• Restorative Dentistry and Endodontics
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• v.31 no.3
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• pp.186-191
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• 2006

This study evaluated the effect of two different calcium hydroxide ($Ca(OH)_2$) paste removal techniques on the apical leakage of canals obturated with gutta percha cones and sealer after removing a $Ca(OH)_2$ dressing using an electrochemical method. Seventy extracted single-rooted teeth were instrumented on with Profile rotary files under NaOCl irrigation. Fifty-eight canals were filled with calcium hydroxide paste, which was then removed using one of the following two techniques. In group A, calcium hydroxide was removed using only NaOCl irrigation, and in group B, the canals were re-prepared with a Profile rotary files-one size larger than the previous instrument and were irrigated with NaOCl. In both groups, the root surfaces were coated twice with nail varnish from CEJ to an area 4 mm away from the apex after canal obturation. Apical leakage was measured using an electrochemical method for 24 days. All the specimens showed leakage that increased markedly in the first three days. There was no significant difference between the two groups (p>0.05). The effect of two calcium hydroxide paste removal techniques on the apical leakage was not different during a short period.

• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.561-574
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• 1998

The purposes of this study were to observe the difference in the root canal wall after hand instrumentation or engine-driven Ni-Ti instrumentation under the scanning electron microscope, and to evaluate the apical leakage provided by continuous wave of canal filling technique with or without root canal sealer and smear layer. Twenty recently extracted human maxillary anterior teeth were instrumented with K-type files or engine-driven Ni-Ti files, Quantec series 2000$^{TM}$ and irrigated with 5.25% NaOCl alone or 15% EDT A and final flush of 5.25% NaOCl. After the instrumentation and flushing, teeth were split in half with a knife and a mallet. They were then examined with a scanning electron microscope Forty-four recently extracted human maxillary anterior teeth were divided into four groups with and without smear layer and then warm vertical canal filling using System-B with or without sealer. The extent of leakage was scored after immersion in India ink for 1 week. The results were as follows: 1. No significant difference of smear layer was observed between K-type file-instrumented group and engine-driven Ni-Ti file-instrumented group. 2. A group without smear layer showed significantly less apical leakage than a group with smear layer when sealer was used for the canal filling (p<0.01). 3. There was no significant difference between a group without sealer and smear layer and a group without sealer and with smear layer (p<0.01). 4. In groups without smear layer, a group with sealer showed significantly less apical leakage than a group without sealer (p<0.01). 5. When root canals were irrigated with NaOCl alone, a group with sealer showed significantly less apical leakage than a group without sealer (p<0.01).

• Restorative Dentistry and Endodontics
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• v.15 no.2
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• pp.127-133
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• 1990

Electronic working length determination is based on the electrical impedence between the root canal and the periodontal ligament Different canal irrigants with different electric conductivity may effect on the accuracy of the electronic mechanism. 0.9% Saline, 2.5% NaOCl and 3% $H_2O_2$ were evaluated either in wet or in dry condition. The results were as follows. 1. The electrical resistance mearured by Impedence Meter (Model #253, portland, USA) were 1 $K{\Omega}$ in 0.9% Saline, 0.1$K{\Omega}$ in 2.5% NaOCl and 48 $K{\Omega}$ in 3% $H_2O_2$. 2. Saline measured -0.57mm from the actual canal length and had significant difference. When dried with paper points, however, it measured -0.25mm demonstrating no statistical difference. 3. 2.5% NaOCl measured -4.07mm in wet and -2.26mm in dry condition and both showed significant difference from the actual canal length. 4. 3% $H_2O_2$ measured +0.02mm in wet and -0.09mm in dry canals and both appeared to be within acceptable range for the electronic working length mechanism.

