

This study assessed the shape and anatomical relationship of the mental foramen (MF) to mandibular posterior teeth in an Indian sub-population.
In total, 475 existing cone-beam computed tomography records exhibiting 950 MFs and including the bilateral presence of mandibular premolars and first molars were assessed. Images were evaluated 3-dimensionally to ascertain the position, shape, and anatomical proximity of MFs to mandibular teeth. The position and shape of MFs were measured and calculated. The Pythagorean theorem was used to calculate the distance between the root apex of the mandibular teeth and the MF.
MFs exhibited a predominantly round shape (left: 67% and right: 65%) followed by oval (left: 30% and right: 31%) in both males and females and in different age groups. The root apices of mandibular second premolars (left: 71% and right: 62%) were closest to the MF, followed by distal to the first premolars and mesial to the second premolars. The mean vertical distance between the MF and the nearest tooth apex calculated on sagittal sections was 2.20 mm on the right side and 2.32 mm on the left side; no significant difference was found according to sex or age. The distance between the apices of the teeth and the MF was ≥ 4 mm (left; 4.09 ± 1.27 mm and right; 4.01 ± 1.15 mm).
These findings highlight the need for clinicians to be aware of the location of the MF in treatment planning and while performing non-surgical and surgical endodontic procedures.
Citations

This study aimed to evaluate and compare the efficacy of the S1 reciprocating system and the D-Race retreatment rotary system for filling material removal and the apical extrusion of debris.
Sixty-four freshly extracted maxillary canines were shaped with size 10 and size 15 K-files, instrumented using ProTaper Gold under irrigation with 2.5% sodium hypochlorite (NaOCl), obturated according to the principle of thermo-mechanical condensation with gutta-percha and zinc oxide eugenol sealer, and allowed to set for 3 weeks at 37°C. Subsequently, the teeth were divided into a control group (
No significant differences were found between the D-Race and S1 groups for primary retreatment; however, using a complementary cleaning method increased the removal of remnant filling (
Classical removal of canal filling material may not be sufficient for root canal disinfection, although a complementary finishing approach improved the results. Nevertheless, all systems left some debris and caused apical extrusion.
Citations

The aim of this article was to review age-dependent clinical recommendations for appropriate root canal instrumentation techniques. A comprehensive narrative review of canal morphology, the structural characteristics of dentin, and endodontic outcomes at different ages was undertaken instead of a systematic review. An electronic literature search was carried out, including the Medline (Ovid), PubMed, and Web of Science databases. The searches used controlled vocabulary and free-text terms, as follows: ‘age-related root canal treatment,’ ‘age-related instrumentation,’ ‘age-related chemo-mechanical preparation,’ ‘age-related endodontic clinical recommendations,’ ‘root canal instrumentation at different ages,’ ‘geriatric root canal treatment,’ and ‘pediatric root canal treatment.’ Due to the lack of literature with practical age-based clinical recommendations for an appropriate root canal instrumentation technique, a narrative review was conducted to suggest a clinical algorithm for choosing the most appropriate instrumentation technique during root canal treatment. Based on the evidence found through the narrative review, an age-related clinical algorithm for choosing appropriate instrumentation during root canal treatment was proposed. Age affects the morphology of the root canal system and the structural characteristics of dentin. The clinician’s awareness of root canal morphology and dentin characteristics can influence the choice of instruments for root canal treatment.
Citations

To compare the formation of dentinal defects using stainless-steel hand K-files (HFs), rotary files, reciprocating files, and Self-Adjusting File (SAF), when used for oval root canals.
One hundred and forty extracted human mandibular premolar with single root and oval canal were selected for this study. Oval canals were confirmed by exposing to mesio-distal and bucco-lingual radiographs. Teeth with open apices or anatomic irregularities were excluded. All selected teeth were de-coronated perpendicular to the long axis of the tooth, leaving roots segments approximately of 16 mm in length. Twenty teeth were left unprepared (control), and the remaining 120 teeth were divided into 6 groups (
The control, HF, and SAF did not exhibit any dentinal defects. In roots instrumented by RS, PTN, WO, and RC files exhibited microcracks (incomplete or complete) in 40%, 30%, 55%, and 50%, respectively.
The motor-driven root canal instrumentation with rotary and reciprocating files may create microcracks in radicular dentine, whereas the stainless-steel hand file instrumentation, and the SAF produce minimal or less cracks.
Citations

The purpose of this research was to identify the top 10 most-cited articles on the management of fractured or broken instruments and to perform a bibliometric analysis thereof.
Published articles related to fractured instruments were screened from online databases, such as Web of Science, Scopus, PubMed, and ScienceDirect, and highly cited papers, with at least 50 citations since publication, were identified. The most-cited articles were selected and analysed with regard to publication title, authorship, the journal of publication, year, institution, country of origin, article type, and number of citations.
The top 10 most-cited articles were from various journals. Most were published in the
This bibliometric analysis revealed interesting information about scientific progress in endodontics regarding fractured instruments. Overall, clinical research studies and basic research articles published in high-impact endodontic journals had the highest citation rates.
Citations

This study compared the amount of apically extruded bacteria during the glide-path preparation by using multi-file and single-file glide-path establishing nickel-titanium (NiTi) rotary systems.
Sixty mandibular first molar teeth were used to prepare the test apparatus. They were decoronated, blocked into glass vials, sterilized in ethylene oxide gas, infected with a pure culture of
The manual instrumentation technique tested in group KF extruded the highest number of bacteria compared to the other 4 groups (
All glide-path establishment instrument systems tested caused a measurable apical extrusion of bacteria. The manual glide-path preparation showed the highest number of bacteria extruded compared to the other NiTi glide-path establishing instruments.
Citations

The aim of this study was to compare the mechanical properties of various nickel-titanium (NiTi) files with similar tapers and cross-sectional areas depending on whether they were surface-treated.
Three NiTi file systems with a similar convex triangular cross-section and the same ISO #25 tip size were selected for this study: G6 (G6), ProTaper Universal (PTU), and Dia-PT (DPT). To test torsional resistance, 5 mm of the straightened file's tip was fixed between polycarbonate blocks (
PTU showed significantly greater toughness, followed by DPT and G6 (
Within the limitations of this study, it can be concluded that the torsional resistance of NiTi files was affected by the cross-sectional area, while the cyclic fatigue resistance of NiTi files was influenced by the surface treatment.
Citations

