• Restorative Dentistry and Endodontics
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• v.31 no.2
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• pp.133-139
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• 2006

The purposes of this study were firstly to identify the microbial species on gutta-percha (GP) cones exposed at outpatient clinics using polymerase chain reaction, and secondly to evaluate the rapid sterilization effect of two chemical disinfectants at chair side. It also evaluated the alteration of surface texture of GP cones after 5-min soaking into two chemical disinfectants. A total of 100 GP cones from two endodontic departments were randomly selected for microbial detection using PCR assay with universal primer. After inoculation on the sterilized GP cones with the same microorganism identified by PCR assay, they were soaked in two chemical disinfectants: 5% NaOCl and 2% chlorhexidine for 1, 3, 5, and 10 minutes. The sterilization effect was evaluated by turbidity and subculture. The change of surface textures using a scanning electron microscope was also examined after 5 min-soaking in two chemical disinfectants. Results showed that four bacterial species were detected in 17 GP cones, and all the species belonged to the genus Staphylococcus. Two chemical disinfectants were effective in sterilization with just 1 minute soaking. On the SEM picture of NaOCl-soaked GP cone, a cluster of cuboidal crystals was seen on the cone surface. Present data demonstrate that two chemical disinfectants are useful for rapid sterilization of GP cone just before obturation at chair side, while CHX-soaked GP cone has cleaner surface without crystal precipitation than that of NaOCl-treated cone.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.2
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• pp.134-144
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• 2014

The aim of this study was to investigate changes in treatment patterns within pediatric dentistry departments by analyzing the distribution of patients and treatment trends. To that end, treatment charts based on electronic medical records (EMR) from the Yonsei University Dental Hospital from 2008 to 2012 were collected and analyzed. The results showed a decrease in the number of new patients and patients cared for by non-specialists, while the number of foreign patients has increased. The under 2 years-old group accounted for a large portion of new patients. Dental caries, dental trauma, and malocclusion ranked as the top complaints. In terms of restoration treatment, the proportion of patients receiving composite resin, amalgam, and sealant has decreased, whereas self-curing glass ionomer and preventive resin restoration have increased. Single-visit endodontic treatment has been increasing, with a decreasing trend in multi-visit endodontic treatment. The rate of conservative pulp treatment, such as pulp capping and pulpotomy, has increased. For reducing patient anxiety, treatments under sedation have increased, especially with the use of nitric oxide. This investigation into the latest treatment trends and patient characteristics is expected to help pediatric dentists to make appropriate treatment plans.

• Restorative Dentistry and Endodontics
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• v.21 no.1
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• pp.202-217
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• 1996

The purpose of this study was to compare the degree of microleakage of Glass-Ionomer root canal sealer possessed several enviable properties with that of the other sealers and to evaluate clinical performance. One hundred twenty single-rooted teeth were used in this experiment. The teeth were cleaned mechanically and immersed for 24 hours in 5.25% sodium hypochlorite and clinical crowns then were removed. After the root canals were instrumented using a step-back technique. one hundred twenty single-rooted teeth were divided into five groups of 24 in each. Group 1 : Tubli-Seal(Kerr Co., MI, U.S.A/ZOE-based), lateral condensation Group 2 : Sealapex(Kerr/Sybron, Romulus, MI/ $Ca(OH)_2$-based), lateral condensation Group 3 : AH 26(De Trey Co., Zurich Switzerland/Resin-based), lateral condensation Group 4 : Ketac-Endo(ESPE GMBH & CO. KG Seefeld:oberbay. Germany/ Glass Ionomer Cement-based), lateral condensation Control group : no sealer. lateral condensation And then. the root canals were obturated by lateral condensation technique with gutta-percha and experimental sealers. The control group were obturated without sealer. The teeth were placed in a vacuum chamber for 15 minutes and immersed 2% methylene blue under vacuum for 15 minutes. The teeth were passively stained for 1 week and 2 weeks and were cleared and evaluated for linear dye leakage using Tool maker's microscope(${\times}200$). The results were as follows: 1. There were statistically significant differences in the degree of dye penetration between the control group and experimental groups(p<0.05). 2. In the experimental groups, Sealapex($1.2871{\pm}0.9180mm$) exhibited the lowest mean value of dye penetration, followed by Ketac-Endo($1.4432{\pm}0.8082mm$), AH 26($1.5030{\pm}0.7752mm$) and Tubli-Seal($1.6458{\pm}1.0292mm$)(p>0.05). 3. There were statistically significant differences in the variation of microleakage between 1 week and 2weeks in Tubli-Seal and Seal apex groups (p<0.05). 4. The degree of dye penetration of all groups were increased as the time elapsed and AH 26 showed the lowest variation(+0.11) and Tubli-Seal(+ 1.03) showed the highest variation (p<0.001).

