• Restorative Dentistry and Endodontics
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• v.38 no.3
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• pp.160-166
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• 2013

This case report demonstrates an unnecessary endodontic treatment of teeth with florid cemento-osseous dysplasia (FCOD) due to a misdiagnosis as periapical pathosis and emphasizes the importance of correct diagnosis to avoid unnecessary treatment. A 30-year-old woman was referred to our institution for apicoectomies of the mandibular left canine and both the lateral incisors. The periapical lesions associated with these teeth had failed to resolve after root canal treatment over a 3-year period. Radiographic examinations revealed multiple lesions on the right canine, the second premolar, and both first molars as well as the anterior region of the mandible. Based on clinical, radiographic and histological evaluations, the patient condition was diagnosed as FCOD. The patient has been monitored for 2 years. To avoid unnecessary invasive treatment, accurate diagnosis is essential before treatment is carried out in managing FCOD.

• Restorative Dentistry and Endodontics
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• v.46 no.1
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• pp.8.1-8.7
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• 2021

Objectives: The reliability and educational quality of videos on YouTube for patients seeking information regarding instrument separation in root canal treatment were evaluated. Materials and Methods: YouTube was searched for videos on instrument separation in root canal treatment. Video content was scored based on reliability in terms of 3 categories (etiology, procedure, and prognosis) and based on video flow, quality, and educational usefulness using the Global Quality Score (GQS). Descriptive statistics were obtained and the data were analyzed using analysis of variance and the Kruskal-Wallis test. Results: The highest mean completeness scores were obtained for videos published by dentists or specialists (1.48 ± 1.06). There was no statistically significant difference among sources of upload in terms of content completeness. The highest mean GQS was found for videos published by dentists or specialists (1.82 ± 0.96), although there was no statistically significant correlation between GQS and the source of upload. Conclusions: Videos on YouTube have incomplete and low-quality content for patients who are concerned about instrument separation during endodontic treatment, or who experience this complication during endodontic treatment.

• Restorative Dentistry and Endodontics
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• v.15 no.2
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• pp.104-114
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• 1990

The purpose of this study was to evaluate the adaptation of root canal filling material to the dentinal wall of root canal and to compare the sealing ability of the root canal filling materials using ultrasonic endodontic instrument with injection-molded thermoplasticized gutta-percha filling method and lateral condensation method. Fifty fresh human single root exlracted for orthodontic treatment, were randomly selected, and instrumented by step-back technique. And then, the teeth were divided into 5 groups according to each root canal filling methods. In the experimental group 1 and group 2, the root canals were filled with gutta perdia cases using ultrasonic instrument with and without sealer. In the experimental group 3 and 4, using jection-moldeed thermoplasticized gutta-percha method by obtul$^{(R)}$ canals were filled with and without sealer. In the control group, the canals were filled with sealer by lateral candensation. And then, 5 teeth of each group were immersed in black Indian ink, decalcified and cleared. The depth of dye penetration into the root canal were evaluated with stereoscope (Reichert Ltd., USA). Among the 5 teeth remaining in each group, the single longituding grooves were made on the labial and lingual root surfaces and then immersed in the liquid nitrogen to fracture the teeth spontaneously without any distortions of gutta-percha. Each specimens were examined with X-650 Scanning Electron Microscope(Hitachi ltd, Japan) to show the adaptation to the canal wall, void, homogenicity of filling material and location of gutta-percha or sealer in the dentinal tubules of the root canal. The observations were as follows : 1. The experimental group 1 showed smaller mean dye penetration than control group, and showed the penetraton of sealer in the dentinal tubules of apical third of the root canal. 2. The experimental group 2 and group 4 showed the penetration of gutta-percha in the dentinal tubules of root canals. 3. The experimental group 1 and group 3 showed less mean dye penetration than the experimental group 2 and group 4. 4. The experimental group 1 and group 2 showed better adaptation of filling materials than control group.

• Restorative Dentistry and Endodontics
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• v.40 no.3
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• pp.241-248
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• 2015

Variation in root canal morphology, especially in maxillary first molar presents a constant challenge for a clinician in their detection and management. This case report describes the successful root canal treatment of a three rooted right maxillary first molar presenting with three canals each in the mesiobuccal and distobuccal roots and one canal in the palatal root. The clinical detection of this morphologic aberration was made using a dental operating microscope, and the canal configuration was established after correlating and computing the clinical, radiographic and cone-beam computed tomography (CBCT) scan findings. CBCT images confirmed the configuration of the canals in the mesiobuccal and distobuccal roots to be Al-Qudah and Awawdeh type (3-2) and type (3-2-1), respectively, whereas the palatal root had a Vertucci type I canal pattern. This report reaffirms the importance of careful examination of the floor of the pulp chamber with a dental operating microscope and the use of multiangled preoperative radiographs along with advanced diagnostic aids such as CBCT in identification and successful management of aberrant canal morphologies.

• Journal of Korean Dental Science
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• v.14 no.2
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• pp.61-68
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• 2021

Purpose: The aim of this study was to investigate the outcomes of endodontic treatment of mandibular second molar with C-shaped canal in elderly patients and related factors affecting the survival of the tooth. Materials and Methods: From 2010 to 2015, the survival rate following endodontic treatment was evaluated in elderly patients over 60 years who visited the Veterans Health Service Medical Center for endodontic treatment. The presence of C-shaped canals was confirmed using clinical records and radiographic features. Patient's age, sex, systemic diseases, tooth location, vitality, signs and symptoms, fractures, caries, apical radiolucency, canal shaping methods, sealer leakage, filling voids, and restoration of prosthesis were included in the analyses as confounding variables. The survival rate of teeth was analyzed using Kaplan-Meire analysis and the relationship between the survival rate and variables was analyzed using Simple and Multiple Cox regression analysis. Result: In total, 107 teeth in elderly patients had C-shaped canal. The survival rate of teeth that received endodontic treatment was 63.70%. None of the factors investigated significantly influenced the survival rate (P>0.05). Conclusion: In elderly patients with C-shaped canal, the survival rate after root canal treatment was not significantly different from that of other mandibular molars.