The purpose of this study was to compare the maximum screw-in forces generated during the movement of various Nickel-Titanium (NiTi) file systems.
Forty simulated canals in resin blocks were randomly divided into 4 groups for the following instruments: Mtwo size 25/0.07 (MTW, VDW GmbH), Reciproc R25 (RPR, VDW GmbH), ProTaper Universal F2 (PTU, Dentsply Maillefer), and ProTaper Next X2 (PTN, Dentsply Maillefer,
Reciproc and ProTaper Universal files generated the highest maximum screw-in forces among all the instruments while M-two and ProTaper Next showed the lowest (
Geometrical differences rather than shaping motion and alloys may affect the screw-in force during canal instrumentation. To reduce screw-in forces, the use of NiTi files with smaller cross-sectional area for higher flexibility is recommended.
Citations

This study aimed to compare two nickel-titanium systems (rotary
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
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.
Novice operators preferred nickel-titanium instruments to stainless-steel, and majority of them opted for reciprocating file instead of continuous rotating system.
Citations

Glide path preparation is recommended to reduce torsional failure of nickel-titanium (NiTi) rotary instruments and to prevent root canal transportation. This study evaluated whether the repetitive insertions of G-files to the working length maintain the apical size as well as provide sufficient lumen as a glide path for subsequent instrumentation.
The G-file system (Micro-Mega) composed of G1 and G2 files for glide path preparation was used with the J-shaped, simulated resin canals. After inserting a G1 file twice, a G2 file was inserted to the working length 1, 4, 7, or 10 times for four each experimental group, respectively (
The diameter at D0 level did not show any significant difference between the 1, 2, 4, and 10 times of repetitive pecking insertions of G2 files at working length. However, 10 times of pecking motion with G2 file resulted in significantly larger canal diameter at D1 (
Under the limitations of this study, the repetitive insertion of a G2 file up to 10 times at working length created an adequate lumen for subsequent apical shaping with other rotary files bigger than International Organization for Standardization (ISO) size 20, without apical transportation at D0 level.
Citations

The purpose of this study was to compare the cutting efficiency of a newly developed microprojection tip and a diamond-coated tip under two different engine powers.
The apical 3-mm of each root was resected, and root-end preparation was performed with upward and downward pressure using one of the ultrasonic tips, KIS-1D (Obtura Spartan) or JT-5B (B&L Biotech Ltd.). The ultrasonic engine was set to power-1 or -4. Forty teeth were randomly divided into four groups: K1 (KIS-1D / Power-1), J1 (JT-5B / Power-1), K4 (KIS-1D / Power-4), and J4 (JT-5B / Power-4). The total time required for root-end preparation was recorded. All teeth were resected and the apical parts were evaluated for the number and length of cracks using a confocal scanning micrscope. The size of the root-end cavity and the width of the remaining dentin were recorded. The data were statistically analyzed using two-way analysis of variance and a Mann-Whitney test.
There was no significant difference in the time required between the instrument groups, but the power-4 groups showed reduced preparation time for both instrument groups (
Ultrasonic tips with microprojections would be an option to substitute for the conventional ultrasonic tips with a diamond coating with the same clinical efficiency.
Citations

This study compared the mechanical properties of various instruments for canal exploration and glide-path preparations.
The buckling resistance, bending stiffness, ultimate torsional strength, and fracture angle under torsional load were compared for C+ file (CP, Dentsply Maillefer), M access K-file (MA, Dentsply Maillefer), Mani K-file (MN, Mani), and NiTiFlex K-file (NT, Dentsply Maillefer). The files of ISO size #15 and a shaft length of 25 mm were selected. For measuring buckling resistance (
The CP was shown to require the highest load to buckle and bend the files, and the NT showed the least. While MA and MN showed similar buckling resistances, MN showed higher bending stiffness than MA. The NT had the lowest bending stiffness and ultimate torsional strength (
The tested instruments showed different mechanical properties depending on the evaluated parameters. CP and NT files were revealed to be the stiffest and the most flexible instruments, respectively.
Citations

The aim of this study was to compare the cleaning efficacy of different final irrigation regimens in canal and isthmus of mandibular molars, and to evaluate the influence of related variables on cleaning efficacy of the irrigation systems.
Mesial root canals from 60 mandibular molars were prepared and divided into 4 experimental groups according to the final irrigation technique: Group C, syringe irrigation; Group U, ultrasonics activation; Group SC, VPro StreamClean irrigation; Group EV, EndoVac irrigation. Cross-sections at 1, 3 and 5 mm levels from the apex were examined to calculate remaining debris area in the canal and isthmus spaces. Statistical analysis was completed by using Kruskal-Wallis test and Mann-Whitney U test for comparison among groups, and multivariate linear analysis to identify the significant variables (regular replenishment of irrigant, vapor lock management, and ultrasonic activation of irrigant) affecting the cleaning efficacy of the experimental groups.
Group SC and EV showed significantly higher canal cleanliness values than group C and U at 1 mm level (
Both VPro StreamClean and EndoVac system showed favorable result as final irrigation regimens for cleaning debris in the complicated root canal system having curved canal and/or isthmus. The debridement of the isthmi significantly depends on the variables rather than the canals.
Citations

Aluminum step wedge (ASW) equivalent radiodensity (eRD) has been used to quantify restorative material's radiodensity. The aim of this study was to evaluate the effects of image acquisition control (IAC) of a digital X-ray system on the radiodensity quantification under different exposure time settings.
Three 1-mm thick restorative material samples with various opacities were prepared. Samples were radiographed alongside an ASW using one of three digital radiographic modes (linear mapping (L), nonlinear mapping (N), and nonlinear mapping and automatic exposure control activated (E)) under 3 exposure time settings (underexposure, normal-exposure, and overexposure). The ASW eRD of restorative materials, attenuation coefficients and contrasts of ASW, and the correlation coefficient of linear relationship between logarithms of gray-scale value and thicknesses of ASW were compared under 9 conditions.
The ASW eRD measurements of restorative materials by three digital radiographic modes were statistically different (
Even though different digital radiographic modes induced large variation on attenuation of coefficient and contrast of ASW, E mode improved diagnostic quality of the image significantly under the under-exposure condition by improving contrasts, while maintaining ASW eRDs of restorative materials similar. Under the condition of this study, underexposure time may be acceptable clinically with digital X-ray system using automatic gain control that reduces radiation exposure for patient.
Citations

