• Imaging Science in Dentistry
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• v.37 no.2
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• pp.103-110
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• 2007

Purpose: To examine the danger zone of mesial root of mandibular first molar of patient without extraction using CBCT (cone-beam computed tomography) to avoid the risk of root perforation. Materials and Methods: 20 mandibular first molars without caries and restorations were collected, CT images were obtained by CBCT ($PSR9000N^{TM}$, Asahi Roentgen Co., Japan), reformed and analyzed by V-work 5.0 (CyberMed Inc., Korea), Distance between canal orifice and furcation was measured. In cross sectional images at 3, 4 and 5 mm below the canal orifice, distal wall thickness of mesiobuccal canal (MB-D), distal wall thickness of mesiolingual canal (ML-D), distal wall thickness of central part (C-D), mesial wall thickness of mesiobuccal canal (MB-M) and mesial wall thickness of mesiolingual canal (ML-M) were measured, Results: The mean distance between the canal orifice and the furcation of the roots is 2.40 mm, Distal wall is found to be thinner than mesial wall. Mean dentinal wall thickness of distal wall is about 1 mm, The wall thickness is thinner as the distance from the canal orifice is farther. But significant differences are not noted between 4 mm and 5 mm in MB-D and C-D, MB-D is thinner than ML-D although the differences is not significant. Conclusion: The present study confirmed the anatomical weakness of distal surface of the coronal part of the mesial roots of mandibular first molar by CBCT and provided an anatomical guide line of wall thickness during endodontic treatment.

• Restorative Dentistry and Endodontics
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• v.39 no.1
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• pp.63-67
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• 2014

This is a case report of chronic maxillary sinusitis caused by root canal overfilling of Calcipex II (Techno-Dent). A 60 year-old male complained of dull pain in the right maxillary molar area after complicated endodontic treatment using Calcipex II paste and was finally diagnosed with a chronic maxillary sinusitis through a clinical and radiological observation. In the biopsy examination, the periapical granuloma contained a lot of dark and translucent Calcipex II granules which were not stained with hematoxylin and eosin. They were usually engulfed by macrophages but rarely resorbed, resulting in scattering and migrating into antral mucosa. Most of the Calcipex II granules were also accumulated in the cytoplasms of secretory columnar epithelial cells, and small amount of Calcipex II granules were gradually secreted into sinus lumen by exocytosis. However, chronic granulomatous inflammation occurred without the additional recruitment of polymorphonuclear leukocytes (PMNs) and lymphocytes, and many macrophages which engulfed the Calcipex II granules were finally destroyed in the processes of cellular apoptosis. It is presumed that Calcipex II granules are likely to have a causative role to induce the granulomatous foreign body inflammation in the periapical region, and subsequently to exacerbate the chronic maxillary sinusitis in this study.

• Restorative Dentistry and Endodontics
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• v.20 no.2
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• pp.610-626
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• 1995

Perforations especially in the furcations during endodontic treatment have notably detrimental effect on prognosis. The purpose of this study was to compare radiographically and histologically the sealing ability and the tissue responses of amalgam, Ketac-Silver, IRM, Vitapex, and mineral trioxide aggregate(MTA) used to repair furcation perforations. Thirty two experimental furcation perforations were created in the mandibular premolars of 6 mongrel dogs and immediately repaired with experimental materials. The animals were sacrificed after 16 weeks and radiographic and histopathologic results were evaluated. The following conclusions were drawn within the limits of the experimental results; 1. All materials tested in this experiment revealed a certain degree of extrusion into the periodontal space. 2. Both amalgam and Ketac-Silver showed the greatest degree of inflammation and bone resorption(p<0.0001). There was no significant difference between the amalgam and Ketac-Silver groups. 3. Both IRM and Vitapex showed a markedly milder degree of inflammatin and less bone resorption than amalgam or ketac-siver(p<0.00005). both IRM and vitapex showed the same respone. 4. MTA showed the least degree of Inflammation and bone resorption(p<0.05). The results of this experiment indicate that among the different materials tested, MTA appeared to be the best material for sealing furcation perforations, although the radiographic and histopathologic differences between the MTA and Vitapex groups were not statistically significant. But further studies with a larger sample are needed to have the exact conclusions.

