• Infection and chemotherapy
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• v.50 no.4
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• pp.340-345
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• 2018

Frequent isolation of Enterococcus faecalis from root canal treated teeth with apical periodontitis, has proposed the role of this organism in endodontic treatment failures. Different factors have been suggested in the pathogenicity of this organism. In this study, 22 E. faecalis isolates from canals of root-filled teeth were identified, and phenotypic and genotypic characteristics were investigated. No resistance to vancomycin and gentamicin was noted, and most isolates (91%) were susceptible to ampicillin. Biofilm formation was detected in 73% of the isolates and may be considered as the most important virulence factor involved in the pathogenesis of these isolates.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.92-97
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• 2004

Traumatic injuries in the young peranent dentition are common, but root fractures, defined as fractures in volving dentin, cementum and pulp, are relatively uncommon. Case 1 is a 9-year-old boy who had a horizontal root fracture of his maxillary right central incisor in the apical third. Root canal therapy was performed in coronal segment and calcium hydroxide therapy was initiated. Six months after treatment, a periapical radiograph showed calcific tissue formation and normal root development. 1 year and 3 months later, the canal was permanently obturated with gutta-percha. Case 2 is a 7-year-old girl who had a vertical root fracture of her maxillary right central incisor. Fractured tooth was intentionally extracted atraumatically, and then the separated fragments are bonded with resin cement. the restored tooth was replanted into the original socket. Recalls up to 8 months showed normal mobility and no periapical pathosis. In these cases, we performed conservative treatment. Clinical and radiographic examination showed no pathosis or abnormality of the teeth and periodontal tissue.

• Journal of Korean Dental Science
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• v.4 no.1
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• pp.1-5
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• 2011

Purpose: Exact knowledge of the location and dimension of the pulp chamber help to maintain the pulp healthy during operative procedure and also reduces the risk of perforation of pulp chamber during root canal treatment. This in-vivo study was carried out to measure critical morphology of pulp chamber of mandibular molar using intra-oral periapical radiograph. Materials and Methods: Mandibular molar teeth of 56 patients were evaluated. The mandibular molar teeth whose pulp chamber was not violated by caries, restoration, fracture crown and those having closed apex were included in the study. The intraoral periapical radiographs were taken with paralleling angle technique using radio-opaque grid with 1 mm space. This grid was placed directly on the film. Results: In 94% of the mandibular first molars specimens the pulp chamber ceiling was at the level of the cemento-enamel junction. The measurements showing the lowest percentage variance were buccal cusp to furcation (approximately 11%) and buccal cusp to pulp chamber ceiling (approximately 15%). The distance from the cusp tip to pulp chamber ceiling height was approximately 6.0 mm, the distance from the pulpal floor to the furcation was approximately 3.0 mm, and the average height of a pulp chamber was 1.5 to 2.0 mm. Conclusion: The exact knowledge of distances of pulp chamber from various anatomical landmarks helps in proper assessment of root canals and ultimately avoids the failure of root canal treatment.

• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.71-95
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• 1995

Bacteria have been regarded as a one of major etiologic factors in root canal infections. In endodontic treatment the effective removal of pathogenic microorganisms in the root canal is the key to successful outcome. Bacterial cell wall components may play an important role in the development of pulpal and periapical disease. The purpose of this study was to evaluate the effect of sonic extracts of Streptococcus spp. on cultured L929 cells and to characterize cell wall protein profiles of Streptococcus spp. Streptococcus spp. were isolated from infected root canals and identified with Vitek Systems(Biomeriux, USA). Five streptococci, namely S. sanguis, S. mitis, S uberis, S. mutans (ATCC 10449) and S. faecalis (ATCC 19433) weere enriched in brain heart infusion broth. Cell pellets were sonicated and cell wall extracts were dialyzed and membrane filtered. Prepared cell wall proteins were applied to cultured L929 cell. The cell reaction were evaluated by monitoring DNA synthesis, cell numbers and the change of cell morphology. The total cell wall protein profiles of microorganisms were characterized by sodium dodecyl sulfate polyacrylamide-gel eledruphoresis(SDS-PAGE). DNA synthesis of L929 cells were reduced by the increasing concentration of sonic extracts. DNA synthesis was significantly suppressed in more than $50{\mu}g$/ml of sonic extract conentration in five streptococci. S. nutans (ATCC 10449) showed stronger suppression on DNA synthesis than remaining four streptococci, which had the similar effect on DNA synthesis. Analysis of DNA synthesis measured by [$^3H$]-thymidine uptake was more sensitvie method than cell counting. Sonic extracts affected the microscopic findings of L929 cells. The protein profiles indicated that all five strains shared two major proteins with molecular masses of 70.8 and 57.5 kD respectively. S. uberis and S. mutans shared common minor proteins of which molecular weights were 147.9 and 112.2 kD respectively. However some minor proteins were unique for S. mitis, S. uberis and S. faecalis.