This study compared the cyclic fatigue resistance of nickel-titanium (NiTi) files obtained in a conventional test using a simulated canal with a newly developed method that allows the application of constant fatigue load conditions.
ProFile and K3 files of #25/.06, #30/.06, and #40/.04 were selected. Two types of testing devices were built to test their fatigue performance. The first (conventional) device prescribed curvature inside a simulated canal (C-test), the second new device exerted a constant load (L-test) whilst allowing any resulting curvature. Ten new instruments of each size and brand were tested with each device. The files were rotated until fracture and the number of cycles to failure (NCF) was determined. The NCF were subjected to one-way ANOVA and Duncan's
Spearman's rank correlation coefficient (ρ = -0.905) showed a significant negative correlation between methods. Groups with significant difference after the L-test divided into 4 clusters, whilst the C-test gave just 2 clusters. From the L-test, considering the negative correlation of NCF, K3 gave a significantly lower fatigue resistance than ProFile as in the C-test. K3 #30/.06 showed a lower fatigue resistance than K3 #25/.06, which was not found by the C-test. Variation in fatigue test methodology resulted in different cyclic fatigue resistance rankings for various NiTi files.
The new methodology standardized the load during fatigue testing, allowing determination fatigue behavior under constant load conditions.
Citations

The aim of this study was to evaluate the shaping ability of newly marketed single-file instruments, Wave·One (Dentsply-Maillefer) and Reciproc (VDW GmbH), in terms of maintaining the original root canal configuration and curvature, with or without a glide-path.
According to the instruments used, the blocks were divided into 4 groups (
The ability of instruments to remain centered in prepared canals at 1 and 2 mm levels was significantly lower in Group 1 (
The Wave·One file should be used following establishment of a glide-path larger than #15.
Citations

The purpose was to investigate the preference and usage technique of NiTi rotary instruments and to retrieve data on the frequency of re-use and the estimated incidence of file separation in the clinical practice among general dentists.
A survey was disseminated via e-mail and on-site to 673 general dentists. The correlation between the operator's experience or preferred technique and frequency of re-use or incidence of file fracture was assessed.
A total of 348 dentists (51.7%) responded. The most frequently used NiTi instruments was ProFile (39.8%) followed by ProTaper. The most preferred preparation technique was crown-down (44.6%). 54.3% of the respondents re-used NiTi files more than 10 times. There was a significant correlation between experience with NiTi files and the number of reuses (
A large number of general dentists in Korea prefer to re-use NiTi rotary files. As their experience with NiTi files increased, the number of re-uses increased, while the frequency of breakage decreased. Operators who adopt the hybrid technique showed less tendency of separation even with the increased number of re-use.
Citations

The purpose of this study was to evaluate the effect of various application methods of one-step self-etch adhesives to microtensile resin-dentin bond strength.
Thirty-six extracted human molars were used. The teeth were assigned randomly to twelve groups (
Manual agitation and ultrasonic agitation of adhesive significantly increased the microtensile bond strength than single coating and double coating did. Double coating of adhesive significantly increased the microtensile bond strength than single coating did and there was no significant difference between the manual agitation and ultrasonic agitation group. There was significant difference in microtensile bonding strength among all adhesives and Clearfil Tri-S Bond showed the highest bond strength.
In one-step self-etching adhesives, there was significant difference according to application methods and type of adhesives. No matter of the material, the manual or ultrasonic agitation of the adhesive showed significantly higher microtensile bond strength.
Citations

To determine the effect of the spectral output of single and dual-peak light emitting diode (LED) curing lights on the microhardness and color stability of commercial resin composites formulated with camphorquinone and alternative photoinitiators in combination.
Three light-polymerized resin composites (Z100 (3M ESPE), Tetric Ceram (Ivoclar Vivadent) and Aelite LS Posterior (Bisco)) with different photoinitiator systems were used. The resin composites were packed into a Teflon mold (8 mm diameter and 2 mm thickness) on a cover glass. After packing the composites, they were light cured with single-peak and dual-peak LEDs. The Knoop microhardness (KHN) and color difference (ΔE) for 30 days were measured. The data was analyzed statistically using a student's
All resin composites showed improved microhardness when a third-generation dual-peak LED light was used. The color stability was also higher for all resin composites with dual-peak LEDs. However, there was a significant difference only for Aelite LS Posterior.
The dual-peak LEDs have a beneficial effect on the microhardness and color stability of resin composites formulated with a combination of camphorquinone and alternative photoinitiators.
Citations

This case report compared the effectiveness of resin infiltration technique (Icon, DMG) with microabrasion (Opalustre, Ultradent Products, Inc.) in management of white spot lesions. It demonstrates that although neither microabrasion nor resin infiltration technique can remove white spot lesions completely, resin infiltration technique seems to be more effective than microabrasion. Therefore resin infiltration technique can be chosen preferentially for management of white spot lesions and caution should be taken for case selection.
Citations

The aim of this paper is to discuss the mechanical and geometric features of Nickel-titanium (NiTi) rotary files and its clinical effects. NiTi rotary files have been introduced to the markets with their own geometries and claims that they have better ability for the root canal shaping than their competitors. The contents of this paper include the (possible) interrelationship between the geometries of NiTi file (eg. tip, taper, helical angle, etc) and clinical performance of the files as follows;
- Fracture modes of NiTi rotary files - Non-cutting guiding tip and glide path - Taper and clinical effects - Cross-sectional area and clinical effects - Heat treatments and surface characteristics - Screw-in effect and preservation of root dentin integrity - Designs for reducing screw-in effect
Based on the reviewed contents, clinicians may have an advice to use various brands of NiTi rotary instruments regarding their advantages which would fit for clinical situation.
Citations

This study examined the effect of 2% chlorhexidine on the µTBS of a direct composite restoration using one-step self-etch adhesives on human dentin.
Twenty-four extracted permanent molars were used. The teeth were assigned randomly to six groups (
Regardless of the application of chlorhexidine, the Clearfil S3 Bond showed the highest µTBS, followed by G-Bond and Xeno V. Adhesive failure was the main failure mode of the dentin bonding agents tested with some samples showing cohesive failure.
The application of 2% chlorhexidine did not affect the µTBS of the resin composite to the dentin using a one-step self-etch adhesive.

