Aim: To compare the quality of root canal treatment provided by dental students in relation to different root canal preparation techniques. Materials and Methods: A pilot study was conducted at King Saud University. Root canal treatments of 46 molar teeth performed by 23 female dental students were included in this study. Each student prepared two molars teeth, first molar prepared with stainless steel (SS) hand K-files using step-back technique and the other molar prepared with ProFile rotary nickel-titanium (NiTi) files in a crown-down manner. Preoperative, working and postoperative periapical radiographs were assessed to evaluate the quality of root canal treatment based on the following criteria; obturation length, density, taper and presence of procedural errors. The data were statistically analyzed using exact conditional logistic regression test and the level of significance was set at 0.05. Results: The percentage of root canal treatment with adequate length was better with the use of NiTi rotary instruments (65.5%) compared to SS hand files (34.5%). No difference between the obturation density and taper in both techniques (P = 1.000) (P = 0.6875). The incidence of procedural errors in teeth prepared with SS hand files (68.2%) was significantly more frequent compared with NiTi rotary group (31.8%). There was a statistically significant relationship between overall quality of root canal treatment and endodontic preparation techniques (P = 0.0386). Conclusion: The quality of root canal treatment performed by King Saud University undergraduate dental student was significantly better in teeth prepared by NiTi rotary filing technique than teeth instrumented with SS hand file.

Introduction: The root canal treatment in asymptomatic necrotic teeth in single visit has been an area of discussion for long. The purpose of this study was to compare the single-visit root canal treatment of asymptomatic nonvital mature mandibular molars with and without the use of 5% iodine potassium iodide (IKI) as an endodontic irrigant with the minimal use of postoperative medications. Materials and Methods: Sixty patients requiring root canal treatment on asymptomatic nonvital mandibular molars were included in the study and were randomly allocated into two groups of thirty each. In Group I, no IKI was used and in Group II, 5% IKI was used as an irrigant. The complete treatment was done in single visit. The occurrence of postoperative pain and swelling was noted at various time intervals. Results: Mann–Whitney U-test showed no statistically significant difference between the two groups regarding both the parameters. In Group I, 20% of patients experienced moderate-to-severe pain during the first 24 h (P = 0.25463) while only 10% of patients experienced moderate pain in Group II. In Group I, 20% of patients developed swelling after 24 h while none of the patients in Group II had any postoperative swelling (P = 0.09342). Conclusion: Irrigants with better disinfection properties, penetration, and quick action such as 5% IKI are important adjunct to complete the disinfection of root canal system in single-visit endodontics.

Background: The root canal system is complex. Eliminating the microorganisms from it is not easy. Diode laser is proposed as one of the effective methods to sterilize the canal. Aims: The aim of this work was to evaluate the diode laser parameters to be used as an adjunct for root canal sterilization to avoid any increase in temperature to prevent any thermal collateral damage to the periodontal tissue. Materials and Methods: A total of 24 single-canal premolars were used; they were divided randomly into two groups (n = 12). Group 1 was irradiated with 1.5 W continuous wave mode of diode laser and Group 2 with 2.5 W/2 5 Hz pulsed mode of the diode laser. The temperature was measured using thermometer and thermal camera at the apical part of the root. Post hoc test, Student's t-test, and paired t-test were used in the study. Results: The results showed a modest increase in temperature at the external root surface for Group 1, with maximum increase of 6.7°C in apical portion, and 8.5°C for Group 2. Conclusions: Within the present parameters, the laser is safe for use as an adjunct for root canal sterilization.

Background and Purpose of the Study: Two of the most critical factors affecting the prognosis of an avulsed tooth after replantation are extraoral dry time and the storage medium in which the tooth was placed before treatment could be rendered. The ability of a storage medium to support cell viability of the periodontal ligament (PDL) can be an important factor in the prognosis, and thus, the aim of this study was to evaluate the efficacy of commonly available storage media. Materials and Methods: Cultured PDL cells of sixty freshly extracted human teeth were randomly divided into four groups of 15 each, Group I: Electral solution, Group II: Ringer's lactate, Group III: Oral rehydration salt liquid (ORS-L), and Group IV: Coconut water. Samples in each group were further divided into three subgroups depending on the time duration they were placed in the storage medium, i.e., 1, 4, and 8 h. Further these samples were subjected to Collagenase assay, the cells were stained with trypan blue and viable PDL cells were counted under light microscope. Results: Statistical analysis showed that Group II demonstrated significantly (P < 0.001) more viable PDL cells in than Groups IV and I, least viable PDL cells are seen with Group III samples. Conclusion: Ringer's lactate maintained highest PDL cell viability followed by coconut water, electoral solution, and ORS-L at various time intervals. More studies with large samples are required to prove the efficacy of Ringer's lactate as viable storage media.

