• Restorative Dentistry and Endodontics
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• 제43권1호
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• pp.5.1-5.9
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• 2018

Objectives: This study evaluated the amount of remaining root canal filling materials after retreatment procedures performed by undergraduate students using manual, rotary, and reciprocating techniques through micro-computed tomographic analysis. The incidence of instrument fracture and the instrumentation time were also evaluated. Materials and Methods: Thirty maxillary single rooted teeth were prepared with Reciproc R25 files and filled with gutta-percha and AH Plus sealer by the continuous wave of condensation technique. Then, the specimens were assigned to 3 groups (n = 10), according to the retreatment technique used: manual, rotary, and reciprocating groups, which used K-file, Mtwo retreatment file, and Reciproc file, respectively. Retreatments were performed by undergraduate students. The sample was scanned after root canal filling and retreatment procedures, and the images of the canals were examined to quantify the amount of remaining filling material. The incidence of instrument fracture and the instrumentation time were recorded. Results: Remaining filling material was observed in all specimens regardless of the technique used. The mean volume of remaining material was significantly lower in the Reciproc group than in the manual K-file and Mtwo retreatment groups (p < 0.05). The time required to achieve a satisfactory removal of canal filling material and refinement was significantly lower in the Mtwo retreatment and Reciproc groups (p < 0.05) when compared to the manual K-file group. No instrument fracture was observed in any of the groups. Conclusions: Reciproc was the most effective instrument in the removal of canal fillings after retreatments performed by undergraduate students.

• Restorative Dentistry and Endodontics
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• 제21권2호
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• pp.628-634
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• 1996

The purpose of this study was to investigate the effect of moisture on apical sealing properties of root canal. Fifty five single rooted human teeth were selected from maxillary and mandibular teeth. After removing crown portion at the cemento-enamel junction, all teeth were routinely prepared with step-back method. And then, the canals were dried with paper point and the teeth were randomly divided into 3 groups of 15 teeth each, and remaining 10 teeth were used as positive and negative control teeth : Group 1 were irrigated with 1ml of 95% alcohol and dried with air and paper point. Group 2 and 3 were intentionally contaminated with 0.05ml of 3.5% NaOCl or saliva, respectively. All the teeth were obturated with sealapex and gutta percha cone by lateral condensation technique, and covered with two coat of nail varnish after 48 hours of obturation. The teeth were immersed in india ink for 1 week and cleaned with methyl salicylate and then the degree of dye penetration were measured with stereomicroscope. The data were analyzed statistically by one-way ANOVA. The results were as follows : 1. All experimental groups showed varying degrees of dye penetration, and the mean degree of dye penetration was 0.1mm to 0.7mm. 2. Saliva contamination group(group 3) showed the highest amount of dye penetration, followed by NaOCl contamination group, then alcohol dried group, but there was no significant difference among three experimental groups. * This results suggest that there was no significant differences of apical leakage after canal obturation between alcohol dried canal and moisture present canals and the use of alcohol instead of paper point is unnecessary to dry the canals prior to canal filling. But other factors such as bacterial contamination and sealer discoloration by moisture must be considered in application of this results to clinical practice.

• Imaging Science in Dentistry
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• 제44권2호
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• pp.115-119
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• 2014

