The aim of this study was to identify the presence of selected microorganisms from pulp space of human deciduous teeth with irreversible pulpitis. 40 children, 3 to 8 years old were involved in the study. The samples were collected from infected pulp spaces using sterile paper points were analyzed for selected pathogens (Enterococcus faecalis, Escherichia coli, Streptococcus mutans, Staphylococcus aureus, anaerobes and Candida albicans). S. mutans in 100% of samples, E. faecalis in 35%, E. coli in 15%, Staph. aureus in 5%, anaerobes in 20% and C. albicans in 15% samples were detected. It can be concluded that human deciduous teeth with initial stages of irreversible pulpitis have a considerable amount of organisms said to be resistant for routine treatment and also predominance of facultative anaerobes over strict anaerobes.

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Objective: The objective of this in vitro study was to evaluate the effect of three different designs of retrograde cavities on the seal provided by amalgam, using a “Rhodamine B Dye Penetration Method”. Study Design: An investigation to study the effect of three different designs of retrograde cavities (funnel cavity, conventional class I cavity and slot cavity) on the seal provided by amalgam, using a microleakage test by “Rhodamine B Dye Penetration Method”. Result: The overall result showed least leakage in conventional class I cavity followed by funnel shape cavity and slot cavity. Conclusion: The results of the present study indicate that conventional class I cavity is a better retrograde cavity design when amalgam is used as a retrofilling material to provide apical seal.

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Objectives:. The objectives of present study are: 1) To compare sterilizing effect on gutta-percha points of five disinfectant solutions: Povidone iodine (5%), Sodium hypochlorite (5%), Ethyl alcohol (95%), Hydrogen peroxide (3%) and a combination of Chlorhexidine (1.5%) and Cetrimide (15%) in equal proportions. 2) To find out which disinfectant solution requires less time for effective sterilization of gutta-percha points. Study design: Gutta-percha cones exposed to dental chair-side clinical environment were treated with above mentioned disinfectant solutions for 1, 3, 5, 7 and 10 minutes. They were later cultured into thioglycolate media at 37° C and observed after 24, 48 and 72 hours for turbidity. Those showing turbidity were sub-cultured for aerobic bacteria in blood agar, MacConkey's agar and chocolate agar at 37° C for 24-48 hours and for anaerobic bacteria in anaerobic blood agar at 37° C for 5 days. Microorganisms were identified by Gram stain and standard microbiological techniques. Results: The results showed that Sodium hypochlorite (5%) and a combination of Chlorhexidine (1.5%) and Cetrimide (15%) were found to be the most effective chemical disinfectants in sterilizing gutta-percha. Conclusion: All the disinfectant agents used in the study were found to be effective in sterilizing the gutta-percha points. However, there were differences in the time taken by these solutions in disinfecting the gutta-percha points. Sodium hypochlorite (5%) and combination of Chlorhexidine (1.5%) + Cetrimide (15%) achieved disinfection of the gutta-percha cones with the immersion time of 1 minute.

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Objectives : A Scanning Electron Microscopic Evaluation of Surface Changes of New and Used Greater Taper Nickel Titanium Hand and Rotary Instruments Materials and Methods : Eighteen freshly extracted single rooted human anterior teeth were selected. The teeth extracted for therapeutic purposes were used. Teeth were randomly distributed among the groups. Crowns of all teeth were cut off at the cemento-enamel junction with a separating disc. A sequential crown down technique was carried in all the three groups of six teeth each. All file were used with a sequential crown down technique. Frequent irrigation was carried out with 3% Sodium hypochlorite and 15%EDTA. Rotary instruments were used in a high torque, low speed hand piece with speed range between 150-350 rpm according to manufacturer’s instructions. All instruments were evaluated for defects under SEM before their use. The files were again observed after 1st, 3rd and 6th under SEM. The scorings for the files were given at apical and middle 3rd at X100-X400 magnification and photomicrographs were taken. Results were statistically analyzed using Kruskal Wallis test and Mann-Whitney U test. Results : The scoring showed that defects were evident in most of the files before use itself. There were no statistically significant difference between the groups but experimental results of the study showed that pro taper hand instruments showed more surface defects than the Pro Taper rotary instruments. Least number of surface defects was seen on the Endo Wave instruments. When number of uses was considered before use all the files showed one or more defects, after one use no much of difference was seen but after third and sixth use the surface defects increased. Conclusion : The surface defects that were seen before and after usage was more in pro taper hand followed by ProTaper rotary and least in EndoWave series of instruments but none of the groups showed any stastically significance.

