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"The use of instruments, such as files and reamers, to open the orifice and cleaning-shaping procedure, in a curved canal in excess of 20-degree angle without precurving instrument and irrigation may form a ledge in the canal. Treatment failure may result due to an inadequate cleaning at the apical third of the canal. This failure may be prevented by eliminating the ledge-correction of the curved canals. The purpose of this case is to highlight the importance of careful use of endodontic instruments to avoid ledging. Therefore knowledge of tooth morphology and the use of files in curved canals is an important factor."

"This case study reviewed conventional root canal treatment of a maxillary first premolar which unexpectedly had a single canal with two foramens. this tooth was recognized as the least frequent tooth appeared neither with additional canal nor unusual root anatomy. Retreatment for this casewas successfull through widening of the access cavity and the root canal. While trying the master cone, it revealed that the canal splitted and had two foramens. A thorough knowledge of the root canal anatomy as well as careful radiograph interpretations were essential in enhancing the root-cleaning procedure."

"ABSTRAKLatar Belakang: Gigi dengan saluran akar c-shape memiliki kompleksitas anatomi yang menjadikan perawatan saluran akar memiliki prognosis yang masih diperdebatkan akibat kesulitan untuk melakukan debridement dan obturasi yang adekuat. Kompleksitas ini mengakibatkan pengetahuan mengenai anatomi saluran akar c-shape penting untuk menunjang keberhasilan perawatan saluran akar. Tujuan: Mengetahui prevalensi dan variasi saluran akar c-shape pada gigi premolar pertama dan molar kedua rahang bawah. Metode: Penelitian menggunakan sampel 60 gigi premolar pertama dan 32 gigi molar kedua rahang bawah. Sampel dipindai menggunakan micro-CT Bruker SkyScan 1173 dengan resolusi 50 m. Pemotongan melintang untuk melihat bentuk saluran akar dilakukan menggunakan perangkat lunak DataViewer. Pengukuran sudut untuk menentukan klasifikasi c-shape dilakukan menggunakan perangkat lunak Fiji ImageJ. Hasil: Prevalensi c-shape pada gigi premolar pertama rahang bawah adalah 17 dengan prevalensi tipe C1 ditemukan paling besar pada tingkat pemotongan M, tipe C2 memiliki prevalensi terbesar pada AM, dan tipe C3 memiliki prevalensi terbesar pada tingkat pemotongan A 2. Tipe C4 mendominasi tingkat pemotongan CEJ-2 dan CM sedangkan tipe C5 hanya ditemukan pada tingkat pemotongan A 2. Prevalensi c-shape pada gigi molar kedua rahang bawah adalah 16,67 dengan klasifikasi yang paling banyak ditemukan pada kelima tingkat pemotongan adalah C1. Prevalensi konfigurasi tipe C2 terbesar ditemukan pada CM. Tipe C3 pada penelitian ini ditemukan pada tingkat O. Prevalensi tipe C4 paling besar ditemukan pada tingkat pemotongan A 2. Perubahan konfigurasi didapati terjadi sepanjang saluran akar. Kesimpulan: Prevalensi c-shape pada gigi premolar pertama rahang bawah adalah 17 sedangkan pada gigi molar kedua rahang bawah 16,67 . Terdapat variasi konfigurasi di sepanjang saluran akar.Kata kunci : c-shape, molar kedua rahang bawah, micro-CT, prevalensi, premolar pertama rahang bawah

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ABSTRACTBackground A tooth with c shaped root canal has a complex anatomy, making root canal treatment prognosis questionable because of the difficulties in doing adequate debridement and obturation. This complexity also makes the knowledge about root canal anatomy important to improve endodontic treatment result. Objective The aim of this study is to know the prevalence and variation of c shaped canal in mandibular first premolars and second molars. Methods 60 mandibular first premolars and 32 mandibular second molars was scanned using micro CT Bruker SkyScan 1173 in 50 m resolution. Transverse sectioning of each tooth was performed using software DataViewer. Angle measurement for determining c shape classification was performed using software Fiji ImageJ. Result The Prevalence of c shaped canal in mandibular first premolars was 17 with type C1 most prevalence in M, type C2 in AM, and type C3 in A 2. Type C4 was the most common classification found in sectioning level CEJ 2 and CM while type C5 was only found in A 2. The Prevalence of c shaped canal in mandibular second molars was 16,67 with the most common classification found in five level of sectioning was C1. C2 was most prevalence in level CM, C3 was most prevalence in O and C4 was most prevalence in A 2. The alteration of configuration happened along the root canal. Conclusion The prevalence of c shape canal in mandibular first premolars was is 17 and in mandibular second molars was 16,67 with variation of root canal configuration happened along the root canal itself.Keywords c shape, mandibular second molar, mandibular first premolar, micro CT, prevalence"

