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The aim of the study is to compare and evaluate the remaining dentin thickness following biomechanical preparation of teeth using different rotary file systems.Sixty noncarious mandibular premolar teeth were collected and decoronated at the level of cementoenamel junction with a diamond disc. All specimens were randomly divided into 5 experimental groups - ProTaper Next (Dentsply Mallifer), Mtwo (VDW, Antaeus, Munich, Germany), RaCe (FKG, La Chaux-de-Fonds, Switzerland), Hyflex electro-discharge machining (EDM) (Coltene-Whaledent, Allstetten, Switzerland), NeoNiTi (Neolix, France) and 1 control group of 10 teeth each. After mounting the samples on a modeling wax sheet, preoperative cone-beam computed tomography (CBCT) scans were taken. Biomechanical preparation of canals was done following the assigned protocol of manufacturers. Postoperative CBCT scans were taken and comparison was carried out with preoperative scans.Difference among the groups was analyzed byA comparison of preinstrumentation and postinstrumentation CBCT images revealed ProTaper Next group to remove more dentin at 7 mm as opposed to other groups in mesiodistal direction. However, no statistical difference was evident between ProTaper Next, MTwo, Race, Hyflex EDM, NeoNiTi file systems at 3 mm, 5 mm, and 7 mm in buccolingual direction. A statistically nonsignificant difference was evident between MTwo, Race, Hyflex EDM, NeoNiTi file systems at 3 mm, 5 mm, and 7 mm in both mesiodistal and buccolingual direction.Race file system performed better and removed lesser dentin in both buccolingual and mesiodistal directions. More dentin was removed at the coronal in mesiodistal direction with the use of ProTaper Next, and significant difference was seen between Protaper Next group and other groups in the study.

To describe the management of endodontic-periodontal lesion attributable to palatogingival groove extending from crown to root surface, contributing to severe periodontal breakdown in relation to maxillary central incisor. Palatogingival groove may act as a nidus of plaque accumulation and contribute to the pathogenesis of endodontic-periodontal lesions. The management of such lesions requires an integrated interdisciplinary approach with careful application of endodontic and periodontal surgical procedures. In the present case, the patient presented with advanced bone loss and negative pulpal response in relation to left maxillary central incisor. The etiology of such isolated periodontal lesion could be attributed to palatogingival groove as there was no history of endodontic pathology or trauma. The treatment plan included endodontic treatment followed by surgical exploration, elimination, and sealing of palatogingival groove using biodentine.

Open apices are a constant challenge to an endodontist. The one-step apexification technique in which an apical barrier is placed to achieve an adequate apical stop has become a popular procedure nowadays. This case series describes eight clinical cases with immature necrosed pulp which were subjected to one-step apexification procedure using different materials and techniques. The materials used varied from mineral trioxide aggregate (MTA) with hydroxyapatite (matrix), biodentine with hydroxyapatite (matrix), MTA alone, tailor-made gutta-percha with platelet-rich fibrin (matrix), and gutta-percha alone. All the cases were successful regarding the resolution of symptoms and periapical healing concluding that one-step apexification has successfully replaced the traditional methods of apexification. No matter what barrier is used or matrix is placed or not, healing takes place if the procedure is followed carefully using recommended protocols.

Successful outcome of endodontic treatment depends on the identification of all root canals which in turn guarantee complete extirpation of pulp tissue, proper chemo-mechanical cleaning and shaping and three dimensional obturation of the root canal system with an inert filling material. However endodontic treatment can fail for many reasons, such as diagnostic errors, persistence of the infection in the root canal system, errors in debridement and shaping of the root canal systems, instrument fractures, poor restorations and extra roots or canals if not detected are the reasons for failure. Undetected extra roots or root canals have been considered as a major reason for failure of root canal treatment. Many of the challenges faced during root canal treatment may be directly attributed to an inadequate understanding of the canal morphology of teeth. A broad knowledge of both the external and internal anatomy of teeth is of great importance for adequate endodontic treatment. We present a case report of 2 roots in mandibular lateral incisor.

Introduction: Determination of the canal wall cleanliness and to detect the residual filling material after removal of old obturating material. Materials and Methods: Thirty single-rooted premolar teeth were instrumented with rotary universal Protaper to size F2 and filled with resilon. The removal of root canal fillings was done with manual Hedstrom files and rotary Protaper retreatment files (RPRs) with orange oil as a solvent. Two-dimensional images of the obturated and retreated roots were evaluated with AutoCAD for percentage of remaining filling material. This area was confirmed under the scanning electron microscope. The data were statistically analyzed by t-test to identify differences. Results: Statistically significant differences were obtained for remaining filling material between hand and rotary both the groups. It was found that the canals instrumented with RPRs had lesser percentage of remaining filling material as compared to the hand files. Residual filling material and debris was found mostly in the apical portion of the root canal, however middle and cervical portions were relatively clean. Conclusion: RPRs were efficient in removing resilon from root canals as compared to the hand files.

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.