OBJECTIVE: To establish an apicoectomy guide template design and manufacturing method, based on multi-source data fusion, computer aided design (CAD) and fused deposition modeling (FDM). The feasibility of the guide template was preliminary evaluated by the in vitro model experiment. METHODS: An extracted upper anterior tooth, after root canal treatment, was optical scanned, after which the extracted upper anterior tooth was poured in an apicoectomy plaster model. Cone-beam computed tomography (CBCT) scanning of the apicoectomy plaster model was performed, after which optical scanning of the plaster model for apical resection surgery was carried out. All of the relevant CBCT and optical scanning data of the extracted upper anterior tooth and the apicoectomy plaster model were introduced into the Geomagic Studio 2012 software. The multi-source data fusion technology was used to virtually simulate the three-dimensional positional relationship of the extracted tooth, the dentition, the alveolar bone and the gingival, based on which, the three-dimensional design of the apicoectomy guide template was completed in the Geomagic Studio 2012 software. With the technology of fused deposition modeling, the apical resection surgical guide template was three-dimensionally printed with the material of polylactic acid (PLA). Under the guidance of the surgical guide template, the root apical resection was performed on the plaster model. After the apicoectomy, the extracted upper anterior tooth was taken off from the apicoectomy plaster model and then was given the optical scanning. The apical resection length and angle were calculated by the function of distance measurement and angle measurement, and the results were compared with the preset values. RESULTS: The length of the apical resection was 2.88 mm along the direction of the long axis of the tooth, which was 0.12 mm lower than the preset 3 mm. The included angle between the apical resection plane and the long axis of the tooth was 77.9°, 12.1° lower than the preset 90°. CONCLUSION This study successfully established a digital design and production method of apicoectomy guide template by combing the multi-source data fusion, CAD and FDM technology. The design route and the production method are feasible. The study will provide a technology and methodology reference for the development of domestic special software for the digital design of apicoectomy guide template.
Apicoectomy/methods* ; Computer-Aided Design ; Cone-Beam Computed Tomography ; Printing, Three-Dimensional ; Software

METHODS: A retrospective observational study was conducted on 164 patients who had been diagnosed with cyst of the jaw, from the database of 168 histopathological diagnoses at the Department of Oral and Maxillofacial Surgery of Busan Paik Hospital at Inje University, from January 2009 to December 2011. The subjects were treated and the following variables were recorded: gender, age, clinical signs and symptoms, histopathological distribution, treatment methods, and complications. A descriptive analysis of the study variables was performed using a chi-square test.RESULTS: Among the 164 patients, there were more male than female patients (male-female ratio: 1.7:1). The most predominant ages were the 20s and 40s. Among the classes of pathological cysts, radicular cysts and dentigerous cysts were the most common, with incidences of 56.0% and 35.1%. Thirty-six percent of the patients had no symptoms; and of those who had symptoms, the main signs and symptoms were swelling (24.4%) and pain (17.1%). The most frequent management method was the combination operation, such as enucleation with or without extraction and apicoectomy of the causative teeth. Of the 164 patients, 13 had complications; and one patient who had been treated with enucleation with apicoectomy had a recurrent cyst.CONCLUSION: Using a chi-square test, no significant differences in prevalence were observed in relation to gender according to age. Comparative analysis of radicular and dentigerous cysts showed a significant difference in their prevalence according to their anatomical location, however, no significant differences in were observed in their incidence rates according to age.]]>
Apicoectomy ; Busan ; Classification ; Dentigerous Cyst ; Diagnosis ; Female ; Humans ; Incidence ; Jaw ; Male ; Methods ; Observational Study ; Odontogenic Cysts ; Prevalence ; Radicular Cyst ; Retrospective Studies ; Surgery, Oral ; Tooth

This case report is to present a maxillary first molar with one O-shaped root, which is an extended C-shaped canal system. Patient with chronic apical periodontitis in maxillary left first molar underwent replantation because of difficulty in negotiating all canals. Periapical radiographs and cone-beam computed tomography (CBCT) were taken. All roots were connected and fused to one root, and all canals seemed to be connected to form an O-shape. The apical 3 mm of the root were resected and retrograde filled with resin-modified glass ionomer. Intentional replantation as an alternative treatment could be considered in a maxillary first molar having an unusual O-shaped root.
Adult ; Anatomic Variation ; Apicoectomy ; methods ; Cone-Beam Computed Tomography ; methods ; Dental Pulp Cavity ; diagnostic imaging ; pathology ; Glass Ionomer Cements ; therapeutic use ; Humans ; Male ; Maxilla ; Molar ; diagnostic imaging ; pathology ; Periapical Periodontitis ; therapy ; Retrograde Obturation ; methods ; Root Canal Filling Materials ; therapeutic use ; Root Canal Preparation ; methods ; Tooth Replantation ; methods

The present investigation assessed the effect of acid etching on marginal adaptation of white- and gray-colored mineral trioxide aggregate (MTA) to apical dentin using microcomputed tomography (micro-CT) and scanning electron microscopy (SEM). Sixty-four extracted single-rooted human maxillary teeth were used. Following root-end resection and apical preparation, the teeth were equally divided into four groups according to the following root end filling materials: (i) white-colored MTA (WMTA), (ii) etched WMTA (EWMTA), (iii) gray-colored MTA (GMTA) and (iv) etched GMTA (EGMTA). After 48 h, the interface between root-end filling materials and the dentinal walls was assessed using micro-CT and SEM. Data were statistically analyzed using the Kruskal-Wallis and Dunn tests. Micro-CT analysis revealed gap volumes between the apical cavity dentin walls and EGMTA, GMTA, EWMTA and WMTA of (0.007 1±0.004) mm(3), (0.053±0.002) mm(3), (0.003 6±0.001) mm(3) and (0.005 9±0.002) mm(3) respectively. SEM analysis revealed gap sizes for EGMTA, WMTA, EWMTA and GMTA to be (492.3±13.8) µm, (594.5±17.12) µm, (543.1±15.33) µm and (910.7±26.2) µm respectively. A significant difference in gap size between root end preparations filled with GMTA and EGMTA was found (P<0.05). No significance difference in gap size between WMTA and EWMTA were found in either SEM or micro-CT analysis. In conclusion, pre-etching of apical dentin can provide a better seal for GMTA but not for WMTA.
Acid Etching, Dental ; methods ; Aluminum Compounds ; chemistry ; Apicoectomy ; methods ; Calcium Compounds ; chemistry ; Dental Bonding ; Dental Marginal Adaptation ; Dental Pulp Cavity ; ultrastructure ; Dentin ; ultrastructure ; Drug Combinations ; Humans ; Materials Testing ; Microscopy, Electron, Scanning ; Oxides ; chemistry ; Retrograde Obturation ; methods ; Root Canal Filling Materials ; chemistry ; Root Canal Preparation ; instrumentation ; methods ; Silicates ; chemistry ; Surface Properties ; Time Factors ; Tooth Apex ; ultrastructure ; X-Ray Microtomography

Actinomyces ; isolation & purification ; Actinomycosis ; microbiology ; Apicoectomy ; methods ; Candida albicans ; isolation & purification ; Candidiasis ; microbiology ; Enterococcus faecalis ; isolation & purification ; Foreign Bodies ; complications ; Gram-Positive Bacterial Infections ; microbiology ; Humans ; Microsurgery ; methods ; Periapical Periodontitis ; etiology ; microbiology ; surgery ; therapy ; Radicular Cyst ; complications ; Root Canal Filling Materials ; therapeutic use ; Root Canal Therapy ; methods