• Restorative Dentistry and Endodontics
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• v.43 no.4
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• pp.36.1-36.12
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• 2018

Objectives: Direct pulp capping is a treatment for mechanically exposed pulp in which a biocompatible capping material is used to preserve pulpal vitality. Biocompatibility tests in animal studies have used a variety of experimental protocols, particularly with regard to the exposure site. In this study, pulp exposure on the occlusal and mesial surfaces of molar teeth was investigated in a rat model. Materials and Methods: A total of 58 maxillary first molars of Wistar rats were used. Forty molars were mechanically exposed and randomly assigned according to 3 factors: 1) the exposure site (occlusal or mesial), 2) the pulp-capping material (ProRoot White MTA or Bio-MA), and 3) 2 follow-up periods (1 day or 7 days) (n = 5 each). The pulp of 6 intact molars served as negative controls. The pulp of 12 molars was exposed without a capping material (n = 3 per exposure site for each period) and served as positive controls. Inflammatory cell infiltration and reparative dentin formation were histologically evaluated at 1 and 7 days using grading scores. Results: At 1 day, localized mild inflammation was detected in most teeth in all experimental groups. At 7 days, continuous/discontinuous calcified bridges were formed at exposure sites with no or few inflammatory cells. No significant differences in pulpal response according to the exposure site or calcium-silicate cement were observed. Conclusions: The location of the exposure site had no effect on rat pulpal healing. However, mesial exposures could be performed easily, with more consistent results. The pulpal responses were not significantly different between the 2 capping materials.

• Restorative Dentistry and Endodontics
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• v.49 no.2
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• pp.12.1-12.10
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• 2024

Objectives: This study evaluated the impact of different methods of irrigant agitation on smear layer removal in the apical third of curved mesial canals of 3 dimensionally (D) printed mandibular molars. Materials and Methods: Sixty 3D-printed mandibular second molars were used, presenting a 70° curvature and a Vertucci type II configuration in the mesial root. A round cavity was cut 2 mm from the apex using a trephine of 2 mm in diameter, 60 bovine dentin disks were made, and a smear layer was formed. The dentin disks had the adaptation checked in the apical third of the teeth with wax. The dentin disks were evaluated in environmental scanning electron microscope before and after the following irrigant agitation methods: G1(PIK Ultrasonic Tip), G2 (Passive Ultrasonic Irrigation with Irrisonic- PUI), G3 (Easy Clean), G4 (HBW Ultrasonic Tip), G5 (Ultramint X Ultrasonic tip), and G6 (conventional irrigation-CI) (n = 10). All groups were irrigated with 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Results: All dentin disks were 100% covered by the smear layer before treatment, and all groups significantly reduced the percentage of the smear layer after treatment. After the irrigation protocols, the Ultra-X group showed the lowest coverage percentage, statistically differing from the conventional, PIK, and HBW groups (p < 0.05). There was no significant difference among Ultramint X, PUI-Irrisonic, and Easy Clean (p > 0.05). None of the agitation methods could remove the smear layer altogether. Conclusions: Ultramint X resulted in the most significant number of completely clean specimens.

• The korean journal of orthodontics
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• v.47 no.6
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• pp.365-374
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• 2017

Objective: The objective of this study is to investigate the eruption pattern and root resorption of the bovine anterior dentition in relation to growth-related parameters based on dental maturity. Methods: A cross-sectional study was conducted on 110 bovine anterior mandibles by using standard radiography, cone-beam computed tomography (CBCT), and actual measurements. We determined the relationships between the stages of dental maturity by using a modification of Demirjian's method and various growth-related parameters, such as the activity of the root-resorbing tissue and mobility of the deciduous teeth. The correlation of growth-related parameters with interdental spacing and distal unusual root resorption (DRR) of the deciduous fourth incisor was assessed. The cause of mesial unusual root resorption (MRR) of the deciduous fourth incisor was determined on the basis of the arrangement of the permanent third incisor. Results: An independent t-test and chi-square test indicated significant differences in growth-related parameters associated with dental arch length discrepancy and factors related to the shedding of deciduous teeth between the low and high dental maturity groups. The samples with interdental spacing and DRR showed a larger sum of mesiodistal permanent crown widths and higher dental maturity than did the respective controls. Samples with MRR tended to show a lingually rotated distal tip of the adjacent tooth crown. Conclusions: Dental maturity has relevance to the interdental spaces and unusual root resorption of mixed dentition. The position of the adjacent tooth crown on CBCT may be correlated with the occurrence of unusual root resorption of the incisor.

