• Journal of Periodontal and Implant Science
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• v.42 no.2
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• pp.39-44
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• 2012

Purpose: Special care is necessary to avoid invading important anatomic structures during surgery when presurgical planning is made based on radiographs. However, none of these types of radiography represents a perfect modality. The purpose of this study was to determine the reliability of presurgical planning based on the use of two types of radiographic image (digital panoramic radiography [DPR] and cone-beam computed tomography [CBCT]) by beginner dentists to place implants, and to quantify differences in measurements between radiographic images and real specimens. Methods: Ten fresh cadavers without posterior teeth were used, and twelve practitioners who had no experience of implant surgery performed implant surgery after 10 hours of basic instruction using conventional surgical guide based on CBCT or DPR. Two types of measurement error were evaluated: 1) the presurgical measurement error, defined as that between the presurgical and postsurgical measurements in each modality of radiographic analysis, and 2) the measurement error between postsurgical radiography and the real specimen. Results: The mean presurgical measurement error was significantly smaller for CBCT than for DPR in the maxillary region, whereas it did not differ significantly between the two imaging modalities in the mandibular region. The mean measurement error between radiography and real specimens was significantly smaller for CBCT than for DPR in the maxillary region, but did not differ significantly in the mandibular region. Conclusions: Presurgical planning can be performed safely using DPR in the mandible; however, presurgical planning using CBCT is recommended in the maxilla when a structure in a buccolingual location needs to be evaluated because this imaging modality supplies buccolingual information that cannot be obtained from DPR.

• The Journal of Advanced Prosthodontics
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• v.5 no.1
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• pp.16-20
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• 2013

PURPOSE. To assess the retention of glass fiber post cemented with self-adhesive resin cement into optimum and over-prepared root canals following obturation in the presence of either eugenol (EB) or calcium hydroxide (CB)-based sealers. MATERIALS AND METHODS. Roots of extracted premolars were endodontically-treated in 5 groups (n = 10). Roots of Group 1 (control) were left with no obturation and then optimally prepared to receive endodontic dowels. Other root canals were obturated with gutta-percha in the presence of either eugenol-based (Groups 2 and 4) or calcium hydroxide-based (Groups 3 and 5) sealer. Dowel spaces were prepared with optimal diameter in Groups 2 and 3, one size larger in Groups 4 and 5. Standardized fiber posts were luted to the prepared spaces using self-adhesive resin cement and its retention was then tested on an universal testing machine. Both one-way ANOVA and Tukey's HSD comparisons (${\alpha}$=0.05) were used to identify the significance of inter-group retention differences. Scanning electron microscopy (SEM) of both optimally and over-prepared dowel spaces was also considered to figure the nature of their interior out. RESULTS. The post retention was significantly higher to the non-obturated, optimally-prepared dowel spaces of Group 1 compared to the obturated, optimally-prepared ones of Groups 2 and 3. For each dowel space diameter, root canals obturated using CB of Groups 3 and 5 showed significantly higher dowel retention compared to those obturated using EB of Groups 2 and 4. Post retention to the over-prepared dowel spaces of Groups 4 and 5 was significantly higher than that recorded for the optimally-prepared ones of Groups 1-3. SEM images revealed traces of endodontic sealer and gutta-percha on the walls of the optimally-prepared dowel spaces. CONCLUSION. Despite the adverse effect of endodontic sealers on the retention of fiber posts, the over-preparation of dowel spaces helps to improve the retention.

• Journal of Periodontal and Implant Science
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• v.50 no.1
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• pp.38-47
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• 2020

Purpose: The aim of this study was to investigate the available alveolar bone height between the maxillary molars and the sinus floor according to their anatomical relationship using cone-beam computed tomographic (CBCT) images. Methods: A total of 752 maxillary first (M1) and second molars (M2) on CBCT scans of 188 patients were selected. First, each maxillary molar was categorized as type 1, 2, 3, or 4 according to the relationship of the molar root with the maxillary sinus floor. The frequency distribution of each type was analyzed. Second, the shortest vertical distance (VD) of each molar was measured from the furcation midpoints of the roots to the lowest point of the sinus floor by 2 observers. Intraclass correlation coefficients and the t-test were calculated for the VD measurements. Results: For M1, type 3 was the most frequent, followed by type 2. For M2, type 3 was the most common, followed by type 1. The VD measurements of type 1 were 9.51±3.68 mm and 8.07±2.73 mm for M1 and M2, and those of type 3 were 3.70±1.52 mm and 4.03±1.53 mm for M1 and M2, respectively. The VD measurements of M2 were significantly higher in female patients than in male patients. Conclusions: Type 3 was the most frequent anatomical relationship in the maxillary molars, and showed the lowest alveolar bone height. This information will help clinicians to prevent complications related to the maxillary sinus during maxillary molar treatment and to predict the available bone height for immediate implant planning.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.2
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• pp.104-111
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• 2015