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This review provides the literature concerning the etiology and manifestations of barodontalgia, as well as important clinical considerations for its management. Barodontalgia is characterized by exposure to a pressure gradient, such as that experienced by underwater divers, aviation personnel and air travellers. This form of dental pain is generally marked by a predisposing dental pathology such as acute or chronic periapical infection, caries, deep or failing restorations, residual dental cysts, sinusitis or a history of recent surgery. The key to avoid barodontalgia is good oral health. Clinicians must pay close attention to areas of dentin exposure, caries, fractured cusps, the integrity of restorations and periapical pathology in those at risk.

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Anatomical variations must be considered in clinical and radiographical evaluations during endodontic treatment. Access cavity modifications may be required for stress free entry to complex anatomy. Higher magnification and illumination can be useful for access cavity preparation and to recognize and locate additional canals. This article describes the diagnosis and clinical management of a clinical case of three rooted maxillary first premolar.

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Various organic acids,ultrasonic instruments,and lasers have been used to remove the smear layer from the surface of instrumented root canals. The purpose of this study was to determine the effectiveness of MTAD(a mixture of tetracycline isomer,an acid,and a detergent) as the final irrigant to remove the smear layer,compared with that of 10% Citric acid and 7% Maleic acid all of them following root canal irrigation with 5.25% Sodium hypochlorite (NaOCl). Forty eight extracted single rooted human teeth were randomly divided into 4 groups and instrumented with crown down technique using rotary nickel titanium files.5.25% sodium hypochlorite was used as the intracanal irrigant. The canals were treated with 5ml of one of the following solutions as final rinse:5.25% sodium hypochlorite,10% Citric acid,7% Maleic acid,MTAD. The presence or absence of smear layer on the surface of root canal walls at the coronal,middle and apical portion of each canal were examined under a scanning electron microscope. The results showed that MTAD is an effective final rinse solution for removing the smear layer in canals irrigated with sodium hypochlorite. When 10% Citric acid and 7% Maleic acid were used as a final rinse, the smear layer was removed from the middle and coronal thirds of canal preparations, but it was less effective in the apical third of the canals.

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Success of endodontic treatment depends on the proper identification of all the canals, thorough chemo-mechanical preparation followed by three dimensional obturation with hermetic seal. Failure of any of these steps may occur due to unusual tooth morphology. Usually mandibular molars have two roots with three canals (mesiobucccal, mesiolingual & distal) but in few teeth, the number of roots and canals vary. The variation in the number of roots is called radix entomolaris.(1) This article presents three case reports of mandibular first molars with extra roots. Also mentioned are the modifications in the canal preparation, problems encountered during the treatment, common iatrogenic errors which occur during the treatment and factors which affect the prognosis.