• Restorative Dentistry and Endodontics
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• v.27 no.5
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• pp.521-529
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• 2002

The purpose of this study was to compare the shaping time of two shaping methods and the leakage of three different obturation techniques. Ninty three canaled human molar teeth were used, which were randomly divided into two groups of forty teeth each and ten control teeth. After working length determination, the one group was prepared crown-down technique using rotary root canal instruments of GT rotary files .12/20, .10/20, .08/20 and .06/20 taper(Maillefer Instrument SA. Switzerland). The other group was instrumented with Gates Glidden burs(#1, #2, and #3) to coronal preparation and GT rotary files .08/20 and .06/30 taper to apical preparation. Shaping time was measured. After root canals were instrumented, they were divided to three subgroups and obturated as follows : Subgroup 1, obturated with single cone method Subgroup 2, obturated with lateral condensation : Subgroup 3, obturated with continuous wave technique. Three subgroups were obturated using non-standardized gutta-percha cone(Diadent, Korea, .06 or .08 taper) and AH-26(Dentsply DeTrey, Germany) as a root canal cement. Ten unobturated teeth served as positive and negative controls. After immersion in 2% methylene blue solution for 1 month, the teeth were washed during 24h. The teeth were demineralized in 10% nitric acid and dehydrated by immersion in 80, 90 and 100% ethyl alcohol. The teeth were finally cleared and stored in 100% methylsalicylate, and apical dye penetration was evaluated under stereomicroscope(Leica M420, LC, U.S.A)at $\times$8.75 magnification. Liner measurement of dye penetration was assessed with the use of digitalized image analysing system (analySIS, GmbH, Germany) The data were analysed statistically using independent T-test and Two-way ANOVA and Tukey test. The result were as follows 1. In canal prepared with GT$^{TM}$ rotary file, shaphing time taked more than the group of using Gates Glidden drill to coronal preparation without statistical significance (p>0.05) 2. The group of single cone obturation using canal preparation of GT$^{TM}$ rotary files showed significantly more apical leakage than those of lateral condensation and continuous wave technique regardless of shaping method (p<0.05). 3 The group of single cone obturation using canal preparation of GT$^{TM}$ rotary files and Gates Glidden drill showed significantly more apical leakage than those of continuous wave technique regardless of shaping method (p<0.05). 4. Regardless of shaping method, The group of continuous wave obturation showed less apical leakage than those of lateral condensation without statistical significance (p>0.05). 5. The group of single cone obturation using canal preparation of GT$^{TM}$ rotary files and Gates Glidden drill showed more apical leakage than the group of lateral condensation using same shaping method with-out statistical significance (p＞0.05).

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.4
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• pp.657-661
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• 2005

Various chemotherapeutic agents have been recommended for pulpotomy of primary teeth, and there are formocresol, ferric sulfate, and calcium hydroxide. Of those, formocresol has fixation effect of pulp tissue and high clinical success rate, so it is most commonly used agent. But formocresol has strong cytotoxic effects, thus many articles reported displacement and loss of permanent successor, amelogenesis imperfecta, mutation by general absorption, possibility of cancer induction. Recently, it has been reported that leakage by imperfect temporary sealing when FC-soaked cotton was inserted into the root canal caused necrosis of surrounding tissues. and that necrosis of alveolar bone related to the use of excessive formocresol. In this case, 2nd primary molar of upper left jaw was treated using formocresol in local clinic, but extracted because of lasting pain. Furthermore, symptoms didn't disappear so patient was refered to us. The patient was 8-year-old male, had foul odor from oral cavity and circular alveolar bone necrosis around the permanent successor' crown. Thus sequestrectomy was operated and observed through 19 months after operation, we found normal root development of permanent successor but no complete regeneration of alveolar bone defect and attached gingiva. Lesion of periodontal tissues by formocresol is irreversible, so we have to confirm the indication in using formocresol and pay attention to complete temporary sealing.

