• 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.

• Restorative Dentistry and Endodontics
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• v.46 no.3
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• pp.33.1-33.12
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• 2021

Objectives: This study aimed to investigate the efficacy of ionic and non-ionic-based contrast media (in vitro study) and the combinatorial effect of chitosan-based endo-radiopaque solution (CERS) (in vivo study) for visualization of the root canal anatomy. Materials and Methods: In vitro study (120 teeth): The root canal of maxillary premolars and molars (in vitro group 1 and 2 respectively, n = 60 each) were analyzed using 4 different contrast media (subgroups: Omnipaque 350, Iopamidol, Xenetix 350, and Urografin 76; n = 15 each) in combination with 5.25% sodium hypochlorite (NaOCl). Based on the results of the in vitro study, in vivo study (80 teeth) was done to compare Xenetix 350 + 5.25% NaOCl with CERS (in vivo group 1 and 2 respectively, n = 40 each) on maxillary and mandibular premolars and molars. Two endodontists used radiovisiography to assess the depth of ingress and identify the aberrant root anatomy after access cavity preparation, and after initial cleaning and shaping of canals. Kruskal-Wallis test was used for in vitro comparison (p < 0.05), and Wilcoxon signed-rank test and Mann-Whitney U test for in vivo analysis (p < 0.01). Results: In vitro study, Xenetix 350 + 5.25% NaOCl facilitated a significant higher visualization (p < 0.05). For in vivo study, CERS had a statistically significant depth of ingress (p < 0.01), and was efficient in identifying the aberrant root canal anatomy of premolars and molars. Conclusions: CERS facilitates better visualization of the root canal anatomy of human premolars and molars.

• The Journal of the Korean dental association
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• v.47 no.7
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• pp.435-443
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• 2009

The purpose of this study was to compare the centering ratio and reduction of canal curvature according to the preparation sizes of #30, #40 and #50 using three rotary NiTi instruments which have different shaft tapers. Seventy-two simulated root canals in clear resin blocks (Endo Training Bloc; Dentsply Maillefer, Ballaigues, Switzerland) were divided as following 3 groups according to the file system; the 24 canal blocks prepared with each of ProTaper Universal system (Group P), LightSpeed eXtra system (Group L), and K3 (Group K). The pre- and post-instrumented root canals were scanned and superimposed to evaluate and calculate the centering ratio and reduction of canal curvature. Mean scores of each group were statistically analyzed using one-way ANOV A and Duncan's multiple range test for post-hoc comparison. The results were as followings: 1. Group L showed better centering ratio, followed by K and P. And all experimental groups generally showed increasing tendency of centering ratio as the apical size was increasing from #30 to #50, except at 1 mm level of group P where showed reducing tendency of centering ratio. The smaller the ratio, the better the instrument remained centered in the canal. 2. Group P showed more decrease of canal curvature at all apical shaping size (p < 0.05). Under the conditions of this study, the shaft design could affect the quality of canal shaping and the smooth taperless flexible (LightSpeed) shaft design was capable of preparing canals with good morphological characteristics in curved canals.

• Restorative Dentistry and Endodontics
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• v.35 no.1
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• pp.1-4
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• 2010

The final preparation (MAF) size in infected root canals is still controversial. Nonetheless, recent studies demonstrated that larger apical preparation sizes produces a greater reduction in remaining bacteria and dentinal debris as compared to smaller apical preparation sizes. Therefore, clinicians should be practiced with treatment strategies guided by evidence-based information, especially in infected/failed root canals.

• Restorative Dentistry and Endodontics
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• v.30 no.4
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• pp.327-334
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• 2005

This study investigated the effect of anticurvature filing method on preparation of the curved root canal using ProFile. Thirty six resin blocks were divided equally into three groups by instrumentation motions: anticurvature filing motion. circumferential filing motion and straight up-and-down motion. Each resin block was sectioned at 8mm level from the apex and at the greatest curvature of the canal and reassembled in metal mold by a modified Bramante technique. All groups were instrumented with the ProFile system. At each levels. image of sectioned surface were taken using CCD camera under a stereomicroscope at $\times40$ magnification and stored. Distances of transportation at the inner and outer area of curvature and the centering ratio were determined and compared by statistical analysis. along with the assessment of the increase of root canal cross-sectional area. The results were as follows; 1. In all groups. there was no statistical difference in the mean increase of root canal cross-sectional area. the centering ratio. and the mean distances of transportation at the inner area of curvature at each level. 2. At 8mm level from the apex. the mean distances of transportation at the outer area of curvature decreases in following order anticurvature filing motion. circumferential filing motion. straight up-and­down motion but. no significant difference at the greatest curvature of the canal among three groups. Effect of anticurvature filing motion using ProFile does not seem to be different from other instrumentation motions at the inner area of curvature in curved root canal.