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Aims: To evaluate and compare the antibacterial activity of Spilanthes Calva DC root extract (100mg/ml) with different concentrations of 3% Sodium hypochlorite (NaOCl) (V-consept, Vishal Dentocare, India), 2% Chlorhexidine (V-consept, Vishal Dentocare, India) and Doxycycline against Enterococcus faecalis (American Type Culture Collection 29212). Materials and Methods: Antimicrobial activity was assayed by Kirby-Bauer (1966) cup-well agar diffusion method. 30 ml culture medium was dispensed in respective petridishes and inoculated with 0.1 ml fresh culture of Enterococcus faecalis. Three cup-wells of 16mm diameter were bored in each petriplate and were filled with respective test agents. Total 60 replicates were taken for the study; each test agent group was assayed in 10 replicates. All the inoculated media plates were incubated for 24 hours at 37^oC under aerobic conditions. The antibacterial efficacy was interpreted from the size of the zone of inhibition measured to nearest in millimeter (mm) as observed from the clear zones surrounding the wells. Results: Statistical analysis revealed that all the irrigants were effective against Enterococcus faecalis. Doxycycline(10mg/ml) was significantly more effective than Spilanthes calva DC root extract, 2% Chlorhexidine and 3% Sodium hypochlorite(P<0.001). Spilanthes calva (100mg/ml) and Sodium hypochlorite showed comparable inhibition (P>0.05) against Enterococcus faecalis. 2% Chlorhexidine was significantly (P<0.001) more effective than 3% Sodium hypochlorite. Conclusion: Under the tested conditions and within the limitations of the present study, it maybe concluded that Spilanthes calva DC root extract may have potential as a root canal irrigant warranting further investigations. Therefore further in vivo studies for the evaluation of the different aspects of the extract would be relevant.

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Aim: To evaluate the DNA quality using Nano Drop 1000 spectrophotometer in samples from root canal treated teeth with apical periodontitis prior to species- or genus-specific PCR procedure. Materials and Methods: Samples from 40 root canal treated teeth with apical periodontitis were collected and subjected to two groups, Group I(n = 40): samples subjected to PCR amplification, Group II(n=40): samples subjected to Nano Drop followed by PCR amplification. Statistical analysis was done using Chi square test. Results: E. faecalis was detected in 70% (28/40)teeth in group 2 and 50% (20/40) in group 1. There was significant difference in the quality of DNA obtained in group 1 when compared to group 2(p<0.01). More number of clear bands were visible in group 2,and higher number of blurred bands (12/40)in group 1. Conclusion: The Nano Drop 1000 technique proved to be beneficial in the measurement of both quantity and purity of DNA in the samples. This technique not only designs better experiments but also ensures better reporting and significant savings in time and money spent for re-running samples. Abbreviations: ng - Nanogram, rpm - Rotations per minute, ml - Milliliter, μl - Microliter, mm - Millimeter, QC -Quality control, nm - Nanometer, mM - Millimolar.

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Objective: To evaluate and compare the sealer distribution in root canals obturated by three techniques. Methods and Material: Thirty freshly extracted human maxillary central incisors were instrumented and divided into three groups according to obturation technique as Group I - Lateral condensation method Group II - Vertical condensation method and Group III - Single cone method Using AH26 silver free sealer (Dentsply). After setting of sealer, teeth were sectioned by disk at two levels from the apex i.e. 3 mm and 6 mm and cross sections were examined for sealer distribution at magnification of X40 using camera which was connected to stereo operating microscope. Data were evaluated in terms of percentage of sealer coated root canal perimeter (PSCP) using digital imaging system (Image Proplus Software). Results: Sealer distribution in Group I at 3 mm and 6 mm was 35.58% and 47.34%, for Group II was 30.40% and 20.34% and in Group III was 85.57% and 89.79% respectively (p<0.01). Conclusions: More sealer distribution seen with Single cone technique.

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Variation of teeth has been an enduring interest to the clinician, is found in almost all the teeth. Knowledge of these variations, particularly concerning the location and treatment of all canals, is very important for the success of endodontic therapy; the inability to find and properly treat the root canals may cause failures. The use of high end diagnostic imaging modalities such as spiral computed tomography can help the clinician in making a confirmatory diagnosis, determining the treatment plan and for successful endodontic management. This article discusses the variations in the canal morphology and the use of latest adjuncts in successfully diagnosing and negotiating them.

