• Restorative Dentistry and Endodontics
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• v.31 no.1
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• pp.30-35
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• 2006

To evaluate the change of working length with various instrumentation techniques in curved canals, working length and canal curvature were determined before and after canal instrumentation in buccal or mesial canals of extracted human molars. Stainless steel K-files ($MANI^{(R)}$, Matsutani Seisakusho Co. Takanezawa, Japan), nickel-titanium K-files (Naviflex $NT^{TM}$, Brassier, Savannah, USA) , $ProFile^{(R)}$, and ProTaper (Dentsply-Maillefer, Ballaigues, Switzerland) were used to prepare the canals with crown-down technique. In two hand instrumentation groups coronal flaring was made with Gates Glidden burs. Apical canals were instrumented until apical diameter had attained a size of 30. Positional relation between the tooth apex and the $\#10$ K-file tip was examined by using AutoCAD 2000 (Autodesk Corp., San Rafael. CA, USA) under a stereomicroscope before and after coronal flaring, and after apical instrumentation. Degree of canal curvature was also measured with Schneider's method in radiographs. Data of working length and canal curvature changes were statistically analyzed with one-way ANOVA and Tukey's studentized range test. Working length and canal curvature were decreased significantly in each step in all instrumentation groups. Coronal flaring using Cates Glidden burs in hand instrument groups and whole canal instrumentation using stainless steel hand K-files caused significantly more working length change than in ProFile instrumentation group (p<0.05). The result of this study demonstrates that all of the above kinds of instrumentation in curved canals cause reduction of working length and canal curvature at each instrumentation steps, and hand instrumentation causes more working length change than ProFile.

• The Journal of the Korean dental association
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• v.53 no.10
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• pp.743-750
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• 2015

Objectives: This study compared the mechanical efficacy of sonic activated and passive ultrasonic irrigation for removing intracanal medicament from a simulated root canal under controlled conditions. Materials and Methods: Thirty simulated root canal in resin blocks were randomly divided into 3-groups. The canals were enlarged using ProTaper files and K3XF (#30/0.06). After cleaning and drying, canals were filled with Calcipex. Overfilled materials were wiped out and measured their weight to the unit of 1/10mg. After one week storage in 100% humidity $37^{\circ}C$ temperature, canals were irrigated using 20mL of saline with one of following methods according to the designated groups (n = 10). For group-NI, 30-gauge nickel-titanium irrigation needle was used. During irrigation with every 5mL, needle was moved in-and-out with 4-mm amplitudes. EndoActivator and ultrasonic tip were used for group-EA and group-UT respectively for 20 seconds after every 5mL irrigation using needle. Then the weight was measured again to calculate the weight of residual remnants. The data were analyzed by one-way ANOVA and Duncan's post-hoc test at a significance level of 95%. Results: The weight of the residual medicaments were $3.62{\pm}0.81mg$, $2.84{\pm}0.28mg$, and $2.73{\pm}0.90mg$ for group-NI, -EA, and -UT, respectively. Group-EA and group-UT had no significant differences to remove intracanal medicament and left significantly less amount of paste than group-NI (p < 0.05). Conclusions: Under the controlled conditions of this study, the sonic activation and PUI have similar mechanical efficacy for removing intracanal medicament.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.30.1-30.12
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• 2018

Objectives: To evaluate sealing ability of root canals obturated with bioceramic-impregnated gutta percha cone (BCC) or gutta percha (GP), with bioceramic sealer (BCS) or AH Plus (AH; Dentsply-Maillefer), in roundly-prepared canals using matched single-cone technique, based on bacterial leakage test, and to analyze obturation quality using micro-computed tomography (CT) analysis. Materials and Methods: Ninety-two distobuccal roots of maxillary molars were prepared using nickel-titanium files to apical size 40/0.06. The roots were divided into 4 groups (n = 20) that were obturated with a master cone and sealer: GP/AH, BCC/AH, GP/BCS, and BCC/BCS. Bacterial leakage model using Enterococcus faecalis was used to evaluate sealing ability for 60-day period. Obturated samples from each group (n = 4) were analyzed using micro-CT. Results: All groups showed bacterial leakage at 20%-45% of samples with mean leakage times of 42-52 days. There were no significant differences in bacterial leakage among the groups. Micro-CT showed minimal gaps and voids in all groups at less than 1%. Conclusions: In roundly-prepared canals, the single cone obturation with BCC/BCS was comparable to GP/AH for bacterial leakage at 60 days.

