The purpose of this study was to compare the apical sealing ability, overfilling and obturation of lateral canals using two gutta-percha techniques: Thermafil obturators and cold lateral condensation. Eighty numbered epoxide blocks with one major and five lateral canals were divided into four experimental groups and obturated according to experimental groups. Four experimental groups were as follows: Group 1 : Filling with Thermafil plastic obturators and sealer(ThermaSeal) Group 2 : Filling with Thermafil plastic obturators only, without sealer(ThermaSeal) Group 3 : Fillng using lateral condensation with sealer(AH-26) Group 4 : Fillng using lateral condensation without sealer(AH-26) All the blocks were stored in 100% relative humidor at room temperature for 7 days. 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 penetration in millimeter under a stereoscope. The length of gutta-percha and sealer in each of the lateral canals was measured, too. The presence or absence of overfilling of gutta-percha and sealer was recorded. The data was analyzed by one-way ANOVA. The obtained results were as follows: l. Apical dye leakage was almost: not occurred in Group Willed with Thermafil and sealer) and Group 3(filled using lateral condensation with sealer), and there was no significant difference in linear leakage between two groups(p>0.01). 2. In both Thermafil and lateral condensation groups, linear leakage of Group I, 3(filled with sealer) was less than that of Group 2, 4(filled without sealer), and there was no significant difference in linear leakage between Group 1, 2, 3(p> 0.01). 3. Overfilling during obturation of Group 1, 2(filled with Thermafil) was more than Group 3, 4(filled using lateral condensation), and there was no significant difference between groups(p> 0.05). 4. Groups filled with Thermafil had significantly more gutta-percha than groups filled using lateral condensation in all lateral canals(p <0.01), the total length of gutta-percha and sealer found in all lateral canals were similar in Group 1 and Group 3.
It is necessary to measure the length of a root canal in order to attain a satisfactory prognosis after root canal therapy. There are several methods for determining root canal length, such as tactile sensation by the dental practitioner, the utilization of x-ray film, and electronic root canal measurement. Among these, the electrical measurement methods, in which the impedence between the oral mucous membrane and periodontal membrane is determined, have advantages of simplicity and accuracy. During root canal treatment, the root canal contains a solution of high electrical conductivity such as pus, blood, sodium hypochlorite and so on. Recently a new electronic root canal measurement device of frequency-dependent type has been developed, which is capable of measuring the length of root canal under moist conditions. Endex and Root ZX, which are frequency-dependent type, were evaluated for accuracy of measuring root canal length in vivo by stereomicroscope. The result were as follows ; 1. 82.5% of Endex and 87.5% of Root ZX measured in the range of ${\pm}0.5$ mm from the apical foramen and both showed 57.5 % in the range of 0.1 mm to 0.5 mm. 2. Endex showed significantly higher accuracy in vital teeth than nonvital teeth(p<0.05). But in case of Root ZX, there was no significant difference between vital and nonvital teeth. 3. As a result of this study, there was no significant difference in accuracy between Endex and Root ZX, and both devices showed file passes the apical foramen in more than half of the cases, and it is thought that this must be considered clinically.
During canal instrumentation of a curved canal, restoring force of endodontic instrument remove more dentin from the inner wall of the curvature. This effect tends to straighten the canal and thus may significantly shorten the working length. This study was to determine the mean reduction in working length after instrumentation according to the curvature. The curvature of mandibular mesial root was determined before instrumentation. 30 canals were divided into 3 groups each 10 on the basis of degree of curvature. Experimental groups as follows. In group 1, canals having curvature from 15 to 20 degrees: in group 2, canals having curvature from 20 to 30degrees; in group 3, canals having curvature above 30 degrees. Experimental teeth in all groups were accessed, and their actual working length determined by passing a size 15 K-file(IAF) just through the minor apical foramen. The canals were sequentially enlarged to size 35 with ProFile .06 series. The change of working length was calculated by measuring the tip of IAF beyond apical foramen by using stereomicroscope. The change of canal curvature following instrumentation were measured using the Schneider technique. The results were as follows. 1. The greatest changes of curvature and working length were observed in the group 3 canals(P<0.05), next were group 2 canals and group 1 canals(P>0.05). 2. Group 1 canals showed a mean reduction in 1.61 degrees and length of 0.12m respectively(P>0.05). 3. Group 2 canals showed a mean reduction in 3.42 degrees(P<0.05) and length of 0.25mm(P>0.05) respectively. 4. Group 3 canals showed a mean reduction in 7.23 degrees(<0.05) and length of 0.64mm respectively(P<0.05).
The purpose of this study was to evaluate the in vitro accuracy of Root ZX(Morita Co., Japan) which is the ratio type electronic apex locator. The 86 extracted human palatal roots of maxillary molar with fully formed apices were used. File lengths with the file tip just visible at the foramen were compared to those measured with Root ZX. For length measuring with Root ZX, saline test model with which the apical 1/3 of each root was submerged into normal saline were designed. The root canal lengths were determined with Root ZX and the radiographs were taken with a file in the canal. The distances from file tips of Root ZX lengths to apecies in radiographs also were measured with Profile projector PJ311(Mitutoyo Co., Japan). The results were as follows : 1. The root canal length determined with electronic apex locator was $0.78{\pm}0.53mm$ shorter than the length with visual measurement. 2. The file tip of Root ZX lengths was located at $0.85{\pm}0.49mm$ away from the apex in radiograph. 3. The accuracy of the Root ZX was 79.1% within 0.5mm of visual working length and 96.5% within 1.0mm.
