• Restorative Dentistry and Endodontics
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• v.46 no.1
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• pp.13.1-13.9
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• 2021

Objectives: This study aimed to evaluate and compare the efficacy of the S1 reciprocating system and the D-Race retreatment rotary system for filling material removal and the apical extrusion of debris. Materials and Methods: Sixty-four freshly extracted maxillary canines were shaped with size 10 and size 15 K-files, instrumented using ProTaper Gold under irrigation with 2.5% sodium hypochlorite (NaOCl), obturated according to the principle of thermo-mechanical condensation with gutta-percha and zinc oxide eugenol sealer, and allowed to set for 3 weeks at 37℃. Subsequently, the teeth were divided into a control group (n = 4), the D-Race rotary instrument group (n = 30), and the S1 reciprocating instrument group (n = 30). After classical retreatment, the canals were subjected to a complementary approach with the XP-Endo Shaper. Desocclusol was used as a solvent, and irrigation with 2.5% NaOCl was performed. Each group was divided into subgroups according to the timing of radiographic readings. The images were imported into a software program to measure the remaining filling material, the apical extrusion, and the root canal space. The data were statistically analyzed using the Z-test and JASP graphics software. Results: No significant differences were found between the D-Race and S1 groups for primary retreatment; however, using a complementary cleaning method increased the removal of remnant filling (p < 0.05). Conclusions: Classical removal of canal filling material may not be sufficient for root canal disinfection, although a complementary finishing approach improved the results. Nevertheless, all systems left some debris and caused apical extrusion.

• Restorative Dentistry and Endodontics
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• v.43 no.1
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• pp.5.1-5.9
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• 2018

Objectives: This study evaluated the amount of remaining root canal filling materials after retreatment procedures performed by undergraduate students using manual, rotary, and reciprocating techniques through micro-computed tomographic analysis. The incidence of instrument fracture and the instrumentation time were also evaluated. Materials and Methods: Thirty maxillary single rooted teeth were prepared with Reciproc R25 files and filled with gutta-percha and AH Plus sealer by the continuous wave of condensation technique. Then, the specimens were assigned to 3 groups (n = 10), according to the retreatment technique used: manual, rotary, and reciprocating groups, which used K-file, Mtwo retreatment file, and Reciproc file, respectively. Retreatments were performed by undergraduate students. The sample was scanned after root canal filling and retreatment procedures, and the images of the canals were examined to quantify the amount of remaining filling material. The incidence of instrument fracture and the instrumentation time were recorded. Results: Remaining filling material was observed in all specimens regardless of the technique used. The mean volume of remaining material was significantly lower in the Reciproc group than in the manual K-file and Mtwo retreatment groups (p < 0.05). The time required to achieve a satisfactory removal of canal filling material and refinement was significantly lower in the Mtwo retreatment and Reciproc groups (p < 0.05) when compared to the manual K-file group. No instrument fracture was observed in any of the groups. Conclusions: Reciproc was the most effective instrument in the removal of canal fillings after retreatments performed by undergraduate students.

• Restorative Dentistry and Endodontics
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• v.48 no.4
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• pp.36.1-36.15
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• 2023

Objectives: This study aimed to compare the effectiveness of a single-file reciprocating system (WaveOne Gold, WOG) and a multi-file rotary system (ProTaper Universal Retreatment, PTUR) in removing canal filling from severely curved canals and to evaluate the possible adjunctive effects of XP-Endo Finisher (XPF), the Self-Adjusting File (SAF), and an erbium, chromium: yttrium, scandium, gallium garnet (Er,Cr:YSGG) laser using microcomputed tomography (µCT). Materials and Methods: Sixty-six curved mandibular molars were divided into 2 groups based on the retreatment technique and then into 3 based on the supplementary method. The residual filling volumes and root canals were evaluated with µCT before and after retreatment, and after the supplementary steps. The data were statistically analyzed with the t-test, Mann-Whitney U test, analysis of covariance, and factorial analysis of variance (p < 0.05). Results: PTUR and WOG showed no significant difference in removing filling materials (p > 0.05). The supplementary techniques were significantly more effective than reciprocating or rotary systems only (p < 0.01). The supplementary steps showed no significant differences in canal filling removal effectiveness (p > 0.05), but XPF showed less dentin reduction than the SAF and Er,Cr:YSGG laser (p < 0.01). Conclusions: The supplementary methods significantly decreased the volume of residual filling materials. XPF caused minimal changes in root canal volume and might be preferred for retreatment in curved root canals. Supplementary approaches after retreatment procedures may improve root canal cleanliness.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.1
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• pp.43-46
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• 2017

Patients with cerebral palsy have higher risk of traumatic dental injuries because of clinical characteristics, such as, ataxia, large overjet and lip incompetency. Especially, intrusive luxation has rare occurrence but higher incidence of complications. It can be treated by expecting re-eruption, orthodontic reposition, and surgical reposition. Clinicians should be aware of management and follow-up in dealing with cerebral palsy patients who are exposed by intrusive luxation, due to their involuntary movement. This case report describes a 9-year-old male patient with cerebral palsy and epilepsy who experienced intrusion of maxillary permanent central incisor. After one-month follow-up, waiting for spontaneous eruption, pulp necrosis on maxillary permanent central incisor had proceeded. Therefore, surgical reposition with resin wire splint and apexification was performed under conscious sedation with midazolam. After two months, removal of resin wire splint was done. Gutta percha filling and composite resin restoration were performed after sixteen months. During five-year follow-up ankylosis and partial root resorption were observed. But there was no significant complications.

• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.55-70
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• 1995

Periapical lesions develop as a result of immunopathologic response to irritants from infected root canal systems. Removal of these irritants from the root canal system and sealing the root canal space may induce he31ing of the periapical lesions. 83 periapical lesions diagnosed as periapical abscess, periapical granuloma, chronic nonspecific inflammation, fibrosis and periapical Cyst were evaluated for the distribution of immunoglobulin containing cells. The influence of the state of root canal treatment on the distribution of immunoglobulin containing cells has evaluated. All lesions were divided into a group with no treatment, a group with canal enlargement, a group filled with gutta percha, and a group filled with Vitapex(calcium hydroxide). The distribution of immunoglobulin-containing cells according to the presence of pain and fistula was also evaluated. The following results were obtained. 1. Statistically significant difference in the distribution of immunoglobulin-containing cells among periapical abscess, periapical granuloma, chronic nonspecific inflammation/fibrosis and periapical cyst were found.(Kruskal-Wallis analysis, P<0.05) The number of immunoglobulin-containing cells in fibrosis was remarkably lower than that of periapical abscess, granuloma and cyst. 2. IgM and IgA containing cells were predominantly observed in periapical abscesses and periapical cysts, respectively. 3. All periapical lesions showed a large number of IgG containing cells followed by IgM, IgA and IgE containing cells. 4. There was a decrease in all Ig-containing cells in the group with canal filling compared to groups without treatment or with enlargement. That is, there is a decrease in Ig-containing cells as treatment progresses. 5. No significant correlation existed between the presence of pain and fistula and the distribution of immunoglobulin containing cells in periapical lesions.(t-test) Results appear to support that immune response are actively involved in the development and progress in periapical lesions. The fact that distribution of immunoglobulins differ according to the state of endodontic treatment suggests that root canal treatment may alter the humoral immune response of the periapical lesions.

• Restorative Dentistry and Endodontics
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• v.31 no.3
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• pp.186-191
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• 2006

This study evaluated the effect of two different calcium hydroxide ($Ca(OH)_2$) paste removal techniques on the apical leakage of canals obturated with gutta percha cones and sealer after removing a $Ca(OH)_2$ dressing using an electrochemical method. Seventy extracted single-rooted teeth were instrumented on with Profile rotary files under NaOCl irrigation. Fifty-eight canals were filled with calcium hydroxide paste, which was then removed using one of the following two techniques. In group A, calcium hydroxide was removed using only NaOCl irrigation, and in group B, the canals were re-prepared with a Profile rotary files-one size larger than the previous instrument and were irrigated with NaOCl. In both groups, the root surfaces were coated twice with nail varnish from CEJ to an area 4 mm away from the apex after canal obturation. Apical leakage was measured using an electrochemical method for 24 days. All the specimens showed leakage that increased markedly in the first three days. There was no significant difference between the two groups (p>0.05). The effect of two calcium hydroxide paste removal techniques on the apical leakage was not different during a short period.

• Restorative Dentistry and Endodontics
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• v.31 no.4
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• pp.323-329
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• 2006

The aim of this study was to evaluate the retrievability of Resilon as a root canal filling material Twenty-seven human single-rooted extracted teeth were instrumented utilizing a crown down technique with Gates-Glidden burs and ProFile system. In group1 (n = 12) canals were obturated with gutta percha and AH-26 plus sealer using a continuous wave technique and backfilled. In group 2 (n = 15) Resilon was used as a filling material. Then teeth were sealed and kept in $37^{\circ}C$ and 100% humidity for 7 days. For retreatment, the samples were re-accessed and filling material was removed using Gates-Glidden burs and ProFiles. Teeth were sectioned longitudinally to compare the general cleanliness and amount of debris $({\times}\;75)$ using SEM. Chi-square test was used $({\alpha}\;=\;0.05)$ to analyze the data. The total time required for removal of filling materials was expressed as mean ${\pm}SD$ (min) and analyzed by the Student t-test $({\alpha}\;=\;0.05)$, Required time for retreatment was $3.25\;{\pm}\;0.32$ minutes for gutta percha/ AH 26 plus sealer and $3.05\;{\pm}\;0.34$ minutes for Resilon. There was no statistically significant difference between the two experimental groups. There was no significant difference between the groups in the cleanliness of the root canal wall. This study showed that Resilon was effectively removed by Gates-Glidden burs and ProFiles.

