• Proceedings of the KACD Conference
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• 2002.11a
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• pp.720-720
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• 2002

A number of investigations have shown that the presence of bacteria is prerequisite for developing pulpal and/or periradicular pathosis. Depending on the stage of pulpal pathosis, various species of bacteria can be cultured from infected root canals. Kakehashi et al. showed that exposure of pulpal tissue in germ-free rats was characterized by minimal inflammation and dentinal bridging while exposure of pulpal tissue in conventional rats with normal oral flora was characterized by pulpal necrosis, chronic inflammation, and periapical lesions. Currently used methods of cleaning and shaping, especially rotary instrumentation techniques, produce a smear layer that covers root canal walls and the openings to the dentinal tubules. The smear layer contains inorganic and organic substances that include fragments of odontoblastic processes, microorganisms, their by products and necrotic materials. Because of its potential contamination and adverse effect on the outcome of root canal therapy, it seems reasonable to suggest removal of the smear layer for disinfection of the entire root canal system. Presence of this smear layer prevents penetration of intracanal medications into the irregularities of the root canal system and the dentinal tubules and also prevents complete adaptation of obturation materials to the prepared root canal surfaces. Removal of the smear layer by an intracanal irrigant and placement of an antibacterial agent in direct contact with the content of dentinal tubules should allow disinfection of this complex system and better outcome for the root canal therapy. A new solution, which was a mixture of a tetracycline, an acid, and a detergent(MTAD), was developed in the Department of Endodontics, Dental School. Lorna Linda University, USA. It has been demonstrated that MTAD was an effective solution for the removal of the smear layer and does not significantly change the structure of the dentinal tubules when used as a final irrigant in conjunction with 1 % NaOCl as a root canal irrigant. Studies are in progress to compare the anti- microbial properties of this newly developed solution with those of sodium hypochlorite and EDTA that are currently used to irrigate the root canals and remove the smear layer from the surfaces of instrumented root canals.canals.

• The Journal of the Korean dental association
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• v.38 no.3 s.370
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• pp.288-292
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• 2000

Perhaps the most frustrating scenario in dentistry lies in the apparently well-instrumented and well-obturated tooth that, becomes symptomatic after treatment of shows a periapical lesion on recall examination. Conventional root canal treatment demands stringent adherence to asepsis, awareness of canal morphology, and mastery of a variety of clinical techniques. But the risk of endodontic failure does not end with canal obturation. The quality of the coronal restoration may have a greater bearing on the ultimate success of a case than the quality of the root canal treatment itself. This review of the endodontic literature will define coronal leakage, describe its influence on endodontic treatment failures, and make specific recommendations on prevention.

• Restorative Dentistry and Endodontics
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• v.28 no.4
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• pp.341-347
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• 2003

This study was conducted to evaluate the temperature rise on the root surface while the root canal is being obturated using continuous wave of condensation technique. Maxillary central incisor was prepared for repeated canal obturation. Ten thermocouples (Omega Engineering Inc., Stanford, USA) were placed at 1 mm increment from the anatomical root apex. The real temperature of Buchanan plugger was recorded before insertion into the root canal. The root canal was obturated with continuous wave of condensation technique as described by Buchanan and the root surface temperature was recorded during obturation at $150^{\circ}C,{\;}200^{\circ}C,{\;}250^{\circ}C{\;}and{\;}300^{\circ}C$ temperature settings of System B HeatSource (Model 1005, Analytic technologies, Redmond, WA, USA). After completion of the temperature recording, the dentinal-cementum thickness at each sites was measured. The data were analyzed using one-way ANOVA followed by Scheffe's test and linear regression test. The results were as follows. 1. When the temperature was set at $150^{\circ}C,{\;}200^{\circ}C,{\;}250^{\circ}C{\;}and{\;}300^{\circ}C$ on the digital display of System B HeatSource, the real temperature of the plugger at the 1mm point from the tip revealed $130.82{\pm}2.96^{\circ}C,{\;}158.00{\pm}5.26^{\circ}C,{\;}215.92{\pm}6.91^{\circ}C{\;}and{\;}249.88{\pm}3.65^{\circ}C$ respectively. 2. The position of 8 mm from the anatomical apex showed the highest temperature increase at each temperature settings and it was significantly higher than those of other positions (p<0.0l). The temperature rise was constantly increased toward coronal portion from apex of the root. 3. The maximum temperature increase on the root surface was $2.37{\pm}0.09^{\circ}C{\;}at{\;}150^{\circ}C{\;}setting,{\;}3.11{\pm}0.12^{\circ}C{\;}at{\;}200^{\circ}{\;}setting,{\;}3.93{\pm}0.09^{\circ}C{\;}at{\;}250^{\circ}C{\;}setting{\;}and{\;}5.69{\pm}0.15^{\circ}C{\;}at{\;}300^{\circ}C$ setting respectively. These results suggest that it be relatively kind to the supporting tissues of the root that the root canal is obturated using continuous wave of condensation technique at $150^{\circ}C,{\;}200^{\circ}C,{\;}250^{\circ}C{\;}and{\;}300^{\circ}C$ temperature settings on digital temperature display of System B HeatSource.

