Introduction: Failures of root canal treatment are mainly due to missed canals and ignorance about the anatomy of the root canal system. The middle mesial (MM) canal is one such type of canal in mandibular molars which is often missed. The aim of this study was to identify MM canals first with unaided eyes, then after troughing, followed by magnification and to compare it with cone beam computed tomography (CBCT). Materials and Methods: Fifty extracted mandibular first and second molars were taken. Preoperative CBCT scans were done for these intact teeth, which were not studied at this stage. Access cavities were made and detection and negotiation of the MM canals was done first with unaided eyes, followed by other added aids like troughing and magnification. Then, CBCT scans were evaluated to compare the incidence obtained and to study the configuration of the found canals. Results: The number of MM canal found with unaided eyes was 29% and 46% in the first and second molars which increased to 41.6% and 50% after troughing the groove between mesiobuccal and mesiolingual canal. It further increased to 45.85% and 53.8% after magnification. CBCT analysis showed same number of canals, but studying the canal configuration, clinically helped in negotiation of five otherwise nonnegotiable canals. Ninety percent of MM canals in the first molars and 100% in the second molars were confluent type, whereas 10% in the first molars were independent type. Conclusion: Troughing, magnification, and CBCT can help us in better identification and negotiation of otherwise difficult to find MM canals.

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Aim: The purpose of this study was to compare the incidence of postoperative pain in 80 endodontically treated teeth, with and without apical patency, in relation to some diagnostic factors (vitality, presence of preoperative pain, group of treated teeth). Materials and Methodology: Apical patency was maintained during shaping procedures with a #10 K-file in one group (n = 40) and not in the other (n = 40). Root canal treatment was done in single visit. Pain was recorded 1st day, 2nd day and 7th day using VAS scale. Results: There were no statistically significant differences between patency and non patency groups regarding incidence and degree of postoperative pain. Only preoperative pain has significant effect on postoperative pain. Conclusion: Our study concluded that maintenance of apical patency did not increase the incidence of postoperative pain when considering all variables together.

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Aim: The objective of this study was to determine the pain produced from needle insertion at bilateral labial site prepared with topical application of 2% lidocaine gel, 20% benzocaine gel, and placebo paste at subsequent visits in a same patient. Materials and Methods: Forty healthy individuals aged 18-30 years old were subjected to three sessions in which they were treated with 2% lidocaine gel, 20% benzocaine gel, and placebo paste. in all sessions, a 26-gauge needle was inserted in maxillary labial mucosa before and 1 min after the drug application. Immediately, after needle insertion, participants indicated pain intensity on visual analog scale (VAS). Results and Conclusions: Pain responses were compared based on subjects' self-report using VAS. Results showed that lidocaine and benzocaine were equally effective, and both were better than placebo in reducing the pain of needle insertion.

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Aim: The aim of this in vitro study was to compare the push-out bond strength of Biodentine (Septodont, Saint Maur des Fosses, France) and mineral trioxide aggregate (MTA) (Angelus, Londrina, PR, Brazil) when treated with 3% sodium hypochlorite (NaOCl) and 2% chlorhexidine gluconate (CHX). Materials and Methods: Forty-six single canal premolars were selected for this study, and the canal spaces were prepared with #5 Gates glidden drill (1.3 mm diameter). The dentin of these teeth was horizontally sectioned into 1-mm-thick slices at the mid-root level. The samples were divided into two groups (n = 20). Biodentine and MTA were placed into the canal space of dentin slices. The samples were wrapped in wet gauze for 10 min and divided into two subgroups (n = 10) to be immersed into 3% NaOCl and 2% CHX for 30 min. No irrigation was performed in the controls (n = 3). After incubation for 48 h, the dislodgement resistance of the samples was measured using a universal testing machine. The samples were examined under a stereomicroscope to determine the nature of the bond failures. Results: Biodentine showed significantly higher push-out bond strength than MTA (P < 0.05) in the presence of both NaOCl and CHX. Within the MTA group, CHX further reduced the push-out bond strength when compared with NaOCl. Conclusion: Push-out bond strength is the force needed for the displacement of the dental material tested. The various irrigants used during the root canal therapy may increase or decrease the push-out bond strength of a material.