"Penelitian in vitro ini bertujuan untuk mengetahui variasi morfologi gigi insisif, caninus, premolar dan molar pada penampang melintang 1/3 servikal, 1/3 tengah dan 1/3 apikal akar.Metode: Penelitian dengan desain observasi deskriptif ini menggunakan 128 gigi yang telah dicabut. Sampel ditandai dengan spidol permanen pada 1/3 servikal (garis batas CEJ), 1/3 tengah dan 1/3 apikal akar. Selanjutnya dilakukan pemotongan secara melintang menggunakan diamond disc dengan low speed straight hand piece pada 1/3 servikal. Saluran akar dipreparasi dengan file kemudian diirigasi dengan larutan NaOCl 2,5%. Setelah saluran akar bersih, dilanjutkan dengan pemotongan secara melintang pada 1/3 tengah dan 1/3 apikal akar. Penampang melintang yang mempunyai 2 saluran akar dipisahkan untuk kemudian dideteksi adanya isthmus dengan pengaplikasian methylene blue. Pengamatan dilakukan dengan stereomicroscope perbesaran 10x dengan digital camera.Hasil: 100% gigi anterior hanya memiliki 1 saluran akar dengan variasi bentuk oval, long oval dan bulat pada penampang melintangnya. 80% P1 atas memilki 2 saluran akar dan 100% gigi premolar bawah memiliki 1 saluran akar dengan dominasi bentuk oval, long oval dan bulat pada penampang melintangnya. Gigi molar mayoritas memiliki 3 saluran akar dan bentuk saluran akar bervariasi mulai dari oval, long oval, bulat dan flat/pipih. Isthmus ditemukan pada gigi P1 atas, P bawah, akar mesiobukal M1 atas, dan akar mesial molar bawah dengan berbagai tipe. Pada gigi molar 2 bawah ditemukan saluran akar berbentuk C (c-shaped) walaupun sangat sulit membedakan c-shaped dengan menyatunya 2 atau 3 saluran akar akibat berfusinya akar.Kesimpulan: Berbagai variasi morfologi saluran akar yang ditemukan pada potongan melintang 1/3 servikal, 1/3 tengah dan 1/3 apikal akar harus menjadi pertimbangan dalam melakukan perawatan saluran akar.

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The purpose of this study was to assess the root canal morphological variations of insisive, caninus, premolar and molar using the cross section method.Methods: 128 extracted teeth were collected and stored in NaCl solution. The teeth were equally divided into a coronal, middle, and apical third. To divide it, the exact lengths of the root canals were determined. The root were resected using diamond disc with low speed straight hand piece. The resected root surface were polished, rinse and dried. The cross-sectional root surfaces that have two canals stained with methylene blue to investigate root canal isthmus classification. All the cross-sectional root surface examine using a stereomicroscope with digital camera.Results: 100% of the anterior teeth demonstrated a single canal, 80% of maxillary first premolar demonstrated two canals and 100% of mandibular molar had single canal. The shaped of canal was varied from oval, long oval or round in the coronal, middle and apical third. The molar teeth showed a high incidence of three root canals and the shaped more varied from oval, long oval, round or flat in the coronal, middle, and apical third. Isthmus frequently presence between two root canals within one root. It can observed in the maxillary first premolar, mandibular premolar, mesiobuccal roots of maxillary first molar and mesial roots of mandibular molar with different type. C-shaped mostly found in mandibular second molar. It may be difficult to distinguish between a C-shaped canal and a mandibular second molar with single or three canals joining apically.Conclussion: These root canal morphological variations should be considered during root canal treatment."

"Penelitian ini bertujuan untuk mengetahui frekuensi dan letak ramifikasi saluran akar yang ditemukan pada gigi molar. Penelitian ini menggunakan 56 gigi molar satu dan molar dua yang telah dicabut. Gigi-gigi ini terdiri dari 14 gigi molar satu rahang atas, 3 gigi molar dua rahang atas, 21 gigi molar satu rahang bawah dan 18 gigi molar dua rahang bawah.Metode : gigi direndam dalam larutan saline sampai saat percobaan. Dilakukan pembukaan akses dan preparasi dengan k-file sampai no. 15 kemudian saluran akar diirigasi dengan larutan NaOCl 2,5%. Setelah dikeringkan, gigi didekalsifikasi. Agar gigi terlihat bening gigi direndam dalam metil salisilat. Untuk mengidentifikasi ramifikasi, tinta cina diinjeksikan ke dalam sistem saluran akar. Masingmasing gigi diperiksa jumlah, tipe dan letak ramifikasi di bawah stereomikroskop.Hasil : Dari 56 gigi molar satu dan molar dua, 60,7% memiliki ramifikasi (46,4% saluran lateral; 10,7% apical ramifications dan 10,7% isthmus saluran akar). Sebanyak 50% ramifikasi terletak di 1/3 apikal dan 19,6% terletak di 1/3 tengah.Kesimpulan: Frekuensi ramifikasi saluran akar pada gigi molar satu dan molar dua cukup tinggi dan paling banyak terletak pada daerah 1/3 apikal."

