OBJECTIVES: The aim of this study was to investigate the relationship between the apical foramen morphology and the length of merged canal at the apex in type II root canal system. MATERIALS AND METHODS: This study included intact extracted maxillary and mandibular human premolars (n = 20) with fully formed roots without any visible signs of external resorption. The root segments were obtained by removing the crown 1 mm beneath the cementum-enamel junction (CEJ) using a rotary diamond disk. The distance between the file tip and merged point of joining two canals was defined as Lj. The roots were carefully sectioned at 1 mm from the apex by a slow-speed water-cooled diamond saw. All cross sections were examined under the microscope at x50 magnification and photographed to estimate the shape of the apical foramen. The longest and the shortest diameter of apical foramen was measured using ImageJ program (1.44p, National Institutes of Health). Correlation coefficient was calculated to identify the link between Lj and the apical foramen shape by Pearson's correlation. RESULTS: The average value of Lj was 3.74 mm. The average of proportion (P), estimated by dividing the longest diameter into the shortest diameter of the apical foramen, was 3.64. This study showed a significant negative correlation between P and Lj (p < 0.05). CONCLUSIONS: As Lj gets longer, the apical foramen becomes more ovally shaped. Likewise, as it gets shorter, the apical foramen becomes more flat shaped.
Academies and Institutes ; Aluminum Hydroxide ; Bicuspid ; Carbonates ; Crowns ; Dental Pulp Cavity ; Diamond ; Humans ; Tooth Apex

The aim of this study was to compare the root canal systems of maxillary and mandibular premolars that had a single root using radiographs and clearing samples. 142 single rooted premolars were selected and mesio-distal and bucco-lingual views were radiographed using intra-oral dental standard films. Four equally trained examiners classify the root canal types from the developed radiographs. After opening the tooth for access, it was stored in 5% NaOCl to dissolve the pulp tissue. Indian ink was then injected into the pulp cavity to stain the pulp tissue. It was cleared in methyl salicylate after being decalcified with 5% nitric acid for 48 hours, and the root canal type was evaluated at a magnification of x 20 using a stereomicroscope. The results are as follows; There were statistically significant differences between the radiographs and clearing samples of the root canal types among examiners (p < 0.05). There might be differences in the root canal types among examiners when the same radiograph is used. Therefore, considering the difficulty in estimating the root canal types, clinicians need to be careful when interpreting radiographs before root canal therapy.
Bicuspid* ; Dental Pulp Cavity* ; Ink ; Nitric Acid ; Root Canal Therapy ; Tooth

The purpose of this study was to quantify the amount of remaining gutta-percha/sealer on the walls of root canals when three types of nickel-titanium rotary instruments(Profile, ProTaper and K3) and a hand instrument(Hedstrom file) used to remove these materials. The results of this study were as follows: 1. In the total time for gutta-percha removal, Profile group was the fastest and followed by K3, Protaper, Hedstrom file group. 2. In case of the evaluation of the volume of remained gutta-percha from radiograph, K3 group got the highest score and followed by Protaper, Hedstrom file, Profile group in the apical 1/3. 3. In case of the evaluation of the volume of gutta-percha remained from stereomicroscope, K3 group got the highest score and followed by Protaper, Hedstrom file, Profile group in the apical 1/3. These results showed that instrumentation using nickel-titanium rotary instrument groups was faster than that using hand instrument group. The effect of gutta-percha removal using Profile group was better than that using Protaper and K3 group in the nickel-titanium rotary instrument groups.
Dental Instruments ; Dental Pulp Cavity ; Gutta-Percha* ; Hand

OBJECTIVES: The purpose of this study was to assess the accuracy of Root ZX (J. Morita Corp.) according to the location of major foramen and open apex. MATERIALS AND METHODS: 81 mandibular premolars with mature apices were selected. After access preparation, 27 teeth were instrumented to simulate open apices. 54 teeth were classified according to location of major foramen under surgical microscope (x16). The file was fixed at the location of apical constriction by Root ZX using glass ionomer cement. The apical 4 mm of the apex was exposed and photo was taken and the distance from file tip to the major foramen was measured by calibrating metal ruler on graph paper. The results were statistically analyzed using ANOVA and Scheffe test at p < 0.05 level. RESULTS: Mean distance from file tip to major foramen was 0.308 mm in Tip foramen group (I), 0.519 mm in Lateral foramen group (II) and 0.932 mm in open apex group (III). Root ZX located apical constriction accurately within +/- 0.5 mm in group I of 85.71%, in group II of 59.09%, and in group III of 33.33%. There was a statistically significant difference between group I and III (p < 0.05). CONCLUSION: Root ZX located apical constriction accurately regardless of location of major foramen. However, Root ZX couldn't find it in open apex. Clinicians have to use a combination of methods to determine an appropriate working length at open apex. It may be more successful than relying on just electronic apex locator.
Acrylic Resins ; Bicuspid ; Constriction ; Electronics ; Electrons ; Glass Ionomer Cements ; Silicon Dioxide ; Tooth ; Tooth Apex

