The indications for surgical endodontics have become fewer with the advancements in non-surgical endodontic techniques and materials. However, there are some cases, which definitely require an apical surgery. The success of apical surgery depends on regeneration of the periapical tissues and filling of the osseous defects. For this purpose, different grafts are being used. One such allogenous bone graft is the newly introduced bio-resorbable, bioactive, natural hydroxyapatite crystals - NATGRAFT. The effects of this graft on bone regeneration is evaluated in this study. This graft was used in 2 cases with osseous defects by a simple procedure.The cases with 3 months follow up are presented here.

Biphasic Calcium Phosphate (BCP) ceramic composed of 60% hydroxyapatite (HA) and 40% BetaTricalcium Phosphate (B-TCP) was used in two endodontic cases. Both the ingradients of BCP have the mineral composition similar to that of bone, are biocompatible and bond well with the bone.The BCP ceramic was used in three surgical endodontic cases. The findings of the study suggest that BCP is a potential osteo-inductive material which will have wide ranging clinical applications in future.

An in-vitro study was carried out to investigate four methods of sealer placement- gutta percha point, file, lentulo spiral and bi-directional spiral to evaluate the location of sealer after obturation with lateral condensation and difference in sealer coverage among the four sealer placement techniques. Forty four freshly extracted human anterior teeth having straight and single canal and fully developed apices were selected. Canals were prepared by step back method and obturated using lateral condensation technique.The teeth were divided into four experimental groups depending upon the sealer placement technique. All the specimens were decalcified in 5% nitric acid solution. After dehydration in increasing grades of alcohol, they were placed in methyl salicylate for clearing. Stereomicroscopic evaluation of the specimen showed that bidirectional spiral- a recent innovation in sealer placement method-exhibited least sealer coverage. But its use showed better chance to fill accessory and lateral canals and prevented apical extrusion of the sealer.

Fractured anterior teeth with pulp exposure are usually restored with conventional post-core technique after being treated endodontically. Fractures that do not involve the epithelial attachment can be readily restored with a direct post and core. A more conservative procedure for these situations is presented in this paper. Reattachment procedure was performed in cases with traumatized teeth. The advantages and disadvantages of this technique is discussed. The recommended technique and may improve the success rate of traumatized anterior teeth in paediatric and adolescent patients. This paper will address the treatment regimen for reattachment of fractured fragments, a treatment option that offers advantages of simplicity, immediate esthetics and conservation in cases of dental trauma.

The aim of the present in-vitro study was to evaluate the efficacy of three endodontic irrigating solutions and also the working time required for effective removal of smear layer formed after biomechanical preparation of root-canals. 17% EDTA (ethylene di-amine tetra acetic acid), 5.25% NaOCl (Sodium hypochlorite) and their combination (17% EDTA and 5.25% NaOCl) were used for a working time of 5,10,15,20,25 and 30 minutes and their efficacy in smear layer removal was evaluated.The result of the study showed that when 17% EDTA was used alone, smear layer was totally removed after 30 min. working time. When 5.25% NaOCl was used alone, it had negligible effect on the removal of smear layer even after 30 min.Their combined use-EDTA followed by NaOCl - kept for a total of 20 min. removed the smear layer completely.

The effectiveness of root canal obturation after removal of smear layer by examining the rate of microbial leakage from the coronal direction was evaluated in this in -vitro study. Fifty freshly extracted human central incisors were decoronated and instrumented in a uniform manner. Following instrumentation, the root canals of 20 teeth were rinsed with 17% EDTA and 5.25% NaOCl to remove the smear layer before obturation. A second group of 20 teeth was flushed with NaOCl alone.The teeth in both the groups were obturated by lateral condensation of cold gutta percha using zinc oxide eugenol as sealer. The third group consisted of five teeth which served as positive control and the fourth group also having five teeth served as negative control. Each tooth was placed in a test tube containing sterile Trypticase Soy Broth (TSB). An inoculum of Proteus Vulgaris in Trypticase Soy Broth was placed in each coronal chamber at five days interval. Daily observation was made for bacterial growth in the apical reservoir for twenty one days. The frequency of bacterial penetration through teeth obturated with intact smear layer was significantly greater than that of teeth from which smear layer had been removed.