• Restorative Dentistry and Endodontics
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• 제33권6호
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• pp.560-569
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• 2008

본 review 논문의 목적은 통상의 근관치료로 해결되지 않는 persistent periapical lesion의 원인이 되는 주요 세균을 제거하고자 시행한 여러가지 실험을 비교분석하여 과연 (1) Enterococcus faecalis가 근관치료 실패의 주요 원인균인지 (2) 그리고 과연 그렇다면 근관치료에 실패한 증례에서 E. faecalis와 biofilm을 제거할 수 있는 치료 protocol이 있는 것인지를 확인하여 보다 나은 근관치료 성공을 위한 치료 protocol의 확립과 앞으로의 연구방향을 재조명하는 것이다. 지금까지 진행되어온 연구 결과에 대한 객관적인 분석이나 적절한 평가가 이루어지지 않은 가운데 어떤 특정한 연구를 통해 E. faecalis를 제거하는데 유의성있는 효과를 보인다고 알려진 세척액이나 약제를 막연한 기대감을 가지고 실제 임상에 사용하고 있는 실정에서 현재 진료실에서 사용하고 있는 치료 protocol에 대한 검증이 절실한 시점에서 review해 본 결과 현재까지 진행되어 왔던 여러 연구 결과를 통해 확신할 수 있는 것은 치료 protocol에 따라 현재 사용하고 있는 근관세척액이나 근관내 약제만으로도 E. faecalis나 그 biofilm을 대부분 제거할 수 있다는 사실이다. 하지만 이 그 protocol에 따라 근관치료 술식을 충실하게 이행한다 해도 근관치료가 100% 성공한다고 보장할 수는 없다. 물론 세균이 아닌 다른 요소에 의해 근관치료의 실패가 일어난다고도 할 수 있지만 그보다는 결국 체내의 면역반응에 저항하는 세균의 능력에 기인하는 것으로 보인다. 따라서 높은 수준의 치료 성공률을 지속적으로 유지하기 위해서는 위에서 언급된 바와 같은 제대로 된 치료 protocol을 따라 근관치료를 진행하면서 좀더 나은 결과를 얻기 위해 새로운 protocol을 개발하고 정립하는 과정이 계속되어야 한다.

• 대한치과보존학회:학술대회논문집
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• 대한치과보존학회 2002년도 추계학술대회
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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.

• 한국정밀공학회지
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• 제24권8호통권197호
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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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• 제45권3호
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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.

• 대한치과의사협회지
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• 제21권2호통권165호
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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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• 제46권1호
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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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• 제20권2호
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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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• 제30권6호
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• pp.461-469
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• 2005

한 개의 치근을 가진 상, 하악 소구치의 방사선 사진 상의 근관계와 동일치아의 투명표본 상의 근관계를 각각 관찰한 다음 상호 비교하기 위해 총 142개의 소구치를 선택한 후, 구내 치과용 표준 방사선 필름을 이용하여 근원심과 협설측으로 방사선을 채득하였다. 동일하게 교육받은 4명의 판독자가 방사전 사진을 판독하여 근관계의 형태를 분류하였다. 동일한 치아에 근판와동을 형성한 후 $5\%$ 질산용액에 48시간 동안 담가 치수조직을 용해시키고 인디안 잉크를 치수강 내로 주입하여 치수조직을 염색하였다. $5\%$ 질산용액에 48시간 동안 담가 탈회시킨 후 메틸 살리실레이트로 투명화시키고 입체현미경하에서 20배의 크기로 근관계의 형태를 평가하여 다음과 같은 결과를 얻었다. 방사선과 입체현미경 소견간에는 판독자 간에 통계학적으로 유의한 차이를 나타냈다 (p<0.05). 따라서 동일한 방사선 사진을 판독할 경우 판독자 간에 근관의 형태에 있어서 차이가 있을 수 있다. 그러므로 임상가는 방사전 사진을 주의깊은 판독과 예견된 근관의 형태에 따라 난이도를 고려하여 근관치료를 시행해야 할 것으로 사료된다.

• Imaging Science in Dentistry
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• 제45권2호
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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.

• 대한치과보존학회:학술대회논문집
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• 대한치과보존학회 2003년도 제120회 추계학술대회 제 5차 한ㆍ일 치과보존학회 공동학술대회
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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.