OBJECTIVES: The purpose of this study was to investigate the incidence of root fusion and C-shaped root canals in maxillary molars, and to classify the types of C-shaped canal by analyzing cone-beam computed tomography (CBCT) in a Korean population. MATERIALS AND METHODS: Digitized CBCT images from 911 subjects were obtained in Chosun University Dental Hospital between February 2010 and July 2012 for orthodontic treatment. Among them, a total of selected 3,553 data of maxillary molars were analyzed retrospectively. Tomography sections in the axial, coronal, and sagittal planes were displayed by PiViewstar and Rapidia MPR software (Infinitt Co.). The incidence and types of root fusion and C-shaped root canals were evaluated and the incidence between the first and the second molar was compared using Chi-square test. RESULTS: Root fusion was present in 3.2% of the first molars and 19.5% of the second molars, and fusion of mesiobuccal and palatal root was dominant. C-shaped root canals were present in 0.8% of the first molars and 2.7% of the second molars. The frequency of root fusion and C-shaped canal was significantly higher in the second molar than the first molar (p < 0.001). CONCLUSIONS: In a Korean population, maxillary molars showed total 11.3% of root fusion and 1.8% of C-shaped root canals. Furthermore, root fusion and C-shaped root canals were seen more frequently in the maxillary second molars.
Cone-Beam Computed Tomography* ; Dental Pulp Cavity* ; Incidence ; Molar* ; Retrospective Studies

OBJECTIVES: The purpose of this study was to investigate the incidence of root fusion and C-shaped root canals in maxillary molars, and to classify the types of C-shaped canal by analyzing cone-beam computed tomography (CBCT) in a Korean population. MATERIALS AND METHODS: Digitized CBCT images from 911 subjects were obtained in Chosun University Dental Hospital between February 2010 and July 2012 for orthodontic treatment. Among them, a total of selected 3,553 data of maxillary molars were analyzed retrospectively. Tomography sections in the axial, coronal, and sagittal planes were displayed by PiViewstar and Rapidia MPR software (Infinitt Co.). The incidence and types of root fusion and C-shaped root canals were evaluated and the incidence between the first and the second molar was compared using Chi-square test. RESULTS: Root fusion was present in 3.2% of the first molars and 19.5% of the second molars, and fusion of mesiobuccal and palatal root was dominant. C-shaped root canals were present in 0.8% of the first molars and 2.7% of the second molars. The frequency of root fusion and C-shaped canal was significantly higher in the second molar than the first molar (p < 0.001). CONCLUSIONS: In a Korean population, maxillary molars showed total 11.3% of root fusion and 1.8% of C-shaped root canals. Furthermore, root fusion and C-shaped root canals were seen more frequently in the maxillary second molars.
Cone-Beam Computed Tomography* ; Dental Pulp Cavity* ; Incidence ; Molar* ; Retrospective Studies

The purpose of this study was to evaluate the effect of the apical sealing according to the depth of the System B Plugger tip when root canal was filled with gutta-percha and sealer by Continuous Wave of Condensation technique in the Type IV canal. 50 simulated resin blocks with J-shaped curvature canals were instrumented by ProTaper (Dentsply Maillefer, Ballagiues, Switzerland) Ni-Ti files using the crown-down technique. Type IV canals were made using a broken ProTaper F3 Ni-Ti file for making a ledge at 3mm short from the working length. And ProTaper F1 Ni-Ti file was used for perforating resin block. The prepared Type IV canals were randomly divided into three experimental groups of 15 each according to the depth of System B Plugger tip. All of experimental groups were obturated with Continuous Wave of Condensation technique. The length of gutta-percha and sealer in lingual of the Type IV canals was measured with a measuring digital calliper under magnifying glass (x 2.3). The results are as follows : 1. In control group, there was no gutta-percha and sealer in lingual canal. 2. 3 mm group showed relatively more gutta-percha than 5mm or 7 mm group (p<0.05). 3. 7 mm group did not showed gutta-percha and relatively more void were observed than 3mm or 5 mm group. (p<0.05) In conclusion, within the limits of the results of this experiment, the 3 mm depth of System B Plugger tip was acceptable for obturating the Type IV canal.
Dental Pulp Cavity ; Glass ; Gutta-Percha ; Nickel ; Titanium

