• Restorative Dentistry and Endodontics
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• v.43 no.4
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• pp.46.1-46.10
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• 2018

Objectives: This study was to evaluate the antibacterial effect of different instrumentation and irrigation techniques using confocal laser scanning microscopy (CLSM) after root canal inoculation with Enterococcus faecalis (E. faecalis). Materials and Methods: Mesiobuccal and mesiolingual canals of extracted mandibular molars were apically enlarged up to a size 25 hand K-file, then autoclaved and inoculated with E. faecalis. The samples were randomly divided into 4 main groups according to the system of instrumentation and irrigation: an XP-endo Shaper (XPS) combined with conventional irrigation (XPS/C) or an XP-endo Finisher (XPF) (XPS/XPF), and iRaCe combined with conventional irrigation (iRaCe/C) or combined with an XPF (iRaCe/XPF). A middle-third sample was taken from each group, and then the bacterial reduction was evaluated using CLSM at a depth of $50{\mu}m$ inside the dentinal tubules. The ratio of red fluorescence (dead cells) to green-and-red fluorescence (live and dead cells) represented the percentage of bacterial reduction. The data were then statistically analyzed using the Kruskal-Wallis test for comparisons across the groups and the Dunn test was used for pairwise comparisons. Results: The instrumentation and irrigation techniques had a significant effect on bacterial reduction (p < 0.05). The iRaCe/XPF group showed the strongest effect, followed by the XPS/XPF and XPS/C group, while the iRaCe/C group had the weakest effect. Conclusions: Combining iRaCe with XPF improved its bacterial reduction effect, while combining XPS with XPF did not yield a significant improvement in its ability to reduce bacteria at a depth of $50{\mu}m$ in the dentinal tubules.

• Restorative Dentistry and Endodontics
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• v.40 no.1
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• pp.44-49
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• 2015

Objectives: This study compared the ability of several techniques to remove calcium hydroxide (CH) from the root canal and determined the influence of CH residues on the accuracy of the electronic apex locator. Materials and Methods: Root canals of 90 human maxillary lateral incisors with confirmed true working length (TWL) were prepared and filled with CH. The teeth were randomly assigned to one of the experimental groups according to the CH removal technique (n = 14): 0.9% saline; 0.9% saline + master apical file (MAF); 17% ethylenediamine tetraacetic acid (EDTA); 17% EDTA + MAF; 5.25% sodium hypochlorite (NaOCl); 5.25% NaOCl + MAF. Six teeth were used as negative control. After CH removal, the electronic working length was measured using Root-ZX (Morita Corp.) and compared with TWL to evaluate Root-ZX accuracy. All specimens were sectioned longitudinally, and the area of remaining CH (CH) and total canal area were measured using imaging software. Results: The EDTA + MAF and NaOCl + MAF groups showed better CH removal than other groups (p < 0.05). Root-ZX reliability to prevent overestimated working length to be > 85% within a tolerance of ${\pm}1.0mm$ (p < 0.05). There was strong negative correlation between amount of CH residues and EAL accuracy (r = -0.800 for ${\pm}0.5mm$; r = -0.940 for ${\pm}1.0mm$). Conclusions: The mechanical instrumentation improves the CH removal of irrigation solutions although none of the techniques removed the dressing completely. Residues of CH medication in root canals affected the accuracy of Root-ZX adversely.

• Restorative Dentistry and Endodontics
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• v.39 no.2
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• pp.104-108
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• 2014

Objectives: To evaluate the effect of passive ultrasonic agitation on the cleaning capacity of a hybrid instrumentation technique. Materials and Methods: Twenty mandibular incisors with mesiodistal-flattened root shape had their crowns sectioned at 1 mm from the cementoenamel junction. Instrumentation was initiated by catheterization with K-type files (Denstply Maillefer) #10, #15, and #20 at 3 mm from the working length. Cervical preparation was performed with Largo bur #1 (Dentsply Maillefer) followed by apical instrumentation with K-type files #15, #20 and #25, and finishing with ProTaper F2 file (Denstply Maillefer). All files were used up to the working length under irrigation with 1 mL of 2.5% sodium hypochlorite (Biodyn$\hat{a}$mica) at each instrument change. At the end of instrumentation, the roots were randomly separated into 2 groups (n = 10). All specimens received final irrigation with 1 mL of 2.5% sodium hypochlorite. The solution remained in the root canals in Group 1 for one minute; and ultrasonic agitation was performed in Group 2 for one minute using a straight tip inserted at 1 mm from working length. The specimens were processed histologically and the sections were analyzed under optic microscope (x64) to quantify debris present in the root canal. Results: The samples submitted to ultrasonic agitation (Group 2) presented significant decrease in the amount of debris in comparison with those of Group 1 (p < 0.05). Conclusions: The hybrid instrumentation technique associated with passive ultrasonic agitation promoted greater debris removal in the apical third of the root canals.

