• Restorative Dentistry and Endodontics
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• v.46 no.1
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• pp.12.1-12.9
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• 2021

Objectives: The present study aims to compare the obturation quality of 2 confluence confirmation techniques in artificial maxillary first premolars showing Vertucci type II root canal configuration. Materials and Methods: Thirty artificial maxillary premolars having Vertucci type II root canal configuration were made. They were divided into 3 groups according to the confluence confirmation technique as follows. Gutta-percha indentation (GPI) group (confluence confirmation using a gutta-percha cone and a K file); electronic apex locator (EAL) group (confluence confirmation using K files and EAL); and no confluence detection (NCD) group. In the GPI group and the EAL group, shaping and obturation were performed with the modified working length (WL). In the NCD group, shaping was performed without WL adjustment and obturation was carried out with an adjusted master cone. Micro-computed tomography was used before preparation and after obturation to calculate the percentage of gutta-percha occupied volume (%GPv) and the volume increase in the apical 4 mm. Data were analyzed using 1-way analysis of variance and post hoc Tukey's test. Results: Statistically significant difference was not found in terms of the %GPv from the apex to apical 4 mm. However, the NCD group showed a statistically significant volume increase compared with the EAL group (p < 0.05). Conclusions: In terms of gutta-percha occupied volume, no significant difference was observed among the 3 groups. Confluence confirmation using an EAL in teeth with Vertucci type II configuration showed less volume increase during canal shaping compared with no confluence confirmation.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.4
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• pp.293-302
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• 2007

I. Objectives The purpose of this study was to compare the shaping ability between the single length technique performed with Mtwo instruments (VDW, Munich, Germany) and the crown-down technique using K3 (SybronEndo, West Collins, CA, USA) and RaCe (FKG, La Chaux-de-Fonds, Switzerland) instruments. II. Materials & Methods Forty five curved canals in resin blocks were equally divided in to three groups. Group 1 (Mtwo) was instrumented used the full length of canal according to the manufacturer's instructions. The simulated canals was prepared to an instrument size of 35, 0.04 taper canal terminus. In group 2 (Race) and group 3 (K3) was instrumented in a crown-down manner and prepared to an instrument size of 30, 0.06 taper canal terminus. Pre- and post-instrumentation images were scanned and assessment of canal shape was completed with a computer image analysis program. Material removal was measured at 7 measuring points, beginning 1mm from the end point of preparation. Differenced of centering ratio were statistically analyzed using One-way ANOVA followed by Duncan's test. II. Results & Conclusion There was no significant difference on 1, 2, 3 and 7mm measuring point. At 4 and 5 measuring point, significant difference showed between the Mtow instruments and other two instruments. (p<0.05)

• Restorative Dentistry and Endodontics
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• v.38 no.4
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• pp.204-209
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• 2013

Objectives: The objective of this in vitro study was to evaluate and compare the cytotoxicity of four different root canal sealers i.e. Apexit Plus (Ivoclar Vivadent), Endomethasone N (Septodont), AH-26 (Dentsply) and Pulpdent Root Canal Sealer (Pulpdent), on a mouse fibroblast cell line (L929). Materials and Methods: Thirty two discs for each sealer (5 mm in diameter and 2 mm in height) were fabricated in Teflon mould. The sealer extraction was made in cell culture medium (Dulbecco's Modified Eagle's Medium, DMEM) using the ratio 1.25 $cm^2/mL$ between the surface of the sealer samples and the volume of medium in a shaker incubator. Extraction of each sealer was obtained at 24 hr, 7th day, 14th day, and one month of interval. These extracts were incubated with L929 cell line and 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyltetrazolium bromide (MTT) assay was done. Two-way ANOVA for interaction effects between sealer and time and Post-hoc multiple comparison using Tukey's test across all the 16 different groups were used for statistical analysis. Results: Apexit Plus root canal sealer was significantly less toxic than other sealers (p < 0.05) and showed higher cellular growth than control. Endomethasone N showed mild cytotoxicity. AH-26 showed severe toxicity which became mild after one month while Pulpdent Root Canal Sealer showed severe to moderate toxicity. Conclusions: Apexit Plus was relatively biocompatible sealer as compared to other three sealers which were cytotoxic at their initial stages, however, they became biocompatible with time.

• Journal of Korean Dental Science
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• v.3 no.2
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• pp.4-11
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• 2010

Purpose: This study aimed at examining the thickness of lateral cortical bone in the mandibular posterior body and the location of the inferior alveolar nerve canal as well as investigating the clinically viable bone grafting site(s) and proper thickness of the bone grafts. Subjects and Methods: The study enrolled a total of 49 patients who visited the Department of Oral and Maxillofacial Surgery at Kyung Hee University Dental Hospital to have their lower third molar extracted and received cone beam computed tomography (CBCT) examinations. Their CBCT data were used for the study. The thickness of lateral cortical bone and the location of inferior alveolar nerve canal were each measured from the buccal midpoint of the patients' lower first molar to the mandibular ramus area in the occlusal plane of the molar area. Results: Except in the external oblique ridge and alveolar ridge, all measured areas exhibited the greatest cortical bone thickness near the lower second molar area and the smallest cortical bone thickness in the retromolar area. The inferior alveolar nerve canal was found to be located in the innermost site near the lower second molar area compared to other areas. In addition, the greatest thickness of the trabecular bone was found between the inferior alveolar nerve canal and the lateral cortical bone. Conclusions: In actual clinical settings involving bone harvesting in the posterior mandibular body, clinicians are advised to avoid locating the osteotomy line in the retromolar area to help protect the inferior alveolar nerve canal from damage. Harvesting the bone near the lower second molar area is judged to be the proper way of securing cortical bone with the greatest thickness.

