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Case Report
Fiber-reinforced composite post removal using guided endodontics: a case report
Changgi Cho, Hyo Jin Jo, Jung-Hong Ha
Restor Dent Endod 2021;46(4):e50.   Published online September 23, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e50
AbstractAbstract PDFPubReaderePub

Although several techniques have been proposed to remove fiber-reinforced composite (FRC) post, no safe and efficient technique has been established. Recently, a guided endodontics technique has been introduced in cases of pulp canal obliteration. This study describes 2 cases of FRC post removal from maxillary anterior teeth using this guided endodontics technique with a dental operating microscope. Optically scanned data set from plaster cast model was superimposed with the data set of cone-beam computed tomography. By implant planning software, the path of a guide drill was selected. Based on them, a customized stent was fabricated and utilized to remove the FRC post. Employing guided endodontics, the FRC post was removed quickly and safely with minimizing the loss of the remaining tooth structure. The guided endodontics was a useful option for FRC post removal.

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Research Articles
Influence of reciprocating and rotary instrumentation on microbial reduction: a systematic review and meta-analysis of in vitro studies
Selen Küçükkaya Eren, Emel Uzunoğlu-Özyürek, Sevilay Karahan
Restor Dent Endod 2021;46(2):e19.   Published online March 10, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e19
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to conduct a systematic review and meta-analysis of in vitro studies regarding the effectiveness of reciprocating and rotary instrumentation on microbial reduction in root canals.

Materials and Methods

PubMed, Scopus, Web of Science, the Cochrane Library, and the gray literature were searched through December 2019. Studies comparing the influence of reciprocating and rotary instrumentation on the removal of microorganisms from root canals that quantified the antimicrobial effect were included. Data extraction was completed using a systematic form for data collection. The risk of bias of the studies was evaluated. Standardized mean differences (SMDs) and confidence intervals (CIs) were calculated using a random effects meta-analysis.

Results

Seventeen in vitro studies were included in this systematic review, of which 7 provided adequate data for inclusion in the meta-analysis. Both reciprocating and rotary systems were similarly effective in reducing the microbial load in infected root canals (SMD [95% CI], 0.0481 [−0.271, 0.367]). Three studies showed a low risk of bias, whereas most of the studies (82%) presented a medium risk.

Conclusions

Although both techniques decrease the microbial content (with reductions of 23.32%–88.47% and 23.33%–89.86% for reciprocating and rotary instrumentation, respectively), they are not able to provide complete disinfection of root canals.

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Removal efficacy and cytotoxicity of a calcium hydroxide paste using N-2-methyl-pyrrolidone as a vehicle
Myung-Jin Lim, Hyun-Jin Jang, Mi-Kyung Yu, Kwang-Won Lee, Kyung-San Min
Restor Dent Endod 2017;42(4):290-300.   Published online October 20, 2017
DOI: https://doi.org/10.5395/rde.2017.42.4.290
AbstractAbstract PDFPubReaderePub
Objectives

This study investigated the removal efficacy and cytotoxicity of a newly developed calcium hydroxide paste (cleaniCal, Maruchi) using N-2-methyl-pyrrolidone (NMP) as a vehicle in comparison with ApexCal (Ivoclar Vivadent) and Calcipex II (Nishika), which use different vehicles such as polyethylene glycol and propylene glycol, respectively.

Materials and Methods

Thirty maxillary premolars with oval-shaped canals were divided into 3 groups and the teeth were filled with one of the pastes. After removal of the paste, micro-computed tomographic (μ-CT) imaging was obtained to assess the volume of residual paste in the root canal of each tooth. The teeth were then split longitudinally and the area of the paste-coated surface was evaluated by stereomicroscopy. The cytotoxicity of each product was assessed using an agar overlay assay. The effect of each vehicle on cell viability was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The data were analyzed using one-way analysis of variance and Tukey's tests to detect any significance (p < 0.05).

Results

In the μ-CT and stereomicroscopic analysis, cleaniCal exhibited less remnants of medicament than ApexCal and Calcipex. cleaniCal showed a higher cytotoxicity than the other pastes in the agar overlay assay. Furthermore, NMP exhibited lower cell viability compared to the other vehicles.

Conclusions

cleaniCal showed better removal efficacy compared to the other products. However, clinicians should be aware of the higher cytotoxicity of the NMP-based material and consider its possible adverse effects on periradicular tissue when it is overfilled.

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Effect of ultrasonic tip designs on intraradicular post removal
Anny Carine Barros Aguiar, Daniely Amorim de Meireles, André Augusto Franco Marques, Emílio Carlos Sponchiado Júnior, Angela Delfina Bitencourt Garrido, Lucas da Fonseca Roberti Garcia
Restor Dent Endod 2014;39(4):265-269.   Published online July 17, 2014
DOI: https://doi.org/10.5395/rde.2014.39.4.265
AbstractAbstract PDFPubReaderePub
Objectives

To evaluate the effect of different ultrasonic tip designs on intraradicular post removal.