The aim of this study was to compare the push-out bond strengths of resin cement/fiber post systems to post space dentin using different application methods of resin cement.
Thirty extracted human premolars were selected and randomly divided into 3 groups according to the technique used to place the cement into root canal: using lentulo-spiral instrument (group Lentulo), applying the cement onto the post surface (group Direct), and injecting the material using a specific elongation tip (group Elongation tip). After shaping and filling of the root canal, post space was drilled using Rely-X post drill. Rely-X fiber post was seated using Rely-X Unicem and resin cement was light polymerized. The root specimens were embedded in an acrylic resin and the specimens were sectioned perpendicularly to the long axis using a low-speed saw. Three slices per each root containing cross-sections of coronal, middle and apical part of the bonded fiber posts were obtained by sectioning. The push-out bond strength was measured using Universal Testing Machine. Specimens after bond failure were examined using operating microscope to evaluate the failure modes.
Push-out bond strengths were statistically influenced by the root regions. Group using the elongation tip showed significantly higher bond strength than other ways. Most failures occurred at the cement/dentin interface or in a mixed mode.
The use of an elongation tip seems to reduce the number of imperfections within the self-adhesive cement interface compared to the techniques such as direct applying with the post and lentulo-spiral technique.
Citations

The aim of this study was to compare apical sealing ability and physical properties of MTA, MTA - AH-plus mixture (AMTA) and experimental Portland cement - Epoxy resin mixture (EPPC) for a development of a novel retro-filling material.
Forty-nine extracted roots were instrumented and filled with gutta-percha. Apical root was resected at 3 mm and the retro-filling cavity was prepared for 3 mm depth. Roots were randomly divided into 3 groups of 15 roots each. The retro-filling was done using MTA, AMTA, and EPPC as the groups divided. Four roots were used as control groups. After setting in humid condition for 24 hours, the roots were immersed in 1% methylene blue dye solution for 72 hours to test the apical leakage. After immersion, the roots were vertically sectioned and photos were taken to evaluate microleakage. Setting times were measured with Vicat apparatus and digital radiographs were taken to evaluate aluminum equivalent thickness using aluminum step wedge. The results of microleakage and setting time were compared between groups using one-way ANOVA and Scheffe's post-hoc comparison at the significance level of 95%.
AMTA and EPPC showed less microleakage than MTA group (
Under the condition of this study, the novel composite using Portland cement-Epoxy resin mixture may useful for retro-filling with the properties of favorable leakage resistance, radio-opacity and short setting time.
Citations

The purpose of this study was to evaluate the effect of Er,Cr:YSGG laser irradiation with hypersensitivity mode on microtensile bond strength of composite resin. Twenty extracted permanent molars were randomly assigned to six groups, according to the irradiation of Er,Cr:YSGG laser, adhesive system (Optibond FL or Clearfil SE bond) and application time of etchant (15 sec or 20 sec). Then composite resin was build up on each conditioned surface. The restored teeth were stored in distilled water at room temperature for 24 h and twelve specimens for each group were prepared. All specimens were subjected to microtensile bond strength and the fracture modes were evaluated. Also, the prepared dentin surface and laser irradiated dentin surface were examined under SEM.
The results were as follows:
The microtensile bond strength of laser irradiated group was lower than that of no laser irradiated group. Regardless of laser irradiation, the microtensile bond strength of Optibond FL was higher than that of Clearfil SE bond. And the microtensile bond strength of 20 sec etching group was higher than that of 15 sec etching group when using Optibond FL. The SEM image of laser irradiated dentin surface showed prominent peritubular dentin, opened dentinal tubules and no smear layer.
Citations

This study compared the effect of an activator, intermediate bonding resin and low-viscosity flowable resin on the microtensile bond strength of a self-curing composite resin used with two-step total etching adhesives. Twenty extracted permanent molars were used. The teeth were assigned randomly to nine groups (n=10) according to the adhesive system and application of additional methods (activator, intermediate adhesive, flowable resin). The bonding agents and additional applications of each group were applied to the dentin surfaces. Self-curing composite resin buildups were made for each tooth to form a core, 5mm in height. The restored teeth were then stored in distilled water at room temperature for 24h before sectioning. The microtensile bond strength of all specimens was examined. The data was analyzed statistically by one-way ANOVA and a Scheffe's test. The application of an intermediate bonding resin (Optibond FL adhesive) and low-viscosity flowable resin (Tetric N-flow) produced higher bond strength than that with the activator in all groups. Regardless of the method selected, Optibond solo plus produced the lowest µTBS to dentin. The failure modes of the tested dentin bonding agents were mostly adhesive failure but there were some cases showed cohesive failure in the resin.

The purpose of this study was to compare the dye leakage of MTA (mineral trioxide aggregate) apical plug produced by two orthograde placement techniques (hand condensation technique and ultrasonically assisted hand condensation technique).
To simulate straight canal, 60 transparent acrylic blocks with straight canal were fabricated. These transparent acrylic blocks were divided into 2 groups (Group C; hand condensation technique (HC) and Group U; ultrasonically assisted hand condensation technique (UAHC)) of 30 blocks with each MTA application method. Each group was divided into 2 subgroups (n = 15) with different canal size of #70 (subgroup C70 and subgroup U70) and #120 (subgroup C120 and subgroup U120). After apical plug was created, a wet paper point was placed over the MTA plug and specimen was kept in a humid condition at room temperature to allow MTA to set. After 24 hours, remaining canal space was backfilled using Obtura II. All specimens were transferred to floral form socked by 0.2% rhodamine B solution and stored in 100% humidity at room temperature. After 48 hours, resin block specimens were washed and scanned using a scanner. The maximum length of microleakage was measured from the scanned images of four surfaces of each resin block using Photoshop 6.0.
Statistical analysis was performed with Mann-Whitney U test. Group U of UAHC had significantly lower leakage than Group C of HC in #70-size canal (subgroup U70) (p < 0.05).

