Prognosis of middle and coronal third root fracture remains questionable. Some clinicians advocate use of rigid intra-canal implant while others believe that it would lead to resorption, and favour extra-coronal resin splint for stabilization of fragments. In this case report, a four-month old case of middle third root fracture, successfully treated with rigid intra-canal implant, is described. At eight months follow-up, it was found that clinically the fragments had stabilized, evidenced from decrease in mobility and on radiograph the separation of the fragments had reduced.

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Antibacterial efficacy of 0.48% bis-dequalinium acatate (Solvidont) and 2% iodine-potassium-iodide solution (12 KI) was compared with camphorated mono chloro phenol (CMCP) as root-canal dressing and with no medicament in the control group. It was found that anti-bacterial efficacy of solvidont and 12 KI used as root-canal dressing was poor and compared with no medicament group. On the other hand, CMCP was found to have significant antibacterial activity. Thus, it was concluded that if intra-canal medication was required between visits, CMCP should be preferred. However, keeping toxicity of CMCP in mind, it should always be used with caution.

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In this in vitro study, the antibacterial efficacy of three test materials – calcium hydroxide mixed with distilled water, mixed with camphorated mono- chlorphenol (CMCP) and an iodoform paste (Walkoff s paste) were tested against three anaerobic organisms i.e. B. melaninogenicus, B. fragilisand CI. perfringens. It was found that all the three had equal antibacterial potency and at the end of 24 hr. and 72 hrs testing, no organisms could be grown. In view of the similar bactericidal potency of the three medicaments, it was felt, that calcium hydroxide alone, mixed with distilled water should be preferred over the other two drugs. Since no additional benefits are to be derived by using either CMCP or iodoform with a liquid containing parachlorphenol, camphor, menthol, and since each of them are potential irritants, their use as an antibacterial dressing in the root canals along with calcium hydroxide, remains of questionable utility.

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In the present study the flora from root canals and adjacent periodontal pockets of teeth with advanced periodontal disease were examined in order to compare the microbial flora from both sites. Three samples were collected from each of the twelve patients, one from the root canal and two from adjacent pocket at two different sites. Criteria for inclusion in the survey were: minimum of 5 mm pocket depth, intact clinical crowns and lack of peri apical lesion. The study has demonstrated that the micro organisms present in root canals of caries free teeth with advanced periodontitis generally resembled those found in adjacent periodontal pockets. The similarity in recovery of organisms suggests that the pocket could be the source of root canal infection in cases of advanced periodontitis.

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The benefits of sodium hypochlorite in endodontic therapy are such that its continued use is justified, but every effort should be made to avoid the introduction of this irrigant into the peri-apical tissues. Clinical picture of this avoidable mishap is being presented alongwith recommended treatment. Wedging of the irrigating needle into the canal must be avoided and a side delivery orifice needle is recommended. Also, before any endodontic treatment in which sodium hypochlorite is to be used, the patient should be asked about hypersensitivity to household bleaching powders.

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A more practical approach towards the restoration of endodontically treated teeth, based on a philosphy that has developed from recent studies has been outlined. Treatment and design criteria of cast posts as well as prefabricated posts and their merits are discussed.

[ABSTRACT]   Full text not available  [PDF]

Full text not available  [PDF]

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Full text not available  [PDF]