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Introduction: The aim of this study was to compare calcium (Ca) ion-releasing capacity of four different light-cured calcium hydroxide [Ca(OH)₂] cements with self-cured Ca(OH)₂cement. Materials and Methods: Five different brands of Ca(OH)₂cements were taken and they were grouped into five groups which are as follows: Group I - Dycal (control group), Group II - Septocal, Group III – TheraCal, Group IV - Cal LC, and Group V - Hydrocal. All specimens (n = 50) were prepared by mixing and curing the cements as per manufacturer's instructions. Each sample was placed on the bottom of a 4 cm high test tube in 10 ml deionized water at 37°C. This stored water was collected for Ca analysis and replaced after 7, 14, and 21 days. In this manner, ion release was measured after 7, 14, and 21 days by inductively coupled plasma-optical emission spectroscopy test. Results: Ca ion release from all groups at various time durations was measured and mean was calculated along with the standard deviation. These values were compared using two-way ANOVA and Tukey's post hoc test which showed highly significant result with P< 0.001. Conclusions: Within the limitations of this study, light-cured Ca(OH)₂cements released high amount of Ca ions compared to self-cured Ca(OH)₂cements. Group V (Hydrocal) and Group III (TheraCal) were found to be the highest light-cured Ca ion releasing materials.

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Introduction: To study the root canal morphology of mandibular incisors and canines in South Asian Indians using a staining and tooth clearing technique. Materials and Methods: One hundred each of mandibular central incisors, lateral incisors, and canine specimens were collected from various dental schools and clinics across India. Pulp tissue was removed and the root canals were stained with Indian ink. The specimens were subjected to decalcification in 10% nitric acid followed by dehydration in ascending concentrations of alcohol. Subsequently, specimens were cleared in methyl salicylate. Results: All hundred mandibular central incisors were single rooted with a single canal. Ninety-six percent had a single and 4% had two apical foramina. While 84% had Type I, 8% had Type II, 4% had Type III, and 4% had Type IV Vertucci's root canal anatomy. No lateral canals were seen. All hundred mandibular lateral incisors were single rooted with a single canal. While 92% had a single foramen, 8% had two apical foramina. While 80% had Type I, 8% had Type II, 4% had Type III, and 8% had Type IV Vertucci root canal anatomy. Four percent of the lateral incisors showed the presence of lateral canals. All hundred mandibular canines studied were single rooted with a single canal, one apical foramen. Ninety-two percent had a Type I and 8% had a Vertucci Type II root canal anatomy with 12% of the specimen showing the presence of lateral canals. Conclusion: Not much variation was seen in the root canal anatomies with Vertucci Type I anatomy predominating. Lateral canals were present in the mandibular lateral incisors and canines.

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Introduction: A successful endodontic treatment depends upon complete debridement of microflora from the root canal system. However, due to complex root canal configuration, complete debridement through mechanical instrumentation alone cannot remove entire bacterial load. So the aim is in vitro evaluation of antimicrobial efficacy of biological extracts against Enterococcus faecalis MTCC-439 strain when used as intracanal medicaments. The medicaments used were Nissin, an antibiotic peptide; neem known for its antiseptic properties; platelet rich plasma (PRP) known for its regenerative properties and propolis, a resin extract derived from bees. Materials and Methods: Sixty single rooted lower premolar teeth which were extracted for orthodontic purpose were collected. Tooth specimens were sectioned at cement-enamel junction with a diamond saw to obtain a standard root length. The root canals of the specimen were instrumented with K3 rotary files followed by inoculation of E. faecalis strains and sealed with dental wax. The specimens were then kept in incubator for 21 days at 37°C and after that randomly divided into six treatment groups: Group I, 5 μL Normal saline; Group II, 5 μL Nisin (Vasta Biotech, Chennai); Group III, 5 μL propolis; Group IV, 5 μL neem; Group V, 5 μL PRP; Group VI, 5 μL Calcium hydroxide. Roots were then incubated for 7 days at 37°C. On 8^th day, to evaluate the degree of infection, dentin chips from root canal of specimens were extracted with a sterile 6% K3 rotary file. Kruskal–Wallis test and Mann–Whitney U-test were applied for difference in colony forming units (CFUs) count for different medicaments. Results: In present in vitro study, Nisin showed no CFU while neem and propolis showed significantly less growth as compared to PRP and calcium hydroxide against E. faecalis. Conclusions: Nisin outreach propolis and neem in eliminating the E. faecalis when used as intracanal medicaments.

