• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.17-24
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• 2011

The aim of this study was to assess the outcome of MTA apexification in young permanent anterior teeth. Among the patients with the traumatized permanent incisors which were treated with MTA apexification, the dental records and radiographs were examined only for the patient who had follow-up examination at least 3 months after the treatment. Forty nine patients with 64 teeth were included in this study. Demographic information, location and type of teeth and periodontal injury, pre-treatment periapical lesion, clinical symptoms, status of MTA filling, healing of apical lesion and apical barrier formation after treatment were investigated. The outcome based on clinical and radiographic criteria were assessed. The results were as follows 1. Of 64 immature permanent incisors with MTA apexification, the clinical and radiographic success rates were 89.1% and 73.4%, respectively. 2. The maxillary incisors showed significantly higher success rates than the mandibular incisors. 3. There was no statistically significant difference in success rates among the teeth with different types of teeth and periodontal injury. 4. The status of MTA filling did not influence the clinical and radiographic success.

• Korean Journal of Dental Materials
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• v.45 no.4
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• pp.275-286
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• 2018

The purpose of this study was to evaluate the effect of needle tip design and position, and irrigant flow rate on apical pressure (AP) during root canal irrigation. Five human mandibular premolars were instrumented up to #35 (0.06 taper) using nickel-titanium rotary instruments. Three different needles according to change of needle tip design (notched, side-vented, and flat) were positioned at the point of 1, 3, and 5 mm from the apical constriction (needle tip position). For each needle tip design and position, APs were measured with varying flow rates of 0.05, 0.1, 0.2, and 0.3 ml/s. When the other conditions were controlled, AP increased with decreasing needle tip position or increasing irrigant flow rate (p<0.05). The AP of flat needle was the highest, followed by notched, side-vented needle for the same needle tip position and irrigant flow rate. The APs at needle tip position of 1 mm or with more than 0.1 ml/s flow rate were higher than central venous pressure (5.88 mmHg) for all conditions. Flat needle was not recommended for clinical use due to sharp increase of AP with changing needle tip position and irrigant flow rate. For safe and effective root canal irrigation, irrigant should be applied with the needle tip position of 3 mm and flow rate of less than 0.05 ml/s.

• Restorative Dentistry and Endodontics
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• v.36 no.4
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• pp.300-305
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• 2011

Objectives: The aim of this study was to evaluate the various NiTi rotary instruments regarding their ability to provide a circular apical preparation. Materials and Methods: 50 single canal roots were selected, cut at the cementodentinal junction and the coronal 1/3 of the canals was flared using Gates Glidden burs. Samples were randomly divided into 5 experimental groups of 10 each. In group I, GT files, Profile 04 and Quantec #9 and #10 files were used. In Group II Lightspeed was used instead of Quantec. In Group III, Orifice shaper, Profile .06 series and Lightspeed were used. In Group IV, Quantec #9 and #10 files were used instead of Lightspeed. In Group V, the GT file and the Profile .04 series were used to prepare the entire canal length. All tooth samples were cut at 1 mm, 3 mm and 5 mm from the apex and were examined under the microscope. Results: Groups II and III (Lightspeed) showed a more circular preparation in the apical 1mm samples than the groups that used Quantec (Group I & IV) or GT files and Profile .04 series.(Group V)(p < 0.05) There was no significant difference statistically among the apical 3, 5 mm samples. In 5 mm samples, most of the samples showed complete circularity and none of them showed irregular shape. Conclusions: Lightspeed showed circular preparation at apical 1 mm more frequently than other instruments used in this study. However only 35% of samples showed circularity even in the Lightspeed Group which were enlarged 3 ISO size from the initial apical binding file (IAF) size. So it must be considered that enlarging 3 ISO size isn't enough to make round preparation.

