuracy between those evaluated in ${\pm}0.5mm$ and those accurately evaluated in the 3 images. 2. When comparing the accuracy of each image without distinguishing the 3 images, in the group accurately determined within ${\pm}0.5mm$, the mesiobuccal group showed significantly higher accuracy compared to the palatal group(p<0.05).

• Restorative Dentistry and Endodontics
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• v.41 no.1
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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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• v.26 no.2
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• pp.111-120
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• 2001

Calcium hydroxide pastes is widely used in conventional endodontics. Along with the expanded clinical use of calcium hydroxide, literatures suggest mixing calcium hydroxide with other substance. Among added substances the vehicle plays the most importance role in the overall process because it is directly related with the velocity of ionic dissociation of $Ca^{2+}$ and OH ion. In this study, we evalutated and compared periapical tissue response and root resorption after canal was filled with mixture of saline and calcium hydroxide(Junsei Chemical Co.. Japan) as a aqueous vehicle, Metapaste(Meta Co., Korea) as a viscous vehicle paste, Vitapex(Neo Dental, Japan) as a oily vehicle paste and IRM(Caulk Dentsply, USA) in replantation of rat molar. A total of 31 maxillary first molars of Sprague-Dawley female rats, 30 days old were used. The upper 1st molar was extracted and the mesiobuccal canal was filled with mixture of saline and calcium hydroxide, Metapaste, Vitapex. IRM and then replanted. Rats were sacrificed 3 weeks after replantation. the maxillae were removed. section of 4 micron were cut and stained with hematoxylin-eosin, Apical tissue response were observed under light microscope. The results were as follows: 1. Saline mixing group and Metapaste group were significant different in fibrous capsule width compared to Vitapex group and IRM group(P<0.05). 2. Saline mixing group. Metapaste group. Vitapex group and IRM group did not prevent root resorption and there were no statistical difference. 3. In saline mixing group and Metapaste group. loss of pastes were observed in all samples. From the results of our study. we observed loss of pastes in saline mixing group and Metapaste group because of water soluble property and assumed it was related to inflammation in apical area and sealing ability of material. So, we should study and develop calcium hydroxide vehicle which is easily removed and more stable and because of only 3 weeks observation we need more evaluation in long period.

• Journal of Oral Medicine and Pain
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• v.19 no.1
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• pp.57-72
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• 1994

This study was undertaken to obtain the data age determination following the eruption of individual cusps of the first molars in the point of forensic odontology. 532 children (294 male and 238 female, born between April, 1989 and March, 1986) from a kindergarten and a primary school in a reesidential district in Seoul were studied. The eruption state of the first molar was divides into 6 stages according to the degree of exposure of individual cusps, and correlation between the stage and age was stastically analysed. The results of the study lead to following conclusions : 1. The most frequently seen eruption sequence of cusps for the upper first molar was mesibuccal cusp, mesiopalatal cusp, distobuccal cusp, mesiodistal cusp, distopalatal cusp. As for the lower first molar : mesiobuccal cusp, mcsiolingual cusp, distobuccal cusp, distolingual cusp. 2. The time of eruption was earlier in the female ethan in the male, but it was stastically remarkable only in upper and lower parts of the right and the left teeth of subjects age between 6.0 and 6.5 and upper part of the right and the left teeth of subjects age over 7.5 3. The eruption of the lower first molar was comparatively earlier than that of the upper first molar and there was no significant stastical difference between the right and the left first molars in the time of eruption. 4. There was no noticeable difference in the eruption sequence of cusps, irrespective of sex and side. 5. The eruption of the upper first molar is started at the age of about 6.4 and complete the age of about 7.1 and as for the lower first molar, it is from 6.3 to 7.0

• Imaging Science in Dentistry
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• v.47 no.3
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• pp.157-164
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• 2017

Purpose: This study determined and compared the distances from the maxillary root apices of posterior teeth to the floor of the maxillary sinus, or maxillary sinus distances(MSDs), and the distances from the mandibular root apices of the posterior teeth to the mandibular canal, or mandibular canal distances(MCDs), in Thai subjects with skeletal open bite and skeletal normal bite. Materials and Methods: Pretreatment cone-beam computed tomography (CBCT) images were obtained from 30 Thai orthodontic patients (15 patients with skeletal normal bite and 15 with skeletal open bite) whose ages ranged from 14 to 28 years. The CBCT images of the patients were processed and measured using the Romexis Viewer program. The MSDs and MCDs from the root apices of the maxillary and mandibular second premolar, first molar, and second molar to the maxillary sinus floor or the mandibular canal were measured perpendicularly to the occlusal plane. The Student t test was used for comparisons between the 2 groups. Results: The greatest mean MSDs were from the root apex of the second premolars in both groups, whereas the least mean MSDs were from the mesiobuccal root apex of the second molars. The greatest mean MCDs were from the mesial root apex of the first molars, whereas the least mean MCDs were from the distal root apex of the second molars. Conclusion: There were no differences in the mean MSDs or the mean MCDs between the skeletal normal bite group and the skeletal open bite group.