The aim of this study was to compare the initial apical file (IAF) length between the mesio-buccanl and mesio-lingual canals of the mandibular molar before and after early coronal flaring. Fifty mandibular molars with complete apical formation and patent foramens were selected. After establishing the initial working length of the buccal and lingual canal of the mesial root using the Root-ZX, radiographs were taken for the working length with a 0.5 mm short of #15 K-file tip just visible at the foramen under a surgical microscope (OPMI 1-FC, Carl Zeiss Co. Germany) at 25X. After early coronal flaring using the K3 file, additional radiographs were taken using the same procedure. The root canal morphology and the difference in working length between the buccal and lingual canals were evaluated. These results show that the difference in the length between the mesio-buccal and mesio-lingual canals of the mandibular molar was < or = 0.5 mm. If one canal has a correct working length for the mesial root of the mandibular molar, it can be used effectively for measuring the working length of another canal when the files are superimposed or loosening. In addition, the measured the working length after early coronal flaring is much more reasonable because the difference in the length between the mesio-buccal and mesio-lingual canals can be reduced.
Dental Pulp Cavity ; Molar*

The aim of this study was to identify the bacteria isolated from acute endodontic lesions by cell culture and 16S rDNA sequencing. The necrotic pulpal tissue was collected from 17 infected root canals, which were diagnosed as being either an acute pulpitis or acute periapical abscess. Samples were collected aseptically from the infected pulpal tissue of the infected root canals using a barbed broach and a paper point. The cut barbed broaches and paper points were transferred to an eppendorf tube containing 500 ul of 1 X PBS. The sample solution was briefly mixed and plated onto a BHI-agar plate containing 5% sheep blood. The agar plates were incubated in a 37degrees C anaerobic chamber for 7 days. The bacteria growing on the agar plate were identified by 16S rRNA coding gene (rDNA) cloning and sequencing at the species level. Among the 71 colonies grown on the agar plates, 56 strains survived and were identified. In dental caries involving the root canals, Streptococcus spp. were mainly isolated. Actinomyces, Clostridia, Bacteroides and Fusobacteria were isolated in the periapical lesion without dental caries. Interestingly, two new Actinomyces spp. (ChDC B639 and ChDC B631) were isolated in this study. These results showed that there was diversity among the species in endodontic lesions. This suggests that an endodontic infection is a mixed infection with a polymicrobial etiology. These results may offer the bacterial strains for pathogenesis studies related to an endodontic infection.
Actinomyces ; Agar ; Bacteria* ; Bacteroides ; Cell Culture Techniques ; Clinical Coding ; Clone Cells ; Cloning, Organism ; Coinfection ; Dental Caries ; Dental Pulp Cavity* ; DNA, Ribosomal ; Fusobacteria ; Periapical Abscess* ; Pulpitis* ; Sheep ; Streptococcus ; Tooth*

OBJECTIVES: The purpose of this study was to evaluate the buccolingual curvature at the apical one third in type II mesial canals of mandibular molars using the radius and angle of curvature. MATERIALS AND METHODS: Total 100 mandibular molars were selected. Following an endodontic access in the teeth, their distal roots were removed. #15 H- or K-files (Dentsply Maillefer) were inserted into the mesiobuccal and mesiolingual canals of the teeth. Radiographs of the teeth were taken for the proximal view. Among them, type II canals were selected and divided into two subgroups, IIa and IIb. In type IIa, two separate canals merged into one canal before reaching the apex and in type IIb, two separate canals merged into one canal within the apical foramen. The radius and angle of curvature of specimens were examined. RESULTS: In type II, mean radius of curvature in mesiolingual and mesiobuccal canals were 2.82 mm and 3.58 mm, respectively. The radius of the curvature of mesiolingual canals were significantly smaller than that of mesiobuccal canals in type II, and especially in type IIa. However, there were no statistically significant differences in radius of curvature between mesiobuccal and mesiolingual canals in type IIb and there were no significant differences in angle of curvature between type IIa and IIb. CONCLUSION: In this study, type II mesial canals of mandibular molars showed severe curvature in the proximal view. Especially, mesiolingual canals of type IIa had more abrupt curvature than mesiobuccal canals at the apical one third.
Molar ; Radius ; Tooth ; Tooth Apex