• Restorative Dentistry and Endodontics
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• v.41 no.1
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• pp.6-11
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• 2016

Objectives: The purpose of this in vitro study was to evaluate the accuracy of working length (WL) determination of four electronic apex locators (EALs), namely, Root ZX (RZX), Elements diagnostic unit and apex locator (ELE), SybronEndo Mini Apex locator (MINI) and Propex pixi (PIXI) using Stainless steel (SS) and nickel-titanium (NiTi) hand files. The null hypothesis was that there was no difference between canal length determination by SS and NiTi files of 4 EALs. Materials and Methods: Sixty extracted, single rooted human teeth were decoronated and the canal orifice flared. The actual length (AL) was assessed visually, and the teeth were embedded in an alginate model. The electronic length (EL) measurements were recorded with all four EALs using SS and NiTi files at '0.5' reading on display. The differences between the AL and EL were compared. Results: The results obtained with each EAL with SS and NiTi files were compared with AL. A paired sample t test showed that there was a statistical significant difference between EAL readings with SS and NiTi files for RZX and MINI (p < 0.05). The accuracy of RZX, ELE, MINI and PIXI within ${\pm}0.5 mm$ of AL with SS/NiTi files were 93.3%/70%, 90%/91.7%, 95%/68.3%, and 83.3%/83.3%, respectively. Conclusions: The results of this study indicate that Root ZX was statistically more accurate with NiTi files compared to SS files, while MINI was statistically more accurate with SS files compared to NiTi files. ELE and PIXI were not affected by the alloy type of the file used to determine WL.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.4
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• pp.435-440
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• 2011

Maxillary canine impaction is a common eruption problem in children. Impaction frequently involves further complications such as root resorption of adjacent teeth, cyst formation and migration of the neighboring teeth, etc. Various treatment modalities include extraction of preceding deciduous canine, orthodontic traction, and surgical extraction followed by immediate replantation of the extracted tooth at the proper position(autotransplantation). Autotransplantation is considered as the treatment of choice when surgical exposure and subsequent orthodontic traction are difficult or impossible due to unfavorable impacted position. The prognosis of autotransplantation is affected by the degree of apex formation, surgical procedures performed, timing of root canal treatment, and length of stabilization period. In these two cases presented, the patients with unerupted maxillary canine were treated with autotransplantation. One case was thought that guidance of eruption by orthodontic traction was difficult because of its unfavorable impacted position. In the other case, parents didn't agree to treat by orthodontic traction, therefore autotransplantation was done. In both cases, autotransplantation was carried out following root canal treatment and orthodontic treatment, and both cases have demonstrated to be successful to this day.

• Restorative Dentistry and Endodontics
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• v.22 no.2
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• pp.536-545
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• 1997

The purposes of this study were to evaluate the degree of cavity cleanliness and to observe cavity wall morphology when root-end retrograde cavity preparation was done with ultrasonics. Root resections were done on 20 extracted human maxillary central incisors after canal filling with gutta-percha, and retrocavities were prepared using a slow-speed round bur as a control, and stainless steel ultrasonic tips of power settings of 2 and 6 ($Miniendo^{TM}$, EIE, SA, USA) as experimentals. The degree of the remaining cavity debris and smear layer, and wall morphology were evaluated under the scanning electron microscope. The results were as follows : Cavity prepared with ultrasonics of either power setting showed significantly less smear layer than did slow-speed preparations (p<0.01). However, there was no significant difference in canal debris (p<0.05). Cavity prepared with ultrasonics showed hatcheted appearance of wall, while slow-speed preparation showed relatively plain one.

• 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.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.192-198
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• 2012

Revascularization of the pulp in a necrotic, infected immature tooth with apical periodontitis was attempting several years. Revascularization of partially necrotic pulp in an immature tooth is based on the concept that vital dental stem cells can survive pulpal necrosis. Revascularization procedure obtains longer and thicker roots in teeth with necrotic pulp diagnosis. Pulp revascularization for immature permanent molars can be possibly applied on cases having difficulty to use conventional root canal treatment due to abnormally thin root canal wall or severe root curvature. Also, when an uncooperative patient does not agree with sedative treatment the revascularization can be useful. And a patient with disability who is barely cooperative can be another indication of this treatment. In this case report, pulp revascularization using triple-antibiotics, metronidazole, ciprofloxacine and minocycline, was applied on the immature first permanent molar infected by caries.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.3
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• pp.383-387
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• 2000

Fusion is defined as union of two separate tooth buds at some stage in their development with confluence of dentin and characterized by separate root canal and large single crown, while gemination is defined as an attempt of the single tooth bud to incompletely divide and usually result in a single root with one root canal and two completely or incompletely separated crowns. It is sometimes difficult to decide whether an abnormally large tooth is the result of fusion of a normal and a supernumerary tooth, or of gemination; use of the term 'Double tooth' may make the clinicians avoid this difficulty(Brook & Winter). Commonly there are no symptoms, but the problems associated with these anomalies include esthetics, possible loss of arch length and delayed or ectopic eruption of the permanent teeth, caries along the line of demarcation, and periodontal disease. Commonly, it dose not need to be treated in primary dentition but in case of permanent dentition, it may be requested to be treated due to esthetics and other problems. In our case, a 8 years old girl showed a Double tooth, we attained the favorable results by performing hemisection with apexification.