• Restorative Dentistry and Endodontics
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• v.33 no.6
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• pp.560-569
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• 2008

Microorganism survived in the root canal after root canal cleaning and shaping procedure is a main cause of root canal treatment failure. There are several mechanisms for the bacteria to survive in the root canal after chemomechanical preparation and root canal irrigation. Bacteria organized as biofilm has been suggested as an etiology of persistent periapical lesion. Recent studies were focus on removal of Enterococcus faecalis biofilm due to the report that the persistence of this bacteria after root canal treatment may be associated with its ability to form biofilm. Several investigations demonstrated that current root canal treatment protocol including use of NaOCl, EDTA and Chlorhexidine as irrigants is quite effective in eliminating E. faecalis biofilm. However, this microorganism still can survive in inaccessible areas of root canal system and evade host immune response, suppress immune activity and produce biofilm. Up to date, there is no possible clinical method to completely get rid of bacteria from the root canal. Once the root canal treatment failure occurred, and conventional treatment incorporating current therapeutic protocol has failed, periapical surgery or extraction should be considered rather than prolong the in effected retreatment procedure.

• 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.

• Journal of the Korean Society for Precision Engineering
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• v.24 no.8 s.197
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• pp.116-121
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• 2007

The length of root canal has to be measured for endodontic treatment. Several electronic apex locators were developed to measure the length of root canal by other researchers. And their accuracies were verified by X-ray or micrometer method. But these methods did not consider the non-linear bends of pulp and had ${\pm}0.5mm$ error which was large enough to measure the length of root canal. The purpose of this study is the introduction of a new method to measure the length of root canal and the verification of the accuracy of an electronic apex locator using a Micro-CT. The length of root canal of 6 teeth were measured with the electronic apex locator. When the electronic apex locator reads 0.5, 0.6, 0.7, 0.8, 0.9 and 1.0 mm length of the file which was inserted in the hole of the tooth to measure the length of root canal. The average (${\pm}$Standard deviation) length of root canal of 6 teeth measured by the Micro-CT was $0.49{\pm}0.03,\;0.59{\pm}0.04,\;0.68{\pm}0.03,\;0.78{\pm}0.03,\;0.90{\pm}0.04\;and\;1.01{\pm}0.03mm$, respectively. The maximum error of the electronic apex locator was 0.06 mm.

• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.34.1-34.7
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• 2020

Objectives: This study evaluated by using micro-computed tomography (micro-CT) the filling ability and sealer apical extrusion promoted by a new Sealer Injection System (SIS; Angelus) with side openings needle, in comparison with the conventional injection system, associated with a new ready-to-use calcium silicate-based sealer (Bio-C Sealer). Materials and Methods: Acrylic resin models containing a main curved artificial canal and 3 simulated lateral canals in apical, middle and cervical thirds were used. The main root canals were prepared using a rotary system up to size 35.05. The canals were filled with Bio-C sealer by using a single cone technique and the conventional delivery system or SIS. Samples were scanned in micro-CT. The percentage of voids throughout the entire extension of the main root canal and in each third of the lateral canals, besides the apical extrusion of the sealer was calculated. Data were submitted to t-test (p < 0.05). Results: There was no difference between both systems in the main root canals filling. Although the volume percentage of voids was similar in the apical and middle thirds of lateral canals, SIS had the greatest filling ability of the cervical third lateral canal. Moreover, the conventional system showed the highest apical extrusion of the sealer. Conclusions: The conventional and SIS obturation systems had an appropriate filling ability of the main root canal. SIS had the best filling of the cervical third of the lateral canals, besides lower sealer apical extrusion, suggesting its clinical indication.

• The Journal of the Korean dental association
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• v.21 no.2 s.165
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• pp.167-172
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• 1983

This study was to investigate the effects of mynol cement on the periapical tissues of 40 molars in ten dogs. Root canal fillings were placed with mynol cement and the animals were killed at different post operative periods ranging from 1 to 5 weeks. The teeth examined on the basis of microscipic findings. The following results may be drawn; 1. 1 week after root canal fillings, the necrosis of cementum and dentin including alveolar bone was to be seen. There were severe inflammatory changes in the periodontal ligament. 2. 2 weeks after root canal fillings, edematous changes and fibrosis in the periodontal ligament were revealed. 3. After 3-4 weeks, fibrosis was more prominent than 2 weeks. 4. 5 weeks after root canal fillings, the osteoblastic activity was found abundantly surrounding the alveolar bone.

• Restorative Dentistry and Endodontics
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• v.46 no.1
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• pp.10.1-10.16
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• 2021

Root canal debridement, which includes the removal of infected tissues and microbial biofilms, is considered the corner stone of root canal treatment. Chemical adjuncts play a multitude of functions in this regard, as tissue solvents, antimicrobial agents and for removing the smear layer. These adjuncts (irrigants) are usually delivered using a syringe and needle. With increasing knowledge of the complexity of root canal anatomy and tenacity of microbial biofilms, the need for strategies that potentiate the action of these irrigants within the root canal system cannot be overemphasized. Several such activated irrigation strategies exist. The aim of this review is to comprehensively discuss the different irrigant activation methods from the context of clinical studies.

