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 (× 2.3).

The results are as follows :

In control group, there was no gutta-percha and sealer in lingual canal.

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.

Type II root canal was defined that two canals leave the chamber and merge to form a single canal at short of the apex. The aim of this study was to analyse the master apical file (MAF) size according to various instrumentation techniques in the type II root canal when each canal was enlarged to working length.

Eighty mesial roots of molar with ISO #15 initial apical file (IAF) size in type II root canals were randomly divided into four experimental groups with 20 teeth each. According to enlarging instruments, four groups are: K-FLEXOFILE® (KF), engine-driven Ni-Ti PROTAPER® (PT), HERO Shaper® (HS), K³ ™ (K3). All canals were enlarged to each working length with ISO #30 size: #30 in KF, F3 in PT, .04/30 in HS, and .06/30 in K3. The master apical file (MAF) size was confirmed by tactile sensation and universal testing machine (EZ test, Shimadzu Co., Kyoto, Japan). The mean MAF size was statistically compared using one-way ANOVA and Tukey HSD test at the 0.05 probability level.

These results show that the MAF size was appeared one or two sizes larger than the final enlarging instrument when all canal in type II configuration were enlarged to each working length. Therefore, the clinician have to confirm the apical stop once more after instrumentation of type II root canal.

C-shaped canals are known to present a complex canal anatomy with numerous fins connecting individual canals, thus requiring supplementary effort to accomplish a successful root canal treatment. This study examined the frequency of the C-shaped mandibular second molars and interrelation between the clinical records and radiographs to recognize them treated in the Department of Conservative Dentistry of the Chosun University Dental Hospital during a six-year period (1998 - 2004). This study reviewed the clinical records of 227 patients who underwent root canal treatment of the mandibular second molars. After opening the chamber, those cases with C-shaped orifices in the pulpal floor were selected, and the C-shaped root canal types were classified according to Melton's criteria. Three experienced dentists evaluated the radiographs of the C-shaped mandibular second molar on a viewer using a magnifying glass in order to determine if the root apex was fused or separated, the distal root canal was either centered or mesial shifted in the distal root, and if there was bilateral symmetry in a panorama. In conclusion, there is a high frequency of C-shaped mandibular second molars in Koreans. Simultaneous interpretation of the root shape and distal root canal using the preoperative, working length and post-treatment radiographs is important for diagnosing a C-shaped mandibular second molar.

The purpose of this study was to obtain the basic information for the improvement of dental environment by investigating the presence of methicillin- or vancomycin-resistant Staphylococcus aureus (MRSA or VRSA) isolated from dental health care workers (DHCWs) and environment of the Chosun University Dental Hospital (CUDH) and a private dental clinic (control group). Staphylococcus aureus (S. aureus) was isolated from anterior nares of 42 DHCWs and 38 sites, unit chairs, x-ray devices, computers, etc., at 10 departments of the CUDH and 20 DHCWs and 11 sites at the private dental clinic. S. aureus was isolated on mannitol salt agar plate and confirmed by PCR with S. aureus species-specific primer. Antimicrobial susceptibility test of clinical isolates of S. aureus against several antibiotics including methicillin (oxacillin) was performed by investigating minimum inhibitory concentration (MIC) using broth microdilution assay. In addition, PCR was performed to detect the methicillin- or vancomycin-resistant gene. The data showed that one strain of S. aureus was isolated from DHCWs of the CUDH and three strains of S. aureus was isolated from 3 samples of the private dental clinic, respectively. All of the isolates from the CUDH and the private dental clinic had resistance to penicillin G, amoxicillin and vancomycin and susceptibility to oxacillin and ciprofloxacin. The S. aureus strains were already obtained the resistance to penicillin G and amoxicillin. These results suggest that two dental clinics were under relatively safe environment.

The aim of this study was to compare the length between the mesio-buccal and mesio-lingual canal of the mandibular molars before and after early coronal flaring at the different measuring time using several electronic apex locators. 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 a surgical microscope (Carl Zeiss Co. Germany) at 25X with #15 K-file tip just visible at the foramen, radiographs were taken for the working length. After measuring the length of mesio-buccal and mesio-lingual canal (control group), the electronic lengths were measured at different times using several electronic apex locators (experimental groups; I-Root ZX, II-Bingo, III-Propex, IV-Diagnostic). After early coronal flaring using the K³ file, the additional electronic lengths were measured using the same manner.

The results were as follows: One canal has a correct working length for the mesial root of the mandibular molar, it can be used effectively for measuring the electronic working length of another canal when the files are superimposed or encountered at the apex. In addition, the accuracy of the electronic apex locators was increased as the measurement was accomplished after the early coronal flaring of the root canal and the measuring time was repeated.

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 × 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.

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 37℃ 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.

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 ≤ 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.