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Aim: Maxillary sinusitis of odontogenic origin accounts for approximately 10%–12% of maxillary sinusitis cases. The primary objective of the present study was to analyze the vertical relationship between the maxillary posterior roots and the adjacent maxillary sinus floor (MSF) in the Indian population using cone-beam computed tomography. The secondary objective was to correlate the data with age and gender. Materials and Methods: The shortest distance between 452 maxillary posterior teeth and the adjacent border of MSF was measured. The data were divided into three groups. Group IS included maxillary posterior teeth roots protruding into the sinus, Group CO included root apices contacting the MSF, and Group OS included root apices not contacting the MSF. The data obtained were correlated with age and gender. Results: The vertical distance of the root apices of second premolars from the MSF was significantly lesser compared to the root apices of first premolars (P < 0.05). The difference between the vertical distance of buccal roots and palatal roots (PRs) of first molar from the MSF was significantly more (P < 0.05). Majority of the roots of posterior teeth were located below the MSF border (Type OS). Type IS was most frequently seen for PRs of maxillary first molars (29.12%). The frequency of Type IS decreased with increasing age. The distance between the posterior root apices and the adjacent border of the MSF was found to be more in males compared to females. Conclusion: The PRs of maxillary first molars were found to be closest to the MSF. Variation in the vertical relationship was found by age and gender.

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The dental invagination is an abnormal dental development merely agreed to be a gene-related disorder. There are three types of invaginations, of which Type I is the most common. The diagnosis is based on clinical and above all radiological examinations. An early prophylactic approach is often the most effective mean of treatment. This paper describes the clinical and radiographic features related to the different types of dens invaginatus and the therapeutic approach through several cases.

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Mandibular canine is generally considered to have one root and one canal, but it may possess two canals and even less frequently two roots and two or three canals. This article highlights the identification and endodontic management of two cases of a rare anatomical variation in mandibular canine with two roots and two canals.

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Apexification is the process of induction of calcific barrier across the open apex or the continued apical development in an immature tooth with infected necrotic pulp. The presented case was of a 19-year-old male patient with discolored and fractured upper front left tooth and open apex. Immature permanent teeth pose difficulties during endodontic treatment because of the wide-open root apex and thin dentin walls. This article describes single-visit apexification using Biodentine, a new calcium silicate-based material as an apical barrier along with platelet-rich fibrin as internal matrix.

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Aim: Clinical evaluation and comparison of the effect of 2% chlorhexidine gel and triple antibiotic paste with calcium hydroxide on incidence of interappointment flare-up in diabetic patients. Materials and Methods: Thirty-six diabetes mellitus patients seeking endodontic treatment were assigned to three groups: Group I - calcium hydroxide paste, Group II - triple antibiotic paste, and Group III - 2% chlorhexidine gel. Access opening and chemomechanical preparation was done followed by the placement of intracanal medicaments. Samples were then assessed for the incidence of intra-appointment flare-up at 1, 2, 3, 7, and 14 days using verbal rating scale. Obtained scores were statistically analyzed using one-way ANOVA test and Tukey's post hoc test. Results: Total incidence of interappointment flare-up was found to be 13%. For all the groups, statistically significant difference (P < 0.05) was seen at days 1, 2, 3, and 7, with insignificant difference at day 14. Intragroup comparison showed statistically significant difference present between Group I and II and Group I and III with (P < 0.05) at days 1, 2, 3, and 7. No statistically significant difference was seen between Group II and III in all 14 days. Conclusion: Both triple antibiotic paste and 2% chlorhexidine gel were significantly effective for minimizing the interappointment flare-up and postoperative symptoms in diabetic patients. 2% chlorhexidine gel found to be more effective clinically, as compared to other experimental groups.

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Aims: To evaluate and compare the effectiveness of periapical surgery using mineral trioxide aggregate (MTA) as a retrograde filling material with/without using hydroxyapatite or platelet-rich fibrin (PRF) in curetted periapical defect and to evaluate the patients clinically and radiographically at each recall visit. Subjects and Methods: The study was conducted on thirty patients having periapical radiolucency in maxillary anterior teeth. The selected teeth were divided into three groups: Group A, Group B, and Group C having 10 teeth each. All the teeth were treated with single visit root canal treatment. The periapical curettage along with apicoectomy was followed thereafter. In all the groups, root end cavity was prepared. In Group A, root end cavity was filled with MTA. In Group B, root end cavity was filled with MTA followed by placement of hydroxyapatite in the curetted periapical defect. In Group C, root end cavity was filled with MTA followed by placement of PRF in the curetted periapical defect. In all the three groups, patient recall visits were scheduled after 1, 3, 6, and 9 months time interval for clinical and radiological examination. Results: A significantly higher rate of healing was observed after 9 months in Group C (82.36%) followed by Group B (65.16%) and Group A (60.12%). Conclusions: Placement of root end filling material contributes greatly to the success of surgical treatment. To enhance the healing of periapical defect, use of host modulating agents such as PRF is preferred over grafts as these are autologous and contain growth factors that promote faster healing of periapical defects.

