The purpose of this study was to compare fracture resistance of Protaper (Dentsply), Hero Shapers (Micromega) and Twisted Files (Sybron Endo) NiTi instrument systems due to cyclic fatigue in curved canals. The methodology used in this study involved testing the cyclic fatigue of curved root canal instrument rotating at 375 rpm. A simulated model was created such that, the instrument will bend at 60 degrees during function, maximum curvature being 5 mm from the tip of the instrument. The number of rotations and time taken for the instrument to fracture was recorded in seconds using a stopwatch. The results were analyzed statistically. Twisted files (Sybron Endo) performed significantly better than Protaper (Dentsply) & Hero Shapers (Micromega). However there was no statistically significant difference between Protaper (Dentsply) & Hero Shapers (Micromega).

Objective: The aim of this in vitro study was to evaluate the influence of smear layer on the penetration depth of three different root canal sealers into the dentinal tubules. Study Design: Fifty two recently extracted human single-rooted teeth (> 20 mm long) were selected. After chemomechanical preparation using K-files and 1% sodium hypochlorite solution, the samples were randomly divided into two equal groups: group A: smear layer remained intact; group B: complete removal of smear layer using 15% aqueous EDTA. Two teeth from each group were used as controls. Eight teeth from each group were obturated with laterally condensed gutta-percha points and sealers Endoseal, Apexit, and AH-Plus, respectively. The penetration of sealers into the dentinal tubules was assessed using scanning electron microscope (SEM). Statistical analyses of the data were performed using one-way ANOVA test. Post-hoc comparisons by the Bonferroni test were used to determine whether the differences between the examined sealers were statistically significant. Results: Smear layer obstructed all the sealers from penetrating dentinal tubules. In contrast, smear layer removal allowed the penetration of all sealers to occur to a varying depth with Apexit and AH-Plus penetrating statistically significantly deeper than Endoseal. Conclusion: Smear layer plays an important role in sealer penetration into the dentinal tubules, as well as in the potential clinical implications.

Background & Objective: Radiographic images are routinely used in the field of endodontics for the diagnosis, treatment planning and follow-up of periapical bone lesions. The possibility of making a distinction between cystic lesions and granulomas among the lesions of endodontic origin may be important in the management of periapical pathosis and in predicting endodontic treatment. Recent developments in radiovisiography (RVG) and Ultrasonography have given the dentist the ability to perform radiographic examinations with greatly reduced rates of radiation exposure. Objective of the study is to assess whether the use of real time ultrasound imaging and RVG can help in the differential diagnosis of periapical lesions of endodontic origin. Method: Ten patients diagnosed with periapical lesions using conventional radiographic findings were subjected to radiovisiography and ultrasound imaging. The comparative evaluation of reports of radiologist and echographist was done to arrive at a tentative differential diagnosis. Interpretation and conclusion: This study has shown that there was definite correlation between the echo structure of a lesion and the nature of lesion. Cystic lesion versus granuloma. The results obtained tallied 90% of the time. Based on the results we can conclude that real time ultrasound imaging and RVG can be used in the endodontic field for the study of periapical lesions.

Objective: To compare the efficiency of gutta percha removal in retreatment using ProTaper retreatment files, RaCe instruments with and without H files – an ex-vivo evaluation. Study design: Seventy five human premolars with straight and single canal were used. Root Canals were prepared using a crown-down technique and obturated with GP and AH plus sealer using cold lateral compaction. The access cavities were filled and all teeth were stored in an incubator. All samples were randomly divided into 5 groups of 15 specimens each. H files [Gr 1], ProTaper retreatment files [Gr 2], RaCe instruments [Gr 3], ProTaper retreatment files followed by H files [Gr 4] and RaCe followed by H files [Gr 5]; were used group-wise to remove GP and sealer from the canal wall. Endosolv-R solvent was used. Canal wall cleanliness was assessed. Time for retreatment was noted. ANOVA test and Bonferroni multiple comparison tests were used for statistical analysis. Results: Combination of rotary NiTi instruments followed by hand instrumentation was more efficient in removing GP and sealer during retreatment. Gr 5 had least amount of remaining debris. Conclusion: RaCe instruments followed by H files were most efficient in removal of root canal fillings. Rotary instruments with or without H files were faster than combination of GGDs and H files during retreatment.

Objectives: The aim of the study was to assess the apical extrusion of intracanal bacteria following the use of various instrumentation techniques i.e hand K files, RaCe & ProTaper systems. Study design: Root canals of 40 single rooted teeth were contaminated with E.faecalis suspension and instrumented. Debris extruded from the canal during instrumentation was collected in the vials and evaluated by culturing. The number of colony forming units were determined and the data analysed using Kruskal Wallis and Mann-Whiteny U tests. Results: The results showed significant reduction in the CFU in the engine driven group when compared to the manual group. Conclusion: The apical extrusion of intracanal bacteria was significantly lesser in the engine driven techniques, when compared to the manual technique. However the differences between the engine driven groups were not statistically significant.

A case is reported documenting successful treatment of periapical cyst involving an, anomalous maxillary right lateral incisors with complete fusion with a central incisor. Surgical endodontic therapy was performed and partial resolution of the lesion was evident at the 1 month, 2 months recall and further resolution at the periodic intervals.

The anatomy of the root canal system determines the parameters under which the endodontic treatment will be accomplished and directly affects the success of the root canal treatment. Mandibular premolars have great variability in their internal morphology due to the possible presence of more than one root canal. This paper presents a case report of a mandibular second premolar with three canals and three different apical foramina. The intraoral clinical examination revealed a tooth affected with deep proximal caries. The radiographic examination showed the presence of three roots. The probable diagnosis was an acute pulpitis. Complete root canal treatment was carried out and the patient was periodically evaluated for prognosis.

