• Journal of the korean academy of Pediatric Dentistry
• /
• v.51 no.2
• /
• pp.140-148
• /
• 2024

This study aimed to enhance the physicochemical properties of sodium iodide-based root filling materials, particularly solubility. In earlier developmental stages, the iodoform-containing paste exhibited high antibacterial efficacy but failed to meet only the solubility requirement among the ISO 6876 criteria. Therefore, this study focused on enhancing the physicochemical properties of the paste under development, particularly centering on reducing its solubility. Four experimental groups were established, including three control group. The previously developed D30 paste was named the Oil 33 group, and the control group was named the Vitapex^® group. The Oil 50 group, in which the oil content was increased, and the Oil 45L group, in which lanolin was incorporated. The physical properties (solubility, pH, flowability, and film thickness) of the four pastes were evaluated according to the ISO 6876 standards. No significant differences were observed between the Oil 45L and Vitapex^® groups in any of the physical property evaluations. While the Oil 33 and Oil 50 groups met the ISO 6876 standards for flowability and film thickness, the Oil 45L group met all the physical properties. However, reducing the overall oil content may be necessary to enhance the antimicrobial properties. The result of the physicochemical experiments showed that the Oil 45L group with the newly formulated composition and incorporated lanolin exhibited low solubility meeting the ISO 6876 standard of ≤ 3%. We were able to develop a paste with more stable solubility than previous iodide-based root-filling materials. Therefore, the oil content must be further adjusted to improve its antimicrobial properties. If other physical properties also meet the ISO 6876 standards and demonstrate excellent results in cytotoxicity tests, this root filling material could potentially replace existing options.

• Restorative Dentistry and Endodontics
• /
• v.44 no.4
• /
• pp.39.1-39.8
• /
• 2019

The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.

• Restorative Dentistry and Endodontics
• /
• v.43 no.2
• /
• pp.16.1-16.9
• /
• 2018

Objectives: Understanding the reason for an unsuccessful non-surgical endodontic treatment outcome, as well as the complex anatomy of the root canal system, is very important. This study examined the cross-sectional root canal structure of mandibular first molars confirmed to have failed non-surgical root canal treatment using digital images obtained during intentional replantation surgery, as well as the causative factors of the failed conventional endodontic treatments. Materials and Methods: This study evaluated 115 mandibular first molars. Digital photographic images of the resected surface were taken at the apical 3 mm level and examined. The discolored dentin area around the root canal was investigated by measuring the total surface area, the treated areas as determined by the endodontic filling material, and the discolored dentin area. Results: Forty 2-rooted teeth showed discolored root dentin in both the mesial and distal roots. Compared to the original filled area, significant expansion of root dentin discoloration was observed. Moreover, the mesial roots were significantly more discolored than the distal roots. Of the 115 molars, 92 had 2 roots. Among the mesial roots of the 2-rooted teeth, 95.7% of the roots had 2 canals and 79.4% had partial/complete isthmuses and/or accessory canals. Conclusions: Dentin discoloration that was not visible on periapical radiographs and cone-beam computed tomography was frequently found in mandibular first molars that failed endodontic treatment. The complex anatomy of the mesial roots of the mandibular first molars is another reason for the failure of conventional endodontic treatment.

• Restorative Dentistry and Endodontics
• /
• v.23 no.1
• /
• pp.379-390
• /
• 1998

In endodontic treatment, calcium hydroxide has been used as intracanal medicament. Although calcium hydroxide should be removed thoroughly before permanent root canal filling, no effective method for its removal has been reported. Because of irregularity of root canal walls, root curvatures and anatomic variations, it is insufficient to remove calcium hydroxide from the canal wall only by mechanical instrumentation Considering the chemical effects of irrigants on calcium hydroxide, $Ca^{++}$ dissolving effect from two calcium hydroxide products is investigated, using dis- tilled water, NaOCl, citric acid and EDTA. Vitapex$^{(R)}$ 0.1g and calcium hydroxide 0.03g were dissolved in distilled water, 5% NaOCl, 50% citric acid and 17% EDTA respectively, at 1, 3, 5, 10min. time interval. The solution was filtered using filter paper(pore size $5{\mu}m$) and $Ca^{++}$ concentration was determined by ion chromatography. The result were as follows : 1. Distilled water, NaOCl, citric acid and EDTA abstracted more $Ca^{++}$ from calcium hydroxide than Vitapex$^{(R)}$ except NaOCl 1, 5, 10 time interval. 2. EDTA and citric acid abstracted more $Ca^{++}$ from Vitapex$^{(R)}$ and calcium hydroxide than distilled water or NaOCl. The overall result support the view that water-based calcium hydroxide product is easily removed than oil-based calcium hydroxide product and EDTA, citric acid are more effective in $Ca^{++}$ elution than NaOCl or distilled water.