• Restorative Dentistry and Endodontics
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• v.11 no.1
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• pp.27-32
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• 1985

The purpose of this study was to examine the influence of canal irrigants and smear layer on the property of apical seal. Fourty-five canals from human teeth were randomly selected and divided into 5 groups according to the irrigants used in conjunction with instrumentation. The irrigants were RC-prep in combination with Naocl, Citric acid, Naocl, Naocl in combination with $H_2O_2$, and normal saline solution. After instrumention and dry the canal with paper point, the canals were obturated by lateral condensation of Zinc-oxide eugenol sealer and gutta percha cone. All the specimens were immersed in 2% methylene blue dye solution for 7 days and the depth of dye penetration into the canals was evaluated by macros cope. The following results were obtained. 1. All the canals experimented showed varying degree of dye penetration. 2. There was no significant difference in depth of dye penetration between the groups known to be effective and ineffective in the removal of the smear layer. 3. The canals irrigated with NaOCl alone showed the highest dye penetration and mean leakage was 7.7 mm. 4. In the canals irrigated with RC-prep in combination with Naocl and citric acid, the mean dye penetration was 5.5 mm and 4.8 mm respectively, and the canals irrigated with NaOCl in combination with $H_2O_2$ and normal saline solution revealed mean dye penetration of 3.9 mm.

• Restorative Dentistry and Endodontics
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• v.7 no.1
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• pp.7-15
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• 1981

This study was conducted to compare the cleansing effect of various irrigants and the function of the quantity of irrigants in apical region. One hundred sixty single rooted teeth were divided into four groups and fourty teeth in each group were individually enlarged and irrigated with each of four irrigants as they would be during clinical condition. The four tested irrigants were Normal saline solution, 3.5% NaOCl, 15% EDTA, and 50% Citric acid. In each group, twenty teeth were flushed with 2cc of each irrigant and another twenty teeth with 5cc of same irrigant after use of each instrument. After final flush and dry, the roots were split longitudinally and the degree of cleansing at apical portion were evaluated under Stereoscope by three observers. The typical specimens of each group were also examined under Scanning electron microscope. The results were as follows. 1. There were no significant difference of cleansing effect among the tested irrigants. 2. 5cc flushed groups have more samples that have high degree of cleansing than 2cc flushed groups. 3. The canals irrigated with 2cc showed the presence of many dentin chips, tissue debris and smeared layer, whereas the 5cc groups revealed relatively clean canal surface and less smeared layer under Scanning electron microscope. 4. The teeth flushed with 5cc of EDTA and with 5cc of Citric acid showed the most clean canal surface at Scanning fictures.

• Restorative Dentistry and Endodontics
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• v.37 no.1
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• pp.24-28
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• 2012

Objectives: The aim of this study was to test the hypothesis, that the effectiveness of irrigation in removing smear layer in the apical third of root canal system is dependent on the depth of placement of the irrigation needle into the root canal and the enlargement size of the canal. Materials and Methods: Eighty sound human lower incisors were divided into eight groups according to the enlargement size (#25, #30, #35 and #40) and the needle penetration depth (3 mm from working length, WL-3 mm and 9 mm from working length, WL-9 mm). Each canal was enlarged to working length with Profile.06 Rotary Ni-Ti files and irrigated with 5.25% NaOCl. Then, each canal received a final irrigation with 3 mL of 3% EDTA for 4 min, followed by 5 mL of 5.25% NaOCl at different level (WL-3 mm and WL-9 mm) from working length. Each specimen was prepared for the scanning electron microscope (SEM). Photographs of the 3mm area from the apical constriction of each canal with a magnification of ${\times}250$, ${\times}500$, ${\times}1,000$, ${\times}2,500$ were taken for the final evaluation. Results: Removal of smear layer in WL-3 mm group showed a significantly different effect when the canal was enlarged to larger than #30. There was a significant difference in removing apical smear layer between the needle penetration depth of WL-3 mm and WL-9 mm. Conclusions: Removal of smear layer from the apical portion of root canals was effectively accomplished with apical instrumentation to #35/40 06 taper file and 3 mm needle penetration from the working length.

