Aim: The purpose of this in vitro study is to provide clinical data on the presence of the second canal in mandibular incisor teeth of Saudi Arabian Samples. Materials and Methods: Eighty extracted human mandibular incisors were collected from Saudi patients. The teeth were accessed by small round bur then placed in 5.25% sodium hypochlorite for 24 hours to dissolve the organic debris. Indian ink was injected inside the root canal systems under negative pressure. The teeth were decalcified in 5% nitric acid for three days then dehydrated in different concentrations of ethyl alcohol. Following the decalcification process, the teeth were cleared in methyl salicylate and evaluated according to Vertucci's classification. Result: Fifty six of both mandibular central and lateral incisor teeth (70%) had type I canal configuration (one main canal and one main apical foramen), while the remaining 30% of the sample (24 teeth) had a type III canal configuration (two separate canals and merged into one canal before exiting the tooth through single apical foramen). Conclusion : The incidence of two canals in mandibular incisor teeth is about one third of the examined Saudi Arabian samples with no difference between the centrals and laterals. The clinician should deal with these teeth as if they have two canals unless it is proved otherwise.

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Background : The rubber dam is one of the best tools for tooth isolation and infection control in the dental field. Our aim is to evaluate the attitudes toward the use of rubber dams by dental interns in Riyadh Dental Colleges (RCsDP) and determine the barriers to their use. Materials and Methods: A self-administered questionnaire was designed and used for data collection. 150 questionnaires were distributed by hand to the dental interns of RCsDP over a period of two weeks. Information sought included the attitudes toward and difficulties for the use of the rubber dam, the time needed to apply the rubber dam, and the patients' allergic history of the rubber dam. Respondents were asked to state their preference on a five point Likert type scale ranging from "strongly dislike" to "strongly like". The information and data of the completed questionnaires were statistically analyzed using Mann-Whitney U test and Friedman test. Results: Of 150 questionnaires distributed, 150 were completed and returned (response rate = 100%). Of those, 46.7% were males and 53.3% were females. In general; (43.3%), interns strongly liked the use of the rubber dam and the rest (46.7%) liked the use of the rubber dam. The majority of respondents liked to use rubber dam in direct restorations more than in indirect restorations and 46.7% strongly liked to use it in posterior teeth for composite restoration. Most dental interns felt that they would strongly like to use a rubber dam for endodontic treatment whether in posterior teeth (73.3%) or anterior teeth (68.7%). 66.7% of interns asked their patients if they had an allergy to latex prior to the use of the rubber dam. Child behavior (mean rank about seven) is the most important reason for not using rubber dam. The time is taken to apply the rubber dam was less than five minutes in most cases. Conclusion: Most dental interns prefer to use rubber dams in the general dental field and are enthusiastic to use it in future.

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The main objective of performing root canal therapy is to eliminate bacteria from the infected root canal system or remove inflamed pulp tissue and close it with a biologically acceptable filling material. If this treatment managed well, regardless of the number of visits, it will create a favorable environment for healing. The recent advances in Endodontic technology, attracts the dental practitioners as well as the Endodontist to perform the root canal treatment in one visit. The question that we consider in this review article focuses on the long term prognosis of one-and multiple appointment endodontic therapy for teeth with vital pulp, necrotic pulp, and apical periodontitis .

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Objectives: To evaluate and compare the antibacterial efficiency of MTAD, Oxytetracycline, 5% NaOCl, and 2% chlorhexidine when used as root canal irrigants against Enterococcus faecalis. Materials and Methods: Fifty extracted human single rooted anterior teeth were selected. The decoronated sterilized root samples were infected with 10μl of 24 hours pure culture suspension of E. faecalis for 48 hours except for 10 teeth in negative control group (Group V). The test samples were divided into four groups (n = 10) as: Group I- 5% Sodium Hypochlorite, Group II- MTAD, Group III- Oxytetracycline and Group IV- 2% Chlorhexidine. The root canals were instrumented while using respective root canal irrigant solution. The bacterial cultures were taken from each root canal and colony forming units were counted on agar plates. The data was statistically analyzed. Results: It was observed that Group-III (Oxytetracycline) showed the maximum antibacterial efficacy against E. faecalis followed by Group II (MTAD), Group IV (2% Chlorhexidine), Group I (5% Sodium hypochlorite). Conclusion: Oxytetracycline has a great potential as a root canal irrigating agent because of its superior antimicrobial efficacy against E. faecalis, easy availability and cost effectiveness.

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Chronic kidney disease is associated with progressive deterioration of renal function resulting in reduced glomerular filtration rate. Multiple drugs used for its management invariably alter the common oral manifestations associated with the disease. The patients require special considerations for endodontic management because of increased tendency towards bleeding episodes, odontogenic infections and drug interactions. The present case report describes the comprehensive endodontic management in a patient of chronic renal disease taking plethora of medications.

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Central giant cell granuloma is considered as reactive lesion of jaws possibly to intramedullary hemorrhage or trauma. It may manifest as radiolucencies anywhere in the mandible or maxilla. In rare cases, it can appear as a localized periapical area and mimic an endodontic lesion. This report presents a case where central giant cell granuloma was misdiagnosed as a periapical cyst in 20-year-old male and was treated by conventional endodontic treatment. However the lesion was refractory to endodontic treatment and proved to be central giant cell granuloma after surgical intervention and histopathological examination. The purpose of this case report is to emphasize on periodic follow-up of periapical lesions after endodontic treatment and surgical intervention if required.

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Root canal treatment of maxillary molars presenting with complex root canal configurations can be diagnostically challenging. The present case describes the endodontic management of a maxillary second molar with a single root and a single canal. The clinical detection of the single canal was made using a surgical operating microscope and confirmed using cone-beam computed tomography scanning.

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In the recent times no other field has shown so much growth in Endodontics as much as that of diagnosis. The human element in diagnosis is enriched by newer technologies available as adjuncts to the process of endodontic diagnosis. The trend of this development has been toward increasing objectivity sensitivity and reproducibility of the pulp tests while decreasing the patient discomfort. Methods like Pulse Oximetry, Laser Doppler Flowmetry, Ultrasound Doppler, Dual Wavelength Spectroscopy, Photoplethysmography besides the thermographic imaging and calorimetric pulp tests are being developed and evolved to suit the current clinical setting for the modern endodontist. A necessity arises here to keep abreast of all the new methods in order to be able to choose the best tools for the successful diagnostician. The aim of this review therefore was to assess the usefulness of some devices and techniques used in endodontic therapy to make the correct pulpal diagnosis.

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