The purpose of this study was to compare the effects of various techniques on the quality and quantity of instrumentation in curved canals. Instrumentation time was evaluated too. Forty eight canals of resin blocks($35^{\circ}$) were divided into three groups and filed. In group A, 16 blocks were instrumented using a step-back technique with stainless steel(SS) K-file(Mani, Matsutani Seisakusho Co.,Japan). In group B, canals were prepared with SS K-files using the Endo-Angle (Nakanishi Dental MFG.CO.,LTD.,Japan). Group C was prepared using N i-Ti engine-driven instruments (Quantec Series $2000^{TM}$ system). Group A and B were filed from # 5 to # 25 at the apex followed by a 1 mm stepback technique, and the coronal half of the canals were flared with Gates Glidden burs(#2,3,4). Group C was instrumented from # 1 to # 8. After the instrumentation time was measured, canals were filled with India ink, and photographed, which to magnify the canal images 8 times. Using these photographs the apical portions were evaluated And scored from 1 to 4 according to the severity of ledging and zipping. On the same photographs, the area of the coronal two thirds of the canals were measured using a personal computer with the computer program Brain and Digitizer (SummaSketch III). The following results were obtained. 1. Instrumentation time was significantly shorter for group C, as opposed to group A and B(ANOVA, P<0.05). 2. The qualitative evaluation of the apical portions of the canals showed no significant difference between the groups(Kruscal-Wallis, p>0.05). 3. The area removed by group C was significantly smaller than group A and B(ANOVA, P<0.05).
Objectives: Molecular mechanism of the pathogenicity of Enterococcus faecalis (E. faecalis), a suspected endodontic pathogen, has not yet been adequately elucidated due to limited information on its virulence factors. Here we report the identification of in vivo expressed antigens of E. faecalis by using a novel immunoscreening technique called change-mediated antigen technology (CMAT) and an experimental animal model of endodontic infection. Materials and Methods: Among 4,500 E. coli recombinant clones screened, 19 positive clones reacted reproducibly with hyperimmune sera obtained from rabbits immunized with E. faecalis cells isolated from an experimental endodontic infection. DNA sequences from 16 of these in vivo-induced (IVI) genes were determined. Results: Identified protein antigens of E. faecalis included enzymes involved in housekeeping functions, copper resistance protein, putative outer membrane proteins, and proteins of unknown function. Conclusions: In vivo expressed antigens of E. faecalis could be identified by using a novel immune-screening technique CMAT and an experimental animal model of endodontic infection. Detailed analysis of these IVI genes will lead to a better understanding of the molecular mechanisms involved in the endodontic infection of E. faecalis.
Objectives: To evaluate sealing ability of root canals obturated with bioceramic-impregnated gutta percha cone (BCC) or gutta percha (GP), with bioceramic sealer (BCS) or AH Plus (AH; Dentsply-Maillefer), in roundly-prepared canals using matched single-cone technique, based on bacterial leakage test, and to analyze obturation quality using micro-computed tomography (CT) analysis. Materials and Methods: Ninety-two distobuccal roots of maxillary molars were prepared using nickel-titanium files to apical size 40/0.06. The roots were divided into 4 groups (n = 20) that were obturated with a master cone and sealer: GP/AH, BCC/AH, GP/BCS, and BCC/BCS. Bacterial leakage model using Enterococcus faecalis was used to evaluate sealing ability for 60-day period. Obturated samples from each group (n = 4) were analyzed using micro-CT. Results: All groups showed bacterial leakage at 20%-45% of samples with mean leakage times of 42-52 days. There were no significant differences in bacterial leakage among the groups. Micro-CT showed minimal gaps and voids in all groups at less than 1%. Conclusions: In roundly-prepared canals, the single cone obturation with BCC/BCS was comparable to GP/AH for bacterial leakage at 60 days.
