• Restorative Dentistry and Endodontics
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• v.24 no.4
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• pp.628-632
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• 1999

Currently electronic apex locators have been widely used to determine working length in endodontic treatment. According to Manufacture's recommendation, it is beneficial to find the working length before instrumenting the canal. However, in crown-down pressureless technique, working length of tooth is established following coronal instrumentation 3mm short of radiographic apex. In narrow canals, mechanically formed constriction might be established by coronal instrumentation in some distance from anatomical constriction. The purpose of this study was to evaluate the accuracy of Root-ZX in the canal with mechanical constriction following considerable coronal enlargement with ProFile .06 series. The 40 root canals in 30 extracted mandibular molars were accessed, and their actual length (AL) established by passing a size 10 file just through the minor apical foramen. The teeth were then embedded in an acrylic container with normal saline. The initial canal length(IL) was measured with Root-ZX by negotiating a size 10 file to the apical constriction. The canal was sequentially enlarged to size 40 with ProFile .06 file 3mm short of actual length. The enlarged final canal lengths (FL) were obtained with a size 15 file. The average values of IL, FL were calculated and compared using Repeated measures Analysis of Variance followed Turkey's Studentized Range test. The results were obtained as follows: 1. The initial canal length was 0.12mm shorter than actual canal length(P>0.05). 2. The differences between initial canal length and final canal length were not significant(P>0.05). 3. As a result of this study, regardless of mechanically formed constriction. Root-ZX differentiated between mechanical and anatomic constriction.

• Restorative Dentistry and Endodontics
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• v.47 no.1
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• pp.1.1-1.13
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• 2022

Objectives: This study assessed the shape and anatomical relationship of the mental foramen (MF) to mandibular posterior teeth in an Indian sub-population. Materials and Methods: In total, 475 existing cone-beam computed tomography records exhibiting 950 MFs and including the bilateral presence of mandibular premolars and first molars were assessed. Images were evaluated 3-dimensionally to ascertain the position, shape, and anatomical proximity of MFs to mandibular teeth. The position and shape of MFs were measured and calculated. The Pythagorean theorem was used to calculate the distance between the root apex of the mandibular teeth and the MF. Results: MFs exhibited a predominantly round shape (left: 67% and right: 65%) followed by oval (left: 30% and right: 31%) in both males and females and in different age groups. The root apices of mandibular second premolars (left: 71% and right: 62%) were closest to the MF, followed by distal to the first premolars and mesial to the second premolars. The mean vertical distance between the MF and the nearest tooth apex calculated on sagittal sections was 2.20 mm on the right side and 2.32 mm on the left side; no significant difference was found according to sex or age. The distance between the apices of the teeth and the MF was ≥ 4 mm (left; 4.09 ± 1.27 mm and right; 4.01 ± 1.15 mm). Conclusions: These findings highlight the need for clinicians to be aware of the location of the MF in treatment planning and while performing non-surgical and surgical endodontic procedures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.2
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• pp.165-171
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• 2008

The aim of this study was to evaluate the incidence of panoramic radiological risk signs related with mandibular third molar extraction, and the relationship between these risk signs and inferior alveolar nerve (IAN) injury after tooth extraction. Cases were defined as 1000 mandibular third molars extracted by surgical approach at Samsung Medical Center during the period from March 2001 to December 2006. Seven radiological risk signs were assessed on the panoramic radiogram by three expert oral surgeons. Clinical demographic data and severity of IAN injury were examined on medical records. Bivariate analyses were completed to assess the relationship between radiological risk signs and IAN injury. The radiological risk signs showed in 381 cases(38.1%). The incidence of each radiological risk signs were; interruption of IAN white line, 152 cases(15.2%); deflected roots, 141 cases(14.1%); darkening root, 119 cases(11.9%); diversion of IAN, 57 cases(5.7%) ; IAN narrowing, 37 cases(3.7%); root narrowing, 17 cases(1.7%); dark and bifid apex, 10 cases(1.0%). The incidence of IAN injury in cases with risk signs were: in the case of any sign, 3.6%; interruption of IAN white line, 2.6%; deflected roots 5.7%; darkening root. 3.4%; diversion of IAN, 5.7%; IAN narrowing, 3.7%; root narrowing, 5.9%; dark and bifid apex, 0%. No IAN injury was showed in 619 cases without risk sign (p<0.05). In conclusion, the presence of panoramic risk signs was associated with an increased risk for IAN injury during mandibular third molar extraction, whereas the absence of risk signs was associated with a minimal risk of nerve injury.

