• Restorative Dentistry and Endodontics
• /
• 제49권3호
• /
• pp.26.1-26.14
• /
• 2024

Objectives: This study aimed to investigate the frequency and type of endodontic procedural errors in cases indicated for retreatment through cone-beam computed tomography (CBCT) analysis. Materials and Methods: The sample consisted of 96 CBCT scans, encompassing 122 permanent teeth with fully formed roots. Errors included perforation, instrument fracture, canal transportation, missed canals, and inadequate apical limit of filling. Additionally, potential risk factors were analyzed and subjected to statistical modeling. Results: The most frequent procedural error observed was the inadequate apical limit of filling, followed by canal transportation, perforation, missed canal, and instrument fracture. Statistically significant associations were identified between various procedural errors and specific factors. These include canal transportation and root canal wall, with the buccal wall being the most commonly affected; missed canal and tooth type, particularly the palatine and second mesiobuccal canal canals; inadequate apical limit of filling and root curvature, showing a higher deviation to the mesial direction in severely curved canals; inadequate apical limit of filling and the presence of calcifications, with underfilling being the most frequent; canal transportation and periapical lesion, notably with deviation to the buccal direction; and the direction of perforation and periapical lesion, most frequently occurring to buccal direction. Conclusions: CBCT emerges as a valuable tool in identifying procedural errors and associated factors, crucial for their prevention and management.

• Restorative Dentistry and Endodontics
• /
• 제47권1호
• /
• pp.13.1-13.13
• /
• 2022

Objectives: This study evaluated the efficacy of 3 reciprocating systems and the effects of 2 instruments for irrigant activation on filling material removal. Materials and Methods: Forty mesiobuccal roots of maxillary molars were prepared up to size 25.06 and obturated. Micro-computed tomography (micro-CT) examination #1 was performed. Teeth were then divided into 4 groups (n = 10), according to the retreatment protocol: (1) manual, (2) Reciproc Blue, (3) WaveOne Gold, and (4) X1 Blue. Micro-CT examinations #2 and #3 were performed after filling removal and repreparation, respectively. Next, all teeth were divided into 2 new groups (n = 20) according to the irrigant activation protocol: XP Clean (XP Clean size 25.02) and Flatsonic (Flatsonic ultrasonic tip). Micro-CT examination #4 was performed after irrigant activation. Statistical analysis was performed with a significance level set at 5%. Results: WaveOne Gold removed a significantly greater amount of filling material than the manual group (p < 0.05). The time to reach the WL was similar for all reciprocating systems (p > 0.05). X1 Blue was faster than the manual group (p < 0.05). Only manual group improved the filling material removal after the repreparation stage (p < 0.05). Both activation protocols significantly improved the filling material removal (p < 0.05), without differences between them (p > 0.05). Conclusions: None of the tested instruments completely removed the filling material. X1 Blue size 25.06 reached the working length in the shortest time. XP Clean and Flatsonic improved the filling material removal.

• 구강회복응용과학지
• /
• 제37권2호
• /
• pp.95-100
• /
• 2021

수산화칼슘제재는 근관치료 과정 동안 근관 내 첩약제로서 널리 사용되고 있다. 이번 증례 보고에서는 근관 세척제로 사용된 수산화칼슘제재가 치근단 병소로 의도치 않게 과충전된 치아에 대해 정확한 진단과 적절하게 행해진 비외과적인 재근관치료를 통해 성공적으로 치료한 증례를 보고하고자 한다. 과충전된 수산화칼슘제재가 치근단 병소의 치유 과정에 영향을 줄 수 있으므로 수산화칼슘제재의 과충전이 발생하지 않도록 주의를 기울여야 한다.

• Restorative Dentistry and Endodontics
• /
• 제35권6호
• /
• pp.436-444
• /
• 2010

연구목적: 이 연구는 근관치료 전문의에 의해 시행된 비외과적 근관치료의 임상적 성공률을 전향적으로 평가하고, 치료 성공율과 관련된 환자요인과 치아요인의 영향력을 평가하는 것을 목적으로 하였다. 연구 재료 및 방법: 비외과적 근관치료가 이루어진 441개 치아 중 175개의 치아를 1-2년 후 임상적 검진과 방사선촬영을 하였다. 결과: 치근단 방사선 병소의 유무로 평가된 비외과적 근관치료의 성공율은 81.1% 였다. 치아요인 중 재근관치료, 괴사된 치수, 치수병변에서 유래된 치은의 부종 또는 sinus tract, 그리고 치료 전 치근단 병변의 존재는 이변수분석에서 치료성공에 부정적 영향을 미치는 것으로 나타났다 (p < 0.05). 환자요인, 치아요인과 근관충전의 길이를 포함한 단계적 로지스틱 회귀분석에서는 치수병변에서 유래된 치은의 문제 (odds ratio [OR]: 4.4; p = 0.005), 치료 전 치근단 병변의 존재 (OR: 3.6; p = 0.011), 그리고 치근단에서부터 1-2 mm 짧은 근관충전 (OR: 9.6; p = 0.012) 이 치료 실패와 관련된 주요한 요인으로 나타났다. 결론: 치료 전 치근단 병변의 존재뿐만 아니라 치수병변에서 유래된 치은의 부종 또는 sinus tract의 존재는 비외과적 근관치료의 실패에 영향을 줄 수 있는 것으로 나타났다.

