• Restorative Dentistry and Endodontics
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• v.28 no.3
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• pp.232-240
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• 2003

This study is to investigate the canal system in the mesiobuccal root of the maxillary first molar. 61 maxillary first molars were randomly selected. Serial transverse sections were made perpendicular to the long axis of the mesiobuccal root. Each section was placed in 3% sodium hypochlorite for 24 hours and rinsed in water and dried. The resected surface was stained with 2% methylene blue dye and examined with stereomicroscope. 1 Canal configuration analysis showed that 36.1% of the specimen classified as type I, 16.4% as type II , 37.7% as type III and 9.8% as type IV. 2. Type II canal was merged in one canal within 1 to 4mm of the apex. 40% of type II canal converged at 2mm of the apex. 3. Type IV canal was divided into two canal within 2 to 4mm of the apex. 66.6% of type IV canal branched off at 2mm of the apex. 4. None of the sections had more than two main root canal. 5. 48.4% of the sections in 3mm with two canals contained an isthmusand more than 70% with two canals has isthmus at 4 to 5mm sections. 63.9% of the mesiobuccal root of maxillary first molar had two canaland 76.5% of sections with two canals in 5 MM had an isthmus. Because of this complexity the clinician should always search for extra canal carefullyand root canal system, including an isthmus, should be cleaned and shaped completelyand obturated three dimensionally for successful endodontic treatment.

• Restorative Dentistry and Endodontics
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• v.33 no.6
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• pp.518-525
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• 2008

The purpose of this study was to evaluate the effect of the apical sealing according to the depth of the System B Plugger tip when root canal was filled with gutta-percha and sealer by Continuous Wave of Condensation technique in the Type IV canal. 50 simulated resin blocks with J-shaped curvature canals were instrumented by ProTaper (Dentsply Maillefer, Ballagiues, Switzerland) Ni-Ti files using the crown-down technique. Type IV canals were made using a broken ProTaper F3 Ni-Ti file for making a ledge at 3mm short from the working length. And ProTaper F1 Ni-Ti file was used for perforating resin block. The prepared Type IV canals were randomly divided into three experimental groups of 15 each according to the depth of System B Plugger tip. All of experimental groups were obturated with Continuous Wave of Condensation technique. The length of gutta-percha and sealer in lingual of the Type IV canals was measured with a measuring digital calliper under magnifying glass (${\times}2.3$). The results are as follows : 1. In control group, there was no gutta-percha and sealer in lingual canal. 2. 3 mm group showed relatively more gutta-percha than 5mm or 7 mm group (p<0.05). 3. 7 mm group did not showed gutta-percha and relatively more void were observed than 3mm or 5 mm group. (p<0.05) In conclusion, within the limits of the results of this experiment, the 3 mm depth of System B Plugger tip was acceptable for obturating the Type IV canal.

• Restorative Dentistry and Endodontics
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• v.27 no.4
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• pp.432-440
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• 2002

The purpose of this study is to identificate root canal system including ideal access placement, root curvature, canal configuration, incidence of isthmus in mandibular incisors for success of endodontic treatment. 200 mandibular incisors were selected. The ideal access placement was determimed as follows. The teeth there radiographed from mesiodistal and buccolingual views using intraoral dental film. The image was divided into coronal, middle and apical third using the proximal film. Straight line access was determined by measuring the faciolingual canal width and placing points at midway point between the buccal and lingual wall at the junction of the middle and apical third and at the juntion of coronal and middle third of the root canal. A line was drawn connecting these two points extending through the crown of the tooth. The point at which the line crossed the external crown surface was recorded as facial, incisal, lingual. Degree of root curvature was determined by Schneider Protractor Method. Both section method and clearing method were used in this study. By section method, 100 mandibular incisors were embedded in clear resin and transeverse serial sectioned at 0.5, 1.0, 2.0, 3.0, 4.0, 5.0mm level from root apex. The resected surfaces were stained by methylene blue and examined under $\times$40 magnification with a stereomicroscope. By clearing method, 100 mandibular incisors were cleared in methysalicylate after decalcification with 10% nitric acid and evaluated under $\times$18 magnification with a stereomicroscope. The results were as follows ; 1. 29% had the center of the plotted straight-line access facial to incisal edge, whereas 71% had straight-line access at the incisal edge. When incisal wear classified as extensive, the straight-line access was plotted on the incisal edge 95.5%. When incisal wear classified as slight/none, the straight-line access was plotted on the facial 65.9%. 2. Degree of curvature of main canal was straight or almost straight, and only 10% in buccolingual direction had a degree of curvature greater than 20 degrees and 5.5% in mesiodistal direction had. 3. In section method, canal configuration analysis showed that 51% of the specimen classified as type I, 27% as type II, 12% as type III, 10% as type IV. For theses setions with two canals, the incidence of an isthmus was 36.7%, 64.3%, 79.2%, 96.3%, 97.4%, 97.6% at each level and highest in 3~5mm sections. 4. In clearing method, canal configuration analysis showed that 74% of the specimen classified as type I, 11% as type II, 6% as type III, 9% as type IV. These results suggested that traditional access from lingual should be moved as far toward the incisal as possible to locate and debride the lingual canal and root canal system should be cleaned, shaped completely and obturated three dimensionally for successful endodontic treatment.

