Journal of the korean academy of Pediatric Dentistry
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v.39
no.1
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pp.43-50
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2012
The concept of revascularization of necrotic pulps regained interest and became an alternative conservative treatment option for young permanent teeth with immature roots. Revascularization of immature teeth with apical periodontitis depends mainly on disinfection of the canal. Since the infection of the root canal system is considered to be polymicrobial, a combination of drugs would be needed to treat the diverse flora. A triple antibiotic mixture of metronidazole, ciprofloxacin, and minocycline was used as an intracanal medicament. However, discoloration was developed after applying the triple antibiotic mixture. It is believed that the marked discoloration is related to the use of minocycline. The aim of this article was to present cases of coronal discoloration after triple antibiotic therapy in immature tooth and was treated with bleaching technique to control coronal discoloration. In conclusion, revascularization by using triple antibiotics promotes a paradigm shift in treating endodontically involved permanent teeth. However, we should understand that triple antibiotics containing minocycline induces tooth discoloration. Further research to prevent coronal discoloration should be investigated and suggested for the safe use of triple antibiotics.
The application of Nd:YAG laser and irrigants to the root surface can change its surface configurations. The purpose of this study was to investigate the effects of Nd:YAG laser and irrigants on the apical seal of obturated canals. In this study, 66 single rooted teeth were randomly assigned to 4 group of 14 teeth each. 8 teeth were served us positive and negative controls. The teeth were divided into 6 groups as follows. Group A: Nd:YAG laser, 5% NaOCl + Rc-prep Group B: Nd:YAG laser, Saline Group C: 5% NaOCl + Rc-prep Group D: Saline Group E: Positive control Group F: Negative control 66 teeth were instrumented using Maillefer ProFile$^{\circledR}$ (Orifice Shapers, .04 taper, .06 taper Dentsply, Switzerland). Two of each group were selected at random, and the canal wall surfaces were examined under a SEM. 12 teeth of each group were obturated using by lateral condensation technique. Specimens were immersed in india ink for 7days, decalcified by 10% nitric acid, dehydrated by 75. 80. 85, 90, 95 and 100% alcohol in order cleared by methyl salicylate and then measured of dye penetration with stereomicroscope($\times$15 magnification) and Image Pro plus. The data were analyzed statistically by one-way ANOVA test and Duncan's Multiple Range test. The results were as follows : 1. The mean leakage was 0.128$\pm$0.376 for group A, 0.237$\pm$0.325 for group B, 0.397$\pm$0.468 for group C, 0.586$\pm$0.402 for group D, and there were statistically significant differences between group A and group D, group B and group D. (p<0.05). 2. Group A had better sealing ability than Group C, but there was statistically no significant differences. (p>0.05). 3. Group B had better sealing ability than Group D and there was statistically significant difference. (p<0.05). 4 Group A had better sealing ability than Group B, but there was statistically no significant difference. (p>0.05). 5. Group C had better sealing ability than Group D, but there was statistically no significant difference. (p>0.05). 6. As a result of observation under SEM, Smear layers were removed in Group A, B. but Smear layers were partially removed and smear plugs were remained in Group C, Smear layers were not removed in Group D. To be specially, Melting of smear layer were showed in Group C. 7. These results suggests that the laser has a potential in reducing the apical microleakage of obturated canals.