• Journal of dental hygiene science
• /
• v.21 no.4
• /
• pp.243-250
• /
• 2021

Background: Endodontic sealers or their toxic components may become inflamed and lead to delayed wound healing when in direct contact with periapical tissues over an extended period. Moreover, an overfilled sealer can directly interact with adjacent tissues and may cause immediate necrosis or further resorption. Therefore, the treatment outcome conceivably depends on the endodontic sealer's biocompatibility and osteogenic potential. This study aimed to evaluate the cell viability and osteogenic effects of four different sealers in osteoblastic cells. Methods: AH Plus (resin-based sealer), Pulp Canal Sealer EWT (zinc oxide-eugenol sealer), BioRoot RCS (calcium silicate-based sealer), and Well-Root ST (MTA-based calcium silicate sealer) were mixed strictly according to the manufacturer's instructions, and dilutions of sealer extracts (1/2, 1/5 and 1/10) were determined. Cell viability was measured using the water-soluble tetrazolium-8 (WST-8) assay. Differentiation was assessed by alkaline phosphatase (ALP) activity and mineralized nodule formation by Alizarin Red S staining. Results: The cell viability of the extracts derived from the sealers excluding Well-Root ST was concentration dependent, with sealer extracts having the least viability at a 1/2 dilution. At sealer extract dilution of 1/10, the test groups showed the same survival rate as that control group, with the exception of BioRoot RCS. Among all experimental groups, BioRoot RCS showed the highest cell viability after 48 hours. The ALP activity was significantly higher in a concentration-dependent manner. Furthemore, all four materials promoted ALP activity and mineralized nodule formation compared to the control at 1/10 dilutions. Conclusion: This is the first study to highlight the differences in biological activity of these four materials. These results suggest that the composition of root canal sealers appears to alter the form of biocompatibility and osteoblastic differentiation.

• Restorative Dentistry and Endodontics
• /
• v.20 no.2
• /
• pp.812-817
• /
• 1995

Endodontically treated teeth are usually restored for crown protection, aesthetics, and prevention of root canal recontamination. Restoration of these teeth, however, often requires intracanal posts. Various depths and techniques have been recommended for the preparation of post space. Therefore the purpose of this study was to evaluate the effect that pst preparation has on the coronal seal by linear dye penetration of root canals obturated by lateral condensation, vertical condensation, and thermafil techniques. Forty canals of roots of incisors and canines were cleaned and shaped with the use of a step-back technique. Thirty canals were obturated, 10 each with lateral, vertical, and thermafil techhniques. Five root canals were obturated without a root canal sealer and served as positive controls. Another five root canals were obturated, and their coronal half was sealed with sticky wax and served as negative controls. The apical 5 to 6mm of the filling materials were exposed to india ink for 48 hours. The depth of dye penetration was measured in all groups and statistically analyzed (ANOVA). The results were as follows. 1. The apical plugs in the thermafil groups had the highest degree of coronal dye leakage. 2. The group filled by vertical condensation technique had the lowest degree of coronal dye leakage. 3. No significant statistical difference was found in the amount of coronal dye leakage in canals filled by lateral condensation versus those filled by the veritcal condensation technique. 4. Significant statistical differences in coronal dye penetration were found between the canals filled by thermafil and those filled by the lateral or vertical condensation techniques (p<0.05).

• Restorative Dentistry and Endodontics
• /
• v.19 no.1
• /
• pp.205-216
• /
• 1994

The purpose of this study is to evaluate of apical plug materials for the contral of extrusion and sealing ability of high-temperature thermoplasticized gutta-percha in plastic root canal blocks. Seventy seven plastic blocks with canal preformed were instrumented with # 50K file 1 mm beyond apical foramen. Blocks were randomly divided into 5 groups of 15 blocks each. Group 1 was filled by high-temperature thermoplasticized gutta-percha only. The another 4 groups were placed with apical plug materials each other and then remaining space was back filled with high temperature thermoplasticized gutta-percha Apical plug materials were used as follows; Group 2: Thermoplasticized gutta-percha (Thermoplasticized gutta-percha group) Group 3 :. Calcium hydroxide powder (Calcium hydroxide group) Group 4 : Silver point (Silver point group) Group 5 : Gutta-percha cone softened by chloroform (Gutta-percha cone group) All the blocks were stored in 100 % relative humidor at room temperature for 14 days. Filling material extruded was removed carefully and then weighed in analytic balance. Each block was placed in centrifuge tube filled with India ink, and then centrifuged for 20 minutes at 3,000 rpm. Apical leakage was measured from the apical foramen to the most coronal level of dye leakage in millimeter by two examiners under a stereoscope. The data were analysed statistically by Student's t-test The obtained results were as follows; 1. The amounts of material extruded through the foramen decreased in all of groups used apical plug materials (P<0.01). 2. Silver point group and gutta-percha cone group were similar linear leakage to high-temperature thermoplasticised gutta-percha technique only (P>0..5). 3. Calcium hydroxide group and thermoplasticized gutta-percha group showed more liner leakage than high-temperature thermoplasticized gutta-percha only (P<0.01, P<0.05). 4. High-temperature thermoplasticized gutta-percha technique with silver point and gutta-percha cone as apical plugs showed less linear leakage and less extrusion of filling material.

