• 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.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.

• Journal of Chest Surgery
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• v.55 no.2
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• pp.180-182
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• 2022

Surgical septal myectomy is the preferred treatment option for patients with medically intractable obstructive hypertrophic cardiomyopathy. Extended transaortic septal myectomy is a widely performed surgical procedure for patients with subaortic obstruction. The transapical approach may provide an alternative surgical option in less common phenotypes, such as apical hypertrophy or long-segmental septal hypertrophy. In this report, we describe a case of a procedure performed to achieve left ventricular enlargement procedure using a combined transaortic and transapical dual approach in a patient with diffuse-type hypertrophic cardiomyopathy with apical aneurysm and mid-cavity obstruction.

• ALGAE
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• v.21 no.3
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• pp.323-332
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• 2006

Mitochondrial distribution and abundance were assessed during the growth of apical and subapical cells in the red algae Colaconema caespitosum (J. Agardh) Jackelman, Stegenga and Bolton and Antithamnion cruciatum (C. Agardh) Nägeli after staining with 3,3’-dihexyloxacarbocyanine iodide [DiOC6(3)] and 2,4’-dimethylaminostyryl-Nethylpyridinium iodide (DASPEI). In fully elongate apical cells of C. caespitosum there were 100-120 mitochondria. During apical cell enlargement and division there is a doubling and then halving of the mitochondrial numbers. Apical cells prior to cytokinesis in young filaments are smaller than in mature filaments (ca. 50 and 100 μm long, respectively) and have fewer mitochondria (ca. 100 and 120 mitochondria per cell, respectively). In older vegetative cells mitochondria tend to aggregate at opposite ends of the cells with some mitochondria associated with the central nucleus or at points of apparent branch initiation. There is a greater density of mitochondria in apical cells of smaller versus larger plants (one mitochondrion per 6.3 μm3 and 9.8 μm3, respectively), suggesting that apical cells of younger plants may be more metabolically active. Male and female gametophytic thalli of Antithamnion cruciatum had similar numbers of mitochondria in apical cells of indeterminate axes, as did gametophytic and sporophytic thalli. There were about 40-50 mitochondria in fully elongated apical cells with about half this number in newly divided apical and subapical cells. Apical cells of determinate branches had more mitochondria (60-77) than indeterminate branches (60-70 vs. 40-50). In both species and in all cell types mitochondrial numbers were highly correlated with cell size.

• Restorative Dentistry and Endodontics
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• v.46 no.3
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• pp.31.1-31.13
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• 2021

Objectives: To evaluate postoperative pain after endodontic treatment of necrotic teeth using large intentional foraminal enlargement (LIFE). Materials and Methods: The sample included 60 asymptomatic necrotic teeth (with or without chronic apical periodontitis), and a periodontal probing depth of 3 mm, previously accessed and referred to perform endodontic treatment. After previous procedures, the position and approximate size of the apical foramen (AF) were determined by using an apex locator and K flexo-files, respectively. The chemomechanical preparation was performed with Profile 04 files 2 mm beyond the AF to achieve the LIFE, using 2.5 mL of 2.5% NaOCl at each file change. The filling was performed by Tagger's hybrid technique and EndoFill sealer. Phone calls were made to all the patients at 24, 48 and 72 hours after treatment, to classify postoperative pain. Statistical analysis was performed by different tests with a significance level of 5%. Results: Age, gender, periradicular status and tooth type did not influence postoperative pain (p > 0.05). Only 1 patient (1.66%) reported severe pain after 72 hours. Moderate pain was reported by 7, 4 and 3 patients after 24, 48 and 72 hours, respectively (p = 0.0001). However, paired analyses showed a statistically significant difference only between 24 and 72 hours (p = 0.04). Sealer extrusion did not influence the postoperative pain (p > 0.05). Conclusions: Acute or moderate postoperative pain was uncommon after endodontic treatment of necrotic teeth with LIFE.

• Proceedings of the KACD Conference
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• 2003.11a
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• pp.546.1-546
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• 2003

Laser doppler flowmeter (LDF) has been applied to the measurement of pulpal blood flow (PBF) in human teeth. As far as we searched, the detection area of the pulp in the blood flow measurement has not been clarified, yet. Therefore, the purpose of this study was to obtain information of the detection area in PBF measurement using LDF. The experiments were performed on the artificial blood circulation in extracted human upper central incisors. The apical portions of examined teeth (n=6) were severed and root canals were enlarged from the apical end to the 2mm incisal to the level of enamel-cement junction. An individual resin cap of each tooth was prepared and a hole was drilled 2mm incisal to enamel-cement junction of the labial side of the cap. The measurement probe of LDF (MBF3D, Moor Instrument, UK) was plugged into the hole of the cap. Heparinized human peripheral blood, which was in advance collected and diluted 3 times with physiological saline, was pumped through the apical foramen of the teeth via a silicone tube and a disposable needle (o.d. 0.7mm) and blood flow signals were monitored. The flux signal significantly increased with the enlargement of the root canal to incisal direction (p<0.01, Friedman analysis). The result indicates that the performance of LDF in PBF with human teeth is limited.

• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.316-327
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• 1995

The purpose of this study was to evaluate canal shaping ability and canal angulation change of K-file, straight endosonic K-file and pre curved endosonic K-file. Twenty staight canals and thirty curved canals were selected and divided into five groups according to canals curvature and canal instrumentation method. VI group was prepared by straight endosonic K-file and H1 group by K-file in straigt canals. V2 group was instrumented by straight endosonic K-file, V3 group by pre curved endosonic K-file and H2 group by precurved K-file in curved canals. Radiographs of canals were obtained before and after canal shaping. And postoperative radiographs were compared with preoperative radiographs using superimposition method. The results obtained were as follows ; l. In straight canals, K-file group demonstrated lager percentage of canal enlargement than endosonic K-file group on facial view, but reverse results exhibit on mesial view. 2. In curved canals, precurved K-file group showed largest percentage of canal enlargement, followed by precurved endosonic K-fine group and straight endosonic K-file group was smallest. 3. Percantage of canal enlargement at convex side was greater than at concave side in apical portion of each group. Especially in straight endosonic K-file group, percantage of canal enlargement at convex side and concave side showed sharply difference. 4. In angulation change, the straight endosonic K-file group exhibited the greatest its change, followed by precurved endosonic K-file group and precurved K-file group was the least. Above results suggest that K-file is more effective endodontic instrument than endosonic K-file, and that precurved file is effective for canal shaping in curved canal.

• Restorative Dentistry and Endodontics
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• v.24 no.3
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• pp.503-510
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• 1999

The purpose of this study was to evaluate the amount of transportation of original canal, zip formation, permanent deformation and fracture of instruments after canal enlargement. In this study, the 60 resin blocks that have curved canals were randomly divided into 3 experimental groups with 20 teeth each according to instrument types and filling methods for canal enlargement. The curved canals of each experimental groups were enlarged to No 40 ISO size with the K-flexo stainless steel file (Group 1), Engine-driven Ni-Ti Profile new series(Group 2) and Engine-driven Ni-Ti Quantec 2000 series(Group 3) according to the manufacturer's recommendation. Pre- and postoperative X-rays were taken at same position and the films were scanned and the canal images were traced to determine the canal curvature according to the method of Schneider. The amount of reduction in canal curvature were calculated between pre- and postoperative X-rays. In addition to zip formation, permanent deformation and fracture of instruments were examined after canal enlargement. The results were as follows : 1. All experimental groups showed some loss of canal curvature after instrumentation. There was a significant change in curvature between before and after instrumentation in each group(p<0.001). 2. Engine-driven Ni-Ti instrumentations resulted in an average loss of curvature of 2.36 degrees for Profile new series, 3.43 degrees for Quantec series, and hand instrumentation showed an average loss of curvature of 6.48 degrees for K-flexo file. There was a statistical significant difference between hand instrumentation and engine-driven Ni-Ti instrumentations(p<0.05). But there was no statistical difference between Profile new series and Quantec series. 3. There were many apical zip formations in group 1(Hand instrumentation). But there were no apical zip formations in group 2,3(Engine-driven Ni-Ti instrumentation). 4. The instrument deformation occured 9 cases in group 1(K-flexo file), 2 cases in group 2(Profile new series) and 3 cases in group 3(Quantec) after instrumentation. And the instrument fracture occured 1 case in each group. The results showed that the engine-driven Ni-Ti instruments, if we use carefully according to manufacturer's recommendations, can be use effectively for instrumenting the curved root canals in case of the MAF was over size 40.

• Restorative Dentistry and Endodontics
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• v.10 no.1
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• pp.127-134
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• 1984

This study was conducted to evaluate the sealing ability of McSpadden technique compared with lateral condensation and Engine reamer technique, and according to the degree of canal enlargement and the use and nonuse of sealer. Seventy single-rooted teeth were divided into 14 groups and each tooth was enlarged and obturated according to the purpose of this study. Obturated teeth were infiltrated by Indian ink and decalcified and cleared. The apical sealing ability was evaluated by measuring the degree of ink penetration into the canal. The results were as follows: 1. All the teeth filled by lateral condensation using gutta-percha cone and sealer proved better in canal sealing ability than McSpadden technique and Engine reamer technique, showing less ink penetration. 2. In the McSpadden technique, there was less ink penetration detected in using the sealer than not. 3. In all of the experimental methods, the difference of the degree of ink penetration according the degree of canal enlargement could not be accepted. 4. There was no significant difference in ink penetration degree between Engine reamer technique using sealer and McSpadden technique without sealer.

• Restorative Dentistry and Endodontics
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• v.30 no.2
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• pp.95-101
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• 2005

The aim of this study was to evaluate the microleakage of teeth according to root canal preparation with & without apical enlargement in various size of apical foramen. 60 extracted one canal roots were cross-cutted at 5 mm from root apex and divided into two groups according to their apical foramen size of large (L) and small (S). Each group was subdivided into two groups accordance with their cross-sectional configuration at 5 mm from apex, round (R) and ovoid (O); SR Group, SO Group LR Group, LO Group. Each group was shaped in .02 taper by Quantec series Nickel-Titanium (NiTi) rotary file, obturated by lateral condensation method. Leakage was measured using a fluid transport model under 40 $cmH_2O$ pressure. After the leakage test, blocks which had showed the leakage retreated with .04 taper and ,06 taper and evaluated the degree of fluid filtration in each group. The data was analysed statistically using chi-square test and fisher's exact test. The results obtained were as follows : 1. Significant difference in leakage was found in groups which had different apical foramen size in .02 taper instrumentation (p < 0.05), but not in .04 taper instrumentation (p > 0.05) 2. The difference in microleakage according to the shape of canal was not evident at 5 mm from apex (p > 0.05). 3. There was correlation between .02 taper instrumentation and .04 taper instrumentation in LR group, LO group (p < 0.05).