• 대한치과의사협회지
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• 제56권10호
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• pp.572-580
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• 2018

Adequate access cavity is the key to achieving endodontic success. The aims of the access cavity can be considered as follows: 1) Creation of a smooth unimpeded pathway for instruments to canal orifices 2) Removal of the entire roof of the pulp chamber in order to inspect the pulp floor, 3) Preservation of natural tooth substance consistent with the above. Recently, contracted endodontic cavities based on minimally invasive endodontics has introduced. This has the benefit of preserving the pericervical dentin more than traditional access cavity with achieving long-term success. However, some studies reported controversial results regarding root canal detection, instrumentation efficacy (noninstrumented canal area, hard tissue debris accumulation, canal transportation, and centering ratio) as well as fracture resistance. Therefore, further studies are required for accepting contracted access cavity, and modified form of traditional and contracted access cavity could be considered.

• Restorative Dentistry and Endodontics
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• 제46권3호
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• pp.46.1-46.9
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• 2021

The aim of this review was to evaluate the effects of different access cavity designs on endodontic treatment and tooth prognosis. Two independent reviewers conducted an unrestricted search of the relevant literature contained in the following electronic databases: PubMed, Science Direct, Scopus, Web of Science, and OpenGrey. The electronic search was supplemented by a manual search during the same time period. The reference lists of the articles that advanced to second-round screening were hand-searched to identify additional potential articles. Experts were also contacted in an effort to learn about possible unpublished or ongoing studies. The benefits of minimally invasive access (MIA) cavities are not yet fully supported by research data. There is no evidence that this approach can replace the traditional approach of straight-line access cavities. Guided endodontics is a new method for teeth with pulp canal calcification and apical infection, but there have been no cost-benefit investigations or time studies to verify these personal opinions. Although the purpose of MIA cavities is to reflect clinicians' interest in retaining a greater amount of the dental substance, traditional cavities are the safer method for effective instrument operation and the prevention of iatrogenic complications.

• Restorative Dentistry and Endodontics
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• 제27권4호
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• pp.389-393
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• 2002

The marginal integrity of the crown can be broken during endodontic access cavity preparation due to the vibration of burs. Therefore, the purpose of this study was to evaluate the effect of endodontic access cavity preparation on the marginal leakage of full veneer gold crowns. 24 intact molars were mounted in acrylic resin blocks and prepared for crowns by a restorative dentist and crowns were cast with gold alloy. 20 Crowns were cemented with glass ionomer cement and 2 crowns were not cemented for positive control. 200 thermo-cycles from 5$^{\circ}C$ to 5$0^{\circ}C$ with a travel time of 20s were completed. Then samples were randomly divided into 2 experimental groups of 9 each. Endodontic access preparation and zinc-oxide eugenol temporary fillings were done in Group 1. Teeth in Group 2 were not treated. Samples were coated with 2 layers of nail varnish and were immersed in 1% methylene blue dye for 20 hrs. Endodontic access was prepared in 2 samples, which were coated with nail varnish on all surfaces for negative control. After washing in running water gold crowns were cut with a #330 bur. Four buccolingual sections, 2 mm apart, were cut from the central section of each tooth and were examined and scored under the microscope for dye leakage. Score 1: leakage to the cervical 1/3 of the axial wall, Score 2: leakage to the middle 1/3 of the axial wall, Score 3: leakage to the coronal 1/3 of the axial wall, Score 4: leakage to the occlusal surface. The median value for Group 1 is 4 and for Group 2 is 2. The result of this study showed that samples in Group 1 leaked more than those in Group 2. This finding was significant(P<0.001).

• Restorative Dentistry and Endodontics
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• 제45권3호
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• pp.33.1-33.10
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• 2020

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.

• 대한치과의사협회지
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• 제48권4호
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• pp.288-296
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• 2010

Although non-surgical endodontic procedures have high success rates, failures do occur, These can be managed by root canal re-treatment or surgical intervention. Intentional replantation is an accepted endodontic treatment procedure in which a tooth is extracted and treated outside the oral cavity and then inserted into its socket to correct an obvious radiographic or clinical endodontic failure. Intentional replantation is indicated when other endodontic treatments performed to maintain the tooth have failed, or when endodontic periradicular surgery is not feasible. Intentional replantation may be particularly useful in these cases because these difficult to access areas can be maximally treated while the tooth is out of the mouth without damaging the periodontal attachment in adjacent teeth. In conclusion, intentional replantation is a reliable and even predictable procedure, and should be considered more often as a treatment modality in our efforts to maintain the natural dentition.