Purpose: The aim of this in vitro study was to determine the sensitivity and specificity of cone-beam computed tomography (CBCT) and digital periapical radiography in the detection of mesial root perforations of mandibular molars. Materials and Methods: In this in vitro study, 48 mandibular molars were divided into 4 groups. First, the mesial canals of all the 48 teeth were endodontically prepared. In 2 groups (24 teeth each), the roots were axially perforated in the mesiolingual canal 1-3 mm below the furcation region, penetrating the root surface ("root perforation"). Then, in one of these 2 groups, the mesial canals were filled with gutta-percha and AH26 sealer. Mesial canals in one of the other 2 groups without perforation (control groups) were filled with the same materials. The CBCT and periapical radiographs with 3 different angulations were evaluated by 2 oral and maxillofacial radiologists. The specificity and sensitivity of the two methods were calculated, and P<0.05 was considered significant. Results: The sensitivity and specificity of CBCT scans in the detection of obturated root canal perforations were 79% and 96%, respectively, and in the case of three-angled periapical radiographs, they were 92% and 100%, respectively. In non-obturated root canals, the sensitivity and specificity of CBCT scans in perforation detection were 92% and 100%, respectively, and for three-angled periapical radiographs, they were 50% and 96%, respectively. Conclusion: For perforation detection in filled-root canals, periapical radiography with three different horizontal angulations would be trustworthy, but it is recommended that CBCT be used for perforation detection before obturating root canals.

• Restorative Dentistry and Endodontics
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• 제39권2호
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• pp.132-136
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• 2014

The presence of radix entomolaris (RE) in a mandibular first molar is a common occurrence in certain ethnic groups, but the presence of RE in a mandibular second molar is a rare occurrence. In the present case, RE was identified from preoperative radiographs and confirmed using cone-beam computed tomography (CBCT). The access cavity was modified to locate the RE. Cleaning and shaping were performed with nickel-titanium rotary instruments. Obturation was completed with gutta-percha cones using AH Plus (Dentsply Detrey GmbH) as sealer. From the CBCT axial images, the RE was determined to have a Type III curvature by the De Moor classification, Type B separate RE by the Carlsen and Alexandersen classification, and radiographically, a Type i image by the Wang classification. The presence of RE in the mandibular second molar makes it essential to anticipate and treat the distolingual root canal. This case report highlights the usefulness of CBCT for assessing RE in the mandibular second molar, which can help the clinician in making a confirmatory diagnosis and assessing the morphology of the root canal.

• Journal of Korean Dental Science
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• 제7권1호
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• pp.1-5
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• 2014

Purpose: Capseal I and Capseal II are calcium silicate and calcium phosphate based experimental root canal sealers. This study sought to evaluate the biocompatibility and mineralization potential of Capseal I and Capseal II. Materials and Methods: The biocompatibility and mineralization related gene expression (alkaline phosphatase [ALP], bone sialoprotein [BSP], and osteocalcin) of Capseal I and Capseal II were compared using methylthiazol tetrazolium assay and reverse transcription-polymerization chain reaction analysis, respectively. The results were analyzed by Kruskal-Wallis test. A P-value of <0.05 was considered significant. Result: Both Capseal I and Capseal II were favorable in terms of biocompatibility, influencing the messenger RNA expression of ALP and BSP. Conclusion: Within the limitation of this study, Capseal is biocompatible, with mineralization promoting potential; thus, it could be a promising root canal sealer.

• 한국치위생학회지
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• 제18권4호
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• pp.423-432
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• 2018

Objectives: Calcium hydroxide, a root canal temporary sealer, has long been used and it has anti-bacterial and anti-inflammatory activity. To investigate the properties of a newly developed calcium hydroxide paste comprising silicon-substituted hydroxyapatite (Si-HA), we examined the anti-inflammatory activity of the new calcium hydroxide paste in RAW 264.7 macrophages stimulated by lipopolysaccharide (LPS), which causes infection of the root canal. Methods: The test materials, including Calcipex II as control group and the newly developed TRC paste, were extracted from cell culture media and then diluted for experiment. In LPS-stimulated RAW 264.7 cells, the cytotoxicity and nitric oxide (NO) production of test materials were measured by MTT assay and Griess reagents, respectively. Also, the expression of the inducible nitric oxide synthase (iNOS) was assessed by western blotting. Results: The IC50 values of Calcipex II and TRC paste were $17.6mg/m{\ell}$ and $13.5mg/m{\ell}$, respectively. The level of NO, increased by LPS, was dose-dependently inhibited more by TRC paste than Calcipex II treatment. In addition, iNOS expression was decreased by 71% and 92% at concentrations of $2mg/m{\ell}$ and $20mg/m{\ell}$ of TRC paste, respectively. Conclusions: We demonstrated that the Si-HA calcium hydroxide paste has a slightly improved anti-inflammatory property and further studies are needed before clinical recommendations are proposed.

