• Journal of Korean Dental Science
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• v.15 no.2
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• pp.112-120
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• 2022

In this article, the contemporary root canal treatment procedure using nickel-titanium (NiTi) instruments was reviewed to understand the correlations between the properties of files and safety of the clinical usage. Literatures were reviewed according to the process of clinical procedure of the root canal preparation, mainly for shaping during orifice flaring, glide-path preparation, and main canal instrumentation. Considering the reasons for NiTi file fracture, clinically implacable issues and ideas were discussed to reduce the fracture risk and increase clinical efficiency of the NiTi file systems. Various kinds of NiTi file systems have their own characteristics and properties given from their geometries and heat treatments and so on. Proper selection and careful usage of the NiTi file systems may reduce the risk of file fracture and increase the efficiency of NiTi file systems. Understanding of the clinical implications from the mechanical properties and characteristics of the engine driven NiTi instruments may decrease the risk of NiTi file fractures and increase the success rate in root canal treatment.

• Proceedings of the KACD Conference
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• 2001.05a
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• pp.259-259
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• 2001

;A new root canal instrument and instrumentation technique: a preliminary report. Cleaning and shaping the root canal system has been and continues to be a challenge for even the most experienced endodontist. Curved. narrow canals. in particular. cause difficulties for the beginner as well as the specialist. A new instrument designed to incorporate new concepts was developed to ameliorate the problems in cleaning and shaping root canal systems. This new instrument has been given the name of SW (Senia and Wildey). The new SW instrument uses controlled right and left rotational forces. This motion was used to clean and shape simulated root canals in plastic blocks and root canals in extracted teeth. Instrumentation appeared to be easier. faster. and more precise than with conventional instruments. especially in curved canals where there was remarkable reduction of canal transportation. A mechanical version of the SW instrument was also developed. It was used to flare the coronal portion of the root canal system. Wildey WL. Senia ES., Oral Surg Oral Med Oral Pathol1989 Feb:67(2):198-207 Another look at root canal instrumentation. Several aspects of root canal instrumentation need additional research. Various factors must be considered in an analysis of instrumentation of the root canal system: the dentin that is cut: the technique used to cut it: the design of the instruments: the material and manufacturing process used to make the instruments: the irrigant used during the procedure: and the anatomic configuration of the root canal system. An analysis of these factors clearly indicates that existing root canal instruments and techniques are less than ideal and. in fact. do not accomplish what is expected of them. Root canals must be properly. but. at the same time. destructive and unnecessary removal of dentin should be kept to a minimum. The Flex-R and Canal Master instruments were developed to address some of the shortcomings of existing instruments and techniques. More scientifically based research is needed to fully evaluate these new instruments and techniques and to develop future instruments. Wildey WL; Senia ES. Montgomery S., Oral Surg Oral Med Oral Pathol1992 Oct:74(4):499-50799-507

• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.34.1-34.7
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• 2020

Objectives: This study evaluated by using micro-computed tomography (micro-CT) the filling ability and sealer apical extrusion promoted by a new Sealer Injection System (SIS; Angelus) with side openings needle, in comparison with the conventional injection system, associated with a new ready-to-use calcium silicate-based sealer (Bio-C Sealer). Materials and Methods: Acrylic resin models containing a main curved artificial canal and 3 simulated lateral canals in apical, middle and cervical thirds were used. The main root canals were prepared using a rotary system up to size 35.05. The canals were filled with Bio-C sealer by using a single cone technique and the conventional delivery system or SIS. Samples were scanned in micro-CT. The percentage of voids throughout the entire extension of the main root canal and in each third of the lateral canals, besides the apical extrusion of the sealer was calculated. Data were submitted to t-test (p < 0.05). Results: There was no difference between both systems in the main root canals filling. Although the volume percentage of voids was similar in the apical and middle thirds of lateral canals, SIS had the greatest filling ability of the cervical third lateral canal. Moreover, the conventional system showed the highest apical extrusion of the sealer. Conclusions: The conventional and SIS obturation systems had an appropriate filling ability of the main root canal. SIS had the best filling of the cervical third of the lateral canals, besides lower sealer apical extrusion, suggesting its clinical indication.