• Restorative Dentistry and Endodontics
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• v.43 no.4
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• pp.46.1-46.10
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• 2018

Objectives: This study was to evaluate the antibacterial effect of different instrumentation and irrigation techniques using confocal laser scanning microscopy (CLSM) after root canal inoculation with Enterococcus faecalis (E. faecalis). Materials and Methods: Mesiobuccal and mesiolingual canals of extracted mandibular molars were apically enlarged up to a size 25 hand K-file, then autoclaved and inoculated with E. faecalis. The samples were randomly divided into 4 main groups according to the system of instrumentation and irrigation: an XP-endo Shaper (XPS) combined with conventional irrigation (XPS/C) or an XP-endo Finisher (XPF) (XPS/XPF), and iRaCe combined with conventional irrigation (iRaCe/C) or combined with an XPF (iRaCe/XPF). A middle-third sample was taken from each group, and then the bacterial reduction was evaluated using CLSM at a depth of $50{\mu}m$ inside the dentinal tubules. The ratio of red fluorescence (dead cells) to green-and-red fluorescence (live and dead cells) represented the percentage of bacterial reduction. The data were then statistically analyzed using the Kruskal-Wallis test for comparisons across the groups and the Dunn test was used for pairwise comparisons. Results: The instrumentation and irrigation techniques had a significant effect on bacterial reduction (p < 0.05). The iRaCe/XPF group showed the strongest effect, followed by the XPS/XPF and XPS/C group, while the iRaCe/C group had the weakest effect. Conclusions: Combining iRaCe with XPF improved its bacterial reduction effect, while combining XPS with XPF did not yield a significant improvement in its ability to reduce bacteria at a depth of $50{\mu}m$ in the dentinal tubules.

• Restorative Dentistry and Endodontics
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• v.46 no.4
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• pp.49.1-49.8
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• 2021

Objectives: To evaluate the fracture incidence of Reciproc R25 instruments (VDW) used during non-surgical root canal retreatments performed by students in a postgraduate endodontic program. Materials and Methods: From the analysis of clinical record cards and periapical radiographs of root canal retreatments performed by postgraduate students using the Reciproc R25, a total of 1,016 teeth (2,544 root canals) were selected. The instruments were discarded after a single use. The general incidence of instrument fractures and its frequency was analyzed considering the group of teeth and the root thirds where the fractures occurred. Statistical analysis was performed using the χ² test (p < 0.01). Results: Seven instruments were separated during the procedures. The percentage of fracture in relation to the number of instrumented canals was 0.27% and 0.68% in relation to the number of instrumented teeth. Four fractures occurred in maxillary molars, 1 in a mandibular molar, 1 in a mandibular premolar and 1 in a maxillary incisor. A greater number of fractures was observed in molars when compared with the number of fractures observed in the other dental groups (p < 0.01). Considering all of the instrument fractures, 71.43% were located in the apical third and 28.57% in the middle third (p < 0.01). One instrument fragment was removed, one bypassed, while in 5 cases, the instrument fragment remained inside the root canal. Conclusions: The use of Reciproc R25 instruments in root canal retreatments carried out by postgraduate students was associated with a low incidence of fractures.

• 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.30 no.4
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• pp.303-311
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• 2005

The purpose of this study was to evaluate which type of Ni-Ti files are able to maintain canal configuration better in the simulated canal with abrupt curvature near it's apex. Ninety six simulated root canals were made in epoxy resin and $\sharp$15 finger spreader was used as root canal templates. The simulated root canals were made with radius of curvature of 1.5mm, 3.0mm, 4.0mm, 6.0mm respectively and the angle of curvature of all simulated canals were adjusted to 90 degree. The simulated canals were instrumented by ProFile, ProTaper, Hero 642, and $K^3$ at a 300 rpm using crown-down pressureless technique. Pre-instrumented and post-instrumented images were taken by digital camera and were superimposed with Adobe Photos hop 6.0 program. Images were compared by image analysis program. The changes of canal width at the inner and outer side of the canal curvature. canal transportation were measured at 9 measuring point with 1 mm interval. Statistical analysis among the types of Ni-Ti files was performed using Kruskal-Wallis test and Mann-Whitney U-test. The result was that ProFile maintain original canal configuration better than other engine driven Ni-Ti files in the canals above 3.0mm radius of curvature, and in the 1.5mm radius of curvature, most of Ni-Ti flies were deformed or separated during instrumentation.

• Restorative Dentistry and Endodontics
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• v.35 no.2
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• pp.88-95
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• 2010

