This study was conducted to evaluate and compare the apical leakage in the following retrofilling techniques after apical resection; No apical cavity preparation and no retrofilling(control group), Amalgam(group I) or silver glass ionomer cement(group II) retrofilling after apical cavity preparation with mini contra-angle and bur, Amalgam(group III) or silver glass ionomer cement(group N) retrofilling after apical cavity preparation with ultrasonic micro endo tip. Extracted ninety upper anterior and lower canine teeth were fixed in skull simulators and root canals were prepared with step-back method and obturated with gutta-percha and zinc oxide eugenol sealer. Obturated roots were resected 2mm from apical ends and apical cavities of 1mm width and 2mm depth were prepared and retrofilled by above mentioned methods. After application of nail varnish on all surface except resected surface, apical 1/3 of the roots were placed in 1% methylene blue solution for 3 days. After longutudinal sectioning to expose central parts of filled materials, depths of penetrated dye were measured by measuring microscope and were analyzed statistically. The results were as follows. 1. Having no relation with instruments used in apical cavity preparation, amalgam retrofilling groups(group I and II) showed less apical leakage which was not significant statistically than no retrofilling group(control group) (P<0.05), but silver glass ionomer cement retrofilling gruoups(group II and IV) showed significantly less apical leakage than no retrofilling group(control group) (P<0.01). 2. In the groups retrofilled with the same material, the apical leakage in cavities prepared with ultrasonic micro endo tip (group III and IV) was less than that in cavities prepared with mini contra-angle and bur(group I and II), but not significant statistically(P>0.05). 3. When apical cavities were prepared with same instrument. the egroups retrofilled with silver glass ionomer cement(group II and IV) showed significantly less apical leakage than the groups retrofilled with amalgam(group I and III)(<0.01).
The final preparation (MAF) size in infected root canals is still controversial. Nonetheless, recent studies demonstrated that larger apical preparation sizes produces a greater reduction in remaining bacteria and dentinal debris as compared to smaller apical preparation sizes. Therefore, clinicians should be practiced with treatment strategies guided by evidence-based information, especially in infected/failed root canals.
The purpose of this study was to evaluate the effect of post space preparation on apical sealing according to the methods and time of gutta percha removal. Forty six extracted single rooted teeth were selected for this study. Forty teeth were used as experimental groups and six teeth as control groups. Forty teeth were routinely prepared by step-back method and obturated with gutta percha cones and zinc oxide-eugenol cement using lateral condensation. All obturated teeth were divided into 4 groups of 10 teeth each. In each group of 1, 2, 3, heated plugger, gate glidden drill and chloroform and K-file were used respectively for post space preparation by removing the gutta percha immediately after obturation. In group 4, post space were prepared with gate glidden drill one week after obturation. In all experimental groups, the post space were prepared so that 4mm of apical gutta percha remained. After post space preparation, apical leakage were measured with electrochemical method for 28 days and analyzed statistically. The following results were obtained ; 1. No statistically significant differences in apical leakage were occured among the experimental groups using heated plugger, gate glidden drill and chloroform and K-file to remove the gutta percha immediately after obturation. 2. No significant difference in apical leakage was found between the teeth prepared post space immediately after obturation and those prepared 1 week after obturation. 3. In all experimental groups, the apical leakage was increased with time passage regardless of the post space preparation time and the gutta percha removal techniques.
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.
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.
When conventional root canal treatment is failed or contraindicated, retrograde root canal filling following apicoectomy is a valuable procedure, aimed at hermetically sealing the root canal against leakage of irritants from the canal into the periapical tissue. In this in vitro investigation, to analyze apical microleakage electrochemically in teeth with different retrograde filling materials and preparation types, single - rooted tooth was cut 2mm from the apex and each Class I and Slot preparation was prepared. Experimental groups : Group 1. Amalgam filling with cavity varnish in Class I preparation Group 2. Scotchbond 2+Silux filling in Class I preparation Group 3. Gutta percha filling with ZOE cement in Class I preparation Group 4. Amalgam filling with cavity varnish in Slot preparation Group 5. Scotchbond 2+Silux filling in Slot preparation Each specimens was immersed in 1% solution of KCl, and applied a potential of 9V external power supply. Measurements of the current flow were obtained at 1, 2, 3, 7, 9, 12, 14, 18, 21, 25 and 28 day after immerson. Marginal microleakage were compared and evaluated. The results were as follows ; 1. The group filled with composite resin with dentin bonding agent shows lower apical microleakage value than the group filled with amalgam following varnish application (P<0.01). 2. In the group filled with gutta percha, apical microleakage value was the hightest 3. There was no significant difference between Class I cavity and Slot type cavity regardless of the used materials.
