• Restorative Dentistry and Endodontics
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• v.44 no.1
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• pp.2.1-2.6
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• 2019

Objectives: The purpose of this research was to identify the top 10 most-cited articles on the management of fractured or broken instruments and to perform a bibliometric analysis thereof. Materials and Methods: Published articles related to fractured instruments were screened from online databases, such as Web of Science, Scopus, PubMed, and ScienceDirect, and highly cited papers, with at least 50 citations since publication, were identified. The most-cited articles were selected and analysed with regard to publication title, authorship, the journal of publication, year, institution, country of origin, article type, and number of citations. Results: The top 10 most-cited articles were from various journals. Most were published in the Journal of Endodontics, followed by the International Endodontic Journal, and Dental Traumatology. The leading countries were Australia, Israel, Switzerland, the USA, and Germany, and the leading institution was the University of Melbourne. The majority of articles among the top 10 articles were clinical research studies (n = 8), followed by a basic research article and a non-systematic review article. Conclusions: This bibliometric analysis revealed interesting information about scientific progress in endodontics regarding fractured instruments. Overall, clinical research studies and basic research articles published in high-impact endodontic journals had the highest citation rates.

• Restorative Dentistry and Endodontics
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• v.44 no.2
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• pp.14.1-14.7
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• 2019

Mucopolysaccharidosis (MPS) is an inherited metabolic disorder caused by a deficiency in enzymes that participate in the degradation of glycosaminoglycans (GAGs) such as heparin sulfate and dermatan sulfate. Left untreated, patients show progressive mental and physical deterioration due to deposition of GAGs in organs. Death often occurs due to cardiac or respiratory failure before patients reach their early twenties. MPS has several oral and dental manifestations. An enlarged head, short neck, and open mouth associated with a large tongue are major characteristics of MPS patients. Dental complications can be severe, including unerupted dentition, dentigerous cyst-like follicles, malocclusions, condylar defects, and gingival hyperplasia. A 21-year-old female patient with MPS was described in this article, with special emphasis on oral manifestations and dental treatment.

• Restorative Dentistry and Endodontics
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• v.48 no.1
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• pp.5.1-5.22
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• 2023

This systematic review and network meta-analysis aimed to answer the following focused research question: "Does the type of endodontic sealer affect the postoperative pain in patients who received endodontic treatment?" Different databases and grey literature were surveyed. Only one randomized controlled trial were included. The risk of bias in the studies was evaluated by using the Cochrane Collaboration's tool. A random-effects meta-analysis was conducted to compare the risk and intensity of postoperative pain. The quality of the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Out of 11,601 studies, 15 remained for qualitative analyses and 12 for meta-analysis. Seven studies were classified at high risk of bias, and 8 studies raised some concerns. No significant differences between the endodontic materials were observed in the direct comparisons, both in risk and in intensity of postoperative pain (pairwise comparisons with 2 studies: I² = 0%; p > 0.05 and 8 studies: I² = 23%; p > 0.05, respectively). The certainty of the evidence was graded as low or moderate. There was no difference in the risk and intensity of postoperative pain after filling with different endodontic sealers. Further systematic reviews should be conducted.

• Restorative Dentistry and Endodontics
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• v.46 no.3
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• pp.37.1-37.11
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• 2021

Objectives: This systematic review evaluated the efficacy of the supplementary use of the XP-endo Finisher on bacteria content reduction in the root canal system. Materials and Methods: In-vitro studies evaluating the use of the XP-endo Finisher on bacteria content were searched in four databases in July 2020. Two authors independently screened the studies for eligibility. Data were extracted, and risk of bias was assessed. Data were meta-analyzed by using random-effects model to compare the effect of the supplementary use (experimental) or not (control) of the XP-endo Finisher on bacteria counting reduction, and results from different endodontic protocols were combined. Four studies met the inclusion criteria while 1 study was excluded from the meta-analysis due to its high risk of bias and outlier data. The 3 studies that made it to the meta-analysis had an unclear risk of bias for at least one criterion. Results: No heterogeneity was observed among the results of the studies included in the meta-analysis. The study excluded from the meta-analysis assessing the bacteria counting deep in the dentin demonstrated further bacteria reduction upon the use of the XP-endo Finisher. Conclusions: This systematic review found no evidence supporting the supplementary use of the XP-endo Finisher on further bacteria counting the reduction in the root canal.

• Restorative Dentistry and Endodontics
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• v.48 no.4
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• pp.32.1-32.8
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• 2023

Ingestions and aspirations of foreign bodies are rare, but do occasionally occur during dental treatment. Although reports exist, few include photos demonstrating the extensive surgical intervention that may be necessary to manage such events. Perhaps this lack of visualization, and associated lack of awareness, is one of the reasons some clinicians still provide nonsurgical root canal therapy (NSRCT) without a rubber dam. This case report outlines the medical treatment of a 30-year-old male who initially presented to a general dentist's office (not associated with the authors) for NSRCT of their mandibular right first molar. A rubber dam was not used for this procedure, during which the accidental ingestion of an endodontic K-file occurred. The patient was subsequently hospitalized for evaluation and treatment, consisting of numerous imaging studies, endoscopic evaluation, and surgical removal of the file from his small intestine. The ingestion of foreign bodies, and the associated complications, can be reduced through the routine use of a rubber dam, which is considered the standard of care for NSRCT. This case graphically illustrates the potential consequences associated with deviating from the standard of care and should remind clinicians that a rubber dam is necessary for all cases of NSRCT.