• Proceedings of the KACD Conference
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• 2001.11a
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• pp.563.1-563
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• 2001

The purpose of this study was to evaluate the effects of EDTA and pulsed Nd:YAG laser on apical of canal obturation. Forty-eight single-rooted teeth were used in thes study. The teeth were instrumented up to a size 40 K-file and irrigated with 2.5％ NaOCl between each file size. And the teeth were divided into 4 groups. In group A, the root canals were irrigated with a final flush of 5ml 2.5％ NaOCl as a control group.(omitted)

• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.29.1-29.9
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• 2020

This study describes the clinical steps taken in the treatment of a patient who had an avulsed right upper central incisor that presented with incomplete root development and chronic apical periodontitis. A 7-year-old boy was referred from a private dentist to a dental office specializing in endodontics. The tooth had remained in a dry environment for 20 minutes, and tooth replantation was performed at an emergency appointment. After clinical and radiographic examinations, root canal decontamination was performed, followed by several changes in intracanal calcium hydroxide medication. Blood clot formation was attempted, but bleeding within the root canal was insufficient; therefore, we opted for an intracanal medication change to stimulate mineralized tissue formation in the apical region. Root obturation was performed 45 days after the last change of intracanal medication, and clinical, radiographic, and tomographic follow-up examinations were performed at 3, 6, 18, and 40 months after the endodontic intervention. The increase in thickness and length of the root structure and the absence of root resorption were verified through follow-up examinations. Therefore, it was concluded that the procedures used were successful for tooth replantation.

• 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.21 no.2
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• pp.628-634
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• 1996

The purpose of this study was to investigate the effect of moisture on apical sealing properties of root canal. Fifty five single rooted human teeth were selected from maxillary and mandibular teeth. After removing crown portion at the cemento-enamel junction, all teeth were routinely prepared with step-back method. And then, the canals were dried with paper point and the teeth were randomly divided into 3 groups of 15 teeth each, and remaining 10 teeth were used as positive and negative control teeth : Group 1 were irrigated with 1ml of 95% alcohol and dried with air and paper point. Group 2 and 3 were intentionally contaminated with 0.05ml of 3.5% NaOCl or saliva, respectively. All the teeth were obturated with sealapex and gutta percha cone by lateral condensation technique, and covered with two coat of nail varnish after 48 hours of obturation. The teeth were immersed in india ink for 1 week and cleaned with methyl salicylate and then the degree of dye penetration were measured with stereomicroscope. The data were analyzed statistically by one-way ANOVA. The results were as follows : 1. All experimental groups showed varying degrees of dye penetration, and the mean degree of dye penetration was 0.1mm to 0.7mm. 2. Saliva contamination group(group 3) showed the highest amount of dye penetration, followed by NaOCl contamination group, then alcohol dried group, but there was no significant difference among three experimental groups. * This results suggest that there was no significant differences of apical leakage after canal obturation between alcohol dried canal and moisture present canals and the use of alcohol instead of paper point is unnecessary to dry the canals prior to canal filling. But other factors such as bacterial contamination and sealer discoloration by moisture must be considered in application of this results to clinical practice.

