• 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.40 no.1
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• pp.79-84
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• 2015

This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment.

• Restorative Dentistry and Endodontics
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• v.37 no.3
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• pp.175-179
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• 2012

The aim of this study was to present a method for endodontic management of a maxillary first molar with unusual C-shaped morphology of the buccal root verified by cone-beam computed tomography (CBCT) images. This rare anatomical variation was confirmed using CBCT, and nonsurgical endodontic treatment was performed by meticulous evaluation of the pulpal floor. Posttreatment image revealed 3 independent canals in the buccal root obturated efficiently to the accepted lengths in all 3 canals. Our study describes a unique C-shaped variation of the root canal system in a maxillary first molar, involving the 3 buccal canals. In addition, our study highlights the usefulness of CBCT imaging for accurate diagnosis and management of this unusual canal morphology.

• Restorative Dentistry and Endodontics
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• v.46 no.2
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• pp.19.1-19.12
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• 2021

Objectives: The purpose of this study was to conduct a systematic review and meta-analysis of in vitro studies regarding the effectiveness of reciprocating and rotary instrumentation on microbial reduction in root canals. Materials and Methods: PubMed, Scopus, Web of Science, the Cochrane Library, and the gray literature were searched through December 2019. Studies comparing the influence of reciprocating and rotary instrumentation on the removal of microorganisms from root canals that quantified the antimicrobial effect were included. Data extraction was completed using a systematic form for data collection. The risk of bias of the studies was evaluated. Standardized mean differences (SMDs) and confidence intervals (CIs) were calculated using a random effects meta-analysis. Results: Seventeen in vitro studies were included in this systematic review, of which 7 provided adequate data for inclusion in the meta-analysis. Both reciprocating and rotary systems were similarly effective in reducing the microbial load in infected root canals (SMD [95% CI], 0.0481 [-0.271, 0.367]). Three studies showed a low risk of bias, whereas most of the studies (82%) presented a medium risk. Conclusions: Although both techniques decrease the microbial content (with reductions of 23.32%-88.47% and 23.33%-89.86% for reciprocating and rotary instrumentation, respectively), they are not able to provide complete disinfection of root canals.

• Restorative Dentistry and Endodontics
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• v.23 no.1
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• pp.391-400
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• 1998

The aim of this study was to determine the shaping ability of stainless-steel K file (S-S K file), nickel-titanium K file (Ni-Ti K file) and engine driven nickel-titanium file (Quantec file) in resin simulated root canal. Computed tomography was used to evaluate the change of the root canal morphology. Thirty nine resin simulated root canal were divided into four groups (A:12, B:12, C:12, D:3). Resin simulated canals were scanned by computed tomography before instrumentation (1st C-T scan). Canals were instrumented using step back preparation technique with S-S K file in group A and Ni-Ti K file in group B. Group C was prepared with engine driven Ni-Ti file. Group D was uninstrumented to compare the 1st C-T scan images with 2nd C-T scan images of root canal. Instrumented canals were again scanned using computed tomography (2nd C-T scan), and reformated images of the uninstrumented canals were compared with images of the instrumented canals. In the sections of 2mm and 6mm from the apex, Quantec file caused significantly less canal transportation than S-S K file and Ni-Ti K file (p<0.05). Quantec file produced more centered than S-S K file and Ni-Ti K file in the sections of 2mm and 4mm from the apex (p<0.05). There was no significant difference in the removed volume of canals among the each groups (p>0.05). However the removed canal volume from the apex to 5mm were significantly higher than them from 5mm to 1mm (p<0.05) in each groups. Under the conditions of this study, preparation with Quantec file was more effective and produce more appropriate canal shapes than S-S K file and Ni-Ti K file.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.31.1-31.7
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• 2018

Despite considerable focus on the regenerative endodontic treatment of immature teeth with necrotic infected pulps and apical periodontitis, little data exist with regard to its possible implementation in necrotic permanent teeth with complete apical and radicular development. The present report describes the procedures and outcome of a regenerative endodontic treatment approach in 2 previously-traumatized incisors with closed apex with apical periodontitis. A 2-visit treatment procedure was employed. At initial visit, the root canals were copiously irrigated, followed by placement of a triple antibiotic paste containing ciprofloxacin, metronidazole, and clindamycin into the root canals. After 4 weeks, the antibiotic paste was removed, and apical bleeding was initiated with size 10 hand files beyond the apices. The root canals were coronally sealed with mineral trioxide aggregate, and the access cavities were restored with bonded resin composite. At post-operative 60 months, both teeth were remained asymptomatic, with the recall radiographs showing complete resolution of apical radiolucency and reestablishment of periradicular tissues. In both teeth, the dimensions of root space remained unchanged as verified by image analysis. The revitalization protocol utilizing root canal disinfection and induced apical bleeding in necrotic, closed-apex incisors may offer a clinically acceptable alternative to conventional root canal treatment.

