• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.71-95
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• 1995

Bacteria have been regarded as a one of major etiologic factors in root canal infections. In endodontic treatment the effective removal of pathogenic microorganisms in the root canal is the key to successful outcome. Bacterial cell wall components may play an important role in the development of pulpal and periapical disease. The purpose of this study was to evaluate the effect of sonic extracts of Streptococcus spp. on cultured L929 cells and to characterize cell wall protein profiles of Streptococcus spp. Streptococcus spp. were isolated from infected root canals and identified with Vitek Systems(Biomeriux, USA). Five streptococci, namely S. sanguis, S. mitis, S uberis, S. mutans (ATCC 10449) and S. faecalis (ATCC 19433) weere enriched in brain heart infusion broth. Cell pellets were sonicated and cell wall extracts were dialyzed and membrane filtered. Prepared cell wall proteins were applied to cultured L929 cell. The cell reaction were evaluated by monitoring DNA synthesis, cell numbers and the change of cell morphology. The total cell wall protein profiles of microorganisms were characterized by sodium dodecyl sulfate polyacrylamide-gel eledruphoresis(SDS-PAGE). DNA synthesis of L929 cells were reduced by the increasing concentration of sonic extracts. DNA synthesis was significantly suppressed in more than $50{\mu}g$/ml of sonic extract conentration in five streptococci. S. nutans (ATCC 10449) showed stronger suppression on DNA synthesis than remaining four streptococci, which had the similar effect on DNA synthesis. Analysis of DNA synthesis measured by [$^3H$]-thymidine uptake was more sensitvie method than cell counting. Sonic extracts affected the microscopic findings of L929 cells. The protein profiles indicated that all five strains shared two major proteins with molecular masses of 70.8 and 57.5 kD respectively. S. uberis and S. mutans shared common minor proteins of which molecular weights were 147.9 and 112.2 kD respectively. However some minor proteins were unique for S. mitis, S. uberis and S. faecalis.

• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.235-249
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• 1995

This study was designed to identify the lymphocytes present and to examine the relation between lymphocytes population and clinical symptoms of the pulps clinically diagnosed as normal and irreversible pulpitis. We recorded the history and severity of the pain and performed several clinical tests, before extirpation of vital, irreversibly inflamed pulps in routine endodontic treatment. Then the teeth were divided into two groups. Five teeth, categorized in acute symptom group, had severe spontaneous pain, particularly at night and were extremely sensitive to cold and heat. The other 15 teeth with history of mild to moderate pain and with or without cold or heat responses were categorized as chronic symptom group. Inflamed pulps were also classified into 8 minor groups by presence or absence of signs or symptoms related to the involved teeth, including the presence of pain on percussion, pain on heat and cold stimuli and the periodontal pocket depth. All extirpated pulps were immediately immersed in ultra low-temperature freezer($-74^{\circ}C$), and they were sectioned $6{\mu}m$ in thickness. Specimens were stained using three-stage indirect immunoperoxidase techniques(DAKO, LSAB kit) and monoclonal antibodies for detecting the presence of T lymphocytes(T), B lymphocytes(B) and helper(T4) and suppressor(T8) lymphocytes. Following results were obtained; 1. All the examined normal and inflamed pull) tissues had positive staining for T lymphocytes and T helper and T suppressor cells. But B cells were observed only in inflamed pulp. 2. Statistically more T and B cells were observed in acute symptom group as compared with chronic symptom group(p<0.05). 3. Cell ratio of BIT in acute symptom group were significantly higher than that of chronic symptom group(p<0.05). 4. Only B cells were significantly increased in the percussion positive group than the number of B cells in percussion negative group(p<0.05). 5. No differences were observed in the number of different cell types among other minor groups.

• Restorative Dentistry and Endodontics
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• v.45 no.1
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• pp.7.1-7.9
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• 2020

Objectives: This study was performed to assess the anatomy of mandibular first molars. Materials and Methods: In this in vivo study, cone-beam computed tomography (CBCT) volumes of 312 bilateral intact first mandibular molars from 156 patients (79 men and 77 women; average age, 35.6 ± 11.2 years) were investigated in terms of the direction of each canal's curvature in the buccolingual and mesiodistal dimensions (direction of the position of the apex in relation to the longitudinal axis of the root), the presence of an isthmus (a narrow, ribbon-shaped communication between 2 root canals) in 3 segments (0-2, 2-4, and 4-6 mm) from the apex), and the presence and number of accessory canals (smaller canals besides the main root canals, connecting the pulp to the periodontium). Data were analyzed statistically (α = 0.05). Results: Mesiolingual canals were mostly buccally and distally inclined, while mesiobuccal and distolingual canals were mostly distally curved. Isthmuses were more common in younger patients (χ² test, p < 0.05). The average numbers of accessory canals in the apical, middle, and coronal segments were 9.9 ± 4.2, 6.9 ± 2.9, and 9.3 ± 3.0 canals per segment, respectively (analysis of variance, p < 0.001). Age and sex were not associated with the number of accessory canals (p > 0.05). Conclusions: The complex anatomy of these teeth deserves attention during non-surgical or surgical endodontic treatment. Around the apex, isthmuses might be more prevalent in younger and female individuals.