Hadi Rajeh Alfahadi;Saad Al-Nazhan; Fawaz Hamad Alkazman;Nassr Al-Maflehi; Nada Al-Nazhan
Restorative Dentistry and Endodontics
/
v.47
no.2
/
pp.24.1-24.15
/
2022
Objectives: Regenerative endodontic treatment is a clinical procedure aimed at biologically regenerating damaged root canal tissue of immature permanent teeth. This study aimed to report the outcomes of regenerative endodontic treatment performed by endodontic postgraduate students. Materials and Methods: Clinical and radiographic data of 27 patients, aged 10-22 years, who underwent regenerative treatment of immature permanent teeth from 2015 to 2019 were followed up, wherein clinical and radiographic examinations were performed for each patient. Postoperative success rate and tooth survival were analyzed, and the postoperative radiographic root area changes were quantified. Results: A total of 23 patients attended the dental appointments, showing that all teeth survived and were asymptomatic. Specifically, 7 periapical pathosis cases were completely healed, 12 were incompletely healed, and 4 cases failed. Moreover, significant differences were found between discolored and non-discolored teeth, and between the presence or absence of periapical radiolucency. Additionally, 3 anterior teeth showed complete closure of the apical foramen, while the apical foramen width was reduced in 17 teeth and failed in 3 teeth. Root length was also found to have been increased in 7 anterior and 4 posterior teeth, and the average length ranged from 4.00-0.63 mm in the anterior teeth, 2.85-1.48 mm of the mesial root, and 2.73-2.16 mm of the molar teeth distal root. Furthermore, calcified tissue deposition was observed in 7 teeth. Conclusions: A favorable outcome of regenerative endodontic treatment of immature permanent teeth with necrotic pulp was achieved with a high survival rate.
The purpose of this experiment was to determine: (1) the safe automatic apical reverse setting that prevents overinstrumentation of the root canal, using Tri Auto ZX$^{(R)}$ and (2) the effect of various irrigant on such instrumentation. The instrumentation was carried out with the automatic apical reverse setting of 0.5, 1.0, 1.5, and 2.0. The root canal irrigants used in usual manner were normal saline(0.9%), NaOCl(2.5%), and RC Prep$^{(R)}$. For each reverse setting and each irrigant, ten teeth were used with the total of 120 teeth. The distance between the file tip and the apical constriction was determined by stereomicroscope using the point that the file began to rotate in reverse direction. When the reverse setting mode was set to 0.5, 18 of 30 were overinstrumented. If these were discriminated by irrigant, 10 of 6 with 0.9% saline, 10 of 6 with NaOCl, and 10 of 6 with RC Prep$^{(R)}$ has the file tip located 0.57${\pm}$0.30mm, 0.73${\pm}$0.39mm, and 0.26${\pm}$0.25mm beyond the apical constriction respectively. In 1.0 setting 15 of 29 were over the apical constriction, and the distribution was 6 in saline, 5 in NaOCl, and 4 in RC Prep$^{(R)}$. The mean distance over the apical constriction was 0.28${\pm}$0.13mm with saline, 0.75${\pm}$0.61mm with NaOCl, and 0.25${\pm}$0.17mm with RC Prep$^{(R)}$. When the autoatic reverse mode was set to 1.5, and 2.0, 5, and 1 teeth were found to be overinstrumented in respective settings. But there were large variations in overinstrumented distances when an attempt was made to compare the effect of irrigants on this overinstrumentations and they were meaningless for the small sample size. When all of the autoreverse setting were combined to compare the number of overinstrumented teeth with each irrigant, there were no significant differences (14 for normal saline, 12 for NaOCl, 13 for RC Prep$^{(R)}$). When 0.5 or 1.0 automatic apical reverse setting mode was used the Tri Auto ZX$^{(R)}$ in clinical application, the possibility of overinstrumentation beyond the apical constriction exists in 55.9% of cases. Therefore 1.5 or 2.0 setting is safer for the preparation inside the canal but this type setting needs additional apical hand preparation of the root canal because the accuracy is lower than 0.5 or 1.0 setting.