• Restorative Dentistry and Endodontics
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• v.45 no.2
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• pp.14.1-14.7
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• 2020

Objective: The aim of this study was to perform a comparative evaluation of the effectiveness of ultrasonic tips versus the Terauchi file retrieval kit (TFRK) for the removal of broken endodontic instruments. Materials and Methods: A total of 80 extracted human first mandibular molars with moderate root canal curvature were selected. Following access cavity preparation canal patency was established with a size 10/15 K-file in the mesiobuccal canals of all teeth. The teeth were divided into 2 groups of 40 teeth each: the P group (ProUltra tips) and the T group (TFRK). Each group was further subdivided into 2 smaller groups of 20 teeth each according to whether ProTaper F1 rotary instruments were fractured in either the coronal third (C constituting the PC and TC groups) or the middle third (M constituting the PM and TM groups). Instrument retrieval was performed using either ProUltra tips or the TFRK. Results: The overall success rate at removing the separated instrument was 90% in group P and 95% in group T (p > 0.05) The mean time for instrument removal was higher with the ultrasonic tips than with the TFRK (p > 0.05). Conclusion: Both systems are acceptable clinical tools for instrument retrieval but the loop device in the TFRK requires slightly more dexterity than is needed for the ProUltra tips.

• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.30.1-30.11
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• 2020

Objectives: This micro-computed tomographic (CT) study aimed to compare the shaping abilities of ProTaper Next (PTN), One Shape (OS), and One Curve (OC) files in 3-dimensionally (3D)-printed mandibular molars. Materials and Methods: In order to ensure standardization, 3D-printed mandibular molars with a consistent mesiobuccal canal curvature (45°) were used in the present study (n = 18). Specimens were instrumented with the OC, OS, or PTN files. The teeth were scanned pre- and post-instrumentation using micro-CT to detect changes of the canal volume and surface area, as well as to quantify transportation of the canals after instrumentation. Two-way analysis of variance was used for statistical comparisons. Results: No statistically significant differences were found between the OC and OS groups in the changes of the canal volume and surface area before and after instrumentation (p > 0.05). The OC files showed significantly less transportation than the OS or PTN systems for the apical section (p < 0.05). In a comparison of the systems, similar values were found at the coronal and middle levels, without any significant differences (p > 0.05). Conclusions: These 3 instrumentation systems showed similar shaping abilities, although the OC file achieved a lesser extent of transportation in the apical zone than the OS and PTN files. All 3 file systems were confirmed to be safe for use in mandibular mesial canals.

• Restorative Dentistry and Endodontics
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• v.43 no.4
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• pp.46.1-46.10
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• 2018

Objectives: This study was to evaluate the antibacterial effect of different instrumentation and irrigation techniques using confocal laser scanning microscopy (CLSM) after root canal inoculation with Enterococcus faecalis (E. faecalis). Materials and Methods: Mesiobuccal and mesiolingual canals of extracted mandibular molars were apically enlarged up to a size 25 hand K-file, then autoclaved and inoculated with E. faecalis. The samples were randomly divided into 4 main groups according to the system of instrumentation and irrigation: an XP-endo Shaper (XPS) combined with conventional irrigation (XPS/C) or an XP-endo Finisher (XPF) (XPS/XPF), and iRaCe combined with conventional irrigation (iRaCe/C) or combined with an XPF (iRaCe/XPF). A middle-third sample was taken from each group, and then the bacterial reduction was evaluated using CLSM at a depth of $50{\mu}m$ inside the dentinal tubules. The ratio of red fluorescence (dead cells) to green-and-red fluorescence (live and dead cells) represented the percentage of bacterial reduction. The data were then statistically analyzed using the Kruskal-Wallis test for comparisons across the groups and the Dunn test was used for pairwise comparisons. Results: The instrumentation and irrigation techniques had a significant effect on bacterial reduction (p < 0.05). The iRaCe/XPF group showed the strongest effect, followed by the XPS/XPF and XPS/C group, while the iRaCe/C group had the weakest effect. Conclusions: Combining iRaCe with XPF improved its bacterial reduction effect, while combining XPS with XPF did not yield a significant improvement in its ability to reduce bacteria at a depth of $50{\mu}m$ in the dentinal tubules.

• The korean journal of orthodontics
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• v.49 no.3
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• pp.161-169
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• 2019

Objective: To evaluate the effectiveness of the Frog appliance in three dimensions by using cone-beam computed tomography (CBCT) images. Methods: Forty patients (21 boys and 19 girls), averaged 11.7 years old, with an Angle Class II division 1 malocclusion were included in our study. They had either late mixed dentition or early permanent dentition, and the maxillary second molars had not yet erupted. All patients underwent CBCT before and after the treatment for measuring changes in the maxillary first molars, second premolars, central incisors, and profile. Paired-samples t-test was used to compare the mean difference in each variable before treatment and after the first phase of treatment. Results: The maxillary first molars were effectively distalized by 4.25 mm (p < 0.001) and 3.53 mm (p < 0.05) in the dental crown and root apex, respectively. The tipping increased by $2.25^{\circ}$, but the difference was not significant. Moreover the teeth moved buccally by 0.84 mm (p < 0.05) and 2.87 mm (p < 0.01) in the mesiobuccal and distobuccal cusps, respectively, whereas no significant changes occurred in the root apex. Regarding the anchorage parts, the angle of the maxillary central incisor's long axis to the sella-nasion plane increased by $2.76^{\circ}$ (p < 0.05) and the distance from the upper lip to the esthetic plane decreased by 0.52 mm (p = 0.01). Conclusions: The Frog appliance effectively distalized the maxillary molars with an acceptable degree of tipping, distobuccal rotation, and buccal crown torque, with only slight anchorage loss. Furthermore, CBCT image demonstrated that it is a simple and reliable method for three-dimensional analysis.