• Restorative Dentistry and Endodontics
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• v.41 no.2
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• pp.114-120
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• 2016

Objectives: The aim of this study was to compare the push-out bond strength and dentinal tubule penetration of root canal sealers used with coated core materials and conventional gutta-percha. Materials and Methods: A total of 72 single-rooted human mandibular incisors were instrumented with NiTi rotary files with irrigation of 2.5% NaOCl. The smear layer was removed with 17% ethylenediaminetetraacetic acid (EDTA). Specimens were assigned into four groups according to the obturation system: Group 1, EndoRez (Ultradent Product Inc.); Group 2, Activ GP (Brasseler); Group 3, SmartSeal (DFRP Ltd. Villa Farm); Group 4, AH 26 (Dentsply de Trey)/gutta-percha (GP). For push-out bond strength measurement, two horizontal slices were obtained from each specimen (n = 20). To compare dentinal tubule penetration, remaining 32 roots assigned to 4 groups as above were obturated with 0.1% Rhodamine B labeled sealers. One horizontal slice was obtained from the middle third of each specimen (n = 8) and scanned under confocal laser scanning electron microscope. Tubule penetration area, depth, and percentage were measured. Kruskall-Wallis test was used for statistical analysis. Results: EndoRez showed significantly lower push-out bond strength than the others (p < 0.05). No significant difference was found amongst the groups in terms of percentage of sealer penetration. SmartSeal showed the least penetration than the others (p < 0.05). Conclusions: The bond strength and sealer penetration of resin-and glass ionomer-based sealers used with coated core was not superior to resin-based sealer used with conventional GP. Dentinal tubule penetration has limited effect on bond strength. The use of conventional GP with sealer seems to be sufficient in terms of push-out bond strength.

• Restorative Dentistry and Endodontics
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• v.46 no.1
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• pp.11.1-11.11
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• 2021

Objectives: The aim of this study was to compare smear layer removal by conventional application (CA), passive ultrasonic irrigation (PUI), EasyClean (EC), and XP-Endo Finisher (XPF), using 17% ethylenediaminetetraacetic acid (EDTA) after chemomechanical preparation, as evaluated with scanning electron microscopy (SEM). Materials and Methods: Forty-five single-rooted human mandibular premolars were selected for this study. After chemomechanical preparation, the teeth were randomly divided into 5 groups according to the protocol for smear layer removal, as follows: G1 (control): CA of distilled water; G2 (CA): CA of 17% EDTA; G3 (PUI): 17% EDTA activated by PUI; G4 (EC): 17% EDTA activated by EC; and G5 (XPF): 17% EDTA activated by XPF. SEM images (×1,000) were obtained from each root third and scored by 3 examiners. Data were evaluated using the Kruskal-Wallis and Dunn tests (p < 0.05). Results: In the apical third, there were no statistically significant differences among the groups (p > 0.05). In the cervical and middle thirds, the experimental groups performed better than the control group (p < 0.05); however, G2 presented better results than G3, G4, and G5 (p < 0.05), which showed no differences among one another (p > 0.05). Conclusions: No irrigation method was able to completely remove the smear layer, especially in the apical third. Using CA for the chelating solution performed better than any form of activation.

• Restorative Dentistry and Endodontics
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• v.39 no.2
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• pp.95-103
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• 2014

Objectives: This study evaluated the effect of three antioxidizing agents on pullout bond strengths of dentin treated with sodium hypochlorite. Materials and Methods: Root canals of 75 single-rooted human teeth were prepared. Fifteen teeth were irrigated with normal saline for a negative control group, and the remaining 60 teeth (groups 2 - 5) with 2.5% NaOCl. The teeth in group 2 served as a positive control. Prior to post cementation, the root canals in groups 3 - 5 were irrigated with three antioxidizing agents including 10% rosmarinic acid (RA, Baridge essence), 10% hesperidin (HPN, Sigma), and 10% sodium ascorbate hydrogel (SA, AppliChem). Seventy-five spreaders (#55, taper .02, Produits Dentaires S.A) were coated with silica and silanized with the Rocatec system and ceramic bond. All the prepared spreaders were cemented with a self-adhesive resin cement (Bifix SE, Voco Gmbh) in the prepared canals. After storage in distilled water (24 h/$37^{\circ}C$), the spreaders were pulled out in a universal testing machine at a crosshead speed of 1.0 mm/min. Pull-out strength values were analyzed by one-way ANOVA and Tukey's HSD test (${\alpha}$ = 0.05). Results: There were significant differences between study groups (p = 0.016). The highest pullout strength was related to the SA group. The lowest strength was obtained in the positive control group. Conclusions: Irrigation with NaOCl during canal preparation decreased bond strength of resin cement to root dentin. Amongst the antioxidants tested, SA had superior results in reversing the diminishing effect of NaOCl irrigation on the bond strength to root dentin.