• Restorative Dentistry and Endodontics
• /
• v.23 no.1
• /
• pp.163-174
• /
• 1998

The purpose of this study is to evaluate the distribution of stress in the root end resected teeth. The finite element method was used to compare stresses along the root and retrograde filling material in seven two-dimensional models of mandibular 2nd premolar. Each model was endodontic treatment and gold crown' restoration. Each model divided with amagam core restoration or gold casting post restoration. Thus each model divided with shape of root end resection, depth of retropreparation and exposure length of root in the bony cavity. The seven models were classified as in the table 1 below. A load of 500N was applied $45^{\circ}$ diagonally on the lingual slope of the buccal cusp. These mode were analyzed with two dimensional finite element methods. The results of this study were as follows : 1. The maximum tensile stress along the inner canal wall was shown on the model 7. 2. When the model 1 was compared with the model 5, the maximum tensile stress along the inner canal wall showed the model 1. 3. Less equivalent stress was shown on the model 6 and more equivalent stress was shown on the model 4. 4. More shear stress was shown on the retrograde filling material of the model 7. 5. The models with increased length of exposed root in the bony cavity demonstrated a gradual increase to the tensile stress in X direction which occurred approximately a boundary between the bone and exposed root in' the bony cavity. 6. The model which had a case of matching the apex of post and a boundary between the bone and exposed root in the bony cavity demonstrated more increase tensile stress in X direction than other models.

• Restorative Dentistry and Endodontics
• /
• v.48 no.2
• /
• pp.21.1-21.15
• /
• 2023

Objectives: This study evaluated the effects of Biodentine (BD), Bio-C Repair (BCR), and mineral trioxide aggregate (MTA) plug on the fracture resistance of simulated immature teeth with replacement root resorption (RRR) and in vitro-induced osteoclastogenesis. Materials and Methods: Sixty bovine incisors simulating immature teeth and RRR were divided into 5 groups: BD and BCR groups, with samples completely filled with the respective materials; MTA group, which utilized a 3-mm apical MTA plug; RRR group, which received no root canal filling; and normal periodontal ligament (PL) group, which had no RRR and no root canal filling. All the teeth underwent cycling loading, and compression strength testing was performed using a universal testing machine. RAW 264.7 macrophages were treated with 1:16 extracts of BD, BCR, and MTA containing receptor activator of nuclear factor-kappa B ligand (RANKL) for 5 days. RANKL-induced osteoclast differentiation was assessed by staining with tartrate-resistant acid phosphatase. The fracture load and osteoclast number were analyzed using 1-way ANOVA and Tukey's test (α = 0.05). Results: No significant difference in fracture resistance was observed among the groups (p > 0.05). All materials similarly inhibited osteoclastogenesis (p > 0.05), except for BCR, which led to a lower percentage of osteoclasts than did MTA (p < 0.0001). Conclusions: The treatment options for non-vital immature teeth with RRR did not strengthen the teeth and promoted a similar resistance to fractures in all cases. BD, MTA, and BCR showed inhibitory effects on osteoclast differentiation, with BCR yielding improved results compared to the other materials.

• Restorative Dentistry and Endodontics
• /
• v.48 no.1
• /
• pp.10.1-10.9
• /
• 2023

Objectives: This study compared the buckling resistance of 3 nickel-titanium (NiTi) retreatment file systems and the torque/force generated during retreatment. Materials and Methods: The buckling resistance was compared among the D-RaCe (DR2), HyFlex Remover, and Mtwo R25/05 retreatment systems. J-shaped canals within resin blocks were prepared with ProTaper NEXT X3 and obturated by the single-cone technique with AH Plus. After 4 weeks, 4 mm of gutta-percha in the coronal aspect was removed with Gates-Glidden drills. Retreatment was then performed using DR1 (size 30, 10% taper) followed by DR2 (size 25, 4% taper), HyFlex Remover (size 30, 7% taper), or Mtrwo R25/05 (size 25, 5% taper) (15 specimens in each group). Further apical preparation was performed with WaveOne Gold Primary. The clockwise torque and upward force generated during retreatment were recorded. After retreatment, resin blocks were examined using stereomicroscopy, and the percentage of residual filling material in the canal area was calculated. Data were analyzed using 1-way analysis of variance with the Tukey test. Results: The HyFlex Remover files exhibited the greatest buckling resistance (p < 0.05), followed by the Mtwo R25/05. The HyFlex Remover and Mtwo R25/05 files generated the highest maximum clockwise torque and upward force, respectively (p < 0.05). The DR1 and DR2 files generated the least upward force and torque (p < 0.05). The percentage of residual filling material after retreatment was not significantly different between file systems (p > 0.05). Conclusions: NiTi retreatment instruments with higher buckling resistance generated greater clockwise torque and upward force.