Materials and Methods

The crowns of forty human canine teeth were removed, and after biomechanical preparation and filling, the roots were embedded in acrylic resin blocks. The post spaces were made, and root canal molding was performed with self-cured acrylic resin. After casting (Cu-Al), the posts were cemented with zinc phosphate cement. The specimens were randomly separated into 4 groups (n = 10), as follows: G1 - no ultrasonic vibration (control); G2 - ultrasonic vibration using an elongated cylindrical-shaped and active rounded tip; G3 - ultrasonic vibration with a flattened convex and linear active tip; G4 - ultrasonic vibration with active semicircular tapered tip. Ultrasonic vibration was applied for 15 seconds on each post surface and tensile test was performed in a Universal Testing Machine (Instron 4444 - 1 mm/min).

Results

G4 presented the highest mean values, however, with no statistically significant difference in comparison to G3 (P > 0.05). G2 presented the lowest mean values with statistically significant difference to G3 and G4 (P < 0.05).

Conclusions

Ultrasonic vibration with elongated cylindrical-shaped and active rounded tip was most effective in reducing force required for intraradicular post removal.

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Original Articles
Effect of two different calcium hydroxide paste removal techniques on apical leakage: an electrochemical study
Chan-Je Park, Kyung-A Jeon, Ho-Beom Kwon
J Korean Acad Conserv Dent 2006;31(3):186-191.   Published online May 31, 2006
DOI: https://doi.org/10.5395/JKACD.2006.31.3.186
AbstractAbstract PDFPubReaderePub

This study evaluated the effect of two different calcium hydroxide (Ca(OH)2) paste removal techniques on the apical leakage of canals obturated with gutta percha cones and sealer after removing a Ca(OH)2 dressing using an electrochemical method.

Seventy extracted single-rooted teeth were instrumented on with Profile rotary files under NaOCl irrigation. Fifty-eight canals were filled with calcium hydroxide paste, which was then removed using one of the following two techniques. In group A, calcium hydroxide was removed using only NaOCl irrigation, and in group B, the canals were re-prepared with a Profile rotary files-one size larger than the previous instrument and were irrigated with NaOCl. In both groups, the root surfaces were coated twice with nail varnish from CEJ to an area 4 mm away from the apex after canal obturation. Apical leakage was measured using an electrochemical method for 24 days.

All the specimens showed leakage that increased markedly in the first three days. There was no significant difference between the two groups (p > 0.05). The effect of two calcium hydroxide paste removal techniques on the apical leakage was not different during a short period.

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The efficacy of chemo-mechanical removal of dentin carious lesion
Soon-Bin Lim, Kyung-Kyu Choi, Sang-Jin Park
J Korean Acad Conserv Dent 2005;30(3):149-157.   Published online May 31, 2005
DOI: https://doi.org/10.5395/JKACD.2005.30.3.149
AbstractAbstract PDFPubReaderePub

Mechanical removals in decayed teeth have been performed using drill and sharp hand instruments. These methods have some disadvantages such as pain, local anesthesia and overextended cavities. Therefore chemo-mechanical excavation of dentin carious lesions has been introduced. The purpose of this study was to evaluate the efficacy of traditional mechanical methods using burs and chemo-mechanical methods (Carisolv) of caries dentin.

Mechanical caries removal was carried with low speed round bur. Chemo-mechanical caries excavation was performed with Carisolv (Medi-team), using the Carisolv hand instruments. The mean time to remove caries with two different methods was evaluated and the data analyzed with SPSS software (ver 11.5) by t-test (p < 0.05). For histomorphometry of caries removal were also carried with mechanical or chemo-mechanical (Carisolv) methods from 20 extracted caries permanent molars. Complete caries removal was verified with a #23 sharp explorers, Caries Detector (Kuraray Co. Japan), and standard apical radiography.

1. Chemo-mechanical method was taken more times than mechanical method (1.5 fold) (p < 0.05).

2. Excavation for caries took more time for molar lesion than premolar lesion, and the least time was taken to remove the caries in incisor lesion (p < 0.05).

3. There were no significant differences to remove the caries between the maxilla and mandible (p > 0.05).

4. The remaining carious dentin was detected after the chemo-mechanical removal of the carious dentin, and no smear layer were seen after the mechanical and chemo-mechanical removal of the carious dentin.

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THE EFFECT OF GUTTA-PERCHA REMOVAL USING NICKEL-TITANIUM ROTARY INSTRUMENTS
Jeong-Hun Jeon, Jeong-Beom Min, Ho-Keel Hwang
J Korean Acad Conserv Dent 2004;29(3):212-218.   Published online January 14, 2004
DOI: https://doi.org/10.5395/JKACD.2004.29.3.212
AbstractAbstract PDFPubReaderePub
ABSTRACT

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.

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.

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.

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