• Restorative Dentistry and Endodontics
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• v.47 no.1
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• pp.6.1-6.9
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• 2022

Objectives: This study investigated the internal morphology of mesiobuccal (MB) roots of maxillary molars with a second mesiobuccal (MB2) canal. Materials and Methods: Forty-seven maxillary first or second molars from Brazilians were scanned using micro-computed tomography. The following measurements were obtained from the MB roots: root thickness, root width, and dentin thickness of the buccal aspect of the first mesiobuccal (MB1) canal, between the MB1 and MB2 canals, and the palatal aspect of the MB2 and MB1 canals at 3 mm from the root apex and in the furcation region. For statistical analysis, the Student's t-test and analysis of variance with the post-hoc Tukey test were used (α = 0.05). Results: In maxillary molars with an MB2 canal, MB roots were significantly thicker (p = 0.0014) and narrower (p = 0.0016) than in maxillary molars without an MB2 canal. The dentin thickness of the palatal aspect of the MB1 canal was also significantly greater than that of MB roots without an MB2 canal at 3 mm from the root apex (p = 0.0007) and in the furcation region (p < 0.0001). In the furcation region of maxillary molars with an MB2 canal, the dentin thickness between the MB1 and MB2 canals was significantly smaller than that in the buccal and palatal aspects (p < 0.0001). Conclusions: The internal morphology of MB roots of maxillary molars with an MB2 canal revealed differences in dentin thickness, root diameter, and distance between the canals when compared with maxillary molars without an MB2 canal.

• Restorative Dentistry and Endodontics
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• v.28 no.4
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• pp.303-313
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• 2003

It has been documented that periodontopathic bacteria are also implicated in endodontic infections. 168 rDNA gene-directed PCR was to examine the prevalence of periodontopathic bacteria including Actinobacillus actinomycetemcomitans (Aa), Prevotella intermedia (Pi), Prevotella nigrescens (Pn), Porphyromonas gingivalis (Pg), Porphyromonas endodontalis (Pe), and Treponema denticola (Td) in the root canals of 36 endodontically infected teeth having apical lesions with or without clinical symptoms like pain, swelling, and fistula. 1. In 36 infected root canals, most frequently detected bacterial species was Pg (61.1%), followed by Td (52.8%) and Pe (38.9%). 2. Of 36 infected root canals, Aa was detected in 6 canals (16.7%) of the teeth, all of which showed clinical symptoms. 3. Of 36 infected root canals, Pi and Pn were found in 4 03.9%) and 5 (33.3%), respectively. Notably, prevalence of Pn in the symptomatic teeth was 50.0%. 4. One of black-pigmented anaerobic bacteria (BPB) including Pi, Pn, Pe, and Pg was detected in all of the teeth that showed pain or especially swelling but not fistula. It was, however, found that prevalence of BPB in the asymptomatic teeth or the teeth with fistula was only 40%. 5. Pe and Pg were detected in the teeth regardless of the presence or absence of symptoms. 6. Td was detected in the teeth regardless of the presence or absence of symptoms. High prevalence of BPB in the symptomatic teeth but low in the asymptomatic teeth suggests that BPB may play an important role in the pathogenesis of periapical lesions.

• Restorative Dentistry and Endodontics
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• v.47 no.2
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• pp.22.1-22.18
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• 2022

Objectives: This systematic review (register-osf.io/wg7ba) compared the efficacy and safety of rotary and reciprocating kinematics in the removal of filling material from curved root canals. Materials and Methods: Only in vitro studies evaluating both kinematics during retreatment were included. A systematic search (PubMed/MEDLINE, Scopus, and other databases, until January 2021), data extraction, and risk of bias analysis (Joanna Briggs Institute checklist) were performed. Efficacy in filling removal was the primary outcome. Results: The search resulted in 2,795 studies, of which 15 were included. Efficacy was measured in terms of the remaining filling material and the time required for this. Nine studies evaluated filling material removal, of which 7 found no significant differences between rotary and reciprocating kinematics. Regarding the time for filling removal, 5 studies showed no difference between both kinematics, 2 studies showed faster results with rotary systems, and other 2 showed the opposite. No significant differences were found in apical transportation, centering ability, instrument failure, dentin removed and extruded debris. A low risk of bias was observed. Conclusions: This review suggests that the choice of rotary or reciprocating kinematics does not influence the efficacy of filling removal from curved root canals. Further studies are needed to compare the kinematics safety in curved root canals.

• The Journal of the Korean dental association
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• v.50 no.4
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• pp.203-210
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• 2012

Objective: The aim of this study was to investigate the incidence of the C-shaped canal of permanent mandibular second molar (PMSM) in Korean sub-population using Cone-Beam CT (CBCT) data and analyze the types of C-shaped canal. Materials & Methods: The protocol for this study was approved by the Institutional Review Board at the Pusan National University Hospital (E-2011039). Among the CBCT images taken of patients who visited the St. Bennedict Dental Hospital (Busan, Korea) from May 2008 to April 2011 for implant surgery and surgical removal of impacted teeth, high-quality CBCTs from 705 patients (361 male and 342 female) were screened and 607 PMSMs of 383 patients were evaluated retrospectively. All PMSMs were anatomically analyzed in detail by using image viewer software (EasyDent; Vatech). PMSMs were evaluated in the axial plane to investigate the shape of root and canals. The C-shaped canals were classified into five types. The total incidence, gender ratio, bilateral and unilateral appearance. and the correlation between right-side and left-side occurrences of C-shaped PMSMs were computed and compared statistically using the chi-square test. Results: Among the 607 PMSMs of 383 CBCTs of 187 females and 196 males, 198 PMSMs(32.6%) had C-shaped root and 158 PMSMs(26.0%) had C-shaped canals. The shape of C-shaped root canals at the furcalion level did not have significant change at the level of mid root (P<0.0001). Female had more prevalence of C-shaped root canals than male (P<0.0001). The prevalence of bilateral occurrence of C-shaped root canals was higher than unilateral occurrence. Conclusions: The occurrence of C-shaped PMSMs among a Korean population was 32.6% and was higher than other countries and ethnicities. Understanding the prevalence of PMSMs with a C-shaped root and/or canal in a Korean population may be useful for successful endodontic treatments.