The use of radiographs for working length determination is usual practice in endodontics. Exposing radiographs following the principles of the paralleling technique allows more accurate length determination compared to the bisecting-angle method. However, it has been reported that up to 28.5% of cases can have the file tip extending beyond the confines of the root canals despite an acceptable radiographic appearance. The accuracy of radiographic working length determination could be affected by the location of the apical foramen, tooth type, canal curvature and superimposition of surrounding structures. Variations among observers by virtue of training and experience may also influence the accuracy of the procedure. The interpretation of radiographs could be affected by film speed and viewing conditions, with the superiority of digital imaging over conventional radiography for working length determination remaining debatable. The combination of several methods is recommended for acquiring the most accurate working length.

Aim: To compare and evaluate the stress distribution of new generation of Twisted File in comparison with ProTaper under bending or torsional conditions using a finite - element analysis model. Materials and Methods: Two NiTi files, a ProTaper file and the latest generation nickel titanium file which is the Twisted File of similar tip diameter were scanned using White light scanning system. Through this a real size digitized models of the two brands of NiTi instruments were obtained. Then, the outline of the instrument was extracted from the stacks of 3D data in software. Finally a mesh of linear, eight-noded, hexahedral elements was overlaid onto the rendered 3D image. The behavior of the instrument under bending or torsional loads was then analyzed mathematically in the software (ABAQUS V6, 5-1) taking into consideration the non linear mechanical characteristic of NiTi material. The results were expressed as von Mises stresses and were calculated by the von Mises criteria. Results: Higher stress values were seen in Twisted Files than the ProTaper universal, however, the angular deflection was seen to be more in Twisted Files. Conclusion: As more angular deflection was seen in Twisted File it was more flexible than ProTaper Universal but did not have the uniform stress distribution like the ProTaper universal.

Background: Sodium dodecyl sulfate polyacrylamide gel electrophoresis let to show the protein content of different tissues. Dental pulp contains connective tissue which is removed during the endodontic treatment. Many studies consider bovine rather than human pulp tissue because of its size. Aim: To evidence the protein content of bovine and human dental pulps and the action of endodontic irrigation solutions through electrophoretic patterns. Materials and Methods: Extracts of human and bovine dental pulps were prepared. Sodium hypochlorite, calcium hydroxide, chlorhexidine and ethylenediamine tetraacetic acid were used as irrigating solutions. Results: Bovine and human pulps have a small difference in two bands of proteins present between 74 kDa and 80 kDa. The denaturizing capacity of sodium hypochlorite and the washing action of calcium hydroxide and chlorhexidine were evidenced. Ethylenediamine tetraacetic acid solution was shown to contain proteins continuously during the endodontic root canal washing. Conclusions: Differences in pulp tissues and the action of irrigating solutions on their protein content would help on the understanding of the biological process of the endodontic treatment.

Objective: The aim of the study was to assess the radiographic quality of root fillings done by the undergraduate students. Materials and Methods: A sample of 258 clinical cases of patients who received root canal treatment from undergraduate students in the years 2010 to 2012 were selected, out of which 194 root fillings were assessed radiographically based on the following criteria; length and density of root filling. Root fillings were categorized as acceptable and unacceptable. Percentages and χ² test were used for statistical analysis. Results: From the 194 root fillings, 119 (61.35%) were having acceptable and 75 (38.65%) were having unacceptable root fillings. From the total 75 unacceptable root fillings, 49 (65.33%) had density problems, 11 (14.66%) were overfilled, and 15 (20%) were under filled. Chi-square test was done for statistical analysis; revealed no significant difference in the radiographic quality between anterior and posterior root fillings. Conclusion: The radiographic quality of root fillings done by undergraduate students was acceptable in 61.35% cases. Most common cause of unacceptable fillings was due to density problems compared to overfilling and under filling. Results from the study indicate that remedial measures have to be undertaken to improve training of undergraduate students in root canal treatment procedure.

Traumatized anterior teeth with sub-gingival crown fractures are a challenge to treat. The management of sub-gingival fractures includes exposing the cervical margin followed by appropriate coronal restoration. The treatment modalities, which involve exposing the cervical margin, are surgical crown lengthening and orthodontic extrusion. This paper reports a case of fractured maxillary anterior tooth at the sub-gingival level that was managed by forced orthodontic extrusion after endodontic treatment followed by esthetic rehabilitation, a much forgotten technique not utilized routinely yet conservative and cost-effective.

This case report describes the successful management of complicated crown fracture of left maxillary central incisor (#21) of 23-year-old male using dentin (biological) post made from human tooth. Endodontic treatment was initiated and sectional obturation was done using ProTaper gutta-percha and AH Plus sealer. The coronal space was modified to receive a human dentin post. A two-step procedure comprising direct and indirect technique of post fabrication was done to achieve the accuracy of biological post. A maxillary cuspid from an institutional tooth bank was taken, sectioned mesiodistally using a diamond disc simulating the length and thickness of mock post. Dentin post was first verified on the plaster model and then cemented in tooth #21. Core build up was done with composite and porcelain fused to metal (PFM) crown was luted. On the follow-up visits, patient was asymptomatic and radiographic evaluation revealed normal periradicular architecture. Biological posts may be good alternatives to conventional post systems as they preserve internal dentin walls, provide excellent adhesion, and resilience similar to natural tooth structure.

Radicular groove is an anatomical malformation that often leads to combined endodontic-periodontic lesions. Treatment of complex groove presents a clinical challenge to the operator. A case of type III palatogingival groove is successfully treated with intentional replantation. With the understanding of the procedure and strict adherence to guidelines improves, practitioners can use intentional replantation as an easy and cost-effective alternative for the management of radicular groove. The paper presents a brief review of palatogingival groove and highlights an easy and predictable alternative for its management.