• Restorative Dentistry and Endodontics
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• v.27 no.2
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• pp.122-134
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• 2002

목적 : 근관 치료의 최종 목적인 근관계의 영구적인 충전을 위해 사용되는 근관 봉함제는 많은 연구와 개선을 거쳐서 현재는 다양한 성분의 봉함제가 시판되고 있다. 이중에서 레진이 주성분인 봉함제는 조작이 편리하고 흐름성이 좋으며 근관의 벽에 높은 밀폐성을 보이고 충분한 작업시간과 높은 방사선 불투과성을 가지는 장점을 가짐에도 불구하고 높은 초기 생체 독성을 나타내는 단점을 가지고 있다. 본 실험에서는 기존의 상용화된 제품 중 레진이 주성분인 두 종류의 봉함제(AH 26, AH plus)와 산화아연이 주성분인 봉함제(Pulp Canal Sealer EWT)와 국내에서 새로이 개발한 제품으로서 레진이 주성분인 두 종류의 봉함제(Adseal-1,2)를 생체조직에 매식하여 국소적인 반응을 비교하여 생체친화성을 알아보고자 하였다. 방법 : 수종 봉함제의 생체 친화성을 알아보기 위하여 64마리의 Sprague-Dawley rat을 사용하였다. 봉함제의 피하조직 매식을 위해 길이와 직경이 각각 5와 1.5mm인 폴리에틸렌 테프론 관을 사용하였으며 이를 에탄올과 증류수로 세척 한 후 고압증기멸균을 시행하였다. Rat에 대하여 케타민으로 복강내 마취를 시행한 후 배부를 면도하고 iodine으로 소독한 다음 네 곳에 절개를 시행하였으며 blunt dissection을 통해 깊이 10mm이상의 피하조직 pocket을 형성하였다. 각각의 봉함제를 제조사의 지시 에 따라 혼합 후 즉시 멸균된 테프론 관에 주사기를 이용하여 담은 다음에 봉함제가 흐르지 않게 유의하며 pocket내로 삽입하였으며 이때 16개의 관을 대조군으로 사용하기 위해 봉함제를 넣지 않은 상태로 삽입하였다. 이 후 절개 부위를 surgical gut suture로 봉합하였으며 1주일 후에 발사하였다. Rat을 1, 2, 4, 12주 후에 각 군 당 세 마리 씩 에테르 흡입을 통해 희생하였으며 이 때 한 마리씩의 대조군도 포함시켰다. 이 후 매식된 관을 주위 조직과 함께 제거하고 포르말린에서 48시간 고정시킨 후 파라핀에 포매한 다음에 micro-tome을 사용하여 6$\mu\textrm{m}$로 serial section을 시행하였다. 정중선 부위의 시편에 Hematoxylin-Eosin staining을 시행한 후 Olsson, Orstavik 그리고 Mjor 등의 방법에 따라 조직학적 변화를 관찰한 후 slight(1), moderate(2), severe inflammation(3)의 단계로 분류하였다. 얻어진 결과를 통계처리 프로그램인 Jandel사의 Sigmastat을 이용하여 Kruskal Wallis Test로 통계처리를 하였다. 결과 : (Table omitted) 결론 : 1) Pulp Canal Sealer를 제외한 모든 군에서 시간이 지남에 따라 유의성 있게 염증이 감소되는 양상을 보였다(p<0.05). 2) Pulp Canal Sealer는 1주, 2주, 12주에서 강한 염증반응을 보였다. 3) AH 26과 AH Plus에서는 1주, 2주에서 강한 염증반응을 보였으나 12주에서는 염증반응이 감소하였다. 4) 새로 개발된 봉함제 Adseal-1,2는 1주, 2주에서는 가장 약한 염증반응을 보이나 4주, 12주 후에는 AH Plus와 비슷한 수준의 염증 반응을 보였다. 5) Pulp Canal Sealer를 제외한 모든 군에서 인정할 만한 생체친화성을 보였다. 6) Adseal-2가 Adseal-1에 비하여 전반적으로 낮은 염증반응을 보였다. 7) 각 군간 결과의 차이에 통계적 유의성은 없었다(p>0.05).

