Clinical efficacy of activated irrigation in endodontics: a focused review

Cheung Amelia Wan Tin,Lee Angeline Hui Cheng,Cheung Gary Shun Pan 대한치과보존학회 2021 Restorative Dentistry & Endodontics Vol.46 No.1

Root canal debridement, which includes the removal of infected tissues and microbial biofilms, is considered the corner stone of root canal treatment. Chemical adjuncts play a multitude of functions in this regard, as tissue solvents, antimicrobial agents and for removing the smear layer. These adjuncts (irrigants) are usually delivered using a syringe and needle. With increasing knowledge of the complexity of root canal anatomy and tenacity of microbial biofilms, the need for strategies that potentiate the action of these irrigants within the root canal system cannot be overemphasized. Several such activated irrigation strategies exist. The aim of this review is to comprehensively discuss the different irrigant activation methods from the context of clinical studies.

Preference of undergraduate students after first experience on nickel-titanium endodontic instruments

곽상원,Gary Shun Pan Cheung,하정홍,김성교,이효진,김현철 대한치과보존학회 2016 Restorative Dentistry & Endodontics Vol.41 No.3

Objectives: This study aimed to compare two nickel-titanium systems (rotary vs. reciprocating) for their acceptance by undergraduate students who experienced nickeltitanium (NiTi) instruments for the first time. Materials and Methods: Eighty-one sophomore dental students were first taught on manual root canal preparation with stainless-steel files. After that, they were instructed on the use of ProTaper Universal system (PTU, Dentsply Maillefer), then the WaveOne (WO, Dentsply Maillefer). They practiced with each system on 2 extracted molars, before using those files to shape the buccal or mesial canals of additional first molars. A questionnaire was completed after using each file system, seeking students’ perception about ‘Ease of use’, ‘Flexibility’, ‘Cutting-efficiency’, ‘Screwing-effect’, ‘Feeling-safety’, and ‘Instrumentation-time’ of the NiTi files, relative to stainless-steel instrumentation, on a 5-point Likert-type scale. They were also requested to indicate their preference between the two systems. Data was compared between groups using t-test, and with Chi-square test for correlation of each perception value with the preferred choice (p = 0.05). Results: Among the 81 students, 55 indicated their preferred file system as WO and 22 as PTU. All scores were greater than 4 (better) for both systems, compared with stainless-steel files, except for ‘Screwing-effect’ for PTU. The scores for WO in the categories of ‘Flexibility’, ‘Screwingeffect’, and ‘Feeling-safety’ were significantly higher scores than those of PTU. A significant association between the ‘Screwing-effect’ and students’ preference for WO was observed. Conclusions: Novice operators preferred nickel-titanium instruments to stainless-steel, and majority of them opted for reciprocating file instead of continuous rotating system.

Preference of undergraduate students after first experience on nickel-titanium endodontic instruments

Kwak, Sang Won,Cheung, Gary Shun-Pan,Ha, Jung-Hong,Kim, Sung Kyo,Lee, Hyojin,Kim, Hyeon-Cheol The Korean Academy of Conservative Dentistry 2016 Restorative Dentistry & Endodontics Vol.41 No.3

Objectives: This study aimed to compare two nickel-titanium systems (rotary vs. reciprocating) for their acceptance by undergraduate students who experienced nickel-titanium (NiTi) instruments for the first time. Materials and Methods: Eighty-one sophomore dental students were first taught on manual root canal preparation with stainless-steel files. After that, they were instructed on the use of ProTaper Universal system (PTU, Dentsply Maillefer), then the WaveOne (WO, Dentsply Maillefer). They practiced with each system on 2 extracted molars, before using those files to shape the buccal or mesial canals of additional first molars. A questionnaire was completed after using each file system, seeking students' perception about 'Ease of use', 'Flexibility', 'Cutting-efficiency', 'Screwing-effect', 'Feeling-safety', and 'Instrumentation-time' of the NiTi files, relative to stainless-steel instrumentation, on a 5-point Likert-type scale. They were also requested to indicate their preference between the two systems. Data was compared between groups using t-test, and with Chi-square test for correlation of each perception value with the preferred choice (p = 0.05). Results: Among the 81 students, 55 indicated their preferred file system as WO and 22 as PTU. All scores were greater than 4 (better) for both systems, compared with stainless-steel files, except for 'Screwing-effect' for PTU. The scores for WO in the categories of 'Flexibility', 'Screwing-effect', and 'Feeling-safety' were significantly higher scores than those of PTU. A significant association between the 'Screwing-effect' and students' preference for WO was observed. Conclusions: Novice operators preferred nickel-titanium instruments to stainless-steel, and majority of them opted for reciprocating file instead of continuous rotating system.