• Restorative Dentistry and Endodontics
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• v.29 no.6
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• pp.515-519
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• 2004

Straight access cavity design allows the operator to locate all canals, helps in proper cleaning and shaping, ultimately facilitates the obturation of the canal system. However, change in the fracture strength according to the access cavity designs was not clearly demonstrated yet. The purpose of this study was to determine the influence of different access cavity designs on the fracture strength in endodontically treated mandibular anterior teeth. Recently extracted mandibular anterior teeth that have no caries, cervical abrasion, and fracture were divided into three groups (Group 1 : conventional lingual access cavity, Group 2 : straight access cavity, Group 3 : extended straight access cavity) according to the cavity designs. After conventional endodontic treatment, cavities were filled with resin core material. Compressive loads parallel to the long axis of the teeth were applied at a crosshead speed of 2mm/min until the fracture occurred. The fracture strength analyzed with ANOV A and the Scheffe test at the 95% confidence level. The results of this study were as follows: 1. The mean fracture strength decrease in following sequence Group 1 (4558.90{\;}\pm{\;}77.40{\;}N$), Group 2 ($494.07{\;}\pm{\;}123.98{\;}N) and Group 3 ($267.33{\;}\pm{\;}27.02{\;}N). 2. There was significant difference between Group 3 and other groups (P = 0.00). Considering advantage of direct access to apical third and results of this study, straight access cavity is recommended for access cavity form of the mandibular anterior teeth.

• Proceedings of the KACD Conference
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• 2003.11a
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• pp.545-545
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• 2003

Chitosan is applied as a dressing for oral mucous wound and a tampon following radical treatment of maxillary sinus. Furthermore, it is being investigated as an absorbing membrane for endodontic and periodontic surgeries. A few studies have reported osteoconduction and osteogenesia at the site of chitosan implant in vivo. However, compared with soft tissue healing processes, the mechanisms concerning effects of chitosan for biological mineralization have not yet been resoil In the present study, we studied the gene expression pattern using cDNA microarray and RT-PCR analyses in hard tissue forming osteoblasts cultured with water-soluble and low molecular weight chitooligosaccharide. cDNA microarray analysis revealed that 16 genes were expressed at 〉1.5-fold higher signal ratio levels in the experimental group compared with the control group after 3 days. RT-PCR analysis showed that chitosan oligomer induced an increase in the expression of two genes, CD56 antigen and tissue-type plasminogen activator. Furthermore, the expression of mRNAs for BMP-2 was almost identical in the experimental and control groups after 3 days of culture, but slightly increased after 7 days of culture with chitosan oligomer. These results suggest that a super-low concentration of chitooligosaccharide could modulate the activity of osteoblastic cells through mRNA levels and that the genes concerning cell proliferation and differentiation can be controlled by water-soluble chitosan.

• Restorative Dentistry and Endodontics
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• v.23 no.1
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• pp.163-174
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• 1998

The purpose of this study is to evaluate the distribution of stress in the root end resected teeth. The finite element method was used to compare stresses along the root and retrograde filling material in seven two-dimensional models of mandibular 2nd premolar. Each model was endodontic treatment and gold crown' restoration. Each model divided with amagam core restoration or gold casting post restoration. Thus each model divided with shape of root end resection, depth of retropreparation and exposure length of root in the bony cavity. The seven models were classified as in the table 1 below. A load of 500N was applied $45^{\circ}$ diagonally on the lingual slope of the buccal cusp. These mode were analyzed with two dimensional finite element methods. The results of this study were as follows : 1. The maximum tensile stress along the inner canal wall was shown on the model 7. 2. When the model 1 was compared with the model 5, the maximum tensile stress along the inner canal wall showed the model 1. 3. Less equivalent stress was shown on the model 6 and more equivalent stress was shown on the model 4. 4. More shear stress was shown on the retrograde filling material of the model 7. 5. The models with increased length of exposed root in the bony cavity demonstrated a gradual increase to the tensile stress in X direction which occurred approximately a boundary between the bone and exposed root in' the bony cavity. 6. The model which had a case of matching the apex of post and a boundary between the bone and exposed root in the bony cavity demonstrated more increase tensile stress in X direction than other models.

• Restorative Dentistry and Endodontics
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• v.25 no.2
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• pp.193-201
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• 2000