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Introduction: The efficacy of the bond between the restorative materials and the pulp capping materials has an important role in the success of vital pulp therapy. Aims and Objective: This study was conducted to investigate and compare the shear bond strength (SBS) of Biodentine, Endocem mineral trioxide aggregate (MTA), and TheraCal LC to resin composite using a universal adhesive at their respective initial setting time and to identify the specific modes of failure using a stereomicroscope at × 25 magnification. Materials and Methods: A total of 60 acrylic blocks were prepared. Each of the blocks were prepared 20 mm high and 12 mm diameter and had a central hole of 2 mm depth and 5 mm diameter. These acrylic blocks were divided into three groups of 20 samples each based on the liner that is condensed into prepared central hole as Group A – Biodentine, Group B – Endocem MTA, and Group C – TheraCal LC. Composite was then bonded to each sample using universal adhesive. SBS analysis was performed at a cross-head speed of 1 mm/min. Observation and Results: Mean SBS of Group B (Endocem MTA) with composite was found to be significantly lower than that of Group A (Biodentine) with composite which was further significantly lower than that of Group C (TheraCal LC) with composite. Conclusion: This present study concludes that the bond strength of resin-based light-curable TheraCal LC showed clinically acceptable and highest SBS values when used with a universal silane containing adhesive.

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One of the most frequent mishaps during root canal procedure is the separation of an endodontic instrument during biomechanical preparation. It prevents proper debridement of the canal apical to the fragment and compromises the success of the treatment. Development in techniques and armamentarium has led to successful retrieval of separated instrument from the root canal. Adequate knowledge, good clinical skill, and experience enable good management of instrument fractured in the root canal. In this report, we present three cases with separated instruments in the root canal which were successfully retrieved with the use of ultrasonics under magnification.

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Tooth structure that remains after endodontic treatment has been undermined and weakened by all of the previous episodes of caries, fracture, tooth preparation, or restoration. A post and core becomes a necessity in most of the cases. The tooth is further weakened when the clinician decides to give a full coverage crown which leads to greater tooth structure loss. In these two case reports, a novel technique has been discussed involving a new material in which lost tooth structure is restored by means of direct composite resin. The teeth following the treatment are structurally strong and possess good esthetics.

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Anatomical variations in the premaxillary region, especially those involving neurovascular structures, can present a diagnostic challenge to a clinician. Correct diagnosis is crucial for treatment decision-making and prognosis assessment of nonsurgical and surgical procedures. Canalis sinuosus (CS) is an anatomical variation of the anterior superior alveolar nerve canal. Its diagnosis may sometimes be confusing, resulting in an inadequate treatment plan. Described is a case of a CS mimicking an external root resorption lesion. Cone beam computed tomography (CBCT) assisted in confirming the final diagnosis.

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Introduction: Nature has bestowed a very rich botanical wealth. Antimicrobial agents of plant origin have enormous therapeutic potential. Azadirachta Indica (AI) & Aloe Barbadensis (AB) are the natural product that has gained interest in endodontics as irrigant due to their antibacterial effectiveness against several endodontic pathogens. Hence the purpose of this in vivo study was to compare the antimicrobial efficacy of herbal (Azadirachta Indica & Aloe Barbadensis) with conventional (Sodium Hypochlorite and Chlorhexidine Gluconate) irrigants in infected root canals. Methodology: One hundred and twenty five patients satisfying the inclusion criteria were selected. Before and after the root canal preparation, two canal samples were obtained by a harvesting method using a sterile paper point and then transferred for microbiological study. Results: The results of present study indicated that use of Sodium Hypochlorite showed greatest percentage reduction in Aerobic Microbial Load (87.58%) followed by Azadirachta Indica (82.24%), Chlorhexidine Gluconate (78.32%), Aloe Barbadensis (27.22%) and Distilled Water (15.73%). In anaerobic microbial load Azadirachta Indica showed greatest percentage reduction (78.43%) followed by Chlorhexidine Gluconate (78.12%), Sodium Hypochlorite (75.16%), Distilled Water (12.38%) and Aloe Barbadensis (-9.74%). Conclusion: The results of present study indicate that the number of post-irrigant positive cultures (CFU/ml) was significantly lower than the pre-irrigant cultures in all the groups.