Lateral condensation with gutta-percha and sealer has been shown to provide an excellent apical seal; however, the lateral condensation technique has demonstrated less favorable apical leakage results in curved canals when compared with straight canals. Placement of endodontic spreaders to within 1 to 2mm of the root canal working length has been advocated for optimum gutta-percha obturation. Due to their stiffness, stainless-steel(SS) spreaders will often fail to achieve this position in curved canals. Newly marketed nickel-titanium(NT) spreaders may offer an advantage in this regard due to the increased flexibility of these instruments. The purpose of this study was to evaluate the effect of NT finger spreader on the sealing ability in lateral condensation technique, compared with conventional SS finger spreader. Twenty four standardized resin models simulating curved canals(30 degree) were randomly placed into 2 groups and instrumented to a #30 master apical file size with Ni-Ti Profile .04 taper series using step down technique. Each groups was obturated with standardized gutta-percha cone by standard lateral condensation technique using SS finger spreader, NT finger spreader. And then, each model was sectioned horizontally with microtome at 1, 2, 3, 4, 5mm levels from the apex. At each of 5 levels, ratio of the area of gutta-percha was obtained by calculating the area of gutta-percha to the total area of the canal. The data collected were then analyzed statistically using a t test for independent samples. The results as follows ; 1. The total mean ratio of area of gutta-percha was 89.20${\pm}$7.00(%) for SS spreader group. 92.20${\pm}$5.17(%) for NT spreader group. There was statistically significant difference between each group(p<0.05). 2. At 3mm level, the mean ratio of area of gutta-percha was 88.32${\pm}$5.41(%) for SS spreader group, 95.25${\pm}$2.60(%) for NT spreader group. There was statistically significant difference between each group(p<0.05). At 1,2,4mm levels, NT spreader group showed greater mean ratio of area of gutta-percha than SS spreader group, too. But there was no statistically significant difference. 3. At 5mm level, the mean ratio of area of gutta-percha was 91.83${\pm}$3.42(%) for SS spreader group, 87.91${\pm}$3.68(%) for NT spreader group. There was statistically significant difference between each group(p<0.05). This study concluded that the NT spreader demonstrated somewhat favorable apical sealing effect than SS spreader in prepared curved canals. The clinical use of NT spreaders may enhance our ability to create better apical seals in curved canals, but further studies in this area will help clarify some of the remaining areas with which practitioners are concerned, such as compaction forces exerted by NT spreaders.
Journal of the korean academy of Pediatric Dentistry
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v.42
no.2
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pp.188-196
/
2015
Endodontic management of an immature permanent tooth with dens invaginatus poses a challenge to efficient treatment planning for the clinicians. Because it is difficult to shape, disinfect, and seal the canal space effectively, teeth with complex root canal structures often require particularly extensive and thorough treatment approaches. The purpose of this case report was to share clinical insight from the results of short-term follow-ups after regenerative endodontic treatment with a dens invaginatus. Two immature maxillary lateral incisors with Oehlers type I and III dens invaginatus and infected necrotic pulp were treated using regenerative endodontic procedures. For the type III dens invaginatus case, an unusual approach toward redesigning the complex internal structure was taken, in order to have sufficient infection control and sealing. Cone-beam computed tomography (CBCT) and a surgical operating microscope were used to aid visualization and treatment. As a result, regenerative endodontic treatment appears to be effective for managing immature permanent teeth with complex dens invaginatus, and can lead not only to clinical and radiographic resolution, but also increased thickness of the dentinal walls.
Kim, Jeong-Yeob;Lee, Sang-Hoon;Lee, Gwang-Hee;Park, Sang-Hyuk
Restorative Dentistry and Endodontics
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v.35
no.6
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pp.429-435
/
2010
Objectives: The aim of this study was to investigate average working lengths of Korean posterior teeth and evaluate validity of endodontic file length. Materials and Methods: The endodontic working length of the posterior teeth of 670 Korean patients were measured than each mean value and standard deviation were investigated than the frequency deviation and standard deviation per each length were calculated. Results: Among the canals of premolar, 66.5% of canal length was marked under 20 mm by endodontic working length and 95.4% could be measured under 22 mm and Among the canals of molars, 95.5% of canal length was marked under 20 mm endodontic working length. Conclusions: With the result of measurement of endodontic working length of premolars of Korean, it suggested that 23 mm endodontic file is more proper than the 21 mm and 25 mm file on the market.
