• Journal of Oral Medicine and Pain
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• v.36 no.3
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• pp.199-205
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• 2011

During root canal treatment, overinstrumentation with hand or mechanically driven files can perforate the mandibular canal, allowing the extrusion of endodontic sealers, dressing agents, and irrigant solutions out of the tooth and into the canal. The patient may report symptoms such as pain, hyperesthesia, hypoesthesia, anesthesia, dysesthesia and paresthesia. Such problems must be resolved as quickly as possible to avoid irreversible sequelae caused by certain neurotoxic materials that form part of endodontic sealants. Although there have been no controlled trials of treatment protocols involving endodontically related injuries to the inferior alveolar nerve, the normal therapeutic sequence for this complication is the control of pain and inflammation and, whenever possible, the surgical elimination of the cause. However, total resolution of pain and reduction in or disappearance of paraesthesia after a non-surgical management have been reported. Antiepileptic drugs such as gabapentin or pregabalin have been used for the treatment of neuropathic pain. This article describes a case of inferior alveolar nerve(IAN) damage after endodontic treatment of a mandibular right second molar and the treatment with non-surgical approach using prednisone and gabapentin medication, monitoring the patient's condition with clinical neurosensory examination and current perception threshold test(Neurometer).

• Restorative Dentistry and Endodontics
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• v.34 no.6
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• pp.484-490
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• 2009

The purpose of this study was to evaluate the effect of soft chelating irrigant on the sealing ability of root fillings by using a glucose leakage test. A total of 45 single-rooted teeth were selected for the study. The teeth were decoronated leaving a total length of 13mm. The root canals prepared using K3 NiTi rotary instruments to an apical dimension of size 45(0.06 taper). The specimens were then randomly divided into 3 experimental groups of 13 roots each and 2 control groups of 3 roots each. Specimen in each group were prepared with different irrigation protocols : group 1, 2.5% NaOCl; group 2, 2.5% NaOCl and 17% EDTA: group 3, 2.5% NaOCl and 15% HEBP. The root canals were filled with gutta-percha and AH Plus sealer using lateral condensation. After 7 days in $37^{\circ}C$, 100% humidity, the coronal-to-apical microleakage was evaluated quantitatively using a glucose leakage model. The leaked glucose concentration was measured with spectrophotometry at 1, 4, 7, 14, 21 and 28 days. There was a tendency of increase in leakage in all experimental groups during experimental period. HEBP-treated dentin showed no significant difference with EDTA-treated dentin during experimental period. From the 21th day onward, HEBP-treated dentin showed significantly lower leakage than smear-covered dentin. HEBP-treated dentin displayed a similar sealing pattern to EDTA-treated dentin and a better sealing ability than smear-covered dentin. Consequently, a soft chelator(HEBP) could be considered as the possible alternative to EDTA.

• Restorative Dentistry and Endodontics
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• v.31 no.3
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• pp.169-178
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• 2006

This study was to verify that the combined application of NaOCl and EDTA was more effective in removal of smear layer than the application of NaOCl alone. furthermore it was aimed to find out the optimal time for the application of EDTA. Thirty five single rooted teeth were cleaned and shaped. NaOCl solution was used as an irrigant during instrumentation. After instrumentation, root canals of the control group were irrigated with 5 ml of NaOCl for 2 minutes. 30 sec, 1 min, and 2 min group were irrigated with 5 ml of 17% EDTA for 30 sec, 1 min, and 2 min respectively. Then the roots were examined with scanning electron microscopy for evaluating removal of smear layer and erosion of dentinal tubule. The results were as follows; 1. The control group: The smear layer was not removed at all. 2. The other groups: 1) $Middle\frac{1}{3}$: All groups showed almost no smear layer. And the erosion occurred more frequently as increasing irrigation time. 2) $Apical\frac{1}{3}$: The cleaning effect of 2 min group was better than the others. The results suggest that 2 min application of 17% EDTA should be adequate to remove smear layer on both $apical\frac{1}{3}\;and\;middle\frac{1}{3}$.

• Restorative Dentistry and Endodontics
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• v.23 no.1
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• pp.477-486
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• 1998

Recently the development of rotary instrument makes it possible that in root canal treatment operator saves much more time, maintans original curved canal shape and easily prepares continuous tapered root canal. The purpose of this experiment was to examine the smoothness of the internal surface of prepared root canal and the effectiveness of debridement in prepared root canal by SEM for the comparison of hand and Ni-Ti rotary instrument. 25 extracted human teeth were access opened and # 10 K-type file was introduced into canal until it was appeared at the apical foramen. The working length was established by subtracting 0.5mm from this measurement. Group 1. The root canal preparation was done to # 30 with working length and then step-back until # 45 with K-Flexofile (Maillefer, Swiss). Group 2. Root canal preparation was done by Naviflex Ni-Ti file (Brasseler, USA) as the same technique with group 1. Group 3. Canal was prepared by Profile .04 (Maillefer, Swiss) taper until #30. Group 4. With use of Quantec (Tycom, USA) root canal was prepared from file number 1 to 8. In group 1 and 2, the root canal irrigant was NaOCl and the other groups, NaOCl and RC-prep (Premine Dental Products, USA) was used. The prepared teeth were notched with high-speed bur as bucco-lingual direction and fractured with chisel and mallet, then examined with SEM. Group 1 showed smooth internal surface. There were scratches mainly to the axial direction. Group 2 showed similar characteristics to those in group 1. Group 3 showed more smoother and linear cutting surface with bised scratches. Group 4 has the almost same characteristics group 3 and there was no difference in the file design. Ni-Ti rotary root canal instrument prepare the dentinal wall more smoother than hand instrument. The effectiveness of debridement was not fully affected by file design. The isthmus area and accessory canals of the root canal system were not prepared in any group. According to the result, hand and rotary type instrumentation techniques were effective in removal of major amount of tissue from root canal but it was not complete. In the direction of cutting movement there was difference between them.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.2
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• pp.168-178
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• 2010

Objective : The aim of this study was to determine the antimicrobical effect of horseradish root extracts against Enterococcus faecalis and Fusobacterium nucleatum isolated from oral cavity compared with reference strain, and compared with that of chlorhexidine. Method : Horseradish root extracts and chlorhexidine were sequentially diluted and tested against anaerobes(E. faecalis, F. nucleatum) isolated from children's oral cavity. The microbes were anaerobically incubated and the minimum inhibitory concentration(MIC) and minimum bactericidal concentration(MBC) were detected. Results :1. Horseradish root extracts showed antimicrobial effect against E. faecalis isolated strain at same or slightly higher concentration compared with MIC of reference strain. 2. $625.0\sim1,250.0{\mu}g/ml$ horseradish root extracts showed similar antimicrobial effect with chlorhexidine($7.8\sim15.6{\mu}g/ml$). 3. Horseradish root extracts showed antimicrobial effect against F. nucleatum isolated strain at same or slightly higher concentration compared with MIC of reference strain. 4. $78.1\sim312.5{\mu}g/ml$ horseradish root extracts showed similar antimicrobial effect with chlorhexidine($7.8\sim15.6{\mu}g/ml$). Conclusions : The results of this study confirm that horseradish root extracts has antimicrobial effect against anaerobes isolated from oral cavity as well as reference strain. And we found the potential of horseradish root extracts as a canal irrigant or disinfectant.