We report the surgical endodontic treatment of a maxillary first premolar with a lateral lesion that originated from an accessory canal. Although lesions originating from accessory canals frequently heal with simple conventional endodontic therapy, some lesions may need additional and different treatment. In the present case, conventional root canal retreatment led to incomplete healing with the need for further treatment (i.e., surgery). Surgical endodontic management with a fast-setting calcium silicate cement was performed on the accessory canal using a dental operating microscope. At the patient's 9-month recall visit, the lesion was resolved upon radiography.

Palatogingival groove (PGG) is an anomaly in the maxillary anterior teeth, often accompanied by the area of bony destruction adjacent to the teeth with no carious or traumatic history. The hidden trap in the tooth can harbor plaque and bacteria, resulting in periodontal destruction with or without pulpal pathologic change. Related diseases can involve periodontal destruction, combined endodontic-periodontal lesions, or separate endodontic and periodontal lesions. Disease severity and prognosis related to PGG depend on several factors, including location, range, depth, and type of the groove. Several materials have been used and recommended for cases of extensive periodontal destruction from PGG to remove and block the inflammatory source and recover the health of surrounding periodontal tissues. Even in cases of severe periodontal destruction, several studies have reported favorable treatment outcomes with proper management. With new options in diagnosis and treatment, clinicians need a detailed understanding of the characteristics, treatment, and prognosis of PGG to successfully manage the condition.

Although fiber-reinforced posts have been widely used, they sometimes fail to obtain sufficient retention because of an extremely large canal space. To address this, several techniques have been introduced including relining of the fiber-reinforced posts. Here, we used a relined glass-fiber post to increase retention and fitness to the root canal in a crown reattachment case. The relining procedure was performed by using an indirect method on the working cast. This case also highlights the esthetic concerns regarding dehydration of the attached crown fragment.

Among dental traumas, horizontal root fractures are relatively uncommon injuries. Proper initial management and periodical evaluation is essential for the successful treatment of a root-fractured tooth. If pulpal necrosis develops, endodontic treatment is indicated, exclusively for the coronal fragment. Fragment diastases exert a great influence on healing at the fracture line and on pulpal necrosis. An adequately treated root-fractured tooth has a good prognosis. This case report describes the treatment and 2-yr follow up of 3 maxillary central incisors, first with horizontal root fracture, second with horizontal root fracture and avulsion, and third with horizontal root fracture and lateral luxation. All three cases were treated with mineral trioxide aggregate (ProRoot, Dentsply). During 2 yr of follow-up evaluation, the root-fractured teeth of the present patients were well retained in the arch, showing periodontal healing, even after endodontic treatment.

The aim of this study was to present a method for endodontic management of a maxillary first molar with unusual C-shaped morphology of the buccal root verified by cone-beam computed tomography (CBCT) images. This rare anatomical variation was confirmed using CBCT, and nonsurgical endodontic treatment was performed by meticulous evaluation of the pulpal floor. Posttreatment image revealed 3 independent canals in the buccal root obturated efficiently to the accepted lengths in all 3 canals. Our study describes a unique C-shaped variation of the root canal system in a maxillary first molar, involving the 3 buccal canals. In addition, our study highlights the usefulness of CBCT imaging for accurate diagnosis and management of this unusual canal morphology.

Cone-beam computed tomography (CBCT) is a useful diagnostic tool for identification of both internal and external root configurations. This case report describes the endodontic management of a lateral incisor with both dens invaginatus and external root irregularity by using CBCT. Nonsurgical endodontic retreatment was performed on the lateral incisor with dens invaginatus. A perforation through the dens invaginatus and external concavity was repaired using mineral trioxide aggregate. After 18 mon of follow-up, there were no clinical symptoms. Recall radiographs appeared normal and showed healing of the periapical pathosis. The understanding of both internal root canal configuration and external root irregularity using CBCT can ensure predictable and successful results.

Mandibular premolars show a wide variety of root canal anatomy. Especially, the occurrence of three canals with three separate foramina in mandibular second premolars is very rare. This case report describes the root canal treatment of an unusual morphological configuration of the root canal system and supplements previous reports of the existence of such configuration in mandibular second premolar.

Herpes zoster, an acute viral infection produced by the varicella zoster virus, may affect any of the trigeminal branches. This case report presents a patient with symptoms mimicking odontogenic pain. No obvious cause of the symptoms could be found based on clinical and radiographic examinations. After a dermatologist made a diagnosis of herpes zoster involving the third trigeminal branch, the patient was given antiviral therapy. Two months later, the facial lesions and pain had almost disappeared, and residual pigmented scars were present. During the diagnostic process, clinicians should keep in mind the possibility that orofacial pain might be related to herpes zoster.

