The use of triple antibiotic paste (TAP) (mixture of ciprofloxacin, metronidazole and minocycline) as an intra-canal medicament have shown very encouraging results particularly in non-vital immature teeth associated with periradicular lesions. Hence, before opting for a surgical approach, a non-surgical approach can be thought of with extended use of TAP as intra-canal medicament, especially in patients who are phobic to invasive procedures. On the flip side, the use of TAP has few side-effects, of which one is the discoloration it can cause due to the presence of minocycline in the mix. The purpose of this article is to presents a case of coronal discoloration due to the use of TAP as an endodontic intra-canal medicament.

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Aim: The aim of this study was to compare the calcium hydroxide (Ca(OH) ₂ ) removal efficacy of the EndoActivator system with that of conventional irrigation with a syringe and hand file manipulation. Materials and Methods: A total of 44 extracted human single-rooted mandibular premolars were used. The root canal systems of all teeth were cleaned and shaped, then filled with Ca(OH) ₂ paste. The teeth were divided into two groups: Ca(OH) ₂ was removed using ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) with hand filing and irrigation (Group 1) or the EndoActivator system (Group 2). Each tooth was split into two halves and examined under a scanning electron microscope. Results: Ca(OH) ₂ particles were completely removed at the coronal level in both experimental groups. More Ca(OH) ₂ particles were present in the apical third than in the middle-third in both groups. No significant interaction was observed between the two experimental groups or among the three examined levels (P > 0.05). Conclusion: Agitation with NaOCl and EDTA improved Ca(OH) ₂ removal only in the coronal third of the root canal. Use of the EndoActivator system did not improve the efficacy of Ca(OH) ₂ removal in the middle and apical thirds.

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Aim: With the whole world looking at the eradication of existing infectious diseases and preventing any new infections, sterilization of instruments is significant to ensure optimal patient care. Infection preventions and controls are the most important components for providing a safe environment for patients and staff within a dental practice. Hence, the objective was to assess the level of knowledge, attitudes, and practices regarding the sterilization of endodontic files by the postgraduate (PG) students from the Department of Conservative Dentistry and Endodontics at dental colleges in Bangalore. Materials and Methods: A cross-sectional study was conducted among PG students of Conservative and Endodontics in Bangalore using a pretested questionnaire. Results: A total of 88% accepted endodontic files need to be sterilized and 60% reported that endodontic instruments can be used four or more times, but 44% practiced it. Interestingly, 74% reported that dental assistants are not trained for sterilization protocols. Conclusion : The study shows that although there is high knowledge and positive attitude regarding sterilization of endodontic files, but it is seldom practiced creating lacunae in motivation. To bridge this gap, frequent reinforcement is needed in the critical area of sterilization.

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The aim of this case report is to present the endodontic management of a supernumerary tooth fused to the maxillary left lateral incisor. Such anomalies pose a challenge even to the most experienced clinician in treating these teeth. This report described a case of 21-year-old male patient with a classic case of complete fusion of maxillary left lateral incisor and a supernumerary tooth. A modified access preparation was made and two separate root canal orifices were identified. Both root canal systems were prepared separately and obturated efficiently until accepted lengths. This reported case highlights the importance of clinical and radiographic correlation in arriving to a definitive diagnosis.

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Aim: The aim of this study was to analyze the cytotoxicity of various volumes of 5.25% of sodium hypochlorite, 2% of chlorhexidine gluconate and mixture of a tetracycline isomer, an acid and a detergent (MTAD) by checking for hemolysis of human red blood corpuscles. Materials and Methods: A total volume of 100 μl of diluted red blood corpuscles obtained through centrifugation was added to three irrigating solutions (5.25% of sodium hypochlorite, 2% of chlorhexidine and MTAD) of six test tubes each. Individual irrigants per group were added in increasing volume starting from the second test tube keeping the first one as the control. After incubation for 3 min hemoglobin content was measured using an automated hemoanalyzer data was analyzed using one sample t-test. Results: Sodium hypochlorite is the most cytotoxic solution followed by MTAD and chlorhexidine. Conclusions: This study suggests that the three irrigating solutions do cause detrimental effects on the diluted red blood corpuscles. A great deal of care should therefore be exercised when using 5.25% sodium hypochlorite during endodontic irrigation.

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Background : Dentin hypersensitivity is a commonly experienced problem that is triggered by an external stimulus, such as hot and cold temperature changes, pressure from tooth brushing and osmotic changes caused due to sweet or sour food and beverages. Various treatment modalities are tried and tested, amongst them desensitizing pastes have been used extensively in the past decades. Objective: The objective of these 15 days, single center, randomized clinical pilot study was to evaluate the dentin hypersensitivity reducing efficacy of two commercially available desensitizing toothpastes: One with Pro-Argin technology and the other with Novamin. Materials and Methods: Eighty subjects of dentin hypersensitivity were sampled in the present pilot study. Subjects were randomly selected and the pastes were prescribed for both the groups. Subjects were advised to brush twice daily for 2 min with the desensitizing paste and also were advised for topical application of the desensitizing paste on sensitive teeth and were asked not to rinse until morning. The evaluation was done by Air blast technique using sensitivity visual analog scale consisting of mild, moderate, and severe parameters rated on a scale of 0-10. Efficacy was compared on baseline, after 1 min of application and after 15 days. Statistical Analysis: t-test was performed and P value ≤ 0.05 was considered as statistically significant. Results: There was no statistically significant difference between the two groups after 1 min of examination, but there was a statistically significant difference in reduction of dentin hypersensitivity after 15 days interval favoring Vantej group (P ≤ 0.02). Conclusion: Desensitizing paste containing 5% NovaMin crystals provided a statistically significant reduction at 15 days interval when compared with the one containing Pro-Arginine.

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Double or fusion of the teeth is a primary developmental anomaly union of two independently developing primary or permanent teeth. The tooth fusion may contribute to various significant problems such as crowding, caries and periodontal diseases. Fused teeth require an interdisciplinary approach combining the endodontic, esthetic and prosthetic treatments. All ceramic restoration meets the requirement of better appearance, biocompatibility and long life. By using restorative therapy esthetic and functional criteria were satisfied. Management of a case of fusion of a maxillary lateral incisor and a supernumerary tooth is presented.

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The existence of several anatomical variations in the root canal system may contribute to failure of the root canal therapy. The planning and performing of endodontic therapy requires knowledge of the internal dental morphology. This paper reports the case of a left mandibular third molar that presented with five root canals; a case of unusual root canal morphology so as to demonstrate the anatomic variations in mandibular third molars. Root canal therapy and case management are described. This report highlights the importance of looking for additional roots and root canals so as to enable clinicians to treat a case successfully, which might have ended in failure.

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