• Restorative Dentistry and Endodontics
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• v.22 no.2
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• pp.659-669
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• 1997

The goals of root canal instrumentation are complete debridement of pulp tissue, removal of microbes and affected dentin, and proper cleaning and shaping of the root canal space before obturation. Instrumentation with stainless steel files has been shown to produce undesirable results in canals, regardless of the improved technique or modified file type used. Nickel-Titanium(Ni-Ti) alloy has been shown to be exceptionally elastic, having a lower bending moment and lower permanent set after torsion, compared with similar gauge stainless steel. The purpose of this study was to evaluate the change of root canal prepared by Ni-Ti rotary and stainless steel instruments. Thirty-four single rooted teeth of similar shape and canal size were divided into three groups. The teeth were scanned by computed tomography before instrumentation. In group 1, canals were instrumented using a step-back technique with K-file. In group 2, canals were prepared with K-flex file using the same technique as group 1. Group 3 was prepared with nickel-titanium(Ni-Ti) rotary instrument using a manufacture's instruction. Instrumented teeth were again scanned using computed tomography, and reformated images of the uninstrumented canals were compared with images of the instrumented canals. K-flex file and Ni-Ti file caused significantly less canal transportation than K-file in the 8mm root canal section from the apex(p<0.05). K-flex file and Ni-Ti file produced more centered canal preparation than K-file in the 2mm section(p<0.05). Ni-Ti file maintained more precisely the center of the canal than K-flex file in the 10mm section (p<0.05). There was no difference in the removed volume of canals among each groups.

• The Journal of the Korean dental association
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• v.49 no.11
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• pp.660-669
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• 2011

Er: YAG laser irradiation utilizing the newly developed RCLase side-firing spiral tip was used for the cleansing of root canals following their bio-mechanical preparation with ProTaper Ni-Ti files. The distal and palatal roots of 20 freshly extracted molar teeth were instrumented to size F3 with ProTaper files. In the experimental group (10 teeth) the pulp chamber and the root canals were filled with EDTA 17% and the root canals were lased for 30 s using the Er: YAG laser irradiation at 600 mJ per pulse and a frequency of 12 Hz. In the control group (10 teeth) the root canals were not lased. Scanning electron microscope analysis showed clean wall surfaces of the lased root canals with open dentinal tubules, free of smear layer and debris. In the scanning electron microscope photographs of the walls of the non-lased root canals a considerable amount of debris could be detected. It appears that an efficient cleansing of the root canal system can be achieved by using the Er: YAG laser irradiation with the RCLase Side-firing Spiral Tip following bio-mechanical preparation of the root canal with Ni-Ti Taper files.

• Restorative Dentistry and Endodontics
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• v.43 no.1
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• pp.10.1-10.8
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• 2018

Objectives: To examine the surface topography of intact WaveOne (WO; Dentsply Sirona Endodontics) and WaveOne Gold (WOG; Dentsply Sirona Endodontics) nickel-titanium rotary files and to evaluate the presence of alterations to the surface topography after root canal preparations of severely curved root canals in molar teeth. Materials and Methods: Forty-eight severely curved canals of extracted molar teeth were divided into 2 groups (n = 24/each group). In group 1, the canals were prepared using WO and in group 2, the canals were prepared using WOG files. After the preparation of 3 root canals, instruments were subjected to atomic force microscopy analysis. Average roughness and root mean square values were chosen to investigate the surface features of endodontic files. The data was analyzed using one-way analysis of variance and post hoc Tamhane's tests at 5% significant level. Results: The surface roughness values of WO and WOG files significantly changed after use in root canals (p < 0.05). The used WOG files exhibited higher surface roughness change when compared with the used WO files (p < 0.05). Conclusions: Using WO and WOG Primary files in 3 root canals affected the surface topography of the files. After being used in root canals, the WOG files showed a higher level of surface porosity value than the WO files.

• 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.

• The Journal of the Korean dental association
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• v.56 no.10
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• pp.572-580
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• 2018

Adequate access cavity is the key to achieving endodontic success. The aims of the access cavity can be considered as follows: 1) Creation of a smooth unimpeded pathway for instruments to canal orifices 2) Removal of the entire roof of the pulp chamber in order to inspect the pulp floor, 3) Preservation of natural tooth substance consistent with the above. Recently, contracted endodontic cavities based on minimally invasive endodontics has introduced. This has the benefit of preserving the pericervical dentin more than traditional access cavity with achieving long-term success. However, some studies reported controversial results regarding root canal detection, instrumentation efficacy (noninstrumented canal area, hard tissue debris accumulation, canal transportation, and centering ratio) as well as fracture resistance. Therefore, further studies are required for accepting contracted access cavity, and modified form of traditional and contracted access cavity could be considered.