• Restorative Dentistry and Endodontics
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• v.30 no.6
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• pp.461-469
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• 2005

The aim of this study was to compare the root canal systems of maxillary and mandibular premolars that had a single root using radiographs and clearing samples. 142 single rooted premolars were selected and mesio-distal and bucco-lingual views were radiographed using intra-oral dental standard films. Four equally trained examiners classify the root canal types from the developed radiographs. After opening the tooth for access, it was stored in $5\%$ NaOCl to dissolve the pulp tissue. Indian ink was then injected into the pulp cavity to stain the pulp tissue. It was cleared in methyl salicylate after being decalcified with $5\%$ nitric acid for 48 hours, and the root canal type was evaluated at a magnification of $\times$ 20 using a stereomicroscope. The results are as follows ; There were statistically significant differences between the radiographs and clearing samples of the root canal types among examiners (p < 0.05). There might be differences in the root canal types among examiners when the same radiograph is used. Therefore, considering the difficulty in estimating the root canal types, clinicians need to be careful when interpreting radiographs before root canal therapy.

• Restorative Dentistry and Endodontics
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• v.46 no.2
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• pp.16.1-16.11
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• 2021

Objectives: The aim of this study was to evaluate the shaping ability of the TruShape and Reciproc Blue systems and the apical extrusion of debris after root canal instrumentation. The ProTaper Universal system was used as a reference for comparison. Materials and Methods: Thirty-three mandibular premolars with a single canal were scanned using micro-computed tomography and were matched into 3 groups (n = 11) according to the instrumentation system: TruShape, Reciproc Blue and ProTaper Universal. The teeth were accessed and mounted in an apparatus with agarose gel, which simulated apical resistance provided by the periapical tissue and enabled the collection of apically extruded debris. During root canal preparation, 2.5% sodium hypochlorite was used as an irrigant. The samples were scanned again after instrumentation. The percentage of unprepared area, removed dentin, and volume of apically extruded debris were analyzed. The data were analyzed using 1-way analysis of variance and the Tukey test for multiple comparisons at a 5% significance level. Results: No significant differences in the percentage of unprepared area were observed among the systems (p > 0.05). ProTaper Universal presented a higher percentage of dentin removal than the TruShape and Reciproc Blue systems (p < 0.05). The systems produced similar volumes of apically extruded debris (p > 0.05). Conclusions: All systems caused apically extruded debris, without any significant differences among them. TruShape, Reciproc Blue, and ProTaper Universal presented similar percentages of unprepared area after root canal instrumentation; however, ProTaper Universal was associated with higher dentin removal than the other systems.

• Restorative Dentistry and Endodontics
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• v.41 no.1
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• pp.1-5
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• 2016

Objectives: The purpose of this study was to assess the ability of ProTaper Gold (PTG, Dentsply Maillefer) in maintaining the original profile of root canal anatomy. For that, ProTaper Universal (PTU, Dentsply Maillefer) was used as reference techniques for comparison. Materials and Methods: Twenty simulated curved canals manufactured in clear resin blocks were randomly assigned to 2 groups (n = 10) according to the system used for canal instrumentation: PTU and PTG groups, upto F2 files (25/0.08). Color stereomicroscopic images from each block were taken exactly at the same position before and after instrumentation. All image processing and data analysis were performed with an open source program (FIJI). Evaluation of canal transportation was obtained for two independent canal regions: straight and curved levels. Student's t test was used with a cut-off for significance set at ${\alpha}=5%$. Results: Instrumentation systems significantly influenced canal transportation (p < 0.0001). A significant interaction between instrumentation system and root canal level (p < 0.0001) was found. PTU and PTG systems produced similar canal transportation at the straight part, while PTG system resulted in lower canal transportation than PTU system at the curved part. Canal transportation was higher at the curved canal portion (p < 0.0001). Conclusions: PTG system produced overall less canal transportation in the curved portion when compared to PTU system.

• Restorative Dentistry and Endodontics
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• v.40 no.2
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• pp.161-165
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• 2015

Three-dimensional (3D) reconstruction of cone-beam computed tomography (CBCT) scans appears to be a valuable method for assessing pulp canal configuration. The aim of this report is to describe endodontic treatment of a mandibular second premolar with aberrant pulp canal morphology detected by CBCT and confirmed by 3D modeling. An accessory canal was suspected during endodontic treatment of the mandibular left second premolar in a 21 year old woman with a chief complaint of pulsating pain. Axial cross-sectional CBCT scans revealed that the pulp canal divided into mesiobuccal, lingual, and buccal canals in the middle third and ended as four separate foramina. 3D modeling confirmed the anomalous configuration of the fused root with a deep lingual groove. Endodontic treatment of the tooth was completed in two appointments. The root canals were obturated using lateral compaction of gutta-percha and root canal sealer. The tooth remained asymptomatic and did not develop periapical pathology until 12 months postoperatively. CBCT and 3D modeling enable preoperative evaluation of aberrant root canal systems and facilitate endodontic treatment.