The purposes of this study were to evaluate the efficiency of dentin cutting and root-end cavity preparation, and to determine the incidence of tooth crack when root-end retrograde cavity preparation was done with. ultrasonic diamond instruments. To evaluate the efficiency of dentin cutting, ultrasonic diamond and stainless steel instruments were applied to 20 exposed bovine dentin surfaces perpendicularly or parallely at the low, and medium power settings for 1 minute ($Miniendo^{TM}$, EIE, CA, U.S.A.). The resultant cavity depth was measured. To evaluate the efficiency of cavity preparation and to investigate the incidence of tooth crack, 165 mesiobuccal, distobuccal and palatal root-ends of extracted human maxillary first molars were resected by 3 mm perpendicularly to the long axis of tooth using a slow speed diamond saw after root canal preparation and filling. Retrocavities were prepared using a ultrasonic diamond instrument or a stainless steel one of the low- or medium power settings of 2 or 6. Time consumed and the number of strokes used for the cavity preparation were measured and the incidence of tooth cracks was evaluated under a stereomicroscope. The results were as follows: Both at the low and medium power settings, and both with perpendicularly- and parallely applied tips to dentin, diamond instruments showed higher dentin cutting efficiency than stainless steel ones did (p<0.01). When tips were applied to dentin perpendicularly, both diamond instrument and stainless steel one showed higher cutting efficiency with medium power setting than with low power one (p<0.01). Both at the low- and medium power settings, both diamond instrument and stainless steel one showed higher cutting efficiency when tips were applied perpendicularly to dentin surface than applied parallely (p<0.01). At the medium power setting, the number of stroke and time consumed were less with diamond instrument than with stainless steel one (p<0.05) for the retrograde cavity preparation. At the low power setting, diamond instrument induced less tooth cracks than stainless steel one did (p<0.01).
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.21
no.2
/
pp.261-273
/
1991
This study was undertaken to document and better defined this condition to help clarify this clinical and radiographical appearances by the analysis of clinical and radiographical features of fibro-osseous lesions in the jaws. A study was made of a series of 128 cases with fibro-osseous lesions. The obtained results were as follows. 1. Fibrous dysplasia of the jaws occurred with equal predilection for males and females. But the females occurred in 68% of cemento-ossifying fibroma and 75% of periapical cemental dysplasia. 2. 43% of fibrous dysplasia and 32% of cemento-ossifying fibroma occurred in the 2nd decades and 33% of periapical cemental dysplasia in 5th decades. 3. 62% of fibrous dysplasia occurred in the maxilla, 73% of cemento-ossifying fibroma in mandible, 90% of periapical cemental dysplasia in mandible. 4. 98% of fibrous dysplasia occurred in premolar-molar region, 77% of cemento-ossifying fibroma in molar region, 68% of periapical cemental dysplasia in incisor region. 5. In serial radiographic features, mature stage were 55% of fibrous dysplasia, 45% of cemento-ossifying fibroma, 59% of periapical cemental dysplasia. 6. 87% of fibrous dysplasia had monostotic lesion, 67% of periapical cemental dysplasia had multiple lesions. 7. In fibrous dysplasia and cemento-ossifying fibroma, migration of tooth occurred in 61.7% and 36.4%, retention of tooth occurred in 4.3% and 9.1%, loss of lamina dura occurred in 6.4% and 9.1%, and root resorption had not occurred in fibrous dysplasia, but occurred in 18% of cemento-ossifying fibroma, displacement of mandibular canal occurred in 14.9% and 31.8%.