The purpose of this study was to evaluate the influence of elastic modulus of restorative materials and the number of interfaces of post and core systems on the stress distribution of three differently restored endodontically treated maxillary second premolars using 3D FE analysis. Model 1, 2 was restored with a stainless steel or glass fiber post and direct composite resin. A PFG or a sintered alumina crown was considered. Model 3 was restored by EndoCrown. An oblique 500 N was applied on the buccal (Load A) and palatal (Load B) cusp. The von Mises stresses in the coronal and root structure of each model were analyzed using ANSYS. The elastic modulus of the definitive restorations rather than the type of post and core system was the primary factor that influenced the stress distribution of endodontically treated maxillary premolars. The stress concentration at the coronal structure could be lowered through the use of definitive restoration of high elastic modulus. The stress concentration at the root structure could be lowered through the use of definitive restoration of low elastic modulus.
Citations

The purpose of this study was to investigate the effects of four restorative materials under various occlusal loading conditions on the stress distribution at the CEJ of buccal, palatal surface and central groove of occlusal surface of endodontically treated maxillary second premolar, using a 3D finte element analysis.
A 3D finite element model of human maxillary second premolar was endodontically treated. After endodontic treatment, access cavity was filled with Amalgam, resin, ceramic or gold of different mechanical properties. A static 500N forces were applied at the buccal (Load-1) and palatal cusp (Load-2) and a static 170N forces were applied at the mesial marginal ridge and palatal cusp simultaneously as centric occlusion (Load-3). Under 3-type Loading condition, the value of tensile stress was analyzed after 4-type restoration at the CEJ of buccal and palatal surface and central groove of occlusal surface
Excessive high tensile stresses were observed along the palatal CEJ in Load-1 case and buccal CEJ in Load-2 in all of the restorations. There was no difference in magnitude of stress in relation to the type of restorations. Heavy tensile stress concentrations were observed around the loading point and along the central groove of occlusal surface in all of the restorations. There was slight difference in magnitude of stress between different types of restorations. High tensile stress concentrations around the loading points were observed and there was no difference in magnitude of stress between different types of restorations in Load-3.

The purpose of this study was to compare the stress distributions of NiTi rotary instruments based on their cross-sectional geometries of triangular shape-based cross-sectional design, S-shaped cross-sectional design and modified rectangular shape-based one using 3D FE models.
NiTi rotary files of S-shaped and modified rectangular design of cross-section such as Mtwo or NRT showed larger stress change while file rotation during simulated shaping.
The stress of files with rectangular cross-section design such as Mtwo, NRT was distributed as an intermittent pattern along the long axis of file. On the other hand, the stress of files with triangular cross-section design was distributed continuously.
When the residual stresses which could increase the risk of file fatigue fracture were analyzed after their withdrawal, the NRT and Mtwo model also presented higher residual stresses.
From this result, it can be inferred that S-shaped and modified rectangular shape-based files were more susceptible to file fracture than the files having triangular shape-based one.
Citations

The purpose of this study was to investigate the distribution of tensile stress of canal obturated maxillary second premolar with access cavity and notch-shaped class V cavity restored with composite resin using a 3D finite element analysis.
The tested groups were classified as 8 situations by only access cavity or access cavity with notch-shaped class VS cavity (S or N), loading condition (L1 or L2), and with or without glass ionomer cement base (R1 or R2). A static load of 500 N was applied at buccal and palatal cusps. Notch-shaped cavity and access cavity were filled microhybrid composite resin (Z100) with or without GIC base (Fuji II LC). The tensile stresses presented in the buccal cervical area, palatal cervical area and occlusal surface were analyzed using ANSYS.
Tensile stress distributions were similar regardless of base. When the load was applied on the buccal cusp, excessive high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The tensile stress values of the tooth with class V cavity were slightly higher than that of the tooth without class V cavity. When the load was applied the palatal cusp, excessive high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The tensile stress values of the tooth without class V cavity were slightly higher than that of the tooth with class V cavity.

The purpose of this study was to compare the effect of various dentin bonding systems on microtensile bond strength of immediate dentin sealing (IDS) and delayed dentin sealing (DDS). Eighteen extracted permanent molars were used in this study. The teeth for DDS group were restored with a provisional restorations, and immersed in saline solution for 1 week, and divided into 3 subgroups according to various dentin bonding adhesives; SB subgroup (3 step total-etch adhesive), SE subgroup (2 step self-etch adhesive), XE subgroup (1 step self-etch adhesive). In IDS group, the teeth were divided into 3 subgroups, and applied with bonding adhesives as in DDS group. The teeth were restored with provisional restorations, and immersed in saline solution for 1 week. Indirect composite disc was cemented with resin cement, and all specimens were subjected to microtensile bond strength. The data were statistically analyzed with one-way ANOVA and Student t-test.
The results were as follows:
The IDS group showed significantly higher µTBS than DDS group in 3 step total-etch and 2 step self-etch adhesive (p < 0.05). In IDS and DDS group, 3 step total-etch adhesive showed the highest µTBS value, followed by 2 step self-etch, and 1 step self-etch adhesive. In IDS group, the µTBS value for 1 step self-etch adhesive was significantly different from those of the other subgroups (p < 0.05), and in DDS group, there were statistical differences in all subgroup (p < 0.05). Failure modes of tested dentin bonding adhesives were mostly mixed failure and only 1 step self-etch adhesive showed adhesive failure.
Citations