• Restorative Dentistry and Endodontics
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• v.33 no.1
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• pp.66-75
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• 2008

This study examined the influence of the apical sizes on the sealing ability of a root canal filling. Thirty-six single rooted teeth with a single canal were divided into 3 groups (n = 12) and instrumented with either the $Profile^{(R)}$ or $LightSpeed^{(R)}$ system to achieve three different apical sizes (master apical file [MAF] of #25, #40, or #60). The teeth were filled with gutta perch a using a modified continuous wave technique. The level of microleakage was determined by immersing ten teeth from each group into India ink for 1 week followed by clearing with nitric acid, ethyl-alcohol, and methylsalicylate. The microleakage was measured using vernier calipers. The data was analyzed statistically using Kruskal-Wallis one-way ANOVA and a Student-Newman-Keuls Method. Two teeth from each group were sectioned horizontally at 1, 2, 3 and 4 mm from the apex in order to observe a cross section. The apical size was significantly (p < .05) influenced the level of microleakage. In the Student-Newman-Deuls Method, MAF sizes of #25 and #40; and MAF sizes of #25 and #60, respectively showed a statistically significant difference. There was no significant difference between #40 and #60. In most cross sections, oval-shaped canals were observed, and the irregularity of the internal surface increased with decreasing apical size. There was also an increase in the area of recess, which is the area where the canal space is not filled with either gutta-percha or sealer. When the root canals are filled using a modified continuous wave technique, canal filling with more consistent and predictable outcome may be expected as the apical preparation size is increased.

• Restorative Dentistry and Endodontics
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• v.27 no.5
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• pp.530-534
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• 2002

최근 치근단 와동 형성 시 초음파 또는 음파 기구를 이용하는 것이 보편화되어 있고 여러 측면에서 평가되어져 왔다. 본 연구의 목적은 혐기성 세균을 이용한 미세 누출 모델을 이용하여 초음파와 음파 기구를 사용, 치근단 와동 형성을 하였을 때 두 기구의 사용이 충전된 치근단 와동의 미세 누출에 미치는 영향을 비교 평가하는 것이다. 48개의 단근치의 근관을 crown-down방법을 이용 Profile로 .06 black까지 근관 성형을 시행하고 수직 가압법을 사용하여 gutta-percha와 AH26 sealer를 이용하여 근관 충전을 시행하였다. 각 충전된 시편의 치근단 3mm를 절제하였다. 각 시편은 이미로 4군으로 나누었으며 1군에서는 치근단 와동을 초음파 기구로 형성하였고 2군에서는 음파 기구로 형성하였다. 3군은 음성대조군으로 4군은 양성대조군으로 분류하였다. 형성된 치근단 와동은 공기 분사침을 이용하여 건조 후 super EBA 시멘트로 충전하였으며 Anaerobic chamber에서 Fusobacterium nucleatum (VPI 10197)을 사용한 혐기성 세균 미세누출 모델을 이용하여 30일간 미세 누출을 관찰한 결과, 초음파 기구를 사용한 군에서는 80%에서 음파 기구를 사용한 군에서는 75%에서 미세누출이 나타났으나 통계적으로 유의성 있는 차이는 보이지 않았다.

• Restorative Dentistry and Endodontics
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• v.26 no.3
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• pp.191-199
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• 2001

