This study aimed to assess the efficacy of canal filling material removal using three different techniques after filling with a Gutta–Percha (GP) cone and calcium silicate-based sealer, by measuring the percentage of volume debris of GP and sealer remaining intracanal with micro computed tomography (micro-CT). The filling material was removed from 30 plastic teeth by a nickel–titanium (Ni–Ti) rotary retreatment system. Final irrigation was performed with 2 mL of saline and 10 specimens were randomly allocated to a conventional group. In the passive ultrasonic irrigation (PUI) group, ultrasonic irrigation was added to the conventional group (n = 10). In the Gentlefile Brush (GF Brush) group, irrigation with GF Brush was added to the conventional group (n = 10). Remaining filling material was measured using micro-CT imaging analysis. The total mean volume of residual filling material after retreatment in the conventional group, PUI group and GF Brush group were 4.84896 mm3, 0.80702 mm3, and 0.05248 mm3, respectively. The percentage of filling material remaining intracanal was 6.76% in the conventional group, 1.12% in the PUI group and 0.07% in the GF Brush group. This study shows that the cleaning effect of the GF Brush system is superior to those of Ni–Ti retreatment files and the PUI system in the apical area.
This case report demonstrates two different uprighting mechanics separately applied to mesially tipped mandibular first and second molars. The biomechanical considerations for application of these mechanisms are also discussed. For repositioning of the first molar, which was severely tipped and deeply impacted, a novel cantilever mechanics was used. The molar tube was bonded in the buccolingual direction to facilitate insertion of a cantilever from the buccal side. By twisting the distal end of the cantilever, sufficient uprighting moment was generated. The mesial end of the cantilever was hooked over the miniscrew placed between the canine and first premolar, which could prevent exertion of an intrusive force to the anterior portion of the dentition as a side effect. For repositioning of the second molar, an uprighting mechanics using a compression force with two step bends incorporated into a nickel-titanium archwire was employed. This generated an uprighting moment as well as a distal force acting on the tipped second molar to regain the lost space for the first molar and bring it into its normal position. This epoch-making uprighting mechanics could also minimize the extrusion of the molar, thereby preventing occlusal interference by increasing interocclusal clearance between the inferiorly placed two step bends and the antagonist tooth. Consequently, the two step bends could help prevent occlusal interference. After 2 years and 11 months of active treatment, a desirable Class I occlusion was successfully achieved without permanent tooth extraction.
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