Introduction: Biological testing of biomaterials on dental pulp stem cells (DPSCs) is one recent advance in endodontic research. The aim of this study was to compare the cytotoxicity, cell attachment properties, and dentinogenic differentiation potential of extracts of white mineral trioxide aggregate (WMTA)/calcium chloride dihydrate CaCl₂.2H₂O combination (fast-set WMTA [FS WMTA]) to that of WMTA on DPSCs. Materials and Methods: The cytotoxicity and cell attachment properties were evaluated on DPSCs using methyl-thiazol-diphenyltetrazolium assay and under scanning electron microscope, respectively. After 1, 3, and 7 days of incubation, the expression of four dentinogenic gene markers (BGLAP, DSPP, RUNX2, and SPP1) was examined using the real-time polymerase chain reaction. Mann-Whitney test and one-way analysis of variance were used for statistical analysis (P = 0.05). Results: While WMTA showed favorable cytotoxicity and cell attachment properties, FS WMTA demonstrated severe/moderate cytotoxicity at three successive concentrations (P < 0.05), and the cell attachment properties were less favorable. However, DPSCs treated with FS WMTA extracts showed higher expressions of dentinogenic gene markers than WMTA (P < 0.05). BGLAP and SPP1 were down- and up-regulated in both groups at all-time intervals, respectively. DSPP was upregulated only in WMTA at day 3 compared to days 1 and 7 in FS WMTA. RUNX2 was upregulated at all-time intervals only in FS WMTA. Conclusions: The addition of CaCl₂.2H₂O increases the cytotoxicity but enhances the dentinogenic differentiation potential of WMTA on DPSCs.

Aim: The aim of this study is to evaluate postobturation apical seal following intracanal irrigation with maleic acid (MA) or a combination of chlorhexidine (CHX) and ethylenediaminetetraacetic acid (EDTA). Materials and Methods: Thirty single-rooted human premolar teeth were decoronated and subjected to root canal instrumentation. Based on the final irrigating regimen, samples were divided into 3 groups: Group 1- Irritrol (EDTA + CHX), Group 2–7% MA, and Group 3–0.9% Saline (control). The samples were then obturated and placed in humidor for 7 days. Specimens were subjected to microleakage analysis at 24 h, 7 days, and 14 days using glucose filtration technique. The samples were then analyzed with a glucose kit in a calorimeter at 500 nm wavelength. Data were analyzed using one-way ANOVA, post hoc Tukey's test, post hoc Games–Howell test, and Bonferroni test. Results: There were overall significant differences in the mean scores among all the three groups (P < 0.001). Saline group demonstrated a significant higher leakage than that of MA followed by Irritrol. 14^th day had significantly higher leakage when compared to 7^th day with least being at 24 h. Conclusion: Final irrigation with Irritrol improved the postobturation apical seal when compared to 7% MA.

Introduction: Rubber dam was introduced more than 150 years ago. It has been the standard of care, especially in endodontics. In spite of its advantages, dentists still refrain from using it. Hence, the objective of this study was to investigate the frequency of rubber dam usage among dental practitioners in Maharashtra, India. Materials and Methods: It was a cross-sectional study. The questions were regarding the usage of rubber dam in their practices which was answered by the dentists. A sample size of the study was 400. Questionnaire included eight questions and the last question was open-ended. Results: Dentists using the rubber dam in their daily practice were only 23.8%. Out of which, only 4.2% dentists use it in 100% of the cases. When the reason for not using the rubber dam was asked, 40% dentists said they do not use rubber dam because its time consuming, 37% do not use it due to patient compliance, 14% responded that it is expensive, and 9% were unsure of the technique. Conclusions: The low percentage of rubber dam usage in Maharashtra is not acceptable, and dentists should follow recommended standard of care. Dental schools should make it mandatory for students to use rubber dam in root canal treatments.

Dens invaginatus (DI) (dens in dente) is a developmental anomaly resulting from an invagination in part of variable depth of the enamel organ into the dental papilla in the surface of the crown before calcification of the dental tissues. This anomaly usually involves the upper lateral incisors. These teeth are frequently expressed by an unusual form of crown and accentuation in the cingulum or a cusp. They are a target for caries leading to pulp necrosis and apical pathosis, so the diagnosis and early prevention measures are important. When treatment is necessary, conservative, endodontic, and periodontal possibilities are very effective. Surgical interventions are only rarely indicated. The present paper deals with the treatment of series cases with DI.

This case report describes the management of formocresol osteo-gingival necrosis in a mandibular molar with lingual and furcal perforations using resorbable demineralized bone matrix and mineral trioxide aggregate (MTA). Three-year postoperative follow-up showed a substantial resolution of the osseous defect as well as a clinically and radiographically sound periodontium. Despite an apparently poor prognosis, conservative management of the case using a combination of demineralized bone matrix and MTA led to a successful outcome. Further, this report warrants that formaldehyde-containing medicaments have no role in contemporary endodontics.

The aim of this work was to present a case report describing lower lip paresthesia following failed endodontic treatment and development of periapical lesion. A 42-year-old female presented difficulty in swallowing with pain in right mandibular second premolar and numbness in the right side of her lower lip. Radiographic examination revealed inadequate root canal and a large periapical lesion in the mental nerve area. The lesion appeared extending into the inferior alveolar canal causing irritation of inferior alveolar nerve and its mental branch. Following root canal retreatment, there was improvement of the clinical symptoms and gradual reduction in size of the lesion. A full resolution of symptoms was demonstrated 4 months after successful endodontic therapy. It was concluded that careful clinical and radiographic diagnosis followed by proper endodontic treatment proved to be successful in treating lower lip paresthesia occurred following failed root canal therapy.