• Restorative Dentistry and Endodontics
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• v.38 no.1
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• pp.26-30
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• 2013

Objectives: The aim of this study was to investigate the relationship between the apical foramen morphology and the length of merged canal at the apex in type II root canal system. Materials and Methods: This study included intact extracted maxillary and mandibular human premolars (n = 20) with fully formed roots without any visible signs of external resorption. The root segments were obtained by removing the crown 1 mm beneath the cementum-enamel junction (CEJ) using a rotary diamond disk. The distance between the file tip and merged point of joining two canals was defined as Lj. The roots were carefully sectioned at 1 mm from the apex by a slow-speed water-cooled diamond saw. All cross sections were examined under the microscope at ${\times}50$ magnification and photographed to estimate the shape of the apical foramen. The longest and the shortest diameter of apical foramen was measured using ImageJ program (1.44p, National Institutes of Health). Correlation coefficient was calculated to identify the link between Lj and the apical foramen shape by Pearson's correlation. Results: The average value of Lj was 3.74 mm. The average of proportion (P), estimated by dividing the longest diameter into the shortest diameter of the apical foramen, was 3.64. This study showed a significant negative correlation between P and Lj (p < 0.05). Conclusions: As Lj gets longer, the apical foramen becomes more ovally shaped. Likewise, as it gets shorter, the apical foramen becomes more flat shaped.

• Restorative Dentistry and Endodontics
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• v.37 no.2
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• pp.68-73
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• 2012

Objectives: The purpose of this study was to assess the accuracy of Root ZX (J. Morita Corp.) according to the location of major foramen and open apex. Materials and Methods: 81 mandibular premolars with mature apices were selected. After access preparation, 27 teeth were instrumented to simulate open apices. 54 teeth were classified according to location of major foramen under surgical microscope (${\times}16$). The file was fixed at the location of apical constriction by Root ZX using glass ionomer cement .The apical 4 mm of the apex was exposed and photo was taken and the distance from file tip to the major foramen was measured by calibrating metal ruler on graph paper. The results were statistically analyzed using ANOVA and Scheffe test at p < 0.05 level. Results: Mean distance from file tip to major foramen was 0.308 mm in Tip foramen group (I), 0.519 mm in Lateral foramen group (II) and 0.932 mm in open apex group (III). Root ZX located apical constriction accurately within ${\pm}0.5mm$ in group I of 85.71%, in group II of 59.09%, and in group III of 33.33%. There was a statistically significant difference between group I and III (p < 0.05). Conclusion: Root ZX located apical constriction accurately regardless of location of major foramen. However, Root ZX couldn't find it in open apex. Clinicians have to use a combination of methods to determine an appropriate working length at open apex. It may be more successful than relying on just electronic apex locator.

• The Journal of the Korean dental association
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• v.10 no.3
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• pp.149-153
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• 1972

The apical foramen is not always found on the very tip of the root. The apical foramen may make its exit on the mesial, distal, labial or lingual side of a root slightly short of the root apex rather than at the root apex itself. The author collected 43 upper first molars and 84 lower first molars as a samples. Apical foramens were carefully checked and examined these location on each tip. (table 1) 1. About 33% to 49% of upper cases were found on extreme tip of roots and the remaining cases were on the distal side or mesial side. 2. Except distal simple canal of lower molars, approximately 40% to 50% were located on the very tip of the root. The remaining cases were on distal or mesial surface. 3. On lower distal simple canal, about 51% of cases made its exit on distal side. The remaining cases located on the tip end or mesial side.

• 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.19 no.1
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• pp.205-216
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• 1994

The purpose of this study is to evaluate of apical plug materials for the contral of extrusion and sealing ability of high-temperature thermoplasticized gutta-percha in plastic root canal blocks. Seventy seven plastic blocks with canal preformed were instrumented with # 50K file 1 mm beyond apical foramen. Blocks were randomly divided into 5 groups of 15 blocks each. Group 1 was filled by high-temperature thermoplasticized gutta-percha only. The another 4 groups were placed with apical plug materials each other and then remaining space was back filled with high temperature thermoplasticized gutta-percha Apical plug materials were used as follows; Group 2: Thermoplasticized gutta-percha (Thermoplasticized gutta-percha group) Group 3 :. Calcium hydroxide powder (Calcium hydroxide group) Group 4 : Silver point (Silver point group) Group 5 : Gutta-percha cone softened by chloroform (Gutta-percha cone group) All the blocks were stored in 100 % relative humidor at room temperature for 14 days. Filling material extruded was removed carefully and then weighed in analytic balance. Each block was placed in centrifuge tube filled with India ink, and then centrifuged for 20 minutes at 3,000 rpm. Apical leakage was measured from the apical foramen to the most coronal level of dye leakage in millimeter by two examiners under a stereoscope. The data were analysed statistically by Student's t-test The obtained results were as follows; 1. The amounts of material extruded through the foramen decreased in all of groups used apical plug materials (P<0.01). 2. Silver point group and gutta-percha cone group were similar linear leakage to high-temperature thermoplasticised gutta-percha technique only (P>0..5). 3. Calcium hydroxide group and thermoplasticized gutta-percha group showed more liner leakage than high-temperature thermoplasticized gutta-percha only (P<0.01, P<0.05). 4. High-temperature thermoplasticized gutta-percha technique with silver point and gutta-percha cone as apical plugs showed less linear leakage and less extrusion of filling material.