The purpose of this study was to compare the sealing abilities of four endodontic temporary restorative materials using a methylene blue dye penetration test under dynamic loading. Standardized access cavities were prepared in forty-four intact human permanent molar teeth, and the cavities were restored with Caviton, MD-Temp, IRM, or ZOE. After thermocycling, an intermittent load of 98 N at 1 Hz was applied for 1,000 cycles to the long axis of the functional cusp of each of the teeth, which were immersed in a 1% methylene blue solution. The teeth were split in half, and the linear depth of dye penetration was evaluated according to the criteria. The results were analyzed using one-way ANOVA (p = 0.05) and Duncan's multiple range test. The results demonstrated that Caviton and MD-Temp showed significantly lower microleakage than IRM and ZOE. It was concluded that Caviton and MD-Temp exhibited better sealing ability than IRM and ZOE under dynamic loading.

This report describes clinical cases of a palato-gingival groove on a maxillary lateral incisor with associated localized periodontal disease and pulp necrosis. The tooth of the first case was extracted because of severe bone destruction. The palato-gingival groove of the second case was eliminated using a round bur, and the resulting defect was filled with synthetic graft and covered by an absorbable membrane. Both diagnosis and treatment of palato-gingival groove were very difficult and usually extraction of the involved tooth is the treatment of choice, but combined endodontic-periodontic treatment allowed the tooth to be saved.

The aim of this study was to evaluate the radiopacity and cytotoxicity of three resin-based (AH 26, EZ fill and AD Seal), a zinc oxide-eugenol-based (ZOB Seal), and a calcium hydroxide-based (Sealapex) root canal sealers. Specimens, 10 mm in diameter and 1 mm in thickness, were radiographed simultaneously with an aluminum step wedge using occlusal films, according to ISO 6876/2001 standards. Radiographs were digitized, and the radiopacity of sealers was compared to the different thicknesses of the aluminum step wedge, using the Scion image software. Using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, the cytotoxicity of each material was determined in immortalized human periodontal ligament (IPDL) cells.

The results demonstrated that EZ fill was the most radiopaque sealer, while Sealapex was the least radiopaque (p < 0.05). AH 26, AD Seal and ZOB Seal presented intermediate radiopacity values. All the materials evaluated, except for Sealapex, presented the minimum radiopacity required by ISO standards. The cell viabilities of resin-based root canal sealers were statistically higher than that of other type of root canal sealers through the all experimental time. Further, EZ fill showed statistically lower cell viability in 24 and 48 hours compared to AD Seal and in 72 hours compared to all other resin-based root canal sealers. However, there was no correlation between the radiopacity and cytotoxicity of three resin-based root canals sealers (p > 0.05).

These results indicate that resin-based root canal sealer is more biocompatible and has advantage in terms of radiopacity.

The aim of this study was to evaluate the ability of newly marketed NRT instruments to maintain the original root canal configuration and curvature during preparation in comparison with the three existing instruments in simulated root canals.

Simulated canals in resin blocks were prepared with ProFile, K3, ProTaper, and NRT instrument (n = 10 canals in each case). Pre- and post-operative images were recorded, and assessment of canal shape was completed with a computer image analysis program. The data were analyzed statistically using the One-way ANOVA followed by Duncan's test.

The ability of instruments to remain centered in prepared canals at 1-, 2-mm levels was significantly better in ProFile groups than in other groups (p < 0.05). The change of centering ratio in NRT groups at 5-mm level was significantly greater than ProFile group and at 6- and 7-mm level than all other groups (p < 0.05).

Although the NRT system was comparable to other systems in regards to its ability to maintain the canal configuration of apical portion, this system was more influenced by the mid-root curvature due to its stainless-steel files for coronal preflaring.

Hemolytic property is a specific feature of bacteria to obtain iron which is essential for its survival in host tissues. Therefore, it is thought to be one of several factors of virulence. The purpose of this study was to investigate the hemolytic properties of Prevotella nigrescens isolated from the teeth diagnosed as pulp necrosis and apical periodontitis under the presence of hemolysin inhibitors such as NaN₃ and dithiothreitol, heat, various pH and cultural conditions.

The results were as follows;

1. Clinically isolated P. nigrescens strains and standard P. nigrscens ATCC 33563 showed hemolytic activity.

2. P. nigrescens showed higher hemolytic activity against human erythrocytes than sheep or horse erythrocytes.

3. NaN₃ and dithiothreitol (DTT) reduced the hemolytic activity of P. nigrescens in a dose dependent manner (p < 0.05).

4. Optimal pH for the maximum hemolytic activity of P. nigrescens was 4.0 and the hemolysin was stable under the 50℃, but the hemolytic activity was significantly decreased at 95℃.

5. P. nigrescens cultured in 10% CO₂ condition showed higher hemolytic activity than the bacteria cultured in the anaerobic condition.

The purpose of this study is to evaluate the effect of additional enamel etching with phosphoric acid on the microleakage of the adhesion of self-etching primer system.

Class V cavity(4 mm×3 mm×1.5 mm) preparations with all margins in enamel were prepared on buccal surface of 42 extracted human upper central incisor teeth. Prepared teeth were randomly divided into 3 groups.