Prostaglandins (PGs) and Leukotrienes (LTs) have been implicated in the genesis of pulpal and periapical inflammation. In this study, the relationships among $PGE_2$, 6-keto-PG $F_1{\alpha}$ (a stable metabolite of $PGI_2$) and $LTB_4$ concentrations in inflamed pulp and periapical lesions were discussed. Pulp tissue were obtained in routine endodontic treatment and periapical lesions in periapical surgery after clinical diagnoses were made. These specimens were divided into four groups as normal pulp group (Control group), acute pulpitis group, chronic pulpitis group, and periapical lesion group. Pulp tissue and periapical lesions were stored in liquid nitrogen. The concentration of $PGE_2$, $PGI_2$ and $LTB_4$ were measured with ELISA. The data were analyzed by one-way ANOVA. Significantly higher levels of $PGE_2$, 6-keto-PG $F_1{\alpha}$ a and $LTB_4$ were found in acute pulpitis group than chronic pulpitis group and periapical lesion group(p<0.05). Periapical lesion group showed significantly higher mean concentrations of $PGE_2$ and $LTB_4$ than chronic pulpitis group. In control and chronic pulpitis group, significant higher levels of $PGI_2$ than $PGE_2$ and $LTB_4$ were found. These results suggested that the high levels of $PGE_2$ and $LTB_4$ in periapical lesions may be due to rich endothelium., fibroblast and lymphocyte known as the main producers of $PGE_2$ and $LTB_4$. $PGI_2$ may be thought to one of the most abundant PGs in normal pulp tissue.

• Restorative Dentistry and Endodontics
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• v.23 no.1
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• pp.379-390
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• 1998

In endodontic treatment, calcium hydroxide has been used as intracanal medicament. Although calcium hydroxide should be removed thoroughly before permanent root canal filling, no effective method for its removal has been reported. Because of irregularity of root canal walls, root curvatures and anatomic variations, it is insufficient to remove calcium hydroxide from the canal wall only by mechanical instrumentation Considering the chemical effects of irrigants on calcium hydroxide, $Ca^{++}$ dissolving effect from two calcium hydroxide products is investigated, using dis- tilled water, NaOCl, citric acid and EDTA. Vitapex$^{(R)}$ 0.1g and calcium hydroxide 0.03g were dissolved in distilled water, 5% NaOCl, 50% citric acid and 17% EDTA respectively, at 1, 3, 5, 10min. time interval. The solution was filtered using filter paper(pore size $5{\mu}m$) and $Ca^{++}$ concentration was determined by ion chromatography. The result were as follows : 1. Distilled water, NaOCl, citric acid and EDTA abstracted more $Ca^{++}$ from calcium hydroxide than Vitapex$^{(R)}$ except NaOCl 1, 5, 10 time interval. 2. EDTA and citric acid abstracted more $Ca^{++}$ from Vitapex$^{(R)}$ and calcium hydroxide than distilled water or NaOCl. The overall result support the view that water-based calcium hydroxide product is easily removed than oil-based calcium hydroxide product and EDTA, citric acid are more effective in $Ca^{++}$ elution than NaOCl or distilled water.

• Restorative Dentistry and Endodontics
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• v.36 no.1
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• pp.1-11
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• 2011

Introduction: The aim of this paper is to discuss the mechanical and geometric features of Nickel-titanium (NiTi) rotary files and its clinical effects. NiTi rotary files have been introduced to the markets with their own geometries and claims that they have better ability for the root canal shaping than their competitors. The contents of this paper include the (possible) interrelationship between the geometries of NiTi file (eg. tip, taper, helical angle, etc) and clinical performance of the files as follows; - Fracture modes of NiTi rotary files - Non-cutting guiding tip and glide path - Taper and clinical effects - Cross-sectional area and clinical effects - Heat treatments and surface characteristics - Screw-in effect and preservation of root dentin integrity - Designs for reducing screw-in effect Conclusions: Based on the reviewed contents, clinicians may have an advice to use various brands of NiTi rotary instruments regarding their advantages which would fit for clinical situation.

• Restorative Dentistry and Endodontics
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• v.43 no.4
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• pp.42.1-42.7
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• 2018

Objectives: The purpose of this study was to investigate the C-shaped root canal anatomy of mandibular second molars in a Korean population. Materials and Methods: A total of 542 teeth were evaluated using cone-beam computed tomography (CBCT). The canal shapes were classified according to a modified version of Melton's method at the level where the pulp chamber floor became discernible. Results: Of the 542 mandibular second molars, 215 (39.8%) had C-shaped canals, 330 (53%) had 3 canals, 17 (3.3%) had 2 canals, 12 (2.2%) had 4 canals, and 8 (1.7%) had 1 canal. The prevalence of C-shaped canals was 47.8% in females and 28.4% in males. Seventy-seven percent of the C-shaped canals showed a bilateral appearance. The prevalence of C-shaped canals showed no difference according to age or tooth position. Most teeth with a C-shaped canal system presented Melton's type II (45.6%) and type III (32.1%) configurations. Conclusions: There was a high prevalence of C-shaped canals in the mandibular second molars of the Korean population studied. CBCT is expected to be useful for endodontic diagnosis and treatment planning of mandibular second molars.