• The korean journal of orthodontics
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• v.41 no.5
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• pp.324-336
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• 2011

Objective: The aim of this study was to conduct three-dimensional finite element analysis of individual tooth displacement and stress distribution when a posterior retraction force of 200 g was applied at different positions of the retraction hook on the transpalatal arch (TPA) of a molar, and over different lengths of the lever arm on the maxillary anterior teeth in lingual orthodontics. Methods: A three-dimensional finite element model, including the entire upper dentition, periodontal ligaments, and alveolar bones, was constructed on the basis of a sample (Nissan Dental Product, Kyoto, Japan) survey of Asian adults. Individual movement of the incisal edge and root apex was estimated along the x-, y-, and z-coordinates to analyze tooth displacement and von Mises stress distribution. Results: When the length of the lever arm was 15 mm and 20 mm, the incisal edge and root apex of the anterior teeth was displaced lingually, with a maximum lingual displacement at the lever arm length of 20 mm. When the posterior retraction hook was on the root apex, the molars showed distal displacement. When the length of the lever arm was 20 mm, anterior extrusion was reduced and the crown of the canine displaced toward the buccal side, in which case, the retraction hook was on the edge, rather than at the center, of the TPA. Conclusions: The results of the analysis showed that when 6 anterior teeth were retracted posteriorly, lateral displacement of the canine and lingual displacement of the incisal edge and root apex of the anterior teeth occur without the extrusion of the anterior segment when the length of the lever arm is longer, and the posterior retraction hook is in the midpalatal area.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.4
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• pp.607-617
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• 2002

The purposes of this study were to evaluate the timing of tooth calcification and the change of tooth position with tooth developmental stage on the mandibular teeth. Seven hundred seventy two children(male:446, female:326), 3 to 12 years of age were examined radiographically with panoramic film. Dental development was determined by inspecting radiographs and assigning a rating according to consecutive stages defined by Moorrees, and tooth cusp position and root terminus position were measured from the lower border of mandibular body and calculated the position index to evaluate the movement of tooth with developmental stage. The results were as follows. 1. There were no significant differences between boys and girls in the timing of calcification until crown completion, but timing of calcification tend to be faster in girls than in boys after root initiation stage. 2. In terms of mean age, crown completion of central incisor in boys and girls occurred at the age of 3.71, 4.05 years, at 4.44, 4.60 years for the lateral incisor, at 5.35, 5.11 years for the canine, at 6.62, 6.36 years for the first premolar, at 7.36, 7.17 years of second premolar, at 3.51, 3.69 years of first molar, and at 7.90, 7.64 years for the second molar respectively. Apex 1/2 closed stage of central incisor occurred at the age of 8.70 in boys, 8.18 in girls, at 9.55, 8.99 years for the lateral incisor, at 12.48, 11.60 years for the canine, at 12.30, 12.01 years for the first premolar, at 12.19, 12.26 years of second premolar, at 9.12, 8.87 years of first molar, and at 12.59, 12.45 years for the second molar respectively. 3. There was no noticeable movement of cusp tip until crown completion (Crc), but showed rapid movement toward occlusion plane after root initiation(Ri) and again maintain stable position after root completion stage(Rc). 4. Root terminus position was stable until root 1/4 formation stage(R1/4), followed by rapid movement toward occlusal plane and was stable again after root 3/4 formation stage(R3/4). 5. Developmental stage at the time of alveolar bone penetration by cusp tip varied with each of the permanent teeth. 6. Canine tooth follicle was at the lowest position in the mandibular body during the early stage of calcification, followed by second premolar, first premolar, lateral incisor, second molar, first molar and central incisor in order.