• Restorative Dentistry and Endodontics
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• 제39권3호
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• pp.201-209
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• 2014

Objectives: This study evaluated the solubility, dimensional alteration, pH, electrical conductivity, and radiopacity of root perforation sealer materials. Materials and Methods: For the pH test, the samples were immersed in distilled water for different periods of time. Then, the samples were retained in plastic recipients, and the electrical conductivity of the solution was measured. The solubility, dimensional alteration, and radiopacity properties were evaluated according to Specification No. 57 of the American National Standards Institute/American Dental Association (ANSI/ADA). Statistical analyses were carried out using analysis of variance (ANOVA) and Tukey's test at a significance level of 5%. When the sample distribution was not normal, a nonparametric ANOVA was performed with a Kruskal-Wallis test (${\alpha}$ = 0.05). Results: The results showed that white structural Portland cement (PC) had the highest solubility, while mineral trioxide aggregate (MTA)-based cements, ProRoot MTA (Dentsply-Tulsa Dental) and MTA BIO ($\hat{A}$ngelus Ind. Prod.), had the lowest values. MTA BIO showed the lowest dimensional alteration values and white PC presented the highest values. No differences among the tested materials were observed in the the pH and electrical conductivity analyses. Only the MTA-based cements met the ANSI/ADA recommendations regarding radiopacity, overcoming the three steps of the aluminum step wedge. Conclusions: On the basis of these results, we concluded that the values of solubility and dimensional alteration of the materials were in accordance with the ANSI/ADA specifications. PCs did not fulfill the ANSI/ADA requirements regarding radiopacity. No differences were observed among the materials with respect to the pH and electrical conductivity analyses.

• Restorative Dentistry and Endodontics
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• 제25권4호
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• pp.543-549
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• 2000

Gutta-percha와 근관sealer를 사용한 근관 충전은 가장 많이 이용되고 성공률이 높은 방법이지만, 현재 사용되는 모든 근관sealer는 미세누출을 나타낸다. 따라서 더 효과적인 근관 폐쇄를 이루기 위한 재료 및 방법들이 연구되어왔다. 이중 상아질 접착제는 근관 충전재와 함께 사용되어 미세누출을 감소시키지만, 근관 내에 사용하기에 술식이 복잡하고 기술이 요구된다. 본 연구의 목적은 gutta-percha와 레진계 근관 sealer로 충전한 근관에서 self-etching primer를 미리 도포한 경우와 도포하지 않은 경우의 치근단 미세누출을 비교하고, self-etching primer를 도포함에 있어 근관 내에 적용하는 방법에 따른 미세누출을 비교하는 것이다. 또한 근관sealer와 상아질 계면을 주사전자현미경으로 관찰하여, 이 결과를 미세누출과 관련시켜보고자 하였다. 36개의 발거된 사람의 단근치에서 치관부를 절단, 제거하고 ProFile로 근관 형성한 후, 무작위로 선택하여 4개의 군으로 분류하였다. 1군에서는 주사기와 30게이지 주사 바늘로 self-etching primer를 근관 내에 적용하였고, 2군에서는 self-etching primer를 paper point에 적셔 근관 내에 적용하였다. 3군에서는 self-etching primer를 적용하지 않았다. 1, 2, 3군의 치아를 gutta-percha와 AH26 sealer를 사용하여 continuous wave 충전법으로 충전한 후 치근단공 주위 3mm를 제외한 치근변에 nail polish를 2회 도포하였고, 4군(음성 대조군)은 치근면 전체에 도포하였다. 1군과 2군에서 각각 2개의 치아는 주사전자현미경적 관찰을 위해 준비하였다. 모든 치아를 Methylene Blue 수용액에 48시간동안 침적, 수세한 후 치아 장축에 평행하게 양분하여 10배의 실물확대현미경 하에서 치근단 색소 침투를 관찰하였다. Self-etching primer를 도포한 군과 도포하지 않은 군 사이에는 평균 미세누출량에 유의한 차이가 없었다. 주사 바늘로 적용한 군과 paper point로 적용한 군 사이에도 평균 미세누출량에 유의한 차이가 없었다. 상아질과 근관 sealer계면의 주사전자현미경 관찰 결과 일부분에서 긴밀한 접착 관계를 나타내었고, 다른 부분에서는 간극을 나타내었다.