"The primary tooth with caries process could be abscess and became non-vital inflammation of the pulp tissue extents into the root canals. An effort to maintain the non-vital primary teeth with fistula ispulpectomy. The primary tooth pulpectomy is a common clinical procedure. The choice of filling material and antibacterial properties against organism to inhabit infected primary root canal is important. The choice of filling material is zinc oxide eugenol and antibacterial medicament is formocresol. One appointment formocresol pulpectomy procedure is indicated when inflammation of the pulp tissueextend into the root canals, and possibly involves the periapical and/or bifurcation area. ln this case, after treatment with one-appointment formocresol pulpectomy in non-vital incisive lateral primary tooth withfistula is successful in one and eight months. This procedure provides an alternative to extraction and space maintenance when the pediatric dentist encounters a non-vital primary tooth."

"The strategy of root canal preparation should be determined according to the ability and authority of the operator. manually root canal preparation is the basic skill before using with machine, cleaning and shaping should be carried out simultaneously, so it takes less time during preparation of the root canal system. With full understanding of the basic principle of treatment and instument handling ability of endodontic, operator can do the improvisation technique of the root canal operation."

"Latar Belakang : Penyebab kegagalan perawatan saluran akar adalah kebocoran apeks yang ditentukan oleh teknik pengisian saluran akar. Tujuan : Untuk menganalisis kebocoran sepertiga apeks pada pengisian saluran akar menggunakan GuttaCore™. Metode : Dua puluh delapan gigi premolar bawah yang telah dilakukan pengisian saluran akar, diinkubasi (37°C, 24 jam), kemudian direndam dalam tinta india selama 7X24 jam. Sampel didekalsifikasi sampai transparan. Kedalaman penetrasi tinta dievaluasi dengan mikroskop stereo. Hasil : Seluruh pengisian dengan GuttaCore™ terlihat adanya penetrasi tinta sedalam 0-0.5 mm. Kesimpulan : Hasil pengisian saluran akar dengan teknik GuttaCore™ dapat menurunkan tingkat kebocoran di sepertiga apeks.

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Background : The cause of endodontic treatment failure is apical leakage determined by root obturation technique. Aim:To analyze leakage in apical third with GuttaCore™ obturation. Method : Twenty eight lower premolars were obturated and incubated (37*C, 24 hours) then immersed in indian ink for 7x24 hours. Samples were decalcified until transparent. Depth of ink penetration was evaluated using stereo microscope. Result: All obturation using GuttaCore™ technique resulted in 0-0.5 mm ink penetration Conclusion : Root obturation with GuttaCore technique is able to decrease leakage in apical third"

"The longevity of a tooth is based not on the pulp, but on the health of the attachment apparatus. Mikroorganism and their toxic products can passed out into the periapical tissue and generates lesions of endodontic origin. The rationale of root canal treatment now is based on biologic principles. Healing will occurr if biomecanical preparation, cleaning and shaping were properly excecuted and the root canal system is hermetically sealed in three dimension."

"Preparasi saluran akar menghasilkan ekstrusi debri, memicu respons inflamasi di periapeks. Tujuan: Mengamati perbedaan jumlah ekstrusi debri ke periapeks pada saluran akar yang dipreparasi menggunakan gerakan rotasi kontinyu dan resiprokal. Metode: Tigapuluh dua gigi premolar secara acak dibagi dalam dua kelompok. Kelompok 1 dipreparasi menggunakan gerakan rotasi kontiyu. Kelompok 2 menggunakan gerakan resiprokal. Penimbangan tabung penampung debri dilakukan dua kali, yaitu sebelum dan setelah preparasi. Perbedaan berat tabung tersebut dianggap sebagai berat debri terekstrusi. Hasil: Tidak terdapat perbedaan bermakna antara kelompok 1 dan 2 (p=0,844) Kesimpulan: Perbedaan gerakan preparasi saluran akar menggunakan rotasi kontinyu maupun resiprokal tidak memengaruhi jumlah ekstrusi debri ke periapeks.

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Root canal preparation produces debris extrusion, lead to inflammation in periapical tissue.

Objective: Assess the differences of periapically extruded debris amount after preparation using continous rotation and reciprocating motion.

Method: Thirty two premolars in a receptor tube were randomly divided into 2 groups. Group 1 was prepared using continuous rotation, Group 2 using reciprocating motion. Amount of the extruded debris was obtained by the receptor tube weight differences before and after preparation.

Results: The difference between groups were not statistically significant (p = 0,844).

Conclusion: Continuous rotation and reciprocating motion have no influence in the amount of periapically extruded debris."