ENDO, 02/2010

Knowledge of dental anatomy is important for successful root canal treatment. A clinician is required to have insights into the morphology of a tooth, regarding its shape, form and structure, before commencing treatment. This report describes the treatment of two cases of radix entomolaris (one with bilateral occurrence) and one very rare case of radix paramolaris in an Indian dental school. Keywords: endodontic treatment, prevalence, radix entomolaris, radix paramolaris

Taurodonts are teeth with enlarged pulp chambers and apical displacement of the bifurcation or trifurcation of roots. The molars and premolars are the teeth that are affected and are more common in the permanent dentition. Taurodontism is usually associated with several syndromes. These teeth have normal coronal structure and can be identified only by radiographs. This condition can be a challenge to an endodontist because of the complex pulp space anatomy. This case report describes a unique case of taurodontism in an otherwise healthy patient - whose existing molars are all taurodonts - and root canal treatment of a taurodont tooth. Keywords: endodontic management, hypertaurodontism, permanent molars, pulp chamber

Aim: To compare the cross-sectional area of sealer plus voids of gutta-percha/AH Plus and Resilon/ RealSeal following root canal preparation with rotary nickel-titanium ProTaper instruments and different apical preparation sizes. Materials and Methods: Forty-eight extracted maxillary anterior teeth were instrumented with the ProTaper system to apical sizes of 25 (F2), 40 (F4) and 60 (F5 + K-files) (n = 16 each). The teeth were divided into six groups (n = 8) for obturation as follows: group 1, apical preparation size 0.25 mm + gutta-percha/AH Plus sealer; group 2, apical preparation size 0.25 mm + Resilon/ RealSeal; group 3, apical preparation size 0.40 mm + gutta-percha/AH Plus sealer; group 4, apical preparation size 0.40 mm + Resilon/RealSeal; group 5, apical preparation size 0.60 mm + guttapercha/ AH Plus; group 6, apical preparation size 0.60 mm + Resilon/RealSeal. All root canals were filled using the warm vertical compaction technique. Horizontal sections were obtained every 1 mm, up to 3 mm from the apical foramen. Samples were observed by scanning electron microscopy under x200 magnification. Sections were digitally photographed under a stereomicroscope and the images were transferred to a compatible PC for image analysis. Using a computer program, the surface areas of voids were calculated and compared statistically for different preparation sizes and obturation systems at all levels, using the Kruskal-Wallis test with Sidak correction and Mann- Whitney U test (P < 0.05). Results: Comparisons within each obturation group (gutta-percha/AH Plus and Resilon/RealSeal) showed the presence of voids, but there were no significant differences between the two groups for apical preparation sizes of 25 and 40 (P < 0.05), irrespective of the level of sectioning. The only significant difference was obtained for canals prepared to an apical size 60: canals obturated with Resilon/RealSeal showed significantly more voids than those filled with gutta-percha/AH Plus, especially at the 3-mm level. Conclusions: Resilon/RealSeal did not achieve better results in terms of sealing ability in the apical third when compared to the conventional obturation materials gutta-percha/AH Plus. Keywords: AH Plus, gutta-percha, RealSeal, Resilon, sealer area

A fundamental step in non-surgical retreatment is the removal of the existing root filling material to permit radicular access. Different root filling materials require different techniques of removal. The endodontic literature is littered with studies exploring the relative merits of one technique of removal over another. In this review, the focus is on the experimental models and techniques employed to investigate the removal of root filling materials during non-surgical retreatment. The correlation and clinical relevance to everyday endodontic practice is also discussed. Keywords: non-surgical retreatment, root filling materials

The management of large periradicular lesions has been somewhat limited in contemporary endodontics to non-surgical or surgical treatment, treatment revision in some cases, and immediate extraction in favour of implant prostheses. Within these choices there are both advantages and disadvantages. With the intent to establish removal of the aetiology and elicit a positive osseous, regenerative response, the use of decompression or marsupialisation techniques afford the patient clinician the opportunity to achieve the ultimate goal of tooth retention within a sound and stable environment. This paper will address the many facets, considerations, ramifications and techniques of using this minimally invasive procedure, in addition to addressing new technologies that purport to enhance the kinetics of periradicular tissue healing when larger periradicular lesions are present. Keywords: decompression, marsupialisation, necrotic pulps, non-surgical and surgical root canal treatment, treatment revision, osseous healing

Objective: The present in vitro study compared the effect of lipase enzyme on the surface topography of Resilon and gutta-percha cones. Method: Specimens of gutta-percha and Resilon cones were divided into experimental and control groups, one positive and one negative. Experimental groups were immersed in lipase. Positive controls were immersed in phosphate buffer saline, whereas specimens from negative controls were not immersed in any solution. All specimens were incubated at 37˚C for 96 hours and then examined under SEM for surface roughness, and scored by two independent observers. Results: A statistically significant difference among mean values was seen, with group II (Resilon/ lipase) showing the highest mean value of 2.675 ± 0.355, and group V (gutta-percha/unimmersed) having the lowest mean value of 1.375 ± 0.270. Keywords: gutta-percha, lipase, polycaprolactone, surface roughness, surface topography