Journal of Dental Medicine

One of the major goals of periradicular surgery is to create a good apical sea! at the apex. This is done by sectioning of 2 to 3mm from the apex, preparation of a class I cavity and filling with a biocompatible material.The purpose of this in vitro study was to determine whether ultrasonic units used for root end preparations could change the surface & structure of resected root ends, as competed to common methods of retropreparation. Eighty-five extracted single rooted teeth were divided into five similar groups. Then instrumented and filled with lateral condensation method. Then three millimeter of apex was resected, retropreparaiions in two groups were done with low speed handpiece and round V) ^ur and cavities in two other groups prepared with the highest power of dentspiay ultrasonic unit with TFI-10 tip and in one other group prepared with the highest power of neo sonic ultrasonic unit with diamond coated CT-1 retro tip.Following root resection and retropreparation the surface of resected root ends were examined for the presence of any cracks or structural changes on the surface of resected root ends with stereo microscope 50x.The results of this study showed thai high power settings of ultrasonic units can increase the potential of crack formation on resected root surfaces. In conclusion it is better to use low power setting of ultrasonic for retropreparation.

Background and Aim: Preserving canal curvature during different phases of canal preparation is an important point. In Endodontic therapy all efforts are made to prepare canal in a way that final canal follows the primary canal curvature. The purpose of this study was to evaluate the efficacy of root canal preparation performed by students at Endodontic Department of Dental School, Tehran University of Medical Sciences.

Materials and Methods: In this retrospective study, classic method of step- back technique was investigated for preserving canal curvature in mesial roots of first mandibular molars and mesiobuccal roots of first maxillary molars between years 2000 and 2004. A randomly selected sample of 400 dental patient records was investigated by 4 observers (Endodontic department professors), searching for procedural errors. A clear explanation sheet of curvature preservation and procedural errors such as ledge formation, apical foramen transportation, zipping and stripping and a questionnaire were prepared for observers. The observers went through reliability test and kappa value for agreement between every two observers. The results were above 0.8. Data were analyzed by EPI6 statistical computer program, using Chi-Square and Fisher exact test with P<0.05 as the limit of significance.

Results: This study consisted of 152 first maxillary molars and 248 first mandibular molars. The prevalence of curvature preservation in mesial root of first mandibular molars and mesiobuccal root of first maxillary molars were 38.5% and 47.6% respectively. Procedural errors detected consisted of 33% ledge formation, 26.1% apical foramen transportation, 1.8% zipping and 4.1% stripping for mesial root of the first mandibular molars. The results for the first maxillary molars were 27%, 19%, 3.2% and 3.2% respectively.

Conclusion: The study results revealed the efficacy of endodontic education and the proficiency of junior and senior students in preparing curved posterior root canals. The results obtained in this retrospective study are comparable to prospective studies.

Background and Aim: Mechanical preparation of canal is one of the most important stages in root canal therapy. Various kinds of hand or rotary techniques are used for mechanical preparation of canal and each of them has advantages and disadvantages. During canal preparation, extrusion of debris from the apical foramen can result in periapical inflammation and increased pain and edema. The aim of this study was to compare hand instrumentation technique with three rotary systems (Profile, Race, Flex Master) regarding the amount of extruded debris from apical foramen during canal preparation.

Materials and Methods: In this experimental in vitro study, one hundred human extracted single rooted mandibular premolars with curvature between 0-10 degrees were selected and divided into four groups of 25 teeth each. All teeth were shortened to 15 mm length by cutting the crown. Group H was prepared by hand step back technique, group P by Profile system, group R by Race system and group F by Flex Master system. For debris collection, vials containing distilled water were used which were weighed before preparation. After the end of canal preparation, vials were completely dried and weighed again. The difference between weights of vials in two stages was the weight of debris extruded from apical foramen. The groups were compared by One-way ANOVA with p<0.05 as the level of significance.

Results: Group H had the highest mean weight of debris which showed significant difference with all three rotary groups (P<0.001). The lowest mean weight of debris was observed in group R (Race) which was significantly different from group F (Flex Master) but not significantly different from group P (Profile).

Conclusion: Based on the results of this study, race rotary system caused less debris extrusion from apical foramen compared to hand step back technique and Flex Master rotary system.