Purpose: The aim of this retrospective study was to investigate the prevalence rate and types of C-shaped roots and C-shaped canal in maxillary molars by analyzing cone-beam computed tomography (CBCT) in a Korean population. Materials and Methods: Total of 357 CBCT images of maxillary molars (186 first molar, 171 second molar) were evaluated by two Endodontic specialists. Results: Eight types of C-shaped roots and 5 types of C-shaped canals were founded, the prevalence rate of C-shaped roots and canals were 21.0% and 5.3% respectively. Conclusion: These anatomical variations were more frequent in second molars than the first molars. Clinicians should have anatomical knowledge about various types of C-shaped root and root canal for successful root canal therapy.

• Restorative Dentistry and Endodontics
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• v.42 no.2
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• pp.105-110
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• 2017

Objectives: This study investigated the cleaning ability of ultrasonically activated irrigation (UAI) and a novel activation system with reciprocating motion (EC, EasyClean, Easy Equipamentos $Odontol\acute{o}gicos$) when used with a relatively new chelating agent (QMix, Dentsply). In addition, the effect of QMix solution when used for a shorter (1 minute) and a longer application time (3 minutes) was investigated. Materials and Methods: Fifty permanent human teeth were prepared with K3 rotary system and 6% sodium hypochlorite. Samples were randomly assigned to five groups (n = 10) according to the final irrigation protocol: G1, negative control (distilled water); G2, positive control (QMix 1 minute); G3, QMix 1 minute/UAI; G4, QMix 1 minute/EC; G5, QMix 3 minutes. Subsequently the teeth were prepared and three photomicrographs were obtained in each root third of root walls, by scanning electron microscopy. Two blinded and pre-calibrated examiners evaluated the images using a four-category scoring system. Data were statistically analyzed using Kruskal-Wallis and Dunn tests (p < 0.05). Results: There were differences among groups (p < 0.05). UAI showed better cleaning ability than EC (p < 0.05). There were improvements when QMix was used with auxiliary devices in comparison with conventional irrigation (p < 0.05). Conventional irrigation for 3 minutes presented significantly better results than its use for 1 minute (p < 0.05). Conclusions: QMix should be used for 1 minute when it is used with UAI, since this final irrigation protocol showed the best performance and also allowed clinical optimization of this procedure.

• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.37.1-37.8
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• 2020

Objectives: This study aims to compare the cyclic fatigue resistance of VDW.ROTATE, TruNatomy, 2Shape, and HyFlex CM nickel-titanium (NiTi) rotary files at body temperature. Materials and Methods: In total, 80 VDW.ROTATE (25/0.04), TruNatomy (26/0.04), 2Shape (25/0.04), and HyFlex CM (25/0.04) NiTi rotary files (n = 20 in each group) were subjected to static cyclic fatigue testing at body temperature (37℃) in stainless-steel artificial canals prepared according to the size and taper of the instruments until fracture occurred. The number of cycles to fracture (NCF) was calculated, and the lengths of the fractured fragments were measured. The data were statistically analyzed using a 1-way analysis of variance and post hoc Tamhane tests at the 5% significance level (p < 0.05). Results: There were significant differences in the cyclic fatigue resistance among the groups (p < 0.05), with the highest to lowest NCF values of the files as follows: VDW.ROTATE, HyFlex CM, 2Shape, and TruNatomy. There was no significant difference in the lengths of the fractured fragments among the groups. The scanning electron microscope images of the files revealed typical characteristics of fracture due to cyclic fatigue. Conclusions: The VDW.ROTATE files had the highest cyclic fatigue resistance, and the TruNatomy and 2Shape files had the lowest cyclic fatigue resistance in artificial canals at body temperature.