• Restorative Dentistry and Endodontics
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• v.46 no.1
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• pp.8.1-8.7
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• 2021

Objectives: The reliability and educational quality of videos on YouTube for patients seeking information regarding instrument separation in root canal treatment were evaluated. Materials and Methods: YouTube was searched for videos on instrument separation in root canal treatment. Video content was scored based on reliability in terms of 3 categories (etiology, procedure, and prognosis) and based on video flow, quality, and educational usefulness using the Global Quality Score (GQS). Descriptive statistics were obtained and the data were analyzed using analysis of variance and the Kruskal-Wallis test. Results: The highest mean completeness scores were obtained for videos published by dentists or specialists (1.48 ± 1.06). There was no statistically significant difference among sources of upload in terms of content completeness. The highest mean GQS was found for videos published by dentists or specialists (1.82 ± 0.96), although there was no statistically significant correlation between GQS and the source of upload. Conclusions: Videos on YouTube have incomplete and low-quality content for patients who are concerned about instrument separation during endodontic treatment, or who experience this complication during endodontic treatment.

• Restorative Dentistry and Endodontics
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• v.45 no.2
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• pp.19.1-19.8
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• 2020

Objective: This study aimed to evaluate the effect of ultrasonic cleaning of the intracanal post space on the bond strength of fiber posts in oval canals filled with a premixed bioceramic (Bio-C Sealer [BIOC]) root canal sealer. Materials and Methods: Fifty premolars were endodontically prepared and divided into 5 groups (n = 10), based on the type of root canal filling material used and the post space cleaning protocol. A1: gutta-percha + AH Plus (AHP) and post space preparation with ultrasonic cleaning, A2: gutta-percha + BIOC and post space preparation with ultrasonic cleaning, B1: gutta-percha + AHP and post space preparation, B2: gutta-percha + BIOC and post space preparation, C: control group. Fiber posts were cemented with a self-adhesive luting material, and 1 mm thick slices were sectioned from the middle and cervical third to evaluate the remaining filling material microscopically. The samples were subjected to a push-out test to analyze the bond strength of the fiber post, and the results were analyzed with the Shapiro-Wilk, Bonferroni, Kruskal-Wallis, and Mann-Whitney tests (p < 0.05). Failure modes were evaluated using optical microscopy. Results: The results showed that the fiber posts cemented in canals sealed with BIOC had lower bond strength than those sealed with AHP. The ultrasonic cleaning of the post space improved the bond strength of fiber posts in canals sealed with AHP, but not with BIOC. Conclusions: BIOC decreased the bond strength of fiber posts in oval canals, regardless of ultrasonic cleaning.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.2
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• pp.471-489
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• 1998

For the successful endodontic treatment, root canal should be cleaned thoroughly by accurate mechanical and chemical canal preparation and sealed completely with canal filling material without damaging the periapical tissues. The accuracy of the root canal length measurement is a prerequisite for the success of the endodontic treatment, and the root canal length is often determined by the standard periapical radiographs and digital tactile sense. In this study, the accuracy and the clinical usefulness of Digora/sup (R)/, an intraoral digital imaging processor and the conventional standard radiographs were compared by measuring the length from the top of the file to the root apex. 30 single rooted premolars were invested in a uniformly sized blocks and No.25 K-file was inserted into and fixed in each canal. Each block was placed in equal distance and position to satisfy the principle of the bisecting angle and paralleling techniques and Digora/sup (R)/ system's image and standard periapical radiographs were taken. Each radiograph was examined by 3 different observers by measuring the length from top of the file to the root apex and each data was compared and analyzed. The results were as follows; 1. In the bisecting angle technique, the average difference between the Digora/sup (R)/ system and standard periapical radiograph was 0.002 mm and the standard deviation was 0.341 mm which showed no statistically significant difference between the two systems(p>0.05). Also, in the paralleling technique, the average difference between these two system was 0.007 mm and the standard deviation was 0.323 mm which showed no statistically significant difference between the two systems(p>0.05). 2. In Digora/sup (R)/ system, the average difference between the bisecting angle and paralleling technique was -0.336 mm and the standard deviation was 0.472 mm which showed a statistically significant difference between the two techniques(p<0.05). Also, in the standard periapical radiographs, the average difference between the bisecting angle and paralleling technique was 0.328 mm and the standard deviation was 0.517 mm which showed a statistically significant difference between these two techniques(p<0.05). 3. In Digora/sup (R)/ system and the standard periapical radiographs. there was a statistically significant difference between the measurement using the bisecting angle technique and the actual length(p<0.05), But there was no statistically significant difference between the measurement using the paralleling technique and the actuallength(p>0.05). In conclusion. the determination of the root canal length by using the Digora/sup (R)/ system can give us as good an image as the standard periapical radiograph and using the paralleling technique instead of the bisecting angle technique can give a measurement closer to the actual canal length. thereby contributing to a successful result. Also. considering the advantages of the digital imaging processor such as decreasing the amount of exposure to the patient. immediate use of the image. magnification of image size. control of the contrast and brightness and the ability of storing the image can give us good reason to replace the standard periapical radiographs.