The aim of this study was to investigate the susceptibility of mutans streptococci (S. mutans and S. sobrinus) and Streptococcus anginosus, for seven antibiotics, penicillin G, amoxicillin, ciprofloxacin, cefuroxime, erythromycin, bacitracin, and vancomycin. The minimum inhibitory concentration (MIC) of seven antibiotics against 3 species (type strains) of mutans streptococci and S. anginosus, 10 strains (wild type) of S. mutans, 7 strains (wild type) of S. sobrinus, and 11 strains (wild type) of S. anginosus, were measured by broth dilution method. All of the type strains of mutans streptococci and S. anginosus had the same susceptibility for penicillin G, amoxicillin, cefuroxime and bacitracin. Type strain of S. anginosus was sensitive in ciprofloxacin, but those of mutans streptococci were not. All of the clinical isolates of mutans streptococci and S. anginosus had the same susceptibility for the seven antibiotics. Our data reveal that mutans streptococci and S. anginosus have similar antibiotic-resistant character. In addition, these results may offer the basic data to verify the antibiotic-resistant mechanism of mutans streptococci and S. anginosus.

The purpose of this study was to investigate the quantity of debris which was extruded apically after canal instrumentation using different types of enlarging instrument in endodontic resin models.

Five groups of 9 endodontic resin models were instrumented using each different technique: hand instrumentation without early coronal flaring, hand instrumentation after early coronal flaring, and three nickel-titanium engine-driven instrumentations (Hero 642, Protaper, K³). Debris extruded from apical foramen during instrumentation was collected on preweighed CBC bottle, desiccated and weighted using electronic balance. The results were analyzed using Kruskal-wallis test and Mann-Whitney U rank sum test at a significance level of 0.05.

The results were as follows:

All of instrumentation techniques produced apically extruded debris.

The early coronal flaring is very important to reduce the amount of debris extruded apically.

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:

In the total time for gutta-percha removal, Profile group was the fastest and followed by K³, Protaper, Hedstrom file group.

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.

The purpose of this study was to investigate the frequency of 7 putative pathogens in endodontic infections. The specimens were collected from infected pulpal tissue of patients who were referred for root canal treatment to the department of conservative dentistry, Chosun University. Samples were collected aseptically using a barbed broach and a paper point. The cut barbed broaches and paper points were transferred to an eppendorf tube containing 500 ml of 1 X PBS. DNAs were extracted from the samples by direct DNA extraction method using lysis buffer (0.5% EDTA, 1% Triton X-100). Identification of 7 putative pathogens was performed by PCR based on 16S rDNA. The target species were as follows: Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Bacteroides forsythus, Actinobacillus actinomycetemcomitans, and Treponema denticola. Our data revealed that the prevalence of P. endodontalis was found in 88.6% (39/54), P. gingivalis 52.3% (23/44), P. nigrescens 18.2% (8/44), P. intermedia 15.9% (7/44), B. forsythus 18.2% (8/44), A. actinomycetemcomitans 2.3% (1/44), T. denticola 25% (11/44) of the samples. The high prevalence of P. endodontalis and P. gingivalis suggests that they may play an important role in the etiology of endodontic infections.

The objective of this in vitro study was to evaluate the efficacy of a Ca(OH)₂ removal before and after early coronal flaring using different types of instruments. 100 plastic blocks with 30° artificial curved canals were used in this study and randomly divided into a control group and 4 experimental groups(GG, OS, GT, PT Group) 20 teeth each. The canals were instrumented, and Ca(OH)₂ was temporary filled into the each canal. Irrigation was performed with Max-i-Probe 25-, 30-gauge probes before and after recapitulation.

The results of this study were as follows:

1. There were no significant difference among the groups in size of irrigating needle(p<0.05).

2. There was a significant difference between before and after recapitulation regardless size of irrigating needle(p<0.05).

3. Before recapitulation, there was a significant difference between 25- and 30-gauge needle in all groups(p<0.05).

4. After recapitulation, there was a significant difference between 25- and 30-gauge needle in the control group(p<0.05). But there were no significant difference among the experimental groups.

It is concluded that the effectiveness of canal irrigation was decided to the depth of irrigating needle into the canal. The effect of canal irrigation tend to facilitate by the early coronal flaring. The recapitulation was the most effective during canal irrigation regardless the size of irrigating needle. Therefore, the recapitulation is a mandatory way to facilitate the effectiveness of canal irrigation during canal enlargement.

The purpose of this study was to compare the initial apical file(IAF) first file that fits to the apex in each canal before and after early flaring to analyze if the size of file to fit to the apex would increase after flaring. Eighty anterior teeth with complete apical formation and patent foramens were selected. The samples were randomly divided into 4 groups(GG, OS, GT, PT Group) of 20 teeth each. A file was fit to the apex in each canal and that size recorded. Radicular flaring were completed using different types of instruments. After flaring a file was again fit to the apex in the same manner as before and its size recorded.

The results of this study were as follows:

1. The mean diameter of IAF before flaring(file diameters in mm×10^-2) was 19.81±8.32 before and 25.94±9.21 after(p<0.05).

2. The increase in diameter of IAF was approximately one file size for all groups.

3. Ranking of increasing diameter of IAF were GG>GT>OS>PT group. There was a statistically significant difference between before and after flaring(p<0.05).

4. Ranking of the time for flaring were GG>GT>OS>PT group. There was a statistically significant difference between GG group and other groups(p<0.05).

5. In the case without change of IAF diameter, they showed decrease in force after flaring when IAF was pulled out from root canal(p<0.05).

This study suggested that early radicular flaring increases the file size that is snug at the apex, and awareness of that difference gives the clinician a better sense of canal size. Early flaring of the canal provides better apical size information and with this awareness, a better decision can be made concerning the appropriate final diameter needed for complete apical shaping.