• Restorative Dentistry and Endodontics
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• v.25 no.4
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• pp.527-535
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• 2000

The purpose of this study was to evaluate effects of smear layer and dentin primers on the sealing ability of root canals. 126 extracted human teeth with single, straight canals and mature apices were used. The Samples were first classified into six groups as follows: presence of smear layer; absence of smear layer; Scotchbond Bond Multi-Purpose; All Bond 2; Mac Bond 2; Clearfil Liner Bond 2. A Positive control was also established. All teeth except the control group were then obturated with thermoplasticized gutta-percha and AH26. Electrochemical and dye penetration technique were later used to evaluate the degree of micro leakage through the root canal. Seventy teeth were then immersed in a 1% potassium chloride solution and An external power supply(DC 10 V) was then applied to the circuit for the electrochemical microleakage test. The degree of Microleakage was determined over period of 28 days before being evaluated. In total, 48 teeth were submitted to the dye infiltration technique. All specimen were suspended in 2% methylene blue dye for 1 week before being longitudinally split. The degree of dye infiltration was measured under a stereo microscope at ${\times}10$ magnification and evaluated. The results were as follows: 1. Apical microleakage increased throughout the test period in all group and one group having a smear layer showed a dramatic increase under electrochemical test (p<0.05). In the group having smear layer, the degree of apical microleakage was the highest, and the micro leakage was much higher than in the smear layer removed group in electrochemical test (p<0.05). Scotchbond Multi-Purpose, All Bond 2, Mac Bond 2 and Clearfil Liner Bond 2 showed lower micro leakage than one group having smear layer. The All Bond 2 and Clearfil Liner Bond 2 treated groups showed the lowest microleakage in electrochemical test (p<0.05). 2. There was no significant difference between the experimental groups in dye penetration technique. These results suggested that the removal of the smear layer from root canal and concomitantly the application of dentin primer into root canal could improve the sealing ability of root canal obturation.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.4
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• pp.213-221
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• 2022

Purpose: The efficacy of the amount of sealer in the root canal and two retreatment NiTi file systems in removing filling materials. Materials and Methods: Extracted premolars with a single root canal were selected for this study. After access opening and root canal preparation up to size #40/.06, the specimens were randomly divided into four groups. Gutta percha (GP) tapers of .06 or .04 were used for each group and filled using a single-cone filling technique with CeraSeal, a calcium silicate-based sealer. Each group was retreated either using the ProTaper Universal Retreatment System (PTUR) or the Hyflex Remover (HR). The time taken to remove the filling material, the amounts of apically extruded debris, and canal cleanliness were measured and compared. Results: The amount of sealer did not affect the efficiency when removing the filling materials. However, the filling material was removed faster in the HR group than in the PTUR group. Two types of NiTi files showed similar retreatment effects in the amounts of apically extruded debris and in the degree of canal cleanliness. Conclusion: The amount of sealer in canal filling had no significant effect on retreatability. Retreatment with HR removed filling materials is faster than PTUR. There was no difference in other removal efficiencies according to the type of retreatment NiTi file.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.11-18
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• 2004

The eruption of permanent teeth represents the movement in the alveolar bone before appearance in oral cavity, to the occlusal plane after appearance in oral cavity, and additive movement after reaching th the occlusal plane. Tooth eruption is mostly controlled by genetic signals. The eruption stage is divided to preeruptive alveolar stage, alveolar bone stage, mucosal stage according to the process of growth and development. If the disturbance is occured in any stage of eruption, tooth does not erupt. The cause of eruption disturbance are ectopic position of the tooth germ, obstruction of the eruption path and defects in the follicle or PDL. In the treatment of eruption disturbance, surgical procedures are commonly used. There are three kind of surgical procedure ; surgical exposure, surgical repositioning, surgical exposure and traction Surgical exposure is basic procedure. This involves removal of mucosa, bone, lesion that are surrounding the teeth, dental sac when necessary to maintain a patent channel between the crown and the normal eruptive path into the oral cavity. To ensure this patency, many techniques including cementation of a celluloid crown, packing with gutta-percha or zinc oxide-eugenol, or a surgical pack, are used. When surgical exposure is conducted, operators should not expose any part of cervical root cement and not injure periodontium or root of adjunct tooth. After surgical exposure, tooth should be surrounded by keratinized gingiva. There is direct relationship between the extent of development of pathophysiologic aberrations and the intensity of the manipulative injury inflicted on the tooth by surgical treatment, so operator should consider this thing. In these cases, surgical exposure is conducted on Maxillary 1st milars that have a eruption disturbance and improve the eruption disturbance effectively.