One of the most challenging task in closing anterior diastema is avoiding "black triangle" between the teeth.

This paper reports a case that the closure of diastema in anterior teeth could be successfully accomplished using direct adhesive restorations and gingival recontouring. The traditional technique using Mylar strip was modified to increase the emergence profile with natural contours at the gingival-tooth interface. Mylar strip was extended out of the sulcus by approximately 1 mm high from the gingival margin, and a small cotton pellet was used to provide the emergence contour. This modified approach is acceptable for the clinical situation.

The aim of this study was to compare the effects of anticurvature filing with stainless steel k-file versus nickel-titanium ProFile in the shaping of mesial root canals of extracted mandibular molars.

A total of 60 canals from 30 mesial roots of mandibular molar teeth were randomly assigned to three groups with n=20 each. They were prepared with different instruments and methods: The first group with stainless steel k-file and circumferential filing, the second with precurved stainless steel k-file and anticurvature filing and the third with ProFile (.06 taper) and anticurvature filing. Using a micro-computed tomography system (skyscan-1076, SKYSCAN, Antwerpen, Belgium), pre-and post-operative specimens were scanned. Subsequently, canal images were superimposed and changes in root dentin thickness were measured at distal side (danger zone) of the canal. The data was analyzed using a one-way ANOVA and the comparison of means was conducted using a post hoc multiple comparison Tukey test.

There were significant differences in the change of root dentin thickness at the 7.5~8.5mm level between group 1 and 2, 3.5~6mm level between group 1 and 3 and 3.5~6mm level between group 2 and 3(n=20, P<0.05).

This study was done to evaluate transportation of the apical foramen after 0.5 mm overinstrumentation by ProFile, ProTaper and K³ in simulated resin root canal.

Sixty simulated resin root canal with a curvature of J and S-shape were divided into two groups. Each group consisted of three subgroups with 10 blocks according to the instruments used: ProFile®, ProTaper™, and K^3TM. Simulated resin root canal was prepared by ProFile, ProTaper and K³ with 300 rpm by the crown-down preparation technique. Pre- and post-instrumentation apical foramen images were overlapped and recorded with Image-analyzing microscope 100X (Camcope, Sometech Inc, Korea). The amounts of difference in width and dimension on overlapped images were measured after reference points were determined by Image Analysis program (Image-Pro® Express, Media Cybernetic, USA). Data were analyzed using Kruskal-Wallis and Mann-Whitney U-test.

The results suggest that ProFile showed significantly less canal transportation and maintained original apical foramen shape better than K³ and ProTaper.

The purpose of this study was to compare the centering abilities of four root canal instrument systems and the amounts of dentin removed after root canal shaping using them.

The mesial canals of twenty extracted mandibular first molars having 10 - 20° curvature were scanned using X-ray micro-computed tomography (XMCT)-scanner before root canals were instrumented. They were divided into four groups (n = 10 per group). In Group 1, root canals were instrumented by the step-back technique with stainless steel K-Flexofile after coronal flaring. The remainders were instrumented by the crown-down technique with Profile (Group 2), ProTaper (Group 3) or K3 system (Group 4). All canals were prepared up to size 25 at the end-point of preparation and scanned again. Scanned images were processed to reconstruct three-dimensional images using three-dimensional image software and the changes of total canal volume were measured. Pre- and post-operative cross-sectional images of 1, 3, 5, and 7 mm from the apical foramen were compared. For each level, centering ratio were calculated using Adobe Photoshop 6.0 and image software program.

ProTaper and K3 systems have a tendency to remove more dentin than the other file systems. In all groups, the lowest value of centering ratio at 3 mm level was observed. And except at 3 mm level, ProTaper system made canals less centered than the other systems (p < 0.05).

The aim of this study was to evaluate the retrievability of Resilon as a root canal filling material. Twenty-seven human single-rooted extracted teeth were instrumented utilizing a crown down technique with Gates-Glidden burs and ProFile system. In group1 (n = 12) canals were obturated with gutta percha and AH-26 plus sealer using a continuous wave technique and backfilled. In group 2 (n = 15) Resilon was used as a filling material. Then teeth were sealed and kept in 37℃ and 100% humidity for 7 days. For retreatment, the samples were re-accessed and filling material was removed using Gates-Glidden burs and ProFiles. Teeth were sectioned longitudinally to compare the general cleanliness and amount of debris (× 75) using SEM. Chi-square test was used (α = 0.05) to analyze the data. The total time required for removal of filling materials was expressed as mean ± SD (min) and analyzed by the Student t-test (α = 0.05). Required time for retreatment was 3.25 ± 0.32 minutes for gutta percha/AH 26 plus sealer and 3.05 ± 0.34 minutes for Resilon. There was no statistically significant difference between the two experimental groups. There was no significant difference between the groups in the cleanliness of the root canal wall. This study showed that Resilon was effectively removed by Gates-Glidden burs and ProFiles.