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Objectives: The aim of this study was to compare manual and two nickel titanium (NiTi) rotary retreatment systems in removing gutta-percha obturated with two different sealers. Materials and Methods: Sixty extracted, human, single-rooted mandibular premolars were selected. Endodontic treatment was performed using ProTaper Universal NiTi rotary instruments. Half of the samples were obturated with Tubliseal and remaining half were obtutared with AH Plus sealer with cold lateral compaction method. Subsequently, twenty teeth were retreated with manual retreatment system, and each twenty teeth was retreated with two different rotary retreatment systems. The roots were then grooved longitudinally, and both root halves were subjected to assessment under stereomicroscope, and images were taken with a digital camera. These images were evaluated for residual obturating material using AutoCAD software. Analysis of variance test and Bonferroni multiple comparison test were used for statistical analysis. Results and Conclusion: Results of the present study showed that no system was able to completely remove all debris from the root canals. The minimum amount of debris was seen in the group obturated using Tubliseal sealer and retreated with Hyflex NT retreatment system followed by Mtwo retreatment system and finally the manual retreatment protocol. Regarding the time taken, Mtwo retreatment files took least time to remove the obturating material in all sealer groups.

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Introduction: Biomechanical preparation (BMP) of root canal damages the root dentin which becomes a gateway to dentinal cracks and thereby causing failure of the treatment. Therefore, there is a need of best instruments to minimize the failure of endodontic treatment. Aims and Objective: The objective of this study is to compare the incidence of cracks observed in the root dentin after root canal preparation with three different rotary instrument systems. Material and Methods: Seventy-five freshly extracted permanent maxillary incisors were randomly selected. Teeth were divided into five groups (n = 15), Group 1 – Untreated (negative control group), Group 2 – BMP done with nickel–titanium K-files (positive control group), Group 3 – BMP done with ProTaper Universal files, Group 4 – BMP done with ProTaper Next files, and Group 5 – BMP done with HyFlex EDM files. Roots were sectioned horizontally at 2 mm, 4 mm, and 6 mm from the apex. All slices were then viewed under stereomicroscope. All findings were analyzed using Chi-square test. Observations and Results: In the apical third, Group 5 had maximum number of fracture cases while Group 4 had lesser number and Group 3 had the least. In the middle third, Group 3 had maximum number of fracture cases while Group 4 and Group 5 showed lesser number of fractures. In the cervical third, Group 3 and Group 4 showed equal and maximum number of fracture cases. Group 5 showed no fracture cases. Group 1 and Group 2 showed no fracture cases in all the root sections. Conclusion: Conventional hand instrumentation is the best as compared to rotary instrumentation. However, rotary systems render various benefits with an acceptable success in comparison to the conventional hand instrumentation. In our study, we found that HyFlex EDM rotary system was the best with least number of fracture as compared to other systems used.

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Aim: This in vivo study was done to correlate the values of three different electronic apex locators: Root ZX, iPex, and Apex ID, with the radiographic working length (WL). Materials and Methods: Nineteen maxillary incisors with completely formed root apices indicated for endodontic treatment were chosen. After access preparation, coronal flaring and pulp extirpation, electronic measurement of WL was done with a No: 15 K file using the three devices on each tooth. A WL radiograph was then taken with the file placed within the canal and the length determined by following Ingle's method. The data were then analyzed using the correlation coefficient and Z-test. Results: Root ZX showed the maximum correlation (r = 0.9881) with radiographic WL followed by Apex ID (R = 0.9731) and iPex (R = 0.9508). Root ZX had a statistically significant higher correlation with radiographic WL in comparison with iPex (P < 0.05). Conclusion: Maximum correlation of readings with the radiographic length was shown by Root ZX followed by Apex ID and then by iPex.