The purpose of this study was to evaluate the sealing ability according to types of spreader and compatibility of accessory cone used in lateral condensation method. 120 plastic blocks with canal preformed were instrumented with K-,H-files and Gates-Gllidden bur. Shaped plastic blocks were divided into six experimental groups according to spreader and accessory cone used in lateral condensation. Then they were obturated by lateral condensation method without -sealer. Six experimental groups were as follows: Group 1 : Filling with #30 spreader & #25 gutta-percha cone Group 2 : Filling with #30 spreader & Fine accessory cone Group 3 : Filling with #3 spreader & #25 gutta-percha cone Group 4 : Filling with #3 spreader & Fine accessory cone Group 5 : Filling with #20,#30 spreader & #25 gutta-percha cone Group 6 : Filling with #2, #3 spreader & Fine accessory cone All the blocks were stored in 100% humidor at room temperature for 2 days. Each block was placed in centrifuged for 20 minutes at 3,000 rpm. Apical leakage was mesured from the apical foramen to the most coronal level of- dye leakage in millimeter under a stereoscope. The data were analysed by ANOVA. The obtained results were as follows; 1. In groups using two spreaders(Group 5,6), the linear leakage was less than one spreader using groups(Group 1-4). 2. Tn groups using two spreaders(Group 5,6), there was no significant difference in linear leakage between standardized -spreader group and non standardized group (p>0.01). 3. When one spreader was used(Group 1-4), standardized-spreader groups showed less linear leakage than nonstandardized spreader groups(P<0.01). 4. In case of using same spreader(Groupl,2 & Group 3,4), there was no significant difference in linear leakage according to accessory cone type. 5. It needs to use one more spreaders to increase apical sealability.
The purpose of this study was to evaluate the resulting root canal angulation and shape change after using various enlarging instruments. The mesial canals (120) of extracted human mandibular 1st and 2nd molars were randomly divided into 6 groups; Control, K-type me, Heliapical me, Canal Master me, sonic and ultrasonic instrumentation group. Vertical angulation of each canal was determined by a straight line through the long axis of canal and another straight line through the apical foramen to intersect at the point where the canal began to leave the long axis of the tooth. By recording and comparing the measured angles of the each set of pre-and postinstrumentation. Then, the roots were sectioned horizontally in the apical, middle, coronal thirds and the canal shapes examined, as was the mesiodistal canal diameter as it relates to the external root surface. The results were as follows: 1. Instrumentation using K-type me group resulted in the highest mean change in angulation ($9.900^{\circ}$) (p < 0.005), while Sonic Air MM 3000 group resulted in the least degree of straightening canals ($8.250^{\circ}$) (p < 0.005). 2. Canal Master file group resulted in the best canal shape at the three levels (P < 0.005). 3. Measured minimal mesial root width produced Heliapical me group at the apical 1/3 level, Sonic Air MM 3000 group at the middle 1/3 level, Heliapical me group at the coronal 1/3 level (P < 0.005). 4. Measured minimal distal root width produced Sonic Air MM 3000 group at the apical 1/3 level (P < 0.05), Heliapical me group at the middle 1/3 level (P < 0.005), Canal Master me group at the coronal 1/3 level (P < 0.005). 5. HeIiapical me group produced more increased canal diameter than any other groups (P < 0.005).
Objectives: The purpose of this study was to evaluate the buccolingual curvature at the apical one third in type II mesial canals of mandibular molars using the radius and angle of curvature. Materials and Methods: Total 100 mandibular molars were selected. Following an endodontic access in the teeth, their distal roots were removed. #15 H- or K-files (Dentsply Maillefer) were inserted into the mesiobuccal and mesiolingual canals of the teeth. Radiographs of the teeth were taken for the proximal view. Among them, type II canals were selected and divided into two subgroups, IIa and IIb. In type IIa, two separate canals merged into one canal before reaching the apex and in type IIb, two separate canals merged into one canal within the apical foramen. The radius and angle of curvature of specimens were examined. Results: In type II, mean radius of curvature in mesiolingual and mesiobuccal canals were 2.82 mm and 3.58 mm, respectively. The radius of the curvature of mesiolingual canals were significantly smaller than that of mesiobuccal canals in type II, and especially in type IIa. However, there were no statistically significant differences in radius of curvature between mesiobuccal and mesiolingual canals in type IIb and there were no significant differences in angle of curvature between type IIa and IIb. Conclusion: In this study, type II mesial canals of mandibular molars showed severe curvature in the proximal view. Especially, mesiolingual canals of type IIa had more abrupt curvature than mesiobuccal canals at the apical one third.
A 12-year-old intact female mixed dog (weighing 6.2 kg) was referred with primary complaints of severe abdominal distension, persistent coughing and exercise intolerance. Diagnostic studies found ascites, jugular distension, loud left and right apical systolic (grade 4/6) murmur, generalized cardiomegaly with caudal vena cava distension and left atrial dilation. Echocardiographic findings were consistent with degenerative mitral and tricuspid valve endocardiosis and bi-ventricular congestive heart failure. There was also a left to right shunting patent foramen ovale. The LV systolic function is depressed relative to the degree of volume overload. Based on diagnostic findings, this case was diagnosed as PFO complicated with mitral and tricuspid valve endocardiosis with ISACHC IIIa heart failure. The dog was treated with furosemide (2 mg/kg, q12hr, PO), sildenafil (1 mg/kg, q8hr, PO), pimobendan (0.3 mg/kg, q12hr, PO), enalapril (0.5 mg/kg, q12hr, PO) and spironolactone (1 mg/kg, q12hr). The clinical signs were gradually improved after medical therapy.
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