Objectives: This study was conducted to evaluate the effects of traditional and contracted endodontic cavity (TEC and CEC) preparation with the use of Reciproc Blue (RPC B) and One Curve (OC) single-file systems on the amount of apical debris extrusion in mandibular first molar root canals. Materials and Methods: Eighty extracted mandibular first molar teeth were randomly assigned to 4 groups (n = 20) according to the endodontic access cavity shape and the single file system used for root canal preparation (reciprocating motion with the RCP B and rotary motion with the OC): TEC-RPC B, TEC-OC, CEC-RPC B, and CEC-OC. The apically extruded debris during preparation was collected in Eppendorf tubes. The amount of extruded debris was quantified by subtracting the weight of the empty tubes from the weight of the Eppendorf tubes containing the debris. Data were analyzed using 1-way analysis of variance with the Tukey post hoc test. The level of significance was set at p < 0.05. Results: The CEC-RPC B group showed more apical debris extrusion than the TEC-OC and CEC-OC groups (p < 0.05). There were no statistically significant differences in the amount of apical debris extrusion among the TEC-OC, CEC-OC, and TEC-RPC B groups. Conclusions: RPC B caused more apical debris extrusion in the CEC groups than did the OC single-file system. Therefore, it is suggested that the RPC B file should be used carefully in teeth with a CEC.
The purpose of this study was to compare the histomorphological change of curved root canal preparation using GT rotary File, Profile .04 taper and stainless steel K-file. 45 mesial canals(over 20 degree) of extracted human mandibular first molars were mounted in resin using a modified Bramante muffle system and divided into three groups. The roots were cross-sectioned at 2.5mm 5mm and 8mm levels from apical foramen. Tracings of the canals were made from preinstrumentation pictures of the cross section. The canals were prepared using a step-back technique with stainless steel K file(group 1), Profile .04 taper rotary file(group 2) and GT rotary file(group 3). Tracings of the prepared canals were made from postinstrumentation picture. Canal centring ratio. amount of transportation, area of dentin removed and shape of canal were measured and statistically were evaluated with Student-Newman-Keuls test using Sigma Stat(Jandel Scientific Software, USA). The results were as followings : 1 Amount of transportation of group 2 was the lowest at apical part, but there was no statistical difference. The direction of transportation was the outside of curvature at apical part. 2. Centering ratio at the apical part of group 1 was the highest, and there was statistical differences between apical and middle part, apical and coronal part(p<0.05). Centering ratio at the middle part of group 3 was the lowest, and there was statistical difference between apical and middle part(p<0.05). Centering ratio of group 2 was the lowest at apical part, but there was no statistical difference. 3. Amount of dentin removed of group 1 was the highest at coronal, middle and apical part among three groups, and there was statistical difference(p<0.05). 4. The majority of the cross-sectioned canal shape after instrumentation were irregular at coronal, middle and apical part. But there are more number of round shaped canals at group 3 than other group.
A model system was used which enabled the same root canal system to be measured before and after coronal flaring of 51 extracted mandibular molars. The concavity of the distal surface of the mesial root was measured and the amount of reduction was compared after coronal flaring using step-back flared preparation, Gates-Glidden dirll or ultrasonic system(Quick-$\varepsilon$) at the furcation and apical 3mm from the furcation. The results were as follows: 1. The mean concavity of mesial root of manchbular molar was $0.73{\pm}0.27mm$ at the bifurcation and $0.65{\pm}0.23mm$ at the 3.0mm apical from the bifurcation. 2. The thickness of the root canal wall of the mesiobuccal canal was $1.08{\pm}0.26mm$ at the bifurcation and $1.00{\pm}0.23mm$ at the 3.0mm apical from the bifurcation. 3. The thickness of the root canal wall of the mesiolingual was $1.09{\pm}0.21mm$ at the bifurcation and $0.98{\pm}0.29mm$ at the 3.0mm apical from the bifurcation. 4. In the amount of reduction at the furcation and at the 3.0mm apical from the furcation there was no statistically significant difference between the step-back preparation and Gates-Glidden drill preparation, and ultrasonic preparation(P>0.05).
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).
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