목적 - 기질금속단백분해효소(matrix metalloproteinase)는 조직의 염증 및 치유과정에서 숙주세포에서 생성, 분비되어 세포외기질(extracellular matrix)의 분해에 작용한다. 다양한 염증반응에 기질금속단백분해효소가 중요한 역할을 하는것으로 보고되고 있으나 치수 및 치근단 질환에서의 그 역할은 거의 알려져 있지 않은 상태이다. 본 연구에서는 염증이 있는 사람의 치수 및 치근단 조직을 채취하여 Enzymeimmunoassay 및 면역조직화학적 검색을 통해 제1형, 2형, 3형 기질금속단백분해효소의 수준 및 그 분포를 측정하여 치수 및 치근단 병소에서 이 효소의 작용을 알아보는 것을 목적으로 한다. 방법 - 연구재료는 근관치료를 위해 서울대학교 병원 치과 진료부 보존과에 내원한 환자를 대상으로 34개의 치아에서 통상의 근관치료 중 발수한 치수조직과 치근단 수술중 얻은 치근단 병소(n=10)를 이용하였다. 치수는 발수 전에 임상진단을 통해 급성 치수염(n=12), 만성 치수염(n=12), 정상 치수(n=10)로 구분하고 정상치수로 진단된 것을 대조군으로 설정하였다. 채취된 표본은 둘로 나누어 절반은 30분 이내에 5$\mu\textrm{m}$ 두께로 동결절단을 시행하여 조직표본을 제작하였고 deep freezer에 보관하였다가 헤마톡실린-에오신 염색 및 면역조직화학적 검색을 시행하였다. 나머지 조직은 ELISA를 위해 액체 질소에 보관하였다. ELISA를 시행하기전 표본의 단백질 정량을 시행하여 모든 표본의 단백질 양을 50mg/$\mu\textrm{l}$로 일치시키고 Amersham사의 ELISA kit를 사용하여 제1형, 2형, 3형의 기질금속단백분해효소의 양을 측정하였으며 그 결과를 Mann-Whitney U test를 사용하여 각 군간의 통계학적 유의성을 검증하였다. 결과 1. ELISA의 결과 제1형 기질금속단백분해효소의 농도는 모든 실험군에서 대조군보다 유의성있게 높게 나타났다.(p<.05). 또한 급성치수염군의 제1형 기질금속단백분해효소의 농도가 다른 실험군보다 유의성있게 높았다(p<.05). 2. 제2형 기질금속단백분해효소의 경우 급성치수염군과 대조군에서만 유의성있는 차이를 보였다(p<.05). 3. 제3형 기질금속단백분해효소의 경우 급성치수염군에서 대조군이나 만성치수염군보다 유의성 있는 높은 수치를 보였다(p<.05). 4. 면역조직화학검색 결과 염증성 치수에 존재하는 급성 및 만성염증세포 주위로 기질금속단백분해효소에 대한 면역 반응이 존재하였으며 주로 제1형과 제3형 기질금속단백분해효소의 경우 대식세포 및 림파구 주위로 강한 발색제의 침윤양상이 관찰되었다. 5. 치근단병소의 면역조직화학적 검색 결과 만성염증 세포 주변으로 미약한 발색제의 침윤양상이 관찰되었다.

• Restorative Dentistry and Endodontics
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• v.34 no.4
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• pp.371-376
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• 2009

We evaluated in vitro microleakage of Mineral Trioxide Aggregate (MTA) powder with 4-methacryloxyethyl trimellitate anhydride (4-META) / methyl methacrylate (MMA) & tri-n-butylborane (TBB) resin as a retrograde filling material by using methylene blue dye method. Fifty-two single rooted, extracted teeth were instrumented and obturated with gutta percha and AH plus sealer. The apical 3mm of each root was resected and 3mm deep ultrasonic root end preparation was done. External surface of roots was coated with nail varnish. Prepared teeth were randomly divided into five groups; Negative control: completely covered with nail varnish; Positive control: coated with nail varnish except for apical foramen; Group 1 (retrofilled with Portland cement); Group 2 (retrofilled with MTA); Group 3 (retrofilled with MTA powder mixed with 4-META/MMA & TBB resin). Immediately after completion of root-end filling, all specimens were submerged in methylene blue dye for 72 hours in $37^{\circ}C$incubator. The roots were longitudinally sectioned and measured for extent of dye penetration by three different examiners under microscope (${\times}$10). The results were statistically analyzed using one way ANOVA and Turkey's HSD test. No leakage was evident in negative control and complete leakage in positive control group. Group 3 showed significantly less leakage than group 1 and 2 (p < 0.01). There was no significant difference between group 1 and 2 (p > 0.01). It was concluded that MTA powder with 4-META/MMA & TBB resin was excellent in reducing initial apical microleakage.