• Restorative Dentistry and Endodontics
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• v.26 no.2
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• pp.141-152
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• 2001

Eliminating the infecting bacteria of the root canal system and preventing reinfection must be the main objectives of all endodontic works. None of commercially available root canal sealers have the properties of desirable tissue compatibility and strong antibacterial activity. The purpose of this study is to develope an ideal root canal sealer using commercially available polyphosphate (polyP), Calgon, which is known to be antibacterial and safe. For the study. resin type AH26, zinc oxide eugenol type Tubli Seal. Ca(OH)$_2$ type Apexit as base sealers for polyP (0~3%) and para formaldehyde containing N2 as a control base were selected. Specimens (3$\times$4mm) of the sealers were prepared in a 37$^{\circ}C$ incubator for 3 and 10 days and their antibacterial activity against streptococci and black pigmented anaerobic rods was observed using an agar diffusion method. The result were as follows: 1. Among 3 day old root canal sealers. N2 as a positive control showed the strongest antibacterial effect. followed by AH26. Tubli Seal and. Apexit which barely showed antibacterial activity against the test bacteria. In contrast. 10 day old AH26 showed a greater antibacterial activity than 10 day old N2. 2. All sealer specimens showed a greater antibacterial activity against black pigmented anaerobic rods than streptococci. Three day old ones appeared to be more antibacterial than 10 day old ones except for Apexit. 3. As compared to N2, 3 day old AH26 demonstrated a similar antibacterial activity against black pig mented anaerobic rods but to a lesser extent to streptococci. Ten day old AH26 showed a greater antibacterial activity against black pigmented anaerobic rods than 10 day old N2. 4. As compared to AH26. Tubli Seal generally revealed a lower antibacterial activity but it showed a greater antibacterial activity aginst S. gordonii Challis. 5. Enhancement of antibacterial activity by polyP was more clearly observed when it was added to Ca(OH)$^{\circ}C$ based root canal sealers. Tubli Seal and N2. 6. The addition of polyP enhanced the antibacterial activity of 3 day old AH26 against S. gordonii G9B (16%) and Challis (29%), and P. gingivalis 2561 (24%) only. Moreover, polyP failed to increase antibacterial activity of 10 day old AH26 against the test strains but P. gingivalis A7A1 28(13%). 7. The addition of polyP increased the antibacterial effect of 3 day old Tubli Seal on several test bacteria including s. mutans GS 5 (50%). s. gordonii G9B (47%) and Challis (122%). and all the test strains of P. gingivalis (13~35%) except for 9 14K 1. The addition of polyP to 10 day old Tubli Seal increased antibacterial activity of the root canal sealer against most test strains. 8. 3 day old Apexit failed to show antibacterial activity. if any very little against S. mutans GS 5 and Pr. intermedia ATCC 49046. However. polyP increased its antibacterial activity by 50 and 69%, respectively. Increase of antibacterial activity of 10 day old Apexit by polyP was more clearly observed than that of 3 day old one.

• Restorative Dentistry and Endodontics
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• v.28 no.4
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• pp.341-347
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• 2003