• Restorative Dentistry and Endodontics
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• 제38권4호
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• pp.187-193
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• 2013

Epinephrine is one of the most widely-used vasoconstrictors in dental treatment including endodontic microsurgery. However, the systemic safety of epinephrine has been in debate for many years because of its potential risk to cause cardiovascular complications. The purpose of this review was to assess the cardiovascular effect of epinephrine use in endodontic microsurgery. Endodontic microsurgery directly applies epinephrine into the bone cavity, and the amount is reported to be much larger than other dental surgeries. Moreover, when considering that systemic potency of intraosseous application is reported to be comparable to intravenous application, the systemic influence of epinephrine could be increased in endodontic microsurgery. Besides, pre-existing cardiovascular complications or drug interactions can enhance its systemic influence, resulting in increased susceptibility to cardiovascular complications. Although clinical studies have not reported significant complications for patients without severe systemic complications, many epinephrine-induced emergency cases are warning the cardiovascular risk related with pre-existing systemic disease or drug interactions. Epinephrine is a dose-sensitive drug, and its hypersensitivity reaction can be fatal to patients when it is related to cardiovascular complications. Therefore, clinicians should recognize the risk, and the usage of pre-operative patient evaluation, dose control and patient monitoring are required to ensure patient's safety during endodontic microsurgery.

• 대한치과의사협회지
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• 제13권11호
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• pp.1071-1073
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• 1975

• 대한치과의사협회지
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• 제50권7호
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• pp.384-393
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• 2012

Successful treatment of a badly broken down tooth with pulpal disease depends not only on good endodontic therapy, but also on good prosthetic reconstruction of the tooth after endodontic therapy is completed. The ideal treatment of endodontically treated teeth has been widely and controversially discussed. Endocrown is a restorative option for endodontically treated teeth. Endocrown design incorporates the core and short post into the crown as a single restoration. The preparation of endocrown consists of a circular equigingival butt-joint margin and central retention cavity of the entire pulp chamber instead of employing intraradicular posts. This design significantly increases the surface area of the preparation available for cementation. It is particularly useful in young patient teeth for long-term provisional restoration and in teeth with short clinical crowns. This technique represents a promising and conservative method for the treatment of endodontically treated teeth that require long-term protection and stability. Endocrown can be considered as a feasible alternative to full crowns or composite overlays for the restoration of non vital teeth.

• 대한치과의사협회지
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• 제55권8호
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• pp.565-573
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• 2017

Root canal perforations are defined as the communication between the pulp cavity, the periodontal tissue and alveolar bone. The occurrence of perforations during endodontic treatment is reported to range from 2.3%~12%, which is not a complication rarely happens. Perforations have iatrogenic or pathological etiologies that involve caries or resorption. It leads to inflammation and the destruction of periodontal fibers and alveolar bone, followed by periodontal defects. Mineral trioxide aggregate (MTA) is currently the most indicated material for repair of root perforation, because of its favorable biocompatibility and sealing ability. Using magnification with dental operating microscope enhance the accessibility and visibility to manage the root perforation. It is important to diagnose and repair perforations immediately if possible.

• Restorative Dentistry and Endodontics
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• 제48권3호
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• pp.25.1-25.13
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• 2023

Objectives: The purpose of this study was to evaluate the influence of endodontic access cavities design on the removal of calcium hydroxide medication of the apical third of mandibular incisor root canal walls and dentinal tubules with different cleaning protocols: EDDY sonic activation, Er,Cr:YSGG laser-activated irrigation, or conventional irrigation with IrriFlex. Materials and Methods: Seventy-eight extracted human mandibular incisors were assigned to 6 experimental groups (n = 13) according to the endodontic access cavity and cleaning protocol for calcium hydroxide removal: traditional access cavity (TradAC)/EDDY; ultraconservative access cavity performed in the incisal edge (UltraAC.Inc)/EDDY; TradAC/Er,Cr:YSGG; UltraAC. Inc/Er,Cr:YSGG; TradAC/IrriFlex; or UltraAC.Inc/IrriFlex. Confocal laser scanning microscopy images were used to measure the non-penetration percentage, maximum residual calcium hydroxide penetration depth, and penetration area at 2 and 4 mm from the apex. Data were statistically analyzed using Shapiro-Wilk and WRS2 package for 2-way comparison of non-normally distributed parameters (depth of penetration, area of penetration, and percentage of non-penetration) according to cavity and cleaning protocol with the significance level set at 5%. Results: The effect of cavity and cleaning protocol interactions on penetration depth, penetration area and non-penetration percentage was not found statistically significant at 2 and 4 mm levels (p > 0.05). Conclusions: The present study demonstrated that TradAC or UltraAC.Inc preparations with different cleaning protocols in extracted mandibular incisors did not influence the remaining calcium hydroxide at 2 and 4 mm from the apex.