• Restorative Dentistry and Endodontics
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• v.34 no.2
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• pp.137-144
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• 2009

The aim of this study was to investigate the shapes and diameters of the physiological foramen and anatomy of the root canal at 3mm from apex in mandibular first molars. Sixty mandibular first molars were randomly selected. The apical anatomy of 60 mandibular first molars was investigated by means of a stereo microscope (60x magnification). The results were as follows; 1. There was a high percentage of two physiological foramina in mesial (61.67%) and one foramen in distal(71.66%) roots of mandibular first molars. 2. There was a high frequency of accessory foramina in mesial roots with one foramen (26.07%). 3. The diameters of physiological foramen was as follows: - 0.329mm in single mesial foramen - 0.266mm in mesiobuccal foramen and 0.246mm in mesiolingual foramen - 0.375mm in single distal foramen - 0.291mm in distobuccal foramen and 0.237mm in distolingual foramen 4. The most common physiological foramen shape was oval (69.93%). 5. The incidence of isthmus in mesial root at 3mm from apex was 55%. The 3mm-sections contained a complete isthmus 31.66% and a partial isthmus 23.34%. 6. 3mm from the apex, the most common canal shape was oval (50.64%). Knowledge of the apical anatomy of mandibular first molar would be necessary for success of surgical and nonsurgical endodontic treatment.

• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.537-549
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• 1998

The purpose of this study was to evaluate the influence of root resection and retrograde cavity preparation methods on the apical leakage in endodontic surgery. To investigate the effect of various root resection and retrograde cavity preparation methods on the apical leakage, 71 roots of extracted human maxillary anterior teeth and 44 mesiobuccal roots of extracted human maxillary first molars were used. Root canals of the all the specimens were prepared with step-back technique and filled with gutta-percha by lateral condensation method. Three millimeters of each root was resected at a 45 degree angle or perpendicular to the long axis of the tooth according to the groups. Retrograde cavities were prepared with ultrasonic instruments or a slow-speed round bur, and occlusal access cavities were filled with zinc oxide eugenol cement. Three coats of clear nail polish were placed on the lateral and coronal surfaces of the specimens except the apical cut one millimeter. All the specimens were immerged in 2% methylene blue solution for 7 days in an incubator at $37^{\circ}C$. The teeth were dissolved in 14 ml of 35% nitric acid solution and the dye present within the root canal system was returned to solution. The leakage of dye was quantitatively measured via spectrophotometric method. The obtained data were analysed statistically using two-way ANOVA and Duncans Multiple Range Test. The results were as follows: 1. No statistically significant difference was observed between ultrasonic retrograde cavity preparation method and slow-speed round bur technique, without apical bevel (p>0.05). 2. Ultrasonic retrograde preparation method showed significantly less apical leakage than slow-speed round bur technique, with bevel (p<0.0001). 3. No statistically significant difference was found between beveled resected root surface and non-beveled resected root surface, with ultrasonic technique (p>0.05). 4. Non-beveled resected root surface showed significantly less apical leakage than beveled resected root surface, with slow-speed round bur technique (p<0.0001). 5. No statistically significant difference in apical leakage was found between the group of retrograde cavity prepared parallel to the long axis of the tooth and the group of one prepared perpendicular to the long axis of the tooth (p>0.05). 6. Regarding isthmus preparation, ultrasonic retrograde preparation method showed significantly less apical leakage than slow-speed round bur technique, in the mesiobuccal root of maxillary molar, without bevel (p<0.0001).

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.2
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• pp.437-445
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• 1999

The purpose of this study was to evaluate the changes of laser doppler flowmeter output associated with stage of root development. Laser Doppler Flowmeter was done in 40 elementary students aged between 7 and 8 years and in 20 adults aged between 23 and 24 years. Among 40 elementary students, 20 had apical foramens with $1{\sim}2mm$ diameters and another 20 had ones with larger diameters than 2mm. The LDF values were analyzed with ANOVA and paired t-test. The results were as follows. 1. Immature root apecies group had a higher tendency than mature root apecies group in LDF values, but there was no statistical significance (p>0.05). 2. There was no statistical significance in LDF values comparing groups with immature root apecies (p>0.05). 3. There were no significant differences between right and left central incisors in LDF values (p>0.05).