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.4
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• pp.455-463
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• 2018

The purpose of this study was to evaluate the effect of the intracanal medicaments on the push-out bond strength of the calcium silicate-based materials. Forty extracted single-root human mandibular premolars were sectioned below cementoenamel junction. Standardized root canal dimension was obtained with a parallel post drill. The specimens were randomly divided into a control group (no medicament), and experimental groups received medicaments with either CH (calcium hydroxide), DAP (double antibiotic paste; a mixture of ciprofloxacin and metronidazole), or TAP (triple antibiotic paste; a mixture of minocycline, ciprofloxacin and metronidazole). Following removal of medicaments with irrigation, roots were cut into sections with 1-mm-thickness. Thereafter, calcium silicate-based materials are applied to the specimens : (i) ProRoot MTA$^{(R)}$ and (ii) Biodentine$^{(R)}$. A push-out bond strength was measured and each specimen was examined to evaluate failure mode. Intracanal medication using CH significantly increased the bond strength to the root dentin. But there are no significant differences on the bond strength of ProRoot MTA$^{(R)}$ or Biodentine$^{(R)}$ among TAP, DAP and control groups. The dislodgement resistance of Biodentine$^{(R)}$ from root dentin was significantly higher than that of ProRoot MTA$^{(R)}$ regardless of the type of intracanal medicaments.

• Restorative Dentistry and Endodontics
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• v.32 no.6
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• pp.522-529
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• 2007

The purpose of this study was to compare the apical leakage of the root canal filled with the System B and the EndoTwinn(the combined application of heat and ultrasonic vibration). Sixty extracted premolars with straight root were cleaned and shaped to size 35. Group SB was obturated using System B and Group ET was filled with EndoTwinn. A size 35 of 0.06 tapered gutta-percha and Adseal were used and the plugger which could be introduced to 4 mm short of working length was selected in the obturation procedure. As the positive control, Group PC was not filled. In Group SB, ET and PC, all external surfaces of each tooth were coated with nail varnish leaving only 1 mm area around the apical foramen. In the negative control of Group NSB and Group NET, all of external tooth surface including apical foramen was coated with the nail varnish. The specimens were immersed in methylene blue dye solution for 2 days. Then the specimens were sectioned at each 1 mm from apex to 5 mm level. The final score of one specimen was given by summing up of the points at all levels. The dye leakage of Group ET was significantly less than that observed in Group SB (p < 0.05). And the frequency of gutta-percha pulling out from root canal when the plugger was removed was more often with the System B than with EndoTwinn but there was no significant difference.

• Restorative Dentistry and Endodontics
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• v.15 no.1
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• pp.187-200
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• 1990

The purpose of this study was to investigate antimicrobial effect of several irrigation solutions on 7 anaerobes and 2 aerobes, which are found frequently in infected root canals. The antimicrobial effects of normal saline, 3% $H_2O_2$, 0.5% & 3.5% NaOCl, 10% & 50% citric acid and mixed solutions of 3% $H_2O_2$ plus 3.5% NaOCl were compared. No. 80 paper points dipped in bacterial broth were soaked in each irrigation solutions and moved into thioglycolate broth, subcultured in agar plate for bacterial growth. The results were as follows: 1. Normal saline had no antimicrobial effect. 2. Mixed solutions of 3% $H_2O_2$ plus 3.5% NaOCl, 10% citric acid had relatively weak antimicrobial effect. 3.3% $H_2O_2$, 50% citric acid, 0.5% NaOCl showed relatively strong antimicrobial effect. 4. 3.5% NaOCl had the strongest antimicrobial effect among used 7 irrigation solutions.