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Introduction: Comparative analysis to assess the efficacy of 5.25% of sodium hypochlorite, 2 % of chlorhexidine, MTAD and 810 diode lasers in reduction of microbial count. Materials and Methods: 40 Patients were selected and randomly divided into 4 groups. Rubber dam was placed and access opening achieved. a no 15 no k file was used to negotiate the canal and infected material was obtained. The content was then transferred in Stuart’s Transport Medium for aerobic and anaerobic culture to a Microbiology Laboratory. This was considered as the first sample. After that the biomechanical preparation of the canal was done and each canal was irrigated according to groups. Group 1 canals were prepared and irrigated with freshly prepared 5.25% of sodium hypochlorite (group I), 2% of chlorhexidine (group II), biopure MTAD (group III) & 810nm of diode laser (group VI). A sterilized no 15 file was reintroduced in the canal and fresh samples were taken. The content transferred for microbial culture. After the calculating total microbial count statistical analysis was done. Results: The data were evaluated and analyzed using ANOVA and t-test. Groups I, II and III reduced total microbial count up to 71.5 %, 73 % and 85 % respectively. Statistically significant differences were observed between the group 1 or group 2 and 3 when compared to group 4 as the total microbial reduction was 90 %. Conclusion: Results indicated that 810nm diode laser reduces microbial count more significantly as compared to 5.25% NaOCl, 2% Chlorhexidine and MTAD solution.

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Aim :- To evaluate the antibacterial efficacy of five different Indian varieties of grape extracts against two antimicrobial resistant strains of Enterococcus Faecalis and Candida Albicans in Endodontics and the effects of the extracts on the growth and survival of the same organisms during storage upto 48 hours. Materials and Method :- Five different Indian varieties of grape extract (Sharad, Dilkhush, Kali-Sahebi, Bangalore Blue, Anab-e-shahi) were obtained using Soxhlet’s extractor and water bath (water extracts) in standardized concentrations. Surface plating and Test Tube inoculation method was used to test the antibacterial activity of the extracts on the pathogenic bacteria such as E.Faecalis and Candida Albicans respectively. Results :- Amongst the bacteria tested, Enterococcus Faecalis exhibited high sensitivity to Anab-e-shahi and Dilkhush grape extracts compared to the rest of the group extracts. Candida Albicans showed resistance to all the extract varieties. Conclusion :- Grape extract exhibits antibacterial efficacy against Enterococcus Faecalis found in the pulp space. Clinical Relevance :- Biologically active compounds, in the form of Grape extracts are effective in combating antimicrobial resistant strain of E.faecalis which can survive in the pulp space, post adequate cleaning and shaping and calcium hydroxide treatment leading to endodontic failures. Toxicity concerns of the commonly used pulp space irrigants are eliminated in the case of grape extracts.

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Successful root canal therapy requires through knowledge of the root and root canal morphology. Knowledge of internal dental morphology is a complex and extremely important point in planning and performing of endodontic therapy. Inadequate awareness of the anatomical variations in the root canal system may contribute to failure of endodontic therapy. Hence during diagnosis and treatment, clinician should be aware of all anatomic variations. This case report describes the identification and treatment of maxillary permanent first molar with three mesiobuccal canals with separate orifices.

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Chemo-mechanical preparation is the basis for successful endodontic treatment and aims at debriding the root canal using various endodontic files. The infected canal consists of numerous bacteria, tissues and debris which need to be removed. During cleaning and shaping the dentin lining the root canal is shaved off for the purpose of shaping the canal though a major part of the canal is left untouched even after thorough cleaning and shaping. The most recent literature reports the removal of thin uniform hard tissue layer from the entire root canal surface, resulting in maintenance of original root canal geometry with a similar cross section but of larger dimensions and this results in avoidance of iatrogenic errors which are the most common errors occurring due to the taper of different files. The purpose of this study is to compare the maintenance of root canal geometry during root canal procedure performed on permanent tooth root with severely curved canals.