Purpose: In the anterior maxilla, hard and soft tissue augmentations are sometimes required to meet esthetic and functional demands. In such cases, primary soft tissue closure after bone grafting procedures is indispensable for a successful outcome. This report describes a simple method for soft tissue coverage of a guided bone regeneration (GBR) site using the double-rotated palatal subepithelial connective tissue graft (RPSCTG) technique for a maxillary anterior defect. Methods: We present a 60-year-old man with a defect in the anterior maxilla requiring hard and soft tissue augmentations. The bone graft materials were filled above the alveolar defect and a titanium-reinforced nonresorbable membrane was placed to cover the graft materials. We used the RPSCTG technique to achieve primary soft tissue closure over the graft materials and the barrier membrane. Additional soft tissue augmentation using a contralateral RPSCTG and membrane removal were simultaneously performed 7 weeks after the stage 1 surgery to establish more abundant soft tissue architecture. Results: Flap necrosis occurred after the stage 1 surgery. Signs of infection or suppuration were not observed in the donor or recipient sites after the stage 2 surgery. These procedures enhanced the alveolar ridge volume, increased the amount of keratinized tissue, and improved the esthetic profile for restorative treatment. Conclusions: The use of RPSCTG could assist the soft tissue closure of the GBR sites because it provides sufficient soft tissue thickness, an ample vascular supply, protection of anatomical structures, and patient comfort. The treatment outcome was acceptable, despite membrane exposure, and the RPSCTG allowed for vitalization and harmonization with the recipient tissue.
Kim, Jong-Min;Choi, Hyung-Jun;Lee, Jae-Ho;Choi, Byung-Jae
Journal of the korean academy of Pediatric Dentistry
/
v.24
no.4
/
pp.781-787
/
1997
In spite of the improvements of the techniques in the field of preventive dentistry, many children still present with extensive destruction of primary anterior teeth. Not only the practioner must consider the pulp state of the primary incisor, but also restore the form, function and esthetics of the tooth. Restorative treatment of primary incisor tooth requires durability, retention and esthetics. Stainless steel crowns used in restoring primary anterior teeth is retentive and durable in comparison with the composite resin, celluloid crown. But they are not esthetic. To enhance the esthetics of the anterior stainless steel crown without reducing its superior retention, an open-face stainless steel crown has been suggested. Several authors have suggested cutting away the labial portion of the stainless steel crown and placing the composite resin in that area. By following this technique, the practioner can prepare a retentive, durable, and esthetic restoration for primary teeth which have suffered from extensive loss of teeth structure. In addition, the single missing primary anterior teeth can be successfully restored by soldering the stainless steel crown together. Open-face stainless steel crown is indicated in the areas of large interproximal lesions involving incisal edge, crown fracture with pulp exposure and congenital malformation of the teeth. By this technique, the practioner can restore primary anterior teeth successfully regardless of the amount of remaining tooth structure, bruxism habit and presence of attrition. In this case, rampant caries with extensive loss of tooth structure and single missing of primary anterior tooth hart been successfully treated with open-face stainless steel crown.
Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment.
Kim, Jong Cheon;Moe, Maung Maung Kyaw;Kim, Sung Kyo
Restorative Dentistry and Endodontics
/
v.45
no.2
/
pp.18.1-18.9
/
2020
Objectives: The purpose of this study was to evaluate the void of root canal filling over time when a calcium silicate sealer was used in the single gutta-percha cone technique. Materials and Methods: Twenty-four J-shaped simulated root canals and twenty-four palatal root canals from extracted human maxillary molars were instrumented with ProFile Ni-Ti rotary instruments up to size 35/0.06 or size 40/0.06, respectively. Half of the canals were filled with Endoseal MTA and the other half were with AH Plus Jet using the single gutta-percha cone technique. Immediately after and 4 weeks after the root canal filling, the samples were scanned using micro-computed tomography at a resolution of 12.8 ㎛. The scanned images were reconstructed using the NRecon software and the void percentages were calculated using the CTan software, and statistically analyzed by 1-way analysis of variance, paired t-test and Tukey post hoc test. Results: After 4 weeks, there were no significant changes in the void percentages at all levels in both material groups (p > 0.05), except at the apical level of the AH Plus Jet group (p < 0.05) in the simulated root canal showing more void percentage compared to other groups. Immediately after filling the extracted human root canals, the Endoseal MTA group showed significantly less void percentage compared to the AH Plus Jet group (p < 0.05). Conclusions: Under the limitations of this study, the Endoseal MTA does not seem to reduce the voids over time.