• Restorative Dentistry and Endodontics
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• v.5 no.1
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• pp.35-40
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• 1979

The author observed thy actual position of apical foramen and the radiographic appearance of files when the files were filled through canals to the external surface of apical foramen in 280 canals of extracted teeth. All the teeth were radiographed by bisecting technic and once again Walton's projection was employed on mandibular molars. The results were as followings. 1. Sixty five percents of 280 canals were actually classed as having foramina deviant from true apex of root. 2. 160 of 280 canals(Fifty seven percents) appeared to be filled short of apex on the radiograph. 3. When Walton's projection was employed to open up two mesial canals of mandibular molars and compared to straight-on projection, twelve of 120 canals Ten percent appeared to be different in radiographic appearence.

• The Journal of the Korean dental association
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• v.21 no.6 s.169
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• pp.467-472
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• 1983

Thirty seven human maxillary third mooars were injected with china ink, decalcified, cleared, and used in vitro study to determine the number of root canals the frequency and location of lateral canals, canals per root, and frequency of apical deltas. The results were as follows: 1. Less than half of the examined teeth showed 3 roots and 3 canals. 2. The mesiobuccal root was ound to contain a single primary canal in 65.4% of the teeth examined and two canals in 34.6% of the teeth studed. 3. In mesiobuccal roots with two canals, the separated apical foramen appeared 30.8% of the specimen concerned, but no common apical foramen appeared. 4. Of the 106 canals studied, 46.2% of the canals were found to contain lateral canals and these ramifications were mainly located in the apical third of the root.

• Restorative Dentistry and Endodontics
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• v.3 no.1
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• pp.12-16
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• 1977

One hundred human maxillary first molars were injected with china ink, decalcified, cleared, and used in vitro study to determine the number of root canals, the frequency and location of lateral canals, canals per root, and frequency of apical deltas. The results were as follows; 1. The mesiobuccal root was found to contain a single primary canal in 53% of the teeth studied and two canals in 47 % of the teeth studied. 2. In mesiobuccal roots with two canals, the seperated apical foramen appeared 32% of the specimens and the common apical foramen 15% of the specimens. 3. Of the 347 canals studied, 26.9% of the canals were found to contain lateral canals and these ramifications were mainly located in the apical third of the root.

• Restorative Dentistry and Endodontics
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• v.6 no.1
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• pp.83-86
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• 1980

Fifty human maxillary second molars were injected with china ink, decalcified, cleared, and used in vitro study to determine the number of root canals, the frequency and location of lateral canals, canals per root, and frequency of apical deltas. The results were as follows. 1. The mesiobuccal root was found to contain a single primary canal in 62% of the teeth studied and two canals in 38% of the teeth studied. 2. In mesiobuccal roots with two canals, the seperated apical foramen appeared 24% of the specimens and the common apical foramen 14% of the specimens. 3. Of the 169 canals studied, 23.1% of the canals were found to contain lateral canals and these ramifications were mainly located in the apical third of the root.

• Imaging Science in Dentistry
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• v.50 no.3
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• pp.183-192
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• 2020

Purpose: This study was performed to assess the accuracy of preoperative cone-beam computed tomography (CBCT), when justified for other reasons, in locating the apical foramen and establishing the working length. Materials and Methods: Six electronic databases were searched for studies on this subject. All studies, of any type, were included if they compared measurements of working length with preoperative CBCT to measurements using an electronic apex locator (EAL) or histological reference standard. Due to the high levels of heterogeneity, an inverse-variance random-effects model was chosen, and weighted mean differences were obtained with 95% confidence intervals and P values. Results: Nine studies were included. Compared to a histological reference standard, CBCT indicated that the apical foramen was on average 0.40 mm coronal of its histological position, with a mean absolute difference of 0.48 mm. Comparisons were also performed to an EAL reference standard, but the conclusions could not be considered robust due to high levels of heterogeneity in the results. Conclusion: A low level of evidence is produced suggesting that preoperative CBCT shows the apical foramen to be on average 0.40 mm coronal to its histological position, with a mean absolute difference of 0.48 mm.