The aim of the present study is to compare the corrosion tendency using two kinds of NiTi files in the various environmental conditions through the visual examination and electrochemical analysis. ProTaper Universal S2, 21 mm (Dentsply Maillefer, Ballaigues, Switzerland) and Hero 642, 0.06 tapers, size 25, 21 mm (Micromega, Besancon, France) rotary instruments were tested. The instruments were randomly divided into eighteen groups (n = 5) by the immersion temperature, the type of solution, the brand of NiTi rotary instrument and the presence of mechanical loading. Each file was examined at various magnifications using Scanning Electron Microscope (JEOL, Akishima, Tokyo, Japan) equipped with energy dispersive X-ray microanalysis (EDX). EDX was used to determine the components of the endodontic file alloy in corroded and noncorroded areas. The corrosion resistance of unused and used NiTi files after repeated uses in the human teeth was evaluated electrochemically by potentiodynamic polarization test using a potentiostat (Applied Corrosion Monitoring, Cark-in-Cartmel, UK).
Solution temperature and chloride ion concentration may affect on passivity of NiTi files. Under the conditions of this in vitro study, the corrosion resistance is slightly increased after clinical use.
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Flexibility and fracture properties determine the performance of NiTi rotary instruments. The purpose of this study was to evaluate how geometrical differences between three NiTi instruments affect the deformation and stress distributions under bending and torsional conditions using finite element analysis.
Three NiTi files (ProFile .06 / #30, F3 of ProTaper and ProTaper Universal) were scanned using a Micro-CT. The obtained structural geometries were meshed with linear, eight-noded hexahedral elements. The mechanical behavior (deformation and von Mises equivalent stress) of the three endodontic instruments were analyzed under four bending and rotational conditions using ABAQUS finite element analysis software. The nonlinear mechanical behavior of the NiTi was taken into account.
The U-shaped cross sectional geometry of ProFile showed the highest flexibility of the three file models. The ProTaper, which has a convex triangular cross-section, was the most stiff file model. For the same deflection, the ProTaper required more force to reach the same deflection as the other models, and needed more torque than other models for the same amount of rotation. The highest von Mises stress value was found at the groove area in the cross-section of the ProTaper Universal.
Under torsion, all files showed highest stresses at their groove area. The ProFile showed highest von Mises stress value under the same torsional moment while the ProTaper Universal showed the highest value under same rotational angle.
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The purpose of this study was to investigate the influence of various occlusal loading sites and directions on the stress distribution of the cervical composite resin restorations of maxillary second premolar, using 3 dimensional (3D) finite element (FE) analysis. Extracted maxillary second premolar was scanned serially with Micro-CT (SkyScan1072; SkyScan, Aartselaar, Belgium). The 3D images were processed by 3D-DOCTOR (Able Software Co., Lexington, MA, USA). HyperMesh (Altair Engineering, Inc., Troy, USA) and ANSYS (Swanson Analysis Systems, Inc., Houston, USA) was used to mesh and analyze 3D FE model. Notch shaped cavity was filled with hybrid (Z100, 3M Dental Products, St. Paul, MN, USA) or flowable resin (Tetric Flow, Vivadent Ets., FL-9494-Schaan, Liechtenstein) and each restoration was simulated with adhesive layer thickness (40 µm). A static load of 200 N was applied on the three points of the buccal incline of the palatal cusp and oriented in 20° increments, from vertical (long axis of the tooth) to oblique 40° direction towards the buccal. The maximum principal stresses in the occlusal and cervical cavosurface margin and vertical section of buccal surfaces of notch-shaped class V cavity were analyzed using ANSYS. As the angle of loading direction increased, tensile stress increased. Loading site had little effect on it. Under same loading condition, Tetric Flow showed relatively lower stress than Z100 overall, except both point angles. Loading direction and the elastic modulus of restorative material seem to be important factor on the cervical restoration.
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The purpose of this study is to compare the shear bond strength of repaired composite resin with different bonding agents and evaluate the effect of bonding agents on composite repair strength. Forty composite specimens (Z-250) were prepared and aged for 1week by thermocycling between 5 and 55℃ with a dwell time of 30s. After air abrasion with 50 µm aluminum oxide, following different bonding agents were applied (n = 10); SB group: Scotchbond multipurpose adhesive (3 step Total-Etch system); SE group: Clearfil SE bond (2 step Self-Etch system); XP group: XP bond (2 step Total-Etch system); XE group: XenoIII (1 step Self-Etch system). After bonding procedure was completed, new composite resin (Z-250) was applied to the mold and cured. For control group, 10 specimens were prepared. Seven days after repair, shear bond strength was measured. Data was statistically analyzed using one-way ANOVA and Tukey's test (p < 0.05). The means and standard deviations of shear bond strength (MPa ± S.D.) per group were as follows: SB group: 17.06; SE group: 19.10; XP group: 14.44; XE group: 13.57; Control Group: 19.40. No significant difference found in each group. Within the limit of this study, it was concluded that the different type of bonding system was not affect on the shear bond strength of repaired composite resin.
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The purpose of this study was to evaluate the effect of additional etching procedure prior to Maxcem resin cement application in indirect restoration cementation using push-out bonding strength.
One hundred and two extracted human molars were used to make indirect resin restorations of gold inlay and Synfony. These restorations were cemented using Maxcem and Variolink II. Additional etching procedures were done for one group with Maxcem. Three groups have 17 specimens in both restoration types. Push-out bond strength was measured using multi-purpose tester and calculated for bonding strength per sqaure-millimeter area. The mean bonding strength values were compared using SPSS 12.0K program for one-way ANOVA and Scheffe's Test with 95% significance.
Under the condition of this study, the additional etching procedure prior to usage of Maxcem resulted in reduced bond strength for both of restoration types.
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The purpose of this study was to evaluate the difference in the surface roughness after polishing and to evaluate the difference in color stability after immersion in a dye solution among four types of composite resin materials. Four light-polymerized composite resins (Shade A2) with different sized filler content (a nanofilled, a hybrid, a microfilled, a flowble) were used. Average surface roughness (Ra) was measured with a surface roughness tester (Surftest Formtracer) before and after polishing with aluminum oxide abrasive discs (Super-Snap). Color of specimens before and after staining with 2% methylene blue solution were measured using spectrophotometer (CM-3700d) with SCI geometries. The results of Ra and ΔE were analyzed by one-way analysis of variance (ANOVA), a Scheffe multiple comparison test and Student t-test (p = 0.05). After polishing, Ra values were decreased regardless of type of composite resins. In surface roughness after polishing and color stability after staining, nanofilled composite resin was not different with other composite resins except flowable resins.
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Currently, various Nickel-Titanium rotary files are used in endodontic treatment, but there is no one perfect system that can be applied to any clinical situation. Therefore, the combined uses of various file systems which can emphasize the advantages of each system are introduced as hybrid instrumentation.
The ProTaper system is efficient in body shaping and apical pre-enlargement but is reported to have more possibility of transportation and produce more aberrations and deformation in more or less severe curved canals. Recently, new ProTaper system (ProTaper Universal) with different configuration and cross-sectional design to overcome the week points of ProTaper have been marketed.
The purpose of this study was to compare and evaluate the shaping abilities of ProTaper, ProTaper Universal system, and two hybrid methods using S-series of ProTaper Universal and Hero Shaper or ProFile.
The time lapses for instrumentation were measured and the used files were inspected for distortion. The pre- and post-instrumented root canals were scanned and superimposed to evaluate the aberrations and reduction of root canal curvature and change of radius of canal curvature. The increased canal width and apical centering ratio were calculated at 1, 2, 3, 4 and 5 mm levels from apical foramen.
Under the conditions of this study, the ProTaper Universal seems to have better shaping ability than ProTaper in terms of instrumented width and instrumentation time. It may be suggested that the ProTaper Universal system is efficient as much as hybrid instrumentation using ProTaper and other constant-tapered NiTi file systems in highly experienced operators.
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The purpose of this study was to compare the apical leakage of the root canal filled with the System B and the EndoTwinn (the combined application of heat and ultrasonic vibration).
Sixty extracted premolars with straight root were cleaned and shaped to size 35. Group SB was obturated using System B and Group ET was filled with EndoTwinn. A size 35 of 0.06 tapered gutta-percha and Adseal were used and the plugger which could be introduced to 4 mm short of working length was selected in the obturation procedure. As the positive control, Group PC was not filled. In Group SB, ET and PC, all external surfaces of each tooth were coated with nail varnish leaving only 1 mm area around the apical foramen. In the negative control of Group NSB and Group NET, all of external tooth surface including apical foramen was coated with the nail varnish. The specimens were immersed in methylene blue dye solution for 2 days. Then the specimens were sectioned at each 1 mm from apex to 5 mm level. The final score of one specimen was given by summing up of the points at all levels.
The dye leakage of Group ET was significantly less than that observed in Group SB (p < 0.05). And the frequency of gutta-percha pulling out from root canal when the plugger was removed was more often with the System B than with EndoTwinn but there was no significant difference.