• Restorative Dentistry and Endodontics
• /
• 제39권2호
• /
• pp.137-142
• /
• 2014

This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.

• Restorative Dentistry and Endodontics
• /
• 제42권1호
• /
• pp.19-26
• /
• 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.

• 대한소아치과학회지
• /
• 제21권2호
• /
• pp.593-598
• /
• 1994

There were two cases of esthetic improvement of discolored teeth. First case was 12-year-old girl whose upper right central incisor was discolored after traumatic injury. She was treated by walking bleaching technique. Endodontic retreatment was done, and then the mixture of Superoxol and sodium perborate was applied and changed every week. After 3 weeks, esthetic result was obtained and fracture site was rcovered with light-curing composite resin. Second cases was 11-year-old girl whose teeth were discolored by fluorosis. She was treated by vital bleaching technique. A resin splint was made and then 30% and 15% carbamide peroxide was applied using this splint. After 4 weeks, a noticeable improvement in the color and the brightness of the teeth was achieved.

• Restorative Dentistry and Endodontics
• /
• 제22권1호
• /
• pp.181-192
• /
• 1997

The difficulty of endodontic retreatment depends on various factors and it is affected by retention of post. In this experiment, root canal therapy was done in extracted human teeth and cut into 10mm length from the root apex, and then cemented by zinc phosphate cement, Vitremer$^{(R)}$(glass ionomer) luting cement and Panavia 21$^{(R)}$(resin cement). Post preparation was done by #4 Parapost drill at 6mm length and cement was inserted by lentulo spiral. After 24 hours, tensile bond strength, post removal time was measured after the ultrasonic application and the separation site was measured. The following results were obtained. 1. In measuring tensile bond strength, there is no statistical difference between zinc phosphate cement and Panavia 21$^{(R)}$, but Vitremer$^{(R)}$ showed lower value compared with those two cements. (p<0.001) 2. When the post removal time was measured after ultrasonic application, significant different value in order of Panavia 21$^{(R)}$, zinc phosphate cement and Vitremer$^{(R)}$ was shown. (p<0.001) 3. As a result of examining the separating site of each cement, all 16 of zinc phosphate cement group showed the fracture site between cement and post, Vitremer$^{(R)}$ was 13/16, and Panavia 2$^{(R)}$ was 8/16. In case of tooth restoration using Parapost, the use of Panavia 21 showed good retention property than Vitremer$^{(R)}$, but when retreatment is needed the difficulty of post removal will be increased.

• Restorative Dentistry and Endodontics
• /
• 제30권3호
• /
• pp.215-220
• /
• 2005

포스트가 축조된 치아를 재근관 치료하는 경우 성공적인 비외과적 재근관치료를 시행하기 위해서는 포스트 제거가 선행되어야 한다. 기존의 포스트를 제거하는 방법으로는 초음파기구, Ruddle post removal system, Eaggler post remover, Masserann kit을 이용하는 방법 등 여러 가지가 소개 되고 있으나 기존의 방법들은 각 기구에 맞게 코어를 삭제해야 하는 시간과 많은 노력이 요구되며 포스트 제거시 치아나 포스트의 파절이 유발되기도 한다 그러나 최근에는 기존의 방법과는 다른 ATD automatic bridge remover를 이용해 포스트를 제거하는 새로운 방법이 소개되고 있으며 코어에 구멍을 형성하는 시간만 소요되어 비교적 빨리 제거 할 수 있다는 장점을 가지고 있다. 따라서 본 증례에서는 ATD automatic bridge remover를 이용해 주조포스트를 제거하고 성공적으로 재근관치료를 시행한 증례에 대해서 보고하고자 한다.

• Restorative Dentistry and Endodontics
• /
• 제46권4호
• /
• pp.49.1-49.8
• /
• 2021

Objectives: To evaluate the fracture incidence of Reciproc R25 instruments (VDW) used during non-surgical root canal retreatments performed by students in a postgraduate endodontic program. Materials and Methods: From the analysis of clinical record cards and periapical radiographs of root canal retreatments performed by postgraduate students using the Reciproc R25, a total of 1,016 teeth (2,544 root canals) were selected. The instruments were discarded after a single use. The general incidence of instrument fractures and its frequency was analyzed considering the group of teeth and the root thirds where the fractures occurred. Statistical analysis was performed using the χ² test (p < 0.01). Results: Seven instruments were separated during the procedures. The percentage of fracture in relation to the number of instrumented canals was 0.27% and 0.68% in relation to the number of instrumented teeth. Four fractures occurred in maxillary molars, 1 in a mandibular molar, 1 in a mandibular premolar and 1 in a maxillary incisor. A greater number of fractures was observed in molars when compared with the number of fractures observed in the other dental groups (p < 0.01). Considering all of the instrument fractures, 71.43% were located in the apical third and 28.57% in the middle third (p < 0.01). One instrument fragment was removed, one bypassed, while in 5 cases, the instrument fragment remained inside the root canal. Conclusions: The use of Reciproc R25 instruments in root canal retreatments carried out by postgraduate students was associated with a low incidence of fractures.