• Restorative Dentistry and Endodontics
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• 제26권1호
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• pp.77-85
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• 2001

The purpose of this in vitro study was to compare the apical leakage in extracted teeth filled with gutta-percha subsequent to dressing with one of three different calcium hydroxide preparations. Thirty six extracted teeth with single canal were used in this study. After working length determination, canals were prepared with K flexo files to a #40 at the working length. Step-back flaring was produced by using #45, #50 K flexo files and #2, #3, #4 Gates Glidden burs. The teeth were randomly divided into 3 groups of 10 each : the remaining six teeth were used for negative and positive leakage control: Group 1, dressed with pure calcium hydroxide powder (Sigma, USA) mixed with distilled water; Group 2, dressed with Metapaste (Metadent, Korea) ; Group 3, dressed with Vitapex (Neo Dental, Japan). Teeth were sealed with Caviton (GC, Japan) and incubated in 100% humidity, at 37$^{\circ}C$ for 1 wk. All kinds of calcium hydroxide were removed from the canal with a MAF and 5% NaOCl. The canals were filled with AH-26$^{\circledR}$ sealer and gutta-percha using lateral condensation technique, incubated in 100% humidity, at 37$^{\circ}C$ for 2 days for the sealer to be set. The teeth were coated twice with nail varnish except for an area of approximately 2mm surrounding the apical foramen. All specimens were placed in 2% methylene blue solution for 2 days. The root were sectioned longitudinally, the amount of apical leakage was measured to the most coronal part of the root canal to which the dye had penetrated. The independent measurements were made for each root using a stereomicroscope ($\times$40 magnification) and the average was recorded for statistical analysis. The results were as follows ; 1. The mean of apical leakage in group of pure calcium hydroxide ranged 0.102$\pm$0.156mm, in Metapaste$^{\circledR}$ ranged 0.062$\pm$0.069mm, and in Vitapex$^{\circledR}$ ranged 0.067$\pm$0.072mm. 2. Group of pure calcium hydroxide exhibited more leakage than those of 2 manufactured calcium hydroxide preparations, but it was not statistically significant. 3. Group of water-based Metapaste$^{\circledR}$ showed lesser leakage than that of oil-based Vitapex$^{\circledR}$, but it was not statistically significant.

• Restorative Dentistry and Endodontics
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• 제2권1호
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• pp.32-37
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• 1976

The author has studied comparatively the sealing quality of polycarboxylate cement, one of the newest dental cement systems, and zinc oxide eugenol cement by means of penetration of 2% methylene blue solution through the root apex of human teeth in 72 cases as time elapsed. Followings are the results obtained from this study. 1) In all groups, there was no increase in penetration related to increased time of immersion in the dye. 2) In polycarboxylate cement groups, there was a significant difference in depth of dye penetration of each tooth, but in zinc oxide eugenol cement group, there was a slight difference. 3) The depth of dye penetration of zinc oxide eugenol cement group is slightly lower than that of poly carboxylate cement groups. 4) In polycarboxylate cement groups, Carbolit cement group showed comparatively lower grade of dye penetration than Carbo cement group.