This study was conducted to evaluate the temperature rise on the root surface while the root canal is being obturated using continuous wave of condensation technique. Maxillary central incisor was prepared for repeated canal obturation. Ten thermocouples (Omega Engineering Inc., Stanford, USA) were placed at 1 mm increment from the anatomical root apex. The real temperature of Buchanan plugger was recorded before insertion into the root canal. The root canal was obturated with continuous wave of condensation technique as described by Buchanan and the root surface temperature was recorded during obturation at $150^{\circ}C,{\;}200^{\circ}C,{\;}250^{\circ}C{\;}and{\;}300^{\circ}C$ temperature settings of System B HeatSource (Model 1005, Analytic technologies, Redmond, WA, USA). After completion of the temperature recording, the dentinal-cementum thickness at each sites was measured. The data were analyzed using one-way ANOVA followed by Scheffe's test and linear regression test. The results were as follows. 1. When the temperature was set at $150^{\circ}C,{\;}200^{\circ}C,{\;}250^{\circ}C{\;}and{\;}300^{\circ}C$ on the digital display of System B HeatSource, the real temperature of the plugger at the 1mm point from the tip revealed $130.82{\pm}2.96^{\circ}C,{\;}158.00{\pm}5.26^{\circ}C,{\;}215.92{\pm}6.91^{\circ}C{\;}and{\;}249.88{\pm}3.65^{\circ}C$ respectively. 2. The position of 8 mm from the anatomical apex showed the highest temperature increase at each temperature settings and it was significantly higher than those of other positions (p<0.0l). The temperature rise was constantly increased toward coronal portion from apex of the root. 3. The maximum temperature increase on the root surface was $2.37{\pm}0.09^{\circ}C{\;}at{\;}150^{\circ}C{\;}setting,{\;}3.11{\pm}0.12^{\circ}C{\;}at{\;}200^{\circ}{\;}setting,{\;}3.93{\pm}0.09^{\circ}C{\;}at{\;}250^{\circ}C{\;}setting{\;}and{\;}5.69{\pm}0.15^{\circ}C{\;}at{\;}300^{\circ}C$ setting respectively. These results suggest that it be relatively kind to the supporting tissues of the root that the root canal is obturated using continuous wave of condensation technique at $150^{\circ}C,{\;}200^{\circ}C,{\;}250^{\circ}C{\;}and{\;}300^{\circ}C$ temperature settings on digital temperature display of System B HeatSource.

• Restorative Dentistry and Endodontics
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• v.22 no.2
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• pp.670-679
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• 1997

The pH changes in 4 small cavities prepared at the facial inner dentin and lingual outer dentin of the cervical and apical portion of root filled with calcium hydroxide pastes were investigated. Forty extracted permanent teeth with single canal were instrumented with step-back method, and then 4 small cavities were prepared. Two inner dentin cavities were cut a distance of about 1.0mm from the canal wall and two outer dentin cavities were cut to a depth of about 0.5mm from the root surface. Root canals and prepared cavities were flushed with 17% EDTA, and then irrigated with 5% NaOCl to remove smear layer. Teeth were randomly divided into four groups. Control group was not filled and the remaining other groups were filled with mixture of calcium hydroxide and distilled water, Vitapex$^{(R)}$ paste and Pulpdent$^{(R)}$ paste respectively. The pH change of the dentin in each cavity was measured at 0, 1, 3, 7, 14, 21, 28, 60, 90 days with pH microelectrode(WPI Co., USA). The results were as follows : 1. The groups obturated with Pulpdent$^{(R)}$ paste and Aqueous calcium hydroxide produced the increased pH level at 1 day and maintained plateau over next 3weeks and decreased after 3weeks. 2. The group obturated with Vitapex$^{(R)}$ paste observed no significant pH change until 2weeks and slight increased pH at 3weeks and sequential increasing after 3weeks. But, the pH in the group obturated with Vitapex$^{(R)}$ paste remained significantly below the pH measured in the other two experimental groups(P<0.05). 3. All experimental groups showed pH level similar to control group after 28 days. 4. The pH of outer dentin is slightly higher than that of inner dentin. There is no significant difference in pH level between apical and cervical dentin throughout the duration of the experiment, though apical dentin showed slightly higher pH than cervical dentin at 1 day(P<0.05).