• Restorative Dentistry and Endodontics
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• v.28 no.1
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• pp.41-49
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• 2003

There are increasing usage of Nickel-Titanium rotary files in modern clinical endodontic treatment because it is effective and faster than hand filing due to reduced step. This study was conducted to evaluate the effect of canal preparations using 3 different rotary Nickel-Titanium files that has different cross sectional shape and taper on the maintenance of canal curvature. Simulated resin block were instrumented with Profile(Dentsply, USA), GT rotary files(Dentsply, USA), Hero 642(Micro-Mega France), and Pro-Taper(Dentsply, USA). The image of Pre-instrumentation and Post-instrumentation were acquired using digital camera and overspreaded in the computer. Then the total differences of canal diameter, deviation at the outer portion of curvature, deviation at the inner portion of curvature, movement of center of the canal and the centering ratio at the pre-determined level from the apex were measured. Results were statistically analyzed by means of ANOVA, followed by Scheffe test at a significance level of 0.05. The results were as follows； 1. Deviation at the outer portion of curvature, deviation at the inner portion of curvature were showed largest in Pro-Taper so also did in the total differences of canal diameter(p＜0.05). 2. All the groups showed movements of center Profile combined with GT rotary files and Hero 642 has no difference but Pro-Taper showed the most deviation(p＜0.05). 3. At the 1, 2, 3mm level from the apex movements of center directed toward the outer portion of curvature, but in 4, 5 mm level directed toward the inner portion of curvature(p＜0.05). As a results of this study, it could be concluded that combined use of other Nickel-Titanium rotary files is strongly recommended when use Pro-Taper file because it could be remove too much canal structure and also made more deviation of canal curvature than others.

• Restorative Dentistry and Endodontics
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• v.28 no.3
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• pp.232-240
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• 2003

This study is to investigate the canal system in the mesiobuccal root of the maxillary first molar. 61 maxillary first molars were randomly selected. Serial transverse sections were made perpendicular to the long axis of the mesiobuccal root. Each section was placed in 3% sodium hypochlorite for 24 hours and rinsed in water and dried. The resected surface was stained with 2% methylene blue dye and examined with stereomicroscope. 1 Canal configuration analysis showed that 36.1% of the specimen classified as type I, 16.4% as type II , 37.7% as type III and 9.8% as type IV. 2. Type II canal was merged in one canal within 1 to 4mm of the apex. 40% of type II canal converged at 2mm of the apex. 3. Type IV canal was divided into two canal within 2 to 4mm of the apex. 66.6% of type IV canal branched off at 2mm of the apex. 4. None of the sections had more than two main root canal. 5. 48.4% of the sections in 3mm with two canals contained an isthmusand more than 70% with two canals has isthmus at 4 to 5mm sections. 63.9% of the mesiobuccal root of maxillary first molar had two canaland 76.5% of sections with two canals in 5 MM had an isthmus. Because of this complexity the clinician should always search for extra canal carefullyand root canal system, including an isthmus, should be cleaned and shaped completelyand obturated three dimensionally for successful endodontic treatment.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.374-387
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• 1997

The purpose of this study was to examine the distribution of lymphocyte populations in normal, reversibly inflamed and irreversibly inflamed human dental pulp tissues using flow cytometry. Flow cytometry, with specific antibody and fluorochrome reagent allows us to know cellular properties of hematolymphoid cells by measuring fluorescence of stained cells. Before extirpation of pulps in routine endodontic treatment, the clinical diagnosis were performed by symptom. The extirpated pulp tissues were divided into normal pulp group (N=5), reversible pulpit is group(N=10) and irreversible pulpitis group(N=7). The specimen was placed into RPMI 1640 medium, minced into small pieces, and then digested in medium with collagenase. The cell suspension was resuspended in PBS for monoclonal antibody staining of T lymhocytes(CD3+), B lymphocytes (CD19+), T helper cell (CD4+) and T supressor cell (CD8+). The percentages of cells were counted by FACStar(BD) flow cytometer. Following results were obtained; 1. In the most normal and inflamed pulps, the percentages of T lymphocyte, B lymphocytes, T helper cell and T suppressor/cytotoxic cell were less than 1 % in total counted pulpal cells. 2. The higher percentages of T, B, T helper and T suppressor cells were observed in irreversible pulpitis group as compared with the normal pulp and reversible pulpitis group but the differences between groups were not statistically significant (p>0.05). 3. The percentages of T helper cells (CD4 + cells) were greater than that of T suppressor/cytotoxic cells (CD8 + cells) in the inflamed pulps.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.347-357
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• 1997