• Imaging Science in Dentistry
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• v.51 no.4
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• pp.383-388
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• 2021

Purpose: The aim of this study was to evaluate the root canal morphology of mesial roots of mandibular first molars. Materials and Methods: Forty extracted mandibular first molars were used in this study. The morphological examination of root canals was conducted in accordance with the Vertucci classification using micro-computed tomography (micro-CT). Any aberrant root canal configurations not included in the Vertucci classification were recorded, and their frequency was established using descriptive statistics. Intra-observer reliability was assessed using the Wilcoxon signed-rank test, while inter-observer reliability was assessed using the Cohen kappa test. Significance was evaluated at the P<0.05 level. Results: The mesial roots of mandibular first molars had canal configurations of type I (15%), type II (7.5%), type III (25%), type IV (10%), type V (2.5%), type VI (7.5%), and type VII (7.5%). The images showed 10 (25%) additional configuration types that were not included in the Vertucci classification. These types were 1-3-2-3, 1-2-3-2-3, 2-3-1, 2-3, 1-2-3-1, 2-1-2-3, 3-2-1, 1-2-3-1, 2-3-2-3, and 1-2-1-2-1. The intra-observer differences were not statistically significant(P>0.05) and the kappa value for inter-observer agreement was found to be 0.957. Conclusion: Frequent variations were detected in mesial roots of mandibular first molars. Clinicians should take into consideration the complex structure of the root canal morphology before commencing root canal treatment procedures to prevent iatrogenic complications. Micro-CT was a highly suitable method to provide accurate 3-dimensional visualizations of root canal morphology.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.35.1-35.7
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• 2018

The aim of this article was to showcase the endodontic management of a maxillary first molar with an unusual crown and root anatomy. Clinical diagnosis of the roots and root canal configuration was confirmed by a cone-beam computed tomography (CBCT) and the detection of the canals was made using a dental operating microscope. CBCT images revealed the presence of 5 roots with Vertucci type I canal configuration in all, except, in the middle root which had 2 canals with type IV configuration. The 6 canal orifices were clinically visualized under the dental operating microscope. Clinicians should familiarize themselves with the latest technologies to get additional information in endodontic practice in order to enhance the outcomes of endodontic therapy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.6
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• pp.432-439
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• 2012

Purpose: The aim of this study was to investigate the blood supply to the maxillary sinus in Koreans using computed tomography of the lateral wall of the sinus, and to analyze the data according to demographic data, and to compare our results with previously published research. Methods: One hundred and three patients (males 51, females 52) who visited the dental clinic were evaluated. We investigated the canals with cone-beam computed tomography, and measured the diameter and length from the bony notch of the vascular canal at the lateral wall of the sinus to each of the reference planes. Results: Most types of vascular canal were type I & II (total 72.2%) which were driving through inside the sinus wall. Type IV, V were frequently investigated in 1st premolar and 2nd molar. Mean height; from anterior nasal spine-posterior nasal spine plane to vascular canal was 5.56 mm in 1st premolar, 2.11 mm in 2nd premolar, 0.98 mm in 1st molar, 4.32 mm in 2nd molar; from the basal layer of the sinus was 4.93 mm in 1st premolar, 5.00 mm in 2nd premolar, 6.05 mm in 1st molar, 7.91 mm in 2nd molar; and from alveolar crest, 20.80 mm in 1st premolar, 16.57 mm in 2nd premolar, 14.01 mm in 1st molar, 16.17 mm in 2nd molar. The mean height of the vascular canal of each reference plane showed no significant difference between sex, site (left or right) and age. The mean diameters of the canals were 1.76 mm in male, and 1.50 mm in female. Diameter decreased with age, and tooth site (from 1st premolar to 2nd molar). Conclusion: These results show that the mean diameter of the vascular canal of the maxillary sinus varies according to age, sex, and tooth site, but that the mean height of canal had no significant difference based on these three factors.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.553-559
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• 2008

Purpose: The lateral orbital wall fractures have been previously classified by some authors. As there are some limitations in applying in their own classifications, we hope to present a refined classification system of the lateral orbital wall fracture and to identify the correlation between the specific type of the fracture and clinical diagnosis. Methods: The facial bone CT scans and medical records of 78 patients with the lateral orbital wall fractures were reviewed in a retrospective manner. The classification is based on the CT scan. In type I, the fracture and its segments are away from the lateral rectus muscle and in type II, they are next to or slightly pushing the muscle in axial CT scan. In type III, the fracture segments compress and displace the longitudinal axis of the muscle or the optic nerve in axial view of CT scan. Type IV fracture includes multiple fractures found around the orbital apex or optic canal in coronal view of CT scans of the type I and type II fractures. Results: The most common fracture pattern was type I(43.6%), followed by type IV(29.5%), type II(20.5%), and type III(6.4%). As diplopia and restriction of extraocular muscles were found in type I and II fractures, severe ophthalmic complications such as superior orbital fissure syndrome, orbital apex syndrome, and traumatic optic neuropathy were found in type III and IV fractures almost exclusively. Conclusion: We propose an easy classification system of the lateral orbital wall fracture which correlates closely with ophthalmic complications and may help to make further treatment plan. In Type III and IV fractures, severe ophthalmic complications may ensue in higher rates, so early diagnosis and treatment should be performed.