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Objectives : The objective of the study was to evaluate the microleakage of various root end filling materials and to find the sealing ability of these materials. Methodology: Sixty (60) extracted single rooted anterior teeth were selected and divided into four groups of 15 samples each. Group A, B, C and D in which root-end filling was done with Surgical Simplex Bone Cement, Super EBA, Ketac Molar Glass Ionomer and Pro-root MTA respectively. The teeth were retrofilled and then the apical halves were submerged in 2% methylene blue dye. The depth of dye penetration and maximum value of leakage in each sample were recorded. Results: Group D had statistically significant difference from Group C (1.73±0.16 mm) as well as Group A (2.10±0.14 mm). Interpretation and Conclusion: Microleakage of group B was minimum. Thus concluding that Super EBA is a good root-end filling material.

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Consistently high levels of success in endodontic treatment require an understanding of root canal anatomy and morphology. To achieve endodontic success, the entire root canal system must be three dimensionally cleaned, shaped and obturated. The clinician must have a thorough understanding of normal anatomy and of its variations from the norm. As with most of posterior teeth, the mandibular second molar has several variants in its canal configuration. This includes single canal, two canals, three canals, four canals and five canals and; C-shaped canal system. All these variations represent a challenge to its thorough debridement and obturation. This has led to the proposal of many modified techniques to optimize the technical quality and hence the prognosis of endodontic therapy.

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Introduction : The purpose of this invitro study was to evaluate the post obturation fracture resistance of endodontically treated teeth obturated with new obturating systems such as Realseal system, GuttaFlow obturation system, conventional lateral compaction technique and Microseal obturation system. Materials and Methods : Fifty extracted single rooted teeth were selected and sectioned at the CEJ. The root canals were instrumented using EasyRace files. The teeth were randomly divided into 5 groups of 10 teeth each. Group I served as negative control and was instrumented and not obturated. The other groups were obturated with new obturating systems. The specimens were evaluated for vertical fracture resistance using Instron universal testing machine. Results : According to the study it was found that the Resilon with Realseal displayed higher mean fracture load in comparison to other experimental groups. Conclusion : Obturation of roots with a resin based obturation material increased the fracture resistance of root canal filled tooth to vertical fracture.

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Aim: To compare, in vitro, the sealing efficacy of Guttaflow, Roekoseal & Endoflux sealers by their microleakage analysis using fluorescent microscopy. Methodology: 70 single rooted teeth were selected & sectioned at the cementoenamel junction. The teeth were cleaned & shaped, and were divided into 5 different groups. Group A: Negative control that were left untreated. Group B: Positive control that were only instrumented. Group C: Instrumented & sealed with Roekoseal. Group D: Instrumented & sealed with Guttaflow. Group E: Instrumented & sealed with Endoflux. The specimens were immersed in propidium Iodide dye, & microleakage was assessed using a phase contrast and fluorescent microscope. An image analysis detector was used for accurate detection of area of root canal covered by the dye. Results: There was a significant difference in mean propidium iodide staining when the control groups were compared with any of the experimental groups. But there was no significant difference between the three experimental groups. Conclusion: Within the limits of this in vitro study it can be concluded that although none of the sealers used completely prevent dye penetration, leakage in totality for all the three test groups was significantly small. Also, no significant differences were observed among the sealers tested.

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An endodontist has to encounter a multitude of pulpo-pathologic conditions. One such challenging condition is resorption. Internal as well as external resorption signifies a very complex pathological interaction of the cells of pulp, periradicular and periodontal tissues. These conditions demand a comprehensive understanding of the pathologic process, so as to identify the cause and arrest the resorptive phenomena. This paper describes two case reports of internal resorption that were managed successfully. It also carries out an elaborate evidence based review on the relevant literature which must be taken into account while treating any case of resorption.

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Tooth loss compromises human oral health. Although several prosthetic methods, such as artificial denture and dental implants, are clinical therapies to tooth loss problems, they are thought to have safety and usage time issues. Recently, tooth tissue engineering has attracted more and more attention. Stem cell based tissue engineering is thought to be a promising way to replace the missing tooth. Scientific advances in the creation of restorative biomaterials, in-vitro cell culture technology, tissue grafting, tissue engineering molecular biology and human genome project provides the basis for the introduction of new technologies in dentistry. The purpose of this article is to highlight the biological procedures to develop the regenerative endodontic procedures.

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