• Restorative Dentistry and Endodontics
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• v.42 no.4
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• pp.332-341
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• 2017

Objectives: To determine the incidence of crack formation and propagation in apical root dentin after retreatment procedures performed using ProTaper Universal Retreatment (PTR), Mtwo-R, ProTaper Next (PTN), and Twisted File Adaptive (TFA) systems. Materials and Methods: The study consisted of 120 extracted mandibular premolars. One millimeter from the apex of each tooth was ground perpendicular to the long axis of the tooth, and the apical surface was polished. Twenty teeth served as the negative control group. One hundred teeth were prepared, obturated, and then divided into 5 retreatment groups. The retreatment procedures were performed using the following files: PTR, Mtwo-R, PTN, TFA, and hand files. After filling material removal, apical enlargement was done using apical size 0.50 mm ProTaper Universal (PTU), Mtwo, PTN, TFA, and hand files. Digital images of the apical root surfaces were recorded before preparation, after preparation, after obturation, after filling removal, and after apical enlargement using a stereomicroscope. The images were then inspected for the presence of new apical cracks and crack propagation. Data were analyzed with ${\chi}^2$ tests using SPSS 21.0 software. Results: New cracks and crack propagation occurred in all the experimental groups during the retreatment process. Nickel-titanium rotary file systems caused significantly more apical crack formation and propagation than the hand files. The PTU system caused significantly more apical cracks than the other groups after the apical enlargement stage. Conclusions: This study showed that retreatment procedures and apical enlargement after the use of retreatment files can cause crack formation and propagation in apical dentin.

• Restorative Dentistry and Endodontics
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• v.39 no.4
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• pp.276-281
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• 2014

Objectives: The purpose of this study was to compare the cutting efficiency of a newly developed microprojection tip and a diamond-coated tip under two different engine powers. Materials and Methods: The apical 3 mm of each root was resected, and root-end preparation was performed with upward and downward pressure using one of the ultrasonic tips, KIS-1D (Obtura Spartan) or JT-5B (B&L Biotech Ltd.). The ultrasonic engine was set to power-1 or -4. Forty teeth were randomly divided into four groups: K1 (KIS-1D / Power-1), J1 (JT-5B / Power-1), K4 (KIS-1D / Power-4), and J4 (JT-5B / Power-4). The total time required for root-end preparation was recorded. All teeth were resected and the apical parts were evaluated for the number and length of cracks using a confocal scanning micrscope. The size of the root-end cavity and the width of the remaining dentin were recorded. The data were statistically analyzed using two-way analysis of variance and a Mann-Whitney test. Results: There was no significant difference in the time required between the instrument groups, but the power-4 groups showed reduced preparation time for both instrument groups (p < 0.05). The K4 and J4 groups with a power-4 showed a significantly higher crack formation and a longer crack irrespective of the instruments. There was no significant difference in the remaining dentin thickness or any of the parameters after preparation. Conclusions: Ultrasonic tips with microprojections would be an option to substitute for the conventional ultrasonic tips with a diamond coating with the same clinical efficiency.

• The Journal of the Korean dental association
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• v.50 no.8
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• pp.507-515
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• 2012

The purpose of this article is to discuss the effect of aging on the treatment of replantation and transplantation of teeth in old patients. I case of replantation and 2 cases of transplantations in old patients are reported in this article. Patients aged 65 and over are included. They had several problems such as periapical lesion, crack or foot fractures. In those cases, the replantation and transplantation were treatment of choice. White ProRoot MTA was used in apical retrograde filling and perforation repair. After replantation and transplantation of teeth, follow-up visits showed signs of healing in 3 cases. Considerations and indications for replantation and transplantation are not much affected by age. Old patients are aware that replantation and transplantation can be performed comfortably and that age is not a factor in prediction success.

• Restorative Dentistry and Endodontics
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• v.22 no.2
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• pp.546-559
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• 1997

The purposes of this study were to evaluate the efficiency of cavity preparation and to determine the incidence of tooth crack when root-end retrograde cavity preparation was done with ultrasonics. 91 distobuccal root-ends of extracted human maxillary first molars were cut by 3 mm perpendicularly to the long axis of tooth using a slow speed diamond saw, retrocavities were prepared using a slow-speed no. 2 round bur as controls, and stainless steel ultrasonic tips of power settings of 1 through 10 as experimentals. Time consumed and the number of strokes used for the cavity preparation were measured and evaluated, and the incidence of tooth cracks was observed under a stereomicroscope. The results were as follows : For the retrograde cavity preparation, time and number of strokes used were decreased as the ultrasonic power setting increased (p<0.001). High power setting of ultrasonics induced significantly more tooth cracks than did the slow-speed bur or low- and medium power setting of ultrasonics (p<0.05). Teeth with previous crack induced significantly more tooth cracks than those without previous one when high power setting of ultrasonics were used for the retrograde cavity preparation (p<0.001). Teeth with initial apical canal size of no. 10 induced significantly more crack than did those with size of no. 15 when low power setting of ultrasonics were used for the retrograde cavity preparation (p<0.05).

• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.555-565
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• 2006

The purpose of the present study is to evaluate the biological stability of the zirconia/alumina composite abutment by histologic and radiographic examination in clinical cases. 17 partially edentulous patients (5 men and 12 women, mean age 47) were treated with 37 implants. The implants were placed following the standard two-stage protocol. After a healing period of 3 to 6 months, zirconia/alumina composite abutments were connected. All radiographs were taken using paralleling technique with individually fabricated impression bite block, following insertion of the prosthesis and at the 3-, 6-, 12 month re-examinations. After processing the obtained images, the osseous level was calculated using the digital image in the mesial and distal aspect in each implant. An ANOVA and t-test were used to test for difference between the baseline and 3-, 6-, 12 months re-examinations, and for difference between maxilla and mandible. Differences at P <0.05 were considered statistically significant. For histologic examination, sample was obtained from the palatal gingiva which implant functioned for 12 months. Sections were examined under a light microscope under various magnifications. Clinically, no abutment fracture or crack as well as periimplantitis was observed during the period of study. The mean bone level reduction(${\pm}standard$ deviation) was 0.34 rom(${\pm}\;0.26$) at 3-months, 0.4 2mm(${\pm}\;0.30$) at 6-months, 0.62 mm(${\pm}\;0.28$) at 12-months respectively. No statistically significant difference was found between baseline and 3-, 6-, 12-months re-examinations (p > 0.05). The mean bone level reduction in maxilla was 0.33(${\pm}0.25$) at 3-months, 0.36(${\pm}0.33$) at 6-months, 0.56(${\pm}0.26$) at 12-months. And the mean bone level reduction in mandible was 0.35(${\pm}0.27$) at 3-months, 0,49(${\pm}0.27$) at 6-months, 0.68(${\pm}0.30$) at 12-months. No statistical difference in bone level reduction between implants placed in the maxilla and mandible. Histologically, the height of the junctional epithelium was about 2.09 mm. And the width was about 0.51 mm. Scattered fibroblasts and inflammatory cells, and dense collagen network with few vascular structures characterized the portion of connective tissue. The inflammatory cell infiltration was observed just beneath the apical end of junctional epithelium and the area of direct in contact with zirconia/alumina abutment. These results suggest the zirconia/alumina composite abutment can be used in variable intraoral condition, in posterior segment as well as anterior segment without adverse effects.