• Restorative Dentistry and Endodontics
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• v.12 no.2
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• pp.111-116
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• 1987

The experimental study was made to evaluate the influence of retentive grooves on the canal wall upon the retention of post, using different type of cements. Ninety periodontally involved anterior teeth were extracted and divided into six groups of 15 teeth. The groups were labeled as follows: Group I: Dentatus post cemented zincphosphate cement into post hole with smooth wall. Group II: Dentatus post cemented with zincphosphate cement into post hole with retentive grooves. Group III: Dentatus post cemented with glass-ionomer cement into post hole with smooth wall. Group IV: Dentatus post cemented with glass-ionomer cement into post hole with retentive grooves. Group V: Dentatus post cemented with composite resin adhesive into post hole with smooth wall. Group VI: Dentatus post cemented with composite resin adhesive into post hole with retentive grooves. The tensile strength was tested by an Instron type tester with cross-head speed of 5mm per minute. The results were as follows: In the group without retentive grooves, three kinds of cement have little effect upon retentive capacity of Dentatus post. The Dentatus post cemented on the canal wall with retentive grooves is more retentive than Dentatus post without retentive grooves.

• Restorative Dentistry and Endodontics
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• v.25 no.3
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• pp.474-482
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• 2000

Currently frequency-dependent type electronic apex locators have been widely used to determine the working length in endodontic treatment. But, accuracy of electronic apex locators is controversial. The purpose of this study was to evaluate the accuracy of Root-ZX(Morita Co., Japan) at different kinds of conditions of root canals compared with the radiographic working length. The 40 extracted human anterior teeth with fully formed apices and without any caries were used. The radiographs were taken for working length with the 0.5mm short of #15 K-file tip just visible at the foramen under the surgical microscope(Carl Zeiss Co. Germany) at 25X. Then the electronic working lengths were determined with Root-ZX at the different kinds of conditions of root canals according to the presence of electrolyte and Crown-down pressureless technique. The results were as follows ; 1. There was no significant statistical difference in working length between radiograph and Root-ZX. 2. There was no significant statistical difference in electronic working length between the canal with electrolyte and without electrolyte. 3. There was no significant statistical difference in electronic working length between the canal without any instrumentation and after Crown-dow pressureless technique. 4. Of the total 40 root canals, 85% in Group I, 92.5% in Group II, 95% in Group III and 95% in Group IV using Root-ZX showed coincidence within 0.5mm accuracy compaing with the radiographic working length. The results showed that the Root-ZX can be use effectively for measuring the working length of root canal after instrumentation with Crown-down pressureless technique regardless of the presence of electrolyte in root canal.

• Restorative Dentistry and Endodontics
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• v.27 no.4
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• pp.421-431
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• 2002

C-shaped canal configuration is very difficult to treat because that clues about preoperative canal anatomy cannot be ascertained from clinical crown morphology and limited information can be derived from radiographic examination. This study was done to get more informations about the root and canal configuration of C-shape root by 3-dimensionally reconstructing for the purpose of enhancing success rate of endodontic treatment. 30 mandibular molars with C-shaped root were selected. Six photo images from occlusal, apical, mesial, distal, buccal, lingual directions and radiographic view were taken as preoperative ones to compare them with 3-D image. After crown reduction to the level of 1-2mm over pulpal floor was performed, teeth were stored in 5.25% sodium hypochlorite solution for the removal of pulp tissue and debris. They were cleaned under running water, allowed to bench dry and embedded in a self-curing resin. This resin block was serially ground with a microtome (Accutom-50, Struers, Denmark) and the image of each level was recorded by digital camera (FinePix S1-pro, Fuji Co., Japan). The thickness of each section was 0.25mm. Photographs of serial sections through all root canal were digitized using Adobe Photoshop 5.0 and then minimum thickness of open and closed sites were measured (open site is the surface containing occluso-apical groove closed site is oppsite). After dizitization using 3-D Doctor (Able software Corp, USA). 3D reconstruction of the outer surface of tooth and the inner surface of pulp space was made. Canal classsification of C-shaped roots was performed from this 3-D reconstructed image. The results were as follows : 1. Most C-shape rooted teeth showed lingual groove (28/30). 2 According to Vertuccis' calssification, type I, II, III, IV, VII were observed. but also new canal types suck as 2-3-2, 1-2-3-2. 2-3-2-1, 2-3-2-3 were shown. 3 There was little difference in minimum thickness on coronal and apical portions, but open site were thinner than closed site on mid portion. Conclusively, 3D reconstruction method could make the exact configurations of C-shape root possible to be visualized and analyzed from multi-directions. Data from minimum thickness recommend cleaning and shaping be more carefully done on dangerous mid portion.