• Restorative Dentistry and Endodontics
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• v.19 no.1
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• pp.97-105
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• 1994

The purpose of this study was to evaluate the smear layer removing efficiency of two root canal preparation techniques. Twelve single-rooted teeth were used in two groups of six each. Group 1 was biomechanically prepared by hand using a K-file with a high volume of normal saline irrigation. Group 2 was. prepared by using ultrasonically activated K-file with a constant high volume of normal saline irrigation. After the experimental procedures, each root was split saggitally. The removing efficiency of the preparation methods were assessed in terms of surface condition of the canal walls at three levels, those coronal, middle, and apical thirds. On the basis of remaining debris, presence of smear layer, and patency of dentinal tubules, each canal was evaluated according to a scale form 0 to 2. A statistical analysis was used to indicated any significant differences in surface condition between the two methods. There was no statistical significance between hand instrumentation and ultrasonic instrumentation at the cervical third but removing efficiency of ultrasonic instrumentation was superior. No statistically significant differences were obhserved for middle or apical third.

• Restorative Dentistry and Endodontics
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• v.24 no.2
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• pp.337-345
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• 1999

The purpose of this study was to compare the shape of root canal after instrumentation with some engine driven NiTi files. Thirty narrow and curved canals(15-35 degree) of mesial canals of extracted human mandibular first molars were divided into three groups. Group 1: After radicular access with Gates Glidden drill, apical shaping using step back method with Flexo file Group 2: After radicular access with Gates Glidden drill, apical shaping with Profile .04 Group 3: Canal shaping with GT file and Profile .04. Using modified Bramante technique, the root was sectioned at 2 mm from apical foramen, height of curvature, 2 mm from canal orifice. Canal centering ratio, amount of transport, amount of dentin removed, shape of canal were measured and statistical analysis is done using SPSS Program V 7.5. The results were as follows: 1. Canal centering ratio of group 3 was the lowest at coronal part, but there was no statistical difference. Centering ratio of group 2 was the lowest at curve part, and there was statistical difference between group 1(P<0.05). Centering ratio of group 2 was the lowest at apical part, but there was no statistic difference. 2. Amount of transport of group 3 was the lowest at coronal part, but there was no statistical difference. Amount of transport of group 2 was the lowest at curve part, and there was statistical difference between group 1(P<0.05). Amount of transport of group 3 was the lowest at apical part, and there was statistical difference between group 1 and group 2, group 1 and group 3(P<0.05). 3. Amount of dentin removed of group 3 was the lowest at coronal part, bur there was no statistical difference. Amount of dentin removed of group 2 was the lowest at curve part, but there was no statistical difference. Amount of dentin removed or group 2 was the lowest at apical part, and there was statistical difference between group 1 and group 2, group 1 and group 3(P<0.05). 4. The shape of the canals after instrumentation varied among the groups. The majority of canals at coronal and curve part for group 1 were round in shape(7 in 10), those at apical part were oval(8 in 10). The majority of canals at coronal part for group 2 were round in shape(7 in 10) and there was no difference in the number of shape at other part. There was no difference in the number of shape at every part for group 3. As above results, NiTi rotary instrumentation showed a trend to remain more centered in the canal than SS file instrumentation. At using NiTi file, coronal shaping with Gates Glidden drill was not statistically different from shaping with GT file. But shaping with GT file showed tapered canals, so it may be said that shaping with GT file is a safe and valuable instrumentation method.