• Restorative Dentistry and Endodontics
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• v.41 no.3
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• pp.182-188
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• 2016

Objectives: The purpose of this study was to evaluate the proximity of the mandibular molar apex to the buccal bone surface in order to provide anatomic information for apical surgery. Materials and Methods: Cone-beam computed tomography (CBCT) images of 127 mandibular first molars and 153 mandibular second molars were analyzed from 160 patients' records. The distance was measured from the buccal bone surface to the root apex and the apical 3.0 mm on the cross-sectional view of CBCT. Results: The second molar apex and apical 3 mm were located significantly deeper relative to the buccal bone surface compared with the first molar (p < 0.01). For the mandibular second molars, the distance from the buccal bone surface to the root apex was significantly shorter in patients over 70 years of age (p < 0.05). Furthermore, this distance was significantly shorter when the first molar was missing compared to nonmissing cases (p < 0.05). For the mandibular first molars, the distance to the distal root apex of one distal-rooted tooth was significantly greater than the distance to the disto-buccal root apex (p < 0.01). In mandibular second molar, the distance to the apex of C-shaped roots was significantly greater than the distance to the mesial root apex of non-C-shaped roots (p < 0.01). Conclusions: For apical surgery in mandibular molars, the distance from the buccal bone surface to the apex and apical 3 mm is significantly affected by the location, patient age, an adjacent missing anterior tooth, and root configuration.

• The Journal of the Korean dental association
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• v.45 no.6 s.457
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• pp.362-369
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• 2007

The aim of this study was to investigate the effect of the hybrid instrumentation method with ProTaper and ProFile on the change of root canal area and distance from the canal to the root surface after canal shaping. The mesial canals of twenty extracted mandibular first molars having $10-20^{\circ}\Delta$ curvature were scanned using X-ray microcomputed tomography (XMCT)-scanner before root canals were instrumented. They were divided into four groups (n=10 canals ter group). In Group 1, root canals were instrumented by the step-back technique with stainless steel K-Flexofile after coronal flaring. The remainders were instrumented by the crown-down technique with, ProTaper system (Group 2), ProFile (Group 3) or ProTaper (Group 4). All canals were prepared up to size 25 at the end-point of preparation and scanned again. Pre- and post-operative cross-sectional images of 1, 3, 5, and 7 mm from the apical foramen were compared. For each level, change of cross-sectional canal are and distance to the nearest external root surface was calculated using Adobe Photoshop 6.0 and image software program. In the change of cross-sectional area, Group 4 was less than Group 2 at 3 mm and 5 mm level (p<0.05). In the difference of the distance from the canal to the root surface after canal shaping, Group 4 was least among the other groups at 7 mm level (p<0.05). According to the results, the methods using ProFile or K file only and the hybrid instrumentation technique using ProTaper and ProFile are more appropriate methods of canal preparation than ProTaper system for narrow of curved canals.

• Imaging Science in Dentistry
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• v.47 no.3
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• pp.157-164
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• 2017

Purpose: This study determined and compared the distances from the maxillary root apices of posterior teeth to the floor of the maxillary sinus, or maxillary sinus distances(MSDs), and the distances from the mandibular root apices of the posterior teeth to the mandibular canal, or mandibular canal distances(MCDs), in Thai subjects with skeletal open bite and skeletal normal bite. Materials and Methods: Pretreatment cone-beam computed tomography (CBCT) images were obtained from 30 Thai orthodontic patients (15 patients with skeletal normal bite and 15 with skeletal open bite) whose ages ranged from 14 to 28 years. The CBCT images of the patients were processed and measured using the Romexis Viewer program. The MSDs and MCDs from the root apices of the maxillary and mandibular second premolar, first molar, and second molar to the maxillary sinus floor or the mandibular canal were measured perpendicularly to the occlusal plane. The Student t test was used for comparisons between the 2 groups. Results: The greatest mean MSDs were from the root apex of the second premolars in both groups, whereas the least mean MSDs were from the mesiobuccal root apex of the second molars. The greatest mean MCDs were from the mesial root apex of the first molars, whereas the least mean MCDs were from the distal root apex of the second molars. Conclusion: There were no differences in the mean MSDs or the mean MCDs between the skeletal normal bite group and the skeletal open bite group.