• Imaging Science in Dentistry
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• v.51 no.1
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• pp.9-16
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• 2021

Purpose: The purpose of this study was to analyze the reliability of 7 panoramic radiographic signs for predicting proximity of the root apices of mandibular third molars to the mandibular canal using cone-beam computed tomography and to correlate these findings with the Pell and Gregory and the Winter classification systems. Materials and Methods: An observational, cross-sectional, descriptive study was conducted on 74 patients with bilateral impacted mandibular third molars. Four panoramic radiographic signs were observed in the tooth root (darkening, deflection, and narrowing of the root apices, and bifid apices), and another 3 in the mandibular canal (diversion, narrowing, and interruption of the mandibular canal). Cone-beam computed tomography images were analyzed to identify disruption and diversion of the mandibular canal and root deflection. Results: Binary logistic regression showed that only 4 of the 7 panoramic radiographic signs were able to predict proximity of the root apices of the mandibular third molars to the mandibular canal: darkening of the root, deflection of the root, narrowing of the root, and interruption of the mandibular canal(P<0.05). Conclusion: Darkening, deflection, and narrowing of the root, in tandem with the interruption of the mandibular canal on panoramic radiographs, indicate that cone-beam computed tomography should be performed when planning the extraction of impacted mandibular third molars. Proximity between mandibular third molars and the mandibular canal is correlated with the Winter classification.

• Restorative Dentistry and Endodontics
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• v.43 no.1
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• pp.3.1-3.10
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• 2018

Objectives: The aim of this study was to compare root canal volume change and canal transportation by Vortex Blue (VB; Dentsply Tulsa Dental Specialties), ProTaper Next (PTN; Dentsply Maillefer), and ProTaper Universal (PTU; Dentsply Maillefer) nickel-titanium rotary files in curved root canals. Materials and Methods: Thirty canals with $20^{\circ}-45^{\circ}$ of curvature from extracted human molars were used. Root canal instrumentation was performed with VB, PTN, and PTU files up to #30.06, X3, and F3, respectively. Changes in root canal volume before and after the instrumentation, and the amount and direction of canal transportation at 1, 3, and 5 mm from the root apex were measured by using micro-computed tomography. Data of canal volume change were statistically analyzed using one-way analysis of variance and Tukey test, while data of amount and direction of transportation were analyzed using Kruskal-Wallis and Mann-Whitney U test. Results: There were no significant differences among 3 groups in terms of canal volume change (p > 0.05). For the amount of transportation, PTN showed significantly less transportation than PTU at 3 mm level (p = 0.005). VB files showed no significant difference in canal transportation at all 3 levels with either PTN or PTU files. Also, VB files showed unique inward transportation tendency in the apical area. Conclusions: Other than PTN produced less amount of transportation than PTU at 3 mm level, all 3 file systems showed similar level of canal volume change and transportation, and VB file system could prepare the curved canals without significant shaping errors.

• Restorative Dentistry and Endodontics
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• v.49 no.1
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• pp.2.1-2.12
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• 2024

Objectives: This study aimed to determine the effects of 1-rooted mandibular second molar (MnSM) teeth on root canal anatomy complexities of the mandibular central incisor (MnCI), mandibular lateral incisor (MnLI), mandibular canine (MnCn), mandibular first premolar (MnFP), mandibular second premolar (MnSP), and mandibular first molar (MnFM) teeth. Materials and Methods: Cone-beam computed tomography images of 600 patients with full lower dentition were examined. Individuals with 1-rooted MnSMs were determined, and the complexity of root canal anatomy of other teeth was compared with individuals without 1-rooted MnSMs (Group-1; subjects with at least one 1-rooted MnSM, Group-2; subjects with more than a single root in both MnSMs). A second canal in MnCIs, MnLIs, MnCns, MnFPs, and MnSPs indicated a complicated root canal. The presence of a third root in MnFMs was recorded as complicated. Results: The prevalence of 1-rooted MnSMs was 12.2%, with the C-shaped root type being the most prevalent (9%). There were fewer complicated root canals in MnCIs (p = 0.02), MnLIs (p < 0.001), and MnFPs (p < 0.001) in Group 1. The other teeth showed no difference between the groups (p > 0.05). According to logistic regression analysis, 1-rooted right MnSMs had a negative effect on having complex canal systems of MnLIs and MnFPs. Left MnSMs were explanatory variables on left MnLIs and both MnFPs. Conclusions: In individuals with single-rooted MnSMs, a less complicated root canal system was observed in all teeth except the MnFMs.