The purpose of this study was to compare apical sealing ability of continuous wave canal filling technique according to various heat source plugging depths.
Eighty one extracted human premolars with straight root were cleaned and shaped to size 35 using .06 taper rotary NiTi file. After cleansing and shaping, the teeth were divided into 5 groups following the heat source probing depths from the apex; 3, 4, 5, 6 and 7 mm. All specimens were filled using E&Q plus with #35 / .06 tapered gutta-percha cone. The positive control teeth were not filled. All teeth were coated with nail varnish except the apical 1 mm around the apical foramen. Negative control teeth were completely sealed include the apical foramen. All specimens were immersed in 1% methylene blue solution for 72 hours. Then the specimens were sectioned horizontally at 1, 2 and 3 mm from the root apex. Each sectioned surface was photographed using a digital camera attached to the stereomicroscope at 12.5 × 2.5 fold magnification. All points at 1, 2 and 3 mm were summed as final score of one specimen. Statistical analysis of the collected data was performed.
Under the condition of this study, there was no significant difference between the heat source plugging depths of 3, 4, 5, 6 and 7 mm in apical sealing ability. All of apical heat source plugging depth from 3 to 7 mm including Buchanan's protocol -from 5 to 7 mm- seems to be acceptable in clinical application.

The aims of this study were to compare the shaping effect and safety between single length technique recommended by manufacturer and crown-down technique using Mtwo rotary file and to present a modified method in use of Mtwo file.
Sixty simulated root canal resin blocks were used. The canals were divided into three groups according to instrument and the manner of using methods. Each group had 20 specimens. Group MT was instrumented with single length technique of Mtwo, group MC was instrumented with crowndown technique of Mtwo and group PT was instrumented with crown-down technique of ProTaper. All of the rotary files used in this study were operated by an electric motor. The scanned canal images of before and after preparation were superimposed. These superimposed images were evaluated at apical 1 to 8 mm levels. Angle changes were calculated. The preparation time, weight loss, instrument failure and binding, canal aberrations, and centering ratio were measured. Statistical analysis of the three experimental groups was performed with ANOVA and Duncan's multiple range tests for post-hoc comparison and Fisher's exact test was done for the frequency comparison.
In total preparation time, group MT and group MC were less than group PT. In the aberrations, group MT had more elbows than those of group MC and group PT. The binding of group MC was least and group MT was less than group PT (
Under the condition of this study, crown-down technique using Mtwo rotary file is better and safer method than single length technique recommended by the manufacturer.