• Imaging Science in Dentistry
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• v.45 no.2
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• pp.95-101
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• 2015

Purpose: This study used cone-beam computed tomography (CBCT) to characterize mandibular molar root and canal morphology and its variability in Belgian and Chilean population samples. Materials and Methods: We analyzed the CBCT images of 515 mandibular molars (257 from Belgium and 258 from Chile). Molars meeting the inclusion criteria were analyzed to determine (1) the number of roots; (2) the root canal configuration; (3) the presence of a curved canal in the cross-sectional image of the distal root in the mandibular first molar and (4) the presence of a C-shaped canal in the second mandibular molar. A descriptive analysis was performed. The association between national origin and the presence of a curved or C-shaped canal was evaluated using the chi-squared test. Results: The most common configurations in the mesial root of both molars were type V and type III. In the distal root, type I canal configuration was the most common. Curvature in the cross-sectional image was found in 25% of the distal canals of the mandibular first molars in the Belgian population, compared to 11% in the Chilean population. The prevalence of C-shaped canals was 10% or less in both populations. Conclusion: In cases of unclear or complex root and canal morphology in the mandibular molars, CBCT imaging might assist endodontic specialists in making an accurate diagnosis and in treatment planning.

• Restorative Dentistry and Endodontics
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• v.40 no.4
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• pp.286-289
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• 2015

Objectives: The aim was to evaluate dentinal crack formation after root canal preparation with ProTaper Next system (PTN) with and without a glide path. Materials and Methods: Forty-five mesial roots of mandibular first molars were selected. Fifteen teeth were left unprepared and served as controls. The experimental groups consist of mesiobuccal and mesiolingual root canals of remaining 30 teeth, which were divided into 2 groups (n = 15): Group PG/PTN, glide path was created with ProGlider (PG) and then canals were shaped with PTN system; Group PTN, glide path was not prepared and canals were shaped with PTN system only. All roots were sectioned perpendicular to the long axis at 1, 2, 3, 4, 6, and 8 mm from the apex, and the sections were observed under a stereomicroscope. The presence/absence of cracks was recorded. Data were analyzed with chi-square tests with Yates correction. Results: There were no significant differences in crack formation between the PTN with and without glide path preparation. The incidence of cracks observed in PG/PTN and PTN groups was 17.8% and 28.9%, respectively. Conclusions: The creation of a glide path with ProGlider before ProTaper Next rotary system did not influence dentinal crack formation in root canals.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.4
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• pp.776-780
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• 1997

Patient with alveolar abscess due to dental caries with severe alveolar bone loss, severe tooth mobility, root resorption need extraction of tooth because it is impossible to carry out pulp treatment and restoration by using conventional method. Early loss of primary molar might cause masticatory interference, extrusion of opposing tooth, problem in maintaining space and interference on eruption of permanent tooth. Especially, early loss of primary second molar before the eruption of permanent first molar might cause space closure by mesially erupted permanent first molar and impaction of second premolar. In such a case, distal shoe space maintainer and removable space regaining appliance was the first choice of treatment. But, distal shoe space maintainer need precise adaptation and might cause chronic inflammation if the oral hygiene is poor. In a case using removable space regaining appliance, patient's cooperation is most important. If the distal root of primary second molar is comparably sound and alveolar abscess with alveolar bone loss is localized at mesial root, hemisection should be carried out for precise guide to eruption of the permanent first molar, restoration of masticatory fuction and solution to the discomfort of the patient

• Restorative Dentistry and Endodontics
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• v.49 no.3
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• pp.26.1-26.14
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• 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.