Objectives: The primary aim of the study was to determine the frequency of middle mesial (MM) canals in mandibular first molars in North Indian population. The secondary aim was to analyze whether an association exists between the detection rate of MM canals and age, gender, and number of distal canals. Materials and Methods: All mature mandibular first molars endodontically treated between March 2013 and March 2015 were included in the study. After instrumenting the main canals, the clinician inspected the mesial developmental groove under dental operating microscope (DOM) using ultrasonic tips and endodontic explorer to detect accessory mesial canals. The canal, if found, was negotiated, cleaned, shaped, and recorded. Results were analyzed using Chi-square test. Results: A total of 258 first molars from 243 patients were treated during the specified period, of which 28.3% had negotiable MM canals. The frequency of MM canals was 36.6% in patients 11-30 years old, 22.6% in patients 31-50 years old, and 18.4% in patients >50 years. Statistical analysis revealed a significant relationship of different age groups with the incidence of MM canals (P < 0.05). A significant relationship was also found between the detection rate of two canals in distal root and the presence of MM canals (P < 0.05) with gender having no influence. Conclusion: The presence of MM canals is quite high in North Indian population. Younger patients had a higher incidence of MM canals. Mandibular first molars with two separate distal canals showed a tendency to have MM canals.

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Talons cusp and palate-radicular groove are commonly occurring developmental anomalies in permanent maxillary lateral incisors. These anomalies present with various esthetic and functional complications that require prophylactic and definitive treatment plans. It is essential to have a thorough knowledge of these anomalies for their correct diagnosis and successful management. This case series presents etiology and various treatment modalities for the management of these commonly occurring developmental anomalies in the maxillary lateral incisors.

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The knowledge of root canal system of different human teeth is a "road map" for the successful root canal treatment. Mandibular canine usually contains one root with a single root canal. Two-rooted mandibular canine is rare. This paper describes two cases of root canal therapy of permanent mandibular canine with two root canals and one apical foramen (Type II) in one root and canine with two separated roots. The clinicians must always suspect anatomical varieties and use all the available tools to diagnose and manage their cases.

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Objective: The purpose of this study was to evaluate the association of the common root canal pathogens namely; Streptococcus mitis and Enterococcus faecalis with specific endodontic signs and symptoms. Materials and Methods: Sixty subjects scheduled for endodontic treatment were divided into two groups comprising of 30 subjects with primary endodontic infections and 30 subjects with failed endodontic treatment. The endodontic signs and symptoms of the subjects were assessed using clinical and radiographic methods. Root canal samples were collected using sterile paper point. Advanced microbiological culture techniques were used to isolate S. mitis and E. faecalis from the root canal samples. The presence of root canal pathogens was then correlated with the corresponding endodontic signs and symptoms. Statistical analysis was done using Student's t-test and Fisher's exact test. Results: S. mitis was significantly associated with pain and periapical lesions in primary and retreatment cases (P = 0.04). E. faecalis had a strong correlation with tenderness on percussion in retreatment cases (P = 0.016). Conclusion: Association of S. mitis with pain and periapical lesion, as well as E. faecalis with tenderness on percussion, suggests a correlation between endodontic signs and symptoms with specific root canal bacterial species. Knowledge regarding the association of root canal pathogens and specific endodontic signs and symptoms could help in better understanding and a predictable therapeutic management of root canal infections.

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Introduction: Voids in the sealer mass have the potential to allow leakage through obturation. They are more critical in single cone (SC) obturation as the volume of sealer used in this obturation is larger when compared to other obturations. Aim: To compare the area of voids in mineral trioxide aggregate (MTA)-based, resin-based, and zinc oxide-eugenol-based sealers when employed with SC obturation technique. Materials and Methods: Fifteen teeth were cleaned and shaped and divided into three groups for SC obturation using MTA Fillapex, AH26, and Pulpdent sealers, respectively. The obturated teeth were sectioned at apical, middle, and coronal third, and area of voids in the sealer was assessed using a stereomicroscope and digital images and image software. The results were statistically analyzed using SPSS software and Kruskal-Wallis and Mann-Whitney tests. Results: The three tested sealers showed voids in all the sections except MTA Fillapex, which was void free in apical and middle sections. There were significant differences between these sealers regarding their section wise area of voids (P < 0.05). Similarly, there were significant differences in their overall area of voids (P < 0.05) with MTA Fillapex showing significantly least area of voids followed by AH26. Conclusions: SC obturation with MTA Fillapex sealer, which showed void free apical and middle third sections, had significantly least area of voids in the sealer followed by the one with AH26 sealer, whereas SC obturation with Pulpdent sealer had significantly most area of voids.