Group 1 : no additional pretreatment with 37% phosphoric acid (NE).

Group 2 : additional pretreatment with 37% phosphoric acid for 10 seconds (E10s).

Group 3 : additional pretreatment with 37% phosphoric acid for 20 seconds (E20s).

The adhesives(Clearfil SE Bond®, Kuraray, Osaka, Japan) and composite resins(Clearfil AP-X®, Osaka, Kuraray, Japan) were applied following the manufacturer's instructions. All the specimens were finished with the polishing disc(3M dental product, St Paul, MN, USA), thermocycled for 500 cycles between 5℃ and 55℃ and resected apical 3-mm root. 0.028 stainless steel wire was inserted apically into the pulp chamber of each tooth and sealed into position with sticky wax. Surrounding tooth surface was covered with a nail varnish 2 times except areas 1 mm far from all the margins. After drying for one day, soaked the samples in the distilled water. Microleakage was assessed by electrochemical method(System 6514, Electrometer®, Keithley, USA) in the distilled water.

In this study, the microleakage was the lowest in group 1(NE) and the highest in group 3(E20s)(NE<E10s<E20s). But no statistically significant differences were found(p=0.5).

On the basis of findings from this experiment, it can be concluded that additional enamel etching has no influence on the microleakage of the adhesion of self-etching primer system.

Ormocer has organic-inorganic compound polymers. One of advantages of ormocer is reduced polymerization shrinkage. The purpose of this study was to compare the amount of contraction shrinkage of composite resins and ormocers. Additionally, the time of each material when there is no further change of contraction shrinkage was analysed.

Four brands of composite resins (P-60, Surefil, Z-250 and Denfil) and two brands of ormocers (Definite and Admira) were used. 20 seconds, 40 seconds and 60 seconds of curing times were given. Contraction shrinkage of them were measured using a linometer for 80 seconds.

The effect of material and curing time to contraction shrinkage at the time of 80 seconds was analysed by two-way ANOVA. The effect of time to contraction shrinkage was analysed by one-way ANOVA, and the time when there was no further change of the contraction shrinkage was analysed. The results are as follows :

P-60, Definite, Z-250 and Denfil had no further change of contraction shrinkage from the time of 20 seconds, and Surefil and Admira had no further change of contraction shrinkage from the time of 10 seconds.

The object of this study was to compare the microleakage between various composite resin systems of multistep, one-bottle, and self-etching systems using electrical conductivity.

After making class V cavities (4×3×1.5 mm around CEJ), they were bulk filled with three kinds of resins of A3. Teeth were storaged in a saline solution for one day, after then, they were finished and polished using Sof-Lex system. Another stress of thermocycling was made for 500 times from 5° to 55℃ with each dwelling time of 10 seconds. Electrical conductivity (microamphere, µA) was checked four times: before and after cavity preparation, after filling, after thermocycling.

One-way ANOVA and 95% Scheffe Post Hoc test was used for checking any statistical difference among groups. Another 95% Paired Samples T-test was also used for estimating any significant difference within group after cavity filling or thermocycling.

The results were as follows:

Every specimen showed various range of microleakage after filling.

There was, however, no difference between composite resin systems.

Within the limits of this study, it was concluded that much more consideration should be needed when using thermally unstable one-bottle and self-etching systems that have multi-advantages from simplified step. More studies will be needed to solve these kinds of problems.

Mechanical properties and microleakage of two composites [conventional hybrid type DenFil (VERICOM Co., Anyang, Korea) / micro matrix hybrid type Esthet X (Dentsply Caulk, Milford, DE, U.S.A.)] were evaluated to assess whether variable light intensity curing is better than conventional curing technique.

Curing was done for 40 seconds in two ways of 2 step soft-start technique and 5 step ramping technique. Three kinds of light intensities of 50, 100, 200 mW/cm² were initially used for 10, 20, 30 seconds each and the maximum intensity of 600 mW/cm² was used for the rest of curing time in a soft-start curing technique. In a ramping technique, curing was done with the same initial intensities and the light intensity was increased 5 times with the same rate to the maximum intensity of 600 mW/cm².

After determining conditions that showed no different mechanical properties with conventional technique, Esthet X composite was filled in a class V cavity, which dimension was 4×3×1.5 mm and cured under those conditions.

Microleakage was evaluated in two ways of dye penetration and maximum gap estimation through SEM observation. ANOVA and Spearman's rho test were used to confirm any statistical significance among groups.

The results were as follows:

Several curing conditions of variable light intensities resulted in the similar mechanical properties with a conventional continuous curing technique, except conditions that start curing with an initial light intensity of 50 mW/cm²,

From the results of this study, it was revealed that ramping technique would be better than conventional technique in mechanical properties, however, soft-start technique might be better than conventional one in microleakage.

It was concluded that much endeavor should be made to find out the curing conditions, which have advantages of both aspects or to solve these kinds of problems through a novel idea of polymerization.