The purpose of this study was to investigate the effects of composite resin restorations on the stress distribution of notch shaped noncarious cervical lesion using three-dimensional (3D) finite element analysis (FEA).
Extracted maxillary second premolar was scanned serially with Micro-CT (SkyScan1072; SkyScan, Aartselaar, Belgium). The 3D images were processed by 3D-DOCTOR (Able Software Co., Lexington, MA, USA). ANSYS (Swanson Analysis Systems, Inc., Houston, USA) was used to mesh and analyze 3D FE model. Notch shaped cavity was filled with hybrid or flowable resin and each restoration was simulated with adhesive layer thickness (40 µM). A static load of 500 N was applied on a point load condition at buccal cusp (loading A) and palatal cusp (loading B). The principal stresses in the lesion apex (internal line angle of cavity) and middle vertical wall were analyzed using ANSYS.
The results were as follows
1. Under loading A, compressive stress is created in the unrestored and restored cavity. Under loading B, tensile stress is created. And the peak stress concentration is seen at near mesial corner of the cavity under each load condition.
2. Compared to the unrestored cavity, the principal stresses at the cemeto-enamel junction (CEJ) and internal line angle of the cavity were more reduced in the restored cavity on both load conditions.
3. In teeth restored with hybrid composite, the principal stresses at the CEJ and internal line angle of the cavity were more reduced than flowable resin.
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The purposes of this study were to examine the variability of adhesive thickness on the different site of the cavity wall when used total-etch system without filler and simplified self-etch system with filler and to evaluate the relationship between variable adhesive thickness and microtensile bond strength to the cavity wall.
A class I cavity in six human molars was prepared to expose all dentinal walls. Three teeth were bonded with a filled adhesive, Clearfil™ SE bond and the other three teeth were bonded with unfilled adhesives, Scotchbond™ Multi Purpose. Morphology and thickness of adhesive layer were examined using fluorescence microscope. Bonding agent thickness was measured at three points along the axial cavity wall, edge of cavity margin
For both bonding agents, adhesive thickness of
Adhesive thickness of internal angle of the cavity was significantly thicker than that of the cavity margin and the halfway cavity wall for both bonding agents. Microtensile bond strength of the thick adhesive layer at the internal angle of the cavity was higher than that of the thin adhesive layer at the cavity margin and the halfway cavity in the two bonding systems.
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The purposes of this study were to compare the apical terminus width of simulated curved root canal prepared with three NiTi file systems used by undergraduates for evaluation the effects of flute angle and pitch or radial land on reducing screw-in effect and to determine more safe NiTi file system for inexperienced operators.
Fifty inexperienced undergraduate students prepared 150 simulated curved root canals in resin blocks with three NiTi file systems ; ProFile®, Hero Shaper®, K3™. The electric motor set at a speed of 300 rpm and torque of 30 in a 16 : 1 reduction handpiece was used. The simulated root canal was prepared to ISO #25 sizes with each file system. The scanned images of pre- and post-instrumented canal of resin block were superimposed. To evaluate the screw-in effect of three NiTi file systems, apical terminus width of root canal was measured from superimposed images and statistical analysis was performed.
There were significant differences in three NiTi file systems. ProFile® had significantly smaller width than Hero Shaper® and K3™ (P < 0.05), but no significant difference was observed between K3™ and Hero Shaper®.
Under the condition of this study, active file system (Hero Shaper®, K3™) with variable pitch and helical angle had more screw-in effect than passive file system (ProFile®) with constant pitch and helical angle. It seems that the radial lands play more important role in reducing screw-in effect.
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The purposes of this study were to compare the effects of one or two applications of all-in-one adhesives on microtensile bond strengths (µTBS) to unground enamel and to investigate the morphological changes in enamel surfaces treated with these adhesives using a scanning electron microscopy (SEM).
Twenty-five noncarious, unrestored human mandibular molars were used. The unground enamel surfaces were cleansed with pumice. The following adhesives were applied to lingual, mid-coronal surfaces according to manufacture's directions; Clearfil SE bond in SE group, Adper Prompt L-Pop™1 coat in LP1 group, 2 coats in LP2 group, Xeno® III 1 coat in XN1 group, and 2 coats in XN2 group. After application of the adhesives, a hybrid light-activated resin composite was built up on the unground enamel. Each tooth was sectioned to make a cross-sectional area of approximately 1.0 mm2 for each stick. The microtensile bond strength was determined. Each specimen was observed under SEM to examine the morphological changes. Data were analyzed with one-way ANOVA.
The results of this study were as follows;
1. The microtensile bond strength values were; SE (19.77±2.44 MPa), LP1 (13.88±3.67 MPa), LP2 (14.50±2.52 MPa), XN1 (14.42±2.51 MPa) and XN2 (15.28±2.79 MPa). SE was significantly higher than the other groups in bond strength (p < 0.05). All groups except SE were not significantly different in bond strength (p < 0.05).
2. All groups were characterized as shallow and irregular etching patterns.
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The objective of this study was to investigate the effects of various occlusal loads on the stress distribution of the buccal cervical region of a normal maxillary second premolar, using a three dimensional finite element analysis (3D FEA).
After 3D FE modeling of maxillary second premolar, a static load of 500N of three load cases was applied. Stress analysis was performed using ANSYS (Swanson Analysis Systems, Inc., Houston, USA). The maximum principal stresses and minimum principal stresses were sampled at thirteen nodal points in the buccal cervical enamel for each four horizontal planes, 1.0 mm above CEJ, 0.5 mm above CEJ, CEJ, 0.5 mm under CEJ.
The results were as follows
1. The peak stress was seen at the cervical enamel surface of the mesiobuccal line angle area, asymmetrically.
2. The values of compressive stresses were within the range of the failure stress of enamel. But the values of tensile stresses exceeded the range of the failure stress of enamel.
3. The tensile stresses from the perpendicular load at the buccal incline of palatal cusp may be shown to be the primary etiological factors of the NCCLs.
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The purposes of this study were to assess the accuracy of measurements in pre-enlarged canals with small instruments and to compare the accuracies, in enlarged canal, with small size instruments and instruments that match the actual canal diameter using Root ZX, Bingo1020, SmarPex, and e-Magic Finder. Ten extracted teeth were embedded in an alginate model made for testing apex locators. A size 10 file was placed into the root canal until the tip of the file reached the plane of the major diameter of the foramen under a dental operating microscope at the 25 × magnification. The measurement was done with digital caliper and defined as actual length. Electronic length measurement with a size 10 file in pre-enlarged canal was done by reading the index indicating Apex of each device to gain a definite value. After completion of canal enlargement to a size 45 file, each difference between actual length and electric measurement value with a size 10 and 40 files in enlarged canal was recorded as L10 and L40. The one-way ANOVA and Scheffe's multiple range tests were computed for analyze the differences among the four apex locators in the same group. The Student's t-test between L10 and L40 of each locator was done. The accuracies of electronic measurements were significantly different among the 4 devices. The file size made no difference on the accuracy of electronic measurement in enlarged canal with same device. The e-Magic Finder was the most accurate device among the 4 apex locators used in this study.
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