• Restorative Dentistry and Endodontics
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• v.39 no.4
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• pp.258-264
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• 2014

Objectives: This in vitro study aimed to investigate the ability of Candida albicans (C. albicans) and Enterococcus faecalis (E. faecalis) to penetrate dentinal tubules of instrumented and retreated root canal surface of split human teeth. Materials and Methods: Sixty intact extracted human single-rooted teeth were divided into 4 groups, negative control, positive control without canal instrumentation, instrumented, and retreated. Root canals in the instrumented group were enlarged with endodontic instruments, while root canals in the retreated group were enlarged, filled, and then removed the canal filling materials. The teeth were split longitudinally after canal preparation in 3 groups except the negative control group. The teeth were inoculated with both microorganisms separately and in combination. Teeth specimens were examined by scanning electron microscopy (SEM), and the depth of penetration into the dentinal tubules was assessed using the SMILE view software (JEOL Ltd). Results: Penetration of C. albicans and E. faecalis into the dentinal tubules was observed in all 3 groups, although penetration was partially restricted by dentin debris of tubules in the instrumented group and remnants of canal filling materials in the retreated group. In all 3 groups, E. faecalis penetrated deeper into the dentinal tubules by way of cell division than C. albicans which built colonies and penetrated by means of hyphae. Conclusions: Microorganisms can easily penetrate dentinal tubules of root canals with different appearance based on the microorganism size and status of dentinal tubules.

• 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.40 no.3
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• pp.253-254
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• 2015

• Restorative Dentistry and Endodontics
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• v.45 no.4
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• pp.53.1-53.11
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• 2020

Objectives: This study investigated the incidence of root dentin defects after the use of different post space preparation (PSP) drills. Materials and Methods: Seventy-two bovine incisors were selected and obtained 14-mm-long root sections. Twelve roots served as controls with no intervention (G1). The 60 root canals remaining were instrumented using the crown-down technique with the ProTaper Next system and obturated using the lateral condensation technique. Specimens were randomly distributed into 5 groups (n = 12) according to the operative steps performed: G2, root canal instrumentation and filling (I+F); G3, I+F and PSP with Gates-Glidden drills; G4, I+FI+F and PSP with Largo-Peeso reamers; G5, I+F and PSP with Exacto drill; and G6, I+F and PSP with WhitePost drill. Roots were sectioned at 3, 6, 9, and 12 mm from the apex, and digital images were captured. The presence of root dentin defects was recorded. Data were analyzed by the χ² test, with p < 0.05 considered to indicate statistical significance. Results: Root dentin defects were observed in 39.6% of the root sections. No defects were observed in G1. G5 had significantly more cracks and craze lines than G1, G2, and G3 (p < 0.05), and more fractures than G1, G2, G3, and G4 (p < 0.05). When all root sections were analyzed together, significantly more defects were observed at the 12-mm level than at the 3-mm level (p < 0.05). Conclusions: PSP drills caused defects in the root dentin. Gates-Glidden drills caused fewer root defects than Largo-Peeso reamers and Exacto drills.

• Imaging Science in Dentistry
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• v.52 no.3
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• pp.245-258
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• 2022

Purpose: This study compared the root canal anatomy between cone-beam computed tomography (CBCT) and micro-computed tomography (micro-CT) images before and after biomechanical preparation and root canal filling. Materials and Methods: Isthmus-containing mesial roots of mandibular molars(n=14) were scanned by micro-CT and 3 CBCT devices: 3D Accuitomo 170 (ACC), NewTom 5G (N5G) and NewTom VGi evo (NEVO). Two calibrated observers evaluated the images for 2-dimensional quantitative parameters, the presence of debris or root perforation, and filling quality in the root canal and isthmus. The kappa coefficient, analysis of variance, and the Tukey test were used for statistical analyses(α=5%). Results: Substantial intra-observer agreement (κ=0.63) was found between micro-CT and ACC, N5G, and NEVO. Debris detection was difficult using ACC (42.9%), N5G (40.0%), and NEVO (40%), with no agreement between micro-CT and ACC, N5G, and NEVO (0.05<κ<0.12). After biomechanical preparation, 2.4%-4.8% of CBCT images showed root perforation that was absent on micro-CT. The 2D parameters showed satisfactory reproducibility between micro-CT and ACC, N5G, and NEVO (intraclass correlation coefficient: 0.60-0.73). Partially filled isthmuses were observed in 2.9% of the ACC images, 8.8% of the N5G and NEVO images, and 26.5% of the micro-CT images, with no agreement between micro-CT and ACC, and poor agreement between micro-CT and N5G and NEVO. Excellent agreement was found for area, perimeter, and the major and minor diameters, while the roundness measures were satisfactory. Conclusion: CBCT images aided in isthmus detection and classification, but did not allow their classification after biomechanical preparation and root canal filling.