• Restorative Dentistry and Endodontics
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• v.46 no.2
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• pp.16.1-16.11
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• 2021

Objectives: The aim of this study was to evaluate the shaping ability of the TruShape and Reciproc Blue systems and the apical extrusion of debris after root canal instrumentation. The ProTaper Universal system was used as a reference for comparison. Materials and Methods: Thirty-three mandibular premolars with a single canal were scanned using micro-computed tomography and were matched into 3 groups (n = 11) according to the instrumentation system: TruShape, Reciproc Blue and ProTaper Universal. The teeth were accessed and mounted in an apparatus with agarose gel, which simulated apical resistance provided by the periapical tissue and enabled the collection of apically extruded debris. During root canal preparation, 2.5% sodium hypochlorite was used as an irrigant. The samples were scanned again after instrumentation. The percentage of unprepared area, removed dentin, and volume of apically extruded debris were analyzed. The data were analyzed using 1-way analysis of variance and the Tukey test for multiple comparisons at a 5% significance level. Results: No significant differences in the percentage of unprepared area were observed among the systems (p > 0.05). ProTaper Universal presented a higher percentage of dentin removal than the TruShape and Reciproc Blue systems (p < 0.05). The systems produced similar volumes of apically extruded debris (p > 0.05). Conclusions: All systems caused apically extruded debris, without any significant differences among them. TruShape, Reciproc Blue, and ProTaper Universal presented similar percentages of unprepared area after root canal instrumentation; however, ProTaper Universal was associated with higher dentin removal than the other systems.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.4
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• pp.371-383
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• 2012

Shaping the root canal system to maintain original canal curvature is essential to clinical success in endodontic treatment. Opposed to most root canals that are curved, endodontic instruments are made from straight metal blanks. They have a tendency of straightening the root canal during preparation and frequently result in procedural errors. A new treatment method to maintain original canal curvature during shaping has been introduced for preventing procedural errors. The aim of this study was to compare the ability of instruments to maintain original canal curvature of continuous rotary system and single file system. Thirty ISO 15, 0.02 taper, Endo Training Blocks(Dentsplay Maillefer) were used. Specimens were assigned to 1 of 3 groups for shaping: specimens in group 1 were shaped with ProFile #20/.06 at the WL. Specimens in group 2 were shaped with Mtwo #35/.04 at the WL. Specimens in group 3 were shaped with WaveOne Primary reciprocating files at the WL after the glide path was achieved with PathFile. Pre- and postinstrumentation digital images were superimposed and processed with Matlab r2010b(The MathWorks Inc, Natick, MA) software to analyze the curvature-radius ratio(CRr), representing canal curvature modification. Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file were analyzed with 1-way ANOVA(P<.05). Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file system were analyzed with independent t-test(P<.05). A statistically significant difference(P<0.05) was noted on each Ni-Ti file. ProFile and WaveOne instrumentations maintained the original canal curvature significantly better(P<0.05) than Mtwo file. There were no significant difference(P>0.05) between continuous rotary system and single file system. Under the conditions of this study, ProFile and WaveOne instruments maintained the original curvature significantly better than Mtwo file and were less modification of the canal curvature compared. There was no significant difference between continuous rotary system and single file system in shaping of simulated canals. As clinical practitioners, it may be advantages to use hybrid approach when root canal shapes depending on the design and usage of Ni-Ti files.

• Restorative Dentistry and Endodontics
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• v.31 no.1
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• pp.30-35
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• 2006

To evaluate the change of working length with various instrumentation techniques in curved canals, working length and canal curvature were determined before and after canal instrumentation in buccal or mesial canals of extracted human molars. Stainless steel K-files ($MANI^{(R)}$, Matsutani Seisakusho Co. Takanezawa, Japan), nickel-titanium K-files (Naviflex $NT^{TM}$, Brassier, Savannah, USA) , $ProFile^{(R)}$, and ProTaper (Dentsply-Maillefer, Ballaigues, Switzerland) were used to prepare the canals with crown-down technique. In two hand instrumentation groups coronal flaring was made with Gates Glidden burs. Apical canals were instrumented until apical diameter had attained a size of 30. Positional relation between the tooth apex and the $\#10$ K-file tip was examined by using AutoCAD 2000 (Autodesk Corp., San Rafael. CA, USA) under a stereomicroscope before and after coronal flaring, and after apical instrumentation. Degree of canal curvature was also measured with Schneider's method in radiographs. Data of working length and canal curvature changes were statistically analyzed with one-way ANOVA and Tukey's studentized range test. Working length and canal curvature were decreased significantly in each step in all instrumentation groups. Coronal flaring using Cates Glidden burs in hand instrument groups and whole canal instrumentation using stainless steel hand K-files caused significantly more working length change than in ProFile instrumentation group (p<0.05). The result of this study demonstrates that all of the above kinds of instrumentation in curved canals cause reduction of working length and canal curvature at each instrumentation steps, and hand instrumentation causes more working length change than ProFile.