• 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.19-26
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• 2017

Objectives: Recently, bioceramic sealers like EndoSequence BC Sealer (BC Sealer) have been introduced and are being used in endodontic practice. However, this sealer has limited research related to its retreatability. Hence, the aim of this study was to evaluate the retreatability of two sealers, BC Sealer as compared with AH Plus using micro-computed tomographic (micro-CT) analysis. Materials and Methods: Fifty-six extracted human maxillary incisors were instrumented and randomly divided into 4 groups of 14 teeth: 1A, gutta-percha, AH Plus retreated with chloroform; 1B, gutta-percha, AH Plus retreated without chloroform; 2A, gutta-percha, EndoSequence BC Sealer retreated with chloroform; 2B, gutta-percha, EndoSequence BC Sealer retreated without chloroform. Micro-CT scans were taken before and after obturation and retreatment and analyzed for the volume of residual material. The specimens were longitudinally sectioned and digitized images were taken with the dental operating microscope. Data was analyzed using an ANOVA and a post-hoc Tukey test. Fisher exact tests were performed to analyze the ability to regain patency. Results: There was significantly less residual root canal filling material in the AH Plus groups retreated with chloroform as compared to the others. The BC Sealer samples retreated with chloroform had better results than those retreated without chloroform. Furthermore, patency could be re-established in only 14% of teeth in the BC Sealer without chloroform group. Conclusion: The results of this study demonstrate that the BC Sealer group had significantly more residual filling material than the AH Plus group regardless of whether or not both sealers were retreated with chloroform.

• Imaging Science in Dentistry
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• v.49 no.1
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• pp.9-17
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• 2019

Purpose: This study aimed to introduce a novel method to evaluate the alveolar bone and interdental septum in the anterior mandible using cone-beam computed tomography (CBCT). Materials and Methods: Fifty-six CBCT scans from adult patients were selected. The CBCT scans were obtained before and after orthodontic treatment. The following measurements were taken: width of the alveolar bone and the interdental septum, height of the interdental septum, height of the bone plates, distance between the cementoenamel junction and marginal bone crests, and vertical positioning of the mandibular incisor, using the lingual plane as a reference. To test the reproducibility and the stability of the lingual plane, a triangle was traced in the anterior mandible. The intra-class correlation coefficient(ICC) was used to determine intra- and inter-examiner agreement. The paired Student t-test was used to evaluate the area of the triangle and the reproducibility of all measurements. Results: The ICC was excellent for the alveolar bone and dental measurements (0.9989 and 0.9977, respectively), as well as for the interdental septum (0.9987 and 0.9961, respectively). The area of the triangles showed stability in the lingual plane (P>0.05). For the alveolar bone, mandibular incisor, and interdental septum measurements, no statistically significant differences were found between the 2 examiners(P>0.05), confirming the technical reliability of the measurements. Conclusion: The method used in this study provides a valid and reproducible assessment of alveolar bone dimensions in the anterior mandible measured on CBCT images.

• The Journal of Advanced Prosthodontics
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• v.11 no.1
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• pp.1-6
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• 2019

PURPOSE. The purpose of this in vitro study was to evaluate the effect of surface grinding and polishing procedures using high speed zirconia diamond burs with different grit sizes on the phase transformation and flexural strength of zirconia. MATERIALS AND METHODS. Forty disc shape specimens ($15{\times}1.25mm$) with a cylindrical projection in the center of each disc ($1{\times}3mm$) were fabricated with 3Y-TZP (Prettau, Zirkonzahn, Italy). The specimens were divided into 4 groups (n=10) according to the grinding and polishing procedures: Control group - grinding (coarse-grit diamond bur), Group 1 - grinding (coarse-grit diamond bur) + polishing, Group 2 - grinding (fine-grit diamond bur) + polishing, and Group 3 - grinding (fine grit diamond bur). Each specimen was analyzed by 3D-OM, XRD analysis, and biaxial flexural strength test. RESULTS. Based on the surface morphology by 3D-OM images, polished specimens showed smoother surface and lower roughness value (Ra). In the result of XRD analysis, partial phase transformation from tetragonal to monoclinic zirconia occurred in all groups. Control group, ground with a coarse grit diamond bur, showed more $t{\rightarrow}m$ phase transformation and lower flexural strength than Groups 1 and 2 significantly. CONCLUSION. The flexural strength in all specimens after grinding and polishing showed over 500 MPa, and those were clinically acceptable. However, grinding with a coarse grit diamond bur without polishing induced the phase transformation and low strength. Therefore, surface polishing is required for the occlusal adjustment using a high speed zirconia diamond bur to reduce the phase transformation and to prevent the decrease of flexural strength of zirconia.