• Restorative Dentistry and Endodontics
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• v.49 no.2
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• pp.13.1-13.7
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• 2024

Chronic osteomyelitis with proliferative periostitis, known as Garre's osteomyelitis, is a type of osteomyelitis characterized by a distinctive gross thickening of the periosteum of bones. Peripheral reactive bone formation can be caused by mild irritation or infection. Garre's osteomyelitis is usually diagnosed in children and young adults, and the mandible is more affected than the maxilla. The following is a case report of a 12-year-old female patient with Garre's osteomyelitis of the mandible due to an infection of a root canal-treated tooth. Without surgical intervention, the patient's symptoms were relieved through nonsurgical root canal re-treatment with long-term calcium hydroxide placement. A cone-beam computed tomography image obtained 6 months after treatment completion displayed complete healing of the periapical lesion and resolution of the peripheral reactive buccal bone. Due to the clinical features of Garre's osteomyelitis, which is characterized by thickening of the periosteum, it can be mistaken for other diseases such as fibrous dysplasia. It is important to correctly diagnose Garre's osteomyelitis based on its distinctive clinical features to avoid unnecessary surgical intervention, and it can lead to minimally invasive treatment options.

• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.682-689
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• 1998

The purpose of this study was to evaluate the sealing ability of the Microseal$^{(R)}$, which was new obturation system made by Tycom company, U.S.A. Forty-five extracted single-rooted human teeth were resected at cemento-enamel junction and divided three groups. All canals were prepared using Profile system, and then each group was obturated by lateral condensation technique (group 1), vertical condensation technique (group 2) and Microseal$^{(R)}$ condensation technique (group 3) with root canal sealer. Teeth were immersed in resorcinol-formaldehyde resin for 5 days at $4^{\circ}C$ and the resin was allowed to polymerize completely for 4 days at room temperature. Teeth were resected horizontally at 1 mm (level I), 2 mm (level II), 3 mm (level III) from the anatomical root apex using low speed microtome and examined with Image analyzer (IBASR, Zeiss co., Germany.) at ${\times}25$ magnification. The gab between the canal wall and the filling material, which was filled with the resin, was measured at each of the three levels. Each ratio of leakage was expressed percentage by calculating the ratio of the area of the resin to the total area of the canal and was analyzed statistically (one-way ANOVA). The results were as follows; 1. The mean ratio of leakage (%) was 6.46% at group 1, 3.06% at group 2, 11.27% at group 3. 2. When evaluating the ratio of leakage at the three levels, there was level I> level II> level III in all groups. Especially, the difference between level I and level III was statistically significant (p<0.05). 3. When evaluating the ratio of leakage at the three groups, there was group 3> group 1> group 2 at all levels. Especially the difference between group 2 and group 3 was statistically significant (p<0.05).

• Restorative Dentistry and Endodontics
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• v.28 no.4
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• pp.295-302
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• 2003

본 연구에서는 인산 칼슘 근관 봉함재 [Apatite Root Sealer (ARS) Type I, II, III]의 세포독성을 혼합후의 시간 경과에 따라서 다른 4계열의 근관 봉함재 (Pulp Canal Sealer EWT, AH Plus, Sealapex, Ketac Endo)와 비교하여 평가하였다. 근관 봉함재를 혼합한 후 1시간, 8시간, 24시간, 48시간, 1주, 2주,4주의 기간동안 배양액을 이용하여 추출액을 얻었다. L929 쥐섬유아세포를 24시간동안 각 시간군에서 얻은 추출액과 함께 배양한 후 dimethylthiazol diphenyltetrazolium (MTT) assay와 neutral red (NR) assay를 이용하여 세포독성(%)을 평가하였다. 실험 결과 ARS Type I, II, III는 전 시간군에 걸쳐 낮은 세포독성을 보였고 (23.65-0.55%) 특히 경화 초기에 다른 계열의 근관 봉함재보다 유의성 있게 낮은 세포독성을 나타내었다. ARS Type I, II, III간의 세포독성은 각 시간군에서 유의성 있는 차이를 보이지 않았다. AH Plus와 Ketac Endo는 초기에 높은 세포독성을 보였으나 AH Plus는 8시간 이후에, Ketac Endo는 24시간 이후에 독성이 급격히 감소하여 ARS와 유의성 있는 차이를 보이지 않았다. Pulp Canal Sealer EWT와 Sealapex는 4주까지 지속적인 세포독성을 나타내었다. 그리고 MTT assay와 NR assay를 이용하여 얻은 각 근관봉함재의 세포독성은 시간 경과에 따라서 비슷한 변화 양상을 나타내었다. 인산 칼슘 근관 봉함재는 생체적합성이 우수한 재료로써 앞으로 지속적인 개발과 평가가 필요할 것으로 사료된다.

• Restorative Dentistry and Endodontics
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• v.45 no.2
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• pp.14.1-14.7
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• 2020

Objective: The aim of this study was to perform a comparative evaluation of the effectiveness of ultrasonic tips versus the Terauchi file retrieval kit (TFRK) for the removal of broken endodontic instruments. Materials and Methods: A total of 80 extracted human first mandibular molars with moderate root canal curvature were selected. Following access cavity preparation canal patency was established with a size 10/15 K-file in the mesiobuccal canals of all teeth. The teeth were divided into 2 groups of 40 teeth each: the P group (ProUltra tips) and the T group (TFRK). Each group was further subdivided into 2 smaller groups of 20 teeth each according to whether ProTaper F1 rotary instruments were fractured in either the coronal third (C constituting the PC and TC groups) or the middle third (M constituting the PM and TM groups). Instrument retrieval was performed using either ProUltra tips or the TFRK. Results: The overall success rate at removing the separated instrument was 90% in group P and 95% in group T (p > 0.05) The mean time for instrument removal was higher with the ultrasonic tips than with the TFRK (p > 0.05). Conclusion: Both systems are acceptable clinical tools for instrument retrieval but the loop device in the TFRK requires slightly more dexterity than is needed for the ProUltra tips.

• 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.