Bacteria can undergo morphological transition after exposure to certain agents such as penicillin. Such bacteria, known as L-form bacteria have a demaged cell wall and are pleomorphic. They can remain dormant in a periapical lesion for months or years after a successful endodontic treatment, and can then start replication. Such phenomenon may be responsible for acute exacerbation of chronic apical lesion. This study attempts to define the role of L-form bacteria in periapical disease.

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A number of bizzare and unusual anomalies of teeth have been reported in the literature. Concrescence is one such odontogenic anomaly wherein the teeth are united by cementum only. It is of utmost clinical significance, as treatment of one tooth can directly affect the other tooth. In case extraction is planned, it can not only result in inadvertent extraction of the other tooth but can also get very difficult if proper pre-operative diagnosis with X-ray was not made. This report describes one such case of concrescence.

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Endodontically treated teeth are anatomically and structurally weakened.They need proper planning and care in restoration.This paper highlights the various factors to be considered in the restoration of endodntically treated teeth

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This study was undertaken to test the antibacterial effect of six endodontic irrigants against five select bacteria. Infected pulp tissue was removed from the freshly extracted carious exposed teeth and used as specimen for isolation of bacteria. Streptococcus viridans, Streptococcus faecalis, Staphylococcus aureus, Pseudomonas auruginosa and Escherichia coli were selected from these bacterial isolations. Test irrigants were 0.2% chlorhexidine gluconate + 2.5% NaOCl, 0.2% chlorhexidine gluconate, 2.5% NaOCl, 3% H₂O₂, 10% EDTA, and 0.9% saline. Pre-sterilized 8 mm Whatman paper disks were soaked in the test irrigant and placed on the agar plates seeded with the test bacteria. After 24 hr. incubation at 37° C, inhibition zones were measured. Among the test irrigants, the combined use of 0.2% chlorhexidine gluconate and 2.5%NaOCl appeared to be the most effective antibacterial agent, 0.2% chlorhexidine and 2.5% NaOCl were moderately effective, 3% H₂O₂ and 10% EDTA were least effective and 0.9% saline proved totally ineffective.

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Gemination is a developmental malformation due to the attempt of single tooth bud to form two morphologically separate entities. But when the attempt is successful, it is called as twinning. Although, certain authors have suggested heredity as the etiologic factor, the cause is still controversial and unknown. Generally such teeth are asymptomatic but it may cause clinical problems such as poor esthetics, caries or periodontal destruction. In the present case, patient reported with a twinned permanent maxillary, lateral incisor with broken crown and radiolusceny at its periapex. There was pulpal communication between the two lateral incisors, which was observed radiographically. The pathology was surgically curetted out and the treatment was successful. The follow up radiograph taken after 2 months reveals bone healing. Esthetic correction can be undertaken, once the bone formation is complete and the tooth is firm.

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Pulp diseases particularly pulpitis are diagnosed on the basis of testing pulp vitality by thermal tests and vitalometer. When radiographic examination shows some periapical changes in a tooth whose pulp is vital, such cases are, therefore, included as pulpoperiapical periodontitis. The purpose of this study was to find out periapical radiographic changes in the teeth with vital pulp having pulp hyperemia, and/or chronic pulpitis and chronic hyper plastic pulpitis. Periapical changes were seen in about 50% of the teeth with pulpitis. It was significantly more in teeth with pulp polyp with chronic pulpitis.The common radiographic changes associated with chronic pulpitis were widened peridontal ligament space and discontinuity of lamina dura, and in pulp polyp were condensing osteitis, discontinuty in lamina dura and widened periodontal ligament space.

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