Knowledge of both normal and abnormal anatomy of the root canal system dictates the parameters for execution of root canal therapy and can directly affect the outcome of the endodontic therapy. The following case report describes the management of the maxillary second molar with two palatal roots in which the diagnosis was confirmed with the help of spiral computed tomography. The article also highlights the variations in the canal configuration and morphology with the methods to successfully diagnose, negotiate and treat the teeth with different anatomical variations.

The aim of this case report is to demonstrate the apical closure and periapical healing which can occur even in large periapical lesions without surgical intervention by the use of Mineral Trioxide Aggregate (MTA) as an apical plug. A 28 year old male patient with a non contributory medical history reported with fractured central incisor which had open apices and periapical lesions .MTA as an apical plug was used after the root canals had been debrided and rinsed with 2.5% NaOCl. Calcium hydroxide paste was placed in the canal for 1 week, before the apical portion of the canal (4.5-5 mm) was filled with the MTA apical plug. A post was paced in the remaining portion of the canal, core buildup was done and a crown was cemented over it. After 6 months of follow-up, the clinical and radiographic examination of the teeth showed a significant reduction of the periapical lesion. At 1 year, the right central incisor had healed successfully.

Aim - Report of unusual presentation of two root canals in all mandibular incisors in a single patient. Summary - A wide morphological divergence of the root canal systems is known to exist. Varying number of the root canals in different teeth, their anatomy and interconnections have been studied and reported. This case report describes the successful endodontic treatment of all four mandibular incisors having two root canals in single individual. Radiographic examination revealed multiple canals in all mandibular central and lateral incisors having two canals in all of them. Endodontic intervention resulted in successful treatment of this unusual canal morphology. Literature reveals multiple canals in the mandibular central and lateral incisor teeth individually, but the highlight of this case report is finding of two canals in all 4 mandibular central and lateral incisors in single individuals.

Root canal treatment of teeth with complex root canal anatomy such as Dens Invaginatus can be problematic because infected pulpal tissues may remain in inaccessible areas of the canal system. The cleaning and debridement of such root canal systems are therefore challenging. An immature apical root end development is another challenge in Root Canal Treatment (RCT) especially in controlling the apical extent of the filling material and achieving an apical seal. This case report presents the endodontic treatment, apicocurettage and retrofilling using MTA in a case of an open apex and class II Dens invaginatus.

Introduction: The purpose of this article is to emphasize on the thorough knowledge of root canal anatomy. Methods: This case report describes the endodontic treatment of mandibular first molar with seven root canals (five mesial and two distal root canals) which was confirmed using angulated radiographs and computed tomography (CT-scan) scanning. Results: CT scan and radiographs showed that both mesiobuccal and mesiolingual root have Vertucci type IV canal pattern, whereas distal root showed Vertucci type II canal configuration. Conclusion: This case report describes the endodontic treatment of mandibular first molar with five mesial and two distal canals, with emphasis on rate of occurrence of multiple canals, and the importance of their identification and treatment.

Clinicians and researchers alike have tried to study the anatomy of the root canal system through various studies and techniques. The focus is presently however on the apical anatomy and the means of shaping and obturating the apex to provide an adequate seal. The complexity of the apical 3rd necessitates adequate access to the region; hence maintenane of a patent apical foramen is essential. This article reviews the significance of patency and patency filing in endodontics.

Microbial infection of the dental pulp, often the result of dental caries is the most common prelude to endodontic treatment. It has been demonstrated that exposed pulp tissues become necrotic in presence of bacterial contamination, chronic inflammation and eventually periapical granuloma develops. In the oral cavity of healthy persons Klebsiella may occur sporadically and in small numbers without producing pathologic changes, serious pathologic state of oral structures involving K. pnuemoniae often in mixed culture may develop under suitable conditions such as lack of oral hygiene…..it is of paramount importance that endodontist should have knowledge about specific bacterial species to administer correct drug regimen.

The primary function of corono-radicular post is to provide retention for a core and this is essential for the longevity of restorations placed on endodontically treated teeth. Individually, cast metal post and core has been a commonly used technique in the past to improve the retention of crowns and bridges on nonvital teeth. Root filled teeth with fractured or discolored coronal aspects often need to be restored, invariably with crowns. Often for mechanical reasons, the abutment has to be reinforced by a post and core system. Metal posts and cores are normally used, because of their superior physical properties. Nevertheless their metallic color poses a problem - aesthetics in anterior all ceramic restorations are compromised, particularly when a high lip-line or a broad smile reveals the entire restoration. Use of post system for the rehabilitation of endodontically treated teeth requires traditional planning for the function of the restoration as well as a structural and aesthetic strategy for novel technologies in ceramic and composite. The use of bondable materials allows the practitioner to unify the structure and morphology of root systems to provide creative solutions to challenges heretofore unmet. Ceramic post-and-core systems offer biocompatibility, aesthetics, reinforcement of the remaining root, and prosthesis retention. Aesthetic posts and cores contribute to the optical properties of the overlying restorations when metalfree crowns are used. With the increasing use of anterior all ceramic restorations to meet aesthetic needs, there is a need for tooth colored posts and cores, that are as good as if not better than their metallic non-aesthetic metal counterparts.

Health-care associated infections are an important cause of morbidity and mortality among hospital patients worldwide. Transmission of health care associated pathogens generally occurs via the contaminated hands of health care workers. Hand Hygiene has long been considered as one of the most important infection control measure to prevent health care associated infections.