This study was conducted to evaluate the insertion depth of Buchanan plugger after shaping by various Ni-Ti rotary files. It was conducted to determine which size of plugger are appropriate, when root canals are shaped with Ni-Ti rotary files and obturated by Continuous wave of condensation technique.

Two type of eighty simulated resin blocks were used : J-shaped and straight shaped canal. The simulated canals were instrumented by ProTaper and ProFile. Buchanan pluggers were inserted into the canal, and then the image was recorded to scanner. The distance from the apex of the canal to the plugger tip was measured by image analysis program. Data were analyzed by one-way ANOVA followed by Scheffe's test.

The results were as follows

1. In straight canal finished up to ProTaper F2 and F3 file, F and FM pluggers were inserted more than 5 mm short of working length.

2. In J-shaped canal finished up to ProTaper F2 file, F pluggers were inserted more than 5 mm short of working length. Finished up to ProTaper F3 file, F and FM pluggers were inserted more than 5 mm short of working length.

3. In straight and J-shaped canal finished up to ProFile .06/#20 and .06/#25, any of Buchanan plugger could not be inserted more than 5 mm short of working length.

These results suggest that canals shaped by ProTaper could be obturated by Continuous wave of condensation technique with F and FM size Buchanan plugger.

To evaluate the change of working length with various instrumentation techniques in curved canals, working length and canal curvature were determined before and after canal instrumentation in buccal or mesial canals of extracted human molars. Stainless steel K-files (MANI®, Matsutani Seisakusho Co. Takanezawa, Japan), nickel-titanium K-files (Naviflex NT™, Brassler, Savannah, USA), ProFile®, and ProTaper™ (Dentsply-Maillefer, Ballaigues, Switzerland) were used to prepare the canals with crown-down technique. In two hand instrumentation groups, coronal flaring was made with Gates Glidden burs. Apical canals were instrumented until apical diameter had attained a size of 30. Positional relation between the tooth apex and the #10 K-file tip was examined by using AutoCAD 2000 (Autodesk Corp., San Rafael. CA, USA) under a stereomicroscope before and after coronal flaring, and after apical instrumentation. Degree of canal curvature was also measured with Schneider's method in radiographs. Data of working length and canal curvature changes were statistically analyzed with one-way ANOVA and Tukey's studentized range test.

Working length and canal curvature were decreased significantly in each step in all instrumentation groups. Coronal flaring using Gates Glidden burs in hand instrument groups and whole canal instrumentation using stainless steel hand K-files caused significantly more working length change than in ProFile instrumentation group (p < 0.05).

The result of this study demonstrates that all of the above kinds of instrumentation in curved canals cause reduction of working length and canal curvature at each instrumentation steps, and hand instrumentation causes more working length change than ProFile.

The purpose of this study was to compare and evaluate the shaping abilities of various hybrid instrumentation method using constant tapered file systems with ProTaper® S1 and the difference between experts and inexperienced clinicians in use of NiTi file.

Three hybrid methods used in this study were composed of ProTaper® S1 and K-Flexofile® (group S), ProTaper® S1 and HeroShaper® (group H), and ProTaper® S1 and ProFile® (group P), respectively. The ProTaper®-alone method (group C) was introduced as a control group.

After canal preparation, the lapse of time was recorded. The images of pre- and post-operative canal were scanned and superimposed. Amounts of instrumented canal widths and centering ratio were measured at apical 1, 2 and 3 mm levels and statistical analysis was performed.

In this study, both of the group C and S took more time to prepare canals than other groups. Inexperienced operators required more time for the entire preparation with the groups C and H than the experienced (p < 0.05). And the centering ratio of group P were preferable to ProTaper®-alone method or the hybrid technique using stainless steel files. As such, within experienced operators, group H also showed better results in addition to the group P.

Under these condition, the hybrid methods of each the ProFile® system and HeroShaper® with ProTaper® are recommendable comparative to ProTaper®-alone method. According to the results, the hybrid instrumentation method is a more appropriate method of canal preparation than single file system for narrow or curved canals.

The purpose of this study was to compare the shaping ability of three Ni-Ti file systems used by dental students or the experts and consequently to aid in choosing a proper systems for educational courses of dental students and beginners.