• Restorative Dentistry and Endodontics
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• v.20 no.2
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• pp.768-779
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• 1995

This study was performed to investigate the effect of root canal shaping techniques on the change of the shape of prepared root canal. 40 mesiobuccal canals of recently extracted mandibular 1st and 2nd molars were divided into 4 groups and shaped by step-down/balanced force technique, step-down/step-back technique, step-back technique and conventional technique respectively. The change of the shape of root canal was traced by superimposing the radiographs obtained before and after shaping of each root canal. The results were as follows. 1. By the experimented techniques except conventional technique, the root canals were more shaped in convex side of apical area and in concave side of most curved and coronal area than in the other sides(P<0.05). By conventional technique, the root canals were more shaped in convex side than in convave side from apex to orifice(P<0.05). 2. By step-down/balanced force technique, the cancave sides at C and D points of proximal view and C point of clinical view were more shaped than the convex side(P<0.05). Through the entire canal, the concave side was more shaped than the convex side in proximal view(P<0.01). But there was no statistical difference between both sides in clinical view. 3. By step-down/step-back technique, the change of root canal shape was not statistically different in concave and convex sides at each point of both views(P>0.05). And through the entire canal in proximal view, there was no statistical difference in shaping percentage between both sides. But through the entire canal in clinical view, the concave side was more shaped than the convex side(P<0.1). 4. By step-back technique, the convex side at B point of clinical more shaped than the other sides(P<0.05). Through the entire canal in proximal and clinical views, there was no statistical difference in shaping percentage between both sides. 5. Comparing the total shaping percentage among techniques, that in conventional technique was the greatest numerically, and followed by the percentages in step-down/step-back, step-down/balanced force and step-back technique. But, in proximal view, shaping percentages were not statistically different among techniques(P>0.05, ANOVA test). In clinical view, shaping percentages in step-back and conventional techniques were statistically different(P<0.01, ANOVA test). * Proximal view: radiograph taken in mesiodistal direction. * Clincal view: radiograph taken in faciolingual direction. A point : 1mm point from radiographic apex B point : center point between A and C points C point : most curved point of root canal D point : center point between C point and canal oriffice.

• Restorative Dentistry and Endodontics
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• v.30 no.6
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• pp.461-469
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• 2005

The aim of this study was to compare the root canal systems of maxillary and mandibular premolars that had a single root using radiographs and clearing samples. 142 single rooted premolars were selected and mesio-distal and bucco-lingual views were radiographed using intra-oral dental standard films. Four equally trained examiners classify the root canal types from the developed radiographs. After opening the tooth for access, it was stored in $5\%$ NaOCl to dissolve the pulp tissue. Indian ink was then injected into the pulp cavity to stain the pulp tissue. It was cleared in methyl salicylate after being decalcified with $5\%$ nitric acid for 48 hours, and the root canal type was evaluated at a magnification of $\times$ 20 using a stereomicroscope. The results are as follows ; There were statistically significant differences between the radiographs and clearing samples of the root canal types among examiners (p < 0.05). There might be differences in the root canal types among examiners when the same radiograph is used. Therefore, considering the difficulty in estimating the root canal types, clinicians need to be careful when interpreting radiographs before root canal therapy.

• 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.

• Proceedings of the KACD Conference
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• 2003.11a
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• pp.547-547
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• 2003

The aim of this study was to compare the effects of three Ni-Ti instruments on leaning ability by evaluating the volumetric and morphological changes in the apical 6mm of the root canals before and after preparation, using three-dimensionally reconstructed root canals of extracted human teeth. Forty-five teeth were used in this study. They were opened the chambers and removed the all pulp remnants ultrasonically. Subsequently, the canal wall was coated with silver paste and prepared using ProTaper, ProFile and GT rotary files according to the manufacturers instructions. Before and after root canal preparation, all the specimens were scanned with micro computed tomography and examined the differences in dentine volume removed, canal straightening, the proportion of the unchanged area and canal transportation. Quantitative analysis revealed that instrumentation increased in canal volume ranging between 0.081 and $1.866{\;}\textrm{mm}^3$. On average, the large apical preparation produced by ProTaper demonstrated smaller proportions of unchanged surface areas compared to the two other instruments in small canals. But in large canals like maxillary central incisor, the preparation of ProTaper instruments was not enough. ProTaper instrument was tended to increase more in canal volume as compared with the other two instruments but unchanged area was no significant difference. These results showed that three instruments had similar preparation ability and micro computed tomography in combination with the coated wall of root canal using silver paste is a nondestructive and valuable tool to study root canal geometry and changes after preparations in detail.