Background and Aim: The role of applying rotary instruments in reducing preparation time and proper root canal preparation have been approved in permanent teeth. The aim of this study was to compare the rotary instruments (Hero642) and K-files in root canal preparation of primary molars. Time and canal transportation were compared.

Materials and Methods: In this experimental, invitro study, 30 human extracted primary molars with 8 mm length were selected and divided into two equal groups. After preparing access cavity, group 1was prepared by K-files and group 2 by Hero642 systems. Before canal preparation, with # 15 K-file and after canal preparation, with master apical file, canal curvature was evaluated by Weine technique using Radiovisiography. Apical transportation was calculated. Time taken for preparation was recorded by chronometer. The results were analyzed with T-test and Mann-Whitney. P<0.05 was considered as the level of significance.

Results: The average canal transportation angle was 3.42 for Hero642 group and 7.33 for K-file group (p<0.04). The mean instrumentation time was 4.28 for Hero642 group and 8.76 minutes for K-file group (p<0.001). There was a significant difference between two groups.

Conclusion: Based on the findings of this study, it is suggested to apply Hero642 rotary instrument for primary molar canal preparation due to less preparation time and less canal transposition.

 The goal of each root canal therapy is cleaning and obturating the entire root canal system. A thorough knowledge of root and root canal morphology and a good anticipation of their possible morphologic variations are essential and will help to reduce endodontic failure caused by incomplete root canal preparation and obturation. In this study, one case of maxillary molar with two palatal roots has been reported in a a 40-year-old woman is reported..

Background and Aims: The purpose of this study was to design a new device assisting dental students to measure the tapering of the prepared teeth for fixed crown prosthesis in which the desired tapering for better clinical prognosis could be obtained.

Materials and Methods: The designed device in this study had two arms that were placed on two opposite walls of the prepared teeth. To evaluate the validity and reliability of this device, 3 dies with different degrees (13, 29 and 45°) were used and 20 teeth were prepared by dental students with undefined tapering degrees. The measurements of tapering were performed by six last year-dental students in two different time periods. Comparison of errors in measurements on standard dies between observers and between time intervals were analyzed by (Wilcoxon) Paired t-test with a significance level of α=0.05.

Results: For the three dies used in this study, we compared the differences for each measurement taken by observers with the standard taper of the dies. Maximum difference of measurements with true standard die tapering was 1 degree. A number of 6 measurements were under the true standard tapers and 2 measurements were above it. Interclass Correlation Coefficients (ICC) of the first and second measurements on prepared teeth were 97.4 and 97.5, respectively.  There were no significant differences between different observers or two measurements of the same observer in different time intervals (P>0.05).

Conclusion: The results indicated that this device can be valid and reliable for measuring the angle of convergence of the prepared teeth and can be used as an educational device in dental schools as a replacement for previous tapering measurement methods.

  Background and Aims: Iatrogenic damage to adjacent tooth during proximal cavity preparation is one of the most common side effects in operative dentistry. The aim of this study was to determine prevalence of iatrogenic damages to adjacent tooth during the preparation of proximal Class II cavities among undergraduate students at dental faculty of Tehran University of Medical Sciences in 2010 .

  Materials and Methods: 106 posterior permanent teeth which had Class II decay with sound proximal surfaces of adjacent teeth were selected and restored by dental students awarding the aims of the present study. After finishing restoration, proximal surfaces were completely dried by air and evaluated with dental chair light. In doubtful cases, surfaces were evaluated with × 3 magnification. Damages were classified into 2 groups abrasion and groove. Data were analyzed using Fishers exact and Pearson chi square tests .

  Results: The frequency of adjacent surfaces damage were 57.5%, with 31.1% damages as abrasion and 26.4% as groove. Students who used matrix band and wedge in proximal area as preventive instruments showed 53.4% damages and other students showed 57.3% damages (P>0.05). A significantly higher number of females and students at restorative course level (3) used wedge and matrix band than males and students at restorative course level (4) for protecting adjacent teeth (P<0.05).

  Conclusion: According to the high percentage of iatrogenic damages on adjacent sound teeth in class II cavity preparation, teaching of preventive methods and using proper techniques is necessary for dental students as future dentists.