• Restorative Dentistry and Endodontics
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• v.22 no.2
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• pp.659-669
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• 1997

The goals of root canal instrumentation are complete debridement of pulp tissue, removal of microbes and affected dentin, and proper cleaning and shaping of the root canal space before obturation. Instrumentation with stainless steel files has been shown to produce undesirable results in canals, regardless of the improved technique or modified file type used. Nickel-Titanium(Ni-Ti) alloy has been shown to be exceptionally elastic, having a lower bending moment and lower permanent set after torsion, compared with similar gauge stainless steel. The purpose of this study was to evaluate the change of root canal prepared by Ni-Ti rotary and stainless steel instruments. Thirty-four single rooted teeth of similar shape and canal size were divided into three groups. The teeth were scanned by computed tomography before instrumentation. In group 1, canals were instrumented using a step-back technique with K-file. In group 2, canals were prepared with K-flex file using the same technique as group 1. Group 3 was prepared with nickel-titanium(Ni-Ti) rotary instrument using a manufacture's instruction. Instrumented teeth were again scanned using computed tomography, and reformated images of the uninstrumented canals were compared with images of the instrumented canals. K-flex file and Ni-Ti file caused significantly less canal transportation than K-file in the 8mm root canal section from the apex(p<0.05). K-flex file and Ni-Ti file produced more centered canal preparation than K-file in the 2mm section(p<0.05). Ni-Ti file maintained more precisely the center of the canal than K-flex file in the 10mm section (p<0.05). There was no difference in the removed volume of canals among each groups.

• Restorative Dentistry and Endodontics
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• v.9 no.1
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• pp.59-68
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• 1983

The purpose of this study was to examine the influence of canal irrigants and the method of canal filling on the quality of canal obturation. Sixty extracted human teeth with single root were selected and divided into three different groups; In group I (control); 5 cc normal saline irrigated after each instrumentation In group II; 2.5 cc-3% NaOCl in combination with 2.5 cc-3% $H_2O_2$ In group III; RC-Prep in combination with 5 cc-3% NaOCl All specimens were cleaned, shaped(#50 file size), irrigated and obturated by lateral condensation and automated thermatic condensation filling method of gutta-percha and AH-26. After all the specimens were immersed in 2% methylene blue dye solution in $37^{\circ}C$ for 7 days and the degree of dye penetration into the canals observed by magnifying glass(${\times}$20) and reflected light microscope The results were as follows: 1. All the the teeth showed some degree of the dye penetration. 2. There were no significant difference among three groups in the degree of the dye penetration in each canal filling method. 3. There were no significant difference of the dye penetration between each canal filling method in group I. 4. There were no statistically significant difference of the dye penetration between each canal filling method in group II and group III, but lateral condensation group was showed slightly more than automated thermatic condensation group.

• Restorative Dentistry and Endodontics
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• v.19 no.2
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• pp.611-620
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• 1994

The purpose of this study was to evaluate the effect of post space preparation on apical sealing according to the methods and time of gutta percha removal. Forty six extracted single rooted teeth were selected for this study. Forty teeth were used as experimental groups and six teeth as control groups. Forty teeth were routinely prepared by step-back method and obturated with gutta percha cones and zinc oxide-eugenol cement using lateral condensation. All obturated teeth were divided into 4 groups of 10 teeth each. In each group of 1, 2, 3, heated plugger, gate glidden drill and chloroform and K-file were used respectively for post space preparation by removing the gutta percha immediately after obturation. In group 4, post space were prepared with gate glidden drill one week after obturation. In all experimental groups, the post space were prepared so that 4mm of apical gutta percha remained. After post space preparation, apical leakage were measured with electrochemical method for 28 days and analyzed statistically. The following results were obtained ; 1. No statistically significant differences in apical leakage were occured among the experimental groups using heated plugger, gate glidden drill and chloroform and K-file to remove the gutta percha immediately after obturation. 2. No significant difference in apical leakage was found between the teeth prepared post space immediately after obturation and those prepared 1 week after obturation. 3. In all experimental groups, the apical leakage was increased with time passage regardless of the post space preparation time and the gutta percha removal techniques.