The purpose of this study was to compare the root canal shaping ability of 4 rotary NiTi instruments in simulated root canals. For the preparation of thirty two curved root canals, Mtwo instruments using "single length"technique, and Profile, ProTaper Universal, and K3 using crown-down technique (N = 8) were used. All canal samples were prepared by reaching an apical canal size of #30. Pre- and post-instrumentation digital images were recorded and an assessment of canal shape was determined using a computer image analysis program SigmaScan Pro (Systat Software Inc., San Jose, CA, USA). The changes of the dimension of inner walls of canals, (2) the changes of the dimension of outer walls of canals, and (3) the centering ratio were measured at 7 measuring points, and then data were statistically analyzed using one-way ANOVA and Duncan's test. The results were as below; 1. The root canal shaping ability of Profile was significantly faster than that of other rotary NiTi instruments (p < 0.05). 2. The deformation and fracture of all instruments used for this study were not experienced. 3. In the degree of changes of the dimension of inner walls of canals, Profile demonstrated the lowest changes of the dimension of inner walls of canals except at the measuring points of the 1 and 2 mm (p < 0.05). However, the ProTaper Universal showed the highest changes of the dimension of inner walls of canals at all measuring points (p < 0.05). 4. In the degree of changes of the dimension of outer walls of canals, Mtwo demonstrated the lowest changse of the dimension of outer walls of canals except at the measuring point of the 1 mm (p < 0.05). However, Profile exhibited the highest changes of the dimension of outer walls of canals at the measuring points of 3 and 4 mm and ProTaper Universal and K3 showed the largest changes of the dimension of outer walls of canals at the measuring points of 1, 2, 6, and 7 mm (p < 0.05). 5. In degree of centering ratio, Profile demonstrated the least centering ratio comparing with the centering ratio shown by other NiTi instruments at the measuring points of 1, 4, 5, and 6 mm. Results suggest that in the coronal part of canal preparation, active cutting files such as ProTaper Universal may efficiently flare the canal orifice and form a better taper, and in the apical part of the canal, files which have a better centering ability such as Profile may maintain the original canal curvature and reduce the shaping time.

• Restorative Dentistry and Endodontics
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• v.31 no.2
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• pp.119-124
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• 2006

The purpose of this study was to evaluate the effect of newly developed endodontic root canal cleanser (MTAD) on the apical leakage of obturated root canal using an electrochemical method. Canals of 60 extracted single-rooted human teeth were prepared by using a crown-down technique with rotary nickel-titanium files. In Group 1 (positive control group) and 2 (negative centre) group), 5.25% NaOCl was used as a canal irrigant and no canal wall treatment was done. In group 3 only 5.25% NaOCl were used as canal irrigant, canal wall treatment and final rinse. In group 4, specimens were irrigated with 5.25% NaOCl, treated with 5 ml of 17% EDTA for 5 minutes and final rinsed with 5.25% NaOCl Specimens of group 5 were irrigated with 1 3% NaOCl and treated with 5 ml of MTAD for 5 minutes. All root canals are dried with paper points and obtuated with gutta-percha and AH plus as a sealer using a continuous wave of condensation technique except in the group 1. The electrical resistance between the standard and experimental electrodes in canals was measured over a period of 10 days. Rising of apical leakage with time was observed for all the groups. Group 4 and 5 showed lower apical leakage than group 3 but differences between the group 3, 4 and 5 were no statistical significance at any measurement time.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.244-253
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• 1997

During preparation of narrow curved canals, procedural accidents such as, ledge, zipping, and transportation are frequently encountered and may lead to failure of endodontic therapy. To reduce these procedural errors and efficiently manage curved canals, various modifications in instrumentation technique and the design and flexibility of instruments have been advocated. This study compared the maintenance of the original canal curvature, cross sectional canal shape, and preparation time during instrumentation with stainless steel hand (K-Flexo) file, and nickel-titanium rotary files (Profile and Lightspeed). Thirty resin blocks with simulated curved canals of 20~25 degrees were used and divided into three groups of 10 each. In group 1, canals were instrumented using a quarter turn/pull technique with K-Flexofiles. Group 2 canals were prepared with rotary NiTi Profiles. Group 3 was prepared with rotary NiTi Lightspeed instrument. Before and after instrumentation, all canals were scanned using stereo microcope, FlexCam camera, and Photoshop 3.0 computer program. The results were as follows : 1. All groups showed some loss of canal curvature after instrumentation. Average loss of canal curvature was 8.6 degrees for K-Flexofile, 7.7 degrees for Profile, and 5.8 degrees for Lightspeed. Lightspeed exhibited significantly less curvature loss than K-Flexofile (p<0.05). 2. At the apical 1-mm level, Profile produced significantly rounder canals than Lightspeed (p<0.05). At the 3-mm level, Profile and Lightspeed exhibited significantly rounder canals than K-Flexofile (p<0.05). 3. Preparation with Lightspeed was significantly faster than Profile and K-Flexofile, and Profile was faster than K-Flexofile (p<0.05). 4. There was no significant difference in incidence of zipping between the hand K-Flexofile and rotary NiTi (Profile and Lightspeed) instruments. Most of apical canals were slightly widened near the apical foramen. As a results of this study, rotary NiTi instruments are superior to the K-Flexofile in regard to the maintenance of original canal curvature, cross-sectional shape and preparation time. But more investigations and studies should be needed to evaluate the ideal canal instrumentation.