Fifty students and ten dentists who have clinical experience over two years prepared 180 simulated root canals in resin blocks with three Ni-Ti systems; ProFile® (PF), HeroShaper® (HS), K3^TM (K3).

After preparation, the Ni-Ti files were evaluated for distortion and canal preparation time was recorded. The images of pre- and post-instrumented canals were scanned and superimposed. Amounts of increased canal widths, deviation, and centering ratio were calculated at apical 1, 3 and 5 mm levels and statistical analysis was performed.

The results were as follows:

HS showed the shortest preparation time and instrumented canal width in K3 was significantly larger than other groups (P < 0.05).

Based on the results, it is surmised that the ProFile® is the safest and most ideal instrument for students and beginners.

This study investigated the effect of anticurvature filing method on preparation of the curved root canal using ProFile.

Thirty six resin blocks were divided equally into three groups by instrumentation motions: anticurvature filing motion, circumferential filing motion and straight up-and-down motion. Each resin block was sectioned at 8 mm level from the apex and at the greatest curvature of the canal and reassembled in metal mold by a modified Bramante technique. All groups were instrumented with the ProFile system. At each levels, image of sectioned surface were taken using CCD camera under a stereomicroscope at ×40 magnification and stored. Distances of transportation at the inner and outer area of curvature and the centering ratio were determined and compared by statistical analysis, along with the assessment of the increase of root canal cross-sectional area.

The results were as follows;

1. In all groups, there was no statistical difference in the mean increase of root canal cross-sectional area, the centering ratio, and the mean distances of transportation at the inner area of curvature at each level.

2. At 8 mm level from the apex, the mean distances of transportation at the outer area of curvature decreases in following order anticurvature filing motion, circumferential filing motion, straight up-and-down motion but, no significant difference at the greatest curvature of the canal among three groups.

Effect of anticurvature filing motion using ProFile does not seem to be different from other instrumentation motions at the inner area of curvature in curved root canal.

The purpose of this study was to evaluate which type of Ni-Ti files are able to maintain canal configuration better in the simulated canal with abrupt curvature near it's apex.

Ninety six simulated root canals were made in epoxy resin and #15 finger spreader was used as root canal templates. The simulated root canals were made with radius of curvature of 1.5 mm, 3.0 mm, 4.0 mm, 6.0 mm respectively and the angle of curvature of all simulated canals were adjusted to 90 degree. The simulated canals were instrumented by ProFile, ProTaper, Hero 642, and K³ at a 300 rpm using crown-down pressureless technique. Pre-instrumented and post-instrumented images were taken by digital camera and were superimposed with Adobe Photoshop 6.0 program. Images were compared by image analysis program.

The changes of canal width at the inner and outer side of the canal curvature, canal transportation were measured at 9 measuring point with 1 mm interval. Statistical analysis among the types of Ni-Ti files was performed using Kruskal-Wallis test and Mann-Whitney U-test.

The result was that ProFile maintain original canal configuration better than other engine driven Ni-Ti files in the canals above 3.0 mm radius of curvature, and in the 1.5 mm radius of curvature, most of Ni-Ti flies were deformed or separated during instrumentation.

The purpose of this study was to evaluate the canal configuration after shaping by ProFile, ProTaper and K-Flexofile in simulated resin canals with different angles of curvature.

Three types of instruments were used : ProFile, ProTaper, K-Flexofile. Simulated root canals, which were made of epoxy resin, were prepared by ProFile, ProTaper with rotary instrument using a crown-down pressureless technique, and hand instrumentation was performed by K-Flexofile using a step-back technique. All simulated canals were prepared up to size 25 file at end-point of preparation. Pre and post instrumentation images were recorded with Scanner. Assessment of canal shape was completed with Image Analysis program. Measurements were made at 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 mm from the apex. At each level, outer canal width, inner canal width, total canal width, and amount of transportation from original axis were recorded. Instrument deformation and fracture were recorded. Data were analyzed by means of one-way ANOVA analysis of variance and the Sheffe's test.

The result was that ProFile and ProTaper maintain original canal shape regardless of the increase of angle of curvature than K-Flexofile. ProFile show significantly less canal transportation and maintained original canal shape better than ProTaper.