Long-term observation of the mineral trioxide aggregate extrusion into the periapical lesion: a case series

Chang, Seok-Woo,Oh, Tae-Seok,Lee, WooCheol,Shun-Pan Cheung, Gary,Kim, Hyeon-Cheol Nature Publishing Group 2013 International journal of oral science. Vol.5 No.1

<P>One-step apexification using mineral trioxide aggregate (MTA) has been reported as an alternative treatment modality with more benefits than the use of long-term calcium hydroxide for teeth with open apex. However, orthograde placement of MTA is a challenging procedure in terms of length control. This case series describes the sequence of events following apical extrusion of MTA into the periapical area during a one-step apexification procedure for maxillary central incisor with an infected immature apex. Detailed long-term observation revealed complete resolution of the periapical radiolucent lesion around the extruded MTA. These cases revealed that direct contact with MTA had no negative effects on healing of the periapical tissues. However, intentional MTA overfilling into the periapical lesion is not to be recommended.</P>

Quality of root canal fillings using three gutta-percha obturation techniques

Ho, Edith Siu Shan,Chang, Jeffrey Wen Wei,Cheung, Gary Shun Pan The Korean Academy of Conservative Dentistry 2016 Restorative Dentistry & Endodontics Vol.41 No.1

Objectives: The goal of this study was to compare the density of gutta-percha root fillings obturated with the following techniques: cold lateral (CL) compaction, ultrasonic lateral (UL) compaction, and warm vertical (WV) compaction. Materials and Methods: Thirty-three extracted mandibular first molars, with two separate mesial canals in each, were selected. After instrumentation, the canals were stratified into three groups based on canal length and curvature, and underwent obturation with one of the techniques. No sealer was used in order to avoid masking any voids. The teeth were imaged pre- and post-obturation using micro-computed tomography. The reconstructed three-dimensional images were analyzed volumetrically to determine the amount of gutta-percha present in every 2 mm segment of the canal. P values < 0.05 were considered to indicate statistical significance. Results: The overall mean volume fraction of gutta-percha was $68.51{\pm}6.75%$ for CL, $86.56{\pm}5.00%$ for UL, and $88.91{\pm}5.16%$ for WV. Significant differences were found between CL and UL and between CL and WV (p < 0.05), but not between UL and WV (p = 0.526). The gutta-percha density of the roots treated with WV and UL increased towards the coronal aspect, but this trend was not noted in the CL group. Conclusions: WV compaction and UL compaction produced a significantly denser gutta-percha root filling than CL compaction. The density of gutta-percha was observed to increase towards the coronal aspect when the former two techniques were used.

Quality of root canal fillings using three gutta-percha obturation techniques

Edith Siu Shan Ho,Jeffrey Wen Wei Chang,Gary Shun Pan Cheung 대한치과보존학회 2016 Restorative Dentistry & Endodontics Vol.41 No.1

Objectives: The goal of this study was to compare the density of gutta-percha root fillings obturated with the following techniques: cold lateral (CL) compaction, ultrasonic lateral (UL) compaction, and warm vertical (WV) compaction. Materials and Methods: Thirty-three extracted mandibular first molars, with two separate mesial canals in each, were selected. After instrumentation, the canals were stratified into three groups based on canal length and curvature, and underwent obturation with one of the techniques. No sealer was used in order to avoid masking any voids. The teeth were imaged pre- and post-obturation using micro-computed tomography. The reconstructed three-dimensional images were analyzed volumetrically to determine the amount of gutta-percha present in every 2 mm segment of the canal. P values < 0.05 were considered to indicate statistical significance. Results: The overall mean volume fraction of gutta-percha was 68.51 ± 6.75% for CL, 86.56 ± 5.00% for UL, and 88.91 ± 5.16% for WV. Significant differences were found between CL and UL and between CL and WV (p < 0.05), but not between UL and WV (p = 0.526). The gutta-percha density of the roots treated with WV and UL increased towards the coronal aspect, but this trend was not noted in the CL group. Conclusions: WV compaction and UL compaction produced a significantly denser gutta-percha root filling than CL compaction. The density of gutta-percha was observed to increase towards the coronal aspect when the former two techniques were used.