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Introduction: To evaluate and compare antimicrobial efficacy of calcium hydroxide, extracts of mushroom and Aloe vera leaves against Enterococcus faecalis, and to assess the minimal inhibitory concentration (MIC) of extracts of mushroom and A. vera against E. faecalis. Materials and Methods: Ninety freshly extracted single-rooted teeth were decoronated and canals enlarged up to F3 (ProTaper). The samples were sterilized and infected with E. faecalis and incubated for 21 days. Teeth samples were then divided into three groups. Group 1: calcium hydroxide, Group 2: mushroom extract, and Group 3: A. vera extract. At the end of 1, 3, and 5 days, microbiological sampling and culturing were done from the root canal dentinal shavings obtained and colony forming units (CFUs) were counted. The MIC was determined for two plant extracts against E. faecalis strains using ELISA microdilution method. Statistical analysis was done using analysis of variance technique and multiple comparisons were done using (post hoc test) Bonferroni test. Results: The number of CFUs was statistically significant in all the groups. Percentage reduction of CFUs was highest in mushroom followed by A. vera and calcium hydroxide. MIC for calcium hydroxide was 40 mg/ml, A. vera extract 60 mg/ml, and for mushroom extract 40 mg/ml. Conclusions: Antibacterial activity of the mushroom extract was highest followed by A. vera extract and then calcium hydroxide, at all time periods tested in this study. Antibacterial activity of all the groups increased with time.

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Introduction: A successful root canal therapy is largely dependent on thorough chemo-mechanical debridement of the root canal space. However, mechanical preparation inadvertently forms an amorphous layer, known as the “smear layer.” Traditionally used irrigants have a deleterious effect over root dentin and thus herbal alternatives can be a better option for smear layer removal with no action on root dentin. Aim: The purpose of the study was to compare the in vitro effectiveness of two potential herbal irrigants: 6% German chamomile extract (GCE) and 6% Morinda citrifolia juice (MCJ), in removal of smear layer. Materials and Methods: Eighty single-rooted human teeth were allocated into two equal groups: one to be instrumented with the self-adjusting file (SAF), while the other with WaveOne (WO). Four subgroups in each group were irrigated with 6% GCE, 6% MCJ, 17% ethylenediaminetetraacetic acid (EDTA) (positive control), and NS (negative control). Scanning electron microscopy (SEM) was used to evaluate the presence of smear layer. Statistical Analysis: As data for smear layer were categorical, Chi-square test was applied for data analysis. P < 0.05 was considered statistically significant. Results: The most effective smear layer removal in the coronal part was observed with SAF-EDTA and SAF-GCE, followed by WO-EDTA. In the middle part, SAF-GCE was equivalent to that of SAF-EDTA, followed by WO-EDTA and WO-GCE. In the apical third, the most efficient smear layer removal was observed with SAF-EDTA, followed by some removal of smear layer by WO-EDTA and SAF-GCE. GCE was as effective as EDTA in removal of smear layer in the coronal and mid-root regions, when used with continuous irrigation.

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Aims: The aim of this study is to evaluate the influence of access cavity designs on the fracture resistance and root canal filling efficacy of simulated young permanent molars. Methodology: A total of seventy human unerupted impacted mandibular third molar teeth were collected. Ten were allocated as control; the remaining were designated as experimental, which were divided into three groups (20 each) based on access cavity design. All the samples were exposed to cone-beam computed tomography (CBCT) scanner before the access cavity preparation. Group I-The control group. Group IIa-traditional endodontic cavity (TEC), Group IIb-conservative endodontic cavity (CEC), Group IIc-ninja endodontic cavity (NEC). Endodontic access cavities were prepared and exposed to CBCT. Pre- and post-treatment percentage volumes of lost pericervical dentin were evaluated. Then the root canals were filled with calcium hydroxide and subjected to CBCT imaging for the evaluation of root canal filling efficacy. Evaluation of fracture resistance was carried out using a universal testing machine. Results: On observation, the volume of lost pericervical dentin was (14.8%) in TEC, (8.3%) in CEC and (6.8%) in NEC. There was no statistically significant difference (P > 0.05) between all the groups on root canal filling efficacy and the number of voids. Fracture resistance of the NEC and control group (P > 0.05) was greater compared to CEC and TEC. Conclusion: NEC is the accepted method that had better fracture resistance, with a minimum number of voids in the coronal and middle third of the root and had adequate apical seal compared to conservative and TECs.

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Calcium sulfate (CS) is a ubiquitous compound that has been incorporated in several medical and dental procedures. This can be attributed to its many advantageous characteristics, including being resorbable as well as its biocompatibility. Primarily, it was used to help treat a variety of osseous defects by acting as a bone substitute. Due to its unique properties, other therapeutic applications have been identified. Whilst the outcomes of these applications are varied, they have shown to be beneficial within the disciplines of endodontics, periodontics and oral & maxillofacial surgery. The aim of this review is to thoroughly discuss CS including its characteristics, chemical and physical properties, and known relative indications in dentistry. Clinical studies reporting the outcomes of CS for particular treatment modalities are further analyzed and discussed.

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