A variety files made of stainless steel (S-S) or nickel-titanium (Ni-Ti) are used during endodontic treatment. The purpose of this study was to evaluate the corrosion susceptibility of S-S and Ni-Ti endodontic files. Three brands of files were used for this study: K-flex® S-S files (Maillefer, USA), Profile® Ni-Ti files (Maillefer, USA), K-3® Ni-Ti files (SybronEndo, USA). 120 files of each brands (21mm, ISO size #20) were divided into 12 groups according to 1) sterilization methods using Autoclave or Ethylene Oxide (E-O) gas, 2) Irrigation solutions using 5.25 % NaOCl or Saline, 3) the number of sterilization (1, 5, 10 times). After above procedures, each of the files was inspected by three examiners with a light microscope and camera at X25. Each file was judged and ranked according to the following criteria: 0; no corrosion, 1; mild corrosion, 2; moderate corrosion, and 3; severe corrosion. The files of high score were examined under the Scanning Electron Microscope.

Data were statistically analyzed with the Kruskal-Wallis test (p < 0.05). Most of the ten time-autoclaved files had showed mild to moderate corrosion. But, one or five time-autoclaved files did not show corrosive surface. NaOCl treatment and E-O gas sterilization did not influence on corrosion. There was a significant difference in corrosion susceptibility between sterilization methods and the number of autoclaving. However, there was no significant difference between brands and file materials.

The purpose of this study was to evaluate the influence of plugger penetration depth on the apical extrusion of root canal sealer during root canal obturation with Continuous Wave of Condensation Technique.

Root canals of forty extracted human teeth were divided into four groups and were prepared up to size 40 of 0.06 taper with ProFile. After drying, canals of three groups were filled with Continuous Wave of Condensation Technique with System B™ and different plugger penetration depths of 3, 5, and 7 mm from the apex. Canals of one group were filled with cold lateral compaction technique as a control. Canals were filled with non-standardized master gutta-percha cones and 0.02 mL of Sealapex. Apical extruded sealer was collected in a container and weighed. Data was analyzed with one-way ANOVA and Duncan’s Multiple Range Test. 3 and 5 mm penetration depth groups in Continuous Wave of Condensation Technique showed significantly more extrusion of root canal sealer than 7 mm penetration depth group (p < 0.05). However, there was no significant difference between 7 mm depth group in Continuous Wave of Condensation Technique and cold lateral compaction group (p < 0.05).

The result of this study demonstrates that deeper plugger penetration depth causes more extrusion of root canal sealer in root canal obturation by Continuous Wave of Condensation Technique. Therefore, special caution is needed when plugger penetration is deeper in the canal in Continuous Wave of Condensation Technique to minimize the amount of sealer extrusion beyond apex.

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 in vitro study was to compare the effects of root canal debridement following rotary Ni-Ti instruments with positive versus negative rake angle. Seventy sound, extracted human anterior teeth & premolars were randomly divided into four groups. The used rotary instruments were Ni-Ti HERO 642(Micro-Mega in France, 20 specimen), Ni-Ti ProFile(Maillefer, Ballaigues, Switzerland, 20 specimen), stainless steel engine reamer(Mani, Matsutani Seisakusho Co.,Japan, 20 specimen) and negative control group(10 specimen) was only extirpated with barbed broach(Mani, Matsutani Seisakusho Co.,Japan)

Group 1 & 2 teeth were prepared to a #40 at the apex followed by 1 mm using crown-down technique. Group 3 teeth were instrumented from a #15 to a #40 in sequential order. After preparation and final irrigation, the roots split longitudinally into a bucco-lingual direction. Root halves were cross-sectioned in apical third portion again. all root specimens were prepared for SEM investigation & photographed. Separate evaluations were undertaken for smear layer on prepared walls with a five score-index for each using reference photograph in root halves. the penetration depth of smear layer into dentinal tubules was also estimated in the other halves. the following results were obtained :

1. Smear layer was observed on all the prepared walls with three experimental groups except negative control group

2. Smear layer characteristics

1) HERO 642 groups showed snowy & dusty appearance & were observed only few some dentinal tubuli open on the prepared walls, and the penetration depth of it into dentinal tubules may be 1-2 µm thick.

2) ProFile groups showed shiny & burnished appearance & complete root canal wall covered by a homogenous smear layer with no open dentinal tubuli and penetration depth of it into dentinal tubules may be 1-2 µm thick.

3) Engine reamer groups showed obviously file's passed tracks on the prepared walls & were observed complete root canal wall covered by a homogenous smear layer with no open dentinal tubuli.

The results revealed that a completely clean root canal could not be achieved regardless of positive & negative rake angle, which is in accordance with the majority of studies on root canal cleanliness.

In conclusion, throughout irrigation with antibacterial solutions or chelating agents is recommended to remove the smear layer on prepared canal walls.