Purpose : To acquire the useful diagnostic information through the analysis of the clinical and radiological characteristics of mandibular odontogenic keratocyst. Materials and Methods : The researchers compared and analysed the clinical and radiological features of 112 cases of mandibular odontogenic keratocyst confirmed by histopathlogic examination. Results : Mandibular odontogenic keratocysts occurred more frequently in males than in females and the incidence is the highest in the 2nd and 3rd decades. These cysts occurred in the mandibular posterior area, angle-ramus area and anterior area $51.8\%$, $31.2\%$ and $17.0\%$ respectively. These cysts had undulating border ($69.6\%$) rather than smooth border ($30.4\%$). Most of these cysts had well-defined hyperostotic border ($94.6\%$). These cysts caused cortical thinning or expansion ($78.6\%$) rather than no cortical reaction ($21.4\%$). Loss of lamina dura was observed in $72.3\%$, displacement of tooth appeared in $35.7\%$ and root resolution appeared in $12.5\%$ of cases. In $71\%$ of cases, displacement of mandibular canal was observed. Internal patterns of lesional radiolucency were even ($61.6\%$) or uneven ($38.4\%$). Conclusion : These results would be helpful in diagnosing of mandibular odontogenic keratocyst. (Korean J Oral Maxillofac Radiol 2005; 35 : 51-4)
de Oliveira Pinto, Martina Gerlane;Melo, Saulo Leonardo Sousa;Cavalcanti, Yuri Wanderley;de Lima, Elisa Diniz;Bento, Patricia Meira;de Melo, Daniela Pita
Imaging Science in Dentistry
/
v.50
no.2
/
pp.141-151
/
2020
Purpose: This study aimed to quantify the influence of tooth position within the field-of-view (FOV) on cone-beam computed tomography (CBCT) imaging artifacts' intensity when assessing teeth restored with various intracanal materials. Materials and Methods: Seventy single-rooted teeth were divided into 7 groups (10 teeth per group): NiCr post (NC), AgPd post (AP), metal core fiberglass post (MCFG), fiberglass post (FG), anatomical fiberglass post (AFG), fiberglass post cemented with core build-up cement (FGCo), and anatomical fiberglass post cemented with core build-up cement (AFGCo). All posts were cemented using a regular dual-curing resin cement (Allcem), except FGCo and AFGCo which were cemented with a core build-up dual-curing resin cement (AllcemCore). Each tooth was scanned on a CS9000 in 5 positions within the FOV: a central position, anterior horizontal peripheral, peripheral superior, peripheral inferior, and posterior horizontal peripheral position. Hyperdense, hypodense, remaining teeth areas and ROI areas were quantitatively analyzed using ImageJ software. Results: Posterior horizontal peripheral position increased the intensity of artifacts on FGCo and AFGCo post groups (P<0.05), and specifically the hypodense artifact intensity on FG and AFG post groups (P<0.05). NC and AP groups presented greater intensity of artifacts than any other post groups(P<0.05). Conclusion: Artifact intensity increases in the presence of high atomic number materials and when the object is not centered within the FOV. The impact of positioning within the FOV on artifact was greater for fiberglass posts cemented with core build-up dual-curing cement than for metal posts and fiberglass posts cemented with regular dual-curing cement.
Objectives: This study investigated the removal efficacy and cytotoxicity of a newly developed calcium hydroxide paste (cleaniCal, Maruchi) using N-2-methyl-pyrrolidone (NMP) as a vehicle in comparison with ApexCal (Ivoclar Vivadent) and Calcipex II (Nishika), which use different vehicles such as polyethylene glycol and propylene glycol, respectively. Materials and Methods: Thirty maxillary premolars with oval-shaped canals were divided into 3 groups and the teeth were filled with one of the pastes. After removal of the paste, micro-computed tomographic (${\mu}$-CT) imaging was obtained to assess the volume of residual paste in the root canal of each tooth. The teeth were then split longitudinally and the area of the paste-coated surface was evaluated by stereomicroscopy. The cytotoxicity of each product was assessed using an agar overlay assay. The effect of each vehicle on cell viability was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The data were analyzed using one-way analysis of variance and Tukey's tests to detect any significance (p < 0.05). Results: In the ${\mu}$-CT and stereomicroscopic analysis, cleaniCal exhibited less remnants of medicament than ApexCal and Calcipex. cleaniCal showed a higher cytotoxicity than the other pastes in the agar overlay assay. Furthermore, NMP exhibited lower cell viability compared to the other vehicles. Conclusions: cleaniCal showed better removal efficacy compared to the other products. However, clinicians should be aware of the higher cytotoxicity of the NMP-based material and consider its possible adverse effects on periradicular tissue when it is overfilled.
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