• The Journal of Korean Academy of Prosthodontics
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• v.31 no.4
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• pp.625-642
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• 1993

Whether stress-absorbing elements are functional in an implant system has been an issue of interest in oral implantology. The unique feature of the IMZ implant system is the planned imitation of the stress-distributing function of the structural unit of the tooth, periodontium, and alveolar bone through the use of an intramobile element(IME). The purpose of this study was to compare the difference in the displacement and the stress distibutions of IMZ implant with a polyoxymethylene(POM) or a titanium IME under static load. Two dimensional finite element analysis(FEA) was applied for this study and two finite element models were created. PATRAN program(DPA Co.,USA), a software for FEA, and SUN-SPARC2GX(SUN Co., USA), a workstation computer, were used. $1Kg/mm^2$ of static load was loaded individually on each three point of crown of implant prosthesis ; central fossa(load 1), mesial cusp tip(load 2), distal cusp tip(load 3), The displacements of X- and Y-axis and total displacement were measured at mesial and distal cusp tips, mesial and distal points between crown and IME, and implant apex. The von Mises stress was measured at mesial and distal points between crown and IME, mesial and distal points between IME and TIE, mesial and distal alveolar crest, the mesial and distal midpoints of implant, and implant apex. The difference in resultant values were compared and evaluated statistically using paired t-test. The results were as follows : 1. Under the load 1, all the displacement of implant with titanium IME at 5 measuring points was larger than that of with POM IME except total and Y-axis displacement at implant apex. And the differences in stress distributions with POM and titanium were varied. 2. Under the load 2, all the displacement of implant with titanium IME at 5 measuring points was larger than that of with POM IME except X-axis displacement at distal cusp tip. And the differences in stress distributions were varied. 3. Under the load 3, all the displacement of implant with titanium IME at 5 measuring points was larger than that of with POM IME except Y-axis displacement at mesial cusp tip. And the differences in stress distributions were varied. 4. For the displacement, there was significant difference statistically only in total displacement (P<0.1), but was no significant difference in X- and Y-axis displacement(P>0.1). For the stress, there was no significant difference among the compared values.

• The korean journal of orthodontics
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• v.54 no.3
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• pp.171-184
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• 2024

Objective: This study aimed to determine the maxillary and mandibular basal bone regions and explore the three-dimensional positional relationship between the dentition and basal bone regions in patients with skeletal Class I and Class II malocclusions with mandibular retrusion. Methods: Eighty patients (40 each with Class I and Class II malocclusion) were enrolled. Maxillary and mandibular basal bone regions were determined using cone-beam computed tomography images. To measure the relationship between the dentition and basal bone region, the root position and root inclination were calculated using the coordinates of specific fixed points by a computer program written in Python. Results: In the Class II group, the mandibular anterior teeth inclined more labially (P < 0.05), with their apices positioned closer to the external boundary. The apex of the maxillary anterior root was positioned closer to the external boundary in both groups. Considering the molar region, the maxillary first molars tended to be more lingually inclined in females (P = 0.037), whereas the mandibular first molars were significantly more labially inclined in the Class II group (P < 0.05). Conclusions: Mandibular anterior teeth in Class II malocclusion exhibit a compensatory labial inclination trend with the crown and apex relative to the basal bone region when mandibular retrusion occurs. Moreover, as the root apices of the maxillary anterior teeth are much closer to the labial side in Class I and Class II malocclusion, the range of movement at the root apex should be limited to avoid extensive labial movement.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.1
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• pp.96-102
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• 1999

