• Restorative Dentistry and Endodontics
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• 제35권1호
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• pp.1-4
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• 2010

감염근관에서의 주치근단 파일의 크기는 학자들마다 많은 논란이 되고 있지만 최근 여러 연구 결과들은 감염근관의 효과적인 세정을 위해서는 근단부 확대 크기가 증가해야 함을 보여주고 있다. 따라서 임상가는 감염근관의 치료 시 새로운 개념에 맞는 치료 전략을 가지고 근관치료에 임해야 한다.

• Restorative Dentistry and Endodontics
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• 제28권1호
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• pp.64-71
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• 2003

The purpose of this study was to compare the initial apical file(IAF) first Ole that fits to the apex in each canal before and after early flaring to analyze if the size of file to fit to the apex would increase after flaring. Eighty anterior teeth with complete apical formation and patent foramens were selected. The samples were randomly divided into 4 groups(GG, OS, GT, PT Group) of 20 teeth each. A file was fit to the apex in each canal and that size recorded. Radicular flaring were completed using different types of instruments. After flaring a file was again fit to the apex in the same manner as before and its size recorded. The results of this study were as follows : 1. The mean diameter of IAF before flaring(file diameters in $mm{\times}10^{-2}$) was $19.81{\pm}8.32$ before and $25.94{\pm}9.21$ after(p<0.05). 2. The increase in diameter of IAF was approximately one file size for all groups. 3. Ranking of increasing diameter of IAF were GG>CT>OS>PT group. There was a statistically significant difference between before and after flaring(p<0.05). 4 Ranking of the time for flaring were GG>GT>OS>PT group. There was a statistically significant difference between GG group and other groups(p<0.05). 5. In the case without change of IAF diameter, they showed decrease in force after flaring when IAF was pulled out from root canal(p<0.05). This study suggested that early radicular flaring increases the file size that is snug at the apex, and awareness of that difference gives the clinician a better sense of canal size. Early flaring of the canal provides better apical size information and with this awareness, a better decision can be made concerning the appropriate final diameter needed for complete apical shaping.

• Restorative Dentistry and Endodontics
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• 제46권3호
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• pp.43.1-43.9
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• 2021

Objectives: This study aimed to evaluate the detection rate of apical radiolucencies in 2-dimensional images using cone-beam computed tomography (CBCT) as the reference standard, and to determine which factors related to the apical radiolucencies and the teeth could influence its detection. Materials and Methods: The sample consisted of exams of patients who had panoramic (PAN) and/or periapical (PERI) radiography and CBCT. The exams were assessed by 2 oral radiologists and divided into PAN+CBCT (227 teeth-285 roots) and PERI+CBCT (94 teeth-115 roots). Radiographic images were evaluated for the presence of apical radiolucency, while CBCT images were assessed for presence, size, location, and involvement of the cortical bone (thinning, expansion, and destruction). Diagnostic values were obtained for PERI and PAN. Results: PERI and PAN presented high accuracy (0.83 and 0.77, respectively) and specificity (0.89 and 0.91, respectively), but low sensitivity, especially for PAN (0.40 vs. 0.65 of PERI). The size of the apical radiolucency was positively correlated with its detection in PERI and PAN (p < 0.001). For PAN, apical radiolucencies were 3.93 times more frequently detected when related to single-rooted teeth (p = 0.038). The other factors did not influence apical radiolucency detection (p > 0.05). Conclusions: PERI presents slightly better accuracy than PAN for the detection of apical radiolucency. The size is the only factor related to radiolucency that influences its detection, for both radiographic exams. For PAN, apical radiolucency is most often detected in single-rooted teeth.

• Restorative Dentistry and Endodontics
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• 제14권2호
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• pp.99-102
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• 1989

Thirty mandibular first molars were fixed, decalcified, washed and embedded in paraffin to observe the root canal size and morphology at apical 5mm area. The results were as follows 1. The 55% of mesial canals were single-canaled at apical 5mm area, but 95% of distal canals were single-canaled. 2. The morphology of canal at apical 5mm area were varied, most of them were round or ovoid and 8-shaped. 8-shapes of them were long, slender or long, thick. 3. The size of mesial canal was $1.8{\pm}0.2$, $0.6{\pm}0.1mm$, but that of distal canal was $1.0{\pm}0.2$, $0.6{\pm}0.1mm$ each.