• 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.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.31.1-31.7
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• 2018

Despite considerable focus on the regenerative endodontic treatment of immature teeth with necrotic infected pulps and apical periodontitis, little data exist with regard to its possible implementation in necrotic permanent teeth with complete apical and radicular development. The present report describes the procedures and outcome of a regenerative endodontic treatment approach in 2 previously-traumatized incisors with closed apex with apical periodontitis. A 2-visit treatment procedure was employed. At initial visit, the root canals were copiously irrigated, followed by placement of a triple antibiotic paste containing ciprofloxacin, metronidazole, and clindamycin into the root canals. After 4 weeks, the antibiotic paste was removed, and apical bleeding was initiated with size 10 hand files beyond the apices. The root canals were coronally sealed with mineral trioxide aggregate, and the access cavities were restored with bonded resin composite. At post-operative 60 months, both teeth were remained asymptomatic, with the recall radiographs showing complete resolution of apical radiolucency and reestablishment of periradicular tissues. In both teeth, the dimensions of root space remained unchanged as verified by image analysis. The revitalization protocol utilizing root canal disinfection and induced apical bleeding in necrotic, closed-apex incisors may offer a clinically acceptable alternative to conventional root canal treatment.

• Restorative Dentistry and Endodontics
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• v.26 no.5
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• pp.418-435
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• 2001

Root canal preparation process is of utmost importance in successful treatment of root canal. Also, one of the most important purpose of the root canal preparation is to enlarge the root canal three dimensionally without changing the curvature of the root canal However as the curvature of the root canal increases, there are many difficulties involved in formation of optimum root canal. Therefore in order to solve the above mentioned problems, new developments in methods of root canal preparation and equipments for such purposes were made. Recently, vigorous studies about newly introduced engine-driven nickel-ti-tanium rotary file are conducted. As shown in research results to dates, it is well established that the use of nickel-titanium file is better suited for curved root canal than stainless steel file in maintaining the curvature or root canal and reducing the deformation of root canal. However it is also acknowledged that there are a few discrepancies in research results according to protocol, due to failure to remove variables in experiments. In addition, although it is recommended by the manufacturer that the GT rotary file should maintain a low rotational speed of 150~350rpm and 'light pressure' as light as not to break the lead of a pencil, academic studies about the vertical force which is not yet standardized are not sufficiently explored. Therefore, this research devised and utilized a special research equipment to standardize the appropriate range of vertical force for GT rotary file through experiments by breaking of the lead of a pencil as expressed by the manufacturer and to accurately measure factors involved through repeating and recreating the environment of root canal preparation. Forming nine experimental groups by varying the vertical forces (150g. 220g, 300g) and rpm (150rpm, 250rpm, 350rpm), the effects of changing vertical forces and rpm on working efficiency were measured in terms of time expended in root canal preparation by crown-down method using a transparent resin block with 35 degree curvature and GT rotary file (z-test). The following research using this special research equipment that involved nine experimental groups and varying the vertical force for root canal preparation from 300g which is within the normal vertical force range to 700g and 1000g which fall outside the normal rpm range. The results were as follows : 1. Analysis of the experiment results revealed that the time spent in root canal preparation decreased as the vertical forces and rpm increased (p<0.05). Also, the effects of rpm were greater than those of the vertical forces within the normal vertical force range ($\beta$-weight test). 2. Observation of the deformation of GT rotary file revealed that deformation increases in a direct correlation with the vertical force increase and in a reverse correlation with the rpm decrease. In the case of the vertical forces close to the normal range, the probability of GT rotary file deformation were quite different depending on the rpm changes. In the case of greater vertical forces, the occurrences of deformation of the file were more frequent regardless of the rpm changes. 3. Deformation and breakage of file were also commonly observed in the expended time measurement experiments and GT rotary file deformation experiments in which low speed rpm (150rpm) was used and at the curved portion of the resin block.

• Restorative Dentistry and Endodontics
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• v.40 no.1
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• pp.79-84
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• 2015

This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment.

• Restorative Dentistry and Endodontics
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• v.42 no.1
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• pp.60-64
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• 2017

Root canal anatomy is complex, and the recognition of anatomic variations could be a challenge for clinicians. This case report describes the importance of cone beam computed tomographyic (CBCT) imaging during endodontic treatment. A 23 year old woman was referred by her general dental practitioner with the chief complaint of spontaneous pain in her right posterior maxilla. From the clinical and radiographic findings, a diagnosis of symptomatic irreversible pulpitis was made and endodontic treatment was suggested to the patient. The patient underwent CBCT examination, and CBCT scan slices revealed seven canals: three mesiobuccal (MB1, MB2, and MB3), two distobuccal (DB1 and DB2), and two palatal (P1 and P2). Canals were successfully treated with reciprocating files and filled using single-cone filling technique. Precise knowledge of root canal morphology and its variation is important during root canal treatment. CBCT examination is an excellent tool for identifying and managing these complex root canal systems.