Tooth avusion implies total displacement of teeth out of its socket. Its frequency range from 0.5 to 16% of traumatic injuries. Replantation procedure is used for the treatment of avulsed tooth. However, its major complications are pulp necrosis, inflammatory root resorption and replacement root resorption. This paper describes 10 years and 2 months old male patient whose both maxillary central incisors were avulsed due to fall-down with slightly underdeveloped root apices. Teeth were replanted 2 hours after accident. Right central incisor's pulp tissues were extirpated and filled with $Vitapex^{(R)}$(calcium hydroxide) at 3-4 weeks after replantation, but left central incisor was filled at 8-9 weeks. Right central incisor showed little inflammatory resorption in apical portion, whereas left central incisor showed severe root resorption. During 18 months' follow-up period, left central incisor showed slightly ankylosis while right central incisor did not. Based upon the above-mentioned results, the following conclusions can be drawn: 1. Inflammatory resorption could be suppressed by endodontic treatment with calcium hydroxide. 2. When apex formation is doubted in replanted tooth due to avulsion, early endodontic treatment with calcium hydroxide seems to act positively for better prognosis.

• Journal of Yeungnam Medical Science
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• v.20 no.1
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• pp.45-52
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• 2003

Background: Immediate implant placement has become an acceptable treatment for the edentulous area. The advantages of the immediate implant placement include considerable decrease in time from tooth extraction to placement of the finial prosthesis, fewer surgical procedures, and better acceptance of the overall treatment plans. But the success is dependent on the quantity and quality of the extraction socket. The purpose of this study is to evaluate the success of the immediate implant placement. Materials and Methods: Twenty-one sites in 16 patients were selected for the evaluation of the immediate implant placement. All of the cases were followed using clinical and radiographic examinations. Criteria of success were the absence of peri-implant radiolucency, mobility, and persistent pain or sign of infection. Results: Of the 21 implants, 13 implants have been succeeded. Of the 13 implants, 10 implants were replaced for the periodontal disease and 3 implants were replaced for the trauma. Conclusion: The criteria of the success in immediate implant placement are as follows. 1) Implants placed into fresh extraction sockets have a high rate of survival. 2) Implant should be placed as close as possible to the alveolar crest. 3) Implant placed into available bone beyond the apex have a high success rate.

• Restorative Dentistry and Endodontics
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• v.42 no.4
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• pp.332-341
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• 2017

Objectives: To determine the incidence of crack formation and propagation in apical root dentin after retreatment procedures performed using ProTaper Universal Retreatment (PTR), Mtwo-R, ProTaper Next (PTN), and Twisted File Adaptive (TFA) systems. Materials and Methods: The study consisted of 120 extracted mandibular premolars. One millimeter from the apex of each tooth was ground perpendicular to the long axis of the tooth, and the apical surface was polished. Twenty teeth served as the negative control group. One hundred teeth were prepared, obturated, and then divided into 5 retreatment groups. The retreatment procedures were performed using the following files: PTR, Mtwo-R, PTN, TFA, and hand files. After filling material removal, apical enlargement was done using apical size 0.50 mm ProTaper Universal (PTU), Mtwo, PTN, TFA, and hand files. Digital images of the apical root surfaces were recorded before preparation, after preparation, after obturation, after filling removal, and after apical enlargement using a stereomicroscope. The images were then inspected for the presence of new apical cracks and crack propagation. Data were analyzed with ${\chi}^2$ tests using SPSS 21.0 software. Results: New cracks and crack propagation occurred in all the experimental groups during the retreatment process. Nickel-titanium rotary file systems caused significantly more apical crack formation and propagation than the hand files. The PTU system caused significantly more apical cracks than the other groups after the apical enlargement stage. Conclusions: This study showed that retreatment procedures and apical enlargement after the use of retreatment files can cause crack formation and propagation in apical dentin.