Solomonov, Michael;Kim, Hyeon-Cheol;Hadad, Avi;Levy, Dan Henry;Itzhak, Joe Ben;Levinson, Oleg;Azizi, Hadas
Restorative Dentistry and Endodontics
/
v.45
no.2
/
pp.21.1-21.12
/
2020
The aim of this article was to review age-dependent clinical recommendations for appropriate root canal instrumentation techniques. A comprehensive narrative review of canal morphology, the structural characteristics of dentin, and endodontic outcomes at different ages was undertaken instead of a systematic review. An electronic literature search was carried out, including the Medline (Ovid), PubMed, and Web of Science databases. The searches used controlled vocabulary and free-text terms, as follows: 'age-related root canal treatment,' 'age-related instrumentation,' 'age-related chemo-mechanical preparation,' 'age-related endodontic clinical recommendations,' 'root canal instrumentation at different ages,' 'geriatric root canal treatment,' and 'pediatric root canal treatment.' Due to the lack of literature with practical age-based clinical recommendations for an appropriate root canal instrumentation technique, a narrative review was conducted to suggest a clinical algorithm for choosing the most appropriate instrumentation technique during root canal treatment. Based on the evidence found through the narrative review, an age-related clinical algorithm for choosing appropriate instrumentation during root canal treatment was proposed. Age affects the morphology of the root canal system and the structural characteristics of dentin. The clinician's awareness of root canal morphology and dentin characteristics can influence the choice of instruments for root canal treatment.
The aim of this study was to compare shaping ability of nickel-titanium rotary files with different taper in simulated resin canals. The instruments used in this study were GT with .04 taper ProFile with ISO-sized tip, .04 taper ProFile with ISO-sized tip alone, and .02 taper Naviflex file and all canals were prepared by crown-down technique. A total of 30 composite images were made from pre- and post-canal scanned images using Scanjet 4C scanner and Corel photopaint 8.0 and then, prevalence of canal aberrations was measured. The amount of coronal substance the instruments removed was also calculated two-dimensionally on digitized images with the Brain C software to compare the relative enlarging efficiency. Finally, the prepared internal canal form was evaluated three-dimensionally with impression technique. The results were as follows; 1. The incidence of zipping in Naviflex group was significantly high compared to the other two groups(P<.05). 2. The amount of coronal substance the GT combined group removed was significantly larger than the other two groups(P<.05). 3. The GT combined group produced canals with good taper and flow. Under the conditionas of this study, the combined use of larger tapered nickel-titanium rotary files prepared simulated canals safely, efficiently and with good three-dimensional form.
The purpose of this study was to evaluate the microleakage of class II composite resin inlays and compare them with the conventional light-cured resin filling restorations. Class II cavities were prepared in 60 extracted human molars with which cervical margins were located below 1.0mm at the cemento-enamel junction using No. 701 tapered fissure carbide bur. All of the prepared cavities were restored as follows and divided into 6 groups. Group I and 2 were restored using direct filling technique and group 3,4,5 and 6 were restored using direct inlay technique that was cemented with dual-cured resin cements. group I: Cavities were restored with light-curing composite resin, Brilliant Lux. group 2. Cavities were restored with light-curing composite resin, Clearfil PhotoPosterior. group 3: Cavities were restored with Clearfil CR Inlay and heat treated at $125^{\circ}C$ for 7 minutes. group 4: Cavities were restored with same material as group 3 and heat treated at $100^{\circ}C$ for 15 minutes. group 5: Cavities were restored with Brilliant (Indirect esthetic system) and heat treated at $125^{\circ}C$ for 7 minutes. group 6: Cavities were restored with same material as group 5 and heat treated at $100^{\circ}C$ for 15 minutes. All specimens were polished with same method and thermocycled between $6^{\circ}C$ and $60^{\circ}C$, then immersed in a bath of 2.0% aqueous solution of basic fuchsin dye for 24 hours. Dyed specimens were sectioned longitudinally and dye penetration degree was read on a scale of 0 to 4 by Tani and Buonocore's method 45). The results were as follows: 1. Microleakage was observed rather at the cervical margins than at the occlusal margins in all groups. 2. Composite resin inlay groups showed significantly less leakage than direct filling groups at the cervical margins (p < 0.001). 3. In composite resin inlay groups, there was no significant difference in microleakage between specimens by heat treating temperature and time (p > 0.05). 4. There was no significant difference in leakage between each groups at the occlusal margins (p > 0.05).
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