• Restorative Dentistry and Endodontics
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• 제33권5호
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• pp.435-442
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• 2008

제2형의 근관형태를 갖는 치아에서 각각의 근관을 모두 근관장까지 확대한 경우, 여러 확대기구에 따른 최종근관장파일의 크기를 상호 비교하여 얼마나 많은 변화가 있었는지를 분석하고자 치근 우식이 없고 치근단공 형성이 완료되었으며 2개의 근관 입구에서 시작하여 하나의 치근단공을 갖는 제 2형의 근관형태를 보이는 상악 소구치, 상악 대구치의 근심협측 치근 및 하악 대구치의 근심 치근을 선택하여 확대기구에 따라 KF군, PT군, HS군, K3군으로 분류하고 치경부 조기 확대를 시행하였다. 초기근관장파일이 15번 크기인 치아를 각 군당 20개씩 무작위로 선택하였고, 모든 근관을 각 군에 해당되는 30번 크기의 파일까지 제조회사의 지시에 따라 확대를 시행한 후, 촉감과 universal testing machine을 이용하여 최종근관장파일의 크기를 결정하였다. 각 군의 최종근관장파일의 크기와 제거 시 요구되는 힘의 크기에 대한 유의성 검증은 one-way ANOVA를 이용하여 비교 분석하였으며, 사후검정은 Tukey HSD test를 이용하여 0.05의 유의수준에서 분석하였다. 본 연구의 결과 제2형의 근관형태를 갖는 치아의 근관확대 시, 모든 근관을 각각의 근관장으로 확대하는 방법은 확대에 마지막으로 이용된 기구의 크기보다 한, 두 단계 정도 증가된 최종근관장파일을 나타냈다. 그러므로 제2형 근관형태를 나타내는 치아의 근관치료 시 임상가들은 근관충전에 앞서 치근단 받침을 다시 확인하고 형성하는 과정이 필요하리라 사료된다.

• Restorative Dentistry and Endodontics
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• 제27권1호
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• pp.66-76
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• 2002

The purpose of this study is to evaluate the effectiveness of customized master cone on apical sealing in various apical size of prepared root canals, that is MAF(Master Apical File) and to know at which apical size the apical leakage is to be significantly reduced using customized master cone. 120 extracted single rooted premolars were divided into four groups according to their apical size(MAF), #30, 40, 50 and 60. And then, each group was subdivided into three in accordance with three obturation methods, lateral condensation with standardized master cone, lateral condensation with chloroform-dipped customized master cone, and continuous wave of obturation technique. Resorcinol-formaldehyde resin was used for the microleakage test of this study. Teeth were sectioned horizontally at 1.5mm(Level 1), 2.5mm(Level 2), and 3.5mm(Level 3) from the anatomical root apex using low speed microtome. All sections were examined under $\times$40 magnification with a stereomicroscope, photographed, and then scanned. With the scanned images, resin-infiltrated area presenting the microleakage was calculated using SigmaScan/Image, and the ratio of leakage to the total root canal area of each group was analyzed statistically(one way ANOVA). The results were as follows ; 1. In groups of MAF #30, there was no significant difference of mean leakage ratio among three obturation methods at all three levels. 2. In groups of MAF #40, the group using lateral condensation with customized master cone had the low-est mean leakage ratio at all three levels, but there was no significant difference among three obturation techniques. 3. In groups of MAF #50, the mean leakage ratio of the group using lateral condensation with standard master cone was the highest among those of three obturation techniques at level 1, and this difference was statistically significant(p<0.05). 4 In groups of MAF #60, the groups using lateral condensation with standard master cone had also the highest mean leakage ratio at all levels, but there was no significant difference at level 1 and 2. At level 3, the leakage of the group using lateral condensation with standard master cone was significantly higher than that of the group using continuous wave of obturation(p<0.05). The results of this study suggested that the obturation method using customized master cone or the continuous wave of obturation is more effective for apical sealing than that using standardized master cone when MAF is larger than ＃50.