• Restorative Dentistry and Endodontics
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• v.27 no.4
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• pp.411-420
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• 2002

The aim of this study is to compare the adaptability of thermoplasticized injectable gutta-percha technique to the canal walls in ribbon-shaped canals. Thirty resin models simulated ribbon-shape canals were instrumented to #40 using .06 taper Profile systems. Three groups of each 10 resin models were obturated by the lateral condensation technique(LC) and the two thermoplasticized injectable gutta-percha technique; Ultrafil Endoset+Obtura II(EO) and Ultrafil Firmset(UF), respectively. After resin model were kept at room temperature for 4 days, they were resected horizontally with micro-tome at 1, 2, 3, 4 and 5mm levels from apex. At each levels. image of resected surface were taken using CCD camera under a stereomicroscope at $\times$40 magnification and stored. Ratio of the area of gutta-percha was obtained by calculating area of gutta-percha cone to the total area of canal using digitized image-ana-Iyzing program. The data were collected then analyzed statistically using One-way ANOVA. The results were as follows. 1 At 1mm levels, there was no statistically significant difference in the mean ratio of gutta-percha among the groups. 2. At 2mm level, EO showed the highest mean ratio of gutta-percha (p<0.05) and there was no significant difference between LC and UF. 3. At 3, 4, 5mm levels, EO and UF had significantly greater mean ratio of gutta-percha than LC(p<0.05) and there was no significant difference between EO and UF. In conclusion, the thermoplasticized injectable gutta-percha techniques demonstrated relatively favorable adaptability to canal walls than lateral condensation technique in ribbon-shaped canals except for 1mm level.

• Restorative Dentistry and Endodontics
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• v.45 no.2
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• pp.18.1-18.9
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• 2020

Objectives: The purpose of this study was to evaluate the void of root canal filling over time when a calcium silicate sealer was used in the single gutta-percha cone technique. Materials and Methods: Twenty-four J-shaped simulated root canals and twenty-four palatal root canals from extracted human maxillary molars were instrumented with ProFile Ni-Ti rotary instruments up to size 35/0.06 or size 40/0.06, respectively. Half of the canals were filled with Endoseal MTA and the other half were with AH Plus Jet using the single gutta-percha cone technique. Immediately after and 4 weeks after the root canal filling, the samples were scanned using micro-computed tomography at a resolution of 12.8 ㎛. The scanned images were reconstructed using the NRecon software and the void percentages were calculated using the CTan software, and statistically analyzed by 1-way analysis of variance, paired t-test and Tukey post hoc test. Results: After 4 weeks, there were no significant changes in the void percentages at all levels in both material groups (p > 0.05), except at the apical level of the AH Plus Jet group (p < 0.05) in the simulated root canal showing more void percentage compared to other groups. Immediately after filling the extracted human root canals, the Endoseal MTA group showed significantly less void percentage compared to the AH Plus Jet group (p < 0.05). Conclusions: Under the limitations of this study, the Endoseal MTA does not seem to reduce the voids over time.

• Restorative Dentistry and Endodontics
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• v.42 no.1
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• pp.27-33
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• 2017

Objectives: To determine the optimal timing for post space preparation of root canals sealed with epoxy resin-based AH Plus sealer in terms of its polymerization and influence on apical leakage. Materials and Methods: The epoxy polymerization of AH Plus (Dentsply DeTrey) as a function of time after mixing (8, 24, and 72 hours, and 1 week) was evaluated using Fourier transform infrared (FTIR) spectroscopy and microhardness measurements. The change in the glass transition temperature ($T_g$) of the material with time was also investigated using differential scanning calorimetry (DSC). Fifty extracted human single-rooted premolars were filled with gutta-percha and AH Plus, and randomly separated into five groups (n = 10) based on post space preparation timing (immediately after root canal obturation and 8, 24, and 72 hours, and 1 week after root canal obturation). The extent of apical leakage (mm) of the five groups was compared using a dye leakage test. Each dataset was statistically analyzed by one-way analysis of variance and Tukey's post hoc test (${\alpha}=0.05$). Results: Continuous epoxy polymerization of the material with time was observed. Although the $T_g$ values of the material gradually increased with time, the specimens presented no clear $T_g$ value at 1 week after mixing. When the post space was prepared 1 week after root canal obturation, the leakage was significantly higher than in the other groups (p < 0.05), among which there was no significant difference in leakage. Conclusions: Poor apical seal was detected when post space preparation was delayed until 1 week after root canal obturation.