• Restorative Dentistry and Endodontics
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• v.32 no.2
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• pp.121-129
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• 2007

The purpose of this study was to assess the antibacterial effect of sodium dichloroisocyanurate (NaDCC), sodium hypochlorite (NaOCl), and chlorhexidine (CHX) on Enterococcus faecalis and to evaluate and to compare the time-dependant antimicrobial effect of NaDCC with NaOCl and CHX in the root canal in vitro before and after instrumentation. Extracted Human single teeth were prepared by serial instrumentation technique. The samples were autoclaved and contaminated for 3 days with E. faecalis monocultures. The teeth were then divided into 4 groups Each group was irrigated and inserted with 2% NaOCl, 2% NaDCC, 2% CHX and steri)ized saline. After 6, 12, 24, 72h, and 1 week incubation, sterilized paper point was inserted into the root canal. Paper points containing root canal contents were then placed on the agar plate. And then each root cana) was prepared with #4 and #5 GG (Gates-Glidden) drill. The debris were collected in the sterilized microtube and the plates were incubated at $37^{\circ}C$ in an increased $CO_2$ atmosphere. After 24h incubation the growth of bacteria around the paper points were measured. NaOCl and NaDCC solution shows similar antimicrobial effect for E. faecalis at 6, 12, 24, 72h and 1 week. In centrol group, irrigated with sterilized saline, no antimicrobial effect was observed. The results are in agreement with other investigators, who have shown the bactericidal property and possibility of NaDCC as a root canal irrigation solution. Thus it seems that NaDCC solutions can be clinically applied into the root canal within 1 week after dilution.

• Restorative Dentistry and Endodontics
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• v.24 no.2
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• pp.399-407
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• 1999

Apical extrusion of canal debris is occurred inadvertently during root canal preparation and this could produce interappointment discomfort or postinstrumentation pain. The purpose of this study was to investigate the influence of canal preparation methods on the apical extrusion of canal debris by means of comparing the amounts of apically extruded debris with several kinds of instrumentation methods. In the first experiment, 40 incisors were divided into four groups of 10 each. They were instrumented using one of the four techniques: Step-back, crown-down pressureless technique with stainless steel K-files, engine-driven instrumentation with Quantec series 2000, and Profile .04 taper series 29. Root canal irrigation was done with 2.52% sodium hypochlorite solution. In the second experiment, 80 incisors were divided into five groups of 16 each and instrumented using step-back, crown-down pressureless technique with stainless steel K-files, engine-driven instrumentation such as Quantec SC, Quantec LX, and Profile .04 taper series 29 No irrigation procedure was performed in this second experiment. Extruded debris from each tooth was collected in a container and weighed by the use of an electronic balance after desiccation. With or without canal irrigation, step-back technique produced significantly more amount of apical debris than the other groups (p<0.05). However, there was no significant difference among crown-down pressureless technique, engine-driven instrumentation with Quantec LX, Quantec SC, or Profile. Therefore, either by hand or engine-driven instrumentation, it is concluded that to minimize apical debris, techniques using reaming motion of files should be applied rather than filing motion.

• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.27.1-27.12
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• 2019

This case report describes a technique in which endodontic treatment and permanent indirect restoration were completed in the same clinical appointment with the aid of a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Two patients were diagnosed with irreversible pulpitis of the mandibular first molar. After access preparation, root canals were located, irrigation was performed until bleeding ceased, and the coronal tooth structure was prepared for indirect restoration. Then, utilizing an interim 3-mm build-up of the endodontic access cavity, a hemi-arch digital scan was performed with an intraoral scanner. Subsequent to digital scanning, restoration design was performed simultaneously with the endodontic procedure. The root canals were shaped using the Race system under irrigation with 2.5% sodium hypochlorite followed by root canal filling. The pulp chamber was subsequently filled with a 3-mm-thick composite resin restoration mimicking the interim build-up previously utilized to facilitate block milling in the CAD/CAM system. Clinical try-in of the permanent onlay restoration was followed by acid etching, application of a 5th generation adhesive, and cementation of the indirect restoration. Once the restoration was cemented, rubber dam isolation was removed, followed by occlusal adjustment and polishing. After 2 years of follow-up, the restorations were esthetically and functionally satisfactory, without complications.

• Journal of Korea Water Resources Association
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• v.55 no.5
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• pp.321-331
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• 2022

In this study, we tried to present a method for calculating the amount of regression using a watershed modeling method that can simulate the hydrological mechanism of water balance analysis and agricultural water based on watershed unit. Using the soil water assessment tool (SWAT), a watershed water balance analysis was conducted considering the simulation of paddy fields for the Manbongcheon Standard Basin (97.34 km²), which is a representative agricultural area of the Yeongsan river basin. Before evaluating return flow, the SWAT was calibrated and validated using the daily streamflow observation data at Naju streamflow gauge station (NJ). The coefficient of determination (R²), Nash-Sutcliffe Efficiency (NSE), Root-Mean-Square Error (RMSE) of NJ were 0.73, 0.70, 0.64 mm/day. Based on the calibration results for three years (2015-2017), the quick return flow and the return rate compared to the water supply amount for the irrigation period (April 1 to September 30) were calculated, and the average return flow rate was 53.4%. The proposed method of this study may be used as foundation data to optimal agricultural water supply plan for rational watershed management.