An accurate working length is an essential factor in the success of endodontic treatment. There are several methods for determining working length; electronic apex locator, tactile sense by clinician, and radiography. Among these methods, the most commonly used method is radiography. But this method requires excessive radiation, long developing time, and many equipments. In additon, it could give an image distortion and two dimensional image. To improve these disadvantages, an intraoral digital radiographic system (Digora$^{(R)}$) which use an imaging plate instead of a film, was developed. The purpose of this investigation was to compare Digora imaging with conventional radiography in determining the working length. Maxillary first or second molars of human dried skull were used. Files were inserted into canals at randomly selected lengths, from 2mm short of the radiographic apex to 2rnm beyond. Radiographs and Digora images(Digora positive and Digora negative) were evaluated to determine the adjustment needed to place the file 0.5mm from the radiographic apex. The results were as follows ; 1. There was no significant difference in accuracy between those evaluated in ${\pm}0.5mm$ and those accurately evaluated in the 3 images. 2. When comparing the accuracy of each image without distinguishing the 3 images, in the group accurately determined within ${\pm}0.5mm$, the mesiobuccal group showed significantly higher accuracy compared to the palatal group(p<0.05).

• Restorative Dentistry and Endodontics
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• v.30 no.3
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• pp.215-220
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• 2005

It is common for clinicians to encounter endodontically tl·treated teeth that contain posts within their roots. If endodontic treatment is failed, these posts must be removed to facilitate successful nonsurgical retreatment. There have been many techniques such as ultrasonic instrument, Ruddle post removal system, Eggler post remover and Masserann kit developed to facilitate removal of posts from the root canal space. But these methods may be disadvantageous because long length of time required for post removal and fracture of post or teeth. In now days new post removal technique using ATD automatic bridge remover was introduced. Advantages of this method are simple and short time consuming compare to others. This article served as a successful case report of post removal using ATD automatic bridge remover.

• Restorative Dentistry and Endodontics
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• v.24 no.4
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• pp.628-632
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• 1999

Currently electronic apex locators have been widely used to determine working length in endodontic treatment. According to Manufacture's recommendation, it is beneficial to find the working length before instrumenting the canal. However, in crown-down pressureless technique, working length of tooth is established following coronal instrumentation 3mm short of radiographic apex. In narrow canals, mechanically formed constriction might be established by coronal instrumentation in some distance from anatomical constriction. The purpose of this study was to evaluate the accuracy of Root-ZX in the canal with mechanical constriction following considerable coronal enlargement with ProFile .06 series. The 40 root canals in 30 extracted mandibular molars were accessed, and their actual length (AL) established by passing a size 10 file just through the minor apical foramen. The teeth were then embedded in an acrylic container with normal saline. The initial canal length(IL) was measured with Root-ZX by negotiating a size 10 file to the apical constriction. The canal was sequentially enlarged to size 40 with ProFile .06 file 3mm short of actual length. The enlarged final canal lengths (FL) were obtained with a size 15 file. The average values of IL, FL were calculated and compared using Repeated measures Analysis of Variance followed Turkey's Studentized Range test. The results were obtained as follows: 1. The initial canal length was 0.12mm shorter than actual canal length(P>0.05). 2. The differences between initial canal length and final canal length were not significant(P>0.05). 3. As a result of this study, regardless of mechanically formed constriction. Root-ZX differentiated between mechanical and anatomic constriction.

• Restorative Dentistry and Endodontics
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• v.25 no.3
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• pp.474-482
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• 2000

Currently frequency-dependent type electronic apex locators have been widely used to determine the working length in endodontic treatment. But, accuracy of electronic apex locators is controversial. The purpose of this study was to evaluate the accuracy of Root-ZX(Morita Co., Japan) at different kinds of conditions of root canals compared with the radiographic working length. The 40 extracted human anterior teeth with fully formed apices and without any caries were used. The radiographs were taken for working length with the 0.5mm short of #15 K-file tip just visible at the foramen under the surgical microscope(Carl Zeiss Co. Germany) at 25X. Then the electronic working lengths were determined with Root-ZX at the different kinds of conditions of root canals according to the presence of electrolyte and Crown-down pressureless technique. The results were as follows ; 1. There was no significant statistical difference in working length between radiograph and Root-ZX. 2. There was no significant statistical difference in electronic working length between the canal with electrolyte and without electrolyte. 3. There was no significant statistical difference in electronic working length between the canal without any instrumentation and after Crown-dow pressureless technique. 4. Of the total 40 root canals, 85% in Group I, 92.5% in Group II, 95% in Group III and 95% in Group IV using Root-ZX showed coincidence within 0.5mm accuracy compaing with the radiographic working length. The results showed that the Root-ZX can be use effectively for measuring the working length of root canal after instrumentation with Crown-down pressureless technique regardless of the presence of electrolyte in root canal.