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Aim: To determine the coronal leakage of various provisional restorations with and without intracanal medication over time after being exposed to human saliva. Materials and Methods: This study investigated Coltosol F, Cavit, Ketac Molar, and IRM as provisional restorative material. Calcium hydroxide and chlorhexidine were used as an intracanal medicament. Ninety-eight single rooted teeth were randomly selected and then mounted in an apparatus that isolated the crown portion of the tooth. Provisional restorative materials were placed in the access cavity following manufacturer guidelines after placement of intracanal medicament. Human saliva and brain heart infusion broth in 3:1 ratio were applied to the samples, incubated at 37°C, and results were tabulated over the course of 4 weeks by the appearance of turbidity in the lower part of the apparatus. Statistical Analysis: The data were statistically analyzed using proportional Z-test. The level of significance was set at 0.05. Results: Coltosol F and Cavit could significantly prevent the bacterial leakage up to a period of 7 days with a P value of 0.01 and 0.005, respectively. Bacterial recontamination was relatively less in the samples treated with intracanal medicaments up to 14 days. After 14 days, however, all materials leaked in over half of the samples. Conclusion: No provisional restorative material can be considered superior in providing a reliable seal after 14 days. Inter-appointments schedule should not extend beyond 2 weeks and after endodontic therapy final restoration should be completed within 1 week.

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Aims: To check the antimicrobial activity of Tinospora cordifolia (TC) (Giloy), Ocimum sanctum (Tulsi), and 5.25% sodium hypochlorite (NaOCl) against 21-day-old multispecies biofilm formed on tooth substrate of extracted human teeth. Settings and Design: In vitro dentin disinfection model used to check the antimicrobial efficacy of herbal extracts. Materials and Methods: The in vitro dentin disinfection model was used to check the antimicrobial activity of the methanolic extracts of medicinal plants along with NaOCl. The polymicrobial biofilm was allowed to grow on extracted teeth sections for a period of 21 days. Remaining microbial load in the form of CFU/ml after the antimicrobial treatment was tabulated and data were statistically analyzed using ANOVA and Bonferroni post-hoc tests. Statistical Analysis Used: SPSS version 17 one-way ANOVA, Bonferroni post-hoc test. Results: Both the plant extracts showed considerable antimicrobial efficacy as compared to negative control. About 5.25% NaOCl was the most effective antimicrobial agent having statistically significant difference against plant extracts and negative control (saline). Conclusions: The methanolic extract of TC (Giloy), O. sanctum (Tulsi), and 5.25% NaOCl has considerable antimicrobial activity against polymicrobial dentinal biofilm of Streptococcus mutans, Enterococcus faecalis, Staphylococcus aureus, and Candida albicans.

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Knowledge of the normal root canal morphology and its variation is essential to ensure a successful root canal therapy. The aim of this report is to describe the endodontic treatment of two mandibular premolars with aberrant root canal morphology with the aid of dental operating microscope. A 29-year-old Saudi male with three mandibular left premolars was referred by the Prosthodontic Department for endodontic evaluation prior to placement of final coronal restorations. The first premolar was diagnosed as having necrotic pulp while the third premolar was previously treated. Root canal treatment and nonsurgical root canal retreatment were performed for the first and third premolars, respectively. The first premolar had a C-shaped configuration and Vertucci's Type V (1-2) canal system while the third premolar had Type III configuration (1-2-1). One year later, the teeth were asymptomatic with normal periapical tissues radiographically. Root canal aberrations may occur in any tooth type, and the clinicians should always assume the presence of these aberrations and use all the available tools to detect and manage them.

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