• Restorative Dentistry and Endodontics
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• v.25 no.3
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• pp.435-445
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• 2000

The purpose of this study was to compare the leakage of four different obturation techniques in conjunction with immediate apical barrier of ${\beta}$-tricalcium phosphate(TCP) in teeth with open apex. Eighty single-rooted human premolar teeth were prepared and sectioned horizontally, so maximum diameter in apex was 4mm. Apical defects that were similar to open apex, were created with #1/2 round bur and SF104R bur. The apical foramen were opened to a size 80 file extended 3mm beyond the apex. The teeth were placed into the oasis block soaked saline to simulate periapical tissue often associated with pulpless teeth and received apical barriers consisting of TCP followed by obturation using lateral condensation technique, vertical condensation technique, continuous wave technique and thermoplasticized gutta-percha injection technique. Two unobturated teeth served as positive and negative controls. Teeth were immersed in resorcinol-formaldehyde resin for S days at $4^{\circ}C$, and the resin was allowed to polymerize completely for 4 days at room temperature. Teeth were then sectioned horizontally at 1.5mm(level 1), 2.5mm(level 2) and 3.5mm(level 3) from the apex, and examined under a stereomicroscope at ${\times}40$ magnification. The photographs were taken at ${\times}40$ magnification of the filling in each level and scanned. The leakage length in tooth/resin interface was measured at each of the three levels. Each ratio of leakage was obtained by calculating the ratio of the leakage length of canal wall infiltrated with resin to the total length of the canal and was analyzed statistically(One-way ANOVA and Scheffe test). The result were as follows : 1. At the level 1, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), but there was statistically significant(p<0.05). 2. At the level 2, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), and the most leakage in the continuous wave technique group(group 3). There was statistically significant difference between the thermoplasticized gutta-percha injection technique group and the continuous wave technique group(p<0.05). 3. At the level 3, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), but there were no statistically significant differences between other groups(p>0.05). These results suggest that thermoplasticized gutta-percha injection technique which had 1mm apical gutta-percha matrix after the formation of TCP apical barrier, can demonstrate favorable apical sealing.

• Restorative Dentistry and Endodontics
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• v.25 no.3
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• pp.381-389
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• 2000

Lateral condensation with gutta-percha and sealer has been shown to provide an excellent apical seal; however, the lateral condensation technique has demonstrated less favorable apical leakage results in curved canals when compared with straight canals. Placement of endodontic spreaders to within 1 to 2mm of the root canal working length has been advocated for optimum gutta-percha obturation. Due to their stiffness, stainless-steel(SS) spreaders will often fail to achieve this position in curved canals. Newly marketed nickel-titanium(NT) spreaders may offer an advantage in this regard due to the increased flexibility of these instruments. The purpose of this study was to evaluate the effect of NT finger spreader on the sealing ability in lateral condensation technique, compared with conventional SS finger spreader. Twenty four standardized resin models simulating curved canals(30 degree) were randomly placed into 2 groups and instrumented to a #30 master apical file size with Ni-Ti Profile .04 taper series using step down technique. Each groups was obturated with standardized gutta-percha cone by standard lateral condensation technique using SS finger spreader, NT finger spreader. And then, each model was sectioned horizontally with microtome at 1, 2, 3, 4, 5mm levels from the apex. At each of 5 levels, ratio of the area of gutta-percha was obtained by calculating the area of gutta-percha to the total area of the canal. The data collected were then analyzed statistically using a t test for independent samples. The results as follows ; 1. The total mean ratio of area of gutta-percha was 89.20${\pm}$7.00(%) for SS spreader group. 92.20${\pm}$5.17(%) for NT spreader group. There was statistically significant difference between each group(p<0.05). 2. At 3mm level, the mean ratio of area of gutta-percha was 88.32${\pm}$5.41(%) for SS spreader group, 95.25${\pm}$2.60(%) for NT spreader group. There was statistically significant difference between each group(p<0.05). At 1,2,4mm levels, NT spreader group showed greater mean ratio of area of gutta-percha than SS spreader group, too. But there was no statistically significant difference. 3. At 5mm level, the mean ratio of area of gutta-percha was 91.83${\pm}$3.42(%) for SS spreader group, 87.91${\pm}$3.68(%) for NT spreader group. There was statistically significant difference between each group(p<0.05). This study concluded that the NT spreader demonstrated somewhat favorable apical sealing effect than SS spreader in prepared curved canals. The clinical use of NT spreaders may enhance our ability to create better apical seals in curved canals, but further studies in this area will help clarify some of the remaining areas with which practitioners are concerned, such as compaction forces exerted by NT spreaders.