• Restorative Dentistry and Endodontics
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• 제25권3호
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• pp.390-398
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• 2000

근관형성을 위해 표준화된 근관형성기구에 비해 taper가 큰 기구들이 사용되고 있으며 이를 이용하여 형성된 근관은 taper가 큰 근관의 모양을 갖는다. 근관충전방법에 있어 근관의 크기에 적합한 1차적 gutta-percha cone을 선택할 필요가 있다. 본 연구에서는 .04 및 .06 taper의 전동화일로 형성된 근관에 열연화충전법을 위해 가장 적합한 1차 cone을 선택하기 위한 지침 마련의 목적으로, 근단공의 크기와 근관의 taper에 따른 gutta-percha cone의 근단부 근관 내 적 합도를 평가하였다. ProFile$^{(R)}$ .04 taper와 .06 taper를 이용하여 Crown down 방법으로 60개의 모형근관을 형성하였다. 표준화 gutta-percha cone, Dia-Pro ISO-.04$^{TM}$ 및 .06 gutta-percha cone, MF, F, FM 및 M 크기의 비표준화 gutta-percha cone의 근관 내 적합도는 치근단 5mm의 근관면적에 대한 gutta-percha cone의 점유 면적비(%)로 하였다. .04 taper, 25번 크기의 근관에서는 F, MF 크기의 비표준화 cone이 표준화 cone과 Dia-Pro 180-.04$^{TM}$ 보다 우수한 근관적합도를 나타내었고(p<0.05), 30번 크기의 근관에서는 F, Dia-Pro ISO-.04$^{TM}$, FM 크기의 gutta-percha cone 모두 표준화 cone보다 우수한 근관적합도를 나타내었으나(p<0.05), 35번 크기의 근관에서는 모든 gutta-percha cone 사이에 유의한 차이를 나타내지 않았다(p>0.05) .06 taper, 25번 크기의 근관에서는 사용된 비표준화 cone 모두가 표준화 cone, Dia-Pro ISO-.06$^{TM}$ 보다 나은 근관적합도를 나타내었고(P<0.05), 30번 크기의 근관에서는 표준화 cone을 제외한 나머지 gutta-percha cone에서 유의한 차이를 발견할 수 없었다. 35번 크기의 근관에는 M 크기의 비표준화 cone이 가장 우수한 근관적합도를 보이고 있는 것으로 나타났으며, FM과 Dia-Pro ISO-.06$^{TM}$ 사이에서는 유의한 차이가 나타나지 않았다(p>0.05).

• Restorative Dentistry and Endodontics
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• 제42권4호
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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.

• Restorative Dentistry and Endodontics
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• 제43권3호
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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.

• ALGAE
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• 제21권3호
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• pp.323-332
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• 2006

Mitochondrial distribution and abundance were assessed during the growth of apical and subapical cells in the red algae Colaconema caespitosum (J. Agardh) Jackelman, Stegenga and Bolton and Antithamnion cruciatum (C. Agardh) Nägeli after staining with 3,3’-dihexyloxacarbocyanine iodide [DiOC6(3)] and 2,4’-dimethylaminostyryl-Nethylpyridinium iodide (DASPEI). In fully elongate apical cells of C. caespitosum there were 100-120 mitochondria. During apical cell enlargement and division there is a doubling and then halving of the mitochondrial numbers. Apical cells prior to cytokinesis in young filaments are smaller than in mature filaments (ca. 50 and 100 μm long, respectively) and have fewer mitochondria (ca. 100 and 120 mitochondria per cell, respectively). In older vegetative cells mitochondria tend to aggregate at opposite ends of the cells with some mitochondria associated with the central nucleus or at points of apparent branch initiation. There is a greater density of mitochondria in apical cells of smaller versus larger plants (one mitochondrion per 6.3 μm3 and 9.8 μm3, respectively), suggesting that apical cells of younger plants may be more metabolically active. Male and female gametophytic thalli of Antithamnion cruciatum had similar numbers of mitochondria in apical cells of indeterminate axes, as did gametophytic and sporophytic thalli. There were about 40-50 mitochondria in fully elongated apical cells with about half this number in newly divided apical and subapical cells. Apical cells of determinate branches had more mitochondria (60-77) than indeterminate branches (60-70 vs. 40-50). In both species and in all cell types mitochondrial numbers were highly correlated with cell size.